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""  THE  GIFT  OF 

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FOR  THE  IJSEOF 
!    tfHE   N.   V.    STATE   VETERINARY   COLLEGE. 

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PHARMACOLOGY,  THERAPEUTICS 

AND 

MATERIA"  MEDICA 


*■ 


A   TEXT-BOOK 


OF 


PHARMACOLOGY,  THERAPEUTICS 


AND 


MATERIA  MEDICA 


BY 

T.  LAUDEE  ptUNTON,  M.D.,  D.Sc,  F.E.S. 

FELLOW  OF  THE  ROYAL  COLLEGE  OF  PHYSICIANS;  ASSISTANT  -  PHYSICIAN  AND  LECTDREB- 

ON   MATERIA   MEDICA   AT  ST   BARTHOLOMEW'S   HOSPITAL;    EXAMINER   IN   MATERIA 

MEDICA  IN  THE  UNIVERSITIES  OF  OXFORD  AND  OF  LONDON  ;  LATE  EXAMINER 

IN  THE  UNIVERSITY  OF  EDINBURGH,  IN  THE   VICTORIA  UNIVERSITY, 

AND  IN   THE  ROYAL  COLLEGE  OF  PHYSICIANS,  LONDON 


ADAPTED    TO    THE 

Wmittlt  states;  $&armaw>;poeta 

FRANCIS    H.   WILLIAMS,    M.D.Boston,   Mass. 
THIRD   EDITION 

CONTAINING   THE 

ADDITIONS  (1891)  TO  THE  BBITISH  PHABMACOPCEIA 

Hon&on 
MACMILLAN    AND    CO. 

AND    NEW    YORK 

1893 
« 

The  right  of  translation  is  reserved 


First  edition  printed  1885 ;  second,  March'  1887 ;  Addenda  inserted  July  1887 
Additions  (1891)  to  the  British  Pharmacopoeia.    Reprinted  November  1891,1893. 


TO 

fflje  'gKemorB  of 
SIR  EOBEET  CHRISTISON,  Baet.  &c. 

HIS   HONOURED   TEACHEB 

AND   TO 

CARL    LUDWIG 

HIS   BELOVED   MASTER 

THIS   BOOK    IS    GBATEFULLY    DEDICATED 

BY 

THE  AUTHOE 


PBEFACE 

TO 

THE    THIED    EDITION. 


The  rapid  exhaustion  of  the  second  edition  of  this  work  has  pre- 
vented me  from  making  as  many  improvements  in  the  present 
edition  as  I  could  have  desired.  At  the  same  time  I  have  tried,, 
as  far  as  the  short  time  at  my  disposal  would  allow,  to  amend 
the  imperfections  of  former  editions,  as  well  as  to  bring  the  work 
up  to  date  and  render  it  more  useful  by  the  introduction  of  new 
matter. 

The  treatment  of  one  of  the  most  important  portions  of  Phar- 
macology, viz.  the  Connection  between  Chemical  Constitution 
and  Physiological  Action,  is  still  very  meagre,  because  I. find  that 
the  size  of  this  work  would  be  too  much  increased  were  I  to  treat 
the  subject  fully,  and  I  am  therefore  preparing  a  small  text-book 
upon  it. 

The  struggle  for  existence  between  microbes  and  the  living 
organism,  which  in  the  first  edition  was  only  illustrated  by  a 
single  diagram  of  a  bacillus  and  amoeba,  is  now  fully  illustrated 
by  woodcuts  copied  from  Metschnikoff's  paper.  The  views  of 
Hughlings  Jackson  on  the  nervous  system  have  been  illustrated 
by  a  diagram  which,  when  covered  with  successive  layers  of  thin 
and  semi-transparent  paper,  exhibits  the  effect  of  anaesthetics 
and  narcotics  in  successively  abolishing  various  faculties.  The 
recent  work  of  Kiihne  and  Politzer  on  the  mode  of  action  of 
curare  has  been  noticed,  and  the  pathology  of  tremor  discussed. 
The  section  on  the  action  of  drugs  upon  the  eye  has  been  care- 
fully revised.  The  section  on  antipyretics  has  been  rendered 
somewhat  fuller,  and  some  diagrams  illustrating  the  pathology, 
of  fever  and  the  mode  of  action  of  antipyretics  have  been  intro* 
duced,*  but  it  is  very  difficult  in  the  present  state  of  our  know- 
ledge to  deal  satisfactorily  with  this  subject.    Paragraphs  on.thei 


