(navigation image)
Home American Libraries | Canadian Libraries | Universal Library | Community Texts | Project Gutenberg | Biodiversity Heritage Library | Children's Library | Additional Collections
Search: Advanced Search
Anonymous User (login or join us)
Upload
See other formats

Full text of "A practical treatise on materia medica and therapeutics, with especial reference to the clinical application of drugs"

Go ogle 



This is a digital copy of a book that was preserved for generations on library shelves before it was carefully scanned by Google as part of a project 
to make the world's books discoverable online. 

It has survived long enough for the copyright to expire and the book to enter the public domain. A public domain book is one that was never subject 
to copyright or whose legal copyright term has expired. Whether a book is in the public domain may vary country to country. Public domain books 
are our gateways to the past, representing a wealth of history, culture and knowledge that's often difficult to discover. 

Marks, notations and other marginalia present in the original volume will appear in this file - a reminder of this book's long journey from the 
publisher to a library and finally to you. 

Usage guidelines 

Google is proud to partner with libraries to digitize public domain materials and make them widely accessible. Public domain books belong to the 
public and we are merely their custodians. Nevertheless, this work is expensive, so in order to keep providing this resource, we have taken steps to 
prevent abuse by commercial parties, including placing technical restrictions on automated querying. 

We also ask that you: 

+ Make non-commercial use of the files We designed Google Book Search for use by individuals, and we request that you use these files for 
personal, non-commercial purposes. 

+ Refrain from automated querying Do not send automated queries of any sort to Google's system: If you are conducting research on machine 
translation, optical character recognition or other areas where access to a large amount of text is helpful, please contact us. We encourage the 
use of public domain materials for these purposes and may be able to help. 

+ Maintain attribution The Google "watermark" you see on each file is essential for informing people about this project and helping them find 
additional materials through Google Book Search. Please do not remove it. 

+ Keep it legal Whatever your use, remember that you are responsible for ensuring that what you are doing is legal. Do not assume that just 
because we believe a book is in the public domain for users in the United States, that the work is also in the public domain for users in other 
countries. Whether a book is still in copyright varies from country to country, and we can't offer guidance on whether any specific use of 
any specific book is allowed. Please do not assume that a book's appearance in Google Book Search means it can be used in any manner 
anywhere in the world. Copyright infringement liability can be quite severe. 

About Google Book Search 

Google's mission is to organize the world's information and to make it universally accessible and useful. Google Book Search helps readers 
discover the world's books while helping authors and publishers reach new audiences. You can search through the full text of this book on the web 



at http : / /books . google . com/ 




lki^M@ 




Gift 
Dr. John Adams. 




y&r^^.^^'f^^'yy^ 



COPTRIOHT, 1880, 

■T 

F. A. DAVIS. 

COPTRIOHT, 189S. 1895. 1898, 

BT 
THE F. A. DAVIS COMPANV. 

COPTRIGHT. 1901, 1906, 

BT 

F. A. DAVIS COMPANV. 
tBagUUrtd at SUHomfi' Ilftll, London. Eng.] 



Fhilwlelphit, Pa., II. S. A.: 

Preu of F. A. Dkrii Companj, 

19t4-16 Cfafrrjr Stntt. 



• -Sr' ^ 



THE MANY PUPILS 

WHO HAVE ATTENDED HIS LECTURES DURING THE PAST THIRTY- 
ONE YEARS AND ARE NOW PURSUING THEIR PROFESSION 
IN THE UNITED STATES OF AMERICA AND IN 
MANY FOREIGN COUNTRIES 

THIS VOLUME, 

ILLUSTRATING AN ALL-IMPORTANT AND PRACTICAL 

DEPARTMENT OF MEDICINE, PHARMACY, 

AND DENTISTRY, 

IS 

RESPECTFULLY INSCRIBED BY THEIR TEACHER, 



The Author. 



PREFACE TO THE SIXTH EDITION. 



The coincidence afforded by the exhaustion of a vety large edition 
of this work, and the publication of a new revision of the United States 
Pharmacopceia, has afforded the author an opportunity of making 
many additions to the text, which he believes will make it fairly, if 
not fully, representative of the present state of therapeutics. The 
numerous pharmacopoeial alterations in nomenclature and in the 
strength of official preparations, and also the many new titles which 
have been added, have necessitated a thorough revision of every page, 
particularly in order to make the second part correspond with the 
present standards, both of the United States Pharmacopoeia and the 
British Pharmacopoeia. Among the notable changes from the last 
edition are the following : Part I is entirely added, having been taken 
from the limited Students' Edition, thoroughly revised, and completed 
by adding a comparative table, giving the changes in the strength of 
preparations and relative dosage, in the present Pharmacopoeia and 
the one which preceded it. Among the new therapeutic agents will be 
observed a consideration of the Roentgen-Ray and the Pinsen Light, 
or Actinotherapy, Serumtherapy, Animal Extracts, Vibrotherapy, 
Hydrotherapy, etc., etc. Every part has been carefully revised, and, 
when possible, condensed, so that, notwithstanding the large addition 
of new material, the work has been really increased only by about one 
himdred pages altogether. The features of the work which have met 
with approval by readers, have been retained. In preparing the present 
edition, the author has kept in view, as heretofore, the needs of the 
medical student, as well as the physician, and he hopes that it will be 
found no less useful to those who consult it than the former editions 
which it supersedes. He will be very much gratified, if it will be 
deemed, at least in some measure, contributory to the progress of 
scientific medicine, and the establishment of rational therapeutics in 
this country. 

J. V. S. 



98104 



TABLE OP CONTENTS. 



PART I. 
Phabmagoloqt. 



pAaa 

General Considerations Concerning Remedies and Systems of Therapeutics 1 

Pharmacology and the Pharmacopoeia 4 

IkUteria Hedica 5 

Pharmacy 14 

Classes of Remedies and Preparations 16 

Pharmaceutical Processes 29 

Preseription-writing and Formula 43 

Poisons and Antidotes 66 

General Therapeuticd 70 

PART ir. 

The Matebxa Medica, ob Phabmageutical Tiiebafeutic Agents, ob Dbuos. 

Official Remedies, or Drugs Contained in the United States and British Phar- 

macopceias 85 to 926 

PART III. 

NON-PHABMACAL REMEDIES AND EXPEDIENTS. 

EJecfricity in Medicine — ^Electrotherapeutics 927 

Physiological Effects of Currents of Electricity 960 

Methods of Elactrodiagnosis in Various Nervous Affections 961 

Clinical Electrotherapeutics 965 

Electrical Foresis 970 

Electricity in the Treatment of Paralysis 976 

Electrodiagnosis in Paralysis 973 

Electricity in Gynecology — the Apostoli Method 981 

Application of Electricity in Dermatology 091 

Removal of Superfluous Hair — Hypertrichosis • 992 

Removal of Foreign Bodies from the Eye with the Electromagnet. . . .- 993 

Electricity in Nose and Throat Diseases 994 

Electrical Illumination in Medicine and Surgery 998 

Kinesltherapy ; Mechanotherapy; Massotherapeutics ; Massage and Rest-cure. . .1000 

Technique of Maasotherapeutics and Mechanotherapy 1001 

Physiological Effects of Mechanotherapy * 1003 

Therapeutic Applications of Mechanotherapy 1006 

Massage in General Medical Practice 1009 

Synergists with Massage 1014 

Contra-indications to Massage 1016 

How to Prescribe Massage 1017 

Vibrotherapy 1019 

Pneumotherapy and Pneumatic Differentiation 1021 

Oxygen 1026 

Preparation of Oxygen 1026 

Physiological Effects of Oxygen 1027 

Therapeutic Applications of Oxygen 1027 

Apparatus ana Technique of Administration 1030 

Ozone 1031 

Physiological Effects of Ozone 1032 

(vii) 



VIU TABLE OF CONTENTS. 

Ozone in Medicine 

Nitrogen and Nitrogen Monoxide (Nitrous Oxide) , 

Pneumatic Differentiation and Treatment by Inhalation 

Medicated Vapors — Atomization — Inhalation 

Formul® for Inhalation 

Hydrotherapy and Balneotherapy 

Physiological Effects of Water 

Clinical Applications of Water in the Treatment of Disease 

Hydrotherapy in Nervous Diseases 

Mineral Springs 

Physiological Effects of Mineral Springs 

Climatotherapy and Climatology 

Climatotnerapy 

Choice of Climate for the Treatment or Prevention of Disease 

Diet in Disease 

Formulae for Special Foods 

Predigestion of Food 

Psychotherapy ; Hypnotism and Suggestion 

Hypnotism 

Hypnotism in General Practice 

Metalloscopy and Metallo therapy 

Heat and Cold as Therapeutic Agents 

Heat as a Remedy 

Physiological Effects of Hot AppUcations 

Therapeutical Applications of Heat. 

Physiological Effects of Hot Applications 

Therapeutical Applications of Heat 

Effects of Abstraction Qf Heat by Cold Applications 

Therapeutics of Cold 

Light and Darkness 

Physiological Effects of Light 

Therapeutical Deductions Concerning Light 

The Roentgen Rays in Medicine 

Radium ' 

Music 

Physiological Effects of Music 

Therapeutic Applications 

Various Therapeutic Methods More or Less Mechanical and Local in tli 

Effects 

Acupuncture 

Antiseptics 

Aquapuncture 

Aspiration 

Bandaging 

Baunscheidtism 

Blood-letting and Transfusion 

Hypoderraoc lysis 

Entcroclysis ; Irrigation of the Bowels, Injectionct, Clysters, and Enematf 

Formulse for Enema ta 

Rectal Alimentation and Intestinal Inhnustion , 

Setons and Issues 

Suspension in Diseases of Spinal Cord and Nerve-stretching in Nerve 

Disorders 

Nerve-stretching 

Formulary for Hypodermic I'se 

General Index. 
Clinical Index. 



PART I. 

GEJHEIEAL CONSIDEEATIOITS GOKCEEirma EEHESIES AND 
SYSTEMS OF THEILAPEXJTIGS. 

Therapeutics, or the treatment of disease, makes frequent use of cer^ 
tain agents, which are known collectively as remedies. In point of fact, 
every preventive, reparative, or restorative means which is, or can be made, 
available for the relief of the sick is a remedium, or remedial agent, in a 
comprehensive sense of the term. It follows from this that remedies are of 
many kinds and of varjing importance ; indeed, they are almost as ntunerouB 
and diverse as the causes of disease themselves. The principal olaases of rem- 
edies, however, are comparatively few, and these may now be taken up 
systematically for consideration. A very important class is composed of 
remedial measures which seek to prevent disease, or, if it be already present, 
to shield the patient from the effects of unsanitary influences and ftius place 
him imder more favorable conditions for recovery than those under which 
the sickness originated; such are known as prophylactio, or hygienic, 
remedies. They presuppose, on the part of the medical attendant, an 
acquaintance with th^ physiological laws of the human body, and of the 
effects of food, clothing, climate, occupation, habits, etc., upon its func- 
tions, and the skill to apply this knowledge to the individual case. Among 
prominent hygienic remedies are dieting, bathing, ventilation, change erf 
residence or of occupation, due regulation of habits, . and especially regu- 
lated exercises, including gj'mnastics and maSsage. These are sanitary, 
prophyl&ctic, or hygienic, agents when employed to preserve health and pre- 
vent disease; they become sanatory, or curatiTe, measures when utilized in 
conjunction with appropriate medical remedies, as they constantly are, in 
the treatment of the sick. In the latter case they are also included under 
the comprehensive term regimen. It is now considered of as great, or even 
greater, importance to regulate properly the ventilation and temperature of 
the sick-room, to direct the bathing and food of the patient, and to decide 
whether he shall have rest or exercise, in most instances, than it is to frame 
a prescription nicely adjusted to the state of the case, although the latter 
15 by no means to be slighted. Light, heat and cold, magnetism, and 
electricity are also capable of powerfully influencing the bodily functions, 
and, when wisely directed, may produce positive sanatory, or curative, effects. 
These imponderable remedies, or forces, as they have been called, are receiv- 
ing much attention at the present day. As a result of the profound and 
painstaking investigations of many scientists and the careful observations 
of expert clinicians, the medical practitioner is now, indeed, for the first 
time,, in a position to satisfactorily apply these remedial agents and to 
record the results of his studies in exact and scientific terms. Mechanical 
remedies include various surgical measures, such as acupressure, acu- 
puncture, aspiration, bandaging, blood-letting, etc. ; also the various forme 
of gymnastics known under the name of Swedish movements, the move- 

(1) 



PHARMACOLOOy AXD (UCNEU-VL TUERAPEL'TICS. 



mcni cure, passive motion, etc. Laetj but l>y no means the kast it 
among remedies which, at. least, are parti)' iiKieluuiical, is massag'e, 
attention has been already called as a hygienic agent, and to w 
coneideratinn will be given hereafter in a Bpcuial section, under Ki 
apy. Finally, there is a class of remedies which are considered of 
portance. and are so commonly n&cd in the ircatiiieiit of every con 
disease, that they iire popularly termed ''nu'dicine:;"; these proj 
drugs, or pharmaceutical remedies. Formerly thoy were divi< 
chemical agents and drugs proper, or Galenicals; bnt this distinc 
lost its force, since it has been shown that herbs, or "simples," c 
medicinal elTecte to **active principles," which are chemical in thai 
and which may he isolated and administered separately in order to 
the characteristic physiological and therapeutical efTects of tlie dr 
Therapcatics (©fpaTt^^a, treatment) considers the apphcation 
dial agents to tlie treatment of disease, and the proper care of 
Other medical studies are only the foundation, ihcrajieutics is th 
structure. As Follicrgill has well said, *Mho ultimate aim of all mc 
search is t)ie treatment and prevention of disease." For conveniei 
divided into surgical and medical therapeutics. Many systems of t 
tics have been formulated in times before the present application 
scientific methiHls to the study of the action nf drugs and the investi] 
pathological nnd clinical problems, and so-ealled ^'schools of medit 
tice"' have been foinidcd thenx)n, which havi' rvow heconie obsolete an 
forgotten. Having at length a sound foundation of accumulated la 
and experience upon which to rest our practice, we are, at the prea 
prepared to base a system of rational therapeutics upon the demo 
and established effects of drugs in healtby and diseased conditic 
upon onr knowledge of the nature and conrse of morbid processe 
human body. The only scientific system possible is one which (1) ei 
to remove morbific causes, or render them inoperative; ("2) seeks t 
the ravages of disease, or to correct abnormal physiological action; ( 
to ameliorate the condition of the patient by relieving prominent syj 
such as pain, fever, sleeplessness, loss of appetite, etc., and (4) plii 
under conditions most favorable to recovery. Symptomatic tr« 
which seeks merely to remove symptoms, without investigating theii 
is obviously unsatisfactory and imscientific, but occasionally is resi 
in an emergency when such s^ymptoms are urgent. Empirical tr 
was the only kind of treatment possible before the mode of action 
effects of medicines were vmdcrstood; it merely directi^d that certai 
cines should be taken for the reason that in apparently similar co: 
their, administration had been followed by good results. Owing 
fallacious character of the teachings of experience, as pointed out 1 
pocrates in his celebrated aphorism, it results that pure, blind em| 
abounds in fallacy, and, as a rule of practice, is the poorest s^-stem c 
nioTit to follow. Where the knowledge obtained at the bedside, h 
IB aided by sufficient acquaintance with the physiological action oi 
already referred to, we have mod(»m *'T?ational Medicine." which ali 
the patient nil the assistance which science and experience combil 
provide towanl hastening and completing his recovery. It is an enlij 
empiricism* which is not based on fixed law, bnt is progressively im; 
in proportion with advances in other departments of science. Any ) 




GENERAL CONSIDERATIONS. 3 

of medicine assuming tp rest upon a foundation less broad than this, or on 
a system which is fixed and stationary, by its own terms separates itself 
from scientific medicine, and makes its followers a medical sect, or "school." 
In the course of centuries many such schools have been brought to light, 
and, after a brief period, have been outgrown and forgotten. Such a fate 
is the natural destiny of any restricted system, based upon dogma. The 
system of medicine which is studied as a department of natural science, 
and which is imrestricted by any hypothesis, or supposed law of cure, in its 
application of remedies to the trealznent of disease, will undoubtedly vary 
somewhat in its results, according to the individual skill of its practitioners, 
the scientific attainments of the time, and the peculiarities of patients ; but 
when statistics are correctly compiled from sufficiently large groups of cases 
it must be more successful than any restricted system whi(3i has been or can 
ever be brought in competition with it. In order to avoid misapprehension, 
it may be proper at the outset to e^lain that in the present treatise this 
system of scientific, or so-called "regumr," medicine, will be followed. Scien- 
tific, or regular, medicine is quite distinct from any school or sect in medi- 
cine, and is equally separate from so-called "allopathy*' or "allopathic prac- 
tice." As every educated physician knows, there is a radical difference 
between "an allopathic doctor" and "a regular practitioner," inasmuch as one 
is sectarian and the other non-sectarian. In point of fact, at the present day 
there are no allopathic physicians and, of course, no "allopathic" examining 
boards, and all followers of scientific medicine should resent the application 
of such a sectarian title to designate the regular practice of medicine. 

At the same time that we discard restrictions as to therapeutics and 
claim the right to employ whatever remedial means experiment and obser- 
vation lead us to believe will benefit our patients, it should not be forgotten 
that the knowledge at our command is derived from various sources, and if 
we are willing to acknowledge the indebtedness of modern medicine even to 
native tribes for many useful remedies, we should not be above admitting 
the fact that useful lessons may also be occasionally learned from followers 
of exclusive schools of medicine, or so-called irregular physicians. "Every 
judicious physician," said Dunglison, "must be an eclectic," in the sense 
that he selects from every source the best means of controlling disease. In 
the ordinary restricted sense, an eclectic is one who confines himself to 
vegetable drugs, or, in other words, is a botanic physician, and in this sense 
it has been appropriated by a sect of physicians who were formerly known 
as Thomsonians, from the name of the founder. In the ranks of regular 
medicine, also, there are specialists in therapeutics, some confining their 
practice to massage or gymnastics, others to electricity, others again to 
bathing, or hydropathy. . The qualified physician or general practitioner 
appreciates the value of all the various agencies that are used in treating 
the sick, and assigns to each its proper place in his therapeutics, directing 
his treatment not against disease, but to the improvement of the health of 
3>atients who are, for the time, in a diseased, or abnormal, condition. 

A complete cyclopsedia of therapeutic agents should include in its con- 
sideration every remedial measure which the best educated and most skillful 
physicians employ in treating the sick, giving to each its proper place and 
value. As there are separate treatises upon hygiene, dietetics, massage, 
balneology, and electrotherapeutics, and the importance of these subjects 
warrants their separate treatment, modem text-books of therapeutics are 



PHARMACOLOGY AKD OENEUAL THEKAPEl'TlCfl. 



usually restricted to treatment solely liy pharmaceutical remedieSjl 
Nevertheless, the author hfls given tlun eonaJderation to the other 
remetlial agencies, sudi as electrotherapeutics, bytlrolherupeulies 
therapy, metalloTherapy, balneology, elimatolog}', and liypuotiBm 
which, in the third part of this work, will he found under theii 
titles. ' 



PHAEMACOLOGY AND THE PHARMACOPEIA. 



1 



Pharmacolo^ ((papuaxov^ *J iiRMlicniiient ; ajul Xoyoc. a trej 
broadly speaking, the science of drutrs. One of its branches is ] 
oognosy, or the study of their nutural history, their physical and c 
characters, tests for purity, etc. Another is Pharmacy, which co 
the various methods of conipouuding iind dispensing ilrugs in theii 
combinations for the treatment "^f disease. The place wliere m 
are dispenscil is also cnlleti a |ihnnnacy. Some aulliors have rcstrit 
term '^iihanuacolog}''' to Ihe results obtained from the study of thi 
ological a*:tiou of drugs, but this is moru u]>pr«)priately named Ph. 
dynamics. 

The Materia Mcdica, or collection of ])harinaeologiciil remedies, 
divided into crudr drugs and pn^parations. The latter nuiy be DC 
conling to established formula*, both olficial and Tion-of!icial, or th 
be extemporaneously eonipoiuuh'd, and dispensed, according to thi 
tions furnished by a physician. The latter are known as "magistral' 
rations; they are comjM>iiiided according to tlic formula contained 
prcftcription, of M-hich more will be said pa'scntly. Official P 
are those recognized by the Phannacop*eia, The formuhe and di] 
for compounding '"'official" preparations are established by the at 
of the pharmaef.>poeia. Since this authority does not extend beyc 
geograpiiiejil limits of the country to which it belongs, it follo\ 
England. Franco, Germany, Sweden, and other countries, as well 
T'nitcd Sbdes. have pharmaco])icirts of their own, Remedies belonj 
each aro distinguished by initials indicating their source; thus TJ. 
means T'nited States Phannacnpfria : B. 1\. British Phnrmacopreia; 
French PharmacopuMa, or Codex I^IcdieamentariuB; 6. P., German 
maeopo?ia; 8. P., Swedish Pluirmacop^cia. In the usual and mod' 
ceptation of the term, a phannacopcEia is a medical hook, issued by aid 
containing a list of recognized drugs, with drscrif>tions and physica 
acters, tests for purity and medicinal activity, and forundic for a< 
prcjiarations. The necessity of lia\ ing sonu^ slandard to dcHm- the chf 
ffstablisli the purity, and regulate the strength o'f medicinal pn-pnrat 
universally conceded. Those countries which do not possess a pha 
pteia of their own usually adopt the French Co<lo\', or the British, 
United States PharniacopiT'ia. Unfortunately, it may happen that fi 
aration will have the same title, hut differ considerably in strength 
fercnt p]ianimcopa*ias, such as the tincture of hclladonnn-h'nvcs anc 
cially the extract of nconitc. which is a source of error in copying fo 
from English, Frencli, or ({ernuin sources, since some preparations ; 
United States PharmacopnMa are considerably etronger than the corrfl 
ing foreign preparations. 



MATERIA MEDICA. O 

The Phaimacopceia of the TTxiited States is not issued directly by 
authority of the government, as in other countries, although it is adopted 
in the medical departments of the army, navy, and marine-hospital service, 
and it has been recognized as the final authority upon the purity and prep- 
aration of medicinal agents in recent Acts of Congress, It is compiled 
as a purely voluntary undertaking by the physicians and pharmacists, in 
accordance with the following arrangement: Every ten years repre- 
sentatives from medical societies and colleges, pharmaceutical societies and 
colleges, and delegates from the Army, Navy, and United States Marine- 
Hospital Service, meet in Washington, forming the National Convention 
for the Bevision of the Pharmacopoeia. After organization and the disposal 
of business, which may come before it, a standing committee on revision is 
appointed, which, having received instructions from the convention, pro- 
i'pi^s to prepare and publish an edition of the United States Pharmacopoeia. 
The first issue was in 1820, and the eighth revision was that of 1905. This 
went into effect September Ist of that year and has displaced the former 
editions. Important changes have been made in the strength of some 
preparations, and a number of new titles have been introduced. It is incum- 
bent upon both physicians and pharmacists to follow the present Pharma- 
copoeia in prescribing and dispensing drugs, especially in those States in 
which it has been adopted as the -legal standard. Many new remedies 
had been brought to the notice of the profession since the previous revision, 
some of which have come extensively into use and possess decided merit, 
others are ephemeral and will soon sink into well-deserved neglect. Owing 
to the present degree of activity in therapeutics, it is impossible that the 
pharmacopoeia should include all the medicinal agents used by physicians 
in the treatment of disease, especially those more recently introduced. 
Therefore, a considerable number of unofficial drugs are in use, some of 
which will eventually prove their right to be recognized and become official, 
while many others will never be able to make good their claim. Proprietary 
remedies, or preparations made by secret formulae, are sold very largely to 
the public* and are sometimes prescribed by physicians, who appear to be 
unmindful of the fact that the Code of Ethics denounces this as a repre- 
hensible practice. The prescribing of preparations of unknown composition 
is opposed to the best interests both of scientific medicine and of the public. 



KATEEIA MEDICA. 

The Materia Medioa consists of official and non-official drugs and their 
preparations. It has several branches. Pharmacognosy investigates the 
p.liysical characters of drugs in order to establish their identity. Medical 
botany establishes their place in the vejjjetable kingdom and their botanical 
grouping or relationship. Plant-chemistry determines the constituents of 
the drug and isolates the so-called active principles; it also teaches the 
chemical antidotes. In the United States Pharmacopoeia all remedies are 
arranged under their Latin titles alphabetically, and, owing to its conven- 
ience, the same plan has been adopted in the present work. A large number 
of unofficial, or extra-pharmacopopial, drugs are also considered. It is 
possible to adopt also a natural method of classification of drugs or an 



6 



PHARMACOLOGY AND GEXERAI. TUEHAPEDTICS. 



artificial arrangement into classes according to the physiological i 
peutical effects. A scheme of the latter kind appears at the concl 
this section. The following list comprises most of the drugs in use, i 
according to their natural alfmities and chemical characters: — 

Inoboanio Materia ilEDicA. 

G»orp T. — yott-metals. 

Hydrogen. Chlorine (chlorinated lime or cl 

Oxygen (ozone, hydrogen dioxide). soda). 

Sulphur (hydrogen sulphide). Iodine (hydriodic acid, the iodidea, 

Oaroon (charcwvl). Nitrogen (nitrii' acid, etc). 

Bromine (liydrobronvic acid). PliosphorviH (pliuwphoric add). 

Group U. — Metala (u) r/f the AJkaOcs and Atkalhw Earths. 

Monml Mt'iaJs. — Potaasium, Sodium, Lilhium, Ammonium, 
Dyad MctaU. — Calcium, Strontium, Barium, Aluminum, Magnesiuni, 2 
per, Cadmium, Silver, Mercury. 

(hj The Heavy Metals. 

Triad MetaU. — Thallium, Iridium, Gallium. 

Tetrad Metals.— heeid, Tin. 

Fi'titad Metfjh. — PhoRphorus, Arsenic, Biftniut.h, Antimony. 

Besad .1/f//;/*.— Chromium, Tungsten, Molybdenum. 

Heptad Metals. — Manganese. 

Vnclassified Metals.— Iron, Nickel, Cobalt, Platinnm, r^old. 



Organic Materia Medica. 



Grocp T. — Carbon Compounds. 

(a J ALIPHATIC, OB TATTY SERIES. 



Flydrociirbona. 

Benzinum. 

Petrolatum. 

Acetone. 

Alcohol (ethylic, raetbylic, 
amylic). 

Aldehydes (ethylaldehyde, 
paraldehyde, and for- 
maldehyde). 



Carbolic nt id, or Phtiiol. 
Creosotum. 
Guaiacol. 
Resorcinol. 

MethylthioiiiniE hydro- 
eld oridum. 
Pyrocatechin. 



Ether. 

Ethereal oil. 
Ethylohloride. 
Amyl nitrite. 
Acetic ether. 
Glycerylis nitrns. 
Ethyl-bromide and iodide. 
Chloral-hydrate. 
Bromfll-hydrate. 

(b) ABO^LATIC SEBIBS. 

Salicylic acid. 

Naphthnlenum. 

Ttctanaphthol. 

Cbinolin. 

Kairin. 

Antipyrina (phenas^onum). 

Phenylis salicylas. 



Ethyl carbamate. 

Methylis aalicylaa. 

Chloroform. 

Chloralformamiduni. 

Iodoform. 

lodoL 

Sulphonmetlianum. 

Hexamethylenamtna 

Sulphonethylmcthan 



Acetanilidtim. 

Acetphenetidinuui. 

Benzol. 

Creaol. 

Toluol. 

Benzoic add. 

Pvridina. 





Group U.— Vegetable Materia Medica, 




SUBKnVGDO&t I.— PHANEROGAM.^. 




1 CIJ^.«6 I. — KXOGE.Vfl. 




DIVISION I. — A?rOI08PEBiC«. 




SUBCLASfi I. — TUALAJtflFLOlLB. 




yaturnl Order. Namr. Synonym. 
Banunculaces. Ranunculus, Crow-foot, buttercup, 
Aconitum, Monk's-hood. 




^^^^^^^^ ^^H 



MATERIA MEDICA. 



yatural Order, 


yame. 


Synonym. 


Ranunculacea [continued). 


Staphisagria, 


Stavesacre. 

■r i_ 




Delphinium, 


I^irkapur. 




Pulsatilla, 


Meadow-anemone. 




Cimiciluga, 


Black cohosh. 




Podophyllum, 
Hydrastis, 


May-apple. 
Golden seaL 


MtgnolUooB. 


Magnolia, 
Ehcium, 


Magnolia. 

Star -anise. 


Menispennacea. 


Menispermum^ 
Calumba, 


Canadian moon-seed. 
Columbo. 




Pareira. 


Pareira, 




Picrotoxinum, 


Cocculus Indicus. 


BerberidacMB. 


Caulophyllum, 


Blue cohosh. 
Poppy. 
Bloodroot. 
Celandine. 


Papaveracefie. 


Papavcr, 

Sanguinaria, 

Chelidonium, 


Crucifene. 


Sinapis, 

Armoracia, 


Mustard. 
Horse-radish. 


Violaccffi. 


Viola, 


Pansy, 


Linee. 


Linum, 


Flaxseed. 


Geraniacece. 


Geranium, 


Crane's-bilL 


PolTgalefie. 


Senega, 


Senega. 




Krameria, 


Rhatany. 


Saptndacess. 


Guarana, 


Paullinia. 


EiythroiylacefiB. 


Krythroxylon, 


Coca. 


MalTteen 


Gossypium, 


Cotton. 




AIth»a, 


Marshmallow. 


Anrantiacee. 


Aurantium, 


Orange. 




Limones, 


Lemons. 


SterenliaceflB. 


Theobroma, 


Cacao. 




Sterculia, 


Kola. 


TenistroemiaceflB. 


Camellia, 


Tea. 


GnttiferflD. 


Cambogia, 


Gamboge. 


CaneUa4!ee. 


Canella, 


CaneUa. 


Vitaces. 


Uvae passae. 


Raisins. 




Vina, 


Wines. 


ZTgophylle©. 


Guaiacum, 


Guaiac. 


M^iilMk 


Azedarach, 


Pride of China. 


Botaeen. Rutese. 


Ruta, 


Rue. 




Cusparia, 


Angostura-bark. 


• 


Bergamum, 


Bergamot. 


IHosmca. 


Buchu, 


Buchu, 


Xanthoxy'.e«e. Xanthoxylum, 


Prickiy ash. 




Pilocarpus, 


Jaborandi. 


SimarnbcM. 


Quassia, 


Quassia. 




suBCZiAee ii. — caltciflors:. 


yatural Order. 


yame. 


Synonym, 


Bhamnacee. 


Rharanus purshiana, 


Cascara sagrada. 




Rhamnus frangula. 


Buckthorn 


Celafitrineffi. 


Kuonymus, 


Wahoo. 


Aquifoliaceae. 


Prinos, 


Alder. 


Anacardiete. 


Mastiche, 


Mastic. 




Rhus glabra, 


Sumach. 




Rhus toxicodendron, 


Poison-ivy. 


Borseracen. 


Myrrha, 


Myrrh. 


LegnmhioMBi Papilionaceje. Glycyrrhiza, 


Licorice. 




Scoparius, 


Broom. 




Tragacantha, 


Tragacanth. 



PHAUMACOLOGY AND OENEttAL THEHAPEUTICS. 



Natural Order. 


Name. 


Stfnonjfm. 


Leguminoste. 


Fapilionaces 


Santftlum, 


Saunders. 


(continued). 


Kino, 


Kino. 






Balsamura Peruvianum, 


Balsam of Peru. 






Balftanium Tolutanum, 


Balaam of Tolu. 






Abrua, 


Jequirity. 






Physostigma, 


Calabar bean. 






Htematoxylon, 


logwood. 






Krameria, 


Rhatany. 






ChrvBarobinum, 


Chrysarobin. 




Ceesalpinae. 


Senna, 


Senna. 






Cassia, 


Purging cassia. 






Tamarindus, 


Tamarind. 






Copaiba, 


Copaiba. 






Piscidia, 


Jamaica dogwood. 




Mimosese. 


Acacia, 


Gum arabic. 






ErythrophlfiBum, 


Sassy-bark. 






Indigo, 


Indigo. 


Rosaceaa. 


Pomese. 


Cydonium, 


Quince. 






Rubns, 


Blackberry. 




''>ryadeeB. 


Rubus idceus. 


Raspbern'. 




Aosese. 


Rosa, 


Rose. 






Cuaso, 


Kousso. 






Quillaja, 


Soap- bark. 




Amygdalece. 


Amygdala dulcis. 


Sweet almond. 






Amygdala amara, 


Bitter almond. 


. 




Prunua, 


Prune. 






Prunus Virginiana. 


Wild cherry. 






T^urocerasus. 


Cherry-laurel. 


Papayaceee. 


Passiflorse. 


Carica papaya. 


Papaw. 


Myrtaceee. 




Caryophyllus, 


• Cloves. 






Pimenta, 


Allspice. 






Chekan, 


Cheken, 






Myrtus, 


Myrtle. 






Cajuput, 


Cajeput. 






E^ucaJyptiis, 


Blue gum. 






Oranatum, 


Pomegranate. 


Cucurbitacese 


. 


Colocynth, 


Bitter cuctimber. 






Klaterinm, 


Squirting cucumbei 






Ppno, 


Pumpkin. 




[mne 


"Rrvonia, 


Bryony , 


Umbellifer». 


Carapylosper 


- Coniiim. 


Hemlock. 


. 


; 'Orthoaperma 


>. Asafostida, 


Asafetida. 






Galbanum, 


Galbanum. 






Ammoniacum, 


Ammoniac. 






T^opnicuhim, 


Fennel. 






Anisum. 


Anise. 






Anethuni, 


Dill. 






(^arum. 


Caraway. 






Sumbnl. 


Musk -root. 




Coelospermee. 


Coriandrum, 


Coriander, 






srncLASs in.— corolltflor^. 


Natural Order. 


Name, 


Spnonfw 


Caprifoliaceee. 


Sambucus, 


Klder. 


Cornaceffi. 




Cornus, 


DogAvood. 


Rubiacee. 


C^inoboneiP. 


Cinchona, 


Cinchona bark. 




CoffefiB. 


Coffea. 


Coffee. 






Gambir, 


Gambir. 



Enuragoga. Ipecacuanha, 



Ipecac. 



MATERIA MEDICA. 



Natural Order, 



Valemnett. 

Capzifoliaceee. 
Composite. 



Lobeliacece. 
Ericacese. 



Sapotacee. 

StyracoB, 

Oleteeae. 

I»guuace«. 



ApocTnaceee. 

Asclepladee. 

Oentkztee. 

Conrolrulacen. 

Chenopodiacefls. 
Solanacee. 



^Tophu]ariac«. 
Labia ts. 



Pedaliacett. 



Name. 

^'aleriaIl, 

Viburnum, , 

Pyrethrum, 

Absinthium, 

Tanacetum, 

Saotonica, 

Anthemis, 

Matricaria, 

Eupatorium, 

Taraxacum, 

lActuca, 

Arnica, 

Calendula, 

Grindelia, 

Inula, 

Lappa, 

XiObelia, 

Uva ursi, 

Chimaphila, 

Gaultheria, 

Gutta-percha, 

Benzoin, 

Olivee oleum^ 

Manna, 

Xux vomica, 

Ignatia, 

Gelsemium, 

Spigelia, 

Apocynum, 

Aspido sperm n, 

8trophanthus, 

Asclepias, 

Hemidesmus, 

Condurango^ 

Gentian, 

Chlretta., 

Scammony, 

Jalap, 

Chenopodium, 

Scopola. 

Capsicum, 

itelladonmt. 

Hyoscyamus, 

Stramoniiun, 

Tobacco, 

IMgitalia, 

Ijq)tandra, 

Kosmarinus, 

Lavandula, 

Mentha piperita, 

Mentha viridis. 

Thymus. 

Hedeoma, 

Marrubium, 

Melissa, 

Origanum, 

Salvia, 

Scutellaria, 

Sesami oleum, 



Hynonym, 

Valerian. 

Black haw. 

Pellitory. 

Wormwood. 

Tansy. 

Santonica. 

Chamomile. 

German chamomile. 

Thoroughwort. 

Dandelion. 

Lettuce. 

Leopard*a-bane. 

Marigold. 

Grindelia. 

£:ecampane. 

Burdock. 

Indian tobacco. 

Bearberry. 

Pipsiasewa. 

Wintergreen. 

Gutta-percha. 

Benzoin. 

Olive-oil. 

Manna. 

Nux vomica. 

Bean of St. Ignatius 

Yellow jasmine. 

Vink root. 

Canadian hemp. 

Quebracho. 

Strophanthus. 

Pleurisy-root. 

Indian sarsaparilla. 

Condurango. 

Yellow gentian. 

Chirata. 

Scammony. 

Jalap. 

American worm-seed. 

Scopola. 

Red pepper. 

Deadly-nightshade. 

Henbane. 

Jamestown weed. 

Tobacco. 

Fox-glove. 

Culver's physic. 

Rosemary. 

Lavender. 

Peppermint. 

Spearmint. 

Thyme. 

Pennyroyal. 

Horehound. 

Balm. 

Wild marjoram. 

Sage. 

Skull-cap. 

Benne oil. 



10 



PHABMACOLOGY AXD GENERAL THERAPEUTICS. 



Natural Order, 
Polygonace®. 

Phytolacca cesB. 
Myristicacese. 

LaurineflB. 



AristolocbUceflB. 

Santalacese. 

Thymelaceee. 

EuphorbiacbsB. 



FiperacesB. 



Salicaceee. 

Juglandaceea. 

Hamamelacen, 



CupuUfena. 
UrticaceflB. 



Ulmett. 
Moren. 
Artocatpen. 
Cannabmeo. 



SUBCLASS IV. — APETAL^. 

yame. 
Kheum, 
Rumex, 
Phytolacca, 
Myristica, 
Macis, 

Omnaraomum, 
Camphora, 
Sassafras, 
Goto, 

^rpentaria, 
Asamm, 
Santali oleum, 
Mezereum, 
Elastica, 
Cascarilla, 
Stillingia, 
Tiglii oleum, 
Ricinus (oleum), 
Eamala, 
Piper, 
Cubeba, 
Matico, 
Salix, 
Juglans, 
Hamametis, 
Styrax, 
Quercus, 
Castanea, 
nmuB, 
Mortis, 
Ficus, 

Cannabis Indica, 
Cannabis Americana, 
Humultis, 



Synonyn, 
Rhubarb. 
Yellow dock. 
Poke. 
Nutmeg. 
Mace. 
Cinnamon. 
Camphor. 
Sassafras. 
Coto. 

Snake-root. 
Canada snake-root. 
Sandal-wood oil. 
Mezereum. 
India rubber. 
Sweet wood. 
Queen's root. 
Croton oil. 
Castor-oil. 
Rottlera. 
Pepper. 
Cubebs. 
Matico. 
Willow. 
Butternut. 
Witch-hazel. 
Storax. 
Oak. 

Chestnut. 
Elm. 

Mulberry. 
Kg. 

Indian hemp. 
American hemp. 
Hops. 



DIVISION II. — QYMNOSPKBM^. 



yatural Order, 
Coniferse. 



Natural Order. 
Smilaceffi. 
LiliacesB. 



Melanthacese. 
Otchidece. 



ScitamlnesB. 



yame, 
Pinus sylvestris, 
Abies excelsa, 
Abies balsamea 
Pinus palustris. 
Thuja occidentaJis, 
Jumperus communis, 
Juniperus oxycedrus, 
Jimiperus sabina, 
Serenoa serrulata, 

CLASS II. — ENDOOEN8. 
Xamt: 

Sarsaparilla. 

Allium, 

Scilla, 

Aloe, 

Veratrum viride, 

Colchicum, 

Sabadilla, 

Vanilla, 

Cypripedium, 

Zingiber, 



Synonym, 

Scotch fir. 
Spruce fir. 
^Isam fir. 
Turpentine pine. 
Arbor vitae. 
Juniper oil. 
Cade oil, 
Savin. 
Saw-palraetto. 



Synonym. 
Sarsaparilla, 
Garlic. 
Squill. 
Aloes. 

Green hellebore. 
Meadow- saffron . 
Cevadilla. 
Vanilla. 
Ladies'-slipper. 
Ginger. 



MATERIA MEDICA. 



11 



yatural Order, 


Name. 


Synonym, 


SeiUminese (continued). 


Cardamomunif 


Cardamom. 


Irides. 




Iris, 


Blue flag. 






Crocus, 


Saffron. 


Falmacem. 




Areca, 


Betel-nut. 


Aroidee. 




Calamus, 


Sweet flag. 


GraminefiB. 




Farina tritid. 


Wheat-flour. 






Avens farina. 


Oatmeal. 






Amylum, 


Starch. 






Triticum, 


Couch-grass. 






Hordeum, 


Barley. 






MaJtum, 


Barley-malt. 






SUBKINQDOM U. — CBYPTOOAlld. 


yatural Order. 


Name. 


Synonym. 


nUces. 




Aflpidium, 


Male fern. 


Liehenes. 




Cetraria, 


Iceland moss. 






Litmus, 


litmus. 


Pongl. 




Ergota, 


Brgot of rye. 






UstUago, 


Corn-smut. 


Alga. 




ChondruB, 


Irish moss. 






Group III.— AnimoZ Kingdom. 


Cla$8. 


Order. 


Name. 


8ynonym. 


yUmaaii$L 


Rodentia. 


Castoreum, 


Castor. 




Rtuninantia. 


Moschus, 


Musk. 






Serum antidiphtlieriticum, 


Diphtheria antitoxin. 






Glandules suprarenaSes 








siccfB, 


Dried ftuprarenid glands. 






Glandulffl thyroidea aicctB, 


Dried thyroid gUmda. 




■' 


Sevum. 


Suet (mutton-suet). 


' 




Adeps lans. 


Wool-fat (purified). 






Gelatinum, 


Gelatin. 






Carbo animalis. 


Bone-charcoaL 






Fel boTis, 


Ox-gall. 




PachydennaU. Adeps, 


Lard. 






Pepainum, 


Pepsin. 






Pancreatinum, 


Pancreatin. 




Cetacea. 


Spermaceti, 


SpermacetL 

%g (of domestic fowl) 


Ares, 


GalliiUB. 


Ovum, 


Pisces, 


Sturiones. 
Tdeoetei 
(gadidsB), 


Ichthyoeolla, 


Isinglass. 


f 


Morrhuffi oleum. 


Codliver-oil. 


Iiuecta, 


Hymenoptera^ Mel, 


Honey. 






Cera, 


Wax. 




HemSptera. 


Coccus, 


Cochineal. 




Coleoptem. 


Cantharis, 


Spanish fly. 


Hrimhitlie% 


Annelida. 


Sanguisuga, or hirudo. 


Leech. 



In the above comprehensive scheme^ which is essentially that of 
Lauder Braton's "Pharmacology," remedies are arranged with reference 
to their natural afiSnities, and in this classification relaHonships are mani- 
fested which ordinarily might be unnoticed by the student. It will be 
observed that drugs are derived from various sources, and vary greatly in 
their properties, physical and chemical. They all agree in one attribute, 
however, which is of influencing bodily functions in such a maimer as to 



12 



FHABUACOLOOY AND GENERAL THEBAPEDT1C8, 



make them useful in the treatment of diseased conditions. The nature of 
these effects and the manner of their manifestations it will be the purpose 
of the following pages to show, especially in Part II, where drugs are dis- 
cussed individually and in detail. 



SCIBKTIFIC SyNOXYMS OF NeW EeMEDIES.' 

3Iost of the remedies of recent introduction bear names which give little 
or no clue either to their chemical composition or therapeutical properties. 
In preparing the following list of synonyms an effort has been made to give 
the correct chemical designation of the drug named, as well as the brand, 
or trade, name adopted by the manufacturers, and it is hoped that the list 
will prove useful to those who have calls for such remedies under their 
chemical titles. 



Scientifie .Vnme. Trade Yamr. 

Acetamidosalol Salophen 

Acetphenetidine Phenacetin 

Acetphenone Hypnone 

Acetylaalicylic acid Aspirin 

Acetylsalicylic acid Acftyaal 

Acetylaalicylic acid Xaxa 

Acetyltannin Tannigen 

AcetyUalol Spiroforin or Vesipyrin 

Albumin iodoform lodoformogen 

Aluminum carbonate Alchol 

Aluminum naphtholsulphonate. .Alumnol 

Amidopyrine Pyramidon 

Amylene hydrochloride Stovaine 

Ammonium ichthyolsuJ- 

phonate Ichthyol, Thiolin 

Ammonium ichthyolaul- 

phonate Ichthosan 

Ammonium ichthyolsulphonate . .Thigenol 

Amylum formaldehyde Amyloform 

AnUpyrine acetybalieylate. . . , . Acopyrin 
Anhydromethylene sodium 

citrate Citarin' 

Amylene chloral Dormiol 

Antipyrine, caffeine citrate. . . .Migrainin 

Antipyrine-ferric chloride Ferri pyrin 

Antipyrine-ferric chloride Ferropyrin 

Apomorphinbrommethylate .. .Euporphin 
Arffentum (See Silver.) 

Atropin methylnitrate Eumydrin 

Benzolylacetyl peroxide Acetozone 

BenzoBUlphinide Saccharin 

Benzoyl guaiacol Bcnzozol 

Benzylmorphine hydrochloride. .Peronine 

Beta-eucaine mandelate Euphthalminc 

Biiimuth albuminate Bismuthose 

Biftmiith cinchonidindiiodide ...Ervthrol 

Bismuth dithiosalicylate Thioform 

Bifimuth fluorbromphonyl . , .- Fluotal 

Bismuth oxiodogallate '. Airol 

Bismuth bctanaphtholate Orphol 



ftcienfific Xame. Trade Yamr. 

Bismuth methylene digallate Bismal 

Bismuth subgallate Dermatol 

Bismuth chrysophanat^ Dermol 

Bismuth cinnamylate Hetof orm 

Bismuth bilactomonotannate ..Lactanine 

Bismuth pyrogallol Helcoaol 

Bismuth phosphate Bisol 

Brominized oil ". Bromipin 

Bornyl valerate Hysterol 

Butipyrine Trigemine 

Codeine brommethylate Eucodeine 

( 'alcium beta naphtholsulphonate . Asaprol 

Copper nucleinate Cuprol 

Casein sodium Nutrose 

Chloral ethylcarbonate ....... .Uralium 

Chloralformamide Chloralamido 

Cotamine hydrochloride ytypticin 

Cotamin phthallate Styptol 

Creosote carbonate Creosotal 

Oeosote carbonate Ciba 

Creosote salicylate Salocreol 

JMacetyl morphine Heroin 

Didymium salicylate Dymal 

Diethylbarbituric acid Veronal 

Diethylmaionylurea Veronal 

Diomidophenol hydrochloride Amidol 

Diiodomethyl salicylate Sanoform 

Dioxybenzol-hexa- 

methvlenamine Hetralin 

EUagic" acid , Gallogen 

Ethyl carbamate Urethane 

Ethylene |)eriodide Diiodoform 

Elixir chloreethanal alcoholate. . .Somnos 

Ethylmorphine hydrochloride Dionin 

Ethyl salicylate Sal-etliyl 

Ethylidene diethylether Acetal 

Kthyl rhioridc Kelene 

Epineplirin hydrate Adrin 

Ferralbumin Ferratin 

(ielatin formaldehyde Glutol 



^ From the Rejwrt of the Committee on New Remedies of the Xew York State 
Pharmaceutical Association for 1900. Amcnran Dntffgist, 1906, pnge 36. 



MATERIA MEDICA. 



13 



Hcientific Name. Trade A'ame. 

Gelatoee silver Albargin 

Guiiacol albuminate Histosan 

Guaiacol cacfxlylate Cacodyliacol 

Guaiacol benzoate Benzosol 

Guaiacol carbonate Duotal 

Guaiacol cinnamate Styracol 

Guaiacol salicylate Guaiacol-salol 

Guaiacol valerate Geosot 

Hexamethylenamine-anhydro- 

methyleiie citrate Helmitol 

Hexamethylenamine Aminoform 

Hexamethylenamine Urapurgol 

Hexamethylenamine. . . . 

Ammonio-formaldehyde 

Hexamethylenamine Cyatamine 

Hexamethylenamine Cystogen 

Hexamethylenamine Formtn 

Hexameth-vlpnamine Uritone " 

Hexamethylenamine Urotropine 

Hggamrethylenamine-BalicylaAe. , 

Saliforniiu 
Hexamethylenamine-ethylbromide. . 

Bromalin or Bromoformin 

Hexamethylenamine- tannin Tannopin 

Hexamethylenamine-quinate. Chinotropin 
Hexamethylenamine-quinate Chinoformin 

Hydrargyrum colloidale Hyrgol 

Iron nucleinate Ferratogen 

Ichthyol albuminate Ichthalbin 

Ichthyol formaldehyde Ichthyoform 

Iron paranucleinate Triferrin 

lodochloroxychinolin Viofonn 

Iodized oil lodipin 

Isobutylorthocresol-iodide ... .Europhene 

Lactylparaphenetidin Lactopnenin 

Lithium quinate Urosine 

Lithium benzoate Uristamine 

Limonin Citarin 

Menthol valerate Validol 

Methylacetanilide Exalgin 

Methylene bromtannin Bromotan 

Methylene dicotoine Fortoine 

Methvlene-ditannin Tannoform 

Methylmorphine Codeine 

Metbylthionine hydrochloride 

Methylene blue 

Mercury, colloidal Hyrgol 

Mercury nucleinate Mercurol 

Mercuric ethylenediamine 

iiulphate .Sublamine 

Methylzanthin sodium 

acetate Theocine-sodium acetate 

Methylenehippuric acid Hippol 

MoDorhloral-antipyrine Hypnal 

Xaphthalol .Betol 

Xaphthol salicylate Betnl 

Xaphthopalol /. Betol 



Scientific Name. Trade Name. 

Nicotine salicylate .Eudermol 

Piperazine quinate Sidonal 

Faramidophenol hydrochloride ..Rodinal 

PvTocatecnindimetnyl-ether Veratrol 

Phenylurethane Euphorin 

Fhenetidine citrate Citrophen 

Potassium-creosote 

sulphonate Sulphosote 

Potassium-guaiacol sulphonate. ..Thioeol 
Potassium-guaiacol 

sulphonate Kasucolum 

Potassium ortho-oxy- 

chinolinsnlphonate Chinosol 

Pyrogallol monoacetate Eugallol 

Pyrogallol triacetate LenigaJlol 

Kesorcin monoacetate Buresol 

Quinine guaiacol blaulphonate. .Guaiquin 

Quinine ethyl carbonate Euquinine 

Quinine ethyl carbonate. .... .Aristochln 

Quinic acid anhydride Sidonal, new 

Quinine-phenetidine ethyl 

carbonate Chinaphenin 

Silver citrate Itrol 

Silver citrate Antiseptic Cred6 

Silver, cot loidal CoUargol 

Silver ichthyolsulphonate ... .Ichthargan 

Silver lactate Actol 

Silver proteinate Protargol 

Silver proteinate Novargan 

Silver protalbin Largin 

Sodium acid oleate Eunatrol 

Sapocarbol Lysol 

Sodium oxycyanocinnamate ...Zymphene 

Sodium lygosinate Lygosine 

Sapocresol Creoline 

Sodium perborate Euzone 

Sodium pyrocatechin 

monoacetate Guaiacetin 

Sapof ormal Lysoform 

Succinic peroxide Alphozone 

Sulphonethylmethane Trional 

Sulphonmethane Sulphonal 

Tannin albuminate Tannalbin 

Tetraiodopyrrol lodol 

Theobromine sodium acetate ...Agurine 
Theobromine sodium 

salicylate Fibrolysin 

Thyminic acid Solurol 

Theobromine sodium salicylate. .Diuretin 

Thymol carbonate Thymotal 

Thymol iodide Aristol 

Thymol iodide Annidalin 

Thymol iodide Thymotol 

Tribromphenolbismuth Xeroform 

Urea salicylate Ursal 

Zinc phenolsulphonate. . 

Zinc sulphocarbolate 



14 



PUABALACOLOOY AND GEKEIUL THERAPEUTICS. 



PHARMACY. 

Pharmaceutical Nomenclature and Classification. — In evurv 8c 
is necesary to ruHow some system of naming the objects under co, 
tion, and if this be done carefully it is a great assistance to its sti 
avoids much conftision. ConimoD names, being used by persoi 
possess but slight knowledge of the enhject, are likely to be frequeni 
applied and are not sutiiciently distinctive. For instance, nitre ma 
sodium carbonate or sodium nitrate, as well as potassium nitrate, v 
the proper chemical title. Milk-weed designates any common plant 
a milkj'^ juice, whereas the name Asclepias tuberosa always serves to i 
a species of asclepias, without confusion or error. Sciextific nai 
therefore not adopted witli the object of making the study of a subje 
difficult to the beginner, but really with the view of making its c 
hension more easy after he has mastered the details of its techniq 
nomenclature. It is absolutely necessary for the student of materia 
to have a knowledge of botanical and chemical terms. In the consid 
of drugs in the present work, every ollloifil drug appears under the titl 
Latin chemical or botanical name, with the letters U. S. P. nr B. P. 
the common name or synonym is also given. In the case of plants t 
botanical name and natural order are usually stated, following tlie 
States Pharmacopoeia. The scientific, or botanical, title is gh, 
Latin so as to avoid mistakes, as this is the name by which it wc 
recognized all over the world, and by which it may easily be idei 
whereas, the same common name may be applied to plants of di 
species having very different physiological actions and medicinal effect 
common language the English name of the remedy is to be used, 
prescriptions the Latin pharmacopceial name shoiild always be emj 
Further remarks u}>on prescription-writing will be found at the end ■ 
section. It is to be understood that throughout these pages the 
U. S. P. after the name of a drug, preparation, or formula indicate tl 
that it is recognized by the United States Pharmacopncia. and is 
wherever this authority is acknowledged. B, P. similarly indicates tt 
remedy or preparation is official in the last edition (1898) of the 1 
Pharmacopoeia. 

The nomenclature of the United States Pharmacopoeia ia based 
the following rules adopted by the Convention of 1800, through its 
mittee on Revision, which have also been followed in the more 
edition. 

"In the choice of titles of official articles the principle governs tha 
vonience, established custom, and consideration of safety against mi 
tlirough similarity or changes in names, should outAveigh purely theoi 
considerations or scientific preciseness. In tlie designation of chemical 
pounds (oxides, salts, etc.), put the hasylous or metallic component 
viz.: sodium chloride, silver nitrate, lithium bromide, lead oxide, et< 
stead of writing chloride of sodium, nitrate of silver, bromide of lit! 
oxide of lead, etc. In the case of the salts of iron and mercury this d 




FHARKACY. 16 

inTolves also the use of the respective terms in ous and tc (ferrous and 
ferric, mercurous and mercuric) which greatly help to distinguish salts 
heretofore frequently confounded. As a matter of precaution, however, the 
distinguishing adjectives, 'corrosive,' 'mild,' ^yellow,' 'red,' etc., have been 
left in the titles of the respective mercury compounds; for instance, 'Corro- 
sive Mercuric Chloride,' 'Mild Mercurous Chloride,' etc. In the case of 
complex iron preparations such as the so-called scide salts (Ferri et Am- 
monii Citras, Ferri et Ammonii Tartras, etc.), which are not true chemical 
salts, yet all of which contain the iron in a ferric condition, the word- iron 
was left unchanged, to avoid the impression that they are definite, double 
salts." These changes in nomenclature were retained in the Eighth Be- 
vision. In addition a few synthetic remedies were introduced, such as anti- 
pyrine, sulphonal, phenacetin, and formin^ under their (condensed) chemical 
titles- Also a few organic remedies were made official. 



Pharmacentical Classes of Bemedies. 

ACIDA — ^ACIDS. 

Two degrees of relative concentration are usually recognized, and in 
one case (acetic acid) there are three. The dilute acids are all of uniform 
lO-per-cent. strength, — one-tenth acid and nine-tenths water, — except di- 
lute nitrohydrochloric, which contains only 7 per cent., and dilute acetic, 
6 per cent, while the aromatic sulphuric acid contains 20 per cent, of the 
official acid, and dilute hydrocyanic acid contains only 2 per cent, of abso- 
lute hydrocyanic acid. The official Acids are : — 

1. IxroBOAinc. 

fa) Liquid Aiid9:-~ (a) Liquid Adda (continued).'^ 

Addmn hydrobromicum dilutum. AoSdum nitrohydrochloricum dilutum. 

Aeidum hydrocliloricuin. Acidum phosphoricutn. 

Acidum hydrochloricuro dilutum. Acidum phoAphoricum dilutum. 

Acidum hydriodicum dilutum. Acidum Bulphuricum. 

Acidum hypophoapfaorosum. Acidum sulphuricum dilutum. 

Acidum hypophoaphorosura dilutum. Acidum sulphuricum aromaticum. 

Acidum nitricum. Acidum sulphurosum. 
Aeidum nitricum dilutum. 



Acidum nitrohydrochloricum. 



(h) Solid Acid:— 
Acidum boricum. 



2. Oboanic. 



(aj Liquid Adda:— (h) Solid Adds:— 

Acidum aceticuiu glaciale. Acidum bemsoicum. 

Addum aceticum. Acidum camphoricum. 

Acidum aceticum dilutum. Acidum citricum. 

Acidum hydrocyanicum dilutum. Acidum gallicum. 

Acidum lacticum. Acidum salicylicum. 

Acidum oleicnm. Acidum stearicum. 

Acidum tannicum. 

Acidum tartaricum. 

Acidum trichloraceticum. 



^^V 16 PUABMACOLOOY AND 


GEXEIUL TIIKRAPEUT1C3. 


^^^^^H The ofticial Alkaloids are : — 






^^^^^^H Aconitina. 




Morpliinfle aeetas. 


^^^^^^H Apomurpliime hydrochtoritiunir 




Morphiuoe hydroehloridunu 


^^^^^^H 




\lniphimp siilphaa. 


^^^^^^ Atropinn^ sulphas. 




Peiletieniiffi tannas. 


^^^^H CalFeina. 




Physoati^minoj siilioylng. 


^^^H citrRUi. 




Pliyfto^itipmime sulphas. 


^^^H Caffeina citrula elKu'vettceiiH. 




I*iloettrpime hydrochlnridun 


^^^H Cinohoninic stilphafi. 




IMloi'iirpiiui? niti-us. 


^^^1 Cocama. 




Quinina. i 


^^^H Cooaiiim hydrouliloridum. 




Quiuimc hUulphas. ' 


^^^H Codeina. 




On in imp hyrlrobTomidum. 


^^^H Codeini? phnnpUas. 




Qnininn? hydrnebloridiim. 


^^^H rodoiiifp *^ii]p1iA4. 




Qurninio finlieyln^. 


^^^^H Coli-hk-ina. 




QuininiP BulphaB, 


^^^^H Homntroptnip hydrnbroniidum. 




Scopolnminr* hydinbramidu] 


i^^^H ITyilraAtinip. 




Sparteinflp sulpha-^. 


^^^^H Hydraj*tininffi hydrnrhloridiim. 




Strychnina. 


^^^H H^'osoinie hydri^brnmithini. 




Stri-elinime nitras. 


^^^^B Hyospynminn^ )iydrn1>ronitduTn, 




Str;vehnimB sulphas. 


^^^^1 HvoAryATnin«e siilpliaa. 




Veratrina. 


^^^^^^ Morphina. 






^^^^^^ 


Pri 


Nt'IPI.Efl. 


^^^^1 Cbry^flrobmum. 




Piperiinim. 


^^^H Elateriniim. 




Salifinum. 


^^^^^^^ Gljoyrrlii/.innni niiinioniatum. 




Santoninum. 


^^^^V 




^^^^^^ 1. EXPOESfiED 


OR 


Fixed Ott-s. 


^^^B Oti?um adfpip. 




Oleum nlivR*. 


^^^^1 OUnini nmyf2dfll(c cxpreasum. 




Olf'Tim ricini. 


^^^^f Otonm ;ro?6ypii oominH. 




Oleum tbeoliromatis. 


^^^1 Oleiim lini. 




Oleum tijrlii. 


^^^^^^ Oleum morrhiue. 






^^^^^^ 2. DiSTIIXKD OR V^OIJiTILE OlT,a. 


^^^H Oleiun amy^dalee aiuarfie. 




Oletim beileomra. 


^^^^1 Oleum anisi. 




Ofpinu iiiniperi. 

Oleum lavHudulfp florum. 


^^^^1 Oleum aiinintii cortiels. 




^^^H Oleum botiOns volatile. 




Oleum limonis. 


^^^H Oleum 




Oleum iiienthiE piperiteo. 


^^^H Oleitm eHJupuU. 




Oleum mprulire viridia. 


^^^H Oleum 




Oleum myri>tie*p. 


^^^H Oleum I'liryophylli. 




Oli'um piris liquiilne. 


^^^H Oleum eheuopodii. 




Oleuru pimentnp. 


^^^^H Oleum finnnmoii]!. 




Oleum rnsm. 


^^^^1 Oleum onpaibm. 




Oleum rosmarini. 


^^^^^ Olpum eorinndri. 




Oleum sabinnp. 


^^^^B Oleitm eiihehfp. 




Oleum »antaJi. 


^^^^1 Oleum erifTcrontia. 




Oleum sassufras. 


^^^^B Oleum 




Oteiim ftinapis vidfttilp. 


^^^^1 OTeum ftpnieuli. 




Oleum tereWntbiuro. 


^^^H Oleum gaultherirr. 


■ 


Oleum terebiutbinoR reettfica 
Oleum <hymi. 



PHARMACY. 



17 



Pharmacopceial Pbeparations. 

The U. S. Pharmacopoeia presents thirty-six classes of official prepara- 
tions: — 



Latin. 














EnglUh. 


1. Acetum. 


[Gen. 


sing. 


, i Nom. 


pi., 


a 


Vinegar. 


2. Aqua. 


u 


M 


w 


tt 


H 


w 


1 Water (aromatic). 


3. Cataplaama. 


I " 


*« 


atia 


.< 


(. 


ata ] 


Poultice. 


4. Ceratum. 


[ " 


tt 


i 


u 


1* 


a 


1 Cerate. 


3. Ch&rta. 


[ " 


tt 


fp 


tt 


tt 


<B 


1 Paper. 


6. CoUodium. 


1 •( 


M 


i 


u 


It 


a 


1 Co lodion. 


7. Confecto. 


u 


tt 


i 


it 


tt 


a 


1 Confection. 


8. Decoctum. 




not declinable 




> Decoction. 


9. Elixir. 


G^n. 


sing. 


. i Nom. 


pl., 


a 


I Elixir (cordial). 


10. Bmplastrum. 


1 it 


11 


i 


tt 


It 


a 


1 Plaater. 


11. Emulflom. 


r •< 


fi 


i 


u 


tt 


a 


1 Emulsion. 


12. Eztraetum. 


ti 


tt 


i 


It 


tt 


a 


Extract 


13. Fluidertractum. 


tt 


tt 


i 


tt 


tt 


a 


Fluid Extract. 


14. Gljceritum. 


1* 


tt 


i 


It 


It 


a 


Glycerite. 


15. Infnsnm. 


' U 


tl 


i 


tt 


It 


a 


' Infusion. 


16. Linimentum. 


\ u 


tt 


i 


t* 


tl 


a 


) TJniment. 


17. Liquor. 


*• 


tt 


oris 


tt 


tt 


ores 


Solutiop. 


18. Massa. 


(.' 


*t 


at 


tt 


i* 


a? 


Pill-mass. 


19. Mel. 


tt 


tt 


lis 


tt 


U 


Hia 


Honey. 
> Mixture. 


20. Mistunu 


tt 


tt 


m 


tt 


11 


<e 


21. Mttdlago. 1 


tt 


It 


inia 


tt 


*l 


ines] 


Mudlage. 
Oleate. 


32. Oleatum. 


tt 


ft 


i 


It 


tt 


a 


23. Oleoresina. i 


tt 


ft 


tF. 


tl 


tt 


(B ) 


Oleoresin. 


24. Pflula. 


M 


tt 


<r 


*t 


tl 


« ] 


Pill. 


25. PulviB. 


(( 


tt 


eHs 


n 


M 


eres 


► Powder. 


26. Bmina. 


U 


it 


Of 


II 


tt 


m 


Reain. 


27. Sermn. 


tl 


tt 


i 


11 


tl 


tt ] 


Serum. 


28. Spiritus 


u 


tt 


U9 


a 


It 


ua ] 


Spirit 


29. Suppoeitorium. 


u 


tt 


i 


tt 


tt 


a 


Sui^ository. 


30. Pympns. ' 


tt 


tl 


i 


It 


tt 


i ) 


Syrup. 


31. Tinctura. 


H 


tl 


m 


tt 


tl 


*B ] 


Tincture. 


32. Tinctura herbanim i 


tt 


tt 


<r 


tt 


It 


<B ) 


Tincture of irea\ 


reoentium. 














herbs. 


3.r Trituratio. 


tt 


tl 


onin 


Gen 


U 


one* 


Trituration. 


34. TrocliMctis. 


it 


ft 


i 


a 


tl 


i ] 


Troche (lozenge). 


35. UnfnientTiin. 


tt 


«f 


i 


It 


tt 


ff ) 


Ointment 


36. Vinum. { 


tt 


tt 


i 


u 


M 


« ) 


vnnt. 



Aoeta, or Yinegars (2). — Liquid preparations made with dilute acetic 
acid. Strength, 10 per cent. 

Acetum opii. Acetum scillfie. 

Aqiue, or Aromatic Waters (IS). — Watery solutions of volatile sub- 
:?tance8, formerly prepared by distillation, now commonly made by adding 
the volatile or essential oil to distilled water, with magnesia and filtering. 
They are generally used as flavoring agents, and the dose is indefinite, ex* 
cept ammonia, chlorine, and creosote waters. Aqua is potable water in 
its purest attainable form. 

Aqua aurantii florum fortior. 

Aqua camphone. 

Aqua chloroformL 

Aqua cinnamomi. 

Aqua creosoti. 

Aqua foeniculL 



Aqua destillata. 

Aqua anunonise. 

Aqua ammonis fortior. 

Aqua amygdalae amans. 

Aqua anisi. 

Aqua aurantii flormn. 



Aqua hamamididis. 
Aqua hydrogenii dioxidi. 
Aqua menthee piperiteOb 
Aqua mentbsB viridis. 
Aqua rosse. , 

Aqua Tosse fortior. 



18 



iniAUAlACOUXiY AM) OENEItAL TIIKlLVI'ErTlCS. 



Cataplasmata, or Poultices (1).^ — Moist, eeiui-Holid inixture^ 
consistency for oxtornal application. J 

CataphimiiH knolini. 1 

Cerata, or Cerates (6). — Fatty mixttires containing wax, so ai 
them firnuT ihini ordinarv ointment?. 



Oratum. 

Ceratum eamphortr. 



Oinititiii t»iU3uiritli!4. C'eriitiiiii rosino;. 



Chartee, <»r Medicated Paper* (1). — l^apers^ of (lotinitc sizt^ 
with drugs. ■ 

Charta sjnapis. 4 

Gollodia* or Collodions (4). — Tiiquid jircparationH r>f collndioi 

CuncHlimn. PoUtKliiini fle^■^(^. 

<'oUnrliuni caiitliarulat iiiii. CoUocUuni stypticui 

ConicctioncB, or Confections (2). — Soft, solid preparations in 
a paste with sugar. 

Confectio mwe. Conf«*ti« HMina*. 

Decocta, or Decoctions. — Liquid prnpHrations of vc;j;ctabl* 
obtained bv iioiliu): witli wntcr. A dtvixtion is din'ctcd Id b*.* imi 
rule, by placing' tin' drup in n Hiiitiiblr* vcbhoI, with a cfivcr, and 
lOOO parts of cold water for each oO nf substance used, covering it \» 
boiling for fifteen minutes. When emd, it is pai^sed thmiigli the t 
adding enough cold water to bring up the product to 1000 partj 
strength of decoct ifuis of energetic or powerful drugs should l>e t^ 
proscribed by the physician. In tlic I'. S. Pharmacopoeia there 
otUcial decoctions; tlie British l*hai'iiuUH)pteia hatf ihre**: Decoctu: 
conipositum. D. gninati radicis. and D. haunatoxyli. 

£lixiria« or Elixirs (3). — The pnpubirily of this class of reinedie 
to their coniparati\i'ly ]>Icawint taste and U* \]w faet that they conta 
hoi and sugar. 



Elixir adjnvans. 
Elixir flroimiticiiin. 



Elixir f**ni. tpiitHf pt strych- 
Tiinir phi*sp)iatum. 



Emplastra, or Plasters (7). — Solid MibstaiKcs rendered t^oft a 
hcsive liy heat, f^** ns to be sjircad upon leather or muslin, of any 
size or phape, for apidieatiou to the surface of the body tn ^vliich the 
is intended to adhere. Oiu* is an exception fo the giMicral ruli; tliat ] 
are to be applit'd with heilt: the eiuplastnnn ichthyocoll^, or isi 
plaster (miirt-plastcr) (I'. S. P., IHflO), is rendered adhesive by nn 



Kmplftstnmi rtrlhnp«inim. 
Rmplji'^tniin iKUadonnBC. 
Emplastnini oapsi<'i. 



Enip'a«tnim hydrarjpyri. 
Eraplrtstriim opii. 



KinplaKtriim plimihi. 



Emuha, or Emulsions (3). — Tluok liquid iireparations contain 
insoluble suhi^tance (generally an oil or a rcsin) suspended in u 
mcnstnainu hv tht* addition of a viscid material. 

Eraulsum oici morrhum. EmuUum olei ninrrloia.* cum KmiiUum oici tf^relni 

ll,^|i^Jpil('^|«llillml. 



PHABMACY, 



19 



Eztracta, or £xtraoti (28). — Preparations of a solid or semisolid con- 
sistency, containing the active principles or constituents of drugs, obtained 
usually by evaporation of alcoholic or watery solutions, the strength being 
from twice to four times that of the official agent from which they are 
made. They often contain glycerin, to keep them in a condition to readily 
make into pills. Assayed extracts contain a definite proportion of the 
active ingredient, determined by chemical analysis. Alcoholic extracts, 
aqueous extracts, acetic extracts, and ethereal extracts are made with the 
aid of dilute alcohol, water, acetic acid, or ether. Many so-called active 
principles, such as leptandrin, macrotin, hydrastin," etc., tised by botanic 
physicians, are simply alcoholic extracts, or impure resins, precipitated from 
strong tinctures by the addition of water. 



Extractum opiu 
Extractum pnysostigmatis. 
Extractum quassise. 
Extractum rhamni pursh- 

ianffi. 
Extractum rheL 
Extractum ftcopoln. 
Extractum stramonii. 
Extractum siimbul. 
Extractum taraxaci. 



Extractum aloSs. Extractum euonymi. 

Extractum bMladonnee foil- Extractum gentiause. 

omm. Extractum glycyrrhuae. 

Extractum cannabis Indicee. Hlxtractum glycyrrbizie 
Extractum dmicifugffi. purum. 

Extractum colcbici cormi. I'^xtractum hiematoxyli. 
Extractum co^ocynthidis. Extractum byoecyami. 
Extractum colocynthidis Extractum kramerise. 

compositum. Extractum leptandrse. 

Extractum digitalis. Extractum malti. 

Extractum ergotce. Extractum nucis vomica. 

Flnidextracta, or Fluid Eztracti (86). — Liquid preparations repre- 
Ht^ntative of organic drugs, usually alcoholic, hydro-alcoholic, or acetic acid, 
and are equivalent to strong tinctures. The rule followed, with a few excep- 
tions, is to have these preparations of definite strength, as related to the 
crude drug, so that one tiiousand cubic centimetres of the fluid extract 
represents the active principle of one thousand grammes of the drug. The 
dose, therefore, is the same, as the rule, in minims as that of the dry, pow- 
dered drug in grains. 



Fluidextractum 
Fluldextract um 
Muidextr actum 
Fluidextractum 
Fluidextractum 
Fl u idex tra c t um 
Fluidextractum 
Fluidextractum 
Fluidextractum 
Fluidex t ract u ra 
FluWextractum 
Fluidextractum 
Fluidextractum 
Fluidextractum 
Fluidextractum 
Fluidextractum 
Fluidextractum 
Fluidextractimi 
Fluidextractum 
Fluidextractum 
Fluidextractum 
Fluidextractum 
Fluidextractum 
Fluidextractum 



aconiti 

apocyni. 

aromaticum. 

aurantii amari. 

belladonnse radicis 

berberidis. 

buchu. 

calami. 

calumbee. 

cannabis Indicie. 

capsici. 

cbimaphile. 

chiratse. 

cimicifugsp. 

cinchonse. 

cocee. 

colchici peminis. 

conii. 

convallar.'ffi. 

cubebffi. 

cypripedii. 

digitalis. 

ergotffi. 

enodiotyi. 



Fluidextractum 
Fluidextractum 
Fluidextractum 
Fluidextractum 
Fluidextractum 
Fluidextractum 
Fluidextractum 
Fluidextractum 
Fluidextractum 
Fluidextractum 
Fluidextractum 
Fluidextractum 
Fluidextractum 
Fluidextractum 
Fluidextractimi 
Fluidextractum 
Fluidextractum 
Fluidextractum 
Fluidextractum 
Fluidextractum 
Fluidextractum 
Fluidextractum 
Fluidextractum 
Fluidextractum 



eucalypti. 

euonymi, 

eupatorii. 

frangulee. 

gelflemii. 

gentians. 

geranii. 

glycyrrhizae. 

granati. 

grindclia. 

guaranse. 

hamamelidia foliorum. 

Hydrastis. 

hyoscyami. ^ 

ipecaeuanhie. 

kramerite. 

lappee. 

leptandre. 

lobeliee. 

lupuUni. 

matico. 

mezereL 

nucis vomicte. 

pareire. 



20 



PHARMACOLOGY AND GENEILAL TiiERAPErTlCS, 



Fluidextractum 
Flttjdeslractum 
Fluidextractum 
Fluidextractiuri 
Fluidextractum 
lluidextractum 
Fluidextractiiitt 
Fluidextractum 
Fluidextractum 

maticuiD. 
Fluidextntetum 
Fluidextractum 
Huidextractum 
Fluidextractum 
Fluidextmctura 
I'luidextractuin 
Flui<lextractum 
Fluidextractum 
Fluidextractum 



Phytolacca'. 

pilociiriji. 

podt^phylli. 

prunt Virginianre. 

qua^sise. 

qucnuK. 

tiUilJuje. 

nmniui purshianic 

rhanini purHliiaiui* 



aio- 



rhei. 

rhoia glabne. 

rosce. ■ 

rubi, 

sabince. 

Baiiguinarifle. 

sarsaparillse. 

KarHaparillR* compositutu. 

Bcillce. 



Fluidextractum 
Fluidextractum 
Fluidextractum 
Fluidextractum 
Fluidextructum 
Fluidextractum 
Fluidextractum 
Fluidextractum 
Fluidextructum 
Fluidextractum 
Fluidextractum 
Fluidextractum 
Fluidextractum 
Fl uid ex t rac t um 
Fluidextractum 
Fluidextructum 
FluidfXtracUKii 
Fluidextractum 
Fluidextracttm; 



scopolce. 

9cutctlariu!*J 

senega?, 

scrpeutaria?. 

apigelite. 

atavisa^ia. 

stillln).Ma?. 

Htrumonii. 

suiubul. 

tjirnxaci. 

tritici. 

uvae ursi. 

valerJHiise. 

veratri. 

viburni opuli. 

viburni prunifo 

xanthoxyli. 

ziriftibi'vi-^. 



Glycerita, Qlycerites (6). — In tiicse proparations, the veliicle t 
cal substances is glycerin, a liquid abtaineJ by ilie decomposition of \ 
or animal fats, or fixed oil?, and containing not less than 95 per cent, 
lute glycerol, a triatomic aIenho[. 



Glyceritum. 

GlyctTitum acidi tannici 

(Jlyreritura amyli. 



Strtcliniiim |jimt*phnlum. 
Glyceritum ferri, qutninee et 
Btrychninie phospliatum. 



Infusa, or Infusions (3). — These are usually made by ponring 
water upon regetable druga and letting them stand for half an he 
covered ves*el in a warm place, and Repariiting the infusion by 
ing. When the strenjrth is not otherwise directed by the p 
copccia or by the prescrijvtion of u physician, thev are to be niadt 
cent, strengtn. The infusions of cinchona (U. S. f ., 1890), and of 
VirjEriniana are best made with cold water, hy percolation. The olfic 
lire not made according to the decimal system. 



Tnfusum digitalis (I'/i per cent). 
InfuMum pruni VirginianHj (4 por 
cont.). 



Infusnm seniife compositum (6 p4 



Linimenta, or Liniments (8). — Preparations, oily or alcoholic, o 
containing medicinal t?ubstances, and intended for external applica 
tlje surface of the hodv, with friction. 



Liniment iini ammonije. 
Liniinentura bellpdonnre. 
Linimentum oaJcis. 



Uninicntiim cnrnplnirw. 
Linimentwm cholorfonni. 
Lioimentum Baponis. 



liinimcntum .«apnnift 
Linimentuin terebint 



Liquores, or Solutions (25). — Liquid preparations of non-volatile 
generally cliemicnls. which are wholly solul*le in the menstnuim emph 



Liquor acidi arscnoei. 
Li<]iior nmmonii acctatis. 
Liquor antisepticus. 
Ijtpior arseni et hydrar- 

f^-T\ iodidi. 
Tjipior cnlcis. 
Ijquor chlori compositus. 
Liquor crefiolis compoi^ituB 



Liquor ffrri t'li!oridi. 
Liquor ferri et nminoTiii 

acctati'*. 
Liquor ft^rri '^ulwulplmtii*. 
Lifjuor ferri ter&uJphiLtifl. 
Liquor InrinnMchvdi. 
Liquor hydrargyri nitralis. 
Liquor iodi compositua. 



Liquor ma^esii citr 
Liquor pinmhi Rubac 
Liquor plunibi sulmo 

diluttiR. 
Liquor potassii hydr 
Liquor potn^ifiii nrsei 
Liquor ]K>ta:^sii citra 
Liquor fio<iii hydroxi' 



A 



PHAEMACY. 21 

liqaor sodie ehlorinatse. Liquor Bodii phosphAtiB liquor zinci chloridi. 
liquor sodii arseiiatis. compositua. 

MassflB, or Kasses (2). — These are soft, solid mixtures of proper con- 
sistency to be made into pills. 

Massa ferri carbonatis. Massa hydrargyri. 

M^lita, or Honejs (3). — Liquid preparations consisting of honey, or 
honey as a basis. 

Mel. Mel depuratum. Mel rosce. 

Kisturse, or Mixtures (4). — Preparations consisting of a liquid used 
as a vehicle, and containing an agent not soluble in the menstruum em- 
ployed. 

Mi-^tuia crctse. Mistura gljcyrrbizee com- Mistura rhei et sod«e. 

Mistura ferri compoeita. poeita. 

Mucili^^es, or Hucilages (4) . — These are rather dense, viscid prepa- 
rations of gum, or mucilaginous substances, dissolved in water. They are 
used for suspending insoluble powders or emulsifying oily substances, 

Miifila^ acaciae. Mucilago sassafraa medulle. Mucilage ulmi. 
Mucilago tragacanthffi. 

Oleata, or Oleates (5). — The official oleatcs are made by dissolving 
medicinal bases in oleic acid, and are in the form of a soft solid or oint- 
ment Some of the non-official oleates are in the form of dry powder. The 
official oleates are : — 

Oleatum atropinse. Oleatum hydrargyri. Oleatum veratrinse. 

Oleatnm cocainse. Oleatum quininee. 

Oleoresiiue, or Okoresins (6). — These are liquid preparations obtained 
by dissolving oily and resiilous matters out of vegetable drugs by means 
of acetone (except ginger, which is extracted with alcohol). Oleo- 
rta»ins differ from fluid extracts in composition and in strength, being the 
most concentrated liquid preparations of drugs that are produced. The 
\ield of oleoresin naturally varies, according to the quality of the crude 
dru^, this class of remedies not bearing a uniform relation (of gramme to 
cubic centimetre), as fluid extracts are required to do. 

Oleoreaina eapsici. Oleoreaina cubebae. Oleoresina piperis. 

(Heorcaina capaici. Oleoresina lupulini. Oleoreeina zingiberia. 

Pilnlse, or Pills (14). — Small spherical masses of medicinal sub- 
stances intended to be swallowed whole; two of the official forms are 
coated with Tolu (pilulae ferri iodidi and pilulse phosphori) ; the rest are 
simply treated with dusting-powder. It is the rule among manufacturers 
also to supply a full line of pills coated with gelatine or with sugar, in order 
to preserve and render them more pleasant to swallow. Sometimes a coat- 
ing of keratin is used where it is desired the pills should not be dissolved 
until reaching the intestinal tract. 

Pilulae aloSs. Pilulae alo^s et mastiches. Pilulffi aaafoetidae. 

Fflulaf aloSa et ferri. PiUilee alo&a et myrrhse. Pilules catharticae compos- 

itae. 



PHAKAL\COLOOY AND GENERAL THEIUrEUTICH. 



Pihilue cathartjeffi yegeta- Pilultp laxativie compoflitee. Pilulie podophylU; 

bilea. Pilulte opii. doniw*, vi capsic 

Pilulfle ferri cnrbonatis. Piliilu^ phosphori. Pilula? rhei coiupo 

Pilulfe ferri iodidi. I 



Pulveres, or Powders (9). — iJrugs in a dry, finely-divided fo 
erally compound**^ or mixed. 

Pulvis a<?etanilidi compos- PuJvis glyoyrrhizce com- Pulvis jalapre coin 

itus. po«iituN. l^lvu iiiorphiiis 

Pulvis ammaticus. Pulvis i])ecacna:ibeD ct itus. 

Pulvia cretflB eompositus. npii. Pulvia rhei compoe 
PulviH cffervesceoa cuiij- 

pOHltUH. 



i 



Eesinse, or B-esins (4). — Solid preparation? of vetjetablc ori 
tained by e.xtnictiug witli ulcoliol and procipitating with wate^. Ql 
tilling the volatile oil from an oleoresin. iHl 

Resina (from turpentine), Resinn jnlnpfe. R««ina scammomi 

Ke»ina j>odo[ihylli. 

Sera, or Serums, am tiuids sfparatrd from tlie coagidated liln 
horse, which has been immunized against certain forms of infection 
one is official at present. 

Serum antidiphtheritioum. 

Spiritus, or Spirits (20). — Solutions of vohitile or aromatic sub 
in which alcohtd is used as the menstrnviin. 



Spiritus oetheris. 

Spiritus ffitheris enmpoa- 

itus. 
Spiritus eetheris nitrosi. 
Spiritus (vmmonise. 
Spiritus ammoTiiip aromat- 

icus. 
Spirilti'i amygdnln? ftmarae. 



Spiritus niiisi. 
Spiritus fltirnntii eomposi- 
tus, 
Spiritus tamphorre, 
SpirituB chlnroformi. 
Spiritus cinnamnmi. 
Spiritu.-* frumcnti. 
Spiritus ujiiiUhjfriie. 



Spiritus ;;lyrprvlis i 
Spiritus junii>cri. 
Bpiritus juniperi coi 

tUB. 

SpiritUH lavan'lulre. 
Spiritus inonMtfp ])ip 
Spiritus nicnlhrp vir; 
Spiritu*) viui {r^Uifi. 



Suppositoria, or Suppositories (1). — Only one formula for suppo; 
ifl now oflicial, hut they arc directrtl to be made cxtempnnineon&ly 
oorporatinp the mediciuiil suhstanccs with eaeno-hutter (oI(*ijm th*X)[jro 
and shapinur them wiili a mold into small, conical masses, wei^hi) 
gramme each, imlof^n ntherwit^o directed. They are intended to he ii 
into the rectum iitiil other cavities of the body, where they melt and 
the medicament to conn* into contnct with an absorI)in;r surface. Sr 
tories of soap »ind fflycerin are Inrirtdy used as hixtitives to empty the 
bowel. Simihir prepjiratinns of cacao-bntter or gelatin, for the uret 
nose, are cnlied l)uginana, or bougies. 

Suppositoria glyrnrini. 



Sympi, or Syrups (29). — These popular preparations are stronj 
tions of sugar in water, containing ttaroring and medicinal suhsi 
They are usually made with the aid of heat, for convenience; but, 



PHARMACY. 



2Z 



heat would be injurious, they are directed to be made by stirring and filter- 
ing, or by percolation. 



Syrupurt. 
Synipuii acacis. 
Syrupus acidi citrici. 
^yrupus acidi hydriodioi. 
Syrupus amygdsuee. 
Synipua aurantii. 
Syrupus aurantii florum. 
Synipus calcii lactophoB- 

phatus. 
Syrupus calcis. 
Syrupus ferri idodidi. 



Syrupus ferri, quininse, et 
strychinffi phoAphatum. 

Syrupus hypophosphitum. 

Syrupus hypophosphitum 
compoaitus. 

Syrupus ipeoacuanbs. 

Syrupus kramerifle. 

ISyrupua lactucarii. 

Syrupus picis liquidae. 

Syrupus pruni \irginianse. 

Syrupus rhei. 



Syrupus rhei aromatieus. 

Syrupus rosfe. 

Syrupus rubi. 

Syrupus sarsaparilUe com* 

positus. 
Syrupus scillse. 
Syrupus sciUse compositus. 
Syrupus senegse. 
Syrupus sennse. 
Syrupus tolutanus. 
Syrupus zingiberis. 



Tinctursey or TinotureB (63). — Liquid preparations of vegetable drugs, 
as the rule, diifering from spirits in not containing volatile substances. To 
this, tinctune iodi, lavanduhe compositor, and moschi are exceptions. 



Tinctunk aconjti. 


Tinctura einnamomi. 


Tinctura moschi. 


"nnctura aJo^. 


Tinctura colchici seminis. 


Tinctura myrrhae. 


Tinctura aloi^ et myrrhcp. 


Tinctura digitalis. 


Tinctura nucia vomicee. 


Tinctura aniicse. 


Tinctura ferri chloridi. 


Tinctura opii. 


Tinctura asafstidse. 


Tinctura gallae. 


Tinctura opii camphorata. 


Tinctura aurantii amari. 


Tinctura gambir composita.Tinctura opii deodorati. 


Tinctura aurantii dulcis. 


Tinctura gelsemii. 


Tinctura physostigmatis. 


Tinctura belladonnas folio- 


Tinctura gentianip compos- 


Tinctura pyrethri. 


rum. 


ita. 


Tinctura quassim. 


Tinctura benroini. 


Tinctura giiaiaoi. 


Tinctura quillajae. 


■nnctura bcnzoini compos- 


Tinctura guaiaci ammoni- 


Tinctura rhei. 


ita. 


ata. 


Tinctura rhei aroniatica. 


Tinctura calendulse. 


Tinctura hydrastis. 


Tinctura sanguinariae. 


Tinctura calumbn. 


Tinctura hVoscyami. 


Tinctura scillae. 


TinctuiH cannabis IndicfP. 


Tinctura iodi. 


Tinctura serpentariee. 


Tinctura cantharidis. 


Tinctura ipecacuanha et 


Tinctura stramonii. 


Tinctura capsici. 


opii. 


Tinctura strophanthi. 


Tinctura carda'momi. 


Tinctura kino. 


Tinctura tolutana. 


Tinctura cardamomi com- 


Tinctura kramerise. 


Tinctura Valerianae. 


posita. 


Tinctura lactucarii. 


Tinctura valerians} ammo? 


Tinctura cimicifugee. 


Tinctura lavandulte com- 


niata. 


Tinctura cinchoxue. 


posita. 


Tinctura vaniMae. 


Tinctura cinchonse compos- 


Tinctura limonis corticia. 


Tinctura veratri. 


ita. 


Tinctura lobeliw. 


Tinctura zingiberis. 



Tinctune Herbarum Kecentium, or Tinctures of Fresh Herbs, are 
«lirected by the Phannacopa?ia to be made of 50 parts of the fresh herb, 
macerated in 100 parts of alcohol for two weeks, and then iiltering the 
product. No special formulae are given. 

Triturationes, or Triturations (1). — This is a newly-recognized class 
of preparations, which represent one-tenth of the strength of the crude drug, 
to every 10 parts of which 90 of sugar of milk are added, and the mixture 
thoroughly incorporated by trituration. The only official representative is 

Trituratio elaterini. 



Trochiti, or Troches (9). — Small, flattened, disk-like, solid masses, 
usually called lozenges. The basis is generally gum and sugar, or fruit- 



PHAUMACOLOOY A}iD GEXKIUL THEILVPELTICS. 



^aste, making a mass wliich can be slowly dissolved in the mot 
medicating the mucous membrane of the mouth and ihi-oat. 

Trochisci acidi tRnnict Ttochisci glycyrrhiza? et Trochisci potassii ( 

Trochisci ammonii chloridi. opii. Troriiisoi santonini 

Trochisci cubebaa. Trochisci kraTnericc. TrocUiaci sodU hiei 
Xrochiftoi ;:ainbir. 

P Unguenta, or "Ung^uents (24). — Soft, fatty preparations, m^ 
the temperature of the body, and suitable for inunction and the adl 
tion of remedies by external application and frictian. 



Unguentuni. 
Ungiiontuni acidi borici. 
Unjcpicntiiin acidi tjiiinici. 
Unguontuin iiqiue roste. 
Ungueiitum iH'lIadonniE. 
Unguentum chrj'aarobini. 
UngueBtura diachylon. 
UngueJituni gallffi. 
Un^enttim hydrargyri. 
Unguentiiin hydrarg-yri dilutiim, 
UngUPiitum hydrariHTi ammonia li. 
UngueiiLiim liydrarjryri nilratis. 



Unguentum hydrargj'ri oxidi fli 

Ln^uontum hydrurgyri oxidi n 
Ingiientum tidi. 
l'n;riipntuin indnfnrmi. 
Ungupntum ]thenoU*. \ 

Ungurntinn piris lit^uidee. > 

Unguentuiii pniassi iodidi. 
Unguertniii slrfimonii. 
Unguentum Bulphurin. 
Unguentum. vuiutrimc. 
Unguentum zinci oxidi. 
Ungwcntiun zinci stearalia. 



Vina, or Wines (10). — Alcoholic preparations in which strongc 
wine is tho menstruum generally employed. 

Vinum album. 
Vinum antimonii. 
Vinum cocse. 
Vinum colchici seminis. 



Vinum ergotfp. 
Vinum ferri. 
Vinum ferri citratis. 



Vinum ipc<^acuanhflB 
Vinum opii. 
Vinum rubrnm. 



Impouxant Chaxoes IX THE KiiiiiTH Revisiox of the 
Phakmacopceta. 



iUpou the succeeding few pages will be found, arranged in a con 
form for reference, tallies showing tlie comparative etrengtli of fh 
infportant pharmaoopreial suhstaneee and preparations as given in t 
ceding and the j-truscut revision : — 





PHARMACY. 



25 



< 
&. 

u 
aa 



X 

ti < 

n 

-< s 
s as 

« < 

si 

a, 

s a 

5 

ad 




^ ^ ^ ^ ^ ^tf ^J ^if s** ■— ** ^ _^ ^i^ ^-^ ^^ ^^ 






IC o 

o -^ 



oo c 



o « ©i d '-^' ^ 



s 

2 S 



3 

n 

At 



o o o2 ^ 



»CJ "O 'O « tS '"S 

W 1; flJ w 4f tt 



'9'5'3 



CO . ^^ •" . . 

S "p 0& -«• "g '2 ' 



P 



-^4-***^ "S =^ S 3 rt 



4) (f * »^'S ^ 



X >< X X »^ 

«3<c tcceec 

■«* -^ -^A <tf -4^ 

o c o o o 
e B c s B 

'H'H'E'E'E 

ti q {^ SB C3 

B B S B a 
-S ^ 4S 5 w 

cc a; oi oi CO 



C O) « 



K X X 



-EC'S 

B B B 
d d ti 






ft)&V<UWQ)4)U4)A)^ 

<Bvs«:«:c:ca<c<stBCBcp 
ooocoooooo 

BBBBBBBBBB 



ssacssseeadcscdcs 

'C 13 "C 'S TS 'O 13 '3 tS 'O 

QflBBBBBBBB 

5-25555^5^^ 

ixxa; — "-"oQtzJOi'ODaj^cococoaKzi 



o© 



CB d 

^^ 

cd S 

■So 



M" 



-^1 oV'sisll 



S « Eb , o ^ o S d ^ te 2 ^ 






o 
s 

X 



5^ .5 ;5 *r T" *^ ^ ^ 






:3 

s 
2 
< 

s 

B 

*u 

B 

|. 

"b 

"S 

3-3 X 

.'Sgg 
<« 



if 






I 






B 

c 

B^ - 



SO. 







S e E E 6 6 S 

S B B B S B 3 



*. y. \>r ¥•. ir. -^ z::, ^ ^ 



X X X X X X 

^ 0; g^ O; O ^ V 
TJ "sJ tS tS 'v3 'w "X) 
3 b*3*b| S S 



2r 



PHAIIMAOOLOWV ASD GENERAL TIIEliArErTICS. 



m 

B 

1 






e 
■< 



I 









B 



s 






S 

■2 *^ 









1- t* t. 

"" _ -JO "* "*■ 



£.V 



o I*: ^ -f oc c '- ir: »'^ C ^ 







•b a a o V Z 

X iK ^ K K K 

tc: '-c ~ ^ G ^ 



■ c •? ■ -!3 -Tj -a -o "^ -^ -« -^ -^ tj -s "9 -a t? ■ 

' ' if. X )>^. '/'. -y. y. i'. y. y y. i-i y. 'A y. s: 



u = : ;k -^ '^ i; 



: ^ -^ -C — -^ ;= ^ '^ ; 



r" — ^ssr-^t*-^— ~r^ = 3'! = a2e = 5 = = = = = = ?rr4'Si■ 



z X « 1^ 4J 
- - « i, s. < 

""§=- s3cc = c = = snccs5331 
w y.' OQ X' X x — -<i w Ti 'M < •/. ?j :c -A -^ -x v: x v: r, -7 y. /_ v: y; y. — -- » 



a = n = a = £. 



■ so '^sT— *" 

- ^ 






, >. :^ 



^•^ -f^ 



: > 






■j--^^ 



. — . := J3 . ;- . r- ^ i ^ ^ .if >. . . ■_ 






jf Ss 




si 

2 S 



i = c 



>< i< 3 7, 

^ s; ss ^ V y 
'5 "- 3 >. ^. 



-3 i^s 



It: 
Ha 



• S 

?3 i! 



*- — - ;^_ « 



E,^E,— i; ? ^ ? ? 

■" "^ '"1 "7 -^ — ^- ~ "^ 






e 

, - ^ - - ? 
■53 3 o o 






^ 



PHARMACY. 



as 

< 



•A 



t < 



z 

o 



> 



■< 



i 



< u 



' Z. I 






Si* 



3 



G 

S 0) k 



a 

CO ^ 

to £.a 

"* rM '•■ 



as as s ai 



*3 






s: 



i'^^ss 



SB'S! a 3iQ H B 
<eo< CO 



s a s 



oo 



o© 
do 



V c> u c5 o o r 

pOppr-t p C^ 



!S8 



Si: 



o c , 






COO 



o c 



c C C fi 
'^ •■< •a ••^ 



><d' 



aua a 



a a 

CC5 



aa 

C5C5 



aa a i'^ B<»iii 



.S©s 

a. a 
o . 
»^a 

S^ 
©■^ 






a a 

CO 



So 



a 
« a 



©i-^p 



a'' 

lO ^ 

la 



* o ^ 



i 



, s 






s 
© $ 



^ o 



= "82 d 



'ga a aiaa aaa'sa 



U U CJ U V 

o V cj c b e 



^.« 



I"?' 



|2 



■gacp o«R«1daJ©©©©'^c'Ri 



ofc. 






^» c e 



'g.H.S'H.S.S.S-s.S.S.S.S.S'E.Su.S.S'E'E.! 






:S, 



:^8 

id *C 



.a c«g «i 

t • c © 



S. 



<5a»<JoD^^x-<^»-^F^i--*4^^^ 



JS C B 



aa 



il3 



usto St) 
r^ (-i *" 2 ' 



•t»-t2 feoi 



, 8 



I .; 



*• •*■ '^r cj 
SSI* Sjb 



..fc ^-e 



S-s «» ar* 

cu -< S o Em <: < 







■S lis 






I 



B 0) & Ot^ 



00 .<i 










PHAKitACOLOOY AND GENEBAL THERAPEUTICS. 



5*: 






B a 



1 


























••1 












^ 


^■> 






1 

ks 




.^ 




i 


s • 








£ : 


2 ^ ^ *J 


4-> 


Q 




3 


.= .5.5.5.= H-=*--3 5°S::^2^^ 




is. ! 


3 

1 


3 5 


d 




'^ 5 5 w 5 g '3 '-^ 'J 3i J J J *. c^ 


3 . 


s 


1 


^^^^„6^^^d<i-«5^^c^ 


•M 


^ 


1 
















■ 












:<3 






1 












:S 








g 






:;::?:: 




Jl 


: t 


. 




CO 








^ ** CQQ 




■4^ 






s! 


iii1ii=^lli-E 


I 1^ 

• — 




1 


Ooi;.ijPt-oc.t;o--Jw^t-p 


; c 


u 




^ 


^ t: & = 'r ^ 3 <s ai S S t ^ ^'S 


^ 




HSSaS i?.S;f. 5 =^^o^2 


■ .. 




1 S^ 


" 


o 


1 


1 

1 
1 

1 


" '?* o cs Z^ -r o 

.2.= .s.s.= -?,s.= = :;Siig"t^ 


S 1 


; 


I 

1 












*A 






: 






; • 




: 


I 


i 












j3 






*j 






:^1 




.*j 
















bO 






A 












1 












1 











D ** 3 







' 


i 






: 


d 


»H 


3 

as « 






K 




1 


§ 


•ei 






1 
1 


1 
1 








; ; 


; -^,-^ 






» 1. " 


; 






■ 






















: : 










1 


1 


















• ■ E 


\ : 




s 

••• 


\ 




ll 

1 

r 




'o 




J V S3 3.-;: 


1.. 




C 
} 

If 


■ 

i 




1 
1 

1 
' i 




S^.|'J 5 ^H;?3s = S£i 




« 1 


1 




esse 2 asrHil^: 


i 


M 


1 




55£^ ^ 53^^^ ""'"SS 


I 


c 


' 




tj'^iJv a "^^y9w,.C^?r^Z 




§ 






c 


: c 


3i 


1 s 


• 








;^f 






r c 


•> 


c 

• > 


c 
> 




1 



t- ^ - - •' e— = 






«. S 
S ■« 



&-= S ^ I 2; 

£ £ c^ = »H 

P * & 1 «^ Sc ^ "5 . 
•^ o i- ^ *^ — 

•3 B E ; S ^ 2 - 

Ji t - -^ *■ i * = 
-^-f =i±-5 J; o >, 

.^ n ^- ^ i» »^ .^ 



c^ =- t? I: -^ "-e _ fr -*-* 



5>. ^ , c ^ I-': S :3 

•- S^ "*^ ^t*— ^ T S '^ 

J ft c- C c c .= V 



pharmagt. 29 

Pharmaceutical Processes^ or Pharmacy Proper. 

Pharmacy is that department of medical science which is devoted to 
the collection, identification, manipulation, compounding, and dispensing 
of dmgs. It comprises the various articles and preparations composing 
the Materia Medica, official and non-official; guards against adulteration 
and substitution; analyzes the composition and determines the standard 
proportion of active constituents, besides providing eligible and efficient 
preparations and indicating the proper procedures in Ming prescriptions 
secundum artem. A knowledge of at least the rudiments of pharmacy is 
absolutely necessary to the practicing phy&ician. It is a great misfortune 
that so many students are permitted to graduate from our medical schools 
with such an imperfect acquaintance with practical pharmacy as they ordi- 
narily possess. A very little carelessness or ignorance on the part of the 
prescriber may cause serious mistakes to be made. 

[In practical pharmacy, a number of preparations known as favorite 
prescriptions or popular remedies, like Squibb's Cholera Mixture, Lafayette 
Mixture, etc., being in frequent demand, are usually kept on hand in the 
shops. Some of these, like Brown Mixture, Compound Licorice Ijozenges, 
and Basham's Mixture, have been admitted to the pharmacopoeia. Others 
are less often prescribed, but the pharmacist is expected to have a for- 
mula at hand so as to prepare the remedy extemporaneously. Such a col- 
lection is known as the "Extra Pharmacopoeia," or simply as a Formulary. 
Some years ago the American Pharmaceutical Association appointed a 
committee to collect the formulaB for such unofficial preparations and to 
select the best of each class, so as to form a National Formulary. This was 
done, and the result of the committee's work was fully approved by the 
American Pharmaceutical Association. The work was issued for the pur- 
pose of obtaining uniformity in unofficial compounds, and to publish for- 
mulae which represent some proprietary preparations. A "Physicians' 
Manual of the National Formulary" is published in Chicago, by C. S. Hall- 
berg, at a trifling cost. Every physician will And it useful to have at hand 
for reference the United States Pharmacopoeia, or a good Dispensatory, 
and ako the National Formulary of the American Pharmaceutical Asso- 
ciation.] 

The principal operations of pharmacy are : — 

1. Weighing and Measuring. 

2. Determination of Specific Gravity and Temperature. 

3. Operations Requiring the Use of Heat. 

4. Operations Chiefly Mechanical. 

5. Pharmaceutical Testing and Analysis. 

6. Extemporaneous Preparations. 

1, Weighing and Meaiuring. — Solids are usually weighed and liquids 
measured ; the denser liquids, however, are often, for the sake of accuracy, 
dispensed by weight, and all liquids might be. Owing, however, to the 
variation in bulk of liquids, and the necessity of making corrections for 
specific gravity and temperature, this plan is not employed in prescribing, 
although parts by weight have been adopted in our pharmacopoeia, which 
in the last edition has largely followed out the metric system. Scales, or 
balances, of various kinds and varying degrees of accuracy, are employed 



30 * , PHAKMACOLOGY AXD GEKERAL THERAPEUTICS. 

in weighing, and care should he taken that scales used in compounding pre* 
seriptions are reliable and sufficiently sensitive for the purpose for which 
they are used- 
Weight is the measure or expression of the attraction of gravitation 
for a given mass of matter at the earth's surface, being dependent prin- 
cipally upon its bulk, density, and physical condition- The comparative 
bulk of bodies is expressed in terms of dimension or measurement. Stand- 
ards of weight and measure are established by law in all civilized countries. 
Those in use in the United States have been adopted by Act of Congress 
of June 14, 1836, when the Secretary of the Treasury was directed to fur- 
nish each State in the Union with a complete set of revised standards based 
upon those of Great Britain. In 1864 the use of what is known as the 
metric system was legalized in Great Britain, but was not marlc compulsory ; 
and in 1866 the United States pursued the same course. It was finally intro- 
duced into the Pharmacopceia in the last two revisions. The measures in 
common use in handling drugs and compounding prescriptions are as fol- 
lows: Troy and Avoirdupois weights for ascertaining the relative pon- 
derosity of bodies ; Wine, or Imperial, measure for quantity of liquids, and 
the Metric System for both solids and liquids. 

Troy, or apothecaries', weight is iised for compounding or dispensing 
drugs; avoirdupois is the standard for commercial purposes, and is used 
in bu\-ing and selling drugs in quantity. 

Troy, or Apothecaries', Weight. 

20 grains (symbol gr.) equal I f^oruple (symbol 3 ) . 

60 grains, or 3 scruples equal 1 draobm (symbol 3). 

4S0 grains, or 8 drachms equal 1 ounee (symbol 51- 

.57fiO grains, or 12 ounces equal 1 pound (symbol lb Troy). 

Avoirdupois Weight. 

437*-^ grains equal 1 ounce (symbol oz.)- 

7000 grains, or 16 ounces equal 1 pound ( >ymbo) lb Av.>. 

The British Pharmacopoeia is peculiar in u?ing in its formulae Avoir- 
dupois weight. As will be noticed above, denominations may be repre- 
sented by symbols. In Troy or Apothecaries' weight, gr. (Lat. granum) 
stands for grain or grains; 9 (Lat- scrupulum) stands for scruple or 
KTuplt.'s; 3 (Lat. drachma) for drachm or drachms, and % (Lat. uncia) for 
ounce or ounce?. In prescriptions, as well as in dispenping. tho::e s^-mbols 
are commonly employi-d ; they will be referred to again under the section on 
"Prescription-writing.'* 

Fluids, as aln-ady stated, may be dispensed by weight; but they are 
usually measured and sold by quantity. 

Apothecaries' Measure, 

*50 minims (^vmhol m) equal 1 tluidrarhm (symbol f3). 

4S0 minims, or 8 fluidraohnw equal 1 Hiiid ounce (*s>-mbol fj). 

70sO minim-', or 10 fluidounces equal 1 pint (syinlwl 0». 

61440 minims, or 8 pints equal 1 galUm (symbol C). 

An Imperial pint contain? t^venty fluidounces: tliere nre eight such 
pints in the Imperial gallon. The latter will contain ten pounds of distilled 



PHAKMACY. 31 

vater (at 60° F.). The Imperial fluidounce weighs 437.5 grains, which is 
less by 18.2 grains than the IJnited States Pharmacopoeia's ounce of water. 
This should be remembered in copying prescriptions from English medical 
publications. 

The Metric System of weights and measures is growing in favor, and 
is employed by nearly all European pharmacopoeias, and also by that of 
the United States. The unit of this system is the metre, which is the 
ten-millionth part of one-fourth of a meridian, or one forty-millionth of 
the polar circumference of the earth. This has been found to be a little 
more than the English yard (3 feet, 3Vs inches), 39.37 inches. From 
this unit of length the unit of capacity is derived ; a thousandth part of 
a cubic metre is a litre, which contains a little more than two pints (S^/^o 
pints) ; it is represented by a cube whose height is one-tenth of a metre. 
The unit of weight is obtained by weighing a quantity of distilled water re- 
quired to fill a cube whose sides measure one one-hundredth of a metre; 
this is called a gramme, and it is equivalent to 15.432 grains. By a 
px'stem of prefixes the quantities are readily expressed by multiplication or 
division; thus, myria = 10,000 times, kilo = 1000 times, hecto = 100 times, 
deka=^ 10 times; whereas deci means Vi^, centi ^/,oo, and milli Viooo- This 
will be readily understood by referring to the following table, in which the 
relative values of different denominations in the metric and English systems 
are approximately given : — 

Measures of Length. 

Vi9» metre =1 millimetre (mm.), or Vm inch. 

Vw metre = 1 centimetre (em.), or Vio inch. 

Vrt metre ==1 decimetre (dm.), or 3 "/„ inches. 

1 metre =1 ketbe (M.) , or 39.37 inches. 

10 metres ^1 Dekametre (Dm.), or 32.81 feet. 

100 metres ^1 Hectometre (Hm.) , or 328.09 feet. 

1000 metres =1 Kilometre (Km.)» or 3280.9 feet. 

10000 metres =1 Myriametre (Mm.), or 32,809 feet, or 6«4 miles. 



Mextsures of Capacity. 

\'vm litre. . . . =r 1 cubic centimetre (c.cm.), or millilitre (ml.) := 16 minims 

Vi« litre. . . . = 1 centilitre 

Vi» litre ^1 decilitre 

1 LITRE ( L. ) = 2 Vio pints 

10 litres* . . . = 1 Dekalitre 

lOO litres . . . = 1 Hectolitre 

1000 litres . . . = 1 Kilolitre 

10000 litres . . . = 1 Myrialitre 



Measures of Weight. 

Vio» fijamme, or 1 milligramme (mg.) equal to */« grain. 

Vm gramme, or 1 centigramme (eg.) equal to V« grain. 

V« gramme, or 1 decigramme (dg.) equal to 1.5 grains. 

1 gramme (Gm.) equal to 15.432 grains, 

10 grammes, or 1 Dekagramme (Dg.) equal to 154.32 grains. 

100 grammes, or 1 Hectogramme (Hg.) equal to 3.52 oz. Av. 

1000 grammes, or 1 Kilogramme (Kg.) equal to 2.2 n»s Av. 



(cl.) 


r= 


2.705 fS. 


(dl.) 


= 


3.381 


«. 


(0) 


:= 


33.815 f5. 


• (Dl.) 


= 


2.641 


gallons. 


(HI.) 


=r 


26.410 


gallons. 


(Kl.) 


_. 


264.19 


gallons 


(Ml.) 


= 


2541.9 


gallons 



PUAUMACOLOGY A\*D OENEHAL THEUAPEUTICS. 



Relation of Metric Weights and Mmsurcs to Apothecaries* Weight. 

^ MMstircs. 



1 f^'ain equals 

1 scruple equnU 

I dracbm equaU 

1 ounce equals 

1 rninim equals 

1 dracbm equBU 

1 ounce cquuls 

1 pint equals 

1 gallon et|Uol3 



0.0047805 gramme. 



1.295 grammes. 

3.SS7 grammes. 

31.103 grammes. 

O.OfilinS cubic centimetre (weighing 0.816 

or 0.05 grain.) 

3.0I»7 cubic centimetres. 

20.57 oubie rentimotres. 

473.11 cubic centimetres. 

3785.0 cubic rentjmetrea. 

Ju ordinary use, in prescription-writing, the followiug table 
found to be nearly correct, and can be easily memorized: — 



mj equaU |00 ccm. 

f3| equal B 4j e.cra, 

f3ij equals 7 50 c.cm. 

fjss equals 15j com. 

f3j eq\ial.s 30] e.cm. 



gr. j equals {065 gram) 

3j equals 4 I grami 

3ij equals. , 8 | grami 

J^s cquuN 1.1 .> grami 

Sj lm|UjiIh 31 1 1 grami 



The use of a decimal lino ;:rcally reduces the jxissibility of m 
in reading such prescriptions. As U.Uti (drug) is lefis than 1 grain, 
4.0 and 32.0 (vehicle) are more than the fluidruchm or ounce, then 
danger of giving a stronger dose than was intended by using this 8 
C.cm. (cubic centimetres), used for Gni. (fjramnies), caust^s an error oJ 
5-per-cent. excess. 

A teaspoonful is usually 4 to 5 c.cm.; a taLlespoonfiil, lo.O c.cm. 
domestic measurements of this kind are so irrcguhir and unreliable 
best to have the patient take his medicine from a properly graduatec 
or a standard spoon. 

Ordinary expressions of M*eight or measure, tl^erefore, may be ap 
matcly reduced to metric tenns by the following rule: Multiply gra 
G, and the result will be ecnligrammoe ; multiply drachms by 4, or t 
by 32, and the result will bo grammes. Id the same manner, by di' 
centigrammes by 0, we oI>tain jrrnins; or grammes by 4 or 32, and the 
will bo the number of draobms or ounces, as the onse may be. 

Liquids are usually measured, when compounding prescriptioi 
convenient glass vessel:*, whicli, on account of having their capacity c 
ated by marks blown or engraved upon them, are known as grad 
They are usually smsilh'r nt the bottom, having a conical slmpe, oi 
may be lyliuilrical. The indications of capacity may be according i 
ordinary a[)oihecaries' liquid m<*)isnre or to the metric system. I 
quantities arc measured in tinned-iron or copper measuroSj where the ] 
is not corrosive; for liquids which cannot be measured in metallic V« 
glass or porcelain can be used. Small quantities are measured by ra 
or by drops. The onlv accurate method of regulating the dosage of 
quantities is by using a 8mall instrument known as a minim-pipette, 
is simply a glass tube, with a slightly contracted extremity, so that r 
deliver its contents not too rapidly. Upon tlie side the tube has gr 
tions engraved upon it. A rubber rap may be applied to the uppc 
tremity, by which fluid may be drawn into the tube when its point is p 
under the surface. The desired amount may then be expelled by 
pressing the cap or bulb, and tlie amount is indicated by the gradual 



PHAOaiAOY. 



33 



thit pipette ifi long enough the rubber bulb can be disj^ensed with and 

■^ aovln Applied to produce suction, tlie liquid afterward being retained 

Ij plaeitig the forefinger over its upper end^ by which also the flow may be 

i^pkted. A little experience vrith this instrument will enable the operator 

tB tZBBftfer small i|uantitiea of liquid from one receptacle to another with 

WMMlmlili accuracy and rapidity. A good way to keep the pipette ready 

far (ue aad clean is to use a p>erforaled cork, passiug the pipette through 

it into a bottle containing alcohol or water. When water or any fluid 

Mable of wetting the glass is used the fluid will creep up the sides of the 

ttie by capillary attraction, and the outer edge of the fluid will therefore 

te hi^ier than the remainder of the surface. In reading the measure it 

icanomary to take tlie level of the centre of the liquid, or a plane shghtly 

it, in order to be accurate. 

In cpite of the fact that every one knows that a drop is not a unit of 

fttre, and that the size and weight of drops of liquid vary according 

to tanpezatore, speciflc gravity, and even the shape of the bottle from 

vioelk tbej oome, and that the drops of some liquids are much larger than 

i^ — for instance, the drop of deodorized tincture of opium being nearly 

Large as that of Uxe ordinary tincture, — physicians constantly 

pnaeribe active medicines by drops when they mean minims, if they mean 

earthing at all definite. This uncertainty with regard to drops is shown 

%j the following table,' where evei-y attempt to maintain uniformity was 

opii 90 drops in 3.70 ccm. or 69 minima. 

b^Ub , . .08 " " " 

■4»ticam .108 

«rt)oIicUTn : ...in 

hTdrocyanicum t» 

UcUcuni in 

phoftphoricum dil 50 " " " 

flulpburicum aromat 140 " " " " 

vulphuricuin dil 00 

fortior 17« 

140 

ite%taiiit» 00 

i-V) 

rMvnm purif 2.V) 

uim 12i 

!«&d«KC belUdonnte radiois.... 
cotcbici nulicift. 



addi 



. . . . 15rt 

.100 

- 07 

57 

• rg. iodidi 59 

lljdru: luli? 131 

lodi oomp, .03 

qnor potAJsa: . . ^ 02 

potAMii aneuitih .57 

' la Mtridii lao 

riemi ... "7 

tigm I'M 

oltlomfomti . 150 

05 

.. 75 
.102 



*rill« 



comp. 



A tabltf prtrpATiM by tho Uit«> Mr. Stephen U TallHit. The preparnUoiu 
lo arr of tbe revi«ion of 1S70. 



34 PHARMACOLOGY AND OEXEEAL THBBAPEUTICS. 

Syrupus senegse 106 drops in 3.70 c.cm. or 60 minima. 

Tinctura acomta 146 ' * 

Tinctura belladonnse 137 " 

Tinctura digitalis 128 " 

Tinctura ferri chloridi 160 " 

Tinctura iodi 148 

Tinctura nucis vomicfie 140 ** 

Tinctura opii 130 " 

Tinctura opii camph 130 ** 

Tinctura opii deodorat 110 " 

Tinctura veratri viridU 145 " 

Vini colchici radicia , 107 " 

Vini colchici seminia Ill " 

Vini opU 100 

Scientific accuracy in prescribing and in dispensing medicines can 
only be obtained by carefully measuring or weighing the agent in gradu- 
ates, or scales, of standard accuracy. Where a fraction of a grain, drop, or 
minim of some powerful remedy is ordered, the division can be made more 
evenly by diflfusing the remedy in a larger quantity of some menstruum 
in which it is soluble, like alcohol, ether, water, or by mixing it with some 
inert powder, like gum arable. Thus, the one one-hundred-and-twentieth of 
a grain of atropine may be obtained by dissolving one grain in 480 mininoB 
of water, of which four minims would represent the desired quantity. 
Croton-oil and similar agents can be dissolved in alcohol or diffused through 
some inert powder, like milk-sugar, and thus be accurately divided into paiis 
smaller than the minim or drop. 

Most pharmacistB are supplied with a full set of metric weights and 
measures, and can compound prescriptions in accordaiice therewith; but 
there are practical objections and diMculties that stand in the way of the 
general adoption of the French system which will prevent its general use 
in preficription-writing for many years, or until they are overcome, as 
pointed out by Prof. Oscar Oldberg. At the same time those physicians 
who have been trained according to the metric system may find it easier 
for themselves to continue to employ it in prescription-writing; they owe 
it to their patients, however, to see that the prescriptions are sent to a 
pharmacist sufficiently versed in the system not only to avoid making mis- 
takes himself, but also to qualify him to detect any errors that may have 
been accidentally made by the physician. The maximum dosage of drues, 
according to the usual metrology, is usually known to a drug-clerk, but ne 
may not be as familiar with the doses according to the metric system, 
and therefore the chances of mistakes in compounding are greatly in- 
creased. Bottles are now provided by the manufacturers, which contain 
definite quantities, according to decimal system, in cubic centimetres or 
millilitres; and pipettes and graduates, marked in metric equivalents, are 
for sale in all establishments for the sale of scientific apparatus, 

2. Determinatipn of Temperature and Specific Qravity. — In some phar- 
maceutical operations it is necessary to take into consideration the tem- 
perature or relative degree of heat, both of the room in which the work is 
going on and of the object manipulated. For instance, the laboratory or 
room may be below zero or above 90 degrees ; it usually is about 65 degrees, 
or between this and 70 degrees, and, where no temperature is specified, it is 
supposed to be at this point. When it differs much, either above or below, 
it should be noted, especially when taking the specific gravity of fluids. 

The instruments employed in measuring degrees of heat are called 



PHARMACY. 



35 



t^amom«i* ■ ' do not indicate absolute heat, but only its relative in- 

Inatj. T: re boat would be re<:iuired to raise a gallon than an ounce 

«f w«tf?r 1 degrt^, and yet the thermometer would register the same in each 

cam. The quantity of heat is calculated in another way, — according to the 

isvs of physics. Thermometers used to indicate the degree of beat are 

I VBtHy made of gl&s&, pure mercury being preferred aa the index because 

i it erpuidfl uniformly between the freezing-point of water and ita boiling- 

' pQZ&t. On account of the contraction of the glass, old thermometers gen- 

oallj read too high. Where the temperature is important, the thermometer 

■aj be compared with a standard, and its variations noted and allowed for. 

Tkononseters should be three years old before being graduated, in order 

to ailow for the shrinkage of the glass, which usually reaches its limit in 

.lUi time^ 

ThermometerB in this country are usually marked according to Faliren- 
Efa exhale, which commences at 32 degrees below the n^eltiug-point of 
divides the intervening space between tliis and the boiling-point 
ST into 212 equal gradations, making 180 degrees between the point 
ii vhich ice melts and water boils; the degrees above and below these ex- 
toflnaa are established by experiment. This form of thermometer is gcn- 
odlj emploTed in this country for laboratory work, and is given the second 
p2aDr bv the U. S. Pharmacopoeia, In Reaumur's thermometer, which is 
sa lase to some extent on the continent of Europe, the freezing-point is 
A ttiLia and the boiling-point 80 degrees. The Centrigrade, or the ther- 
■wncTrr nf Cehius, is principally used for scientific work all over the world, 
mti kaa b«an adopted in the U. S. Pharmacopoeia (1890). The melting- 
pot of ice la zero and the boiling-point of water is 100 degrees, the inter- 
vcainir *p«ce being equally divided into degrees Centigrade. The reading 
m Fursnbeit degrees may be converted into Centigrade by a simple rule. 
in mind that the former begins 32 degrees below freezing, which 
»ero o£ the other, and that the space in the former occupying 180 
only covers 100 degn*es of the latter, we have the following: — 
To ooBvert Fahrenheit de£n*ees into Centigrade, subtract 32> multiply 
ly l4iO, anH divide bv ISO, — the result will be degrees Centigrade. 

To convert Centigrade degrees into those of Fahrenheit, multiply bv 
itD. diride by 100, and add 32. 

Am both scales are in use in clinical medicine, it is necessary for the 

ftt to familiarize himself with this calculation and remember the rules. 

JUl thermometers are not equally sensitive; while some reach their 

reading in one minute, others require three or four minutes, or 

«pr -- "* -ip to the proper degree. 

I 'ir Gravity of any substanne is an expression of the relative 

Stit ':.uiti(y of the subst^mcc as compared with an equal bulk of 

He* ii a temperature of 60° F. and under ordinary conditions 

V atl Boa p b>*nc presj^ure ns indicated by the barometer. It may be ascer- 
Qaikt^ ^inTl!v in the cai»e of a liquid by placing it in a lx)ttle which, when 
fi]. point with distilled water, would contain just 1000 

0auj> "i ^'" ,..;:. r, and weighing it accurately; in this way, by subtracting 
ife wiirfat of ii»e V>oltli\ we jret the weight of a quantity of liquid which 
flEKtiT filla the pp«<*e that 1000 grains of water would. The result is the 
" ^frarilT or the liquid. .\n easier, though less direct, method is to 
tperiflcHtrnyiiy heads, which are small, balloon-ehaped, glass globes, of 




36 PHARMACOLOGY AND GENERAL THERAPEUTICS. 

different sizes and weights, so adjusted that they have different degrees of 
buoyancy. Figures are scratched upon each one, showing the specific 
gravity of the medium in which it swims indifferently, neither floating nor 
sinking. These are known as Levi's beads, and are used in cases where a 
liquid is to be evaporated until it attains a given specific gravity. They 
are hydrometers having only one specific gravity. An improvement on 
this, which is in general use, is the mercurial hydrometer, of which two are 
used, — one for liquids heavier than water and one for liquids lighter than 
water. The form in general use is that of Baum6, which consists of a closed 
glass tube,' loaded at the lower end with mercury or shot, and having an 
expansion, just above the weight, containing air, which causes it to float in 
an upright position. The original scale of Baum6 has been superseded by 
the specific-gravity scale, which is engraved upon the stem of the instru- 
ment. Hydrometers are usually floated in cylindrical glass jars, the instru- 
ment sinlang to a certain depth in liquids to be tested; the degree marked 
upon the scale cut by the surface of the fluid indicates the specific gravity 
at the ordinary temperature (60 degrees). Alcoholmeters, elaeometers, and 
lactometers are used for alcohol, oils, and milk, respectively. The uri- 
nometer, used in testing urine, is a specific-gravity hydrometer. The best 
form for this purpose is that manufactured by Dr. E. R. Squibb, of New 
York, which is remarkably accurate, as it is graded at 77° (F-)? which is 
nearer the usual room-temperature than is 60* (F.). 

3. Heat is indispensable in pharmaceutical operations. Any of the 
.ordinary sources of heat may be utilized, but it is found more convenient' 
to use alcohol or illuminating-gas for the majority of the purposes to which 
heat is essential. The ingenuity of inventors has supplied us with small 
lamps or stoves, burning alcohol or petroleum, which are most convenient 
and cleanly. A Bunsen gas-burner, or one of its many modifications, is 
now an indispensable adjimct to the pharmaceutical laboratory. 

The following are lie principal procedures requiring heat : — 

(a) High Temperatures. — Ignition, or burning. Fusion, or melting. 
Calcination, or driving off volatile substances by heat. Deflagration, or 
burning with the aid of oxygen or some substance, like nitre or potassium 
chlorate, capable of yielding oxygen. Carbonization, or heating organic 
substances without exposure to air; the volatile substances escape, and the 
residue is of a dark color, like charcoal. Torrefaction, or roasting. In- 
cineration, or reduction to cinders by consuming all the carbon. Sublima- 
tion, or separation of a volatile solid substance from another not volatile 
by heat. 

(&) Temperatures Less Iligh. — Among these are the water-bath; 
steam-bath ; glycerin-, oil-, or sand- bath. In the water-bath it is not possi- 
ble to raise the temperature higher than 212* F., but addition of salt in- 
creases the density and raises the boiling-point to 227** F. By using steam 
under pressure the temperature may be still further increased 100 degrees. 
Vaporization and evaporation are employed to separate volatile substances 
from fixed bodies. *^^hen vaporization is used to separate a volatile liquid 
from a less volatile liquid it is called evaporation. When the object sought 
is the volatile liquid it is called distillation. When it is used to separate 
a volatile liquid from a solid it is called desiccation, exsiccation, or grana- 
lation. When it is used to separate a volatile solid from another body it is 
called sublimation.'* 



FHAHMACT. 



»r 




Mmny of the znoet useful classes of preparations are made with the aid 
of iDOderate degree of intensity. Irtfttsions are liquid preparations 
Ur treating regetable substances with either hot or cold water, but 
h Hie former. The preparation must not be boiled. Cold water ie 
^akctod as a menstruum when tlie drug contains some volatile substance 
whkh msT be ilLssipated by heat, such as in prunus Virginiana. The gen- 
«ml direct'' -n by ll»e pharmacopeia are to take 5 parte of the sub- 

tfaace and _ water q. s. to make 100 parts. 'Tut the substance into 

asoitebJe Te*aei provided with a cover, pour upon it the boiling water, cover 
tbe TTMol tightly, and let it stand for half nn hour. Then strain, and pass 
okMijeh water tJirough Uie strainer to make the infusion wei«:h 100 parts." 
three official solutions this system is not followed. The infusion of 
Ui« is only I'/a P^r ceni,^ that of wild cherry is 4, and the compound 
^contains 6 per cent, of senna and 12 each of manna and 
ium. The stren^h of energetic or powerful substances 
spedalTv prescribed by the physician. 
Heeoctians require not only boiling water, but boiling vegetable eub- 
with water. The general oOlicial formula for an ordinary decoction, 
th^ fftrencrih of which is not directed by the physician nor specified by the 
pbannacoparut, is bai^d upon the same proportion of ingredients as the 
laltUMio, hut the process differs. Put the substance into a suitable vessel 
|iwidc>d with a cover, pour upon it 100 parts of cold water, cover it well, 
Md boil for fifte^ minutes; then let it cool to about 40** C. (104° F,), 
opHJBi^ strnin the ejtpressed liquid, and pass enough cold water tlirough 
dM fiiail>er to make tlie product weigh 100 part.'?. Of the two ofticial 
dnoctiona, that of cetraria conbiins 5 per cent. ; that of sarsaparilla comp. 
iflfttains 10 of sarsaparilla* with 2 each of sassafras, guaiac, and licorice- 
fMt, and aIso 1 of mezereum. 

In making extracts, the heat of the water-bath is utilized in erap- 
maiing tl" ^ t to a pihdar consistency. Heat is also employed in 

M^'ng Oil -. cerates, suppositories, solutions, in spreading plasters, 

•mI a rariety f*i tithr-r pharmaceutical manipulations, 

4. Bone operationi are chiefly mechanical; among these are commi- 

sstkm, •olntioD. separation of fluids and solids, filtration, clarification, de- 

^^|terstion, pwvipitation, cri-stallization. granulation, dialysis, extraction, 

^^^Krffluon, percolation, maceration, separation of immiscible fluids, decan- 

^RIBoo, luid siphonage. 

r Gomminntion is the process of breaking a solid into small pieces. In 

nf herbs, the agent may be broken up by cutting, slicing, or 
or, if it be s\ilhciently dry, it may be ground in a mill or mortar, 
m It wody bt rasjjwl or grated. When it is reduced to fragments by being 
Alii«*rfri«f to a Bucccssion of blows, the process is called contusion. Drugs 
Mt^ -illy cut or sliced and then contused, preparatory to making phar- 

preparations, such as infusions, decoctions, or tinctures. For 
ititir^i the mortar and pestle are generally used, but larger quanti- 
I in a drug-mill. Different degrees of fineness of powder may 

ing regulated by the fineness of the meshes of sieves through 

vtidi it w to Im* passed to separate it from the coarser particles and maJce 

it tanfonxu When nnluced to a very minute subdivision it is siiid to be 

tmpmlnahU*-, JMx*nu8e the substance bas lost its chamcter of hardness, and is 

^ sd liiarht t'^ th*^ touch. Very fine powder passes through a sieve having 






38 PHARMACOLOGY AND GENEEAL THERAPEUTICS. 

eighty or more meshes to the linear inch, and is known as No. 80 powder ; 
fine powder passes through a sieve of sixty meshes to the inch and is called 
No. 60 ; moderately fine powder passes through one having fifty meshes to 
the inch, — No. 50 powder ; moderately coarse powder passes through a sieve 
of forty meshes to the inch, — No. 40 powder; and coarse powder is only 
required to pass through a sieve having twenty meshes to the linear inch, 
— No. 20 powder. These are the five different degrees of fineness and 
names to distinguish them adopted by the United States Pharmacopoeia. 
For very fine powders bolting cloth is used, which gives a product as smooth 
as flour. Levigation is the term applied to a process for reducing solids to 
a powdered state by adding some Hquid in which they are not soluble, the 
paste thus formed being rubbed up in a shallow mortar or on a glass slab 
with another piece of glass somewhat bell-shaped, with a solid, flat base, 
which is known as a muller. When a porphyry slab and muller are used 
the process is termed porphyrization. Another method is to use an excesa 
of liquid, in which the fine, insoluble powder is suspended, and then de- 
canting the portion of the liquid containing the lighter particles, which is 
set aside; the fine powder subsequently subsides to the bottom of the re- 
ceiver, and the supernatant liquid may then be poured off and the powder 
dried. This is known as elutriation ; a good illustration is the preparation 
known as prepared chalk, which is made in this way. By a modification of 
the latter process the semiliquid, pasty mass, containing the elutriated 
powder, may be placed in a funnel-rfiaped receptocle fastened in a wooden 
frame, having a short leg near its middle, and a handle. 

The material having been placed in the receptacle, the apparatus is 
held in the hand, and the leg tepped slightly upon a teble of chalk or 
other porous substance; the shock of impact causes a small portion to 
become detached from the rest and to fall in the form of small, conical 
masses or troches, which, with a little practice, may be made nearly uni- 
form in size. Pastils (Fastilla) are small masses of this kind, which are 
usually made with aromatic substances and used for fumigation. Sub- 
stances refractory to pulverization, like gold-leaf, may be pulverized by rub- 
bing them into a paste with honey or potassium sulphate, afterward removing 
the foreign element by washing with water. Camphor is pulverized by the 
addition of a few drops of alcohol or chloroform, although it may be obtained 
from the spirit by the addition of water, and elutriation or filtration, and 
afterward removing the alcohol or water by evaporation, Metellic tin ia 
granulated by agitating melted (fused) tin with chalk-powder, the latter 
being subsequently removed by washing or by chemical solution with an 
acid. Phosphorus may be pulverized by heating it in the presence of water 
until melted and keeping it agiteted until cooled- Calomel, calcined mag- 
nesia, and sulphur may be sublimed, and by introducing steam an excep- 
tionally fine product is obtained. A coarse powder is produced by evaporat- 
ing a solution to point of concentration and continuing the evaporation, 
while stirring the liquid, until all the fluid is evaporated. This process is 
known as granulation. Granular effervescent salts are made by thoroughly 
mixing the perfectly dry material and moistening the mixture with strong 
alcohol. The pasty mass is pressed through a sieve, and the granules quickly 
dried in a hot chamber and packed in hermetically-sealed bottles to exclude 
the moisture of the air. Pulverization is sometimes preceded by ezncoation, 
by which water of crystallization is driven off; this is usually required for 



• PHARMACY. 39 

salts like alum and sulphate of iron, which contain a large proportion of 
water of crystallization. Some metals, like zinc, are granidated by melting 
them and pouring them in a fine stream into water. Pepsin and similar 
adhesive substances are reduced to a powdered state by being dissolved and 
painted on glass plates, from which, after drying, they are scraped off in fine 
Bcalea. If a finer powder is needed, a cold mortar, perfectly dry and washed 
with alcohol, is used. The operation is facilitated by combining some rather 
hard solid with the powder, — like milk-sugar. 

Solution is the process whereby a solid or gaseous substance is made 
to lose its physical identity by the power of some liquid known as a solvent 
or menstruum. When the liquid has dissolved some, and will take up no 
more of the substance, it is called a saturated solution. A simple solution 
is one which contains the original substance chemically unaltered and will 
yield it again by evaporation. A chemical solution is one in which some 
chemical action takes place, and the evaporation of the liquid will yield a 
body having different chemical properties from the original substance. 
Solution is favored by agitation and usually by the application of heat. 
Rapid solution is accompanied by change of temperature and abstraction 
of heat from surroxmding bodies, so that the process may be used as a cool- 
ing agency. Freezing mixtures are made in this way. On the contrary, 
where chemical change occurs, there is apt to be a rise of temperature. 

A decimal solntioii contains one part of the substance in ten of the 
mehstmum; a 1-per-cent. solution is a centesimal solution. The principal 
solvents employed in pharmacy are the following: — 

Water, preferably chemically pure, or recently distilled, water (as 
ordinary spring- or river- water contains more or less earthy and organic 
matter, in solution or suspension) is used in making liquors, medicated 
waters, infusions, decoctions, solutions, syrups, etc. Alcohol is used very 
^rgcly, and is next in importance to water. As it has antiseptic qualities, 
solutions with alcohol are not so liable to fermentation, as watery prepara- 
tions are. Moreover, alcohol is a solvent for many substances that are insolu- 
ble in the former menstruum, such as resins, volatile or fixed oils, alkaloids, 
glucosides, etc., while gum, albumin, and starch are not affected by it. This 
affords an opportunity of dissolving out the medicinal qualities or prin- 
ciples, and leaving the inert, woody, and starchy matters. In some of the 
manipulations dilute alcohol is directed, which contains one-half water, or, 
more correctly, according to the pharmacopoeia, it contains about "41 per 
cent, by weight, or about 48.6 per cent, by volume, of absolute ethyl-alco- 
hol, and about 59 per cent., by weight, of water." Alcohol is the basis of 
the spirits, elixirs, tinctures, medicated wines, and many of the fluid ex- 
tracts of the pharmacopoeia. Ether, benzol, chloroform, carbon disulphide, 
acetone, acids, and oils are all recognized as solvents in appropriate cases. 