viii  PEEFACE   TO  THE 

treatment  of  cough  and  on  the  pathology  and  treatment  of 
asthma  have  been  introduced.  The  researches  of  Adami  on 
diuretics  have  been  noticed,  but  they  have  not  necessitated  any 
essential  change  in  the  text,  as  the  communication  between  the 
portal  vein  of  the  kidney  and  the  renal  artery  had  been  already 
allowed  for  in  describing  Nussbaum's  researches  in  the  first 
edition.  The  views  expressed  in  the  first  edition  regarding  the 
mode  of  action  of  caffeine  have  been  confirmed  and  extended  by 
the  observations  of  Schroeder  and  Munk.  The  researches  of 
Jendrassik  on  the  diuretic  action  of  calomel  and  the  explanation 
advanced  by  Locke  have  been  noticed. 

The  arrangement  of  the  Vegetable  Materia  Medica  has  been 
almost  entirely  remodelled  on  Hooker's  plan,  and  a  short  intro- 
duction has  been  added  to  it,  in  which  I  have  tried  to  show  the 
use  of  botanical  arrangement,  as  well  as  to-  protest  against  the 
abuse  of  it  in  the  examination  of  students  in  Materia  Medica. 

By  the  use  of  small  type  for  matters  which  are  of  practically 
little  interest  to  general  students,  and  yet  are  occasionally  wanted 
for  reference,  a  certain  amount  of  space  has  been  gained,  at  the 
same  time  that  the  general  student  is  enabled  at  a  glance  to 
distinguish  the  parts  which  are  of  little  or  no  interest  to  him. 
Notwithstanding  my  efforts  to  condense  it,  the  present  edition 
contains  about  120  pages  more  than  the  second,  but  by  using 
thinner  paper  the  bulk  of  the  volume  has  been  little,  if  at  all, 
increased. 

The  General  Index  has  been  carefully  revised.  The  Index  of 
Diseases  and  Eemedies  ha3  been  revised  to  a  certain  extent,  but 
it  still  remains  a  mere  skeleton  of  what  it  ought  to  be.  It  is 
little  more  than  a  list  of  drugs  which  have  been  recommended 
by  somebody  or  other  at  some  time  or  other  in  the  treatment  of 
certain  diseases.  In  a  few  instances  the  conditions  supposed  to 
indicate  the  use  of  one  drug  in  preference  to  another  have  been 
given,  but  I  have  not  yet  been  able  to  sift  the  statements  which 
have  been  made  regarding  the  different  drugs.  The  only  use  of 
the  Index  at  present  is  simply  to  remind  the  practitioner  who  is 
treating  a  disease  of  the  names  of  drugs  which  have  been  proposed 
as  remedies  for  it.  Thus,  under  the  head  of  Hydrophobia  I  have 
mentioned  a  number  of  remedies  which  have  been  used  or  pro- 
posed, because  those  who  may  have  to  treat  a  case  of  this  disease 
may  wish  to  try  some  remedy,  although  my  own  experience  leads 
me  to  think  that  almost  all  well-marked  cases  will  have  a  fatal 
isBue  whatever  the  drugs  employed  may  be. 


THIED  EDITION.  ix 

The  idea  of  a  Therapeutic  Index  was  taken  from  that  in 
Ringer's  '  Therapeutics,'  and  I  wished  to  make  one  still  more  full 
and  complete  by  comparing  his  index  with  those  of  Bartholow  and 
H.  C.  Wood,  with  Waring's  '  Therapeutics,'  and  with  the  wonder- 
ful '  Medical  Digest '  of  Dr.  Neale.  After  I  had  begun  to  do  this, 
I  found  that  a  similar  idea  had  occurred  to  Dr.  S.  0.  L.  Potter, 
who  had  already  published  an  index  of  '  Comparative  Thera- 
peutics,' in  which  he  gave  a  list  of  remedies  taken  from  the  works 
of  Aitken,  Bartholow,  Niemeyer,  Phillips,  Piffard,  Binger,  Stille, 
Tanner,  Trousseau,  H.  C.  Wood,  Waring,  and  some  others. 
After  finding  that  Dr.  Potter  had  already  compared  together 
more  works  than  I  expected  to  do,  I  used  his  list,  along  with 
Naphey's  '  Medical  Therapeutics '  and  Neale's  '  Medical  Digest,' 
in  preparing  my  Index.  I  was  unable,  however,  even  with  the 
aid  of  these  works,  to  make  the  Index  anything  more  than  a 
mere  list  of  names,  excepting  in  a  few  instances.  So  imperfect 
was  it,  indeed,  that  up  to  the  last  moment  I  intended  to  cancel 
it,  and  would  have  done  so  had  not  a  case  occurred  in  my  own 
practice  which  showed  me  that  even  a  mere  list  of  drugs  may 
sometimes  be  desirable.  I  was  not  unmindful  of  the  old  adage 
that  '  Fools  and  children  should  not  see  half-done  things,'  but  I 
felt  confident  that  the  majority  of  my  readers  would  not  belong 
to  either  of  these  classes,  and  so  I  allowed  the  Index  to  remain. 
My  intention  to  cancel  it,  however,  led  me  to  omit  an  acknow- 
ledgment of  my  indebtedness  to  Dr.  Potter,  and  I  have  pleasure 
in  acknowledging  it  now. 