Solids may be separated from liquids, or solutions containing them, by 
filtration, precipitation, decantation, eiphonage, evaporation, and crystal- 
lization. Dialysis is a process by which a crystallizable substance in solu- 
tion may be separated from non-crystallizable (colloid) substances. Grsr 
ham, in 1861, brought out this very useful process, which depends upon the 
diffasability of certain solutions through porous partitions. The usual form 
is a circular frame, like a sieve, in which the wire meshes are replaced by 
a diaphragm of parchment or parchment-paper (made by inunersing un- 
sized white paper in a cold mixture of two measures of sulphuric acid and 



40 



PHARMACOLOGY AXD GEyEBAL THERAPEDTIGS. 



one of water). The dialyzer is floated upon the Burfaee of wator ir 
receptacle, and the mijcture to be separated is placed within it. j 
suspended in a glass jar would answer the sanie purpose. This 
used to separate alkaloids from organic mixtures, especially for 
of quantitative testing, crystalloid substances passing out thn 
diaJyzer, leaving colloid substances behind. It is particidarly 8 
to toxicological investigations. 

When the object in view is to separate active principles from 
constituents of drugs, a liquid is employed, termed a meusiiuurn, 
the desired principles are soluble. Tlie principal modes of extrac 
ployed by pharmacy, at present, are maceration and expression, pei 
digestion, infusion, and decoction. Maceration requires the drug 
a coarse powder, contused or properly comminuted. The usual n 
to place the powder and menatninm in a ]arge bottle, tintil the sob 
stituents are all taken up: a process which may be facilitated by o< 
shaking during a week or more. This was formerly the process e 
in making tinctures, and is still followed by the German Pharm 
In this country it is now superseded by the process of percolation, 
much more expeditious, and, when properly done, equally etlectiv 
eolation, or displacetnont, is the process by which a powder pacl 
coiiical or cylindricnl receiver known as a percolator is exhausted of i 
principles or medicinal qualities by the descent through it of a 
fiolvent. Lixiviation is the name applied to this process when the &\ 
is first incinerated, as in the process of extracting lye from wood-ash 
U. S. Phamuieopnaia gives specific directions for percolation, ■« 
largely used in making tinctures and fluid extracts, as follows: '*The 
of percolation, or displacement, directed in this phannacopoMa, con 
subjecting a substance, or mixture of substances, in powder, co 
in a vessel called a pen'olator, to the solvent action of successive por 
a certain menstruum in such a manner that the liquid, as it travel 
powder in its descent to the receiver, shall he charged witli the solul 
tion of it, and pass from the percolator free from insoluble matter. 

''When the process is successfully conducted tiie first portion 
liquid, or percolate, passing through tlie percolator will be nearly sa 
with the soluble constituents of tlie substance treated; and if the q 
of menstruum be sufficient for its exhaustion, tlie last portion of tl 
colate will be nearly free from color, odor, and t^iste, other than those 
menstruum itself. 

*'The percolator most suitable for the qtnintities contemplated 1 
pliarmacoptpia should be nearly cylindrical, or slightly conical, with 
nel-shnped termination at the smnller end. The neck of this fimi 
should be rather short, and should gradually and repidarly become na 
toward the orifice, so that a perforated cork, bearing a short glass tub 
be tightly weilged into it from within until the end of the cork is flus! 
the outer erlge of the orifice. The glass tube, which must not project 
the inner surface of the cork, should extend from 3 to 4 cm. 1 
the outer surface of the cork, nnd should hp provided with a closely- 
rubber tube, at least one-fourth lonsrer than the percolator itself, and t 
in another short glass tube, whereby the rubber tube may be so sub| 
that its orifice shall be above the surface of the menstruum in thej 
lator, a nihber band holding it in position. 



PHABMACY. 41 

**The size of the percolator selected should be in proportion to the 
quantity of drug extracted. When properly packed in the percolator, the 
drug should not occupy more than two-thirds of its height. 

"The percolator is prepared for percolation by gently pressing a small 
tuft of cotton into the neck above the cork, a thin layer of clean and dry 
sand then being poured upon the surface of the cotton to hold it in place. 

'*The powdered substance to be percolated (which must be uniformly 
of the fineness directed in the formula, and should be perfectly air-dry be- 
fore being weighed) is put into a baain, the specified quantity of menstruum 
is poured cm, and it is thoroughly stirred with a spatula, or other suitable 
instrument, until it appears uniformly moistened. The moist powder is 
then passed through a coarse sieve — No. 40 powders, and those which are 
fiaer, requiring a No. 20 sieve, while No. 30 powders require a No. 15 sieve 
for ttiis purpose. Powders of a less degree of fineness usually do not require 
this additional treatment after moistening. The moist powder is now 
tranaferred to a sheet of thick paper, and &e whole quantity poured from 
this into the percolator. It is then shaken down lightly and allowed to 
remain in that condition for a period varying from fifteen minutes to sev- 
eral hours, unless otherwise directed, after which the powder is pressed, by 
the aid of a plunger of suitable dimensions, more or less firmly, in propor- 
tion to the character of the powdered substance and the alcoholic strength 
of the menstruum, strongly-alcoholic menstrua, as a rule, permitting finer 
packing of the powder than the weaker. The percolator is now placed in 
position for percolation, and, the rubber tube having been fastened at a 
suitable height, the surface of the powder is covered by an accurately-fitting 
disk of filtenng-paper, or other suitable material, and a sufficient quantity 
of the menstruum poured on through a funnel reaching nearly to the sur- 
face of the paper. If these conditions are accurately observed, the men- 
Btraum will penetrate the powder equally until it has passed into the rubber 
tube and has reached, in this, a height corresponding to its level in the 
percolator, which is now closely covered to prevent evaporation. The appa- 
ratus is then allowed to stand at rest for the time specified in the formula. 

'*To begin percolation, the rubber tube is lowered and its glass end 
introduced into the neck of a bottle previously marked for the quantity of 
hquid to be percolated, if the percolate is to be measured, or of a tared 
bottle if the percolate is to be weighed; and, by raising or lowering this 
receiver, the rapidity of percolation may be increased or decreased as may 
be desirable, care being taken, however, that the rate of percolation, unless 
the quantity of material be largely in excess of the pharmacopoeial quan- 
tities, shall not exceed the limit of 10 to 30 drops in a minute. A layer of 
menstruum fiiust constantly be maintained above the powder, so as to pre- 
vent the access of air to its interstices, until all ^as been added, or the 
requisite quantity of percolate has been obtained. This is conveniently 
accomplished, if the space above the powder will admit of it, by inverting 
a bottle containing the entire quantity of menstruum over the percolator 
in such a manner that its mouth may dip beneath the surface of the liquid, 
the bottle being of such shape that its shoulder will serve as a cover for the 
percolator. 

"When the dregs of a tincture, or of a similar preparation, are to be 
subjected to percolation, after maceration with all or with the greater por- 
tion of tiie menstruum, the liquid should be drained off as completely as 



42 



PHARMACOLOGY AXD GENERAL THERAPEUTICS. 



possible, tlie solid portion packed in a percolator, as before descri 
the liquid poured on, until all has passed from the surface, whe 
diately a sufficient quantity of the original menstruum should bi 
on to displace the absorbed liquid, until the required quantity ] 
obtained. 

"Authority ia given to employ, in the case of fluid extracts, 
may be applicable, the process of repercolation without change of tl 
menstruum."' 

Fractional percolation is the same process applied to two si 
portions of the powder, the result being identical with repercolati< 

Expression is the process of forcibly separating liquids from so 
is a very ancient method, the best-known form bein^ the wine- ( 
prees. After macerating a cnide dnig for tlie desired len^rth of t 
full amount of tincture is obtained by decantation and expression. 

Precipitation is the process of separating solid particles from a 
by the action of physical or chemical means. If the precipitate is < 
specific gravity than the liquid it will float iipon its surface; if, as 
is the case, it is of higher specific gravity it will sink to the botton 
receptacle. Precipit^^tes may be curdy, granular, flocculent, gel 
crystalline, amorphous, etc. A magma is a thick, more or less te: 
precipitate. Substances containing albumin arc precipitated by hea 
precipitates silver salts; but the most frequent mctlmd of precipit 
by chemical action. This is resorted to (1) for the purpose of obtainj 
stances in the form of a powder, (2) as a means of purification, (3) J 
ing chemicals, and (4) to isolate chemicals. In nssuming the crv 
form some salts take up considerable water, which is known as w 
crystallization ; the amount varies in different salts, but it is impoi 
bear this in mind with some salts like sulphate of iron or alum, 
water should he expelled by heat before making them into pills or p 
Such salts are liable to deliquesce and become moist or liquid by abi 
more moisture from the air, or in a dry atmosphere they may eS 
from loss of water. 

5. Pharmaceutical testing and analysis is the method followed ii 
taining the presence of certain constituents and determining the pro] 
if present. The methods followed are not difTorent from those empk 
organic chemistry and in the laboratory. The pharmacopana sup] 
list of standard reagents for the purpose of applying the tests prescri 
the text. As the processes of analysis are not peculiar to pharmac 
space will not be taken here to consider them in detail. In practical 
macv the microscope is indispensable for the recognition of dru^ 
adulterants and for the examination of ervptalline deposits aftd sedi 

6, The preparation^ of extemporaneous formolse is not different ii 
ciple from tlie official, except that some extemporaneous preparation 
be ordered which have no relation to tlio pharmacopceia. For ins 
some preparations of the English, German, or other phnrmncopceii 
occasionally prescribed, or fnrmida^ which are original with the phyt 
Unoflicial articles, or now remedies, are also often included in the ma^ 
prescription, but care should be taken that this is not done to exces 



^ PharmacopcEia of the United States of .\raerica, 7t!i DeepnniBl Re* 



PRESCRIPTION-WRITING AND FORMULA. 43 

is by no means creditable to a physician to be constantly trying much- 
vaunted new remedies or proprietary preparations, and neglecting to use 
the older remedies of established reputation and of standard composition, 
which have received the sanction of the pharmacopoeia. The art of pre- 
scribing will now be taken up for consideration. 



PBESCBIPTIOH- W BITIEQ ASB TOBXJTLM, 

In the progress of the science of medicine it has been found necessary, 
owing to the accumulation of knowledge, to institute special departments 
of study, as well as specialties in practice. It having become inexpedient 
for a physician to collect his own herbs in the fields, to make his own prep- 
arations, and to dispense his own prescriptions, these duties have been dele- 
gated and entrusted to the trained pharmacist and his assistants, who have 
special qualifications for the task, to which they devote their whole time and 
attention. This division of lahor is to the advantage of scientific medicine, 
as the practitioner of medicine is relieved of routine work and has more 
leisure to devote to the study of pathology, diagnosis, and therapeutics. 

The Prescription. — ^The physician usually writes his directions, regard- 
ing the medicines which the patient is to take, according to a general form, 
the writing being called "the prescription^' {prcBScribo, prcBscriptum, prce- 
scripiio, in Latin, — something written for, or ordered; in French, ordour 
nance). As a prescription furnishes very tangible evidence of the attain- 
ments of a physician, and, being preserved on the prescription-file of the 
pharmacist as a matter of record, may confront him in the courts of justice, 
it is of considerable importance that students should be well drilled in pre- 
scription-writing before graduating, so that they may be spared mortifica- 
tion and possibly the loss of reputation, caused by blunders or carelessly- 
written formulae, to say nothing of the risk to the patient. 

The first point to be settled, in composing a prescription, is to deter- 
mine the therapeutic indication and to decide upon the drug to be employed, 
and in what form it shall be given, — ^whether solid or liquid, and whether 
alone or combined with other remedies. Following this is the question of 
dosage and the number of doses and length of time during which the 
remedy is to be given, which determines the quantity to be ordered in the 
prescription. The body of the prescription, or the formula, may have the 
quantities written according to the metric system, but, sb pharmacists and 
physicians ar^ more familiar with apothecaries* weights and measures, it is 
better — for present purposes, at least — ^to follow the prevailing method, as 
a matter of precaution, and to prevent mistakes. It has been found that, 
hy adopting a certain form in writing prescriptions, the work of compound- 
ing and dispensing is made easier and more certain, and the task of transla- 
tion facilitated. In framing a prescription, certain principles should be 
kept in mind, in order that the product shall be creditable and accomplish 
the purpose for which it was written. The tendency of the day is toward 
simplicity, the elegant pharmaceutical preparations at our command having 
removed tiie necessity of the resort to polypharmacy, as it is called, when 
a large number of agents are combined in one prescription. As remedies 



44 



PHARMACOLOGY AND GBNEUAL THERAPEUTICS. 



are modified in tlieir action by association with otliers, it is oft 
tageoiis to make such a combination, and knowledge and expe: 
sometimes displayed to a marked advautage in onglnating such coi 
mida?. Instances of tliis will be abundantly given in tJae sectio 
to the consiflenition of drugs. It used to be the rule that a pr 
should contain four parts, — (1) the base, (2) the adjuvant, (3) 
gent, and {■!) the vehicle; the dose of the first having been decided 
quantities of the otiier iugredieuta were made to correspond with 
to make the desired quantity of the medicine to be taken at a d 
preparations of the j}harmacopceia, as a rule, may be prescribes 
addition, except with water, or some other convenient diluent, wht 
istered. 

The first rule in prescribing should be to make a judicious 
of the active remedy or remedies to constitute the basis of tlie pre 
always taking a single remedy, unless a distinct advantage can I 
by using others in conjunction witli it. In this connection, it t 
noted that some drugs can be given in larger doses when thus c 
whereas others must have their doses reduced. As a general ru 
agents are from the same therapeutical class they mutually enha 
other's effects, and must he given in smaller doses than when giv( 
when they belong to ditferent classes, and especially when they 
dilTerent organs, the dose can often be largely increased with ac 
Having settled upon the mnin remedy and its associate, and the 
desired to he given, the question of eligibility comes up, in decidi 
the special pharmaceutical form to be employed. There are freque 
resentatives of the drug in question in several pharmaceutical c 
some in solid form, others liquid, — each having, or supposed to ha 
special application or advantage in certain cases, and offering i 
opportunities for combination. It may be a matter of indiJTcren< 
form or prepn ration of the remedy is chosen, but the probabilities 
it is not; and that some are better suited than others. Thus, som 
preparations of iron are astringent, i>thers acid; others contain aU 
are combined with tonics and alteratives; one combination is ei 
diuretic, anotlier is used as styptic, and rarely given internally; on« 
only as an antidote for arsenical poisoning, nnd so on. 

Having decided upon the principal therapeutic agent, if we ( 
to give it alone, that will complete the prescription formula, and ■ 
only to add the directions to tlie pharmacist and to the patient (t> 
directions being simply what is desired to be copied upon the labe 
medicine-bottle or packiige). If we wish to combine our remedies, 
lowing objects may govern our selection: First, an addition may I 
of some agent which will assist the action of the main ingredient, 
or more may be selected which mutually aid each other. This aid 
chemical in character, as where dilute sulphuric acid is added to 
sulphate to help in its solution, or hydrnchlnnc ncid is added to a d 
mixture containing pepsin; or it may be physiolo^cal, and iiitendet 
upon some associated organ, so as to make the effect of the remed 
favorable; or thirdly, to prevent some incidental, disagreeable resul 
example of the former is w^here resin-bearing purgatives, or chol 
agents, and a sedative like boUndnnna or hyoseyamus are introduced 
purgative pill; an example of Ihe latter is wliere hydrohromic acid h 



d 



PRESCRIPTION-WBITING AND FORMULA. 45 

to a cinchona preparation to prevent noises in the ears, or where carmina- 
tives are combined with a cathartic remedy, or the unpleasant effects of mor- 
phine are prevented by combining with it a small proportion of atropine. 
The object, not infrequently, may be purely pharmaceutical, as where a dry 
powder, as an excipient, is added in making pills. The third object of ad- 
ministering remedies in combination is to obtain as pleasant, or at least as 
unobjectionable, a form as possible. 

When a remedy is exhibited in a form that the patient is utterly un- 
able to swallow it, or is so repulsive that each dose causes nausea or vomiting, 
no matter how cbrrect the prescription may be from the therapeutic stand- 
point, the patient will pronounce it a failure, and will probably relieve his 
feelings by uttering maledictions upon the doctor. On the other hand, if 
the remedy be attractive in appearance and pleasant to the taste, it will be 
regarded as a signal success, even though of less therapeutical activity. An 
agent is sometimes given merely for the mental and moral effect, without 
having any medicinal action directly. Such a combination is called a 
pltoebo, because it is administered simply to please the patient. Although 
placebos are rarely resorted to, patients should always be well treated, and 
with a little care much can be done toward making preparations pleasant. 
In choosing a physician, the voice of the patient would, in the majority of 
cases, be given, without hesitation, in favor of the prescriber who orders 
pleasant medicine, over him who has a special reputation for giving in- 
tolerably nasty ones. The young physician can get a hint from fiiis which 
may greatly contribute to his success in after-life. Hence, a practical ac- 
quaintance with the expedients which modem elegant pharmacy offers, for 
overcoming the objectionable character of remedies, is of the highest serv- 
ice, has no mean intrinsic value from a financial point of view. A few 
suggestions for prescribing may be given here. Solid medicines may be given 
in compressed pills, coated with chocolate, in pills sugar- or gelatin- coated, 
in hard or soft capsules, or in suppositories. Powdeza can be given in cachets 
de pain, gelatin capsules, or suspended in a dense syrup or other vehicle 
(such as stewed fruit or currant-jelly). Soluble or flmd agents, if unpleas- 
ant, are more difficult to hide, but they may be given in combination with 
aromatic or orange elixir, some fruit-syrup or in aromatic water. Many illtis- 
trations will appear, and formulae will be given of good forms of combina- 
tion, in the discussion of individual drugs under each head. A proper un- 
derstanding and appreciation of this principle of combination will not only 
make the remedies more effective, but the patient will be lees likely to for- 
get to take his medicine, and thus will co-operate with the physician rather 
than oppose him in every possible way. This is seen to the best advantage in 
the management of sick children, where the remedies must be palatable or the 
struggles of the child to escape a nauseous dose may cause the attendant to 
give up in despair and conclude that the excitement may do the child more 
harm than the medicine will do him good. 

In combining our remedies the question of incompatibility demands 
consideration. Bemedies may be (1) pharmaceutieally incompatible, (2) 
chemically incompatible, or (3) physiologically incompatible. Agents are 
pharmaceutieally incompatible when the proposed combination is either 
impracticable or extremely undesirable. Thus, the addition of water to a 
tincture of a resin-bearing drug precipitates the resin, or oleoresin, which 
floats upon the surface, thus spoiling the appearance of the preparation, and 



46 



PHARMACOLOGY AND GEXEIUVL THERAPEUTICS. 



possibly permitting too large a quantity of the active principle to 
with the first doses from the bottle. As a rule, such tinctures si 
be combined with sohitions, aroinatie waters, or infusions, Prepa] 
vegetable drugs coutainiu<? tannic or gallic acid sliould not be j 
with iron, as this combination produces an unsightly mixture, and 
is precipitated in au insoluble form. A survey of the Materia Mt 
afford niany instances of the ineligibility of particular remedies L 
forms of combination. Volatile and corrosive substances, or hy 
bodies* should not be given with powders; bulky dru^s ghould not 
to pills. In alkaloids of great ]>hysiological activity, such as stl 
delphinine, or aconitine, the pill-form should not be resorted to on 
of tlie danger of unequal mechanical division, and, in solution, it s 
seen to that nothing be added that would render them in.=olubIe. 
tlie combinations, inexpedient from a pharmaceutical standpoint 
follows : — 

(a) Form Explosive Compounds. — Chlorate of potassium and t 
gallic acid. Bromide and alcohol. Nitrate of silver iiud creo 
vegetable extracts containing glucose. Iodine and pohitions of aj 
Chromic acid and glycerin. Chloride of lime with sulphur. Spirit ' 
ether with certain fluid extracts. Calcium or sodium hypophosphi 
dry powders, or when triturated alone. 

(b) Form UnsighiJy or UndesirahJe Mixtures. — Chloral with s 
containing alcohol. Vegetable tinctures containing oils and resi: 
water. Spirit of nitrons ether with potassium iodide, iron snlpliate, 
of g^aiac, antip}T*in, mucilage, tannic and gallic acids. Compound i 
of gentian with infusion of wild cherry nr of cinchona. Copaiba i 
with watery preparations (unless suspended by acacia or other emu 
agent). Acids with ftmmoniated glycrrhizin. 

Chemical incompatibility ia caused by chemical decomposition n 
production of a compound (srU) having characters and reaction d 
from its com|X)ncnt3. It should be avoided, as the rule, except wh 
prcssly intended liy the prescriber. A knowledge of chemistry will g€ 
put the physician upon his guard, but there are special illustrations, 
must be home in mird. where the combination is particularly unde 
and, when ordered in a prescription, will defeat the object of the tre 
and bring discredit upon tbe attendnnt. The general rules of chemi 
compatibility are iisually stated ns follows: — 

As a rule, a remedy is not to be ordered in combination with it 
dotes and chemical tests, cspecifilly if the latter depend upon the fori 
of an insoluble precipitate or a corrosive nr poisonous salt. Thus, nil 
re usually precipitated by mercurials and other metals, and may 
royed by compounds containing free chlorine, cnustir alkalies, or 
sinm pcrmangannte. Tannic and gallic acids usually precipitate thi 
loids in a nearly insoluble form. The alkalies usually cause precip 
when added to solutions of metallic salts. Qlucosides are decomjm 
free acids or by emulsions. 

Special incompatibilities will be studied in connection with ind 
dmgs. Among those that are most likely to give trouble are prepa: 
containing corrosive chloride of mercury, silver nitrate, solutions of 
and iodides, arsenic, lead, quinine, strychnine, and tannic acid, and/ 
rule, such combinations should be avoided and the agents given bj' 



PKESCKIPTION-WHITINQ AND FOBMUI^. .47 

selves or simply in some vehicle. Care should be taken in mixing powerful 
oxidizing agents with easily-combustible bodies. Among the former are 
chromic. acid, concentrated nitric or nitrohydrochloric acid, potassium chlor- 
ate or permanganate. Some of the latter are oils, alcohol, ether, glycerin, 
sulphur, and phosphorus. Mixtures of chromic acid and glycerin or alcohol, 
88 already stated, are explosive ; so is silver nitrate with a vegetable extract, 
or glucose. Compressed tablets of potassium chlorate sometimes explode 
from slight friction. 

Incompatibilities of Some New Bemedies. ^ — I^e task of avoiding in- 
compatibilities in the dispensing of the newer remedies of synthetic origin 
has become correspondingly diflBcult with their increasing number. 

A favorite method nowadays with some physicians is to prescribe a 
large variety of drugs in wafers. Many remedies, however, are unsuitable 
for dispensing in wafers, because they attract moisture and soften the wafers. 
Among these are sodium bromide, calcium chloride, strontium chloride, 
chloral, the glycerophosphates, piperazine, and the dry vegetable extracts 
from drugs obtained by desiccation in vacuo. Iodides should not be pre- 
scribed in wafers, as they decompose or change color. 

Some of the pharmaceutical incompatibilities are due to the fact that 
the mixture of some solids produces a liquid. Thus, camphor mixed with 
naphthol makes a liquid, while antipyrine and sodium salicylate give rise 
to a semi-liquid, pasty mass. Antipyrine gives also an oily liquid with 
chloral, betanaphthol, salol, resorcin, phenol, pyrogallol, thymol, and ure- 
thane. 

Aeetaoilide is incompatible with chloral, thymol, reaorcin, and menth<^. 
Betanaphthol should not be mixed with antipyrine, camphor, menthol, phenol, 

and urethane. 
Camphor should not be dispensed with betanaphthol^ chloral, exalgine, menthol, 

phenol, pyrogallol, resorcin, salol, thymol, and urethane. 
Camphor mono^omide is incompatible with chloral, phenol, salol, and thymol. 
Chloral is incompatible with acetanilide, camphor, camphor bromide, exalgine, 

menthol, methacetiDe, phenaeetin, phenol, salol, thjTnol, and urethane. 
Exalgine is incompatible with chloral, naphthol, menthol, phenol, pyrogallol, 

resorcin, salol, thymol, and salicylic acid. 
Menthol cannot be mixed with naphthol, chloral, phenol, pyrogallol, resorcin, 

salol, thymol, and urethane. 
Sodium salicylate should not be dispensed with antipyrine and phenoL 
Phenaeetin is incompatible with naphthol, chloral, and phenol. Phenol decom- 
poses antipyrine, naphthol, camphor monobroraide, camphor, chloral, ex- 
algine, menthol, methacetine, sodiimfi salicylate, pyrogallol, resorcin, salol, 
thymol, and urethane. 
Pyrogallol is incompatible with antipyrine, camphor, exalgine, menthol, and 

phenol. 
Reaorcin forma new compounds with acetanilide, camphor raonobromide, ex- 
algine, naphthol, menthol, methacetine, phenol, and urethane. 
Salol reacts with antipyrine, camphor, camphor bromide, chloral, exalgine, 

phenaeetin, pyrogallol, and thymol. 
Thymol ia incompatible with acetanilide, antipyrine, camphor, chloral, exalgine, 

menthol, phenol, salol, and urethrane. 
Urethane should not be dispensed with antipyrine, naphthol, camphor, chloral, 
exalgine, phenol, pyrogallol, reaorcin, 'salicylic acid, salol, or thymol. 



>Frmn the Report of the Committee on New Remedies of the New York State 
rhaTmaceutical Association for 1906. American Druggist, 1906, p. 37. 



48 



PIURilACOLOGY AND GEKERAL THEILiPEDTICS. 



Great care should be taken in preparing mixtures of syrups c< 
cia with certain phenol derivatives and synthetics. Incorapatib: 
pt to occur as the result of the presence of an oxidizing ferment oi 
in tlie gum, in virtue of which chemical changes take place, eitlier 
in a precipitation or a change of color. Witness, for example, the : 
combination which occurs in an article by Tanzi, quoted in Repe 
Th i'. rape utique : — Jk 

l»j'ranudou 0120 Gm. 

Sodium bromide 25 Cim. 

Syrup of gum ucocia 130j Gm. 

9 

This mixture at once turns a bluish-violet, then violet, then p 
after a few hours becomes yellow. 

Syrup of acacia gives a blue color with guaianira resin; a pi 
turning black with phenol; a violet color, and later a blue precipit 
niphanaphthol; a gra3aBh white opacity with betanaphthol ; a y< 
brown color and a garnet precipitate with pyrocatechin ; a white pr 
with vanillin; and a deposit of white crystals of oxy-morphine wi 
phine hydrochhiride. Syrup of acacia is also incompatible with 
adrenalin, synip of tar, and the liquid preparations of aloes. 

Physiological incompatibility is based upon the physiologica 
of drugs, the rule being that drugs having dissimilar effects upon 
organs should not be combined in one prescription, especially wl 
principal action of the drugs is antagonistic. Inasmuch as the el 
individual remedies are not restricted to one orgim or set of orga 
as it never happens that t^vo dnigs will be found exactly opposed 
other throughout tlioir whole ran^e of action^ considerable latitude 
respect is permitted in prescribing. Jn fact, there is sometimes an 
tage in modifying the activity of a drug by one which is antagonisti 
instance, morphine and atropine are opposed in their effects, and y 
pine is very frequently added to an opiate to diminish the disii^ 
effects, — headache, nausea, and constipation, — and heighten the i 
and anodyne qualities. Illustrations of such incompatibility are lai 
be found under the antidotes to the toxic efTects of drugs, a remed; 
considered incompatible with its p]iysiological antagonists, as the 
rule. Some prominent illustrations are the following: — 

Acetanilidc: Alcoholt ammonia, CAffeine, cardiac stimulants. 

Aconite: Alcohol, ammonia, atropine, amyl nitrite, dij^talis, stropi 

itrychnine. 
Agaricus albua: OpiTim, strychnine, pilocarpine. 
A^ftricus uuiscftrius: Atropine, digitalis, stimulants. 
Alcohol: Ammonium, acetato, digitalis, strj-ehnine, catTeine, liyosoyara 
Atropine: Acouitinc, chloral-hydrate, hydrocyiinic acid, jaborandi, mu 

morphine, pfayaostigmine (escrine). 
Caffeine : Opium. 

ClilorHl-hydrfite: Ammonium salts, atropine, alcohol, many alkaloids. 
Chloroform: Amyl nitrite, ammonia, digitalis, strychnine. 
Digitalis: Aconit(s muKcarine, saponin. 
Gelsetniimi: Opium, atropine, strychnine. 
Hydrocyanic noid: Atropine, hyo&cynmine. 
Morphine: Atropine, caffeine, nicotine, physostigmine, 
Miiscnrine (see AKarieus muscarius). 
Opium: Atropine, gclaemium, veratnim viride, potassium i>erman;,'Qnat 




PKESCBIPTION-WEITING AND FORMULA. 49 

PhTBostigmine: Atropine, chloral-hydrate, morphine. 

Saponin : Digitalis, strophanthus. 

Strychnine: Amyl nitrite, chloral, potassium bromide, chloroform, etc, 

Veratnim viride: Opium. 

The risks of incompatibility in prescribing can be entirely avoided if 
due precaution is taken. Whenever a new or unfamiliar combination is 
ordered, the careful prescriber will, if possible, supervise the preparation of 
the prescription, and examine the completed product. If an insoluble 
precipitate be formed, it 'should be at once investigated and its character 
determined. Very often a skilled pharmacist will be able to detect an in- 
compatibility in a prescription, owing to his practical acquaintance with the 
combining of drugs, and in this way point out the fact that such an unin- 
tentional incompatibility may exist, and thus show his willingness to work 
with the physician. It is expected by the general comm\mity that a phy- 
sician should be able to recognize a remedy or preparation by its physical 
characters alone. In order to do this it will be necessary for him to cultivate 
a close acquaintance with drugs and the results of combinations which he 
wishes to order, so that he may pronounce a verdict upon a preparation and 
decide whether or not it is properly compounded. If he has not such tech- 
nical knowledge, he should make it his business to acquire it in a laboratory 
or a pharmacy. 

Form and LanipDUige of the Prescription. — For many- reasons formulae 
are usually written in the Latin language. However, if any physician 
choose to write his prescriptions entirely in English he is at liberty to do 
so; but the demands of accuracy require that he write the official English 
titles without abbreviation. Such titles as muriate of ammonia, balsam of 
copaiba, saltpetre or nitre, brown mixture, spirit of turpentine, etc., may be 
used in conversation, but in prescriptions the correct titles should be given; 
either ammonii chloridum or ammonium chloride; copaiba (not balsam); 
potanii nitras or potassium nitrate ; mistura glyoyrrliizec oomposita or com- 
ponnd licorice mixture ; oleum terebinthine reotiflcatum or rectified oil of 
turpentine, and so on. Many popular titles are very objectionable; thus, 
oidic acid is sometimes called essential salt of lemons or salt of sorrel, lead 
ac-etate is called sugar of lead, while an attempt to trace the vulgar names 
of plants leads to endless confusion. Sometimes preparations of different 
strength may be indicated; thus, prussic acid may mean concentrated acid 
or the official 2-per-cent. dilute acid ; oil of almonds may mean oil of sweet 
almonds or oil of bitter almonds, which differ very much in their properties 
and effects. The only safe rule, therefore, in writing prescriptions, is to 
IcDow exactly what is intended to be ordered and to legibly write the scien- 
tific name and quantity of the article desired, and if this is done, the lan- 
guage may be left to the choice of the prescriber. As a rule, it will be found 
that physicians who are competent to do so prefer to write in Latin, and 
those who cannot write them correctly in the language of the pharmacopceia 
cannot write them correctly in English either. 

As to the status of a prescription, although really a communication 
from a physician to the pharmacist, directing the preparation of the remedy, 
bv tacit consent of all parties it is generally admitted to be the property of 
the patient, who haa ihe privilege of having it repeated or refilled at his 
pleasure. When thie prescription is marked *'not to be repeated," the patient 
i« understood to assume all the responsibility of an injury which he may 



50 



PHARMACOLOGY AXD GENERAL THERAPEUTICS. 



experience from disobedience to the physician's directions, the 
pharmacist generally satisfying his conscience by calling atteutio 
fact that the physician did not desire the remedy to l>e continued, 
chiring that the entire responsibility must rest with the patient, b 
the prescription just the same. In this way the alcohol habit, tl: 
habit, the chloral habit, the cocaine habit, the antip\Tin or bronu 
are fostered by the resources of modem pharmacy, which preset 
agents in the form of cordials and otht^r attractive preparations; 
physicians hesitate to pro:=cribe them, for foar of the eonsoi]uences oi 
patients acquainted with these seductive preparatiuns. as there is pr 
no restriction on their sah\ It is only ju.-^t to add that there are mt 
orablc pharmacists to whom the above remarks do not apply, and 
deavor to co-<ipernte with the physician and who practice pharmt 
special department of the practice of ineflieine. 

Besides the formula, the complete prescription contains insi 
to the pharmacist conceniing the combining or compounding of tl 
cine and direct ions t-o the patient as to the dose of, find the manner e 
of taking, th*? proparation. Finally the document must bo signed an 
and, as a matter of precaution, it is advisable to write upon it the ] 
name and address, so that, if the pharmacist should make a mistak 
liver the wrong medicine, he will be able to trace it at once. Thii 
a safeguard against error in administration where more than one pi 
mider treatment in a family or institution. Many physicians reqi 
formula to be copied upon the label, a plan that is often very useful. 

Proceeding to the actual framing of prescriptions, assuming i 
ledge of tlie Materia Medica and pharmacopoeia 1 titles BufScient to 
the prescriber to determine what remedy he wishes to give and its 
he writes, as legibly as possible, upon a piece of paper, the formula 
has in his mind, making the csit^e endings agree with the rf'quirement 
situation. For instance, aa the first word is *'Recipe," the iniperati'V 
of the verb "take" requiring the accusative case, it follows that th< 
which follow referring to quantity should be considered as in the ac< 
case. Thus, **RecijH\ 1 G. or 8 e.cm.." means: "Take one gramme i 
cubic centimetres" of any desired agent. The latter, however, \? to b€ 
in the genitive case whenever the quantity is expressed; thus, "B 
ealcis, 15 c.cm./' means: "Take Irt e.cm. of lime water/' On thi 
liand, when the quantity is not given in any denomination of we 
volume, the subject itself being directly taken, the latter is put 
accusative case; thus: — 



'B Vitpllum ovi, 

Aqun? cinnnmomi. 



.q. s. ad 30 c.vm, or J 



means: "Take the yelk of an Qgg. and enough cinnamon-water (wj 
cinnamon) to maJce thirty c.cm, or one iluidouncr'," the letters q. s. st 
for qjtntifum stifpciai. or "as much as may be required to make i 
amoimt specified." If the case-endings are known » the proper case 
be ascertained by trying to insert the word "of"; where this can h 
the word following it should be written in the genitive case; thus, in 
of cinnamon, or syrup of orange, tlie words cinnamon and orang 
always he in the genitive ease. To students unfamiliar with Lati 
difficulties in the way of o:irrect writing of prescriptions may seem 



••• • 




FaESCBIPTION-WBITING AND FORMULA. 51 

moontable; but they will disappear after a little attention and practice- 
One of the best ways of learning the genitive case of pharmacopoeial nouns 
is to study the list of fluid extracts or tinctures in which the remedial agent 
is in the genitive (fluid extract or tincture of — ), Familiarity with the 
names of the Materia iledica will supply the needed information in the 
majority of drugs regarding the case-endings. 
The general form of the prescription is : — 

T^ (for recipe, or take) 
B<ui$. of A (in the genitive case), a certain quantity (in the accusative case). 

Adjuvant, of B (in the genitive case), a certain quantity (in the accusative caae). 
Corriffcnt. of C (in the genitive case), a certain quantity (in the accusative case). 
rfMcie. of D (in the genitive case), a certain quantity (in the accusative case). 

Pharmaceutical DirecHons. Let such or such preparation be made. 
Directions for the Patient. Write (upon the label) the specific directions for dosage, 

time of taking, alone or with any vehicle, etc. 
Siffnature. Physician's name. 

Date. 
Same and Address of Patient. For Mr. So-and-HO. 

It is not at all necessary that the classical arrangement of base, ad- 
juvant, and so on, should always be observed, but it seexna natural to write 
the most important agent first, and follow this with any agent or agents 
which we desire to combine with it, and, finally, a menstruum or vehicle if 
any be needed. For illustration, suppose it is desirable to give a patient an 
expectorant cough mixture. In order to render the secretions more liquid 
we may use potassium iodide, or a vegetable substance, like ipecacuanha, 
and, perhaps, may decide to combine them. Associated with them we may 
give ammonium chloride, which acts beneficially upon the bronchial mucous 
membrane, causing the development of more healthy epithelium. Finally, 
a suitable menstruum would make the mixture more palatable. We next 
decide upon the quantity for each dose, and the prescription now appears 
in this form: — 



20 Gm. or gr. iij. 
75 Gm. or gr. xij. 
12 c.cm. or mij. 
50 c.cm. or f3ij. 



Recim 

Potassii iodidi 

Amxnonii chloridi 

Floidextracti ipecacuanhee 

Syrupi sarsaparillse compositi q. s. ad 

MiBoe et fiat mistura. 

Or (in English form) : — 

Take 

of iodide of potassium twenty centigrammes, or three grains 

of ammonium Chloride. . , seventy-five centigrammes, or twelve grains. 

of ttuid extract of ipecac twelve centigrammes, or two minims. 

of rompound syrup of sarsa- 

parilla enough to make 7.50 cubic centimeteres, or two drachms. 

Mix. Let a mixture be made. 

Having settled that a dessertspoonful (7.50 c.cm., or 2 drachms) will 
be a sufficient dose to give, we decide upon the number of doses to be or- 
(iered. If twenty be the niunber selected, the entire prescription will then 
equal twenty times this quantity, or 150 c.cm., and, when completed, will 
fom a mixture, with directions like the following : — 



52 



PHARMACOLOGY AND GENERAL THERAPEUTICS. 



Gm. 


or 3j. 


5 Gm. 


or 3iv. 


50 c.cm. 


or msh 


c.cm. 


or f3v. 



Potaasu iodidi 4 

Ammonii chloridi 16 ( 

Huidextracti ipecacuanhee 21 

Syrupi sarsaparilUe compositi q. s. ad 150 

Misce et fiat mistura. 

Signa: Take a dessertspoonful every four hours for cough, as directed by 
Phila,, Sept. 30. 1900. Dr. X. 

For Mr. A. 

Another illustration may be taken: — 

n 

Base. Quininse sulphatis 3 

Adjuvant. Acidi sulphurici diluti 4 

Corrigent. TincturK cardamomi compositae 

Vehicle, Elixir aromatic! 90 

Sig.: Take a teaspoouful with water after meals, 



July 20, 1900. 



Gm. or gr. xlviij. 
com. or ^j. 
com. or fSvij. 
c.cm. or fS"j* 

I>H. A. 

For Mrs. O. 



The principal object of the addition of the sulphuric acid is to increase 
the activity of the quinine by changing it into the more soluble bisulphate. 
The compoimd tincture of cardamom makes the mixture more acceptable 
to the stomach, and increases the tonic effect, in which the alcohol, both of 
the tincture and the elixir, will participate. Where the latter is objection- 
able, the syrup of the red orange may be substituted for the elixir. 

There is no essential difference, as regards their form, between pre- 
scriptions for internal remedies and those for topical or local use; for in- 
stance, we may write as follows ; — 

B Olei tiglii 41 c.cm. or f3j. 

Olei amygdales expreasi 7|50 c.cm. or fSij. 

M. Sig. : For external use. Apply with a earners-hair pencil, once daily, over 
a space aa large as a silver dollar, as directed. Dr. B. 

U Acidi ^lUci 41 Gm. or 3j. 

Glyeerini 30] c.cm. or fSj. 

H. ft. solutio. 

Sig. : Apply, night and morning, to the throat as directed. Dr. C. 

B Potassi chloratis 81 Gm. or 3ij. 

Glyeerini 30 ccm. or fSj. 

Extract! geranii fluidi 15 ccm. or f3tv. 

Aquce roses q. s. ad 180( ccm. or fjvj. 

M. et ft. mistura. 

Sig. : Use as a gargle several times daily, diluting with water if necessary. 

Db. D. 




Time and Interval in Eelation to Dosage. — In addition to the question 
of dosage and the proper form in which to administer remedies, the problem 
of the frequency of giving the dose must be decided ; and the time of the 
day, the relation to meal-time, all come up for settlement. The old and 
pT(?v:iilin;:r tlii>^« tinioii ^]aih^ or ter in die, method of ordering medicine to 
be tdkcTi am^r from ilie natural division of time and the custom of eating 
ft morning, noon, aiiil evening meal. Remedies affecting the stomach 
jtlv nir iisTiflUy ffiven when the organ is empty, — that is, before meals, — 
Je iigf^t)tivt> agotit^?, to assist the assimilation of food, would properly be 
DiaistfTed dnriDg tlv? period of digestion. Systemic remedies, in a sim- 
annor. nro- lic^t fiiven a short time after meale, so as to mix with the 




ADHIKISTRATIOX OF BEMEDIES. 53 

food and be absorbed with it and so enter the circulation. Laxative pills 
may be taken after the principal meal of the day (dinner-pills), or, if they 
contain cathartics of a slowly-acting character, they are best given upon 
retiring at night, so that in case they cause griping it will not give so much 
pain or inconvenience as if it occurred during the day. On the other hand, 
salines, such as Rochelle or Epsom salts, or natural purgative waters con- 
taining them, are more efficient when taken early in the morning, when the 
stomach and intestinal tract are not occupied in digesting food, and are 
thus more directly affected. It is sometimes of importance that the bowels 
should be moved just before retiring at night ; for instance, where there are 
haemorrhoids, it is found that they are liable to come down during the act 
of defecation, and afterward to cause pain and irritation during the time 
the patient is in the erect posture. In such a case a laxative, such as com- 
pound licorice powder, or rhubarb, may be given at an hour in the after- 
noon which a little experience will determine so as to bring about the desired 
result Xarcotic and sedative remedies are more effective if given just 
before the patient is accustomed to sleep : just as bitter tonics intended to 
excite the appetite should be given a little before the times appointed for 
the meals. Remedies may be given for a temporary purpose, as where alum 
and molasses, or an ipecac mixture, is ordered for croup, or preparations 
ordered for headache, or cough, which are to be discontinued as the symp- 
toms are relieved or the object of the treatment is accomplished. In treat- 
■ ing a patient for tape-worm it is considered advisable to have the intestinal 
tract nearly empty, and the action of the remedy is greatly assisted by a 
preliminary purging to carry off the mucus which is thrown out as a result 
of the irritation caused by the parasite. For the administration of a purga- 
tive or the removal of a tape-worm the medicine is frequently taken on 
Saturday night, so as to enable the patient to rest the following day in case 
of overaction of the drug. When it is desired to evacuate the stomach by 
an emetic, it is advisable that some warm water or gruel shall be swallowed, 
60 as to moderately distend the organ and give the muscles something to 
contract upon. On the other hand, when vomiting is not desirable, as 
when ipecac is administered for dysentery and it is not intended to be 
rejected by the stomach, the patient should abstain from drinking water 
before or after taking the medicine. Seasons and locality have some effects 
upon dosage ; in hot weather the system usually does not bear strong medi- 
cation as well as in winter-time. In some localities, where malaria is rife, 
antiperiodics must be given in larger doses, and are required in almost 
every disease. The numerous modifying elements that arise from circum- 
stance and place, or the condition of particular organs, will receive due 
attention in another part of this work. 

The Model of AdministratioiL, from a pharmaceutical standpoint, have 
already been referred to, but a few words remain to be said from the thera- 
peutical or physiological point of view. Remedies produce systemic effects 
because they enter the blood and become a part of the circulating fluid, or 
they may occasionally produce an impression upon the peripheral nerves, 
and thus produce local or remote effects, owing to reflex action. It must 
alw be admitted that disturbances of function, similar to those produced 
by medicines, may be produced by emotion or mental states. In certain 
^m sensitive subjects, usually hysterical, it has been found, in Charcot's 
flinic, that the effects can be apparentlv obtained by "suggestion," without 



54 



PHARitACOLOGY AND GENTRAL THERAPEUTICS. 



administration of the remedy. This is very similnr in princip! 
metnllotherapy of Rurq nnd to the traclothcrapy of Perkins. Th 
just adverted to will he further discussed in the chapter upon **H 
and Allied StatoB." For the pn-sent we are concerned with the act 
iolofrical action of remedif^, which may enter the cireiilation (1 
mouth and stomach, (2) by the rectum, (3) by the bladder or va^ 
by the &kin, (v>) by the brftnt-ho-pulnionary mucous membrane, an< 
the veins or capillaries u[nm p[ranulating surfaces. 

1. The mouth being the natural channel for the introduction 
or sustenance, it seems the most convenient route for tlie admin 
of medicines, and ie adopted, as a rule. Nature has placed sentii 
in the form of the pistatory nen^es and papilke, and innumerable ex 
have been resorted to in order to enable badly-tasting remedies to pi 
out exciting repugiinnce or nausea. Patients differ «rreatly with r 
to their ability to take medicines. Some can take castor-oil w^ith 
otluTS enjoy asafcetida as a condiment to their food; some are so i 
that they are nauseated even by the idea of taking medicine of aj 
The latter often tax the resources of the pharmacist and physicia 
some more suitnble channel is found for introducing the remed 
abBorption of medicines is largely by means of the capillaries or sma 
but the lymphntics or lactoals also participate. After entering th 
tlie l>?nl"•[lie^ are carried by it into the Ciij«illaries of the central 
system and the various orgnns of the body. After remaining in the 
for a greater or lest^ length of time, nnd exerting certain charai 
effr-cts upon the functions of the several organs, these a,gentfi ma; 
enter the circulation, and be excreted from the system by the emuE 
As a nile. tlte remedy acts as an excitant or stimulant to the organ Ir 
it is separated from the blood. They are subsequently to be found 
vnrious secretions and exerefione, either in their original form o 
derivative of it. The iibj^orption of insoluble substances is depender 
their being transformed into soluble form ; this may be done by tl 
gastric juice or the alkaline intestinal juice. In some cases of ingea 
corrosive poisons the individunl may perish from shock, or from sp 
the glottis; but, as the rule, there is sufficient time for absorption 
poison from the alimentary cnnal before death occurs. When a toxit 
has been swallowed it is important to evacuate the stomach and int 
at once, so as to prevent tlie continued absorpliojj nf the poison. 

2. Remedies may be introduced by enema, — otherwise called inj 
lavement, or clyster. In this instance the mucous membrane of the i 
takes the place of tlie lining membrane of the str>maclK There can 
question with regard to the absorption <tf rumodies by the bowel, si 
con be so readily demonstrated. Thus, suppositories of opium produ 
usual systemic effects of this drug; quinine, intitiduced into the n 
stops intermittent fever; nutritive enemnta support life for monthi 
so on. Injections of starch, with laudanum, are especially useful in p 
affections of the rectum or the other pelvic organs, and clieck secret 
diarrho-a or dysentery. When an enema is to be retained it should l 
more than from 1 to 4 ounces, according to eircumstartcea; as a lav 
or clyster, as large an nnioimt as can bt* borne by the patient without 
ing actual pain may be given, — thus, from 2 to 4 pints may be inJ€ 
an adult, from one-eighth to one-fourth this quantity for a child. 




ADMIKISTRAXIONT OF REMEDIES. 55 

2 ounces for an infant. The instrument used for this purpose is called a 
syringe. It may be the classical form, with a piston and receiver, the latter 
b«ing furnished with a tube, through which the fluid is forced when the 
piston is forced down. The. best are made out of hard rubber ; those made 
of pewter or glass are very inferior. In addition to these, \^e have the soft- 
rubber tube, terminating in a tube of metal or of hard rubber ; in the course 
of this tube there is a rubber bulb, which, expanding after compression, 
exercises suction, and, by alternate compression and expansion, forces fluids 
along the tube. This is a great improvement over the old style, as it is easily 
operated and can be used as a self-injecting apparatus. The fountain- 
syringe is simply a rubber bag or receiver, of adequate capacity, terminating 
in a tube, through which the water flows by force of gravity, when the 
reservoir is elevated. A pneumatic syringe is also made, in which the solu- 
tion is placed and is afterward forced through the tube by pumping air into 
the bottle, reversing the aspirator of Dieulafoy. The ordinary injertion used 
for evacuating the bowel consists of warm water containing some Castile soap 
in solution. In addition to this, we may add 30 to 60 c.cm. of castor-oil or 
a teaspoonful or more of oil of turpentine, in order to make the injection 
more stimulating. Glycerin may be used for the same purpose, from 4 to 
16 c.cm. (1 to 4 drachms) being generally sufficient to evacuate the lower 
bowel. When gaseous enemata are administered, the gas diffuses rapidly 
into the blood, and is excreted by the lungs. It was thought that the intro- 
duction of sulphuretted hydrogen in this way might benefit tubercular 
lesions in the lungs (Bergeon^s method) ; but it has not been found to be 
of much service, clinically. Anesthesia for surgical operations may be pro- 
duced by the injection of the vapor of ether into the bowel ; but this metiiod 
is not devoid of danger and has not met with much favor. 

3. The bladder or vagina may be used for the administration of reme- 
dies; but, nsually, agents here applied are only intended to act locally. A 
weak solution of silver nitrate, or of some sedative antiseptic, — ^boric acid or 
carbolic acid, — ^is sometimes resorted to, with excellent effect, in cases of 
inflammation ; but remedies are rarely, if ever, introduced by either of these 
channelB into the system. 

4. The ikin, or general surface, may be utilized in several ways for the 
introduction of medicines. In the first place, the agent may be simply ap- 
plied to the surface and kept in contact with the skin, — the enepidermio 
method. Friction may be called to our assistance to force the agent through 
the skin, — ^the epid«rmio method. The cuticle may be removed by a blister 
or other means, and the agent applied directly to the derma, — the endermio 
method. Eemedies may be introduced beneath the skin and thrown into 
the areolar tissue, — ^the hypodermic method. With regard to the first three 
bnt little need be said. There are in use a large variety of lotions and lini- 
ments, some of which are active coimter-irritants, which are used principally 
for a local effect. At the same time, remedies can be thus made to produce 
a systemic effect, as where mercurials are applied by inunction ; or quinine 
is used in the same way. Occasionally, medicines applied to the surface 
for a local effect may produce a general one, as where a belladonna ointment 
or plaster produces dilated pupils, or croton-oil causes a general eruption. 
Similarly, remedies injected under the skin will produce sj'steraic effects. 
The last-named, or hypodermic, method will require a more extended notice. 

By the subcutaneous or hypodermic method, remedies in a state of 



56 



PHARMACOLOOT AND OKNERAl THERAPEUTICS. 



solution arc introduced by means of a ?mail syring'c, amied with 
needle, which is made to perforato the skin. This plan was first bi 
the notico of the profession by Dr. ^Vlexandcr Wood, of Edinbu: 
being adopted, soon acquired a remarkable popularity. It has sorat 
advantages over ordinary methods, in that it admits of greater pre 
dosage, sinee the entire dose rapidly outers the circulation; where 
by the moutli, some may escape absorptioTi, It produces prompt ef. 
infhu^nce being observed in from five to fifteen niiniiiesi, wbieli mal 
valuable in the ease of pain. It eonibines a local with a peueral e 
according to Dr. Wood, the injection should be administered as ne* 
site of pain as possible. It is clean, it is convenient, and it is ehea|: 
the patient has it given to him. On the other hand, if an overdose 
dentally administered the poisoning must be met by physiological a 
since it cannot be withdrawn from the circiiktion after being injec 
_the needle be not strictly sterilized, or aseptic, it may communicate 
ad instances have been known of pyaemia and tetanus following 
" the h)iiodeniiie needle. The greatest objection of all is that, by 
some patients acrniire the morphine liabit, they are apt to become in 
with the little instrument and the effects of the punctures, and soon 
confirme<l morphinomiiniacs. It is the latter consideration part 
which lias induced physicians to use the hypodermic needle with in» 
caution, and to refrain from its use whenever the remedy can be g 
the stomach. 

The hypodermic syringe is iisually made of glass, of 1.30 c.( 
twenty minims) caj>acity, the gradations being engraved upon the b 
the piston-rod. The needles may be of steel or platinum ; it the form 
may be gohl-plated. Various modifications have been made in the e 
shape, but the form used by Pr. Kobert Koch, of Berlin, has an adv 
from an antiseptic stand-point, in that it is free from a piston and p 
The fluid is sucked up by aspiration, l)y means of a rubber ball atta 
the end of the syringe, and, by compression of the hall, is again fore 
The nf^edle is fittctl upon the glass barrel by ji earefullv ground frietio] 
and llie whole iiistnnnent can readily be taken apart and washed wit 
septic solutions or treated with hot water. Tlie construction of the i 
is readily understood from the foregoing, but a more extended degc 
can be found in the 2ledical Bulkiin of February, 1891, by those esf 
interested in the Koch treatment. Tliere are numerons makes of hypo 
t:yringes in the market, and tliosse are to be ])referr*Hl wliicli can moBt : 
lie made aseptic and luive the smallest needles. Bartholow, who has 
much attention U^ thie method, reconnnends a silver-plated instrumer 
ing a fiat side to the piston-rod, upon which is marked the quantity o 
tion contained in the barrel. He makes the proper suggestion that, 
using such an instrument, it should be carefully tested with a sta 
minim-glass, in order to see that it is properly graduated. For conve 
of steriijzution, hypodermic syringes may now be obtained made entii 
glass. Tlypodcrmic syringes of larger size are also supplied for the s 
administration nf diphtheria antitoxin. The instrument must he kef 
gically clean : the lu'cdles pliould l)e small and sharp, and tlie s^Tinf 
quently washed with antise])tic solution, in order to keep the packi 
the piston in good order and ]>rcvent it fmm bccnminir dry. As rep 
solution, it should be chemically pure and made with great accura 




ADMINISTKATION OF REMEDIES. 



57 



not too concentrated. It should be fresh, because a fungus often develops in 
the course of a few days (penicillium) , which destroys the alkaloid. "Where 
the synnge is not frequently used it is better to rely upon extemporaneously 
prepared solutions made with recently-boiled water, and powders, compressed 
tablets, or triturates containing the desired quantity. Distilled water that 
is not fresh is not so good as recently-boiled water for making the solutions. 
Chloroform-water, orange-flower water, peppermint-water, or carbolic-acid 
solutions will keep for a comparatively long time without spoiling. 

In administering a hypodermic injection, a part of the skin free from 
superficial veins should be selected and the surface washed with soap and 
irater and made surgically clean. The previously-sterilized needle is intro- 
duced in a plane nearly parallel with the surface of the surrounding skin. 
If, when the needle is in position, the piston be pulled out slightly and 
blood is seen to flow into the syringe, the needle should be withdrawn and 
another spot selected. Profound narcotism (possibly fatal coma) might re- 
sult from the injection of morphine directly into the circulation by puncture 
of a vein. The place being selected, — generally in the outer aspect of the 
arm or forearm, or on the back, — ^the skin is pinched up into a fold between 
the forefinger and thumb of the operator's left hand. The needle is then 
introduced lengthwise into the fold, which is slightly elevated aa the desired 
amount is injected; the needle is withdrawn from the little wound by a 
twisting motion, and the puncture rubbed gently with the finger. A small 
tomor or swelling is caused by the injection, which is dispersed into the 
cellular tissue by rubbing. No further attention to the puncture is neces- 
sary, although, if it be painful, the next day it may be washed with carbolized 
water (1 to 128), as a local sedative as well as antiseptic, or a lead-water- 
and-laudanum compress be applied. The following are frequently employed 
for hypodermic medication : — 

AIcoW , Dose, 

.Ether " 

Ammonise (aqua) " 

Apomorphina hydrochloridum ... " 

Araenicnm ( Fowler's Solution ) . . " 

Aeidum carbolicum ( liq. phenol. ) . " 

Amyli nitris " 

Atropime sulphas " 

Atropine et morphiiuB sulphas . . " ^ 

Caffeine citraa '* 

B Caffeinse citratis 6|36 Gm. or gr. xcvj. 

Glycerini, 

Aquie aa 15| c.cm. or f^ss. 

M. Twelve centigramTnes are contained in 0.6 cubic centimetres (ten minims 
contain two grains}. 



60 to 


2 


20 to 


4 


60 to 


2 


004 




12 to 




01 to 




20 to 




0005 to 




0004 to 




0004 to 




065 to 





ccm. 


or mx-xxx. 


ccm. 


or mxx-lx. 


c.cm. 


or wx-xxx. 


Om. 


or gr. V,.. 


30 c.cm. 


or ffiii-v. 


13 Gm. 


orgr.V.-ij. 


30 c.cm. 


or miii-v. 


0008 Gm. 


orgr.V«-V«. 


0005 Gm. 


or gr. Vi«.-Vw atropine. 


021 Gm. 


or gr. V,.-Vi morphine. 


13 Gm. 


or gr. i-SJ. 



Cocaime hydrochloras Dose, |016 to |065 Gm. 

B Cocainae hydrochloridi |75 Gm. 



or gr. V.-j. 



Aque aurantii florum 15| 

M. Twenty minims contain one grain. 



or gr. XI J. 
c.cm. or f3iv. 



Curare Dose, |003 to |021 Gra. or gr. Vi» 

Coniinae hydrobromldum , " 10015 to ' (?m. or nr. V„. 

Chloroformum puriflcatum " 130 to 1| c.cm. or *wv-xv. 

or Spiritus chloroformi '* 1|20 to 2|60 c.cm. or «ixx-xl. 



v.. 



58 



PHARMACOLOGY AND OENEUAL THERAPEITICB. 



\m to 


l! tim. 


or pr- 


001 


Gm. 


or gr. 


0004 to 


001 Gni. 


or gr. 


13 to 


20 Gm. 


or gr. 



Chloral Doae, |G5 

Colchioina, 

UulxfieiinaQ sulpbun, or hydrobroraas 

Ergota ; 

ft Fluidcxtracti prpotte. 
Glycerini, 
Aqua; ua 30 c.ciu. or f5j- 

M. Sig.: Ufte 1.20 to 2.0 c.cm. (or twenty to thirty minima) by injectio 

Hyoeoina Dose, |0000 Gm. or 

IJ Hyoseinie hydrobromidi 1012 Gm. or 

Glycerini 1(20 c.cm, or 

Aquas q. 8. ad 6[20 c.cm, or 

M. Sig.: 0.30 com. (or live mioims) contains 0.0006 Gm. (or Vim grain) 

HyoBcyamintc Dose, jOOOO Gm. or 

R Ilyoecyaiiiina' sulphat |03 Gm. or 

Aquce chloroforraj SOj c.cm. or 

M. Sig.: 0.(K) c.cm. (or ten minims) constitute a dose (0.0008 Gm.^ or gr. 

Hydrargyrum (aee article "Hydrargyrum" in Part II). 

MorphiniB suJphfVfi ' Dose, jOl to \03 Gni. org 

H Morphirm^ Huii)hiit |60 Gm. or g 

Phenulia liquefacti 120 Gm. or j 

Aquse 30| com. or f] 

H. Sig.: 0.60 c.cm. (or ten minims) equal 0.01 Gm. (or gr. Vc)* Powders 
siUes may aUo be used. 

ft Morphina; Bulphntis 25[ CJm.* or ( 

K. et divide in chnrtit- vt'l cappellai no. x.viv. Each contain 0.01 Gm. (or | 
To be used for making an extemporaneous solution. 

Quininic hydrobromidum Dose, |06o to |05 Gm. or ^ 

H Quiniiice hydrobromidi 1|60 Gm. or g 

AqiiflB deatlltatiE 30| com. or i 

M. Sig.: 0.60 c.cm, (or ten minims) contains O.OGd Gm. (or one grain) of q 

ft QuininjB aulphnvinatis 81 Gm. or o 

Aquee chlorofortni 15] c.cm. or £ 

M. Sig.: O.lin I'.cm. (or ten minims) contniris 0.32 Gm. [or five grains). 

The quininip biniuriata cHrbainidata, the double chloride of quinine luid i 
soluble in an equal part of water, and is very siutable lor b)-podorni 

Scopolamine (same as Hyoscine). 

Strychninffi Dose, |001 Gm. orgr. 

ft StrychiiintB aulphatis |015 Gm. or gr. 

Acid, acetic, dil., q. s. ad solve. 

Aquaj creosoti q. s. ad 15j c.cm. or f3i' 

M. Sig.: 1.20 c.cm. (or twenty minims) contains 0.001 Gra. {or gr. V**) of a 
nine. 

"Many other instances of elijrible forms for the administration of ( 
iiypodermicallv will bo found, in tlio following pages, specially ment; 
umh.-v flip (lniL!:s oonoenied. 

Parenchymatous injection is a form of hypodennic injection in v 
the solution is thrown deeply into the tissues instead of merely "undei 
akin. It is eraploved in eases of ncuiralgia to deposit the remedies 




ADMINISTRATION OF REMEDIES. 59 

in contact with the affected nerve. Bartliolow formerly used chloroform 
in this way, with marked benefit in cases of sciatica. Bichloride of mercury 
hns been injected into the lung-tissue in the treatment of acute and chronic 
pneumonitis. Liquefied phenol, or tincture of iodine, has been injected into 
the cavity of the tunica vaginalis testis in the treatment of hydrocele ; and 
acetic acid and ergot have been thrown into the substance of various new 
growths. Ether has caused the disappearance of sebaceous tumors when 
injected into their interior, and parenchymatous injections of cocaine are 
u:=ed as a local anaesthetic for small surgical operations. Insoluble prepara- 
tions of mercury, like grey oil and calomel, are much used in France, in the 
treatment of syphilis. The injection is made into the gluteal muscles, and 
is very slowly absorbed. 

5. By inhalation, remedies may be introduced, through the route of 
bronchial mnconi membrane, into the blood. Although rarely employed, 
except for producing surgical anaesthesia, this method promises, in the 
future, to play a more important part in therapeutics. The remedies may 
be in the gaseous form, as where oxygen or nitrous oxide is administered; 
they may be in a vapor, and inhaled with steam ; or made into a spray with 
the atomizer, and thus inhaled; or they may be used in fumes, as where 
tar or asthma pastilles are burnt, or sulphur or mercury vaporized. Con- 
cerning the extravagant hopes that have lately been raised (especially in 
the tr^tment of pulmonary consumption) of the bactericidal effects of in- 
halations, the results have not been very favorable. When the smaller bron- 
chial tubes and air-cells and their walls are filled with bacteria the only 
antiseptic that can reach them is the opsonin contained in the blood and more 
particularly that contained in the healthy white blood-cell. At the same 
time salicylic acid and other agents are capable of being introduced into 
the bronchial tubes, and, by liquefying and favoring the expulsion of the 
secretions and making them less septic, they are capable of affording much 
relief to the patient and retarding the progress of the disease, if not hasten- 
ing the cure. Hay fever is much relieved by applications of cocaine and 
iiJialations of weak solutions of quinine ; a similar treatment may sometimes 
be devised for acute and chronic pulmonary affections. For the production 
of a fine spray by mechanical action, instruments known as atomizers are 
used. Hand-atomizers consist of bulbs, which, by compression, deliver a 
blast of air throxigh a tube past a capillary orifice in another tube, the latter 
being partially immersed in water or other desired solution. The blast of 
air produces a partial vacuum, and the fluid ascends the tube until, escaping 
by drops, it is blown into fine spray at right angles to the extremity of the 
tube. This is a very convenient instrument for small quantities of medicated 
?olutionfi. When the quantity is larger the hand would become tired, and 
steam may be resorted to, or we may use compressed air by means of an air- 
pump. Some very neat and even ornamental forms of the latter have been de- 
vised by ingenious instrument-makers, and they may now be met with in the 
offices of all physicians who pay special attention to treatment of diseases of 
the throat or lungs. 

6. The intraTenons administration of medicine is the most direct 
method at our command of obtaining prompt physiological effects from our 
remedies. The transfusion of blood is an ancient therapeutic device, and 
it naturally suggested the employment of remedies in the same manner. 
In the collapse of cholera, intravenous saline injections have saved numerous 



60 



PIIABMACOLOGY AN'D OEXEHAL TIIEHAPECTICS. 



lives that were apparently in a hopeless condition. The luniiul^ 
by Hayera is : — ■ 

Sodium flulplmle 261 Gm. or f 

Sodium chloride 6|30 Gm. or ( 

Sodium hydrate 1| Gm. or j 

Wattir nO| c.cm. or t 

This should be filtered and brought to the temperature of the bloo' 
surface, or not more than 100° F. Of such a solution as much aa ! 
have been used at one i^peration, but, as a rule, 1 quart will be qu: 
cient. It is important to inject the fluid slowly, so as to imitate the 
blood-current. Holutiong of sodium ]>bo5;plmte and cldoride (specific 
filiout 1050) have nho been employeil ^ith success. The late Dr 
employed the !attt*r sohitiou in tJio Irontment of diabetic coma with 
able iniprovemcnt after 2i^ ounces (imperial) had been thus used. 
of collapse froui ha-niorrha^^', milk litis been emiilnyed by a number o 
tors, with gratifying ret^ults. Hal ford, of Australia, has fihown tha 
a wound from a venomous snake, the intravenous injection of aqua an 
fortior (1 part) with aqua destillata {2 parts) is well home and i 
system in Bustainin^ itself under the effects of the poison, altliough 
not i>e directly autidotal, as was at first supposed. J. T. Eskrid^e u 
diluted aqua ainnmnii^' fortior, injected into the rein of the arm. ^ 
bad consequences and with ret-overy of the patient, who had been aspli 
with hydrogen sulphide. It is also ijf service in tln*oiid)Osi8 of the 
nary artery, chloroform asphy.xia, hydrocyanic poisoning^, etc. The 
of admitting: air into the vein is not very great and its evil consei 
have been jL'^reatly exaggerated; however, it may readily be averted 
little care. It is hardly necessary' to add that the huicet, and, in fact 
the instruments slmuld be fiur^cally dean, and that every antisept 
caution should be scrupulously observed. 

Transfusion of blood has been performed many times, and i 
modifications of inslnnneuts have been invented to accomplish it 
trouble is that, when the emergency arises, the instruments are not a( 
except in a large general hospital, and the practitioner must exten 
a transfusion apparatus out of n 4- or G-ounce syrin^je and a rubbi 
^laas tubes. Immediate transfusion is where the blond lV>ws from the i 
blood-vessel into the recipient's, through a tube which had been pre^ 
filled with an antiseptic solution. A Bvrin^e may be introduced, so 
measure the amount of Idood, as in the instrument of ^lartin, of 1 
Tlie instrument of Aveling, of London, is simply a rul^ber tube with s 
ous enlargement in the middle. The capacity of tbe bulb is 2 dn 
Silver cannulas are placed at tJie ends of the tube, which is nl>out ] 
inches in length. Each cannula is guarded by a stop-cock, and the en 
beveled or rounded, so as to facilitate the insertion, Tlie modu of ope 
is to carefully cleanse the apparatus by immersion in warm, recently 
water. The air is entirely expelled, and a warm saline solution used tc 
pletely fill the tube. The veins of the donor and recipient being select 
generally in front of the elbow, — tiie incision is made with a scalpel 
tube inserted into each, and held in place by the fingers of an assists 
preference to a ligature. Now, the stop-cocks being turned, the ti 




ADMINISTRATION OF REMEDIES. 61 

pinched on the side toward the donor, and the fluid is forced onward; the 
efferent tube is then pinched, and the bulb allowed to slowly refill, when it 
is again emptied and again refilled, until the proper quantity of blood (6 to 
8 ounces usually) has been delivered. The apparatus is then withdrawn, a 
ligature placed upon the veins, and a proper dressing applied. 

In mediate transfniion the blood is drawn into a warm bowl, beaten 
or whipped with sterilized straw to remove the fibrin and prevent sub- 
sequent clotting; then the blood is taken up into a previously warmed 
s}Tinge and slowly injected, through a cannula, into the vein, the median 
basilic generally being chosen for the purpose. In this way repeated charges 
may be slowly and gently delivered, but, as Bartholow taught, from 4 to 8 
ounces of blood will usually be sufficient to strengthen the heart and avert 
threatened collapse. The use of lambs* blood was advocated by Gesellius 
and others, but the transfusion was generally followed by a rigor and sweat- 
ing, which greatly prostrated the patient, and it is no longer practiced. 

Transfusion has been performed in phthisis and other chronic diseases 
without benefit. It is of greatest service in acute emergencies, such as severe 
bemorrhage (traumatic or posl-partum), htematemesia, intestinal haemor- 
rhage, epistaxis, etc. In the hsemorrhagic diathesis it has been successfully 
used by Dr. Buchser, of New York, but it has failed in simple ansBmia, In 
acute poisoning by phosphorus, or carbonic oxide, transfusion has been re- 
sorted to successfully by a number of clinicians. A modification of this 
method has been proposed by Albanese and Hueter in arterial transfniion. 
In this method an artery of one of the extremities is selected and divided 
(generally the radial or posterior tibial being taken), and the blood is in- 
jected just as in mediate transfusion. The advantage sought for is the pre- 
vention of clotting and the danger of embolism, and that there is less danger 
of the introduction of air. Where a large quantity is to be injected, it might 
be better to employ this expedient, so as to avoid any danger of suddenly 
overwhelming a weak heart. The effects following the transfnsioiL of milk 
have been found to be very much the same as those from the use of blood, 
except that albuminuria is more apt to follow. When milk is used it should 
be taken directly from the cow or goat, and after being carefully strained, 
without being allowed to cool, it should be gradually introduced into the 
circulation by means of the syringe and cannula. The results, in some cases, 
of the treatment after hsemmorrhage have been to warrant further trial. At 
the same time, the report of those who have gone over the entire subject 
critically is that nothing can be a complete substitute for human blood 
for the purpose of transfusion. The later plan of injecting a quantity of 
blood into a large serous sac like the peritoneum, as recommended by Pon- 
fick, has found few followers, and, whereas some good results have been 
reported, others have occuired in which death resulted from peritonitis. 

The introduction of large quantities of water or of normal salt solution 
into the peritoneal cavity or under the skin has been followed by excellent 
results in the collapse of cholera and after haemorrhage. It will be con- 
Fidered fully under the title "Hypodermoclysis." 

Medicines may be applied topically to wounds and granulating surfaces, 
or injected into suppurating cavities. The fact that such agents may be 
absort>ed and produce systemic poisoning should lead us to be careful in 
applying carbolic acid, corrosive sublimate, or other active antiseptics which 
have powerful toxic effects upon the human organism. By what is called 



62 



PHABMACOLOGY AND CENEEAL THERAPEUTICS. 



galvanic cataphoresis medical solutions may be made to pass thro 
akin, and directly into tlie tissues and the blood (see Electrothera] 
Idiosyncrasy : Individual Peculiaxitiefl Aff ectingr the Dosage < 
of Administration of Drugs. — Pereonal peculiarities on the part 
patient, as regacds the etl'ects of remedies, often cause serious em 
ment to the prescriber. They are usually attributed to idiosyncre 
this is merely a term wherewith to hide our iterance of the rea 
One of the puzzles of experimental therapeutics is the occasional i 
in the action of remedial agenta in dilTerent species of animals, — ejj,, 
arc very slightly affected by opium and are not injured by a quantit; 
would be fatal in man; a deer can eat tobacco, or a rabbit belladonnf 
without producing toxic effects. Something of a similar character 
among palimts. It is simply impossible to ana'stheti/.o some patier 
ether, and we are obliged, in such cases, to resort to chloroform whc] 
gical operation is required. There is also a great difference with re 
susceptibility to the effects of alcohol; gome persrins are easily overc 
it, and quickly rendered helplesa and unconscious; others can tal 
large amounts, and, while showing its physiological effects by inebrii 
not discommoded by it to the extent of losing control of themselves, 
times we encounter indivndunJs who arc rendered very uncomforti 
calomel, even a small do^^e bringing on neuralgia or gouty pains in the 
others require quite large doses to prodnce any effects at alL Cincho 
its alkaloids (quinine, cinciionine, quinidine, etc.) sometimes cause d 
ance of digestion and eruptions upon the skin, even purpura lisemorr 
cases of the latter having been reported by Dr. Woodbury.^ The obj 
to taking quinine sometimes encountered, however, are probably i 
ignorantly confounding it with other agents, such as mercury, Soi 
tients cannot take colchicum at all; others can use it in large dose 
good results. Opiun\ and its alkaloids, uiorpliino especially, are oft€ 
ductive of unpleasant consequences; and, iusteEid of soothing a patie] 
producing sle^^p, they occasion excitement, restlessness, headache, irr, 
of the skin (followed by vomiting and prostration), or an eruption 
bling urticaria or erythema. In the same way, potassium iodide, b 
small doses, occasions severe coryza in some patients, while in oti 
vesicular or bullous eruption appears, resembling varicella or variola, 
pectod progtration and sMnptoms of poisoning have occasionally fa 
the adminislrntion of ordinary doses of chh>r;i]-hydrate, tlie cases ten 
ing fatally, in ppite of everything that could be done. This occurs s 
quontly from chloroform that its use as an ana?stlioti<' has been aban 
by many surgeons, or employed only with great caution. Iodoform 
surgical dressing, even, may cause poisoning in C('rtain susceptible pe 
The new aromatic compounds — antipyrin, acetanilide, sulphonal, etc.— 
sionally excite a peculiar tniin of toxic effects, for which, as yet, no exj 
tion, except idiosyncrasy, has been given. On the other linnd, it is some 
necessary to give large doses of quinine, opiu7n, calomel, chloral, or ] 
sium iodide, in order to produce a desired, or positive, theTHpeutic r 
When such unpleasant effects forbid the enq)loyment of a remedy, it be< 
necessary to resort to a substitute, or succedaneum, as it is called, " 



' Phitadeli»f>i<i Mt'fUcal Times, Sept, 18. 1880. 




ADKINISTBATION OK REMKDZE8. 



03 




tberapeatic offectB without the objectionable features of the former 

From all tt l>o<?n said in the pnvediug pages, the explanation is 

maSy jntvo of ; -n why the dose of a drug cannot be stated with the 

mmm defiiuteiKfi& aa iti? specific gravity, for instance. While we can say that 
qnandtr is a customary* or usual dose, and that a larger quantity 
maximnni dose, which, under ordinary circumstances, it is not well 
ni the same time we may find patients who cannot take even the 
nr doee without great discomfort, and others who actually require 
^cOanrdmATily lar^e doses before obtaining Ihe anticipated therapeutic re- 
Tbe Committee on Revision has introduced the average or medium 
ic dosi*« into the Pharmacopceia ; but has very wisely avoided the 
of majimum dosage. It is customary, when a very large dose is 
tfjpolated in a prescription, for the pharmacist to ascertain from the phii'si- 
daft if the dose was intended, or was due to a mistake, owing to haste or to 
Aammp tion while writing it. Physicians can save delay, in a case where 
a hrigr «lf*e*is intentional, by underlining it or putting a star after it, to 
^^f^>tr that notice has already been taken by the author of the prescription, 
^ it i- ' esjyiry to call it to his attention again. 

Frc g for Children. — If the doses for adults are subject to such 

factvaboo Aud uncertainty, it is evident that any calculation by mathemat- 
mi formala of the dose for a child at any given age, based upon the adult 
idae, mast be unreliable. Several such schemes have been proposed. Thus. 
Dr. Toon^s plan was to diminish the dose in the proportion of a fraction 
ahoie numfTator is a figure representing: the cliild*s age and the denominator 
&ea^ of the child increased by 12. The rule would therefore be: Multiply 
ikr wait do«e by a figure corresponding to the years of a child's age and 
^nitby the ago plus twelve. Thus, if a child's age is G years and the adult 
itm 80 grains, we have the follon-ing formula : — 



^- 



20 X 



«+l2 



or J = (>§ grains. 



fact that the development of children depends upon other factors than 
ia anffictent to show the fallacy of this scheme, especially if we remem- 
that *'•; ' "' ' !. like adult.*, are very susceptible to medicines. A 
■iDevhat I ^1 plan than the preceding is based upon the weight 

rf die ^iHiL whith ia taken as the numerator of a fraction whose denom- 
aator ia 140, which is arbitrarily taken as tlie average adult weight. Inas- 
wmth aa many circumstances besides the age and weight of an individual 
^ 1 > ♦^«« »?oo*tion of dosage, and as this ia even more evident in prescribing 
fcr n tJian among adults, we cannot advocate any such mathematical 

fconoj-^ ^'lining the dose for children. Caution should be obsen^ed 

■ ma "tics to very young children; a single drop of laudanum 

llP <3iv Ifath of an infant, while, on the other hand, they may bear, 

«il^3Qt . relativelv large dopes of belladonna, conium, arsenic, and 

^ acmrr. Ptyalism should never be intentionally set up in children by 
m -migwiVr nae of mcrcnr>', because it may be followed by inflammation 
^ «foni;hin^^ of the li}>s and che«'k and other serious lesions. In writing 
« af*s«iption f^r a child it is sometimes of advantage for the pharmacist 
% fcflovr the fact, which may be indicated by addressing it *'for baby," or 
*^ Willie or Mary," or simply "for Mr. Blank's child." 



' 




^^^ 64 PHARMACOLOGY AXD OEXERAL THEIUPEUTICS, T 




^^^ In concluding this 


jart of tlie work, the following table vinlLJ 




^1 useful ill reading and w 


riting prescriptions: — 


1 




^^f Latin Terms and Phrases Employed in Pbescriptioxs. 




H WORD OB PBBXeS. 


USttAX COKTRACTIOW. 


BNOLISB EQiriV/ 




H A or Ab (prep, with abla- 


A or Ab 


From or Out of. _ 
To or Up to. 1 




^H Ad (with aooutiative) 


Ad 




■ Adde 


Add 


Ad(L 




■ Ad dime vices 


Ad 2 vie. 


In t\vo takings or 6 




^H Ad tei'tiam vioein 


Ad 3 Vic. 


At three tatcings Of 




^H Ad libitum 


Ad Ub. 


At pleasure. 




^m Absent e k'bre 


Abs. feb. 


Fever being absent. 




^H Adstitnto febre 


Ad. leb. 


Fever being present 




^H Adtiibcndus 


Adhib. 


To be adminiatercd. 




^M Ad move 


Admov. 


Apply. 




^H AUiiuot 


Aliquot 


Several. 




^H Alt(.>rnis lioria 


Alt. Iioris 


Every second hour. 




^H Alvo ndKtricta 


Alv. adHtrict. 


The boweU being b 




^1 Ana 


lU or aft. 


Of each. 




^M Ante cibuni 


Ante cib. 


Before food. 




^H Aqua astricta 


Aq. ostr. 


Ice. 




^M Aqua bullifna 


Aq. bull. 


Boiling water. 




^H Aqua dostillnta 


Aq. dest. 


Distilled water. 




^1 Aqua ex Ilimiine 


Aq. ex flum. 


River water. 




^M Aqu:i ffTvena 


Aq. ferv. 


Rot water. 




^H Aquu Huvinlia 


Aq. Huv, 


River water. 




^H Aqun fuiitts!i or foutana 


Aq. font. 


Spring water. 




^m Aquii pluviuliii 


Aq. phiv. 


Rain water. 




^B Aqua pura 


A.|. pur. 


Pure water. 




^M l^eue 


Bene 


Well. 




^M His in die 


Bis die or* Bisind. 


Twice daily. 




^^^_ Biiii^da 


Boug. 


A long auppositorj-o 




^^H Bulliat 


Bull. 


Let it boil 




^^V Capiat 


Cap. 


Take. 




^V Cauto 


Caute 


Cautiously. 




■ abua 


Cib. 


Food or Sleal-lirne. 




^m Cochleare ma^muin 


Coch. mag. 


A tablcspoonful. 




^H Cotrhl«>nre modiiim 


Coch. med. 


A dcBsertspoonful. 




^H Cocl!li?ar*> pmn'um 


Coch. imrv. 


A teanpoonful. 




^M Cola nr L'olftiir 


Col. or Colet 


Strain. 




^1 Cullyrtuin 


Collyr. 


An eyo-waish. 




^M Colorotnr 


Colore t. 


lA't it be ci^lored. 




^m Compositu.s 


Co. or Comp. 


Compound. 




^m Pongiua 


Cong. 


A gallon. 




^H Continnantur rpmetlia 


Cont. rem. 


Continue the medici 


1 


^M Co<)uc. Co<|UAntur 


Coq. 


Boil 




^B Craft, Crarttinus 


Crast. 


To-morrow. 




^B Crfls marc »umendus 


Cms mane buhl 


Take to-morrow mo 


r 


H Cujufl 


F^J-- ... 


Of wbichj of any. 




^H C*iijuft lihet 


Cuj. lib. 


Of nnv you plpflae. 




^1 ('urn (with ablative) 


Cum 


With. ' 




■ CHathus 


C. or Cjrath. 


A glass. 




^M C>'nthus vinnn'uH 


C. vin. 


A winc-gln.^s. 




^M Ik*bitA «|>i8Mtiii]i) 


Deb. spiM, 


Proper consistence. 




^m OectibituB 


Decub, 


Lying down (or A h 


e 


^H De dii- in ilifm 


Of d. in (li. 


From day to day. 




^m Diobus altoniiH 


Dicb. alt. 


Hvery second ilay. 


1 


^m Tiivhwi* tertins 


Dieb. tert. 


Every third day. 


I 


^M Dilue, Dilutus 


Dil. 


Dilute, diluted. 


1 



LATIN TERMS AND PHRASES IN PRESCRIPTIONS. 



65 



WORD OB PBBABE. 



USUAL CONTBACTION. 






Dimidius 

Divide 

Divktatnr in partes 

squales 
Donee alrus soluta fuerit ! 
DosiB ' 

Drachma 
Durante dolore 
Eadem I 

Ejufidein 
tor Ex 
Fac or flat 
Fac pilulaa duodecim 
Femu* 

Fiant chartulie duoderim 
Fiant pilulsp duodecim 
Fiat emplastrum ' 

Oargarisma ' 

(iradatim | 

Gntta, Guttse i 

Guttatim 
Haustus 

Horft decubitus ' 

Hor& somni I 

Horse uniua spatio i 

Idem 
in dies 
Infrico 
Infusa 
Intime 
Jus 

Liflimentum 
Lotio 
Maoero 
Magnus 
Mane 

ifane prime 
Mcdica men turn 
Mica nanis 
Minimum 
Miaee 
Mitte 

Mitte decem tales 
Modicus 

Mode ■ prsescripto 
Mollis 
Morbus 
More dictu 
More BoHto 

Ke tradas sine nummo 
Noete maneque 
Xomen proprium 
^OB repetatur 
Ortarios 

Onmi horft (or Omnia horia) 
Omnibus aJtemis horis 
Omai bihoris 
Omni quadrante hone 
Omni mane vel nocte 
Optimns 
Partes nqualea 
Pamilus 



Dim. 
Div. 
Div. in par. seq. 

Done alv. sol. ft. 

D. 

Dr. or 3 

Dur. dolor. 

Ead. 

Ejusd. 

E. 

F. or ft. 

F. pil. xij. 

Ferv. 

Ft. chart, xij. 

Ft. pil. xij. 

Ft. empl. 

Garff. 

Grad. 

Gtt. 

Guttat. 

Hau»t. 

Hor. Deeub. 

Hor. Bom. 

Hor. 1 spat. 

Id. 

Ind. 

Infr. 

Inf. 

Int. 

Jus. 

Lin. 

Lot. 

Mac. 

Mag. 

Mane 

Man. prim. 

Med. 

Mic. pan. 

M. or Min. 

M. 

Mitt. 

Mitt. X tal. 

Mod. 

Mod. prssc. 

Moll. 

Morb. 

Mor. diet. 

Mor. Rol. 

Ne tr. 8. num. 

Noct maneq. 

Nom. prop. 

Non . repetat. 

O., Oct. 

Omn. hor. 

Om. alt. hor. 

Om. bih. 

Om. V« h. 

Om. mane vel noc. 

Opt. 

P. eeq. 

Parv. 



I ENOUSH EQUIVALBNT. 

One half. 

Divide. 

Let it be' divided into equal 
' portions. 

I Until bowels are open. 
' Dose. 
I A drachm. r 

During pain. 

The same. 

Of the same. 

Out of, from. 

Make, or let be made. 

Make 12 pills. 

Hot. 

Let 12 papers be made. 

Let 12 pills be made. 
I Let a plaster be made. 
' A gargle. 

By degrees. 
I Drop or Drops. 

By drops. 
' Draught or Potion. 

Bed-hour. 

I Hour of sleeping. 
i One hour's time. 

The same. 
I Daily. 
I To rub in. 

Let it infuse or steep. 

Thoroughly. 
I A broth (juice). 
; A liniment. 
I A lotion. 
! To macerate. 
■ Large. 

I In the morning. 
I First thing in the morning. 

A medicine. 

Crumb of bread. 

A minim. 
I Mix. 

Send. 
' Send 10 such. 
I Moderate- sized. 
I In the manner written. 

Soft. 

A sickness. 

In the manner directed. 

As accustomed. 

Collect on delivery. 

Night and morning. 

The proper name. 

Let it not be repeated. 

A pint. 

Every hour. 

Every second hour. 

Every two hours. 

Every fifteen minutes. 

Every morning or night. 

Best. 

Equal parts. 

Small. 



66 



PHARMACOLOGY AND OENEaAL THEKAPEUTICS. 



WOBO OB PHBABB. 


USUAL CONTBACTION. 


ENGLISH EQUIVALENT. 


PeniciUum camelinum 


Penicil cam. 


Camel-hair penciL 
Through or By. 


pier (accusative case) 


Per 


Phiala priiu agitata 


P. p. a. 


The bottle being first shaken. 


Post (accusative) 


Post 


After. 


Pro (ablaUve) 


Pro 


For or According to. 


Pro ratione aetas 


Pro rat. eet. 


According to patient's age. 


Pto re nata 


P. r. n. 


As occasion arises. 


Quantum libet 


Q. lib. 


As much as pleases. 


Quantum sufficiat 


Q. suff. 


As much as suffices. 


Quftque hoTd 


Qq. hor. 


Every hour. 


Quoque 


Quoq. or Q. 


Also. 


Quotidie 


Quotid. 


Daily. 


Recipe 


5 


Take. 


Redactus in pulverem 


Red. in pulv. 


Powdered. 


Kepetatur 


Repetat. 


To be repeated. 


Scrupulum 


Scrap, or 3 


A scruple (20 grains). 


Secundum artem 


Sec. a. 


According to art. 


Semi or Semisse 


Ss. 


A half. 


Semihora 


Semih. 


Half an hour. 


Sesqui 


Sesqui. 


One and a half. 


Signa 


SiR. 


Write. 


Simul 


Simul 


Toflrether. 


Sine 


Sin. 


Without. 


Singnlorum 


Sing. 


Of each. 


Si opus sit 


Si op. sit 


If need exists. 


Solve 


Solv. 


Dissolve. 


Statim 


Stat. 


Immediately. 


Stct or Stent 


St. 


Let it (or them) stand. 


Subinde 


Subind. 


Frequently. 


Succus 


Sue. 


Juice. 


Sumat talem 


Sum. tal. 


Take one such. 


Sume 


Sum. 


Take. 


Talis 


Tal. 


Of such. 


Tere 


Tere 


Rub. 


Ter in die 


T. i. d. 


Thrice daily. 


Tritura 


Trit. 


Triturate or Grind. 


Tussis 


Tus. 


Cough. 


Ultimus Prsscriptus 


Ult. preesc. 


The last ordered. 


rt dictum 


Vt diet. 


As directed. 


Vel 


Vel 


Or. 


Verus , 


Ver. 


Genuine. 


Vesper I 


Vesp. 


The evening. 


Vitellus 


Vitel. 


Yelk of an egg. 



FOISOirS AND AiniDOTES. 

A general formula for administration in cases of poiiioning by an un- 
known agent is sometimes useful as a sort of universal antidote. Dr! Murrell 
recommends the following combination : — 

B Liquor ferri sulphatis (ad <iaturandum) .• 100 

Aquce 800 

Magnesise 88 

Carbonis animalis purificatee •. 40 

The iron solution is to be kept separate fmm the mixture of calcined 
magnesia and animal charcoal until wanted, and then the ingredients should 
be put in a bottle and well shaken together. The solution should be drunk 



POISON'S AXD ANTIDOTES. 



67 



nue tne uuoiiible ingredients are in a state of suspension. A wineglassful 
«A do«e, frequcDtlj repeated. 

The foUoiring table is placed here for convenience of reference; for 
tethrr details of treatment the reader is referred^ to t]ie paragraphs relating 
to taxk eflects and antidotes under the individual titles in the section de- 
■Mh-H to drugs. 



Poisons. 






1 




TApors Afid ga«e«: 



oXMie (CO). 
dIoKide (CO.), 



Treatment, 
DifTusible stimulants, hot ale<^>hnUo drinks, hot coffee, 
i»timulatiiigeiitrnuita,hypodefniic injections of atro- 
pine, digitalij^ or nitroglycerin. 



Magnesia, chalk, dilute solutions of alkaline carbo- 
nates (soap, tooth powder). l>emulcents: milk, 
albumin, oils.. (For hydrocyanic acid the treatment 
U the same oa for oyauidc of potassium.) 



Vmeffar, dilute acids, lemon- juice. Demulcent*: 
milk and oil, flour and water, etc. Opium, mor- 
phine, and atrupine to relieve symptoms. 



I Finely divided animal charcoal, tannic acid, coffee. 



Pre^h «ir, oxygen initiations, artificial respuration. 
Intravenous injcctiona of ammonia. Transfusion 
of blood. 



r DifTuAiblp Mimulaiit^, trtnnic aoid. coffoe or tea in- 
J fusion, alcohol, smnionia. Hypodermic injections 
I of dij^tnlis, strophanthuR. ntropine, or amyl ni- 
I trite. Hot pack. Faradization. 

\ Coffe**, ammonium aretale, strichnine, stimulating 
\ enemutn. mtheterization, stomach-pump. 

f Artificial respiration, inhiilntion of nmmonia or amyl 
\ nitrite, faradization, inversion of the body. 

f Tannic acid, albumin, milk, and demulcents, with 
\ hypodermic injections of morphine and atropine. 



For farth- ' ■ ^^>alk»n concerning poisons and their nntidote» the reader will 
I tb« UkIi' img* in Part II. He also will find Dr. Murrell's little book, 

10 ]>o In Ca3<; of Poisoning," very convenient for reference. 



68 
Apomorphine. 

Areenic. 



Atropine. 
(Belladonna). 



Belladonna. 

Brucine. 

Calabar bean. 
( Physostigmine) . 

Cannabis Indica. 
Cantharides. 
Carbolic acid. 

Chloral. 

Cinchona 
(Quinine, 
Cinchonine, 
Quinidine, etc.)* 

Codeine. 

Colchicum. 

Conium. 

Copper. 

Corrosive sublimate. 

Croton-oil. 

Curare. 



Cyanide of potassium. 
(Hydrocyanic acid). 



PHABMAGOLOQY AND GENERAL XHERAFECTICS. 



f Chloroform mixture; digitalis hypodermically. Dilu- 
\ ents and stimulants. 



' Freshly-precipitated hydrated sesquioxide of iron, 
ferric hydrate in a moist and pulpy state (a table- 
spoonful to each grain of poison), or hydrated oxide 



of iron with magnesia, or dialyzed iron. Animal 
charcoal, magnesia levis, with opium to r^eve 
pain and vomiting or diarrhoea. Demulcents. 

Fixed alkalies. Caffeine, or fresh infusion of coffee 
or tea, artificial respiration. Morphine, cautiou&ly 
given, physostigmine, muscarine, and pilocarpine 
are physiological antidotes. 

•| (See atropine.) 

i Same as for strychnine. 

( Stimulants, fixed alkalies, atropine hypodermically, 
\ artificial respiration. 



< Atropine. 

{ 



Opium, demulcent drinks, saline cathartics. Avoid 
oils and fats. 



r Soluble sulphates, saccharated lime, stimulants and 
\ anodynes. Alcohol. Glycerin. 

/ Hot infusion of tea or coffee, strychnine hypoder- 
\ mically, warmth and exercise. 

r Tannic-acid and astringent infusions: iodine forms in- 
•I soluble compounds with the alkaloids. Morphine 
I. and atropine hypodermically. 

< (See opium.) 

-j Opium, stimulants, astringents. 

I Alkalies, astringents, strychnine hypodermically. 

< Morphine, albumin, demulcents. 

-[ Albiunin, atropine, and morphine. 

j Opium, stimulants, astringents. 

j Strychnine and atropine, oxygen inhalations, artificial 
\ respiration. 

f Artificial respiration, ammonia inhalations. Cold 
-j affusions to the spine, transfusion of blood. Ether 
( hypodermically. 



POISONS AND ANTIDOTES. 



69 



DigiUlia. 

Lead salts. 
Lobelia. 

Mercunald. 

Muscarine 
(Mushrooms). 

Xitrit«s : — 

Sodium, 
Nitroglycerin. 

Opium 
f Morphine, 
Codeine) . 

Phosphorus. 

Picrotoxin. 

Pilocarpine. 

Savin. 

Silver nitrate 
(Lunar caustic). 

Snake-venom. 

Sirv'^hnine. 
T(»bacco. 

Turpentine, oil of. 
Veratrine, 
Zinc salts. 



i Opium, nitroglycerin solution. 

( Atropine, strophanthus, hot alcoholic stimulants, 
\ hypodermic injections of ether. 

i Magnesium sulphate, opium, potassium iodide. Baths. 

i Morphine, strychnine, strophahthus, stimulants. 

( (See also corrosive sublimate.) Albumin, demulcent 



drinks, opium or belladonna. 

timulants and cathartic agents 
micaliy, with morphine, if needed. 



< Stimulants and cathartic agents, atropine hypoder- 



Stimulants, digitalis, atropine, artificial respiration, 
hot and cold douches, ergot. 



IKmetics or stomach-pump, coffee, exercise, friction 
or flagellation, caffeine by the rectum, atropine 
hypodermically, faradization, artificial respiration, 
warmth, permanganate of potassium. 

f Old oil of turpentine; sulphate of copper. Avoid oils 
X and fats. Transfusion of blood. 

•j Chloral, bromide^, morphine. 

i Atropine and morphine hypodermically, stimulants. 

■j Soluble sulphates, demulcents, anodynes. 

f Table-salt, chlorides, demulcents, potassium iodide. 

Ligature of limb, with application oi cuppmg glass 
or caustic alkali. Ammonia inhalation, stimulants. 
Artificial respiration. Heat to surface. Solution 
of potassium permanganate injected into the 
wounds. Digitalis or ammonia hypodermically. 

( Chloral, potassium bromide, chloroform by inhalation. 



/ Strophanthus. hot applications, and cardiac stimu- 



alkalies, tannin, alcoholic stimuUints. 

trophanthus. hot applications, an 
X lants; strychnine hypodermically, 

-j Magnesium sulphate, demulcents, opium. 

{Diffusible stimulants, caffeine; rest in recumbent 
posture. 

{Spdium carbonate and demulcents; anodynes if 
needed. 



70 



PHARMACOLOGY AND GENERAL THEBAPEDT1C8. 



GENEBAL THEEAPEUTICS^ 

Therapeutics is the application of knowledge to the treatn 
the sick. It comprises in its widest scope everything relating to t. 
vention, cure, or alleviation of disease. The special pharniaceutical 
employed in the treatment of sickness in the human subject, taken 
aggregate, constitute the Materia Medica. Among these are many im 
elements and their compoujids; but by far the larger proportion ii 
up of orgiiuic sub?taiu't'9, espeeially certain veua'table structures, 
crude drugs and their derivatives form the principal part of the ^ 
classes of official pharmaceutical preparations. A smaller portion : 
plied by animal bodies, such as the organic extracts, antitoxins, di| 
ferments, etc. 

The drugs and preparations which constitute the United States 
macopceia are, in this country, spoken of as official. All other re 
are unofiBcial. In the following pages the remedies of the British PI 
copceia are also systematically considered, but these are only official 
the British standard authority govema. The official remedies repre 
select class of therapeutic agents, the value of which has been estat 
by careful investigation and clinical experience. The results of the 
lent work of the Committee on Revision of the United States Pharmac 
deser\^e high appreciation. 

The Materia Medica does not represent the sum-total of the reai 
of modern medicine. In addition to his knowledge of the action of 
the physician must understand the value of hygienic measures, whic 
greatly to the comfort of the patient and facilitate his recovery, 
human body is an assemblage of organs designed collectively as a 
paratus for the transformation and evolution of energy. The activ 
the vital forces gives the living body recuperative power which, when 
erly directed, tends to restore disturbed functions to their normal i 
tions. A knowledge of physiology often enables the physician to anti* 
Nature's methods and to place the patient under circumstances most : 
able for his recovery. 

Modern therapeutics is not based upon mere theory, but upon a i 
tific foundation of physiologic experiment and clinical experience, 
maeology is afHliated with the other natural sciences, and its facts, i 
are determined by true scientific methods, are capable of demonstrati 
the laboratory and clinically. They also agree with the general expei 
of mankind. In his early struggles for existence man learned by ace 
the medicinal qualities of mineral springs and some vegetable substc 
In the course of centxiries the elTecU of these drugs became tlioroi 
established by experience, and their application to bodily disorders 
better defined. It ip to be not<?d that these actions of drugs upor 
human body and its functions are elementary facts and are essential < 
acters of the substances in question. They are supported by the 
character of evidence as the statement that sugar tastes sweet or qu: 
bitter. Tlicy are true bincheniical phenomena or physiologip reactions. 

The influence of the mind upon the body, especially during the 
of strong emotions or of subconscious attention, is fully recognized 
pathologists and clinical observers, as a cause of disordered function, 
as aphonia^ paralysis of sensation or motion, and various neuroses. It 




GKXaUL TnERAPBrTICS AND CLASSIFICATION' OF HEMEDIES. 



71 



kca wbown by experience that, frequently, such eases may be cured by 
f^ggvtion, or br simply acting on the mind of the patient. The practical 
to be learned is that the mind is a powerful factor in causing or 
miy^nf^ 'listurbances of the bod)*, and, on the other hand, is a very 
• t in thernpoutic<. The oinincnt Dr, Rusli appreciated this 
• ligfc lie always, when giving a remedy to a patient, took particu- 

kretr* ^-i**- ui»on the iiulividuarsj mind ihe etfet-is whirh he expected 

Id Calk -^ _.^ --imimBtration. This practice is now followed by many, who 
iR ockiioTledged to be the most successful exponents of modem medical 

It hss often been observed that among patients of highly developed 
«siw» organization the adniiniPtration of s<'»me almost inert remedy, or 
eitn the nee of some mysterious agent (such as Perkins's tractors, Hay- 
fVth'ft imitation tractors, the iron ring for rheumatism, the horse-chestnut 
m potato carried in the pocket for other disorders, amber necklaces for 
tH^ ete.) may be followed by apparently m&rvelous results. The eminent 
Amentmn &argeon, Joseph Pancoast, in lecturing to his class, pointed out 
tet fame patients suffered discomfort or disease, without having any bodily 
lacr' -; --' he insisted upon the clinical fact that, whether a man be 
9tk or in his mind, he is sick, and appropriate treatment should 

W Adxmiujtcrcdy physics for the bodily sick; psycho-therapy for the mentally 



Tbcre can be no success in therapeutics without recognizing the im- 

of the psychical factor in disease. Sometimes a sudden mental 

win restore speech to an aphonic patient, or it may be expectant 

-'one that accomplishes the result. Sir Humphry Davy reported 

m . :\js case of a paralytic patient, who remarked, after experiencing 

the Eoei seneation of having a clinical thermometer placed under hia 

that he felt better. I'pon repeating the procedure daily he steadily 

and fully recovered at the end of a fortni;?ht witliout any other 

t.* Patients of neurotic ancestry, without being actually insane, 

haTe dehision?, or morbid fears, about their health. In such cases, 

m called the moral treatment is of the highest importance. In order 

to obtain the best results in therapeutics, it is essential that the physician 

^alJ oae every prop<'r means to secure the confidence and co-operation of 

tka patient. Expectant attention is aoknowleged to be a powerful thera- 

' a ' "^' '-^tion undoubtedly has a strong influence, and is a 

ir ■ I be reckoned with. 

Diaea^^ «» frvq\ienily causcKl or maintained by certain states of the 
^li|^* These may be provisionally divided into three classes. 1. Those 
^^^■kich there is a diminution or absence of certain principles in the blood 
^Pln are necessarj* for cell-development and metabolism. Thus, a peculiar 
^CivWd condition (cachexia stnimipriva) has been observed to follow re- 
r^avsl, or destmction by disease, of the thyroid gland, apparently because 
Aa kh>od is deprived of some important constituent or internal secretion 
aUdi this gland elaborates and which is necessary to health. This con- 

>nft Connecl(*d with the Hi«lory and Practice of Medicine and 
^^^. . ^ JciKr])h Pettigrew, Philndelphia, 1844. 

I from on «ddre*« on "Our Thcrnpeutics," delivered bv the author 
^^f, ■ .\t9! Menliral Society. Journal of th^ American Urdica) AnnoHation, 

ins a, 1H?|P. 





78 



PHAHMACOLOGV AND GENEIUL THERAPEUTICS. 



dition has been bIiowq to be amenable to treatment by means of 
extract obtained from the organs of sheep. When we treat anaem 
iron, rickets with lime-salts, scurvy with lemon-juice, or neurasthen 
hypophosphites. this principle is followed of supplying to the blood 
proximate priiiriplis wliicli arc needed for healtliy inetaboliBm. Sii 
we may siipfiiy ?ome suliPtuucv which tlie lilfHtd need:? to enabi 
resist infection or throw off the consequences of infection. Thui 
toxin is used in diphtheria and similar bodies in er3'sipelas, tetanus, t 
fever, pla^e, pneumonia, tuberculosis, cholera, and yellow fever. 2. 
is another claes of cases in which certain elements normally present 
blood are in such excess as to cause symptoms of disorder. Tn di 
for example, there is an excess of glucose in the blood, and the n 
manifested in glycosuria. In gout and litha-mirt, we have evidence of 
of uric acid, or of other compounds of the xanthin group. In jauudic 
is biliary }dg[nont in tlie t ireiiliitinLT fluid. The oliji^et el Ireatni 
such cases is to diminish the quantity of the pathogenic element by t 
istering drugs which reduL-e produrtidn and auginrnt excretion, thus ] 
the patient in a condition a|)]tniachiug the noruial. 3. In a third 
there are present in the blood substances which are not among its or 
constituents and which cause disturbance of cell-action (alcohol, nii 
muscarine, metallic poisons, etc.). There is a large class of substan 
bacterial origin which cause symptoms of disease when introduce* 
the blood. In addition to the group of infections diseases, which are 
lar instances, there are also toxins absorbed fi-i>m the alimentary tra( 
productive of symptoms, the origin of which is often overlooked, 
eczema may be produced in this manner. A case has been reporl 
which, after the removal of a Fallopian tube, which was distended witi 
a lupus of the face underwent a spontaneous cure. Albuminuria it 
wise occasionally due to toxins. In all these instances it is seen that 
the active cause of the disease is recognized and removed the symptom 
disappear. How drugs may be utilized in bringing about this result i 
be the object of therapeutics to show, as vriU he made manifest in th 
lowing sections on tlic uses of drugs. 



TlIEIlAPEUTIC T'LASStFICATION OF EeMEDIES. 



Classification has been found as difficult in Materia ilcdica as in 
other bnnicii of natural science. It is impossible to mark out. with e: 
tudc, definite linuts to the action of drugs on account of the fact that 
often simidtimeously influence different organs ami functions. If. fron 
point of view, a medicine Ije described as a diuretic, fnini ani'thcr s 
point it might I>e no less jireperly jtlaoed among the carthiirtics or diajdior 
When we seek to understand the mechanism of its aeti(»n and its intli 
upon the composition of the urine, we must also study its effect upoi 
central nervous system, the cardiac nerves and ganglia, the heart-mi 
and tlic muscular coat of the arterial pystcm. The orgaiLs couccrne 
sanguification may likewise be affected, and this result is evidenced hi 
changed projHiriion of the urinarv constituents. If a drug specially 
press(^s the chief nerve-centres, its range of rniluence must extend moi 
less powerfully and direetly to every important organ. It need not, 




OBXC&AI. TlCClUPElTlCd AND CLASSIFICATIOX Of R£M:KD1K^. 



^tore, meKtn stmn^ that no elassiiicatiou of remedies has received imiversal 
sspfdfft. In »J(*5*^^riliing iht- [irciMi-rtiei? and applicfltiona of drug3, the alplia- 
fctfbi w i arrui^einent i« here adopted, as it is the moet simple and it facilitates 



Dillervnt methods of classification of the articles of the Materia Medica 
employed for different purposes. Thus, a botanical basis may be 
or tlni^s and preparations may be arranged according to their 
and pharmaceutical relations; or remedies may be classified ac- 
cording' to their most prominent physiological or therapeutical effects. It 
BfacTsllT Teccpnized that drugs affect function because they contain cer- 
tUB prQXimate principles, or extractives, by virtue of which they produce 
dwir pbjmoloincai action and iheir therapeutical powers. A cinchona-tree 
vtadi fe prown in a botanical garden, and on this account contains no 
■BBUkr ■ ark. will have no medicinal value, and preparations of such 
lark tri. ■. no thorapeulit' i^ffect, except it may bo through mental im- 

■WMiim^> upon the patient who thinks that he has taken an antiperiodic. 
la pac«inir. it may ble nientionc<] that one of the great sourtrs of fallacy in 
dsaical therayjeutics exists in the varying quality of drugs and the conse- 
fmut uncrrtainty as to their effects. This may be obviated to a large 
dteot bj n£ing precautions to obtain only the best quality of drugs and 
Ife vmtf what are called etandardized preparations, in which the proportion 
^ tile active principle is ascertained and guaranteed to be uniform. 

It ift only proper to state that the therapeutical classification is ncces- 
mw^x- -.iiU- ,» general one, and many exceptions can be taken. Especially 
<1 that it is not to be inferred that this classification is ex- 
Mc, ati>j iuat, because the principal action of a remedy under ordinary 
»tanees is sm-h as to warrant its being placed under a special head- 
, it might not also be entitled to a place under another heading. This 
Ity arises from the multiple action of drugs, and that they often 
aet opon Mveral organs :simidtaneously. Thus a drug, like quinine, may 
ta an antiaeptic and it may also be a stimulant, or an antiperiodic. As an 
abdentnl effect it may act as a depressant or cause certain eruptions on 
tfe ckin. Th<^ oil of turpentine is an antiseptic and a stimulant to the di- 
fcstiTe or^ns and the heart, it is also a diuretic; but it is capable in some 
ciMs of cauainK toxic symptoms and general inflammation of the skin, or 
dSB^nrr atid nephritia. even from small doses. With reference to this 
feenliar ility of individuals to the action of drugs, called 

fv oiL« i-y. no satisfactory' explanation can be given. 

opici! id of acting as a narcotic as it generally does, sometimes 

> aa a 51.: :: morphine in some individuals causes wakefulness and 

Liting and annoying itching of the skin. Cannabis Indica may cause 
SDfitaa and ncn'nus excitement instead of soothing the nervous system. 
haoAie eaa»e» alcuhol acts like a narcotic poison, in others it produces acute 
'•ration of the actions of dnigs in the next section 
»▼ »i 1 be referred to. Enough have been mentioned here 

that classification of drugs according to their effects 
IS only tentative and suggestive at the best, and is 
;t to many <orn.»ctions as applied to individual cases. The therapeu- 
..irirj- aw ]ir. of the incidental effects of drugs, is constantly on the alert 
inent when they are manifested. 
- i...i. |)ft divided into classes (after Garrod): — 





76 



PHARMACOLOGY AND GENERAL THEBAPEUTICS. 



The alkallfs coniliinr* with and neutralize acids. Tiieivft 
■usoful in overcoming hyfJtnacidity of the fitomacli, whether due to 
fcssive production of hvdrocldoric acid or to fermentative chang 
the proiliutioii of fatly acids. Thov ]>rojiiiite the gecretiou of acid, 
sti'ain tliat of alkaline, fluids. Hence, when administered imn 
before a nual. an alkali e.xcites a flow of gastric jiiiee, and, in t\ 
promotes digestion and h ger^-iceable in dyspepsia. On the othc 
given immediately after a meal, such a ivmedy, by neutralizing 
trie juice, corrects hyperacidity and relieves the symptonis of indi 
it may, however, embarrass digestion and favor fermentation. 
readily he understood, therefore, how the prolonjjed nso of alkalies 
]>opsia at length diporders appetite an<l aggravates the condition fo 
they were originally prescribed. A dilute alkaline solutiou chrcki* 
charge of acute eczema, which posseBses the j^nme reaction : it all 
itching and smarting of this disease, nr the Iturning pain of superfieii 
and scalds. Para-tithe^in, whether deiiendent u]M>n L'nn:?titutional * 
or excited by local causes, is often anu-nnble to the intluence of an 
lotion. The same pre])aration is beneficial by neutralizing acid so 
from the bowel, vaginn. or the ^kin, and obviating their elTccts. Pr 
administration of an alkaline remedy may lie injurious and give rise 
elation iiml <iehility from the a<*eelerated disiiitcgralion of nitrogenoii 
These remedies aid in the resolutiou of inlhnnmatory exudations. 

A diminished alkalinity of the blooil in rheumatism and gout ia 
caused by the pivsenee. respectively, of laetic or uric acid, with ot 
crementitious substances, in excessive (pmntity. The alkalies are 
tageiuia in tliese diseases, ctmibintng witli the jieitl and facilitating i* 
ination. The siime result takes place in the urine. The reaction 
fluid being rendered alkaline, uric aeid is disstdved rir forms solubi 
biniitionSj irritatiim of the urinary tract is rjuicted, and the precipitu 
the uric acid in the kidney or Idadder is preventtnl. Alkalies are usefi 
ft uric-acid calculus is ]>resent. They luay be able to dissolve a sm 
soft stone. At all events, they ]jrevent further dc])osit nnd ndieve 1 
extent the irritation, which tlie foreign body and acid urine have i-»ccfi 

Alkaline remeilics consist of: potassium hydrate, potassium ca: 
nnd bicarbonate, sodium liydrate, sodium carbonate and bicarbonate, 1 
carbonate, calcined magnesia and n^agnesiuin carbonate, lime-wate 
eipilated calcium carbonate, and prepared thalk. The combinati 
potassium, sodium, Mid lithium witli the vegetable iicids do not act a 
lies in the stomaeh, luit. being convert<:*d into carbonates in tlie bloo^ 
alkalinize the urine as they esca])e from the svrstem. Finally, an nlki 
as n chemical antidote in |)oisnning by an aeid. 

Acids. — When given after meals, these supjdy tlic arid medium in 
pepsin is ctTicient, They, therefore, improve the appetite and digestic 
are useful in digestive disorders. They promote secretion and allay 
and nausea. Administered before a meal. i»y reducing the secretion ( 
by the peptic glands, and by ]ireventing fermentation, they check 
acidity of the stomach. Tlic niinerfil acidic possess astringent pro] 
and are of service in lessening hfcmorrhagep. morbid secreti<*ns. an 
charges. They are, likewise, usually antisc]>tic: they disinfect the a 
tary canal and restrain deleterious feritH'ntnti«m of its contents. Is 
centrated form thev act as esclmrntics. 




G£N£RAL THSRAPEUTICS AND CLASSIFICATION OF REMEDIES. 75 

Irritants are applied to the skin in order to produce nervous and vas- 
cular reaction. According to the degree of their action, they are classed as 
nibefaeients, or those which simply redden the surface; epispastici (or 
Teneantt), those which occasion blisters; and pmtulanti, which excite suffi- 
cient inflammation to form pus. The rubefacients most in use are mustard, 
capsicum, arnica, turpentine, chloroform, ether, and iodine. Among ves- 
icants are ammonia, cantharides, euphorbium, mezereum, and iodine. The 
principal pustidants are tartar emetic, croton-oil, and silver nitrate. The 
prolonged application of a rubefacient often gives rise to a blister. 

Escharotict or canstici destroy tissues and lead to the formation of a 
slough. The principal escharotics are : liquefied phenol, glacial acetic acid, 
chromic acid, strong mineral acids, caustic potash, caustic soda, and the 
galvanocautery or actual cautery. 

Local sedatiTes diminish nervous and vascular excitement in the part 
to which they are applied. They consequently relieve local inflammation and 
pain. Among agents of this group are bismuth, acetate of lead, aconite, 
cocaine, opium, belladonna, etc. 

Bmnlcents are bland substances used to protect, mechanically, the gas- 
tro-intestinal tube from contact with irritant poisons, to allay inflammation 
of the same canal, of the respiratory or genito-urinary passages. Many of 
them possess some nutritive value. This class embraces acacia, flaxseed, elm, 
m&rshmallow, Iceland and Irish moss, starch, gelatin, olive*oil, etc. 

Emollients axe applied to the external surface. They resemble de- 
mulcents in being of a bland, soothing character, protect the surface from 
friction and from air, relieve tension, and diminish pain. Among emollient 
Hibstances are : lard, olive-oil, spermaceti, glycerin, starch, cacao-butter, etc. 

Local Astringents and Styptics. — The astringents and acids, which are 
useful in checking haemorrhages and morbid discharges when administered 
internally, usually have the same effect when locally applied. 

Antiparasitics. — The term antiparasitic, or parasitieide, is generally 
restricted to agents which have the jxjwer of destroying the animal and 
Tp^etable parasUes which may infest the exterior of the body. The prin- 
cipal antiparasitic remedies are: sulphur, iodine, salts of mercury, lique- 
fied phenol, and boric acid. 

ttsmatinicB are given internally to influence favorably the composi- 
tion of the blood. ITseless, or even deleterious in health, such a drug 
tends to improve, in ceriain diseased states, the quality of the blood, and, 
consequently, the nutrition of the entire organism. D^truction of its cor- 
puscular elements and drain of its albumin indicate that the nutrient fluid- 
tissue urgently requires increased and appropriate pabulum. Remedies be- 
longing to this class are, or contain, normal constituents of the body, and 
are necessary to the maintenance of structure and the performance of func- 
tion. Prominent among the ha»matinics are preparations of iron, manganese, 
codliver-oil, other animal and vegetable oils, and a good diet. 

Alkalies. — When alkalies, in concentrated form, are brought into con- 
tact with animal tisues, they enter into chemical combination with the 
ongen present, and thus give rise to an active necrosis, or destructive in- 
flammation. Alkalies are, likewise, solvents of albumin. These physical 
and chemical properties render the caustic alkalies useful in producing pow- 
erful counter-irritation. Their escharotic effects have been made use of in 
chronic synovitis, myelitis, and meningitis, and in the destruction of mor- 
bid tissue, whether of neoplastic or inflammatory origin. 



78 



PHARMACOLOGY AND GENEIIAL THERAPEUTICS. 



Alteratives counteract the effects of various forms of toxemia, 
of chronic malaria, sypliilis, scrofula, tuherculosis, carcinoma, and 
mineral poisoning. 

The principal agents of this clafs are : gold and sodium ohlorid 
arations of arsenic, propnrntions of mercury, preparations of iodin 
form, iodol, potassium chlorate, antimony, inexerouni, sulphur, su 
colchicum, guaiacum, sanfruinaria, xanthoxylum, calcium chloride, st 
sarsaparilla, codliver-oil, and phosphorus. 

Exhilaranta determine an active cerebral cirouktinn and stimu 
functions of cerebral centres; but if administered for loo long a ■ 
in excessive quantities, a depresing effect is produced. The effect n; 
higher is reflected to the lower centres, the heart strengthened, the : 
tion deepened, and muscular vigor promoted. Substances belonging 
class support the system under prolonged and unusual strain, and ai 
useful in the trentmciit of mental nlienation. Among exhilarants 
ranked the prepnrationj? of belladonna, hyoscyamus and stramoniun 
tea. coffee, tlie primary action of ether, and alcohol. 

Hypnotics and Anodyiies. — Hypnotics cause sleep, anod^-nes alia 
Sound sleep obliterates the perception of pain; the relief of pain, 
other liand, permits sleep. A close rehitionsliip exists, therefore, h 
these remedies. An hvpnotie will often abolish pain, while an anody 
frequently overcome wakefulness. In some suhstatices, however, Ih 
notic, and in others the anodyne, influence is more conspicuous. 
sleeplessn(*ss depends upon anxiety, mental excitement, or prolonged 
lectual effort, the treatnumt differs from tliat to be adopted when int 
is due to pain. Hy]>noties act chiefly by influencing the circulation tl 
the brain, nnodnies by their effect upon sensory centres. 

The chief romedies belonging to this class are : opium, chloral-h; 
ehloralamid: potnssiuui, sodium, and ammonium bromides, acetone, a 
paraldehyde, ethvl carbamate, sutphonelhylmetliane. and sulphonm€ 
'AnBEsthctics. — Agents of this class abolisli consciousness and sen 
bv inhibiting the functions of the liigher cerebral centres. When th* 
fluence is continue<l. the sensory and motor centres of the spinal coi 
of the medulla oldojigata are, in turn, affected. The first result of 
inhalation is a stage of intellectual, emotional, and motorial exeit4 
This is succeeded by a stage of narcosis. Anaesthetics destmy life by' 
ysia of the centres situated in the medulla oblongata. Thev are em] 
for the purpose of relaxing spasm and producing a condition of x 
sciou8ne?s, during wliioh suririea) oi^erations may be painles<lv perfo 

The chief memhrrs of this group are: ether, chloroform, ethyl-brc 
ethyl chloride, anil nitrous oxide. 

Spinal Stimulants. — Agents belonging to this chips, when givi 
medicinal doses, exalt the functions of the cord, invigorate the aetii 
the heart and lungs, and promote secretion and nutrition, by influe 
gastric motion and peristalsis. 

These remedies are useful in atonic dyspepsia, atouy of the bo\i 
bladder, cardiac weakmess, emphysema, neuralgia, spinal neurasthenia, ] 
ysis, and phthisis. 

The principal members of this group are: nux vomica and its re 
dpecies, ignatia. and alcohol and camphor in small doses. 

Spinal Sedatives. — These are substJinces which have the properl 



OSXC&AL TUUUPEUTICS AXD CLASSIFICATIOX Of tlKUi;DIKS. 



79 



the fnnctions of the spinal cord. They may act directly upon the 
lis or proiiace tlieir effect by an influence on the circulation through 
te eord. Ejiceseive doses cause paralysis. Spinal sedatives are valuable in 
of irritation, or congestive excitement, of the cord. The chief 
beloQ^ng to the gfoup are; potassium bromide, sodium bromide, 
petsemiucu. oonium, hydhx-yanic acid, potassium nitrate, physostig- 
\ ■■* aAiirA'late, and tobacco. ^lagnesiiun sulphate, when injected into 
ypouil Ci>rd. \s a powerful sedative. 

Aatispaflxnodios. — Antispaf^modic 'drugs allay irregular action of the 

tr - involuntary muscles by a calmative influence upon nerve-cen- 

i!>* of use in many disorders characterized by nervous excite- 

K At) ^i>asm. 8uch as hysteria, colic, asthma, and intc^stinal 

T' . /al antispasmodic remedies are: ammoniated valerian, 

CAmphor, musk, castor, and ether. 

. — Tonics improve appetite, digestion, assimilation, and secre- 

ana,. «trra^tben the circulator}* apparatus, improve the composition of the 

kked, invigorate the muscular system, and promote the nutrition of nerve- 

and fibres. The most powerful members of this class also possess 

IKhdlir • - Tonics are useful in the treatment of digestive dis- 

in li* 1 conditions of tlie nervous system and nutrition in gen- 

«ai« and in •li^^aiics characterized by periodicity. The former variety 

: gentian, calumba. chirata, serpentaria, and eucal\'ptus. The prep- 

of iron and manganese act as tonics when the quality of the blood 

impairv-d. Certain mineral salts, as zinc oxide, silver oxide, and zinc sul- 

•^ exert a similar influence in nervous affections, as chorea and epilepsy. 

Ywrnlf r Stimulants. — Memliers of this class stren^hcn the action of 

^ baart an*l blood-vessels. Tbey are, therefore, advantageously employed 

^wmtkeati' ions of the central organ of tJie circulation, in transuda- 

ih« dor Xr. lams. and in liaMuorrhage. Chief among vascular stimu- 

latsar '1, preparations of ammonium, caffeine, convallaria, digitalis, 

tfTopha: ind scoparius. 

Vascular Sedatives. — Tbese remedies render the heart's action more 
^rm aad Irt* forcible. They moderate cardiac excitement, and are of service 
« ftArrile and intlnmmiitory affections of n sthenic t>'po. Examples of this 
1^^ - iite, veratrum, gelsemium, antimony, muscarine, jnlocarpine, 

^ . :c acid. 

fitalagosaea. — Sialagogues excite the secretion of saliva, either by an 
sinsTiT lAcnl eilect, with a reflex stimulation of the salivary glands, or by a 
^- 'iienoe upon the glands during their elimination. Examples of 

^ ;, . .... . varifty are: capsicum, mustard, ginger, pellitory, and mezereum; 

V the lattrr: preparations of iodine and mercury, pilocarpus, muscarine, 
phTao^tisiTia, 

^tiaialiea check salivar>' secretion. Tliis is the action of belladonna, 
and pot lilorate. 

letiea. — cause vomiting, either by irritating the terminal 

of th- nerves or by exciting the nervous centre which pre- 

ihr .; MU'sis, Rem«Mli»*s which act by direct irritation aro; 

copper sulphate, zinc sulphate, and mercuric substilphate. 

•--^nj t-r -»r-iomic L*melic8 are; aiwmorphine, ipecacuanha, tobacco, and 

«rlar emetic. 

Aati-einetiea allar irritability of the gastric nerves or the vomiting oen* 





78 rHAHMACOLOGy AND GEVEUAL THERAPEC 

Alteratives counteract the effects of various forms of toxEBuiia, 
of chronic malaria, eyphilis, scrofula, tuberculosis, carcinoma, and 
mineral poisoning. 

The priiieifjiil agents of tliis class are : gold and sodium chlorid 
arations of arsenic, proparntions of mercury, preparations of iodin 
form, iodol, potassium elilorate. antimony, niezereum. sulphur, su 
colrhicum, guaiacum, sanniiiri^i'i'i. xantlmxyluiu, calcium chloride, at 
sarsjipfirilla, cotiliver-oil, and phosphonis. 

Ezhilarants determine an active een-brnl circulation and stimu 
functions of eeix'bral centres; but if administered for too long a ' 
in excessive quantitie?. a depresing effect is produced. The effect m 
higher is reflected to the lower eentreta, the heart ehvngtliened. the 
tion dee])encd. and muscular vigor promoted. Substances hojonging 
class support the system under prolonged and unusual strain, and ai 
useful in the treatment of mental alienation. Among e.xhilnrnnts 
ranked tlie preyxiration? of hr"lladi>nna, hv^^Rcyamus and stramoniun 
tea, cofTee, the jirimnry action of '4her. and alcohol. 

Hypnotics and Anodynes. — Hypnotics cause sleep, anodynes alia 
Sound sleep obi iterates the perception of pain; the relief of pain, 
otlier hand, permits sleep, A chise rehitioufhip exists, therefore, fc 
these remedies. An h\7inotic will often abolish pain, while an nnody 
frequently overcome wakefulness. Tu some substances, liowever. th 
notic, and in others the anodyne, influence is more conspicuous. 
sleeplessness depends upon anxiety, mental excitement, or prolonged 
lectiial eiTort. the treatment differs from that to be adopted when ini 
is due to pain. Hypnotics act chiefly by influencing the circulation tl 
the brain, anodynes by their effect upon sensory centres. 

The chief remedies belonging to this class are: opium, chloral-h; 
chloralamid : ])otnssiunu sodium, and ammonium hromi4les, acetone, a 
paraldehyrle. ethyl Ciirbamate, sulphonctliylmethane. and sulphonmt 
'Ansesthetics. — Agents of this class niKilish consciousness and sei 
by inhibiting the functions of the higher cerebral centres. Wlicn tb 
fluence is continued^ the sensory and motor centres of the spinal coi 
of the medulla oblongata are. in turn, alTe<:*ted. The first result oi 
inhalation is a stage of intellectual, emoliomil. and motorial exciti 
This is succeeded by a stage of narcosis. Anaesthetics destroy life by 
yais of the centres situated in the medulla oblongata. Thev are era] 
for the purpose nf relaxing spasm and i>roducing a condition of x 
sciousness, during which surgical o]nTations may be painlessly perfo 

The chief memlnTs of this grou]> are: ether, chloroform, cthyl-brc 
ethyl chloride, ami nitrous oxide. 

Spinal Stimulants. — Agents belonging to this class, when giv» 
medicinal doses, exalt the functions of t!ie cord, invigorate the aeti 
the heart and lungs, and promote secretion and nutrition, by influe 
gastric motion and peristalsis. 

These remedies are useful in atonic dyspepsia, atony of the hmi 
bladder, cardiac weakness, emphysema, neuralgia, sj>inal neurasthenia, ] 
ysis, and phthisis. 

The principal meml»er-i of this group are: nux vomica and its r€ 
rfpecies, ignatia. nnd alcolml and camphor in small doses. 

Spinal Sedatives. — These are substances which have the propen 




GEXERAL THEaAPEDTICS AND CLASSIFICATION OF REMEDIES. 79 

reducing the functions of the spinal cord. They may act directly upon the 
nerve-cells or produce their effect by an influence on the circulation through 
the cord. Excessive doses cause paralysis. Spinal sedatives are valuable in 
conditions of irritation, or congestive excitement, of the cord. The chief 
remedies belonging to the gfoup are : potassium bromide, sodium bromide, 
lohelia, ^Isemium, conium, hydrocyanic acid, potassium nitrate, physostig- 
mine salicylate, and tobacco. Magnesiimi sulphate, when injected into 
the spinal cord, is a powerful sedative. 

Antispasmodics. — ^Antispasmodic drugs allay irregular action of the 
voluntary- or involuntary muscles by a cahnative influence upon nerve-cen- 
tres. They are of use in many disorders characterized by nervous excite- 
ment and muscular spasm, such as hysteria, colic, asthma, and intestinal 
colic. The principal antispasmodic remedies are: ammoniated valerian, 
asafetida, camphor, musk, castor, and ether. 

TonicB. — Tonics improve appetite, digestion, assimilation, and secre- 
tion, strengthen the circidatory apparatus, improve the composition of the 
blood, invigorate the muscular system, and promote the nutrition of nerve- 
centres and fibres. The most powerful members of this class also possess 
antiperiodic virtues. Tonics are useful in the treatment of digestive dis- 
orders, in depressed conditions of the nervous system and nutrition in gen- 
eral, and in diseases characterized by periodicity. The former variety 
includes : gentian, calumba, chirata, serpentaria, and eucalyptus. The prep- 
arations of iron and manganese act as tonics when the quality of the blood 
1$ impaired. Certain mineral salts, as zinc oxide, silver oxide, and zinc sul- 
phate, exert a similar influence in nervous affections, as chorea and epilepsy. 

Vascular Stimulants. — ^IVIembers of this class strengthen the action of 
the heart and blood-vessels. They are, therefore, advantageously employed 
in weakened conditions of the central organ of the circulation, in transuda- 
tion due to blood-stasis, and in haemorrhage. Chief among vascular stimu- 
lants are : alcohol, preparations of ammonium, caffeine, convallaria, digitalis, 
^rophanthus, and scoparius. 

Vascular Sedatives. — ^These remedies render the heart's action more 
«Iow and less forcible. They moderate cardiac excitement, and are of service 
in febrile and inflammatory affections of a sthenic type. Examples of this 
class are : aconite, veratrum, gelsemium, antimony, muscarine, pilocarpine, 
and hydrocyanic acid. 

Sialagogues. — Sialagogues excite the secretion of saliva, either by an 
irritant local effect, with a reflex stimulation of the salivary glands, or by a 
specific influence upon the glands during their elimination. Examples of 
the former variety are : capsicum, mustard, ginger, pellitory, and mezereum ; 
of the latter : preparations of iodine and mercury, pilocarpus, muscarine, 
and physosti^rma. 

Antisialics check salivary secretion. This is the action of belladonna, 
opium, and potassium chlorate. 

Emetict. — Emetics cause vomiting, either by irritating the terminal 
filaments of the gastric nerves or by exciting the nervous centre which pre- 
sides over the act of emesis. Eeraedies which act by direct irritation are : 
alum, mustard, copper sulphate, zinc sulphate, and mercuric subsulphate. 
General or systemic emetics are: apomorphine, ipecacuanha, tobacco, and 
tartar emetic. 

Anti-emetics allay irritability of the gastric nerves or the vomiting cen- 



80 



PHARMACOLOOY AXD OENERAL THERAPECTIC8. 



tre. Bismuth, cerium oxalate, creosote, carbolic acid, chloroform 
caloiDol, an*l silver nitrate soothe gastric irritatiou. Opium, hydi 
acid, bromides, and chloral-hydrate quiet the excitement of this nerv( 

Purgatives jtrodiice evacuation of the intestinal canal by im 
secretion, or transiidfltion, along the tract and l)y excitin^^ perigtalti 
mentfl. According to the intensity of their action, pur^mtives or ca 
are subdivided into several varieties' 1. Laxiitivc^ cause fiiight inc: 
secretion and perisitalis, resulting in softened jitools. Among laxat 
ranked nmnna, sulphur, figs, prunes, olive-oil, rhnnwuis purshiani 
eyamus, sfiap, etc. 2. Simple purgiitivi-s. or purgatives ]iniper, are ii 
cidedly stimulant, and oecnsion seiniliquid motion*. Belonging to thi 
are: senna, aloes, rhubarb, castor-oil, and calomel. '^. Drastic cathai 
strongly irritant to the intestinal mucous menihrsnc. and occasi- 
transudiiti'Hi from its ves?;t'l? and uhnost fluid stools. The nclifm of 
ie often accompanied by eonsitleral^lc j:ripiug ])ain. Exampb^-s of drasi 
jalap, colocvnth, ganibog*^, scanniiony, elateriuni. podophylhnn, and 
oil. Excessive doses of simple purgatives have a very similar eifi 
Hydragogue purgatives remove abundant serum from the intestinal 
vessels and protluce large, watery motions. Ebiti^'rium, cream of 
and croton-oil are ilhistrations. An analogous action is exerted I; 
ous salt^ of the alkalies and alkaline earths. Large iloses «^f the 
cathartics have t}ie effect of bydrngognes. Tlie principal saline pin 
are Radium sidi)biite» miiErnesiuin sulpliate, magnesium citrate, |>o' 
tartrate and hitartrate. and potassium and sodium tartrate. 5. Cho 
purgatives stirnukte. either directly or iiidi redly, the liver, cause 
creased flow of bile, tpiieken the peristnltie movements, and produce 
ish, liquid evacuations. Among the cholagogueii! are included some i 
mercury, aloes. euon\Tnin. iridin, rliuhnrb. le])tandra, and podophyllu 

Anthelmintics cau^o destruction or expulsion of intestinal 
Those agents which destroy are termed vernneides; those wliich ex 
kno^vn as vermifuge remedies. Tape-wonns are killed or removed by 
of aspidiiuu. kiimabi, kous?o, poniegnniate (or pr'llr-tierine), pumpki 
turpentine, ami chloroform. Remedies which act against round-won 
santonin, spigLdia. chenopodium. nnd nzedarach. Seat-worms are dei 
by enemata containing tahle-salt. tannic acid, quflssia. eucalyptol. et< 

Stomachics-. — Stomachics stimulate the gnstric muc-ous membra 
crease fl])petite, promote the secn^tion of giistric juire. and assist di^ 
Carminatix'cs restrain abnormal fermentatinn and dispel intestinal 
Among stomachics are: cnpsieum, piper, cardamom, cloves, mustar 
ginger. 

Hepatic Stimulant*. — These are medicines which excite the li 
incrciised fiiiictional activity. Thev occasion an nngmcnted format 
bile, and thus promote the normal elaboration of nitrogenous aliment 
increased quantity of bile i? not always accompanied by a eorrpspond: 
crease in the ehanicteristic bile-salts. 

The [>riiici[>al substances which increase production ipf bile are: 
hvdroehloric acid. ij>ecacnanhn, sodium ple^spbate. mennmic eh 
aloes, podophylHn, rhubarb, colocvnth. enrmymin. iridiu. etc. The qr 
of virea is inerensed by nmmoniimi chloride, arsenic, nntimony, pbosB 
and iron. The glyeo^rnnic function is stimulated by nitrohydrochJorw 
amy! nitrite, and sodinm bicarbonate. 

Hepatic Depressants. — Agents belonging to this class reduce! 




GENERAL THERAPBUTICS AND CLASSIFICATION OF REMEDIES. 81 

tional activity of the liver, diminishing the formation of bile, urea, and 
plycopen. Those which lessen the secretion of bile are : opium, lead acetate, 
alcohol, and quinine. The amount of urea is decreased by opium, alcohol, 
quinine, and colchicum. Glycogenesis is diminished by opium, phosphorus, 
Arsenic, and antimony. 

Expectorants. — Expectorant remedies modify the character of the bron- 
chial secretions and facilitate their expulsion. Small or nauseating doses of 
«^metic substances increase and liquefy the secretions of the mucous mem- 
branes. Larger dos&s by causing vomiting, mechanically aid the expulsion 
of mucus from the air-passages. The terra "stimulating expectorants" is 
pven to a group of drugs eliminated by the bronchial mucous membrane, 
which they stimulate, and the secretion of which they at the same time alter 
and improve. Certain substances, when dissolved in the mouth, aid ex- 
pectoration by a stimulating influence upon the cilia of the trachea and 
bronchi. These are called ciliary excitants. The nauseating expectorants 
are: antimony, ipecacuanha, apomorphine, lobelia, pilocarpus, etc. Among 
the stimulating expectorants are : ammonium chloride, balsams of Peru and 
Tolu, senega, squill, sulphur, and terpin hydrate. Ciliary excitants are: 
ammonium chloride, potassium and sodium chlorate, gum acacia, etc. 

Pulmonary sedativea relieve cough by allajing irritability of the re- 
spirator}' centre, or the terminal fibres of the nerves distributed to the bron- 
chi and lungs. Examples of this class are : opium, belladonna, stramonium, 
hjoscyamua, hydrocyanic acid, etc. 

Anliydrotics check excessive sweating; among them are atropine or 
belladonna, camphoric acid, mineral acids, especially aromatic sulphuric 
acid, also agaricin and adrenalin. 

Diaphoretics increase perspiration by stimulating the sudoriparous 
fflands in the course of their removal, as sulphur, guaiacum, sarsaparilla, 
-^rpentaria, mezereum, and camphor. Other agents produce the same effect 
bv causing relaxation of the cutaneous capillaries. In this subdivision are 
found the nauseants and emetics, as tartar emetic, ipecacuanha, lobelia, and 
Dover's powder, as well as opium, ether, and alcohol. A third group of 
rpmedies excites diaphoropia by an influence upon the sweat-centres, as pilo- 
carpus, veratrum, and salts of potassium. 