My  use  of  Dr.  Potter's  book  has  led  me  to  include  in  the 
Therapeutic  Index  one  remedy  which  the  homoeopaths  claim  as 
theirs.  His  book  contains  a  list  of  remedies  taken  from  homoeo- 
pathic works  as  well  as  from  those  I  have  already  named.  The 
two  classes  of  remedies  are  kept  apart  in  different  columns ;  but 
I  find  that,  in  one  instance  at  least,  the  amanuensis  whom  I 
employed  to  copy  out  a  number  of  the  drugs  from  Dr.  Potter's 
book  has  made  a  mistake  in  the,  column,  and  has  taken  '  Apis '  as 
a  remedy  for  tonsillitis  from  the  Homoeopathic  column.  To  the 
best  of  my  knowledge  this  is  the  only  remedy  I  have  taken  from 
a  homoeopathic  source.  If  any  other  remedies  claimed  as 
-'  homoeopathic  '  have  been  introduced,  they  have,  I  think,  been 
copied  from  the  works  of  one  or  other  of  the  authors  already 
mentioned,  and  in  Dr.  Phillips's  work  there  are  some  remedies 
mentioned  without  references.  But  as  I  intended  up  to  the  last 
moment  to  cancel  the  whole  list,  my  revision  of  it  was  hasty  and 


x  PBEFACE   TO  THE 

imperfect;  and  as  I  omitted  to  expurgate  'Apis,'  I  may  also 
possibly  have  overlooked  other  remedies.  If  any  such  omission 
has  occurred  I  am  sincerely  sorry,  and  I  can  assure  the  homoeo- 
paths that  it  is  perfectly  unintentional. 

Perhaps  it  may  be  well  to  take  this  opportunity  of  saying  a 
few  words  in  regard  to  homoeopathic  remedies  and  homoeopathy 
generally. 

The  mere  fact  that  a  drug  in  small  doses  will  cure  a  disease 
exhibiting  symptoms  similar  to  those  produced  by  a  large  dose 
of  the  drug  does  not  constitute  it  a  homoeopathic  medicine,  for 
this  rule  was  known  to  Hippocrates,  and  the  rule  similia  simi- 
libus  curantur  was  recognised  by  him  as  true  in  some  instances. 
But  Hippocrates  was  not  a  homoeopath,  and  he  recognised  the 
fact  that,  while  this  rule  was  sometimes  true,  it  was  not  invari- 
ably so. 

It  seems  to  me  that,  in  founding  the  system  of  homoeopathy, 
Hahnemann  has  proceeded  with  his  facts  as  he  did  with  his  medi- 
cines— diluting  his  active  drugs  with  inert  matter,  and  diluting 
his  facts  with  much  nonsense. 

In  what  I  am  about  to  say,  I  may  be  to  some  extent  open  to 
correction,  for  I  cannot  claim  to  know  his  doctrines  so  thoroughly 
as  those  who  believe  in  and  follow  him.  So  far,  however,  as  I 
know  his  doctrines,  it  seems  to  me  that  they  consist  in  raising 
the  rule  similia  similibus  curantur  to  the  rank  of  a  regular  law ; 
in  claiming  a  curative  power  for  infinitesimal  doses,  and  in  be- 
lieving that  the  diminution  in  the  dose  of  the  drug  was  made  up 
for  by  the  potency  conferred  upon  it  through  prolonged  tritura- 
tion. It  is  no  doubt  true  that  in  some  instances  the  power  of  a 
drug  may  be  increased  by  trituration,  inasmuch  as  fine  subdivi- 
sion either  makes  it  more  easily  absorbed  or  alters  its  chemical 
composition,  as  in  the  case  of  mercurial  compounds,  where  the 
prolonged  exposure  to  the  air  and  friction  involved  in  the  tri- 
turation may  greatly  increase  the  power  of  the  drug  by  oxidising 
it,  and  changing  it  from  a  mercurous  to  a  mercuric  salt.  But 
in  both  cases  the  increased  activity  conferred  upon  the  drug  is 
strictly  limited,  although  it  may  be  great  in  the  case  of  the  salts 
of  mercury.  To  suppose  it  to  be  exerted  ad  infinitum  is  sheer 
nonsense,  and  the  absurdity  of  infinitesimal  doses  has  been  so 
often  demonstrated  that  it  is  useless  to  say  more  about  it. 