Diuretics. — The quantity of urine excreted is increased by remedies 
which raise general or local arterial tension, and by those which stimulate 
the secreting* cells of the kidney. The free ingestion of water assists the 
action of diuretic drugs, and is mechanically serviceable by irrigating the 
rf-nal tubules. Among the stimulant diuretics are found cantharides, co- 
paiba, cubeb, turpentine, colchicum, squill, broom, juniper, potassium ace- 
tate, and calomel. The principal agents which act by elevating blood-pres- 
snre are: digitalis, belladonna, nux vomica, and alcohol. 

Lithontriptics. — This name has been given to a class of remedies which 
increase the flow of urine, and at the same time, by modifying its chemical 
reaction, dissolve and prevent the deposition in the urinary passages of uric, 
phosphoric, or oxalic acid, or insoluble salts of those acids. If precipitation 
ha3 taken place, they are given with a view to dissolve or remove gravel or 
calculi. Potassium carbonate, bicarbonate, and citrate, and lithium carbon- 
ate and citrate are the principal solvents for uric acid. The agents which 
are given for the purpose of acting upon phosphoric calculi are : benzoic acid, 
ammonium benzoate, and diluted nitric acid. 



PHARMACOLOGY AND GENER.VL THERAPEUTICS. 



Hemostatics. — Apentg for checking pulmonflrv haemorrhage, oi 
ing excessive menstrual flow, or bipinorrhnge from the uterus at oth< 
than the monthly periods are frequently (iemanded. They may ac 
tlirough the nervous systtnn, as when atropine is injected hypodei 
or oil of erigeron administered, or they may act throuirh contractioi 
muscular fibres^, aa when ergot or stypticin is given. Cold causes vaa 
constriction, ai* when ice is applied to lia?morrhoids, or introduced i 
vagina or rectum. 

Ecbolici. — These remedies, also known as oxytocics, stimulate t\ 
nant womb to contraction. They may thus lead to abortion, if pren: 
giveOj hut, administered during labor, are often of valuable assist) 
invigorating the organ. It is sunuisod thnt eobolioB may act either 1: 
ing direct irritation of the muscular structure of the womb, or exciti 
traction through an influence upon the uterine centre in the core 
principal acholics are: ergot, cotton-root bark, nstilago, quinine, ant 

Emmenagog^ues. — Emmeniigogucs excite the menstrual ilux eil 
a direct stimulant elTcct upon the uterus or indirectly by improvi 
quality of the blood and nutrition in general. Small doses of ecbolit 
dies are usually emmenagogue. Direct cmmenagognes are: ergot, 
cantharis, rue, myrrh, etc. Indirect emmi^nagogues are: preparat 
iron and uianganeso, nux vomica, codliver-oii, etc. 

Aphrodisiacs (*xcite the sexual appetite and the genital functions 
object they accoujplish by stimnlntion. either direct or reflex, of tl 
tres which govern the genital organs. Whatever promotes uutritior 
indirectly to invigorate the sexual apparatus. The oliief aphrodisiac 
are; cantbari?, phosphorus, nicohol, camphor, and cannabis Indica. 

Anaphrodisiacs diminish st*xunl desire and power. They allay 
bility of the genital centres and diminish irritation or hypera?mia 
generative organs. Among anaphrodisiacs arc iiirhided potassium, s 
or ammonium bromide; potassium iodide: krge doses of camp! 
opium : tobncco, gelsemium, etc. Whatever depresses general systemi* 
has likewise an indirect anaphrodisiae effect. 

Mydriatics produce dilatation of the pupil by stimulation of th 
organs of the sympathetic, with contraction of the radiating fibres 
iris as a n-sult. and by pfiralysis nf the third nerve, causing relaxation 
circular filtres. The principal n^ydriatics are: atropine, eocainC; ho: 
pine, daturine, duboisinc. and hyoscyaraine. 

Myotics cause the pupil to contract by stiraiilating the circular 
of the iris. Eserine, or physostigmine, thus acts when locally applied, 
used by ophthalmologists for this purpose. Other drugs which contri 
pupil, though not administered for that purpose, are opium, pilocarpn 
muscarine. 

Antiseptics net upon pathogenetic micro-organisms, prevent 
growth and multiplication, and thus protect the system against irtft 
Tlie most valuable nntiseptics are: raerouric chloride and iodide, ci 
acid, creosote, salicylic acid, chlorine, naphthol, quinine, thymol, snlpl 
acid, iodine, iodoform, resorcin, etc. 

Disinfectants are used for the purpose of destro^nng the organic 
of disease, as they may exist in the atmosphere, clothing, water, pathol 
discharges, etc. Substances whicli accomplish this purpose are: Fort 
hyde, sulphurous-acid gas, chlorine, bromine, zinc chloride, mercuridl 
ride, etc. A high degree of heat is also disinfectant. 




GBNEEAL THBEAPEUTICS AND CLASS IFICATIOX OF REMEDIES. 83 

BoH^. — ^By the dosage of a remedy is meant the definite quantity of 
the agent required to produce a desired therapeutical result. Naturally a 
considerable margin exists, owing to different degrees of vigor in patients, 
and to the amount of impression we desire to make upon the bodily func- 
tions. It is evident, then, that, even among patients of the same age, some 
will require larger doses than others in order to produce a particular effect. 
Thus arises the distinction between the minimum and maximum doses, the 
former being the smallest dose capable of physiological or therapeutical 
effect, the latter being the largest dose which it is considered safe to give. 
The toxic dose rapidly develops the physiological action of the drug in a high 
degree, giving rise to the characteristic symptoms of poisonous action of the 
remedy. Broken or fractional doses are merely doses much smaller than 
those usually given, and intended to develop the physiological effects by 
degrees, being the reverse of toxic doses in the sense that they singly pro- 
duce no marked disturbance, and are within perfectly safe limits. In the 
following pages reference may be found to a full or single dose, the inter- 
rapted dose, and the continued dose. The full dose is the maximum amount 
which the patient will require to produce the physiological action of the 
remedy, and it is usually not intended to be repeated. For instance, an 
ounce of magnesium sulphate, or several cathartic pills, may be ordered to 
accomplish a certain therapeutical result, and, this being obtained, there is no 
need to give any more. Where the symptoms tend to recur, as where purga- 
tive remedies are required in chronic constipation, or amyl nitrite for angina 
pectoris, it becomes necessary to repeat the administration of the remedy 
from time to time, the system having opportunity to recover fully from the 
effects of one dose before another is administered. The intermpted dose 
\s generally smaller than the full dose, although exceptionally it occurs that 
by the frequent repetition of a remedy the system becomes accustomed to 
it, and larger doses are required to produce the same effect. The continued 
doie is where each succeeding dose is given before the effects of the 
preceding have passed away, so that when the intervals are short a cumu- 
lative action of the remedy is seen. The latter obviously depends upon 
the rate of elimination of the agent ; some drugs, like alcohol or ether, are 
excreted very quickly, and exert a cumulative action only when the intervals 
are very short; others, like arsenic, mercury, and digitalis, are excreted 
slowly, and may show a cumulative effect after awhile, even when only one 
or two doses are given daily. The alternating administration of drugs by 
rotation, as a practical principle of treatment, is designed to overcome the 
tendency to toleration of drugs by the system. Rotation has been advocated 
bj Ewart* on these grounds: 1. Some drugs — and these are chiefly the 
mmnlants and the sedatives — ^lose more and more of their effect the longer 
they are continued. 2. Other drugs, being slowly eliminated or distinctly 
(Emulative, acquire through prolonged administration an increased activity, 
uid in some instances a modifled, and sometimes a dangerous, action. 
3. The most active dose, in the case of any stimulant or sedative, and in that 
'if many tonics, is (putting aside summation of doses or of their effects) the 
f-ret dose. These considerations led Ewart to the adoption of a principle 
»hich may be regarded as novel, that of a systematic "rotation of drugs," 
»hiph, not unlike the farmer's "rotation of crops," rests as well as fertilizes. 

^British Medical Journal Oct. 1, 1898, p. 938. 



84 



PHARMACOLOGY AND GENERAL THERAPErXICS. 



Without advocating an excessive poiypliarmacy, it appeare ovidei 
patients may ofton be placed with advuntngG under the joint influence 
eral dnifjs; l)iit in winie cases they will derivo moyt l>cnefit from 
qneiit renewal (thanks to intervening hrenks) of the first impression 
had buen prodinvd by eaeli drug. An Jiltematins rotation- — daily, t 
or of any other i>eri()d — of tlic (lru<.'s to be administered would work 
game di reel ion. 

Systemic. Specific, and Analeptic Eemedies. — A systemic remedy 
vrhieh is not desi^ied to espoeially atTeet the organs by Avhieh it cnt< 
cirenlation, nor those by which it is finally excreted : it is given with 
of bringing about some change in the general sidids or fluids of the 
80 as to affect nutrition, and, as a rule, does tliis through some effect 
the nervous system. Remedies designed to affeet special organs, 6t 
the liver, kidneys, heart, genitorurinary tract, or alimentary canal, an 
or organic remedies. Remedies are also divided into inorganic and oi 
in relation to their nature and origin, as they belong to the mineral kil 
or to the animal or vegetable kingdom. A specific remedy is one Imvii 
p<iwer to stop tlu^ course of a particular disease and act as an antidote 
effects. Tlicre are no ''sure cures'' in nsedicine. ami no true spcvifics. 
the manifestations of malaria are so uniformlv contridled by cinchona, 
ilis by mercurv, rheumatism by salicylic ncid, and gout by colchicum 
these remedies are considered as approaching the cliaraeter of sp€ 
although they sometimcB fail, and often must be couibined with other 
dies in order to produce tlie best results. Analeptic remedies are 
whicli build up the system: they are tonics and restoratives; tliey 8tin 
the. nutritive functions, and sorue of them, such as codliver-oil, act as 

A rrmedy is sumetinies said, technically, to he ^'indicated" whe 
symptoms sli^w that tlie function of some part of the l»ody is disord 
and our knowledge of the physiologicul action and clinical effects t 
remedy indicates to us the j>rohability tliat its administration would pr 
a favorable result; thus, an emetic would be indicated in narcotic poia 
or in croup, a purgative would ho indicated in f?ecnl impaction of the b 
or in cerebral congestion ; the sponge-hnth and antipyretics are indicai 
fever. It is not meant that tliere is any mvsterions relation existing he' 
certain diseases and particulsir remedies in the sense that nature is c 
out for a certain drug, and that no utluT would he scrviceidile, or tlia 
patient would necessarily <Iic if the medical att(mdnnt failed to discer 
indication or to decipher the cabalistic inseri[>tion bv which nature tea 
skill. 

Diseases arise from ennaea ; the object of treatment is (1) to re 
the cause of disorder, if possible, and if not (2) to obviate its effects fc 
moval of tlio patient to more sanatory surroundings, or placing him i 
improved physical condition, and better able to resist the further pro 
of the disea.se: {'A) to make the pnlicTit comfortable: (4) to avert any 
tendency which may arise: rtnd (Ti) to do everything jjossible to haste; 
recovery. This is rationni medicine: it is also seientitic medicine be< 
based upon exact knowledge of the effects of drugs and other remedial ap 
From various sources an immense* fund of information has been colli 
and classified. The application of this knowledge to individual cases of 
ease constitjites the art of medicine, or practical tberapeutics. 




PART n. 

PHABMACEUnCAL THEEAPEUTIC AOEKTS, OB BBTTGS. 

In this section will be considered, systematically and in alphabetical 
order, the remedial agents or drugs in present use in the treatment of dis- 
ease. All of the drugs and preparations made o£&cial by the United States 
and British Pharmacopceias receive notice and consideration in proportion to 
their importance. Some of the most valuable of the new remedies which 
are coming largely into use by the profession have also been introduced, 
these being distinguished from the omcial agents by the absence after them 
of the letters U. S. P. or B. P. 

Each drug will be considered individually and from three different 
points of view: (1) the botanical or chemical definition and physical char- 
acters of the remedy, with the strength and dosage of its various prepara- 
tions; (2) its physiological actions, including toxicology and antidotes, with 
special effects, if any, upon individual organs and tissues; and (3) the thera- 
peutical indications, with illxistrative formulae, comments, and suggestions 
as to eligible forms of administration, or cautions concerning its use. This 
arrangement is the one which has been found by experience to be the most 
convenient to facilitate reference and study. 

ABBXJS. — Jequirity, Wild Licorice, or Abrus precatorius (Leguminosffi) , 

Pharmacology and Toxicology. — Abrus is a native of India, but grows 
f^I^ewhere in the tropics. The part used in medicine is the seed, or bean. 
These are small, nearly round, of a bright-red color, with a black spot at the 
hilum. The poisonous constituents are a globulin, and an albumose, the 
action of which closely resembles that of toxins of bacterial origin. These 
bodies, of similar chemical composition, are both extremely toxic, and their 
systemic effects have been likened to those produced by the venom of the 
snake. The temperature is lowered and the blood remains fluid after death 
(Martin and Wolfenden). The seeds do not contain an alkaloid. The 
root contains glycyrrhizin (15 per cent.) and an acrid resin (8 per cent.). 
The leaves contain 10 per cent, of glycyrrhizin. 

Therapy. — The infusion is made by triturating three seeds in a mortar 
with an ounce of cold water, to which is added an ounce of hot water. 
When cold, the solution is filtered; the resulting filtrate, containing the 
globulin and albumose, if introduced into the eye, is highly irritating, 
and sets up a purulent inflammation. It has accordingly been success- 
fully used in ophthalmological practice in the treatment of granular lids, 
or trachoma. It is applied three times the first day and repeated on the 
wrond and third days, if necessary. This powerful application should 
be made with care, since Dr. T. E. Murrell describes three cases of strict- 
ure of the nasal duct that had resulted from its careless use or too frequent 
application. Hypodermic injections produce local gangrene. 

The cases in which jequirity is apt to prove most serviceable are the 
later stages of trachoma or the fibrous state of the conjunctiva following 
trachoma. Good results also follow its cautious use in vascular keratitis 
produced by a burn. The powdered drug may be applied by means of a 

(85) 



86 



PHARMACEDTICAL THERAPEUTIC AGENTS OR DHUGS. 



camers-hair brush to the everted lid, a very small quantity being u 
first, in order to avoid an excessive reaction. Jequirity has been en 
in chronic buppurative otitis, and also in chronic metritis. So 
should be recently made, as they rapidly undergo decomposition. 

Abrus is not used internally. Injection of the infusion in 
circulatinn nf tlie Imver aiiiuials causes death by cardiac depressior 



consists of the leaves ai 

4 



ABSINTHIUlil,— European Wormwood: 
of Artemisia A1**inihiu!n (Cf^mpositje). 

Preparations. — Worniwoud has du oflicial preparations. 

Pharmacology. — An herb, bitter and aromatic to the taste, indi, 
to Europe, but naturalized in this country, and common along waysid 
contains theglucosideAbsinthinand a very bitter resin; the fomierof 
is soluble in water, alcoliol, and ether. Wormwood also contains an 
volatile oil, more in the dried plant than in the fresh state. The oil c 
largely of Thujone, or absintholf with a blue coloring principle. A li 
flavored with aromatics, called Absinthe, is used to a large extent as 
toxicant in France^ where its pernicious effects have attracted the att 
of sanitarians. The constant use of absinthe produces profound dis 
of the nervous system, epileptiform convulsions, and renders the sul 
physical wreck. These effects are similar to those produced by the v 
oil of wormwood upon the lower animals^ in which it acts as a depres 
nervous energy, followed by stupor, clonic muscular spasms, and fatal 
According to the experiments ol Cadeac and Albin Meunier upon an 
the oil of wormwood, in email and large doses, possesses decided anti 
properties. The oil is frequently adiiltcratt/d with oil of turpentine. 

Toxicology. — Poisonous elTects may be counteracted by cold affu 
followed by friction of the skin and sinapisms, with careful administ 
of ammonia by inhalation^ or by the mouth, or by injection under the sit 
into a vein. Evacuation of the contents of the stomach should be obt 
by stimulating emetics; or, if these fail, by the stomach-pump. The 
ment of abBinthism calls for hygienic and restorative measures, partici 
nerve-tonics, in addition to the usual treatment of alcoholism. The i 
absinthe as a stimulant should bo discouraged on account of the gTa\ 
terioration, moral and physical, which it produces. 

Therapy. — Wormwood has been used medicinally in the form c 
fusion (4 to S Gm. to 473 c.cm., or m-ij to Oj), b wincglassful beiuj 
dose, as a tonic or as an anthelmintic, for children. The infusion is 
wise employed as an enema for the destruction of thread-worms. 

Hiccough due to flatulent distension may be checked by the adn 
tration of a few drops of the volatile oil. The dose of the powdered I 
is 1.30 to 3.00 Gm. (or gr. xx-xl), or, of the oil, O.OC to 0.18 c.cm. {or m 

It is a domestic remedy for flatulent dyspepsia and weak digestion, 
ternally, it has been used as a stimulant application to indolent vi 
According to Dr. J, L. Corning, the volatile oil of wormwood is a vali 
local aniesthetic, and may be aerviceably applied for the purpose of relic 
rlietimatic pains. A wine slightly tinctured with wormwood, know 
Vermouth, is sometimes given to increase appetite and hasten convalesce 
Absinthin has been employed recently as a bitter tonic in doses of 0.015 
(or gr. V4 before meal's. Tlio Gorman Pharmacopoeia recogni 
extract and a tincture of absinthium. 




ACACIA, 87 

ACACIA (TJ. S. P.).— Aoacia (Gum Arabic, Oum Senegal). The dried^ 
gummy exudation from Acacia Senegal, Willdenow, or from other species 
of Abrus (LeguminossB). 

ACACIiE 0I7MUI (B. P.). — Gtun Aoacia. A gummy exudation from 
the stem and branches of Acacia Senegal and of other species of Acacia. 

Preparations. 

Synipus Acaciee (U. S. P.)- — Syrup of Acacia (acacia, 100 parts, with sugar, 800, 
and distilled water to make 1000 parts). Dose, 2 to 7.5 c.cm. (or f5.s8-ij ). 

Pulvis Cretee Compositus (U. S. P.)- — Compound Chalk Powder (prepared chalk, 
30; acacia, 20; sugar, 50). For making chalk mixture. Dose, 1.67 to 4 Gm. (or 
gr. rt-3j). 

Mueilago Acacise (U. S. P., B. P.). — Mucilage of Acacia (U. S. P. contains 34 
parts, with lime-water 33, and plain water enough to make 100 parts by weight). 
Dose, 2 to 7.5 c.cm. (or fSes-ij). 

These are the only official preparations of acacia, and are simply used as vehicles. 
The density of the solution of gum arable enables it to be used io suspend insoluble 
powders or oils; in the latter case the resulting mixture form^ an emulsion. 

Pharmacology. — Gum arabic comes in white, or nearly colorless, trans- 
lucent, irregular lumps, which are brittle, odorless, and almost tasteless. Its 
solution is valued for its adhesive qualities. Acacia also possesses some nu- 
tritive properties, and in the East it is eaten as food. It is soluble in water, 
but insoluble in alcohol. It has a faint odor and a mucilaginous, insipid 
taste. Acacia consists of a peculiar principle called arabin, or arabio add, 
united with calcium, potassium, and magnesium. Arabin is described as an 
amorphous, glassy, and transparent substance when dry and of a milk-white 
color when moist. The solutions of acacia readily undergo acetous fer- 
mentation, unless some antiseptic is added to preserve them. As a rule, they 
should be freshly made. 

Therapy. — In bowel disorders and fevers, a thin mucilage, flavored with 
lemon and sweetened, makes a nourishing, bland drink which relieves thirst. 
Irritation in the throat is relieved by ^m-arabic troches. Coryza is relieved 
by a snuff of acacia and bismuth subnitrate, to which a little morphine may 
be added, as in Fender's snufE: — 

B Morphinee sulphatis .^ 32 Gm. or gr. v. 

Pulveris acaciffl '. 8 Gm. or 3ij, 

Bismuthi subnitratis 23 32 Gm. or 3vj. 

M. et ft pulria. 

Sig.: A few grains to be snuffed into the nostrils, aa directed. 

For sore nipples, a good combination is as follows: — 

B Pulveris Bcacifie 15 6 Gm. or 3iv. 

Pulveris Bodli boratis 4 Gm. or 3j. 

Pulveris camphors 32 Gm. or gr, v. 

Pulveris marantee 8 Gm. or Sij. 

M. Sig.: Vusi over the surface. 

Another serviceable application, in some diseases of the skin, is: — 



B Pulveris acacisQ 12 

Pulveris rind oleatis 2 

Adipis laniB hydrosi 15 



Gm. or 3iij, 
Gm. or 588. 
5 Gm. or Jbb. 



M. Sig.: Ointment for sore nipples, intertrigo, or acute dermatitis. 



88 



PHAUMACEtTTICAL THERAPEUTIC AGENTS OR DBUCIS. 



Powdered gum arable may be used to check bleeding from leect 
The mucilage acts as a protective to slight bums and excoriations. 

The emulsion may likewise be employed as a demulcent vehicle in 
chitis, and in irritation of the genito-urinary passages. 

Gum arable is chiefly employed for pharmaceutical purposes, 
preparation of emulsions, pills, etc. 

ACETANILIDUM (U. S. P., B, P.).— Acetanilide, or Phenyl-acefc 

Acetanilide {B. P,). Also known bv trade name of Antifebrin. 

Dose, O.OG to 0.30 Gm. (or gr. j-V). B. P., 0.0G6 to 0.2 Gm. (or gr. 

Preparation. 

Puh-is Acotanilidi CompoKitua (U. S. P.). — Compound Aevianilide I 
(Acetauilidcs 70; caffeine, 10; and sodium biourbonnt^, 20 jmrts.) Dose, 0.10 
Urn. (or gr. ij-x). 

Fbarmacology. — Acetanilide is an acetal derivwtive of auiliue. ] 
white powder, of neutral reaction, slightly pungent, without odor, sL 
soluble in water and freely soluble in ether and in alcoholic solutions, 
not chanced by acids or alkaliep. 

Physiological Action. — In ordinary dose, the action of acetauill 
mnch less marked upon a person m health than when fever is prese 
its most evident action is to reduce temperature, possibly by conv* 
oxyfaEPmoglobin into inetha'iiinglobin in the red blond-ooqnt^c*le and " 
fering with oxidation. Tlie efTect does not depend upon swoating-, sij 
occurs wlien no per5]iiration is produced. Acetanilide, which at firs 
introduced as nn an ti pyretic, h;is been fouiul to fn>?;sess renuirkiihlo 
gesic power. It is the chief constituent of popular headache rerai 
to take the place of which the eniiipound acetanilide powder was*! 
duced into the pharmaeopann. When a toxic quantity has been ahs 
the patient becomes prostrated, the lips and finger-nails are dark eo] 
the pulse rapid and compressible, and the skin pale and moist; the 
linity of the blood is lessened, many red corpuscles destroyed, hiemog 
is liberated and eventually appears in the urine, which becomes dark b 
in color. Tlie quantity of unc acid and urea in the urine is incre 
Peptonuria may be produced. The drug is eliminated by the kid: 
Large doses cause diastolic arrest of the heart, preceded by tremors, 
YulsionE, depressed temperature, coma, and motor and sensory paralyeifl, 
smaller doses, the action of the skin and kidneys is increased; the b; 
pressure is at first elevated, but snon falls, and the hearths action deore 
In some cases, however, whether owing to ])eculiar susceptibility, or 
purity in the drujr. symfilonis of poisoning — cyanosis and collapse — 
resnlted even from small doses. Vomiting or profuse sweating have 
followed moderate doses of acetanilide. Toxic s}Tnptoms are espec 
apt to occur when acototoluld is present as a contamination. Tht 
effects of the drug must be couuteraeted by use of external \ 
vifforoiis alcoholic stinmlatioUj together with the hypodcrnne use 
ether, atropine, and stryrhTiine. in ordnr to support the respira 
and rirculatinn. Tn patients siTpTerinar with fattv or dilated h« 
acetanilide shonld be used with great caution, if at all. Owing 
its action upon the blood-cclls, it should not be used repeatedly or in 
doses, in the low fevers. Tlie prolonged adni^riistration of acetanilide g 




ACETANILIDUM. 89 

rise to congestion of the liver, spleen, and kidneys. In animals poisoned 
by acetanilide the heart, liver, kidneys, and other organs have heen found 
af ecied by fatty degeneration. When used as a dusting-powder, combined 
with an equal quantity of starch or zinc stearate, in the treatment of inter- 
trigo of infants, it has caused death from absorption of the drug, in several 
cases (Journal of ih^ American Medical Association, Feb. 1, 1896, p. 239). 

Ilierapy. — Acetanilide possesses antiseptic properties and may be ad- 
TEQtageously used as a local remedy. It is an efficacious local application 
to chwicroids and ulcerated chancres, used as a dusting-powder. In the form 
of an ointment containing 1.30 Gm. (or gr. xx) to 31 Gm. (or gj) it is of 
service in obstinate and irritable ulcers, erysipelas, eczema, herpes, urticaria, 
and other diseases associated with considerable irritation. Combined with a 
mercurial it exercises a beneficial influence upon the lesions of psoriasis. A 
gargle, containing 0.25 Gm. (or gr. iv) of acetanilide to 30 c.cm. (or fgj) of 
water, may be beneficially employed in pharyngitis. Finely-powdered ace- 
tanilide and boric acid constitute an excellent dressing to bums, scalds, and 
small lacerated wounds. In many cases it has been found to prevent the 
production of pus. It has a beneficial influence upon ulcers and has been 
applied with success to mucous patches. 

Given in fever (0.20 Gm., or gr. iij, or less) every hour, it usually is 
followed by prompt reduction of the temperature to the normal. It is also 
antispasmodic, and has been used in small doses in epilepsy, asthma, and 
whooping-cough. In whooping-cough it is given in the dose of 0.03 to 0.32 
Gm, (or gr. ss-v), according to the age and condition of the child. Improve- 
ment has taken place in chorea, also, in consequence of its administration. 
For the relief of pain it has been employed in nervous affections, and relieves 
attacks of facial neuralgia, locomotor ataxia, sciatica, etc., in doses of 0.06 
to 0.30 Gm. (or gr. i-v). In migraine, or neuralgic headache, it is also an 
efficient remedy. Acetanilide is highly esteemed in the treatment of dsy- 
menorrhoea, especially of yoxmg girls. In doses of 0.20 to 0.32 Gm. (or gr. 
iii-v) thrice daily it is of value in relieving seasickness. Acetanilide may be 
used with lupulin for the affections just named: — 

9 Acetanilid., 

Lapulini aa 6{50 Gm. or gr. c. 

M. et ft. eftpsuIsB no. xx. 

Sig.: One or two capaulea every two or three hours. 

It may be employed with camphor, as — 

IJ CamphoTsa 3126 Gm, or gr. 1. 

Acetanilid 6|60 Gm. or gr. c. 

Olei tbeobromatis, q.s. 

K. et ft snppositoria no. z. 

Sig. : Insert one into the bowel every two or three hours, for the relief of neu- 

nlgia. 

In tratunatic tetanus, doses of 0.25 to 0.38 Gm. (or gr. iv-vj) of ace- 
tanilide every third or fourth hour, in conjunction with hypodermic injec- 
tions of carbolic acid, have been used with success. 

A combination of value in the treatment of neuralgia, headaches, mus- 
cular and acute articular rheumatism, dysmenorrhcea, influenza, and various 
febrile affections is thus given by Dr. W. Blair Stewart: — 



90 



PHARMAOEUTICAL THBRAPEUTIO AGENTS OH DRUGS. 



^ Acetanilid., 

Quininte bisulplmt aa [DOS Gm. or gr. J. 

CocflinJE hy*irochloridi |(M)4 Gra. or gr. Vh 

The ingredients are compressed into the form of a tablet triturff 
one tablot can he administered every three or four lumr'i. according 
effect and the nature of the case. 

Acetiinilidc is said to be of vnhie in the treatment of olistuiatt^ vol 
especially when due to nervous distiirbance or extreme irritability 
stomach. It has also been employed with success in order to relie 
vomiting which follows surgical operations or the use of an aniestheti 

Dr. llollopeter recommends, in simple fevers of children, the foL 
combination: — 



R Aoetanilid 1 

Hydrarg. clilor. mitis 

Sodii bicArb 

Sacch. lact 1 

M, et ft. chart, no. xij. 

Sig.: One every two nours until three are taken. 



20 Gm. or gr. t 

065 Gm. or gr. j. 

76 Gm. or gr. i 

Gm. or gr. i 



ACETOKUM (U. S. P. ) .— Pyroacetic Spirit, or Ether (C^n.O o 

COCII,). 

Dose, 1 to 1.3 com. (or mxv-xx). dissolved in spirit of nitrous et 
Acetone is a liquid containing not les^s than \^9 per cent, by i 
of absolute acetone (dimcthylketone). It should bo kept in well- 
vessels in a cool place, rf>mote from lights or ftro. 

TheiEpy. — P>Toacetic spirit has a peiufiar ethereal, faintly min 
odor, and a punj^i^nt, sweetish taste. It has been used as an antip; 
or febrifutTP, und jis a sedative for cough, espeeifilly in puliiiouiiry 
culosis. It has nlso been used to relieve flatulence and pain in colic, a 
ing diarrhaM or dysentery. It checks vomiting. Wlieu iuludi'd. it ha8 
ana?sthetic olTecL but caiipos bronchial irritation. It is n miUl hypnoti 
analgesic, and has l»cen used in rheumatism and gout. Acetone is i 
Btiluent of the urine in diabetes, and occasionally in that of healthy 
viduals whih; nn a pr"tr*id diet. 

ACETPHENETIDIN (TJ. S. P.).— (See Phenacetine. ) 

ACIDUM ACETICTJM (U. S. P., B. P.).— Acetic Acid, composed 
per cent., by weisjht. of absolute acetic acid, U. S. P.; 33 parts of hyd: 
acetate, Pi. P. 

ACIDTJM ACETICUM GIACIALE (U. S. P., B. P.).— Glacial i 

Acid, nearly or ipiito absolute acetic acid (contains 99 per cent, of C,T1 

Preparalions. 

Acidum AcetKuin Dilntum (U. S. P., B. P.). — Diluted Acetic Acid contains 
cent., by weight, of ul>solute acetii' acid, U.S. P.; 4.27 parta of hydro^'en a( 
B.P. The Omiiin dilute acotic acid in 30 per cent. 

UnimoiituDi Tprebintliiiire Aootioum (U, P.). — Liniment of Tiirpt'ntirii? and . 
Acid (composed of oil of turpentine, glacial acetic acid, and liniment of cam] 

Dilute acetic acid i:^ the \msn of the Afvtn, or olticial vinegatB, exoopt A< 
Cantharidis (B. P.), which contains glacial acetic acid. 

Pharmacology and Toxicology. — Acetic acid is a clear, colorless : 
having a strong vinegar-like odor, with acid taste and reaction. It mixes 



ACIDUM ACETICUM. 91 

vater or alcohol in all proportions. Glacial^ or absolute, acetic acid is a 
czystalline solid at 59** F.; it attracts moisture from the atmosphere^ and 
should therefore be kept in well-stoppered bottles. Acetic acid in tho 
strongest form acts as an escharotic to tiie tissues; and, if taken internally, 
is a violent corrosive poison, causing vomiting of sour-smelling liquid, also 
intense pain, followed by convulsions and fatal coma. If the case is pro- 
longed, gastro-enteritis is produced by the acid. It has some antiseptic 
quaJjties, and, if swallowed, slightly increases the acidity of the urine. 

Aeetiun, or vinegar, which contains from 6.3 to 7 per cent, of acetic acid, 
is not official in either the United States Pharmacopoeia, or British Phar- 
macopceia, as dilute acetic acid takes ite place. The use of a 60-per-cent. 
acetic acid is recommended by good authority as a menstruum for extracting 
the active principles of drugs, with which it seems, in many instances, to 
form soluble compounds. 

PyroligneouB acid, or crude acetic acid, a dark-brown fluid having a 
anoky odor, obtained from the destructive distillation of wood, may be used 
with advantage as a disinfectant. Glacial acetic acid is partially eliminated 
by the intestinal canal, but chiefly by the kidneys. In cases of poisoning, 
milk or flour and water should be freely given, and vomiting encouraged. 
Weak alkaline solutions should be administered as chemical antidotes. 

Therapy. — Glacial acid is used successfully as an application to lupus, 
epithelioma, ulcers, papillomata (or warts), and nasal hypertrophies, and 
also as an application to ringworm and other forms of tinea. A mixture of 
30 parts of acetic acid and 2 parts of salicylic acid is esteemed an efficacious 
appUcation to venereal warts. Vinegar (not official), or dilute acetic acid, 
has been given internally to check night-sweats and to relieve diarrhoea. 
After constipation has been overcome vinegar has been employed with good 
effect in the treatment of lead colic. Vinegar is a convenient antidote for 
poisoning by caustic alkalies. It is also used externally for the relief of 
headache, and the entire surface of the body may be sponged several times 
a day with vinegar and water to reduce high temperature and acid sweating. 
It will also prevent the formation of bed-sores. The vapor of vinegar dif- 
fused through the sick-room is, according to Dr. S. J. Bumstead, of Decatur, 
m., beneficial in cases of catarrhal, membranous, and diphtheritic croup. 
Engelmann claims that the direct application of vinegar answers a good 
purpose in diphtheria. Warholm recommends the use of vinegar for the 
pnrpose of relieving or preventing nausea, vomiting, and headache following 
the inhalation of chloroform. A compress saturated with the liquid is placed 
oTer the nose and kept in that position until consciousness has returned. 

The following liniment is useful in chronic rheumatism of the joints. 
It is Stokes's or St. John Long's liniment, the Linimentum Terebinthinae 
Aceticum of the National Formulary: — 

B 01. terebinth 100| c.cm. or f Jiiiss. 

Omm recent,, 

01 Hmoni« 4] c.cm. or f3j. 

Acid, acetic 20 c.cm. or f3v. 

Aqiue ro8» 851 c.cm. or fjiiss. 

K et ft. linimentum. 

Properly diluted, acetic acid is sometimes able to mitigate the intense 
praritus of urticaria. It is capable also of checking moderate bleeding, as 
from leech-bites, superficial wounds, and epistaxis. In post-partum hffina- 
onbage, weakened acetic acid, or vinegar and water, expressed from a mop 



92 



PHARMACEUTICAL THERAPEUTIC AGENTS OR DRUGS. 



or sponge into the cavity of the womb, will cause that organ to contn 
prevent the loss of more blood. Acetic acid may be of serrice in b] 
from the stomach. Dr. E. Maguire reports good results in acute gon* 
from the use of injections, consisting of 1 part acetic acid to 4 of 

ACIDUM AKSENIOSUM (B. P.).— Arsenious Anhydride. 
Dose, 0.001 to 0.004 Gm. (or gr. V.o-Vis)- 

ARSENI TRIOXIDUM (U, S. P.).— White Arsenic (As.O^). 
ACIDUM ARSENOSVM (V. S. P., 1S!K)). 
Dose, 0.002 to 0.005 Gm. (orgr. V,o-7,j). 



U, S, P, Preparations, 

Ar8«ni lodidum, — Arsenic Iodide. Do9e» 0.0027 to 0.008 Gra. (or gr. V**" 

Sodxl Arsenas. — Sodium Arsenate. Dose, 0.0027 to 0.005 Gm. (or gr. Vn 

Sodii Arseiiua Kxsicciilii^^. — Dried Arstnato of Smliimi. Dohp, two-thirds 
cediiijLj. 

hiqtior Afidi Arsenoai. — Solution of Arsenous Acid ( 1 per cent.). Doae, 
0.60 c.cm. (or mi-x). 

Liquor Pntasnii ArseiiiliK. — Solution of Potnssium Arsenite (equal to 
I'pnt. of nrsenit' trinxi<lp.), Fovvjcr'n HoIutJon. Dow, 0.06 to 0.60 com. (or w 

Liquor Sodii ArrtL-nfttiy. — Solution of Sodium Arsenftto (I per cent, a 
arscuuteof sodium l. Dose. O.Utt to O.tIO v.vni. (or irii*x). 

Ijquor Arseni ct Uydrargyri lodidi. — Solution of Arsenic and Mercuric 
(1 per cent, each of arsenic iodide and red mercuric iodide). Donovan's Sc 
Dose, 0.00 to 0.00 c.cm. (or wri-x). 

B, P. Preparations. 

Ferri Arsenas. — Iron Arsenate. Dobo, 0.004 to 0.015 (or gr, '/«-'/«). 

Arsenii lodidum. — Arsenioua Iodide. Dose, 0,003 to 0.013 Gm. (or gr. ' 

Sodii Ansenas.— Dos*, O.UOHi to 0.006 Gm. (or gr. V*.>-Vw). 

Liquor Arsenicalis. — Araenical Solution, Fowler's Solution (1 per cent.). 
0.06 to 0.60 c.cm. (or mi-viij). 

Liquor Sodii Arseuatia. — Solution of Sodium Arsenate (1 per cent.). Doi 
to 0..50 c.cm. (or wi-viij). 

Liquor Araenii et Hydrargyri lodidi. — Solutton of Ar&enioua and Mi 
Iodides. (Same strength and dose as L'. S. I', preparation.) 

Liquor Arsenici HydrochloricuB. — Hydrochloric Solution of Arsenic (100 
contain 1 Gm. of areenioue auhydride). Dose, 0.12 to 0.50 ccm. (or mii-viij). 

Pharmacology. — A white, nlniost tasteless, henvv jKiwder, conte 
not less tlmii 9r».S per cent, of pure flraonic trioxide. It is soluble in ^0 
of cold water or ir> of boilinjr water; nlso in glycerin mid in bydrocli 
acid solution. When thrown upon burning charcoal it volatilizes, tlu 
lick}- fiunes Uein^^ very poisonous. It is nM^o^ized by Marsh's test: h 
peneration of bydroi^en in tlie presence of a solution contaiuin*: ar 
arsenuretcd hydrogen is produced, which leaves a dark ring on a eold 
held in its flnnu' : this i\ho i(H extremely poijionous if inlmled. Reinsch* 
eonsiets in addinj: a few drops of hydroclilorie acid to the suspected roU 
and inimersino: in it a polished plfite of copper; the solution bein^^ h< 
mctnllic arsenic is deposited upon the copper. Arfsenie po8soi>8es antis 
qualities, an<l ]*res«*rves bodies from decay: when death occurs froi 
effix'ts, it, therefftre, remains for a long time in the stomach, liver, and,i 



"Annual of the Universal Medical Sciences," 1890, vol 




ACIDUM ARSEKOSUM. 93 

organs. Owing to its tastelesfiness and want of color, arsenous acid is fre- 
quently given with homicidal intent, but it is the most easily recognized 
by its tests of all the mineral poisons. Paris green, or Scheele's green, 
is an impure copper arsenite, used for killing potato-bugs, and as a pig- 
ment' in wall-papers, and is a frequent cause of poisoning. 

Clemens'! solution of anenio bromide is made by boiling powdered 
arsenous acid and potassium carbonate (of each, 4.74 Gm., or gr. Izziij) in 
distilled water (60 c.cm., or fjij), and the resulting solution cooled. Add 
295 c.cm. (or f^x) of water, then bromine, 7.7 Gm. (or gr. 117), and after- 
ward enough water to make 473 c.cm. (or Oj). The fluid is kept four 
weeks, being frequently shaken during the first week, or until it forms a 
permanently-clear solution. The dose is 0.06 to 0.30 c.cm. (or mi-v) daily, 
freely diluted and given after meals. 

Gftcodyle, or kakodylio acid (see Acidnm Caoodylicum), is a white 
mstalline powder, soluble in water. 

Fhynological Action. — To the surface of the skin, if moistened, arsenic 
acts as an irritant, and produces inflammation and sloughing. Arsenic is 
readily absorbed, and is supposed to enter into combination with the red 
blood-corpuscles. It diminishes the elimination of carbonic acid and prob- 
ably of urea. 

Taken in small doses, arsenic exerts a tonic effect upon the nervous 
system, stimulates the circulation, and permits an increased amount of ex- 
ercise to be taken without fatigue or short breathing. Large doses depress 
the action of the heart and diminish blood-pressure. The respiratory cen- 
tre is stimulated by small and depressed by large quantities. Medicinal doses 
decrease, and excessive amounts increase, the metamorphosis of nitrogenous 
tissue. When administered for a long time, the system becomes habituated 
to its use and much larger doses may, in some cases, be taken without seri- 
ous consequences. The arsenic-eaters of Styria can take 0.50 to 0.65 Gm. (or 
gr. viii-x) at a dose. It is said that but few can tolerate such large doses. 
Mid they are careful not to drink water afterward; so that absorption prob- 
ably goes on very slowly, at the same time that it is eliminated rapidly by 
the kidneys. It is possible that the tolerance may be partly explained by 
heredity, as imitators of the arsenic-eaters, sooner or later, experience the 
toiic effects of the drug. Inflammation of the stomach is one of the results of 
poisoning by arsenic, even when introduced per enema or absorbed through 
the general surface. The urine becomes scanty, albuminous, or bloody. 
The skin is affected by arsenic; superficial oedema, especially of the face, 
appears, and may be followed by eczema, urticaria, herpes zoster, bronzing 
in patches, or exfoliation of the epidermis. The hair and nails may fall and 
conjunctivitis may occur. If the remedy is not discontinued at this time 
the puffiness of the eyelids and face may increase until a general anasarca 
is the result. Cases of idiosyncrasy have occasionally been observed in 
vhich the prolonged administration of arsenic in medicinal doses has given 
rise to urethritis, which gradually abated when the use of the drug was 
abandoned. The digestive organs are stimulated by small doses, but large 
ones cause gastro-enteritis, with burning pain in the epigastric region, vom- 
iting, purging, and collapse resembling Asiatic cholera. In fact, when symp- 
toms of this kind appear in the absence of an epidemic of cholera, they 
are very likely caused by arsenical poisoning, and should always excite sus- 
picion of the administration of arsenic. Arsenical poisoning is occasionally 



94 



PHARilACEUTICAL XnERAPEUTIC AGENTS OR DBUGS. 



accompanied by paralysis of one or more extremities. According to t 
servation of Dr. Thomas Buzzard, the continued use of arsenic will 
sionally give rise to multiple neuritis. Arsenic is eliminated from tl 
tern by the kidneys, and can be readily detected in the urine, when re 
ingested. Knecht and Deardon* have shuwn that m sinall part arsei 
capes from the system through the hair. Their method employed "W 
only one of detection, but also estimation, and obtained as high a prop 
of arsenic as 1 to 10,000. There is also at the present time abundaj 
denee to show that the fate of arsenic in the body is partly in the hai 
this fact cannot but be of the utmost importance in medicine, esp 
in toxicology. 

The neuritis and paralysis so often observed in alcoholics may at 
be due, not to alcohol, but to a contamination of arsenic in the c 
beverages. The attention of the profession has recently been called t 
important subject by Dr. E. S. Reynolds, of Manchester, England, wl 
nounced at the meeting of the Manchester Medical Society on Novemb 
1900, that the epidemic of multiple neuritis then existing in that cit 
caused by arsenic in the beer drunk by those so affected; he found thi 
arsenical contamination was due to the use of sulphuric acid employed i 
preparation of glucose being made from arsenic pyrites, the acid bein( 
taminated witli arsenous acid to the extent, in some instances, of 1. 
cent, of its weight, the arsenized glucose carrying with it as high ai 
Gm. (or gr. ij) of arsenous oxide to the gallon of beer. This depl< 
occurrence, it is hoped, will serve as a warning to brewers of the danj 
substituting cheap and impure products for the proper ingredients, 
general appearance of the patients was described- as frequently, liut ■ 
means always, that of persons suffering with alcoholism. Usually th 
tients walked with difliculty, in an ataxic manner; pigmentation o 
skin in various parts of the body was observed in almost every case, c 
of exposed parts and of the axillne, the groins, the areola; of the breasts 
the region surrounding the umbilicus. In many cases there was hi 
erythema, or an eruption of pnpules; cramps and pains resembling 
gurant pains of tabes dorsalis were common; and the soles of the feet 
exceedingly tender, so that walking, besides being ataxic, was exquii 
painful. Other symptoms noted were tremors, exaggerated reflexes, * 
nution or absence of knee-jerk, and a condition resembling en'thromeU 
nausea and vomiting were often complained of, but in many cases then 
no vomiting. The exact number of cases poisoned in Manchester alo 
not definitely known, though ut one time more than three hundred case* 
been under observation. 

The vagina also has been used as a route for the introduction of an 
into the system, and a number of eases have been reported in which it 
thus administered criminally, either in solution or in crystals. In the 
century a peasant in Hungary, as reported by Mangar, poisoned three v 
by introdufing iirscriir into the vagina after coitus. JliUirrda^ n»]>orts a 
of a young woman who apparently had committed suicide in this way 
the autopsy there was found acute inflammation of the surrounding or 
and a paper package containing arsenic crystals was found in the vag 

* Lancet, March 2.3. IftOl. 
*yew York SMicfil Jourvfil, December 15. 1000. 

* rtntralhlatt fiir Gj/nakologie, No. 50, 1806. 




ACIDUM ABSBN08UM. 95 

vault, imbedded in thiek fibiinouB exudations. The patient died with symp- 
toms of peritonitis. 

In exceptional cases of poisoning by arsenic the gastro-intestinal symp- 
tonu are not prominent, but profound collapse or stupor may be the chief 
manifestation and herald a speedy death. After recovery from the imme- 
diate effects of overdoses of arsenic various disorders, especially of the 
afimentary canal and nervous system, may occur as a result. Myelitis, 
peripheral neuritis, motor paralysis, hypersesthesia, or anaesthesia are among 
the after-effects of this drug. A case fell imder the observation of Dr. Boget 
in which epilepsy occurred as one of the secondary effects of the poison. 
Chronic arsenical poisoning is not uncommon among workmen on account 
of the extensive employment of this substance in the arts. A summary of 
the most typical manifestations of this form of toxaemia is thus given by the 
late Professor Taylor: "Dryness and irritation of the throat, irritation of the 
rnucons membranes of the eyes and nostrils, dry cough, languor, headache, 
loaa of appetite, nausea, colicky pains, numbness, cramps, irritability of the 
bowels attended with mucous msoharges, great prostration of strength, a 
fererish condition, and wasting of the body." 

In workmen employed in making arsenical dyes local affections are 
produced by constantly handling the substance. Among these effects are 
nlo^s about the roots of the nails, papular and eczematous eruptions, and 
eryBipelas. To these local difficulties the constitutional sjrmptoms of chronic 
intoxication may subsequently be added. Afler death from arsenic, fatty 
degeneration of the heart, liver, kidneys, and other organs has been found. 
The temperature is depressed by toxic doses. Fly-poison, or cobalt, an im- 
pure arsenical oxide, is sometimes swallowed by mistake; so is rat-poison, 
made by mixing arsenic and meal ("rough-on-rats" contains 50 per cent.). 
Arsenic is excreted from the body by the kidneys and intestinal canal. It 
also escapes by way of the skin, and it has been found in different secretions, 
as the saliva, tears, and milk of nursing women to whom it had been admin- 
istered. 

As arsenical intoxication is occasionally due to wall-paper, the follow- 
ing test is of easy application in suspicious cases: A small piece of the paper 
placed in strong ammonia-water will give rise to a bluish color if arsenite of 
copper be present. A yellowish deposit upon a crystal of silver nitrate, 
moistened with a drop of the fluid, points to the presence of arsenic. Death 
has been caused by the ingestion of 0.13 6m. (or gr. ij) of white arsenic. On 
the other hand, considerable amounts have been taken without fatal conse- 
quences, the immunity being, in all probability, due to prompt emesis and 
the form in which the poison was taken. Death from arsenic usually occurs 
within horn eighteen hours to three days, but it has taken place in twenty 
minutes, while, on the contrary, the patient has lingered imtil the sixteenth 
to twentieth day. 

Antidotes. — ^The antidotes to arsenous acid are the freshly-precipitated 
sesqoioxide of iron, or the official ferri hydroxidum cum magnesii oxido, of 
which about 1.30 Om. (or gr. xx) must be given for each grain of arsenic 
nrallowed. The solution of dialyzed iron is also a convenient preparation 
for this purpose. Calcined magnesia and milk may be freely administered, 
and the stomach emptied by the stomach-pump, or by free vomiting. 
Oleaginous or mucilaginous drinks are also serviceable. If purging has not 
occurred, the bowels should be emptied by magnesium sulphate or Eochelle 



96 



rUAEMACEUTICAL THERAPEUTIC AGENT'S OH DRUGS. 



Ealt. The case siibgequently may require treatinent for resulting 
inflammation. Tlie autopsy reveals lesions of the oesophagus and st< 
with erosions and ecch^Tnoses, congestion of the lungs, and fatty de^ 
tion of different organs. The arsenic may be detected not only in tt 
tents of the stomach, but also in the urine and in the tissues, especia 
liver and great nerve-centres. The antidotes to Fowler's solution e 
ferric salts, especially the official solution of ferric acetate, to which 
ammonia should be added to neutralize the free acid. 

Therapy. — When administered internally, arsenic has oocafii 
shown considerable power over morbid growths, and is the only rem< 
have at our command that has any effect upon the development of 
of the viscera. In epithelial cancer and other superficial growths ar 
paste has been employed (cinnabar, 70; dragon's blood, 22; arsenou 
8), but, as previously stated, it is a very painful treatment, and ma 
be applied to a small area at a time on account of the danger of pro< 
toxic effects. The excessive use of an arsenical paste or powder has 
death by absorption of the poison. 

Dr. Wight regards arsenic bromide as the most efficacious agent 1 
venting the dissemination and extension of malignant growth. In sa 
he recommends a combination of this preparation with calcium cart 

In ague and ohronic malarial disorders, and also as a proplv 
against malarial poisoning, arsenic is used very effectually in small do8< 
may be combined with quinine and iron: — 

B Lin- potassii araenitla |18 to [30 c.cm. or wiii-i 

Tr. cinchona comp TpO e.cm. or f3ij, 

M. Pro dosi. 



9 Sodii arsenatis 

Mass, ferri cHrbonatis 1 

Quininffi Bulph 1 

M. et ft. piU no. xx. 

Sig.: One tlirce times a day. 



066 Gm. or gr. j. 
3 Gxn. or gr. x. 
3 Gm. or gr. x 



B Araeni sulpbidi 13 Gm. or gr. IJ 

Aloini 065 Gm. or gr. j, 

Ferri pyrophoephatis 2 60 Gm. or gr. zl 

M. et ft. pil. no. xx. I 

Big.: One three times a day. 

Dr. C. F. Bryan believes that arsenic acts as a prophylactic ap:ain5t 
let fever and, perhaps, against diphtheria and influenza. The use of a 
in pulmonary tuberculosis is advocated by Dr. Karl Hochhalt, who ; 
that in fifty cases the appetite improved, the weight increased, and the 
diminished^ wiiile Fnwlcr's solution wns beinp administered, hi neiu 
arsenic frequently exercises a very happy effect, especially when given i 
form of the solution of sodium arsenate. Larger doses are required for 
cases of chorea, but the effect is very marked. According to Dr. Wi 
Murray, of Newcastle-on-Tyne, the most effectual method of treating c 
is by the administration of large doses of Fowler's solution. He begi 
giving 1 or 1.20 c.cm. (or mxv-xx) three times a day, in the middle 
meal. He claims that these heroic doses may be given for a few days wi 
distnrliing the stomach, and that it cures clioroa witliin a week. A 
metiiod is to begin with a small doiie, and increase eacli day until the 
mum is reached ; then stop for a few days, and begin again. 




60 


Gm. 


or gr. viij 


32 


Gm. 


or gr, V. 


32 


Gm. 


or gr. V. 



ACIDUM ARSEXOSUM. 97 

A course of arsenic has a valuable tonic influence in organic heart dis- 
ease, and under its use dyspnoea, palpitation, and oedema improve. It also 
corrects intennittency of the pulse. This remedy is of service in certain 
fomis of chronic albuminuria. Dr. Phillips has employed it with advantage 
for many years in albuminuria following scarlatina. Arsenic will not in- 
frequently succeed in relieving haemorrhoids. 

It may be administered with advantage thus: — 

B Liq. sodii arsenatis^ 

Fluidext. nucia vomieee aa 41 ccm. or fSj. 

£Ux. gentians 150] ccm. or f3v. 

M. Sig. . One teaspoonful in water after meals. Used in neuralgia and chorea. 

Sawyer* higlily extols arsenic in gastralgia, where pain exists when the 
stomach is empty and is relieved by taking food. He gives 0.0027 Gm. (or 
fr. Vj«), in pill with some vegetable extract, three times daily, half-way 
between meals. 

A pill highly extolled in the treatment of neuralgia ia: — 

B Arseni iodid |065 Gm. or gr. j. 

Ext. belladonnce fol, 

Morphin. valerianat. aj 

Pulv. ext. gentiansD 

Pulv. ext. aconiti 

M. et ft. piL no. be. 

Sig: One to three piUs during the day. 

Some spasmodic disorders of respiration, asthma, hay fever, and chronic 
catarrhal bronchitis are controlled by arsenic, and, if there is no acute in- 
flammation^ it may be used with the atomizer. Arsenic is of service in 
catarrhal pneumonia. Cases of periodical sneezing, dependent upon reflex 
action, have been cured by the use of this remedy. 

In irritative dyspepsia, with morning vomiting and clean, red tongue, 
arsenic ia of service; also -in the diarrhoea coming on immediately after 
eating. In skin diseases arsenic is valuable in proportion to the absence of 
irritation or acute inflammation. In all chronic processes, especially when 
accompanied by desquamation or infiltration of the skin, such as psoriasis, 
the persistent use of small doses is often curative; also in the dry form of 
eczema and impetigo, as well as in pemphigus and lichen. In the vesicular 
or bullous eruptions of children small and repeated doses of arsenic are 
nffoally followed by speedy improvement. It is contra-indicated in the early 
itage of each of these affections except psoriasis. Sawyer^ recommends 
arsenous acid for gastralgia given in pill form with gentian or other vege- 
table extract. 

Prof. 0. Lassar* gives an account of three cases of cancroid in which 
the internal use of arsenic was followed by a disappearance of these growths; 
in one case sections were made of the growth before treatment, which upon 
examination gave the appearance of a beginning epithelioma; the arsenic 
vas administered in pills containing 1 milligramme, increasing the dose to 
the physiological limit and continuing treatment for several months. In 



'Lancet, July 4, 1896. 
•Iflficr*, July4, 1896. 
'Berliner Klinvtche Wockenschiift, March II, 1001. 



98 



PHARMACEUTICAL THEEL4PEUTIC AGENTS OR DRUGS. 



one patient there had not been a recurrence of the growth at the 
eight years. 

Dermatitis herpetiformis and recurrent herpes are benefited by ■ 
minietration of arsenic. It is generally of service also in the treatn 
chronic urticaria. The internal administration of arsenic will pr 
benefit in chronic scaly affections. The persistent administration o: 
doses of arsenic is usually of seryice in the small pustular and papular 
of acne, especially in cases dependent upon debility or anaemia. 

The following are serviceable formulse in the diseases referred to 



li Liq. potAMii araenitia 41 c.cm. or f3j. 

Tinot. nueia vomica TJSO c.cm. or f3ij 

M. Sig.: From 1£ to 20 drops in water three times a day. 

R Sulphurifl aubUmati fllSO Gm. or gr, c 

ArMt'iii trioxiiU |O0B Gm. or gr. j 

M. et ft. capsulie no. xx. 
Sig.; One after n^eaU. 

In diabetes mellitus, the solution of arsenic bromide (not official), 
in Vichy water after each meal, has produced remarkable results in the 
of Clemens, probably owing to its action upon the liver. 

Quinquaud has experimentally demonstrated that, in animals fee 
arsenic, diabetes cannot be produced by lesion of the bulb. In disc 
the liver or kidneys, especially the early stages of cirrhosis, arsenic som< 
has a very decided effect. In vomiting and diarrhoea, especially in in; 
copper arsenite in infinitesimal doses (0.0005 Gm., or gr. Vi28> ^o wate 
c.cm., or foiv, a teaspoonful being given every hour or less) has bee 
lowed by good results; but the older method of using Fowler's soluti 
the same way is probably better, because less poisonous than the c 
arsenite, the effect being largely due to the antiseptic action of the ai 
which acts more elTiciently in the soluble form* 

The vomiting of pregnancy is often remarkably relieved by the ai 
istration of a drop of Fowler's solution immediately before each meaL 
same preparation is valuable in chronic gastritis (especially when it hafl 
produced by alcohol), in chronic gastric ulcer, and cancer of the stoi 
Arsenic is sometimes beneficial in chronic rheumatism. In rheum 
artliritis Phillips testifies that under the continued use of this drug h 
known the joints to return to their natural size. In angina pectoris A 
asserted that arsenic was of decided service in mitigating the severity i 
tacks, especially in ansemic patients suffering from overwork and an: 
Syphilitic affections are sometimes better treated by the combination of 
cury with arsenic than by mercury alone. Donovan's solution is espei 
useful in old syphilitic skin lesions. 

Dr. H. Smith has reported a case of secondary syphilis, in which ar 
produced a rapid improvement, after mercury and iodide of potassiuna 
failed. An isolated case of trichinosis was successfully treated by Dr. Mi 
by means of Fowler's solution in doses of 0.30 c.cm. (or tnv) thrice ( 
gradually increased until constitutional effects were produced. Pre^ 
to its administration the patient was steadily growing worse. Done* 
solution in doses of O.fiO c.cm. (or nix) three times a day is said to doj 
in gleet- Finally, in chlorosis and auBemia the tonic effects of arsenic 




ACIDUIC ARSENOSUM. 99 

well be combined with those of quinine and of iron. The usual dose of 
aisenous acid is 0.0027 Gm. (or gr. ^/^^, to be cautiously increased. The 
best method of administration is in solution. Arsenic iodide has been found 
extremely effective by R. St. Philippe in cases of chronic eczema, inflam- 
mation of the eyes, intestinal catarrh, and other manifestations of scrofula. 
From 0.30 to 1.20 c.cm. (or mv-xx) a day, of a 1-per-cent. solution, in cold 
vater, of arsenic iodide were administered, with no local treatment except 
sterilized water. Recently he has confirmed this, after an experience of over 
3CK) cases. 

In a case of leukaemia which Dr. Drew treated by means of an arsenical 
solution, in ascending doses until the physiological limit was reached, the 
spleen, which had been greatly enlarged, became, in the course of three 
months, diminished in size, the proportion of wiute blood-corpuscles was 
decreased, and the number of red corpuscles was augmented. When amenor- 
rhcea is caused by congestion of the uterus, anaemia, or chlorosis, the admin- 
istration of arsenic will usually be followed by a return of the catamenial 
flow. Professor Renaut, of Lyons, advocates the administration of arsenic 
by the rectum. Three injections may be given daily, of a solution contain- 
ing a third of a milligramme (gr. Vi«o) in 5 c.cm. (mlxxv). The treatment 
may be continued for months. Should any rectal irritation be caused, the 
addition of a few drops of laudanum will obviate it. This treatment is 
highly recommended by Renaut in the early stage of tuberculosis; also in 
diabetes mellitus, and in exophthalmic goitre.^ 

Radcliffe was the first to use arsenic hypodermically for the relief of 
chorea, in 1866, and since then it has been frequently used in scaly skin 
diseases, lymphadenomata, ^nd nervous disorders. This method is also of 
advantage in the treatment of obstinate cases of malaria which have resisted 
the action of quinine. Very marked hypertrophy of the liver and spleen 
due to malaria may be reduced by the injection of Fowler's solution. Dr. 
Hq^, of Rouen,' used hypodermic injections of 1 to 1000 solution of arsen- 
0116 acid in inoperable cancer. In a case of epithelioma of the cheek he claims 
to have effected a complete cure. Planel obtained the same result in a case 
of cancer of the breast. This agent has also been used in several cases of 
recurrence of cancer; in some the progress of the disease has been distinctly 
rt'tarded, in others the treatment had no effect. Hu6 used the following: — 



H Arscni trioxidi |20 Gm. or gr. lij, 

Cocaine hydrochloridi 1| Qm. or gr. xv 

Aqnee destUlatfls 90| ccm. or f^HJ. 



Of this, 1.20 to 2.50 c.cm. (or mxx-xl) were injected into the substance 
of the tumor, at intervals varying from two to eight days. In the successful 
ease of epithelioma above mentioned Hu6 gave daily injections during sev- 
eral months. 

The ointment of oleate' of arsenic is also a useful application in the 
treatment of old ulcers, epithelioma, and lupus. The following combina- 
tion will be found of service in the diseases just named: — 



' Vouvw^ue RmUde9, April 24, 1898. 
•Semaine MMiodU, Nov. 6, 1895. 

' See "Ointments and Oleates, especially in Skin Piseases/' by the author. F. A. 
DtTif, 1890. 



10** rnARMACEUTlCAL TILERAPECTIC AGENTS OR DttL'GS. 

I) Morphine sulphatia 113 Gm. or gr. i 

Zinci chloridi 32 Gni. or gr, t 

Pulvcris tnarftntro 4 Gm. or 3j, 

Ungt. arseni oleatia I5|5 Gni. or Jas. 

M. Sig.: Apply on old muslin for several hours. 

Arsenic iodide (0.25 or 0.32 Gin. to 4 Gm,, or gr, iv or v-5j) i 
rneiit is a va!ual)Ic stiiiiiilatinf: isj^plitalioii in old dry eczema. 

In warts, Unna advises the application of mercurial ointment c 
ing from 5 to 10 per cent, of arsenic. E. Mansel Sympson declares t 
internal administration of small doses of arsenic has a curative €ffe< 
warts. After a week or two of this treatment the growths hegin to dis 

Tlu' cjicodylale of truaiiual is a wiiite salt, wry finhihle in alco! 
and glycerin. l)iit in water only r* parts in 1(»0. Tlit* addition nf 1 p 
of free gnniiicol inakc^-i tlic watery solution iiioro pcrinanHii, and ai 
local ajia?sthetic w[i<>n the sointi<m is us^ed hyiKMlerniieaUy, Introduc 
medicine by Dr. Barljary, of Nice, in liJOd, Dr. Burlureaiix* has I 
advocated its use in tuberculosis and in la grippe. One or two in; 
of 5 centigrammes reduces temiXM-ature, and ameliorates all the syn 

ACIDUM BENZOICUM (U.S. P., B. P.).— Benzoic Acid (HC. 
An organic acid usually obtained from benzoin by sublimation, 
pared artificially, chiefly from toluol. (See Benzoinum.) 

ACIDTDI BORICUM (U. S. P., B. P.).— Boric Acid (HaBO.). Fc 
Boracic Acid. 

Dose, 0.32 to 2 Gm. (or gr. v-xxx). B. P., 0.32 to 1 Gm. (or gr 

Preparations. 

Ulyi'mtuiii Boroglyooriui {V. S. P.). — Glycerile of Boro|p;lyeerin. Gly 
Acidi Boriri (B. I'.). — Solution of Roro^^lyeeride. (Contains 50 per cent, by 
of borojilvi-erin.) For extcnml use. 

SodU Boras (U. S. P.).— Sodium Borate. Borax. Dose, 0.32 to 2 Gm. 
v-xxx). 

UnijriK'ntum AM'\ Borid (U. S. P., B. P.).— Bnrie-Arid Oinlnifnt (10 p< 
with parulhn ointment). 

Borax (B- P.).— Borax, Sodium Biborate. Dose, 0.32 to £ Gm. {or gr. v- 

Glycerinum Boracia (B. P.).— Glycerin of Borax (1 to G). 

Mel Boracis (B. P.). — Borax Honey (borax, 60; glycerin, 25; clarified 
400 Gm.). 

Li(|iif)r Antirtepticus (U. S. P.). — Antiseptic Solution (boric auid, iJO Om.; 
acid, 1 *Im.; thyinoK 1 Om. ; with oiiealyptUM. 0'2'>; pi'pperinint *iil. 0.50 G 
gaulthiria, 0.25 (int.; u\. thyme, 0.10 Gm.; iilcuhol, jriO f.iin.; with ^ullicjeiit V 
make KMJO o.cm.). L'rtetl a» a dentifrit-e ami an lui aiitiricptic spray fur the the 
no«e. ilay be taken Intprnally in doses of 2 to 8 com. (or fSss-ij). 

Pharmacology. — Boric acid is in transparent, colorless, six-sided 
soluble in 25 parts of water or 15 parts of alcohol, and in 3 parts of 1 
water or 5 of boiling alcohol. The alcoholic solution gives a green 
Borax is soluble in 1(J parts of cold water, but not in alcohol. The sol 
of boric acid is greatly increased by the addition of borax. When a a 
of equal parts of boric acid, borax, and water are heated together a ac 
is obtained known as the tetraborate of sodium^ which is apparently 
salt, as it is of neutral reaction. Sodium tetraborate is a white, im 



'■ liiitlrtin Grit, df Th^rapeutitiur, January 23, 1900. 




ACIDrU BOBICI'M. 



101 



vviiki^ resdily soluble in vrater and free from caustic or toxic properties. 

woe add baa a fcebly-acid taste and borax a sweetish, alkaline tnste and 

'"'*- —'t-.on. BoVoglycerin ib a comhiuation of boric acid (6'4 j)er 

■ riji. An equal quantity (»f glyt-crin added to this makes the 

fisu- of boroglyooriu. Lister's antiseptic ointment for dressing 

fVQC^li <* l>y addin<r 1 part each of lioric acid and white wax. to 2 

pn> each of paraflin and aln)ond-i:)il. Boratetl lint or l)orated colton-wool 

iiivmriMfit tHktton) is made by steeping the Fuhstancc in a saturated solution 

* xifie acid and allowing it to dry. Boral, a trade preparation, consists 

'^mm\ r^ftrt? of boric acid and acetanilide, in (ine powder. 

Physiological Action and Therapy. — Boric acid is antiseptic. The pres- 

«fr ni II food notably retards the airtion of saliva uikui t^tarch, Afi 

^k^n \ iiuents made by C T. Fox, under the direction of Professor 

VcbefyOt i.'v*luinbus, Ohio. 

Chittenden and Gies* found that moderate doses of boric acid (up to 3 
fia^ or gr. xl v, daily) are practically without influence on protcid metabolism 
^vpoo general nutrition. The same is true of borax, up to daily doses of 
' 'itn. (or gr. Ixxv). Larger doses of borax from 5 to 10 Gm. (or oiVi-iifis) 
*k;it, hare a direct stimulating effect upon proteid metabolism, and lead to 
aoeased cjccretion of nitrogen; also of sulphuric and phosphoric acids. 
Hry retard the assimilation of proteid and fatty foods. With very large 
imm there is a tendency to diarrhrea from increased secretion of mucus. 
|paz d«CTeaaea the volume of urine, gives it an alkaline reaction, and, owing 
t» "fi excretion by this channel, raises the specific gravity. Neither borax 
»• acid liaB any inlluence upon the ptitrefaetive process**? of the in- 
^^iii%r. They are rapidly eliminated from the body (twenty-four to thirty- 
ex boon). 

Boric acid is rapidly eliminated in the urine and is said by Max Griiber 
the elimination of urea and the quantity of urine passed. Acci- 
from its use are rare; but a few cases have been observed in which 
bmt acid excited cutaneous eruptions. The eruptions which may be ex- 
ited by the internal use of boric acid assume a number of forms. Erythema, 
nalaa. blebs, generalized urticaria, and confluent nibeola-like rashes have 
Wb obaerred. Disturbances of the nervous system have also been caused. 
Tfca •ymptoms have been attributed to non-elimination of the acid by the 
bdacya. Suppuration of the ear, or running from the ear, is cured by 
dfltDsing the canal and insufflating finely-powdered boric acid. In the 
tntiDent of aural suppurations and wounds Dr. Jaenicke, of Gorlitz, rec- 
mmoidB sodium tetruborato, which is also considered as a valuable appli- 
■n^ in conjunctivitis and keratitis and is said to restrain the formation 
rfpM. Dr. J. Darri5 Pierpont suggests that finely-powdered boric acid is 
ttmdr meana of dia^osticating small perforations of the memhrana tym- 
MtL After the external ear has been cleansed and dried the powder is 
Sni into the canal until the membrane is completely coated. Wlien an 
^minMiian is made, a few hours subsequently, the perforation, if present, 
rSMppemr aa a dark or discolored spot upon a white field, the discharge, in 
^MttDr throuja:h the opening, having partially or wholly dissolved the acid. 
IWdered boric acid is regarded by McCandliss' as an excellent application 




4m4V<£V** Jnumot of Phjjiioloin/, «Un., 1808. 
Chirn^ J#r«f{cai MUiittnary Journal, Ugc, 1890. 




102 



PHARMACEUTICAL THERAPEITIC AGENTS OH DUUUS. 



to leg ulcers. It is entirely miirritating when applied to the akin, ai 
been used as a dressing for wounds in powder or ointment. 

JL B. Wild.* after citing a nniiiher of cases, including some of hi 
distinguishes two forms of intoxication from boric acid — one in wl 
large quantity of the drug is rapidly absorbed from the alimentary 
from a serous or other cavity, or from an extensive raw surface; ia 
cases vomiting and diarrha?n, general depression, and partial paralysis 
nervous and muscular systems occur, and may cause death. A rash is 
in many instances, especially when the patient recovered or lived 8om( 
after the absorption of the drug. The other class of cases results fro: 
administration of boric acid or borax in comparatively small doses foi 
periods, and the symptoms appear at a variable time after the comnC 
ment of the drug. In some of thpse cases it is mentioned that the Id 
were diseased, and the author gives, as a possible reason for the iram 
to the injurious effects of boric acid, its very rapid elimination by h< 
kidneys.- FurthcTmore, it is possililo that cast's of intoxieatiou ocrur 
frequently than is at present recognized. Boric acid may unwitting 
taken in food and cause a toxic skin-eruption which may be mistake 
eczema, psoriasis, or exfoliative dermatitis. It may be noted that a 1 ti 
solution corresponds to 1.13 Gra. (or gr. xviiss) per pint of the acid, a 
large dose for an infant on milk diet and one likely in some cases to 
duce disturbance of the alimentary canal. It should also be ascertained 
the milk ordered in cases of kidney disease is free from excess of boric 
or boras. The use of boric acid or the borates in surgery and their int 
administration ought to be carefully guarded in patients with diseased 
neys, and immediately discontinued on the appearance of dermatitis or < 
toxic symptoms. In suspected cases examination of the urine may a 
valuable evidence of the presence of the drug, 

A solution of boric acid is an agreeable application in conjunct! 
and is very efficient in the treatment of burns, applied upon lint or absor 
cotton. The saturated solution is used in various chronic, scaly, and ] 
sitic skin eruptions, and is the best remedy for bromidi*osis of the fei 
fetid perspiration. Among the beneficial combinations are: — 

B Aridi borici 2] Gra. or Sss. 

Glycerini, 

Ticct. opii aa 15[ c.cm. or fjss. 

Aq. camphor 30| ccni. or fly 

M. Sig.: Ten drops to be insUHed into the ear for earache. (Dr. Prout) 

B Acidi borici, 

Btsmuthi subnit aa 12j 6ni. or 3iij. 

M. Sig.: For running from the ear and in excesaive and fetid perspiration. 

B Acidi borici 81 Gm. or 3ij. 

Pulv. zinri carb. imp. 15|6 Gm. or 5m. 

IkL Sig. : In acute eczema, and erythema. 

B Acidi borici 41 Gm. or 3j. 

Aquffi hamamelidia dt^t 12o| c.cm. or f Jiv. 

M. Big. : Use in fetid pcrspinition and in an oily state of the skin. 



^ La»ort, No. 31»:i2, p. )i:i. 

' Merck* ft Arrhirr», Jan., 1899. 




ACIDUH BOBICUM. 103 

In pharyngitis Dr. Capart prescribes the following combination: — 

3 Sodii boratU 4{ Gm. or 3j. 

Sodii sftUcylatis 2 Gm. or Sss. 

Decoctionift altluen 180| ccm. or fSvj. 

M. 8ig.: To be given in divided portions through the day. 

Whitla, Keegan, and others haye employed boric acid in typhoid fever 
with good results. The temperature was lowered and the diarrhoea checked. 
Dr. Tortchinsky^ has used uiis remedy in 240 consecutive cases of typhoid 
fever, and reports very favorably of its action. It is stated that the course 
of the disease was considerably shortened and that complications were very 
rare. The effect of the boric acid was enhanced, in the late stages accom* 
panied by cerebral symptoms and in relapses, by a combination with quinine. 
The same writer has obtained equally satisfactory results from the use of 
boric acid in the summer diarrhoea of children. 

Good results have been obtained in erysipelas, even of the phlegmonotis 
form, by the application of lotions containing this remedy. 

Borax in substance, mixed with white sugar, is applied to aphthous sore 
mouth in infants. Aufrecht recommends the internal administration of 
borax in the stomatitis of elderly and debilitated persons in whom the dis- 
ease extends to the oesophagus and stomach, causing dysphagia and defective 
nutrition. A piece of borax of about 0.13 to 0.20 Om. (or gr. ii or iij) placed 
in the mouth is said to be useful to speakers and singers by producing saliva- 
tion and relieving hoarseness; its solution is a cooling application to super- 
ficial inflammations of the skin, and for pityriasis versicolor and seborrhoea 
of the scalp, or dandruff. 

The late Dujaxdin-Beaumetz used the following as a favorite prescrip- 
tion for a dentifrice: — 



Gm. or 3viV4. 
Gm. or gr. xv. 
26 Gm. or gr. iv. 
ccm. or Oi*/*- 



9 Acid, boriei 25 

Phenolis liquefacti 1 

Thymol S 

AqiMB 828 

M. et ftdde:— 

Sp. menthse 160 ccm. or mx. 

Sp. anisi. 9|25 ccm. or fSiisa. 

Coed q. 8. ad colorand. 

Sp. Tini rect. 90| com. or fjiij. — ^M. 

The above author lays stress upon the importance of attention to the 
mouth, in many diseases, but especially in diabetes mellitus, in order to 
avoid lesions of the mucoua membrane, gums, and teeth. 

A lotion containing borax may be used in order to allay the itching of 
urticaria and parsesthesia. Internally, borax, in 1.30 Gm. (or gr. xx) doses, 
relieves irritable bladder and reduces the acidity of the urine. It has, in 
Bome instances, given encouraging results in epilepsy. The general tend- 
ency of borax is to diminish the number of attacks. It will sometimes suc- 
ceed in cases which potassium bromide has failed to relieve. A combination 
of the two drugs has disappointed expectation. It is recommended to begin 
with doses of 0.60 to 1 Gm. (or gr. viiss-xv) and rapidly increase the amount 
until the limit of tolerance or a decided effect upgn the disease is produced. 
Professor Mairet, of Montpelier, states that when daily doses of 8 Gm. (or 
3ij) are insufficient to hold the attacks in check it is to be feared that larger 

^British Medical Journalj Jan. 14, 1893. 



104 



PHARMACEl'TICAL THEnAPHUTIC AGEXTS OU DRrcS. 



doses will prove no more successful. When the paroxysms have Le< 
strained, he advises the reduction of the amount to about 4 Gm. (or 3 
diem. Among the disadvantages of the prolonged administration of 
are salivation, impairmert of appetite and digestioii, diarrhoea, emaci 
swelling of the face, «dema of the lower extremities, cutaneous rasheSj 
junctivitis, fissures of the lips, fall of the hair, and alterations in the 

According to Dr. G. Lemoine, a blue line, resemblin','^ that of lea^ 
Boning, may form upon the gums after the prolonged use of borax. 

Gowers has, when administering borax in epilepsy, seen psoriaa) 
velop in several instances, and is disposed to attribute the disease of th« 
to the influence of the drug. Both psoriasis and eczema have been attril 
by other writers to the ingestion of borax. Borax is said to be better 1 
when administered in glycerin instead of aqueous solution, or when i 
tinal antisepsis is conjoined. Dr. Ch. Fere, after an experience of six 
with borax in epilepsy, regards it as distinctly inferior to the bromid 
efficacy. The renal trouble excited by prolonged use of the drug doe 
always subside on suspension, and one case is mentioned which termii 
fatally from uremic coma. When the epileptic attacks are nocturnal, a 
tion of the drug should be given during the night. In order to cove 
taste of borax M. Gay recommends solution in an infusion of licorice 
the addition of a little glycerin; in sweetened milk and strong coffee; 
syrup of orange-peel with julep. Syrup of orange is said to be the 
vehicle. Professor Lashkevich considers the borate of ammonium of se 
in phthisis. It is said to reduce the expectoration and, in some cases 
fever, ile combines it with conium, hvoscyamus, or some other seda 
Dr. Golding-Bird asserts that borax cannot be employed with impunil 
women, as it has a stimulant action upon the uterus, and states that in 
instances he has seen it produce abortion. Some have employed bora: 
the purpose of exciting uterine contractions in protracted cases of h 
It has also been administered in amenorrhoea and dysmenorrhcea. 

Dr. Sacaze, of Montpelier, reports an excellent result from the m 
borax in a case of paralysis agitans. It was first given in 0.25 Gm. (or gi 
doses three times a day. After a few days the dose was gradually incre 
to double that quantity. Improvement was rapid. 

Several cases of poisoning, some of them fatal, have been repoi 
apparently due to the local application of boric acid or its solutions tc 
tfrnal cavities: the vagina or stomach. The symptoms were reductioi 
temperature, depression of spirits, sickness of the stomach, feeble pulse, t 
in some instances, hiccough and ccchjrmoses. The mind usually remai 
clear, but coma sometimes occurred. 

Solution of boroglyceride (50 per cent.) is a pleasant and efficient aj 
cation for conjunctivitis, pharyngitis, and as a dressing for wounds 
granulating surfaces, having the important advantage of not being poii 
0U8. It is especially recommended for the local treatment of diphtht 
Boroglyceride ointment, made by adding to it unguentum aqua? rosie, 
pleasant application for sunburn, pruritus, and other skin ailections. Bo 
acid ointment (in lanolin or zinc ointment, 1 to S) is used as a dressing 
wounds and ulcers. The sdution of boroglyceride is a valuable applical 
in chronic eczema of the palms of the hands and the soles of the feet. I 
also useful in subacute and chronic eczema of the genital organs, especii 
when the scrotum is invaded. It ran he prpscribed with witch-hazel. 




ACIDDM CARBOLICUM. 105 

The addition of borax is said to increase the laxative effect of glycerin 
suppositories. 

ACIDTTM CACODYLIGnH. — Cacodylic, or Bimethalarsenic, Acid is a 

white crystalline powder, odorless, soluble in M'ater, and containing 54.4 per 
cent, of metallic arsenic, which is equivalent to 71.4 per cent, of arsenic 
oxide. Cacodylic acid and sodium cacodylate have lately been occupying the 
attention of Continental investigators as substitutes for the usual prepara- 
tions of arsenic on acco\mt of being less toxic in their effects. The cacody- 
lates of potassium, magnesium, lithium, quinine, iron, guaiacol, and mer- 
cury have also been introduced. 

Dr. DanloSj^ of Paris, France, made a second report of his investigations 
with the use of the sodium cacodylate before the Paris Medical Society on 
June 16, 1900. He has treated some sixty cases of psoriasis, with good 
results, although he has to note a tendency to relapse, the method of ad- 
ministration being by hypodermic injections. Internally this author has 
used cacodylic acid with good results in lupus erythematosus, and in tuber- 
culosis of the skin. 

Dr. M. H. Billet,^ attached to the military hospital at Constantine, 
Algeria, reports thirteen cases of. malarial cachexia more or less pronounced 
that had been treated with cacodylate of sodium. This drug following 
immediately upon treatment by quinine, had restored the red blood-cells 
from about 3,500,000 per millimetre to normal, in the space of from fifteen 
to twenty days. The number of injections was from four to six, at intervals 
of three or four days, the dose employed being 0.23 Gm. (or gr. iii V4) for 
each injection. The haemoglobin proportion had been raised simultaneously 
with the increase of red blood-corpusclos. It has also been noted that the 
offoniilve garlic smell of the breath, when given internally, is obviated by 
h}'poclcrmic administration. 

Dr. William Murrell, of London, reports toxic neuritis and other bad 
rt'sults, from doses of 0.6 Gm. (or gr. j) three times a day. He considers 
it a dangerous drug. 

ACTDTTM CAMPHOEICUM (U. S. P.)— (See Camphora.) 

ACIDTrM CABBOUCTJII (B. P.).— CarboUc Acid. PHENOL (U. S. 
P.). (C,H,OH). 

DofC, 0.03 to 0.13 Gm. (or gr. ss-ij). 

A constituent of coal-tar, obtained by fractional distillation, and sub- 
sequently purified. 

ACIBUM CAKBOUCTJM UaUEFACTUM (B. P.).— Liquefied Car- 
bolic Acid. 

Contains 10 parts of water to 100 parts, by weight, of phenol. 

PHENOL LiaTTEPACTUM (r. S. P.).— Liquefied Phenol. 
Contains 90 per cent, phenol, with 10 per cent, water. 

PTeparaiions. 
Olyceritum Phenolis (U. S. P.). — Glyoerite of Phenol (20 per cent). 
Glycerinum Acidi CarboHoi (B.P.).— kilycerin of Carbolic Acid (20 per cent.). 

^''Bulletins et If ^moires," vol. xvi, p. 5HS. 
*Kew York Medical Journcl, Aug. 25, 1900. 



106 PHARMACEUTICAL THEEAPEnTIC AGENTS OH DRUGS. 

Sodii PhcnoUulphomia (U. S, P. ),— Sodium phenolsulphonate. Sodii S 
carbolas (B. P.). 1X)»(», 0.32 lo 2 Gm. (or gr. v-xxx). 

Unguentiim Pliprnlis (U. S. P.). UngiUMitiim Acidi CarboUci (B. P.).— Oil 
of Phenol (U. S. P., 5 per cent.). Carbolic Acid Ointuu-nl (B. P., 4 per cent.). 

Trochiscus Acidi Carbolici (B. P.).— Phenol Lozenge 10.005 Gm., or gr. j 
Tolu basis). 

BtippoBitoria Acidi Carbolici (B. P.). — Phenol Suppositories. Elach co 
0.0G6 Gm. ^or gr. j) with white bees-wax and cacao-butter, 

ZiiH'i Plu'iiolsiilphftims {U. S. P. ), Sulphncarbolat^* (B. P.). — Phenolaulpl 
of zinc. Dosf^T O.Ofl to DJJO Gm. (or gr. i-v). 

Phamiacolog^y. — -Liquefied phenol is a liquid obtained during tb 
tillation of coal-tar Itctwcen the ternporalureB of 180* and l^O'' C. (35 
374° F.). What is called crude carbolic acid is distilled at a somewhat ! 
temperature, and contains also cresylic acid and other substances ? 
render it unfit for medicinal use, except as a disinfectant for drains, et 
mixture of coal-tar constituents has, under the name of saprol, been 
posed as a cheap disinfectant. Saprol is a dark-brown, oily substance 
floats upon the surface of water, which extracts from it carbolic acid, c; 
and other soluble products of coal-tar. In 1-per-cent. solution, saprol 
energetic agent, and is well adapted to the disinfection of dejecta in barr 
prisons, and schools. It must be borne in mind when using this fluid tl 
is of an inflammable nature. 

Pure carbolic acid is crystalline at ordinary temperatures, and at 
is colorless, but reddens after exposure to the air. It has a charaete 
odor and pungent taste; it is very soluble in all the usual menstrua, ha 
the peculiarity of bein^ liquefied by 5 per cent, of waterj but the fui 
addition of water produces turbidity until the proportions are reverse 
to '^0), when it remains permanently clear and is not afTected by fui 
dilution. It resembles creosote in its disinfectant properties, but differs ; 
it by being converted into picric acid when nitric acid is added to it; whe 
with creosote, nitric acid forms oxalic acid. Resorcin is also of a sii 
character, but is in the form of a powder. Both creosote and resorcin 
be considered separately. 

The following unofficial preparations are sometimes used: — 

Unofficial Preparations, 

Aqua Acidi Carbolic! [8 Gm. in 473 c.cni. of water, or 3)j in Oj). Dose, 4 to 
c.cm. (or fSi-ij) ; also aa a \\aah« gargle, or spray. 

Carbasua Acidi Carbolici (gauze, containing carbolic acid, 1; resin, 5; par 
7 part«). 

Oleum Acidi Carbolici (1 in 20 of olive- or cotton-seed- oil). 

Carbolic-Aind Camphor. — Disnolve U pArls* acid in 1 of alcohol, and mix wit 
parts camphor, fonoing a clear, oily solution. 

Liquor Sodii Carbolatua (N. F.). — Solution of Carbolate of Soda (carbolic 
12.60 Gni.,or gr. cIxAxviij ; caustic soda, 2 Gm.. or gr. x.vxj; wiiter, I'JO com., or f; 
For externa] use, properly diluted. Pb^nol-iwdique. 

Liquor Sodii Boratia Compositua (N". F.). — Dobell's Solution (borax and soc 
bicarbonate, each, 8 Gm., or 3ij ; carbolic acid, 1.56 Gm., or gr. xxiv, in water; 
c.cm., or Oj). For external use in spray for nose and throat. 

Tribromophenol. — A compound of Bromine with Carbolic Acid with strong 
mine odor. In the form of soft, white needles; used aa an antiseptic externally 
internally. Dose, 0.20 Gm. (or gr. iij). 

Parachlorphenol. As an antiseptic. 

Calcium Carbolatura. — Carbolated Lime. For disinfecting purposes. 

Physiological Action. — Carbolic acid and its preparations are dis 
guished by their destructive action upon the lower forms of life, but, ow 



ACIDUH OARBOLICUM. 107 

to their tarry smell and toxic effects, they cannot be used for preserving food, 
and are not popular in the household. When applied to the skin, carbolic 
acid causes irritation, and sometimes sloughing. Gangrene sometimes fol- 
lows the use of carbolic acid as a surgical dressing. According to the ob- 
serrations of Dr. E, T. Eeichert, this result is most apt to be caused by the 
use of moist applications and occurs especially in weak subjects, women and 
children. According to some reported cases, the presence of chronic alco- 
holism or diabetes seems to favor the occurrence of this accident. Carbolic 
acid is a local ancesthetic. It is also readily absorbed through the skin, and 
toxic effects have been produced in this way, although much more frequently 
by the absorption through the raw surface of a recent wound. Two cases 
of coma due to the application for a variable time of a 5-per-cent. solution 
have been reported by R. Clement Lucas and W. Arbuthnot Lane. The 
urine is diminished in quantity, and on standing acquires an olive-green 
color; this is generally the earliest symptom of intoxication. We also notice 
loss of appetite, nausea, vomiting, frothy salivation, difficulty in swallow- 
ing, and nervous symptoms. The pupils are contracted and the functions 
of the brain and spinal cord are affected, suspended reflexes and impaired 
sensibility and motility being observed. Large doses exert a depressant in- 
fluence upon the circulation, and after lethal amounts the heart stops in 
diastole. Death occurs from respiratory paralysis; the temperature is at 
first increased, but afterward is reduced. La severe cases there is shock, 
great pallor, and sudden death. At the autopsy the drug may be recognized 
by its penetrating odor; evidences of corrosive action may be seen if taken 
in concentrated form, but even in small quantities it produces gastritis. As 
elimination takes place principally by the urine, the kidneys may be con- 
gested or inflamed; the blood is dark and imperfectly coagulated. 

According to the observation of Dr. W. J. Wilkinson, the number of 
red blood-corpuscles is reduced, but the percentage of haemoglobin remains 
unaltered. Zwaardemaker has shown that rats and cats are particularly sus- 
ceptible to the action of carbolic acid. After a poisonous dose death some- 
times comes on with great rapidity. In rare cases it is delayed for several 
hours or days. The fatal dose varies within wide limits, the minimum being 
rather more than 4 Gm. (or 3j). 

Treatment of Poisoning. — When carbolic acid has been swallowed 
prompt treatment is required. The soluble sulphates (soda or magnesia) 
are the best antidotes, but the liquor calcis saccharatus, or syrup of lime, is 
tlso useful, if at hand. Alkalies, soap, albumin, flour and water may be 
given, and the stomach washed out with the stomach-pump. Oils should 
not be given, as they favor absorption. The bowels should be freely opened 
vith magnesium, or sodium, sulphate. Collapse is relieved by hypodermic 
injections of atropine, by hot applications, arterial stimulants, and friction. 
The soluble sulphates should be administered in small doses for several days, 
in order to remove the carbolic acid from the system. Professor Carleton, 
of New York, states that vinegar is an excellent antidote to phenol. When 
applied to a cutaneous or mucous surface which has been burnt by the acid 
the characteristic whitish appearance produced by the caustic at once dis- 
appeara and subsequent scarring is to a large extent prevented. Vinegar is 
also said to be equally good as an antidote when the acid has been taken into 
the stomach, and it is recommended that the patient should as soon as pos- 
sible drink some vinegar mixed with an equal part of water, after which other 



108 



PHARMACErTICAL TilEKAPEUTIC AGEXTS OB DflUGS. 



measures may be taken to more fully counteract the poison. Drs. P 
and Powell state that alcohol is an absolutely safe and sure specific a| 
the escharotic action of concentrated carbolic acid. Dr. Gross, of 
Wayne, further suggests the use of alcohol internally as an antidote fo 
bolic-acid poisoning. Cases successfully treated by alcohol given freely, 
by the mouth and hypodermically, have been reported by Dr Kel 
Brooklyn, and Dr. Hair, of Bridgeport, Conn.' As cases of poisoning b 
agent are focconiing quite common, it has been suggested that every phyi 
should keep on hand sulphate of soda, which is a prompt and safe ant 

Therapy, — TIr' aiitizviintlic and aiitisc^ptic qualities of li<niefiod p 
have been largely utilized in surgery, although it has now been nearly a 
seded by the solutions of mercury, which have no offensive odor. Fon 
the spray of carbolic water was considered an indispensable feature o 
Listerian method, but this has been found to be unneccesary and has 
abandoned, as asepsis can be secured without it. The solution is still 
as a detergent and as an application upon dressings. In the treatme 
carbuncle or malignant pustule, after incision and scraping, the applio 
of pure carbolic acid not only acts as an antiseptic, but also as a local j 
thetic, relieving pain. 

Dr. Oscar H. Allis, of Phiiadelphia, and Dr. B. F. Gardner, of Bk 
burg, Pa., apply undiluted cnrholir arifl in the treatment of woundi 
burns. The tissues turn while immediately after its application and are 
cleansed by douching with sterilized water. They have witnessed fro: 
use in this manner neither shock nor 83'stemic absorption. It also exei 
hirinostatic clfect, espet-ially upon the caiiilliiry vessels.'-' Czerny*' re 
three cases in which carbolic-acid solution was applied to the fingen 
gangrene resulted. In two of the cases, a 3-per-cent. solution was ap] 
but it was kept on for several days. The duration of the application is 
important tliiiti the coiici-nlrntiou. T^r. llouijoll^ liiis collwtod forty- 
cases of earholic-acid gangrene and calls attention to the fact that i 
been caused by solutions as weak as 1 or 2 per cent. He warns phyai 
to discard its use as a dressing for the estrcmitiee in all strengths. Carl 
acid camphor, being free from offensive odor, may be used as a substitut 
the pure acid. In weak solutions carbolic acid has been used as a 
fiiticide in various forms of tinea; and it has also been used topically fo 
prevention of pitting from small-pox. An ointment containing car 
acid and camplior lias proved of service also in mitigating the pruritu 
companying variola. In the treatment of burns, in the form especial 
carbolized oil, it is much employed. In acute vesicular eczema, eryth 
and in dermatitis, especially from various poisonous subBtances, the ai 
has employed this combination with great service: — 

B Pliciiolis liiiiicfac'ti |38 Gm, or gr. vj. 

Pulveris zinci cnrb. imp 31( Gm. or 5j. 

Liq. cftlciB, 

Glycerini na 00| c.cm. or fjilj. 

M, Sig.: Shake well, and mop frequently over the surface. 



' The Medical Butletin, Feb.. 1900. p. 57. 

* Pee pftpor hv Dr. Osoar H. Alli.s, on "Carbolic Acid Used iu Pull Sirens' 
Surgery." in Alviiicat Uulletin, Jan., 1894, p. 4. 

* Muehrner wcdirinischi' Woohviifirhrift. Anril 20, 18fl7. 

* liritrtiijr ziir IJini'^thr rhiniiyjlr^ Ji. 10. TT. 3. 




ACIDUM CARBOLICUM. 109 

An ointment containing carbolic acid, sulphur, and camphor is most 
effective in many pruritic diseases of the skin, especially papular eczema, 
psoriasis, lichen, and urticaria (or nettle-rash): — / 

B Phenolis Uquefacti 132 Gm. or gr. t. 

SulphuriB 8ubl. 2 Gm. or 3ss. 

CamphonB > . . . 66 Gm. or gr. x. 

Ungt rinci oxidi 3l| Gm. or 5j. 

M. Sig.: Apply frequently to the irritable eurfiice. 

Lotions containing carbolic acid also allay the itching which accom- 
panies jaundice. 

In the vulvitis or leucorrhoea of young girls lotions or injections of car- 
bolic acid in the strength of 5 parts to 1000 of water are beneficial, pads of 
lint saturated in the same solution being used to separate the inflamed parts 
in the intervals. The gonorrhoea of females has also been successfully man- 
aged by the application once or twice a day of tampons moistened with the 
following mixture: — 

H Phenolis liquefacti II Gm. or gr. xv. 

Alcohol, vel sp. odorat 301 com. or fSj. 

Aqtue ; 75| c.cm. or fSiise. — ^M. 

Scabies has been cured by friction with a l-to-15 carbolized oil. 

Internally, carbolic acid, sometimes, rather unexpectedly produces 
symptoms of poisoning, which fact restricts its use. In fermentation accom- 
panying flatulent dyspepsia and in dilated stomach, carbolic acid will check 
the process and relieve the symptoms. It is useful in irritable vomiting, 
given frequently in broken doses. The author suggests the following pre- 
scriptions in the variety of dyspepsia referred to: — 

B Phenolis Uquefacti . ^ |25 Gm, or gr. iv. 

PuIt. aromatic! |75 Gm. or gr. xij. 

M. et ft. pil. no. xij. In capsulte duris. 
Sig.: One before meala. 

Q Phenolis liquefacti |32 Gm. or gr. v. 

Synipi acacue, 

Aqus cinitamomi aa 45| c.cm. or fSisa. 

M. Sig.: One teaspoonful before meals. 

Carbolic acid is also of service in the treatment of diarrhoea. It has been 
used in pill form in the treatment of tape-worm. It is part of the so-called 
specific treatment of t3rphoid fever in extemporaneous combination with 
tincture of iodine (1 to 2 of iodine) in doses of 0.12 to 0.18 c.cm. (or mii- 
iij) every three or four hours, given in mint-water. The acid has been 
given in typhoid fever imassociated with iodine. Surgeon E. H. Quill, of 
the British army, has used in typhoid fever a combination of carbolic acid 
and chloroform (the proportion of acid to spirit of chloroform being as 3 
to 10), and gives the most favorable reports of this method. In puerperal 
septicsemia, alone or alternated with quinine, it has been thought to answer 
a good purpose. Carbolic acid has been recommended by some writers as a 
valuable prophylactic against scarlet fever. In offensive breath, the cause 
may be in the mouth, throat, or bronchi, and in any of these cases the use 
of the steam-atomizer with a 5-per-cent. solution of carbolic acid will often 
relieve the patient very promptly. Caries of the teeth may be relieved by a 



110 



PHAnMACEUTIOAt, THEBAPEITIC AGENTS OU DRUGS. 



mouth-wash containing carbolic acid or phenol-sodiquc, well diluted, 
same applied with a brush or atomizer has been used in diphtheria and 
ous forms of sore throat. Weak solutions are used in hay fever, chronic 
catarrh, coryza, and influenza, and afford marked relief; the one kno^ 
Dobell's solution is widely used for the purpose, and for cleansing the 
trils. It is the liquor sodii borntis c'omp. of the* Xatiomil Formulary. 

Subcutaneous injections of a 2-per-cent. solution have been mad 
checking the progress of erysipelas, and parenchymatous injections inb 
lungs in pulmonary phthisis. In the early stage of furuncle, and ii 
larged lyinpbatic glands, tlie parendiymatous injection of the same sol 
often proves cirectiial in preventing tbe formation of pus. The same m* 
has been employed with success in the treatment of chronic synovitis] 
it has proved of service in certain forms of functional spasm, accompi 
by localized pain, the injection being made at the painful spots. Caa 
tetanus have been successfully treated by the subcutaneous injection, 
joined with warm baths and enemata containing chloral and potaa 
bromide. 

Dr. F. E, Place has treated successfully tetanus in horses by hypode 
injections of pure carbolic acid. His method is to inject in the neighborl 
of the neck and shoulders 4 Gm. (or 5j) every two houi-s, for the first th 
two hours of treatment, and leas frequently later. A large swelling apj 
at the site of the injections, but disappears in about fourteen days. Si 
times there is a loss of hair over the spots, but it is not permanent. Ht 
never administered less than G4 Gni. (or 5xviss) in a successful case.^ Nii 
and Amy5- have reported 4 cases of tetanus in the human subject treate 
injections of 2-per-cent. solution of carbolic acid under the skin in 
neighborhood of the wound. The patient who received the largest quai 
was the only one to recover. In each case chloral-hydrate and potass 
bromide were given simultaneously in large doses*. The case which te 
ered received 17.20 Gra. (or gr. cclxvij) in eight days, of which 6.5 Gm. 
gr. c) were given in the first twenty-four hours, without untoward effec 
any kind. 

Dr. Flavel Woods,^ of Philadelphia, reported recently a satisfac 
recovery from tetanus by means of large doses of carbolic acid. This met 
was introduced by Baccelli. Bab^s* speaks of it in very high terms, 
says thfit the statistics of the antitoxin treatment do not show any better 
suits. Bab^s injected 0.50 Gm. (or gr. viiss) of a y.-per-cent. solution al 
the spinal column every two hours. Areoli injected a 2- or 3-per-cent. si 
tion in small doses, the patient receiving 0.32 Gm. (or gr. v) a day. ' 
Accademia Medica, of Rome, published these statistics: One death in 
cases with Baccelli's treatment; 8 deaths in 40 with Tizzoni'a serum; 4 
11 cases with Behrin^'s serum No, 1 ; 2 in 9 cases with Behring's serum Nc 
Lieutenant-Colonel W. G. H. Henderson" reports success with the carbo 
acid treatment of tetanus in both man and animals. Of 20 patients trea 
three times a day with injections of 0.13 Gm. (or gr. ij) of carbolic acid 
1.20 c.cm. (or mxx) of water, 7 recovered. Kitasnto has demonstrated t 



* rjancet, Feb. 24. 1900. 

* 8t. Loui9 Medical Rcviete, Dec.» 1899. 
•Editorial in Medicfil Record, Oct. 21, 1899. 
' "Twentieth Century Practice of Medicine." 
*Laneet, June 3. 1899. 




ACIDUM OARBOLICUM. Ill 

carbolic acid acts as an anaesthetic, then as an antiseptic^ and as an antidote 
to the toxin of tetanus. 

J. M. Atkinson recommends large doses of carbolic acid hypodermically 
in treating the bubonic plague, and reports a successful instance of its use.^ 
Subcutaneous injections of carbolic acid were found very eflfective by 
Skultecki in 2 cases of severe erysipelas and 1 of septic puerperal fever; aU 
recovered promptly, and he recommends the treatment as strongly as it has 
already been lauded for tetanus and anthrax. The erysipelas patients re- 
ceived seventy-two to eighty-four injections, a total of 1.44 to 1.68 Om. 
phenic acid (or gr. xxi'/^-xivj), in a 2-per-cent. solution, 1 c.cm. (or mxv) 
every four houra. The puerperal fever was treated with 0.38 Gm. (or gr. vj) 
of phenic acid every three hours, the first day, and afterward with 0.30 6m. 
(or gr. ivss) every lour hours, for a week, when the cure was complete.* 

A. Strubell reports a severe case of gangrenous and necrotic anthrax 
spreading from the tip of the nose, with chills, fever, etc., completely cured 
with scarcely a scar, by frequent injections of a 3-per-cent. solution of car- 
bolic acid, a total of 400 Pravaz syringefuls in eighteen days, combined with 
copious stimulants, warm baths, and hot cataplasms at a temperature of 50" 
to 55° C, applied locally every ten minutes, night and day. The growth 
of the anthrax bacillus is checked at 40** and permanently arrested at 42**. 
Cultures from the nose were very virulent, but no bacilli were foimd in the 
biood.* ^ 

Ziemssen recommends in tonsillitis the injection into the substance of 
the gland of 0.50 c.cm. (or mviij) of a 2-per-cent. solution. Relief is rapid, 
often after only a single injection has been made. As a prophylaxis against 
frequent recurrent attacks of tonsillitis, gargling the throat with a carbolized 
alcoholic solution has been advised. The pure acid (1 to 1.30 Gm., or gr. xv- 
u) has been used by Levis as an injection into the tunica vaginalis, in cases 
of hydrocele, with successful results. In haemorrhoids, carbolic acid, either 
ptire or diluted with oil, has been employed with satisfactory results; but 
there have been some accidents. It has also been recommended in weak 
wlution for the treatment of ascarides by enema, but the danger of absorp- 
tion is too great for its use in this way; it may, however, be applied ex- 
ternally, as it is an excellent antipruritic. 

The vapor of carbolic acid may be inhaled for whooping-cough or 
phthisis, in the place of the spray, by placing a few drops upon some ab- 
Eorhent cotton in an inhaler. 

Dr. H. Ernest Schmid relies entirely, in every stage of whooping-cough, 
upon the use of a spray composed as follows: — 



H PhenoUs liquefacti 

Menthol (4-per-ceiit. »ol.) 15 

Gocftin. hydrochlor. (3-per-cent. sol 11 

Glycerin 4 

Aq. Uurocerasi q. b. ad 30 



38 Gm. or gr. vj. 

c.cm, or fSiv. 

c.cm. or fSiij. 

ccm. or 131. 

c.cm. or fSj. — ^M. 



The solution is used by means of an atomizer every third hour, the 
nozzle of the instrument being directed as far as possible into the mouth 

* Lancet, Dec. 9, 1809. See also article on the "Bubo Plague," by author, in 
teviied edition of "Reference Hand-book on the Medical Sciencea." WiUiam Wood 
*Co,.New York. 1900. 

^Umaine M^dicule, May 25. 1898. 

*ifuncltener medidniache Wochenachrift, Nov. 29, 



l\2 I'lIARMACEL-TICAL THKRAPEITTIC AOEKTS OH DHrcS. 

of the patient. The use of a weak solution of carbolic acid hy atomic 
combined with its internal administration, is of service in pulmonar 
p:rent'. In the S('i>tic dist^aso.'S. — sniall-pi>x, septica'mia, puerperal fever, 
the pheiuili?uli>honate6 liave been used with asfiericd success. In ^ 
fever Dr. Waugh hafl had good n^sults fr(»in zinc phenoIftul])honjite, iu 
of 0.13 to 0.20 Gnu (or ^'r. ii-iij), four or five times a day. It has i 
viinTa^'-c, over the carbolic acid and iodino treatment, of being le:?s depi 
to the heart and less inJLirimi.'^ to the kidneys. 

Prof. M. Charteris, of Glasgow, believes that pure carbolic acid 
good results in the treatment of typhoid fever. He gives it in the f< 
a pill containing 0.16 Gm. (or gr. iiss) of pure acid made up with so] 
nocuous powder and covered with keratin, for the purpose of delaying 
tion until it has passed into the bowel. He is also of the opinion 1 
may be useful as a prophylactic and therapeutic agent in cholera, ani 
it might, with advantage, be tried in diphtheria in doses of 0.13 Gm. i 
ij) every two hours. 

ifagnesium phenolsulphonate is said by Dr. G. Tarozzi to be aui 
cious laxative and intestinal antiseptic in doses of 1 to 2 Gm. (or | 

XXX ). 

Farachlorphenol — obtained by the action of chlorine on phenol-^ 
by Girard, of Beine, to be more stable, energetic, and constant in actio! 
other drugs and its toxicity is much less than mercury, cresol, or pi 
Sui»eutancous injections of 1 Gm. (or gr. xv) per kilogramme of body-i 
are reLpured to form a toxic dose for a dog or rabbit. A 2-per-cent. so 
kills the epores of anthrax in an hour, whereas a 5-per-cent. soluti 
phenol requires twenty days. It forms a valuable antiseptic dressil 
wounds or for cleansing surgical instruments. 

Fhenosalyl.' — -CombinationH of anti^eptir tinl)8tances liavi? ortei) 
proposed for the purpose of securing inerea^ed action, lessened to; 
greater solubility, etc. Dr. J. de Christmas, of the Pasteur Institn 
Paris, has <levised a mixture width he lenu."^ PhenosalyU liir (onni 
whieh is as follows: — 

Phenol 90 parts, 

Lactic Hcid 20 part* 

Salicylic acid 10 partSi, 

Menthol 1 part., 

Thi^ forms a clear, syrupy liquid, which partially crystallizes £ 
temperaiorc!^, Init ujxui the addition of a small (quantity of glycerin, a 
solution n^sults. This will not again crystallize and rtnidily dissolves in 
water, alcohol, and ether. In cold water it is soluble to the extent of 
cent. Experiments have shown that phcnosalyl is considerably less p' 
ou8 than carbolic acid. It has been used in 1-per-cent. solution for th 
infection of hands and instruments, for irrigations, etc. A solution r 
same strength pro%*ed rapidly curative in a case of impetigo, while 
5-per-eent. phenosalyl pencils were beneficial in endometritis and uretl 
Phenosalyl has been advantageously used as an antiseptic in obstetric 
A 2-per-cent. solution injected into the bladder was productive of exc- 
results in purulent cystitis. An ointment of 1 part of phenosalyl to 1 
160 parts of vaselin was successfully employed by Dr. Berger in bleph 
enitia and a 0.2- to 0.4-per-cent. aqueous solution in different forr 
conjunctivitis. Scheurlen and Bechmen, a few years ago, published tl 




ACIDDM CHROMICUM. 113 

salts of experiments proving that the germicidal action of carbolic acid is 
decidedly increased by the addition of sodium chloride. A solution of 1 
per cent, of carbolic acid with 24 per cent, of common salt gave better 
results than 6 per cent, solution of carbolic acid in plain water. 

ACIBTJIC CHEOMCUM (B. P.).— Chromic Acid (CrO,) 
CHBOHn TBIOXIBUH (IT. S. P.).— Chromic Trioxide. 

It should contain not less than 90 per cent, of chromic anhydride. 

Preparations. 

Potassii Dichromaa (U. S. P., B. P.).— Potassium Dichromate. Uoae, 0.006 to 
0.012 Gm. '(or gr.V«-V.). 

Liquor Acidi Chromiei (B. P). — Solution of Chromic Acid (25 per cent, of CrO,). 

Pharmacology. — Chromic acid occurs in the form of small, crimson^ 
needle-shaped crystals, deliquescent and very soluble in water. They shoidd 
not be added to alcohol, as mutual decomposition takes place, sometimes 
explosively. An explosion results instantly from a mixture of 1 part of 
chromic acid with 2 parts of glycerin. For the same reason chromic acid 
should never be combined with spirit of nitrous ether, 

FhyBiological Action and Toxicology. — On account of its marked 
afl&nity for water and its contained oxygen, chromic acid rapidly destroys 
tissues, forming an eschar, and it is a powerful antiseptic. In solution 
(from 5 to 20 per cent.) it acts as a caustic. When swallowed it is a cor- 
ro«ive poison, and requires prompt treatment by demulcents and alkalies, 
with irrigation of the stomach. If death does not occur at once from shock, 
it may result from inflammation and sphacelation of the mucous coats of 
the stomach. Workmen in factories where chromic acid is used are liable 
to have perforation of the nasal septum from the local action of the acid 
applied accidentally upon the fingers. Eczema of the hands is liable to 
occur in those engaged in making the bichromate solution used for dyeing 
purposes- Cloth dyed with this material is apt to produce ulceration of the 
integument. The electropoion fluid (Liquor Electropoeieus, N. F.), or 
battery^floid, contains potassium dichromate in powder, 186 Gm. (or gvi) ; 
commercial sulphuric acid, 180 c.cm. (or f^vj); cold water, 1419 c.cm. (or 
^xlviij). Being of an attractive red color, and in such common use among 
physicians, it may be swallowed by mistake, and instances of poisoning in 
this way are not uncommon. In such cases, soap-suds and milk may be given 
at once, and the stomach carefully washed out with a soft tube, as vomiting 
may rupture the stomach. Arterial stimulants and external counter-irrita- 
tion and hot applications may be required. Chrome yellow, or lead chro- 
mate, has been used by bakers in order to give a rich color to cakes. The 
s^-mptoms are principally indicative of lead poisoning. 

Therapy. — The solution of chromic acid is an excellent remedy for warts, 
syphilitic mucous patches, and enlarged tonsils (0.65 to 30 c.cm. of water, 
or gr. x ad aq. f5j), applied with cotton or a camel's-hair brush once or twice 
a day. It has also been used in gynaecological practice in uterine hsemor- 
Asge and endocervicitis, and has been injected into haemorrhoids, and ap- 
plied to hypertrophies of the nasal chambers, and also to some malignant 
p^wths. Sweating of the feet (hyperidrosis) is relieved by sponging the feet 
daily with a weak solution. Parasitic skin diseases, sycosis, lupus, tinea cir- 
dnata, and condylomata require a stronger solution (6.60 to 30 c.cm., or gr. c 



114 



PHARMACEUTICAL THERAPEUTIC AGEXTS OR DBUGS. 



to fjj). As the caustic action tends to spread, it should be used with ca 
covering; the neighboring gurfnce with petroUiluiii, or some other pro! 
ointment, and promptly rcmo^nng excess of aeid with an nlkMline wash 
In favns, after the crusts have been removed, an ointment compoi 
follows has proved serviceable: — 

B Pota«8. dichromat II Gm. or rr. xv. 

Adipia 3l| Gm. or Sj. i 

M. ft, ungt. 

A 1-per-cent. solution of chromic acid in water has been fout 
Professor Knnfman, of Alfort, to be an excellent remedy in cases of ^ 
bites. As an application to chronic ulcers the following combination ii 
ommcnded: — 

R Clironiii Irioxidi 21 Gm. or gr. xx 

Acid, tnnnic 1 30 Gm. or gr. xx 

Miir|vhirisB sulpli |32 Gm. or gr. v, 

Clilorflli liydrati 23|32 Gm. or 3vj. 

Aquee 473| c.cm. or Oj. 

M. Sig.: Apply frequently with camers-hair brush. 

Chromic acid has been successfully used by Dr. W. R. H. Stewa 
the treatment of ranula and cystic goitre. After the tumors had been op 
their contents washed out, and after haemorrhage had ceased, a satu 
sohition of trioxido of chroniivira w;i?api>lird to several points of the cyst- 
Chromic acid is not used internally; but tlie potassium dichromate has 
administered in doses of 0.006 to 0.012 Gm. (or gr. Vio-Va); ^t acts i 
emetic in doses of 0.048 Gm. (or gr. */*)- It has been used in chronic i 
matism and sypliilis, made into pill with some vegetable bitter^ but^ 
doubtful utility in these conditions, j 

Potassium' Dicliromate. — Dr. Joseph H. Tluut, of Brookl\Ti, praise 
action of f)otiiSf?ium dirlironifito as an expectorant in catarrhal conditio: 
the respiratory tract. To children of a year old, he is accustomed to gi 
in 0.0033 Gm. (or gr. Vso) doses. When the respiration is seriously en 
rassed, he repeats the dose every fifteen or thirty minutes until the 8] 
toms are ameliorated, when he diminishes the frequency to hourly inter 

Following the suggestion of Vulpian, Professor Fraser, of Edinhu 
has, with advrtntage, made use of potassium dichromate in numerous i 
of aggravated dyspepsia,* some of which were associated with distin< 
symptoms of gastric ulcer. The remedy was generally given in the do5 
0.005 Gm. (or gr. Vis)^ sometimes increased to 0.01 Gm. (or gr. Vn), t 
times a day. Professor Fraser adnscs that the remedy be given during : 
ing, while the stomach is, as far as possible, empty. He states that potass 
dichromati' is capalde of relieving, and often in a short time uf r<'tno\ 
the entire group of symptoms, except constipation and anaemia, encounb 
in dyspepsia. It is particularly useful in alleviating pain, nausea, and v 
iting. In gastric ulcer it did not succeed in checking hiemnrrhage. 
obstinate vomiting, gelatin capsules, each containing 0.006 Gm. (or gr. \ 
have been given every hour or two, with good results. In gastraleia 
they have been successfully given, 1 three times a day, on an empty stomi 
by Bradbury, of London.^ Professor Fraser, of Edinburgh, read a pc 

'lancet, April 14. 1894. * Lancet, Sept. 14. 1895. 




ACIDUU FOBMICUM. 



115 



hdan the International Medical Congress at Rome on the use of this salt, 
seoDauDcnding it in certain affections of the stomach.* 

PaCaautun dichromate has likewise be<'n adminiBtered with assorted 
ladt in locomotor ataxia. Dr. Diago reports very favorable results from 
Af odiifliTe ■dministration of this remedy in seveu cases of haemaiochyluria, 
tknv of which depended upon the presence of filariss. It was given in the 
km of 0.02 to 0.03 Gra. (or gr, V»-ss) in half a pint of water. He regards 
iWmH sc of value in the treatment of pernicious malarial anaemia. In cases 
rf poMoniDg by pota^ium dichromate the same means are employed as in 
Arauc-ttcid poidoning. At tlie present dav it is rardv prescribed iuter- 

ACTDUIC CrTRICTJM(U. S. P., B. P.).— Citric Acid(H,C,H,0, + H,0). 
0.65 to 2 Gm. (or gr. x-3es). B. P., 0.32 to 1.30 Gm. (or gr. v-xx). 

Preparation, 
Aridi GStrici (U. a P.).— One per cent. Dose, 7.50 to 30 c.cm. (or 



Sr^ 



Fhsraftoology. — Citric acid is an organic acid, usually prepared from 

k^uD-jnice; it occurF in the form of colorless crystals soluble in less than 

own weight of water. Citric acid is soluble likewise in alcohol and 

■. It ifl not infrequently adulterated with tartaric acid, which may be 

ited in the form of bitartrate by the addition of a strong neutral solu- 

; of carbonate of potassium. It has a sour taste, not unpleasant in weak 

ioDA. In substance it is irritating to the gastro-intcstinal mucous mem- 

aod may thus act us a poison. It renders the urine acid. It is elim- 

to •ome extent by the bowels, but principally by the kidneys. 

ttcrmpy. — In the proportion of 37 Gm. (or gr. dlxx) to 473 c.cm. (or 

Oj) of distilled water it forms a solution of the average acidity of lemon- 

^ h may be further diluted and SM*eetened as a refripjerant drink for 

fj9 been used also as a substitute for fresh lemon-juice in the treat- 

^1 '--. but is less efficient. 

1 has likewise been employed for the purpose of relieving in- 
leCTit^ of the liver and catarrhal jaundice. A l-per-cent. aqueous solution 
•^ ritric acid is said to be useful as an injection in gonorrhoea. 
Citric acid has the power of sterilizing polluted water. 

ACnnnC FORMICTTM.— Formic Acid (011,0,). 

Fharmaoology. — Many sjnvies of ants contain formic acid in its own 
term. The r»M «nt, Formica Rufa, indexed, contains about half its weiglit of 
^m p«cutiAr constituent, the name of formic acid having been derived from 
Ifc^ f^rt. Th'**** "fits possess no stings; but they can inflict very irrit4iting 
«i«Didi apr ■ n body by bitinjr tbrouL'h the skin with their strong 

mmtiMc$ hi - formic acid into the flesh. The powerful irritation 

hm art np was at one time utili;;ed in therapeutics by taking rlieuuiatic 
^'- «n an ants' nest, and making the insects angry so that they 
rxpo*od surface around the atfected joints, llecently, this 

a^> ( in 1C70) two physicians, Wray and Fischer, obtained 



i»: ri,.-il 



I in scientific medicine by substituting the hypodermic noe<llG 
ufiect for the introduction of the formic ncid. Xearlv thnn.- 



iM^^. ApHl U. 1W4. 




,' thnn.' i 



IIG PUARMACEUTICAL THERAPEUTIC AGESTS OR DRUGS. 

acid by distilling ants with vater-vapor. They introduced the solut 
formic acid into medical practice, principally for external use as a r 
oient, and, to a limited extent, for internal use, as a general stimulai 
aphrodisiac. It has been only lately discovered that formic acid, b 
methane derivatire, can be ]iroduced in different ways, notably I 
oxidation of methyl-alcohol, or liy breaking up oxalic acid in the pres€ 
glycerin. The latter, devised by Berthelot, is the method now gei 
adopted. 

Formic acid readily combines with bases to form a series of 
known as formates, which offer special advantages for the internal ad 
tration of thig active aj^ent. It hap been demonstrated that the al 
formates, notably the sodium and calcium formates, have a very stiraii 
fflt^'t ujion the nuiscular elements, both fitriated and non-striated, Hu 
of Paris, in n communication to the Academy of Medicine (March 14, ] 
reported, as the results of exton.sive laboratory investigation, that *^i 
acid salts increase tlie work performed by the muscular tie^ues, tlir 
four-fold, without fatigue." He regards them as superior in their effc 
caffeine, kola, strychnine, or spermine. Dr. Garrigues, alM, as the 
of liis personal observations, reported to the Academy (March 28, 
thai the administration of the formatci? induces not only an increase < 
muscular Btrcngth, but alr^o piimulates the appetite. This stateraer 
been confirmed by Clement, of Lyons, and others. The conditions in 
the formates of calcium and of godiuni have been administered succesi 
were certain forms of eonstipation, incontinence of urine, defective 
holism, and poor circulation, especially in phthisis, general asthenia, 
rexia, and amcmia. The duses of the formates vary according to ci 
stances. Tn Huclinrd's physiological experiments upon himself and p 
they took from ^^ to 'A grammes per day (15 grains, two or threi* times a 
with very decided benefits, as shown by the ergograpli, ami, he claimj 
without any deleterious after-effects. In phtliisical patients, the urine ■ 
tion was increased from 20 to 52 grammes. Other observers have cone 
that the more lasting results can be obtained by giving small doses, 
times a day (0.06 to O.oO Cim., or gr. j-v) for a prolonged period, 
glycero-phosphates are synergistic with the formates, and they nu 
used in eomliination with strychnine or other cardiac tonic. 

Pure formic acid (TICO. OIT, molecular weiglit 4.">.(j7) has the pe< 
property of acting both as an aldehyde and as an acid. It i? crj'staUi 
but, at a temperature above S.3° C, it is a colorless liquid, having a 
pungent odor and burning taste. It is caustic and destructive to the 
wiien applied lu full strength. 

Therapy. — In modem therapeutics, formic acid is coming into t 
a counter-irritant, in a oO-per-cent. stdution ; and in more dilute form, 
to 3 per cent. For internal adiuinistration tlie German Pluirmaec 
provides spiritus formiearnm. or spirit of ants, which is composed of 3 
formit' acid, 35 parts alcohol, and ^'^ parts water. This f^olution mj 
given in doses of from *20 to 30 Tuinims, as a genernl stimulant, acting 
much like ammonia. The oiVper-cent. solution has been applied Ic 
with success, as a counter-irrit^int, in treating neuralgia and rheuma 
It has also been used to prevent bed-sores. I'he ?V.^.-per-cent. solutii 
used in acute rheumatic nrtliritis. It has recently been used hypodennw 
with remarknblv beneficial results, bv Dr. Lcuiis B. Crouch (Medical R{ 
June 24, lOOr.)". 




ACIDUM HYDEIODICUM DILUTUM. 117 

ACIDTTM OALLICTrM(U. S. P., B. P.).— GaUic Acid(HCAOB + HaO). 

Dose, 0.13 to 0.65 Gm'. (or gr. ii-x), B. P., 0.32 to 1 Gm. (or gr. t-xv). 

An organic acid usually prepared from tannic acid (U. S. P.). A tri- 
hydroxybenjEoic acid. It may be prepared by the action of diluted sulphuric 
acid on tannic acid (B. P.)- 

Fharmaoology. — Galls are lumps or nodes upon the oak-tree, caused 
by insects. They contain about 50 per cent, of tannic acid, which, chem- 
ically, is an anhydride of gallic acid, and, in fact, is convertible into gallic 
acid by acids or simply by immersion in water. Its solutions strike a black 
color in the presence of iron, and they should not be prescribed in combina- 
tion with chalybeates. Gallic acid is in the form of long needles, nearly 
colorless, slightly acid, though less astringent than tannin; it is soluble in 
100 parts of cold water, 4 ^/j parts of alcohol, or 3 parts of boiled water. 

Therapy. — Like tannin, gallic acid has the effect of restraining secre- 
tion, reducing swelling, and hardening tissues. It is eliminated by the kid- 
neys under its own form. In solution, as the glyeerite (1 part to 8 of glyc- 
erin) it forms a favorite application to sore throat or tonsillitis; and the 
ointment of gallic acid is a good application to hsemorrhoids, being an im- 
provement upon the ointment made of powdered galls. The alcoholic solu- 
tion is useful as a local application to ^e membranes in diphtheria. 

Internally, gallic acid is given in haemorrhage (1.30 Gm., or gr. xx, at a 
dose) from the alimentary canal, kidneys, or lungs; also in monorrhagia, but 
here it is inferior to ergot. 

In haemoptysis, xdcer of the stomach, hemorrhage from the bowel, 
especially in typhoid fever, the following formulae can be used: — 

Gm. or 3ij. 
c.cm. or fSj. 
066 Gm. . or gr. j. 
c.cm. or Sj. 
com. or fSij. 



B Acid, gallic 8 

Acid, sulphuric, arom 4 

Morphinae sulph 

Tinct. cardamom, co au 

AqusB rowe 60 



M. 8ig. : One tea«poonful in water every hour c»- two. 

H Acid. ^Uic 8| Gm. or 5ij. 

Glycenni 901 c-cn*. or fSiij. 

U. Sig.: One teaepoonful every half-hour or hour until relieved. 

This combination is a useful application to subacute pharyngitis or 
tonsillitis. 

It has also been used to reduce the quantity of albumin in Bright's 
disease. On account of its astringent effects gallic acid is useful in a number 
of disorders attended by excessive secretion or transudation, as chronic bron- 
chitis, cystitis, chronic diarrhoea, dysentery, and the night-sweats of phthisis. 
It is likewise serviceable in purpura haemorrhagica. It retards the progress 
of pyelitis or pyelonephritis, and diminishes suppuration. Combined with 
opium, it has been found beneficial in diabetes insipidus. 

ACIDUM HTDBIODIGUM DILUTUM (U. S. P.).— Diluted Hydriodio 
Acid. 

Contains not less than 10 per cent, of absolute acid and about 90 per 
cent, of water. Dose, 0.30 to 2.50 c.cm. (or wiv-xl). 

Preparation. 
Sympus Acidi Hydriodici (U.S. P.). — Syrup of Hydriodic Acid (contains about 
1 per cent., by weight, of absolute acid). Dose, 2 to 15 com. (or ffixxz-f^sa). 



118 



niARMACErTICAL TnEUAPEUTIC AOEXTS OB DRUGS. 



Pharmacology. — Hydriodic acid is a gas which may be prepared 
action of iodine upon phosphorus in the presence of water, with the 
gentle heat. It is colorless, but produces white fumes in air; it can be 
iied or even rendered solid by strong pressure and a low tcmperatu: 
solution of hydriodic acid in water, if exfxjsed to the air, soon becom 
colored, and after a time deposits crystals of iodine. The solution 
official, but the U. S. P. recognizes a syrup. 

Therapy. — The syrup of hydriodic acid is a valuable means of 
ducing iodine into the system. When administered in this way the iot 
liberated in the body, and is peculiarly active in its nascent form, and 
cially adapted for administration to scrofulous subjects and cases of cat 
pneumonia of the chronic type. In some skin diseases of the same cha 
the syrup of hydriodic acid, when properly made, has proved of great 
It is very efficacious in spasmodic asthma, especially of that variety wh 
linked with the gouty diathesis. 

The syrup of hydriodic acid is an efficient remedy in tertiary sv] 
acute and chronic rheumatism, lumbago, rheumatoid arthritis, chronii 
poisoning, bronchitis, exophthalmic goitre, and other affections in * 
iodine is indicated. 

Dr. James Craig, of Jersey City, speaks very highly of the syr 
hydriodic acid in acute rheumatism. He gives from 7.5 to 11 c.cm.(0T f3 
in a winecrlassful of water every two or three hours until relief is experie 
afterward reducing the dose and continuing the remedy for several d 
required. The pain and fever are reduced within forty-eight hours, a: 
believes that this treatment exerts an important influence in preventinj 
diac complications. Its power over serous exudation and fibrous adl 
inflammation is well illustrated in pleurisy with large effusion, or in p 
pleurisy with adhesions. As the latter is a prominent predisposing cai 
phthisis, it is important that it should receive attention early and be 
come by the administration of iodine, especially in the form of syn 
hydriodic acid. Wile has used this preparation with success in various i 
of lead poisoning. 

AciDUM hydrobromicum: DILTJTUM (U. s. p., B. p.). — Dl 
Hydrohromio Acid (HBj + [HjO],). 

Dose, 2 to 7.50 c.cm. (or mxxx-foij). B. P-, 1 to 4 c.cm. (or mxv- 

Pharmacology. — Hydrobromic acid resembles hydrochloric aci 
being official only in solution, each being a gaseous substance. Dil 
hydrobromic acid contains 10 per cent., by weight, of absolute hydrobr 
acid (hydrogen bromide, B. P.). It is a clear, colorless solution with an 
taste, and can be given in Icmon-syrup or simple elixir. 

Therapy. — Hydrobromic acid should be an excellent antiseptic 
dressing wounds, being sedative, non-poisonous, and bactericidal ir 
action. It was introduced as a substitute for the bromides, but it has 
fulfilled the expectations of its projectors, although it has some ano( 
and hypnotic effects. It is more pleasant to take than the bromides, is 
apt to produce an eruption or physical depression, but it is more irritai 
the stomach. In some cases of nervous cough, neuralgia, headache, 
nervousness it has a good effect, but is ordinarily given in too small d« 
Its action in epilepsy may be compared to that of the bromides, but 
gastric irritability which it excites is a bar to its continued use. 



d 



ACIDUJI UYDHOCHLORICUM. 



119 



SciwrmiU has found it useful in headache due to eyestrain. In cases of 
assaying tinnitus after taking quinine it is paid to give prompt relief, 
clhotigh it often fails in relieving tinnitus from other causes. Two flui- 
fuchias (7.50 ccm.) arc equivalent to 18 grains (1.16 Qm.) of potassium bro- 



To rcUcYe irritatiTe cough in phthisis:- 



» CV)Jtia» 

Aridi hvdrobronuci dil. 
Stt. aurantii 



M. Doae, 1 or 2 ttfftspoonfuli. 

B ACIDUM HYTBOCHLOEICTTM (U S. P., 
HbBIHrtj K^uiatic Acid (contains 31.9 per cent. 
HIliK ftcid^ with water, 68.1 per cent.; B. P. 
af hydiogra chloride). (HCl + [H5O].) 



1065 Gm. or gr. j. 
301 ccm. or f5j. 
60| ccm. or fSij. 



B. P.). — Hydrochloric Acid, 
by weifjht of absolute hydro- 
, 31.79 per cent., by weight, 



^^^^L Arm 



Preparation. 



.AriuuEu Hydrochloricura Dilutum (U.S. P., B. P.). — Diluted Hydrochloric Acid 
UAA lO per crnt. of fthnolute hydroohlorio a.cid in water: B. P. containa 10.58 
•C hydrofcm chloride ia lOO parts of water). Dobc, 0.60 to 2 ccm. (or wx-xxx). 

Pkazmacology. — Tbe acid itsolf is an irritating, irrespirable gas. Its 
•4atMiift are clear, colorless, and decidedly acid. When applied to the skin 
fj mre antiseptic and astringent: in some persons with delicate skin hydro- 
ic acid is irritnting and slightly caustic. The salts of hydrochloric acid 
f» nfllcially termed hydrochlorides. Prominent among them are apomor- 
fkaoB^ cocaine, hydmstiniiie, morphine, pilocarpine, and quinine hydro- 

Pfayiiological Action and Toxicology. — When taken internally in poi- 
doees, it acts as a violent irritant, causing burning pain, a strong 
iMfte in the mouth, red and swollen tongue, and discoloration of the 
Vomiting occurs at once, and may be accompanied by bleeding. The 
frtitot ia at first feverish, but soon falls into collapse, and dies of shock or 
ion. Violent gastric inflammation is found after death, and the 
and mouth show the effects of a corrosive poison. The vapor 
tf aBUunua escaping near the vomited matters produces a white cloud of 
nuDoniuzn chloride. The treatment is the same as for other corrosive min- 
e*i *^".ic — demulcent drinks, flour or soap and water, milk, oil, or eggs. 
Th nates may be given cautiously, for fear of rupturing the stomach 

^T tr.c e**2aping carbonic-acid gas. The stomach being softened by the acid, 
': Usonlfl be evacuated by the tube rather than by emetics, if vomiting does 
aoC occur apontaneously. There is, moreover, danger that, in the act of 
matttinir* a portion oi the acid may find its way into the air-passages and 
ftw ftill further extend the mischief. Subsequently, the patient must be 
tRBf«*rT f. r t!io resulting lesions, which are not limited to the intestinal tract, 
li^ n of the kidneys and lungs may also occur. Medicinal doses 

ifitooijitv WM appetite and promote digestion. 

nermpj. — Topically, hydrochloric acid is applied to septic wounds, dis- 
mtHxtg wound*, or bites of rabid animals. It has also been used, mixed with 
.■_-.*t. 1'-,^.-_„ . .,_ - ., — . _•_ ^-phtheria. 

diseased 



iotmI proportion of honey, as an application to the throat in dip' 
k impotiBnt that this application should be made only to the ( 



I 




120 



PHABMAOEUTICAL THBHAPEDTIC AGENTS OH DRUGS. 



surface. It is a good addition to baths in cases of skin disease, as pitji 
versicolor or tinea^ and in full strength it is used to destroy warts ol 
hands of children. The undiluted acid has been successfully used as a fl 
ter-irritant in sciatica. Dr. Gennatas, of Montpelier, applies three or 
coats by means of a small brush, along the affected nerve, and wraps ui 
part in cotton. The application may be repeated in twenty-four or e 
eight hours> 

Dr, Morris, of New York, has, in some cases, utilized hydrochloric 
for the removal of carious and necrotic bone. Through a sinus or ine 
a 2- or 3-per-cent. solution of hydrochloric acid in distilled water is inj< 
every two hours, or at bed-time, according to the circuiustanccs of the i 
The exposed portion of bone is rapidly decalcified, after which there i 
jected every second day an aeid-pepsin solution made by adding 1 c 
(or mxy) of hydrochloric acid and 2 Gm. (or 5ss) of pepsin to 120 ccm 
fjiv) of distilled water. The decalcified bone with caseous or fatty mat 
is digested out within a few hours, leaving exposed clean dead bone, w 
can be attacked in the same manner. 

When hydrochloric acid is given well diluted, it is acceptable to 
stomach, being one of the constituents of the gastric juice. When fermi 
tion of the food takes place, causing flatulence, or "windy dyspepsia," it 
be due to a deficiency of this element. At all events, cases of weak digef 
and dyspepsia are sometimes much benefited by 0.60 to 1,20 ccm. (or mx 
of the diluted acid with half the quantity of tincture of nux vomica, i 
each inenl. Where acid stomach is caused by the presence of bacteria, 
antiseptic action is best obtained by administering the hydrochloric 
when the stomach is empty, shortly before eotiug. It is also held that 
excessive secretion of hydrochloric acid (which forms one variety of 
stomach) may be prevented by administering an acid solution just be 
eating, on the rule that acids check acid secretions. Hydrochloric acid sc 
times affords great relief in nausea. In intestinal indigestion with diarrl 
this agent is also very effective, given one or two hours after meals, 
temporary administration of pepsin in combination with the acid is of g 
value in eases of this kind, but the pepsin should not be continued too h 
or the peptic glands may lose their functions, 

A digestive mixture which is very beneficial is; — 

B Acid, hydrochlor. dil lfi| e.cm. or f3iv. 

PepBiii. pur 151 Gm. or 3iv. 

Glycerini 90| e.cm. or fSiij. 

M, 6ig. : One teaspoonf ul in water after meals. 

In fevers, where the secretions are very much diminished and hyc 
chloric acid is not secreted, its administration is of great service in assist 
digestion. In typhoid fever, dilute hydrochloric acid is very useful (0,6i 
l.SO ccm., or mx-xx, every three hours), and it exercises an important 
fluence upon the contents of the bowels, being slightly astringent and j 
venting the multiplication of bacilli. Relapse is less frequent under 1 
treatment because autoinfection is less likely to occur. In other infecti 
zymotic diseases — as scariet fever, small-pox, or diphtheria — hydrochh 
ncid, or compound chlorine solution, may oe administered in the same m 



*^ Lancet, Nov. 20. 1897. 




ACI0UM HYDHOCYAKICCM DILUTUM. 121 

It is seiriceably combined with the tincture of iron in the treatment 
of diphtheria, and the mixture may be used both internally and as a local 
application. The presence of a mineral acid has been shown to diminish 
the virulence of the toxins of diphtheria. 

In phthisis it is serviceable in disinfecting to some extent the alimentary 
canal, checking excessive sweating, or watery discharges from the bowels, 
and promoting constructive metamorphosis. 

A very beneJScial combination for phthisis is: — 

3 Add. hydrochloT. dil., 

Tinei. nnds vomicA aa 12 30 c.cm. or fitcc. 

Tlnct capsici 4 ccm. or f3j. 

Tinet. cinchonee 150 ccm. or fSv. 