I  think  one  is  justified  in  describing  Hahnemann's  experiment 
with  cinchona  bark  as  the  foundation-stone  of  his  doctrine  of 
homoeopathy;  for  Dr.  NankivelL  in  his  Presidential  Address  to 


THIED  EDITION.  xi 

the  British  Homoeopathic  Congress  at  Norwich,  says,  with  regard 
to  the  action  of  quinine  in  ague,  that  '  it  was  this  very  instance 
of  successful  empirical  treatment,  of  specific  medicinaj  action, 
that  led  Hahnemann  first  to  investigate  the  actions  of  drugs  on 
the  healthy  human  frame,  and  thus  to  lay  "the  foundation  of  the 
most  complete  and  lucid  system  of  scientific  therapeutics  that 
the  world  has  yet  seen.'  But  I  have  shown  in  the  body  of  this 
work  (p.  52)  that,  although  Hahnemann's  observations  were  in 
all  probability  perfectly  correct,  the  conclusions  he  drew  from 
them  were  utterly  erroneous. 

But  there  is  another  side  to  the  question  which  I  think  it  is 
only  fair  to  consider  also.  While  Hahnemann's  theory  was 
certainly  bad,  there  can,  I  think,  be  little  doubt  that  he,  like 
Paracelsus  and  Priessnitz,  has  done  good  service  to  medical 
practice.  Paracelsus  gathered  information  from  shepherds,  wise 
women,  and  quacks  of  all  sorts,  and  thereby  obtained  a  know- 
ledge of  popular  remedies,  not  generally  employed  by  the  profes- 
sion, but  which  were  nevertheless  useful. 

Priessnitz  did  not  invent  the  use  of  cold  water  as  a  remedy, 
for  it  was  known  nearly  eighteen  hundred  years  before  his  time. 
Musa '  saved  the  life  of  Augustus  by  the  cold  bath,  but,  not 
knowing  exactly  how  and  when  to  employ  it,  he  killed  the  nephew 
of  the  Emperor  by  it,  and  such  failures  brought  the  treatment 
by  water  into  discredit.  Priessnitz  revived  it,  and  now  in  the 
use  of  cold  sponging,  wet  packs,  baths  and  douches  we  have  a 
powerful  means  of  treating  fever  and  curing  disease. 

Hahnemann  also  did  good,  and  the  system  which  he  founded 
has  done  great  service  by  teaching  us  the  curative  power  of 
unaided  Nature,  the  use  of  diet  and  regimen  in  treating  disease, 
and  the  more  than  inutility,  the  actual  hurtfulness,  of  powerful 
drugs  in  many  instances.  The  physician  is  bound  to  do  the 
very  utmost  he  can  for  his  patient,  and  his  very  anxiety  has 
frequently  led  him  to  do  harm.  He  has  been  afraid  to  leave  the 
cure  of  disease  to  Nature,  and  by  the  administration  of  powerful 
drugs  has  frequently  injured  instead  of  benefited  his  patient. 
The  use  of  infinitesimal  doses  which  could  not  affect  the  body 
of  the  patient  one  way  or  the  other,  but  kept  the  mind  of  both 
patient  and  physician  easy,  and  allowed  the  vis  medicatrix  natures 
free  scope,  has  helped  us  to.  a  more  perfect  knowledge  of  the 
natural  course  of  disease.  The  use  of  infinitesimal  doses  has  also 
led  to  much  care  being  bestowed  by  those  who  use  them  upon 
diet  and  regimen.     When  a  physician  administered  a  large  dose 


xii  PEEFACB   TO  THE 

of  tartar  emetic  or  of  salts  and  senna,  he  knew  that  his  remedies 
would  produce  vomiting  or  purgation  respectively  with  consider- 
able certainty,  whatever  the  diet  or  regimen  of  the  patient  might 
be ;  but  the  case  was  quite  different  with  infinitesimal  doses.  If 
a  patient  was  being  treated  with  carbo  vegetabilis  in  the  thirtieth 
dilution,  the  utmost  care  was  necessary  in  regard  to  his  diet,  for 
if  he  happened  to  eat  a  single  piece  of  burned  toast  at  breakfast, 
he  would  consume  at  the  one  meal  as  much  vegetable  charcoal 
as  would,  when  properly  diluted,  have  served  him  for  medicine 
during  the  remainder  of  his  natural  life. 

Moreover,  the  homoeopathic  practice  of  giving  only  one  drug 
has  tended  greatly  to  dimmish  the  practice  of  polypharmacy,  and 
the  tinctures,  powders,  and  globules  they  employ  show  us  a  good 
example  in  regard  to  the  administration  of  remedies  in  ah  agree- 
able form.  But,  although  this  mode  of  practice  may  be  employed 
by  homoeopaths,  it  is  not  homoeopathic.  We  are  not  homoeopaths 
because  we  use  a  single  drug  at  a  time  and  give  half  an  ounce  of 
infusion  of  digitalis  to  a  patient  suffering  from  heart-disease 
without  thinking  it  necessary  to  mix  it  with  broom,  squill,  or 
spirit  of  nitrous  ether.  Nor  are  we  homoeopaths  because  we  use 
l-50th  of  a  grain  of  digitalin  instead  of  the  infusion  of  digitalis. 
Nor  are  we  homoeopaths  even  if  we  get  a  manufacturing  chemist 
.to  make  up  the  digitalin  into  a  globule  with  a  quarter  of  a  grain 
of  sugar  of  milk  instead  of  with  five  grains  of  extract  of  Kquorice. 
Nor  do  we  become  homoeopaths  merely  because  we  may  employ 
a  small  dose  instead  of  a  large  one,  and  begin  with  ten  drops  of 
the  infusion  of  digitalis  instead  of  half  an  ounce. 

It  is  not  the  use  of  a  single  drug  at  a  time,  of  a  small  dose, 
of  a  globule,  nor  even,  as  we  have  already  seen,  of  a  drug  which 
may  produce  symptoms  similar  to  those  of  the  disease,  that  con- 
stitutes homoeopathy.  The  essence  of  homoeopathy,  as  es- 
tablished by  Hahnemann,  lies  in  the  infinitesimal  dose  and  the 
universal  application  of  the  rule  similia  similibus  curaniur.  But 
the  infinitesimal  doses  are  so  absurd  that  I  believe  they  have 
been  discarded  by  many  homoeopaths.  To  such  men  all  that 
remains  of  homoeopathy  is  the  universality  of  the  rule  similia 
similibus  curantur,  and  the  only  difference  between  them  and 
rational  practitioners  lies  in  the  fact  that  the  latter  regard  the 
rule  as  only  of  partial  application.  At  first  sight  this  difference 
may  seem  to  be  only  slight,  but  it  is  not  so  in  reality ;  for  white 
the  rational  practitioner,  refusing  to  be  bound  by  any  '  pathy,' 
whether  it  be  allopathy,  antipathy,  or  homoeopathy,  seeks  to 


THIED  EDITION.  xiii 

trace  each  symptom  back  to  the  pathological  change  which  caused 
it,  and,  by  a  knowledge  of  the  action  of  drugs  on  each  tissue  and 
organ  of  the  body,  to  counteract  these  pathological  changes,  the 
homoeopath  professes  to  be  in  possession  of  a  rule  which  will 
enable  him  to  select  the  proper  remedy  in  each  case  by  a  consi- 
deration of  the  symptoms,  without  reference  to  the  pathological 
condition.  He  may  thus  dispense  with  anatomy,  physiology, 
pathology,  and  pharmacology.  All  that  is  necessary  is  a  list  of 
morbid  symptoms  on  the  one  hand,  and  a  list  of  the  symptoms 
produced  in  healthy  men  by  various  drugs  on  the  other. 

It  is  the  falsity  of  the  claim  which  homoeopathy  makes  to 
be  in  possession,  if  not  of  the  universal  panacea,  at  least  of  the 
only  true  rule  of  practice,  that  makes  homoeopathy  a  system  of 
quackery ;  yet  this  arrogant  claim  constitutes  the  essence  of  the 
system,  and  the  man  who,  leaving  Hahnemann  and  going  back 
to  Hippocrates,  regards  the  rule  similia  similibus  curantur  as 
only  of  partial  and  not  of  universal  application,  has  no  longer 
any  right  to  call  himself  a  homoeopath. 