M. Big.: Two teaspoonfula in water after meaLi. 

The liquor pepsini (!N*. F.), or liquid pepsin, contains saccharated pep- 
sin, 40 parts ; hydrochloric acid, 12 parts ; glycerin, 400 parts ; and water, to 
make 1000 parts. It is practically an artificial gastric juice, and can be 
used locally to cleanse wounds, or injected into the bladder to dissolve 
blood-clots. The usual dose for indigestion is a tablespoonful after eating. 

Chlorine, for bleaching or disinfecting purposes, can be obtained by 
ponring hydrochloric acid upon manganese binoxide. It is a greenish-col- 
ored, intensely-irritating gas. (See Ghlomm.) 

ACIDirM HTDEOCTANICXTM DIlTmrM (U. S. P., B. P.). — Diluted 
Hydrocyanic Acid (Prussic Acid). (HON + [HaO].) 

Dose, 0.06 to 0.30 ccm. (or mi-v). 

Phannaoolog^. — ^A liquid composed of 2 per cent., by weight, of abso- 
lute hydrocyanic acid (hydrogen cyanide, B. P.) and 98 per cent, of water. 
It is colorless, faintly acid, with taste and odor of peach-kernels, rapidly 
loses the volatile acid when exposed to the air and light, and deteriorates 
if kept too long; so that the dose is variable. We should always commence 
with the minimum dose and cautiously increase, because of the different 
degrees of activity of this preparation. Cherry-laurel water (Aqua lauro- 
cerasi) is official in the British Pharmacopoeia, but not in II. S. P.; it is also 
of very variable strength, but is used in considerably larger doses (2 to 8 
com., or wixxx-3ij). Diluted hydrocyanic acid is also present in the com- 
pound tincture of chloroform and morphine (B. P.) . The cyanides of potas- 
sium and of silver are official (U. S. P.). By the addition of an acid to 
either of these salts, it will be decomposed and hydrocyanic acid set free, as 
in the following prescription : — 



B PotaasU cyanldi 

Add. dtrfc 

Syr. Tolutani 60| vel 90 

K. Big. : A teftspoonful as a dose for an irritable cough, 



065 Om. or gr. j. 

32 Gm. or gr. v, 

ccm. or ftii vel iij. 



Physiological Action and Toxicology.-^Hydrocyanic acid is very poi- 
sonous as a gas, and given in the ordinary solution, in sufficient quantities 
to cause death, it is almost immediately fatal. In cases where it does not 
cause death at once, there is great prostration of bodily powers; weak, flut- 
tering pulse; cold extremities, and impending collapse. Atropine, hypo- 



12S 



PUAKMAC£UTICAL TilEBAPEUTIC AGENTS OR DRUGS. 



dprmically, is the physiolo^ral antidote. The chemieal antidote is pi| 
carb. 1.30 Gm. (orgr. xx) in water, 120 c.cni. (or 5iv), followed by ; — ' 



B Fcrri sulphate 

Tine t. f erri chlor 3 

Aquse , 124 

M 



66 Gm. or gr. : 
88 Gm. or 3j. 
4 Gm. or ^iv. 



According to Dr. Johann Antal, cobalt nitrate is an efficacious chei 
antidote, but no time should be lost before eraptyiag^ the stomach witl 
aid of stimulating emetics. Cold affusions to the spine, with frictions 
faradifim to the surface, and liot applications are also efficient. The peo 
bitter-almond odor of the ejecta indicates the character of the poison. D 
generally occurs by suffocationj from paralysis of respiration. Elimina 
as well as absorption, of hydrocyanic acid is very rapid. Ringer states 
if life can be supported for half an hour recovery will usually occur, 
feasor Kobert advocates the use of hydrogen dioxide as an antidote to hj 
cyanic acid. He uses a 3-per-eent. solution hypodermically and a 30- 
cent. solution for washing out the stomach. Vomiting is to be cncourj 
and artificial respiration practiced. Where poisoning has occurred b} 
halation, it will not be necessary to wash out the stomach. Kob 
method of treatnieut lias been used for several years in English ] 
iiig and smelting works, where a great deal of cyanide is used, lie 
onimends a cabinet containing both solutions in hermetically sealed fli 
with hypodermic syringe, also a stomach-tube and funnel, to be kept 
stantly ready for immediate use in chemical laboratories, photogra 
studios, gold-beating establishments, where the acid or cyanides are U£ 

Locally, hydrocyanic acid at first slightly irritates the skin, but aJ 
ward acts as a sedative. It should not be used in skin diseases when the i 
is broken, for fear of absorption. It has some action upon the brain, e 
ing vertigo and hebetude; the respiratory centre is enfeebled and the ra^ 
nerves paralyzed, producing great muscular feebleness. The condud 
power of the sensory ner\'e3 is diminished. It is a decided cardiac sedat 
the pulse becoming slow, with lowered arterial tension. The poison 
acts upon the respiratory function of the red blood-corpuscles, and prev( 
them from carrying suthcient oxygen to the tissues. 

Therapy, — llydrocynnic acid has been used as an antispasmodic 
various forms of reflex vomiting, such as the vomiting of pregnancy ; 
that of phthisis. It has also been employed in nervous cough, in irritt 
heart, and asthnia. Whooping-cough, acute mania, and melancholia r 
also be relieved by the administration of hydrocyanic acid. As it is rapi 
eliminated from the system, the dose should be repeated at short interv 
Its sedative effect upon the gastric mucous membrane renders it valuabh 
painful affections of that organ, such as gastralgia, ulcer, and cancer. T 
same benefit is obtained from its use in enteralgia. For external use it v. 
be added to rose-water (7.50 to 240 c.cm., or foii-foviij) with a little glycei 
to be applied in cases of troublesome pruritus. 



ACIDUM HYPOPHOSPHOROSUM 

Acid. (See Acidum Phosphoricum.) 



( U. S. P. ) . — Hypophosphor 



* Merck's Archives, March, 1000, p. 94. 




ACIDUM LACTICIM. 



123 



ACZDnX HYPOPHOSPHOROSTJM DILUTTJM (U. S. P.).— IHlute Hy- 
fipko^horoaft Acid. (See Acidum Fhosphohcum.) 



I 



ACIDirM LACnCUM lU. S. p.. B. P.).— Lactic Acid ( IR',,11,0,). 

An organic acid, usually obtained by subjecting milk-sugar, or grape- 
•-:;%T^ to lactic fermentation; composed of 75 per cent., by weight, of abao- 
..:* lactic icid (hydrogen lactate, li. P.) and 25 per cent, of water. 

Preparations. 

Bfimptm C&lcii LactopliO!4pliAtis (U. S. P.). — Synip of Calcium Laotopliosphate. 
ff^m, i ttf 730 ccrm. (or fSse-ij). 

Wmri ImcXmb. — Ferrous UictAte. Dosp, 0.13 to 0.32 Gm. (or gr. iiv). 

Zkaimacology. — A colorless, odorless, syrupy liquid, with an acid taste. 
Ui icooont of carelessness in manufacture it may contain hydrochloric, sul- 
OT tarcolactic acid and traces of metallic impurities. It is soluble in 
sad alcoholic solutions. The ordinary dose is from 1.20 to 2 c.cm. 
iir rnxX't^es), diluted and sweetened. 

njsuilofical Action. — Lactic acid is present in the stomach during 
^ digestion of carbohydrates, especially during the first stage of gastric 
n. When in excess, it forms one variety of sour stomach, and causes 
ID different parts of the body, headache, etc. It has been asserted that 
itxsm is due to an excess of this acid in the system, and the fact that 
eymptoms sometimes develop after partaking of sour milk or 
kilk acid ee^ms to lend support to this view. Such patients are benefited 
fcy tbe Mte of alkaline treatment. Large amounts act as depressors to the 
ivfoOB system and decrease the normal alkalinity of the blood, thus favor- 
rngmrtl^c and neuralgic attacks. 

Bcrmpy. — Locally, lactic acid, diluted with water and glycerin, has 
Ian ased in tuberculosis of the throat and larynx and in diphtheria and 
a eolvent of false membrane. In lupus or tubercular ulceration of 
Um^e it has been found very useful, as well as in lupus of the face^ 

" <16 to 30 per cent.). 
A •olutioD of lactic acid varying in strength from 10 to 30 per cent. 
10 m beneficial application to many laryngeal tumors. In a 20- to 40- 
it. iolution it has been employed with good result in suppurative 
and nlcen of the nasal fossx. AIosctig-Moorhof has used concentrated 
acid locally in caries, lupus, and epithelioma. 
lo the external lesions of tuberculosis. Dr. Zippel, of Hamburg, pre- 
la the application of gauze tampons soaked in lactic acid. In the treat- 
moA of lubcrculous iistuls the same writer recommends the introduction 
^9«da composed of a paste made by gently heating 50 grammes (oiSv) each 
tf Mlatin, lactic acid, and water, and then adding 30 grammes (5j) of men- 
Ak. Tbc rods made of the congealed paste are covered with a layer of 

^vith deficient secretion, pepsin may be combined with 

'I after nioal?. Lactic acid is useful in lirha;niin and i)hos- 

lu thp green diarrhoea of infancy, attributed by Hayem to a 

tliift ^gewi Well diluted (4 c.cm., or foj, in a tumblerful of recently- 

^^}^^» **'eetened with white sugar, of which solution a teaspoonful 

giTdi erery half-hour or hour, according to the case) is a very effi- 






124 PHABMACEUTICAL THERAPEUTIC AGEXTS OR DRUGS, 

cient remedy, controlling" irritability of the stomach, relieving paioj 
changing the character of the discharges. It has been shown, however, 
some of these cases are due to a specific microbe, while others depend 
hepatic disorder. In the latter class of cases the remedy ia of no ti 
Lactic acid is also of value in the vomiting of newborn babes caused by 
gestion. It is likewise useful in the diarrhcea of typhoid fever, intei 
catarrh, and intestinal tuberculosis. Dr. N, V. Lojkin regards lactic a( 
of great value in the treatment of chronic dj'sentery. 

From theoretical consideration, the use of lactic acid in diabetes me 
was proposed by Cantani. Cases have been reported in which, coni( 
with appropriate dietetic regimen, it appeared to favorably influenc* 
disease and lessen the quantity of sugar excreted. In other cases, ago; 
proved a faihire. 

Dr. Foucaut, of Orleans, suggests the use of lactic acid as a pre 
lactic in gout. lie gives 4 c.cm. (or f.>j) a day for three weeks or a m« 
when the remedy is discontinued for ten or eleven days, after whichi 
resumed in the same manner It is said to reduce the number of attackj 
to render them less painful. , 

Lactic acid has been successfully used in arthritis deformans. J 
torin/ in a case of ten years' standing, the last year of which the pa 
kept her bed, began with 0.60 c.cm. (or mx) on an empty stomach, no 
being allowed for an hour and a half afterward, and gradually increa8e< 
dose to 2.50 c.cm. {or mx\) a day. In three weeks the woman could ge' 
of bed and walk a little, the iiftins being much relieved and the joini 
cumferencc slightly diminishod. The improvement continued uiilil no 
was required* and ordinary duties could bo resumed. No intermil med 
other than luetic acid was given, and no external treatment except 8 
massage. 

The ammoniacal decomposition of the urine which takes plac 
chronic cystitis is checked by the administration of this remedy. 

Ferrous lactate is in the form of greenish, crystalline ecales or cr 
and is used as a chalybeate tonic, being less astringent and constipating 
other iron salts. Zinc lactate has been used in the treatment of epileps 
0.13 Gm. (or gr. ij) doses, thrice daily, gradually increased to 0.65 Gm 
gr. x). 

ACIDTTM NITItlCirM: (U. S.R, B. P.).— Nitric Acid (HNOJ. 

Preparation. 

Acidum Nitricum Dilutum (U. S. P., B. P.). —Diluted Nitric Acid (contalr 
per cent., by weight, of absolute nitric acid; B. P., 17.44 per cent.). Dose, O.J 
1.20 c.cm. (or mv-xx). 

Pharmacology, — Nitric acid (U. S. P.) contains GS per cent., by wei 
of absohite nitric acid and 32 per cent, of water. B. P. contains 70 
cent,, by weif^dit, of hydrogen nitrate. 

The anunonium, lead, and eodium nitrates and nitrohydrochloric 
are oflBcial in the IL S. P.; potassium and silver nitrates, spirit of niti 
ether, bi&iTiuth subnitrate, and diluted nitrohydrochloric acid in U. S 



' La Mtdeoine Modeme. vol. ix. 




ACIDUX XITRICfil. ^^^^ 125 

"P. The solutions of ferric and of mercuric nitrate are official in the 
■ , and solutiuu of ferric nitrate and acid solution of mercuric nitrate 

j^ b. P. 

n7Biolog:ical Action and Toxicology. — Diluted nitric acid when ap- 
fbtd to the skin produces a yellowish discoloration. Stronger applications 
MBMioo a bullous eruption resemhling pemphigus. 

latrodnced into the stomach in a concentrated solution, nitric acid is a 
okat corroeiTe poison, and produces vomiting, pain, and distress, at once, 
Uknnd bj inflainmation and sloughing of the mucous membrane of mouth 
tad fBtophAgas. Alkalies, demulcents, and milk diet constitute the treat- 
■sbL ratal accidents occasionally happen from inhaling the fumes of 
Bstric, or other mineral, acids. In small doses nitric acid stimulates the in- 
glandfi. 
When its use has been too-long continued, nitric acid causes salivation, 
and bleeding gums, with loosening of the teeth, foulness of the 
la«stk« dyspepsia, colic, headache, and debility. These untoward effects 
diaappear when the remedy is suspended. 

Therapy. — Nitric acid is an oxidizing agent in the laboratory, and when 
in etrong solution it has a decidedly caustic action, staining the skin 
It is the preferred caustic for venereal sores, warts, poisoned wounds, 
;;^edijena. In uterine ulceration, prolapse of bowel, and 
■ acid i:? a useful application. Nitric acid has been suc- 
OMltt Uy employed in the form of a lotion or foot-bath in the treatment of 
'*«llilaxxi8. Introduced into the system in small doses, well diluted, it acts 
la astringent tonic, especially useful in cases of atonic dyspepsia, in uric- 
tfid iH^thwia and oxaluria. Small doses of nitric acid are servicea1>Ie in 
ACBtatiti&. In broken-down syphilitic subjects, or in chronic liver disease, 
atrie acid is a useful restorative. 

A rery yaluable prescription, especially for the treatment of chronic 
rTpliilifi, is as follows: — 

B Jui6i njtrici dil , 12130 ccm. or wcc, 

rhiidrxtracti lapptr *. 90| ccm. or fjiij. 

flaUrTtraoti xanthoxyli 60| ccm. or fjij. 

M. ctf ■ Od? or two Iciittpoonfuls in water three times a day. 

Tp ^Tilnte solution (O.fiO or 1.20 to 30 ccm., or wx-xx to f^j) it has 
;*. '. in ra«w^ of phosphatic calculi, to wash out the hladder, and it may 
w . :" -r injection into sinust'S connected with dead bone. A few drops 
rf6::r:t ijiid to 30 ccm. (or fjj) of water is an excellent stimulant application 
wiadolent nJcers. In whooping-cou^h, or bronchial catarrh, it has been 
id«9atcd, and in hoarseness of public speakers a few drops in a glass of 
•Iter afford relief. It is inadvisable to continue too lonsf the administration 
^BifnV «.-:*?_ fl*. in that case, it excites gastro-intestinal catarrh. The same 
T^^. to the other mineral acids. 

ij3 iTJuii> olvin diseases, such as impetigo, lepra, acne, the addition of 
mine 9eid to the bath has l>een found useful in addition to its internal ad- 

mamtntiou, 

JBgtnm. Camphora Acida (N. F.). — AntidYsenteric mixture, or Hopes 

^phor mixture:— 




126 



PHARMACEUTICAL THEHAPEUTIO AGENTS Olt DRUGS. 



B Acidi nitrici* 1 75 c.cm. or fiixxv1| 

Tincturn? opii 1 20 c.cm. or wixix, 

AquBB campliornj 100 c.cm. or fSiiisB. 

M. Dosi', a tablespoonful every hour or two, according to syiuptonis. 
for diarrliOEiis of relaxation, t-spccially in elderly persona. 

Diluted nitric acid will often relieve chronic diarrhoea, and ita eS 
may be increased b}' the addition of witch-hazel, thus: — 

3 Acidi nitrici dil 10! c.cm. or mclx. 

Fluidext. humanielidia 11 c.cm. or f3iij. | 

Syrup. auranlU iSOj ccm. or f^iv. 

Al. Sig. : From one to two tca^poonfulft in water three or four Umea a di^ 

In the daily dose of 4 to 15 c.cm. (or f5i-iv) dilute nitric acid has » 
times proved successful in diabetes insipidus, and it is said to allay the t 
of saccharine diabetes. 

Full doses of well-diluted nitric acid, every fourth or sixth hourj 
useful in intermittent fever. After the paroxysm has been broken ui 
quinine, nitric acid may be aen'iceably given, in order to relieve inact 
of the lirer and intestinal glands. Small doses of nitric acid are bene) 
in aphthae and ulcerative stomatitis. 

Nitric acid reddens morphine, and probably decomposes it; and, tl 
fore, should not be prescribed in solutions with this agent, as the rule, 
nitrites have a decided lowering influence upon the temperature and 
culation; they will be considered in connection with arayl nitrite. 

ACIDUM NITROHYDROCHLOKICUM (U. S. P.).— Nitrohydrochl 
Acid, Nitromuriatic Acid (nitric acid, 18 parts; hydrochloric acid, 82 pa 

Preparation. 

Acidum Nitrohydrochloricum Dilutum (U.S. P., B. P.). — Diluted Nitroh} 
chloric Acid (Dilut'ed Nitromnriiitic Acid J (contaiHS 4 parta of nitrir acid, ] 
hydrocliloric noid, and 78 parts of distilled wntt»r). I>»*c, O.SO to 1.20 r.cm* 
mv-xx ) . 

The B. P. preparation i» confiiriernbly stroiigor (Nitric Acid Enj] liydroch 
acid fjiv; diHtilli^d water fjxw. ) 

Symptoms of poisoning and methods of treatment same as given ui 
Acidum Hydrochloricura. 

Pharmacology and Therapy. — The strong combination of nitric 
hydrochloric acida is nllicial only in the U. S. P. It should be allowi'i 
stand for tw^ wcekfi after mixinir, and kept in a cool place. The coin 
traterl Rohition readily dissolvos gold leaf when imiuei-sed in it. For mod 
purposes, it should be greatly dihitod. It is supposed to have a special ari 
xipon the hepatic functions, and is a good tonic and nstrinfient. It has b 
applied upon eomprespes in ehronic liver disorders, in a si>lution (15 e.c 
or f'ss, to 473 c.cni.. or Oj, of water). 

Internally, the dihite aoid i."? given in plenty of wnter, nnd genori 
through a glass tube, in torpidity of the liver, the chronic hepatitis of 
tropics, and in the early stage of hepaile cirrhosis. It is of service in cliro 
diarrham and dysenteric diarrhcen. This aeid has been occasionnlly hue 
to produce salivation. 

*The original formula for this preparation called for nitrous acid, but as c 
mercial nitric acid usually contains som*? nitrous, it mar ho URcd as ahove. 




ACIDOM OLEICUM. 



127 



ACaxm OLEICUM (U. S. p., B p.).— Oleic Acid (HC^jH^O.). 

An organic acid, prepared in a sulficiently-pure condition, by cooling 
eoBBcrdal oleic acid to about 5" C. (41* F.), then separating and preserv- 
9g tb« liquid portion. 

Preparations. 

QlmtaBi Airopann <U. S. P.). — Oleutc of Atropine (2 ];cr cent.). 
OIntam Cocaine (U. S. P.J.— Uleate of Cocaine (5 per cent.). 
Olfliiiii Qnin iru^ — Oleatc of Quinine (25 per cent.). . * 

CW— twin Veratriiue (U. S. P.}.— Oleate of Veratrine (2 per cent.). 
niwatiini Hydnugyri (U. S. P., B. P.)-— Oleate of Mercury (U. S. P. preparation 
^miMitm 9)L£3 per cent, ^^ith oluic acid, representing 25 per cent, mercuric oxide). 

CaglMeBtum Uydrargyri Oleati» (B. P.). — Mercuric-Olcate Ointment (1 to 3 of 

rq^ocatum Zinci Oleatta {B. P.). — Zine-Oleate Ointment (50 |>er cent.). 

Ikarmacolcgy. — Oleic acid is an oily, yellowieh, tasteless liquid, grad- 
aZIf becomiikg brown, rancid, and acid when exposed to the air. It is 
sahible m. water, but i^oluble in alcohol, ether, etc. 

Oleic acid, fresWy prepared, is a bland and unlrritating application 
^dttikin. and was brought forward as an addition to ointments and lini- 
BflBlsto increase their penetrating power, but lanolin has now largely taken 
^ plic« for this purpose. Lately, greatly through the influence of the writ- 
: -1 of the author, it has been much used in the manufacture of oleates, 
•«j£h arc now produced in the form of true chemical compounds, instead of 
mixtures, as heretofore. 

Tb« following is a summary of the action of the oleates, from "Oint- 
itB and Oleates, especially in Diseases of the Skin''^: — 

The Oleates, 

JiaamHiac 01e«te. — Xot verr active. Can be used in neuralgia. 

Oleate. — Diluted one-half with Urd or home fatty substance, it forms 

it of the oleate of aluminum, which is decidedly astringent 'It is useful 

the muc<>-j)urulrnt discharges of dermatitis and eczema, and in chafing, 

, especially in infants and young children. In hyperidrosis and in bromi- 

it m very efTective. This ointment is also a uwful dressing to burns, foul ulcers. 

ftad sinuses. 

WB Oleate — A valuable alterative and eschftrotic, but it roust be used 
MOtfaiii The »teate. when melted with lord or ointment base (1 to 4 or 1 to 0), 
I tW ointment of arscnum oleate. This hns little action upon a healthy skin, 
vktB tbe epidermis has been removed, or on granutnting surfaces, it produces 
and destroys the vitality of the tissues to a considerable depth. When 
it exertfl a most excellent alterative impression upon the integument; 
in itlc^nitiMa epithelioma, in lupus (after scraping), and in old scrofulou« 
*«*• ihim 6a of great utility. In sycosis, soborrhtpa. tind chronic pceeroa it is like- 
«i» «f w» t r fc c e . After scraping or puncturing the affected area, it can be umhI to 
irarta. corns, horns, eondylomata. old granulations, and na?vi. It may be 
y combined with opium, belladonna, hyoscyamus, arnica, arrow-Voot, 
tfc. ' Kor foriiMiIir, %«• author's *to<>k on **' Mf*«tes." i 

Oleate. — Not very active. Constitutional elTccts not produced except 
s^Bv fefM Mirfare^ are snointed. 

Mamuth Oleate. — Emollient and slightly astringent. In all puatular eruptions, 
s fWHtifl. it relie'ves the itching and often aborts the pustules. It allays irritation 
S Hjijinlaa ms%d aiinbuni. In none rosacea, it relieves the inflammntion. and. in 
a^HBOS trith acorifl cation of the stirface. in curative. In acute ecxeina, this oleate 
%aHCto«4 ladUpenaable in arresting the progresA of the malady. Cracked and sore 




' 



"Qifiil ErfHion- Philadelphia: The F. A. Davis Company, Publishers. Phy- 
' Stu<l«nta' Keady- Reference Series. 1890. 



138 



PHARMACEUTICAL THERAPEUTIC AGENTS OR DRUGS. 



nipples are usually healed by the olcatc-of-bismuth ointment (1 part of bismuth' 
to 7 parts of ung. aquse rosse). 

Cadmium Oleote it stimulatinff and irritating. It hat been used in d 
eczema with great infiltration, exuoerant gronulationa, and enlarged gland 
strength of the ointment being adapted to each case. 

Cocnint' Oloiitu (U. S. P.) I'outainft '» pfr cent, of the alkaloid. It can b< 
bincd with equal parts of ointment or hinolin. It has not answered expectati* 
a local anodyne or anresthetic. but has b<»en used with some Umefit in pt 
pudendi and ani, or eczema marginatum. 

Copper Oleate, in the form of 10- or 20-per-cent. ointmeut, has no visible 
upon the healthy akin, but penetrates deepiv into the lolliclea, where it ex 
stimulating and antiseptic action- It is deeiuedly astringent to the broken d 
raw surface, reducing exuberant granulations, checking haemorrhage from ir] 
sores and old ulcers. Owing to iti» parasiticide action, it is the best remedy fi 
various forms of ringworm. In tinea versicolor, even in favus, it is equally cfl 
in destroying the pura&ite without epilation. Cojjper oleate, melted and sprea* 
plaster, will very often cure worts, corns, bunions, and thickened conditions i 
epidermis. The ointment above referred to is also useful in freeklea and oth< 
colorations of the skin. It is esfietitiril that the sa.lL should be made from pun 
acid, as otherwise the application may be accompanied by irritation or inflamo 
of the skin. The weaker ointment (0.32 to 0.65 Gm., to 31.1 Gm., or gr. v-x 
should be first tried and the strength gradually increased. 

Iron Oleate is a valuable styptic and astringent. The use of a weak oiii 
in the inflammatory form of eczema, in which the surface is raw and bleed! 
followed by good results; also in pustular eczema, sycosis, furuncles, and in sera 
sores. Mixed with the oil of ergot or any bland oil. the iron oleate is of gm 
vantage in dry seborrhoea and in patches of alopecia. The early stages of acne rJ 
are often entirely relieved by the weak application of ointment of iron i 
In ulcers caused by arsenical poisoning, this has given better results than any 
remedy in the hands of the writer, especially with tlie addition of I per ci 
carbolic acid. 

F.end Oleate. melted with equal parts of lard-oil, or lard, forms a cream-c< 
semisolid ointment, which is superior to Goulard's cerate or Hebra's litharge oint 
It allays irritation in papular or pustular etKema, and also in fissured eczema > 
hands or feet. In hard and indurated papules, as in acne of the face, neck, and 
it is excellent in its clIin-tM. Thymol, naphtlml, curbulir acid, oil of chamomile, 
of cade may be combined with it, according to the case. 

Manganese Oleatfi has been used (a 10- to 20-per-eent. solution in ointmei 
a remedy in amcnorrha^a and other uterine affections, applied with friction f 
flbdomt^n. rrolmbly its asserted good efTects are to be attributed to the mi 
rather than to any constitutional effect from the manganese, as tliere is no ev] 
of its absorption. 

Mercuric Oleate (U. S. P., B. P.). — The ointment of mercuric oleate is a y 
ish substance of fatty consintence. it is stimulating to the skin, and has a d' 
alterant action n|>on the glandular structure.-*. In old eczema, with thickening ■ 
skin, this twofold action ia very beneflcial ; also in pnpuhir and tubercular lesion 
infiltration attendant upon abscesses. In intlammation of the hair-follicles, s} 
and wrofulodermata it is quickly curative. Its bactericidal action makes it val 
in all cases of parasitic invasion of the skin: and, in the treatment of louaines 
addition of picrntoxin (Va of 1 per cent., or gr. i-J]) is advisable, in order to d< 
the vitality of the nits. If it is desired to produce a constitutional impression, h 
may be added, or mercurous oleate substituted. In fact, mercuric oleate is aba 
only very slowly. I^rge quantities have been applied to the surface without 
ducing constitutional effects. 

Mercurous Oleate. — This ointment contains a higher percentage of mercury 
the preceding (41.6 per cent.); it is aubstitutod when it is desired to make a 
profound impression upon the structures of the skin, or to practice the inur 
treatment of syphilitic affections, and for this is far superior to either the ord 
blue ointment or the mercuric oleate. In old 8pot« of peoriaaift and chronic pi 
and palmar eczema it can be used alone, or combined with some form of t 
uaphtliol. 

Morphine Oleate has only a feehle action upon the integument, and hi 
special advantage. 




ACIDUM OXALIOUH. 129 

Nickel Oleate, in the form of ointment with some latty base, has a very decided 
utringent action upon abraded surfaces. In the proportion of from 6 to 20 graina to 
the ounce of lard it acta well in epithelial ulcerations, old callous ulcera, or chronio 



Quinine Oleate (U. S. P.), 25 per cent, alkaloid, has some antiseptic action, bat 
has no special advantages. 

Silver Oleate coagulates albumin, and, when sprinkled over sores, coats the sur- 
face and excludes the air; at the same time it stimulates granulations and cleans off 
the surface. Dissolved in oleic acid and mixed with lard (5 to 60 graina to the ounce )» 
it forma a dark-brown, pliable ointment, which may be applied in cases of eryiipelaa 
to keep Uie inflammation from spreading. In superficial lupus it sometimes lessens 
oeU-innltration and reduces active Inflammation. In boils, carbuncles, eczema around 
the genitaia or on the buttocks, especially if attended by irritation or itching, marked 
relief followa the application, either alcme (m* combined with opium, belladonna, or 
hyoecyamuB. 

Strychnine Oleate has no special value as an ointment. 

Tin Oleate. — ^The ointment (0.65 to 4 Gm., or gr. x to Ix-Sj) ia & ^yiah-brown 
ointment, possessing some astringent and tonic action. It is of especial service in 
diseases of the nails and in irritation of skin around the nails (agnail, etc.). 

Veratrine Oleate (XT. S. P.) is official in 2-per'Cent. solution in ointment. It hat 
decided counter-irritant and benumbing effects upon the skin, making it useful in 
some cases of neuralgia or tender spots. 

Zinc Oleate (U. S. P., B. P.), is a fine, pearl-colored powder, soft and soap-like to 
the touch, is astringent in its effects, and can be used as a dusting-powder in hyperi- 
drosia and bromidrosis. In local sweating of the axillffi, genitalia, hands, or f^t, 
f^teeially when attended by maceration o7 the epidermis, this agent is very useful. 
Murrell, of London, has also used it in .the sweating of phthisis, combined with thymol 
(1 to 300), Salicylic acid (3 per cent.) or French chalk may be added to it, for 
the treatment of local afi'ections, such as comedo and acute vesicular eczema. In all 
such acute inflammatory affections it can be used with advantage, where greasy 
applications cannot be borne. It has also been used in gynecology as an application to 
cancerous ulceration of the cervix uteri. Here it may be combined with iodoform 
(zinc oleate, 1; iodoform, 2 parts). 

ACIDXTM OXAnClTM.— OxaUc Acid il^,Cp^2B.^0). 

Fhannacology and Therapy. — Oxalic acid is an irritant poison, and is 
sometimes taken by mistake for Epsom salts. Its antidote is lime, chalk, 
calcium carbonate, or whitewash. 

Dr. F. J. L. Hart* reports two cases of poisoning by oxalic acid: One 
in^ance was a boy, aged 15 years, who had taken about 12 Gm. (or 3iij) of 
the acid; he had several convulsive seizures, his pupils were dilated, lower 
jaw fixed in a tetanic spasm, froth exuding between the teeth, and pulse 
could not be felt — stomach- washing and the hypodermic injection of apo- 
morphine, 0.006 Gm. (or gr. ^/io)> were resorted to as well as brandy, strych- 
nine, and digitalis. The patient in a few days made a good recovery. In 
the second case the quantity taken was unknown, the patient dying withia 
one hour. • 

Dr. Talbot Jones, of St. Paul, has reported four cases in which acute 
articular rheumatism was apparently produced by prolonged contact with a 
Eolntion containing oxalic acid. The patients, engaged in making bluing, 
vere accustomed to keep the hands and forearms immersed while stirring 
the solution. 

According to Taylor, 4 Gm. (or 3j) is the smallest quantity of oxalic 
acid which has been Imown to destroy life at the age of sixteen years, death 
occurring in eight hours. Under three minutes is given as the shortest- 



* lancet, Oct 1, 1898. 



130 



PHARMACEUTICAL TIIERAPErTIO AGENTS OR DRUOS. 



known period of survival alter an unknown quantity of this poisoil 
been takiin. 

Oxalic acid has, at the suggestion of Dr. F. Poulet, been emploj 
an emmenagogn^ie. Dr. A. W. Marsh hag found it useful in nnienon 
He remarks that the remedy is not unpalatable, and. in medicinal ( 
is unirritant to the stomach. Dr. Marsh also recommends oxalic ac 
the treatment of acute cystitis from whatever cause. He is accusfe 
to prescribe: — 

H Acidi oxalici 1 1 G"»- or P", xv, 

Svr. nurant. cort 301 c.cm. or fjj. 

Aqii* 9m c.cm. or Qiij. 

M. et ft, sol. 1 

Sig.: TeHBpoonful every four hours. 
Poulet has found oxalic acid useful, likewise, as an expectora) 
asthma, capillary bronchitis, and tuberculous bronchitis. He recoran. 
the following formula; — 

R Acidi oxnlici 2 Gm. or 3s3. 

Infua. eamelliae 180 ccm. or fjvj. 

Syr. nurant cort. 00 c.cm. or fjij. , 

M. et ft. sol. I 

Sig.: A teaspoonful every hour. 

In some cases where oxalic acid wfts given in 0.032 Gm. (or gi 
doses. Dr. F. W. Talley, of Philadel|)hia, ol)servi^d that the remedy ct 
nausea, gastralgia, and an eruption resembling urticaria. When adir 
tered in solution the acid nuist be disgolvcd in t'ither rain or distilled m 
in order to avoid the deposition of oxalate of calcium of hard water. 



ACIDUM PHOSPHOEICTm (U. S. P.) — Phoaphoric Acid. 

ACIDUM PHOSPHOEICUM CONCENTRATUM (B. P.).— Concenti 
Phosphoric Acid. 

ACIDITM HYPOPHOSPHOROStTM (U. 8. P.).— Hypophosphc 
Acid (30 per cent, absolute acid). 

Preparations. 

Acidum Phosphoricum Dilutum (U. S. P., B. P.). — Diluted Phosphoric Aoi* 
per cent., by weight, of oithopho.sphoric acid; K. P. contains 13.8 parts of hydi 
orihophosphattO. Doac, 0.12 to 1.20 coin, (or wii-xx). 

Acidum Hypophoaphoroaum Dilutum {U.S. P.). — Dilutwl Hypophosphi 
Add (conlnins 10 per cent by weight of absolute acid, with flO of water). Dose, 
to 2 c-cni. (or »/(x-xx.\). 

Syrupus Hypopliosjiliituin Compo:^itiim {U. S. P.). — Compound Syrup of I 
phosphites. Dc>st», 4 to S com. [or 3i-ij ) . 

Pharmacology. — Phosphoric acid in the solid form, glacial phospli 
acid, is not ofhcial. The official phosphoric acid is a colorless, odor 
syrupy liquid, containing not less than S5 per cent., by weight, of abso 
orthophosphoric acid and not more than 15 per cent, of water. The Bri 
concentrated phosphoric acid contains only 66.3 per cent, of hydrogen or 
phosphate. The diluted acid contains 10 per cent., by weight, of abso 



orthophosphoric acid and 90 of water (13.8 parts of hydrogen orthop 
phate in B. 1\). The dose of phosphoric acid is 0.13 to 6.5 c.cm. (mij-vi 




ACIWM PHOSPHORICL'M. 



131 



?^a>lMfiii>l Action. — Phosphoric acid, locally, is an irritant, and 
ti iome escharoiic effect. When taken internally, well diluted, it aids 
litioa anil growth, as it is an essential element in all bony and vascular 
in the form of phosphatea. It is also, like nitric acid, a stimu- 
kax to oxidation. It improves the appetite and the digestion, increases 
■ovtion, u>d is synergistic with the vegetable bitters. Phosphoric acid has 
ken kaown to give rise to an eruption resembling that of pemphigus. 

Tkermpy. — In all debilitated conditions of the system, in anaemia, in 

4e€xluitwtioii of prolonged lactation, in bronchial catarrh of the ajred. phos- 

acid IS an excellent tonic; it is also useful in struma and wasting 

Its action being different from phosphorus in substance, it is less 

Dt in the treatment of neuralgic conditions. 

Pboephoric acid is especially valuable as a tonic in the following for* 



ft Aodi pbo«pborici dil 15 

Tl3ct. nucifl Tomica 12 2 

Ttect. fern chloridi 60 

^rr pruDt \"iTg. 75 

N '"■? ' From one-half to one teaspoonful in a wineglass of water, taken through 
h«L«r mcala. 



ccxn. or fSsa. 
30 com. or mcc. 
c.cm. or fjij. 
c.ctn. or fjiiss. 



S AcfiA* fAiOsphorici dU 1 

8UjtJuia« sulph 

QiftmMk 34 

8yr. ■vrantii 105 



c.cm. or f3iij. 
03 Gm. or cr. ss. 

ccm. or IZ'tx. 
ccm. or fSiiiss. 



One teaipoonful in wineglaas of water, taken through a tube after 



Vadcr the name of liquor acidi phosphorici compositus (N. F.) an 
tA tonic ia furnished, composed of the following ingredients: — 

Botie-sah 1000 parta. 

Ncilpburic acid (free from aracojc) 7S0 porta. 

Water 4000 pwta. 



ei- 



>kieh ic spproximated by the following formula: — 



UQVrm rHO^l'HATlM ACIBL'S ACID BOtfTlOX OF PHOSPnATES. 

CiUii pfaoaphatifl 25 Om. or gr. 384. 

phoAphatU 4 25 Gm. or gr. ft4. 

phMphatU 2 10 Gm. or gr. 32. 

FIbtI pbo«phali« 4|25 Gm. or gr. 54. 

Aeiai phosphorici (tp. gr., 1.710) 60 c.cm. or m 808. 

^■B q* •• ad 4731 ^■'^Qi* ^^ fSxvj. 

M. SIg.: TlUa preparation may be given in teaspoonful doses, well diluted with 



Giren before myala, phosphoric acid is beneficial in h\7)eracidity of the 
iMBftch, whether due to increased production of hydrochloric acid or the 
wmit of ferineDtative changes in the food. Phosphoric may reasonably be 
^rdemd to the other mineral ncids in the treatment of typhoid fever when 
^ pivdofninftA ^ symptoma denote great nervous prostration. In diahefes 
^Sm nhoephortc-acid lemonade answers a useful purpose by a&suaging 
^ ^ 1^ t^MB been employed in rickete. 



132 



PHARMACEUTICAL THERAPEUTIC AGENTS OR DRUGS. 



The diluted solution may be applied as a stimulant to indolent I 
and it has been proposed to inject it into enlarged glands. 

The comiwimd syrup of the hypophosphites is a jwpular and an I 
able tonic. (See formula pven under Calcium.) 

Dose, 4 to 8 c.cm. (or 3i-ij jj given in water, three times a day. i 

ACIDUM PICEICTTM.— Picric Acid. 

Pharmacology. — Picric, or earbazotic, acid (trinitrophenol) is i 
form of pale-yellow scales, soluble in water, and has a very bitter 
Owing to its power of coagulating albumin, its watery solution foi 
convenient test for albumin in the urine ; it is also a test for peptones. ] 
doses cause Yorailing, purging, and collapse. Internal dose from 0* 
0.13 Gm. (or gr. ss-ij) ; of the ammonium salt, 0.03 Gm, (or gr. ss.) 

Therapy. — The application, five to ten times daily, of a G-per 
solution of [licric acid has been found useful in erysipelas. Picric acid 
stitutcs also a good dressing to superficial burns, and has been use 
several years for this purpose in the Charity Hospital of Paris. A 
rated solution (about 0,5 per cent.) of picric acid is applied upon 
presses. It exerts an analgesic eifcct upon the surface. It usually 
rise to no irritation, and the only disadvantage of the method is tha 
solution communicates a yellow stain to the tissues with which it c 
in contact. Dr. Charles Willems* of Ghent,* speaks favorably of it: 
in burns of the first and second degrees; he uses it in the form of an 
ment in the strength of 1 to 2 per cent.; he has never observed any 
symptoms from its use, and the only inconvenience has been a yellow 
coloration of the skin, which may be got rid of by alcohol washing or 
watery solution of carbonate of tithium. The late Dr. Quinquaud re 
mended picric acid as a local remedy in epithelioma. In chronic ec; 
Calvelli claims good results from the application, several times a da 
a solution of 1 y. parts of picric acid in 250 parts of distilled water. 

The ammonium salt has been highly praised in the treatmd 
whooping-cough and malaria, the average dose being 0.032 Gra. (or g: 
four or five times daily. Dr. Marten Clark asserts that this salt has pi 
eflficient in malarial neuralgia. Picric acid should be used, cither inter 
or externally, with caution, since it is apt to excite urticaria and other 8} 
toms of systemic intoxication. 

Shoes lined with leather dyed yellow by picric acid have been kr 
to excite violent dermatitis, the feet becoming swollen and being cov 
by innumerable vesicles, which coalesced and became filled with pun; 
serum. Constitutional reaction was also observed. 



ACIDUM SALICYLICUM (U. S. P., B. P.).— Salicylic Acid (R€,E.^ 
Dose, 0.32 to 1.20 Gm. (orgr. v-xx). 

Preparations. 

Ammonji Salioylus (U. S. P.). — Ammonium Salicylate. Dose, 0.12 to 0.60 
(or gr. H-x). 

Bismuthi Subiialicylaft (U. S. P.), Bismuth salicylat* (B. P.). — Dose, 0.1 
1,3 Gm. (or gr. ii-xx). 

Quinine RftUcylaa (U. S. P.). — Quinine Salicylate. Dose. 0.13 to O.QO 
(or gr. ii-x). 

^Annalcs de la SocUt^ Beige de Chintrgie, May 15, 1898. 




AGIDUK 6ALICTLI0UM. 



133 



Sovntii SftlkyU* (L\ S. P.).— Stroutium SAlicylatv. Dose, 0.30 to 2 Gm. 
^gt- T-3be). 

Lhhii Salicybu (U.S. P.). —Lithium S&licylate. Dose, 0.32 to 2 Om. (or gr. 




Pbenji SalicTlu (U. S. P.).— Phenvl SaUcrlate. (See Salol.) 
^o^ SabcyUft (U.&P^ B. P.) .—Sodium Salicylate. Dose. 0.65 to 2 Gm. (or 
1^ X xxz». 

Uv^aflBtuiB Acidi Saticylici (B.P.). — Salicylic-Acid Ointment (2 per cent.). 
Aaylltm. — Aoetrl-aalicylic Aci<L Dose, name as Salicylic Acid. 

Fiiarmacology. — Salicylic acid is an organic acid existing naturally in 
— liiiialioD in various plante, but most largely prepared synthetically Irom 
ozbolic flcid. It occurs as fine, white, needle-shaped crystals, soluble in 
tfi pAits of eold or 14 parts of hot water; and in alcoholic solutions in 
IQ putt of chloroform, 60 parts of glycerin, and in 2 parts of olive-oil (by 
■d of heftt). Thirty c.cm. (or fgj) of sweet spirit of nitre will dissolve 1.04 
Gb. (or gr. xvj) of salicylic acid. The solution remains clear even upon the 
rirfrrtop of water. Crystallized salicyhc acid is pure and without odor; 
fttcd acid has a rather peculiar, disagreeable taste; the sublimed acid 
pink colored, and smells of phenol. Dialyzed salicylic acid is pre- 
11 ia claimed that the natural acid made from the oil of gaultheria 
k»the best and purest form in which to prescribe it. 

njnolof^cal Action. — Salicylic acid is an antiseptic and antiferment, 
md prerents souring of beer, cider, or milk, or the putrefaction of urine. 
flSTTHte the action of saliva upon starchy food. It is injurious only when 
1 eoBstantly and in relatively large doses. It is very irritating to raucous 
and is not to be administered in pill, powder, or capsule, but 
rfn^ft in eolution, and preferably with ammonium or potassium acetate, 
inzn citrate, or ammonium phosphate, which increases its solubility 

r, or it may be given in some syrup or elixir of orange. 
lUcen internally, it reduces abnormally high temperature. In health 
i action is not observed, although some observers assert that a slight re- 
is produced. Sometimes headache, giddiness, and ringing in the 
■nkave been noticed, but usually no marked effect is seen upon either pulse 
irnmiration. According to Vanden Corput, salicylic acid diminishes the 
Incootial activity of the testes, although it is asserted to cause congea- 
fi« of the uterus and ovaries. It may produce abortion and, therefore, 
Aoold ba cautiously given in pregnancy, especially when a tendency to 
akMJoo or premature confinement exists. Toxic doses cause slowing of the 
hnalfcing'. Convulsions, nausea, burning in the throat, vomiting, and gaa- 
ttk irritjibilitT have also been observed to occur, followed occasionally by 
■buninnria, ha^maturia, or almost complete stoppage of urine. This is a 
^Tiatjon from the normal action, for in ordinary cases it acts as a diuretic, 
•ilfc afi^t increase of elimination of the urates and urea. Piccinini states 
ttst* afC£r the administration of sodium saHcylate, peptone is to be found in 
Af mine. Salicylic acid is absorbed with rapidity, but slowly eliminated. 
h teste nephritis it diminishes the quantity of the urine and increases the 
■eportioD of albumin. It is stated that deleterious etTects are particularly 
I to occur in drunkards from the use of salicylic acid. 
The t»**tm^nt of intoxication by this agent is that for an irritant poi- 
tlie atomach should be washed out with warm water, decoction of coffee 

ler^> ***^ ^^^ patient treated symptomatically. The effects rapidly 

t off «« th« acid is carried out from the system by the urine, principally 





134 



PHARMACEUTICAL THERAPEUTIC AGENTS OR DRUGS. 



without change, partly also as salicin and salicyluric acid. Probably 
also escapes in the sweat and saliva. After excessive doses the urine bee 
olive-green in color, from the presence of indican and pyrocatechin. T 
substances result from the action of the pancreatic juice upon salicylic 
or it may indicate the presence of phenol in the salicylic acid. A soli 
of chloride of iron strikes a violet color with urine which contains sali 
acid. In the body, the acid combines with glycocol in the liver and 
where, and becomes converted into salicyluric acid. The ingestion of 
cylic acid, or sodium salicylate, may be followed by the development of 
ous cutaneous lesions. Erythema with oedema, intolerable itching and 
gling of the skin, and fever have been caused by large doses of the so* 
salt. Other effects which have been observed are vesicles, pustules, 
patches of ecchymosis. 

Therapy. — For external use salicylic acid may be combined with c 
as a dentifrice. A similar mixture may be used for the relief of fetid 
spiration (feet or ajiilla), or witli talc or corn- or rice- flour. In jL,'an;xrei5 
sloughing cancer, it may be applied. Sut causes burning pain. D^es:^ing 
be saturated with an alcoholic solution and subsequently dried. It is n 
powerful as carbolic acid, yet it has the great advantages of bein^ odo 
and freer from danger of toxic symptoms following absorption. It is 
used in solution as a substitute for carbolic acid in the details of the mo 
antiseptic method. (A solution can be made by adding 8 parts of bora 
100 parts of boiling water, and, when dissolved, adding 10 parts of sali 
acid, and filtering when cool. On account of its irritant action it is r 
good application for diphtheria or croup.) A saturated solution of salii 
acid, in collodion, is a very effective application to corns and warts. Tine 
of cannabis Indica is often added, but it produces an unsightly stain wit] 
conferring any additional advantage. The solution of salicylic acid in 
lodion is likewise asserted to be an efficacious application in scabies, thel 
having previously been cleansed by means of a hot alkaline bath. An < 
ment containing this substance is sometimes of benefit, especially in chr 
eczema and in ulcerated lupus vulgaris. A similar application is efficac 
in lupus erythematosus of the face and eyelids. A powder composed 
parts of salicylic acid, 15 parts of zinc oxide, and 30 parts of powdered sti 
may be employed to relieve the itching of urticaria and in ecz< 
From 0.32 to 4 Gm. to each 31 Gm. (or gr. v-lx to Jj) of lard, lanolin, or o 
excipient will sometimes remove freckles. On account of its germic 
virtue, it may be advantageously used in the treatment of tinea circin 

It has been found useful as a topical application in thrush and catar 
stomatitis, in which conditions it acts as a local anodyne. It allays the bi 
ing pain of the erosions left after the vesicles have ruptured. The solu 
is made by dissolving 1 part of acid in sufficient alcohol and adding 250 p 
of water. Salicylic-acid solutions have likewise proved of value in irriga" 
of the large intestine for dysentery. Acute intestinal catarrh has t 
treated in the same manner with very successful results. In the la 
malady the internal use of the remedy may be conjoined. 

Salicylic acid may also be employed in fetid l)ronehitis as an inhala' 
with a steam-atomizer, using 15.5 Gm. (or ,>ss) of borax in 503 c.cm. 
f5xvij) of boiling water, to which 15.5 Gm. (or ^ss) of salicylic acid is t< 
added. The same solution can b€ used in catarrhal pneumonia, in phth 
etc. 




ACIDUM SALICTLICUM, 135 

The following formule will be serviceable as local applications: — 

B Addi Balicylici 8 Gm. or 3ij. 

Bismuth, aubnitrat 15 5 Qm. or Sss. 

PuIt. anci oleatia 8 Gm. or 3ij. 

H. Sig.: Dust over the surface. Useful in excessive or fetid sweating and in 
•eborrhoea oleosa. 



B Acidi salicjlici 2| vel 4 

Ungt. hydrarg. nit 12 

jinthol 



Gm. or Sss vel 3j. 
Gm. or Siij. 
66 Gm. or er. x. 



fv. 



Betana^b 

Ungt. sinci oxidi 19 5 Gm. or 

H. Sig.: Rub well into the surface several times a day. For fissured eczema of 
the palms of the hands and soles of the feet. 

Lassar's paste is an excellent application for dry eczematons patches : — 

B Actdi salicylici |65 Gm. or gr. x. — ^M. 

Zinci oxidi, 

Amyli aa 81 Gm. or 3ij. 

Petrolftti 161 ^"^ ^^ 5^^" — ^• 

M ft. unguentum. 

Internally, the i^se of salicylic acid in acute rheumatism (0.65 to 1.30 
6m-, or gr. x-xx, doses every hour until 4 to 8 Gm., or 3i-ij, have been taken) 
for two days is generally followed by prompt relief. On account of its com- 
parative insolubility, salicylic acid is now less used than sodium salicylate, 
vhich is given in the same doses. It is believed that the soda salt is rapidly 
converted into the original acid by the carbonic acid of the blood. 

Salicylic acid approaches the character of a specific remedy in acute 
rheumatism. Its most marked effects are reduction of the articular swell- 
ings, the pain, and the fever. But it is not able to prevent the occurrence 
of heart trouble or of relapse. It is a good practice, and perhaps shortens 
the absolute duration of the case, to reduce or abandon the salicylic acid 
after it has produced its most notable results, and to replace or combine it 
with an alkali. It does not prevent hyperpyrexia, since that condition has 
been known to occur while this remedy was being administered. It will 
sometimes give rise to delirium when administered for a considerable period 
in the treatment of rheumatism. The virtue of the salicylic treatment is 
much less decided in chronic rheumatism, though stiffness and pain are re- 
lieved in a certain proportion of cases. In subjects who are much debilitated 
quinine salicylate may be employed, or, if anaemia be marked, the salicylate 
of iron. In muscular rheumatism salicylic acid will sometimes afford relief, 
and will often fail. The pain and swelling of rheumatoid arthritis are some- 
times relieved and the progress of the disease arrested by sodium salicylate. 
The same salt is, in some instances, serviceable in gonorrhoeal rheumatism. 
In acnte articular gout and in irregular gouty manifestations good results 
have likewise attended the use of salicylic acid or the sodium salicylate. 

It has been found that the local application of salicylic acid is bene- 
ficial in acute articular rheumatism. The drug acts by absorption, as it 
may be detected in the urine within half an hour after the application has 
been made. Dr. Bourget, who has long relied upon the external use of sali- 
cylic acid, regards the following as the best formula: — 

B Acidi salicylici, 

Adipis lanre hydrosi aa 10 Gm. or SJiRS. 

Olci terebinthintt rectiflcat 6 25 c.cm. or fSiiss. 

Adipis 77 5 Gm. or Siise. 

Ft. unguent. 



136 



PHARMACEUTICAL THERAPEUTIC AGENTS OR DRUGS. 



It must be noted, however, that cases of intoxication have occum 
a result of the excessive local use of the remedy. 

When the salicylate causes gastric disturbance, it may be given bj 
rectum, which should be previously washed out by mr-ans of a cath 
enema. It is well to combine laudanum with the salicylate in order to 
vent irritation of the bowel. Labeeb has witnessed benefit from the ,, 
use of salicylic acid in sprains, irrespective of the presence of the rhemi 
diathesis. 

Salicylic acid, or its sodium salt, has been found usefid in those a 
tions so often associated with or dependent upon the rheumatic diath 
B8 the various forms of neuralgia, especially migraine, trifacial neura 
and sciatica, chorea, tonsillitis, urticaria, and erythema nodosum. Sod 
salicylate is serviceable also in erythema multiforme, especially when, i 
frequently the case, the disease is dependent upon a rheumatic diath 
The remedy suppresses the eruption and relieves the articular pains, 
sciatica, Ringer prefers it to any other remedy. Rheumatic iritis may( 
yield to its influence. 

Gay has successfully employed this remedy in Meniere's disease, gt 
0.20 Gra. (or ^v. uj] three times a day. The attacks of vertigo, which 
been very frequent, rapidly diminished in number and severity. As impr 
ment progressed, the remedy was suspended during considerable inter 

In the experience of Dr. Strizower, salicylic acJd is an excellent ren 
in the treatment of gall-stones. He is accustomed to give it in O.Go Gm. 
gr. x) doses three or four times a day in the intervals between attack 
colic, and states that it prevents the formation of concretions and has' 
their expulsion. 

Salicyhc acid has been successfully used as an anthelmintic. Ti 
solium has been removed by five hourly doses of 0.50 Gra. (or gr. viij) ei 
preceded and followed by a dose of castor-oil. Round-worms and soat-wo 
are destroyed by the same agent, the latter by the local effect of an inject 
the former by the internal use of the drug. 

Salicylic acid may be given in 0,32 Gm. (or gr. v) doses in order to pu 
the foul breath sometimes present in phthisis. Improvement has someti 
followed the administration of salicylic ncid, or its combination with sodi 
in dinbetes. An antidiabetic powder employed by Dr. Monin is compc 
as follows: — 

B Sodii bicarbonat 621 Gm. or 5ij. 

Sodii bonzoat. 39 Gm. or 3x.. 

Sodii salicT-lat 19 S Gm. or 3v. 

Lithii carbonat ISp Gm. or 5m. 

M. Sig.: Teaspoonful at each meal. 

The same remedy is of service in diabetic neuralgia. It is also * 
ployed for its antipyretic effect in typhoid fever, pneumonia, erysipelas, ! 
phthisis, but it is regarded as especially serviceable in blood-poisoning i 
sapraeniia, pyaemia, etc., and the eruptive fevers of children. Dr. de R 
attributes prophylactic virtues to this substance in case of exposure to s( 
let fever. Dr. C. A. Bryce esteems salicylic acid as of decided efficacy in 
treatment of small-pox. He states that it reduces temperature, relieves pi 
and limits the development of pustules. In relapsing fever it is said 
render the relapse shorter and of less severity. It promptly checks 
yeasty vomiting dependent upon the growth of Sarcina ventriculi. Soi 




ACIDUM SAiaCYLICUM. 



137 



disturbances of the circulation occur from medicinal doses in 
I €rf fcTcr. It is very probable that in some of these cases the results 
lOTsttbtetable to impurities in the salicylic acid. Urticaria, erythema, and 
entaneous symptoms have been noticed after its administration. 
fttt dceqiMTDation has sometimes followed the erythema. In exceptional 
I the exhibition of salicylic acid is followed by haemorrhage, usually from 
Cfet gVB* or nose. The soda salt is believed to be free from this objection. 
Bemlieiiii makes use of hypodermic injections of salicylic acid in order 
toirlicrc the night-sweats of phthisis. The solution which he employs con- 
luf 6 Om. (or oise) of the acid in 30 c.cm. (or fjj) distilled water, to which 
■ added 11 c.cm. (or foiij) of glycerin and 15 c.cm. (or f^ss) of alcohol. He 
■jfltU 8 ccm. (or mxxx) of the solution on four or five successive evenings. 
Tkt wane writer has reported five cases of inoperable cancer of the cervix 
tfBriia which the injection of salicylic acid into the growth was followed by 
AnpoBTiDce of the hsemorrhages and otfensive discharge, with diminution 
B tw sixe of the tumor. Sodium salicylate in 0.65 Qm. (or gr. x) doses will 
etimefi assuage the pain of carcinoma. 

Dc Becker has treated a number of cases of acute pneumonia witli sali- 
:acid. He gave to a child of four years 0.10 Gm. (or gr. iss) every hour 
f'^tt fOcc*g >pf til result. In adults he gives 0.50 Gra. (or gr. viij) every two 
rlkrw*- ' ' As soon as the expectoration is free, he diminishes the dose. 
Bit «^: ►.-e, tea, chocolate, and milk are good vehicles for the medi- 

d*t. He believes that if salicylic acid is given early (on first or second day) 
t will be found a true abortive of pneumonia. He treated twelve cases, with 
mt death; the fatal result was due to meningitis. The others rapidly reeov- 

tRd." 

The granular effervescent form is a good one in which to administer 
^ Htliejlates, or they may be given in effer\*e8cent draughts, or in combina- 
te like this: — 



a 8odU MUcylaUs 8 

T&act. Uvanclule comp 15 

g jmy . auratitii 105 



Gm. or 3ij. 
c.cm. or f3iv. 
com. or fSiiiss. 



M. Si^.: Give b ublespoonful every three (or four) hours for acute rheumatism. 

The following prescriptions may likewise be recommended as beneficial 
tions in acute rheumatism, gout, and neuralgia: — 

Gm. or 3ij. 
c.cm. or fjiv. 
C.cm. or fjj. 



B A^di saUrynci 8 

AaC arlheris nitrosj 120 

tWc cardamom, co. 30 

31. &g, z Two tc«»poonfuU in water erery two boars. 



S Aadi «alicyiki 

J^, axntnon. acetatt« 
Aqmm cmmvhoras . 
Bp€. mih^rim nitrosi 



13{ Gm. or gr. cc 



as 18160 C.cm. or f3v. 

q. s. ad aO| c.cm. or fjij. 

A traspoonful in uaitr every two or three houra. 



% 



The appended formula is serviceable in chronic rheumatism and gout: — 



B JUidi 



kli<^lici 12 

•vt. rltamuj purebiaiur.. H 

iiial. tN. !■.) .120 



Om. or Siij. 
c.cm. or i3ij. 
C.cm or iliv, 



iL &M" -^ tableapoonful in water two or three times s day. 



■ 0rtti^ Sf^*^^^ Journal, Epitome, 1062. 1898, p. 87. 




138 I'U^nMACEOTlCAL TUEKAPEUTIC AGENTS OK DRUGS. 

On account of its influence upon the utero-ovarian circulation, the i 
may be advantageously given in cases of amenorrhaeii and dysmcnorrh 
Sodium Ealicyiate has been used with excellent effect in chronic plem 
It promotes absorption of the effusion by a powerful diaphoretic action, c 
parable to that which it exerts in rheumatism. 

Since the use of salicylic acid has sometimes been followed by anaei 
Professor Peabody, of New York, combined it with iron, as follows: — 

I^ Acid, salicylic 1130 Gm. or gr. 

Ferri pyrophosph |32 Gin. or gr. v. 

Sodii phoBphat 3|25 Gm. or gr. 1. 

Aquse Idj c.cm. or fSas. 

M. Sig.: To be taken at a dose. 

ACIDITM STEAHICTFH (U. S. P.).— Stearic Acid (HCi^H.^Oa). 

Stearic acid is an organic acid which, in its commercial, more or 
impure, form, is usually obtained from the more solid fats, chiefly tall 
It is a hard, white, somewhat glossy, solid; odorless and tasteless, and ; 
muncnt in the air. Insoluble in water, it dissolves in about 45 parts of a 
hoi at 15° C. (59** F.); it is readily soluble in boiling alcohol and in et 

Stearic acid has no physiological action upon man and is employe<: 
medicine only in the manufacture of glycerin suppositories. The fiiec 
fatty oils, of either animal or vegetable origin, consist mainly of a mixt 
of three fatty principles, — olein, palmitin, and stearin, — which are g 
erides of the corresponding acids. Immanuel Mimk has shown that fi 
acids alone are competent to produce the nutritive effects of fat, the glyc< 
being unnecessary and sometimes injurious. Senator has advocated, 
cases that cannot tolerate codliver-oil, the administration of the fatty ac 
which can be given in keratinized pills so as to pass through the stom 
unchanged. He regards the saponiiied fat acids, or soda-soaps, as prefers 
either to fats or pure fat-acids. Being already in a soluble and absorbs 
condition, they make no demands upon the digestive capacity of the 
testines. 

ACIDITM SULPHORICINICTnU.— Sulphoricinic Acid. 

Pharmacology. — This derivative of castor-oil is only slightly irrit 
to the skin, though rapidly fatal to animals when injected into the ve: 
pleura, or peritoneum. The sulphoricinate of sodium is made by exa< 
neutralizing sulphoricinic acid with soda. 

Physiological Action. — The salt is antiseptic and deodorizing and 
hcres well to the skin. Berlioz found that a 10-per-cent. solution entir 
destroyed the odor of five or six times its weight of very fetid pus. 

Therapy. — The sodium salt has been used as a topical remedy 
ozjena, diphtheria, and laryngeal tuberculosis. Several antiseptic cc 
pounds have been prepared with the sulphoricinate of sodium. Sulp 
ricinated naphthol forms an emulsion whieli lias been used in oz:pna. S 
phoricinated creosote is used pure, or made into an emulsion with wai 
in laryngeal tuberculosis. Sulphoricinated salol has been employed eitl 
in its own form or diluted, as an application to ulcers. Sulphoricinai 
phenol is made by dissolving, with a little heat. 40 Gm. (or ,v V^) of pi 
carbolic acid with 100 c.cm. (or f^iiifaij) of sulphoricinate of sodium. 




ACIDUM SCLPHUHICUM. 



139 



■teboD of one-fourth of this strength is used in some of the hospitals of 
Itei in diphtheria. The mixture adheres well to the surface and does 
Mt irriute or cause pain. It is applied upon pledgets of cotton, and is 
Mt ruhed off by gargles or irrigations. A comhination of 10 parts of 
■U, Z parts of creosote or terpin hydrate, and 80 parts of sulphoricinate 
d M^om is also serviceable as a topical application in diphtheria. 



lb 



ACIDUli STJXPHTJKICirM (U. S. P.. B. P. ) .—Sulphuric Acid 

Preparations. 

Sulphiiricum Dilutum {V. H. P., B, P.). — Diluted Suli>hiiric Acid 
& P.I cODtAitiH 10 (HT cent., by weight, of absolute sulphuric acid; U. V.» 13.65 
seatt. of bydn>geii Bulphntel. Dose, 0.30 to 1 c.ein. (or mv-xv). 
Aeidviii Salphuricum Aromnticum (U.S. P., B. P.). — Aromatic Sulphuric Acid, 
ir of Vitriol (U. S. P. contftma sulphuric acid. 100 c.cm.; with tincture of ginger, 
^iB.; oil of dxtnanioii, 1 com.; and alcohol, q. s. to make 1000 c.cm.). Dose, 
im 1.20 r em (or mx-xx). 



narmaeolog^. — The official U. S. P. acid contains not less than 92.5 
fs cent., br wcijjht, of absolute sulphuric acid and not more than 7.5 per 
of wuxer. The B. P. acid contains 98 per cent., by weighty of hydro- 
i iolphate. It must be colorless^ without odor, and of an oily consistence. 

xrry canstic and corrosive, and should be kept in glass-stoppered bot- 
The commercial acid (oil of vitriol) contains various impurities, — 
lead, nitric ucidj etc. 

Thysiological Action and Toxicology. — Sulphuric acid, in full strength, 
dttrs aaitnal substances and has a strong affinity for water. Applied to the 
dbn, U Acta aa a caustic, redissolving the coagulum formed and penetrating 
ivplT, taming the surface black. When taken internally, the lips and other 
|vu of ihe mouth are blackened, and smptoms of corrosive poisoning are 
indoeed; there is intense pain, with efforts at vomiting. Collapse and death 
WKj npidJj ensue from the intense congestion of the oesophagus and stom- 
•di, or it may occur secondarily from the resulting gastric ulceration and 
mnttnteB of the ce£ophagu8. 

BdiAl lesions have been found by Drs. Eugene Frankel and F. Reiche 
ii tiaoe CMCfi of poisoning from sulphuric acid, one of which caused death 
ttirelionr&y while the other two cases were fatal in from two to four months. 
Ik mpfte^mtice of the organs was much the same in the three cases. In 
mA, cooirtilation-necroBis was present and was more extensive in the first 
ftn is the succeeding cases, in which the lesion was limited to small patches. 

The *toinach-piimp, if employed, should be used with extreme care on 
^EBQBt of the danger of tearing the softened mucous membrane or of 
ii|>liiilnjt tb^ etoraach. Alkalies should be given, with milk or soap-water, 
mi morphine hypodermieally to relieve pain, combined with atropine as a 
^nita^ stimulant. Oil, white of eggi, and magnesia are also appropriate. 
S^ialccnts and appropriate treatment for the succeeding inflammation will 
b maided Sulphuric acid is sometimes maliciously thrown upon a person. 
It in the face. In such a case soapy water is to be used to wash off 
of acid, and an alkaline wash applied; to relieve pain, opium in- 
I^hDjt will be needed. The subsequent treatment is that of an ordinary 




140 



PHAHMACEUTIOAL THERAPEUTIC AGENTS OR DBtJOS. 



Sulphuric acid is eliminated to a small extent by the kidneys and pi 
ably also by the lower bowel and skin. 

Therapy, — On account of the pain following its application, enlph' 
acid is not much used as a caustic, although it is an efficient destroyei 
tissue. Velpeau used it in cancer^ and Eicord for chancres, the acid b€ 
mixed with some absorbing substance like sawdust or charcoal. In ca 
and necrosis, and suppurating cavities ot sinuses, it may either be app 
upon a glass rod or on lint, diluted with 4 to 6 parts of water. 

Internally, dilute sulphuric acid acts as an astringent and antisej 
The elixir of vitriol is the preferred form for checking the night-sweati 
phthisis, and in some cases of diarrhoea. Sulphuric acid, with water, sw* 
ened so as to make a pleasant drink, is a valuable prophylactic against 1 
poisoning, often used by operatives in lead works. It also has been foi 
to be a preventive of attacks of Asiatic cholera, when taken regularly dm 
the prevalence of an epidemic. 

ft Acid, sulphurici diluti fi 26 c.cm. or fSiiaa. 

Tr. opii dcodorati , 4 c.cm. or f3j. 

Elixir aromatici 30 ccm. or f5j. 

Aquse q. 8. ad 120 ccm. or fJJv. 

M. Sig.: Take a tablcBpuonful for catarrhal dysentery every hour or " 
Watch with care the action oi the opium. 

Sulphuric acid has been given as an a.-^trintrent in tV7)hoid fever. It i 
be preferred to hydrochloric acid when the diarrhcca is excessive. Lead c 
is relieved by the use of sulphuric acid, and the constipation of lead poia 
ing is effectually treated by a combination of diluted sulphuric acid, quit 
sulphate, and magnesia sulphate. On account of its astringent proper 
it is beneficial in hiemorrhage from the uterus, stomach, or intestinal cai 
and in purpura. The following prescriptions have been found beneficial 

li Acid, sulph. aromat 7|50 c.cm. or fSij. I 

Fill i<I<*\t nut i hiinijimelidis, 

Fluidextracti ergotie aa 60] c.cm. or fjij. 

M. Sig.: Two teaspoonfuls in water every two or three hours. U&e eapeci 
in haemorrhage from lungs, stomach, or vomb. 



fi Acid, eulpb. aromat 15 

Magnesii sulph 02 

Spt. chluroforini U 

Inf. rosce galUcs q. a. ad 240 



ccm. or fSs*. 
Gm. or 5ij. 
e.em. or fSiij. 
ccm. or fSviij. 



M. Sig.: A tablespoonful every three hours, 
and constipation. 



Useful in hajmorrbage from rect 



B Acid. Bulph. dil 161 com. or fj^s. 

Quininae sulph 175 Gm. or gr. xij. 

Tinct. opii 7 50 c.cm. or f3ij. 

Syrupi ct aquoe q. s. ad 90[ ccm. or f^iij. 

M. Sig.: A tenspnonful in water every four hours in enteric fever with t« 
eney to diarrhcsa and sweating. Also useful in sweating of phthisis. 

Liquor Acidi Sulphurici Halleri (Haller'a acid drops) — not official- 
a mixture of equal parts, by weight, of acid and alcohol, gradually adc 
with constant stirring, taking care that the temperature of the mixture d 
not get so high as to vaporize the alcohoL It contains ethcTj alcohol, 8 
phuric acid, and sulpho-ethylic acid, and is used for the same purpose 




ACIDUM grLPHCROSUM. 



141 



te aroniatic acid^ in about half the dose, on account of the larger amount 

AiUm SnlpliOTiiiicuin, or ethyl-siilphiiric acid^ is prepared by adding 

■ipbaric ftcid to alcohol in combining proportion. It is freely soluble in 

Aobol, and mixes with water (1 or 2 parts) without losing its oily character. 

11 ia • jfvUoirifih liquid, with slightly astnngent taste, and is neutral in re- 

«tm. The ethyl sulphates are crystallizable and soluble in water. The 

ittrjl-ffolphate (or sulphovinate) of sodium has been used as a saline ca- 

ftastic Ethyl-sulphuric acid is an example of an acid ether, and is a solvent 

aphor (25 per cent.), iodoform (3 per cent.), sulphur, naphtalin, chry- 

etc., and can be used as a vehicle for these remedies in the treat- 

of akiii diaeaaeB. 

k ACIDnV STTLPHUIIOSUM (U. S. P., B. P. ) .—Sulphurous Acid 

■ Bote, 0.30 to 4 c.cm. (or mv-f5j), well diluted. 

H Pteparationa. — In combination with a base, sulphurous acid makes sul- 
B^fiea. Of its combinations, the following are official in the U. S. P. : so- 

■ turn fiu!phiti\ sodium bisulphite, and sodium thiosulphite. 
narmacology. — Sulphurous-acid gas (sulphur dioxide, SOj) is pro- 




t !ig snlphur in the open air; when combined with water, it 

ti ii acid. It has a sour, sulphurous, somewhat astringent taste, 

md cnotatns *>.4 per cent., by Aveight, of the gas, and not more than 93.6 per 
mmL of water. Tlie P.P. acid contains the equivalent of 5 per cent., by 
nj g h t, of sulphurous anhydride, or dry sulphur dioxide. 

Fhyaiological Action. — This acid and its salts are very destructive to 
Ibv forms of animal and vegetable life, owing to their affinity for oxygen. 
ft ii Dot well borne by the stomach, and sliould be given freely diluted with 
its taste and odor are very unpleasant. Locally, it does not excite 
irritation in medicinal doses, but inhalation of air containing from 1 
to I parta of sulphurous acid per 10(tO produces in animals intense inflam- 
of the respiratory passages and lungs. Injection of a 5-per-cent. 
into the stomach was found by Dr. L. Pfeiffer to excite severe gas- 
Animals not killed by the acid recover very rapidly from the imme- 
effecta, though they may subsequently perish from inflammation, 
haa demonstrated that 96.5 per cent, of sodium sulphite is eHmi* 
in the urine as sulphate, the remainder only as sulphite. Nearly all 
rfa lanre quantity of sulphite administered was eliminated in five hours. 
Tl^rapy. — As a local antiseptic or bactericide, sulphurous acid is highly 
m those forms of skin disease caused by parasitic invasion, such as 
tonsurans and tinea versicolor. It may be effectively used in tinea 
by the simple device of Dr. Schiister. A net of strings is stretched 
the lower third of a card-board box made to fit the head. A saucer 
ntig biirninsr sulphur is laid upon the net of strings and the box cor- 
Th« patient must sit still for half an hour. An abundance of sul- 
icia gaa is generated, the sulphur ceasing to bum, of course, as 
p mil th^ oxygen is exhausted. In various forms of sore throat it is 
but particulaTly in diphtheria, where it can be used topically and 
taken internally. 

It i» bcnefi*^^®^^^ applied to unhealthy or sloughing wounds or ulcers. 
.|^ ~ 5 c^cm- (or foi-ij) of the official acid to 30 c.cm. (or fjj) of water. 




■ 





142 Vn.UtlCACEUTICAL THERAPEUTIC AGENTS Ott DIIUGS. 

or water and glycerin, is of service in chilblains and chapped hands. J 
phurous acid, as Ringer points out, may be used in such a manner as to i 
scabies with the utmost rapidity. This method consists in exposing 
patient, his head excepted, to the influence of sulphurous-acid gas, gener 
by burning 46.7 Gm. {or oxij) of sulphur in a suitable closed apparatus, j 
clothes should be, at the same time, put in boiling water. Dr. Dewar^ 
omniends equal parts of sulphurous acid and of water as an etficient drei 
in erysipelas. 1 

in fermentation of food in the stomach, flatulent dyspepsia withi 
stomach, pyrosis, dilated stomach, etc., sulphurous acid, properly dill 
has been recommended. In typhoid fever it has also been used, and,i 
asserted, with success, and may be tried in measles, scarlatina, and small- 
In Bome bronchial atlections — catarrh, whooinng-cough, dilated bronc 
tubes — it may be inhaled with a steam-atomizer. It is also of great ser 
in many skin al5*ections, such as urticaria and purpura, after other met! 
have failed. 

The author would recommend the following formulse for the dise 
just referred to: — 1 

H Acidi sulphurosi, | 

Syrup, zingiberis aa 60) c.cm. or fjij, 

M. S'\g,t From one to two teaspoonfuh in water three" times a day. 

H Acidi aulphurosi. 

FIui*iL'Xt. erg\>t(e, 

Syrup, aurantii aa 30] c.cm. or fjj. 

M. Big.: Two tea«poonfuU in water tliree or four times a day. 

The fiulphitps and hyposulphites are employed to fulfill the same \] 
cations. The administration of the sulphites in pyasmia was advocated 
Polli, but later clinical observers have not been able to obtain the good 
suits that he reported. (The sulphides will be considered under the Jian 
Salphur.) VH 

ACIDTTM TANNICUM {U. S. P., B. P.).— Tannic Acid (Tannin). 
Dose, 0.U65 to 1.30 Gm. (or gr. i-xx). B. P., 0.13 to 0.32 Gm. (or 

Preparations. 

CoUodium Stypticum (XJ. S. P.). ^Styptic Collodion (consists of 20 part-« 
tannic acid, 5 of alcohol, 25 of ether, and 50 of collodion). For external use as 
astringent. 

Vnguontum Acidi Tannici (U.S. P.). — Ointment of Tannic Acid (contttins 
per cent, of tannic acid). 

Glycoritum Acidi Tannici (U.S. P.). — Glycerin and Tannic Acid (20 per cei 

Trochisci Acidi Tannici {U.S. P., B. P.).— Troches of Tannic Acid (oach 
Gm., «r gr. j; B. P.» 0.03 Giti., or gr. ss). 

Glycorinum Acidi Tannici (B. P.). — Glycerin of Tannic Acid (20 per cent.). 

Suppcsitorin Acidi Tannici {B. P.). — Tannic-Acid Suppositories (0.20 Gm., or 
ii], of tannic acid). 

Tnnnalbin. — Tannic Acid and AJbiunin. Dose, 2 to 8 Gm. (or Sssij). 
Tannnlbin. 

Pharmacology, — Tannic acid is a common constituent of vegetable 

ganigms, especially those noted for astrin^ency, such as oak-bark. Gi 
contain about 50 per cent, of tannic acid, which can be obtained by expos 
powdered galls to dampness and afterward dissolving out the tannic acid w 




ACIDrai TAJfKIClTM. 



143 



tie tad of ether. It occurs in light-yellowish scales, soluble in 16 parts of 
aid mmt€T, and slightly soluble in alcohol. It is likewise soluble in glycerin, 
Jtwaywhttt aJbumin and gelatin, and strikes a black color with preparations 
^MMUa^iroD. Solutions containing tannic acid (decoctions of black tea or 
iAi) ire antidotes for poisoning by some metallic salts, and especially 
■tlMQj or tartar emetic, and the alkaloids. 

IkfaoiogicBl Action. — Tannic acid^ when locally applied, has an 

*=r^r*^t action upon the tissues, owing to its affinity for albumin. In- 

:t acts as a weak acid upon the digestive tract, but when its chem- 

• -• are satigfied by combination with a base or neutralizing it with 

- no longer capable of precipitating albumin, and therefore no 

>eft an astringent action upon the parts with which it comes in 

ace, according to Stockman, it can exert little, if any, action 

»««cular system, and, as it is not excreted by the bronchial mucous 

- :^\ ^ery little, or none, upon the flow of the bronchial secretions. 

V^aiii«|^rd to its action upon the kidneys, as it is excreted principally by 

Aadktnoely it ia conceivable that it may have some influence in diminishing 

liVBamrra, although even this he regards as doubtful. Lewin, however, 

aE^BBenda the administration of tannic acid in the form of an albuminate, 

tkk& it free from irritation and is more readily absorbed (tannic acid, 2 

^; vater, 90; mix well, and add white of egg, 10 parts). The external 

€atrraal nse of tannic acid mar occasion erythema or urticaria. 

Tkcsapy. — As a local astringent, tannic acid heads the list. A com- 
ol iodoform and tannic acid (2 to 1), finely powdered, is a good 
ypowder for moist eruptions, some forms of eczema, and for insuflla- 
tcsto the nose to reduce secretion in catarrh. After the severity of the 
ition has somewhat subsided, the glyccrite of tannin is a good sp- 
in acute eczema. It may be applied twice daily, and allays the 
pain and itching. A solution of tannic acid and camphor has been 
Evith good results as a topical application in erysipelas anc^ lyraphansitis. 
' riy<*rtie of tannic acid is a g<M»d topical applicntiou to tonsillitis or 
Dgitia. It tnav also he use<l as a j^pray. properly diluted, in haiinoptysis. 
i$Uigigcr solution (oO per cent.) has been recommended by CapuUauo ^ as 
lto«nff for burns nf nil de^inx's. For disorders of the lower bowel, ulcers, 
Pf^ p^ hasmorrhoid-s, pn>lapsuR, and to expel thread-worms, n solution may 
ititeted, or suppoeilorii^ used, each containing 3 to 5 grains, with caoao- 
l» or starch. 

Liebersolm has obtaine<i good results in severe acute dysentery from 

^oe of hot ent'm.ata of tannic and boric acids. The injections were given 

-.^ .v^<.^. hours and consisted of a 4-per-cent. solution of boric acid, in 

■ to. (or gr. x) of tannin were dissolved. A few drops of laudanum 

▼»-» icoi..: i»» cnch enema. The effect was to arrest ha?morrhage, diminish 

9H tad icT' -iiiw-. and materially abridge the course of the disease. A plan 

ItmtOient ii^ ^ <:d by Cantani has been used with advantage in the 

l^tBge of ci Large enemata of tannic acid are thrown into the 

Ibert^nd the lUo-ciwal valve. From G to 13.5 Gm. (or 5iss-v) of tannic 

BMlved in * litw^ (or Oiv) of woter, with the addition of 2 c.cm. (or 

) of Im u<1^ti u m And 46.5 Gra. (or 5iss) of powdered gum arabic, are in- 



j^jput Cimp*'^ , yr p uq>b>T IS, l«»i«!. 



144 



PHARMACEUTICAL THEUAPEUTIC AGENTS OB DRIGS. 



A solution of tannic acid is useful in cases of leucorrhcea. The glya 
or iodoform-tannin, is an excellent application for catarrhal inflamml 
of the cervix uteri. Even in carcinoma uteri the glycerite of tannic a^ 
efficient in moderating discharge and allaying odor. Its virtue ml 
assisted by combining it with a email proportion of liquetied phenol. 1 

The odor of oza»na and other affections attended by fetor may, aet 
ing to Dr. B. W. Richardson, be overcome by the application of cotton-^ 
previously moistened in a saturated watery solution of tannin and driec 

In gonorrhcea, after the acute stage has passed off, tannic acid is a 
ful medicament. In men it may be administered, dissolved in water, 
urethral injection. Dr. Hanika, of Munich, has treated gonorrhoea bj 
ing the urethra with a powder consisting ol equal parts of tannin, iodca 
and thallin sulphate. The powder is introduced through a metal tube] 
or twice daily immediately after the patient has emptied his bladdeta 
women a watery solution may be used as a vaginal injection, or the vi 
may be packed with gauze covered with tannin. Solutiona of tannic! 
may also be employed for the purpose of hardening tender nipples and t^ 
feet. A concentrated solution of tannin may answer a useful purpose 
palliative remedy in ingrown nail. A lotion of tannic acid is frctjuentl 
service in herpes. It is useful in phagedenic ulcers and alopecia circ 
scripta. Made into a pomade, it has been found of benefit in dan^ 
Ringer recommends the glycerite of tannic acid in otorrha?nj not, hoi»i| 
during the acute stage, but after this has beon relieved and hut a mod< 
discharge is left. The remedy is more beneficial when the menibnina 1 
pani is intact. The canal is filled with the solution, which is rctainc* 
cotton-wooL 

With alkaloids tannic acid generally forms insoluble compounds 
should not, therefore, be prescribed with preparations containing salt 
quinine, strychnine, etc. i 

Xotwithstanding the chemical arguments urged by Dr. Stocla 
tannic acid has long been successfnllv administered as an astrin^^iit rem 
As, however, it enters the blood under the form of gallic acid, its rei 
effects are, in reality, due to the latter acid. Tannic ncid is preferably 
ployed as a local application, gallic acid as a ByRtemic remedy. The th 
peutical uses of gallic acid have been already described, and need not be '. 
repeated. | 

Tannic acid has boon u^ed in tuberculosis undor the thoory that it is 
to destroy the banillus of the disease, M. Arthaud has detailed the ref 
obtained in two thousand cases from this method of treatment. He ch 
that the effect of tannin is superior to that of creosote. 



ACIDUM TARTARICUM (U. S. T., B. P.).— Tartaric Acid (1 
H,OJ. 

Dose, a.3'3 to 1.30 Gm. (or gr. v-xx). 

Preparations. — The U. S. P. official salts are antimony and potass 
tartrate (tartar emetic^, iron and afnmonium tartrate, iron and potass 
tartrate, potassium tartrate, potassium and Podium tartrate (Fochelle s] 
and pntni^r^imn bitnrtrnte (cream of tartar). Scidlitz powder, or pn 
cfFerveBCcns compoaitus (U, S. P.), pulvis sodee tartaratse cffervescens (B. 
is dispensed in two small papers,, a blue one containing 8 Gm. (or 3ij' 
pota.?sium and sodium tartrate, with 3.60 Gm. (or gr, xl) of sodium hi 





ACIDCM TaiCULORAOETICUM. 



145 



A i 



} 



^**«Jr, ftuci a white oae containing 2.25 Gm. (or gr. xxxv) of tartaric acid. 
-n administered tbeao are separately dissolved, each in about GO c.cnu 
" "* water, and the two eoiutione mixed and drunk while effervescing. 

mon inipn3ves the flavur of the dose. 

JfHarmacology and Physiological Action. — Tartaric acid ie obtained bj 

decomposition of cream of tartar (potassium bitartrate) found in old 

<'-caak&. It is laxative and sli^fhtly diuretic. It reduces the alkalinity of 

*!«yo<I and makes the urine acid. In larger doses it is an irritant; indeed, 

•i it resembles oxalic acid, and the morbid appearances are also 

lie same. In excessive amounts tartaric acid retards and weakens 

ntg of the heart. Its saturated solutions are irritant even to thte 

fi-w instances death has resulted from the ingestion of this sub- 

. e ityraptom^ are best relieved by demulcents, the alkalies, mag- 

.«ik, soap, milk, etc. 

frapy. — Certain of the tartrates are used as laxatives, magnesium 

rding a good substitute for the citrate. Rochelle salt, in 15.5 Gm. 

- before breakfast, is a good remedy for habitual constipation- 

:trate (in doses of 0.65 to 1.30 Gm., or gr. x-xx) exerts a de- 

i i; action, and in combination with washed sulphur (1 to 2) it 

icellent laxative remedy for haemorrhoids. 

• ' ination of diuretic and cathartic virtues renders potassium 

useful in the treatment of chronic Bright's disease. It re- 

ee <edeni« and delays the manifestation of uraemia. For a similar reason 

* Q*eful in ascites. Potasvsiuni tartrate, or Rochelle salt, proves of utility 

a b^patic indigestion accompanied bv an excess of uric acid in the urine. 

Lathium bit-Tiriti* also is useful in lithemia and chronic rheumatism- 



^HMTiru 



ACTDUK TRICHLOHACETICUM (U. S. P.)-— Trichloracetic Acid 
iT!(\rl,U.). 

FhATiDaoclo^ and Therapy, — This acid, a crystalline and deliques- 
t «;jf>e.!dnce, readily soluble in water, is an efficacious caustic and astrin- 
r^ri Ii has been successfully employed in the removal of enlarged ton- 
hied follicles of the pnarynx, and polypoid excrescences. Its 
more strictly limited than that of some other caustics, but 
^» for use when large masses of tissue are to be destroyed. It 
iied to the pharynx without any previous antesthetization. In 
lowever, the surface should first be touched with a 10-per-cent 

^ ».^v s^rynx with a 20-per-cent. solution of cocaine. It is notable for 

#» d i J II can* of the eschar which it produces. Trichloracetic acid is a 
ivrSocAblc application to warts, vascular nsevi, pigment patches, and in- 
dent olcers. 

Am ah afrtringcot^ the following combination is recommended: — 

r^ T 15 

■ villd 19 

\. ),<, Tri< hlorvcctjci 16|6 to 31 



(,lTi « Tim 



60 



5 Gm. 


or Jm. 


4 Gm. 


or 3v. 


Gra. 


or Jsft-j. 


c.cm 


or fjij. 



i 



U. thg- : Appl/ to the affected Burftcc on a pledget of cotton. 

j>f * !-!-.», Bronner employs trichloracetic acid in the treatment of 

kos uae of a 10- to 15-per-cent. aqueous solution and applies 

to the roucoue membrane covering the septum and turbinated hones. 





146 PlLMiMAOEDTICAL TUEUAPEUTIC AGENTS OH DRUGS. 

The operation i8 repeated two or three times a week for several we 
Cozzoliijo recommends the use of trichloracetic acid in epistaxie, touct 
the bleeding-point with a piece of cotton saturated in a solution of 1 
(or gr, xv) of trichloracetic acid to 30 c.em. (or fjj) of water. 

ACONITINA (U. S. P., B. P.).— Aconitine. 

Averiigo dose, 0.00015 Gm. (or gr. ^''^oo)- 

ACONITUli (U. S. P.).— Aconite. (Monk's-hood.) 
ACONITI RADIX (B. P.).— Aconite Hoot. 

Preparations. 

Fluidextnirtmn Acnniti (U. S. P.).— Flui.l Kxtruct. of Aconite. (100 e.cn 
UlDB 0.4 Cm. of Aconitine.) Pohp, O.OWJ to 0.00 c.cm. (or m'/„)-j). 

Tinctura Aooniti (U. 5^. P.. IJ. P.).— Tincture of Aconite {10 per cent.; as 
to contaiu in viwU 100 c.cm., 0.045 Cm. of aponitinv U. S.). I)osp. 0.(lt( to 0.30 i 
(or mi-v). B. P., 0.30 to 1.20 com. (or mvxs)\ if frequently repented, 0.12 to 
cem. (or mii-x). (Tlie V, S. P. formula is iieiVrlv twice the strength of that of 
B. P.). 

Unguentum Aconitinfe (B. P.). — Aconitine Ointment (2 j>er cent.). 

Linimcntum Aconiti (B. P.). — Liniment of Aconite (500 Gm. in 760 com.). 
external use, witli caution. 

Fharmacolo^. — The dried tuherotis root of Acouituni Nape 
( Han uncu laces), collected in autumn, yielding, when assayed hy U. S. 
process, not less than 0.5 per ccjit. of aoonitine. The British Pharmacop 
requires that ilio root^: -ilial! Ik- ^^ollentcfl frmu ])hHits cultivated in Gi 
Britain. Monkshood is a porennial plant indigonous to Europe, but so 
times cultivated here in gardens for its ornamental spike of blue flow 
All parts of the plant are poisonous, but the active principle* an nlkaL 
Aconitine, exists in greater proportion in the mot, aspnniated with piprac( 
tine anil aconine. (Napulliiie is probably identical with aconine.) Accuii 
erystalli'/os in rhombii:- or lioxagoual plates; is soluble in alcohol, other, i 
ehloroforrn. and in '.V^Ol\ jiarts of wnter. 

Dunstim and Cash luive found that different samples of aconitine dl 
extremely as regards toxic properties. What has been termed "amorph 
aconitine" contains but a very small proportion of true, or crystalline, ace 
tine, which is the official form. Wtien aconitine is heated at its mclti 
point there is obtained a new alkaloid, wj^ich they proposed calling pyracc 
tine. This suhstarnv re^idily dissolves in aeids, forming salts which can 
crystallized. Tlie solutions of these salts have a bitter t^ste, and are 
toxic in small doses. When heated with diluted acids, or witli water ii 
closed tube, pyraconitinc and its salts are eonv(Tted into benzoic acid and 
alkaloid, which has been named pyrnconinc. Pyracouine is soluble in wa 
and ether. It combines with acids to form crystalline salts. 

All the species of aeonitum are, as a rule^ virulently active, but 
napellus is the only ollicial one. The root of aconite in winter-time 1 
been dug up in the garden and eaten in mistake for horse-radish, with fa 
eonsequences. It is only necessary to be aware of this liability in order 
efFectually guard against the error. The aconite-root is premorse, and 
not tapering throughout its length, as the root of annoraeia is; it is also 




ACONITUM. 147 

a brown color, and when scraped has a disagreeable odor, and does not give 
out the irritating vapor that is so characteristic of the latter. 

Phytiol<^oal Aotion. — The effects of aconite are those of its active 
principle, aconitine. Many researches have been made, but the results have 
differed so widely that it is evident the various investigators have worked 
with impure or different substances. In the physiologic investigation by 
Professors Cash and Dunstan,^ the greatest care has been taken to insure 
the alkaloids used being chemically pure. They found that aconitine 
kills mammals by its action on the respiratory centre; diacetyl-aconitine 
has much the same action, but is not so powerful, while benzaconine and 
aconine are much weaker. On the heart, all have finally a depressing effect, 
but aconine, compared with the others, proved to be rektively harmless. It 
was found that atropine and digitalis exercised a certain amount of antag- 
onistic effect to aconitine. The addition of the two diacetyl groups to aconi- 
tine slightly weakens its action, but produces no radical change. The re- 
moval of an acetyl group from aconitine, to form benzaconine, greatly re- 
duces its toxic power and greatly alters many of its minor effects, although 
in a ffeneral way its depressing action on the respiration and temperature 
resembles that of aconitine; but it is no longer a strong heart-poison. Aco- 
nine is very much less poisonous, it has a curare-like action, and actually 
strengthens the heart and opposes the asequence and inco-ordination which 
aconitine produces. The introduction into its molecule of benzoyl, and 
still more of acetyl, to form the other alkaloids, heightens its lethal 
effects and modifies its action to a very remarkable degree. The au- 
thors also found that there is a certain antagonism in action between 
aconine and benzaconine, on the one hand, and aconitine, on the other. 
It should be mentioned here, in explanation of the difference in effect 
from different specimens of aconite, that the alkaloidal strength and 
the physiological activity of the plant are much affected by circum- 
stances of its growth, the wild varieties being more poisonous than the 
cultivated. In this way the well-known differences in the activity of differ- 
ent specimens of the drug are explained. Murrell has called atten- 
tion to the fact that English aconitine is seventeen times stronger than 
the German, while the French is variable, but generally between these. 
The crystalline variety (DuquesnePs or Merck's aconitine) is to be pre- 
ferred when prescribing, on account of its uniform strength. Aconite re- 
duces cardiac action and blood-pressure, diminishes excitability of cerebral 
centres, the sensory tract of the cord, and the peripheral terminations of sen- 
Eory nerves. It also promotes the action of the skin and kidneys. The ex- 
ternal application of preparations containing aconite has sometimes been 
attended by redness and the development of vesicles, pustules, and blebs. 
Tlie internal use of aconite will occasionally produce profuse diaphoresis 
together with vesiculation and more or less itehing. 

Toxie Effects. — Theodore Cash" thinks that the uncertainty of aconi- 
Hne is due to the mixture vrith the other alkaloids of aconite, which differ 
to a great extent in potency and physiological action. The difference in the 
lethal dose is shown by the following table: — 



* British Medical Journal, Nov. 11, 1899, p. 1365, from Philosophical Trans- 
ttrtioHS, 

*BHtish MtdicalJoumal, Oct. 8, 1898. 



148 



ril.UiMACEUTlCAL TIlKIUrKUTlC AHENTS OH DUL'US. 



KABBIT. FROG. 

A w AAAAio n ( 0.000580 Gm. March 

^co^^^^^e ^'^^^^^ ^^' \ O.OOU Gm. July. j 

Benzaconine 0.0273 Gm. 0.284 Gm. i 

Aconine probably 0.28 Gm. 1.055 to 1.75 Gm. ] 

per kilogramme of body-weight. Aconitine is about 2Q0 times ae toj 
benzaconine, and 2000 times as toxic as aconine. The aconitine, ia< 
doees, slows and steadies the pulse, with a slight decrease of pressurej^; 
zaconine has a like effect, in a much more marked degree, while aconintf 
this property. The first produces the characteristic tingling of the irt 
membrane and impairs sensation, gtmerally by its action on the perip 
sensory nerves. The other two have no such action. They all have a 
taste, but the last is not so marked. Death from aconitine is primari^ 
to respiratory failure, although in small doses it at first stimuliites if 
spiratory centre, then finally depresses it by paralyzing the sensory fibi 
the pulmonary vagi. Benzaconine acts much like the above, except t] 
has very little effect upon the sensory nerves, while it depresses the i 
group and also the muscle-fibres. It also lacks the antipyretic actit 
aconitine. Aconine is not such a cardiac depressant as are the two oi 
but, as above stated, actually strengthens the heart and opposes the 
quence and inco-ordination which aconite produces; upon the motoi 
tern it is a decided depressant and acts like curare, i 

Applied to the skin or mucous surface, aconite first is slightly irr 
but this is soon followed by numbness, whicJi may be accompanied bj 
gling sensations. If a bottle containing aconitine be held to the nose, pa 
irritation of nose and eyes results. In relatively large doses death o 
very promptly, and, if given hypodermically, the fatnl result may folic 
less than a minute, according to Wood. It is destructive to all forms o: 
mal and vegetable life; sonietimes very small doses produce extremely 6€ 
symptoms. A case of decidedly marked impression from a quantity i 
to 0.18 c.em. (or miij) of the tincture has been reported by Woodburi 
which vomiting; loss of power of extremities, with panesthesia and n 
ness; loss of sight, mild deliriiim, weak pulse, and threatened stupoi 
collapse occurred, l.ife being saved apparently only by very prompt anc 
oroiis treatment. The fii*st symptom observed in a case of poisoning is 1 
ing or tingling in the mouth and throat, soon extendini^ to the extrem 
and sometimes over the whole body. The surface of the extreniitiea is 
or clammy and numb, but at the same time the patients complain that 
feel as if the limbs were flayed. Sight may be lost and hearing dulled 
ordinarily the intellect remains clear. Convulsions occur occasionally, 
pulse becomes weak nnd variable; slight exertion may bring on a fatal 
cope. The unisicular t^lrongth is early affected, so that the |Kitit^ut is ui 
to stand. Owing to the lowering of the blood-pressure and the dilatati^ 
the arterioles caused by the aconite, the heat of the body is at first broi 
with the increased blood-ilow, to the surface, and there the blood losi 
heat by radiation and the temperature of the interior of the body is qu 
lowered. The depression is accompanied by increase of perspiration, w 



' "Proceedings of the College of PhyBiciaiiB of Pliiladelphiaj" third series 
X. p. 450. 




ACONITUM. 149 

still further reduces temperature. This occurs more obviously when there 
is pyrexia present than when the temperature is normal to begin with. 
Death results from failxire of respiration generally, but it may occur Bud- 
d^y from syncope, as already stated. Aconite, applied locally, first paralyzes 
the sensory nerves, beginning with the end-organs and ascending the trunk 
to the centre. The motor nerves are next affected. The reflex function of 
the cord is impaired. Uncertainty still exists, however, concerning the mode 
and order in which aconite affects the different portions of the nervous sys- 
tem. Binger concludes, upon the basis of his and Dr. Murrell's experiments, 
that aconitine paralyzes all nitrogenous tissues, abolishing the functions, 
first, of the sensori-pereeptive centre, acting next upon the nerves, and, 
finally, upon the muscles. Similarly, first the ganglia of the heart are at- 
tacked, next its nerves, and lastly its muscular structure. After a fatal dose 
has been taken the symptoms usually make their appearance very rapidly, 
and death may result in half an hour. The average time required to produce 
death is rather more than three hoxirs, the longest case on record being five 
and a half hours. 

Antidotes. — The antidotes to aconite are tannic acid, astringent in- 
fusions, alcohol, and ammonia. Digitalis appears to be the physiological 
antagonist to counteract the depressant effect upon the heart, or tincture of 
strophanthus may be substituted. The hypodermic injection of atropine 
also acts in the same manner. Inhalations of amyl nitrite, administered 
freely, appeared to save life in Dr. Elliott^s case. The patient should be 
kept in a recumbent position, with his head lower than his feet, and be kept 
warm. The stomach-pump, artificial respirations, ether or alcohol, and 
tincture of digitalis or strychnine hypodermically, a hot pack, even faradiza- 
tion over the epigastrium and cardiac region, are each useful. 

Therapy. — Locally, the benumbing effects of aconite have been utilized 
in the treatment of neuralgia, the best combination, probably, being the 
Baltimore liniment, or the linimentum aconiti et chloroformi (N. F.): — 

B Tt. aconiti, 

Chloroformi aa 12150 c.cm. or fSiij, mviij 

Ijiiiiinent. saponii 75{ c.cm. or fjiiss. 

M. Sig.: Poison. For external use. To be applied, with friction, along th6 
eoarse of the affected nerve. 

The oleate of aconitine (2 per cent.) has also been used with asserted 
good results for neuralgia. An ointment of aconitine is official in the British 
Pharmacopoeia. This preparation contains 0.65 6m. (or gr. x) to 26 Gm. (or 
gr. ccccz) of lard, the aconitine being dissolved in 6.20 Gm. (or gr. Ixxx) of 
oleic acid before being rubbed up with the fat. Aconitine ointment will often 
assuage the pain of chronic rheumatism, gout, and myalgia. It serves the 
Bune purpose, also, in herpes zoster, but care must be taken, in this affection, 
not to apply it to the abrasions produced by rupture of the vesicles. The 
Mine ointment also affords relief in neuralgia of the skin, paraesthesia or 
pnxritns, papular eczema, and prurigo. It must never be placed upon a raw 
rarface. 

Its control over the circulation places aconite in the first rank in the 
treatment of the fever process; in many cases we may get the best results 
if given in fractional doses (every ten, fifteen, or twenty minutes, give a tea- 
tpoonful of water from a tumbler in which 0.60 to 1 c.cm. (or mx-iv), of 



150 



PIIAnMACEUTICAL TIIERAPEUTIO AGENTS OH DRUGS. 



the tincture has been dropped). This is invaluable in the treatme: 
the ephemeral fevers of childhood and hyperpyrexia attendant upoi 
exanthemata. In adults the results are also very positive; so that aconii 
almost entirely taken the place of the lancet in the antiphlogistic treati 
Aconite, however, should be avoided in typhoid fever or other diseai 
asthenic character. 

In the early stage of inflammatory processes — pneumonia, pleurisy, 
carditis, peritonitis, erysipelas, rheumatism, meningitis — and in chile 
diseases, it modifies materially the severity of the symptoms, reduces 
perature, and moistens the skin. 

In the treatment of rheumatic iritis Dr. Jonathan Hutchinson w 
mends the tincture of aconite in 0.60-c.cm. (or mx) doses* three times 
(equivalent to tinctura aconiti, U. S. P., 0.30 c.cm., or wfv), ^iven in 
bination with alkalies and the iodide of potassium. He looks upon ac 
as of service in mitigating the pain of carcinoma. It also serves a n 
purpose in acute congestion of the brain. In spasmodic croup aconit 
lievea the dyspnoea within a few hours. Aconite has been recommend 
a sedative in relieving the vomiting of pregnancy. It is asserted that a( 
is an antidote to the sting of the scorpion. 

Asthma, especially in children, and preceded by coryza, is gen4 
benefited by the use of this remedy. Ringer states that a drop of the tine 
every hour, is useful in acute gonorrhrea. In coryza and quinsy, or i 
tonsillitis, it is highly prized for its influence in shortening the cour 
the disease; and it has also been given to abort or prevent urethral 
after the use of instruments. It affords prompt relief in congestive dys 
orrhoea; and in araenorrhcea, produced by exposure to cold, it is often 
cacious in re-establishing the flow. In facial neuralgia the extract mi 
given internally, in combination with quinine and a carminative, viz.:- 

H Fliiidextracti uconiti 125 Gm. or gr. iv. 

QuininsB bieulphat 4 Om. or 3j. 

ftperin |32 Gm. or gr. v. 

Div. in pil no. xx. 

Sig.: Give one every two hours until relieved, and then one every four 
u long as needed. 

In migraine, or sick headache, it may be combined with cam 
Indica: — 

B Tr. aconiti 12 c.cm. or mij. 

Tr. onnnabis IndiMB 1 c.cm. or mxv. 

Tr. cardamom, co q. a. ad 4 c.cm. or f3j. 

M. For one dose, to be repeated every hour, or two hours, until patie 
relieved. 

Tincture of aconite will relieve the pain of epididymitis and of c 
glandular struftiiros, commencing with 0.32 c.cm. (or jmv), to bo folic 
by 0.13 c.cm. (or vtlj) every half-hour until pain is relievjed or the I 
shows its effects by lowered rate and diminished arterial tmsion. In i 
0U8 palpitation and overaction of n lieart somewhat hypcrtrophied. jind ii 
tobacco-heart, aconite, when cautiously used, gives much relief. 



*Tho tincture of aconite of the British Fhannacopreia is only one-half ol 
strength of the tinctura aconiti of the United States Phttrmacopmia. 




ADEPS. 



151 



Aeonitiiie should neyer be ^ven, even in the smallest dose, where there 
m% vcak or fattv heart. It was used by Gubler in the treatment of facial 
I, and Seguin also advocated the crystallized aconitine in trigeminal 
in doses of 0.0002 to 0.00024 Gm. (or gr. Vaop or Vi^o), to begin 
leprated cautiously, and gradually increased until numbness is felt 
all the body, with chilliness and, in some instances, even nausea and 
wHKztin^. Xapelline has also been used in facial neumlpa in doses of 0.03 
Qb. (orgr. as), repeated every two hours until the pain has disappeared. 

^•on has employed the crystallized aconitine nitrate in the treatment 
af imal erystpeW, and reports that it almost invariably diminishes the 
4witTon of the disease and prevents the occurrence of complications. It 
aaTRj energetic salt, but it can be readily administered and regulated as 
li^aida do0e by dissolving it in a mixture of distilled water, glycerin, and 
^nhoU having exactly the density of distilled water, so that 3.10 com. (or 
al) contain o.boi Gm. (or gr. Va*). It may, therefore, be used in the dose 
rf 0.00002 Gm. (or gr. Vaaoo): 1 minim of the solution. He usually add§ 
.lUBOl Gm. (or gr. V»J of aconitine nitrate to a mixture, and gives it, in 
landed dofies, in the course of twenty-four hours. 

Aconitine cannot be regarded otherwise than as a dan^i^erous remedv. 
Itina bren found that the toxic dose and the susceptibility both vary greatly 
idiflerent aabjects. 



ADEPS (U. 8. P., B. P.).— Lard. 

Preparations. 

1 Adipis (U. S. P.).— I^rd-oil. 
Brnzoinatxis (U.S. P.). — 13cnzoinatod LarJ (benzoin, 2 per cent. During 
5 per c*nt., or more, of the lard should be replaced by white wax). 
Adcp* Bcnzomtus (B. P.). — Benzoated Lard (benKoin, 3 per cent.). 



icology. — Lard is the prepared internal fat of the abdomen of 
^■■iMfii^ Linne (class. Mammalia; order, Pachydermata), purified by \va8h- 
m^ with water^ melting, and straining. The specific gravity of lard is about 
CLJ38. It is entirely soluble in ether, benzin, and disulphide of carbon. It 
mdlt at or near 95^ F. to a clear, colorless liquid. It consists chemically 
rf ^ per cent, of olein^ or fluid fat, and 3S per cent, of the hard fata, 
pilaitiii and stearin, The olein may be separated by pressure, or by the 
mt of boiling *ilcohol. The salt with which it is frequently impregnated 
WKj be removed by boiling the lard with twice its weight of water. The 
IndcDcy to rancidity is obviated by the addition of benzoin; it may also be 
—t il ""'* ^v digesting tlic lard witJi botjinaphthol. or poplar-buds. As a con- 
fix: lual fat. lard is largely used in pharmacy as the basis of ointments 
ad '.ej^aitj?; and in domestic practice it is universally employed as a lubri- 
By the addition of benzoin it is prevented, not only from becoming 

ad, ' ;igret'able odor is also imparted to it; dehydrated lard is pre- 

t% .0 presence of water is considered objectionable. Lard-oil ia 

prixnc'^ utM-il for illuminating purposes. It can be adminisiered, in caset 
rconctttre |Kii£oning, as an tintidote. except where phosphorus or carbolic 

iiaa bo^n swallowed. Lard is an article of food, or, more correctly, it 
rmpJoj^l in preparing other articles of food. 

Jiexapy-' — I-J**"*! brt!* more penetrating power than petrolutuuj or vaselin, 

rttre- a^*^^^^ (sueli as mercury or the alkaloids) can be combined with 



152 PUAUMACEUIICAL TUEHAPEUTIC AGENTS OH DUUOS. 

it for administration by inunction. Washed lard, beaten up with an et 
quantity of lime-water, and a few drops at oil of bitter almonds, thymol 
of carbolic acid added, makes an eletjant substitute for carron-oil as a di 
ing for burns, or for some acute inflammations of the skin. Stiffened i 
a little yellow wax, it forms the simple ointment of the U. S. P. 1 
preparation is well adapted to fulfill the general indications of a fat, ani 
serve as an excipient for more active ingredients. When the secretory ft 
lions of the skin are suppressed, inunction with lard serves as a partial £ 
•titute for the natural secretion, softens the hard tissue, and reduces 
heat. It sheaths the surface, and prevents the contact of the atraosph 
air with its floating germs. It lessens or prevents the effect of irritant i 
charges. Lard softens and removes scabs. The free application of sin 
ointment relieves the intense heat of the skin and itching in scarlatina, i 
at the same time it assists in reducing the pulse-rate and temperature of 
body. Inunction is likewise of value in measles. It has been claimed t 
it is useful as an antidote to strj-chnine, and that a dog which has ha 
poisonous dose of strychnine will recover if given lard froely. ■ 

I 
ADEPS LAN-ffi (U. S. P,, B. P.).— Purified cholcsterin-fat of shei 

wool, ! 

ADEPS LANiE HYDROSTTS <U, S. P., B. P.).— Hydrons Wool-fat. 

Tliis is tiie ])urificd fat of the wool of the s)ie<'p. iiiixt'cl with not m 
than oO per cent, of watL'r. (LanoHn is n trade name for Adeps lana\) 

Phajmacology. — In the washings of wool is found a variety of fat whi 
owing to the presence of cholesterin, combines readily with more than 
own weight of water; it does not become rancid, and resists saponificati 
It is neutral and is a good vehicle for remedies to be used by inunction, 
it passes readily through the skin; it is not adapted as a protective 
this reason. The sheepy smtll of the fat is removed by repeated washic 
and pure lanohn is now obtainable that is nearly odorless. 

lanolin used as a medicament contains from 25 to 30 per cent, of wal 
which is not, however, chemically combined, and is readily separated 
heat. Anhydrous lanolin is completely eohibie in ether, benzol, and chlo 
form; sparingly soluble in stronger alcohol; and insoluble in water. Pu 
fied lanolin is of an unctuous, tenacious consistence and whitish color. 1 
A. Gottstein, of Berlin, has demonstrated that lanoHn is indestructible 
impermeable by micro-organisms. Its employment may, therefore, be 
garded as an aseptic measure. 

Physiological Action. — Lanohn has a soothing action on a delicate 
irritable skin. It is not used internally, but only as an unguent. 

Therapy. — Lanolin is a serviceable dressing in cases of burns, seal 
erysipelas, frost-bites, erythema, and dermatitis. Its property of absorbi 
water, its blandness and aseptic nature, render it an excellent medicamc 
or base in acute eczema. In chronic eczema with infiltration and in psoria 
lanolin softens the skin and favors the action of remedies with which it m 
be combined. Lassar highly recommends it in the treatment of impeti, 
contagiosa. When suitably diluted and perfumed, it is an admirable toil 
pomade. It rapidly heals chapped hands and lips, and may be spread up' 
the face before retirinfr at night in order to soften the skin after exposure 
cold and wind. Lanolin, in conjunction with appropriate internal remedi* 
Tcstores the lustre or gloss of the hair when it has been lost in consequen 




ADHATODA JC8TICIA. 



153 



tic disease. It is valuable in the treatment of atrophy of the hair, 
ami covnteracts that dry, harsh condition of the hair which is natural to 
fli^K xDdiriduals. Senile atrophy of the skin may be benefited by the per- 
HtaBt md syMeinatic use of lanolin. Inunction with this substance is one 
^ tki best means at our disposal for the obliteration of wrinkles. Lanolin 
tile proper performance of the glandular functions of the skin, and 
ioas in anidroeis and comedones. In iclithyosis and scleroderma it 
the surface of the integument. It is an excellent vehicle for the 
made use of in tinea versicolor, tinea favus, and the varieties 
of ODfla trichophytina. It is admirably adapted to serve as an ointment basis 
the oleate of mercury or copper in the treatment of the affections speci- 
L Ob account of the ready miscibility of lanolin with mercury and its 
fflBKnuTe pover, it is peculiarly serviceable in the inunction treatment of 
^pkilic. In affections of the nasal nnd genito-urinary tracts^ lanolin is 
^fgwaX advantage combined with cocaine hydrochlorate. 

It is a good vehicle for the anodynes — atropine, cocaine, morphine, 
: — in cases of neuralgia or rheumatic joints. As an ointment alone 
iv the ere, lanolin is too thick, tenacious, and sticky, and to remedy 
defects a combination of 1 part of benzoinated lard to 3 parts of 
has been preferred; this makes a fine, smooth ointment, which has 
fcmnd a good vehicle for eye ointments, and, even alone, is often used 
X$ spfplj at night to the eyelids in conjunctivitis and almost all external 
nmations. Lanolin containing a large proportion of water is efficient in 
■in* the itching which accompanies measles, scarlet fever, and chicken- 
in. Tne gradual evaporation of the water produces a cooling effect upon 
ftctkin. In these affections Dr. Klein adds to 31 Gm. (or 5J) of pure an- 
Mmas Luiolin 1*^ Gm. (or 5iij) of vaselin and 1S.5 c.cm. (or f3v) of distilled 
liter. Ufbreich recommends the injection of a lanolin cream into the 
for the relief of infiammation and erosions of the rectum and lia?mor- 
Lanolin seems to heighten the efficacy of many of the drugs for 

it U employed as an oiniment-base. This is especially the case as re- 

padb c^TjBttTooin. Applied upon a bougie it has been found of advantage 
■ ibe treatment of gonorrhoea. 

ASHATOOA JVSTICIA.' — Adhatoda vasica, A. gendarussa, or A 






?karaMO0log7 and Fhysiological Action. — The leaves of this plant 
ciooging to the Acanlhacea*. indigenous to India and neighboring 
stnds) IiATc been used with asserted benefit in pulmonary and catarrhal 
Aetitfoa. It contains an alkaloid. Vasicine, combined with adhatodic 
•si HoofH*r found it poisonous, when used in infusion, to flies, frogs, and 
d tJbe anvaller organisms, but harmless to large animals. 

Tbarmpy. — In asthma, 0.65 Gm. (or gr. x) doses of the powdered 
^Mt* ' times daily, afford great relief, the patient being also 

|g^, fho leaves in a pipe, or to inhale the smoke. On ac- 

■■it of ita ba< ii properties, Dr. H. H. Rusby has recommended 

l^mt of adhAt* ision in diphtheria, and it has been suggested that 

Saicbt aUo bo eiTieient in typhoid fever, and by inhalation of the spray 
hm ibc atomizer io casea of phthisis and fetid bronchitis. It is prob- 



r of tbe tJniTerml Mediml Sciences." 1890, toI. t, p. A-7. 




154 



J'llAHMACEL'TlCAL TIIERAPKUTIO AGENTS OK DRCOS. 



able that it might also be useful in infucLious dyspepsia due to the all 
mai fermentation of food in the stomach. 

ADONIS VERNAUS. — False Hellebore, or Pheasants Eye, f 
perennial herb (bt?lo]iging to the Raimnculaceaf), indigenous to Eui 
having bright, showy flowers. There ore Uso annual species, the A. testii 
flowering in May, and tht* A, autumnalis. flowering In September;' 
former has orange, tlie bitter red, flowers; hence the common name ol 
chamomile. 

Physiolo^cal Action. — The active principle, Adonidin, appears t 
a mixture, coii.sisting ui' yrllow adoiiidoquercitrin, adonidodulcit, ado; 
acid, with a brown glucoj*itb'. and a hitter, poisonous gkicoside^ pieradon) 
according to the analysis of I'odwissotzki. Adonidin ia a yellowish-W 
hygroscopic, bitter powder, devoid of odor, sohible in water and alc< 
insoluble in ether, chloroform, and benzin. jNIcrck has isolated a cr}'sta 
principle termed Adonite, which lias been shown to be a peota!iydric ale< 
converted into a sugar by oxidation. Adonite is very soluble in water 
has a slightly-sweet taste, but, according to Robert, has no decided pW 
logical action. 

Whether used, as the peasants of Russia are said to he in the h 
of doingj as an infusion, as the fluid extract, or in the form of adoni 
adonis acts upon the heart as a stimulant or cardiac tonic, rcsemblin 
its action digitalis or strophanthus. Adonis is said to increase the art< 
tension and in large doses causes diastolic arrest of the heart. In L 
doses the first rise is succeeded by a decided fall of arterial pressure, ^ 
paralysis both of the heart and blood-vessels. 

It is claimed that, in moderate doses, adonidin is devoid of dai 
from cumulative effect, and that it agrees well with the digestive org 
Huchard, however, found in some cases, that it caused vomiting or ( 
rhoea. In a case in which 0.20 Gm. (or gr. iij) of adonidin was takei 
mistake, vomiting and diarrhcea were prominent symptoms. The actio 
this drug is very promptly manifested. In accordance with the obse 
tion that it increases arterial pressure, there is an increased flow of ui 
but adonidin exerts no efCect upon the secreting structure of the kidneys. 

Therapy. — Internally in cases of raitral or aortic regurgitation i 
claiuicJ to be of grcjit vahio. In functional irregularity of the heart J 
Da Costa found much benefit from adonidin (in doses of 0.003 to 
Gm., or gr. Vso'Vm thrice daily). In cardiac asthma it also affords n 
to the dyspncen. The fluid extract (normal) is a good preparation in d 
of 0.06 to 0.12 c.cra. (or nn-ij) cautiously increased. 

Professor Bckhtereff has observed a favorable influence fronJ 
addition of adonis vernalis to a bromide solution in the treatment 
epilepsy. The combination which he has for several years employed ii 



B Pofaas. bromid 8| to 12 

Tinct. adonidia 4 

Codeinffi sxilph 

Aqure 

M. et ft. sol. 

Sig. : Tflbleflpnonful from four to eight limes a day. 



,240 



Gm. 
c.cm. 
20 Gm. 
c.cm. 



or 3ii-iij. 
or f3j. 
or gr. iij. 
or fjviij. 



The tincture of adonis a^tivalis, an allied species, in O.fiO c.cm. (or i 




^THER. 



155 



three times a day, is reported to be efficient in removing fatty tissues 
tfma the heart and relieving the dyspncea which accompanies obesity. 



ADEEHALIinTM.— Adrenalin, Epinephrin. (See Glandulee Supraren- 



^^^ X8CULVS HTPPOCASTANTTM. — Kippocastannm, Horse-chestnut. 

^^^ PlMrmacology and Therapy, — The horse-chestnut. .Esculys hippo- 

riftimiiii (Hippocastancffi), is a large tree cultivated in Europe and North 

P Aaerica as a shude-lree; its original habitat was India. The bark coa- 

tns tumic acid and two neutral bitter principles — ^iEscnlin and Fraxin* 

Tktir effects are those of the vegetable bitters; the bark also has some 

ntipcnodic powers. A fluid extract, with dilute alcohol, is the best prep- 

I oatKOD. The fluid extract has been administered in malarial disorders and 

I m tt«ara]gic affections in doses of 1.20 to 4 c.cm. (or mxx-iZj). JEscuIin 

•onirs in the form of brilliant, white crystals and is soluble in hot water. 

k» said to have been given with good result as a substitute for quinine 

LBAlarial fevers, especially of the remittent form. 

JETHEK (U. S. P., B. P.).— Ether (iEther Fortior, U. S. P. 1880). 

iETHEE PUEIFICATUS (B. P.).— Purified Ether [(C.HJjO]. 
Omc» 0.60 to 2 c.cm. (or mx-xxx) for repeated administration; for a 
Sftsie administration, 2.40 to 4 c.cm. (or mxUlx). 

PrBparations, 

.£th«reum (U.S. P.). — Ethereal OU. Equal volumes of ether and heavy 
tafwtML 

^Irittts jEtheria (U.S. P., B. P.).— Spirit of Ether. Dose, 0.30 to 2 cent, (or 

Spiiitus .-Etheris CompositUB (U.S. P. B. P).— Compound Spirit of Ether, or 
mmnn'm Anodyne (U. S. P., composed of ether, .325 c.cm.; alcohol, 650 c.cm.; and 
«tWrmiR. 25 c.cm.). Dose, 0.30 to 2 c.cm. (or mv-xxx). 
Spuitua .ttheris Nitrosi (U.S. P, B. P.).— Spirit of Nitrous Ether, or Sweet 
of Nitre. Dose, 2 to 4 c.cm. (or fSss-j). 



FfcOTinacology. — Ether is a liquid composed of about 96 per cent., by 
vt^gbt, of absolute ether, or ethyl-oxide, and about 4 per cent, of alcohol, 
matmining a little water. "A volatile liquid prepared from ethylic alcohol 
temction with sulphuric acid. It contains not less than 92 per cent. 
ime of ethyl-oxide. It was formerly termed sulphuric ether* (B. P.). 
led ether is: "ether from which most of the ethylic alcohol has been 
r^ by mashing with distilled water and most of the water by sub- 
st dJ5tinatinn in the presence of calcium chloride and recently-pre- 
fmd lime" (B. P). It is a thin, very diffusive, clear and colorless liquid, 
rid a r- " chnrflctoristic odor, a burning and sweetish taste, after- 

iteali^ '--•,' ■ ^' "^^^^ ^ neutral reaction. It is soluble in all proportions 
1 akobol, chloroform, benzol, benzin, fixed and volatile oils; aissolves in 
rt ttn tiiTiea its volume of water at 59* F.. and it boils at 98.6** F. It is 
mn inflammnblo, and its vapor, mixed with air and ignited, explodes vio- 
' " The vapor is slightly irritating to the conjunctivae, and at first to 
jnchial mticous membrane. 





k 







fllfliologio&l Action. — When ether is poured over the skin it evapi 
uickly that a sensation of cold is experienced, and when its applici 
on is continued, as with the atomizer, the temperature of the part is lowere 
and it may be frozen, which is announced by eudden blanching of the sku 
When the escape of the vapor is prevented ether acts as a counter-irritan 
causing reddening; even vesication may be produced. 

When taken internally, ether is a diffusible stimulant, resembling ale* 
,ol in its effects, which, although manifested earlier after ether, are moi 
transitory. When introduced into the circulation, by absorption from tl 
stomach or the rectum, by inhalation, or hypodermically, it is found tempt 
rarily to increase arterial tension and acts as a cardiac stimulantj the heai 
continuing to beat after failure of respiration. In these respects it ia anta^ 
onistic to chloroform, which lowers arterial pressure and is a cardiac sedativ 
Ether-vapor is inhaled pure, while chloroform-vapor must be combined wit 
95 to 97 parts of atmospheric air. Upon the nerve-centres ether acta vei 
much like alcohol, atlecting (1) the cerebrum; (2) the sensory, and later tl 
motor, functions of the spinal cord; (3) the sensory centres in the raeduU 
oblongata; and (4) finally the motor centres in the medulla. Kemp^ foun 
a decided increase in the amount of indican excreted after ether, and b 
the use of the oncometer demonstrated a special contraction of the arterioU 
of the kidney, and damage to the secretory cells. Therefore the presenc 
of albuminuria or pulmonary cedema is usually regarded as a eufficien 
centra-indication to its use. 

The State of Anaesthesia. — Anjestheeia produced by the inhalation c 
ether-vapor, when complete, nearly apprcximates the state of coma. It aj 
proaches by well-defined stages, the first being one of excitement or exhij 
aration; the second is narcosis: the third is abolition of sensibility am 
reflexes, and, carried further, it ends in paralysis and death from failure o 
respiration, owing to paralysis of the centres in the medulla oblonffato. Tb 
nerve-centres are affected in the following order: The higher centres in th 
brain, the motor and sensory centres in the medulla spinalis, and, ulti 
mately, the sensory and motor centres of the medulla oblongata. The vapo: 
of ether is at the beginning of the inhalation irritating to the air-passagea 
and may cause strangling sensations to the patient, but this soon passes awa^ 
as anesthesia becomes established; it may be necessary, at the outset, t( 
allow some admixture of air, so as not to frighten the patient, but as soot 
as may be possible the pure ether-vapor ia to be administered, so as to pre 
vent efforts at vomiting. Owing to this irritation of the bronchial mucom 
rnembrane, there may be produced congestion or cedema of the lungs, espe- 
cially when the patient is not kept warm during the operation, or pneumonia 



^may follow 



The presence of bronchitis centra-indicates the use of ether. Accord- 
ing to the observation of Poppert, osdema of the lungs is the frequent im- 
mediate cause of death from ether, and is due to the toxic influence of the 
anesthetic. Scnger draws attention to the danger of cerebral hiemorrhage 
during ether-narcosis, in patients sulTering from arteriosclerosis. During 
operations upon the mouth, and particularly in the extraction of teeth, the 
blood running down the throat mav cause asphyxia. A few "dontV should 
be borne m mind when administering ether:— 

^Ncw York Medical Journal, Nov., 1809. 




JBTHER. 



167 



I. Don^t give it to a patient whose kidneys are diseased. 
8- Don't give it when the stomach contains undigested food; the pa- 
Ehould be fasting for at least four hours, if possible. 

3. Don't give it without removing artificial teeth from the mouth, 
are liable to fall into the throat. 

4. Don't give it unless the clothing is so loose as to allow freedom of 
lion. 

L^ 5. Don't give it when the pleural cavit)' is full of fluid, 

^k 6, Don't give any anaesthetic to women, eepeeially young women, ex- 

Htipt in the presence of witnesses, who can testify as to your actions during 
Vfte period of unconsciousness of the patient, as under such circumstances 
" vooMD fionetimes acquire fixed delusions which can only be met by testi- 
mtmy abeohitelT proving their falsity. 

7. Don't forget that ether-vapor and air make an inflammable and 
fl^osire mixture, and that ether may take fire from the actual cautery as 
ml as from a candle. 

fi. Don't forget that there are different qualities of ether, and that 
Am proper kind for surgical purposes is the official ether of the best make. 
9, Don't forget that ether, like alcohol, lowers temperature, and that 
ibe patient shoxild not be too much exposed to cold during operation. 

10, Don't forget that ether causes death by respiratory failure, and 
the color of the lips and ears is a better guide to the state of the blood 
the radial pulse. 

II. Don't forget that the ansesthetic state is a state of danger, and the 
pitkikt i£ not safe until the effects of the ether have entirely passed off. 

18. DoD*t forget that ether is eliminated rather slowly by the lungs and 
1^ kidneys; so the patient should be watched for several hours after the 
aAniaistration. 

Xhe Choice of Aneesthetics. — The ancesthetic agent should be suited to 
ftc operation and to the circumstances of each case. For many trivial opera- 
tidM, or thofie which are rapidly performed, pure nitrous-oxide gas is sutli- 
cieit and much safer than the others. In young children chloroform-vapor 
s tmamr of administration than ether, and comparatively free from danger 
vfccB properly administered. It also is preferred where the actual cautery 
vto be u^ed, or where lights are required near the patient. In midwifery 
inctiec it also is the preferred anaesthetic. For all ordinary cases ether is 
■fa' than chloroform, and is by far the most frequently used. 

A valuable paper has been published by Dr. Julliard.* of Geneva, upon 
the Illative safety of ether and chloroform. From the records of several 
hmdrrd thousand administrations of ether and chloroform it was shown 
tftst the mortality from the latter is from four to five times greater than 
faiUB ether ^[ethylene bichloride has been tried in England to some extent, 
Ht as ordinarily sold it appears to be merely an alcoholic solution of chloro- 
^yi Kthyl-bromide is of more recent introduction, and when pure 
well for short operations, but does not have decided advantages 

the be»t ether, except in having a slightly more agreeable odor. For a 

Epperation it is well to precede the amesthetic by the administration 
fO to 1^0 com. (or fjii-iv) of whisky. In a similar manner an hypo- 
riection of morphine n 0^n Om. (or gr. VJ a°d atropine 0.0005 Gm, 



^^ioale de ta Suiatte Romans, Feb.. 1B91. 




158 



PHAKUACEUTICAL THEIt^PElTlC AGENTS OH DUUGS. 



(or gr. V120) may be given before operating (Nussbaiim's method). Variot 
mijctures of anjesthetics have been proposed, the beet Icnown being the A. ( 
E. miitiire of the London hospitals^, containing alcohol, 1; chloroform, J 
and ether, 3 parts; but, owing to the different density and var^nng rates t 
diffusion, it is impossible to tell just how much of each is being given; ther 
fore, these mixtures are not recommended. Gurlt finds that when a mixtu: 
of agents was used the proportion of accidents from asphyxia was great* 
than when chloroform alone was employed. By the use of an inhaler, ethe 
vapor mixed with oxygen can l>e administered, the gas passing through 
wash-bottle containing the other; by this method asphyxia is avoided an 
greater safety secured. 

Where a patient dislikes ether, or takes it badly, the administration mfi 
commence with nitrous oxide and ether substituted later, or it may be pD 
ceded by a few whiiTs of chloroform. Dr. A. Diaz de Liano has invented a 
apparatus by means of which ether can be administered at a temperature < 
88° F., and claims that by his method the disadvantages both of cold eth« 
and chloroform are obviated. It is claimed by some clinicians that the pn 
liminary application of cocaine solution to the nasal mucous membrane prt 
vents irritation, and the unpleasant after-effects are, to a large extent, pn 
vented. 

The production of surgical anaesthesia by absorption of ether-vapc 
from the mucosa of the rectum was advocated by Pirogoff in 1847, and wa 
prominently called to the attention of the profession by Axel Iversen, c 
Copenhagen, and Daniel Molii^re, of Lyons. Alore recently, Stcdman/ c 
the Sheffield Hospital, made a plea for this method. It is accomplished b 
attaching to a rectal tube a rubber pipe connected with a bottle, partly fille 
with ether, which is placed in a bucket containing warm water. The absenc 
of irritation of air-passages, struggling, and vomiting by this method suje 
gests its adoption in suitable casea. On the other hand, it is slow in actioi 
requiring from five to thirty-five minutes, and it may be necessary to supple 
ment it by ordinary inhalation. At least two deaths have been caused b 
rectal etherization. In another case, death retfultcd from rupture of th 
intestine at the site of an old cicatrix from an ulcer which yielded unde 
pressure of the vapor. Calderon^ believes ether-narcosis by the rectum ti 
be of special service for surgical operations ai>out the head, and reports ; 
mastoid operation done successfully upon a child with its aid. 

What is called "primary an:esthesia" occurs early in the administrotioi 
of the ether, at the time when narcosis begins. During this stage, whicl 
is very brief, small operations, incisions, punctures, etc., may be done with 
out waiting for complete amesthesia. In order to ascertain when it occurs 
the patient is directed to extend one of his arms perpendicularly upward anc 
to hold it up as long as he can. At the moment when narcosis occurs th< 
arm falls, which is the signal for the operator to cut and for the adminis- 
tration of ether to cease. The patient regains consciousness at once, an£ 
generally there is no vomiting or other ill effects. 

Treatment for Toxic Effects. — When a patient appears asphyxiated^ 
rhythmical traction upon the tongue by Laborde'a method^ artificial res- 
piration, inhalation of ammonia, slapping the exposed surface of the chest 
with wet towels, and the application of the faradic current to the epigastric 

' Quarterly Medical Journal, Sheffield, Jan. 18, 1805. 
* Pacific Medical Journal, March, IflOO. 



.£TH£R. 



i5y 



i will osoally restore him. Rubbing the body so as to keep up the cir- 
, or the use of stimulating encmata, is also of service. Oxygen might 
taJBUUstered, or a mixture of oxygen and nitrogen monoxide (2 to 1), or 
,_BTiBitrite cautiou&ly inhaled so as to flush the brain and medullary centres 
«n blood. Xitroglycerin, 0.0006 Gm. (or gr. */ioo)j ^^7 ^e given hypoder- 

uL Effects of Ether. — The unpleasant results which sometimes follow 
rW*^-- f. ..*r-!.tion of ether, such as nausea and vomiting, ma}' be overcome 

• lent a cup or two of eitiier strong, hot coffee or t*ia. After 
■ -ns, where it is especially iniportiint to prevent vomiting, 

'fit the administration of any food, medicine, or water 
: a period of 12 to 24 hours, or longer. Thirst can be re- 

• »ns of water into the rectum, and strength sustained by 
- iiTc njvniata. Suppositories or small liypodermic injections of mor- 

nuv Im^ iriven to relieve pain. For dental operations, ether is pre- 

Id > irm, on account of greater safety. In the event of nausea, 

u wakefulness supervening after extracting teeth, Dr, Dorr 

aiboat 1.60 Gm. (or gr. xxv) of potassium bromide in strong 

.or fiom a few minims to 4 com. (or f.'j) of compound spirit of ether 



tj ( X.- » »_" 



The author can also commend sodium bromide (1 to 1.30 Gm., or gr. 
II, ID goda-water, soda-mint-water, or cinnamon-water), camphor-water, 
anmiatic spirit of ammonia, caffeine citrate or hydrobromate (0.0(55 to 
Gm^ or gr. i-iv, at a dose), tincture of caps^icum (0.60 to 1.20 e.cm., or 
x^at a dose), or the effervescent salts of sodium or caffeine bromide, all 
WB heinp especially suitable for the treatment of the ill effects following 
iteim^lratiozi of ether. In order to control hiccough and vomiting 
anesthesia. Dr. Bernard Joes is in the liabit of making digital com- 
_ of the phrenic and vagus nerves against the sternal end of the clav- 
He states that, as a rule, vomiting immediately ceases. The pressure 
laetsQocd for a few momenta in order to prevent a return of the sickness. 
.Ficderick Silk's* conclusions on "ether pneumonia" are; 1. Ether in- 
is only one of the minor exciting causes of croupous pneumonia. 
Jlxnalatini? properties of the vapor may even help to ward off an attack. 
coDuitions of the mucous membrane of the air-passages are uni- 
cther, and their tendency is to subside on withdrawing the 
In m small proportion of eases, however, an inflammatory condition 
and the patient's life is in jeopardy. Other concomitant causes 
ireneralJy be found at work: e.g., cold and exposure. 3. To limit 

^ncy, careful precautions will usually suffice, especially in the direc- 

«i^aToidin;Er exposure, cold, and draughts. 

fLmfm pY -Ether may be used locally for its refrigerating or detergent 

^0T^ m finr^cal operation. It dissolves fat from the skin, and is 

hI £p ^ ' ^ the hands by surgeons, in connection with antisep- 

^ 'pi, may be use<l to bernimit a part of the skin before 

»ii ; and, in chorea, ether-spray has been applied to the spine 

,,:^. The ether-^pray is nl&i often very serviceable in allay- 

^f tictiralffia. especially when peated in a superficial structure. 



pmm 
fiber Ut 



directed immediately ujxm the course of the aching nerve. Sir 



'i»«<ar<Mo**^- 



March, 1(KK). 



160 



rnAHMACEL'TlCAL TIIEBAPEDTIG AGENTS OR OUUdS. 



James Sawyer jxiints out that ctlKM* is the best nienstruuin fur the solut 
of many remedies to be used upon the skin ; ether being a good solvent of 
active principlefi of many drujrs; nnil aUo of wliacoouR matter. It may 
used as a menstruum for rnakiji^^ t'thL-rtsil tinctiirps nr tiniineiits. In sti 
gidatcd heraia. 30 ta (iO com. (or t7^i-ij) of utluT may be sprayed upon 
tumor, as eueetssfully employed by Fiuk<'lsteii^^ and ("insciiljaner. or allo^ 
to fall upon the surface drop by drop. 

Dr. Charles E, Ilughes, of St. Louis, has had good elfect from lavem 
with ether for the relief of pain; thus, in severe headache he has pou 
ether on the scalp freely with prompt cure. 

A case in which a fistula remained after an operation for cholecys 
omy has recently been described by Dr. John W. Walker. Seven mon 
later a stone again entered the duct and was dissolved by a mixture of eq 
parts of ether and glycerin placed in a small glass tube attached to a syrit 
the tube pressed directly upon the stoue and the ether-glycerin injected d 
by drop. 

Ethereal preparations may be used internally for hysteria, colic, and 
passage of biliary or renal calculi. Durand's remedy for gall-stones is ec 
parts of ether and turpentine-oil, given a teaspoonful at a dose. 