Yet  we  hear  some  leading  homoeopaths  say,  'We  do  not 
claim  any  exclusiveness  for  our  method,' '  and  then  complain 'that 
they  are  excommunicated  by  the  medical  profession.  If  they 
have  renounced  the  errors  of  Hahnemann's  system,  they  ought 
not  to  retain  its  name,  but  frankly  acknowledge  their  error  and 
return  to  rational  medicine,  of  which  Hippocrates  is  regarded 
as  the  father.  As  a  medical  man  is  bound  to  do  his  utmost  for 
the  good  of  his  patient,  it  is  obvious  that,  although  he  may 
employ  baths  or  packs  as  a  mode  of  treatment,  he  cannot, 
without  becoming  untrue  to  his  profession,  throw  aside  all  other 
means  of  treatment  and  become  a  hydropath ;  nor  can  he  consult 
on  equal  terms  with  those  who,  either  through  ignorance  or 
wilful  blindness,  deny  the  use  of  other  means  of  cure  and  limit 
themselves  to  the  application  of  water.  What  is  true  of  hydro- 
pathy is  true  of  homoeopathy.  I  dislike  controversy  extremely, 
and  should  not  have  taken  up  so  much  of  the  preface  with  con- 
troversial matter  had  I  not  been  forced  to  defend  myself  by  the 
attacks  which  certain  homoeopaths  have  made  upon'  me. 

I  may  now  turn  to  the  pleasanter  task  of  acknowledging  my 
indebtedness  to  many  friends  who  have  helped  me  in  the  pre- 
paration of  this  edition.  In  addition  to  some  of  those  who 
helped  me  with  former  editions,  I  have  to  thank  Dr.  Hughlings 

1  Preface  by  Eichard  Hughes  to  The  Medical  Treatment  of  our  Time.  London : 
Unwin  Brothers,  Ludgate  Hill. 


xiv  PEEFACE   TO  THE   THIED  EDITION. 

Jackson  for  assistance  in  the  construction  of  the  diagram 
which  illustrates  his  views  of  the  nervous  system ;  Mr.  W.  H. 
Jessop  and  Mr.  Tweedy  for  much  aid  and  many  suggestions  in 
revising  the  section  on  diseases  of  the  eye ;  and  I  am  especially 
grateful  to  my  friend,  Dr.  Thin,  who  has  greatly  added  to  the 
value  of  the  book  by  writing  an  account  of  the  uses  of  various 
remedies  in  skin  diseases.  I  am  indebted  to  Mr.  Whitehead,  Dr. 
Halliburton,  and  especially  to  Dr.  Sidney  Martin,  for  their  assist- 
ance in  passing  this  edition  through  the  press.  To  Dr.  Martin 
I  am  also  indebted  for  many  valuable  suggestions,  and  for  such 
an  amount  of  help  that,  but  for  him,  the  preparation  of  this 
edition  would  certainly  have  been  delayed  for  many  months. 

T.  LAUDEE   BEUNTON. 
March,  1887. 


PBEFACE 


TO 


THE    FIEST    EDITION. 


Some  apology  is  required  for  the  long  delay  in  the  appearance 
of  this  work,  for  a  number  of  years  have  now  elapsed  since  it  was 
advertised  as  being  in  the  press.  More  than  fifteen  years  ago,  I 
had  a  work  on  Materia  Medica  completely  written  out  and  ready 
for  the  printer.  Some  time  afterwards,  all  the  arrangements 
had  been  made  for  its  publication,  and  in  the  course  of  a  few 
weeks  it  was  to  have  been  issued  from  the  press.  Just  as  I  was 
about  to  send  it  to  the  printer,  however,  I  asked  for  a  little 
delay  in  order  that  I  might  make  some  improvements  and  remove 
some  redundancies,  for  the  work  as  it  then  stood  was  considerably 
larger  than  the  present  one. 

As  I  went  through  it,  I  found  so  many  unsatisfactory  state- 
ments and  uncertainties  regarding  the  mode  of  action  of  drugs, 
which  I  thought  I  could  decide  by  a  few  experiments,  that  I 
wished  for  a  little  time  in  order  that  those  doubtful  points  might 
be  settled ;  but  as  I  went  on  the  labour  grew,  other  engage- 
ments became  pressing,  and  longer  and  longer  delay  was  required. 
From  greater  experience  as  a  teacher  and  examiner  also,  I  came 
to  the  conclusion  that  the  plan  of  the  work  might  be  altered 
with  advantage  ;  and  so  finally  the  whole  manuscript  was  thrown 
aside,  and  the  book  entirely  re-written. 