Ether is a diffusible stimidant, and can be used hvpodermically in hej 
failure (1.20 to 2 c.cm., or mxx-xxx). Taken with water or syrup (2 t 
c.cm., or f.lss-j), it atTords relief in flatulence, spasmodic asthma, or co 
It bus siijiilnr cllVct^ to \Uo^ of alcohol, and a luibit of etlKr-driuking- 
in like manner been established in some persons (although the odor of 
breath plainly announces to others the fact that it has been taken), but 
effects are more transitory than those of alcohol. 

The internal administration of ether is capable of relieving mild atta 
of angina pectorifi. It is a good plan to combine O.GO to 1.20 c.cm. 
mx-xx) of ether with codlivcr-oil when the latter substance is not well boi 
Ether facilitates the digestion and absorption of the oil, probably by incn 
ing the secretion of pancrentic fluid. Hoffmann's anodyne in 2 com. 
f5ss) doses is useful in sick headache. The hypodermic injection of froi 
to 2 c.cm. (or mxv-f5ss) of ether in the neighborhood of the affected n€ 
has proved of value in sciatica, gastralgia, and various forms of rheumi 
neuralffia, Barth obtained very excellent results in typhoid pneumonia fj 
these subcutaneous injections of ether. The injections were given from i 
to four times daily, and were followed by notable increase in the stren 
and volume of the pul?e. Castel reports favorably of the same method 
small-pox. After puerperal, pulmonary, or other severe haemorrhage ot 
thrown under the skin stimulates the heart and may avert fatal syncope 

The following combinations of ether will be found serviceable: — 

H Spt. ictheris comp 6(1 

Tinrt. cnpsici ' 4 

Spt. aininon. anunntic 12 S 

Mint, sodaj et nicntlifr (X.K.) 6n 

M. Sig.: A tensponnful in water every few minutes until relieved. This 
scription is especially imeful in the treatment of syncope, flatulence, and neryoui 
hystericnl paroxysms. 

' "Treatment of Straugiilntotl l!ernia by Applications of Ether, after the Met 

of Fiiiklofttoin." <7orr//r Mrrlirah- (fr dtra/thonrff. No. 3. ^ffirfli 1, IrtftS. 

'See interenting nddn'S'^ on "Ether-drinkinfj. its PrcvahMiw ami Results,*' 
Erne^^t Hnrt. dplivercd Iwfore the Society for the Study and Pure of Tnebrietv 
the Provinfiat Mrtlical Jourual, Xov. 1, lftf>0. 



c-cm. or fjij. 

c.cm. or f3i. 

25 ccm. or mcc. 

c.cm. or fjij. 



JETUER. 



IGl 



R Stiaritn<% ••(brris romp.. 



FlakUxtr4uni I 



ipu 



linL 



TiBcl. Tatrhutiie tiuunouiatiie. 



30| c.cm. or f5j. 



p.: Tho U'lifcfMK'nfuls in water even' fifteen or twenty minutes. For hy»- 
ervotts ftick headache, neurasthenin, angina peotoriti^ and spaBitiodic asthma 

The diagnuetic use of etlier anaestlietria is frequently illustrated in sur- 
ptrr. vbere it is <»rni>i*\ved in order to examine fracturt^K, expl<ne eavitiefl 
t. . r«.-..-i...i .rT^... iT.^ ^,r foreign luxlies, and to detect malingering. Emerson 
<t»^ the employment of ether-vapor, in place of hydrogen 
^ >*^nn > • if detei'mining" the ])resence of perforations in the inles- 

fosw 4ft«'r "n»y- f'"*r g-imsliot wounds/ 

SfFuitiu iEtheris Compoaitas (U. S. P., B. P.). — In hysteria, flatulent 
cofic, and oerrousnej^ this solution is much in demand. Compound spirit 
«€«lher « likewise very serviceable in the treatment of hiccough, functional 

prir" ^ of the heart, or syncope. It will often afford relief in gastralgia, 

mt iiictinies prove of marked benefit in angina [ictloris. It is a 

&f -■iniulant and antispasmodic, and is popularly known as HofT- 

Bi.. yne. 

Tbtr /ollovriug fonnula*. containing conij>ound spirit of ether, are 
»f a] : — 

B Sodii bic«rbonatis 6| Om. or Siss. 

SpC ammon arom., 

Tiact. dairiberis aa 41 com. or f3j. 

Sjptntiis Athens comp 120| c.cm. or fjiv. 

JC S%.x Two teaspoonfulB in water for hysUria or flatulence. Repeat when 



B Spirit u» «fthen» eomp. 
Vim 



30 

AOl 



c.cm. or fjj. 
c.cm. or f^ij. 



S||s. : FTT>m itm*-h»U to a tuMesfMHuifiil. iu watl^^, every hour or two, as % 
in Kvnt4^nii, dviimenorrhii'a. or llntulent colic. 



^nritiu -fftheria Nitrosi (XT. S. P., B. P.), spirit of nitrous ether, 

Molarlr known as sweet spirit of nitre> is an alcoholic solution of ethyl- 

•>»;.. vw TJmiit^ when freslily prepared and tested, not less than 4 per cent 

It ift made by the action of sulphuric acid upon sodium 

w carbonate, water, and alcohol. 

a<'o|HT*iaa dini*et tliat it should be kept in small, glass-stoppered 

djK-e rcTuote from light.- or lire. Very much of the spirit 

I>en!i«^d i.« defieirnt in strength, and has become acid from 

Wb«^ llii^ i»rt»» fKTurred it should not lie used. Tho loss of the ethyl- 

;. fir»>vt»nti'<l, tit a large extent, by a eombinntion with an alkali or 

. tato or citrate. When fresh, it rendeni excellent service in tea- 

-.^, wcll-<liluted, given s**veral times a day, in scanty secretion of 

•rlv people. 

-•ther rcecmblcs the other nitrites in its sedative effects upon 
^^^ tit ita action is overcome or modified in this form by the com- 

^i^^j^ In, Mntity of alcohol accompanying it, which really makes 

fcraiht of : '^ ether a diffusible stiranlant For this reason Whitla 



^ citmiu et ' 



mr 



m^ 



•J^r*M»l f»f '^' 



\mffifiu\ Sfrdical Aanon'ation. .fulv 2^, IftOS. 



162 



PlIABMACBrTlCAL TIIKUAI'EVTIC A0ENT8 OH DRCOS. 



especially commends it in the dropsy of debilitated subjects. In fever 
may be given in cold water or lemonade, or in combination with other ren 
dies, as aconite or veratnim viride. It acts upon the ekin as well as up 
the circulation, and reduces the temperature. It is useful, above all, in t 
febrile affections of infancy and childhood. It enters into Brown mixti 
(Mist, glycyrrhizse co.), of which it constitutes 3 parts in 100, forming 
popular roinedy for acute bronchitis, and which is used as a vehicle for q 
nine and other remedies. 

Spirit of nitrous ether can be employed in the following combinatio 
with advantage: — 



Q Spiritus cetheris nitrosi, 
Aqute caznphone, 

Uq. ammon. acetatis aa 60 

Antimonii pt potasaii tart. .,,, ....... 

Morphinie eulphnlia .«. 

M- Sig. : A tablespoonfiil in water every hour or two until relieved, 
broncbitia, acute rlieuiiiutism, and in fevers. 



c.cm. or fSij. 
nfiS fim. or gr. j. 
03 Om. or gr. 



fSij. I 

r j- 1 

For aci 



B ^piritua letheria nitrosi, 
Elix. humull (N.P.), 
Syr. Inctucflrii aa 60| c.em. or fjij. 

M. Sig.: From a half to a tableapoonful every hour when unable to sleep, 
ieeablc in insomnia^ general ncrvouancBs, and debility. 



J 



a;THEE ACETICUS (U. S. P., B. P.).— Acetic Ether. 1 

Dose, internally^ O.GO to 2 c.cm. (or mx-xxx). 

Acetic ether is a liquid composed of about 90 per cent., by weight, 
ethyl-acetate (CJI^.CHaO^) iiiKi about in por cent, of alcohol contain! 
a little water (U" S". P.). It is soluble in ID part^ nf wafer (at .59'' F.), a; 
mixes in al! proportions with alcobril. ctlier. rblorofonri, nnd fixed or vo] 
tile oils. It enters into cologne water (tij>iritnf^ odonitii?, U. S. P. 18J>0). 
haa similar elTects upon the system to t'lliyl-oxide, and also can be nsed 
inhalation nc an nuirsthetic, but is slower in its nrtion. 

According to the experiments of Krautwig on rabbits, moderate qua 
tities of acetic ether greatly increase the respiratory capacity, the eflFect an 
menting in proportion to the dose. There was no influence from the sai 
quantities upon the blood-pressure and no ill effects upon the heart. I 
halation of the vapor of acetic ether allays laryngeal and bronchial irritatio 
In spasmodic asthma and in nervous cough also it mny be used with go 
effect. It is rather more irritating to the skin than ordinary ether. 

aiTHEK VALERIANICUS.— Valerianic Ether. 

Pharmacolog:y and Therapy. — Valerianic ether, or the ethylic eth 
of iso-valerianic: acid, is a colorless fluids having an odor resembling that 
valerian. It is ii less volatile fluid than ordinary ether. The dose of vale) 
anic etker is 0.12 c.cm. (or waj), but in practice it is found preferable 
dilute it with sulplmric ctbor, luid it is llius prepared and put up in seal 
gelatin capsules, each capsule cnntuinin;i abuut 4 drops. Vulerianic other 
a aerviceable remedy in dyamcnurrhiea, nervous hcadjiche and exciteuiei 
aathma and other simsmodii.- disorders, neuralgia, and nervous vomitin 
It is of advantage in mania a potu, by controlling arterial and nervous e 




-aiTHYLIs BHOMiDCM. ' 163 




Bt 4l»cl tremor. In periodic hay fever. Dr. J. D. ChrLsiinaii, of AUea- 
PtL, found it decidedly useful.' 

MTSYIJS BROMTDTTM.— Hydrobromic Ether, or Ethyl Bromide (C^ 
'■■ Mr) ( It niu?t not be confounded with Ethylene Bromide.) 

nuxDACoIog^. — This liquid has rather a pleasant odor and sweetish 
':■ When pure it is colorless, volatile, non-inflammable, and resembles 
T or chiorofonn in its effects when taken internally or by inhalation. 
it tfftij slightly soluble in water, but freely soluble in alcohol and ether, 
ikktrafonn and oiL Air and moisture cause its decomposition. Under 
t^ iafheoce of light the bromine gradually separates, causing discolora- 
Utt of the ethyl, when it becomes unfit for use, owing to the poisonous 
Ac^ at bromine. 

Aetm^. — For anffisthesia, the pure ethyl bromide only should be 

mei, MS dangerous symptoms, even fatal results^ have been ascribed to 

^ OM of impure preparations. It is thought that some, sit least, of the 

tcjl ca^efl may have been caused by the employment of ethylene bromide 

>uke for ethyl bromide. An easily applied test for the purity of ethyl 

-■— litf ia g-iven by Sternberg: if a drop of ethyl bromide be let fall in a 

^Mion of potassium iodide 3 centimetres (about 1 y^ inches) deep, it 

teid reach the bottom without being colored violet. In experiments upon 

aaaU, <'tbvl bromide has generally proved fatal by arrest of respiration. 

EmUct, however^ has reported a case in which death occurred from a 

wUbi cesaation of the heart's action. Chumical examination demon- 

Oitcd that a pure sample had been employed. In other cases, which did 

MC t^munale fatally, the inhalation of ethyl bromide occasioned nausea, 

^vitiiig, collapses spasm of the glottis, cyanosis of the face, or other dia- 

QHUf ejmptoms. In some instances irritability of the stomach, loss of 

Mttit, and prostration continued for days after the anaesthetic had been 



la doea^, it stands between ether and chloroform, and probably 
pies th© same relative position with regard to safety. Its character- 
effects, when inhaled, are the rapid approach of aniestbesia, its brief 
fantian, and the rapid return of consciousness. It is, consequently, ill 
Aattd for tise in prolonged operations. When sprayed upon a part it 
fMoeea local anaesthesia. It may be inhaled in epilepsy, chorea, and 
^eriMiiroodic diseaso^ (about 4 o.cm., or f->j, at a time). Not very in- 
temble and not unpleasant, it may be used instead of ether for minor 
aniealopcr - One advantage which ethyl bromide posi^esses is that 

fl£w not ij *^P mucous membrane of the upper rcsjiiratory tract. 

Thaacent is n" ^priate for use in the reduction of fractures and die- 

'•^Kii«*. Its it I ^ to e.xeite muscular spasm. It it* reparded as unsafe 

^* of drunkards and those suffering from disease of the kidneys, 

Fr^ni :i r-» ries of experiments relative to the action of ethyl bromide, 

fl tiif>y K.-.iir>T coocludes that small quantities produce narcosis without 

Arterial pressure. liarge amounts diminish blood-pressure by 

1^ th© peripheral vasomotor constrictor system. It is without 

vpon the central vasomotor dilator system or upon the vagi. Toxic 

'V«rfiMl fTM/rrfla, Jan, 1892. 



164 



Pir.\RM.VCHL'TlL'.\L Til KHAPEmC ACIENTS OR DRVOS. 



doses disturb the action of the heart, but, as a tuIl\ produce arrest of re 
ration before that of the heart. The same precautions should be ta 
in administering ethyl bromide as when giving chloroform. 

Coryl. — Under this name a mixture of methyl chloride and ethyl cl 
ride has been employed as a local aiia?sthetic in dentistry and minor i 
gery. Though it does not produce as much cold as methyl chloride, it 
the advantage of being a fluid at 32° F., while the latter boils at a m 
lower temperature. 

Ethylene Bromide. — This iluid has at first a sweetish and sul 
quently a burning taste, and an odor which resembles that of chlorofo 
It dissolves in water and mixes with oil or alcohol. Ethylene bromide 
been used with success in a number of ciises of epilepsy as a substitute 
potatssiuni lirninide. It contains IH).li prr <vnl. nf bromine. The d(x^ 
adults is from O.IS to 0.*) c.cin. (or miii-viij) tlirice daily, and can 
gradually and- cautiously increased to 2 c.cm. (or foss) two or three ti] 
a day. It can be admirn'stered in wine or in capsules, Tt is never usod 
inhalation, . 

.SITHYLIS CARBAMAS (U. S. P.).— Ethyl Carbamate, or Ethyl t 
thane ( ('()\H..(H',,H. ). This is an t^tcr of ciirltiimiuic acid, obtained 
the refU'linii of [ilcolutl upon urtji or one nf ]t?i salts (T', S. P.), It can t 
be oliTnined l)y tbe action of aminnnia or ethyl carbonate, or fhlorocarbon; 
and likewise by direct union of cyanic acid with ethyl alcohol. Ethyl c 
bamato, or urethane, is in the form of tasteless, white crystals, which 
soluble in water, alcohol, ether, chloroform, and glycerin. Tfic lujui^us ?*> 
tion i> of a neutral reaction. 

Physiological Action. — Yon Jaksch^ found it markedly liypnotic 
doees of 0,50 to 1 Gra, (or gr. viiss-xv) in various pathological conditio 
Urethane is not an siualgesic, and does not relieve the neiinilgic pains 
locomotor ataxia, for instance. Urethane resembles paraldehyde in be 
free fnun any decidedly df'j)rcssing action upon the circulation and respi 
tion, differing in this important n'spwt from chloral liydrat(\ and its all 
When the i-irculation is wcnk, urethane is to be preferred as a hypno 
instead nf chlnraK nlthough tbe latter has a stronger hypnotic action (Cu 
ing). Overdoses, however, cause distinct depression of the spinal co 
heart, and resinration. Death froui a fatal rjuantity is caused liy asphyj 

Therapy. — In adults it is recommended for use as a sedative and h^ 
notic, where otlier a^onts cannot be used* in doses of 1 ttm. (or gr. x 
every two hours. Deninie regards it especially suited to children, givi 
0.25 Gm. (or gr, iv) at the age of 1 year as a true hyT^notic. He consid 
that larger doses are safe even in weakly children, as he has seen no off* 
upon the circulation, respiration, digestion, or nerve-centres. As an enen 
1)0 used it successfully in ''dfunjisiji. It may also ]»e given in solution hv} 
dermically in dog(»s about on*^-fourth of those for ordinary use. Abb 
reports a case of tetanus eureil in tAvo days, from 0.5S Gm. (or gr. ix) 
urethane every t^'o hours, with 2 Gm, (or gr. xvx) administered at nig 
Jfaresti, also, successful Iv treated a ease of tetanus by means of urethai 
Prof. J. P. Crozer Griflith looks uiMin urethane in ordinary doses, as an t 



J;ihrt'Hl»enolit der Phurm. T!»erap./' 1886. 




AOAttlCUS ALBITS. 



165 



, CT ^ ' - '" ' 1c hypnotic, though in large doses it may at times prove 
.1 iiri'thane may Ije ooinltinotl,- forming Chloral-urethane, 
^BtlonbvlK vMiuiJUU of which is known u^ Somnal. TTralium- is a similar 
I", if not ideutical with, somnal. Uralium is a crystalline suIj- 
!o in alcohol and ether, but insoluble in cold Mater. It has 
* **^ an hypnotic in dost^s varying from 1 to 3 Gm. (or gr. xv-xlv). 






£THYIJS CHLOEIDTrM.— Chloric Ether, or Ethyl Chloride (CjH.Cl). 

K'* r 1 "'iVirji!.' i^ a onjorltss HumI of fthcroal odor, and boils at 50° F. 

iiaBethcsia by its rapid evaporation. The skin is first 

. ».,.. ..:.ich it becomes perfectly white, and a snow-white coat- 

- upon its surface. Ethyl chloride is put up in hermetically-sealed 
>-s containing 9.25 c.cm. (or f5iiss), one end being drawn out into a 

t- When this is broken off the heat of the operator's hand 

a fine spray upon the surface to be anaesthetized. Ethyl chloride 

- used successfully to allay the pain of neuralgia, lumbago, and 

It has also been found serviceable in minor surgery and den- 

irnuit-reially, it is supplied imder the name of **Ke!ene/' by whicli 

' i.>wn in EuTo|K*. Etiiyl chloride has also b»vn etiiployed for gen- 

- -la, hut it is loss safe than ether, A death has boon reported from 
I T«H>rge K. GiflTord.' 



iTHYLIS lODIDUM.— Hydriodic Ether, m Ethyl Iodide (C,HJ). 

T 5 is very analogous to ethyl bromide, iodine merely replacing the 
^---!--^ It can be administered from a vial in drops on a handkerchief 
«^ gelatin capsules containing 0.30 c.cm. (or mv) each. It is not used 
fcrprod'- ■■- r ".niesthesia, but may be cautiously inhaled for syphilis, bron- 
^ikK. pK catarrh, whooping-cough, asthma, or other spasmodic dis- 

Do&c, U.3 to 1.2 c.cm. (or mv-xx), by inhalation. 



AGABICITS ALBITS. — Purging Agaric. (Polyporus officinalis, Boletus 
hsiQ*; onier, Basidiomycetes, Hymtnomycetes.) The European larch 
in « fungus which grows in large, hoof-shaped masses horizontally from 
tjmnk, and penetrates, with its mycelium, deeply into the wood. The 
collected in Europe and Apia Elinor, and, after peeling and 
they form yellowi>ili-white, friable, spongy, irregular balls, from 
of an orange up to that of a cocoa-nut. It has a heavy, fungus- 
«dnr; * sweetish, followed by a bitter, nauseous taste; and its powder 
srhtatiDi; to eyes and nose. It largely consists of resinous matter. 
Id doses of 0.05 Gm. (or gr. x) or more it acts as a purgative^ 
.mall doeof i.s tonir and anhydrotio. 
T hyi ological Action. — In small doses (0.065 to 0.32 Gm., or gr. i-T) 
ip<^ t» Htrnpiiu*. hut does not dilate the pupil. It is a compound 

i^\ principle of which is termed agaricic acid. Hoffraeister has 

t' -tance uau.'illy employed under the name of ngaricin or 

Bi~. . : npure product. Pure agaric acid is a white, light, crys- 




of the UnJi^crsnl Muilicul Sciences. " 



A-luO. 



1899. vol. V, p. 
tt H^tfh il^pUali, Milnti. Feb. tf, nnd HrHish Metiira) Journal, MnrrH 

July 8, 1D06. 




166 



PHARMACEUTICAL THERAPE0TIC AOEXTS Ofl 



talltne powder, of a silky lustre. It crystallizes out of absolute alcoho 
groups of tuft-like needles or as distinct rosettes. Its melting-poin 
138** C. (280.4* F.). The free acid is but slightly soluble in cold wa 
but is moderately soluble in boiling water. Its alkaline combinations 
freely soluble, but its heavy metallic salts are insoluble. It is a str 
local irritant, and its subcutaneous injection results in active inflam 
tion, with the production of pus. On account of its slow absorptior 
produces no grave symptoms in warm-blooded animals. The subcutane 
or intravenous injection of a soluble salt first excites, and then paraly 
the vagus and vasomotor centres. Death is preceded by convulsions, 
results from cessation of respiration or, in animals when artificial resp 
tion is kept up, from the extreme fall of blood-pressure. The infiue 
upon the secretion of sweat is not central, but is exerted upon the att 
tory glands. I 

Therapy. — Agaricin, in doses of 0.005 to 0.066 Gm. (or gr. Vu-jl 
used to check night-sweating, and sometimes to suppress lactation. 

B Agaricin 066 Gm. or gr. j. 1 

Acid, sulph. aromat 16 

Elixir 4fi 



066 Gm. or 

c.cm. or f3iv. 
c.cra. or i^isa. 



fl 



M. Sig.: Take one drachm every four hours in water. 



Agaricin also suppresses perspiration due to other morbid causes, 
solution of agaricin in alcohol has been suggested as of value in hyperit 
818. It has also been recommended to combine a small quantity of Dov 
powder with each dose of agaricin, when there is a tendency to loose: 
of the bowels following its use. 

In order to reduce the fever and restrict the night-sweats of ] 
monary tuberculosis, Dr. J. M. Anders sometimes resorts to the follow 
combination: — 



K Quinin. aulphat., 

Antipyrin aa 

Agaricin 

M. et ft capflulse no. xij. 

Sig.: One capsule three times a day. 



1155 Gm. or gr. xxiv. 
|lO Gm. or gr. iss. 



AGAEICUS CHntURGORTJM.— Polyporus Igniarius is an allied i 
gus to the preceding, but is used solely on account of its porous texti 
It has been employed as a mechanical haemostatic and for its slow burn 
as a moxa. It may be soaked in potassium nitrate or chlorate soluti 
which makes it more inflammable. 



AGABICUS MUSCARIirS.— Amanita Muscaria, or Fly-fungus (Ba 

iomycetes, Hymenomycetes), is a poisonous mashroom, consisting lar^ 
of fungus-cellulose. Its active principle is a syrupy alkaloid, Muscan 
It is without taste or odor, but produces powerfully-intoxicating eff< 
somewhat analogous to ])iloc[irpine in its action, and antflgoni7:i?d by al 
pine. Amanita Vema, or Plia]l<iidcs, allied species of niuslirooms, are ^ 
poisonouB. In addition to muscaria, they contain phallin, and also a tl 
principlCj which haa not been isolated. For the latter two elements no a 




ai;athin- 



167 



>!!nr!. They act like serpent-venom, in eausing solution of 
Trt'Htinent of niushroom-poi6<)ning should commence with 
tft to ck*ttr tJie aliinentan' eanal ; then use atropine and diffusible 
Is. Digitalis may alsti be given hypodermically, ajid etimulating 
^tfMJJi administered, 

Fkyiiolo^cal Action.— The action of the heart and of the lungs is 
iauiusbed by Urtiv dofi*.'s of agaric, the heart being finally arrested in 
fartnti'. S; .liisf^ diminish blood-pressure and reduce temperature, 

•h^oQ^ ll.' V heat may be secondarily inere>ased. The secretions 

il tkv skill, the hven aud intestinal tract are increased, while that of 
^ kidneys is sometimes reduced or suppressed. The muscular system 
m rd^xed* but convulsions may occur from accumulation of carbonic acid 
m iktf blood. Upon the brain a marked narcotic or stupefying effect is 
ttecrred, ^o that it has been used in Asia as an intoxicant. The pupil con- 
tacts from the effects of the internal administration, while the local 
ippBcalion of muscarine may cause dilatation. 

Tkcn&py. — Administered medicinally, muscarine has some reputation 
it cb«^ng the lever and sweating of phthisis. It may be used in affec- 
MS of the respiratory tract where there is a deHciency of secretion or in 
Cavrders of the alimentary canal where the same indication is to be met, 
•ad to overcome a tendency to constipation. Muscarine can therefore be 
htned with such drugs as belladonna, hyoscyamus, strjxhnine, aloin, 
.gradfl, or sulphur, with advantage, as in the following formula: — 

U MnmMTiom 120 Om. or gr. iij. 

Ext. niici* voniii'W |065 Gm. or gr. j. 

Aloml. 

Ext. lM*riiulonni» foliur aa 110 Gm. or gr. ist. 

£xt. geotianas l{ Gm. or gr. ryj. 

M. «C ft. pO. no. xTj. 

Skg.L One pill two or three times & day. Beneficial in constipation and in cat&T^ 

The dose of muscarine is usually 0.008 to 0.13 Gm. (or gr. */8-ij)i in 
wIiImmi, or muscarine nitrate may oe given in somewhat smaller doses. 
tm the sweating of phthisis, Murrcll uses a 1-pcr-ccnt. solution, of which 
fte do9« IS 0.30 c.cm. (or mv). 

AOATHTW is the name bestowed upon a new synthetical compound 
r.^.,«-A«^ by Dr. Israel Boos, of I'rankfort-on-the-Main. It is a derivative 
Hcjd, and its chemicjil compositiou ia expressed by the title 
:* ^ j-aiiiehvde-metliylphenylliytlrazin.'' 

Airathtn occurs in the form of small, light-green, crystalline scales, 
JBtituN 11 or taste, insoluble in water, soluble in alcohol and ether, 

Dr; 74*' C. (KIS'* R). 

Fhysiological Action and Therapy. — Moderate doses have no ill effect 

I qniniiiN When administered to the human subject, agathin gener- 

M^ appetite and excretion of perspiration. It has been found 

"" in neuralgia and rheumatism, being generally given 

Grn. (or gr. viij) two or Three times a day. Its effect 

4. : ' rtt.NJ, and its us*', it is clnimed. does not usually 

•"1 by any drawbacks. On the contrary, Ilberg and 

kstm obak^rveti i which agathin gave rise to headache, vertigo. 



t '^ 




168 



PHAUMACEITICAL TU KlIAriil'TR' AtiKXTJ* OU DlirCS. 



insomnia, vomiting, diarrhcea, thirst, sensation of heat, and smarting pa 
during micturition. 

ATLANTHirS GLANDULOSA.— Ailanthns-tree, or Chinese Sumac 

The Ailnnthus, or Tree of Heaven (belonging to the natural order Simai 
baceai), i)roii<rhl trom I'liinu, is* nmv njitunili/.ed in this cfnintrv. and. bei 
oruamenUl. h uhmI a^; a j^batU'-tiVi'. TJii' iunor hjirk. \vhit:li ih thi.; |>ari u»( 
contains an oleopfi:iu arnl a vulatiie oil. 

The fluid extract (O.GO to 4 com., or mx-foj) and the tincture (in do* 
of 2 to 7.5 c.cm., or fSss-ij) have been used. The bark may be given 
doses of from 0.32 to 0.65 Gm. (or gr. v-x). 

Fhysiological Action. — When taken in full doses, ailanthus naupeal 
and purges; it also gives rise to vertigo, headache, pains in the back a" 
limbs, and prostration, with numbness or tingling. Both respiration a: 
pulse-rate are reduced; death results from arrest of respiration. 

Therapy. — The fresh bark has been used in the treatn^ent of taj 
worm, iu decoction (15.5 Gm. to 473 c.cm., or Siv-Oj) or the oleoresiu (in 
c.cm., or f5j, doses). It has also been used in malignant scarlatina, 
Bpasmodic disorders, and in dyspepsia. An infusion of the leaves has be 
employed in dysentery. 

AIB.' — A mixture of oxygen and nitrogen, with smaller quantiti 
of carbon dioxide, argon, and ^'atery vapor, together with accideni 
organic and inorganic constituents, composing the atmosphere, which y 
breathe. (For the ett'ects of air, sim- section devoted to Climatotherap 
also Pneumotherapy and Pneumatic Differentiation. For Liquid Air, a 
section on Keat and Gold as Therapeutic Agents.) 

AIROL. — This is a trade designation for bismuth-oxyiodogallal 
which is a grayish-green, odorless, tasteless ]>owder. It is insoluble 
alcohol, water, etc. It has been employed as a surgical antiseptic dastin 
powder or as an emulsion with glycerin (10 per cent.), or also as an oirj 
ment, as a substitute for iodoform. Airol has also been u?ed internally 
an intestinal astringent, in doses of 0.13 to 0.32 Gm, (or gr. ii-v) sevet 
times daily. In ophthalmic practice Bonivento had good results in for 
cases of infectious, ulcerous keratitis, the remedy being lightly dust) 
upon the affected area after preliminary antiseptic cleansing. Its applic 
tioD is usually painless. 



turn.) 



ALBAHOIN.— A trade name for gelatose silver nitrate. (St'f Arge 



ALCOHOL (T. S. P.). SPIRITUS RECTiriCATITS ( B. P.).— Alcoh( 
Spirit of Wine (TJIOlI). 

Preparations. 

Alrnlinl Dilitlum (P. S. P.). — Diluted Alcolml (iHpitil pails nUtiliol iiiul wntei 
SpirituB Pnimenti (U. S. P.). — Whi»ky {contflinf* about 60 p«r cent, of alcohol) 
Spiritus MyrciflB (U.S. P.). — Bay-rum. For external use. 





ALCOHOL. ^^^^^^^^^ 109 

Aibum (U. S. P.).— WTiitc Wine ( 10 to 12 per cent, alcohol). 
Rabnim (U. S. P.).— Red Wine (10 to 12 per cent, alcohol). 

Absolutum (U.S. P., B. P.).— Absolute Alcohol (containing not more 
cent., by weight, of water). 

Vini Gallici (U.S. P., iJ. P.). — Brandy (contains about 60 per cent, of 

IGMorm Spiritus Vini Gallici (B. P.).— Mixture of Brandy (brandy, 113 c.cm.; 
hv«ter. US r.cm. ; re6ned sugar, 14 Gm.; two yelks of eggs). Dose, 30 to 
(or IBi-ij). 

Aurantii (B. P.). — Orange-wine (contains 10 to 12 per cent, alcohol by 
K 
Tiaam Xericum (B. P.). — Sherry Wine (contains not less than 16 per cent, of 
' by volume). 

Not Offfcial 
Spiritns GeneTK. — Oln (dilute alcohol flavored by juniper-berriea). 
^ikftns Jamaic«nsts. — Jamaica Bum (spirits from molasses). 
%irtt«» Odoratus. — Bau'dt-Coloijnf, Cologne-water. 

JUoohol ia a liquid composed of 91 per cent., by weight (94.y by vol- 
t»»l. ' ' ' ' 'hoU and of 51 per cent., by weight (o.l by volume), of 
■4?*T - .:wlv, o.H-^0 at .M»° F. It is a transjmrent. enlnrlt^ss, vola- 

■ ■ e-ulistaricv. with a I'liaraoteri.'itif, punjrent, rnther ugrt^^aMi- 
The British Pharmacopceia recognizes absolute alcohol and 
nctafcd spints, the latter containing 90 per cent., by volume, of ethyl- 
\0^mx\^e. Proof spirit contains 50 per cent, of absolulo alcohol. 

FkarmACology. — The hydrate of the hydrocarbon radical (C^Hj) ia 
Jy understood to be meant by the term alcohol, although many other 
ane known tn the chemi.'it. Kthyl-nlcohol, also, is the alcoliol 
^ hasodjt whisky, wine, and various spirits and cordials. Its effects upon 
tW organism are less toxic than those of other alcohols, such as amyliCy 
■Bihjiic, or butylic. During distillation of grain, unless carefully managed, 
ble amylic alcohol will pass over with the ethylic, especially if the 
be continued too long. By keeping whisky stored for several years, 
fte wmjlic alcohol becomes largely changed into various ethers, which ira- 
■it a flaror or bouquet to the spirit. The United States Pharmacopoeia, 
inRforv, rlin*<.*t»i that grain-spirit (whisky) slionld be at least four years old, 
mk tba spirit from fermented grapes (brandy) at least four years old. Wine 
taadc bj fermentation without distillation. Hed wine is a deep-red, alco- 
Wic liquid, made by fermenting the juice of colored grapes in the presence 
diiym ekins; white wine is of a pale-amber or straw color, and is obtained 
•■ fann^'**"*'/ the unmodi6ed juice of the grape, free from seeds, stems, and 
.*^ Genevffi (ein, or Hollands) is not official: it is obtained by 

j Iterries to diluted alcohol. Rum, or molasses spirit (spiritua 

c . icencis), is made by distillation from sugar or molasses which 

adaxgoDc ulcohoUc fermentation; it is about the same alcoholic 
ongth aa whisky. 

AJiXihoI dii(SoIveg alknloids, fatty and resinous substances, and is largely 
mi i« a menstruum in obtaining the active principles of drugs in an avail- 
•Uf form for administration. It is the basis of the U. S. P. spirits, tinct- 
wm. i ffwl elixirs; epirits being solutions of volatile substances in alcohol; 
liitiUML »olntions of active principles of plants, generally obtained by 
iwmttOD And percolation. An eli.Tir is a cordial flavored with orange 
M^frrup generally used as a vehicle for other remedies Malt liquors — ale, 
W porter etc.— «re produced by fermentation of mnlt and hops, and con- 



I 



tain nutritive niaterial, together with a small proportion of diastase, wh 
makes them iiaeful in certain cases of weak digestion. They contain a 
from 6 to 10 per cent, of alcohol. Malt liquors can be taken by those ^ 
suJTer from the cerebral effects of wine, but to some they are unpleasani 
their effects upon the brain, owing to the oil of hops which they conf 
(Rossbach). 

Absolutely-pure alcohol is rarely found, even in the laboratory of i 
chemist. Owing to its great affinity for water, it will in time abstrao 
from the air. Absolute alcohol; of the shops, usually contains about 2 ! 
cent, of water. It is a colorless, pleasant-smelling liquid, with a sharp, w| 
taste. When added to water, heat is developed, and the mixture does I 
measure as much as the sum of its constituents, owing to combination. \ 
sides its affinity for water and its power as a solvent, it has a coagulat 
action upon albumin, and is an antiferment when in solution containinj 
least 18 per cent, of alcohol. 

Physiologrical Action. — Owing to volatility, it gives a cool sensation 
the skin at first, but afterward, if evaporation be interfered with, it cai 
irritation and heat, and, if continued, produces inflammation. It | 
hardens the integument by abstracting water from it, coagulating some 
its albuminoid constituents, and dissolving its fat. It has the same efi 
v.pon mucous membranes, thus enabling it to act as an astringent. It ^ 
some anaesthetic action, possibly by reducing the congestion by its cool 
or constringent effects upon the smaller blood-vessels. 

After alcohol, in the strength of ordinary spirits, is swallowed, in sit 
quantity (15 to 60 c.cm., or f^ss-ij), there is a sensation of heat in the « 
gastrium, which soon diffuses itself over the body. The experiments of ; 
Beaumont showed that small amounts increased the vascularity of the stc 
ach and stimulated the flow of gastric secretions. Under favorable circu 
stances, thereforcj alcohol increases the digestive power, causing an a' 
mented gastric jxiice. If taken in large quantities, appetite is lost and nau 
appears, and the digestive power is suspended. As a result of long-ci 
tinued indulgence in alcohol, the stomach undergoes changes in its coi 
new areolar tissue being formed, which, by its subsequent contracti 
strangulates the gastric glands; hence, dyspepsia and gastric catarrh, w 
morning vomiting, are very common among drunkards. In addition 
structural changes, alcohol, in excess, precipitates pepsin from the gast 
juice, and thus increases digestive difficulties. 

H. Wendelstadt,* of Bonn, as a result of some experiments made toH 
termine the inllucnce of alcohol on the respiration in man, found that thi 
was much individual variation, but in 29 cases in which pure alcohol v 
ingested, 7 showed diminution of respiratory activity; but, when the alcol 
was taken in the form of wine, only 2 showed such diminution, while t 
amount of increase in every case in which it occurred was greater. The 
crease was also more marked in cases of fatigue or debility. He thereft 
concludes that in debilitated states of the body, alcohol, especially in i 
form of wine having much aroma, is the best stimulant. 

Dr. Glascr has recently studied the effect of alcohol upon the kidn< 
and urine. He finds t!u»t a moderate quantity of alcohol causes irritati 
of the kidneys and alters the solubility of the urinary salts, favoring 1 



T 



'Lancet, Feb. 17, IIKM). 




ALCOHOL. 



171 



pj i'IuIjuc of lime and uric acid. The influence does not extend be- 
tr-sii hours, but the continued use of alcohol produces a cuinula- 
et. Dr. David Cerna, who has also investigated the action of alcohol, 
that in large doees it enhances coagulation of the blood, while in 
qsuatjties it destroys the ozonizing power of that fluid and causes a 
■pantiuUi of haexnoglobin from the corpuscles. Over-indulgence in alcohol 
]mi kMKg been thoujjht to impair the Bexual nower^ and there seems reason 
to infer fruni «?rtam experiments made by m. Bouiu und M. C. Gamier* 
&it it mav actually cause decided degenerative changes in the testicles. 
fiifing ■* ' ] chronic alcoholism in a number of white rats, in two of 
li* rant* ■-• found atrophy of the testicles, with almost complete de- 

tfnction oi theliura of the seminiferous tubules. 

Dobois ' i that certain plants exuded droplets of moisture over 

itfoifac^ when exposed to the influence of chloroform, ether, benzin, and 
ikabol. ^Tr- '-•insiders the process on indication that the vapors penetrated 
tie proE' I of the plant-tissues and forced out the water, taking its 

ylue. ^Kj.t'1 - bases a theory in regard to the effect of narcotics in man on 
the cbserration of this phenomenon, suggesting that certain substances in 
lit protaplasxna of the cell, — the lecithin, etc., — so important to the healthy 
bDctMnting of the cell, are dissolved out of their normal proportions of solu- 
aad combination in respect to the other components of the cell, — the 
T, salts, albumin, etc., — -by the tension of solubility between them and 
driarofonn, alcohol, and other narcotics, analogous to the effect of salt in 
tfcff m^niem. If this theory is correct, then all chemical substances which 
iiiilii fat and bodies resembling fat — lecithin, protagon, etc. — must pro- 
te» a narcotizing effect on living protoplasma, and the effect would be 
■■t marked on the cells which contain the largest proportion of these eub- 
IdBcca: the nerve-cells. The effect would also depend on the mechanical 
iCnsty of the narcotics for the other constituents of the cells besides the 
yttj matters^ especially the water, and also on its co-eflicient of division in 
twxture of water and fatty substances. 

Upon the nervous system alcohol first has an exciting effect, followed 
1^ -s, — -on and coma. The arterioles are dilated, thus admitting more 
yop '.' brain, and this is succeeded hy diminution of mental activity, 

1^ uj tae effects of the alcohol upon the ganglion-cells, weakening their 
A Mnailar effect is seen on the spinal cord, usually occurring later 
, bat aometimes preceding, the brain s}Tnptoms. The reflex action of the 
it reduced and the power of co-ordination impaired, so that walking is 

Efring gait, and finally the knees will no longer support the body. 

I paralyzing effect is also seen in the sympathetic system, since the dila- 
tiZaoD of certain vascular areas must be due to the loss of function of the 
«»ciinoior nerve«. The action upon the centres in the medulla is seen in 
Aa lowered temperature, the slowing of the pulse after a preliminary accel- 
oitkm, and the sighing respiration or stertor. Death is produced by re- 
mawtorj paraly^'is and lowering of the bodily heat. From this it is seen that 
Aocbnl will not protect from cold, but will actually hasten the occurrence 
ildoath from cold. The experience of Arctic voyagers is to the effect that 
ftow peraons endure the rigors of the winter best who abstain from alcohol. 
Ik. Parkv«> In the Ashnntee campaign, also found that the fatigue of march- 




i 



* Ptysm: lfMical«» Jan. 17. 1000. 

'Arrhtr f. Krp. Pnth. «. PhfirmakolOf;i'', xH'i. 2 to 4. 



172 I'lIAKMACEUTICAL Til miAPEL'TIC AOENTS OK DKUflft. 

ing in the tropics is borne better without the aid of a spirit ration, owi 
to the diminution of muscular and nervous energy and capacity for wo 
due to the physiological action of this agent. The only advantage deri^ 
from its use was to take away the feelings of fatigue after the men fc 
come into camp, and thus enable them to eat. It is also useful, in the t<4 
of hot drink, to revive a person, who has been exposed to cold, after i 
exposure has ceaseil. Major Charles E. Woodruff, United States Army, 
lievee that small quantities of alct>hoI are useful in the tropics, to countefi 
the stimulating elfect of excessive sunlight. ^^ 

As to the changes that alcohol undergoes in the body, Anstie sta 
that a variable amount (4 to 15 c.cm.. or foi-iv) disappears, or is burnt up 
the blood or the tissues; this quantity may be increased by habit. T 
excess is thrown off by the lungs, kidneys, bowels, and possibly by the sk 

Pn)f. \\\ {). Atwiiter, of Miildletowu, (.'onu., from experiments to del 
mine the effects of nuxieriite (ht^va of alonhol, frmm] : 1. That extremely lit 
of the alcohol was given off uueonsuinod. "2. That in tlie oxidation all of t 
potential energy of the alcohol was transformed into heat or muscular euerj 
3. That the alcohol proteeted the material of tlie hoily from consumpti 
just as effectively as the corresponding amounts of sugar, starch, or fat. 
is, however, to lie borne in mind that the inllueuee of the aknhol upon i 
circulatory and nervous functions is et^pecially iii4)ortant, and that thi 
nnitters did not come within the limits of Atwater's experiments.^ T 
inference souglit to be drawn from tliese experiments that aleohol is a Bf 
and useful food is questioned by Woodbury and Egbert, who assert tli 
akohol at Un^ best is useful only as a stimulant and excitant to the circu 
tion and nervous systems rluring emergencies, nnd they quote authorities 
prove that as a food its objections outweigh its alleged ndvantagos.* 

Toxicolo^. — The symptoms and treatment of acute poisoning 
alcohol differ so much from those of the clironic form of alcoholism tb 
each state must be separately considered: — 

1. Acute poisoning by alcohol manifests itself by an exaggeration 
the physiological action. The rapidity with which grave symptoms appe 
is in proportion to the quantity of alcohol taken, its form, and, to soe 
extent, its temperature, as hot drinks more rapidly intoxicate than col 
Where a large quantity Is taken at once, as when a whole bottle of whisl 
is drunk on a wager, or a comparatively large quantity administered to 
child, the stage of excitement is too brief to be noticed, and the patient fa) 
at once into a stupor, which may be followed by coma or fatal convulsior 
Where the administration is spread out over a longer period, drunkenne 
comes on progressively, but ends in unconsciousness and insensibility, ar 
the patient is said to be dead-drunk, because of his complete helplessnes 
Since alcohol increases the blood-supply of the brain (and especially sin* 
drunken men are apt to fall heavily and strike their heads), the state t 
alcoholic coma may often be accompanied by meningeal hsemorrhage < 
apoplexy. Intoxicated persons shoidd never be allowed to sleep off the 
drunkenness, but should be treated as if they were poisoned, as — in fac 
— they are. The treatment consists simply in evacuating the stomach wit 
emetics (mustard, etc.,) or the pump, and administering ammonia, eithc 



,1 




* Bulletin No, 69. of the V. f?. Department of ApricuUure, Nor., 1899. 
'Journal of the American Medical Asfiociaiion, March 31, 1900. 



ALCOHOL. 



173 



fbt ATonutic spirit or the carbonate, both by the mouth and by inhalation. 
The fpiiit of Mindcrerus likewise fulfills the 6aine purpose. Digitalis may 
W given hypodennically; on if the patient is noisy, morphine and atropine 
mmoiexnte doee«. It is said that 30 or 60 c.cm. (or f§i-ij) of cider-vinegar 
ks • fobering effect; and after emptying the stomach with the stomnch- 
it i* well to introduce a pint of warm coffee, — it should not be hot 
for fear of injuring the stomach during unconsciousness. Artificial 
on and electricity may be required to keep up the breathing and 
fivfciit the undue accumulation of carbonic acid in the blood. Cold affu- 
•BOft should be used with care, on account of the lowering of temperature 
*f the alcohol; but heat and sinapisms are of great utility. Apoplexy, or 
««rbrtl haemorrhage, may be suspected when there is marked deviation of 
fte^pM or unequal dilatation of the pupils, especially if there is co-existing 
pmijOB of one side of the face or of the arm or leg. In such a case the 
of eurgical interference would come up, to decide upon the pres- 
of fmcture of the skull or meningeal hsemorrhage and the appropriate 
taatmect therefor. 

8. Chronic poisoning by alcohol may be shown by the changes taking 
]faee in the stomach, liver, and kidneys; increase of fibrous or areolar 
taroe, followed by contraction and destruction of the characteristic secret- 
inf c^Ib, «nd fatty infiltration; or, in other words, the type of cirrhosis due 
i»tbt long-continued action of alcohol upon the tissues. Gastric catarrh, 
indigestion due to deficient action of the liver, and albuminuria from con* 
tactod and crippled kidneys are commonly met with in old alcoholic sub- 
icti. Chronic laryngitis and bronchitis, also chronic catarrhal pneumonia 
ad fibroid phthisis, are also frequent in such subjects. The effects, how- 
fftr, ire moct marked upon the nervous system. Dr. Wilks has reported 
■0 of paraplegia and numbness. Anaesthesia and violent shooting pains 
Ir* foUowcd the long-continued and excessive use of alcohol. A case of 
^anotor disturbance due to the habitual use of alcohol has been recorded 
k'Dr. G. Ka^mpfer. A man, who had been an excessive drinker, was at- 
tKfcad* within half an hour after taking any alcoholic fluid, by an eruption 
«»1m» *kin itiUiS-ifftinp of patt•lle^^ of erythema of variable size and tf>l<tr. 

The damage produced by the habitual consiunption of alcohol is not 
^mg^^ ^ *- •»•<* drunkard, but is transmitted to his children. It has been 
Hoidmj vm that the offspring of alcoholics are degenerates, afflicted 

nik IBorLt;il craving for drink and subject to epilepsy, idiocy, chorea, hys- 
tsv, and phvsical defects. When alcoholic poisoning is mentioned, we 
^menBr understand it to mean delirium tremens or mania a potu. These 
ataoc identical; the latter is, to all intents and purposes, an acute attack 
tfsania causc^d or incited by alcoholic excess. Delirium tremens, on the 
iMnrr »a • milder form of delirium, due partly to the action of the alcohol 
»« tba brain* but also very largely to anaemia of the great centres. In 
^fcnoer the patient is violent, and requires several men to control him; 
^ooee controlled, and the proper medicines given (potassium bromide, 
- hy^robromatc, or chloroform inhalations), the patient, after a 
• - cN-t-r*. ti?"^l'y rapidly recover?. In delirium tremens the symp- 
of anteraia of the brain; it is apt to occur after a 
. .,^ 'fC several days, during which very little food is eaten 

t bv vomiting from the excess of alcohol. Hero the patient 
dcliVium, and has hallucinations of sight and hearing, which 



PBM I 






lagu. 



\€t 



in many cases may not greatly annoy him, but, on the other hand, h 
visions may be horrifying and very distressing. These patients are het 
treated with digitalis, and amyl nitrite may be cautiously given by inhah 
tion, or nitroglycerin by the mouth. Nourishment must be given in a fori 
readily assimilated and at short intervals, hot broths, well seasoned, bein 
the most acceptable to the stomach. If, as is usually the case, the patiei 
has been a steady drinker for a long time, alcohol should not be entire! 
withheld from him, but given in combination with food. In such subjeci 
the blood-vessels are generally the subject of atheromatous changes, an 
the heart requires its accustomed stimulation in order to carry on the cii 
culation. If the patient cannot sleep, he may be helped by sodium broraid 
and chloral (aa 0.65 Gm., or gr. x), by hop-tea with capsicum, or the an 
moniated tincture of valerian. For the debility and tremor, nnx vomic 
has proved very useful in comparatively large doses of the tincture (2 com 
or foss, or more). Hypodermic injections of strychnine nitrate are ala 
^LflsefuL After death from chronic alcoholism the organism shows change 
^Kn every part, which Biirtholow suMinied up in two words, ''fibrosis an 
^Heteatosis.'' 

^B By inliaUng the vapor of jilcohol, coaiplete aiuesthesia may he pre 
^pduced, and the different degrees of intoxication up to insensibility. In sue! 
^^ cases the stomach need not be emptied, but artificial respiration in the ope: 
air, or the inhalation of oxygen will soon restore the patient to consciousness 
^tTbis may be hastened by a stimulating enema. 

^f Absinthism, a form of alcoholic poisoning attended by epilepsy, follow 
1^ ing indulgence in absinthe, has been already discussed. 
^^ Methylic apirit, or wood-alcoliul, on ai-munt of its cheapness, is 8om€ 

^ftiimes used to adulterate whisky, or as a substitute for it, and is largely em 
^■"ployed in the arts. Under tlie name of Columbia spirits it has an extensiv 
I sale. It is much more toxic than pthyl-alcnhol, and has the peculiar propert; 
^vof causing optic neuritis and blindness. 

^P Therapy. — Alcohol may be used as an evaporating lotion in cases <X 
"local inflammation, or of bruise or sprain. Diluted alcohol (90 c.cm., or fgiij 
with lead-water (30 c.cni.. or fjj) lind morphine acetate {0.G5 Gra., or gr 
i), applied upon a single layer of cloth or absorbent cotton and allowed t< 
evaporate, forms an excellent lotion to keep down inflammation, and in poim 
of cleanliness is much better than the old lead-water and laudanum. Absolut* 
alcohol is used as an astringent application to exuberant granulations (poljrpi 
in the ear, and also applied as just directed to control acute inflamraatior 
of cellular tissue, and in erysipelas. Ordinary alcohol is a good appHcatioi 
to prevent bed-sores, and for this purpose it is customary to add a little alun 
(4 Gm. to 473 c.cm., or 3i-0j). Hot applications of alcohol relieve pain, and 
in facial neuralgia, cold in the face, or toolluicbe, the eiuplnynicnt of a smal! 
flannel bag containing hops and dipped in hot whisky will generally afford 
marked relief. In some skin diseases, as ulcers, loss of hair» frost-bite, ei^ 
cessive secretion of sweat or oil, fetid sweating, freckles, and vegetable para- 
sitic affections, concentrated alcoholic preparations may be used. Somfi 
useful formuliB are here added: — 

B Alcoholia, 

Glyceriti boroglycerini *. . . . aa CO] c.cm. or Qij. ' 

M. Sig. : Apply freely in excessive or fetid swefttlng, and in vegetable parasitiQ 
[diseasea of the akin. 

I 
I 




ALCOHOL. 175 



When glycerin does not agree, we may prescribe:- 

Q Alcoholis 60 

Cocainffi hydrochloridi 

Addi borici 4 



acm. or fSij. 
32 Gm. or gr. v. 
Gm. or Sj. 



If. 81^.: IJBe with old muslin or cotton in frost-bite, oily secretion, freckles, 
tod other pigmentary deposits. 

9 Spt. vini galUci ]20| c.cm. or fjiv. 

linct. nucis vomicse 15| c.cm or fjss. 

Tinct. capsici 7{60 ccm. or fSij. 

M. Sig. : Apply on the scalp for loss of hair, with friction once daily. 

Leloir recommends the local application of alcohol or an alcoholic solu- 
tion as an effective abortive measure in herpes. The same treatment will 
relieve the pain of herpes zoster. 

L. NeustadP reports a case confirmatory of Biers and Salzwedel's ex- 
perience as to the great value of alcohol dressings in tubercular lesions. 
In the case referred to there were tendo vaginitis and osteitis tuberculosa 
of the left hand. After the daily applications of a compress wet with alco- 
hol for sii weeks, it was completely cured, although it had been pronounced 
a proper case for amputation previous to the treatment. Angerer has also 
reported 7 cases of local tuberculosis treated by alcohol, 3 of which were 
cured and 4 remarkably improved. 

Its antiseptic virtues and the astringency which it possesses in con- 
Mquence of its power of coagulating albumin renders alcohol, when properly 
diluted, an excellent gargle in pharyngitis, stomatitis, scurvy, and salivation. 
It is also useful to apply an alcoholic lotion to the nipples of nursing women, 
in order to prevent the formation of fissures. Alcohol possesses considerable 
value as an haemostatic, and may be utilized in cases where capillary oozing 
occurs, the following prescription being very valuable: — 

Q AlocAolis, 
Lilt, saponis, 

Fluidext. hamamelidis aa 30{ c.cm. or fSj. 

M. Sig.: Employ as a styptic in local heemorrhage. 

To the action upon the digestive organs and the stimulating effect upon 
the nervous system and the circulation are to be ascribed the usefulness in 
the treatment of disease of alcohol judiciously given. It is not used in 
sickness to reduce temperature, although it accomplishes this in health; 
Eor is it given as a narcotic, although its sedative action may not be un- 
desired. In almost all cases it is intended to act as a restorative,, and, there- 
fore, its administration must be kept well within physiological limits. In 
fiome cases, especially in typhoid fever, unfortunate results have followed 
:tg use with too free a hand. In most cases of fever, from 60 to 120 c.cm. 
for f^ii-iv) of whisky daily is amply sufficient for an adult, and more than 
thif may do harm. It is judicious, however, to make allowance for the 
patient's previous habits. One accustomed to the daily use of alcoholic 
bererages will, generally speaking, require proportionately larger doses than 
an abstainer, when attacked by any severe disease. 

In phthisis a tolerance seems to exist, and patients can take relatively 
Urge quantities without showing symptoms of intoxication. The late Austin 

^Proper medMnUi^ Woohensehrifi, Feb. 15, 1900. 



176 



PHARMACErxICAL THERAPKI'TIO AOKNTS f)lt lUtl »;s. 



Flint reported the case of a young lady who took a pint of whisky daily i 
nearly two year^, for piilnioiiary phthisis, iiml was finally cured. In t 
course of a disease, when the powers of life are succumbing, the first sou: 
of the heart is weak; the pulse feeble, soft, and irregular, but genera 
rapid; when syncop<? or delirium threatens, akxihol si\ould be given, c 
deavorin^ to combine it with food, such as broth, milk, grne], etc. T 
period at which these symptoms generally appear is, in typhus fever, abo 
the end of the first week; in typhoid, al the end of the second week; 
small-pox, when the secondary fever commences. The excellent practic 
rules formulated by Dr, Armstrong for the use of alcohol in fever may 
confidently followed. Alcohol is beneficial when the dry tongue moiste 
under its use, the rapid pulse becomes more slow, the skin less parched, a 
the respiration more tranquil, and, it might be added, where it suits t 
patient. If opposite results follow, the remedy should be suspended. ' 
the above rules. Ringer adds that alcohol does good when it produces sle 
and quells delirium. In measles, when the eruption turns dark or hiem< 
rhagic, alcohol is best given in as large dnses as will be borne, and at she 
intervals, as pointed out Ly Dr. John M. Keating. In acute iuflamniatio] 
as in pneumonia, when the heart begins to fail and s}Tnptom3 of dcbilj 
appear, alcohol can usually lie given with marked benefit. In hyposta' 
congestion of the lungs, typhoid pneumonia, or the pneumonia of the ag( 
alcoholic stimulation is particularly indicated. Diphtheria, phlcgmono 
erysipelas, and tuberculosis of bones, joints^, or glands are affections in whi 
stimulation is demanded. The strong^er alcoholic beverages — such as wii 
whisky, or brandy — are valuable in old age, when digestion is weak and i 
Bomnia marked. Hot spirits and water, cautiously administered, is usei 
as a restorative in the condition of shock the result of injury. During cc 
valescence from fevers, when the structures of the heart and stomach ha 
been altered by the fever process and digestion is weak, it is often fou 
that malt liquor in some form increases appetite and digestion, iraproi 
nutrition, and enables the patient to sleep better at night. In the same wi 
persons who follow sedentary occupations, and whose bodies are insu: 
ciently nourished, often find much benefit from the use of alcohol in mc 
erate quantities, given just before or after or taken with their meals. Its an 
septic powers are useful in infectious dyspepsia, where digestion is stopp 
by the growth of micro-organisms, which set iip excessive fermentation 
the stomach and intestinal canal. Its acknowledged value in the zymoi 
diseases, and pre-eminently in diphtheria, is partly due to its antisepi 
action in the alimentary tract. In a similar manner, in cholera epidemi' 
alcohol has decided prophylactic effects, and this is not controverted 
the fact that persons weakened by debauches and alcoholism arc most lial 
to perish from the disease. In cholera infnntum, also, brandy exerts i 
excellent influence; and, indeed, in many bowel disorders among adu! 
(which are often connected with the growth of micro-organisms) alcohol 
the form of brandy or red wine (port or Burgundy) is of great assistance 
the trealment. When flatulent colic or neuralgic pains occur in the abd 
men, cloths wet with Imt whisky externally, and some liot toddy internal! 
give prompt relief; in infants, gin and hot water is a remedy often used i 
colic by old nurses. 

Forms of Alcohol. — In order to estimate the effects of different fon 
of alcoholic liquors, the following comparative strength should be remei 
bered: — 




ALCOHOL. ^^^^^- 177 

f, whUkT, rum. gin. cordials.. .30 to 50 per cent, of absolute alcohol. 

h and Italian sweet wines 13 to 17 " " " ** 

a»d claret 8 to 11 

Alt or porter 4 to 6 

filovt or beer 4 to 5 ' " 

g*~ **■ 1 to 3 " " " " 

Champe^e contains from 8 to 10 per cent., but the presence of the 
cmoBir-acid gas makes it more "heady"; that is to say, the cerebral stim- 
ilftiao is produced more quickly, and with a smaller quantity of alcohol 
Aui bj the still wines, and the after-elfects in the way of headache or 
■vebnl congestion are less apt to occur. Moreover, the carbonic acid acts 
M% sedative to the stomach, thus making champagne especially serviceable 
vfaete the stomach is irritable, and where prompt stimulation is required, 
m xxk MAfickness or in yellow fever. Where the expense is an insuperable 
objection, a good substitute may be made extemporaneously by the addition 
«f Gtrbanic-acid water or koumiss to wine or brandy. 

i peg ud Applications. — As an antidote in snake-bite, alcohol enjoys an 
atmaiTe reputation, which has not much scientific foundation. The liquor 
ihoold be giTen only, a wineglassful or so at a time, repeated at intervals^ 
tat should not be given in excessive quantities on account of the danger of 
fatal alcoholic coma. A ligature should be thrown around the limb or mera- 
kr bitten, if possible, and the part cut out or cauterized; if a finger, it might 
k Mier to amputate it. If not, the ligature should after awhile be loosened 
fndnally, and immetliately tightened upon the reappearance of the symp- 
iBaBft. In this way the system will be able to throw oif the poison; whereas, 
rTf«^ wh(»lo quantity were to be introduced at once, it would be overwhelmed. 
\ iiere acts, not as an antidote, but as a cardio-vascular stimulant 
w. 5- t- v.|. the circnlntion until the poison is eliminated. 

In septic poisoning — septicaemia, saprjemia, dissecting wounds, etc. — 
dtobol is considered to have an antidotal effect, and, with quinine, consii* 
tileB the ^reat rclianee for overcoming the tendency to a fatal result and 
htpuig up the strength. Alcohol is, in some measure, antidotal to the poi- 
■Bof use DaciUus tuberculosis, and it is to this action that its unquestionable 
iriov in prolonging life in phthisis is due. 

T*\^Ar^ nrid Powell' claim that alcohol is the best antidote for carbolic- 

Phelps declares it a safe and sure local application to prevent 

i I. action of tlie latter upon the s^kin and mucous membranes. 

' - ; -tiinces have Wu reported in which a fatal dose of the acid had 

1, l>ut, owing to prompt use of whisky or brandy, the patient 

(9^^ Phenol.) 

!•! not» a? the rule, be given in liver disease, nor iu nephritis. 

!• wines and malt liquors are inadmissible, but, if a stimu- 

hisky may be used cautiously, on account of the tendencj 

_w fcjj;;ijtr> ...»3^c^... . Malt liquors and sweet wines are injurious in diabetes, 

LdfT wine, whisky^ and brandy sometimes answer a useful purpose in that 

bj promoting nutrition without increasing the loss of sugar. During 

' coixTsc of a gonorrhcea or urethritis, it is customary to forbid the use of 

bol in any fonn. It should not be used in hypertrophy, with overaction 

j« heart. 

For tho relief of cancer of the breast, Hasse, in 1873 (at a meeting of 

• Mrrrk'B A rrhlcts, Dec. ISW. 



178 PHARMACEUTICAL THERAPEUTIC AOEXTS OR DUUOS. 

German Physicians' and Naturalists' Association), presented a communi* 
tion advocating injection of alcohoL The subject of the treatment of cant 
by interstitial injections of alcohol has since been reviewed editorially by I 
C. E. lie M. SuJMUs.^ Dr. Edwin J. Kuh has reported a case of pritnarv d 
cer of tlie nnso-plittrAiix cured by injections of alcohol. '• but subst'(|uently 
ports several faihires of the treatnit^nt/ 

ALETEIS. — Star-grass, Blazing-star, Mealy-starwort, Colic-ro 
ptris farinosa (Liliaceae) is an indigenous plant, the leaves of whi 
spread upon the ground in the form of a star. The rhizome contai 
starch and a bitter principle, hut appears to be free from tannin. T 
virtues of the root are extracted by alcohol. In snuill doses ulelris is 
bitter- tonic; it increases the appetite, loosens the bowels, and promo) 
the secretion of urine. In larger quantities it acts as a cathartic a 
emetic. Aletris has been used in colic, chronic rheumatism, and drop 
It is said to be serviceable, likewise., in dysnicnorrhcea. The dose of t 
powder is 0.65 Gra. (or gr. x). An infusion (1-16) is given in tablespooni 
doses. The National Formulary contains a fluid extract. 



ALLIUM.- Garlic. 

Preparation, 

SjTupiw AUii. — The syrup of ^rlic contains rt.iHc (20 pt*r cent.), with iHIu< 
acetic udd, and sugar. Dtiso, 0.00 to 4 ccm. (or wx-fSj). 

Pharmacology. — Garlic is the bulb of the Allium sativum (Liliacea 
a native of Asia and Egypt, but now naturalized in Europe and Americ 
and refi*»nib!ea the oninu and loek in its chfmicfil oharaetors. Its acti 
principle is a vohitilc, oily substance (n/?.*i jkt cent.). Garlic i.s more acti 
than the others, owing to possessing a larger proportion of the active pri 
ciple. The bulbs 'may be kept unchanged for years bj placing them in lar 
glass bottles containing a small amount of alcohol and securely closing t 
bottles by stoppers of glass or cork, as proposed by Mr. A. P. Sharp (Pn 
A. P. A., 1864). The pharmacopoeia directs that garlic should be used wit 
out being dried. 

Physiological Action and Therapy. — Garlic is antiseptic, but its effec 
are chiefly those of a stimulating expectorant. Wiile its antiseptic pro 
ertfes have been tried in phthisis without successful results, it is useful as ] 
expectorant in chronic bronchitis, or in suffocative catarrh (capillary bro 
chitis of iufjints). Here it may also be made one of the ingredients of poi 
tices to be applied to the chest, or the oil may be used externally, but t! 
offensive odor of garlic will in most families be a bar to its use. A garl 
poultice may also be successfully employed in infantile eonvulsiont?, ai 
relieves the pain of gastro-enteritis. The &>Tup is a good addition to couj 
mixtures, hut cannot be used in conjunction with alkalies, such as ammoniu 
carbonate or the bromides, on account of its containing free acetic acid. Tl 
syrup of garlic can be administered thus with service in the treatment 
bronchitis, especially of children: — 



^Monikhf Ctfrlo[iafliti of Prartiral Mcdivinr, Jan.. 1898. 

' Mrdirni Rrront. April IT. l!^I>7. 

' Philadciphia Mcilk-al JounmK Mny 28, 1808. 




ALLIUM CEPA. 

B Symp. ftUii 60| c.cm. or fjij. 

MC ether, nitroei, 

GljrccTiBi aa 30| c.cm. or fjj. 

IL Si^. : From od« to two teAApoonfuIs in water every hour or two. 

B Syrup. alUi 901 c.cm. or fjiij. 

SjTu^ picis liquidK 00{ c.cm. or fJij. 

Jft. S%.: A tfiAflpoonful or two in water every two or three hours. 



179 



The jnice of garlic in the dose of 2 to 5 drops has been given for the 
TTous vomiting. 
.^, like the onion, has antiscorbutic effects, and is a stimulant car- 
Dose, 2 Gm. (or gr. xxx); best given as a syrup. It is destructive 
icoid or round worms. It is also etHcient against ascarides when 
I iffumistergd bv the rectum. Garlic is a domestic remedy in whooping- 
and t garlic potiltice applied to the perineum is said to relieve 

AUyl-tribrozmde. — This compound, otherwise known as tribromhydrin, 

ely pelait-d to the oil of garlic, is a colorless or faintly-yellowish fluid, 

has a specific gravity of 2.43, solidifies at 50° F., and boils at 422'' F. 

fl-txibromide dissolves in ether, and in 5-drop doses, inclosed in capsules, 

been given with advantage in various spasmodic affections, as hysteria, 

whooping-cough, infantile convulsions, and angina pectoris. 





ALLTUM CEPA. — The onion (Liliacese) is cultivated everywhere, and 

lb is commonly used as a food. Onions are also largely used in 

practice as a cataplasm for "earache" or for acute bronchitis; 

kdded to sugar and water and given as a cough-syrup. Parkes 

^Practical Hygiene'*) states that "on account of its volatile oils the onion 

tzibe ia largely used, and is a capital condiment, and has an effect as an 

asdacarbatic." The oil appears to be identical with that derived from 

fuiic, (CjHjjjS. Onions contain phosphoric acid, citrate of lime, mucil- 

and sugar, in addition to the allyl sulphide. 

AccordLig to the careful studies of Dr. Pilacki, the consumption of 
causes a decrease of the assimilation and metabolism of nitrogenous 
tarial. 1*he assimilation exceeds the loss of nitrogen. The urine is gen- 
crallj increased. The diminished assimilation may be due to the injurious 
^ <ifc c t of large quantities of onion upon the gastric juice and digestion, 
^^^ft Popoff has shown that onions neutralize the acid of the gastric juice, 
^^^n «mu]I quantity, however, onions promote digestion. Onions, and 
^^Bt ^^arlic, produce a decided augmentation of secretion of bile. In 

^^■et;d ^ivnt dependence is placed on the onion as a prophylactic against 

W^ '* oints out that, owing to the large proportion of sulphur 

rkirb it t .the Spanish onion may be satisfactorily employed in 

cases oi skin disease in which it is desirable to administer sulphur. 

ae action of the volatile constituepts enhances that of the sulphur. 

B«ile<l Spanish onion, eaten freely at bed-time, is an excellent laxative. 

iIV author mentioned values the onion particularly in chronic catarrh of 

larger respinlory tubes. According to George Covert, sweet milk 

MXt* the ouor of onion from the breath. 





180 PH^VRMACEUTICAL THERAPEUTIC AGENTS OR DRrG8. 

The raw sliced onion can be used as a counter-irritant; ita volatil 
constituents are especially irritating to the conjunctiva. 

ALNITS. — Alder-bark. The bark of the American alder or tag-aldei 
Alnus serrulata (Betulaceje), contains tannic acid, a resin, and an oil. I 
is used for its astringent effects, chiefly in the form of Huid extract or in 
fusion (diluted freely), as a mouth-wash for spongy gums, a gargle fo 
sore throat, an injection in leucorrhoea, and for applications to ulcers 
Internally, it has been given in diarrhoea and hajniatuna. It is reporter 
to have alterative effects, and has been used successfully in scrofula, syph 
ilis, and some cutaneous diseases. The dose of fluid extract is 0.6 to 2.i 
c.cm. (or mx-xl). Alnuin, an alcoholic extract, compulsed principally of th 
resin, has been empluycd internally in doses of U.065 to 0.20 Gm. (o 
gr. i-iij). 

ALOE (U. S. P., B. P.).— Aloes. 

ALOE PURIFICATA (U. S. P.).— Purified Aloes: a Strained Alcoholl 
Extract. 

Dose, 0.065 to l.:3Cl Urn. (or gr. i-xx). 

17. S, P. Preparations. 

Aloinutn.— Aloin. Dose, 0.006 to 0.13 Gm. (or gr. 'A^-ij). 

Extractura Aloea.^Extract of Aloes. Doac, 0.03 to 0.32 Gm. {or gr. ss-v). 

Pilulas Aloes. — Pills of Aloes. Dose, 1 to 6 pUls, 

riliila? Aloes et Ferri.— Pills of Aloes and Iron. Dose, 1 to 5 pills. 

Pilulte Aloes et Mastiches. — PilU of Aloes and Mastic. Dose^ 1 to 5 pilU. 

Pilulre Aloes et Myrrhee. — PilU of Aloes and Myrrh, Dose, 1 to 5 pills. 

Piliila? La\aliv:t LoinpiisitiP. — Ccnipoiind Liixutive Pills (aloin. i^. '/j; bella 
donnu exi.. gr. V»; stryelmiue, ct. Vm? ipocnc, gr. Vn; glycyrrliiza, gr. 'Z^, each pill) 

Pilulffi Rhei Compositne. — Compound Pills of Rhubarb. Dose, 1 to 5 ptlls. 

Tinedira Aloes. — Tinrtiir^ of ANips (1(1 per rent.). Dose, 7.50 r.cm. (or 3ij). 

Tinctura Aloes et Mynhec. — Tincture of Aloes and Myrrh (of each, 10 pe 
cent.). Dose, 2 to 7.50 c.cm. (or f5s3-ij). 

B. P. Preparations. 

Aloinum. — Aloin. Dose, 0.03 to 0.13 Gm. (or gr. ss-ij). 

Extractum Aloes Barbadensis. — Extract of Barbadoea Aloes. Dose, 0.065 tc 
0.26 Gm, (or gr. i-iv). 

Pilula Aloes Barbadensie. — Pill of Barbadoes Atoes. Dose, 0.25 to 0.50 Gm 
(or gr. iv-viij). 

Pihila Aloes Socotrinte, — PHI of Socotrine Aloes. Dose, 0.25 to 0.50 Gm. (oi 
gr. JT-viij). 

Pilula Aloes et Asafcetidie. — Pilt of Aloes and Asafetada. Dose^ 0.25 to 0.5G 
Om. (or gr. iv-viij). 

Pilula Aloes et Ferri. — Pill of Aloes and Iron. Dose, 0.25 to 0.50 Gm, (or gr. 
iv-viij). 

Pilula Aloes et Myrrha*.— Pill of Aloes and Myrrh. Dose, 0.25 to 0.50 Gm. (oi 
gr. iv-viij). 

Tinctura Aloes. — Tincture of Aloes. Dose, 2 to 4 c.cm. (or fSss-j) for repeated 
administration; for single administration, 6 to 7.5 com. (or fSiss-ij). 

Decoctum Aloes Coniposiluni (B. P.), or Baume de Vie, contains about 0.25 Gm. 
(or gr. iv) aloes to 30 c.cm. for fjj), with cardamom, licorice, saffron, and myrrh. 
Dose, 15 to CO c.cm. (or fSss-ij). 

Aloes also enters into compound extract of colocynth and compound tinctura 
of benzoin (U. S. P., B. P.) ; compound pill of colocynth (B.P.) ; compound 
pill of liyoscyamus (B. P.) ; and compound pill of gamboge (B. P.). 




ALOE. 



181 



Plurmacology. — Aioe is tht- in^jiisgated juice of tlie leaves of Aloe vera, 
Ji^^ ^ .in.-M-t>. and AW Perrvi (Liliaceie). Owing to the fact that aloe 
6v^aar -.uas foreign matters, the. United States Pharinacopa»ia directs 

IhA h*T -\'^ proparations?. purified aloes only should he used (ohtaiued 

ly diasoiving commercial h\ol^ in alcohol, parsing the solution through a 
foxiDrr, and aUowing the alcojiol to evaporate). This occurs in dark 
9mmi» of « yt'Uowiish-hrown color, the fracture presenting a liver-like ap- 
peimirc *•--.> sometimes called hepatic aloes). It ha^? a very Litter 
iHlr. b- in alcohol, Icj^s cioluhle in water (unless boiling), and cxin- 

lKn» Aioui emodin, a trace of volatile oil, and a resin, Barbadoes aloes and 
dp* ■ioi'? i-nch contains a special variety of aloin. known as barbaloin and 
ttUloin)» which may lie distinguished by tests from thut present in Soca- 
tnae «i<»^^. which is called socaloin. They are now equally othcial. 

Aloinum ^U, S. P., B. P.). or Aloin, is a neutral principle obtained from 
Urcral Tarietiee of aloes, chiefly Barbadoes aloes (yielding barbaloin) and 
fiwnfiii or 21aiizibar aloes (yielding socaloin), dilfering more or less in chem- 
iai compoeitioii and physical properties according to the source from which 
ft tt derived. It is a yellowiph-white, or bro^^-nish crystalline substance, solu- 
Uff m hot water and alcohol, sparingly soluble in ether, chloroform, and 
hosoL It 15 of neutral reaction, destitute of odor, and its taste, which is 
•Bfttiah at first, subsequently becomes very bitter. 

XlijBiological Action. — The principal etfect of aloes is that of a slowly- 
purgative^ principally affecting the large intestine. It increases the 
"Ltic movements without producing excess of secretion; so that the 
formed and only slightly softened. It is a true cholagogue, in- 
mMJTH]^ the secretion of biliary salts, and renders the bile more watery when 
pTtn in large doses. As it sometimes gripes, it is best to combine some 
^eminatiTe with it. It may cause irritation of the bladder, diminution of 
Kae, and albuminuria from renal congestion. It also has emmenagogic 
Moperties. Following large doses, the uterus and appendages are more or 
W in a fttate of congestion and hiemorrhoids are apt to be irritated. If 
ibm has been an overdose and these symptoms are aggravated, it would be 
■rfiiii III to give large draughts of demulcents, and an anodyne in the form 
d ui opinm etippoaitory. It is stated that such phenomena do not follow 
fte adsoinietration of aloin, which requires only about one-third or" one-half 
it doM in order to produce the physiological effects of aloes. 

The chemical and physiological investigations of Professor Meyer seem 
Si a>dh ' 't aloin itself is not an active purgative, but that it becomes 

piadisa! inpot^rx^ in the intestine into emodin, or trioxymethylan- 

ttnfvinone. It is tliought that this may account for the slowness of its 

Powdered aloes, dusted upon an abraded or blistered surface, may be 

Krferbrd and exert a purgative effect. Aloin has been detected in the urine. 

Thsnpy- — Aloes, or aloin, is a slowly-acting purgative, and, therefore, 

^mJd generally he administered at bed-time; in this way it operates during 

and gripingifi avoided. For the same purpose it is well to combine 

ith a carminative, as in the compound decoction, or the compound rhu- 

pill, which J8 a useful purgative for an ordinary attack of constipation. 

TW fnllowing are likewise excellent formulfe to use in the same class of 




182 PHARMACEUTICAL THERAPEUTIC AGENTS OR DHrOS, 

a Vini aloes, 

Fluidext. rharani purahianae aa 221 ccm. or f3vj. 

Elix. aromatic q. 8. ad 180| c.cm. or fjvj. 

M. Sig.: A tables p 00 niul morning and erening. 

B Alo€s purificatffi 121 Gm. or 3iij. 

Pulv. glycyrrhizee comp 124] Gm. or 5iv- 

M. Sig.: From one-half to three teaspoonfulB in water or milk, early in the mom- 
iog or ou retiring. 

Kohlstock has experimented in the clinic of Professor Senator^ of Berliflj 
with aloin and other cathartics applied locally to the rectum. The aloin was 
dissolved in a small quantity of glycerin and subsequently in formamide, 1 
Gm. (or gT. iv) of the former to 10 Gm. (or gr. cl) of the latter. A do8€ 
representing:, of the aloin, 0.38 to 0.50 Gm. (or gr. vi-viij), was found effi- 
cient, in all mild cases of constipation. 

The pill form is also useful for the expulsion of ascarides, which are 
apt to lodge in the ca?cura. With this may be combined injections of aloes ir 
solution (4 Gm. to 473 c.cm., or 3i-0j} and irrigation of the bowel. For the 
latter purpose, in young children, a soft catheter can be inserted beyond the 
sigmoid flexure of the colon.. In aniemia affecting young girls (chlorosis) Sii 
Andrew Clarke claimed that constipation has much to do with its causation: 
he called it fsecal intoxication. Here aloes, in combination with iron, is oJ 
much service: — 

B Aloes purificatw 81 Gm. or Sij. 

Alasase ferri carbonatia 2 60 Gm. or gr. xl. 

Pulv. aromatici 1 130 Gm. or gr. x.x. 

M. et ft. pil. no. xx. 

Sig.: Take one or two at bed-hour. 

Sir Andrew Clarke's pill is likewise valuable: — 

B Aloin., 

Ferri Bulph. exsic, 

Ext. belIadonn» ale. (B.F.), 

Ext. nucia vom., 

Pulv. ipecac,, 

Pulv. myrrh, 

Saponis' aa |03 Gm. or gr. as. 

M. et tt. pil. no. j. 

Sig.: One pill one hour before last meal, should. the bowels not act during the day 

Ipecac is omitted if there is any cardiac weakness. 

In cases of hysteria, with anajmia and constipation, the pills of aloes, 
with asafetida, may be given (3 to G daily). These have also a carminative 
effect. An atonic condition of the muscular coat of the large intestine maj 
allow its contents to accumulate, to press upon the common bile-duct, and 
obstruct the passage of the biliary secretion into the upper bowel. This con- 
dition and the jaundice which is its result are relieved by the administra- 
tion of aloes, with which belladonna and strychnine, or hyoscyamus and 
ipecacuanha, may be very usefully combined, in such formulse as the follow- 
ing:— 

Gm. or 398. 



i 



H Aloes purificat« 2 

Ext. bl'lladonna folior 

Strychnine sulphatis 

M. et ft. pil. no, xij. 

Sig.: A pill three times a day. 



065 Gni. or gr. j. 
03 Gm. or gr. ss. 




ALOE. 



183 



Ell, nurii^ vomk'ce 

Pair, ipecflcuanhae 

)t eC ft. pit no. x. 

Skg.z A pill three times a day. 



065 Gm. or gr. j. 

66 Gm. or gr. x. 
065 Gm. or gr. j. 
13 Gm. or gr. ij. 



Aloes is &n excellent emraenagogue; given for several days before the 
ttptcttd period, it is generally successful, especially when employed thus: — 



a AMau 

Mam. feiri c«rb 

ApioL 

Ji. et fL capsaUe no. xij. 

S%-: A capsule morning and evening for five or six days before the menstrual 



113 Gm. or gr. ij. 
240 Gm. or grr. xxxvj. 
4 c.cm. or 



Si. 




la scanty menstruation, depending upon anaemia, the chalybeates 
Aa«U aifio be poshed, preferably usisg the preparations of iron which are 
art <^ti«tiDating, such as the dialyzed iron, or the carbonate, or pyrophos- 
phs' r than the sulphate, which is contained in the oflBcial pill. When 

indigestion is caused by deficient secretion of bile, aloes is of spe- 
loc and enjoys a reputation as an ingredient in **dinner-pills" of many 
Where the mental symptoms of dyspepsia — drowsiness, depression of 

S" ts, or melancholia — are marked, the use of a good aloetic pill imme- 
dj after dinner is often effective. 
ui cases where there are hieraorrHoids, the aloes sometimes irritates 
&cm ; under such circumstances the proper course to pursue would not be 
li neglect such a valuable remedy, but to operate surgically upon the piles 
ad remoTe them. The passive turgescence of the inferior hsemorrhoidal 
voada, however, is not infrequently relieved by the use of aloes. Whitla 
Maks of having obtained surprising results in obstinate diarrhoea in ehil- 
on OT "■ *■- from the administration of a few 30- to 60-c.cm. (or f.v-ij) 
4flMS o: mjx>und decoction of alcK?s (B. P.). We may prescribe the 

loflorving. fur an adult with obstinate diarrhcea: — 



M Aknsi 

Salpliuris subl 6 

Est. IwlUdonxui folior. 

Si. d ft, eapsulff no. xx. 

Q^: A capMtle three times a day. 



13 Gra. or gr. 
50 Gm. or gr. 
13 Gm. or gr. 



I 



In snsall doees aloes acts as an hepatic and intestinal tonic. Where diar- 
A«n is nsaintflined by the action of germs of fermentation, the increased 
Ibv of bile exerts an antiseptic effect and the diarrhoea may be checked after 
tprehminarj purge; although the rule is that, where diarrhoea is due to irri- 
from abnormal condition of the contents, the cause of disturbance 
he removed by a more prompt cathartic, such as sulphate of magnesia 
\m the citrate) or by nn antiseptic purgative like calomel or blue mass. 
Aloetic purgntives should be usea with care during pregnancy and lactation. 
TW ndUr of women talcing aloes will purge babes whom they suckle. Aloes 
mar h^ iia«M! as a derivative in cerebral disorders. 

ji 't» of aloes is prepared by evaporating the tincture and adding 

- J , ..is mixture may be applied to fissures, abrasions, and ulcers. 

ter Xaete of aloes is sometimes utilized by applying a solution to the 

:z£tT-<ads of children in order to break them of the habit of biting their 



mmtM 



184 PHARMACEUTICAL TFIERAPEUTIC AGENTS OR DKIOS. 

nails or suckiiig their thumbs, or to the nipple when it is desired to weai 
an infant, \rhich is unnecessary cruelty. The compound tincture of benzoli 
contains 2 per cent, of aloes. This fact should be borne in mind when treat 
ing cracked nipples with this preparation, as the infant may be weaned to( 
early. 

AIPHOZONE.— DiBuccinyl Peroxide, or Succinic Dioxide (('(K>H 
Cir.( H.t'n )^,( »^. A iii'W ly-uilnMluri'st clifinical (Mim|POUiHi, wirit poworfu 
germic'iile proptTties, diseovernl liv Pidf. A. M. ('ln\cT, of tlu' I'uivL'rsitj 
of Michigan. It is a. wliito, crystalline powder, soluble in about iMt parts ol 
water, fidorless, and with sliglit bitter imte. In fombinntion with water ii 
undergoes bydrolysis, and forms succinic perucid. It is claimed to he equa! 
to mercuric bichloritlc as a germicide. It is usc<l in W^n ^^ '/noo polution at 
nrj exteninl application. It has also licen userl internally, Ijotli as a gargU 
and tu lie swaltowi'd, in ly[>]ioid and other iurccuous diseas^e^i. Dose, 0.12 
dm. (or gr. ij). in half a glassful of water. 

ALTH^A (U. S. ?,).— Mar&hmallow. 

Preparation. 
SjTupus Althfwe. — Syrup of Altheea (5 per cent.). 

Pharmacology. — Tbi- drit^d rrxtt nf Altluea nflieinnli^ < Mi'l^'^<'<?"P}T ^^^' 
lectcd froni plains (d' j^ccnnd year's *,^rn\vtli. and deprived iff it^ pfridenn. It 
conlains a nuu ilnginous [iriutiple, with about 'J ]K-r cent, of asparag^, but 
no tannin. Altha>a is a constituent in uiassa hydrargyri (blue mas^s) and 
pboftplionis pills. 

Therapy. — The powdered root treated with hot water may be used as a 
poultice. It is slightly diuretic, on account of the asparagin, which would 
make it of service in children's diseases in the form of a fresh infusion, espe- 
cially in Bright'e disease. The confections are usefiil in sore throat, in scar- 
latina, and diphtheria. The syrup is an agreeable addition to cough-mixt- 
ures. Dose,, indefinite. Althfea combined with benzoinatcd lard is a bland 
dressing for skin diseases. Asparagin has been recommended as a diuretic 
in gout and cardiac dropsy, in doses of 0.065 to 0.13 Gm. (or gr. i-ij). 

ALUMEN (U. S. P., B. P.).— Alum (AlaKjCSO,], + 24HjO). 

Preparations. 

Ahintini Hydroxidum (I*. S. V.). — Aluminum Hydroxide. lk»»e, 0,20 to 1.30 
Gm. (or jrr. iii-xx). 

Aluniini Sulphas (U.S. P.). — Aluminum Sulphate. For external use. 

AUimen Exsiccatum (U.S. P., B. P.). — Dried Alum (alumen usturn, or burnt 
alum). Dose, 0.(105 to 0.32 Gm. (or gr. i-v). 

Glyocrinum Aluminis (B. P.).— Glycerin of Alum (about 13 per cent.). 

Pharmacology. — The U. S. P. alum is potassium aUun (r'.uitniuing not 
less tbau 9*:V /.^ per cent, of pure aluniinum and potaseiuui sulpliate). The 
"Britisii rhiiniuuopivia rocogui/.ts \h){]\ ptttassium alinn and anunouium alum 
(nluiuinuni ami auurinuiuni sulphate^. Alum is in tlic fonn of tran>luront, 
wliitf, nctubcdral crystals, with a pwwtish, njitrin^a'ut ta.^^tc and acid reac- 
tion. It contains water of crvstallization, which tan Itc driven off by heat. 





ALl'MEK. ^^^^^^ 185 

.?r;.^! iiluiiK AinitiQQia uJum, which wa* formerly the official alum, 

the same pn^jwrties, and is often dispensed for alum. The 

fmi-jmiT-<uni Is not officifll. In ai>penrance it is like silver, hut is much 

mod in«re durable; is us<*ful for making surgicsl and household 

Ffcynological Action. — Dried alum is astringent, and is a mild escha- 
:iot fungous ^rranulations. The glycerite (20 per cent.) is useful in cases 
rf toasillitifi or pharyngitis of subacute character. In solution alum con- 
4aM« tuKues by coagulating their albumin, and acts as an astringent. 

Xkenpy. — It checks excessive sweating in phthisis when applied with 
ftifon^ (4 Gm. to 473 c.cm., or 5i-0j of whisky and water). It is used as an 
, in leucorrhcea and in gonorrhoea, and a watery solution of the glyc- 
im useful ftfi a collyrium in conjunctivitis. In the latter affection alum- 
netixnea applied (2 Qm,, or oss, beaten up with the albumin of a 

In chronic granular conjunctivitis. Dr. W. T. Montgomery, of Chicago, 
use of: — 

B Ctopri sulpha t., 
ZlBct sulphat., 
Frrri salphat., 

PAiuttints aa 132 Gm. or gr. v. 
Aq. ilcvtfl 30| com. or fjj. 
v. S^.t Brush upon the inside of the lids once daily. 

Applied locally in the form of powder or saturated solution, alum is an 
wariknt stTptic. A most useful alum stvptic combination is the follow- 

R A :i: jT.i.. (rhcerini, »B. P.), 

AlfohrlM, 

Lia. ■aponis sa ftO| c.cm. or fS>j-^M. 

Compresses soaked in the preparation just formulated, or a solution of 

Abv mar be nsed to restrain capillary hsemorrhage from wounds, bleeding 

h^ thm gmns, or leech-bites. In epistasis a plug of cotton moistened in 

,4^ft-«Stcr amy be passed into the nares; a solution may be thrown in by 

imMiaa or ponrdered alum may be snuffed. These measures will frequently 

Csvoccssfnl. In ciironic pharyngitis, tonsillitis, and nasal catarrh the 
Klioo of powdered alum is bene^cial. A prescription composed thus is 
^kicffertual:— 

ft FWvol liqurfacti 118 C.cm. or ;/iiij. 

AtomlnU ^lycoriin 901 c.cm. or fjiij. 

nrtBoliB ioUitIi 2| Gm. or 3«s. 

;e App\j with cotton or a cfime|*s-hoir brush once or twice a day over 




Ji mmj aliKi be used in solution as a gargle with good effect. The local 

I of a solution of alum is of benefit in cases of mercurial ptyalism. 

I asserts that garjbrling the throat with 4 to 8 Gm. (or oi-ij) of alum, 

J»ed in about ISO to 210 c.cm. (or ovi-vij) of a decoction of barley with 

'tUition of 7.50 c.cm. (or foij) of honey of roses, is a serviceable practice 

dte caar of speakers and singers, shortly before using the voice. 

Aa injection of alum is a serviceable astringent in haemorrhage from 



L 



180 



PUAR.MACEUTIC.VL THEKAPEUTIC A(iKNT8 OK DKL'Oa. 



the rectum or \r\ gonorrhcea. 
mended: — 



For gleet, the following formula is recon 



IJ Pulv. aluminia 81 

Fiviidext. geranii 15 

Aquffi roaffi 135] 



6tn. or 3ij. 
ccm. or fjBs. 
c.cm. or fjivas. — M 



Tu tJie vulvitis of cl^ildren^ n p-Dlution of n drfiulim of alum to a pint • 
water is a serviceable local application and may from time to time be nst 
ae an injection. A solution of 0.65 to 473 c.cm. (or gr. x to the pint) ifi 
useful injection in chronic cystitis, as it relieves vesical pain and frequem 
of micturition, while decreasing the production of ropy mucus, 

A lotion containing alum may be successfully employed in the prolapse 
bowel of children. From 4 to 8 Gm. (or 5i-ij) of alum to 473 c.cm. (or a pii 
of water, or alcohol), is a beneficial application in hyperidrosis. It is sa; 
that 0.65 Gm. (or gr. x) of alum, placed upon the tongue, will sometini' 
arrest a paroxysm of asthma (Ringer). According to Ringer, many cases i 
chronic oziena are rapidly relieved by irrigating the nasal chambers with 
solution containing a drachm of alum to the pint of water. The discharge 
checked and the foetnr removed. Pruritus of the vulva sometimes yields to 
hot alum solution. The local astringent action of this substance is sometim 
found beneficial in purpura. An ointment containing alum is often useful 
herpes, and the same preparation removes the offensive odor of bromidrosi 
The following formula are of service in the diseases just named: — 

R Pulv, aluminia 41 Gm, or 5j. 

Ptienylis stalicylHtis 21 Gm. or 3s8. 

Bismuth, subnit 4 Gm. or 3]. 

Ungt linci oxidi 31 1 Gm. or Sj. — M, 



B Tulv. nluminis 15 

Glycerini 30 

Aqufp hamamelidiB 150 



5 Gm. or 5*9. 
c.cm. or f5i- 
p.cra. or fjv. — M. 



In chilblains, also, a solution of alum has been used with asserted a 
vantage. 

As an emetic in croup, a heaping teaspoonful of alum may be dissolvi 
in 120 c.cm. (or f'iv) of simple syrup, of which a teaspoonful is given eve 
fifteen minutes until vomiting is produced. It is useful in bronchorrho 
and in whooping-cough, especially where the secretion is excessive. Givt 
internally, alum checks haemorrhage and profuse discharges. "WTiitla esteen 
it the best remedy in haemorrhage of the bowel due to typhoid fever. It nu 
be given with good result in the ha?matemesis dependent upon chrhosis 
the liver and in haemoptysis. The local action of alum may be aided by i 
internal administration in the night-sweats of phthisis. It checks excessi' 
production of mucus in chronic gastric and intestinal catarrh, and it reliev 
the pain of gastralgia and enteralgia. Alum is an efficient remedy 
some fonns ofdiarrhren. 

Clysters containing alum have been successfully employed in chron 
dysentery, and even in the acute form of the disease have sometimes be( 
found of service. The drug may likewise be given internally in the manag 
ment of dysentery. 

Whitla considers the internal exhibition of alum of service in leuco 
rhcea. The following formulae are advised: — 




ALPMEX. 



187 



r 



alBminis 12 Gm. or 9itj. 

Wilph ATom. ..,..,,,., 4 p.cm. or f3j. 

.t, gvr^nii 60 c.cm. or fjij. 

9jrmp. zin^iberis 90 c.cm. or fjiij. 

X. Sg.z One to two teaspoonfula in water every half-hour or hour until hsemor- 
h mute d. For hemoptysis, hiematuria, znenorrhagia, and uterine hemorrhage. 



M Ptetr. alanunifl, 

FWBjIift saiirylatis aa 6|d0 Gm. or gr. c. 

3L ti fL cap>nlie na xx. 

Sp-: A capsule three or four times a day. Employ especially in cata.rrh of the 

■ad iVMtaUtia. 



E Potr. aluxziinia 13 Gm. or gr. cc. 

Tiact- kino 45 c.cm. or ISias. 

Tiaet. opii camph 30 c.cm. or fSj. 

Acidi sulph. arom 4 ccm. or f3j. 

Spt. Tini gallici q, b. ad 150 c.tm. or fjv. 

3C One to two teaspoonfula in water every three or four hours. Serviceable in 
iHir ^AirtKea, dysentery, and in hiematuria. 

have been reported in which alum was thought to be useful 
mellitu3. It would probably prove of more decided utility in 
i^et«« insipidus 

^^J& comparatively large doses (2.60 to 4 Gm., or gr. xl-3j) alum acts as a 
^^^pe, uid hfts been used in colica pictonum. In this condition it relieves 
I^^Ki and overcomes the constipation. I)r. Phillips speaks of its being 
miiil m other forms of gaetralgia and colic. It has proved of benefit in inter- 
: feTer in 0.32 (im. (or gr. v) dose?, although its action is not uniform 
i affectioD. Irnn-alum has been employed in intermittent htematuria. 
in the ear, a solution of aluminum acetate (25 per cent.) may be 
intr* !he ear frequently, and the canal plugged with cotton. Alum 
OS an adulterant of baking-powder, and its use for this 
un . . ...ily causes indigestion. 
Tfie aluminum salts are antiseptic and can be used as injections for leu- 
(0.65 Gm. to 30 c.cm., or gr. i-f5j)» and saturated solutions are mild 
The oleate of aluminum arrests morbid discharges when used as 
application. 

AXU1DI0L is the trade-name given to a substance discovered by 
of Bre«lau. It consists of a mixture of aluminum salts of naphthol- 
ic acid, and contains o per cent, of aluminum and 15 per cent, of 
Aluznnol occurs in the form of a fine white or light pink-colored 
frte from odor, not hygroscopic, readily soluble in water, soluble 
leaa so in alcohol, and insoluble in ether. Its solution in alco- 
odlibit? a beautiful blue Ruorcscence. The solutions possess an acid 
te of alumnol is sweetish and astringent. Alumnol pre- 
a and gelatin, but is redissolved in excess of those sub- 

It possesses marked penetrative action. It strikes a blue color 
tlntions of ferric chloride. Alumnol darkens upon exposure to the 
out losing its properties. 

logical Action. — This substance is antiseptic, astringent, and, 
trat4*d fornu caultrant. 
nxnool exerts no toxic influence, except when employed in very 






188 



PIIARMACEITILAL TIIERAPErXIC AOEN'TS OR DBUOS. 



large quantities and under very favorable conditions for absorption, 
practice, no aluminum was found iu the urine of patients who had be 
treated by large doses and for a considerable period. 

Therapy.— Aluiiinul is a fccrvitcable applicatit»n to ukors^ wounds, a 
abscesses. Jt may be used as a lotion, ointment, or jilaster. For 1 
irrigation of abscess-cavities it may be used in a 10- to 2u-per-cent. so 
tion. A 1-per-cent. solution is beneficial as an injection in gonorrhc 
and in endometritis, due to gonorrhcea, sticks or bougies containing frc 
2 to 5 per cent, may be employed with advantage. 

A 4-per-cent. solution dropped into the eye arrests the flow of tei 
for several minutes: a property which will, in certain instances, mate 
ally facilitate examination. 

Dr. Stipanics, of Budapest, has used alumnol with advantage in t 
treatment of chronic rhinitis, hypertrophic rhinitis, simple ozaena, aci 
and chronic pharyngitis, tonsillitis, etc. This writer regards the reme 
as of special efficacy in affections of the larynx. Hoarseness due to larj 
geal catarrh was speedily removed by inhalations of Vj- to l-per-cei 
aqueous solutions. Dr. Wolffberg recommends a 4-per-cent. solution i 
the purpose of cleansing the eyes in gonorrhoeal ophthalmia. By 1 
Brieger alumnol has been used with success in the treatment of purulc 
inflammation of the middle ear, 

M. Chotzen has reported his experience with this remedy in more th 
three hundred cases. He describee it as a beneficial application to cha 
cres and chancroids, balanitis, and erosions. Solutions containing from 
to 5 per cent- are of value in moist and papular eczema, acne, and furunc 
losis. An alcoholic solution of 2.5 to 10 per cent, is effective in urticar 
sycosis, and psoriasis. Incorporated with lanolin, in the strength of 2 
5, 10, and 20 per cent., it is successful in eczema, seborrhcea capitis, pso 
a.sis, and favus. In erysipelas and iupug, ahmiuol is abo employed wi 
good results. In these affections Dr. Chotzen applied the remedy accoi 
ing to the following formula: — 

R Alumnol 4| 



Adipid lanse Id 

Paraflini monis 13 

Cereajn* 2 

M. et ft. ungt. 



Gm. or 3j. 

Gm. or 3v. 

c.cm. or fSiiiss. 

Gru. or 3ss. 



Aluminum acetioo-tartaricum. — This compound occurs in the for 
of almost-colorless pieces, having an odor resembling that of vinegar, 
slightly-ncid and not disagreeable taste. It is soluble in water, but n 
in alcohol. It is chiefly used as a mouth-wash and gargle. A 50-per-cer 
solution is recommended in the treatment of frost-bite. This substan 
has been applied also as a dressing to wounds. It is non-toxic, astringer 
and antiseptic. 

Boral and Cutol. — Alumininn iinrotartrate (under the name of Bora 
and ahinuinuu borotnnnale (under the title of Cutol) have been broug 
forward as antiseptic and astrincfent preparations, suitable for use in de 
nuitolair.v. Borul is soluble, ainl cutol is insoluble, in water. Tlie latt' 
may be rendered soluble by the addition of tartaric acid> in which form 

' Ce rosin i« a nntiirnl ininornf pvi>flti»*t whidi cl"f**"ly rf^ciiiMt's nbit*' wnx. 
consistR of a mixture of solid paraRin with some oxygenated bodies, and is found 
Galida and aouthcm Utah. 




AMHOKIACUH. 18^ 

is claimed to be useful as an injection in gonorrhoea. Gutol has been em- 
ployed with alleged success in facial erysipelas. 

Aluminum boroformate. — This compound is made by heating to- 
gether boric acid, formic acid, and alumina. It occurs as large crystalline 
scales, soluble in water, contains 33.5 per cent, alumina, and has been used 
as a substitute for other preparations of aluminum. A solution of boro- 
fonxiate, saturated with ammonia and evaporating the clear fluid, consti- 
tutes aluminum ammonio-boroformate. 

Sozal. — Under this name an organic salt of aluminum has been in- 
troduced for use as an antiseptic application. Sozal is obtained by dissolv- 
ing aluminum hydrate in phenol-sulphonic acid. It is a crystalline sub- 
stance, readily soluble in water, glycerin, and alcohol. Sozal has an astrin- 
gent taste and a faint odor of carbolic acid. A 1-per-cent. solution was 
found beneficial as an injection in abscess, tuberculous ulcers, etc. 

ALVELOZ is the milky juice of Euphorbia heterodoxa, belonging to 
the Euphorbiacese: a native of Brazil. The usual irritating effects of the 
juice of plants of this genus is very marked in alveloz, which is said to act 
as a caustic upon the skin verv much like zinc chloride. It has been used 
in treating cancerous and syphilitic lesioiis with asserted success, and the 
application is comparatively painless. 

AMBEAQBISEA. — Ambergris is an odorous, fatty substance, found 
in large masses floating upon the water, and is believed to be produced 
in the intestines of the spermaceti-whale. It has a consistence like wax^ 
softening at the temperature of the hand, and melting below the boiling- 
point of water; it is almost entirely volatilized by heat, and is inflammable. 
In composition it is like cholesterin, and is not aaponifiable. It is believed 
to have some antispasmodic effects, and is official in the French Codex as- 
a 10-per-cent. tincture. Ambergris is used in making perfumery. 

AMmOFOBM. — A trade name for Hexamethylenamine. 

AMMOHIAGUM (B. P.).— Gum Ammoniac. 
Dose, 0.32 to 1 6m. (or gr. v-xv). 

Preparations. 

Emplastrum Ammoniaci cum Hydntrgyro (B. F.), — ^Ammoniac and Mer- 
nirr Pla»teT (contains ammoniac, 2 oz.; mercury, 3 oz.; with olive-oil, 56 grains; 
and sublimed sulphur, 8 grains). 

Mistura Ammoniaci (B. P.). — ^Ammoniacum Mixture (ammoniac, 6; syrup of 
Tohi, 10; distilled water, 150). Dose, 16 to 30 c.cm. (or f5as-j)- 

Emulsum Ammoniaci (not off.)> — ^Emulsion of Ammoniac (4 per cent.). Dose,. 
4 to 15 ccm. (or f3i-iv). 

Pbarmacolofi^. — Ammoniac is a gum-resin obtained from Dorema Am- 
moniacum (Umbelliferse), containing a volatile oil. It occurs in the form of 
t€are, of variable size, hard and brittle, having a faint, unpleasant odor and 
& bitter-sweet, somewhat acrid, taste. It forms a milky emulsion when 
rubbed up with water. 

Therapy. — ^It is a stimulating expectorant and laxative, and resemblea 



190 PELiaMACEUTICAL THERAPEt'TrC AOEXTS OR DBCG8. 

asafetida in its effects upon the system. It has been used, with alkaliei 
relieve chronic bronchitis and asthma. It is especially beneficial in chr 
bronchitis associated with emphysema, or occurring in aged persons, 
algid stage of cholera has beun treated in tlie Fiume Hospital by gum 
raoniac intemal]>% conjoined with stimulants and the hypodermic injec 
of ether. Warm baths were also administered. The piasters are usefu 
glandular and joint swellings. By fusing ammoniac and other resins ^ 
caustic potassa resoroin is obtained, which is a valuable antiseptic 
official. 



1 



AMMONIUM. — AnimoniixTO has not been isolated and is known on] 
its corabiuations. which are numer<n]s and important. According to Amj 
its constitntirin is Xfl^; it is therefrtre a compound radical, and as sue 
forms permanent salts whicb are analogous to potassium snUs. Amnii 
(XHj,) is a gas, which can be liquefied by pressure. It is soluble in water 
m alcohol. 

U, S. P. Preparadons (Liquid). 

Aquft Ammoniffi. — Water of Ammonia (containa 10 per cent, of gaieous as 
nia). Dose, 0.12 to 0.60 c.cm, (or mii-x). 

Aqua Ammouise Fortior. — Stronger Water of Ammonia (28 per cent, gas 
anmionia). External use. 

Lininicntura Ammoniffi.^Liniment of Ammonia {ammonia-water, 35; alci 
6; cotton-seed oil, 60 com.). For external use. 

Spiritus AmmonisB. — Spirit of Ammonia (10 per cent.). Dose, 0.30 to 1 < 
(or mv-xv). 

Spiritus Ammonife Aroniaticufl. — Aromatic Spirit of Ammonia. Dose, 2 iA 
c.cm. (or fSsa-ij). 

Liquor Ammonii Aoetatis. — Solution of Ammonium Acetate. Spirit ol 
dereniB. Dose, 4 to 15 c.cm. (or f3i*iv). 

Tinctura Guaiaoi Ammoniata. — Dose, 2 to 4 c.cm. (or i»xxx-lx). 

Tinctura Valeriame Ammoniata, — Dose, S to 4 c.cm. (or tSss-j). 

B. P. Preparations (Liqtiid). 

Liquor Ammoniae. — Solution of Ammonia (contains 10 per cent., by weigh 
ainiHitnia. NH,). 

Liquor Amnionise Fortis. — Strong Solution of Ammonia (32.5 per cent, 
weight, of ammonia, NH,). 

Liquor Ammonii Acetatis. — Solution of Anunomum Acetate. Dose, 7.5 t 
c.cm. (or f3ii-vj|. 

Liquor Ammonii Citratis. — Solution of Ammonium Citrate. Dose, 7.5 t) 
c.cm. (or f3ii-vj). 

Spiritus AramoniiE Aromaticus. — Aromatic Spirit of Ammonia, Spiritus An 
ni« Compositus, Spirit of Sal Volatile. Dose, 1.20 to 2.40 c.cm. (or tnxx-xl), 

Spiritus Ammonia; Fcetidus. — Fetid Spirit of Ammonia. Dose. L20 to 2.40 c 
(or m.xx-xl). 

Linimentum Ammonite. — Liniment of Ammonia (solution of ammonia, 25 a 
almond-oil, 25 c.cm.; olive-oil, 50 c.cm.). 

Ammonia is contained in several of the B. P. official tinctures, also in the 
moniated Liniment of Camphor. 

Official Solid Preparations, 

Ammonii lodidum (U.S. P.). — Ammonium Iodide. Dose, 0.32 to 0.65 Gra. 
8T. v-x). 

Ammonii Salicylas (T. S. P.). — Ammonium Salicylate. Dose, 0.13 to 0-65 
(or gr. ij-x). 



Tit OX 




AMMOXU'M. I'Jl 

AimmmSk V«Wrku <U* S. P.). — Ammonium Valeriatc. Done, 0.13 to 0.32 Cim. 

AsMooii Benzoas (U. S. P., B. P.)— Ammoniuzn Ben2o«t«. Dose, 0.13 to 0.05 Gm. 
ivfr. O-ZK 

AflUMMui Bromidum (U. S. P., B. P.).— Amznonium Bromide. Do«e, 0.66 to 1 Gm. 
MT^. x-rr). 

ABAOttli OtrboDM (U.S. P., B. P.). — Ammonium Carbonate. Dose, 0.13 to 0.32 
m UDGm, lor gr. ii-v or xx). 

AjMbOttii Chloridum (U. S. P.» B. P.).— Ammonium Chloride. Dose, 0.32 to 1.30 

Trc>«<!iii*ci Ammonii Chloridi {U. S. P.). — Troches of Ammonium Chloride. 

•:iiTryTTfamnum Ammoniatum (U.S. P.), — Ammoniated Glycyrrhixin. Dose, 0.03 
ia 4Jtt titn, { or gr. &a-v ) . 

Hj^r%rgjTum Ammoniatum (U.S. P.). — Ammoniated Mercury, White Precipi- 
ate. Uanl only externally. 

Anmottii Pbospbaa (B. P.). — Phosphate of Ammonia. Dose, 0.32 to 1.30 Gm. 
MTgr. T-xa). 

Pharmacolagy and Physiolo^cal Action. — Ammonia is a gaseous body, 
rritating, even suffocating, to tlie air-passages, and may cause acute 
3£u2imation with cedema of the glottis. It stimulates the trifacial nerve, 
the blood-tension by reflex action upon the vasomotor centre, and 
Its syncope. If applied to the skin it is rubefacient, and, if diffusion 
ta ptrrented, it vill soften and vesicate the skin. The strong solution also 
fmncef Tecication and softens the cuticle. Ammonium chloride, on the 
«tber handy is cooling and absorbent. The chloride, after absorption, hastens 
•wth^hsl proliferation of the bronchial mucous membrane and liquefies 
lEKkcned mucoiifi secretions. The carbonate is probably decomposed in the 
^fstire tract, and its effects are identical with those of the gas or of aqua 
•sBKmia in stimulating the heart and circulation. 

Ammonui acts upon the ganglionic nervous system especially, and has 

toU effect upon the higher centres, thus differing from alcohol. It in- 

fmmes the functional activity of the spinal cord and is a promptly acting 

ODdiae stimulant. Its accelerator nerves and the heart itself are stimulated 

tTns«'dicinal doses of ammonia. Blood-nressure is moderately increased, but 

• j-^r .^>?es ammonia interferes with the oxygen-carrying power of the red 

Wood-corpuscles, and if long continued produces emaciation. Ammonia 

I'hsiir stitnulates the respiratory centre. In small doses the aromatic spirit 

^■BUBonia act£ as an antacid and a carminative; but the protracted use of 

mijiinis. by neutralizing the gastric juice, enfeebles digestion, and may 

4r«finste gastro-intestinal catarrh. Injected into the blood-vessels, the 

ll«od-corptiscles are liable to become dissolved, and after death the blood 

■Baxna naid. Ammonia likewise assists in maintaining the solution of the 

Ana of the blood. Such injections are likely to be followed by vomiting. 

TW carbonate mav be given for the same purpose by the mouth, but, in large 

^asa is apt -*: vomiting. Ammonia increases the secretions not only 

M the bron jcous membranes, but also the intestinal, and may set up 

Aafrbcea. '1 he volution of ammonium acetate acts upon the skin, especially 

afsrar. AmmoDia has no special action upon the kidneys, except that the 

vca is increased by oxidation of ammonia, according to the observation of 

f« lu.^.^ Jonea, who also found that nitric acid made its appearance in the 

the administration of ammonia or its salts; it is eliminated espe- 

': ' hroncho-pulmonary tract, and skin. Ammonia pos- 

virtues. 

Poiwning. — Aa the ammonia-water, or "spirit of hartshorn," is found 



I 



193 PHARMACECTICAL THEBAPEUTIC ACENTH OR DRVOS. 

in every household, cases of poisoning by accidental swallowing not ra? 
occur. When the stronger solutions are swallowed, there is great distres 
burning pain along the oesophagus and in the stomach, with choking senw 
tions from inhaling the gas or the admission of a few drops into the laryn 
After death there are evidences of softening and acute inflammation of tl 
stomach. 

Treatment. — Vomiting is likely to occur immediately, but if not, tl 
administration of large quantities of bland liquid, such as water, oil, or mil] 
would be serviceable, and if the solution of the gas has been taken it ms 
be neutralized with vinegar or lemon-juice. Treatment should be prompt! 
instituted in order to avoid such a degree of inflammation as would prodm 
stricture of the oesophagus. If the patient is in a state of shock, warm i) 
fusion of cofiee may be administered by the mouth or rectum and tinctu] 
of (ligitalifi, or strychnine given hyiJoderniically. The diet should be liquii 
only. 

Therapy. — The local uses of ammonia have been already intimated. ] 
sprains, bruises, and old rheumatic swellings the liniment is of service, esp' 
cially if some oil of turpentine or chloroform be added. 

The water of ammonia may very serviceably enter into the compositic 
of a stimulating application iu nloperia. In the iK'ailacho, whirli attends di 
ordered nuMiptnialion or the menopause, Dr. Tilt lias seen Uaspail's si<?dati^ 
lotion afford much relief. This preparation contains 60 c.cm. (or f'ij) < 
stronger ammonia, 62.2 Gm. (or ^ij) of common salt, 9.2a c.cm, (or foiiss) * 
spirit of camphor, and 1 litre (or Oiif,>ij) of water. The liquid may be appli< 
upon a sponge or linen cloth. Weak solutions of ammonia will sometim 
relieve the itching of urticaria. For this purpose 7.5 c.cm. (or foij) of tl 
official water of ammonia may be added to a pint of water, or ammou 
carbonate may be employed in the strength of 4 Gm. (or oj) to 130 c.cm. (( 
f^iv) of water. The following combinations of ammonia are also of servi^ 
for external use: — 

I^ Aqum ammonicB, 

Fhiidext. nniicce, 

T-in. gaponia. 

Olei tcrebinthinc aa 60| c.cm. or fjij. 

M. Sig.T Rub in well several times a day. For rheumatism, bruises, and sprair 

B Lin. ammoniffi 601 c.cm. or fjij. 

Spt. c-hloroformi SO] o.cm. or fSj . 

Lin. menthol' 601 c.cm. or fjij. 

TincL opii 30] c.cm. or fjj. 

M. Sig. : Apply well oyer the surface, when necessary for lumbago, neuralgi 
and sciatica. 

R Spt. animon. aromat lo\ c.cm. or f^sa. 

Tinct. cflpaici 301 c.cm. or IX j. 

Spt. lavandulffi 7 1 50 c.cm. or fSij. 

Tinct. nucia vomica 151 c.cm. or fXss. 

Lin. camphorsB ~5\ c.cm. or fjiiss. 

M. Sig,: Apply with friction to the scalp for loss of hair and for dandruff. 



'Linimcntum menthol as suggested by Martindale (see **The Extra Pharm 
copojia/' London) is composed of menthol, 3 parts; chloroform, 4 parts; and oliv 
oil, q. s. to make 16 parta. 




AMMONIUM. 



193 



I II Tia*l! ri) I Lr III 



M. tliimble-blistering may be practiced over tbe paiulul spots 
ppiug 3otue stronger aqua ammouiffi upon absorbent cotton^ 
; f^crinin^ u with a watch-glass or thimble in contact with the skin. 
Spirit of ammonia is a good application to wounds caused by stings of 
k or stuikif-bites. In the latter case, ammonia-water can also be injected 
I a vein in order to counteract the depressing effects of the Tenom. In 
; bj eewcT-gas intravenous injection of the official aqua ammonia haa 
fc. Ammonium-chloride solution (8 to 15.5 Gm. to 473 com., or 5ii- 
j) removes ecchymosis from contusions. This solution is applicable 
to epididymitis after the acute stage has subsided. It is, in fact, 
Jent dressing in the latter stage of superficial inflammation, and pro- 
riiie abaorption of exudation. Dr. J. H. Freeman, of Nevada City, Cal., 
recommends ammonium chloride in the treatment of rhus-toii- 
Iron poisoning. He dissolves 8 Gm. (or 5ij) of the salt in 120 c.cm. (or 
5^) of water, and directs it to be applied to the affected parts two or three 
IJBtta day. The swelling and the burning pain rapidly disappear. 

Internally, ammonia is invaluable as a cardiac and nervous stimulant in 
>nia and all typhoid conditions, in poisoning by prussic acid, in syn- 
jaiid in heat-eahaustion. The carbonate is the most eligible form, given 
dotes of 0.33 to 0.65 Gm. (or gr. v-x). In capillary bronchitis in infanta 
^ following answers a good purpose: — 




ft Asunonii rsrbonatia ^.. |75 to 1 

Syr. toliitani «^t.....i 16 

Liq. anunonii acetatu 76 



60 Gm. or «■. j 
c.cm. or Riv. 
c.cm. or fBiiM. 



xU-zzir. 



X. S%-: Give » U«spoonful every hour or every two hours. 

According to Dr. Beverley Robinson, ammonium carbonate, in rather 
ta»md frequently-repeated doses, is very etftcient in aborting a cold. The 
Hnring formula is often most efficient as an expectorant, especially in the 
kft* ctage of bronchitis: — 



i 



ft AiBBMmiS cftxb. 

9tt. •^i^eji* . - . 



4 
15 
11 
30 

jP|»t I niornmrini 11 

jLq. ramphore q. t. ad 120 



Om. or Sj. 
ccm. or fSiv. 
acm. or fSiij. 
ccm. or fSj. 
c.cm. or fSiij. 
c.cm. or i$iv. 



One to two teaspoonfuli ever^r hour or two until relieved. 



In the broncho-pneumonia of children, Marfan orders: — 



acetat, 
btnaoat. . 

|p.rlfriiF«11 
^fyr. toliitAni, 
^ acaciJ» ■ 
H Sic- : Deasertvpoi 






ll&O Gm. 
4 ccm. 



^•. 



XXIV. 



na 60| c.cm. or fjij. 

on/ul every ho\ir or two according to age. The quantity of 
according to age. 



Tbtf Talue of ammonium carbonate in scarlet fever has been extolled 
•? fmru Wilkinson, and Witt. It was employed in 0.20 to 0.32 Gm. (or gj, 
»-t) do«€#r hourly, or at longer intervals, according to the severity of the 
mt. Il reduce* fever and cerebral excitement and promotes sleep. The 
of ammonium acetate is also highly recommended in scarlatina. 



H 



194 



J'llAliM.Vl IJl rU'AI, TIIKIi.AI'Kirif AdKNTS OK OKl'OS. 



The plan is to administer the remedy in large doses, which have been fouB^ 
to be well borne, even bj children. The carbonate has likewise been em 
ployed in measles, in vrhich disease Ringer states that he has used it largel 
with considerable ijenefit. The same salt is valued by some practitioners ii 
the treatment of small-pox and erysipelas. 

Delirium tremens, being usually associated with cerebral ansemia am 
weakcntMl cardiac notion, uiay bi- hrncHtt'd bv ainmniiiuiii curljoiuitc. 

Ftir the relief di* persistent cpista.vitJ, small do^^s, t».i;i to Ll.:^0 Uni. (o 
gT, ij-iij). may be givtm frnni three to six timpg a day, nr every ten minute 
duriujr the lia*morrJi!iu'c. 

Ammonium carbonate and acetate have been used in diabetes mellitiu 
Eichhorst states that in two of his cases the use of the carbonate was fol 
lowed by rapid disappearance of the sugar from the urine; 3'et the progres 
of the pulmonary lesions was not interrupted. 

Pereira says that liquor ammonii acetatis is available in those cases o 
fever of a continued type where all violent action has subsided and the brail 
is not much disordered. Its diaphoretic action should be promoted b; 
diluents and by warm clothing. 

The aromatic spirit of ammonia may be given in threatened syncop' 
and should be well diluted with water when administered. It is also usefu 
in heat-exhaustion with small quantities of tincture of capsieuni, which alsi 
relieves nuusea. It is likewise of service in the sour stomach ajid lympanitee 
which not infrequently occur in hysterical women. Nervous headache i 
often relieved by the same preparation. Ammonium chloride may be admin 
ifitered thus as an hepatic stimulant: — 

I^ Ammonji clilor 121 Gm. or 5iij. 

Sodii chlorid 4 Gm. or 3j, 

Kluidi'xt, tarnxat'i 60 c.cm. or fSij. 

Decocti aloes co ad 240[ c.cm. or fjviij. 

M. Sig.: A dessertspoonful to a tablespoonful in water three or four times ■ day 

The chloride increases the flow of bile (Ringer)^ and is, therefore, usefu 
in torpor of the liver, sick headache, biliousness, and also in jaundice due U 
obstruction of the gall-ducts. It has some reputation as an emmenagogue 
Ammonium chloride is esteemed of value in catarrh of the stomach anc 
bowels, and Bartholow considers it usefu] in the first stage of cirrhosis. 

M, Marotte esteems this salt as of value in cholera. He administers il 
in doses proportionate to the severity of the disease and states that it pro- 
duces a return of warmth and perspiration and also stimulates the kidneyt 
to action. Dr. J. J. Trussewitsch regards ammonia as one of the best cardiat 
stimulants in cholera. He gives it by hypodermic injection, making use oi 
3 to 8 drops of the saturated solution diluted with a syringeful of water. 
The effect is prompt, and continues for some time. It may also be given 
internally in the same disease. 

In myalgia and neuralgia this salt is capable of affording relief, and 
should be given in rapidly-increasing doses until the effect is obtained oi 
the system becomes intolerant of the remedy. It has also been used in in- 
termittent hsematuria. It is best given in capsules, on account of its nau- 
seating, sea-water ta«{f. Licorice cover.-^ the tiisti* in mixture.';. 

Dr. H. Campbeirs favorite prescription for neuralgia of the fifth nerve 
is: — 




AAIMOKIETM. 



195 



% Aammii ehloridi 2 

XteoLcriaanii 

ItecL aeoaiti •<*.•,,«*, 

FhdAcxt. glre^TThizir •«,*.«.. 4 

A^mm q. s. nd 30 

K. SSy.: To be taken in one dose every hour when the pain comea on, until 
t Are taken.* 



6m. or gr. xxx. 

60 ccm. or mvMw, 
06 c.cm. or mj. 

c.cm. or f3j. 

c.cm. or f3j. — M. 



Dr. G. Corrie states that ammonium chloride is an excellent remedy in 
cystitis from various causes. He gives it in doses of 1 to 2 Gm, (or gr. xv- 
ixxj, aud obtains marked and rapid relief. 

In bronchitis m its first stage, with deficient secretion, it may be com- 
follows: — 

Om. or 3ij. 
Gm. or pr. xvj. 
c.cm. or mxxx. 
C.cm. or fBiv. 



% AMBonii chloridi 8 

Pateaaii iodidi « *.^t« 1 

TIarL ipecmcuanhK 2 

Ififft. gfycTTThixB comp q. &. ad 120 

IC. 8ig.: Dose, a tablespoon ful every four boura. 



Thi£ formula is of special service in acute catarrhal pneumonia. The 
cUoride is particularly valuable in chronic bronchitis accompanied by pro* 
hm fccretion. It is asserted that the continued use of large doses of this 
«lt nuj excite ulceration of the stomach. It is also a remedy of great utility 
IB tropical or malarial fevers, such as are encountered in India. In these 
fct€3g . f^f a highly inflammatory type, it must be given in doses not less than 
I V- *.m. (or gr. xv-xx) several times daily. 

V iyt;at(\- of ColomlK), Ccvlon. ri'ports oxcellent results from am- 
■oaiviD chloride in acute, tropical dysentery, given in 4 Qm. (or 3j) doses 
cvtrj four hours and the patient placed on milk-and-arrowroot diet. In the 
mmjtmtj of cases blood disappeared from the stools on the third or fourth 
hn. In a few cases this treatment was supplemented by small doses of opium. 
lalodia amrDonium chloride is esteemed to be especially valuable in malarial 
i ntja of n highly-inflammable type; it should be given in doses of 1 to 1.30 
<bL (or gr. xT-xx). 

la catarrhal conditions of the respiratory tract Krakauer recommends 
^ nae of ammonium chloride in the form of a spray. Ammonia carbonate 
■iT also be tiMd as an emetic in such cases. In the later stages of pneumonia 
u/nt (iifitinn is promoted by the same remedy. Liquor ammonii acetatis is 
mit of our most reliable diaphoretics, and enters into the composition of 
fever mixture*: — 



Fluid' >U |16 c.cm. or gtt iij. 

9pL c ' ni . . 161 c.cm. or fSiv. 

Uf. arrjmoMii aeetatii 75| c.cm. or fSiiss. 

M. S4f . • Give a deasertapoonful every two or three hours in fever. 

Both the ammonium chloride and the solution of the ammonium ace* 

( are effect! rely given for the purpose of quickly removing the eflfects of 

_t>l or £ol>ering a drunken person. 

Aflunonium bromide has a special influence over whooping-cough, and 

be aabatituted for the potash salt in epilepsy and nervous aflections. A 




• xrv TorM 3ie4ital Journal, Sept 23. 1899. 
*»rMMh yt^irat Journal, May 7. 1898. 



19G PIIARMACELTHJ^L THKUAl'EUTiC AGENTS OK DRUGS. 

double salt, ammonium and rubidium bromide, has recently been introdu^ 
as a remedy for epilepsy. The substance is readily soluble in water. Its dos( 
\b that of the other bromides. Active doses are from 2 Gra. (or gr. xxx) up- 
ward; as much as 8 Gm. (or 3ij) daily, or even more, may be given, dissolved 
in syrup of lemon and water. Laufenauer has used it in all the epileptic 
states with the exception of hystero-epilepsy.* In acute rheumatism with 
nervous svniptonif:. Do Costa rcp<"trtod good results from the use of amnion' 
ium bromide {1.30 \n 2.fin Gni., or gr. xx-xl) several times daily. 

A very suitable prescription for insomnia and in gouty subjects is:- 



B Sodii bromidi 21 

Tinct. lupulini '. 60 

Spt chloroformi 7 

Aqutt camphorse 60 



50 Gin. or Svas. 

c.cm. or fjij. 

60 c.cm. or fSij, 

c.cm. or fjij. 




M. Sig.: Two teaapoonfuls in water every hour or two when nececuary. 

The valeriate enjoys souie rupiitation for its iiil!ui*iHe over hysterica 
manifestations, and may be given in capsules (0.32 to 1.30 Gm., or gr. v-xx' 
or as an elixir* (not official): — 

H Amnionii valeriatis 6!S0 dm. or jfr, c. 

Elixir aurantii 240| ccm. or f3viij. 

Aquce ammonii - .q. s. ad react, neut. 

M. Sig.: Dose, u Uiblcrtpoonfui, wnU fliluU^d, in iien'ous attack*? of women. 

Of the remaining salts little need be said. The phosphate is diuretic 
and has been used in gout, which may be connected with deficient excretioi 
of urea. The beuzoate, \vhere the urine is nllcaliue, as in cystitis, has advo 
cates, as it is excreted as hippuric acid, and thus prevents phosphatic de 
posits. The nitrate is only used to prepare nitrous-oxide gas, which it yield 
by exposure to heat. The sulphate is used in making other salts. The iodidi 
may be employed in syphilitic affections, where the other iodides are to< 
depressing. 

In the strength of 2 Gm. (or .^s) to 30 c.cm. (or f^j) of glycerin, am 
monium iodide is recommended as an efficient local application to enlarge( 
tonsils, being painted upon the glands once daily with a camers-hair brush 
Ammonium borate, according to Professor Lashkevich, reduces expectora 
tion and, at times, the pyrexia of pulmonHry tuberculosis. 

Aqua nmmonire mny he admmiEtered by cautious inhalation, h'V'pnder 
mically, or by the mouth, in shock, in chloroform-narcosis, in poisoning h 
hydrocyanic acid or hydrogen eulphide, and also in heart-clot, thrombosis 
and snake-poisoning. Where a prompt etfect is needed, the remedy shouh 
be injected directly into a vein (O.fiO to 1.20 com., or mx-xx) diluted witl 
sterilized water. 

AMYGDALA AMARA (U. S. P., B. P.).-^Bitter Almond. 

AMYGDALA DULCIS (U. S. P.. B. P.).— Sweet Almond. 

The pharmacopoeias recognize two varieties of almond (Rosaceae): 1 
Amygdala amara, the seed of Pnmus Amygdalus; variety, Amara. 2 

'MMicfil BuUftin. July. 1890. 

*Ib the National Fnrmiilnry the elixir of ammonium valerianate coninins vanill 
•nd K littU rhtorofom) to onvpr the odor nnd taste of the 8«lt, of y^ hich tfacre_j|r 
present 0.13 Gm. (or gr, ij) to 4 c.cm. (or fSj). ^" 




AMYGDALA. 



197 



Amj^AmIa dolcis, or sveet almond, which is the seed of Fnmus Amjgdaliis; 
* ty, Dulcb. 

PrepdraHona. 
AmfwdaSm Amane (U. S. P.).— Oil of Bitt«r Almond. Dose, 0.015 to 0.06 

UK. (« «V.-j>. 

Aqttfr Amygdalje AmMre (U.S. P.).— Bitter-Almond Water. Doee, 15 o.cui. (or 

Srrtt|Hu AmTgdalffi (U.S. P.). — Syrup of Almond, "Orgeat" Syrup (coutaiuing 
hdk ***«?t and bitl^-r Hlinondsi. l>>Kt\ 7.5 to 15 com. (or f3ii-fSHs}. 

Spiritus AmygdaUe Amarse (U.S. P.), Spirit of Bitter Almonds. Dose, 0.06 to 
tJI c^cm. {ormi-xx). 



Amygdale (U. S. P.).— Emulaton of Almond (sweet almonds). Dose, 
U Is U c^cm. (or fSii-fSBs). 

QlnnD Anygdalffi Expreeeum (U.S. P.). — Expressed Oil of Almond (either bitter 
). Doee. 7.5 to 16 can. (or f3ii-Qss). 



» 



Uttgueatum Aqufl& Rosse (U.S. P., B. P.}. — Ointment of Rose-water ("Cold 

Otofun Anijgdftle (B. P.). — Almond-oil (expressed from the Bitter or Sweet 
*>. 

Mistarm Araygdal« (B. P.). — Almond Mixture (compound powder of almonds, 
9Gm.: distilled water, 160 c.cm.). 

PtatriA Amygdalae Corapositua (B. P.)- — Compound Powder of Almonds (contains 
flv«ft alncNida* 20 Gm. ; sugar, 10 Qm.; acacia, 2.5 Gm.). 



nArmacology. — Both varieties of almond contain fixed oil and emul- 
but only the bitter variety has also amygdalin. Hydrocyanic acid is 
temcd wb€n amygdahn and emulsin react upon each other, and it is to 
tbt acid thus formed that the sedative and antispasmodic effects of oil of 
ktcer almond are due. Its toxic effects are also iaentical with hydrocyanic 
wait uid call for the same treatment. 

Therapy. — The volatile oil of bitter almond must not be confounded 
axtfa the fixed oil obtained from either variety by expression, the latter being 
a Ua&d application, especially in the form of ung. aqus rosse, to irritable 
fkm or chapped hands or lips. In doses of 4 to 7.5 c.cm. (or foi-ij), it is laxa- 
XXPtr and may be used as a substitute for olive-oil. The oil of bitter almond 
kK been employed in emulsion as a local application in pruritus, and in- 
InalJy for the same purposes as hydrocyanic-acid solution. The official 
^nlnon i* made with sweet almonds, forms a soothing application, and may 
ht combiDed according to these fonnulte: — 



EoiiiIb. amyf*dalsB 
Hianiuth. iiubnit. . 
XhrnX'ti** iiMlidi 



30 

4 
4 



c.cm. or f5j. 
Gm. or 3j. 
Gm. or Sj. 



Sig^t For local application to freckles and skin pigmentations. 



B KiDula. amysdalce 



7?' 
Hjrdrars. chlor. corros. 



301 



SC »#.; 



chloridi 
Valuable in skin pigmentations. 



20 
25 



% HyArmrg, chlor. corros 

Emttla. amygdal« 

Sig-t For rxtemal use in ocne rosacea. 



|065 to 113 
120 



Gm. 
c.cm. 




Under t)io name r»f Bcsorbin, Leberaiann has introduced a mixture 

iB aaid to be very readily absorbed by the skin. It is made by eraul- 

poreat almond-oil vith distilled water, a small quantity of yellow 



198 



I'llAllMACEDTICAL TKEIUPELTIO A(JKNTS OK DRUGS. 



wax, gelatin, and soap^ and is brought to an exact consistence by the addition 
of a little lanolin. It is recommeDded us an excellent vehicle for active drugs 
in medication of the skin, and may be used in ichthyosis, pityriasis, sclero- 
derma, sclerema neonatorum, seborrhoeic eczema, prurigo, and scabies. Re- 
sorbin will, it ia claimed, promote the absorption of mercury by the skin. 

Bitter-alraond water is a good vehicle in which to administer narcotic 
drugs. The syrup of almond may be appropriately added to cough-mixtures. 
The emulsion of almond is an agreeable demulcent, and may very well be 
employed as a vehicle of more active remedies. 

Flour prepared from blanched sweet almonds is used in making bread, 
cakes, and puddings for diabetic patienta. Almond-meal is used instead of 
soap for the toilet, rendering the skin soft and smooth. 

AMYUS NITKIS {V. 8. P., B. P.).— Amyl Nitrite. A liiiuid contain- 
ing about »S(t ]K*r rent, of amyl {chiefly ipomnyl) nitrite^ wJicii rtt^saycd by 
IT. S. P. pmeess. (Thero is alw) an flniyl nitrjili^; hut it never is ui;tHl inter- 
nally.) 

Dose, O.Oir. in n.32 c.cm. (or nt^/^-y), intomally; by inlitilation, 0.18 to 
0,30 c.cm. (or miii-v). 

Pharmacology, — A clear, pale-yellowish liquid, of an ethereal, fruity 
odor, an aromatic taste, and a neutral or slightly-acid reaction. It is insolu- 
ble in water, but soluble in alcohol, ether, and chloroform, in ail proportions. 
It volatilizes at ordinary temperatures, and should be kept in a glass-stop- 
pered bottle, or in small glass pearls, each containing 0.18 to 0.30 c.cm. (or 
fniii-v). Vessels or tubes containing this fluid must be handled with care, as 
it readily explodes at ordinary temperatures. It results from the reaction of 
nitric acid upon amylic alcohol, and may be contaminated with nitric or 
hydrocyanic acid. 

Physiological Action. — No local effects are ascribed to this remedy, but 
when taken internally, by the digestive tract, or by inhalation of its odor, 
very remarkable phenomena are produced. There is at once observed a flush- 
ing of the face, with fulness and throbbing of the temporal vessels, the 
patient complaining of headache, fulness, and oppression, with giddiness 
and confusion of ideas. The reflex excitability of the cord is diminished. 
The brain is indirectly influenced, and its functions exalted by the temporary 
congestion. The action of the heart becomes excessively rapid, with weaken- 
ing of the pulse and marked lowering of arterial tension, owing to the gen- 
eral enlargement of the vessels, due to action of the drug upon the muscular 
coats of the arteries, and not to the nervmis system or vasomotor centres. 
Larger do^*es oeciision fjiilinvrif eiinliac fiction, arrest tJikiii<r phu-e in diastole. 
According to the investigations of the late Prof. Leech, of Manchester, the 
nitrites affect especially the blood and muscles. They depress the nerve- 
centres and nerves, but their action in this respect ia less marked. Amyl 
nitrite diminishes oxidation, and the arterial and venous blood both become 
of the same dark color. Respiration and temperature are both reduced. 
Sugar appears in the urine after inhalation, probably as the result of in- 
creased circulation in the liver. It increases the flow of urine, possibly, in 
the same way, or because the liver-sugar may act as a diuretic. In poisoning 
from amyl nitrite the blood assumes a characteristic chocolate color, due to 
the formation of mcthaDmoglohin, 

In some patients the nitrites excite gastric irritation and diarrhoea. 




AMYUS XITKIS. 



Leech regards these compounds as useful, unirritating diuretics. 
kmjl lutrite is absorbed and eliminated with great rapidity. 

Itenpy. — From a consideration of its physiological action Dr. Lauder 
kmtOD was induced to recommend the use of amyl nitrite in the paroz- 
fimof tngina pectoris, and clinical experience has shown the value of the 
'f. Whether the relief be due to lowering of arterial tension, as Brunton 
. or to the alleviation of the neuralgic condition, as claimed by John- 
, it not very material, since by inhalation of a few drops of this remedy 
p«tirat has complete control over the attacks. Dyspnoea due to other 
I of cardiac disease and to pulmonary lesions is also relieved by admio- 
ttation of this remedy. It is particularly adapted to symptoms dependent 
I dtieMe of ihe mitral valve, but aortic incompetence, according to Pro- 
I-iw^h, offers no objection to its use in small quantities when the 
facs' - oppressed. In asthma, where the spasmodic element is strong, 

iB\ •_ promptly affords amelioration, 

Ulizmann recommended as an injection in chronic cystitis, where the 
flovtion is catarrhal and has a bad odor: — 

% AmjIU nitrilis .... 130 c.cm. or mv. 