In  the  original  work  I  discussed  the  physiological  and  thera- 
peutical actions  of  each  drug  separately,  in  the  same  way  as  in 
the  third  part  of  the  present  work,  though  on  a  much  more 
extended  scale.  I  found,  however,  that  this  plan  necessitated  a 
good  deal  of  repetition  regarding  the  experimental  methods  by 
which  the  action  of  the  drugs  had  been  ascertained. 

Moreover,  the  physician  does  not  want  to  know  only  what  the 
actions  of  any  one  drug  are ;  he  rather  requires  a  knowledge  of 


xvi  PREFACE   TO  THE 

classes  of  drugs,  and  of  the  manner  in  which  the  actions  of  the 
individual  members  of  a  class  differ  from  each  other.  He  requires, 
in  fact,  a  knowledge  of  the  ways  in  which  the  various  functions 
of  the  body  can  be  influenced  by  drugs  both  in  health  and 
disease,  in  order  that  he  may  restore  health  to  his  patients. 

It  has  appeared  to  me,  therefore,  better  to  devote  a  complete 
section  of  the  work  to  a  discussion  of  the  methods  by  which 
the  action  of  drugs  is  determined;  io  the  manner  in  which 
each  function  of  the  body  can  be  modified  by  drugs  ;  and  to  the 
general  rationale  of  the  use  of  drugs  in  disease,  i.e.  to  devote  a 
section  to  general  pharmacology  and  general  therapeutics. 

Considerable  experience  both  in  teaching  and  examining 
has  shown  me  that  students  sometimes  find  a  difficulty  in 
applying  physiology  to  pharmacology  and  therapeutics,  and  I 
find  that  many  others  are,  like  myself,  apt  to  forget  those  parts 
of  physiology  which  they  are  not  constantly  studying.  I  have 
therefore  thought  it  well,  for  the  sake  both  of  students  and 
practitioners,  to  give  a  short  account  of  the  normal  functions  of 
the  different  parts  of  the  body,  before  proceeding  to  discuss  the 
alterations  which  are  produced  in  them  by  drugs,  or  which  they 
undergo  in  disease.  In  the  case  of  the  heart  and  the  kidneys 
also,  where  the  action  of  drugs  is  complicated  and  difficult,  I  have 
found  it  necessary  to  enter  a  little  more  fully  into  the  physiology 
of  these  organs  than  is  done  in  the  ordinary  text-books." 

I  have  found  that  a  similar  difficulty  occurs  with  pathology 
as  with  physiology,  and  I  have  therefore  occasionally  discussed 
pathological  questions  when  I  have  thought  that  by  doing  so  I 
could  render  the  action  of  drugs  in  disease  more  intelligible,  and 
thus  aid  the  student  of  rational  therapeutics. 

In  the  second  part  of  the  work  on  general  pharmacy,  I  have 
classed  together  the  various  pharmaceutical  preparations,  and 
given  lists  of  them  for  reference.  It  is  by  no  means  my  intention 
that  these  should  be  learned  by  heart  by  any  student,  and  indeed 
I  think  it  is  well  to  take  this  opportunity  of  protesting  against 
the  injustice  of  the  demands  which  are  sometimes  made  upon  the 
memories  of  students. 

It  is  probable  that  the  majority  of  the  best  and  most  successful 
practitioners  would  be  very  much  puzzled  if  they  were  required  to 
state  the  exact  quantity  of  every  ingredient  in  each  pill  or  each 
ointment  that  they  prescribe,  or  the  exact  quantity  of  the  crude 
drug  from  which  the  infusions  or  tinctures  which  they  use  have 
been  made.     They  know  the  action  .of  the  pill  or  ointment,  they 


FIEST  EDITION.  xvii 

know  the  action  of  the  infusion  or  tincture,  and  they  do  not  trouble 
themselves  about  details  which  are  only  useful  to  the  chemist  who 
is  making  up  the  preparation. 