Ai|«w» «l#«*tilUt* 120| rem. or fjiv. 

M. &9-t Tableepoonful in wgter Bufficient for a vesical injection. 

Amrl nitrite can often be resorted to with benefit for aeasickness, espe- 
daily in this formula^ given by Martindale: — 



c.cm. or TOxvj. 
c.c-m. or fSij. 



B Aroyli* nitritiN . ]| 

Akobolis 7|5 

IGmv et Bild^: — 

PdIv. tmgftcanthe 138 Gm. or 

Jl4|iMB dc«tUUUe q. a. ad 120| ccm. or 

T^ poirdered gum trBgitcanth should he in a dry four-ounce bottle, into which 
I amyl aoloUon U poured, and the wat«r added gradually aftenvnrd. Shake welL 
^ 4 to 73 ccnu (or f3iij). 



ffT. vj. 



ff« o*^;k,,^^t'^ tetanus, neuralgia, chloroform-narcosis, and in strychnine 

nitrite has been tried with gratifying results; in whooping- 

in it xias lailcd. Benefit results from its inhalation in neuralgic dysmen- 

^ and it ie recommended by Dr. Winterbum for the relief of after- 

CHis practice is to saturate a small piece of tissue-paper with 5 or 6 
of the nitrite and place it in ^ tightly-corked 8 Gm. (or oij) vial, from 
vbdi the patient can inhale when the pain is severe. Professor Benedikt 
ttOHafB^nds a miiture of 5 parts of amyl nitrite with 10 parts of volatile oil 
d firanrl, for the relief of angiospastic hemicrania. Five drops are to be 
M9fd upon a handkerchief and cautiously inhaled. Amyl nitrite is bene- 
loal m ini|?raine dependent upon local vasomotor spn^m. 

In ADJ^mic epileptics, the inhalation, iniinediatfly bt^l'urc a lit. may 
pnrrent tin: fit. The roinedy sliould n^tt Ik» given to plethoric cpi- 
nor to elderly people with brittle arteries. It is particularly adapted 
kTtkoae caaca of epilepsy in which an appreciable interval occurs between 
a aura and convulsion. Dr. S. Weir Mitchell states that amyl nitrite may 
-'fvantagrouidy employed as a means of diagnosis between undoubted p€til 
<nd attacks simulating that disorder, but caused by temporary congea- 
nerve-centres. In the latter class of cases amyl nitrite intensifies the 




200 PHAKMACErnCAL THEHAPEUTIC AOENTS OB DBUGS. 

paroxysm. Sir Crichton Brown has found this agent specially serviceable i] 
the status epilepticus. 

Inhalation of amyl nitrite is sen'iceable in stimulating the heart in th 
event of sudden failure, which may occur in fatty heart or after haemorrhage 
It has proved beneficial in intermittent coryza. In intermittent fever it wi) 
ivert or suppress the chill, but is without influence upon the hot stage. 

In the treatment of epidemic influenza, or grippe, where pneumonia oc 
curred as a complication, Dr. S. Solis-Cohen* had successful results fror 
the administration, iuttTiuilly, of '» drops of aniyl nitriie in alcohol, ever 
three hours, associated with atropine sulphate, 0.0005 Gm. (or gr. Vuo), an* 
strychnine sulphate, 0.003 Gm. (or gr. V2o)j every five hours; also, for a time 
ammonium carbonate, 0.65 Gm. (or gr. x), every hour, at first, afterward a 
longer intervals. Although recovery was delayed by infection with ery 
sipelas, the patient made a good recovery. 

In case of unpleasant, or serious, symptoms after the use of nitrite o 
amyl, the cxhilntiun »>f aim^ionin by inhalation, hy the niotith, or intrs 
venous injfctimi, and tlic hypndenriic injection of atrojiine or ether (ethyl 
oxide) with cold water or ice-bag to the head, sinapism to the epigastri 
region, a mustard foot-bath, at the same time keeping the patient in th 
recumbent posture, will very soon be followed by relief. 

AMYL VALERIANATE, Valerianate of Amyl, is an active prepara 
tion, which is regarded as a valuable hypnotic and antispasmodic. It i 
combined, according to Dr. W. F. Wade's formula, by taking 1 part of amy 
valerianate to 19 of alcohol, to which is added amyl tfcctate in the propoi 
tion of 0.0(i c.cra. (or mj) to 60 c.cm. (or f^ij). Dose, 0.37 to 0.5 c.cm 
or mvi-viij). This dissolves cholesterin readily, and is considered bette 
"in cases of gall-stone than either chloroform or ether. 

Amyl valerianate relieves the pain of hepatic colic and prevents reciu 
rences. It has been found of advantage in muscular rheumatism and i: 
dysmenorrhcea. It is useful likewise in relieving hysterical manifestations 
Amyl valerianate is a colorless liquid of pleasant taste. 

AMYLENE HYDRAS.— Amylene hydrate is tertiary amylic alcoho 
(dimethylethylcarbinol). 

Pharmacology and Physiological Action. — It is n mobile, oolorles 
liquid, with a camphor-like odor. It boils at 102.5° C. (216.5° F.), am 
at 200** C. (392° F.) is decompoi^od into amylene and water. It forms com 
pounds with chlorine, bromine, and with iodine. Oxidation converts i 
into acetic acid and acetone. Miscible with alcohol in all proportions, ant 
is soluble in eight parts of water. 

Harmack and Meyer state that amylene hydrate at first excites, bu 
afterward successively paralyzes, all the nerve-centres. It likewise de 
presses the temperature. In medicinal doses, 3 to 4 c.cm. (or mxlv-foj) 
it is said not to affect the respiration, the frequency of the pulse, or thi 
action of the heart, but acts principally upon the cerebrum. In excossivi 
doses it depresses the medulla and spinal cord, and causes death by respira 
tory failure. According to the experiments of Peiser, amylene hydrat- 
diminishes the waste of nitrogenous tissue. He therefore regards it ai 

* Philadrlphia Hojipttal Rfport$, vol. i, 1890. 




AyACAHDICM. 



201 



pptimlarty adapted to those cases in which an hypnotic is needed for 
pralonged use, and in which decided nitrogenous waste occurs. 

Ikcrapy. — It may be used as an antispasmodic in doses of 1 to 2 c.cra. 
(««XT-ixs>. ^ven in capsules, in alcoholic solution (mixed with beer or 
«iDe),or w.' :ious preparations. It has been used in insomnia and 

TMBiin In I tions Dr. Hans Evonsen regards auiylene hydrate 

WflBmevhat uneenaih, but finds it particularly useful in cerebral amemia. 
It ha« b«en given also in delirium tremens, and in nocturnal epilepsy. 
Jkaefa coincided with Wildermuth as to the efficacy of amylcne hydrate in 
fctq aea t and severe attacks of epilepsy, especially where the bromides 
lare failed. He thinks that pelii mat and nocturnal epilepsy are much 
batfited by the drug. It has also been recommended for whooping-cough 
■Dd to relieve the cough of phthisis. No dangerous after-effects have been 
iibiiinJ from the use of this remedy. 

AMTLTJM (I'. S. P., B. P.) —Starch. 

Preparations. 

Giywrvtam Amyli (U.S.P.).— Glycerite of Starch (10 per cent.). Local use. 
GlyveriDaiD Amyli (B. P.). --Glycerin of StArch (about 12 per cent.). 

_naimacology and Therapy. — The official (F, S. P.) starch is the 

obtaiiiod from the fruit of Zea ^lays ((^iraniinese). The Brit- 

>p«T'ift diretts that starch be procured from tlio grains of com- 

■rheat. Tritimni sativum ; maize, Zea Mays; and rice, Orvxa sativa. It 

- 5f. i"f»-.rfaDt olenient of food, and forms a large part of nee^ wheat, bar- 

- lot, and ntlier commonly-used carbohydrates for administration 

V tije i<u*K. Starchy food phould not be given to young infants, who have 

s^fafBcirni saliva or intestinal juices to digest them, for they may undergo 

Mtrrfartive changes in tlie bowel and cause colic and dinrrhcea. Starch 

HI % fine, white powder, bec^»ming adhesive when moist, ami is a good appli- 

fii6oo for hums or scalds, and for intertricro, or chafing in infants. With 

WTrnff u nr.T tli" starcb-granulcs swell and burst and a homogeneous mass 

• •ra very well as a poultice for alleviating local inflamma- 

■ ■ is useful application in some skin affections, thougli 

imes proves iiTitant, on account of its affinity for water. 

aurcU - Tit antidote to most corrosive poisons, when mixed with 

for free iodine, as it turns blue when brought in contact 

rtJ Starch-water is made by mixing up a tahlespoonful of 

1 water to H smooth paste, to which a pint of boiling water 

I aMMi, while stirring. 

B Aii«* amyli 301 ^ c-cm. or fSj. 

nUtDulhi cubnlt. 2| * Om. or 3m. 

Ttoct. opti |30 to |60 c.cm. or mv vel x. 

If. f*ig-- Injrot Into the bowel when necessary. I'w in diarrhcra after each 




AJfACABDIirM.— Cashew-nut. 

FluiniLacology and Therapy. — Anacardium occidentale (Terebin- 
r) is a >:m«ll tree, indigenous to tropical America, and naturalized 
parts of Africa. The nut is inclosed within two shells, between 
lennUined an acrid, oily liquid, which turns black when in contact 



20'i PIIAHMACKUTICAL THEUAPEUTIC .MJEXTS OR DRFOS. 

with the air. The principal constituents of this fluid are Anacardic Acid, 
a white, crystalline substance, and Cardol, a yellowiBh or reddish oil. 

The juice, or oil, is an active local irritant, and has been employed 
for the destruction of corns and warts, for the cure of obstinate ulcers, and 
ringworm. It has also been used as a topical agent in the treatment ol 
leprosy. The tubercles and a portion of skin surrounding theni are 
painted with the oil, which is then rubbed into the akin. After a little 
oozing a scab forms, and when it falls it is seen that the tubercle is dimin- 
ished in size. The oil should not be applied to a surface of more than six 
inches square. In young persons and upon parts where the integument ia 
thin the oil gives rise to violent irritation. 

AWETHI FEUCT¥S (B. P.).— Dill-fruit. 

Preparations, 

Oleum Anethi (B. P.).— The Oil distilled from Dill-fruit. Dose, 0.03 to 0.18 c.cm, 
{or mas-iij). 

Aqua Anethi (B. P.). — Dill-water. Distilled from the fruit. This ia a pleaannt 
carminative and stimulant agent ordinarily employed to relieve flatulence or colic. 
Dill-vrater is an agreeable vehicle which derives its value from the volatile oil. 

Pharmacology and Therapy. — iHIl \i^ the thiutl ripe fruit of Auethnm 
graveolun.-i {Fanf. rmht'liii'ura.^), n nutivy of Spain and tho south of France. 
Tlie seeds, as the fruit is L'omuionly culled, have a stronp: iiromatic odor, 
le?^ agreeable than fennol-swd, and a nioilenitdy jiiiugi'nt ta.str. The princi- 
pal ttvnstitncnt is a jjakMellow. volalilo oil. having a liot. swt^ij'tish-acid taste. 

Dill-fruit has the property common to all aromatics, but is rarely used 
in this country. In flatulent colic of infants the oil can be given in doses 
of 0.06 to 0.18 c.cm. (or mi-iij) on some sugar; the dose of the fruit to adults 
is from 1 to 4 Gm. (or gr. xv-5j). 

ANHALOMTTTM. — Tln» tlricd tops of .Viihnloniuni Tjcwinii (Cactact'a*). 

Pharmacology. — Mrnoiil hntlons. "pollott',"' have lu^en used, in the 
religious ceremonira of tlie Indian tribes t>f the Stiiithwest, as an intoxicant. 
Prentice and Jlorgan,' who investigated the pliysiologicn! action, found 
that three *T]utton8" were usually sufficient to produce churacteristic 
effects. Among these are hallucinations of vision, color-phenomena pre- 
dominating, hut with remarkable figures and forms. The mind was com- 
paratively unimpaired, but the muscular system was much depressed. The 
pupils were dilated. The heart-action was at first slower and stronger, 
then rose to normal, and was never depressed. Tliere was a sense of full- 
ness of the stomacli and occasionally nau.^^ea and vomiting. The ])assage of 
time was unnotic<Ml,*nnd insomnia existed for twelve to twenty-four hours; 
in thip respect, and in tlio ahs<Mice of exhilarating cluiracter from the visions, 
a sharp contrast is offered to cannabis Indica. Similar results were re- 
]>ortrd by Wi'ii' ^litrlirll. Sr\'or;iI vrrv toxic jilknloids liavc bi'i-ri isolated: 
Anhalonine, or Fellotine; Mescaline; Anhalonidine; Lophophorine; also 
a n'sinoiis suUstaiu-c. width appears to bc^ an im])ortnnt constituent. An- 
halonine, in dvcidi'd ilosi-s, luts like strvchniuL' as a i-onvulsant and tetanJ2= 



* Medical Rrroni, Aug. 22, ISOG. 




A>'I>CAL EXTRACTS, 8ECKETI0XS, AND SEUlilS. 



203 



It in fmgs. In luau, small aiiiounts Hct like opiiiin, n^ a calinuut, 

only weariness and ternporarv slcepleesacss, in dosee of 0.049 to 

10 '.'jn-*/ !»)• Al'tor perfioual fxporieuc*' Dr. Havelock Ellis 

Mi- iicuouiena of inoscal intoxication aiv mainly a saturnalia 

I - -t^. and chiefly ^n or^' of vision. He believes with Dr. 

U 1^ thortf is every likelihood that moseal will become popu- 

JE. it ceruunly has a )tnii\i future before it with tliose who cultivate the 
OM^nvdin^ dnigs. At the same time it is of no little interest to the 
i fc wk J ugM t and ]>fiychologiBt. 

Aer^py. — The jniwdered buttons;, fluid extraet, and tinctures nm<le 
kom them have been used in the treatment of various conditions dependent 
^DQ oerroiis irritability, and with considerable success. In therapeutic 
imm (flanl extraet w/^«-j, gradually inorea?od to mii-iij — or 0.0'>') to 0.20 
LOL)* it doM not produce insomnia, but frequently removes its cause, and 
Mcvuxlucrs t«» natural sleep; it has been of most use in sATuptomatic treat- 
mekL ft3 in c&Bea of ner^-ous headache and cough, active delirium, mania, 
|lf)MkoQdriasi&. and melancholia. It has also been used &< a respiratory 
in pneumothorax and angina pectoris. It has been n:'Com- 
as an adjuvant to digitalis when used ae a heart-tonic. 



AJTEHAL EXTRACTS. SECEETIONS. AND SEKTTMS. 

kEtermacology. — Various remedies of animal origin are now made use 
ia tbrrapeutics. They contain certain complex organic compounds of 
' afiac, phoaphoros^ nitrogen, etc.; in some instances products of bacterial 
mmity < ptomaines, toxins, antitoxins, etc.), and in others some internal 
«fvtioa of normal glands or organs, which have been ascertained by 
si and observation to be available for the treatment of disease. 
of extracts of organs, senune, and disease products. For in- 
, the extract obtained from the sheep's testicle by M. Brown-S^quard, 
[cBplojed by him and others for the relief of organic and functional 
tfiaorders and certain constitutional diseases, owes its activity to and 
under the lith' of H|><'rmin hydrochloride, the virtue of testicular 
: hariog been shown to depend upon the presence of sp^rmin: a sub- 

rhich is also contained in other glands, especially the pancreas. 
Ihjaiolo^cal Action. — The injection into the human body of extracta 
" from animal tissues may prove of service by modifying the consti- 
ttiaa of the blood, or by supplying to it elements of which it stands in 
aai. Il is conceivable that, when the functions of certain organs, espe- 
■^ylhoae concerned in nutrition and sanguification, are suppressed, the 
■ferivtiain of ii^^ corresponding serums, secretions, or extracts derived 
Im healtby animals may prove beneficial. Acting upon this theory, 
PMnaliiiiU representing muscular, nervous, cardiac, suprarenal, renal, 
Wthrrosd substance have been employed in practical therapeutics. As 
te4e manner of formation of antitoxins, A. C. O'SuUivan holds that the 
VMctimoIatefi the cells of the body to produce the antitoxin, and that it 
•»t the bloorl-cells, but the tissue-cells, that do so. When we come to 
Mile what fb*? particular cells are which produce antitoxin, we are met 
Vfrwtrr '-^''^ulties. Tetanus affords the most promising field for solv- 
jf tliii n, because it is evident that tetanic poison acts directly 

*lk(CC2il/ai iierv<*"* system. Wasserman has shown that an emulsion of 




204 



PHAHMACECTICAI. TlLJilUPEUTIC AGENTS Oft DfiUOS. 



Ihe brain of an animal which is sensitive to tetanus has strong antitetan 
properties, while if the animal has been poisoned by tetanus its brain los' 
this power. Here we have a case of neutralization of antitoxin by toxi 
and this, not in the serum, but in the brain-ceils themselves. Other e: 
periments tend in the same direction, and we may say that in the case * 
tetanus, at all events, the cells of the brain, which are those attacked I 
the toxin, are also those which produce the antitoxin. It is easy to s< 
that such a thing is extremely hard to prove or disprove in other diseas* 
where no specific cells are especially attacked, and, of course, the vie 
goes counter to all the work of Metclinikol! and his pupils ou the pr 
tective action of the wandering cells of the body. As to the secor 
question, how do the antitoxins act? the facts which have been establish* 
are the following: 1. The toxin enters into chemical, or molecular, cor 
bination with the cell-protoplasm, and when in this combination is ne 
tralized: i.e., is innocuous for other cells. 2. The toxin enters into cher 
ical combination with the antitoxin, and when in this combination is ne 
tralized. 3. The antitoxin is produced by the cell, and is thrown off 1 
the cell into the blood. 4. The cells which produce the antitoxin are tl 
same cells as those which combine with the toxin. We are almost forci 
to the conclusion that the element in the blood which proceeds from tl 
cell and neutralizes the toxin in the blood is the same element whi* 
neutralizes the toxin in the cell. And so Ave arrive at the first part 
Ehrlich's hypothesis: "That element or group of atoms in the cell-prot 
plasm which combines with the toxin when it is thrown of! by the c« 
into the blood is the antitoxin." But we have seen that it is the acti< 
of the toxin on the cell, and that only, which stimulates the coll to pT 
duce the antitoxin; that is to say, when any of the combining groups 
the cell-molecules are taken up by the toxin, they are replaced by the ce 
and replaced in very much increased numbers, as usually happens in i 
tissue-regeneration. Ehrlich supposes that these combining groups, whi 
they become numerous, lose their hold on the cell-molecules and pass ov 
into combination with the molecules of the fliiid in which the cell 
bathed, and so get into the blood, and that the injection of a given qua 
tity of toxin will stimulate the cells to produce many hundred equivaler 
of antitoxin. But there is more than this, for toxin does not merely coi 
bine with cell-protoplasm, it also destroys it. There is plenty of eviden 
to show that the part of the toxin-molecule which poisons is not the sai 
as that which first combines with the cell-molecule. The toxins of dip 
theria and tetanus, when kept in the liquid state, gradually lose their t03 
power down to a certain point, but tlu-y do not lose their power of coi 
Dining with antitoxin. It takes exactly the same quantity of antitoxin 
neutralize a given quantity of toxin, no matter how long it has been ke 
or how weak it may have become. In Ehrlich*s terras, the haptopho 
group in the toxin-molecule remains unaltered, while the toxophore gro" 
is changetL Thus, the toxophore group is ranch leas stable and less rap 
in combining tlian the other, and hence is probably much more comply 
Many facts connected with ihe infectious diseasea receive a ready explar 
tion by means of this hypothesis: e.g., what is a naturally-immune animt 
A naturnlly-immune animal is one whose protoplasm-molecule contai 
few or none of the groups capable of combining with the toxin in questic 
Again, the incubation-period of a disease, which appears in poisoning 




JiNlllJlL EXTRACTS, SECRETIOXS, AND SERUMS. 205 

1 tfl well as by the living organism, is the time in which it takes the 
group to get to work after the toxin has been anchored on the 
le by it3 combining group. Again, it is found that the produc- 
&■■ of immunity and of antitoxin, although the cause of both is the same, 
i0 &DC at all run parallel to one another in amount. An animal in the 
«trfj ftages of immunization may be hypersensitive to the poison while its 
Mood it full of antitoxin; and, on the other hand, in the later stages ani- 
tr« oft*n found to be practically completely immune, while their 
' yields BO antitoxin at all. 

Therapy. — 1. Organic Extracts. — A glycerin-extract of gray matter of 
ip^s brain has been used by M. Constantin Paul with encouraging re- 
[ in neurasthenia, locomotor ataxia, and senile debility. Dr. Dana has 
" amendment in the same class of cases from the use of a glycerin 
teaiD-«xtTmct, and instances particularly a case of rapidly-advancing bulbar 
mky in which marked improvement was effected. Seven months after the 
a^nming of the treatment no trace of the disease remained except slight 
Ugoe idfter long conversation or mastication. In regard to some of the 
vnatt is specially stated that the injection of water had been ineffectual, 
a fxooi that the amendment was not due, a.s thought by some critics, to 
am iiOggestion. Dr. Julius Althaus. of London, has also given favorable 
tetinkODy concerning the effect of injections of nervous substance. The 
ksiB-extract, which he terms Cerebrin-alpba (in order to distinguish it 
firm thr alkaloid cerebrin obtained from brain-matter), was prepared by 
Kxing 1 part, by weight, of rabbit's brain with 1 part of glycerin and a 
CS-pcr-cent. carbolic solution. The extract of the cord is made in the 
■Be manner and is called Myelin-alpha, to avoid confusion with the mye- 
fc which ia one of the constituents of the central nerve-fibre. Dr. Althaus 
had that the extracts were of no benefit when swallowed, as they were 
inoaipo^ed by the gastric juice. When injected into the substance of 
■aide they were active in the average dose of 0.30 c.cm. (or mv). Both 
ipiBts aeemed of equal service in cerebral and spinal diseases. They were 
loallcial in locomotor ataxia, progressive muscular dystrophy, and in 
tfcosa maladies and conditions mainly characterized by loss of nerve-power. 
b fa&ctional nervous disorders good results were obtained from the use 
rf dieae extracts alone, but in organic affections they seemed to act chiefly 
• •djuTanta to other treatment. They were useful also in promoting con- 
nkjcrncc from acute diseases and in relieving the disabilities of old age. 
Fvom hif ex]>erience. Dr. Althaus also dissents from the idea that the re- 
■lt> ar« simply due to suggestion. 

BaMa has employed an emulsion made by mixing normal brain and 
ifiBal cord with broth in the proportion of 1 part of nerve-tissue to 5 of 
Wotk. About 4 c.cm. (or f3j) of the mixture was injected and proved useful 
M eaaea of epilepsy, melancholia, obstinate insomnia, chronic headache, 
matica, and other disorders of the nervous system. 

Socrmin hydrochlorate or hydrochloride, according to Professor Poehl 
1^7 r, i« the active agent in the orchitic fluid in producing the 

|k%-.j..L.';.,wil phenomena chronicled by 'SI. Brown-S^quard, in his cora- 
aHaJcatinn in the French Academy. It is obtained from the testicular 
|caa of tho lower animals hy n carefully-conducted process, which protects 
^ nrodnct from contamination hy infectious micro-organisms and isolates 
hfmfcallj pure, n* a salt of hydrochloric acid, S[>ennin is a cr^-stalline 



i 



206 



l-JlAliMACEUTICAL TUEBAPErTlV vVliKNT.s OU PIirGS. 



finb?tanco, snhiblc in wator nnd aUsnliite akoliol, Imt insoluble in ether. 
jiUs()ri)s wnlvr and carbonic acid from the aToiosphorf. From experinien 
u|if>ii rabbits, I>r. SidrkwclK nf IK^troit. declares that this agent prodiic 
[towcrfnl niul prolon^'rd stiiniilation of the synipalhetic nervous systoi 
iitost, strou;;ly iminirrsti'd tlin^u/^li tin- ^penrlatit• jdexus. It stiniuhiteH tJ 
vasomotor eentri', iiirrca^os blond-[)n:'P8iire, and aids oxidation. In tox 
doses it indiioeii dit^treasina: tetanie spasm and interferi^ with respiration 1 
spasmodic fixation of rnustdoii, including the diaphra^im. Cutaneims hype 
a^slliesia and increnr^ed inusculnr activity were t*bt;t'rved. Sexual erethifl 
was marked in many instances. Hie liypodcnnic injection of an extra 
from ilie recent tcstich^s of minnnials was found by Brown-Se<piard* 
have a stiniuhitiii^'' cifoct u[>on nutrition, and to lie f>]»ecial!y active as 
restorative in failing nutrition due to ohl agi-. Dr. H. P. L<x)niis, of Xc 
York, found ttiat the injections, "as claimed, j>ro<luce nutritive modilicatio] 
in the tissu<'s of elderly men, due, probably, to stimulation of the uerv 
centres.*' In tuberculosis this substance has also been rocomuiendec; 
^larked imjiroiement has lu^en reported as occurring in some cases of leproi 
after the injintion of testicular fluid. In locnmotor ataxia ami varioi 
forms of pjiralysis the same tn-ntmeul has bc^-n followed by auiendmen 
Several luindred cases of Labes have been treated by tliis method by ditterei 
obrJiTvers and in a very large projiortion llic symptoms nf {he disease we 
unmistakably relieved. In hysteria, on the contrary, little or no good hj 
resulted from the injections. They were also found inefficient in epileps; 
In delirious epilepsy and in various forms of insanity the practice has bee 
followed by improvement. In annemia, also, good results have been ol 
tained. Brown-S6quard claimed that testicular fluid had been used wit 
decided advantage in about 100 eases of cancer, in nearly ail of whic 
cessation of pain and ha'morrhajre and cicatrization of ulcers demonstrate 
the efficacy of the method which ho advocated. He also asserted that I 
was cognizant of cases of disappearance of uterine fibromata and of morbi 
deposits of connective tissue in the heart, arteries, and muscles. It 
stated by those who have practiced this method that better results hav> 
as a rule, been obtained in organic than in functional diseases. In chorei 
however, Professors Oilier and Tessier and other writers have ^sntnosse 
rapid improvement in consetjuence of these injections. Notable amelion 
tion has, in a large number of cases of tuberculosis, followed the use < 
these injections. Professor Poehl, of St. Petersburg, is of the opinion thf 
the injection of spcrmin is of service in Asiatic cholera, particularly in th 
early stage of the disease. 

The injections of an extract were followed by relief in cases of ir 
Bomnia, hypochondria, feeble heart, cardiac asthma, and f^pinal irritatioi 
as reported by Dr. H, C. Brainerd, of Cleveland. 

The most decided results from the use of animal tissues or extract 
have been obsena^d following the administration of Thyroid preparation] 
esfMH'ially in llic treatment of uiviedrma.'' This di-^case depends upo 



' 8ee paper by the author on "The Case of Dr. Browii-S^uard," The Timea an 
RegiMer, Nov. 30,^1880. 

* See lecture by Dr. D. Uspenski, on "Brown-S^uard Fluid in Tuberculosis,** i 
DeuUche medizinal-Ztitung, Dec. 29, 1890. 

* See report of London Clinicfll Society, Lanctt, Feb. 4. 1893; uIm) the BrUi* 
Mfdical Journal, Feb. 4, 1893. 




INIMAL KXTIUCTS, SKCnETIUNN AND KfcUtrMb. 



207 



*Kiiiooa 01 the fiinctious of the thyroid gland. Dr. Murray, of New Castle, 

^g*— *^, demonstrated that grafting of a healthy thyroid upon the body of 

Ikt psbent or the injection of an extract made from the gland is foUowed 

bf resmkable and rapid amelioration. Thyroid extract is made by cutting 

tatfbad into thin slices, bruising, and adding about 4 c.cm. (or f5j) each of 

I (Ijvena and sterilized water to each gland. After standing for twenty-four 

was the fliiid, which is thick and of a dull-red color, is strained. The 

fmnuiy of the extract thrown in is 1.55 c.cra. (or mxxv), and the operation 

■ vppemted once or twice a week, according to the severity of the case and 

Ac tate of improvement. At the end of a month or six weeks the condition 

tai j^cnertlly been so signally benefited that the procedure can be practiced 

at koger intervals. The extract is prepared by mincing the gland, freshly 

tifcrn frcrm a healthy animal, maceration, and filtration under pressure. The 

Bftpafstion and injection should be made with every antiseptic precaution. 

^jWmuiKrous favorable cases, in all stages, which have been reported, leave 

^^^■losa for doubt that in this method we have acquired an effective weapon 

H^Bst a disease which had been unamenable to any other mode of treatment. 

B^ It has been demonstrated by Dr. Hector Mackenzie, of London, and 

■ Ilr. E- L. Fox, of PIvTiKiuth, that the administration of the th3Toid or a 

l^fetno-itxtracc of the gland, by the mouth, is, perhaps, as efficacious as the 

^JBCtioii. The gland may be given raw, finely chopped, seasoned, and added 

U b«af*tea, or it may be lightly fried. Thorough cooking would probably 

itim its virtue. It is not necessary that a large quantity of the remedy 

Awilif be taken. Half a gland or, at most, one gland, or an equivalent 

^matity of the extract, twice a week, is sufficient, and if a proper amount 

ii ocavded vomiting and increased frequency of the pulse are produced. 

Otinn ma^ be enjoined as regards the sudden resumption of physical 

cnraae when improvement takes place. A sudden or excessive strain upon 

aviaiened heart mav occasion syncope. 

Sluidttlfle Thyroideas Siccae (U. S. P.).— I)isiiratt:*d Thyroid Glands. 

TV.tr^.iiTi.iirn fciiccuni (B. p.). Dry Thyroid is **tlie clcaneil, drie<l. nnd pow- 

»1 glands of the sheep (oris arir^), free from fat.'* Liquor Thy- 

tvtdn \i*. i'-) is a liquid thai et)ntain!? the products of the fivsli antl ht*altliy 

cUbaL in a 0.5-j»iT-rrnt. phenol solution witfi glycerin. The dose of the 

|MV> " (<ir gr. j), gi\en in cai»iiuU% thrw times a day. to be grad- 

to 1 <iiu. (or gr. XV). The ilost- of the litpiid Is O.Uo to 1 

■.^), 

^. > MvCohen has observed that thyroid extract has a very decided 

power, and has employed it with satisfaction as a diuretic in a 

-♦V, r.i, apparent disease of the thyroid gland. He speaks also of a 

. uly in which the administration of the same remedy alle\iated 

iiggests that it may be of service in a recent case by preventing 

ireement of the pituiUiry body. 

\utwerp,* has found that the continued administration of 

- exerts a depressing effect upon the functions of the pelvic 

axid a stimulating effect upon the lacteal glands; in every case 

■BHmiiagia was cun.'d by them and menstruation became normal, while the 

hetcal aecTftions were remarkably increased. He also recommends it for 

^ea&^eative disturbances of the pelvic organs. 



ttP 



4 



• ttuU. 4r VAcad. dr UHl. de Rrlgiqur 



208 



puak.maci:l:tjcal rmiitArKLTic AuJiMb on dkuos. 



In some forms of amenorrhoea, especially of the congestive variety 
th}Toid extract in small doses may be employed with asserted good results 
At a recent meeting of the Liverpool Medical Institution Dr. Glynn relatei 
that in young girls in whom temporary amenorrhoea, or a delay in men 
struation in consequence of slight developmental changes occurred, th 
administration of thyroid extract in doses of 0.03 Gm. (or gr. ss) at bed 
time proved sufficient to re-establish or to institute the function of men 
Btruation. 

Byrom Bramwell and Arthur T. Davies have reported several cases o 
stubborn psoriasis and eczema which were cured by thyroid feeding or th 
use of tablets of thyroid extract. Bramwell was led to make use of this ageu 
on account of its favorable effect upon the skin in myxoedema. 

Bruce^ reports his obser\'ations with thyroid extract in twenty-thre 
cases of insanity, including mania, general paralysis; puerperal, lactationa 
climacteric, syphilitic, and alcoholic insanity; he founcl that, to obtai. 
benefit from this treatment, it was necessarj' in some cases to give maasiv 
doses (4 Gm., or gr. Ix, daily). Its administration is contra-indicated i 
cases of mania where the excitement is acute, the loss of body-weight rapic 
and danger of exhaustion from mahii^similation of food; but a course of th 
lh\rijitl treatment led to ultimate rocovDry, where the recovery had been pn 
tracted, or where a tendency to drift into ik^nientia existed, and especiall 
in the insanity of the adolcecont, climacteric, and puerperal periods. 

From an investigation of the chemical composition of the thyroid glanc 
Dr. Frederick Gourlay states that it contains no ferment capable of dissoh 
ing mucin, that the only proteid which can be obtained from it is a nuclec 
albumin, and is inclined to believe that its usefulness in the treatment c 
myxcedema is due to the presence of the nucleo-albumin. He asserts, alet 
that the secretion of the gland does not consist of mucin. The dried an 
powdered gland has also been employed under the name of Thyroidin. Th 
powder is of a grayish-yellow color and a peculiar odor. It is thought to I 
better tolerated than the gland. The virtues of an entire gland of mediui 
size are said to be represented by 0.59 Gm. (or gr. ix) of the powder. Tb 
efficacy of the gland does not seem to be lost by drying. The powder hi 
been usually administered in the form of pills in daily doses of 0.10 to 0.2 
Gm. (or gr. iss-ivss), which amount may be gradually doubled. Dr. Byroi 
Bramwell has derived the same results from the use of this preparation s 
from the gland itself or its extract. 

Dr. J. D. Menzies, of the British navy, reports several cases in whic 
thyroid tablets were of advantage in precocious malignant syphilis, specifi 
medication being suspended. Dr. N. Yorke-Davies asserts that, in the trea* 
ment of obesity, the use of these tablets is of great assistance. 

According to experiments and extended clinical observations of Eorge 
th}Toii1 extract, though ofton ptiieacions, is siWl not a suitable remedy for a 
cases of obesity. The advantages claimed for tlie method an? that it effec' 
positive results, and t]ds without in any way restricting the patient's diet c 
his ordinary habits of life ns regards exorcise and occupation, — matters oftc 
of gn-at importance in privnto practice; but certain wrll-murkcd subjectii 
disturbances — snob ns iDilpitfltion, restlessness, tremor, and insomnia — ^ 
hand in hand with tlie nnprovementa, and give the individual more or lei 



'Journal of Mmtal Science, No. xli, 1895. 




AMMAL EXTRACTS, SECitETIONrf, AND SEUl'MS. 



20J> 



> 



^< — '-t. Th}Toid tablets are sometimes used by patients without mecli- 
i;i . anil commonly for the reduction of adipose. G. Carri^re (Nord 

MtiUaUf, Lille, Xoromber 1, lHOo) has seen six cnse? of sudden angina, 
ptmrm^ry n-(1i»mo, acute asystolia, from such unauthorized use of the reni- 
edr. ' pioni* were violent and alarming, but the suppression of thy- 

wmA r 'U banished tliem completely and permanently. Some fatal 

ttiE» hate lie^n refMiried. The toxic etfects from this agent are grouped 
taprtber omler the general title of Thyroidism. The principal contra-indica- 
lioB i* \o lie found in constant, greatly-increased nitrogen excretion, an in- 
A^ ' '^ ' _ , ill albuminous breaking-down, and which cannot be ter- 
It Iv cutting off the drug, but continues for an indefinite 

^^^^^ "' ^'"i' i»it<r its administration has hcvn stopped. 

^m Thyreoglobulin constitutes about 10 per cent, of the gland (wet) and 
*M»*«tn* the iodine constituent of the th}Toid in the original form it has 
m the gland. According to Oswald/ thyreoglobulin was found to have the 
tmme influence on the excretion of nitrogen in animals in metabohc equilib- 
ham as ihe entire gland. His view is confirmed by its action in two cases 
4f DTXc^ema. He obtained from thyreoglobulin a product resembling 

^|iot}> -iipposed to be the bearer of the specific qualities of the gland), 

Btt c z 14,3 instead of 9.3 per cent, of iodine. 

Dr. Ciiarles Macalester, of Liverpoob used preparations of the Thymus 
Slaad with advantage in cases of pseudohypertrophic paralysis and general 
Itjinphsdenoma. 

Mikulicz, in ten cases of goitre and one of Graves's disease, obtained 
CBDonraging results from the use of thymus glands. He gave at one dose 

^# or 15 Gm. (or oii '/Viv) of raw sheep's thymxLS, finely cut up and spread 

^BoD tcmat. The ouantity was gradually increased to 25 Gm. (or oviss), 

^^ 9'eplmn. n snliiie, glycerin extract of Uic cortical substance of the kid- 
■rr, has H.-^n pr<']>'^>scd as a remedy in cases of nephritis. Subcutaneous in- 
yrtinn^ *»f nephrin will, it is thought, prove of service in the treatment of 
Br»tntB. M- Dieuhifoy has described the results of his experimental use of 
■rplirin in an aggravated case of uraemia. The patient suffered with sup- 
|ic«sckio ttf urine, anleuia of the lung, copious perspiration, and diarrhoea, an 
alMui'lAiit*e of urea being contained in the excreted fluids. After injections 
i4 orphrin. urine was again sei-reted^ sweating of urea ceas^^d, the mind 
dcmr«<l. «nd the patient was able to ppeak. Furtlier clinical experiments 
been made bv Teissier and Fraenkel. Tht^e observers found that the- 



I 



4 





4 

^ 



JBJcdinn "? n trhcerin-extract of sheep's kidney in patients suffering froiu 
a iy hr '-d the j>owrr to excrete toxic sul^stancea in the urine. The 

iDbj«i:' ., ed a sense of general amelioration. Albumin, at least in 

carets di«^p[»eanHl from the urine during the days when the injections 
ifivni- Th»'n:» was litth^ or no influence upon the quantity of urine- 
.1. 

Glaadnltt Snprarenalcs Siccse (F. S. P.), Dcsiccnted Sujirarcnnl 
Gtexfet)*- ^f^' "th*' rlt'MMi'd. ilri*'d. and powdered suprarenal glands of the 
rf >» r p ri)-*). i.r o\ (Bos tjiunijs). freed from fnt." This substance 

\mk DC.:. :. ..nd to possess extraordinary astringent powers upon the smaller 
Uood-veiveit, causing intense anemia when applied to the surface of mucous 
tbranefl. The adrenal extract, owing to its convenience and activity, is 

mrd, TTorA., 1899, xxxiil. 



210 



PHARMACEUTICAL THERAPEUTIC AGENTS OR DRUGS. 



largelj used in order to produce bloodless operations in nasal surgery. Ex- 
tensive operations upon the septum, or upon the turbinated bodies, are now 
performed without hjemorrhage by means of a preliminary application of 
a solution, which may be prepared as follows: — 



B Olandul. suprarenalum sicca 4 

Acid, boric 1 

Cinnamon-water 15 

Camphor- water (hot) 30 

Distilled water (hot) q. a. ad 00; 

Macerate for four hours, then filter. 



Gm. 

Gm. 
com. 
c.cm. 
c.cm. 



or 3j. 

or ffr. xvj. 

or f3iv. 

or f5j. 

or fjij. 



Dr. E. A. Peters' has used a 10-per-cent. solution of the suprarenal 
extract for the pain in carcinoma of the niamrase. stricture of the cesophagus, 
tuberculosis of the larynx, and periodontitis. In none of these patients was 
there any apparent delett*rious effects. 

Suprarenal extract has also been used in Addison's disease, with grati- 
fying results in some cases, beginning with 0.13 Gm. (or gr. ij) three times 
a day and gradually increasing until 1.30 Gm. (or gr. xx) are taken daily, 
extract, for the pain in cjircinoma of thv iiiamuwv, stricture of the oesopha- 
gus, tuberculosis of tlio larynx, and periodontitis. In none of these patients 
were there any apparent deleterious effects. 

In 1901, Takumine and Aklrich, working independently, isolated the 
active principle of tlie suprarenal ghind. Adrenalin (Ci(,IIi-XO„), which 
occurs as a light, \\h\b\ inicrocrystallinc p<nv(lci\ of a slightly-bitterish 
taste, leaving a numbed feeling on the spot of the tongue where it is applied. 
The nanus Epinephrin uuA Suprarenin have been appliod to similar deriva- 
tives, by Abel and vnu Fdortb. ExjiorinRnts shoAvcd tliat o drop of an 
aqueous solution in the strength of 1 to ln.OOO l)lanchcd the normal con- 
junctiva within thirty to sixty seconds. Dr. Emil Mayer- gives his results 
with the use of this agent in thirty-five rhinologicol operations. He found 
that an application of a 1 to 1000 solution produced blanching of the tis- 
sues within a few secf>nds, the operation? b(*ing pitlicr bloodless or attended 
with very little ha'morrhage, and in uo instance was there any constitutional 
disturbance. 

Dr. E. Fletcher Ingals' suggests that, if adrenalin is dissolved in a 
normal salt solution, it lessens the pain and smarting. He has found that 
a 1 to 5000 in normal salt solution acts with the same rapidity and in- 
tensity as the solution made with 2 Gm. (or gr. xxx) of the desiccate"] gland 
to 30 c.cm. (or fjj) of water. In acute coryza, acute Inryn^otraeJieitis. and 
acute laryngitis this agent has promptly reduced the swelling and coiiges- 
tioTiy and in a few days the patients weni well. In order to prevent fungous 
formations in these solutions Dr. Tngals has suggested the following: 1 
part of adrenalin to 5000 of liquid containing 0.50 Gm. (or gr. viij) of boric 
acid, cinrnmon, and camphor-water, of each, 7.6 c.cm. (or foij); and dis- 
tilled water. 15 c.cm. (or f,3ss). 

Abel'* gave the name of Epinephrin to w bt>dy he isolated from ad- 
renal extract, and to which he attributes the well-known effects on blood- 
pressure of this substance. From the reactions of epinephrin it would seem 

^TAtncri, March 2. ll>ni. 

* PhiJndelphia Mrd\v<i\ Journal, April 27. 1001. 

' Jounwi of the Amrrican J/crfi/yi/ Aaaodatloyi, April 27, IftOl. 

*Z€it8chr. f. physiology. CAcmiV, xxviii. p. 318. 




AXUCAL EXTIUCTH, SECRETIOXS, AND SERUMS. 



211 



^ Srloog lo the group of animal alkaloid?, and it is either identical with 
•->«AUn, or is a derivative from it. It is obtained from aqueous extracts 
si tt< ulnenald by the action of benzoyl-chloridej and from the benzoyl com- 
i-jijijon thus formed Abel isolated the free base, and made a piorate, bisul- 
fiatt. bjdrochlorate, and hydrobromate, as well as a triacet}*lnephrin and a 
^^r " I'rnzin derivative. Its various decomposition reactions seem to 
afr . Lnephrin a place among the pyrrol or skatol bases; treatment 

»tUi -uiui^ alkalies forms a dark pigment, which the author denominates as 
fpinrphrinic acid, and a base of coniin- or pyridin* like odor. On fusion 
crti Tw>ta£einni; appreciable quantities of skatol result. 

The free base cannot be produced except at the expense of its physio- 
hpeai ^cacy. On the other hand, most of its salts react on the system 
ftn eneceticallr; they have a slightly-bitter taste, cause a partial anses- 
lifr- •' tongue, and produce a local vasoconstriction. When introduced 

B3 rcnlation, small doses at first excite and then centrally depress 

•BF] . heart-failure follows larger amounts. The insolubihty of the 

jwoarauoc, however, which increases on keeping, unfortunately renders it 
«fufla avail therapeutically than might otherwise be expected; since the 
zic doae is far above that required to produce the physiological action. 
.'•eiytiirin, the normal pigment principle of the urine, in part exhibits 
cblUt properties to epinephrin, and the probability of a relationship be- 
rvt^n the two bodies seems very great. 

Extractmn Pancicatis. — Many cnses of diabetes are dependent upon or 
•t ^:*5t a^sociattd with dLsoase of the pancreas. It has been demonstrated by 
Sakonld and Ton Mering that removal of the pancreas causes glycosuria, 
j p ttp ective of the nature of the diet. If, however, only a small proportion 
«< Uk gland is left behind, diabetes does not develop. Furthermore, when 
peees of the pancreas taken out of the abdominal cavity were grafted into 
OM abdfsminal wall the advent of diabetes was prevented. Minkowski was 
M to beliere that the pancreas performed some function indispensably 
auMMmry to the normal transformation of sugar within the organism. Pro- 
kmct Lupine has ingeniously argued that the pancreas generates a ferment 
ajikh is necessary to assimilation of amylaceous foods. In view of these 
fvCa and bvpotheses it was thought that the ingestion of the pancreas or 
pnpantiona derived from that viscus might prove serviceable in the treat- 
^mt of some forma of diabetes. Clinical experiments have been accord- 
airik made in that direction and the results, which, unfortunately, fall far be- 
)iv *TTi*-f ration, have been published by Mackenzie, Hale- White, Neville, 
IT©. istini, and N. S. Davis (Jr.). The patients subjected to this 

adhuu (iii^e generally experienced improvement of subjective symptoms, 
od tooie hare gained in weight. The quantity of urine was not, as a rule, 
in one case reported it was even increased. The specific gravity 
were uninfluenced, and in most cases the amount of sugar was not 
• ssened. In one case ingestion of raw pancreas was followed by 
h«*ma. accompanied by fever. We may, nevertheless, agree with 
,.»n of ifackenzie: "For myself I would rather find an improve- 
■ ' general condition of the patient, increased strength, dimin- 
and diminished quantity of urine as a result of treatment, than 
Tc GMiiiniition of the amount of sugar in the urine without such im- 

ient. - . » It is evident that liquor pancreaticus is no specific, 

the effect* in these cases are encouraging enough to induce me to make 







212 



PHARMACEUTICAL THEEAPEtTIC AGENTS OR DRUGS. 



further trial of it, and it is possible that in cases of true pancreatic diabetes 
the benefit nii^ht be greater." 

The United States Pharmacnpo^ia recognizes as official Pancreatinum : 
a powder which consists of the enzymes naturally existing in the fresh 

Eancreas of warm-blooded animals. The British Pharmacopoeia containa 
iquop Pancreatis: a liquid containing the digestive principles of the fresh 
pancreas of the pig. These preparations are used mostly as digestive agents, 
especially in those disonses and conditions where starch and fat are imper- 
fectly digested (see Pancreatinum) , As these preparations contain the active 
principles of pancreas, and are more paliitable than the raw gland, they may 
be administered in those cases of pancreatic diabetes where irritability of the 
stomach is a prominent feature. Tlie injection of pancreatin into malignant ^ 
growths ha? been nTontly advoocated. 

An extract prepared from the Parotid Gland has been used in doses of 
0.13 to 0.32 Gm. (or gr. ii-v) in some nf the functional disorders of the pelvic 
viscera, especially ovarian neuraliria, with gratifying results. Improvement 
has also been noted in acromegaly after the use of an extract from the 
Pituitary Gland; and preparations of Cardiac Tissue have been injected 
hypodermically for the relief of weak heart. 

Bone-marrow has been given with decided advantage in ansemia by 
Dr. J. Dickson Mann, of Manchester, and Professor Fraser, of Edinburgh. 
The pnrt which marrow performs in the development of red corpuscles allows 
us to believe that in this substance we have gained a valuable remedy. Dr. 
Mann thinks that, as the tisstie-forming power is more active in young than 
in old animals, the bones of the former are preferable as a source of marrow- 
extract. The extract which he employed was made from the heads of long 
bones of animals freshly killed, together with other portions of bone which 
contain red marrow. The bones are broken into small pieces and digested 
in glycerin with fretjnent agitation. Several days are required to accomplish 
complete extraction. The result, after filtration, is of a red or reddish-brown 
color and has no unpleasant taste or odor. It may be given in leaspoonful 
doses once or twice a day, either by itself or spread between thin slices of 
bread. Dr. ilann gives the results of a case ef haemophilia in which extract 
of bone-marrow was employed. A boy had been rt-peafedly treated for 
attacks of hiemorrhage which had left him the subject of pronounced 
aniemia. After a few weeks of treatment by bone-mnrrow a marked increase 
in the number of red corpuscles had occurred and his face acquired a healthy 
color. The same result was obtained in aniemia from other causes. Professor 
Fraser's case was one of pernicious ana?mia, which had lasted for about four 
months, when the patient entered the hospital. Treatment by means of iron 
and arsenic, both alone and combined, was altogether ineffectual, and the 
proportion of red globules and hnemoglobin steadily fell. After the admin- 
istration of bone-marrow — which was given, uncooked, by the mouth — 
improvement was almost immediate, the quality of the blood began to 
change, and at the end of six months the man was practically in a normal 
condition. Dr. W. G. Bigger has published the history of a case of letika?mia, 
which was apparently cured by the use of bone-marrow, given raw, spread 
upon thin slices of bread, and produced a remarkable improvement in the 
symptoms of the disease. At the end of several months the boy was reported 
as perfectly well and the ^;plcon of normal size. 

2. Serums and Antiioxius, — Blood has been used as a restorative for 




AM M A Tr EXTH.\CTS. SECBETIOKS, AKD SEBUUS. 



213 



is^ 



^jr^r T».ape, Ixith hy the stomach aud hy transfusion. Solares strongly 

th > tJje serum from the lilood of bullocks as a nutritive agent in 

?i- . especially in children. He considers it suiM?rior to inuscle- 

^ ali»iiifi. It may be ^iveu by the mouth or the rectum. An 

ifticA^: i of investigation relate?^ to the cmpLiyment of Blood-serum 

A* m hit -il agent and to the modification of the blood by means of 

iMTtrriiii pHniucts and llie production of iniuumiiy or cure. Tlie funda- 

■mtal T<r:n. idc is the alteration of the scrum in such a manner as to ren- 

«ler it ivo to certain specific bacterial products. This method of 

nstmir n applied experimentally to several dHn>:enm8 infectious dis- 

cviSw - vrjis one of the first mahulies to be thus studied, Behring 

bftft COL ii»? of ex|}eriments vith a view of first rendering an animal 

jmmvv by inoculntion with the toxin elabnrated by the bacillus 

•f • ;iud, pccoudarily, utilizing the senmi of the immunized ani- 

tt» :jvi» remedy for the established disease in another animal or 

li man. iDununity is secured by successive injections with the toxin of 

fl.f.»M« fn gradually-increasing doses. He believes that he has proved that 

■li? of the immunized serum into the subjects of tetanus will cure 

The quantity of the modified serum must bear a certain pro- 

ihe ^>ody-weight ; so that much more is required for men than 

.UMtiviU. Dr. Behring succeeded in preparing a standard serum 

IQS antitoxin. The longer the stage of incubation and the more 

lit tlie «»urse of the malady, the more favomble is the effect of the 

t-fi'»ns- A number of ca?es in the human subject have l)eon reported in 

• txfcvory appeared to be due to the employment of this method. The 

,ijrT i...ii?i niv said to be in themselves harmless. In one of the successful 

pVe^ the period of incubation was only six days. Dr. Joseph F. Hobson, of 

^L reports the successful treatment of a case of tetanus, which de- 

md the tenth day after a con»pound fracture of the til)ia. An injec- 

t( l4*i i-.L-m. (or f3ii */J of the serum was given, and repeated at in- 

_of four to feix hours for the next five or six days, when, owing to 

ji*-ut, tliey were given with less regularity. Besides the serum, 

"Tiydrale, 1 Gm. (or gr. xv). and hyoscine hydrobromide. 0.0006 

(or ^. '/,cw)* were given every four hours; also morphine sulphate 

' ■ '^', 0.016 Gm. (or gr. V*)* was given about four times daily 

rkl was sh*epless or nervous. The local wound was not laid 

(vd henlthy. Ue<*overy followed, the serum being dis- 

wmi tenth day. These procedures and their results have not 

Ittled to meet with adverse criticism, but in view of the inadequacy of for- 

m^ T:.rhi-»t\s the path of inquir>' is certainly legitimate, and it is probable 

tki: lead to an effectual means of combating a severe disease. The 

aeX' —um is now also prepared in a dry state and sent out in tubes 

•Ml :^' 4 or 5 Gm. (or 5i-i VJ: a quantity rather larger than the 

■c -*rded as curative in the case of a man. The dose varies 

Met'- verity of the symptoms, and is repeated for several days 

a nB«ili!^r qtiaiiUJy, The dried serum is to be dissolved in distilled water 

oi #obcutane^usly injected. Several cases of recover)' from tetanus of 

csomatic origin have been reported, in which intracerebral injections of 

etxtoxin » ere givt^n, in connection with other treatment. Roux and Bor- 

from experiiuente at the Paris Pasteur Institute, demonstrated that the 

toxin i< extracted from the blood and is fixed by the nerve-cells, 



. 





214 



PHARlUCEUnCAL THERAPEUTIC AOBXTS OR DRUGS. 



while the tetanic antitoxin, when injected into animals, remains in the 
blood; so that the antidote does not come in contact with the poison, and 
the two substances, though so near to each other, fail to meet. This ex- 
plains why, in man as well as in animals, the subcutaneous and intravenous 
injections so often fail, for when ihey are resorted to the nervous system, as 
pointed out also by Dr. George G. Ranibaud, has already fixed a smaller or 
greater quantity of the toxin, and while the antitoxin, thus administered, 
neutralizes the toxin circulating in the blood and limits the poisoning, it 
does not reach that which is attached to the cerebral or spinal cells. Of 45 
tetanized guinea-pigs, treated with intracerebral injections, 35 recovered; 
of 17 others, treated with simple subcutaneous injections, only 2 survived; 
of 17 not treated with antitoxin at all, all died. 

The technique of the operation in man is simple. After the removal 
of a small button of bone by a trephine (V* inch), the intracerebral injec- 
tion is made, into a neutral area, such as the forepart of the frontal lobes. 
The quantity of the serum injected is small (5 to 6 c.cm. of a concentrated 
serum made by drying 10 parts and thus redissolving in 5 parts) by the slow 
introduction of which any undue compression is avoided. In addition to 
the intracerebral injection, it is necessary to give antitoxin intravenously 
or subcutaneously for a few days, so that thereby the toxin circulating in 
the blood and nny that may later be secreted at the site of injury, may be 
neutralized before it can affect 'the nervous centres. Out of 9 cases thus 
treated, collected by Rambaud, 4 recovered and 5 died. Successful cases 
have been likewise reported by Dr. Charles A. Church, of Passaic, N. J.; 
Dr. E. Forgal, Montpellier, France; and Dr. Semple of the Army Medical 
School at Netley, Enprland.^ 

Scrum Antidiphthericum (U. S. P.). — Diphtheria Antitoxin, This is 
a fluid separated fmni the blood of a horse, Eqnus Cabnllu?, L, imnumizod 
through the innrulatimi of di]>htherin toxin. It should be kept in sealed glass 
eontainerfi, in n dnrk place, at temperatures between 4.5** and l-'»° C. (40" 
and 59° F.)- Brhring onginally obtnined a curative serum from the blood 
of sheep which had been rendered immune tn diphtheria. Thip senim has 
been clinically employed by Heubner, Henoch, von Bergmann, Kossell, and 
other observers ivith encouraping results. 

Highly-satisfactory results are obtained from the official serum, which 
is nmv universally made from horse-serum. Diphtheria antitoxin of good 
quality is now manufaetured in this cnunlTV bv manv municipal lnl>orntorie9, 
also by H. K. Mulfoid .*f Co., of Phihdelpliia ; Parke, Davis & Co., and Fred- 
erick Steams &■ Co., of Detroit, and otheris. 

The use of diphtheria antitoxin is not altotrether free from accident. 
The injections may occasion erythema, urticaria, fever, swollen glands, 
arthritis, hematuria, and albuminuria. They have also been thought to 
favor an increased tendency to paralysis. Several deaths have been reported 
directly following an injection of antitoxin. Owing to the precautions taken 
at present in the manufacture, such accidents are now extremely rare. The 
usual custom is to administer a maximum dose once daily flOOO to 1200 
units), but Dr. John H. iNfusser advocates giving smaller dngea (500 units) 
and repeating them every four or six hours, according to effect. Accumulat- 
ing experience having shown the safety of this agent, larger doses are now 



^British Medical Jounutl, Jan. 7, 18&0, 




ANtUAL EXTlLiCTS, SKCRETIONS, A\D SEKUM9. 



215 



I 



!. The ordinary dose given by some' is 2000 units, and thjg may 
itA ererj' three hours in a severe case. Every care sliould be taken 
fresh antitoxin and to sterihze thoroughly the hypoderiuic needle 
nd plAc« of injection, which is usunlly in the hmibar region, or buttocks, 
Off bKvfen the shoulder?, or under the skin of the abdominal wall. The giiid- 
iag priDciple in tbe administration of the serum is that it must be given 
ntil U»e characteristic effects are produced, namely: shriveling of the false 
aonbrane, diminution in nasal discharge, correction of fetid odor, and gen- 
«nl iniprruement in the condition of the patient. 

Edwin I?o?*-»ntlmP hns taken much pains in obtaining statistical in- 
fonn^rion respecting the mortality records in eases of diphtheria, and with 
till? end has obtained reports from one hundred and fifty-seven cities, in 
tike United States, having organized bureaus of health. A summary of the 
reralts 13 as follows: — 

I Number of cases previous to the senun period, 182,256, with a mor- 

ItStj of 38.4 per cent. Number of cases since the antitoxin period, 132,548, 
with A mortality of 14. G per cent. The latter were not all treated with 
ieniiD; in computing those cases treated with the serum alone the mor- 
UHtj was 9.8 per cent. 
Jefferie Turner* records his experience of the treatment of diphtheria 
*za the Children's Hospital, Brisbane, and compares the results obtained 
liace tlie injection of antitoxin was begun in that institution with those 
obirrred in the same hospital in the preantitoxin period, from July, 1889, 
UBTTf 1895. As regards laryngeal cases, in the author's experience an 
mortality of 59.2 per cent, for the preantitoxin period has been 
icvd to an average mortality of 18.6 per cent, since the use of antitoxin. 
g the same periods, whereas formerly only 8.4 per cent, of tlie laryu- 
' fcsl CAMM recovered without operation, since the introduction of antitoxin 
flB average of 38.4 per cent, have recovered without operation. As regards 
•pention cases alone, whether intubation or tracheotomy^ or both, the aver- 
^^K« mortalit}* of 65.7 per cent, for the preantitoxin period has been reduced 
^m) an arrrage of 28.4 per cent, for the antitoxin period. The author states 
^■^t ■ five years that have elapsed since the introduction of the use of 

^^^3' the diminution in the hospital mortality of diphtheria has been 

' Bof ' -rt of marvelous to all but a few who had mnde themselves ac- 

Cith the thorough and uninipenchable experimental basis on which 
new treatment had been based." He emphasizes the importance of its 
aKr?v «'! ministration, and concludes that, with certain necessary qualifica- 
tioT 39 the occasional difficulty of diagnosis during the early stages, 

•do « t:ii'i "Ught to die of diphtheria." 

Paenmonia Serum. — Prs. 0. and F. Kleinperor recommend a curative 
snun for croupous pneumonia. Immunity in rabbits was produced by in- 
|gtaon# of sali\a from pntients, a glycerin extract of pncunnxocci, and, 
m^er certain conditions, bouillon-cultures. Immunized scrum acts with 
m»Tt certainty when injected directly into the blood-current, and is believed 
la Deutrahze the poisonous products of the pneumococci. These investigators 
ode that "we have in the serum of immune rabbits, the poisonous 




• .Vrtr York UrHionl Journal November U, 190.3. 

f'Ut^iml /'rT«, ^iit in, jiMK>. 

• tm4rrmatiirHal Mriical Jovnial of AmtralaHa, Bee. 20, ISMK 




■ 




21 C 



PHARMACEl'TICAL TUEKAPEl'TIC AOEXTtt OH DHL'GS. 



action of which we are able to destroy, a specific against pnetimonia." The 
action of tlie material was tried ia six patient? Buiferinsj vitli pneumonia, 
and in every case there was a considerable reduction of temperature, pulse, 
and respiration. The effect was manifested in from sis to twelve hours, and 
in two cases the temperature remained normal, while in the remaining cases 
it rose at the end of six hours. In several cases treated by other observers 
an improvement followed the ui:e of this method. In other cases failure has 
resulted. In one case of pneumonia following influenza, Fourriere derived 
benefit from the injection of 11 c.cra. {or foiij) of goat's blood, the operation 
being repeated four days later, the blood presumably acting by virtue of the 
bactericidal 4uality of its serum. 

An antipneumococcic serum now in the market 1;=^ <»btainLMl by injecting 
living cultures of ihe pneuniococcus into the veins of a horse, and, when 
immunity has become established, separatiu;.'; the seruin from the recently- 
drawn blood of the animal, and, after the addition of a small amount of 
preservative (tricresol), it is sealed up in small flasks. This remedy is used 
by hypodermic injection (dose, 10 to 20 c.cm., or foii 'A-v) in cases of acute 
croupous pneumonia. The results reported by Dr. James C. Wilson^ were 
not very encouraging, affording a mortality of 23.2 per cent, against 20 per 
cent, by other methods; hvjt this is jtmnounced a temjJting field for further 
investigati'tii!^ in ^ii-runt-thenipy. 

Similar experiments have been made, with excellent results, in the 
treatment oi tjhtmirrs in the hort^e by means oni inHiumi/-ed s^runi, Mallcin, 
but have not yet l»een extended to the human subject. JIalkin, as it is 
called, is now employed principally fur diagnostic purpctses. but it should not 
be used when the teaipetature is above nnrnuil, Beruheiui has made use 
of tlie same jtrineiple in ihe treutmeut of mnre than !'>(» eases of tabereulosis 
and a.sserts that ibo efTeet was benetieial, iiml stales that in thirty i^atients 
the physical signs and synijjtnnis had sliown improvement fur five inunths. 

Prophylactic and curative inoculations have been recently employed 
against hjphoid fewr. Fraenkel and Mnnehot nbtained a sterilized liquid 
from a culture of typhoid bacilli in bouillon, made from the thymus gland of 
a calf. They employed it clinically upon fifty-seven cases of typhoid fever, 
administering 0.5 c.cm. (or mviiss) of the sterilized fluid by deep injection 
into the buttock, without unfavorable local or general effects. The next day 
1 c.cm. (or 7/ixv) was similarly injected into the buttock of the other side. 
In the majority of cases the second injection produced chilly sensations, 
elevation of temperature, foHowed by a decided fall. The injections were 
given every other day, with amelioration of symptoms and early deferves- 
cence. Klem}>erer and I^vy suhseipjontly injected similar bouillon cidtures 
of typhoid bacilli into dogs and obtained a blood-scrum capable of immuniz- 
ing susceptible animals and of treating the disease, after infection. 

In Sonth Africa this preventive antityphoid inoculation was carried on 
in officers and men, during the siege of Ladysmith, of which Dr. A. E. 
Wright- gives sf»nie statistics, in tabular forin. He states tliat wliilr it is at 
this stage impossible to determine precisely that the inocidated were pro- 
tected, yet the results would appear to be distinctly encouraging, inasmuch 
as they show that the proportion, on the one hand, of attacks, and, on the 



^Journal of the American Medical Asaocintiont Sept. 8, 1000. 
^Brituih ^rcdiv^tl Journal, July 14, IIMIO. 




AXIUAL EXTRACTS., SECHETIO.VS, AND SEfirilS- 



*m 1 i 



' liand, of deaths, from typhoid, was seven times smaller in the inocu- 
lum m the uninoculated. Dr. A. Conan Doyle, in a letter from South 
!•' xUv lir\(i»h JJftlical Journal, ivgvots that iuoculation for enteric 
Dot nutde coinpuUory% and considers this a mistake, which will not 
ftud in any suUequeut campaign, li it had been made compulsory, 
nj vooW have escaped from most of its troubles. The strong im- 
;rsioq, hii n experience, is "that, although it is by no means an 

alsdnUf f: • , it certainly modifies the course of the disease vt-ry 



Ci^.— ... J.- another infection which it is sought to control by injection 
' laeeuution with products derived from the cholera bacillus. Professor 
; has separated from cultures a material which he terms anticholerin: 
' a ckar, brownigh-yellow viscid liquid, which has been purified by removal 
if products deleterious to the animal organism. Anticholerin has no toxic 
act upon man, but is thought to antidote the virus of cholera. A trial 
m a Bainbiii:g hospital, limited to serious cases, is said to have given 
ine rfsuils. 
M. •-' has devised a method of vaccination with matter derived 

- r.. ( oiuires of cholera bacilli, and is now engaged in prosecuting 
- ' -t^ on a large scale in India, with what bentfit remains yet to be 
Ihe theory is now advanced that the bactericidal power of blood- 
resides in the nuclein, the reproductive element of blood-cells, and 
ast the Duclein contained in immunized serum acts by stimulating the 
of sanguification. In response to this stimulation a fresh supply of 
tin is given to the blood. 

Ifi ttjiJtilig the soruui of the lamb and of the ox has been injected 
1 subjects, in a uunil>er of cases, by Italian clinicians, and the 
' tlie malady have undergone decided improvement. The 
■yed was about 6 c.cm. (or foiss), thrown, upon alternate 
;o the subcutaneous tissue of each buttock. S'o other medica- 
'-^ in these experimental cases. Cotterell made use of dog's 
;ii.e5 of recent syphilis. The rash and other manifestations 
,.^ --- , i ared under the inliuence of the injection. • Some observers 
tbougbt that improvement followed the injection of dog's serum in 
inr tuberculosis and neurasthenia. The serum of the dog was 
q pai un entally employed by Tommasoli in three cases of lupus. The 
•aikfid, however, proved of doubtful utility. Though the lesions were 
iiwirablj iDodifi«'d» especially in one case, the disease took on fresh activity 
ii ihe end ' 'ith. The subject deserves continued investigation. It 

t^',.iS%:» : blood of animals insusceptible to syphilis may have an 

aKi - action (o the virus of that disease. 

rt upon the pronerties and uses of Nuclein has been made by 

- \% It i« f»blnine(i from the nuclei of vejretable colls, the pulp of 

" '* vi^lk of egg. It is distinguished from other albumins or 

presence of phosphoric acid. Nuclein is a colorless or yel- 

' '•■ in water and alcohol, but soluble, after I6ng boiling, 

ng and in water. It is given in the daily dose of 

xx-xh ), and causes n considerable increase in the nuuiber 

Presumably for this reason it is etTicacious in pleurisy, 

ot her infectious diseases. Nuclein i? thought to be possessed 

-ji»»^i.K. y.i\ue in latent tuberculosis, producing a transient fever, with 



218 



PHARilACEUTICAL THERAPEUTIC AGENTS OR DRCGS. 



congestion of the apices. The action of nuclein upon micro-organisms hi 
been studied by Dr. Victor C. Vaughan, who, by its use, succeeded in curin 
guinea-pigs sufftTiiig with tulierciiloi^iB prodiKied by inocuhitiou. This ii 
TGstigator also states that the injection of nuclein into guinea-pigs rendei 
them immune to pneumonia. The same method of therapy has Ijeen applie 
to tuberculosis in tlie hiuuan *iul»jovt, wilh very eucouragiug res^ults. 

Adamkiewicz has endeavored to arrest the progress of carcinoma h 
iujectiou of a substance which he calls Cancroin and which is a product < 
the living cancer-cell. In respect to chemical composition, cancroin ! 
identical with or closely related to neurin. As prepared, cancroin is a 
aqueous solution of neurin, to which carbolic and citric acids have bee 
added. Blood-serum or toxins from horses inoculated with erysipelas ha^ 
lately been used by parenoliyinatous injection in caroinonifi. "The meag( 
reports are conflicting. A scrum antidotal to streptococcic infection ht 
been administered subeutaneously by Roger, with reported favorable result 
in several cases of puerperal fever, erysipelas, and suppurative tonsilliti 
Anti-streptococcic serum brought out hy Mamiorek as a remedy for scarh 
and suppurating diseases has been used by Baginsky in scarlatina, who foun 
that it is not a specific in the sense that antitoxin is against diphtherii 
Louis Fischer has reported unfavorable esperiences with this agent. 

Sarcoma has been successfully trentecT by Coley, of Xcw York, Uy a 
original method. The folIowin*r ore his directions for use of the combine 
toxic products of erysipelas and prodigiosus: Inject dose every day into th 
tumor, or in its neighborhood if inaccessible, aiming to get a rise of tem 
perature to 103* to 104° F. Begin with 0.03 c.cm. (or mss) and increas 
dose as required. If the patient shows little or no reaction, the dose can b 
increased beyond 0.5 c.cm. (or w^viij) without danger. If too great depres 
sion follows the injections, they may be given at longer intervals: two day 
or more. Shake the bottle before using, and keep well stoppered in a coo 
dark place, — on ice is best. The needle of the hypodermic syringe shouL 
be passed through an alcohol-flame before and after using. After removin 
stopper place sterilized needle of the hypodermic syringe into the bottle ani 
withdraw enough, or a little more than enough, for the required dose, an- 
quickly close the bottle. For first few doses, up to O.IS or 0.34 c.cm, (or mi: 
or iv); dilute with boiled water. 

Antivcncne is a curative serum obtained from a horse which has bee] 
immunized against snake-venom. According to Dr. Joseph SIcFarland, i 
is a very efficient antidote against the poison of venomous snakes. In th 
Infernational Medical Magatintf September, 1900, he gives the results o 
experiments upon animals, and demonstrates the protective value of anti 
venene. The following is the treatment to be pursued when a patient ha 
been bitten by a poisonous snake: 1. Immediately stop the circulation i] 
the bitten part of the body, so as to prevent absorption of the poison. % 
Incise and enlarge the fang-wound and extract the poison by suctioi 
(preferably by a cupping-glass, or with the mouth, if the mucous membrani 
of lips is sound). 3. Inject hypodermically 0.18 to 0.37 c.cm. (or miii-vj) o: 
a fresh lO-per-cent. aqueous solution of calcium chloride into about a dozei 
places around the wound. 4. Give strychnine hypodermically to stimulah 
the respiratory centre. Whisky should not be given at all, or only in ver] 
i small doses, because an excess of alcohol still further depresses the hear 
already depressed by the venom. 5. Immediately inject 10 to 20 c.cm. (o) 




ANI8DM. 219 

5ii */,-v88) of antivenomous senim, and repeat the injection frequently, Mc- 
Farland advises people living or going into regions where there is danger of 
snake-bites to carry a bottle of antivenomous serum with them. He pro* 
Bounces permanganate-of-potassium injections of little value. Dr. Louis de 
Plasse, of New York, claims to have demonstrated the curative eflEects for 
Calmette's Antivenene in rattlesnake-bite. 

AHIOPOL. — M. Sedan, of Marseilles, has recently introduced an anti- 
fennent under this name, for which he claims remarkable power as a safe and 
always reliable antiseptic and an excellent deodorizer, even the most fetid 
cancerous or gangrenous wounds becoming odorless. This new product is a 
solution of trimethanal. In a solution of 1 to 100 it destroys, within five 
minutes, nearly all microbes; in the streiigth of 1 to 10,000 or even 1 to 
20,000 it sterilizes any culture whatever. The exact bactericidal proportion 
has been fixed by M. M^rieux, director of the Pasteur Institute at Lyons, at 
1 to 5600; but numerous experiments prove that the tubercle bacilli, con- 
tained in saliva, are destroyed in six hours by a solution of 1 to 500, which 
is a very satisfactory result. 

It is necessary to understand the action of the strength solution used; 
doses that are too strong will sterilize a wound, but will dry it and prevent 
cicatrizing. A moderate dose, 1-4000 to 1-3600, on the contrary, favors 
healing. For the nostrils or mouth, a solution at 1 to 15,000, at the least, 
and 1 to 3000, at the strongest, produce complete disinfection. For dis- 
infecting the hands and surgical instruments, a proportion of 1 to 2000 gen- 
erally suJSces. 

ANISI7H (TJ. S. P.).— Anise. 

ABISI FETJCTU8 (B. P.).— Anise-fruit. 
Dose, 0.60 to 1.30 Gm. (or gr. x-xx). 

Preparations* 

Oleum AnUi (U.S. P., 6. P.). —Oil of Anise. Dose, 0.30 to 0.60 c.cm. (or mv-z). 

Aqua Anifti (U.S. P., B. P.). —Anise-water (oil, 2 parts per 1000). B.P., dis- 
tiOcd from fruit. 

SpirituB Anisi (U. S. P., B. P.). — Spirit of Anise (10 per cent.). Dose, 4 to 7J( 
tan. (or f3i-ij). B. P., 0.30 to 1.20 c.cm. (or mv-xx). 

Anise also enters into the U. S. P. official spiritus aurantii composltus, elixir 
tromaticus, and tinctura opii camphorata. 

Anise, or sweet cumin, is the dried, ripe fruit of the Pimpinella anisum 
(Tmbelliferse). The physiological effects are due to its volatile oil, which 
is also found in star-anise (Illicium verum). It is carminative, and, having 
tn agreeahle odor and taste, is much used, in sweetened infusion, in treating 
flatulent colic in infants. Anise may be used in the form of hot, sweetened 
infusion ; or given combined with other agents, as in the following : — 

9 Magnesii carb 2 60 Gm. or gr. xl. 

Spt. chloroform! 30 c.cm. or mv. 

Syrup. simpUcis 7 6 ccm. or fSij. 

Aqua anisi q. s. ad 30 ccm. or f^ij. 

U. Sig.: A teaspoonful, for a child under one year, eveiy hour. 

In bronchial catarrh, anise is expectorant and sUghtly sedative, and is 
therefore used in cough-mixtures. It has likewise been regarded as possess- 
ing the power to stimulate the secretion of milk, but without much ground. 



2'H\ 



PH.'^RMACErTICAt THERAPEUTIC AGEXTS OR DRD66. 



ANTHEMIS (U. S. P.).^Chamomile. 

AUTHEMIDIS ILOEES (B. P.).— Chamomile-flowers. 



Dose, 0.13 to 0.50 Gm 
0.03 to 0.18 c.cm. (oi 



Preparations. 

Extractum AnthemidiB (B. P.). — Extract of Chamomile, 
(or gr. ii-viij). 

Oleum Anthemidis (B. P.). — OH of Chamomile. Dose, 
wiss-iij). 

The tlricfl flawcr-Jieade of Anthemis nobilis (Camposita?) collects 
from rnltivated plants. Tlie Briti?li Pliarmacnpfpia n'(]iiire.c thnt the flower 
gluiiiltl bf e\])an(le(l before iieiiig cuiltrteih 'J1ie oil hns a ]>">\vrrful lowerinj 
Gction upon the reflex excitability of the sitiiinl cord. The hot iiifa.^ion act: 
ns an emetic when freely used. lu smidler ciuantity it i!= aromatic ftud car 
luiriativct and farors perspinitinn and the action of the kidneys. It check; 
reflex cough. A very good eombination after a severe cold, iu simple ferer 
and often in acute* rhcnmatism, is prepared In* pouring 473 e.em. (or 1 pint] 
of boiling wnter over *n Gm. (or ,^ j ) each of chanioinile-flower<i! and tht 
leaves and flowering tops of boneriet. T]\e patient should drink about one 
Imlf, hot^ on retiring, as a diaphoretic, or the entire pint, should emesis b* 
desired. A very excellent preseripiiou for flatulence, and esi^ecially flatu 
lent colic in children, is : — 



Infus. anthemidis, 

Mist. BodsB menth aa 90| c.cm. or fSiij* 

Sig.: From one-half to two tables poonfuU when necessary. 



I 



Locally, a chamomile cataplasm may be used when heat and moisture 
with some sedative action, are desired. The recent infusion is employee 
either hot or cold in domestic practice, in the treatment of colds, bronchitis 
and intestinal disordergj or dyspepsia. The oil has been proposed as an anti- 
dote in strychnine poisoning, and is useful in spasmodic asthma. The oil 
of chamomile^ on account of its sedative action, is a very good addition tc 
fatty preparations for various inflammations of the skin. Used in the oint 
ments named, it will prove of value: — ^ 

IJ 01. nnthemidis (30 to |60 c.cm. or mv vel x. 

Bismuth, subnit 4] Gm. or 3j. 

Ungt. zinci oxidi 3l| Gm. or 5j. 

M. Sig. : Apply well over the surface for er}-Bipcla8, acute eczema, and erythema 

B 01. anthemidis |37 to 

Hydrarg. chlor. mitis 

01. eucalypti 

Adipirt lano! Jiydrosi 31 

M. Sig.: Use upon old muslin, and apply to the surface in infantile eczema and 
in f'^borrhoea. 

ANTHRAROBIinJM. — Anthrarobin is a yellowish powder, not solubk 
in acids or water, but soluble in alkalies, glycerin, and alcohoL Anthrarobin 
is related to chrj'sarobin, for which it is a useful substitute as an application 
in skin diseases. It produces less irritation and staining than chrysarobinj 
and is said to have no toxic effects. Autharobin is excreted, for the most 
part, by the urine unchanged, though some of it is oxidized to form alizarin. 
It colors the skin yellow and the hair red. In psoriasis, tinea versicolor, and 



75 c.cm 
65 Om. 

30 c.cm. or mv. 
Gm. or 5j. 



or wivi vel xilj 
or gr. X. . 




AXTIMON'ICM. ^^^^^^ 221 

! in lO-per-cent. ointment or alcoholic solution, which should 
bcflMd'. -. least every week. 

Aiit:.rj.r^!im can be prescribed thus, with advantage: — 

B AntiLrarobini 4| Gm. or 3j. 

Cb^ hydmrg. nitratis .*.•,..-. (2 Gni. Or 3>*3. 

Unyt. cinci oxidi 31 1 Gm. or Jj . — M. 

fW ckronic erxema and psoriasis. 

B Antkrarobiiii 4| Gm. or 3j. 

ITagt. hjdnrg. oleatia (10 per cent) 31| Gm. or 5j-— M. 

Cw ia tinea vtrsicolor, as well as in ringwonn and favua. 

HydTOxylamin Hydrochloride (XH.OHHCl), a substance allied to 
wtkrarDlttQ and rhr^-yintljin. (Kcin'* in the fonu of colorU^s, hygixn-coplc 
tTTttaU. ' ■ in water, alcohol, and glycerin. It has tlie advantatre of not 

<nfiiny ii. bat is hitrbly irritant aud is capable of producing toxaemia. 

It hm htyiu ii-^^l in psoria?i^, Iu]>u8, scnbieH, and vegetable parasitic diseased. 
ffrdnflfyLftmin hydrtx-hloride should not be applied, to begin with, in greater 
^rmfftb than V'|„ of I per cent, dipsolved in equal parts of alcohol and 
riwrin. The proportion may be gradually increased within the limits of 
iVfaDee. Thi? componnd is not adapted to internal use. It is employed 
dirtily m photography a? a developer. 

MWUMOimrM.. — Antimony. 

U. S. p. Preparations. 
AvUfDomi et Potassii Tartras. — Antimony and Potassium Tartrate, Tartar 

Do*«, 0.001 ti to 0,0115 Gm. lor gr. Wj). 
TIansn Anliinotiii. — Antimonial Wine (contains about 4 Gm. tartar emetic to 
*-i inno crm., '»r 0.13 *^;»i., ur gr. ij. in each 30 c.cm.. or fjj). Dose, 0.12 to 2 c.cm. 
■. \xy, «« an expootornnt, or 4 to S c.cm. (3i-ij| as an emetic for adults. 
TAT rtneiic also enters into syrupus ^iUte compositus (U.S. P.). Mistura 
^frjrrhixm compoMtA (U.S. P.), or brown mixture, contains antimonial wine, 6 
VVU iji It"*, «»r ot tJirtnr emelir. iibout U.OOS Gm. in 30 c.cm. (or gr. '/, por ounce). 

B. P. Preparations. 
AaUtKKiniuni Tartarntum. — Tartarated Antimony, Tartar Emetic. Dose, as » 
O.0027 to 0.008 Gm. (or ^. Vj*-V,) ; as an emetic, 0.005 to 0.13 Gm. 

p. i-ii). 

Amtiasunii 0\iduin — Anlimonious Oxide. Dose, 0.000 lo 0.13 Gm. (or gr. i-ij). 

AaUmomii Nigrum Parificatuia. — Antimonious Sulphide (for pharmaceutical 
>. 

JUitiiitonram Sulpfauratum. — Sulphurated Antimonv (• mixture containing anti- 
■^M«« «iil|>liiiU* nml oxide, nntimonic sulphide and oxide, and sulphur). Dose, O.0tl5 
to4U Cm. <or er. i -ii*. 

Pa|« 1- -li-*. — Antimonial Powder. I\»'*c. 0.20 to 0..38 Gm. (or gr. iii-vj). 

ron2_i i Sutx-hloridi CompoMta. — Compound Pill of Mennirous Chlo- 

Viaazn .-iiitiii-.titrtle. — Antimonial Wine. Dose, O.rtO to 2 com, (or mx-xxx) ; 
1^ P1«mSDcr*« Pill. Dose, 0:25 to O.&O Gm. (or gr. iv-viij). 
i«-. 4 to K r.cm. (or fSi-ij) to adulLs. 



ST 



Pltarroacolo^v — Antimoninm and potassium tartrate, or tartarated an- 
' \n/\, 4- 11.0). iB in colorless, transparent rngtals, 

_ v.. ...lin not li/?* tliJin 99.5 per cent, of pure antinionium and 

nm utrtnit-*, nnd should bo kept in well-ptoppcred bottles** (U. S. P.). 

n - ^rful irritant, and, applied to tlie mucous membranes, 

\ n. To the «kin it gives a sensation of burning, with 

foiluwed by a pustular eruption, resembling small-pox, aud deep 




I 



222 



PHAHMACEL'TICAL THERAPECTIC AGENTS OU DRUGS. 



ulcers, whidi are slow* in healing. When swallowed, it is a depressing eraetie 
also causing an increase of the secretions of the intestinal tract, with occa* 
sional diarrha?a. It has a powerful diaphoretic action, and is elin\inflted bj 
the bile, milk, sweat, urine, and the intestinal secretions. Upon the circula* 
tion it is depressing; under its influence the heart's action becomes weal 
and irre^ilar. and the arterial tension is lowered. The pulsations are like- 
wise retarded. The depression of the vasomotor system i^ both centric and 
peripheral. Respiration het-nrnt^ slower and the bronchial sfxretiona art 
increased. The brain is not directly affected, except that under certain con- 
ditions tartar emetic exerts a sedative action, esjieeially when combinec 
with opium. Large doses diminish reflex excitability of the spinal cord 
and may produce both motor and sensor paralysis. A special action hai 
been noticed ujxm the liver, the waste of nitrogenous elements being in- 
creased, with diminished oxidation of the non-nitrogenous elements. Ex- 
cessive doses have a toxic eifect upon motor nerves and muscles. The rate 
of absorption from the stomach and intestines is slow, and the rate ol 
elimination liv all the cliannels of excretion is also slow. 

Toxicology. — PoisonouB doses of tartar emetic (0.065 Gm., or gr. j, 
or more), cause vomiting, with burning pain at the epigastrium, severe 
colic, purging, and email, frequent pulse and early collapse, with much pros- 
tration of muscular system, rapidly occur. Kespiration is shallow, and, aa 
in cholera, the patient suffers from cramping pain in the calves of the legs. 
In some cases furious delirium has occurred. Death is usually preceded bj 
stupor or convulsions. Toward the close of the ease the urine may become 
bloody and scanty or may be suppressed. In some instances vomitin? is ab- 
sent and there is profound nervous prostration. Repeated small doses ol 
tartar emetic may occasion a chronic intoxication, evidenced by nausea^ 
purgation, a small, frequent pulse^ and, fmally, death from exhaustion. In 
this class of cases suspicion should be aroused that the drug has been admin- 
istered for criminal purposes. Absorption and elimination are rapid. The 
drug is eliminated by the mucous membrane of the stomach and bowels, but 
especially by the kidney. Death may result from exhaustion, or from re- 
sulting gastro-intestinal inflammation. The antidote is tannic acid, which 
renders the salt insoluble, to be followed by demulcents and anodynes to 
relieve the pain. Depression is counteracted by alcohol and digitalis. Tartar 
emetic is incompatible with acids, alkalies, and drugs containing tannic acid. 
Infusions of coffee and tea are, therefore, both physiological and chemical 
antidotes to tartar emetic, and may be used to irrigate the stomach. The 
body shoukl be kept warm by hot-water bnjrj=, and cardiac and respiratory 
stimulants given rather freely. Chmaic poisoning pniduces constant nausea 
and entire anorexia, with subnormal temperature, moist, clammy skin, 
diarrhcpa. and, finally, death from exhaustion. 

Therapy, — Tartar-emetic ointment is a powerfid counter-irritant, but 
is seldom used on account of the datiger of producing sloughing and scars. 
The treatment of inflammation by tartar emetic in large doses has been 
abandoned, but fractional doses (0.0016 Gm., or gr. V40) alone or in combina- 
tion with Dover's powder (0.13 Gm., or gr. ij) and nitre fO.^O Gm., or gr, 
iij) have proved very servicable in sthenic pneumonia and in pleurisy. In 
bronchial inflammation with deflcient secretion the wine of antimony, or 
compound syrup of squills, is frequently given. Dr. I. G. Davis writes with 
approval of the action of the golden sulphuret of antimony in chronic bron- 




ANTIXERVIX. 



223 




He admini^ere it in doses of 0.0012 to 0.002 Gm. (or gr. Vjo-Vso) 
ox:wntr*l vith sngar of milk. 

IT emetic should not be given in croup (especially diphtheritic), as 

' depressing. For broncliitis in children. Ringer advises a solution 

I Gm. (or gr. j) to 473 c.cm. (or Oj) of water, of which a teaspoonful is 

kfrren every quarter- or half- hour. Tartar emetic should rarely, if ever, 

E adai&LStered to infants or very young children. 

Smmil doees of tartar emetic have also been recommended in orchitis, 
tonsillitis, parotiditis, muscular rheumatism, and spasmodic 
A combination of tartar emetic and opium is very serviceable in 
delirium which attends some cases of typhoid and typhus fevers, 
condition in delirium tremens is relieved by the same treatment, 
ktA also been used with success in puerperal mania. Ringer states 
tckona i£ sometimes benefited by tartar emetic given in doses sufHcient 
l^indiice Tomiting, once or twice a day. Administered in the same man- 
^ St has been found capable of relieving rebellious cases of lumbago and 
orfthr rheumatism. In acute gonorrhoea Surgeon-Major Lawrie regards 
lusL (or mxx) of antimonial wine, given every second hour, as an excellent 

la some skin diseases — as chronic eczema, psoriasis, and other scaly 
-the use of tartar emetic, or the oxide, or sulphurated antimony, 
doco», and frequently repeated, is of much service. 
Hut to-called tolerance of antimony was due to the fact that after the 
iry of the s^'stem became lowered by its action, comparatively large doses 
flU be swallowed without producing vomiting. 





AT 



AJmHXB.VTN' ( Salicylanilid-bromacetanilid) is a proprietary com- 
of acetanilid, salicylic acid, and bromine, with the formula C..Hs^^ 
,iOn» ( 1'<:M] + ('.jH^Br.XnX'IIjCO. according to its introduct-T, 
& Badlauer, of Berlin. It is a white, crystalline, granular powder, with- 
«ior. and almost tasteless. This substance is soluble in alcohol, dilute 
and hot water, and almost insoluble in cold water; it is more soluble 
slightly acidulated with hydrochloric acid or in dilute solution of 
potmeaa. The dose is 0.32 to 0.50 Gm. (or gr. v-viij). 
Ihyiialo^eal Action and Therapy. — Its physiological action is similar 
of oth^r remedies of this clflss: it is antiseptic, antipyretic, and hyp- 
It TV " ' ^ antipyrin in its effects upon the sensory nerves and has 
vwd u 'V (1) to relieve pain; (2) to produce sleep; (3) to allay 

cotigb; (4) to reduce fever; (5) to arrest fermentation in infec- 
rw^ricia. In the small doses usually given (0.32 to 0.50 Gm., or gr. 
es headache and restlessness and produces natural sleep. In 
■ f influenza, or grippe, tliis drug roducos tlie fever and allays 
esness. AHiere cough becomes spasmodic and paroxysmal, 
jises a sedative effect and produces sleep. It is of advantage 
agh (0.0fi5 to 0.13 Gm., or gr. i-ij, every two hours) or in 
irr of cardiac or bronchial origin. It has been used in Ger- 
nth all<v<'*' siKTo^H. in dinltote*i, rt*dufiiig both the swgnr and the 
of urine; and it is stated to be particularly serviceable in acute 
•«. .-1 . iifuatism. Dr. Ludwig Sior, of Darmstadt, ascertained that 
.a was given in 1 Gm. (or gr. xv) doses at hourly intervals 
F&rec n«''"r», beginning about noon, it exercised a decided influence in 






224 PHARMACEUTICAL THERArECTIC AGENTS OR DRUGS, 

reducing temperature. The miniimim temperature was generally red 
from six to nine hours after thy admiaistratiou of the first dose. Abo' 
twelve hours from the same period the temperature began gradually ' 
ascend. The reduction of temperature was not accompanied by unpleasa: 
manifestations. As a rule, copious perspiration and, frequently, a sleep 
several hours were produced. In acute rheumatism its action was equal 
that of sodium salicylate. It was beneficial in trifacial neuralgia, migrait 
the pain of transverse myelitis, and in headache from various causes. As t 
analgesic it was usually given in doses of 1 Gm. (or gr. xv), repeated, wht 
needed, twice during the day. In the cases where it was used no deleteria 
eilects upon the heart or nervous system were detected. 



ANTIPYRINA {V. S. P. | .— Antipyrine. 
PHENAZONUM (B. P.). (See Phenazonum.f 



I 



APOCYNUM (U. S. P.).— Apocynum (Canadian Hemp). 

Preparation. 

Fluidextrftctiim Apoi^vni (V. S. P.l.— Kluiilcxlriicl of Apor.vniim. Po-^o. 0.30 
1.20 f.<i?i. (or /jrv X.X). (KM) per cent.) 

Pharmacology and Therapy. — The dried rliizamo and roots of Ajkx 
ninn ('iiini;iUiniirii. oi" of closely nllicd 3]>eeii-v of Apoeynum (Apocynacea 
contains the bitter, resin-like tiluc^>siilcs. Apocynin mid Apocynein, t 
fonni-r nohible in alroln>], tbf hitter in wiU.r. Thisi^ jiriiiLiplcs iu sm 
<loses act upon the eireulation, like strophantluw. n.s a toiiio. In larj 
anmunts ihey are emetic, cntluirtie. nn*1 diuretic. 

Apocynum usually.* but not coniiiantly, increases arterial tension, 
acts as a diuretic without irritating the renal epithelium. It is probal 
that the emetic and cathartic effects of this drug are due to apoc^Tiein a' 
its diuretic virtue to apocynin. The decoction of apocynum is irritant 
the stomach and bowels, but the tincture is free from this disadvantaj 
The tincture (1 to 10) has been employed in the daily doses of 4 to 6 c.c 
{or mLx-xc). A decoeti'in has been used in the dose of 30 to 60 com. ( 
fji-* j ) ill ^be treatment nf dropsy, but the iiuid extract i? mnre reliable. 

Dr. W. T. Eichmond regards apoeynum as of value in the treatmc 
of ascites, Bright's disease with or without dropsy, and valvular heart d 
ease with general anasarca. He employs the fluid extract, beginning wi 
7 or 8 drops, and gradually increasing till the desired effect is obtaim 
Toleration is established by continued use, and the dose must therefore 
raised from time to time. Dr. Richmond has also seen it of service in jav 
dice. In the dose of 0.015 to 0.03 Gm. (or gr. VrVs) apocynin hag been us 
as an expectorant. 

Dr. J. Olinski has found that apocynum relieves the functional cl 
turbances which accompany organic heart di.sease and diminishes the ai 
of dullness in dilatation. The drug seems to have no cumulative effect. 

APOMORPHIN^ HYDHOCHLOEIDTrM (U. S. R, B, P.).— Apom 

phine Hydrochloride {r,,[l,,No,HCl). 

Dose, 0.003 to O.OOfi Gm. (orgr. V-o-Vio) 1)"^ hypodermic injection. ' 
the mouth O.dOn to 0.015 Om. (or gr. Vio-V*)- " 

Pharmftcolo^ and Therapy. — Apomorphine is an artificial alkal< 
prepared from morphine or codeine by pure hydrochloric acid, 20 parts 





AI-OMORPfllN-.K nVDltOCULOKtlM M. 



125 



ktter being added to 1 pail of the former, iu a strong glass tube, and 

* to A high teniperature, Apomorpliine hjdrochloride occurs in the 

of oolorle«3 or grayish-white crystals, soluble in wnter and alcoliol, 

insoluble in ether or chloroforn). 

AeoonliDg to the investigations of Rcichert, toxic quantities of apomor- 

)^SB« rive rise to convulsions followed by paralysis, chiefly of spinal oripn. 

Bvui vhen given in ordinary medicinal amounts extreme prostration and 

oeostToIUibTe vomiting may follow^ with weak, thready pulse and low 

mttnl premure. Poisonons doses cause rapid and irregular respiration. 

Apoawrphine hydrochloride ie a svhteniic emetic and can be u^ed hypo- 

4ermicallj in the dose of 0.008 Gm. (or gr. V») to empty the stomach. In 

^nUcrdoccs it can he given as an expectorant in bronchitis. It is of value 

a tike treatment of dry. hacking cough, attended with httle or no secretion. 

ift the result of a scries of clinical experiments, MurrelP has ascertained that 

rsf'TE'^rnhin-p, eiven by the month, is tolerated in much larger doses than had 

He was able to administer 0.065, 0,10, or 0.13 Gm. (gr. i, iss, 

ly without exciting nausea. In these quantities he found apo- 

■'■Lloride an oJccoUent expectorant in chronic bronchitis, bron- 

-^., anu emphysema. Murrell usually prescribes the apomorphine in 

wild cherry, of tar, or of lemon. The addition of a few drops of 

hloric acid to the mixture is advantageous. The same observer 

t^d apomorphine as a spray with very satisfactory results. He 

jcutlj given as much as 2 c.cm. (or foss) of a 1-per-cent. solution in 

^ _:.., water for each inhalation. A combination of apomorphine and mor- 

iksat is raloable, and has been employed by Rossbach in phthisis. The 

tmt^ *"'--m€s lees frequent and the sputum more fluid. 

rphino hyrlrochloride is often s(^rviceable in the treatment of 
Trtirr, uie writer prescribing it thus: — 




B Apotoorphi-n 



hvdri>chIori<ii 
'^•ric. dilui. . 
:r<M.'IiIori<li 



13 



Gm. or gr. ij. 
e.cxD. nr fSiss. 

Mon irtK'IiIoridi . 066 Gm. or gr. j. 

tfilvT. t".uM!ii 80 ccm. or Rj. 

Aq. rhloroforttii ..q. 9. ad 24<)[ r.rm. or fSviij. 

|"fiijp : Fifteen cubic ceniinieirea, or half an ounc«, every third hour until 
is relieved. 

Vis or strophanthus may be combined with the above if there ii 
T f-».-utac debility. 
Apomorphine should not be continued too long, as it is liable to pro- 



'I 



ultD' 



lema. 



mrbe 



F. Samuels bos written of the value of apomorphine in 

vinp 0.0013 Gm. (or gr. Vm) every ^\e or ten minutea 

produced. If the child is unable to swallow, the remedy 

rd beneath the skin. J. S. Horelcy has found this alkaloid 

••-^ , ^.iiitrollin^ convulsions. He successfully employed hypodermic 

f 0.004 to O.OOfi Gm. (or gr. Yis-Vio) tn a case of strychnine poi- 

nriter recommend* apomorphine in the treatment of convul- 

1- phenomena of hyi^tcrift. In hypodermic dof^s of 0.002 Gm. 

i^' \ m) apomorphine hydrochloride is a valuable sedative and hypnotic 



'-0»tl 



£<.CP^ In I*" -^' 



'•rphine and Apocodeinc, with Reference to their V«ltt« 
■ lit of Chronic Hronchitii,** by William MurreU, M.D^ 
Will. March. 1801. 



22G I'MAItMvVCEUTICAL TUKUAl'Kl'TlC A0KNT8 Oil Dltr<JK, 

in casus of in&LHiinia. tldiriuni treiiiont;, and iiu)rf>lnnisiu. Tlic first ilosc 
should be not niort^ than half the abovf, in order to test the tolerance of 
the patient. Vomiting iilwav? indicates ton large a dose. Thtrc is no dan- 
ger of a (Ini^ hatiii Wiwg acquired. The renie<iy may also be n?ed in mania- 
cal deliriiiiii, hystL'n>-e|iilt*]>fiv, eliorea, Mnd per?iptent hiccough. It ha.s bt^ui 
adniinisteri'd to }>rtKluee relaxation ol" n ii;.'iil os uteri. Aponiorphine may 
also !»e uilininistered, in coiiibinaliou with ^trythnine, by the mouth. Paul 
E. Reehet, of Xew (h'h'anf^, give?* 0.(K»y Gni. (or ^r. Van) "f t^-ieh of tht-se, 
at three-hour intervals, in delirium ehrinauui. or acute aleoholisni. 

AQUA (U. S. P.).— Water (Efi). 

I'oisihle Avater in its [iure>t attainable irttate. 

AftUA DESnilATA (U. S. P., B. P.).— Distilled Water. 
A colorless limpid liquid, without odor or taste, and perfectly neut 
to litmus- paper. 

AQUA HYDEOGENH DIOXIDI (U. S P ), UQUOE HYBROGENn 

PEROXEDI (B. P.).— Solution of hydrogen dioxide. (See Barii Dioxidum.) 

ARASA is a native of Brazil and Uruguay. The portion used is the 
bark of the root. It is employed in South America in cases of metrorrhagia, 
2 Gm. (or 5ss) of the hark being boiled in a cupful of water and administered 
for several days before and during the menstrual period. The taste is said 
to resemble that of cascarilla, and no unpleasant i^econdary effects have been 
observed. 

AEEGA. — Areca, or Betel nut, istluseedof Arerarati-rlui ( l*nluiacefe). 
E. Jnjinp fMiind time alkaloids in areca-nut : Arecoline, Arecaine« and* 
Ouvacine. Another, ralleil Arecaidine. is an isoiuer nf areeuinc. Arecolinr 
is nietliyl-iireeaidine, inul is convertible intti arecaidine iiinl the latter intf» 
an^coline. It also contains tiinnit- nn<l ^^ullic acids. Aretaine i? a crystalline 
body, soluble in water, insoluble in alcohol, ether, and ehlornfonn. Areca-nut 
IB a ]K)Wcrful tituiacide and poiiion. The alkaloid arecaiiie slows the heart 
and respiration, and purges by increasing intestinal peristalt*is. I'owdereil 
areea has for a long time been used us a tieniaeide in vet(M'inary ]>ractice. 
More recently this remedy lia?; been used for the same purpose in the 
human subjcit. Dose, II. 'V^ to l..'iit Mm., or gr. v-xx (1 to 8 Om.. or oi-ij, as 
a vermifu;:e). The fluid exiniet is the best preparation. Its administra- 
tion should be preeinled nnd folliuved by a purgative like castor-oil. Betel- 
nut is believed also to increase the secretions from the salivary glands, -and 
has a slightly stimulating etfeet U))on the eerebrul centres. Large doses may 
cause tetain'e ((mvujsions, F)eath is caused by respiratory failure. 

Arecoline hydrotromide is a myotic. When afiplied in \/^-iK'v-t*ent. 
watery solutii'U. it causes n sliizlit stinging si'nnation for a few moments, but 
leaves no conjunctival or ciliary congestion. Chetwood-Aiken' considers it 
superior to eserine in the treatment of glaucoma. Its action is more rapid 
and more powerful, but its effect is of shorter duration, and is devoid of 
the beiulache and t»ther unpleasant nfter-elh-els so often noted with t-serine. 

Ijavagna' describes the action of arecoline, a drug extraetcil from the 



British Medunl Joumol, Jan. U. 1899. 
^GioiTUilr thWn U. Kroiicmin tli }friiirinn tli Forttta, lsl>5. \o8. 3 and 4. 



AKCENTUM. 



221 




tfii' Italian ari»ca tn-e. Frohner found smue tinic ajjo tliat arix:olino 
ii the be«t sialagogue, being superior to pilocarpine, and that it equals 
■Buw as a laxative. 

Dr. liSTa^iia has ol)»en'ed that the instillfition nf a drop of a 1-per-cwit. 
of ihc hviirobromidc into the conjunctival sac causes a sensation 
tvAluith, and afterward some lachr^Tnation and spagni of tlie eyelids. The 
lasts scarcely more than a minute, and is followed by alight hyper- 
of the conjunctiva and subcorneal injection, which disappear after 
tninutee. After '2 minutes, violent clonic spasms of the iris are pro- 
and there is distinct diminution of the pupillary space. The myosis 
I iivtij noticeable after 5 minutes, and reaches its maximum in 10 minutes. 
Tins Bflximuni is maintained for 25 to 30 minutes, after which the pupil 
to enlarge, and becomes normal once more after about 70 minutes. 
AttlBK end of 90 minutes the pupil is about one-half millimetre larger than 
***"*T^ Dr. Lavagna has not noticed any modifcations in intra-ocular ten- 
mam du* to the drug. Before acting on the iris, arecotiue causes a spaeim of 
Ak dimry muscle, which gives rise to increased refraction in the eye for the 
being. 

AUGEimjM. —Silver. 

Preparations. 
±,^^^ti Cyanidum (U. S. P.).— Silver Cyanide. Dose, 0.0016 to 0.003 Gin. (or 
(Should contain not less thjtn lM).ft |H»r rent, nf [>ure silver cyanide.) 
Nitraft Fusus (U. S. P.).— Molded Silver Nitrate, Lunar Caustic. Ar- 
Induratus (B. P.). — Toughened Caustic (Do to 5). External use. 
1 Nitma Oilutus (U.S. P.). — Diluted .Silver Nitrate (^'ilver nitrate. { part; 
^tt f-rtTr-r'r* mtrate* 2 |)art«). Argenti Nitran Mitigatuft (6. P.). — Mitigated Caus- 
tK. fUtwl tt*r. 

'"rag (U.S. P.. B, P.).— Silver Nitrate. Dose, 0.01 to 0.03 Gm. (or gr. 

.-^rg^ww <^'Xidum (U.S. P., B. P.).— Silver Oxide. Dofte, 0.03 to 0.13 Gm. (or 

Fhaxxnacolo^. — Metallic silver is a white metal taking a hiirh polish. 
^Ki U4A <«»jIv aiftH'totl by acids or by oxygon, although readily tarnished 
^ calphttr. It is oflicial only in the form of salts, of which the nitrate is 
wm^ largely used. Silver nitrate is an anhydrous salt which crystallizes in 
^kirh wr rhomhir plates. It w readily soluble in oolH water, and has a 
flfUllif -TO. Upon the addition of hydrochloric acid or a soluble 

tyaridf **n of the nitrate, a white, curdy precipitate is formed. 

• prrectpitate is wholly soluble in ammonia. The crystals, fused and cast 
iUm^ present the form of round, grayish sticks. The cyanide is con- 
at for thi* fxl«*mpornneou6 preparation of hydrocyanic acid, which is 
[>le by adding an excefta of some mineral acid to the solution con- 
LlBBiw thia salt. Melnllio silver is used in surgery in the form of silver 
- HTid for jiinking cannnbe for trat*hef>tomy, catheter?', etc. 
.cal Action. — Silver nitrate, in weak solutions, acts as an 
it^ anti. in substance, coagulates the albumin of the tissues and de- 
»f.!r vifjililv. acting as a caustic. The mitigated stick of lunar caustic 
" -ial in its action; the pure nitrate may cause sloughing 
Uiie objection to its use is the discoloration it leaves behind, 
»iniDg black after exposure to the light. (VNTien the physician's 
ijoed with nitrate of silver in making an application^ the color 



228 



PIlARilACECTICAL TIIERAPEITIO AGEXTS OR DRCGS. 



may be removed by washing with a solution of cyanide of potassium. Accord- 
ing to Hahn, the stains may be removed from the skin or clothing also 
by a solution containing 5 Gm. (or gr. Ixxv) each of corrosive sublimate and 
ammonium chloride in 37 c.cm. (or f.lx) of distiliod water.) Local applica- 
tions of silver nitrate whiten muc(»iis membrane. Wien swallowed, symp- 
toms of irritant poisoning appear, with pnin, distress, and vomiting. Com- 
mon salt is the antidote, and vomiting should be encouraged by administering 
warm salt water; after cleansing the stomach the bowels shniild be purged 
by oil. When any of the silver salts (hut especially the nitrate) has been 
taken for a length of time, a state-colored line appears along the gums and 
there is darkening of the conjunctiva, and soon afterward the entire surface 
of the body becomes dingy or slnte-colorcd, due to the deposit of metallic sil- 
ver in the pigment-layer of the skin ond in all the constituents of the skin 
below the Malpighian layer. This condition is known as Argyria, and is per- 
manent. The patient should therefore be carefully observed during the 
administration of silver, and the remedy from time to time intermitted. 
Argyria has also resulted from the local use of silver nitrate, as reported by 
Hutchinson, in the Annah of Surgery for April, 1892. In medicinal doses 
the silver salts act as a tonic to the nervous system and changes occur in the 
blood; tissue-change is increased; the flow of bile is also increased, and in 
larger doses there is embarrassment of the respiration, depression of the cir- 
culation, and reduction of temperature. Tetanic convulsions or paralysis 
may be produced by overdoses, the paralysis being of central origin. 

Therapy. — Silver foil, or metallic silver in very thin sheets, is employed 
as a surgical dressing for wounds. At Johns Hopkins Plospitol the practice 
originated of applying silver-leaf dressings for bums, the lesion being sim- 
ply covered with the leaf without the use of any adhesive material. It is 
fin excellent protective dressing which may be painlessly removed and re- 
newed. It prevents suppuration and is said to reduce shock. In Albany 
Hoepitfll it has been used as a dressing for laparotomy wounds, the leaf being 
retained by a giuize coinprehS and Imudcige. Silver nitrate is used locally in 
2-per-cent. solution, dropped into the eyes of newborn infants to prevent 
purulent conjunctivitis (ophthalmia neonatorum) after the method of Crede. 
G. E. De Schweinitz^ has seen marked conjunctivitis neonatorum appear 
after the employment of Crede's method and has also observed severe cases 
of conjunctivitis with haziness of the cornea, and one case of persisting con- 
junctival haemorrhage, which nearly proved fatal. He insists that Crede's 
method should be reserved for the eyes of those children who have passed 
through a birth-eanal known to be infected, or from which the suspicion of 
infection could not be positively eliminated prior to the birth. Whenever 
infection, or the suspicion of infection, can be excluded, Crede's method is 
not necessary, milder methods of prophylaxis being suflleient. The miti- 
gated stick is a good application to granular lids, chancroids, small-pox ves- 
icles (in order to prevent pitting), and in general to excite a healthy action 
of granulating surfaces. In gynaecology, the lunar causitic, in solid form, is 
used in chronic cervical catarrh and in venereal sores. An application of 
the solid stick to the scrotum has a good elTect in acute epididymitis or 
orchitis; also along the course of the atTected vessels in lymphangitis of the 
forearm from a poisoned wound of the finger. Thoroughly applied to the 



* PhiladflphUi Medical Journal, vol. iii. 351, 





AUliENTL'M. 



229 



' ' y the bite of a rabid animal, it is claimed by Youatt to be a 

nst hydrophobia. For chronic nasal catarrb, it may be 

>;um acacia, pulverized, and blown into the throat or nose. In 

-, tonsillitis, and laryngitis, solutions (made with water or spirit 

^ tther of 1.30 to 2.60 Gm. to each 30 c.cm., or gr. xx-xl per ounce) 

o^ with excellent results; Dr. Horace Green advocated the stronger 

'i with a probang to the larynx in diphtheritic croup. In 

...'.-■ ',u-c« these solutions arc valuable in gonorrhcea and urethritis. 

': abortlTe method of treating gonorrhoea has had its advocates, and 

. "- :illj in ihe injection of a'strong solution of silver nitrate dur- 

:age of the disease. Pn»fe;?sor Diday insisted upon the iui- 

*'i Uie following points: Tlie strength of the solution should be 

'I. to 30 c.cm. (or gr. xxiv to fj^j) of distilled water, which, in most 

■ It slight pain at the moment of injection; if sharp pain 

iately the tluid should not bo allowed to remain for more 

' lids: when the pain is moderate it is allowed to remain for 

«.;i,A;^^, .iv;.urding to the tolerance. This method has been abandoned 

aeeotint of the liability of producing sloughing and stricture of the 

■ r results are now obtained from the employment of the new 

c is with alliuniin, casein, or nuclein, which destroy the gono- 

i, axtii arc ie>3 irritant to the mucous membrane. 

In rrjaipelas the disease may sometimes be arrested by delimiting the 

Act«d area with silver nitrate. It has also been used with good results in 

pnhtQ* rulrK, herpes, eczema, and lichen, when they occur in eircum- 

ienb««) patches. Boils may sometimes be aborted in this way, and a stye 

« the ere may be checked by an early application. Buboes are treated by 

C^nJir-r, wliclhor •*tij>puratiou has occurred or not, by puncture, tlirougn 

vkkdi a 5J-per-cent solution of silver nitrate is injected. Recovery is said 

U W rapid and the formation of an unsightly scar is avoided. After disin- 

fartioa of the wound, Simmons recommends the injection of a solution of 

idrar mtrate, with a view to preventing the development of tetanus from 

|«Drtured wounds. The solution which he employs contains 0.65 Gm. to 30 

X to f^). Dr. Lazzaro proposes silver fluoride as an efficient local 

in anthrax. It is a brown or blackish-brown hygroscopic mass, 

' ' in water, antiseptic, equal in caustic effect to the nitrate, and 

• the anthrax bacillus, while harmless to the human organism. 

'^ nitrate is useful in restraining the bleeding from leech- 

.L- course of a chronic illness, bed-sores threaten to form, 

aiiun of 8 solution containing 1.30 Gm. to 30 c.cm. (or gr. xi 

. _r nitrate will avert the mischief. Ringer has found the same 

ul in whooping-cough. A solution may be applied to the throat by a 

or * r^- or it mny be used in the form of a spray. The latter method, 

-pplicable to children less than three years of age. The stain 
fv^docrc, raoreovcr, is a serious objection to the spray. A strong solution, 
m tike aolid atick, is a good stimulant to indolent ulcers and to ulcer of the 
w ^ mo A 8.60 Gm. (or gr. xl) solution in nitrous ether has been used in 
6Ma trichnphvtOBis, A solution containing from 1.30 Gm. (or gr. xx) to 7.6 
um. (f " '^30 c.cm. (or f^j) of water may be successfully employed, by 
mgeetioi^ --. ^.a^U quantities (a few drops) into the sac of an hydrocele or 
fpbe tumor. A aponge probang saturated with a very weak solution of 
t tfvrr aitmte is sometimes of service in spasmodic stricture of the cesophagus. 




2.10 VIUKMACEPTICAL THERAPEUTIC AGENTS OK DUUUS. " 

Applications shoiikl be iiiiidL* occHsionally, at iutcrvnls of Ht'V*>rnl dnys. In 
pseudomembranous enteritis it is a good practice, in the intervals ot parox- 
3rBms, to irrigate tlit- Intwe! with i).'.V2 to O.G.t Oni. (or ^r. v-\) of silver 
nitrate in a pint nf \vnt(.^r. Prolopsi-d rcvtum, ei?[)ecially in oliihlron, is bene- 
fited by fnntorixatir>n witl> niirigiitcd silver nitrate. 

On Mcodiint at tJif staining of tlie skin, silver nitrate ie now little used 
internally, although it has acknowledged effects upon the nervous system. 
Caccianiga has collected 60 cases of acute lobar pneumonia in which treat- 
ment by silver nitrate seemed to be clearly beneficial. Of the group only 3 
died. The dose was from 0.10 Gra, (or gr. iss) in children (eight to ten years) 
up to 0.25 to 0.32 Gm. (or gr. iv-v) in adults, given in pill or suspension. In 
cases of urgency, a 0.50-per-cent. solution of protargol was injected hypo- 
dermically. Beyond some vomiting, no ill effects were observed from the 
treatment either by silver nitrate or protargol. The most marked effect of 
the silver salt was the reduction of the temperature, which began in tlie 
first twenty-four hours and was noticed in all the cases. Apyrexia occurred 
by crisis in 48 cases, by lysis in 12. When small doses were given, apyrexia 
generally occurred by lysis; with larger dnsos, by crisis. In the defervescence 
due to silver, the pulse did not come down at tlio samp time, hut later. 8ilver 
oxide is said to be less subject to this objection and equally efficient, especially 
in the early stages of locomotor ataxia and in epilepsy. A double salt, the 
sodium and silver hyposulphite, has been recommended by Curci and others 
as efficacious in locomotor ataxia, and free from the disadvantage of staining 
the skin. It is very soluble in water, does not coagulate albumin, and may 
be given by the mouth in iloses of 0.045 to 0.20 Gra. (or gr. ^A-iij), or h>T30- 
dermically, from O.Ol to O.o4o Gm. (or gr. Vn-^/i) ^^ the course of the day. 
In gastralgia, also, the silver salts are sometimes remarkably curative. They 
have effected improvement, likewise, in chronic gastritis and ulcer of the 
stomach. The silver nitrate has been successfully given for the purpose of 
allajnng yeasty vomiting. When, in typhoid fever, symptoms of irritation 
in the alimentary tract become prominent, and peritonitis or lijemorrhage 
apppnrt* ijinninenf. the following prescription was used by \Vitlitui» Pepper, 
in the Philadelphia Hospital: — 

B .Argents nitrntia . . . / 113 Gm. or gr. ij. 

Mucilag. acaciae G0| ccm. or fjij. 

M. Siff.: A teaspoonful three or four times daily, combined with tincture of 
opium or bclIadoriDn, if necessary, for diarrhoea or constipation. 

Silver nitrate sometimes yields good results in enteritis or colitis, espe- 
cially if ulceration is present. Silver nitrate or oxide may also be given as 
follows: — 

B Argenti nitratis, 

Extract! opii na |13 Gm. or gr. ij. 

M. et ft. pil. no. vHj. 

Sig. : A pill every four hours, for gaitric ulcer. 

B Argenti oxidi 113 Gm. or gr. ij. 

Ext. belladonnte fol 1005 Gm. or gr, j. 

Ext, gentianoe 1|30 Gm. or gr. xx. 

M. et ft. pil. no. xvj. 

Sig.: A pill throe times a day. 



AUfiKSTrM. 



231 



An efficient prescription for neuralgia and chorea ;- 



B Afg«nU Ditratia 

'^ ipecac. 



Bulphatis 
KaciL acAcue 



30 
00 



Si- 



"J- 



f.z A teaspooaful in wat«r, three tinies a day, before meals 
chronic diarrhceA, especiftlly of phthisi&. 



20 Gm. or 

com. or 
065 Gm. or ffT. j. 

c.cm. or ftij. 

Exertfi marked 



la gwtric catarrh, the gastro-intestinal catarrh of phthisis, ulcer of the 
"i, or chronic diarrhoea we may combine it as follows: — 



B OodetM 

Afffcati aitnt ^• 

PbIt. Bcaciie 

Dtt. in pU. DO. xij. 

fi|f.: GiT« one every two to four hours. 



|20 Gm. 
|38 Goi. 
q. 5. 



or gr. 111. 
or gr. Tj. 



f 



lo catarrhal juurulice. silver nilrato has hoi'u given in O.OO.") Gm. (or gr, 
^,,c^-^ u-iili iiiUjinta^rc. In pill form theetfect is more sustained and the 
II in hirger doses than when in solution. When used in 
Mi liir Mnmach. the remedy is l)est given half an hour or eo before 
«r<ltT that the local effect may be eecured. It should not bo used 
jH»nod '. tMthcr in pill or in solution. 
Drventery, with ulceration of the large bowel, is very much benefited 
ly hrjpe injections of weak solutions of silver nitrate (0.0075 to 0.015 Gm., 

* er. V ,-'/4, tn ;50r.('n»..nr fjj^of mueilao;*^). Bartholow advi^jed the internal 
mt of the nitrate^ combined with opium, in addition to the treatment by 
otjretion^. According to the same writer, both tlic nitrate and the oxide are 
w mSu l in nervous dyspepsia, cholera infantum, and jaundice depending upon 
ottnii of the bile-ducts. Silver is sometimes beneficial in chorea. Silver 
vide j? occafiionally able to check profuse perspiration, and may prove use- 
W rrhagia. The nitrate has given relief in obstinate enteralgia. 

^ rocq, of Brussels, claims that silver nitrate is a valuable remedy 
a phthisis, promoting appetite and digestion, diminishing cough, expectora- 
fcco, and night-sweats. lie administers from 0.009 to 0.02 Gm. (or gr. Vt" 

* ,) during the day. Mr. P. A. Brady, forty years ago, regarded this salt as of 
Beat Tal«e in the treatment of phthieis. He was accustomed to give it in 
2ms of 0.01 Gm. (or gr. V4) combined with 0.20 Gm. (or gr. iij) of Dover'a 
|nvdrr tlinn' tinu-s a day. Dr. Thomas May.s, of Philndel])hia, reported some 
MBarkable results from. hypodermic injections of solutions of silver nitrate 

the akin of the neck, over the pneumogastric nerve, in the treatment of 
y^faChifeia ymlmonalis. In Home ranes. striking benefit was noted. 

Vanoiie reinedic-'* have been proptsed for tlic Argyria, or tlio skin dis- 
lon produced by silver. Tnfortunately, none has proved reliable, and 
a iha T««t majority of cases the stain proves permanent. It has been claimed 
#Bt Miatering will lighten the color. Dr. Eichmann st-ates that in two cases 
thr eol<^r diMpp'^orod after the use, four times a week, of pota^^h-and-sonp 
litha. le has been given internally for the same purpose. 

.1* cmnuoii now as fnrintTly, <ince silver is no longer 
iliinyed in ihe tp'atment of epilepsy and locomotor ataxia. 
.wUroine is a lo-per-ornt. sohilion of silver plioriphate in nn aqueous 
n i>f •■fhylencdinmin. This snlutir»n \^ said to <y>ntain as nnieJ) silver 
p-pt'-T-o-nt. M»ltitinn nf silver nitrate. Tlii^* new combination is 




232 



PilAUMACEUTlCAL TUKUAI'KL'TIC AGKXTS OU DULOS. 



brouglit forward ats a substilutu i'or the silver nitrate. Argeutaiuiuc is a 
permauent, limpid fluid, readily miscible with water, of an alkaline reaction 
and anuuoniacal odor. It does not precipitate albumin, and has a very 
slight c:iii»^tio action. The *^oh^tioD is -a clear, colorless liquid, and, according 
to Dr. St'luifrer, }»oijiie.4.*es bactericidal properties which will render it valuable 
in the treatment of gonorrha-a and diphtheria. In the anterior urethra it 
should not l>e used stronger than l-tiOdO; for the posterior urethra, 1-250. 
In ophthaluiohigy it ha? been ut^ed in o-j)er-eent. strength. It becomes de- 
composed when left exitosed to the light. 

Arg:entxun Cred^,^ or soluble metallic r^ilver (colloidal silver), as origi- ' 
Dally reconnnended by B. Crede, of DreBden, at the Moscow Congress, is 
used in medicine as a lO-per-cent. ointment: the nnguentnm Crede. It is 
employed by inunction, ubing 3 Gjn. (or gr. xlv) for an adult, or for children 
1 Gm. (or gr. xv), especially in septic cases. More recently Cred6 has used 
colloidal silver in a pill, containing 0.01 Gm. (or gr. '/«) ^^"'^h sugar of 
milk, glycerin, and water, q. e., giving 2 pilU two or three times daily in 
acute erysipelas, and in cases of gaslro-intestinal disease in which it has been 
customary to give tlie nitrate of silver. Argyria was not observed.- 

Dr. Oscar Wcrler' warmly advocates the use of the lactate and citrate 
of silver, for the power of penetrating the entire organism and effecting a 
general disinfection of the entire body. In sepsis he obtained good results 
by inunction and the washing of the wound with citrate-of-silver solution 
(1 to -1000). The metliod by inunction with ungucntum Crede (made with 
eoluble metallic silver) and local application to the wound of silver-citrate 
Bolutinn, is suited both to chronic sepsis and furunculosis. 

Argonin. — An organic combination of silver with casein has been 
introduced under this name by Drs. Rohmann and Liebrecht. Argonin con- 
tains oue-fificenth the amount of silver present in the nitrate. It is soluble 
in water, non-irritant, not precipitated by salt, and is claimed to be antidotal 
to the gonococcuB. Dr. Johann Jtdliuok, of Budapest, Hungary, has 
written on a new preparation of artjoitln called *'Argonin L." He extols 
this preparation as having the advantage of not decomposing after being 
kept in solution for several months, and again containing 10 per cent, of 
silver instead of 4.2 per cent, as in ordinary argonin. The author uses a 
1-pcr-cent. solution in urethritis. Imth anterior and posterior. (See also 
Lar§fin.) 

ARISTOL— (See Thymol lodidum.) 

ABMORACIA EADIX (B. P.).— Horse-radish Root. I 

Preparation. 
Spiritua Arnioraciffi Compositus (B. P.). — Compound Spirit of Horw-radish. 
(Contains aUn bitter orange-peel aucl nutmeg.) Oofie, 4 to 7.5 c.cm. (or fSi-ij). 

PharmacologT' and Therapy. — The fresh root of Cochlearia Armoracia 
collected from cultivated plants. 

Horse-radish, in its fresh state, grated to a pulpy mass, to which n little 
Tinegar is added, is a familiar condiment as a dressing for meat at our tables. 
It ig pungent, and excites the flow of secretions of salivary and gastric glande 

'Tliis is also cnllpd "('(i!liii%n>lijm." as prepared ])V vim Heyden. 

*Kh'tt. Thrntfi. ^yurh^•ttM^'hrlft, ISflS, 

* Deiitsrhe i»edi(irtii*rhr Worhrth^rhrtft. Ot. ft. \90H. 



ARXICA. 



233 



mhI iliniQUt^ the appetite. It contains an active principle analogous to the 
loiitik oil of tnustanl, and yields about 0.5 per cent, of oil. It also contains 
a little resin. Externally, horse-radish is rubefacient. Internally, it is a 
to the stomach and increases the urinary flow. The addition of 
borae-radish to cider makes it actively diuretic, and useful in dropsy. 
tb n e n med with success in scurvy. The dried root is not employed in 
e. The compound spirit is a good addition to other diuretics. 

AUnCA (U. S, P.). — Arnica-flowers (Leopard's-bane). 
Bow, in substance, 0,65 to 2 Gm. (or gr. x-xxx). 

ARSICX BHIZOMA (B. P.).— Arnica-rhizome. 
Ooae, in Fubslaurc, o.^;.") to 2 Gm. (or gr. x-xxx). 

Preparations. 
Tbr-*"--, ^minp {V. S. I*.).— Tincture of .■Vriiicu (20 jwr vetit.). Dose, 0.00 to 

l> : ■ ArmCTB( B. P.), — Tincture of Arnica from the root. (5 per cent). 

Plurmacology. — Arnica^ florcs, the dried flower-heads of Arnica mon- 
tton. aiB official in the U. S. P.^ but not in the B. P., wluch recognizes only 
fc- riiiBoroe and roots. The plant belongs to the natural order Compositae, 
md it is indigenous to northern Europe and Siberia and also the northwest- 
«» P*rt of the Unitf'd States. The flowers are orange-yellow, disk- 
if^jcrt. with rays, of feebly aromatic odor, and of a hitter, unpleasant taste. 
IhMillT'I&inin has been obtained from the flowers, but the principal con- 
c'^t^A to ^ULch its local effects are probably tlue is a volatile oil; besides 
r« is a ^lucoside, Amicin. and also inulin^ tannic acid, resin, and 
r-^x^r unimportant elements. According to some writers, arnica also con- 
Inw two alludoidfi; amicine and oytisine, tbe latter of which is apparently 
identical with the principle of the same name derived from the laburnum. 
Fhymiological Action. — Applied to a delicate skin, arnica frequently 
fmdiMic* redness and' inflammation resembling erysipelas. A pustular erup- 
(irn mar also be produced by the application of this remedy. It acts as a 
«■■- tant and revulsive. Internally^ in small doses, it has some stimu* 

kbi.^ ...i.wivnce, raising the blood-pressure and the action of the heart, pro- 
4KSD;r a feelinja: of warmth over the body and increasing the secretions. It 
^ bev: " ' '. small quantities of arnica exert a stimulatinp influence 

t} -trie nervts. Larir**r dt)St'S cause depression, parah'sis of 

IT 1(1 by vomiting and collapse. Death results from the cpssa- 

p»; 1 t's octiotu aiwl in part from the awumulation of carbonic acid 

I the biood. Atropine is the physiological antidote, with stimulants, arti- 
fwpiration, and counter-irritation. 

Tkerapy. — Tincture of arnica is externally used in domestic practice 

* • -I.' foreign pracfitioiiers as a n>mefly for sprains, contusions, myal- 

imfltism and local paralysis, and it is also believed to have some 

-. U is asserted by some authorities that any 

It ;ig absorption of ecohy Miosis is really due to the 

of i >iiv which is coiiuitoTily used. The author, from clinical 

«fwr>ri>rc. that arnica has most efTective local action upon the tis- 

fM» 1 rhfumatism, boils, abscesses, and in all thickened condi- 

&R^ ^* t..^ ™:.^ument. The following combinations are especially of 




234 



PHAKMACKrTlL'AL TllEiUPiil-TlC AGENT8 Oil DBUUH. 



B Tinctura arnica?, 

Lin. saponiet, 

Tinct opii nn 30] c.cm. or f5j. 

M. Sig.: Apply with friction for boiU, abscesses, and thickening of the skiid 

B TiiU'tuni rtniioip. 

Aquie hauiaiiielidis (lest aa 90{ c.cm. or fjiij. 

M. Sig.: Use on niualm or lint for hflemorrliagea, A rheumntip joint may 
covered with cloth* saturated with the arnica and witch-hazel, the combination often 
being more elTecUve when applied hot. 

Arnica has been used internally in large doses in mania with high arte- 
rial excitement, in delirium ebriosum, and in acute rheumatism in sthenic 
Eubjects. Small doses of the tincture are useful in fever attended with much 
depression. This remedy may likewise be beneficially employed in chronic 
diarrhoea, chronic dysentery, and in various forms of haemorrhage. It has 
been thoupht to be u?efid in paralysis of the bladder. 



ARSENI lODIBUM {\\ S. P., li. P. ) .— Arsenous Iodide (A3I,). (See 

Arseni trioxidum.) 

ASAFCETIDA (U. S. P., B. P. ) .— Asaf etida. 
Dose, 0.65 Gm. (or gr. i). 

Preparations. 

Emulsum Asafcetidse (U.S.P.). — Emulsion of Asafetida (4 per cent.). Dose, 
15 to 30 c.cm. (or fjss-j). 

Pilulro Asnftrtidrn (U. S. P.).— Pills of Asafetida (each containing 0.20 Gm., or 
gr. iij, of usafetida). Dose, 1 to 4 pills. 

Tinctura Asafaelidip (U.S. P., B. P.).— Tincture of Asafetida (20 per cent). 
Dose, 2 to 4 c.cm. (or fSsa-j). 

Pilulflp Aloes et AsufaHidiP (B. P.). — Pills of Aloes and Afafetida (t'qual pari* 
of each*. Doso. 0.25 to O..i0 (Sin. (<tr gr. iv-viijt. 

Spiritus Ammonia; Kcetiduft (B. P.^.— Fetid Spirit of Ammonia (contains 7.5 Gm. 
of asafetida in a nien8tr\ium of 10 parts of strong solution of ammonia with 00 parts 
of alcohol: &0 per cent.). Doso, 1.20 to 2.50 c.cm. (or mxx-xl). 

Pilula Galbani Composita (B. P.). — Comjwund Pill of Galbaniim (contains 33 
per cent, of asafetida). Dose, 0.25 to 0.50 Gm. (or gr. iv-viij). 

Pharmacoloiry- — Asafotiila is deriveil from the rhizome of Ferula foe- , 
fidiu antl jimbubly from other Fi])rcit*8 uf Fenda (T^nibeliiferfr), and is 
obtaiiit'd, by in<isioii, fi'oin tin* h'vin;^ mot. The smirce of the nsafetida of 
comment numt still be ronsiiN-rrd doubt fnl: it usually is brought to tins 
country from Afghnnistan nnd ludin. Tlio i]r\)^ is an riily ^mn-resin and is 
rt fonilflie I'Ster of asan'^inotannol. It occurs as rough, irreguUir, rather s<"»ft 
miusses. of hrowc color, somenhat giirlieky odor, and aerial to the taste. The 
odor depends upon a volatile oil, wliich appears to be allylporsulpbide. The 
agent also contains ferulaic acid, resin, gum, bassorin, with tmecF of acid 
calcium nuilate (PeUetirr) uml in coiumeree ibtually is much nthdterated. 

Physiological Action. — The effects are moderately stimulating, anti- 
spasmodic, and expectorant. Large doses cause vomiting and diarrhcea, espe- 
cially in persons unaccustomed to its iife. Tn medicinal doses it is car- 
minative, and ibcreases the qnantity of the gastric juice. The sexual func- 
tions are said to be stimulated, and a general feeling of warmth is diffused 
through the body. Asafetida increases the action of the heart and arterial 




stimulates the functions of the skin and kidneys, and is a mild 
excitant. It is eliminated by the Uifigs, bowels, skin, and kidneys. 
Therapy. — Asafetida is not used locally (although the plaster was for- 
■■rij official), since, to those unaccustomed to its use, the odor is very 
This, howcTer, makes it additionally useful in treating some 
disorders, such as hysteria. Qoodell advised that a teaspoonful of 
Ifca tincture be mixed with hot water under an hysterical patient's nose, and 
Bha prt-n liv the stomach, nr as lui enema. In uervousuesii of children, the 
fib an* ser\'icable, and in colic, or oonvulfiinnH, the emulsion or milk of 
aafftida may be used freely as an injection. The mixture of magnesia and 
■rfffti^a (not official) is used as a carminative for infants with colic, but 
fttopiiim in it must not be overlooked. The pil. galbani comp. is used for 
fadeoce and intestinal indigt^tion, in flderly ixxtple. The combination 
•".'h tloca is theoretically useful in amenorrhoea, but, practicall}', it is just 
■z 'Jusa cases that asafetida can only rarely be used, on account of its odor 
ai taste. Italian physicians recommend the systematic administration nf 
■detida during pregnancy, when there is a history of previous abortions, 
«vben abortion is immediately threatened. It is given in doses gradually 
mtm^ng from 0.20 to 1 Gm. (or gr. iii-rv) a day, after which the amount is, 
il tb* same m.anner, reduced. Its use is not advocated, however, in cases 
it upon syphilis, tuberculosis, or disease of the uterus and its ap- 
The favorable influence nf asafetida in tlH»se eases has been oon- 
by Warman, who found that the drug reduced haemorrhagCj had a 
taaquillizing^ effect, and was particularly useful in cases of habitual abor- 
IK. Small doses of asafetida are valuable in the later stages of bronchitis, 
npgiillj that occurring in old people. Its combination of expectorant and 
itive virtues likewise renders it of service in emphysema. It may 
be advantageously employed in spasmodic asthma, especially used as 



30| 



Af an 



ccm. or fjj. 
c.cm. or fjias. 



■ sa(oetid«e 

.1 mroon. valerianatts, 

hamuli ftfl. 45| 

A tMupoonful or two in water every hour or two. 

antispasmodic and expectorant, asafetida has been employed in 
abgoptng-cough. It may also be given with advantage in chorea, especially 
Afli that affection occurs in weakly girls about the period of puberty and 
aaadatad with menstrual dithculty. In the flatulence and constipation of 
^jorfiondriasis, it is a good remedy, and is especially appropriate on account 
dv Sted exhilarant effect upon the brain. The mixture of asafetida 

■ir^.... ....o the rectum is efficient in promoting the expulsion of flatus, and 

asr be reeorU-il to in the tympanites of typhoid fever. Asafetida can i)e 
fjflK d int<»mally, thus: — 



I 



E tiDd aMfortidff. 
T1ac<- rardamom. co 
apt. »mmcn arom. • 
Aqua DKnth. pip. . ■ 



aa 30 
... 4 

... 60 



ccm. or f5j. 
c.cm. or fjj. 
c.ciii. or fXij. 



K. f^g ■ One to two tettspoonfuts in water every tno or three hours. 

.•^APR'^T — » 'Miciuni bcUi-naphthol-alpha-monosulphouate ( tC,(>H« 
• i haa. for convenience, been termed asaprol. It 
wdor, vory soluble in wairr and alcohol, and is destruc- 




23G PliAEMACEUTICAL THERAPEUTIC AGEXTS UK DUL'GS. 

tive to many forms of bacteria. It is administered in daily doses of 2 Gm.; 
(or gr. xxx), pradualJy increasing to 4 Gm. (or 5j). Aj?iiprol is incompati- 
ble MJth alkaline idrnlidcs, sulphates, and with nio^t of the alkaline salts. 
Quinine nnd its salts are also incompatible with thin compound, Aaaprol 
redacts febrile temperature and augments the secretion of urine. This sub- 
stance lias renderod service in the treatment of intluenza. gaiit, asthma, boils, 
carl>uncle8, tum^illitis, etc. Asaprol is of advantage in acute rheumatism, 
and in chronic foi*ms of the disease it is useful in relieving pain. It is use- 
ful, also, in atonic dyspepsia. This remedy has been employed as an anti- 
pyretic in typhoid fever and pneumonia and as an analgesic in sciatica,) 
intircnstal neuralgia, and tic doidorcaux. 



ASCLEPIAS.— Pleurisy-root. 

Preparation. 



i 



FliiiilfNtnifttiin Asclepiadia. — Fluid Extract of Aselopins. Do(it\ 1 to 4 ccm. 
(or »ixv-f3j). 

Pharmacology. — The root of Asclepias tuberosa (Asclepiadea?) containB 
resin and fatty matter. Asclepiadin is a mixture of re^in and glucoside, pre- 
cipitated from a strong alcolndic tincture by t!ie addition of cold water, or 
tannic acid. It has been giveu in doses of 0.065 to 0.3'2 Gm. (or gr. i-v). 

Physiological Action. — The infusion is used in the southern portion of 
this country as a diaphoretic and expectorant; in large quantities it is emetic 
and cathartic. It depresses the hearths action and increases the functional 
activity of the skin and kidneys. 

Therapy. — The recent infusion (31 Gm. to 473 c.cm., or 5J to Oj ; dose, a 
wineglassful) is used in domestic practice for colds and pulmonary affectionB 
of an inflammatory and catarrhal character. In diarrhix^a, dysentery, and 
painful disorders of the stomach or bowels it is often eiTective. a very good 
prescription being: — 

B Fluidext. asclcpiadia 60 ccm. or fjij. ^M 

Spt. vini gallici 30 c.cm. or f.^j. ^B 

Syrup, rubi idasi 90 c.cm. or fjiij. 

M. Sig.: A teaspoonful to a tablespoonful every hour or two, for diarrlKea and 
dysentery. 

As a diaphoretic, it is used in the exanthemata, in order to facilitate 
the eruption and reduce the fever, and it is said to be advantageous in articu- 
lar rheumatism, in controlling the inflammation and reducing the hearfa 
action. 

A decoction, made from the root-bark of Asclepias syriaca, also poa- 
eesses diuretic properties, and has been found useful by Dr. G. D. McGauran 
in the relief of renal dropsy. In cedema of cardiac origin it appears to be 
of no avail, A tincture of the root of Asclepias verticiilata has a popular 
reputation in the South as an antidote to the bites of venomous serpents 
and insects, as well as in hydrophobia. Three hundred and si^cty c.cm. (or 
ffixij) of a hot saturated decoction are said to relieve pain, produce perspira- 
tion, and promote sleep. 

ASEPTOL. — Sozolic Acid. A syrupy, dark liquid, freely soluble in 
alcohol, water, and glycerin. It contains orthophenol-snlphonic acid (33 Vg 




ASPIDIUM. 



23? 



I) diluted with water, and resembles carbolic acid in odor, though 

It id less caustic, but is decidedly antiseptic, and is said not to be 

When usi.'d, it is to be diluted ( 1 to 20 or more) for surgical practice. 

ASPASjIGUS. — AsparagTis. The root of Asparagus officinalis (Liliaceie), 
ibe& 'n^h, is used in decoction or infusion (31 to 62 Gra. tiD 473 c.cm., or 
5^ to Oj) as a diuretic, laxative, and blood-purifier. The fre&h shoots are 
Wtim food, and increase the flow of urine, while imparting to it a peculiar, 
fanj odor: in some cases it has apparently caused congestion of the kidneys, 
•all bstnaturia. Aspara|^, which is obtained principally from the root, 
ttf af«d4tive action upon the circulation, reducing the force and frequency 
tl thr heart's action, and causing frontal headache. The peculiar odor 
CK^tted by urine passed after the ingestion of asparagus depends, in all 
pniMbilitT, according to Professor Nencki, upon the presence of methyl- 
vercsptan. This substance is thought to be produced in the albuminous 
icnt^ration which accompanies the germination of the plant. 

Xferapy. — Asparagus was believed by the ancients to have valuable 
ijirodi*iac properties, and was used as an emmenagogue; the writer con- 
sas the obserration of Ehrhardt, that a discharge resembling that of gonor- 
iam or orethritis may be caused by eating asparagus. Asparagus is usually 
■Kide*' '' iful in gonorrhcea. Though it increases or even excites scald- 
81^ jfft -n appears to be very uncertain. Berkely Hill,^ in a series 

iltvent . allowed one-half the number to eat asparagus and found 

te »iii- i partake of it with impunity, while in others it produced 

■E}ca»«d congestion and flow of discharge. 

TH<* ingestion of asparagus^ therefore, causes, in some individuals, 
fedftxirfaance of the functions of the kidney and a notable decrease in the 
^MOttt of urine excreted. A fluid extract is used in doses of 4 to 15 c.cm. 

It has been claimed that asparagus has special effects upon the uterus 
• la oiTtocic after miscarriage, or in labor., A tincture (1 part of the dried 
^ to 8 of proof-spirits) is used as a diuretic, in doses of 2 to 4 c.cm. (or 
Oin": ^7 T>T. Jefferson, of England. Asparagin, in dosee of 0.13 to 0.20 Gm. 
Ir ^ u may be used as a diuretic in dropsy, and, according to Whitla, 

Wf^M.r i" act in gout like weak doses of colchicum. It is- also of some 
KTice in cardiac dropsy, chronic rheumatism, and gout. The combination 

flnnainn vriih one of the bromides for the latter affections in this pre- 

* ■ is often of value: — 

U JLMpmtmgin 1| Gra. or gr. xvj. 

Sodii bromidi 19|4 Gm. or 3v. 

SjTVp. aurantii 120| c.cm. or fjiv, 

JL Si^.: Two tcaspoonfuls in wnter three or four times a day. 

ASProrUH (V, S. p.).— Aspidium. 

TT fTT MAS (B. P.).— Male Fern. 

Do«e (in povder), 2 to 6 Gm. (or 3s3-is£). 

Preparations. 
tHuLf ■in fl AvpMii (U.S. P.). — Oleorefiin of Aspidium. Dose, 2 to 7JS o.om. (or 




¥ 



"Tliraoic i;r«'t*»»"iti« and it* Trtfttment," I-ondon, 1890. 



23G I'lIAHMACEUTICAL THERAPECTIC A0ENT8 OK DRCOS. ^H 

tive to many forms of bacteria. It is administered in daily doses of 2 CHH 
(or pr. xxx), gradually increasing to 4 Giii. (or 3j). Asaprol is incompati-j 
ble witli alkaline idodidcp, sulpliatos, and witli most of the alkaline salts. 
Quinine and its s:ilts are also imonipatible with this compound. Asaprol 
reduofs feljrile tcniperature and luiguu-nls the secrelion of urine. This sub- 
stance has rendered service in the treatment of influenza, gout, astlinia, boilS| 
carbuncles, tonsiUitis, etc. Asaprol is of advantage in acute rheumatism,; 
and in chronic forms of the disease il is useful iu relieving pain. It is use* 
ful, also, in atonic dyspepsia. This remedy has bo<'n employed as an anti- 
pyretic in typhoid fever and pneumonia and as an analgesic in sciatica, 
intercostal netiral^ia, and tic ikiulorcaux. j 

ASCLEPIAS.— Pleurisy-root. ^M 

P Preparation. ^H 

KhiidcxtrMftum AscIepindiB. — Fluid Extraft of Asclepias. Do»*». 1 to 4 c.cnu 
(or mxv-fSj). 

Pharmacology. — The root of Asclepias tuberosa (Asclepiadeee) contauiA' 
resin and fatty matter, Asclepiadin ig ji mixture of resin and glucoside, pre- 
cipitated froit) a stronj; ulcoiiolic tinclure l»y the addition nf cold water, or 
tannic acid. It has been given in doses of U.065 to 0.3'si Gm. (or gr. i-v). 

Physiological Action. — The infusion is used in the southern portion of 
this country as a diaphoretic and expectorant; in large quantities it is emetic 
and cathartic. It depresses the heart's action and increases ihe functional 
activity of the skin and kidneys. 

Therapy. — The recent infusion (31 Gm. to 473 c.cm., or Sj to Oj; dose, a 
wineglassful) is used in domestic practice for colds and pulmonary affections 
of an inflammatory and catarrhal character. In diarrhoea, dysentery, and 
painful disorders of the stomach or bowels it is often effective, a very good 
prescription being: — 

B Fluidext. osclepiadia 601 ccm. or fjij. 

Spt. vini gallici 30 c.cm. or fKj. 

Syrup, rubi idai 90] c.cra. or fjiij. 

M. Sig.: A teaapoonful to a tflblespoonful eveo' hour or two, for diarrhoea and 
dysentery. 

As a diaphoretic, it is used in the exanthemata, in order to facilitate 
the eruption and reduce the fever, and it is said to be advantageous in articu- 
lar rheumatism, in controlling the inflammation and reducing the heart'a 
action. 

A decortion, made from the root-bark of Asclepias syriaca, also pos- 
sesses diuretic properties, and has been found useful by Dr. G. D. McGauran 
in the relief of renal dropsy. In redema of cardiac origin it appears to be 
of no avail A tincture of the root of Asclepias vorlieillata has a popular 
reputation in the South as an antidote to the hites of venomous serpents 
and insects, as well as in hydrophobia. Three hundred and sixty c.cm. (or 
f^xij) of a hot saturated decoction are said to relieve pain, produce perspira- 
tion, and promote sleep. 

ASEPTOL. — Sozolic Acid. A syrupy, dark liquid, freely soluble in 
alcohol, water, and glycerin. It contains orthophenol-sulphonic acid (33 Vt 




ASPipiuM. 237 

per cent) diluted with water, and resembles carbolic acid in odor, though 
fainter. It is less caustic, but is decidedly antiseptic, and is said not to be 
toxic. When used, it is to be diluted (1 to 20 or more) for surgical practice. 

ASFABAGTJS. — ^Asparagus. The root of Asparagus officinalis (Liliacese), 
when fresh, is used in decoction or infusion (31 to 62 Gm. to 473 c.cm., or 
Ji-ii to Oj) as a diuretic, laxative, and blood-purifier. The fresh shoots are 
used as food, and increase the flow of urine, while imparting to it a peculiar, 
heavy odor; in some cases it has apparently caused congestion of the kidneys, 
with haematuria. Asparagin, which is obtained principally from the root, 
has a sedative action upon the circulation, reducing the force and frequency 
of the heart's action, and causing frontal headache. The peculiar odor 
emitted by urine passed after the ingestion of asparagus depends, in all 
probability, according to Professor Nencki, upon the presence of methyl- 
mercaptan. This substance is thought to be produced in the albuminous 
disintegration which accompanies the germination of the plant. 

Therapy. — Asparagus was believed by the ancients to have valuable 
aphrodisiac properties, and was used as an emmenagogue; the writer con- 
finns the observation of Ehrhardt, that a discharge resembling that of gonor- 
rhcea or urethritis may be caused by eating asparagus. Asparagus is usually 
considered harmful in gonorrhoea. Though it increases or even excites scald- 
iiiff, yet its action appears to be very uncertain. Berkely Hill,* in a series 
of twenty cases, allowed one-half the number to eat asparagus and found 
that some could partake of it with impunity, while in others it produced 
increased congestion and flow of discharge. 

The ingestion of asparagus, therefore, causes, in some individuals, 
a disturbance of the functions of the kidney and a notable decrease in the 
amount of urine excreted. A fluid extract is used in doses of 4 to 15 c.cm. 
(or 5i-iv). 

It has been claimed that asparagus has special ef ects upon the uterus 
as an oxytocic after miscarriage, or in labor., A tincture (1 part of the dried 
tops to 8 of proof-spirits) is used as a diuretic, in doses of 2 to 4 c.cm. (or 
tops-j) by Dr. Jefferson, of England. Asparagin, in doses of 0.13 to 0.20 Gm. 
■or gr. ii-iij), may be used as a diuretic in dropsy, and, according to Whitia, 
appears to act in gout like weak doses of colchicum. It is- also of some 
service in cardiac dropsy, chronic rheumatism, and gout. The combination 
of asparagin with one of the bromides for the latter affections in this pre- 
scription is often of value: — 



Gm. or gr. xvj. 



]^ Asparagin 1 

Sodii bromidi 19 4 Gm. or 

Syrup, aurantii 120 c.cm. or fjiv, 

M. Sig.: Two tcaapoonfulfl in ivater three or four times a day. 

ASPIDIUX (U. S. P.).— Aspidium. 

mix MAS (B. p.).— Male Fern. 

Bote (in powder), 2 to 6 Gm. (or Sss-iss). 

Preparations. 
Oleoresina Aspidii (U.S. P.). — Oleoresin of Aspidium. Dose, 2 to 7.5 ccm. (or 



B»ij). 



' *M:hnMuc Urethritis and its Treatment/' London, 1890. 



238 



PHAKMACliLTJCAL TUKlUl'EUTiC AGENTS OK DIUTos, 



Extractum Filicis Liquidum (B. P.). — Liquid Extract of Male Fern. Dose, 3 to, 
fl c.cm. (or ffixlv-xc). 

Pharmacology, — Aepidium is tlit* dried rbjy/iiiie of llie Dryoptfri:* FilLx- 
nms aiid of Itn<»ptori8 uiarginalis (Filice^) (U, S. P.), and the rhizome 
of Afipidiuru Filix-majH (B. P.). The 'Mnk' Fern, or lirvttptfris Fili\-nia&, 
is found in ahiiost every portion of tlie world; the tiiar^inahB i» in- 
digenous to Nortli AnnTJca, The rhizome, the portion oniploved (which 
deteriorates on heing retained for a long time), lias a swwtisli-hitter, astrin- 
gent taste, with wmie Hli^riit (»dfir. It etuitMiiifi an nelive priiiei|)le, Filicio 
acid, a fixed and volatile oil, filix-tannie, and gallie aeids. Its virtues are 
due Id the ethereal extract, or ole«rev*:in. The rhi/oniLM>f nolle fern eontainsin- 
tereellnlar glaml^, whieh liold a greenish yeeretion. When seetions of this 
are. preserved in glyeerin, crystnln are fornud, which are soluble in ether. 
It is to this peeretion that the antheljnintie ipudities of the drug are due, 
according to Lauren.^ The oleoresin of aspidium is a dark, thick fluid, of a 
hitter and nauseous taste. Aee<^rding U> Professor Kol)ert its virtues do not 
depend rntirrly upon the lilieie aeid pnvsent, Ijut iilso upon the ethereal oil. 
From hin eheiuical and physitdogical invegtigatittnK E. Poulssori eonehides 
that the crvHtaUiue suhstanee heretoffMe known as fdieie acid is really the 
anhydride of the a*dd, nnil he pmposes to nail it Filicin. (hi standing, filicie 
anhydride precipitates from preparations of male fern as a granular, white 
powder without taste or flnu-lh insoluhle in water, but sojutde in boiling 
flicohoL If tliese small crystals are dissolved in alkali aiul repreeipitated by 
aeid, they litHome again rnnserted 1o the arttvt* form of filicie acid. 

Physiological Action and Toxicology. — Agpidiuni possesses the power 
of expelling, and perhaps destroying, ta^nige. Harley believes that it is only 
able to detach the entozoon from the intestinal wall. It is especially active 
against the bothriocephalns latus. 

Large doses of the ethereal extract, or oleoresin, may occasion nausea, 
vomiting, and choleraic diarrho?a, followed by death from the congestiorf 
and inflammation of the gastrc^-intestinal tract by the irritant action of the 
drug. In the Wiener Hinisrhe \Voche?ischrift is reported the case of a child, 
5 Va years old, to whom 7.5 c.cm. (or foij) of the oleoresin were given, in 
three doses, within one hundred minutes. In an hour and a half, part of the 
tapeworm was expelled, then vomiting occurred, and somnolence, which was 
followed by twitching, sopor, and trismus of ten minutes' duration, ending in 
death five hours after the last dose of the extract. 

A post-mortem examination of a case of poisoning and death from male 
fern revealed congestion and ecchymoses of the stomach and blood-clots 
over its surface. Poisoning from male fern should be treated by the admin- 
. istration of magnesium sulphate and by the hypodermic injection of water 
of ammonia, from O.tiO to 2 c.cm. (or mx-foss), properly diluted. Accord- 
ing to Prevost and Binet, death usually results from paralysis of the heart, 
which is found, after death, firmly -contracted and unresponsive to irritation. 
Male fern generally reduces the amount of urine secreted. 

Therapy. — As a tseniacide, the ethereal extract, or oleoresin, is the most 
eflieient preparation, but being a thick, hitter, njist:H>us siihslanee, it is 
best given in capsules. It can be given, but not so welL in milk or mucilage. 
It can be acceptably administered with an equal quantity of aromatic syrup 



' Therapmtische Monatshefi, April, 1899. 




ASPIDOSPERMA. 239 

of rhubarb. The doee should be preceded and followed by a purgative, 
Cdomel may be given as a preliminary purge. A full dose of castor-oil, two 
houis after the administration of the remedy, will usually bring away the 
entire parasite. Trousseau and Pidoux advise the restriction of food to a 
milk diet for a day or two previous to the institution of the treatment. 
Whitla has found tiiat male fern is efficient among children, in a reduced 
dose, when combined with turpentine. 

This combination of male fern often acts well: — 

Q OleorefliiuB aspidii, 21 ccm. or f3sa. 

01. peponifl expreasi 15 ccm. or fjsa. 

01. terebinthliuB 2| ccm. or mxxx. 

M. 8ig.: Take at a doae after fasting, and foUow by a purgative. 

Lanara claims good results from the application of male fern in eczema. 
The formula which he employs is as follows: — 

R Ext. filicis liquid! (B. F.) 281 ccm. or Sviiss. 

Alcoholis 15{ ccm. or fjSB. 

Ext. myrrh., 

Sxt. opit aa 4{ Om. or 3j. 

H. Sig.: For external use. 

In several cases of cysticercus disease, Dr. R. Feletti has observed im- 
provement to follow the use of ethereal extract of male fern. The result was 
especially favorable when the lesions were situated in the subcutaneous or 
muscnlar tissues. 

In Finland, the aspidium spinulosum is used as a tseniacide more fre- 
quently than the official drug, as it is a more common variety in this region. 
It was found to be equally efficient in doses of 1 to 4 Gm. (or gr. xv-lx) of the 
extract, by Lauren and Schumann. 

ASPIDOSFEBUA.— Aspidosperma (Quebracho). 

Preparation. 
Kluidextraetum ARpidospermatip. — Fluid Extraet of Aspidosperma. Dose, 2 to 
4 cxm. (or f3sB-j). 

Pharmacology, — The bark of Aspidosperma Quebracho-bianco (Apo- 
t\Tiacese) : a large tree of Brazil. It contains six alkaloids, the most im- 
fKjftant of which is Aspidospermine. The others are named Aspidosperma- 
line. Aspidosamine, Quebrachine, Hypoquebrachine, and Quebrachamine, 
It also contains tannin and two sugars (quebrachit and inosit). 

Aspidospermine commercially consists of the mixed alkaloids of the 
I'ark. It occurs in the form of colorless crystals, insoluble in water, moder- 
ately soluble in alcohol and ether. 

Quebracho is also found in Catamarea, of the Argentine Republic, where 
it has a popular reputation as a febrifuge and antiperiodic. Another species, 
the red quebracho, contains a large amount of tannin and less of the bitter 
principles. It is used largely for tanning leather, and is sometimes mixed 
with white quebracho as an adulteration. 

Phynological Action. — Quebracho is bitter and stimulant to the salivary 
elands, astringent to the intestinal tract. In large doses in animals it pro- 
ducea paralysis of the limbs, of central origin.^ It also causes salivation, 
paralysis of respiration, and diminished frequency of the heart's action; 

» F. Penzoldt, Berliner klinische Wo€hen9chrift, No. 19, 1870. 



240 



PHARXLVCEUTIOAL TUEIUPEDTIO AOEXTS OH DRUGS. 



death is caused by paralysis ami convulsions due to apncea. Moderate doses | 
retard breathing, and make inspiration slower and fuller. Aepidospermino j 
increases the respiratory movements in the higher animals by stimuiatingl 
the respiratory centres. It is said also to cause an excess of oxygen to be 
taken up by the red blood-cells, and may thus induce apnaa. In man it I 
has no influence upon the temperature or the frequency of the pulse, but is 
said by Hale to ''impart some tonicity to the heart/' 

Therapy. — The special action upon the motor apparatus of respiration j 
makes quebracho valuable in treating dyspncea of all kinds, whether bron- 
chial, cardiac, or nervous. In emphysema, with or without asthma, it haa^ 
been very serviceable in the form of fluid extract, 1.20 to 2.50 c.cm. (or, 
mxx-xl), several times a day. Quebracho is also of service in spasmodic 
croup. Dr. Picnt states that it is advantageous to the respiration when taken 
before hill-climbin-:. The effect of quebracho in relieving cyanosis Is very 
marked. In the case of a child, suffering with double pneumonia. Dr. Law- 
rence witnessed decided improvement of the respiration and circulation fol- 
low the use of this remedy. This drug very sensibly diminishes the pulse 
and temperature in acute rheumatism and inflammations of serous mem- 
branes. An elixir, d wine (G per cent.), and a tincture (40 to 50 per cent.) 
have also been used. The alkaloid, aspidospermine, has been employed as 
a febrifuge, and, according to Guttraann, its dose as an antiperiadic is 1.20 
Gm. (or gr. xviij), the ordinary dose being 0.005 to 0.13 Gm. (or gr. i-ij). It 
is soluble in oils or 50 parts of pure alcohol. Bardet has given aspidosper- 
mine in d^yspnuea with good results. In serious cases the drug can be well 
administered by hyjmdcrmic injection, (^uclinuhine hydrochloride has been 
given both by the mouth and by hypodermic injection for the relief of dysp- 
nn?a,the dose employed being from 0.065 to 0.13 Gm. (orgr. i-ij). Triturates 
of V,o and Vjoo of aspidosperniine (all the alkaloids) are also used. The solid 
extract is a useful preparntinn for asthma, given in n.n(t5 Gm. (or gr. j) doses 
three times a day. The fluid extract is no longer otlicial. 

ASPmiN, or aeetyl-salieylie acid. (C„H,CO(J-Ht'U,CH,), is obtained 
by heating acetic anlirdride with salicylic acid; it occurs in white, 
crystaline uc^edlcs, which have a melting-point of I3b° C. (875° F.). It is 
readily pohil)if in alcohol nud ether; not very s<^>liihle in cold water; but is 
soluble in an acid solution like gastric-juice, and gives with ferric chloride, 
a blue color. 

Wnhl«reinuth^ reports his results in 10 casci; ButTering witli rheumatoid 
manifestations; in 2 cases of acute rheumatism in which sahcyiic acid and 
antipyrin had been used with negative results, aspirin was given in doses of 
3 Gm. (or gr. xlv) daily; the patients improved almost immediately; pain 
and swelling disappeared within a few days, without any gastric disturbance. 
The remaining S cases were not true joint rheumatism; some had scarlet 
fever, others diphllicria or angina; these patients were given 1 Gm. (or gr. 
xv) three times daily for eight days without feeling any ill effects. The 
action of aspirin on the rheumatio joint is identical with salicylic acid, and 
is, according to this author, to be preferred to sodium salicylate, chiefly 
because of its non-irritating character when administered by the mouth; it 
should be given in powder, and not in a solution. Elbersou^ observed a 
general epythema produced by five grains of aspirin. It nelded promptly 



* Thcrap, llomtt.. No. 7, 3n04. 
'Thcrap. \fonat., May, 1801). 



d 



AURiCNTII COBTEX. 241 

to salines, and a dusting powder locally. Tinnitus aurium has been noticed 
after its administration, and it often causes profuse perspiration. Occaflion* 
ally it depresses the heart. It is recommended as a good antipyretic for la 
grippe. 

ATEOPIHA (U. S. P., B. P.).— Atropine (C„H„NO,). 

ATBOFIKiB STTLPHAS (U. S. P., B. P.).— Sulphate of Atropine. (See 
Belladon2La.) 

AUBANTn AMABI GOBTEZ (U. S. P.). — Bitter Oran^re-peel. The 

dried rind of the fruit of Citrus Amara, Citrus Bigaradia, and Citrus Vul- 
garis (Rutaceae). 

ATJEANTn BITLCIS COBTEX (U. S. P.): — Sweet Orange-peel. The 

tmdried, outer rind of the ripe fruit of Citrus Aurantium (Rutaceae). 

AVBANTn COBTEX BEGEKS (B. P.).— Fresh Bitter Orange-peel 
"The fresh outer part of the pericarp of Citrus Aurantium." 

AUBANTn COBTEX SICCATTTS (B. P.). — Bried Bitter Orange-peeL 
"The dried outer part of the pericarp of Citrus Aurantium." 

U. 8. P. Preparations, 

Oleum Aurantii Corticis. — Oil of Orange-peel. 

Fluidextractum Aurantii Amari. — Fluid Extract of Bitter Orange-peel. 

Sympus Aurantii Florum. — Syrup of Orange-flowera. 

Syrupus Aurantii. — Syrup of Sweet Orange-peel. 

Tinctui^a Aurantii Dulcis. — Tincture of Sweet Orange-peel (20 per cent.). 

Tinctura Aurantii Amari.— Tincture of Bitter Orange-peel (20 per cent.). 

Spiritus Aurantii ComposituB. — Compound Orange Spirit. Used in making the 
elixir aromaticum, and also the aromatic fluid extract of rhamnus purshiana. 

Ellixir Aromaticum. — ^Aromatic Elixir. 

Aqua Aurantii Florum.— Orange-flower Water, 

Aqua Aurantii Florum Fortior. — Stronger Orange-flower Water. 

The dried ped of bitter orange enters into the U.S. P. compound. tinctures of 
cinchona and gentian. Orange-flower water is used in syrup of calcium lactophos- 
phate. 

B. P, Preparations, 

Aqua Aurantii Floris. — Orange-flower Water, 

Sympus Aurantii. — Syrup of Orange. Dose, 2 to 4 com. (or fSss-j). 

Syrupus Aurantii Floris. — Syrup of Orange-flower. Dose, 2 to 4 ccm. (or 
f3»-j). 

Tinctura Aurantii. — Tincture of Orange. Dose, 2 to 4 ccm. (or f3ss-j). 

Inlufum Aurantii. — Infusion of Orange-peel (dried bitter orange-peel, 6 Gm.; 
boitiiw distilled water, 100 ccm.). Dose, 15 to 30 ccm. (or fjss-j). 

InfuBum Aurantii Compositum, — Compound Infusion of Orange-peel (orange- 
peel and lemon-peel, with cloves, in boiling distilled water). Dose, 15 to 30 ccm. 

(orf5»-j). 

Vinum Aurantii, — Orange- wine (wine made by the fermentation of a saccharine 
■olution to which fresh bitter orange-peel has been added; 10 to 12 per cent, of 
aleohol). 

The dried bitter orange-peel enters into the 6. P. compound spirits of horse- 
radish, and compound tinctures of cinchona and gentian; the tincture of orange into 
aromatic syrup, and aromatic syrup of cascara. 



242 



PHARUACErTICAL THEBAPEUXlC AOEKTS OR DRUGS. 



Fharmacolo^. — The United States Pharmacopoeia preparations are 
obtained from tlie bittor, Citrus auiara, Bigaradia^ or Vulgaris, and from 
the sweet orange, C'ilrufi aurantium (Aurantiacetv) : the fruit of small trees 
vhich ^iinv in warm regions of the East<-*rn and Western Hemispheres. The 
British Plianna(H)jKeia j>ri'p:)nitiuns are made from the outer part of the I 
poriearj> of the Citrus Aurautium. 

Therapy. — Urange-juicc, with water and suji^ar, may be used as a drink 
for fevers and as an antiscorbutic. Care should be taken, after typhoid 
fever, not to allow ehildren to suck the juice from the orange, as death has 
been caused by the passage of a seed through an ulcerated patch in the in- 
testine. Death has also been caused by a child's eating the heah rind, which 
contains the volatile oil. Erythema, a^dema, vesicles, and pustules may be 
occasioned by paring bitter oranges. The elixir is an agreeable vehicle for 
other reniedieSj having the alcoholic strength of a cordial. The other prepa- 
rations are pleasant Havoring agents. 

AUEI ET SODH CHLOEIDITM (TJ. S. P.).— Gold and Sodium Chloride 
(AuCl, + NaCl). 

Dose, O.Oai to O.OOG Gm. (or gr. Vso-Vio)- 

Pharmacology. — A mixture composed of equal parts, by weight, of dry 
gold chloride and dry sodium chloride, containing not less than 30 per 
cent, of metallic gold. On account of its position among metals, gold has 
been credited with having some special medicinal value, altliough not a nor- 
mal constituent of the human body. It is practically non-corrosive, and 
was formerly used to some extent to protect instruments from rusting. 
In a pure state, gold is too soft for most purposes, although it is the best 
material for wire and for filling teeth. The only gold preparation official is 
the gold and sodium chloride. This forms an orange-colored powder, 
slightly deliquescent in the presence of dampness, freely soluble in water. 
It is easily deconipoBed by sunlight and by or.iianic mattcrj and is best dis- 
pensed as a tablet triturate. Lainer has recently prepared a gold and potas- 
sium chloride by dissolving pure gold in aqua regia by the aid of heat and 
adding a concentrated solution of potassium chloride. The compound is 
said to be stahlc and neither acid nor deliquescent, but no clinical reports 
of its use have yet been made. 

Physiological Action. — The effects of the gold and sodium chloride re- 
semble those of the mercuric chloride. It has very decided bactericidal 
powers. According to Sternberg, a solution of 1 to 40,000 restrain the 
growth of anthrax bacillus, and one of 1 to SOOO destroys it. This statement 
has been questioned by L. Hektoeu. who fonnd that 1 to 40,000 delayed the 
growth, but that 1 to SOOO did not destroy it. A strength of 1 to 1000 de- 
stroys the bacillus of diphtheria and 1 to 500 the bacillus of typhoid fever. 
Gibbes and Shurley demonstrated its bactericidal power against bacillus 
tuberculosis by physiological experiments upon animnls.* In concentrated 
Bolntion it has an eseharotie action upon tlie skin. Internally, in very small 
doses, it nets upon the giaudular structures of the stomach nnd liver, — stimu- 
lating nutrition and assimilation ; but, in larger doses, it produce? violent 
gastro-onteritis. witliout uleeratii^n or salivation. These svmptonis have 
been produced in an adult by 0.0*i5 Gm. (or gr. j), and this same dose has 



^ Thcrapcutio Gozftte, April 15. 1801. 




AUBI £T 60DII CHIX)RIDUH. 243 

produced death in a dog in four minutes, as reported by Daniel R. Brower.* 
In ansemia it increases the percentage of hsemoglobin and the number of red 
blood corpuscles, but large doses reduce the oxidizing power of the red blood- 
cells. Large doses excite salivation, but do not affect the teeth, cheeks, or 
gams. This salt exercises a constipating effect upon the bowels. Upon the 
brain and spinal cord its effects are those of a tonic. In some instances it 
produces decided mental exhilaration. When its use has been too long con- 
tinued it gives rise to what has been termed "auric fever,** a condition charac- 
terized by profuse sweats and an increase of saliva and urine. The remedy 
acts upon the kidneys, increasing the urinary flow, and the secretion, after 
large doses, is colored yellow. Renal hypersemia with albuminuria is caused 
by toxic doses. It is claimed that gold has aphrodisiac powers, causing pain- 
ful erections in men and increasing the menstrual flow in women. Gold is re- 
moved from the body chiefly by the kidneys, but to some extent also by the 
liver and bowels. For the gastro-enteritis, vomiting, etc., similar to corrosive 
chloricle of mercury, caused by large doses, the antidote is albumin and 
demulcents. 

Therapy. — From the physiological action upon the glandular system of 
the stomach and liver, and the resulting improvement in the powers of as- 
dmilation, gold may be especially valuable in atonic dyspepsia, enabling the 
p&tient to digest more food. It is of decided service in nervous dyspepsia. 
Mso, in gastric catarrh, chronic inadequacy of the hepatic functions (torpid 
liver), and early stage of cirrhosis, the gold and sodium chloride is a useful 
remedy. Administered in this prescription, it often is most effective in gas- 
tric catarrh and torpid liver; — 

03 Gm. or gr. 
Gm. or I 
Gm. <« ! 



Q Ami et sodii diloridi 

Ext. nuclB vomicsB 

Est. tAraxad 4 

M. et ft. pU. na xzx. 

Sig.: Two pills three times a day. 



20 Gm. or or. iij. 



In cirrhosis, of the kidney, and albuminuria due to interstitial nephritis, 
iccording to MiDard, it has a special place. Culbertson reports relief of a 
case of albuminuric retinitis from gold and sodium chloride. This salt is 
beneficial in arteriosclerosis and the vertigo of the aged dependent upon 
atheromatous vessels, and also in vertigo due to indigestion. It is useful 
in hysteria and functional impotence. In spasmodic affections (whooping- 
cough, laryngismus stridulus) it has some advocates. Where amenorrhcea 
or dysmenorrhoea is due to deficient innervation, and not to local lesion or 
obstruction, this remedy has given good results, and also in habitual abortion. 
Uncomplicated chronic ovaritis is benefited by the administration of gold. 
The double salt is also said to afford relief from ovarian neuralgia. Follow- 
ing out th€ physiological action, we find that, in spinal sclerosis, premature 
senility, in depression and hypochondria, it has a high degree of efficiency. 
This remedy has also been given with advantage in neurasthenia, progressive 
general paralysis, utero-ovarian c(Vng€stion, menorrhagia, subacute metritis, 
Dymphomania, and spermatorrhoea. Dr. John Strahan, of Belfast, suggests 
that it may be useful in insomnia dependent upon cerebral ansemia. In the 
treatment of impotence, Professor Glenn, of the University of Tennessee, has 
fonnd the following combination of service: — 

* Journal American Medical Aasociationj Oct. 1, 1899, p. 754. 



244 



PHAEMACEITICAL THERAPEUTIC AGENTS OB DRUGS. 



I^ Auri et sodii chloridi 

Strychnin. Bulphat 

Zinci phoephidi 

Ext. dumiausB 4 

M. et ft. in capsulas no. xxx. 
Sig.: One capsvle thrice daily. 



20 Gm. or gr. iij, 

0^ Gm. or gr. j. 

20 Gm. or gr. lij. 

Gm. or 3j. 



Gold and sodium chloride is, in some cases, an efficient substitute for ' 
mercuric chloride in the treatment of syphilis, and it has been given in this 
combination, where there was an undue susceptibility to mercury, with de- \ 
cided benefit: — 



^ Auri et sodii chloridi 

Ext. eaDguin9.riffi 

Ext. calumbfe 2 

M. et ft. pil- no. xxx. 

Sig.: One pill three times a day. 



065 Gm. or gr. j. 
13 Gm. or gr. ij. 
Gm. or gr. xxx. 



Gold also proves of avail in the late manifestations of syphilis, and is 
sometimes effectual, after failure of the mixed treatment by means of mer- 
cury and iodine, or when these remedies cannot be borne on account of 
idiosyncrasy or debility. It has been of service in ulcerations of the throat, 
laryngitis, oza?na, diseases of the bones, and syphilitic cachexia. Dr. J. A. 
Bobinson reports two cases of diabetes mellitus in which gold and sodium 
chloride caused a steady decrease and final disappearance of glycosuria. In 
hypochondria and melancholia the double sM is highly recommended. In. 
one case of pyelitis. Dr. G. Frank Lydston, of Chicago, found the h3^podeTmic 
injection of gold and sodium chloride to produce decided improvement. 
Gold chloride is useful in the treatment of chronic tobacco poisoning and 
morphine addiction. 

From the results of fifty-two experiments made upon various species 
of warm-blooded animnls, Cnlmette concludes that the subcutaneous injec- 
tion of gold is antidotal to the poison of the cobra di capello. He believes 
that the venom may be neutralized, even after it has been absorbed, and 
that the treatment' may be successfully applied to human beings. His 
method is to cast an elastic ligature around the limb, to inject 7.50 to 9.25 ; 
c.cm. (or f3ii-iiss) of a l-per-cent. solution of gold chloride into the wound ' 
and beneath the surrounding skin, not more thnn 1 c.cm. (or mxv) being 
deposited at any one spot. Injections are also made at the level of the liga- 
ture as well as between it and the heart. The solution may be thrown either 
into the connective or muscular tissue. As soon as the injections have been 
made, the ligature may be removed. The method merits trial in the case of 
bites from other venomous serpents, since, as Weir Mitchell has shown, the 
poisons are substantially of the same chemical composition. | 

In appropriate cases this salt may be given under the skin. Thua 
Gibbes and Shurley^ have reported successful results in twenty-seven cases 
of pulmonary tuberculosis, by gold and sodium chloride given hypodermic- 
ally, in doses of 0.003 to 0.01 Gm. (or gr. Vso-V*)^ during three to eight 
months. Pepper also reported a case of phthisis apparently cured by this 
drug.^ 

Dr. Joseph Drzewiecki reports the cure of a case of lupus by the internal 



» Loc. Ht. 

* University Medical Magazine, Dec., 1896. 




BALSAMUK PEBUTIANUM. 245 

administration of the same salt in the dose of 0.0003 6m. (or gr. V150) three 
times a day. 

AVEHA. — Oat, the fruit of Avena sativa (Gramineae), is used as a food 
in the fonn of meal, of which cakes, gruel, or norridge is made. It is a 
highly-nutritious food, containing oil, nitrogenized principles, carbohydrates, 
phosphates, etc.; but on account of its concentrated form and the presence 
of irritating fragments of the outer coat, containing silica, oatmeal is likely 
to cause indigestion, and in young children diarrhoea. The habit of eating 
porridge with milk and large quantities of sugar is apt to cause sour stomach 
and pyrosis, which may be avoided by using butter or cream and salt instead 
of the milk and sugar. Skin eruptions have been attributed to the use of 
oatmeal, particularly eczema, in infants, which are cured by a change of diet. 
An alcoholic tincture of oats has been supposed to have a sedatiTC action upon 
the cerebral centres and to remove the craving for drink. For the latter, it 
Tould be more rational to recommend an infusion than a tincture. 

AZEDAKAGH.— Asedarach (Pride of China). The dried root-bark 
of Melia azedarach (Meliaceae) is used in our Southern States in the form 
of a decoction (124 Gm. to 946 c.cm., or 5iv-0ij, boiled down to 473 c.cm., 
or Oj), as a vermifuge, in cases of round worm 15 c.cm. (or f^ss) being 
given to a child every two or three hours until the bowels are freely moved. 
Large doses may cause vertigo, dilated pupils, and stupor. A fluid extract 
has been also used (dose, 4 c.cm., or fSj), but the fresh decoction is the best 
preparation. 

BAISAKUK CAKADEITSE.— Canada Turpentine. (See Terebinthina 
Canadensis.) 

BALSAWIM PEEUVIANUM (U. S. P., B. P.).— Balsam of Peru. 

Doie, 0.30 to 1 c.cm. (or mv-xv). 

Pharmacology, — A balsam obtained from Toluifera Pereirae (Legu- 
minosae) TJ. S. P.; Myroxylon Pereirae (B. P.) : a tree of Central America. 
It is a brown, heavy liquid, of fragrant odor and a warm, rather acid taste, 
containing resin, volatile oil, and both benzoic and cinnamic acids. It is 
inflammable, burning with a white sinoke and fragrant odor. It is entirely 
soluble in 5 parts of alcohol, and should not diminish in volume when agi- 
tated with an equal bulk of benzin or water. The National Dispensatory 
states that the balsam contains 60 to 64 per cent, of benzyl benzoate (C7H5 
C^H.Oa), a colorless oil, vanillin, cinnamic acid, benzyl cinnamati, and 30 
to 38 per cent, of resin, composed of benzoic and cinnamic esters of peru- 
Tt^ino-tannol, 

Physiological Action and Therapy. — Peruvian balsam is carminative, 
stimulant, and expectorant. It has been extolled in Europe by Landerer 
tnd Schnitzler in phthisis pulmonalis and chronic bronchial catarrh, given 
in capsules or emulsion, and also used in an inhaler. Professor Landerer 
has convinced himself that the virtue of balsam of Peru in tuberculosis de- 
pends upon the presence of cinnamic acid, which he has of late employed in 
place of the balsam. The cinnamic acid of which he makes use, however, is 
obtained from storax. It is colorless, crystalline, feebly soluble in cold water, 
freely soluble in hot water, alcohol, and warm oil. A 6-per-cent. emulsion 
of the acid is prepared with almond-oil, yelk of egg, and normal salt solu- 



246 



rilAHMACLlTICAL THERATECTIC AGEKTS OR DBUOS. 



tion. Before use, the emulsion must be rendered alkaline by a few drops of 
a 25-per-cent. solution of liquor potassae. The emulsion is preferably thrown 
into a vein. The method is not applicable to the later stages of pulmonary 
tuberculosis. From 0.12 to 0.37 c.cm. (or mii-vj) of the emulsion are in- 
jected twice a week. In lupus, Landerer employs an alcoholic solution of 1 
part of cinnamic acid, 1 part of cocaine hydrochlorate, and 20 parts of alco- 
hol., 0.06 to 0.12 c.cm. (or nii-ij) being injected into the nodules till 0.60 
c.cm. (or mx) have been used at one seance. At the end of a week the pro- 
cedure is repeated. As it is a deodorant and antiseptic, it is useful as a local 
application to open wounds and compound fractures, and also in the treat- 
ment of oziena and old ulcers. In uterine affections we may u^e: — 

R Todoformi 1515 Gm. or 3iv. 

Balsflmi Peruviani 7 6 c.cm. or fSij. 

Adipis lanse liydrosi 62| Gm. or 5ij- 

M. Sig.: For local application on absorbent cotton or carded wool. 

In infantile eczema we may prescribe: — 

B Acidi borici 21 Gm. or 3sa. 

Balaami Peruviani GO c.cm. or mx. 

Adipis lana' hydrosi 3l| Gm. or 5j. 

01. amygdalte expressi q. s. ft. ungt. 

M. Sig. : Apply frequently upon soft linen. 

Balsam of I'eni, pure or in an ointmontj is an efficient application Tn" 
pruritus of the vulva and senile ]>ara'sthesia. It is likewise efficacious in 
scabies. Lcucoplakin, or local epithelial thickening of the mucous mem- 
brane, is removed by applications of Peruvian balsam; in leprosy it may be 
thorou^hlv rubbed into the affected areas. It is also a good local application 
for diphtheria. The internnl use of Periivian bnlsam hns been recommended 
by Tnvusseau and Pidoux in chronic intestinal catarrh and typhoid fever. 
Nuggia has found it sen'ieeahle in the gastro-intcstinal disorders of child- 
hood. The e.xtornal application of balsam of Peru has, in some instances, 
been followed by an erythematous, urticarial, or eczematous eruption. Dr. 
Lohaus has reported a case of fatal gastritis in a six-dny-old babe caused 
by balsam of Peru which had been applied to the mother's nipples on account 
of fissures. 



BAISAMUM TOLUTANUM (U. S. P., B. P.).— Balsam of Tolu. 
Dose, 0.32 to 1 Gm. (or gr. v-xv). 

Preparations, 

Tincturn Tohitnna (U. S. P., B. P.).— Tincture of Tolu (20 per cent.). Dos©, 
2 to le.cm. (or fSss-j). 

SyrupuB Tolutanus (U<S. P., B. P.),— Syrup of Tolu. Dose, 7.5 c.cm. (or f3ij) 
or more. B. P., 2 to 4 c.cm. (or f3as-j). 

Tinctura Benzolni Coinposita (U. S. P., B, P.). — The compound tincture of ben- 
zoin contains Tolu. Dose, 1.30 to 4 c.cm. (or fmcx-iZ}). 

Pharmacology and Therapy, — A balsam obtained from Toluifera Balsa- 
mmn (Legiiminosje; U. S. P.); Myroxylon Toluifera (B. P.): a tree of New 
Granada. It is a resinous exudation, which yields 7 per cent, of an acid, 
aromatic, oily liquid, chiefly benzyl lienzrijilp, with a little benzyl cinnaraate 
Also 0.5 to 1 per cent, of a volatile oil, chiefly Tolene, and 75 to 80 per cent, 
of resin. It has an agreeable odor and taste. 




BABII CHLORIDUK. 247 

Balsam of Tolu ia, when fresh, a thick, viscid fluid, but is, in time, con- 
verted into a hard, translucent solid. It is slightly antiseptic and expecto- 
rant; the ayrup is a favorite basis for cough-mixtures, chiefly on account of 
its pleasant taste. The balsam itself may be administered in emulsion with 
egg or mucilage. It should not be used during acute attacks of inflamma- 
tion. The syrup coven the taste of chloral or croton-chloral.(Brunton). 

BAPTISIA. — Wild Indi£^. The root of Baptisia tinctoria (Legu- 
minosae), indigenous to North America. Bapttsin, an impure resin, is con- 
sidered to have cholagogic properties (dose, 0.065 to 0.32 Gm., or gr. i-v), 
and has been found of service in amenorrhoea. The decoction or fluid extract 
may be used as a cathartic in large doses, or tonic astringent in small. In 
n-pboid fever and bowel disorders, small doses of a tincture have been used, 
but not according to the best practice. The decoction may be employed as 
a douche in nasal catarrh, chronic ulcers, leucorrhoea, etc., or as a mouth- 
vash in stomatitis. 

BABn CHLOBISTrK. — Barium Chloride* Barium, in its action upon 
the blood-vessels, resembles both ergot and digitalis. It causes the cardiac 
contractions to become more slow and forcible. Tonic spasm of involuntary 
muscular fibre is produced, peripheral blood-vessels are constricted, ana 
blood-pressure rises. Peristalsis is likewise excited. Overdoses give rise to 
salivation, thirst, vomiting, purging, embarrassed breathing, slow pulse, 
dilated pupils, and paralysis of the extremities. In experiments upon ani- 
mals Pilliet and Malbec found that barium chloride, injected subcutane- 
onsly in toxic doses, caused diarrhoea, albuminuria and haemoglobinuria, and 
convulsions, followed by rigidity. After death lesions were found in most of 
the organs. The glomendi of the kidneys were particularly affected, .and 
hemorrhages into the straight tubes were also observed. According to M. 
Bardet, barium chloride occasions coagulation of the blood, and death results 
mechanically from embolism. Death has occurred in consequence of 0.17 
Gm. (or gr. iiss), the quantity not having been taken in one dose, but in 
daily portions of 0.015 Gm. (or gr. Va)- The symptoms of intoxication mani- 
fested themaelves at the end of a week. This, however, must be regarded 
as an exceptional case. The drug, in small medicinal doses, is devoid of 
active poisonous properties. Barium chloride is a white, crystalline sub- 
stance, of a bitter and disagreeable taste, readily soluble in water. This salt is 
scarcely soluble in absolute alcohol, hut dissolves in rectified spirit. The 
sulphates are incompatible with the salts of barium. In cases of poisoning 
the sodium, or magnesium, sulphate, with white of egg, may be used as 
antidotes. Usual dose is 0.006 to 0.03 Gm. (or gr. Vio"Va) ^^ solution. 

Therapy. — Barium chloride may be used as a cardiac tonic in valvular 
insnfficiency with irregularity of the heart. The late Prof. Da Costa ob- 
serred that, in these conditions, ii^ relieves pain and the sensation of un- 
easineas, acting as a fairly good diuretic and capable of being given for a 
considerable period without disturbing digestion. In minute doses it is a 
stimulant and alterant, and mav be used in scrofula. 

Prom an administration of this salt to seventy-six children, Lelli con- 
dndes that it is efficacious in the gastritis which accompanies the torpid 
form of scrofula, but that it is injurious in the florid form. In the begin- 
ning, the remedy irritates the mucous membrane of the bowel and renders 



248 



PlLUllIACECTICAL TUEUAPEL'TIC AOEVTS Oil DUIOS. 



the process more acute, but the membrane is iinally favorably modified. 
Barium has been recommended likewise in chlorosis and in cachectic con- 
ditions. In amenorrhoea it has been given with advantage. It has yielded 
good results in varicose veins and aneurism. It alTords relief to the vascular 
phenomena of exophthalmic goitre. 

An ointment of barium chloride (V, to 1 per cent.) has been used for 
reducing enlarged glands. 



BAEn PIOXIDUM (Xot Oflicial).— Barium Dioxide (Ba03). 

Preparations. 

Aqua H^rdrogenii Dioxidi (U.S. P.)* — Solution of Hydrogen Dioxide, or Peroxido 
of Hydrogen. Three per cent, by weijflit of pure lU*j, ti^uivjilenl Il> ten volmiu'S of 
avnihible oxygen. 

Liquor Hydrogenii Pcroxidi (B. P.). — Solution of Hydrogen Peroxide. Dose, 2 
to 7^ c.cm. (or fSss-ij). 

The dioxide, or peroxide, of barium should be anhydrous and kept in 
vell-cIosGd vepsels. It is used in the manufacture of the solution of bleach- 
ing liquid, or dioxide of hydrogen, now entering largely into use for medical 
and Burgical purposes. 

Pharmacology. — The commercial dioxide of hj'drogen is a colorless so- 
lution of this agent in water. It is, when undiluted, a syrupy fluid, destitute 
of odor, of a harsh, slightly-acrid taste, has a specific gravity of 1.45, and is 
of very unstable composition. Its formula is H.O., and it decomposes into 
water and nascent oxygen, yielding 475 times its own volume of oxygen and 
leaving behind 1 vohime of water. The freshly prepared oflicial solution con- 
tains about 3 per cent., by weight, of the pure dioxide. This dilution is a 
clear fluid, having but little odor or taste, and is of a slightly-acid reaction, 
corresponding to «boiit 10 volumes of avnilablo oxygen. Another stn^ngth 
employed by surgeons is called the IS-volnme solution, becfluse each portion 
of the solution yields 15 volumes of the oxygen. It is an active oxidizing and 
antiseptic agent. As it grsdually decomposes it must be kept in a cool place 
and in loosely-stoppered bottks in order to prevent explosion. 

Physiological Action and Therapy. — The solution of hydrogen dioxide 
destroys pus and the micro-organisms, which excite suppuration, and coagu- 
lates the albuminoid components of the inflammatory products. It has also 
the property of checking fermentation. It is destructive to the pathoge- 
netic micro-organisms and is an excellent agent for purifying drinking-water. 
Dr. Jakovleff has asccrtnined by experiment that the solution of hydrogen 
dioxide increases the general acidity of the gastric juice and the proportion 
of free hydrochloric acid, but diminishes the amoimt of lactic acid. It pro- 
duces a marked incrense of the digestive power of the gastric juice. When 
pure and of official strength, it is free from irritating qualities, and can be 
poured over wounds, injected into sinuses, or into the ear, or used as a spray 
in ulcerations of the pharynx and of the larynx. It produces a frothinj? up 
when it encounters pus, owing to the liberation of oxygen, and the cessation 
of this commotion indicates the removal of all the pus. The surface of the 
woimd or ulcer becomes blanched, but is not injured by the application. 
As a rule, the fluid exerts an aualgesic elTect upon the surface with which it 
is brought into contact. Tubercular and memjnar}' abscesses especially are 




BABII DIOXIDUM. 249 

▼ell treated in this way. Boils, carbuncles, fdons, and ulcers are improved 
and their pain assuaged by the use of this remedy. Unhealthy or poisoned 
wounds and phlegmonoiis erysipelas receive decided benefit from the use of 
hydrogen dioxide. This solution is a beneficial application in cases of senile 
gangrene, phagedena, and syphilitic ulceration. It is peculiarly adapted for 
injection into cavities, fistulas, and sinuses communicating with bones or 
joints. This fluid, moreover, possesses the valuable property of disintegrat- 
ing carious or necrosed bone, and is, therefore, of service in hip-joint disease. 
Granular pharyngitis and stomatitis are benefited by the same application. 
It has been utilized with advantage for the purpose of disinfecting cavities 
in carious teeth, in the treatment of abscesses of the alveoli or antrum, and 
for bleaching discolored teeth. 

For the last-named purpose it is made into a naste with chalk or cuttle- 
bone. It enables the dentist to blanch and fill at tne same sitting a sensitive 
pulp or cavity. Dr. H. F. Brownlee, of Danville, Conn., made use of hydro- 
gen dioxide with marked advantage in a case of empyema which was char- 
acterized by the excessive amount of pus evacuated from the pleural sac. 

For comedones, Unna advises the use of a preparation containing from 
20 to 40 parts of hydrogen dioxide, 10 parts of lanolin, and 20 parts of 
vaselin. The application of the liquid is also of avail in acne. Hydrogen 
dioxide, on account of its bleaching properties, may be used to decolorize the 
dark lanugo hairs which not infrequently disfigure the faces of women. 
M. Gallois prefers hydrogen dioxide to tincture of iodine, as a parasiticide 
application in pityriasis versicolor. It is also effective in trichorrhexis 
barbae. 

Dr. Golovin commends the action of hydrogen dioxide in various dis- 
eases of the conjunctiva and cornea. In ulcers, of the cornea suppuration 
is diminished and healing promoted. Infiltrations undergo absorption. The 
remedy is of value in hypopyon, and may render operative interference un- 
necessary. Hydrogen dioxide is likewise beneficial in phlyctenular conjunc- 
tivitis and acute gonorrhoeal ophthalmia. It has been used with good results 
in dacryocystitis. It is serviceable in suppurative diseases of the ear. Hy- 
drogen dioxide has given very favorable results in the treatment of mastoid 
disease, being doubly beneficial by virtue of its action, both upon the pus 
and the bone. Care should always be taken to provide a free outlet for the 
frothv discharge caused by the peroxide, or pain will be increased and pus 
may be driven deeper into the attic and cells, and extend the infection. 

In ulcerative tonsillitis, fetid breath, and in some bronchial affections, 
a spray of dilute hydrogen dioxide is productive of benefit. A spray of this 
agent is likewise of utility in chronic nasal catarrh, ozaena, and scarlatinal 
anjrina. It should be made alkaline before using. Hydrogen dioxide is a 
useful application in mercurial and other forma of storaatitiB, and is also 
Used as a disinfectant of the mouth during febrile and wasting diseases. 

In diphtheria and croup its value has been established; a 2-volume 
lolntion is specially recommended in young children as a local application, 
and particularly after separation of the membranes in order to remove the 
odor and disinfect the surface.* It is stated by Dr. A. Jacobi, of New York, 
that in certain instances even a weak solution proves irritant to the throat, 
abrades the mucous membrane, and that it, consequently, sometimes proves 

»Dr. E. R. Satiibb, "On the Medical Uses of Hydrogen Peroxide," Qaillard'9 
MtdUsal Journal, March, 1889. 



250 



PHAHMACEUTICAL. TKEIL^PELTIC AGENTS OR DHU08. 



detrimental in diphtheria and must be abandoned in such cases. In gyna- 
cological practice this remedy has effected improvement in vaginitis and 
endometritis, and in chronic cystitis. It may be beneficially employed, like- 
wise, in septic conditions resulting from abrasions or wounds of the female 
genital tract. It has been used with success in the treatment of gonorrhoea, 
of both sexes. It is thought to be especially valuable in the chronic form 
of the disease. Dr. Willard Parker Worster, of New York, has obtained good 
results from the treatment of chancres by hydrogen dioxide. The ulcer was 
sprayed every day and in the interval kept covered with iodol. 

In surgen* of llie nose, hydrogen dioxide is urkI as a styptic. It is 
also of advantage in the treatment of passive hjemorrhages. It may be em- 
ployed in the form of a spray for the relief of pulmonary hicmorrhnge, or 
injected in cases of hcematuria and hfemorrhages of tlie lower bowel. Spray- 
ing the post-nasal passages with a 1- or 2-per-cent. solution, combined with 
an alkali, will generally check epistaxis, even of severe typc.^ In carcinoma 
of the rectum or uterus it relieves pain and cleanses the diseased surfaces. 
The use of a spray of a 10-volume solution is recommended as a disinfectant 
of the sick-room in case oi eruptive fevers and other infectious diseases. 

It has been administered, well diluted, in gastric affections, and has 
been found useful in flatulent dyspepsia, heartburn, catarrh of the stomach 
and bowels, etc. It would probably be of service in the treatment of gastric 
ulcer. It has even ameliorated the symptoms of cancer of the stomach. 
Hydrogen dioxide, combined with tannin and injected into the intestine, is 
beneficial in chronic dysentery. Irrigation of the bowel by means of liquid 
soap, potash, and glycerin, combined with the internal administration of 
hydrogen dioxide, was found by Dr. Elmer Lee to yield favorable results in 
Asiatic cholera. In cholera nostras, typhoid and yellow fevers, the use of 
this agent either by irrigation or by the mouth promises to be of superior 
efficacy. 

Sir Benjamin Ward Richardson, of London, has employed this agent 
for more than thirty years, beginning at a time when it was regarded as a 
chemical curiosity. He has reported a case cf epilepsy of long standing cured 
by the use of 7.5 c.cra. (or f."5ij) of a 10-volume solution twice daily in water. 
He advises a systematic trial of this remedy in epilepsy, especially in the 
Jacksonian variety. From a number of formula which have been published 
by Dr. Richardson the following have been selected: — 
It Acid, tannie |0^ 

Glycerin 30 

Sp' vini rectificat 15 

Aq. deatiUat 120 

Aq. hydrog. diox. (10 vol.) q. a. ad 240 

M. Sig.: An antiseptic and astringent gargle. 



B Aq. hydrog. diox. (10 vol.). 



15] 



Acid, tannic, pur |32 Gm 

Aq. rossB q. b. ad 2401 

M. Sig.: A useful colljrium. 

B Aq. hydrog. diox. (10 vol.) 75 

Acid, sulphuric, dil 2 

Glycerin 16 

Aq. destillat q. a. ad 180 



*3: 
Sib 



M. Sig.: Dose: two tablespoon hi Is, well diluted, 
colliquative sweating of phthisis. 



Gm. 


or 


PT- X. 


com. 


or 


m- 


c.cm. 


or 


ilSB. 


c cm. 


or 


fjiv. 


c.cm. 


or 


fSviij. 


c.cm. 


or 


f3iv. 


Gm. 


or 


gr. v. 


c.cm. 


or 


fjviij. 


e.cm. 


or 


f.?iis8. 


c.cm. 


or 


fSas. 


ccro. 


or 


fSaa. 


c.cm. 


or 


fSvj. 



An excellent mixture in the 



' \itc York Medical Journal Nov. 25, 1892. 




BELLADONNA. 251 

Q Aq. hydrog. diox. 751 c cm. or fJiiBB. 

Liq. morphm. hydrochlor. 4| c.cm. or f3j. 

Syr. tolutan 22 c.cm. or fSvj. 

Aq. desUU q. 8. ad 180| ccm. or fSvj. 

M. Sig.: Dose: one ounce, diluted with iced water. Recommended in astiienie 
broochitiA and phthisis with severe cough and sleeplessness. 

3 Aq. hydrog. diox 761 com. or fSilas. 

Syr. codein 7|5 ccm. or f3ij. 

Sp. vini rectificat., 

Glycerin aa 221 ccm. or tSrj. 

Aq. deetillat. q. e. ad 180] ccm. or fSvj. 

11 Sig.: Dose: one ounce in iced water. A palliative of decided value in dia- 
betes, giving much better results than codeine alone. 



B Aq. hydrog. diox 76 

Acid, phosphor, dil. 4 

Syr. ferri superphos 22 



c.cm. or fSiiss. 
ccm. or f3j. 
ccm. or f3vj. 



Glycerin. 30 ccm. or fjj. 

Aq. destiU. q. a. ad 180 c.cm. or fS^j- 

H. Sig.: Dose: one oimce in iced water. Recommended in asthenic cases. Used 
vitb advantage in the early stages of phthisis. 

Fyrozone. — Thia name has been given to different standard solntions 
of hydrogen dioxide in water and ether. Medicinal pyrozone contains 3 
per cent, of hydrogen dioxide in water. It is used internally and externally 
as an antiseptic remedy. Antiseptic pyrozone is a 5-per-cent. solution in 
ether, and is recommended as an application to ulcers, rhinitis, and diph- 
theria. In this strength pyrozone is used by dentists duriiig operations, 
luiving been found of decided assistance in arresting bleeding and keeping 
the parts perfectly dry. Caustic pyrozone, a 25-per-cent. solution in ether, 
is an efficacious remedy in common and 83rphilitic ulcers, sinuses, etc. In 
dentistry it has been employed for the purpose of bleaching the teeth, in 
the treatment of dental abscesses, and in pyorrhoea alTColaris (Eiggs's dis- 
ease). 

BELLADOinr^ FOLIA (U. S. P., B. P.).— Belladonna-leaTes. 

BELLADOinr^ RADIX (IJ. S. P., B. P.).— Belladonna-root. 
Dose of powdered leaves or root, 0.006 to 0.13 Gm. (or gr. Vio-ij)- 

U. 8, P. Preparations, 

I.EATS8. 

Extractum BeUadonns Foliorum. — Extract of Belladonna-leaves. Dose> 0.0015 
to 0.065 Gm. (or gr. V«-j). 

Tinctura BeUadonnce Foliorum. — Tincture of Belladonna-leaves (li) per cent.). 
Dose, 0.30 to 1.20 c.cm. (or mv-xx). 

Uneuentum BelladonnEe. — Ointment of Belladonna (contains, of the alcoholic 
atraci, 10 per cent.). 

Eoiplastrum BelladonnsB. — Belladonna Plaster. 

PQulse Laxative Compositce (U. S. P.). — Compound lAxative Pills (aloin, 1.3 
Gm.: strychnine, 0.06 Gm.; extract belladonna-leaves, 0,8 Gm. ; and ipecac, 0.40 Gm.j 
with licorice in powder, to make 100 pills. Each pill contains about 0.0005 Gm. [or 
FV,»] of strychnine, and 0.008 Gm. [or gr. Vgl of belladonna-extract). Dose, 1 or 
SpiUs. 

PflulA Podophylli, Belladonnee, et Capsici (U. S. P.)- — (Each pill contains resin 
of podophyllin, 0.015 Gm. [or gr. V.l ; extract of belladonna, 0.0075 Gm. [or gr. VJ ; 
apsicum, 0.03 6m. [or gr. ViT; with acacia and sugar of milk.) Dose, 1 to 3 pills. 



252 PHARilACECTICAL TUEIUrEUTIC AGENTS OR DRV03. ^M 

BOOT. ^* 

Flu idex tract um Belladonnas Radiets. — Fluid Extract of Belladonna* root. Doae, 
0.006 to 0.12 p.cm. (or f«*/,.>-ij). 

Lininientum Belladonnte. — Belladonna Liniment (contains, of fluid extract, 96; 
camphor, 5 parts). i 

B. P. Preparations. J 

LEAVES. ^M 

Extractum Belladoiime Viride, — Green Extract of Belladonna (from freah learl^ 
and young branches). Do8«, 0.015 to O.Olio Gm. (or gr. 'A-j)- 

Succus Belladonnaj. — Juice of Belladonna. Dose, 0.30 to 1 c.cni. (or wv-xv), 

ROOT. 

Extractum Belladonna* Alcoholieum. — Alcoholic Extract of Belladonna (contatn- 
ing 1 per cent, of alkaloids of belladonna-root). Dose, 0.015 to 0.00*) Gm. (or gr. V«-j). 

Extractum Bellaaonnce U()uidum. — Liquid Extract of Belladonna (contains V« 
of 1 per cent, alkaloids). Dose. 0.03 to O.OG ccm. (or m8a.-j). 

Tincturu Beliadonnte.^Tincture of Belladonna. Dose, 0.30 to 1 c.cm. (or mv-xv). 

Linimentum BeJIadonnie. — J^ininient of Belladonna (contains liquid extract of 
belladonna, 25 c.cm.; camphor, 2.5 Gm.; dintiUed A\'ater, 5 c.cm.; alcohol, 00 per 
cent., q. s. ad 50 com.), 

Unguentum Belladonnse. — Belladonna Ointment (100 parts contain 0.0 part of 
the alkaloids of bclladomia-root). 

Eniplaatnmi lielladonniE. — Liquid Extract and Resin Plaster (contains Vi p«r 
cent, of the alkaloids of belladonna-root). 

Suppofiitoria Belladonnnf. — Belladonna Suppositories (each contains O.OOl Gm., 
or gr. Vwi of the alkaloids of bclladonna-root). , 

Active Principles and Preparations, 

Atropina (U.S. P., B. P.). —Atropine (C„HaNO,). Dose. 0.0003 to 0.001 Gm. [or 
gr. V«,.V«). 

Atropine Sulphas (U.S. P., B. P.). — Atropine Sulphate. Dose, the same as atro- 
pine. 

OU>ntuiii .\trupiute (U. 8. P.). — Oleate of Atropine (contains 2 per cent, of 
atropine). 

Utigiientum Atropinre (B. P.). — Atropine Ointment (2 percent.). 

Liquor Atropinffi Sulpliatis (B. P.). — Solution of Atropine Sulphate (1 per cent.). 
Dose, 0.03 to 0.06 c.cm, (or wss-j). 

LamelljB Atropinro (B. P.). — Discs of Atropine (each 0.013 mgr., or gr. V»». of 
atropine sulphate). 

PhaLTmacologfy. — The dried leaves and the root of Atmpa Belladonna 
(Solanar-ete), or doadly nifrht^^hade. are caeh official. The dried leaves must 
yield, when assayed by the United States Pharmacopccia process, Bot less 
^han 0.35 per cent, of its alkaloids. The root is required to yield not less 
than 0.5 per cent, of its alkaloids. It is a native of Europe, and is culti- 
vated here. All parts of the plant are active. Tiie erect, purplish, branch- 
ing stems stand about three feet high, and the leaves with short stalks are in 
pairs of unequal size, oval, entire. The large, cultivated leaves are said to 
have less of the active principle than the smaller leaves gathered while the 
plant is in flower. The roots are taken from plants at least three years old; 
those which are tough and woody, breaking with a splintering fracture, 
should be rejected. Belladonna contains atropine and hyoacyamine, or 
belladounine. The United Slates Pharmacop»T?iR defines atro])tne as ''^an 
alkaloid derived from Atropa Belladonna and otJier plants of the same 
family. As it occurs in commerce, it is usually accompanied by a small 
portion of hyoscyamine, from which it cannot be readily separated." The 
sulphate of atropine is a more permanent salt, neutral to litmus-paper, read- 




BELLADONNA. 253 

ily soluble in water, and is generally preferred for medical purposes to the 
alkaloid. Atropine chemically is tropyltrope'ine (formula CiTHjgNOj), and 
lias been synthetically made by heating together tropine and tropic acid. By 
substituting different acids, Ladenberg obtained salicyl-tropeine, benzoyl- 
tiopeine, cynnamyl-tropeine, etc. Atropine and hyoscyamine are isomeric, 
bat the former is the more stable form. 

Thynologieal Action. — Locally, belladonna affects the end-organs of 
the sensoiy nerves, and reduces painful sensibility, contracts the vessels, and 
checks the action of the sweat- and mammary glands. It is readily absorbed 
through the unbroken skin, and symptoms of poisoning have appeared after 
its topical application. When applied to the eyes, belladonna (or its alka- 
loids) widely dilates the pupil and relaxes the ciliary muscle, so as to tem- 
porarily paralyze the power of accommodation of me eye. Double vision 
may be observed. In tiie throat, it produces dryness and choking sensations^ 
and this is one of the first effects of its toxic action. The skin is also dry, 
the face flushed, and the surface-temperature increased 1" or 2** F. 

Upon the brain it has an exhilarating effect, and a talkative delirium 
of mila form may appear. In some cases the delirium is of a violent type. 
Subsequently, sleep usually occurs. In the lower animals (frogs) atropine 
produces arrest of breathing, followed by convulsions. The transient flush- 
ing, or erythema, which appears after its use, is probably due to its effects 
upon the sympathetic system, as a stimulant. In some instances it produces 
a rash, which closely resembles that of scarlet fever and which may even be 
followed by desquamation. The influence of the drug upon the heart and 
circulation is believed to be indirect through the nervous system. Bella- 
donna paralyzes the inhibitory filaments of the pneumogastric nerve, and, as 
a result, the heart, under the influence of the sympathetic plexus, runs at a 
rapid rate without being checked by the paralyzed pneumogaatrics. The 
force of the heart's beat is also increased. Coincident with this, and as a 
result of its action upon the blood-vessels, arterial tension is increased. In 
toxic doses, however, blood-pressure is reduced. The contraction of the 
smaller vessels may be due to action upon the muscular flbres of the walls^ 
or it may be secondary to the action upon the nervous system. Respiration 
becomes more rapid, owing to stimulation of the respiratory centre. Con- 
tradictory statements have been made in regard to the effect of belladonna 
upon the respiratory centre. Dr. David Cerna, as a result of experimental 
and clinical study, coincides with the observation of Reichert, that *^atropine 
acts upon the respiratory fimction in two opposing ways, one (peripheral) 
tending to diminish, the other (central) tending to increase, the increase or 
the decrease of the respirations in the normal animal depending upon which 
one of these factors predominates/' 

The flow of urine is increased at first as the result of increased arterial 
tension, but there is no increase in the solid constituents of the urine. Larger 
doses decrease the quantity of urine, apparently by virtue of a paralyzing 
action on the terminations of the vagus, if we may accept the experimental 
results of Lazaro and Pitini.* The secretions generally are checked, notably 
those of the mouth and skin; the flow of milk is also arrested by it. Though 
intestinal secretion is at first diminished, it is, probably, subsequently in- 
creased, since the alvine evacuations become more frequent and more liquid 



*Ar^lMo de Farm, e Terapia; v, DeulacAtf medizinahZHtunff, If^b. 3, 1898. 



B Alropin. sulphat., 

Duboisin, Bulphat aa 

Cocain. hydrobromat. 2 

Aq. deatillat DO 



20 Gm. or gr. ivaa, 
Gm. or RT. XXX. 
c.cin. or ftijj. — M. 



In eye-practice, belladonna is used less frequently to dilate the pupil and 
relax the accommodation in order to facilitate examination of the eye and 
determine its refraction, than to prevent mlhesions between the pupillary 
border of the iris and the len?, or to avoid protrusion of the iris through 
an ulcer of the cornea. According to the observation of Dr. George Carpen- 
ter, the instillation into the eyes of infants, though it may cause phyeiologi- 
cal symptoms, is unsatisfactory as regards its action upon the pupil, dilata- 
tion being generally very tardy and mcompletc. 

Some oculists consider atropine santonate as the best combination as a 
mydriatic, but atropine sulphate is the salt generally employed, in from 
0.015 to 0.25 Gra. to 30 c.cm. (or gr. Vriv to fjj). The same solution is 
beneficially used in treating diseases of the ear, pain from inflammation of 
the middle or external ear, or membrana tympani, or carRohe, being re- 
lieved by dropping it in warm, when necessary. (See also Homatropine.) 



254 PHARMACErTICAL THERAPEPTIC AGENTS OR DRUGS. 

during the administration of belladonna. In small doses it stimulates to i 
more rapid movement the muscular coat of the bowel. Belladonna is elim- H 
inated chiefly by the kidneys, but partly by the bowels. Like other alkaloids, 
atropine is, to a certain extent, destroyed by the liver. I 

Toxic Effects and Antidotes. — Poisonous symptoms occasionally appear , 
as the result of the introduction into the system of a very small quantity, ,, 
either by absorption, as stated, or by passing from the eye into the nose, and I 
thence into the throat. In such cases nothing more serious occurs than dry- 
ness of the throat, dilated pupils, possibly an erysipelatous or erythematoua 
eruption upon the skin, and some fever and restlessness. Larger doses cause 
thirst, dryness, and aching of the fauces; flushing, rapid pulse, and hurried 
breathing; without decided increase of temperature, followed by coma or 
convulsions and death. The physiological antagonists which may be em- 
ployed as antidotes are morphine, physostigmine, muscarine, and jaliorandi 
(or pilocarpine). McGowan reports a case in wliich two injections of 0.03 Gm. 
(or gr. V2)» of pilocarpine unquestionably saved life. Chloral-hydrate has 
also been used as an antidote. According to Binz, morphine is particularly 
serviceable in alla}iDg the restlessness and mental excitement caused by 
belladonna. F'ailing respiration is combated by strychnine. External heat 
will be useful if a state of collapse occurs. Animal charcoal, fixed alkalies, 
and demulcents, followed by free evacuation of the stomach and bowels, may 
also be prescribed. The compound tincture of iodine is a ch<?mical antidote, 
precipitating the atropine and rendering it inert. 

Therapy. — Belladonna ointment, or the liniment of belladonna, may 
be used with good results in neuralgia and chronic rheumatism; also in local 
sweating. In the form of atropine it is a mydriatic, but is less used now 
than formerly, as it is liable to cause glaucoma. The solutions of atropine 
for ophthalmic practice, or for use hypodenuically, should be freshly pre- 
pared and sterilized each time, in order to avoid the development of penicil- 
lium in tlie liquid, which destroys the alkaloid, besides giving us an infected 
solution. M. Berger advocates the combination of alkaloids, believing that 
in tliis manner the same effects may be obtained by smaller doses. As a 
mydriatic he employs; — 




BELULDOyyA. 



955 



03 Gm. or gr. as. 

10 Gm. or gr. i«a. 

c-cra. or mij. 

Gm. or Sj. 



Rigidit J of the oe uteri during labor is said to be relieved by local appli- 
i of belladonna ointment. The same preparation is useful in epaBms of 
tkt Mck of the bladder or of the sphincter ani, and in vaginismus. If rubbed 

7aa the abdomen, the eitract of belladonna is said to check the vomiting 
pttgnancT and to relieve other reflex disorders dependent upon the gravid 
olmK. In leucorrhcea dependent upon inflammation of the eervii uteri, 
Wbdoims, in association with tannic acid, is a soothing application and re- 
i discharge. 
It relieves the pain of herpes zoster, and of irritable and malignant 
It also is sen'iceable in painful haemorrhoids and Assure of the anus. 
h cheeks the suppurative process in boils, and promotes the resolution of en- 
arjffd glands. For any local pain^ the appended formula, known as Lud- 
irr'» ointment, is very useful: — 

B Atrcminae ralphatis 

ACOMltilUB 

OW Uglii 

Fetrohiti 31 

X, Si^. : To be used by nibbing in a piece about the size of an ordinary pea. 

Belladonna ointment may be advantageously employed in the relief 
, cf mlaiiicd joints. The following are also good combinations: — 

B Unct. benadonnsE 21 Gm. or Zst. 

Jk4£pke lAiue hydroiii is's Om. or Sss. 

Orati plnmbi subncetat 12| Gm. or 3iij. 

UagC zinci oxidi 15j5 Gm. or in. 

Sarriecftble in furuncle, abscess, carbuncle, and herpea xoater. 

B Cocaine hydrochloridi. , . 132 Gm. or gr. v, 

Ub^ belladonmi; 3l| Gm. or |j, 

M. rt ft. ttis^ 

A food application in ulcerated carcinoma or sarcoma, irritable ulcers, etc. 

The pupils and throat should be carefully watched when belladonna 
st IB uaed upon open surfaces. Accidents, probably due to idiosyn- 
r, somrtixnes follow the use of atropine solutions in the eye. In addition 
!»tbe osujil tnanifestfltion of belladonna poisoning, cellulitis of the eyelids 
mi face, ar^ " - txis Ims been observed. In some persons the use of oven 
ysffctlj iif lutione of atropine proves markedly irritant to the con- 

^ Bfc ll I ■ afid give* rise to what is known as "atropine conjunctivitis." It 
&f«ii9 mctB as an irritant in certain cases of iritis, especially those occurring 
rbcGxnatic patients with posterior synechia?. Its use requires great cau- 
la tn glaucoma. In lat<»nt cases it may excite an acute exacerbation. In 
iBUBatcTTT glaucoma it increases intra-ocular tension. Belladonna is an 
ficjellest local remedy in intercostal neuralgia or pleurodynia, and in the 
r^t pafnfT of phthisis. The liniment may be applied with friction, and is 
_'ent. but strapping the chest with belladonna plaster is 
tent in pleurodynia or neuralgia. The plaster usually 
relief in irritable heart. The same preparation is ef- 
and myalgia. It may be spread upon the abdomen in 
neuralgia, or, in these affections, the agent may be em- 
• iu the method of Trousseau. This consists in combining 

rn. (or gr. i-ij) of the extract with 0.38 to 0.50 Gm. (or gr. 

') oi laxinic acid, and applying it to the cervix uteri upon absorbent 




256 



rilAnMACEl'TICAL THERAPEUTIC AGENTS OR DRL'OS. 



cotton, or introducing it into the vagina in the fonn of a sxippository. 
combination is often valuable in leucorrhoea: — 



This 



B Ext. hcllii'lonnie foliorum 1160 Gm. or gr. xxiy. 

Acidi tannici 6| Gin. or 3ia«. 

Olci theobromatis q. i. 

M. et ft. ftuppositoria no. xxiv. 

Three or four suppositories maj be used daily. 



lOB^ 



A suppository containing the extract of belladonna, alone or in union, 
with opium, is very valuable in dysmenorrhoea dependent upon spasm of the 
cervix uteri. Belladonna, locally applied, has the power of alleviating that 
perversion of sensibility known as parsesthesia^ or pruritus. Hence, a lotion 
or ointment containing this agent may be sticcessfully used in pruritus of 
the genital.s, urticaria, and chronic eczema, attended with excessive itching, 
A prescription like the following may be written: — 



B Betannfththol l|30 Gm. or gr. 

TJngt. cHinphorse, 

Ungt, menthol aa 81 

Ungt. belladonnffi 15J6 

M. et ft ungt. 

Or:— 



Gm. or 3ij. 
Gm. or 5bs. 



B Acid, cflrholiei 21 

Linimenti belludonnse 60| 

Glycerini, 

Aq. rosee ^ . . .aa i20| 



o.cm. or fSss. 
c.cm. or fSij- 

c.cm. or il'iv. — M. 



The liniment of belladonna, applied several times a day, has a remark- 
able power in restraining local excessive sweating. A solution of atropine 
in equal parts of alcohol and chloroform, the strength being- 1 per cent. (0.32 
Om., or gr. v, of the alkaloid to 30 c.cm., or fjj, of menstruum), will some- 
times, according to Earthulow, allay obstinate cerebral or reflex vomiting. 

Instead of belladonna, atropine may be used in proper quantity in form- 
ing ointments and lotions. The following is an elegant ointment for use in 
chronic ovarian, uterine, or pelvic disease: — 



B Atropin. sulphatis 113 Gm. 

01. neroli 3T com. 

Ungt. aquie tossb 15|5 Gm. 

M. et ft ungt. 



or gr. ij. 
or rnvj. 
or Sas. 



It has been asserted that atropine oleate (made by dissolving 1 part of 
atropine in 30 parts of oleic acid and adding 50 parts of olive-oil) makes a 
suppository of far more uniform composition than when extract of bella- 
donna is employed. 

Belladonna is chiefly employed internally to alleviate pain, relax spasm, 
and check excessive secretion or morbid discharge. It is a valuable remedy 
in neuralgia, especially of the trifacial nerve, though other forms are fre- 
quently amenable to its influence. Anstie esteemed it superior to any other 
agent in neuralgia of the pelvic viscera. Belladonna is beneficially given by 
the mouth in dysmenorrhea, e8p>ecially if the disorder is due to spasm of the 
neck of the womb. 

Atropine is often productive of the happiest results in gastralgia, en- 
teralgia, and gastric ulcer. As neuralgia is often expressive of insufficient 



BELLADOKKA. 257 

nutrition and is generally associated with ansmia, a combination of bella- 
donna with iron^ strychnine^ and other tonic drugs is frequently successful, 
A formula similar to the following has been widely used: — 



3 Ext. beUadonzifiQ fol 

Quinin. Bulphat. 1 

Ferri sulphat. exaic 

Strychnin, sylphat 

Oleoresinae piperis 

Arseni trioxioi 

M. et ft. pil. no. xv. 
Si^.: A piU thrice daily. 



25 Gm. or gr. iv. 
40 Gm. or gr. xxij. 
50 Gm. or gr. viisa. 
016 Gm. or gr. V4. 
012 Gm. or gr. Vb. 
50 ccm. or mviisa. 



For the relief of migraine, Trousseau was accustomed to administer 
U.Ol Gm. (or gr. */<,) of the extract of belladonna, every hour, until the symp- 
toms Tanished or vertigo made its appearance. The form especially amen- 
alile to this treatment is the congestive headache, in which the pain is of a 
dull, compressive character, made worse by stooping over, with swelling of 
the face and throbbing of the temporal arteries, aggravated by noise; by 
movement of the body, efforts to read, or any intellectual exercise. In such 
cases the combined action of belladonna with a purgative like podophyllin or 
aloin is especially effective. The tincture or fluid extract of belladonna, or 
airopine sulphate, is useful in relieving the spasm of laryngismus stridulus, 
hiccough, spasm of the oesophagus, or local convulsive manifestations of 
hysteria. Intestinal, hepatic, or renal colic is ameliorated by this remedy. 
Belladonna is likewise of service in lead colic. A combination of atropine 
and potassium iodide is recommended as possessing decided efficacy in the 
treatment of plumbism. Belladonna has also been successfully employed 
for the relief of strangulated hernia, 0.015 Gm. (or gr. ^/^ of the extract 
being given hourly, spontaneous reduction occurring after administration 
of four to six doses. 

Atropine in doses of from 0.001 to 0.0045 Gm. (or gr. ^A©- Vu) ^^s been 
successfully employed by Dr. Batsch, of Grossenhain, in cases of intestinal 
oktruction where the symptoms were subacute or where there was necessity 
to temporize. In some cases a single injection sufficed to produce an evacua- 
tion, followed by recovery. In others, the injection resulted only in the es- 
cape of flatus and a small quantity of faeces, deflnite relief only following a 
second injection on the next day. 

Belladonna is of service in epilepsy, but needs to be given persistently 
in gradually-increasing doses for a long period of time. It is particularly 
apphcable to the pBtit mal or nocturnal epilepsy and to anaemic subjects. 
Wachenheim reports a case of the treatment of epilepsy with combined usage 
of atropine and potassium bromide. He considers epilepsy in idiopathic cases 
u due to an autointoxication, producing an abnormal irritation on the part 
of the cortical cells. According to his theory, the mechanism of the treat- 
ment is as follows: The bromides diminish the sensibility of the cortical cells, 
which have become hypersesthetic to variations in the blood-supply; atropine 
Btimulates the vasomotor centres, thereby making the blood-supply more uni- 
iorm. In the "early stages of treatment bromides are useful to dull the irri- 
tability of the cortex until the proper vascular tonus is established. When 
that point has been reached, they are of less importance, and may be reduced 
or withdrawn. Neither the bromides nor atropine can in any way meet the 
causal indication. If the disease depends on a passing intoxication, these 



258 



PUAUMACKUTICAL THEJIAI'EUTIC AGENTS OH DHUG8. 



drugs will suspend the destructive action of the epileptic seizures until the 
materia peccans has ceased to act; if there is a permaniint cause, as seems to 
exist in the majority of ca^es, such treatment will naturally be at best only 
a palliative. Belladonna is one of the most esteemed remedies for whooping- 
cough. It should he exhibited in sulticienlly large dosee to produce dilata- 
tion of the pupils, and is generally well borne by children in proportionately 
large doses: — 

H Tinctura belladonnee fol 3 c.cm. or ml. 

Vin. ipecacuunhce 1 I'.cm. or tnw. 

Syr. tolutani q. b. ad 60 ccm. or ill). 

M. 6ig. : Give a teuspoonful evory Lour Lo a child fivo years of age until relieve 
or physiolugical eiretts are obaerved, and then coutiime every three or four hour 
with sanit* or half the quantity. 

Belladonna is sometimes of signal service in spasmodic asthma. The 
most advantageous method of administration is that proposed by Dr. Salter, 
0.65 com. (or mx) of the tincture being repeated every two or three hours 
until disturbance of vision occurs or relief is obtained. The paroxysm may 
likewise be alleviated, thou|,di less certainly, by smoking belladonna-leaves 
in a pipe, or made into a cigarette. The tinctiivc of belladonna is cnpable 
of allording marked benefit lu exophthalmic p')itre. When nocturnal in- 
continence of urine is caused by spasmodic contraction of the bladder, the 
fluid extract of belladonna is the best remedy which can be employed. The 
same treatment may be of avail in the incontinence of the aged. Atropine 
sulphate possesses considerable efficacy in sperrmitorrhoea and prostate rrhcea. 
It is best given at bed-time. Torticollis and mu.-cular cramps are generally 
ameliorated by belladonna. Precordinl patn and overaction of the heart are 
relieved by the internal use of belladonna. This drug enters very serviceably 
into remedies for habitual constipation. In disease of the kidney it relieves 
congestion by its action on tlit^ nrtt'riob's. In typhoid and typhus fevers. Dr. 
John Ilarley has derived decided ndviintage from the use of IfcHadonna, 
which cleans and moistens the tongue and quiets the brain. Inflammation 
of the pharynx and tonsils is lessened I'y the use of belladonna, which may, 
with great utility, be combined with aconite and given in n solution of potas- 
sium chlorate. A suitable prescription may be thus formed: — 



R Potass, fhloratis 5|20 (im. or gr. Ixxx. 

Acid, hydrochloric, dil 6 Gm. or f3isa. 

Tr, nconiti 1 c.cna. or mxvj. 

Tr. belladonna' fol 2 c cm. or f3sa. 

Infus. rhoia glabrae q. s. ad 120 c.cm. or fSiv. 

M. et ft. flol. 

Sig.: Tablcspoonful every third hour. 



i 



On account of its marked influence upon the throat, belladonna has been 
used in scarlatinal ansrina. Much has been written concerning its value as a 
prophylactic in scarlatina, but in the experience of the author no reliance 
can be placed upon the drug as a preventive of that disease. It possesses 
some virtue as an internal remedy in erysipelas, and in this affection also i? 
usefully given irt conjunction with aconite, especially if much fever and 
delirium are present. It is sometimes able to check the vomiting of preg- 
nancy. Aphonia due to fatigue of the cords soon disappears under the use 
of atropine. Belladonna is useful in allaying nervous cough, and, according 




BELLADONNA. 



259 



to Bsrtholov and Fothergill, has an excellent effect in caseous pneumonia, 

CMdtd it be given in the stage of deposit before softening has taken place. 
•it doses of belladonna or atropine three or four times u day check the 
' discharge of mercurial ptyalism. Prof. H. Kobner, of Berlin, linds 
the administration of belladonna facilitates the treatment of certam 
of the mouth, as leukoplakia, mucous patches, syphilitic ulcera- 
>cCg^ as it re-strains salivation and the consequent rapid removal of the 
produced by the caustic. He usually gives the extract of belladonna 
iirfrr rl in water^ but atropine pills may be used with equal advantage. 

Tbf -"' -Treating which occurs in weakly children, after slight exertion 

•rdttxir , is suppressed by belladonna. The copious watery discharge 

if tliefir&t sta^je of acute coryza is controlled by atropine, which is one of the 

krt remediefi also in the nigbt-sweats of phthisis, given at bed-time in the 

km of 0.0008 to 0.001 Gm. (or gr. Vso-Voo)- The free discharge of chronic 

Inttchitxa is restrained by belladonna. Colliquative diarrhcea is arrested by 

dui remedy, according to M. Delpage. In certain cases of metrorrhagia^ 

vhieh had proved unamenable to other remedies, the hypodermic injection 

«f the atropine sulphate, in the dose of 0.0003 Gm. (or gr. Vaoo) twice daily, 

hm bvcs attended with complete success. Usemoptysis has also been con- 

tnllcd in ilie same manner. Atropine is useful in ulcer of the stomach when 

ipanied by hyperacidity. The remedy is beneficial in hyperjemic and 

itory conditions of the brain or cord. Li^geois and other writers 

•mmlj rvcomniend the internal administration of belladonna in chronic urti- 

Airopine sulphate is a valuable agent for diminishing the effect of 

It may be given, in the dose of 0.0006 or 0.0008 Gm. (or gr. 'Aoo- Vtb)> 

kvpodermicaUy, after a severe injury or prior to a surgical operation. Sir 

Leader Brtmton suggested that the hypodermic injection of atropine may 

pr^rr of aervioe in the algid stage of cholera, and cited the case of a child who 

RBorered apparently as a result of this treatment. Great caution should be 

ei'<} in employing this method, for, as pointed out by Professor Manas- 

; *ilh the revival of the circulation and absorbent capacity, toxic mani- 

■l)on might very readily be produced. In many cases it is advisable to in- 

IKt alropino into the atfected tissues (parenchymatous administration). In 

tep-ftratcd neuralgia of large trunks, as, for instance, in sciatica, the most 

Mid relief is obtained by this method. In sciatica and myalgia it is a good 

iba to combine a small quantity (0.008 Gm., or gr. Vb) of morphine sul- 

fhitr with the atropine solution for subcutaneous injection. The effect of 

^b ii\}cr\}<^u\ is heightened by the combination. Dr. I. L. V'an Zandt' uses 

«lrr ite, 0.001 Gm. (or gr. */«oK hypodermically in the algid state 

rf - 1 jiialarial fever. If no decided elTects are produced in twenty 

\ minutes, the dose is repeated. As a synergist for the atropine he 

- h nine sulphate, 0.002 to 0.003 Gm. (or gr. Vao-Vjo)- Stirling 

• he hypodermic use of 0.0004 Gm. (or gr. V150) of atropine valu- 

4Uc ID. a c-aae of hasmorrhage from the lungs. In tic douloureux, likewise, 

Ul^puio f-hrown under the skin is egpecially useful. 

jforetti recommends the hypodermic injection of atropine in paralysis 
tfdaiUL Ortermayer esteems the same procedure as a valuable sedative and 
mbtct hypnotic in the treatment of insanity. Massey has obtained good 
tsotl* in angina pectriris from the subcutaneous injection of atropine cora- 



ijffvvdf .ircA^r^r*. .\pril, 1901. 



2G0 



PIIAUlt-lCEUTICAL THERAPEUTIO AGEXT8 OR DRUGS. 



bined with morphine. Leszynsky has reported the successful employment of 
hypodeiTaic injections of atropine in a case of muscular torticollis, which was 
probably due to the influence of lead, as the patient was a painter. Various 
remedies, including electricity, had been used M'ithout effect. In torticollis 
excited by other causes the same procedure is of advantage. Some writers 
are of the opinion that belladonna retards the growth, as well as lessens the 
pain, of cancers, and promotes the absorption of enlarged lymphatic glands. 
Atropine is serviceably employed as an antaf^onist to a number of powerful 
vegetable poisons, as opium, morphine, physostigma, agaricus muscarius, etc. 

BENZALDEHYDUM (17. S. P.).— Benzaldehyde, Synthetic Oil of 
Bitter Almond, (Sco Amygdala Amara, page — ). • 

BENZANILID, — Phenylbenzamid is a white powder, which melts at 
321.8° F.J is insoluble in water, soluble in alcohol, and, with difficulty, in 
ether. In chemicfil composition it is closely allied to acotanilid. It is with- 
out odor and has a slightly caustic taste. It is given in single doses of 1 Gm. 
(or gr. xv), and from 4 to 6 Gm. (or 5i-iss) may be administered in the 
twenty-four hours. Though at lirst well borne in these amounts, intoler- 
ance is generally manifosled after several days* use. 

Physiological Action.^Iien:ianilid depresses febrile temperature. Its 
effects are manifested from half to one hour after exhibition; the maximum 
is reached in four or five liours; the temperature then begins to ascend, and 
reaches its original height in ten to twelve hours, Respiration is not usually 
affected, though occa.sionai]y it is hastened. The pulse is rendered more 
slow and soft. Benzanilid produces no alteration in the quantity or reaction 
of the urine, but communicates to that fluid a greenish or even blackish 
color. After having been used continuously for several days it gives rise to 
pallor of the face and cyanosis of the mucous membrane. Dr. Luigi Cantu, 
of Pavia. states thnt it npjx'ars to have a cumulative effect. 

Therapy. — The activity of benzanilid seems to be limited to the reduc- 
tion of temperature, having no influence upon the course of the disease. It 
has been given in typhoid fever, rheumatistn, pneumonia, neuritis, sciatica, 
malaria, etc. Dr. Cantu did not perceive any good effects from its use in 
chorea, neuritis, and sciatica. It exerted no favorable influence in malaria. 
It relieved the puiii nf acute rheumatism, but did not prevent extension of 
the <li<eiise tn other jnintK. ^ 

BENZINUM (T;. 8. P.).— Petroleum Benzin. 

BENZINUM PUBIFICATUM (U. S. P.).— Purified Petroleum Benzin. 
Lose, OJ>n to 2 c.cm. (or nix-f5ss), in mucilage or capsule. 

Phannacolo^. — A purified distillnte from American petroleum, eon- 
si:*ting i»f hvilroearbons (CJl,^ and C,JI,4 and hojuologous compounds), 
ehieflv of the nuiTsh-gas series, and having a specific gravity of from 0.63S 
to tl.lU)0, and boiling at 47)° to 60° C. (113° to 140^ F.). Ben7in, or petro- 
h'Uin-etlier, is a clear, colorless, diffusive liquid, yielding inflnniniable vapors, 
wbiclu when mixed with air, arc explosive; it, therefore, should be kept in 
well-stopponvl bottles, or tin cans, in a cool place, remote from lights or 
flame. It is soluble in alcobob etber, au'l oils, but insoluble in water. Fats, 
nsiufs. and caonichouc are dissolved hv it. 




BENZOINUM. 261 

Physiological Action. — Benzin resembles oil of turpentine in its local 
effects, especially when applied with friction. It is likewise an irritant when 
swallowed, but does not cause vomiting nor diarrhoea. It produces intoxica- 
tion, faintness, headache, palpitation, or convulsions, which may end fatally; 
death may also be caused by gastro-enteritis, though relatively large amounts 
have been taken and the poisonous action overcome. The treatment should 
be directed toward evacuating the stomach and bowels, and counteracting 
the effects of the agent by diflEusible stimulants and atropine, or ether, hypo- 
dennically. 

Therapy. — Externally, benzin is used as a counter-irritant, applied upon 
a flannel bandage, or with friction, for neuralgic or rheumatic pains, but its 
(xlor is penetrating and unpleasant. Locally, benzin has been used as a 
dressing for wounds and ulcers. The addition of 2 per cent, of menthol 
makes it a local anaesthetic. Its action must be carefully watched, 
however, as it has been known to cause extensive blistering and death from 
exhaustion. Internally it is not used in medicine, although it is a domestic 
remedy for lumbricoid worms and taenia. It is claimed to be a good para- 
siticide in itch and pediculosis. (See Petroleum.) Benzin has been em- 
plojed with success in the treatment of trichinosis, and is thought by Dr. 
Putter, from an experience with twenty-seven persons who had eaten trich- 
inous pork, to possess prophylactic virtues against this species of poison- 
ing. Benzin has been administered by inhalation with asserted advantage in 
whooping-cough. It has recently been used for producing anaesthesia in 
Schleich's method, which employs a combination or mixture of ether, chlo- 
roform, and benzin. It has been shown, however, that the benzin has de- 
cided toxic effects, and that patients, sometimes, show a tendency to rapid 
collapse, requiring artificial respiration to prevent a fatal accident. 

BEHZOnniM (U. S. p., B. p.).— Benzoin. 

Preparations, 

Adeps Beozoinatus (U. 8. P.). — Benzoinated Lard (2 per cent.). 

Tinctura Benzoin! (17. S. P.). — Tincture of Benzoin. Dose, 2 c.cm. (or fSsa). 

Acidum Benzoicum (U.S. P., B. P.). —Benzoic Acid. Dose, 0.32 to 1 Gm. (or gr. 

T-XV). 

Tinctura Benzoini Composita (U.S. P., B. P.). —Compound Tincture of Benzoin 
(C. S. P. contains benzoin, 12 Gm. ; aloea, 2 Gm. ; atorax, 8 Gm. ; Tolu, 4 Gm. ; alco- 
hol, q. s. ad 100 c.cm.). A number of old remedies resembled it in composition, such 
as Turlington's balsam, Friar's balsam, Jesuit's dro4>s, etc. Dose, 2 to 7.6 ccm. (or 

f368-ij). 

Trocbiscus Acidi Benzoic! (B. P.). — Benzoic- Acid Lozenge (0.03 Gm., or gr. ss, of 
benzoic acid in each, with fruit basis). 

Adeps Benzoatus (B. P.). — Benzoated Lard (benzoin, 15 Gm.; lard, 500 Gm.). 

Ammonium and Sodium Benzoates are official in both pharmacopceias, lithium 
beazoftte in the U. S. P. only. 

Pharmacology. — Benzoin is a balsamic resin obtained from Styrax Ben- 
zoin, and from another unknown species of Styrax (Styracege). The best 
quality is in light lumps or tears, but it also occurs in large masses. It con- 
tains, besides resin and a volatile oil, from 14 to 20 per cent, of free benzoic 
and cinnamic acids, the latter in small proportion. It also contains Styracin, 
2 to 3 per cent., some vanillin, styrol, and benzaldehyde, with phenol-propyl 
cinnamati, 1 per cent., and 75 per cent, of the cinnamic esters of benzoresinol 



2()i 



PHARMACEUTICAL THERAPEUTIC AGENTS OU DHDOS. 



and rusinotannol. The latter yield about one-tliird their weight of ciuuamic 
acid. Benzoic Acid is in white, lustrous ecales, or friable needles, permanent 
in air, haviiip^ a slight, nromiitic odor of benzoin ; a warm, acid taste ; and an 
acid reaction. It is soluble in 500 parts of water, 15 of boiling water, 3 of 
alcohol, or 1 of boiling alcolioi, in fitted oils and alkaline solutions. Benzoic 
acid melts at 250° V. It forms neutral salts with the alkalies. 

It is volatilized by heat. Two other sources of the benzoic acid of com- 
merce are known: it is a derivative of toluol and also of hippuric acid, the 
hippuric acid being derived from the urine of horses and cattle. The benzoic 
acid may retain some traces of its source, and, therefore, the pharmacopoeia 
directs that it shall sraell of benzoin. Benzoin prevents fat from becoming 
rancid, and hence it is, in small quantity, a useful addition to ointments, for 
which the benzoinated lard is a good basis. 

Phyaioloi^ical Action. — In solution in the form of the tincture, benzoin 
is protective to excoriated surfaces, and, like other gums, is antiseptic. After 
absorption it has a stimulating effect upon mucous membranes; part of it 
is decomposed in the system to form hippuric acid, and, being excreted by 
the kidneys, increases the acidity and the quantity of the urine. Benzoic 
acid haa some power in preventing the growth of bacteria, possessing the ad- 
vantage over carbolic acid of being non-poisonous. Sodium benzoate haa a 
stimulating effect upon the liver, and, according to the experiments of Carl 
Virchow, increases nitrogenous elimination from the kidneys. Benzoic acid, 
or sodium benzoate, inhaled or taken internally, may, in exceptional in- 
stances, give rise to an erythematous, or small papular, eruption. In some 
cases of idiosyncrasy, urticaria may be produced- 

Therapy. — The tincture, especially the compound tincture, is used to 
paint over abrasions and excoriations in order to protect the surface, par- 
ticularly in cases of tender nipples. It may also be painted on the skin for 
chilblains after bathing the surface with 5-per-cent. solution of carbolic acid. 
It was formerly employed as a dressing for ulcers. As an expectorant, we 
may give tincture of benzoin in chronic bronchitis. The ofHcial camphorated 
tincture of opium (paregoric elixir) contains benzoic acid. In troublesome 
cough, the combination with opium is necessary, although the opium checks 
secretion and expectoration; a better combination would be: — 

B CodeiTiEB 138 Gm. or jfr. vj. 

Acidi benzo*ci 16|5 Gm. or 3iv. 

Syr. tolutani, 

Aqufp cflznphors a& 90| o.cm. or fjiij. 

M. Big.: Take a deesertapoonful every four hours. 

Inhalations of steam impregnated with the compound tincture of ben- 
zoin are beneficial in acute and chronic laryngitis. Morell Mackenzie used 
a vapor of the compound tincture of benzoin, 1 teaspoonful to a pint of water 
at 140*^ F., inhaled frequently, for acute laryngitis. 

The following gargle is recommended in pharyngitis: — 



B Sodii henzoat 

Tinct. benzoin 2 

Infus. rosee fol. 15 



65 Gm. or gr. x. 
r.cm. or fSss. 
ccm. or f5B«. — M. 



Sodium benzoate is also used with advantage in chronic diarrhcea and 
dysentery. In 0.65 to 8 Gm. (or gr. x-ixx) doses it is very useful in liver dis- 
orders, likewise in chronic indigestion dependent upon inactivity of the 




BENZOIKUit. 263 

liver and accompanied by an abundant excretion of nric acid. This salt is alao 
of Bervice in septic and febrile diseases, in doses of 8 to 15.5 Gm. (or Sii-iv) 
daily (Senator). Owing to its solubility, it is preferable to benzoic acid, and 
is equally as efficient in acute rheumatism. In scarlet fever and small-pox, 
sodium benzoate reduces the temperature and mitigates the severity of the 
disease. This salt has proved very useful in the treatment of diphtheria, 
administered internally, and at the same time applied by insufflation to the 
seat of the lesion. Its employment has seemed to be attended with good 
results in typhoid fever and whooping-cough. The same remedy in the form 
of 8 Jipray has been extolled in phthisis, but it has no such decided effect 
upon the tubercle bacilli as had been hoped. Benzoic acid, in daily doses 
of 10 to 12 Gm. (or 3iiss-iij), has been found of service in acute rheumatism, 
but is inferior to salicylic acid. In erysipelas, benzoic acid has been given 
vith reported good results. It is of advantage in the treatment of chronic 
bronchitis. 

In its exit from the system this acid acta as a gentle stimulant and local 
antiseptic to the bladder and urethra. In chronic cystitis with fermentation 
of urine and deposit of phosphates, benzoic acid is extremely useful, reduc- 
ing the alkalinity of the fluid and the irritability of the bladder. For similar 
reasons it sometimes proves of service in chronic gonorrhoea, in obstinate 
irritation of the urethra due to the condition of the urine, and in incon- 
tinence caused by an alkaline reaction of the urine. In all these conditions 
KKiinm or ammonium benzoate may be used instead of the acid. Benzoic 
acid promotes the solubility of gravel, whether composed of urates or phos- 
phates. A favorite formula of Dr. Golding-Bird was: — 

3 Sodii carbonatiB 6| Gm. or Sias. 

Acid, benzoici 2 60 Gm. or gr. xL 

Sodii phosphatia 12 Gm. or Siij. 

Aq. ferventis : 120| c.cm. or fjiv. 

Solve et adde: — 

Aq. cinnamom 2251 ccm. or f^viiss. 

Tr. hyoscyami , 16| ccm. or fSiv. 

M. Sig.: Two tabiespoonfuU three Umes a day. 

In ursemic conditions, and what has been called lithsemia, lithium ben- 
zoate has a most happy effect, carrying oS the excess of uric acid and urates, 
acting also as a diuretic. Even in albuminuria, the benzoates have been used 
with advantage, especially calcium benzoate. 

Freckles may be removed by the topical application of tincture of ben- 
zoin, containing corrosive chloride of mercury: — 

Q Hydrarg. chlor. corrot !03 Gm. or gr. bs. 

Uncttire benzoini 26 c.cm. or fSiiss. 

Glycerini 7 60 ccm. or f5ij. 

Aqnse rosre 180| ccm. or f Jvj. 

M. Sig.: Ub6 as a lotion to affected spots. 

The above may also be used in pityriasis versicolor, or moth-spots, and 
chronic urticaria. The compound tincture of benzoin is sometimes able to 
relieve the itching of urticaria and eczema. A solution of benzoic acid in 
cologne-water makes a pleasant application, frequently successful in urti- 
caria- Mixed with an equal quantity of glycerin, the tincture or the com- 



204 



tMlAUilACEUTlCAL THEIUPia'TIC AGENTS OU DUL'OS. 



pound tincture is useful in chapped lips and liand?. The compound tincture 
is a good styptic, and yields excellent results when injected into old sinuses. 
It disinfects the tract, and promotes healing. Benzoic acid is an efficient 
antiseptic application lo nnhfalthy wounds and ulcers. 
As a dentifrice, Professor Miller recomnaends: — 



H Acid, ihymici 

Acid, benzoici 3 

Tr, eucalj-pt. fol 15 

Alcohol, nbsolut 00 

OI. gauUheriie 1 



25 Gm. 

Gni. 

ccra. or ?5ss. 

c.cm. or fSiij- 
55 c.cm. or git. xxv. 



or gr. IV. 
or gr. xlv. 



M. ^ig.: A teaspoonfu] or two in half a glass of water, as a mouth-wash. 

Bismuth benzoate is an excellent dressing to chronic, unhealthy, 
aloughing ulcers, chancroids, open buboes, chancres, and ulcerated lesions 
of late syphilis. It is usually applied in the form of a powder, the surface 
having previously been thoroughly cleansed by a weak solution of corrosive 
sublimate or liydrogen dioxide. 

BENZOL ( Jl. P.). - Benzol or Benzene. Phenyl hydride. 

Pharmacology. — A mixturL^ of homologous hydrocarbons obtained from 
light coal-tar oil. It contains about TO per cent, of benzene (CallJ and 20 
to 30 per cent, of toluene (CoHsCIIg). This is distinct from and should not 
be confounded with benzin obtained from petroleum. It is a thin, colorless 
fluid, very volatile and inflaniniubJc, and has an aromatic, not very unpleas- 
ant, odor. It is almost insoluble in water, but dissolves in four parts of 
alcohol. It may be obtained by distilling a mixture of benzoic acid with 
lime, or by fractional disi^tillation fmm naphtha: a derivative of coal-tar. 

Physiological Action. — Benzol is antiseptic and antiparasitic, with but 
little local action beyond the extraction of oily matters from the skin. Owing 
to its i-olvent action upon many alkaloids, it might be useful in local medica- 
tion by enabling the remedy to penetrate the skin. Taken internally, benzol 
produces intoxication^ anaesthesia, and coma. 

Therapy. — It has been given in a few drop doses as a remedy for dys- 
pepsia, and also in trichinosis. It is employed in pharmacy as a solvent, but 
is not often administered, or employed in practical medicine. Dr. A. Da 
Socca has used, locally, with alleged good results, a mixture of 1 to 6 of 
tincture of iodine and benzol in diphtheria. Benzol has been advantageously 
given in whooping-cough by Dr. Robertson, in doses of 0.12 c.cm. (or mij) 
in mucilage to children six mouths of age. The same writer reports good 
results from the use of benzol in inflnenzo. He administered it in the form 
of an emulsion in lemonade, 0.:^) c.cm. (or mv) at a dose, repeated every 
three hours. It was always well tolerated. It had the effect of reducing 
temperature and relieving the general discomfort. Convalescence was gen- 
erally rapid. ^ 

Nitrobenzol. — This product, known commercially as the oil of mirbane, 
or artificial almond-oil, is used extensively in the mnnnfacture of dyes, per- 
fumery, and explosive compounds. Cases of acute or chronic poisoning fol- 
low the absorption of nitrobenzol. The workmen subjected to its influence 
frequently suffer from a train of symptoms which have been studied by Dr. 
Prosser WTiite, The usual manifestations are sleepiness, headache, languor, 
and a severe form of anaemia. There is a decided loss of weight, the appetite 

^London Lancet, Kov. U, 1893. 




. - '-apncious or altogether fails, nausea and vomiting may oecur, the 

1 - • i*-. nn.'f's darkened in color and contains aniline. The temperature of 

t^ U:- ■ 'v raised, but the extremities become very quicklj- chilled. 

Then waste of the muscleSj especially those of the extremities. 

Hyperrstiieeia is a characteristic symptom. Sensation in the extremities may 

ht dlghtly impaired. The sexual opi>ctite is weakened or lost. The reflexes 

$n genemWy enfeebled. The eyes are not iisnaliy affected, though nitro- 

kuol maj prtxluce a peculiar form of retinitis, with f^rcat defect of sight. 

IW pulse ifi feeble and thready, arterial tension is low, the blood is chocolate- 

or black. The corpuscles are decreased. No direct antidote is 

It is said that, when taken into the stomach, nitrobenzol may re- 

for aome time unabsorbed, and an emetic or the stomach-pump will, 

tW f gf ore, be of service. A saline cathartic is also advisable, but oils, fftts, and 

<al»hol are uot recommended. (Viunter-irrilation to the chest, friction of 

IW limbe, and ammonia as a stimulant may be employed. Artificial res- 

piratkin is of avail. Dr. White states that 1 c.cm. (or vixv), taken by the 

—nth, has ••aused death. Letheby and Filehne pive the fatal dose as vary- 

mg Crosn 0,12 to 7.5 o.cm. (or f«ii-f3ij). A case has, however, been reported 

ly Dr. r ^ -. 1. of Vienna, in which a woman, it is stated, took nearly 105 

CJXL. (■ -) of nitrobenzol and yet recovered. The symptoms were deep 

^«Bon»y fe» '1 respiration, small pulse, and dribblin;: of urine, which 

«atain«d t ^ c agent. Camphor injections were administered and arti- 

iod respiration was practiced. Consciousness returned and recovery fol- 

WrJ; on the fourth day the urine resembled that of a case of cystitis. 



S. P.), GLUSn)TJM (B. P.), or Saccharin, 
arid (C'-I1,.^N0,^S) is a coal-tar doriv- 



^'^ZOSULPHINIDTrM (IT. 
'-hr»-(;ulpbamino-l)fnzoic 

'•'tl in Proffhsor Kemscn's laboratory of Johns Hopkins Uni- 

"^t described by C. Fahlberg in 1S70, It is a sweet imide de- 

rnm toluene (B. P.). It ia a white, crystalline powder, with an acid 

n, but an intensely-sweet taste. Its odor, which becomes stronger on 

.C. i* frtintly suggestive of nitrobenzol. This substance is soluble in 

part* of cold water, readily soluble in alcohol and ether. Saccharin dis- 

'-« al^to in jclvcerin. Its solubility* in water is promoted by the addition of 

am hie: " '»• in the proportion of 2 parts to 3 of aaccliarin. Com- 

lial ea< < niuy contain a large number of impurities. Pure sac- 

' 11 can bo jf»e|»arated from the mixture by means of ether. Dose, 0.13 to 

Off^. (nr grr. ii-v), 

^ charin fonua soluble salts with the hydrates of carbonates of the 
--' = . It melts at 220'' C. (428" F,), and when fused with potassic 
IS salicylic acid. One part dissolved in 70,000 parts of water 
mpmxi» -olution a dietinctlv-sweet taste; it is about 300 times sweeter 

^ka cMu^ - ^i"* which it resembles in taste, except for a peculiar slight 
fcror of LittiT iilnionds. 

7>»\^« joloerical Action. — Saccharin is excreted by the kidneys unchanged; 

t d in the body, and has little if any elTcct upon digestion, 

. .inenr? of C. T. Fox have demonstrated that, when added 

rin checks the action of saliva upon starch. 

noticeable effects upon the urine are that it does not so readily 

ntntinn, and the chlorides are slightly increased. Pure 

irm w* not possessed of toxic or deleterious effects upon the human 



266 rUAUHAOKLlTICAL XUEKAPEOTIG AUENX8 Oil DBUG8. ^ 

organism, even in doses as large as 5 Gm. (or gr. lixv). Saccharin has con- 
siderable antiseptic virtue, which, according to Constantine Paul, is impaired 
when it acts in an acid medium. 

Therapy. — Saccharin is uhiefly employed to take the place- of sugar in 
the diet of obese and diabetic patients. For this purpose it is beat prescribed 
in the form of a syrup containing 10 parts of saccharin and 12 parts of 
sodium bicarbonate in 1000 parts of distilled water, made with gentle heat 
at 40° C. (104° F.). It has also been claimed by Dreschfeld that saccharin 
relieves some of the symptoms of acid dyspepsia. Dr. James Little asserts 
that saccharin freely administered is an efficient remedy in chronic cystitis 
with ammoniacal urine. Two parts of saccharin dissolved by means of 3 
parts of sodium bicarbonate are said to fonn an excellent tooth-wash. Four- I 
nier his found a moutli-wash containing saccharin eiiicacious in aphthae. 
By Dr. Fclici, of Rome, it has been utilized as an application in ozsena. The 
cmists having been removed by vaselin-oil and the cavity cleansed with a 
saline fluid, a solution containing from 0.50 to 1 Gm. (or gr. vii-xv) of 
saccharin is appUed twice daily to the affected parts. The remedy was espe- 
cially usefu! in cases where there was atrophy of the turbinated bones and 
mucous membrane and in those characterized by the odor and discharge of 
ozo^na without apparent anatomical changes. 

Saccharin is largely used in confectionary to add to glucose and make 
it correspond more closely in sweetness with cane-sugar. It may be com- 
bined with quinine, in order to overcome the bitterness: — 

R Quinin. sulphat 41 Gm. or 5j. 

Saccharin 2| Gm. or gr. xxx, 

M. et div. in chartulffi no. xxx. 
S\g.: Take one four times a day. 

BERBERIS (U. S. P.).— Barberry. 

Preparation, 

Fluidextractum Berberidia (U. S. P.). — Fluid extract of B«rberia. Dose, 0.10* , 
to 0..10 com, (or fnii-v|. 

The rhizome and roots of the Ore^jon grape, or Berberis aquifolium. or 
of athfr species of Berberis (Borboridaceje). It contains an alkalnid, 
Berberine, which also exists in Hydrastis. 

Berberis is tonic and diuretic^ and is believed to act as an alterative, mak- 
ing it valuable for the treatment of blood diseases, dyspepsia, hepatic dij?- 
ordor, habitual constipation^ and skin ili?enses dependent upon unhealthy 
secretions or conditions of the digestive tract. Vehsemcyer claims to have 
produced decided iTiiprovnmi'nt, in the case of an infant afflicted with leu- 
ka?mia, by the administration of borberine sulphate. Berberis hns been 
topically employed in conjunctivitis, and the berberine hydrochlorate has 
betm u?ed with advantage as an injection in gonorrhuea. Internally, ber- 
berine or its hydrorlilorate Tnay be ^iven, in doses of 0.015 to 0.32 Gm. (or 

BETANAPHTHOI (U. S. P.).— Betanaphthol; Naphthol (B.P.). (See ] 

NaphthoL 





BISMUTHUM. 'lOr 

SISMUTHUM.— Bismuth. 

Freparaiions. 
Otras I U.S. P. |.— Bismuth CitTate. Dose, 0.065 to 0.32 Gm. (or gr. i-v). 
Iii el Ammoniw Citras (U.S. P.). — Bi«muth and Ammonium Citrate, 
to 0.32 Gin. (or gr. iv). 
■thi Subcarbonaa (U. S. P.). —Bismuth Subcarbonate. Dose, 0^2 to 1.30 
l«rp. r-xjc). 
BhiBiiHii BnbnitrM (U.&P., B. P.)-— Bismuth Subnitrate. Dose, 0.32 to 1.30 



Bhmn" 



laUki Cju-bonas (B. P.).— Bismuth Oxycarbonat^. Dose. 0.32 to 1.30 Gm. (or 
t). 

Bbimathi Salicylas (U. S. P.. B. P.).— Bismuth Salicylate. Dose, O.OG,') to 1.30 
Qb. Cv gr- i-xx). 

Btoaalhi SabffaJka <U. S. P.).— Bismuth Subgallate. Do&r, 0.3 to 1.30 Gm. (or 

Binsothi Dxiaum (R P.). —Oxide of Bismuth. Dose, 0.32 to 1.30 Gm. (or gr. 

Liqoor BUmutht et Ammonii Citratis (B. P.). — Solution of Bismuth and Am- 
■■laBi Cftrmte, or Liquor Bismutbi (0.05 Gm. in 1 c.cm., or gr. iij of bismuth oxide 
•» '^' ' Do«e, 2 to 4 c.cm. |or fSss-j). 

iiiarus Bismutbi Compositus (B. P.). — Compound Bismuth Lo/enitre (bismuth 
■• nate, magneaium carbonate, heavy, of paeh, 0.13 Gm., or gr. ij; prectpitated 
. :im cmrbooate, 0.25 Gm., or gr. iv, with rose basis). 



'--logy and FhyBioloi^oal Action. — Bismuth in the metallic 
ie in], and ha? no medical iiitero.<'t. Its salta, however, are of 

CTaJut, the insoluble ones differinfj greatly in their applications from 
vhich ar»^ soluble. Tlie subnitrate and subcarbonate arc, or should 
K IS the form of white, impalpable powder, which has a slight astringent 
ad abaorbent action when dusted upon excoriated or ulcerated surfaces. 
TW free nae of subnitrate of bigmuth a«i a dressing for wounds or ulcers may 
W to absorption and poisoning. Among the consequences are acute stoma- 
tCM^aod a dark disroloration of the gunis, spreading over the entire mouth, 
ttwed br diarrba>n and nephritis. Dr. F. P. Ilenry,* of Philadelphia, 

rtfl a fatal nroident of this chanicter. Whon taken internally, these 
have very much the 54ime effect along the digestive tract as upon the 
mhte of the body, cliecking excessive secretion and exerting a sedative 
aivncr. When injected under the skin, part of the salt i? ahporhed and 
^woemff may result. Or. if large doses are taken by the mouth, death may 
%Am from ^nstm-^nteritis, the symptoms being very much like those caused 
•^ nlA Icftd, and mercury. After death, bismuth is found in the liver and 
Of rbc^ra, and in the urino and saliva. A purplish line upon the gums, 
*alliiur that of lead, has been noticed. The treatment is by demulcents, 
wAq tjf out tho stomach, and the ndministration of the antidotes to ars^^nic, 
nA which native bismuth is usually combined. When the soluble prepara- 
toiare given for a considerable lime, the bismuth is apt to accumulate in 
fcBfer: bnt this is not likely to follow the administration of the insoluble 
j^ rr,i i.,^j^j^ or eli.xirs, purporting to contain bismuth in combina- 

Ib V ^^- are unscientific and may be dangerous. The discharges 

(^ . ' ■* blackened by bismuth. The tongue becomes coateil with 

i^t^ The prolong(»d administration of bismuth subnitrate 

ivWn known U» cause a larsre intestinal concretion. It may, under these 

alao give rise to plough? in the mouth nuii gastro-intesHnal 

ftlao t« dr«qnamativ<» nephritis and albuminuria. 



L ^Jomrx 



Jomrp^**^ ^f ^^ .4meruH2fi itedical AMOciaiion, Dncember 7, 1001. 



■ 



2fi8 



rHARMACEUTICAL THEUAPECTIC AOKNTS OR DRIG8. 



Therapy. — Tn using bismuth it is essential that it shall be pure and free 
from arsenic When well made, the subnitrate, or subcarbonate, is very use- 
ful as a dusting-powder for excoriated surfaces, and as a dressing after 
wounds or amputations; but w^hen used freely has led to poisoning by ab-* 
sorption. However, it is valuable in small wounds and in some old ulcers. 
Combined wilh mucilage (4 Gm. to 180 or 240 com., 5j to o^'i-viij), it is a 
good injection for gonorrhcea during the early stage; or it may be used as a 
soluble boupe, or as a vaginal suppository for leucorrhcea. The same prep- 
aration is likewise useful in ulcer of the rectum. 

The addition of a small proportion of carbolic acid or acetanilid will en- 
hance its antiseptic effect. In acne, intertrigo, and erythema in infants, or 
in vesicular eczema, the subnitrate, or subcarbonate, of bismuth may be 
lightly dusted over the surface. In the case of wounds, the red oxyiodide is 
preferred by A. Sidney Reynolds^ to iodoform, as an antiseptic and also as 
an ointment in skin diseases. This salt is a local anjeethetic and antiseptic. 
It does not stain the skin or clothing, and may be employed as a dusting- 
powder or an ointment. It is an excellent appHcation to chancre, chancroids, 
open buboes, ulcers, unhealthy wounds, and phlegmonous erysipelas. The 
following is a good combination: — 

Q Naphthalin 2 Gni. or 3»3. 

Bismuthi subiodidi 4 Gm. or 3j. 

Unguenti simplipis 25 Gm. or Sriss. 

M. et ft. ungt. Useful upon chancrea, chancroids, and gyphilitic ulcers, 

Subnitrate of bismuth in powder haa been used with success in simple 
oza?na, snufTed into the nostrils, though it is inferior to other remedies. It 
may also he employed in aphthous or nursing sore mouth, and in mercTirial 
ptyalism. It may be of service in chronic conjunctivitis and granular lids. 
Made into an ointment, it is an excellent applicatif>n to chancroids, irritable 
ulcers, erjrsipelas, blisters, pemphigus after the bullte have ruptured, leaving 
raw surfaces exposed, the erythematous and bullous forms of burns, and in 
the first stage of dermatitis. . In these conditions an ointment may be thus 
composed: — 

H Bismuthi subnitratis 2 Gm. or Sss. 

Pulv. marnntSB , 15 5 Gm. or Jsg. 

Morphinaj siilpIiatiB i..«...«....«i .. 20 Gm. or gr. iij. 

Adipis Innae hyd 15 5 Gm. or S^b- 

M. et ft ungt. 

An ointment consisting of bismuth subnitrate and boric acid, with 
lanolin and olive-oil, is regarded by Wertheimer as particularly appropriate 
to the treatment of burns in childrm. An ointment containing the oleate 
of bismuth is also valuable in diseases of the skin. It may be prescribed as 
follows: — 



B Ext. belladonnsB folior 165 Gm. or gr. x. 

Ext opii 1 130 Gm. or rt. xx. 

Ungt. bismuthi olpatis 15|5 Gm. or 

M. For furuncles, cnrbunclea, and eczema of the genitals. 



CT. > 
598. 



* 



The internal administration of insoluble bismuth preparations is prin- 
cipally based upon their local action upon the stomach and intestinal tract. 

• Medical 7{nc9, Oct, 1888. 



BISKUTHUM. 269 

They form a coating over the infamed or irritated surfaces and keep them 
fioffl coming in contact^ while they also exert an astringent and sedative 
effect. In gastraigia, irritable stomach, and some dyspeptic conditions they 
are of much value : — 

B Bumuthi subnitraiis 8 Gm. or 3ij. 

Pepaiui aaccharati 4 Gm. or 3j. 

Cteosoti 24 com. or miy. 

M. et di7. in chartulse no. xij. 

Sig.: Give one every hour until relieved. (The oil of gaultheria may be substi- 
tuted for the creosote, in case of children, and the powders made smaller.) 

In painful dyspepsia and gastraigia, Dujardin-Beaumetz prescribed : — 

1^ Bismuthi subnitratis, 

Magnesise, 

Crets prseparatffi, 

Calcii phosphatis aa 10| Gm. or Siiss. 

M. et div. in chartulsB no. xl. 

Sig.: One powder before each meal. 

Bismuth may be given in j)owder also, as: — 

Q Bismuth, subnit., 

MagnesU carbonatis aa 41 Gm. or 3j. 

MorphinsB sulphatis |065 Gm. or gr. j. 

M. et ft chartuUe no. xij. 

Sig.: A powder every hour or two. Employ in gastraigia, dyspepsia attended 
vith acidity, and in cancer of the stomach. 

In half-grown children with irritable stomach, the result of improper 
feeding, a good combination is: — 

9 Bismuth, subnit. 2| Gm. or Sss. 

Sodli bicarb., 

Pulv. rhei aa |65 Gm. or gr. x. 

M. et ft. chartuls no. x. 

Sig.: A powder every four hours. 

The following liquid combinations of bismuth are likewise of service, 
especially in gastric catarrh and some varieties of dyspepsia: — 

H Bismuth, dtratis 81 Gm. -or 5ij. 

Glycerini pepsinse (B. P.) 90| c.cm. or fjiij. 

M. Sig.: A teaspoonful before meals. 



9 Bismuth, subnit 8 

Pulv. rhei 6 

Pulv. acacie 8 

Spt myristicse 7 

Aquse menth. pip 240 

H. 8ig-: A tablespoonful in water every four hours. 



Gm. or 3ij. 
Gm. or 3iss. 
Gm. or 3ij. 
50 c.cm. or f3ij. 
ccm. or fSviij. 



The salicylate is a soft, white powder; insoluble in water, alcohol, ether, 
and chloroform, but soluble in acids. In gastro-enteritis, or summer com- 
plaint in young infants, the salicylate gives excellent results in small doses 
(0.065 to 0,13 Gm., or gr. i-ij). This combination is likewise valuable in the 
'liarrhcea of typhoid ferer, in which it is serviceably given with naphthol. 
Bismuth salicylate is useful for the purpose of securing gastric antisepsis in 
(^Dcer of the stomach. It may be associated with betanaphthol or ealol. 
This salt, also, is highly esteemed as a remedy in infantile diarrhoea. 



^70 



PHARMACEUTICAL THERAPEUTIC A0EST8 OB DRIOS. 



Gastric ulcer is much benefited by the subnitrate in 0.C5 to 1 Gra. (or 
gr. 2-xy) doses, given every three hours, or oftener, if there is much pain. 
Where malJo^Bant ulceration is guspected, opium and belladonna may be ad- 
ministered at the same time. The vomiting of pregnancy may sometimes 
be relieved by bismuth subnitrate. It serves a useful purpose in the chronic 
gastritis bo common in drunkards. In acidity of the stomach it is useful, 
and also in flatulent dyspepsia. A combination of bismuth with charcoal is 
-efficacious in the latter condition, as: — 



^ Biamuthi subnitratia, 

Pulveris nTomatici aa 8! 

CRrboniB ligni (recentia) 15|5 

M. et div. in chartiilee no. xij. 



Gm. 
Gm. 



or 3ij. 
or 5fls. 



In diarrhcea. tJie subnitrate is usually a reliable remedy, but, as Einger 
advises, it should be preceded by a doae of castor-oil, in order to remove fer- 
menting material or other causes of irritation. In the diarrhnea of phthisis, 
it can be given in combination with pepsin or pancreatin. It may be given 
in hot milk to children; but it is almost tasteless, and may be placed at 
once upon the tongue and washed down with water or milk. In chronic ' 
diarrhcea, bismuth sul>nitratB not iufiequently atlords marked relief. Ab 
excellent prescription for diarrhcea, particularly when acute, is : — 

It Bismuth, subnit. 781 Gm. or Siias. 

Pulveris myristlcsE 2(60 Gm. or 3 ij. 

Aqure cinnfimomi, 

Syrup, acacire aa 60| com. or ii'ij. 

M. Sig.: Two teflspoonfulR every Jia]f-hour, or hour, until relieved. 






In cases of infantile diarrhoja, when the stools are grceni.sh, contain 
casein, and are accompanied by abdominal pain. Dr. Zinn^ relies upon the 
following prescriptions: — 

B Bismuth, flubnitrat 3 Gm. or gr. xlv. 

Liq. calcia 6 c.cm. or fSiss. 

Syrup, aurant. 15 c.cm. or fjsa. 

Aqufc focniculi 60 c.cm. or fjij. 

Sig.: Teaspoonful every two hours. 



M. 

B 

M. 



Bismuth', subnitrat 3 

Syrup, aurant 15 

Infus. calumbfe 60 

Sig.r One or two teaapoonfula every two hours. 



Gra. 

c.cm. 
c.cm. 



or gr. xlv. 
or fSsa. 
or Qij. 



In epidemic dysentery, large doses of bismuth Imve been administered 
with benefit. Trousseau was accustomed to order bismuth injections in 
dj'sentery. 

A solution of bismuth and ammonia citrate is official in the British 
Pharmacopceia. An extemporaneous formula may be used, like the follow- 
ing:— 



Bismuth! et ammoaiic citrat 

Aquflp rUloTofonni 15 

Elixir aurantii 45 



32 Gm. 
c.cm. 
c.cm. 



or gr. V. 

or fjsa. 
or f5is& 



4 



M. Sig.: Take 16 c.cm. (or fjaa) three or four times daily, for irritable stomach 

This double salt has been employed in the treatment nf acute and 
chronic diarrhoea. P. Vigier has prepared a bismuth benzoate as a substi- 




BISMinilLM. 



371 




ime lor the ^ - — Mi salicylate, or &ubnitrato. Bisatuth benzoate contains '27 
per ccDt. of : acid, and may be advantageously used as an intestinal 

MdMpbc, anii 15 a preferable substance to the Balicylate as regards its elim- 
■iliiHi by the kidneys. 

KsBBth Subgallate, or Dermatol. — Under this name Dra. Heinz 

aoi Liebrechi have introduced a new combination which occurs in the 

iarm of m fine, saffron-yellow powder, odorless and innocuous; insoluble 

a viter, alcohol, and ether; not hygroscopic or otherwise affected by ex- 

tc «ir or light. It possesses astringent, antiseptic, and desiccant prop- 

This substance is also possessed of local ana-sthetic power. It is of 

Tfiliie in lesions attended by profuse secretion, as eczema, burns, 

V . and diseases of the eye and ear. Dr. Eugene Doernberger 

Mt results from its use in pemphigus, herpes zoster, and ab- 

of the skin occurring in children. Dermatol has been advantageously 

to chancroids and ulcerated chancres, to balaJiitis, varicose and other 

of the leg. Suspended in raucilage, it has been used as an injection 

«aeateaud chronic gonorrhoea. ^lixed with an equal quantity of castor-oil, 

QnnBiaxi has employed it in the treatment of sore nipples. It is considered 

if vtloe as a dressing to abdominal wounds and in perineoplasty. Tampons 

■■le of gatize impregnated with dermatol are of service in the treatment of 

va^nal catarrh. A powder composed of 20 parts of dermatol, 10 parts of 

avch, and 70 parts of talc is a good application in hyperidrosis of the hands 

wtd feeC Dermatol may be used pure as a dusting-powder, as a 25-per-cent. 

amtaient, a collodion emulsion, and as a 10- to 20-per-ccnt. gauze. 

Colasanti and Dutto report favorably of the internal employment of 
i uaia tol in different forms of diarrhwa, including that of typhoid fever and 
ttbcrcQloats. It was given in daily doses of 2 to 3 Gm. (or gr. xxx-slv) in 
fcidad portion^- Dr. Austin Mint recommends bismuth suhgallate in the 
Mtment of fermentative dyspcpt^ia. He has had excellent results from its 
Wt SB chronic c^scs, giving 0.32 Om. (or gr. v) in capsule or tablet before 
m-^ttrr each meal. A number of loose combinations of bismuth have lately 
hem introduced as antiseptic remedies. Fhenol-bismuth, cresol-bismuth, 
itoJ bttftllAphthol-bismath are decomposed in ihe stomach, the phenol and 
cscBol being absorbed and eliminated by the kidnej's, while the bismuth is 
iteoct cotni>I*'tely removed by the bowels. Naphthol is partly eliminated 
ndb the tirine and partly through the intestine. In daily doses of 1 to 3 
Qm. (or gr. rv-xl?) Dr. jasenski. of St. Petersburg, gave phenol-bismuth 
wah adrantage in typhoid fever, acute and chronic i:astric and gastro-in- 
^tfina) catarrh, and in diarrhoea. Tribromphenol-bismnth is a yellow, in- 
nlgki^ •-^'^wder. without odor or taste and almost free from toxic action. It 
5 per cent, of bismuth oxide and 50 per cent, of tribromphenol. 
- "pe, of Prague, recommends it as a valuable agent in the treat- 
cholera. Bctanaphthol-bismuth is a brown, odorless powder, 
iter, and containing 80 per tent, of bismuth oxide. In doses 
(or »»r. xv-xxx) it acts as an excellent intestinal antiseptic. 
Mith and tribromphenol-bisniuth are etticient remedies 
; -la, and chronic intestinal catarrh dependent upon the 

of njicro-orpanisms. Dr. Reynold W. Wilcox has found the former 

iMiiKMilnl to answer an excellent purpose in chronic membranou^s enteritis. 



BaChiwtaxi- 
afiemientai 



TM«osiphenol*'bismuth possesses rather a sweetish taste, 
iMiiiiM ril properties nf other compounds of bismuth. 



and shares 




212 PHAIOIACEUTICAL THEIUPEUTIC AGENTS OR DBLGS. 

Bismath chrysopliaiiate has been introduced under the name of dermoL 
It is an amorphous yellow powder of neutral reaction, insoluble in the ordi- 
nary menstrua. It is proposed for use, in tlie form of ointment, in disetises 
for which chrysophanic acid is employed. 

Thioform is a combination ol bismuth, sulphur, and salicylic acid, and 
occurs in the form of a light, grayish-yellow powder insoluble in water, 
alcohol, and ether, Thiofonn is dcviiid of odur or taste. It is comparatively 
free from toxic effects, and has been used with success upon burns, ulcers, and 
sloughing wounds. Dr. E. Tromm reports favorably concerning its actioa 
in conjunctivitis, purulont ophthalmia, and the etrumous ophthalmia of 
children. Thioform has also been employed as a styptic in the operation of 
enucleating the eyeball. 

Bismuth sulpliite has been found useful by Cesaris and Racchetti as 
an intestinal antiseptic and ant}ielinintie. Bismuth tannate has been iised 
internally as an astringent in diurrhiea in doses of O.Go to 2 Gm. (or gr. 
x-xxx). 

BOLDUS. — Boldo, or Peumus boldus (Jilonimiaccffi), is an evergreen 
belonging U> the wester-n coast of South America. The dried leaves and 
steriis contain a bitter extractive, a volitilo oil, and a bitter alkaloid (about 
0,1 percent), Boldine. A limture (.') per cent.) is used in (KW c.cm. (or 
my) doses or niorc, gradually increasing:, and produces vomiting and purging 
in full doscH. and also a nedaiive or njin-otic ctTovt upon the brain. In small 
doses it is carminative and stimulant to the stomach. 

Therapy. — In South America, xhis plant has some reputation for its in- 
fluence upon genito-urinary disorders, ganorrhcea, gleet, cystitis, and ca- 
tarrhal inflammations of the kidneys. It has also been used for rheumatism, 
and as a tonic in dyspepsia and general debility. In cirrhosis it is especially 
rwoinmciulnl by Campenon. Boldine, the active principle^ hns li}']motie 
powers, and has been successfully tried in France as a substitute for opium or 
chloral ( Junmville) . It also has a local ;uia\-*thptic actimi, like cocaine. 



BOBAX (B. P.).— Borax. (See Aciduni Boricum.) 

BROMUM (IT. S. P.).— Bromine. 

Dose, tt 12 to 0.18 c.cm. (or mii-iij), vreli diluted. 



i 



BROMOFORMUM (V. S. P. ) .— Bromof orm, Tribromomethane (CH 
Br3). 

Dose, n.(M; to 3.25 c.cm. {fny\). 

Preparations. 

Olcii Bromidum (U.S. P.). — Calcium Bromide. Dose, 0.32 to 2 Gim, (or gr. 
v-xxx). 

Lithii Bromidum i U.S. P.).— Lithium Bromide. Doee, 0.32 to 1.30 Gm. (or 
gr. v-xx). 

Zinci Bromidum (U. S. P.).— Zinc Bromide. Dose, 0.066 to 0.13 Gm. (or gr. i-ij). 

Ca.mph*ra Monol>romata (U.S. P.).— Monobromated Cnmphor. Dose, 0.065 to 
0.32 Gm. (or gr. i-v). 

AniHionii Bromidum (U. S.P., B. P.). — Ammonium Bromide. Dose, 0.65 to 2.60 
Gm. (or gr. x-xl). 

PotttBsii Bromidum (U.S. P., B. P.),— Potassium Bromide. Dose. 0.65 to 4 Om, 
(or gr. x-Sj). 




BROMUM. 273 

Sodii Bromidum (U.S.F.,B. P.). —Sodium Bromide. Dose, 0.65 to 4 Gm. (or 
gr. x-3j). 

Acidum Hydrobromicum Dilutum (U.S. P., B, P.). —Diluted Hydrobromic Acid 
(10 per cent). Dose, 1.20 to 7.5 com. (or mxx-f3ij). 

Unofficial Preparatiofu, 

iEthylis Bromidum. — ^Bromide of Ethyl, or Hydrobromic Ether. For inhalation 
u a general ansesthetic 

Auri Bromidum.— Bromide of Gold. Dose, 0.01 to 0.03 Gm. (or gr. Vt to Vi). 

Auriet Ammonii Chloridum.— <,'hloride of Gold and Ammonium. Dose, as 
above. 

Kiccoli Bromidum. — Nickel Bromide. Dose, 0.065 to 0.32 Gm. (or gr. i-v). 

Syrupua Ferri Bromidi. — Syrup of Ferrous Bromide (10 per cent.). Dose, 0.60 
to 4 ccm. (or mx-f3j). 

Coniinse Hydrobromidum. — Coniine Hydrobromide. Dose. 0.004 to 0.005 Gm. 
(orgr.Vi.-Vu). • 

Phurmacology. — Bromine, which obtains its name from its offensive 
odor, is a brownish-red, non-metallic liquid element, obtained from sea- 
water; combining readily with alcohol, ether, or chloroform; and soluble 
in 33 parts of water at 59° F. When added to water, ozone is liberated. It 
completely volatilizes upon exposure to the air, giving off a highly-irritating, 
suffocating odor like that of chlorine, with which it may be contaminajed- 
The pharmacopceial tests require the chlorine to be not more than 3 per cent., 
and that there shall be only traces of iodine. 

Physiological Action.— It is unfortunate that the smell of bromine is 
80 obnoxious, since it is a true disinfectant, rivaling mercuric chloride, and, 
it is claimed, has even more influence than that agent in preventing the 
derelopment of spores. A 2-per-cent. solution in water destroys the spores 
of anthrax. Applied to the skin, it is a penetrating caustic in its pure state, 
and, diluted, is astringent and antiseptic. Internally, its effects resemble 
those of iodine and chlorine, causing paralysis of the brain-centres, death re- 
sulting from paralysis of respiration. 

In cases of poisoning by swallowing this agent, the stomach must be 
thoroughly irrigated, and a purgative like croton-oil administered in alkaline 
solution (Vichy water). When inhaled, warm vapor from the steam-atomizer 
with alkaline solution (Dobell's solution) would afford relief to the irritation. 
The bromides taken upon an empty stomach in concentrated form sometimes 
csuse gastralgia, which may be relieved by hot water and an hypodermic in- 
jection of morphine, combined with atropine, if stupor be present. After 
death the bromides are found in the brain, principally (Doyon). 

In medicinal doses the bromides and hydrobromic acid exert a sedative 
effect upon the functions of the brain, produce insensibility of the mucous 
membrane of the fauces, and allay irritability of sensory nerves, as is very 
well, shown by their effect in the treatment of tinnitus aurium after admin- 
istration of quinine. It has a special action upon the genito-urinary tract, 
obtnnding sensibility and preventing erections or ovarian excitement. On 
the other hand, sodium bromide has, in a few instances, been known to pro- 
duce nocturnal erections and seminal emissions £rom relaxation. The bro- 
loides act directly upon the spinal cord, reducing reflex action and, when 
continued, diminishing motor power and producing paralysis of the legs. 
The circulation is also affected by their action upon the cardiac ganglia. In 
the case of potassium bromide, we have superadded the toxic action of potash 
Dpon the heart-muscle, by reason of which, when given in large doses, the 



274 



PHARMACEUTICAL THERAPEUTIC AOEXTS OR DHrOS. 



arterial tension is reduced and the pulse-rate lowered. Id the usual dosea, 
however, this effect is hardly obserrable. 

According to the studies of Germain S6e, potassium bromide causes 
dilatation of the heart. The right side of the organ appears to be more 
decidedly ntFectcd, It wag said {by Hammond) to reduce the cerebral cir- 
culation, causing anaemia by contraction of the arteriole?. It i^ probable that 
the hypnotic effect of bromides is due more directly to their action upon the 
brain-centres, especially the motor and intellectual portion of the cortex 
cerebri. To its faculty of reducing reflex nervous excitability is to be ascribed 
its well-known antispasmodic effects in convulsive disorders. No marked 
effect upon temperature or respiration has been observed from medicinal 
doses; very large doses may reduce both, and also diminish tissue-waste. , 

The xatc and the force of the heart's action are lilfewise diminished i 
and arterial pressure reduced by excessive doses. When continually admin- 
istered in moderatelj^-large doses, the bromides sometimes excite nausea and 
diarrhcea. A sedative action is exerted by the bromides upon the sympa- ' 
thetic nervous system. 

The bromides have considerable diffusive power, and are found in most 
of the secretions and in the interior of glands like the liver; after long 
administration they accumulate particularly in this organ, and the amount 
of bromide retained in the liver is very great. It has been surmised that 
this saturation of the system by bromide predisposes to tuberculosis. M. 
Fere states that, although he has seen nothing in patients to corroborate the 
supposition, guine£-pi^s saturated with potfissium bromide and inoculated 
with tuberculosis succumb more rapidly than animals to whom the salt had 
not been given. It has likewise been shown that the bromides accumulate 
in the brain and other organs. The glandular elements of the skin are stim- 
ulated and an acneiform eruption follows their prolonged use. 

The use of the bromides is occasionally followed by the development 
of erythema or a brownish discoloration of the skin. In other instances it 
has caused an eruption similar to that of eczema, wheals, or ulcers. The 
effect upon the skin may be produced within a day or two after administra- 
tion of the drug, but usually occurs only after saturation of the system. An 
eruption occasionally appears upon the body of a nursinp; infant, when the 
mother is upon a course of bromide treatment. The bromides are eliminated 
from the system by the secretions generally, but more particularly by the 
glands of the fauces, skin, bronchi^ and bowel*, and by the kidneys. Ab- 
sorption is much more rapid than elimination. 

Therapy. — P'or its caustic effect, bromine has been used in alcohol (1 
to 2 or 3) in hospital gangi-ene, and in gyna?cology as an application to can- 
cer of the uterus. Diluted with sweet oil (O.GO c.cra. to 30 c.cm.. or mx to 
f5J), it is a sedative dressing for rhus-poisoning or chancroids. Broraipe is 
employed, like carbolic acid, as a disinfectant for drains, but is too offensive 
for use in this way in the sick-room. The bromides arc not often used as 
topical remedies, though an aqueous solution of the strength of 0.65 to 1.30 
to 30 c.cm. (or gr. x-xx to fjj) may be serviceable in paraesthesia. Finely- 
powdered potassium bromide is stimulant to chronic ulcers, and has been 
advantageous in epithclinma. It has been applied, added to 5 parts of glyc- 
erin, to hajmorrhoids and fissure of the anus, in order to relieve pain. In 
treating laryngeal diphtheria, or membranous croup, the 
used: — 



he following may be 



BROUUM. 



275 



M WOlBi 



PutMJB^ii brotnidi 4 

Sjrrupi eimplici-* 



Deeoti alUufcA- 



28 

.q. s. ad 120 



30 c.cm. or rnv. 
Gm. or 3j. 
c.cm. or f3vits8, 
can. or fjiv, — M. 



' a child of one year, the bromine should be reduced to one-third, and 
I me to four years two-thirds, of the quantity in this formula, of which 
lOcxm. (or f5j) are to be given every hour, while the symptoms are urgent 
(Bedobecher). The official solution oi hydrobromic acid has not answered 
te expwrUtion of those who urged its use as a substitute for the bromides; 
ii WMj be iesB liable to produce acne, but it is irritating and less etHcient. 
It BWj be given for the relief of tinnitus aurium, headache, or to prevent 
It sjinptoms from the eftecta of quinine: — 



R Qutainjp hydrobromidi . 



Arid, hydrobromic. dilut 16 

Elixir aurantii 105 

M. Si^-: I>ooe, a Ublcspoonful after meala. 



65 Om. or gr. xxiv. 
c.cm. or ftss. 
ccm. or fjiiiss. 



I 



Speeial Applications. — The special use of the bromides is found in the 
tastmexit of ccnTulsive disorders, such as spasm of the larynx or epilepsy. 
btbe former affection a few doses of 0.G5 Gm. (or gr. x) or more in a child^ 
mt wnaUj sufficient to accomplish a cure; but in the latter the treatment 
Aed extends over months and years. When the bromides are continued for 
tka^ time, bromism is apt to be produced, the physiological action of bro- 
xiat being shown by eruptions upon the skin, especially of the face; loss 
4i«flexee; dragging, heavy sensations; and difficulty in locomotion, and 
ii Moe cases special tendency to convulsive attacks appear. It therefore 
Weoaa«« necessary to intermit the bromide or change from one to another, 
adL if there is too much depression of the vital powers, digitalis may be 
■venbed in combination, or strychnine given hypodermically in minute 
iaH (0.CM>O5 to 0.001 Gm., or gr. Viio-V«o) several times daily. Brown- 
Ismrd preferred a combination like the following, in treating epilepsy, for 
cdiild ten vears of age: — 



B Pot*««U iodidi 4 

Pola^ii bromidi 31 

Awmanii bromidi 10 

pMaaffii bicarbonatlv 2 

SnirituB chlorofonni . . . . ! 7 

IftfttA) cttluRibe q. i. ad 180 



Gm. or 3j. 

Om. or Sj* 

Gm. or 3iift8. 
60 Gm. 6r gr. xl. 
60 c.cm. or i3ij. 

c.cm. or fjvj. 



!£. Doae« 7-5 ccnu (or f3ij) morning and noon and II c.cm. (or fSiij) at nigbt, 
I^Ukiatf th*> quantity after the convutsiona ceane, but contintiing the remedy at 
fff tmperimUy at the time when the 6ts nre liable to recur. If the pHtienl be 
«Mk, t^ Snfiuuon of digitaJis may be iubetituted for the caluniba. 

JL Gh. F^r6 states that most of the ill effects of the bromide may be 
swdrd b; the simultaneous administration of an intestinal antiseptic. In 
" I nnuiiretnont of epilepsy he has often made use of the following cora- 



PMaaalfi bromid. . 6| Gm. or Sisa. 

■«.--•,*■,. ! 41 Gm. or Sj. 

, yXmt, 2| Gm. or 3ft». 

^^S '• 1 <^ ^ <SiTfded into thrve doieft. One dose to be tAlcen three times a day. 



2T6 



niARMACEUTICAL THEUAPEmC AGENTS OB DRUGS. 



Qm. or 3iij. 
Gm. or 3iv. 
c.cm. or f5j. 
c.cm. or fSiv. 
c.cm. or fjviij. 

This com- 



In treating epilepsy, the partial insensibility of the fauces is the guide 
to the administration of bromides; this Bhould be established as booh aa ( 
possible and maintained during the continuance of the treatment, which 
should not be pushed to the point of bromism. Small doses of arsenic will 
prevent, to some degree, the eruption in persons eepeciallj susceptible to 
bromides, and it is well to alternate the iodides with the bromides in order 
to prevent undue accujnuJation of the latter in the system. The beneficial 
action of the bromides is particnlarly marked when epilepsy is due to dis- 
order of the sexual apparatus. On the other hand, the pelit mal is much 
less amenable to their influence than the general convulsive seizures. Potas- 
sium bromide has a certain sphere of usefulness in whooping-cough. It is 
of no avail when the bronchitis is severe, or when pneumonia is present; but 
in simple uncomplicated pertussis, above all when convulsions or a tendency 
to convulsions exist, this remedy is of great service in allaying the congestion 
of the nervous centres. Spasmodic asthma is, in some instances, consider- 
ably benefited by the exhibition of bromide, and its efficacy is enhanced by 
combination with the iodide. The bromides are of decided value in infantile 
convulsions, especially wlien these depend upon reflex irritation. They are 
likewise of service in the convulsions symptomatic of simple meningitis, and 
not altogether without avail in alleviating those of tubercular meningitis. 
Uraemic convulsions may sometimes be successfully treated by potassium bro- 
mide in combination with chloral-hydrate, assisted by active purgation and 
diaphoresis. AVhen cholera infantum is associated with excessive nervous 
irritability, potassium bromide serves a useful purpose, as it does also in those 
cases in which flatulent colic of infants is connected with marked intestinal 
spasm. Dr. Harvey Vanatta, of Seal, Ohio, administered potassium bromide 
with success in a case of invagination of the bowel. 

In treating nervous irritability, restlessness, and insomnia it is well to 
combine bromides with other hypnotic agents: — 

H Potasaii bromidi 1| vel 1130 Gm. or gr. xv vel xx. 

Chlorali hydrati |65 Gm. or gr. x. 

Aqu8B camphone, 

Syr. lactucarii aa 4] ccm. or f3j. 

M. Sig.: Pro dosi. For nervous headache with insomnia. 

The sedative and antispasmodic effects are increased by combination 
with gelsemium, asafetida, or valerian, and smaller doses are required than 
when each ngrnt i^ a'lniinistertMl alone. In Mi*ni(>ro'e disease, Ferreri reports 
good results irom the use of large doses of potassium bromide in conjunction 
with ferric valerianate. In the affections of the genito-urinary organs the 
bromides are of especial value when apaam or pain is present. The quantity 
of urine is increased and also the proportion of urea. The sexual functions 
are depressed; and the bromides are largely used as anaphrodisiacs in pria- 
pism and nymphomania, especially when given in conjunction with tartar 
emetic in minute doses, 

A good formula used by the author for gonorrhcea with chordee is the 
following: — 

R PotasAii bicarb 12 

Potaftsii bromidi 15 

Tincturffi hyoBoyami 30 

Spiritus ihloroformi 15 

Inf. buehu q. a. ad 240 

M. Sig.: A tAbleajKJonful in barley-water every three or four hours, 
binaiion relieves scalding and chorde«. 



the I 

4 



BBOHUH. 277 

The following are also valuable prescriptions containing the bro* 
mides: — 

B Sodii bromidi 271 Gm. or Srij. 

Antimonii et potasBii tart |03 Gm. or gr. m. 

Aqum camphonB, 

Spiritus cetherii xutron aa 451 ccm. or fSiea. 

Syrupi aurantii 60| ccm. or fSij. 

M. Big.: Two teaapoonfuli in water eyerj two or three hours until relieved. 
Seniceable in epididymitiSi cystitis, and prostatitis. 

ft AmmJidi bromidi, 

SaloL aa 4| Gm. or 3j. 

M. et ft. capsuUe no. xij. 

Sig.: Two capsules every hour or two. Employ in gonorrhcsa and all irritable 
ANiditions of the genito-urinary organs. 

The menses are delayed and rendered less in quantity, by the use of the 
bromides. When znenorrhagia is caused by ovarian congestion, potassium- 
bromide restrains the flow, and the same agent sometimes proves of service 
in metrorrhagia. In the profuse and irregular menstrual discharges, which 
often occur as the menopause is neared, the same remedy is of value. The 
headaches, flushing of the face, subjective sensations of heat, and other 
anomalous symptoms which characterize the same period receive notable 
relief from the bromides. Chordee occasionally yields to the same agent. 
In Bpermatorrhoea and atonic impotence, dependent upon irritation or sub- 
acute chronic inflammation of the deep urethra, the bromide is valuable by 
diminishing the reflex irritability of the genital centre in the cord. But, in 
diunal pollution due to debility of the genital centre, this remedy is harm- 
foi and should be avoided. In all cases of reflex nervous disorders having 
origin in ovarian irritation the bromides have a well-established reputation, 
bat should not be given freely in ansemic subjects. In reflex cough — or so- 
called uterine cough, atomach-cough, ear-cough, etc. — ^we may give: — 

9 Potassii hromidi |32 to 165 Gm. or sr. v vel x. 

Syr. pmni Virg. 7|5 ccm. or 6ij. 

M. Take every four to six hours. The above is also useful In the cough of ehil- 
dren, in smaller doses. 

When it is desired, in laryngology, to make an examination or an opera- 
tion upon a very sensitive throat, the use, for a few days, of full doses of 
potassium bromide will greatly assist in reducing such hypersesthesia. In 
Tarioos hysterical throat affections, the bromides are of the greatest value. 

In irritability of the bladder in women who use sewing-machines, or 
others, the following is serviceable: — 

B Potassfi Tel sodil bromidi 1130 Gm. or sr. xx. 

Infns. UV8B ursi 4| ccm. or ?3j. 

H Sig.: Take every hour or two tmtil relieved. 

In migraine, the combination with opium is valuable : — 



B Tr. opii deodorat. 4 

Potassii bromid. 8 

Acid, hydrobrcmle. dil 00 

Syr. auraotii q. s. ad 120 



ccm. or fSj. 
Gm. or 3ij. 
ccm. or fSij. 
ccm. or fjiv. 



M. Sig.: Take a dessertspoonful in water, every two or three hours. 



278 PHARMACEUTICAL THERAPEUTIC AGENTS OR DRUGS. T 

Cases of maniacal excitement, puerperal, alcoholic, or other, are relieved 
by full doses of bromides, especially when combined with chloral . 

Many acute attacks of fever in children, with delirium, are promptly 
cured by bromides, in small doses given every few minutes. Seasickness and 
the vomiting of pregnancy are controlled by small doses of bromides in 
effervescent salt; large doses have occasioned temporary derangement of 
mind, and have brought this remedy into disrepute because improperly used. 
In poisoning by strychnine and in tetanus, large doses of the bromides have 
proved successful in subduing the convulsions. 

In acute cerebral congestion potassium bromide is of great value through 
its influence upon the vasomotor system. It is very serviceably given in con- 
junction with the fluid extract of ergot, which aids its action by constringing 
the cerebral vessels. The headache and wakefulness are also relieved by the 
bromide. The same drug is efficacious in allaying cerebral vomiting. In- 
Bomnifl, caused by nervous strain or excessive mental application, is success- 
fully treated by means of the bromide. The headache of pachymeningitis Is 
generally best controlled by a combination of potassium bromide and iodide, 
as: — 

B Potaasii iodidi )0| Gm. or Siiss. 

PotasBii bromidi 1*15 Gm. or 3v, 

^ Syrupi ourantii, 

H Syrupi aimplicis au 60| c.cm. or f^ij. 

M. Big.: Dose, two teaspoonfuls three or four times daily. 

In exophthalmic goitre, the excessive cardiac action may often be re- 
strained by the bromide. This remedy may be useful in subacute and acute 
rheumatism, especially when the aciite form of the dipease is accompanied 
by considerable fever and delirium. The restlessness and delirium of the 
third we^k of typhoid fever are often admirably controlled by a bromide. The 
same agent is very eflficacious in preventing the night-terrors of children. 
It is claimed that potassium bromide is useful in diabetes mellitus of nervous 
origin. The salt relaxes nervous spnsm of the oesophagus and allays the nerv- 
ous symptoms of rachitis. Potassium bromide and iodide are recommended 
in eliminating metals — as mercury, copper, or lead — from the system. The 
bromide may be useful in reducing enlarged lymphatic glands and spleen, 
though far inferior to the iodide. A bromide addition to a prescription in- 
creases the effect of hypnotic or narcotic medicines, and it is often able to 
obviate the unpleasant consequences of opium. 

Victor Augagneur has found potassium bromide of service in certain 
syphilitic manifestations. Dysphonia or aphonia sometimes occurs, espe- 
cially in women, in the sixth or seventh month of the disease. In the belief 
that it depends more upon disturbed innervation than upon the erythema 
of the laryngeal mucosa, he is accustomed to give bromide in combination 
with potassium iodide with very good results. In serious tertiary disease of 
the larynx the iodide may give rise to dyspnea. In this condition it is ad- 
vantageous to practice mercurial inunction and depend upon the bromide to 
reduce reflex excitability. When the dyspnoea has been allayed, the bromide 
and iodide may be administered in association. The addition of the bromide 
to the iodide is also of value in cerebral syphilis. 

According to Dr. Wilks, the bromides often have a good effect in caus- 
ing reduction of goitre. They have also been used with success in order to 
diminish the volume of fibroid tumors of the womb. 



II 




BBOHUH. 279 

During administration of the bromides the digestive functions maj 
become disordered, and it is necessary to occasionally give cholagogal cathar- 
tics to keep the liver up to its work. 

In comparing the bromides we observe some difference in their effect 
and therapeutic applications. 

Potassium bromide is the most frequently prescribed, and is the most 
efficient. Where the circulation is weak, the other salts, especially the am- 
monium salt, are to be preferred. 

Sodium bromide is the least toxic, and is preferred in cases where nutri- 
tion is poor, especially in anaemic women and children. It is not so efficient 
in cases of a uric-acid diathesis or lithsemia, as other salts, and notably that 
of lithia. 

Lithium bromide has been thought to possess more hypnotic power than 
the potassium bromide. Ammoniiim bromide combines the stimulating 
action of the ammonia with the hypnotic effect of bromine, and is useful in 
cerebral rheumatism. The manifestations of bromism are not so readily ex- 
cited by the ammonium salt as by that of potassium or sodium. Ammonium 
broniide is useful in whooping-cough. 

Nickel bromide, introduced by Da Costa for the treatment of epilepsy, 
has the advantage of the smallness of the dose, but the disadvantage of the 
metallic poisoning when too long continued. It is best given in effervescent 
salt or in the form of a syrup mixed with orange-flower water. The salt is 
green in color, deliquescent, and soluble in water. It is well borne by the 
stomach, relieves congestive headaches and convulsive movements. Zinc 
bromide is little used; it is supposed to combine the well-known action of 
line upon the central nervous system with the bromide action. The syrup 
of ferrous bromide has been employed for chorea in anaemic children, with 
good resTilts. 

Strontium bromide appears to have decided advantages over the other 
bromidies in the treatment of epilepsy. Dr. Antony Hoche has published^ 
notes of successful cases and says that he has not met any case in which the 
bromide of strontiimi, given in the prescribed doses and according to his 
method, has failed to diminish the number of the attacks. In many in- 
itances there had been no return for periods extending to two, three, or 
eren four years. He usually begins the treatment of epilepsy by ordering 
2 Gm. (or 56s) of the strontium salt, night and morning in some vegetable 
tonic infusion. Should this dose not control the attacks, he rapidly in- 
creases it until he flnds the quantity that will suit the individual case. In 
cases where there is distinct warning before the attacks he gives 2 6m. (or 
Sb) at once, and directs this dose to be repeated every hour, if required. 
In this way he has succeeded in preventing an attack. In order to get the 
fnll benefit of the treatment he has found it necessary to give this remedy 
in large doses and to continue it for a long period. Dixon Mann in his 
"Manual of Medical Jurisprudence" says, with regard to the safety of this 
treatment, that strontium salts cannot be regarded as poisonous. He had 
himself taken 12 Gm. (or 3iij) daily for weeks without any unpleasant symp- 
toms. The strontium bromide does not cause the depression that follows 
the potassium salt. 

Bromaiaid. — Fischedick and Koechling have introduced a compound 

'lancet, Oct. 15, 1S08, p. 987. 



280 



PIIARMACKrxICAL TIIEItAPEPTIC AGENTS OH DRfaS. 



of the aniline group containing 75 per cent, of bromine and designated bj 
them as bromnmid. It is obtained in the form of colorless, odorless, and 
tasteless needle-shaped cn'stals, insoluble in water, but soluble in boiling 
alcohol, ether, chlorofonn, and the fijied oils. It melts at 243° F. and 
volatilizes at 310° F. without change. No symptoms are produced in doga 
by doses of 2 Gm. (or gr. ixx). The pulse-raie is, in adults, retarded by a 
dose of 0.65 Gm. (or gr. x). Bromnmid reduces a febrile temperature 1° 
to 2.5° F. without excessive sweating. It does not disorder digestion or 
produce diuresis. This substance has been employed as an antipyretic and 
antineuralgic in doses of 0.65 to 1 Gm. (or gr. x-xv) several times a day 
to adults and 0.065 to 0.32 Gm. (or gr. i-v) to children. Bromamid may 
be administered in capsules and wafers or suspended in a fluid. 

Bromipin is a solution of bromine in sesame-oil (lu per cent.). It 
has been used internally in the treatment of epilepsy by Zimmermann, of 
Hanover. The dose is 4 to 15 c.cm. (or f3i-iv) three or four times daily; 
with epileptics the dose may he increased to double this quantity. (One 
tablcspoonful of bromipin represents about 1.49 Gm., or gr. xxiij, of com- 
bined bromide, equivalent to 2.20 Gm., or gr. xxxiv, of potassium bromide.) 

Bromoform. — Tribromometbane. If to methane, or marsh-gas (CHJ, 
be added 3 atoms of bromine in substitution for 3 of hydrogen, we get methyl 
bromide, or bromoform (CHBr^), analogous, therefore, in coni])osition to 
chloroform or iofJoform. Bromoform is an oily liquid, having an agreeable 
odor resembling that chloroform. It has a sweet taste, does not atfeCt the 
mucous membrane of the mouth, and has no irritant effect. It is rapidly 
decomposed by light. Its density is 2.7i, and it boils at 150** C. Insoluble 
in water, it dissolves in alcohol and ether, its reactions being similar to chlo- 
roform. It usually is prqscnt in small proportion in commercial bromine, 
and is made by adding bromine to a solution of an alkaline hydrate in alcohol 
or woo<]-spirit. A fluid "anur of l^rmnnfnrni contain? .360 drop:^. 

Bromoform was first introduced by Stepp, of Nuremberg, in 1SS9, as 
a valuable remedy in whooping-cough. In children aged from six months 
to one year, 0.12 c.cm. (or mij) maj* be given three or four times daily, and 
the dose is increased by about a drop for every additional year of age. The 
dose for adults is 0.545 to 0.80 c.cm. (or mvii-xiij) in capsules. Bromoform 
diminishes the frequency, severity, and duration of the parox}'sms of per- 
tussis, has a favorable influence upon the mucous secretion, and generally 
abolishes vomiting and the hjcraorrhages within a short period. The most 
severe cases are perceptibly benefited within eight da^'s. Dr. S. Solis-Cohen 
has used bromoform with beneficial results, as a local application, in the 
treatment of tubercular and other ulcers of the throat. He recommends its 
combination with iodoform. The local application of bromoform is also of 
utility in ozaena. 

Dr. Ponticaccia reports that bromoform, given in daily doses, pro- 
gressively increasing from 1 to 3. 25 c.cm. (or mxv-1), has an excellent 
sedative t^leci in cases of acute mania. He found the same remedy of value 
in delirium tremens, in which it allayed restlessness and induced sleep. 
Several fatal cases of [)oisouiiig frnm bromoform have lnvu repi^rtod, the 
paliont in each case being a clnld who had taken a large quantity (30 to 40 
minims). 

When bromoform is given suspended in a gummy mixture, accidents 
have bnp]>cned through neglecting to tborouglily shake the bottle, before 




BRYONIA. , 281 

pouring out the medicine. It is insoluble in dilute alcohol, but may be dis- 
Bohed by the aid of glycerin, and a formula has been proposed by the late 
P. W. Bedford which forma a perfect and palatable solution (each fluidrachm 
contains 0.06 c.cm.> or mj, of bromoform): — 

3 Bromofonn 1| ccm. or mxvj. 

Alcohol, 

Tr. cftrdam. co. aa 716 ccm. or fSij. 

Glycerini 45| ccm. or fjiss. — M. 

Bromogallio Acid. — This substance, otherwise known as bromogalloli 
reaembies bromic acid, in which two atoms of hydrogen have been re- 
placed by bromine. The blood of a dog poisoned by bromogallol was of a 
Bftffron color and contained a large quantity of methsemoglobin. Respiration 
was at first accelerated, but afterward retarded. Lupine and Cazoneuve, of 
Lyons, have employed it as a succedaneum of potassium bromide. It appeared 
to be useful in chorea, but less efficient in epilepsy than the salt of potas- 
eiam. This preparation, known also as gallobromol, has been used with 
success locally in eczema rubrum and other stubborn forms of -eczema in the 
fonn of a 1- to 2-per-cent. solution, powder, or ointment. In cystitis and 
epididymitis 2- to 4-per-cent. solutions have been employed by irrigation. 

^mol, or Tribromphenol, is obtained by the action of bromine in 
excess on carbolic acid. It possesses antiseptic properties, and has been used 
with advantage in the local treatment of wounds, ulcers, and diphtheria. In 
the last-named affection Pademaker recommends a mixture of 1 part of 
bromol with 25 parts of glycerin. Bromol has been given internally in 
cholera infantum in doses from 0.005 to 0.015 6m, (or gr. ^/la-VJ- On 
the ground of his experimental and clinical investigations. Dr. Tschourilow 
states that tribromphenol is an excellent application in erysipelas. He made 
ose of it in the form of a 1-, 2-, or-3-per-cent. ointment. 

BEYONIA.— Bryonia (Bryony). 

Preparations. 
Tinctura Bryonue. — Tiiieture of Bryonia (10 per cent.). Dose, 4 to 15 ccm. (or 
l^ir). 

Bxtractnm Biyonitt Fluidum. — Fluid Extract of Bryonia. Dose, 0.30 to 1 c.cm. 

(or «IT-XT). 

Bryonin. — ^The active principle. Dose, 0.01 to 0.02 Gm. (or gr. VrV«). 

Pharmacology. — Bryonia alba and Bryonia dioica (Cucurbitacese) are 
the official sources of the root known as bryonia, which must be recently 
driKl. as an old drug is useless. It contains two glucosides, Bryonin and 
Bryoaidin; tlie former is a poison, and is the principal constituent; it ap- 
p^rs in pearly crv'stals or in white powder ; it is very bitter ; soluble in water 
and alcohol. On being boiled with diluted sulphuric acid, bn'onin splits up 
into glucose and a resin, Bryogenia. A second resinous principle, BryoresiEy 
i? also found in the root. 

Fhyiiologioal Action. — The juice of the fresh plant blisters the skin. 
The drug, taken taken internally, acts as an irritant, and is a hydragogue 
cathartic. It also increases the flow of urine. Br\'onia acts as an irritant 
npon serous membranes, and in toxic doses causes gastro-intestinal inflamma- 
tion, with nausea and vomiting, and gives rise to symptoms of meningitis. 
l*^th has followed in several cases. Its antidotes are opium and stimulants. 



283 PHAKMACEITICAL THEBAPEUTIC AGENTS OR DRUOS, ^" 

Therapy. — As there ere better purgatives, bryonia is not required for 
this purpose. It is reported to have been used with success in atonic dys- 
pepsia. It is used, in small doses, in rheumatism, pleurisy, and other serous 
inflammations, after the fever has abated. It appears to be especially serv- 
iceable in the muscular pains and stiffness following colds. In chronic 
bronchitis it has been advocated. Brj'onia has been recommended in the 
catarrhal stage of %vhooping-cough and in cases of enlarged spleen from 
chronic malaria, and, also, by Petresco, in cases of hiemorrhage, especially | 
in epistaxis. In chronic or aubnctUe pharjTigitiB, the tincture has been em- 
ployed, with asserted good results. 

BUCHU (U. S. P.)-— Buchn. 

BUCHU FOLIA (B. R),— Buchu-leavcs. 

He Preparat ioiu. 

Fluidextriwtum Buehu (U. S. P.).— Fluid Extract of Buchu. Dose. O.tiO 
4 c.cm. (or mx-f3j). 

Infusum Diuhu (B, P.|. — Infusion of Buchu {one to sbcteen). Dose, -t to 8 
c. cm. (or fSi-ij ). 

Tinctura Buchu (B. P.).— Tincture of Buchu (20 per cent). Dose. 2 to 4 c.cdl 
( or f 3s8-j ) . 

PhannacoIogT', — The dried leaves of Biirosina bctulina (Rutnccir), 
derived fr«ini gontl-sized^ erect,, and widely-liranching shrubs of southerti 
Africa. Tliey contain an aleoresin, which is the most active coostitueut. 
They also contain a bitter glucosido, Barosmin, The oil of Buchu contoina 
30 per ceut. of the characteristic, crystallizable phenol kuowu as diosphenol 
(^^'inHjcO^). The fluid extract does not unx rejidily with water, on acc<>unt 
of tJie jirfSunce of the oil and extractives. 

Fhyfliological Action. — Buchu-Ieaves have a strong, mint-like odor and 
a bittiT, pungent taste. When takon into the stomach, a warmingr, canuina- 
tive effect is produced by small doses, but very large ones cause irritation. 
The volatile oil diffuses into the blood, slightly stimulating the circulation, 
increasing the quantity of the urine, and imparting to it a peculiar, aromatic 
odor. In process of excretion the remedy acts as an astringent and disinfec- 
tant upon the urinary organs, especially the bladder. As a portion is 
eliminated by the bronchial mucous membrane, a stimulating influence is 
also exerfed here in relaxed conditions accompanied by increased secretions. 
When used to excess or for a long period, or in too large quantity, the kidneys 
suffer and de^enernte or inflammatory conditions are initiated. 

Therapy. — The principal use of this agent is for disorders of catarrhal 
character affecting mucous membranes and diseases of the genito-urinary 
organs. In incontinence of urine, or want of tone in the bladder, good re- 
sults usually promptly follow its administration, Buchu affords relief in 
irritability of the bladder, in subacute or chronic cystitis, and in pyelitis. 
Through the enterprise of the owners of proprietary remedies, buchu has a 
popular reputation for the cure of gonorrhoea, but, owing to the quantity of 
alcohol contained in the fluid extract, this should not be used during the 
existence of acute inflammation, and only with great care in chronic ure- 
thritis, or gleet. The recent infuesiou is perhaps tlie best prepiiration. It 
may be combined with uva ursa (5iv of each to a pint of boiling water). 



CICTUS. 



283 



ITkcre are many good reasons for believing that the much-advertised 
for gonorrhoea contain no buchu-leaves whatever, but are 
Mir from the leaves of uva ursi and other domestic plants. Buchu resem- 
Ha <n] of turpentine very much in its physiological effects, and is useful 
ii Midi the same class of cases. In gleet it appears to be highly serviceable. 
Bachtt has been used with success in chronic bronchitis, atonic dyspepsia, 
iftBEfeft; and in chronic rheumatism it may be administered sometimes 
«ift adra&tage. Not having very decided diuretic properties, it is of little 
i^aeia dropsy. 




BinSA PASTORIS.— Shepherd's purse is a small plant belonging to the 
*^enE, a native of Europe, but growing luxuriantly in this country in 
■hhated lands during the months of April and May. The plant has a 
tear, astringent, and strongly-pungent taste. It contains a volatile oil, 
MKmbling oil of mustard, a glucoside, bitter principle, resin, etc. 

According to tob Oefele, the virtues of the plant depend upon the pres- 
oot of busuuc acid, the salts of which, with iron and sodium, may be given 
■IlIOOxd. (or gj. iss) doses several times a day. Of the tincture, made with 
Ml leaves, the doee is 0.60 to 4 or 15 c.cm. (or tnx-foi-iv), given in cases 
tf kcraorrhage from the lungs, kidneys, or uterus, and also in diarrhoea and 
fyKBtery. A fluid extract is also made, the dose of which is from 2 to 4 c.cm, 
*efaes-j). Hoth preparations are miscible with water without precipitation. 

BUm^CHLORAL HYDRAS (B. P.). — Butyl-chloral Hydrate. (See 
ainal Hydrate.) 

CACTUS, — Cactus. Xight-blooming Cereus, the Cereus grandifioria 
fOttiBeem), is a plant of Mexico, with large, showy, nocturnal-blooming 
favBi^ of pearl-white petals, which have a heavy perfume. A tincture of 
dv frafa etems and flowers (124 Gm. to 473 c.cm., or o^^'^j alcohol) is 
by Babini to be a valuable cardiac tonic in doses of 0.06 to 0.30 
(or mi-T) three times a day. Probably these doses mio:ht be much in- 
aa Knnge gave 1.20 c.cm. (or mxx) at once, and II. C. Wood was 
to perceive any effect from them at all. A difference might be 
lied for on the ground that some use the fresh plant and others the 

J and leaves recently dried, the latter being the stronger preparation. 

Ik cooatitti^*uts of Cactus are unknown. It contains several acia, glucosidal, 
nawMtf bcK^ies. and also an alkaloid, which is present in very small quantity. 
Innrt and Boy-Teiseier determined that, in frogs, cactus increases cardiac 
l,,.. »K*,( ^j,e effect is transitor)*. Dr. Re^-nold W. Wilcox states that 
phy^ '1 action of cactus is upon the intracardiac ganglia and ac- 

itor mn*--*, through the cardiac plexus of the 8}Tnpathetic system, and 
tat tbrt^ ^** "*> interference with the inhibitor}' nerves, nor does its admin- 
■zxtino ♦? nny very marked vasomotor changes. It shortens the ven- 

(nraisr - ^nd increases the blood-pressure. Sultan has extracted an 

msr '■■ pl^» which he terms Cactin, from the young flowers of the plant. 

He^jkir^ i.iiit cftctin increases the energy of the cardiac contractions, height- 
iftartPTtai tension, and has a direct action upon the motor centres of the 
^ml coftl- It produces reflexes, increases the general nervous tone, and 
«a b« naed for a long period without causing gastric symptoms or cumuln- 
Both pulse and bloofl-pressure are reduced by toxic amounts. 



284 



I'HAUMACEUTICAL THERAPKITIC At*EXTS OR DRUGS. 



The action of the heart is rendered irregular and it is arrested in systole. 
Death is preceded by clonic and tetanic convulftions, caueed by overstimula- 
tion nf the motor tract of the e<n*d. I>r. Wilcox found it especially useful 
in uncompensated cases of vulviilar dL'jease, in relative incrompeteney due to 
muscuiar degeueration. in weak hearts after ty[d>oid fever, m funitional 
heart dif^coses from alcohol, dyspei>sia, sexual exhaustion, etc., and in the 
paljdtation of exoplithalniic goitre. In aortic regurcfitation. he considers 
it to be the drug par excellence, while in mitral stenosis it should be avoided, 
Watson Williams has found cactus bi-neficinl in mild cases of angina pec- 
toris. Cactus has also prov^'d itsi'lf oHicieut in cardiac dropsy. 

CADMIUH.- — Cadmium is hiund (-(uubined with ziiu-, in native ores. 
It resembles tin in general appearance, and its salts are white and perma- 
nent; they are soluble in water. They are astringent and resemble the 
correspondino; zinc salts, producing emesis, but they are principally employed 
for their local effects. SiuuU doses of the salts of L-adniium e.xcite (wliether 
given by the mouth or hypodurmie injection) inthunmatiou of the gastro- 
intestinal mucous membrane, and ulceration may occur. In addition they 
may cause giddiness, loss of consciousness, and retardation of circulation and 
of respiration. Alkaline carbonates and white of egg are the proper anti- 
dotes. The ointment of the iodide (1 to S of lard) or the oleate may be used 
in chronic enlargement of glands or joints, and especially in goitre. It has 
also been recommended as an application in cases of enlarged gpleen. It 
is said not to discolor the skin. Lincke has made use of injeetiona of cad- 
mium sulphate in leucorrhoea and gonorrhoea. The sulphate may be em- 
ployed as an astringent wash (in solutions, Yj per cent.) or as an ointment 
(1 to 40 benzoinated lard). In solution the sulphate is used as a oollyrium. 

CAFFEINA fU. S.P'., B. P.).— Caffeine, Theine (C^H^oN.O^ + H,0). 

Dose, t).13 to 0,G5 Gra. (orgr. ii-x). B. P., 0.0G5 to 0.32 Gm. (or gr. i-v). ( 

Preparations, 

Caffeina Citrata (U. S. P.).— Citrated Caffeine. Doae, 0,065 to 0.32 Gra. (or 
gr. i-v). 

CalTeina Citrata Efferveacens (U.S. P.).— Effervescent Citrated Caffeine. Dose, 
4 to 12 Gm. (or 3i-iij). 

Caffeince Citraa (B. P.). — Caffeine Citrate. Dose, 0.13 to 0.05 Gm. (or gr. ii-x). 

Caffeinte Citras Efferveacens (B. P.). — Effervescent Caffeine Citrate. Dose, 4 to 
6 Gm. (or 3i-ij). 

PharmacologT'. — Caffeine is a feebly-basic proximate principle obtained 
from the dried leaves of Thea sinensis (Temstromiaceas), or from the dried 
seeds of C'oUV'a arabica (Knbiaocie), and found aUo in olhtr ]>hnit>, or pre- 
pared syntfictically (U. S. P.). An alkaloid usually obtained from the dried 
leaves of Camellia Thea, or the seeds of ColTea arabica (B, P.). Paraguay 
tea, or mate, the Brazilian holly (lle.K Parao^ieneis), also contains caffeine, 
and is laro^ely used as a hot beverage and stiraulnnt in South America. It 
exists aim in the kola-nnt of Africa, the fruit of Sterculia acuminata {Ster- 
culiacea?.). It is closely related to theobromine, existing in tlieobroma cacao, 
and to cocaine, found in erythroxylon cocn, both in chemical composition 
and effects upon the human body. Caffeine has been synthetically made 
from Alanine; and also by heating, in closed tubes, theobromine silver with 
methyl-iodide. 

Citrated caffeine is most frequently employed in medicine on account 




CAFFEINA. 



285 



■fiu greater solnbility, but Tanret has recently shown that by the addition 
if «i eqaal weight of sodium salicylate, or benzoate, tJie solubility of caffeine 
vfTefltly increased. Antipyrine has also been found to have the same action ; 
m XhMt bj this means the hypodermic administration is greatly facilitated. 
Oaeuid A half Gm. (or gr. xxiv) of antipyrine will enable 1 Gm. (or gv. xv) 
cIcsffoBe to dissolve in 30 c.cm. (or f.^j) of distilled water, with the aid of 
bmt, forming a p«rmanent1y-limpid solution. 

Caffeine is in the form of colorless, silky, inodorous crystals, sparingly 
leiiible in alcohol and cold water (75 parts), but much more Bolublc in boil- 
iBf vater (9.5 parts). It is precipitated from its aqueous solution by tannic 
Kid« or solution of potassium iodide and mercury; with the latter reagent 
die deposit is crystalline, whereas, with other alkaloids, the product is always 
OBorpliotu when this test is employed. Caffeine was first extracted from 
taSet in 1821, by Felletier and Ca^entou, and by Robiquet and Runge. 
' ig to Wurtz, it chemically is methyl-theobromine (or trimcthyl- 
ine). Thf^ caffeine of commerce is usually derived from damaged tea. 

Physiological Action. — It has been claimed by Dr. Mayp, of Philadel- 
aUi, that ihe physiological effects of (he caffeine obtained from coffee differ 
nm tboae following the administration of the alkaloid from tea. Mays 
ommB that theine possesses analgesic properties which are absent in caffeine; 
aJ that the latter will not affect the heart, while the former causes palpita- 
tatt. Thc-ine, he has asserted, when injected hypodenmically, produces local 
■M^K pctg •whereas pure caffeine will not affect sensibility. Tanrot and 
fyprd. ■ ** cfintrary, regard caffeine ns an efficient local anicsthetic. It 
Im beeri that the well-known difforenoes in the physiological effects of 

mend coffee were due to other constituents, and especially to volatile oils, 
ml in the ordinary method of manufacture these might still contaminate 
dr caffeine. It has been shown that tea contains another base, theophylline, 
mmeric^ but not identical, with theobromine and paraxanthine. The pres- 
ort of this boae might also affect the physiological results. The experi- 
— f of I>uiiatan and Shepheard demonstrate that caffeine and theine are 
ftstieal in chemical properties. Investigntions with caffeine prove it 
«i have verv decided physiological p«->wers. There is. after its administra- 
^■a, at first increase, but later diminution, of the activity of the reflex cen- 
tov of the spinal cord. In frogs convulsions and muscular rigidity are 
owd; the heart's action is at first accelerated and afterward slowed. Arte- 
la] preaanre at first rises, but subsequently falls. Caffeine stimulates the 
TMttmotor centre and exerts a direct influence uprm the heart. It assists the 
fivteiB to reaist hunger and fatigue. It has a decided diuretic action. The 
^f^, f tirea is at first increased, afterward diminished. Sobieranski,* 

iHt: - 'S of experiments in the line of Ludwig's theory of urinary secre- 
ji ^f^ found that, in animals killed at various intervals after the injection 
4 OHlieo-cftrniiTi, this substance was secreted by the glomeruli alone; it 
^m nercT found in the baeal epithelium of the convoluted tubules, which 
|nT(4 airain that this epithelium does not secrete. Further experiments 
■vred that after the administration of diuretics, and while the system is 
Ut under their inffnence^ the injection of indigo-carmin varies in its ef- 
h^ With cafTi^ine. the cells of the convoluted tubules were no longer 



tf^Bcd onlr a weak coloration here and there in the secreting epithelium^ 



•Cfwrrrtf*'"'^ ffir PhynU*1offif, April 4. 1900. 




286 



PHARMACEUTICAL THERAPEUTIC AGENTS OR DRUGS. 



which he explains bj the assumption that caffeine paralyzes the absorbing 
power of the convoluted tubulesj and to this he ascribes its diuretic action. 
The diuretic salts — sodium chloride, nitrate, and acetate — produce their 
effect through the blood's increasing the secreting power of the glomeruli 
while only slightly affecting the absorbing function of the tubules. Urea 
and kindred substances stand between these, as they raise the osmotic co- 
efficient of the glomeruli on one hand, while they diminish the absorbing 
power of the convoluted tubules on the other. 

When caffeine is given in ordinary doses the rate of respiration is re- 
duced, blood-pressure lowered; temperature slightly increased, afterward 
diminished. The cerebral functions are stimulated, and, in many persons, 
wakefulness results. Delirium, alone or associated with visual hallucina- 
tions, is sometimes excited by the administration of caffeine. It counteracts 
the effects of narcotic remedies, and fe valuable in the treatment of opium 
poisoning, although not a complete antidote. When taken into the stomach, 
caffeine diffuses readily into the blood, and is eliminated by the kidneys and 
the liver, principally. Small doses increase the appetite and facilitate diges- 
tion; there is some irritation of the digestive tract, increasing peristalsis and 
in some cases causing venous congestion and haemorrhoids. From a dose of 
0.75 Gm. (or gr. xij) of caffeine, Dr. Pratt experienced restlessness, sleepless- 
ness, mental depression, and tremor. A dessertspoonful of the citrate of 
caffeine produced nausea, stupor, extreme pallor and debility, soft pulse, 
slow and sighing respiration; but recovery followed the use of emetics, hot 
applications, and brandy. Zenetz^ calls attention to the dangers of caffeine. 
"With doses of 0,20 to 0.32 Gm. (or gr. iii-v), two or three times a day, the 
blood-pressure rises slowly, but steadily, and the quantity of urine is in- 
creased. Between the fourth and sixth days the patient complains of con- 
striction in the chest, dyspmea, and restless nights, due to increased blood- 
pressure. Death may result from tetanic contraction of the heart. Caffeine 
continues to be excreted, from the urine, for at least ten to fifteen days after 
the last dose is taken; so that it resembles digitalis in producing a cumula- 
tive effect. Caffeine should be used with caution in all renal diseases, in 
arteriosclerosis, and atheroma, and all cardiac diseases secondary to them. 
Another danger of catrcine consists in the existence of idiosyncrai^y or exces- 
sive susceptibiiitj', Zenetz reports three cases of, in his opinion, death from 
caffeine; in each the heart was found to be so strongly contracted that it 
could be cut with difficulty. One was a youn^ man with croupous pneu- 
monia, who was only taking 0.20 Gm. (or gr. iij) three times a day and who 
died suddenly on the third day. 

Therapy. — In migraine, caffeina citrata may be administered, 0.065 Gm. 
(or gr. j) every hour, with excellent effect; or a cup of strong tea or coffee 
given. Where there is co-existing liver, kidney, or stomach disorder, a purga- 
tive should begin the treatment. Anaimic headache also may be relieved by 
the administration of caffeine. The hypodermic injection of this agent is 
eometinicfj dhciciit in nenrnlgin ; or it may he administered as follows: — 

R Caffeinie cilnvtie ... ij30 Gm. or gr. x-\. 

Acetphpnctidin 

Pulv. aromntic ftft 2[ Gni. or Sss. 

M. ct ft. c:liurtulue no. .\. 

Sig.: A powder every two or three hours. Serviceable in migraine, and in neu- 
ralgia about the scalp, face, and in sciatica. 



' Wiener mcdicinlsche Wocftrnschrift, Dec. (*. 1809. 



CAFFEINA. 287 

H CaffeiiuB citrat 1|30 Gm. or gr. xac 

Acetanilidi 1 30 Gm. or gr. xx. 

Ext. cannabis IndicflB |20 Gm. or gr. iij. 

M. et ft. capsuls no. x. 

8ig.: A capsule every two or three houra for neuralgia. 



B CkfTeinse citrat. 

Ammonii bromidi 12 

£lix. guarans 60 



Gm. or 38S. 
Gm. or 3iij. 
e.cm. or fSij> 



M. Sig.: A teaapoonful every hour or two until relieved of pain of neuralgia. 

In despondency and hypochondriaflis, caffeine, or a cup of hot coffee 
infusion, will sometimes serve a good purpose. It may be given in order to 
dissipate the drowsiness which is often produced by a hearty dinner. 

As a cardiac stimulant in valvular diseases, dilated or fatty heart, or 
in the myocarditis accompanying rheumatism, in low fevers, and in dropsy 
due to weak heart, caffeine may be given hypodermically (0.065 to 0.13 Gm., 
or gr. i-ij, every two to four hours), or the sodio-benzoate may be employed 
as recommended by Huchard. When being administered in these cases, 
caffeine vn\\ sometimes give rise to so much insomnia that its use will have 
to be abandoned, or, at least, temporarily suspended. Dr. Petrescu, of 
Bucharest, indeed, claims advantage from largely increasing the usual doses, 
uid states that he has administered with good effect as high as 2 to 4 Gm. (or 
gr. xxz-lx) daily for several consecutive days. Misrachi recommends the use 
of the sodio-benzoate in puerperal haemorrhage, and states that when given 
hypodermically it acts more rapidly than ergot. In chronic Bright*s disease 
caffeine diminishes albuminuria and dropsy. It may be used in co-operation 
with hydragogic cathartics in ascites. Ursemic coma may sometimes be 
lightened by the hypodermic administration of caffeine. The hypodermic 
injection of caffeine is also of assistance in the treatment of opium poisoning. 
It may be used during the intervals of administration of digitalis, or, where 
this drug is too slow, given in the following combinations: — 

H Caffeine citrat 3{25 Gm. or gr. 1. 

Liquor potaasii citratia, 

SpirituB etheris nitrosii 

Infua. digitaUa aa 60| c.cm. or fjij. 

M. Sig.: A half-teaapoonful in water every three or four hours. Employ in 
T»lTuUr insufficiency, attended with dropsy. 

In weak, dilated heart, with gouty tendency, and in nephritis, the fol- 
lowing are useful: — 

H Caffeinse citrat., 

Lithxi citratia aa 6 £ 

Strychninee sulphat. 

01. gaultherise 

H. et ft. capaulffi no. xz. 
Sig.: One every four hours. 

B Caffeinae citrat. 3 i 

Tinct. atrophanthi 4 f 

Aqne camphorse 90 

M. Sig.: A teaapoonful three times a day. Use in parenchymatous nephritis 
Attended with dropsy. 

In pneumonia, or congestion of the lungs with weak heart, in elderly 
patients, caffeine is an excellent remedy in moderate doses (0.065 to 0.13 Gm., 



50 Gm. or gr. c, 
015 Gm. or gr. V*. 
30 c.cm. or mv. 



26 Gm. or gr. 1. 
50 Gm. or tnlxx. 
c.cm. or fjiij. 



288 



riLARMACEUTICAL TnEILVPECTIC AGENTS OR DRUGS. 



or gr, i-ij, given hypodermicallj every two to four hours). It is likewise of 
value in the weakened heart of typhoid fever and pneumonia, after the febrile 
Btage has passed. In the diarrhoea of relaxation, typhoid fever, sporadic 
cholera, etc., the sodio-beuzoate or sodio-salicylate may be used, in combina- 
tion with nux vomica or strychnine. 

Cholera infantum and the diarrhcea of phthisis are "not infrequently 
benefited by caffeine. An asthmatic parosy&m may often be relieved by thia 
remedy. On account of its tendency to produce wakefulness it has, gen- 
erally in the form of a strong coffee (either given by the stomach or injected 
into the rectum), long been a valuable adjuvant in the treatment of opium 
poisoning. 

Caffeine Tri-iodide. — This compound, a dark-green crystalline sub- 
stance, readily soluble in alcohol, is a slinnilant and diuretic, which has been 
used in cardiac dropey in the dose of 0.13 to 0.25 Gm. (or gr. ii-iv). 

Caffeine-flulphonic Acid. — This compound, introduced by Drs. Heinz > 
and Liebrecht, is claimed to stimulate the secreting power of the kidneys 
without increasing blood-pressure. It has been given in the form of a so- 
dium combination, and, while acting as a good diuretic, had no ill effect 
upon the digestive processes. The salt is, therefore, well adapted to the 
treatment of cardiac or renal dropsy. Caffeine-sulphonic acid will also unite 
with lithium, and it is thought that this salt will prove useful in lithiasis, 
gout, and gravel. 



CAJUPUTI OLEUM (U. S. P.).— Oil of Cajuput. (See Oleum Cajuput 
CALAMUS (U. S. P.).— Calamus (Sweet Flag). 

Preparation. 



ti.) I 



Fhii»U*\t(Tirtiiin Calmni (L". S. P.). — Fluid Extract of Calamus. Doee, 1 to 
4 ccni. {or mxv-f3j). 

Pharmacology. — The dried, unpefled rhizome of tlie Acorus calamiid 
(Aracoiv) h slitrhtly nromjitic and quite puncront to the tisto, and is car- 
niiiijuivo. It coiiTaiiiji n noutrnl. bitter glucoside, Acorin, a nitrogrnons prin- 
ciple» rt volatile oil, benzoic acid, etc. 

Therapy. — In consequence of its feebly-aromatic taste, calamus is some- 
times useful, and is popularly employed, in overcoming a tendency to flatu- 
lence, by chewing it slowly and SM-allowing the saliva. It is sometimes 
adopted as a subslitute for tobacco, }jy those who desire to overcome the 
hal>it of chewing. It is a constituent in various "bitters'* used as appetizers 
and stimulants. An infusion (31 Om. to 47^ c.cm., or o^-Oj) may be ad- 
ministered in wineglassful doses as a stomachic tonic. 

CALCIUM.— Calcium. 

27. S. P. Salts and Preparations. • 

Calx. — Lime. Calcium Oxide. Not used internally. 

Calx Chlorinatft. — ChlorinnttNl Lime ^available chlorine, at least 30 percent.); 
often improperly callvti Hiloriilt* of limp. 

Calx Sulphuratn. — .Siilphurnted Lime iTnuJe Calcium Sulphide). A nuxture 
containinir nt lenHt ()(1 ppr ccnx. of ('jiIciniM Mrnittsiilpliide, to^etlier with unchanj^ed 
Calcium Snlphntp, and fitrlKni. in varvifi^ [irnportion*. Dow?, 0,01,j to 0.13 Oiiv (or 
gr. Vri.il. 

Caloii Broinidum.— Calcium Bromiile. Dose, 0.65 to 4 Gm. (or gr. x-5j). 



I 




CALCIUM. 



289 



ObIcU CftrboiULS Prsecipitatus.— Precipitated Calcium Carbonate, X>o»e» 0.65 to 
CJBO«. (or ft. 3L-xl). 

Caleii Caloridum. — Calcium Chloride. Dose, 0^*2 to 2 Gm. (or gr. v-xx). 
C^ktt Uypopltoftphia. — Calcium Hypopho&phite. Duao, 0.65 to it Om. (or gr. 

C&lc&i Fho»{>liA» l'nin:ipitalus. — Precipitated Calcium Phoflphate. Ooae, 0.65 to 
Z G^ <or gr. x-xxx}. 

CWWii rtqtphaa Exsiccttus.— Dried Calcium Sulphate. Contains 05 per cent., b; 
of calflsum sulphate and about 5 i>cr cent, of water. (Plaster of Paris for 
ponxMea.) 
OtwiM Ww'parata.— Prepared Chalk. Dose, 0.05 to 1.30 Gm. (or gr. x-xx). 
Hrrlmrpyrum cum Cveta. — Mercury with Cliatk (mercury, 38 Gm.: rhftlk. 57 
^4^U together with honey and water and afterwards dried). Doi^, 0.065 
lor gr. i-x). 
iaBini«ntttsn Calcic. — Lime Liniment (ei)ual parts of linie-water and linae«d-oll). 
OImibaI nae (fomierly known as carron-oil). 
Uqr- ^ -^ is. — tSoluliMn of Calcium Hydroxide, or Lime-water. Dose, 15 to 60 
. (ix A saturated solution containing not Ichi^ than 0.14 per cent, of 

Wd. .f Umc. 

MiacmrM cri?t;r,— Chalk Mixture (compound chalk-powder, cinnamon -water, and 
trU Doa«, 4 to 15 c.cm. (or f3i-iv). 
PkHaaaa cum Calce. — Pota«sa Vith lime. Vienna or Caustic Paat« (equal parta 
' fy>4ii^««i and lime|. 

'*rrtae Compositus. — Compound Chalk-powder (prepared chalk, 30 Gm.; 
■E^ ::t.; sugar. 50 Gm.). Dose, 0.32 to 2 Gm. (or gr. vxxx). 

■'3'nipus Calci*. — Syrup of Lime. Dose, 2 to 4 cxrm. (or f3as-j). 
Sjrupus Calcii I^actophosphatis. — Syrup of Calcium Lactophosphate. Dose, 4 
^ IS r,«m. (or f3i-i%'t. 

Si I mm * nypophosphitum. — Syrun of the Hypopho9phit«R (calcium, 45 Gm.; 

15 Gm. ; sodium, 15 Gm.; dilute hypophosphoroufl acid, 2 (Jin.; spirit ol 

_ar, sod water to make 1000 c.cm.). Dose, 2 to 15 c.cm. (or fSse-iv). 
drrvpos Hypophosphitum Compositus. — Compound Syrup of Hypophosphite* 
""Ba cftlriuDi hypopho^phitc, 35 Gm.; potassium hypophospliitc, 17.5 Gm.; 
lijpophosphite, 17.5 Gm,; ferric hypopho^phite, 2.25 Gm. ; manganese hypo- 
s' Om.; quinine. 1.1 Gm.; strychnine, 0.115 Gm.; sodium citrate, '3.76 
4U«tail hjpophoHpliunis lu-iil, 15 c.cm.; siigur and water to UHH) c.cm. I. Dose, 
4 to IS cm. <or f3i iv). 

B. P. Salts and Preparations. 

Calx. — Ljbi« (obtained by calcining chalk, lime-stone, or marble). 
C^x Cblorinata. — (^lonnated Lime, containing 33 per cent, of available chlorine: 
C^Xx S^iilpburata. — Sulphurated Lime (a mixture containing not much less thai 
9 Mr ••at. of calcium sulphide [CaS], with calcium sulphate and carbon). Dose, 
«4U to OJMS Gm. (or gr. 'Aj). 

ChlcU C&rbonas Prwcipitatus.— Precipitated Calcium Carbonate (Precipitated 
k>. T>o«e. 0.65 to 4 Gm. (or gr. x-lx). 

Calcfi Chloriduni. — Calcium (^orlde. Dose, 0.32 to 2 Gm. (or gr. t-xxx). 

QUctt Hydras. — Calcium Hydroxide (Slaked Lime). 

Cklcii Hypopbo»phis. — Calcium U\ pophosphite. Done. 0.65 to 2 Gm. (or gr. 
x». 

i:alril Pho«phaii. — Calcium Phosphate. Dose, 0.32 to 2 Gm. (or gr. v-xxx). 

Cnrta Pr»parata.— Prepared Chalk. Du«ie. 0.n5 to 4 Gm. (or gr. x-lx). 

Hyiiimjgyiu gi cum Creta. — Mercury with^Chalk. Dose, 0.065 to 0.32 Gm. (or 

U^Qor CVilcis. — Solution of Lime (Lime-water). Dose, 30 to 120 c.cm. (or fji-iv). 
Lsqoor Calciii Chlorinatw. — Solution of Clilorinated Lime (3 per cent, of avail- 
■" ' r). Dose. 1.20 to 4 ccm. (or mxx-fSj). 

liqvor Calcts Saccharatus. — Saccharated Solution of Lime (calcium hydroxide. 

a Qhlj refined sugar. \00 Gm.; distilled water, 1000 c.cm.). Dose, L20 to 4 com. 

i-lx). ContainM alwut 2 per cent, of calcium hydroxide. 

L iMUwii tiim Calci«. — Liniment nf Lirne (equal parts of lime-water and oHve-oil). 

Lodo Hydrargyri Flava. — Yellow Wash (corrosive sublimate, 0.46 Gm.; lim*- 

L). 

IS 




290 



PHAttMACEUTICAL THERAPEUTIC AOEN'TS OR DRUGS. 



Lotio Hydrargyri Nigra. — Black Wash (calomel, 0.685 Gm.; glycerin, 6 e.cm.; 
tragacanth iiutc-ilage, 12.5 c.cm.; lime-water, q. e. ad 100 c.cni.). r^or external use, 

Mifltura Cretse. — Ohalk Mixture, Dose. 15 to 30 c.cm. (or f^as-j). 

Piilvia CretcB AromoticuB. — Aromatic Powder of Chalk (cinnamon-bark, 80 Gm.; 
nutmeg, GO Gm.; clovea, 30 Gm.; cardamom-aeeds, 20 Gm.; sugar, 500 Gm.; prepared 
ehalk, 220 Gm.). Dose. 0.65 to 4 Gm. (or gr. x-3j). 

Pulvis Crelfie Aromaticus cum Opio. — Aromatic Powder of Chalk with Opium 
(containing 0.005 Gm., or gr. j, of opium in 2.00 Gm., or gr. xl). Do»e, 0.05 to 1.30 
Gm. (or gr. x-xx). 

Syrupus Calcii Lactophosphatia. — Syrup of Calcium Lac to phosphate. Dose, 4 
to 16 ccm. (or f3i-iv). 



Pharmacology. — Lime is an alkaline earth which is usimlly obtained by 
calcining any native calcium cnrbonate, such as chalk, liuiestoue, or mar- 
ble, driving off tlie CO, and leaving enlcium oxide, which, when fresh 
from the lime-kilns, is in large, hard, grayish-white masses. In this stnte 
it is known as quicklime, which has a great afl&nity for water, even slowly 
taking it from the air. Under the inflnence of moisture, lime generates bent 
and breaks np into a wet powder, which is a mixture of calcium oxide and 
calcium carbonates, and constituteB slaked fine. When tliis is mixed with 
three or four parts of water, the product is called ''milk of Ume.'^ It is 
alkaline in taste and reaction. Calcium oxide is only slightly soluble (1-760) 
in cold, and even less so in hot water. Chalk, or calcium carbonate, is a 
valuable antidote in cases of poisoning by carbolic, sulphuric, or oxalic acid. 
It is found in the household in tooth-powder, convcjuent for prompt adminis- 
tration. 

Physiolog'ical Action. — Some preparations of lime are sedative, others 
astringent or caustic; quicklime is irritating and caustic to mucous mem- 
branes. Lime-water and chalk are astringent and alkaline; they reduce the 
acidity of the contents of the alimentary canal, thus relieving irritation, and 
filso exert a slightly aptringent effect. In patients suffering from deficiency 
of lime in the food, lime-water is a useful and acceptable remedy, and may 
be continued for a long time. Calcium phosphate serves an important func- 
tion in promoting the nutrition of the motor apparatus, — bone, cartilage, 
tendon, and muscle. The presence of a certain proportion of lime-salts in 
the blood is essential to general nutrition. When this amount is reduced, 
disturbances arise, affecting particularly the bony and lymphatic glandular 
Bystems. Calcium chloride is more of an irritant; it has a reputation for its 
influence as an alterative. Pota.ssa ^vith lime, or Vienna paste, is used in sur- 
gery as a caustic. According to the investigations of M. Binet, the salts of 
the alkaline earths are capable of causing respiratory and cardiac affections. 
from which death may directly ensue. They may also cause derangement 
of the gastro-intestinal system. Eventually they may occasion loss of nerv- 
ous excitability and muscular contractility. Toxic doses of calcium arrest 
the heart in systole. Calcium exerts a special action upon the nervous sys- 
tem, occasioning a condition of torpor with preservation of reflex excitability 
and sensibility. 

Therapy. — Lime is an ingredient in depilatory powders, which are now 
superseded by the process of removal of hair by electrolysis. Freshly-slaked 
lime absorbs the products of decomposition, and is used ar a disinfectant in 
cess-pools, manure-heaps, etc.; but the chlorinated lime, which prevents de- 
composition by virtue of the available chlorine, is far better. In the treat- 
ment of onychia maligna. Professor Vanzetti recommenils the application of 




CALCIUM. 291 

caustic lime. Lime-water is a stimulating dressing for wounds and ulcers, 
and, combined with oil, is used as a dressing for bums. <jarron-oil consists 
oi linseed-oil and lime-water. It is suggested that the addition of V, to 1 
per cent, of thymol augments the value of carron-oil by rendering it aa anti- 
septic application. A better dressing is made by beating up lard (unsalted) 
with lime-water and adding a few drops of oil of bitter almonds. A very 
good prescription to use in bums will be: — 

B Calda pnecip " 41 Gm. or 3j. 

Phenolia Uquefact 8| Gm. or 3ij. 

01. olivEB, 

Aqiue calciB a& I60| ccm. or f^v. — M. 

Carron-oil also relieves pain caused by the stings of wasps and other in- 
sects. According to Dr. Joseph Bell, applied to the face on a mask of 
cDtton-wool, it will decidedly diminish the pitting in small-pox. 

lime-water is of undoubted value alone, or combined with glycerin, in 
the treatment of acute vesicular eczema. It may be employed for this as 
well aa other varieties of eczema, especially when the surface is dry and irri- 
tahle, with very great relief. Pruritus, which often becomes intolerable in 
eczema and other inflammatory afections of the skin, and itching present 
in old persons, may be relieved or cured by the application of lime-water, 
with rose-water, glycerin, or one of the oils. A very suitable application in 
the diseases just referred to is: — 



B Liquor calcis 90 

CreosoU 

Pulveris zinci carb. (impur.) 31 

Glycerini vel ol. oUvfle 90 

M. Sig.: Shake well and mop over the surface. 



c.cm. or fSiij. 
60 c.cm. or mx. 
Gm. or 5j. 
ccm. or f3>ij< 



For the relief of pruritus ani. Dr. A. L. Berger advises the use of a 
pledget of cotton-wool soaked in the solution of chlorinated lime and intro- 
duced into the bowel. In seborrhoea, hyperidrosis, bromidrosis, and in 
bruises of the skin and deeper structures, the preparations of calcium are 
often used with great benefit. The following are excellent combinations: — 

9 Calcii carb. prsecip. 3I{ Gm. or Sj- 

Glyceriti boroglycerinie 16| c.cm. or fSw. 

M. Sig.: Smear over the parts bniiaed. 

Q Calcii chloridi, 

CUdi carb. pnecip., 

Pulv. amyli aa 31| Gm. or 5j. 

M. Big.: Dust over the aurface, eapeciaUy in oily conditions of the akin and in 
exceasive and fetid perspiration. 

Prepared chalk is employed very largely, alone as well as an ingredient 
of many very good dentifrices, on account of its antacid, astringent, and 
sedative action upon the gums and the mucous membrane of the buccal cav- 
ity. Garreteon recommended the appended formula as being a good tooth- 
powder: — 

9 Crettt prepAT., 

Polv. uidis Flor. aa 1616 Gm. or Jaa. 

PuIt. osais sepice 8| Gm. or Sij. 

Olei limonis q. a. — M. 



292 



i'UAiiilACKUTlCAL TiiEK-iPKLTlC AGKNTS OH. DUUOb. 



Prepared chalk is a good dusting-powder in intertrigo and hyperidroE 
and may be used upon the surface of ulcers as a protective dressing. 

The preparations of calcium are especially useful in childhood because 
of the deficiency of lime in the food of many children. Lime-water added 
to milk gives material foV bones and teeth, improves nutrition, and overcomea 
a tendency to rickets. It relieves irritability of the stomach and vomiting. 

The syrup of lime, or the English saccharated solution of lime, contains 
more of the base than the solution, and is a convenient antidote to poisoning 
by oxalic, sulphuric, and other mineral acids. In children's diarrhcea, often 
due to sour stomach, chaUc mixture is very useful, and may be combined with 
an antiseptic and opiate: — 



n 



Creoaoti 

Tinct. opii caxnph. 

Mist, creta , 



124 



c.cm. or wiiv. 

4] c.cm. or f3j. 

q. s. ad 6o| ccm. or fjij. 
M. Sig.: A teaapoonful every t^o hours to child two years old. 



4 



The same mixture is useful in adults, with corresponding increase of 
dose and the addition of a decided astringent, such as tincture of kino, or 
fluid extract of coto-bark. 

The following combination is said to be useful in phthisis and chronic 
pulmonary alfections: — 

B Creosoti 10 

Alcoholia {90 per cent.) 90 

Calcli phophat 10 

Aqus deatilUta 18 

Syrupi 106 

Vini alba (Mnlnga) q. b. ad lOOO 

Each tablespoonful contains about 0.16 c.cm. (or miias) of creosote and 
0.32 Gm. (or gr. v) of monocalcic phosphate.* 

Other very effective prescriptions containing lime are: — 



c.cm. 


or fSiimxl. 




c.cm. 


or f5iij. 




5 Gm. 


or 3v. 




6 c.cm. 


or (Zy. 




c.cm. 


or fjiiiu. 




c.cm. 


or Oiifjij.- 


-M. 



M. 
rhoea. 



Calcii carbonatiB pr»cipilflU 12 

Tincttirte gambir 30 

Tincturae opii 7 

SpirituB chloroformi 15 

Pulvcria acaciic B 

Aquee menth. pip 195 



Gm. or 5iij. 
ccm. or f5j. 
c.cm. or f3ij. 
c.cm. or fSiv. 
Gm. or 3ij. 
c.cm. or fSviBs. 



Sig.: One or two tcaspoonfuU in water every hoar or two, for acute diar 



^ Liquor calcis, 

Fluidext. coto eorticie, 

Syrup, acacin ua 30| c.cm. or fSj. 

M. Siff.: From one to two teaspoonfuU in water or milk every three or four 
hours, for chronic diarrhtea. 



nii^ ' 



Special Applications. — In tlic diarrhcea of relaxation in young children 
lime-water alone may be sufiiciont where the motions are too frequent and 
watery an<l ncid iu their reaction. It is also used per e»ema against threail- 
wonni-\ nritl it niflv be given as an injection in leucorrhtea. In fliphtheria 
inneh relief is experienced from tlie use of a spray of lime-water, preferably 
with the steam-atomiwr, directed to the fauces, or from inhallnt^ the vapors 
from ;*laking lime; it is chiimod that the lime loosens the fnlse membrane 



' Journal de» FraUclem, Feb, 24, 1900. 




OALCIUM. 



293 



^^ fnArTi'filtt' flic^lves it. It is also useful in the same manner in croup and 
fii- The vapor obtained from chlorinated lime Ib advantage- 

m.- n hay fever. In adults, where it is desirable to administer 

OBi u found necessary to add lime-water to it to prevent curdling. 

Ic il feeding of infants the addition of lime-water to cows' milk is 

«f —nr^ by rendering the curd more soft and flaky, and conse- 

^- of digestion. Milk and lime-water will not infrequently 

■fci: - ... : . .-., and even, in some instances, the pain of gastric carcinoma. 

Ib ihe UttPr affection it also allays the vomiting. The prolonged adrainis- 
traooD of lime-water renders the urine alkaline, and hence it may prove use- 
t%\ iti lithiasis. It has been shown that, under the same circumstances, car- 
hoBiic acid may appear in the urine. The acid is united to the lime and 
oom the fluid to emit an ammoniacal odor. In combination with opium 
flid aromatics, as in the puh-is creta^ aromaticus cum opio of the British 
r^limaiojiii ill chalk is of great value in diarrhoea. The carbonate of oal- 
CHB is likewise beneficial in diarrhoea, and, finely powdered, is a good 
rroplicfttioB in intertrigo and acute eczema. Calcium phosphate is useful in 
-^^i^f; also in amemia, general debility, diarrhoea, in small doses, given 
--vpentlj ; it appears to have a stimulating effect upon the liver, and sliould 
^ jn^'f*!! in preference to mercury to infants with clay-colored stools, and 
jamidioe. The anemia due to profuse suppuration, or to lactation, may 
- remedied by the administration of this salt. It is advantageous, more- 
»»T!f, in molHties ossium, delayed union of fractured bone, caries and 
rwTT^U. and scrofulous inflammation of the lymphatic glands. The 
nd phosphate has been warmly recommended as relieving the sickness 

hurata is useful in styes, acne, and furuncles; given in 0.015 
ift u.<^ Giii- vor gr. V4-^) doses several times a day, it hastens maturation of 
^talci. If given early, it prevents the formation of pus, but, if suppura- 
&Ma liaa occurred, calcium sulphide limits its extent and favors early and 
anaplete evacuation. This combination is serviceable in both acu^e and 
c^rrrtdc eczema. It is likewise beneficial in the suppuration of scrofulous 
liMtdc. Dr. Frank P. Norbury finds it useful in acute tonsillitis, especially 
tf atmiDOUs patients, with a tendency toward rapid suppuration. It prevents 
m limits the formation of pua. Dr. Witherle, of St. Paul, states that cal- 
OTm iulphide is beneficial in the early stage of pulmonary tuberculosis, 
• n in ao$e8 as large as can be tolerated. The swelling of the upper lip and 
of the nose so often seen in scrofulous children may be decidedly ira- 
MVT«d br the exhibition, night and morning, of 0.015 Gm. (or gr. V«) doses 
il«mlcinin sulphide. In diphtheria, during the period when the membrane 
slaoarning and suppuration is taking place, Phillips recommends the ad- 
kzBtfCration of this salt in doses of 0.01 to 0.015 Gm. (or gr. V»-V«) every 
fevor everv two hours. A case of elephantiasis has been reported in which 
Aa ftaJt was" successfully employed. 

It is given with good effects in ophthalmia and sores in scrofulous chil- 
hm. Calx eulphurata is the official equivalent of calcium sulphide, which 
te iMen U5ied in conjunction with defervescents by Dr. T. M. Lloyd, of 
JkwU^B, N'. Y., in measles and scarlatina, with the apparent result of 
9M/ds^g the course of the fever. In pertussis the same remedy reduced the 
amher and severity of paroxysms. It was administered in doses of 0.03 Om. 
fifp gg\ half -hourly to children between two and five years of age. Rubbed 



i 




294 



PHARilACEUTICAL TUERAPEUTIC AGENTS OE DRUGS. 



up with sugar of milk it was taken without repugnance. This salt will occa- 
sionally produce an eruption of vesicles, pustules, and furuncles. Dr. A. M. 
Osness advocates the treatment of diphtheria hy local swabbing with a mixt- 
ure of carbolic acid, tincture of chloride of iron, and alcohol, and the internal 
administration of calcium sulphide, 0.05 Gm. (or gr. ^/^), every half-hour for 
a period of thirty-sis hours, water being taken freely to help elimination of 
the toxin. 

Calcium chloride (not calx chlorata) is given, well diluted, in glandular 
enlargements, and is said to be curative in eczema and lupus; it ia claimed 
that it aids cicatrizatioa in tubercular ulcerations, and is useful in chorea 
and colliquative diarrhoeas in strumous children. Calcium chloride allays 
vomiting produced by the presence of sarcinae ventriculi. 

Dr. Crombie, of the East Indian medical service, has found calcium 
chloride efficacious in the treatment of boils and pneumonia. Dr. A. E. 
Wright has ascertained by experiment that the addition of calcium chloride 
to blood renders coagulation more rapid, lie has given the salt internally 
with advantage in a case of haemophilia, and suggests that it will prove useful 
in the treatment of internal hsemorrhage and aneurism. He has known it 
to arrest an obstinately-recurring epistaxis and a severe li.rmoptysis. In 
a case of haematemesis and gastro-intestinal haemorrhage in a child 4 days 
old, L. A. Parry^ gave frequent doses of 0.32 Gm. (or gr. v) of calcium chlo- 
ride every hour during the day and every two hours at night. The child 
took 10.35 Gm. (or 160 grains) in three days, when the medicine was discon- 
tinued l^tx-au.sc bleeding had ceased for twenty-four hours. In cases of 
haemopliilia ret|uiring surgical operation, great advantage has been observed 
from the administration of calcium chloride for a few days previous to opera- 
tion, for reducing the bleeding. 

Dr. S. Solis-Cohen prefers the calcium chloride to any other drug in 
the treatment of haemoptysis, administering it in doses of 0.fi5 to 1 Gm. (or 
gr. x-xv) every second hour in glycerin, simple elixir, and water, or infu^Jicn 
of gentian. Dr. Saundby has employed the same salt with success in purpura 
hcGmorrhagica, administering 0.38 Gm. (or gr. vj) every two hours during 
the day. Sir J. Sawyer has employed the chloride in chronic pulmonary 
tuberculosis with good results, and states that in addition to its other advan- 
tages it will often suppress night-swents. Both the chloride and the car- 
bonate have been serviceably given in order to restrain haemorrhage caused 
by a fibroid tumor, and to check menorrhugia. 

Calcium hypophosphitc has a special reputation ff>r the treatment of 
phthisis, and is a useful tniiic in i^uch cases. The official syrup of the hypo- 
phosphites, in appropriate cases, is one of the best general systemic tonics 
that we possess. It may be substituted by the following, when more strych- 
nine or iron iR desired : — 



B Synip. ferri Inctnti:** .... 

Synip. hypophofipliiturn aa 120| c.cm. or f^iv. 

Strychninae sulphatia |015 Gm. or gr. '/•■ 

M. Sig.: A half-tablcspoonfal in water three times a day. 

Calcium bromide was brought forward, by Hammond, as a substitute 
for bromide of potassium in cases where the depressing effects of the latter 

^The lAJncei, July 16, 1898. 




CALCIUM. 



295 



^^■■Jd forbid its use, such as epilepsy or chorea in auiumie subjects (in do&eg 
^^^■to S Gm.y or ."te-ij). Professor Germain See regarded both the bromide 
HHa cUoffide aa advantageous in the treatment of dytipepsia and many dis- 
Vvflcd eoDditions of the stomach. This salt would, however, seem well 
" rfw ttfd to falfill the indications of a bromide in rachitic subjects. The bro- 
'«nrifi held to coaiain one-sixth more bromine thnu the potassium bromide. 
Hq^ Woods prefew the calcium oxyiodides to the other iodine preparations, 
LsowUiining more iodine. According to the testimony of Dr. Beebe, who 
^■b OMTobomted by Dr. Lawrence, idorlized calcium is of service in mem- 
HWmmmu croup. These writers advise that 0.01 to 0.02 Gm. (or gr. */«-'/■). 
B ftifcln d in wnter, should be given every fifteen, thirty, or sixty minutes, 
> a atdiii y to the severity of the symptoms, (irube reported^ good resultB 
B dUbetCB nnellitus from the *'cgg-sheir' treatment, the patient talking a 
lutponnfol of powdered egp-shdl daily. This is also useful in boils. He 
W# suggested a powder in imitation of egg-shells for the same jnirpose and 
n-fH>rtfi very encouraging nsults. (1 rube's powder contains calcium car- 
V-oate, 93 parts; with calcium phosphate and magnesium phosphate, each, 
I V> parts. Of this4 Gm. (or 3j) are to be tak^ daily. The syrup of calciiun 
ketophoephate (made by dissolving calcium phosphate in lactic acid, with 
OBge-flover water and syrup) is a pleasant and very useful remedy for im- 
mrrtag- nutrition in young children, especially if there be a scrofulous taint. 
u contains about 0.75 Gm. (or gr. xij) of calcium phosphate in each ounce. 
It ss also a valuable agent in treating many skin diseases due to malnutrition. 
rU« combination may be advantageously prescribed, in vesicular emphysema, 
chnmic bronchitis, phthisis, debility, and wasting diseases, thus: — 



B ^jTup. calcii laotophosphatis 90 

OIri gmultherie 2 

PttlTeii* aeacue 4 

f.|ooor pfluicrestici 30 

OIm morrbufle 150 

3C «t ft. «IDUlU0. 

S^i A tableepoonful three times a day. 



c.cm. or fjxij. 
c.cm. or nixxx. 
Gm. or 3J. 
com. or fjj. 
c.cm. or fjv. 



Dr. H. V. Knaggs ascribes valuable antispasmodic properties to calcium 

balphiie, in spasmodic diseases. He gives 0.003 Gm. (or gr. Vzo) to a child 

TIBS Tear old, sutTcring with convulsions from dentition, meningitis, and even 

Btc tuberculosis. A saturated aqueous solution of the bisulphite is an 

,11. .^f non-poisonous disinfectant. The preparations of chalk, if given 

sea for a considerable period of time, may form intestinal concre- 

V nicium salicylate, a salt which is soluble in water, has been recom- 

^'^tod^d as a remedy in diarrhrea, especially that of children. The dose is 

ftvwn 0.50 to 1.30 Gm. (or gr. viii-xx), and it is given either alone or combined 

vitb bsaznuth aalicylate. It is a white, odorless, and tasteless crystalline 

povdcr. 

Calcinm carbide has been used in inoperable cancer of the uterus by 

of St. Petersburg, for its caustic action when brought in contact 

vater and the disinfecting properties of the acetylene. Under its use 

rhaiM? has been checked and the ulcerative processes retarded. 



» Thems>mtl9cKe MonaUchefte, May. 1890. 




296 



PUAItilACEUTICAL THEKAPKUTIC AUEX'fS OH UULU». 



Calcium Eosolate is a eulphosalt of the aliphatic creosote esters, 
and is said to contain 25 per cent, of creosote. Its formula is given as 
(CpH-S^^O, 2)3083. In lar^^e doses it produces griping pains in the intestines, 
with diarrhoea. The tlierapeutic dose is from 0.25 to 0.65 Gni. (or gr. iv-x) 
three or four times a day. It is a grayish powder, feeling to the touch like 
finely-pulverized pumice-stone. Its odor is slightly punirent and somewhat 
ethereal, its taste a little acrid and leather)-. It is soluble in from 8 to 10 
parts of cold and in 7 parts of hot water. It is very slightly soluble in 
alcohol, and insoluble in chloroform nnd turpentine, but is readily dissolved 
by hydrochloric, citric, and by some other organic acids, while it dissolves 
only slowly in acetic acid. 

Dr. Heinrich Stern,* of New York City, gives the hii^tory of a remark- 
able case of diabetes inspidus, in a boy of sixteen years, who was passing over 
one and one-half gallons of urine per day that had a specific gravity lighter 
than water. He was dwarfed in stature to that of a child of seven years, and 
for a long time had shown no signs of development. Under the calcium- 
eofiolate treatment, in conjunction with 3 c.cra. (or wixlv) doses of fluid ex- 
tract of ergot four times a day, h^ for the first time in years steadily began 
to increase in weight, lost his nervousness, the hydruria gradually dimin- 
ished; though occasional increases occurred for a brief period, there was an 
increase in the excretion of solids, and thirst was diminished. At the time 
of the report the patient still continued to improve. 

Five cases, reported by Dr. Stern, of diabetes mellitus under treatment 
with calcium eosolate and a milk diet ceased excreting dextrose, gained in 
weight, and improved otherwise. One of the cases at a later date died of 
endocarditis. Ten cases of phthisis showed decided signs of improvement 
under small doses of the eosolate in conjunction with other remedies. 



4 



CALENDITLA (U. S. P.).— Marigold. 

Preparation, 

Tinctura Calendulae {U.S. P.). —Tincture of Calendula (20 per cent.). Dose, 2 
to 4 com. (or fSss-j). 

Pharmacolo^ and Therapy. — The dried ligulate florets of Calendula 
oflBcinalis (CrtiupcKitje) rnntuin Calendulin, n vulntile oil, an a!Mor]dious bit- 
ter prinriplr, yellow coloring mutter, ptc. It is used hs mi emmeuagogue 
and as ii diaphoretic, in rt-cent infusion. Ju the form of tincture, it is 
reputed to he Ionic, antispasmodic, and alterative, and may be employed 
locally as a revulsive in 8i)rains, bruises, or in superficial burns and scalds, 
resembling nmica in its applications, though less active. 

CALITMBA (U. S. P.)-~Ca!umba (Columbo). 
CALTTMBiE BABIX (B. P.).— Calumba-root. 
Dose, 0.32 to 0.65 Gm. (or gr. v-x). 



Flnidextractura Cnhimbfe 
to 2 c-cm. (or wixv-xxx). 



Preparations, 

(U, S. P.).~nuid 



Extract of Calumbu. Dose, 



* Journal of the American Medical Association, xxxiv, p. 467 




iWMIUHMA. 



297 




CoJumbfle (U.S.?., B. P.)-— Tincture of Caliuuba. Dose, 4 to 7.6 ccm. 

Lienor Calumbe Cooccntratus (B. P.) . — Concentrated Solution of Calumba 
flcafaan^, fiOO Gm.; alcohol [90 per cent.]. 225 ccm.; distilled water, q. b. ad 1000 
L|. Dose, 2 to 4 c.cm. (or f3as-j). 

Imforam Cklumboe (B. P.). — Infusion of Calumba (5 per cent.). Dose, 15 to 30 
L (orOa^j). 

Pharmacology. — The dried root of Jateorrhiifia paluiata (Meuisper- 
I*. ) ; Jiitoorrhiza Cnlumba (B. P.) of Africa contains, among 
El -, bcrboriuo, calunibin, calumbic acid, and starch. It is free 

fi«n tannin, and therefore its iiiT'i)arationg may be coml»ined with iron. 

Tliymiolog^cal Action and Therapy. — In composition and physiological 
Acdon calumba. resembles quassia and gentian, though lighter and more 
acrveible than some of the other remedies of this class, and more acceptable 
to the etomach. As a bitter tonic, calumba may be used during conva- 
laccooe, or in atonic dyspepsia or other enfeebled constitutional conditions. 
h a bcliered to be somewnat sedative and antispasmodic; in cases where 
tikii qaalitj is required it would be better to use the fiuid extract or powder 
ftca th€ tincture. A small dose of the tincture or infusion of calumba will 
iftcn rdiere nan&ea and vomiting. Atonic diarrhoea is benefited by calumba. 
When the tincture is prescribed as an appetizer, the danger of forming the 
akdiol habit should be kept in mind: — 

B Ext. calombsB 13 Gm. or gr. ij. 

Sodii bicarb 05 Gni. or gr. x. 

PoIt. rhei 32 Gm. or gr. v. 

Pair, zingiberis 66 Gm. or gr. x. 

If. «t ft. chart. Mitte tales no. xxx. 

Si|r. : Take one before each solid meal, for weak digestion. 

As m good carminative mixture Dr. Crutchfield prescribes: — 

R Tr. cAlotabs lit c.cm. or f3iij. 

8p. ammoD. aromat. 6 c.cm. or fSiM. 

Tr. eardam. co ,.., q. a. ad 90) com. or fSiij. 

M. Poflc: Tableapoonful in water aa required. 



■ 



Dr. Schultz has had very good results from the tincture of calumba in 
^ trestment of gastric catarrh. Calumba has been especially recommended 
m a Talnable tonic in convalescence from influenza. Dr. A. F. Myers,' of 
■»aming Glen, Pa., considers calumba as the best of the vegetable tonics; 
loth as a stomachic in mild forms of dyspepsia and as a general corroborant 
ia the convale^ent stage of acute diseases and in general debility. 

CAMBOOIA (U. S. r.. B. P. ) .—Gamboge. Pipe Gamboge. 
Boae, 0.006 to 0.20 Gm. (or gr. Vio-i»j)- 



raui 



rgr hr Tlij). 



Preparation, 

Cambogiir Compofcita (B. P.). — Compound Pill of Gamboge (containing 
Bftrbadoea aloes, compound cinnamon powder, of each. 1 part; hard soap. 2 
ffyrup of glucose. 1 part Mix to form a maaa). Dose, 0.25 to 0.50 Gm. 



I 



* Mf^it^^ o^^ Siirfficat Rtporttir, May 16, 1898. 



29 s 



PIIAUMACEUTICAL THERAPEUTIC AGENTS OK DRUGS. 



Phannacolog:y. — Gamboge is a gum-resin, obtained from the Garcinia 

Hanburri ((TiittilVne) : a tree of Siam. It consists largely ol* cambogic acid 
(73 per cent.), and is partly soluble in alcohol and ether, and forms an eraul- 
eion witli water. It has no oflicial propiirationa in the United States Phar- 
maeopoein, and is rarely administered by itself, but is a constituent of the 
compound cathartic pill (enoli pill containing 0.015 Gm., or f^r. ^/^, of gam- 
boge). 

Physiological Action. — Gamboge is not a systemic, but a local, irritat- 
ing purgative. It is at first insipid, but aftenvard produces an acrid taste, 
with increased secretion of saliva. In tJie intestinal tract, it has a drastic, 
hydriigogic, cathartic effect. It stimulates the intestinal glands, but not the 
liver (Eutherford)» and is also believed to have some power as a diuretic, as 
it imparts a bright-yellow color to the urine. It carries off the bile in the 
intestinal canal and prevents reabsorption. Large doses cause vomiting and • 
gastro-enteritis. 

Therapy. — Gamboge has no local effect beyond staining the skin. It 
was formerly used in cardiac dropsy as an hydragogic cathartic to carry off 
large quantities of fluid and promote absorption, but the compound jalap- 
powder accomplishes this result more quickly, agreeably, and certainly. 
The comptDund cathartic pill is a good remedy for constipation and at the 
beginning of the treatment of malarial poisoning. In minute doses (0.006 
Gm., or gr. Yk,, every hour or two) it is claimed that gamboge affords much 
relief in flatulence and intestinal indigestion. 

CAMELLIA. — Tea. The estemporaneously-prepared infusion of the 
dried leaves of Camellia thea (Ternstrcemiaceae), or Chinese tea-plant, is now 
60 widely used at the table as a beverage that it has given its name to the 
evening meal. It contains caffeine (or theine), theophylline (Rossel)/ a 
volatile oil, tannin, etc. Green tea is made from the younger leaves, dried 
with a moderate heat, so as to retain their color (sometimes fraudulently 
colored with Prussian blue, turmeric, and copper), while the black tea is 
made of the older leaves, and contains more tinnin. (See Caffeina, page- 
284). 

Physiological Action and Therapy. — The effects of tea are not fully 
represented by caffeine; probably theophylline, which is isomeric with theo- 
bromine, and the volatile oil assist in producing its physiological action upon 
the system. Dr. Thomas IT. Mays claims that the physiological action of 
caffeine derived from Camellia is different in its effects from that of coffee. 
It is an antidote to narcotic poisoning by virtue of its caffeine, and to anti- 
mony and many alkaloids on account of its tannin: it is also a physiological 
antidote to agents which depress nerve-function or the heart. In small doses 
infused with boiling water, tea is an agreeable stimulant, removing a sense 
of fatigue and giving a feeling of well-being. It is useful in headache from 
overwork or worry, and will often relieve migraine. Tea is an accessory food, 
but, on account of its convenience, it often becomes the principal article of 
food for persons who think that they cannot spare time to prepare a ful! 
meal, or have not the appetite to eat it. lu many cases of what has been 
called tea-drinkers' dyspepsia, in sewing women, it is found, upon inquiry, 
that the tea is drunk with every meal, and that very little food is taken with 



^Zeitsc^rift fur PhyMoloffi/trhe Chemie. ThtrapeuHc Qazctie, March 15. 1990. 




OAMPHORA. 299 

it except bread or hot biscuit. Such cases of debility, palpitation of the 
heart, flatulence, anorexia, constipation, etc., are not really instances of 
**theiBm," but cases of starvation and chronic indigestion, and require good 
food, sunlight, exercise, and tonics. Men who deal in tea, and constantly 
taste it, only exceptionally show symptoms of nerve-disorder ascribable to 
this cause; even tiien it may be due to idiosyncrasy, for persons have dif- 
ferent degrees of susceptibility to the effects of tea. Some cannot use it at 
all; others are proof, apparently, against any ill effects. Many can drink 
black tea who cannot stand the effects of green tea. Strong green tea may 
embarrass digestion and give rise to constipation. Tea may also diminish 
the tendency to sleep and in people of highly-nervous temperament may 
cause obstinate wakefulness. Ordinarily, the moderate use of tea relieves 
fatigue and disposes to mental cheerfulness, 

Theocine, or synthetic theophylline, has been used with good results as 
a cardio-vascular stimulant, and &]&o as a diuretic in dropsy. It acts chiefly 
npon the secreting fimction of the kidney. It relieves air-hunger in cardiac 
dTspnoea or asthma. Dose, 0.25 to 0.30 Qm. (or gr. iv-v), given usually 
with sodium acetate. 

CAMPHOEA (U. S. P., B. P.).— Camphor (CioH„0). 
Dose, 0.065 to 0.32 Gm. (or gr. i-v). 

ACIDTJU CAHPHORICinil (U. S. P.).— Gamphorio Acid. 
Dose, 0.30 to 2 Gm. (or gr. v-xxx). 

Preparations. 

Ceratum Camphoree (U.S. P.)* — Camphor Cerate. 

Camphora Monobromata (U. S. F.). — Monobromated Camphor. Doae, 0.065 to 
0^2 Gm. (orgr. i-v). 

Aqua Camphone (U.S. P., B. P.). — Camphor-water (U. S. F. contains 8 Gm. ta 
1000 ccm., or gr. iv-l5j). Dose, 4 to 16 ccm. (or f3i-iv). 

Spiritus Camphoree (U.S. P., B.P.). — Spirit of Camphor (10 per cent). Dose, 
0^ to 1.20 ccm. (or mv-xx). 

Linimeninm Camphors (U.S. P., B. P.). — Camphor Liniment, Camphorated Oil 
(eamphor, 20; cottonseed-oil, 80 parts). External use. (In B. P. olive oil is used.) 

Linimentiun Camphorea Ammoniatum (B. P.) . — Ammoniated (or Compound) 
Uiument of Camphor (camphor, 60 Gm.; oil of lavender, 2.5 ccm.; strong solution of 
tmmonia, 1(X) com.; alcohol [90 per cent.], a sufficient quantity to make 400 ccm.). 

tlnctiira Camphorse O>mpoaita (RP.). — Compound Tincture of Camphor (Pare- 
Korie, or Paregoric BUixir: tincture of opium, with benzoic acid, camphor, oil of anise, 
ud iitcofaol). Each 4 ccm. (or drachm) contains the equivalent of 0.016 Gm. (or gr. 
Vi) of opium, or nearly 0.6 miUigframme of anhydrous morphine in each cubic centi- 
nietre. Dose, 2 to 4 ccm. (or f3s&-j). 

Camphor ia a constituent in the following official preparations: Camphorated 
tincture of opium, compound morphine powder, and cerate of subacetate of lead 
(U.S. P.); soap, belladonna, and chloroform liniments (U.S. P., B. P.); compound 
tiBetnre of camphor and mustard liniment (B.P.). 

Phaimaoology. — Camphor is "the dextro-gyrate modification of the sat- 
urated ketone C^HigCO, obtained from Cinnamomum Camphora (Lauri- 
Dejfi), and purified by sublimation." The tree is a native of the East Indies 
«nd China. It contains a solid, volatile, fatty substance, or stearopten, which 
f^tists in all parts of the plant and crystallizes naturally in the wcJod and un- 
•ier the bark. As collected by natives, it is called crude camphor, which is 
^bsequently purified and sublimed in this country. Camphor comes in white, 
tnualncent, partly-crystalline masses, of penetrating, aromatic odor and a 



300 



I'SAHMAOBUTICAL THERAPEDTIC AGENTS OB DEC08. 



cool, acrid taete. It is lighter than water, in which it is very sparingly solu- 
ble, but is readily dissolved by alcohol and ethereal substances. Camphor 
is quite soluble in milk, which may often, therefore, be used as a convenient 
Tehicle. It is easily ignited and bums with a smoky flame. With chloral- 
hydrate, camphor combines when triturated, forming an oily liquid. When 
three parts of camphor are rubbed with one part of crystallized carbolic acid, 
a clear liquid is lorraed. Camphor cannot be powdered by trituration alone, | 
but can be when moistened with alcohol, chloroform, or ether. 

Physiological Action. — When applied to the skin, camphor slightly irri- 
tates and reddens the surface, and probably diffuses through into the deeper 
structures, so as to eiert a local sedative effect. In considerable doses, cam- 
phor causes vertigo and confusion of ideas, diaphoresis, delirium, or stupor, 
followed by epileptiform convulsions and maniacal excitement. There ifl 
lowering of the reflex excitability of the spinal cord and muscular weakness. 
In some cases the first manifestation -of its toxic action has been a sudden 
loss of consciousness with or without convulsions. Upon the circulation a 
stimulating effect is observed from small doses and the arterial tension is 
raised, but larger doses cause prostration and weakness of the heart's action 
Camphor is antispasmodic, and is a valued sedative in allaying abnormal 
nervous excitability often encountered in women, especially in cases where 
opium disagrees or is undesirable. It is, in full doses, a sedative to the gen- 
erative functions and allaya pain attending menstruation. Poisoning has 
followed the use of a saturated solution in alcohol (Rubini's tincture, or so- 
called '*mother-tinetuTe"), which should not be used for internal administra- 
tion 88 so small a quantity as 0.50 c.cm. (or mvij) has produced poisonous 
effects. Toxic doses give rise to inflammation of the stomach. In cases of 
poisoning, if any of the drug remain in the stomach it should be removed 
by the stomach-tube, the patient allowed to drink cold water freely contain- 
ing magnesium sulphate (31 Gm., or .>j), and the symptoms combated with 
arterial stimulants and hypodermic injections of morphine and atropine. 
Camphor is eliminated by the kidneys, lungs, and sudoriparous glands. 

xhcrapy. — Camphor is highly prized in the household, for headaches 
and various neuralgic pains, tho spirit, or "Eau Sedative/'* being applied 
upon a handkerchief or a flannel bandage. It is also a common ingredient in 
popular liniments. Camphor-chloral is used in neuralgia and myalgia as a 
rubefacient and anodyne. It dissolves morphine readily: — 

B Mnrphinie sulphat 1130 Gm. or (fr. xx. 

Camphor-chloral 8| Gm. or 3ij. — M. 

For local application to painful spots. 

Cavazzani applies to chancroids, with excellent results, a mixture of 5 
parts of cbloral hydrate, 3 of camphor, and 25 of glj'cerin, 

A combination of camphor and carbolic acid (3 to 1) is a valuable anti- 
septic dressing for wounds, the odor being more pleasant than that of car- 
bolic acid, and, the solution being anodjoie, it cannot be diluted with water 
or glycerin, hut mixes with oil or alcohol. It is a beneficial application in 
herpes and erysipelas, in vaginitis, vulvitis* and partesthesia of the vulva. 

* The Atjua Scdativa (N. F.) consists of ammonia water, 125 c.cm. (or fjiv) ; 
spirit of ramplior. 12 com. (or f3ii.i) ; sodium chloride. 05 (im. {or 5ij gr. Ixxiv) ; and 
water sufficient to mnkc 1000 c.cm.. or two pints. This is nlfio known as "Eau 




Tkft liquid overcomes the fcetor of lochial discharges On account of its 
CBOthedc proi>erties it is useful in the treatment of inverted toe-nail. It has 
Wa foccefisfull^* griven by the mouth in doses of 0.30 to 0.60 com. (or gtt. 
f-x) for the relief of gastric and intestinal catarrh. Carbolic-acid camphor 
■ • Bcrric^able local remedy in pharyngitis or tonsillitis. ParaBsthesia may 
vftcB be relieved by the topical use of this agent, either in its pure state or 
vcikefied bv some suitable excipient. 

Sttlol and camphor, and betanaphtol and camphor, also form fluids bav- 

ataiottble antiseptic powers. By mixing equal parts by ■weight of camphor 
ibsolnte alcohol, and dissolving pyroxylin in the solution (in the pro- 
ftftiOB of 1 to 40), an excellent substitute for collodion is obtained, Cam- 
fhaid u the name given to the fluid, and it is also a good solvent for salicylic 
9tH carbolic acid, and iodoform. Camphoid forms, in drj'ing, an elastic 
Sm, which is not dissolved by water and is a good coating for abrasions, 
■■ufitjal wounds, etc. A mixture of equal parts of canjphor and menthol 
intied with a mineral oil has been used successfully by Dr. Seth S. Bishop, 
i& A 10-per-oent. solution, in acute nasal catarrh and laryngitis. In h}'per- 
dsfhic rhinitis a 25-per-cent. solution can be used. A 3- to 5-per-cent. solu- 
tm iB sufficiently strong for injection into the ear for disease in the tympa- 

A solntion of camphor in ether (30 to 180) has been applied to ery- 
Bttlatoas inflammation with benefit. Camphor has been used for the pur- 
■BM of aborting boils. The seat of inflammation is touched three times a 
ay with an alcoholic solution, and, after this haa evaporated, the surface is 
with camphorated oil. Powdered camphor, likewise, is an efficient 
fttion to indolent ulcers, and has been used with success upon specific 
of the genitals. Inhalation of a solution of camphor in cologne-water 
fncft relief in that form of headache, which may occur at the menopause. 
Cnphor and morphine, locally introduced or applied externally on a hot 
ftoaeed poultice, allays toothache. A liniment or ointment containing cam- 
fhor is nseful in chilblains. The camphor ointment of the National For- 
■nlarr (camphor, 22; white wax, 11; lard, 67 parts) may be used as an 
ippHcation to indolent ulcers. Camphor, either alone or combined as fol- 
1w^ jields serviceable antipruritics in eczema and parsesthesia: — 

K OampboTK. 

Btttatiaphrliol. a& |65 Gm. or gr. x. 



OX. anthemidis .. 
Basmuth. tubnit. . 
Polv^rifl marnntEp 
17b|^ zuici oxidi . 





30 c.cm. 


or mv. 


4 


Gm. 


or 5f. 


4 


Gni. 


or 3j. 


31 


Gm. 


or Sj.-M. 




65 Gm. 


or (rr. X. 


2 


Om. 


or 3ss. 




flO c.cm. 


or mx. 




60 c.cm. 


or mviij. 



Bpbor« 

Svlpnarii tublimaU 2 

OL •aralypti 

Ct«oM>ti 

Uagrt. aqu* roMP. 

Un^ xiDci oxidi aa 1515 Gm. or ^ia. — M. 

Camphor with palicylic acid (14 to 11) combines with the aid of heat^ 
iftd, in the fonn of ointment, has been used in lupus and chronia ulcers. 
The odor of Ciimphor is inhaled with some relief in coryza. Camphor cerate 
• Asse/ni application for chapped hands and roughness of the akin, or the 

lior cAn he incorporated in suet or lanolin: — 



302 PHAUMAOEUTICAL THEttAPEUTIO AGENTS OE DECOS. 



Om. or 3ss. 
18 c.cm. or miij. 
24 c.cm. or miv, 
Gm. or Sij. 

M. Sig.: Rub a small piece in the palm of the hand until soft, and appl^ over 
the surface for chronic eczema; chapped hands; fissures on the lipa, at the angle of 
the mouth, or around the nipples, aniu, or genital organs. 



B Camphors 2 

01. neroli 

Phenolis liq •«*. *.. •> 

Sevi .»... 62 



3 Camphorffi 1 

01. juniperi 1 

Adipis Inna; hydrosi 31 

M. Sig.: Use in the diseases above named. 



30 Gm. or gr. xx. 

20 c.cra. or fiixx. 
Gm. or 3j' 



Internally, camphor is valuable as an anodyne, antispasmodic, and car- 
minative, in disorders of the digestive organs attended with pain or cramps, 
and is generally combined with astringents and opiotes. Velpeau's diar- 
rhoea mixture consiste of eqxial parts of spirit of camphor, tincture of opium, 
and compound tincture of gamoir. 

For diarrhoea Hope's camphor mixture is useful, especially in diarrhoea 
of relaxation in elderly subjects. Parrish's camphor mixture (mistiira cam- 
phorae aromatica, N. F.) is also valued: — 



B Tr. lavandulse co. , 120j c.cm. or fSiv. 

Sacchari 15 6 Gm. or 5s«. 

Aquae camphorce 473j c.cm. or fjxvj. 

M. Sig. : A tableepoonful every three hours for diorrhoBa. 



4 



This remedy is likewise very serviceable in infantile diarrhoea. It has 
been found efficient in j^Vsiatic cholera, provided it be given at the inception 
of the disease. 

Camphor, in 0.13 Gm. (or gr. ij) pills, is serviceable in dysmenorrhcea, 
hysteria, and obscure nervous manifestations in women. It may likewise be 
given to relieve palpitation of the heart. Monobromated camphor is es- 
teemed a valuable remedy in ehordee and irritable bladder; it has also been 
used in spasmodic ailections, hysteria, epilepsy, chorea, delirium tremens, 
whooping-cough, etc. 

IJ Camphone 1(30 Gm. or gr. xx. 

j-Ktheris q. s. ad ft. pulv. 

Ammonii carbonat. II Gm. or gr. xvj. 

Pulv. opii |26 Gm. or gr. iv. 

M, et div. in chartuls no. xij. 

Sig,: Give one every two or three hours, in coryza. 

In order to allay the mental excitement of hysteria, M. Blocq orders: — 

B Camphor, monobrom 31 Gm. or gr. xlv. 

£xt. quassise 2| Gm. or 3ss. 

Byrupi q. a. 

yi. et ft. pil. no. XXX. 

Big.: One, two, or three pills a day. 

It has likewise been successfully employed in spermatorrhoea. Dr. 
Bourneville has obtained excellent results from the administration of mono- 
bromated camphor in the treatment of epilepsy, accompanied by frequent 
attacks of vertigo. As a result of his studies, Dr. Bourneville concludes that 
in vertiginous epilepsy the administration of monobromated camphor alone 
is remedial, but in the typical paroxysmal variety it should be given together 





CAMiniORA. 



303 



■'•*■ 1 combination of bromides. It is a curious fact that the addition of a 
irops of camphor to a glass of water will, when injected into the rectum, 
a prompt evacuation of the bowels, thus offering a means of over* 
t*?ndency to constipation. 

•r has at times been successfully employed in the management 

' .elancholia, and delirium tremens. A combination of camphor 

-m relieves the after-pains of labor. The same drugB are advan- 

«_.y given in the form of a suppository after operations upon the ure- 

1, and in prostatorrhcea (enlarged prostate), cystitis, and, in fact, in 

tii doEases of the genito-urinary organs, according to these formulse: — 



B Caaohortt, 

lodolortn. vel anstol. vel iodoL..*.^4-tT<- ^^ 4| 

OL thecbromAtie q. 

M. *t ft. suppoe. no. xv. 

Sg.: iBarrt one, when neoessaiy. into the bowel. 

B Cttmpbone, 

Lapalhii na 

Exx. belUdonne folior 

OL UirobronmliA . 
M. rt ft- vupposiloria no. x. 
8i|f.: lasrrt one in the boMcI every two or three hours. 



Gm. or 3j. 



41 Gm. or Sj. 
(Id Gm. or gr. iia». 
• q. e. 



* - camphor escapes from the system largely by the bronchial mucous 

-ine, it is a useful remedy in chronic bronchitis, especially when 

-^sr in the weak or aged, or associated with emphysema. Its stimulant 

render it useful, also, in capillary bronchitis and typhoid pneumonia. 

bstance may be very serviceably administered in typhus or typhoid 

r in the eruptive fevers, in order to strengthen the action of the heart. 

-<r Baelz.* of Tokio University. Japan, in fact, for five years has 

— hor to the exclusion of all other medication, in typhoid fever, ad- 

_• 1 Gm. (or gi. xv) daily. He considers it superior to any other 

at he has employed, 

influenza Dr. F. W. Devereux Long prescribes: — 

ft Spiriftu camphone. 

Tr. Uii^nd. CO »ft 71 

8pL rhloroformi 4 

Mueila^. tr«^caiith 00 

AquM q- s- ad 180 

M, 8^-r Two tableapoonfuls every fourth hour. 

fJn iment of camphor, or camphorated oil, is an excellent application to 
laollrti and painful breasts during lactation. Injections subcutaneously of 
?D5phnrate<3 oi! ore said by Alexander to be of benefit in tuberculosis, acting 
ening the heart, and reducing fever. In laryngeal tuber- 
it (linvtly to the U'sion. Obstinate liiccouglis were re- 
V a hypodermic injection of camphorated oil, by James Tyson. Dr. 
I- M«u3^is has mJule Uiw* of thin combination in threatened heart-failure, in 
^^■«»a, pneumonia, typhoid fever, and other debilitating diseases. This 
mter gave 2 to 4 c.cm. (or gtt, xxx-lx) daily of a 1-per-cent. to 5-per-cent. 
«M«ii&. B- Aloxandcr ■ has for eleven years used, in the treatment of pul- 



e.cm. or f3ij. 
c.cm. or f3j. 
c.cm. or fjij. 
c.cm. or f5vj. 



*j0mrmai of the JLmrricnn Mrdieat AHmtcintion, p. 1238» vol. xxxiii, Nov. 11, 18W. 
mediciniAcht Wochenjtchrift, Kcb. 27, IfXX). 



304 



I'HARMACEUTICAL TlIEKAPEt'TIC AOENTS OR DKIGS. 



mnnary tuberculosis, hypodermic injections of the camphorfltod oil of the 
Gemian Fharmacopa?ia (11 to 9), with remarkable benefit The injections 
nre made once a day, 1 to 3 eg. (or gr. ^/o-^/j) each, in febrile or afebrile 
cases, or 1 eg. (or gr. V^,) every day for four days and then suspended for 
eight. Improvement is noted after the second injection, even in advanced 
eases. Dr. Courtin reports good results in the treatment of tuberculous 
adenitis from injections of a mixture of 1 part each of betanaphthol and 
camphor and 4 parts of 60° alcohol. 

Borneol is i\n artilicial camphor obtained from oil of turpentine by treat- 
ing it with hydrochloric acid. It is said to be identical in chemical compo- 
sition, and to closely resemble, in its ph3'sical characters, the natural cam- 
phor. According to Stockman, it has the same effects upon the circulation, 
but shows a tendency to depress or paralyze the pneumogastric nerves, and 
induces palpitation of the heart- 
Camphoric Acid is the product of the oxidation of camphor with nitric 
acid. It occurs in the form of fine, white, crystalline lamellae, melts at 368.6** 
F., is slightly soluble in water, readily soluble in ethylic alcohol and ether. 
It is without odor, but*has a somewhat acid and slightly astringent taste. 
In a healthy person it produces congestion, of the face, neck, and conjunctivffi, 
with pain in the ]win\. It checks the secretion of sweat, even in the normal 
man, hut seems to have no influence upon the saliva or to cause dryncsi^ of 
the throat nnrl skin. Cnmy^horii- acid is oliminatcd in the urine and pre- 
serves this fluid from undergoing putrefactive changes for several days. It 
may bo given in doses of O.riO to 4 Gm. (or gr. viii-lx). The ammoniacal 
urine of cystitis is speedily cleared and rendered acid by the administration 
of 1 Gm. (or gr. xv) three times a day. It is of avail, also, as a local remedy 
in chronic cystitis, the bladder being washed out twice daily with a Va-per- 
cent. solution. A stronger solution than 1 per cent, is too irritant for use. 
The 1-per-cent. sohiiion in wjitnr nuiy he used in larjmgological practice as a 
spray in catarrhal affectioii:^: it probably exerts some antiseptic as .well as 
a serliitive effect. The local application of a 2-per-cent. solution of camphoric 
acid is useful in acute eoryza. 

A 1-per-cent. solution is also a serviceable gargle in many forms of sore 
throat. Alone, or in combination with other remedies, such as horic acid or 
sodium borate, it is valunlile in treating strangury and irritability of the 
bhulder, and in the night-sweats of phthisis. The suppre^ssiou of night- 
sweats is produrtd by daily doses of 3 Gm. (or gr. X5x), or more; cer- 
tainly by singfe doses of 2 Gm. (or gr. xxx), according to the experiments 
of C'umbemale. Dr. Howard has also seen camphoric acid repress profuse 
perspiration in acute articular rheumatism. In a case of myoma of the 
uterus in which excessive nocturnal sweating had followed electrical treat- 
ment. Dr. Ralph Stockman, of Edinburgh, ordered 1 Gm. (or gr. iv) lof cam- 
phoric acid at night, and after taking it for two weeks the tendency to sweat- 
ing completely disappeared and never returned. The same author has 
used it in cases of hyperidrosis after influenza, am^ in other cases where 
there was certainly no tubercle present, and, in all of them, doses of 1 to 2 
Gm. (or gr. xv-xxx) gave fairly satisfactory or good results. Dr. Stockman 
emphasizes its value in non-tubercular cases. He considers it as efficient as 
atropine, but in some obstinate cases it is less powerful as an anhydrotic than 
picrotoxin. Its toxicity is very slight. It may be used in spermatorrhoea 




CAXNABIS IKDICA. 



305 



WBi ifi enuresis; and it has also been thought to have some influence over 
tfik' v*a^ hysteria, and other spasmodie affections. 

0^j*w«a«ipliOT. — By the action of hypochlorous acid upon camphor, and 
tnating \he product witli an alcoholic solution of potassium hydroxide, 
"lot (Cj^Hj^O,) ie formed, which cryfitallizes in needles, has the 
and taste of camphor, and can be sublimed without change. It melta 
tf IK* C. (or STS.*)** F). Oxycnmphor rotluces the excitability of the 
nspntory centre, and has been used by Rumpel, of Hamburg, and others, in 
kmm of 0.50 to 1 c.cm. (or mviij-xv) ; the maximum quantity in the day 
iufM not be more than 4 c.cra. (or 3j). Oxycamphor in oO-per-cent. solu- 
tiRO, in alcohol, is the most convenient for prescribing. Thig solution ia 
"" — commercially nlso by the name ( registereri ) of Oxaphor. Rumpel 
- the drug in the following combination: — 

R SpWtna oxrc&niphor (50 per cent.) 121 com. or 3iij. 

telriln^ vini ,. 6 c.cm. or 3j^. 

Fiald«- '<i g1ycrrr1iiz» 3| e.cnu or mxlr. 

JUfOS' > tffi q. s. nd ISOJ c.cm. or 5vj. 

X. Duwe, a tablespoooful containing eight inininu. 

CA2IXLUE COBTEX.— Canella-bark. 
Dose, 0.60 to 2.G0 Gm. (or gr. x-xl). 

The bark of Canella Winterana (Canellacese), deprived of ita corky 
«}rT and dried. This aromatic bark is sometimes called "white cinnamon. 
I: cubtAins a Litter extractive, Engenol, and a volatile oil, but no tannin. Aa 
tcarmxniitiTe, it is used in hot infusion. For dysmenorrhopa, the powder of 
and canella (X. F.), anciently known ns hicra picra (aloes 8 parts, 
2 p«rt«) , is given, in doses of 0.65 to 0.30 Gm. (or gr. x-xi) . 

CAHKABIS IKPICA (U. S. P , B. P.).— Indian Cannabis, Indian Hemp. 

Preparations. 

P^ald«9Ctnletutn Cannnbia Indiorc (U, S. P.). — Fluid Extract of Indian C&n- 

e, 06 to 060 c.cm. (or mix). 
ExtTVCtun Omnabifl Indict (U.S. P.. P. B.).— Extract of Indian Cannabit. 
, am Gm. (or gr. <«). B. P.. 0.015 to 0.065 Gm. (or gr. V.-j). 
Tlii»«tnra rannnbis Ioi)ict«> (U. S J*., B. P.). — Tincture of Indian Cannabis (10 per 
. Xj. S. p.: 5 ptr cent. B. P.). Doae, 0.12 to 0.50 com. (or mil-viij), U. S. P.; O.SO 
«»lv.aB. lor mv-xT), B.P. 

Pharmacology. — Cannabis Indica officially is "the dried, prepared tops 
«f tbe pifft ' * h\nis of Cannabip sativa (Frticacea?), ^ro^m in the Eaat 
an*: d while the frnits are still undeveloped and carrying the 

of t' iral resin." Indinn hemp should not be confounded with 

llhpiin i: -u which is snmetimes called white Indian hemp, or vith 

iporTnuns i JiiiiKihinum, Canadian hemp. A native confection made from 
haup is railed '^ha^hieh** or "^ninjah"; an inferior kind is known as 
^mng.^ The American and East-Indian plants are botanically the same, 
kgi tbe latter contains n larper quantity of the active principles, which are a 
Mm, a rr>lfltile alkaloid Cannabinine, and a yellow, aromatic, volatile oiL 
Tram tbe latter may be obtained Cannabene, oif which the hydride is a crys- 
llAae «nhetanoe. The resin appears to he, or to contain, the active con- 
C]faD#nt nf thr dnijff. Wood. Spively. and Eastrrfiehl, in addition to several 
Wnvrw-tf. i«olntc<I n substance fmm the resin for which they proposed the 




306 



PUAKMACELTICAL THEnAPEUTIC AGKNTS OR UKIGS. 



name of Cannabinol. By oxidizing the resin with nitric acid, Bohi. and 
Fnmce obtained a metalline subtiitance, oxy-cannabine' lC2„IL..jN:.U7). 
Cannabin tannate haa been employed in jnedicine in doses of 0.005 to OSo 
Gni. (or gr. i-x), but it does not appear to have very active therai)eutic pow- 
ers, t'hurrus is the native naiuf for tiie impure or crude resin. A watery 
extract (the Extraeturn Cannabis ludine A*junsuni Fluidum), according to 
Dr. Cowan l..oes, has a manifest anodyne and hvpnotic elTect, wliile free from 
the intoxication, bordering on poisoning, which follows the use of the alco- 
holic prcijarutions. The dose for odults is from 2 to 4 c.cm. (or i«xxx-Lx). 
It i? claimed by Dr. Leee to he especially valuable for tlie relief of cough in 
hiberculnsiB of the lungs and also as a soporific in diseaaes of children. 
Hasliishin is an unofBclal nlcoholic extract waslied with water, used in dys- 
pepsia and gastric neuroses. (Dose, 0,04 Gm., or gr. ^/^^ per day). 

PhyMological Action. — Indian hemp has no local action. Upon the 
digestion and circulation no evident effect is produced. It acts like opium, 
in first stimulating the nervous system and afterward depressing the vital 
functions. The primary stage of intoxication is accompanied by exhilara- 
tion, uliich lasts for some lime before sleep occurs. During this period the 
imagination is actively engaged, intent upon visions of its own creation, 
which at first are pleasant, but which after awhile may become terrifying. 
It is noticed, as one of the first manifestations of the toxic elTect, that the 
ideas of space and time are disturbed and become exaggerated; there is often 
a curious sense of double consciousness. Numbness and tiuffling in the ex- 
tremities are observed, followed by anaesthesia and diminution of muscular 
sense. Cannabis is antispasmodic, analgesic, hypnotic, and, in the East, is 
believed to he aphrodisiac. If a large dose be taken, coma or catalepsy may 
supervene, but a fatal effect rarely follows. The subsetpient results from 
indidgcnce in this drug as an intoxicant are dullness and lassitude, vertigo 
and headache, and diuresiSj but not constipation. Freijuent uj^e of the drug 
brings about mental deterioration and unfitness for labor. The abuse of 
Cannabis Indica is a prolific cauee of insanity in Eastern countries. An 
irresistible impulse to kill is, according to Dr. Thomae Ireland, occasionally 
one of the characteristic symptoms of intoxication from this drug. Dr. C. 
R. Marehall reports an interesting personal experience in which the char- 
acteristic toxic symptoms were produced by a small dose of Cannabinol, 
0.1 to Q.13 Gni. (or gr. iss-ij).^ A case has been reported by Dr. J. Xevins 
Hyde in which, after a dose of 0.065 Gm. (or gr. j) of Cannabis Indica, a 
papular anfi vesicular eruption made its appearance upon nearly every part 
of the body, and gave rise to severe itching. Toxic symptoms have been 
manifested after taking two doses of 0.75 c.cm. (or fwxij) of the English 
tincture, four liours apart, as in a case reported by Dr. Antony Roche." 

Therapy. — Owing largely to the uncertain quality of the drug, hemp 
is not employed to the extent that its physiological action would warrant. 

Cannabis Indica has been found extremely useful in acute dementia 
due to mental anxiety, and also in melancholia. This agent also may be 
Buccessfuliy prescribed in order to combat the wakefulness of delirium 
tremens, and good results have been ascribed to it in the management of 

^ Dr. C. R. Marshall, on 'The Active Principle of Indian Hemp," Laneet, Jan. 
23 1807. 

^Lancet, Jiin. 23, 1897. 
* Lancet, y>s*i. 24, im»8. 




CANXABIS INDICA. 307 

tetaniu. It has been employed with advantage in chorea, and may some- 
times be of avail in epilepsy. Amelioration has been produced by this 
remedy in senile trembling and paralysis agitana. In fieuralgia and migraine 
good resalts follow its cautious use. In other painful affections, Cannabis 
Indicft may be resorted to with advantage. Dr. Stephen Mackenzie has 
foimd cannabis of value in the severe headache of cerebral tumors, in chronic 
and persistent cephalalgia, and in the violent pains of locomotor ataxia. He 
has fonnd it of service also in gastralgia and enteralgia. It may be admin- 
istered to mitigate the snfEering caused by the passage of an hepatic or' renal 
calculus. In acute or chronic rheumatism, in gout, and in carcinoma hemp 
may often be very serviceably substituted for opium, over which it has the 
adrantsge that it does not derange the secretions. 

Cannabia Indica quiets the delirium of cerebral softening. Dr. R. T. 
Edes, of Boston, has, in a number of instances, observed the use of this 
drug to banish the tendency to bad dreams. It allays the itching of eczema. 
Id the itching which accompanies many cutaneous affections, and particu- 
larly in senile pruritus, the internal administration of Cannabis Indica will 
often afford relief. In various uterine disorders it is used to relieve pain 
ind bring about contraction of uterine muscular fibre. The pain of dys- 
menonhcea may not infrequently be controlled by Cannabis Indica. Its 
influence upon the muscular structure of the womb renders it valuable in 
menorrhagia. Its virtue is enhanced, in this affection, by combination with 
ergot. It has been found particularly useful in the abundant floodings which 
sometimes precede the menopause, and, in fact, it possesses considerable 
power as a general hemostatic. 

Cannabis Indica has also been used with advantage in uterine subin- 
Tolution and chronic endometritis. The headaches which attend the grand 
climacteric will sometimes yield to this remedy. In combination with nuz 
Tomica it is regarded by de Schweinitz as of value in headache dependent 
Dpon retinal asthenopia. It may be productive of good results in impotence 
imconnected with gross lesion. In spasm of the bladder and dysuria it gives 
relief, and also, in acute gonorrhoea with chordee, we see good effects from 
ita eihibition. It can be given in either of these combinations with marked 
benefit for relieving the latter distressing symptom: — 



B Fluidextrftcti cannabis Indies 2 

Sodii bromidi 12 

Mift tode xnenth 90 

Symp. aurantii 60 



cctn. or f38s. 

Gm. or 3iij. 

ccm. or fjiij. 

ccm. or ^ij. 



Sig.: A tablcBpoonful at bed-time. Repeat every bour or two until relieved. 



120 Gm. or ffr. iij. 
4l Gm. or 3j. 
|38 Gm. or gr. vj. 



B Extract! caanabii Indies 120 Gm. or ffr. iij. 

Chlorali hydrati 4 Gm. 

Extract! opii |38 Gm. 

OL theobromatis q. 

M. et ft rappodtorlK no. xlj. 

Sig.: Insert one in the bowel on retiring, and every two or three hours when 
^^1m with chordee. 

By some practitioners it is esteemed of value in acute and chronic 
Wright's disease, the presence of hsematuria especially indicating its employ- 
Jwnt. Trial has been made of the drug in diabetes mellitus. Though it 
|MT, at times, be able to moderate cerebral irritability, it exerts no marked 
infinence upon the course or severity of the disease. The spasm of asthma 



308 PUAIIMACEUTICAL TUEBAPEUTIC AGENTS OR DKUGS. 

is sometimes very rapidly relieved by hemp. In whoopiBg-cough, also, it 
may prove of aervice. It is a good remedy in irritable or reflex cough. 

Mackenzie recommends the use of Cannabis Indica in hay fever and 
hay a^ithma. Germain See wnnnly rwnrnmends Cannabis Indica as a gastric j 
sedative of particular value in f iiuutioDal disorders of the stomach and bowels 
attended with pain, acidity, and flatulence. He advises 0.04 Gm. (or gr. V4) 
of the extract to be given in three doses, or it can be prescribed in the form 
of the fluid extract, and creosote added with great advantage: — 



I^ Fluidextructi cuunabis lii'liae 3 

Crcosoti 

Syrup, ftcaciffi 90 

M. 8ig. : A teaspoonful before meals. 



10 c.cm. or mi. 
30 c.cm. or mv. 
c.cm. or fjiij. 



J 



It is also of value in the treatment of gastric ulcer and may be com- 
bined with silver nitrate, the efficacy of which it increases. Cannabis Indica 
is said by Macconnell to be of value in diarrhoea dependent upon indigestion. 
Cannabis Indica is said to do good in exophthalmic goitre, and to cure, in 
some instances, the opium or chloral habit. The tannate of cannabin is a 
good hypnotic, and has been used for insomnia among the insane. The same 

Sroperty is shared by cannabin and cannabinone, both of which are given in 
OSes of 0.03 to 0,13 Gm. (orgr. ss-ij). The oil of hemp-seed (oleum cannabis) 
is a drying, fixed oil expressed from the seeds; it is green in color, disagree- 
able to smell, and bland to the taste. It is used in the manufacture of a 
green Boft-soap of deservedly high reputation in treating eczema and other 
skin diseases. 

The tincture of Cannabis Americana is regarded by some as equal in 
value to copaiba or sandal-wood in the treatment of gonorrhcea. The prep- 
aration should be made from the fresh plant and be given in doses of 3 to 
6 drops three or four times a day after subsidence of the acute symptoms. 

CANTHARIS (U. S. P., B. P.).— Cantharides. (Spanish Flies.) 

Preparations. 

CoUodium Canthoridatum (U.S. P.). — Cantharidal CoUodion (60 per cent). 

Ceratum Cantliaridis (U. S. P.). — Cantharidea Cerate (cantharidea, 32 Gm.; yel- 
low wax and resin, aa IS Om.; lard, 22 Gm.; oil of turpentine. 15 c.cm.). 

Emplaatnim Picia Cantharidatum (U.S. P.)- — Plaster of Pitch and Cantharides; 
Wftrming Plaster (Burgundy ^tJteh. 02 Gm.; cerate of cRntharideB. 8 Gm.)- 

Tinctiirii rnntlmriiliK 1 1 . S. P., It. P. ( . — Tiufturi' of l nntlmrides ( 10 per cent.). 
Doee, (U.S. P.), 0.00 to 0.00 c.cm. lor mix). (The British tincture is only IV* per 
cent,). Do&e, 0.30 to 4 c.cm. (or mv-3j). 

Acetum Cantharidia (B. P.). — Vinegar of Cantharides (10 per cent.}. 

Liquor Epiapasticua (B. P.). — Blistering Liquid (50 per cent, with acetic ether). 

Un^entum Cantharidia {B. P.). — Cantharidea Ointment (cantharidea, bruised, 1 
Gm.; l>enzoflted lard, 10 Gm.). 

Emplaatrum CantharidiB (B. P.). — Cantharidea Plaster (36 percent.). 

Emplastrum Caiefaoiens (B. P.). — Warming Plaflter. 

CoHodium Vesicans (B. P.). — Blistering Collodion (blistering liquid, 40 c.cm.; 
pyroxylin, 1 Gm.). 

Pharmacology. — Cantharis vesicatoria (class, Inaecta; order, Coleop- 
tera), thoro;iplily ilried, at a temperature not exceeding 104" F., occurs in 
pbannacy, either whole or in a more or less fragmentary condition, or as a 
brownish powder, in which the bripht-green fra^ents of the elytra are very 
noticeable. The dust is very irritating, and the eyes should be protected 
when the drug is powdered in the mortar. The perfect flies are stronger 




CANTHABIS. 



309 



i A^ powder, which often has been damaged by the ravages of mites or 

hmet forms of life. The active constituent is Cantharidin, the anhydride, 

«<lftCtaaCy of cantharadinic acid (discovered by Eobiquet in 1810) which is 

fitaniwl diiefly in the soft parts, and especially the generative apparatus, 

tl» bloody and in the eggs (Leidy). It is soluble in alcohol, ether, chloro- 

Sms. etc. Beeidefl this, which constitutes rather less than 1 per cent., there 

««• green oil, black matter soluble in water, a yellow viscid matter, fat, cal- 

osm «nd magnesinin phosphates, acetic, formic, and uric acid-=, and a volatile 

Mmdple itpon which the fetid odor depends, and which, according to 

uifefidorff, acts upon the system like cantharidin. The green coloring 

■■fcter appears to be identical with chlorophyl. 

Phyiiologieal Action. — When applied to the skin, an active preparation 
d emiharides causes burning pain with hyperjemia, to which, in the coursa 
rft few hours, succeeds the formation of vesicles, exhibiting a tendency to 
na together and form a large bleb corresponding with the area of applica- 
boB. If the action is continued, sloughing and ulceration result. The 
Oforgement of the capillaries in the superficial structures is associated with 
of the deeper structures. When applied to the chest, the lung un- 
Bth becomes pale and ana?mic, and, if its action be too long continued, 
may cause inflammation of the pleura; or it may produce perito- 
I if applied to the abdomen. Slight elevation of temperature attends the 
mtkm of the blister, which may be followed by depression of temperature 
■id weakening of the heart's action. Constitutional effects may be caused 
br absorption of the active principles through the integument. When intro- 
daecd into the stomach, cantharides is capable of setting up much irritation 
md eren eastro-enteritis, with vomiting, or purging and tenesmus. The 
■ctH^ principles soon pass into the blood, and at first slightly stimulate the 
iMTta action; but the effect is most marked upon the genito-urinary organs, 
m the kidneys are the chief organs by which they are excreted. Extreme 
ffTitation of the bladder is produced, the urine is voided frequently, and, 
wmg to the congested state of the kidneys, often contains albumin and 
llaa£ There may be suppression of urine. Associated with this is priapism, 
vift pain in the glans penis, urethra, bladder, and aching in the renal region. 
Soughing of the external genitals has been known to occur in consequence 
rf ihe administration of cantharides. Toxic doses, according to Cautieri, 
MBiaa rapid diminution of blood-pressure, decreasing the force of the heart's 
1, but increasing the pulse-rate. In fatal cases inflammatory changes are 
in the alimentary canal, with intense hypera?mia of the bladder and 

The mlgar notion that cantharides causes erotic Bensations, or increased 
fsaal power, has no foundation except in the evidences of congestion and 
iafiasBtnation of the urinary passages just referred to. The resiilts of swal- 
lawmfT a few grains of Spanish flies may be quite serious, and it is regarded 
h^ ■ as a penal offense to administer this drug surreptitiously and with 

e» The treatment of poisoning by cantharides is by bland drinks 

■adoptateflandahotbath. Bismuth and cocaine are also of service. Animal 
^sicoal haa also been recommended as an antidote. An anaesthetic may be 



Therapy. — Blisters are usually spread with cerate of cantharides, or 
iwferably with the cerate of the extract of cantharides, the prescription 
leiBg M follows: — 



310 



PHAHMACErTICAL THEUAPELTIC AGENTS OR DBUOS. 



H Cerati cantharidis, q. 8. ^ j 

Fiat emplastrum 2 X 3 in. ^H 

Sig.: Apply to designated spot and allow it to remain four hourt. Then renu^l 

it and aiibntitute a moist compress. 

The skin overlying the effusion should not be removed, but simply 
punctured to allow the serum to escape; the spot is then dreseed with some 
bland fat, such as suet or benzoinated lard. A good way to raise a blister 
is to use the blistering collodion and paint one or two coats over the desired 
area, and lay over it a piece of waxed paper, under which the bUster raises 
in a few hours. Saint-Philippe has suggested that the danger of strangury 
may be lessened by the preliminary use of an alkaline diuretic until the urine 
has become alkaline. It is also a good plan to sprinkle a small quantity of 
morphine and camphor over the surface of the plaster before it ia placed in 
position, Blisters are employed therapeutically to relieve pain, to reduce 
inflammationj and as revulsants to promote absorption of inflammatory 
products. The warming plaster is very useful in pleurodynia. Meningeal 
or pleural inflammation may be checked by the prompt application of a good- 
sized blister to the scalp or to the chest. In iritis, blisters behind the ears 
are often serviceable. Dr. C. Ziem recommends painting cantharidal col- 
lodion behind the ear, extending downward as far as the jaw, in the treat- 
ment of certain acute inflammatory affections of the eye. He makes use of 
the same method for relief in cases of abscess of the thyroid gland, and in- 
flamniiitiou of the fmntnl sinus nnd nntrum of Highmore. In poncarditis, 
marked relief may be afforded by blistering. A blister over the stomach will 
arrest obstinate vomiting; and gleet is sometimes cured by a blister to the 
perineum. Vesication of the back of the neck is said by Swan to be a useful 
measure in cases of incontinence of urine. Neuralgia is promptly relieved 
by a small blister to the painful point; and neuritis is cured by fly blis- 
ters; that is to say, a succession of small blisters along the course of the 
nerve. In acute rheumatism, marked relief is sometimes afforded to a swollen 
joint by surrounding it with small bUsters. A blister over the affected joint 
is a good r