It  is  very  greatly  to  be  regretted,  for  it  is  a  stumbling-block  in 
the  way  of  true  progress,  that  students  who  have  afterwards  to 
become  medical  practitioners  and  not  pharmaceutical  chemists, 
should  be  asked  at  examinations  the  quantities  of  crude  drugs 
from  which  particular  preparations  are  made — quantities  which 
even  the  manufacturing  chemist  himself  would  never  dream  of 
carrying  in  his  memory,  but  would  obtain  by  reference  to  his  books 
whenever  he  required  them.  As  the  late  Professor  Sharpey  used 
very  truly  to  say,  '  You  may  as  well  require  of  a  medical  student 
a  knowledge  of  the  whole  art  of  cutlery  before  you  set  him  to 
dissect.'  Medical  science  is  now  advancing  in  every  direction,  and 
unless  we  cut  off  some  of  the  less  useful  kinds  of  information, 
which  medical  students  were  formerly  obliged  to  acquire,  it 
becomes  impossible  for  them  to  learn  all  that  is  truly  valuable.  In 
Materia  Medica  we  now  oblige  them  to  learn  the  physiological 
action  of  drugs,  a  subject  regarding  which,  until  quite  recently, 
little  or  nothing*  was  known,  and  to  oblige  them  to  learn  all  this,  in 
addition  to  what  they  were  formerly  expected  to  know,  is  to  treat 
them  as  Pharaoh  treated  the  Israelites,  and  compel  them  to  make 
the  same  number  of  bricks,  while  giving  them  no  straw. 

I  am  so  much  impressed  with  the  necessity  of  lessening  the 
amount  of  unnecessary  work  sometimes  required  as  a  preparation 
for  examinations,  that  at  first  I  omitted  from  this  book  all 
reference  to  the  composition  of  pharmaceutical  preparations.  But 
as  it  is  intended  not  only  as  a  text-book  for  students,  but  also  for 
the  use  of  practitioners,  I  afterwards  considered  that  it  might  be 
convenient  to  have  the  composition  of  some  pharmaceutical 
preparations,  at  least,  for  the  purpose  of  reference.  I  have  omitted 
the  composition  of  such  preparations  as  are  like  to  be  got  ready- 
made  from  a  chemist,  but  have  inserted  the  composition  of 
infusions  which  often  need  to  be  prepared  when  required.  I  have 
also  given  the  composition  of  various  compound  pills,  but  only 
for  the  purpose  of  reference. 

In  consequence  of  this  change  in  the  plan  of  the  work  while  it 
was  passing  through  the  press,  the  preparations  of  rhubarb  have 
been  omitted  from  their  proper  place  at  page  924,  and  are  to  be 
found  at  page  1005. 

In  the  preparation  of  this  work  I  have  to  acknowledge  my 


xviii  PREFACE   TO  THE  FIRST'  EDITION. 

obligations  to  the  admirable  works  of  Bartholow,  Binz,  Buchheim, 
Dujardin-Beaumetz,  Edes,  Husemann,  Nothnagel  and  Bossbach, 
Binger,  Schmiedeberg,  and  H.  C.  Wood.  Messrs.  Chapman, 
Soutter,  Spencer,  Spry,1  Steinthal,  Stubbs,  Walsh,1  Wells,  and 
Wright  for  the  excellent  notes  they  took  of  my  lectures;  to 
Dr.  D'Arcy  Power  for  the  verification  of  references ;  to  Dr. 
Mitchell  Bruce,  Mr.  T.  W.  Shore,  and  Mr.  H.  W.  Gardner  for 
much  kind  assistance  in  the  preparation  of  the  work,  and  to 
Prof.  Matthew  Hay,  of  Aberdeen,  whose  criticisms  and  suggestions 
have  been  invaluable.  To  Dr.  Francis  H.  Williams,  of  Boston, 
Mass.,  I  am  indebted  for  the  adaptation  of  this  work  to  the 
United  States  Pharmacopoeia,  which  by  tending  to  familiarise 
medical  men  on  each  side  of  the  Atlantic  with  the  preparations 
employed  in  both  countries  may,  I  trust,  tend  to  facilitate  the 
introduction  of  an  International  Pharmacopoeia. 

T.  LAUDEE  BBUNTON. 

March,  1885. 

1  These  names  were  inadvertently  omitted  in  the  preface  to  the  first  edition, 
but  were  mentioned  in  the  preface  to  the  second. 


Articles  and  Preparations  included  in  the  British  Pharma- 
copoeia of  1885,  which  were  not  in  that  of  1867  nor 
in  the  '  Additions  '  of  1874. 


Acidum  Borieum. 

Acidum  Carbolicum  Liquefactum. 

Acidum  Chromicum. 

Acidum  Hydrobromicum  Dilutum. 

Acidum  Lacticum. 

Acidum  Lacticum  Dilutum. 

Acidum  Meconicum. 

Acidum  Oleicum. 

Acidum  Phosphoricum  Concentratum. 

Acidum  Salicylicum. 

Alcohol  Ethylicum. 

Aloin. 

Anisi  Fructus. 

Anisi  Stellati  Fructus. 

Apomorphinse  Hydrochloras. 

Aqua  Anisi. 

Argeuti  et  Potassii  Nitras. 

Arseuii  Iodidum. 

Bismuthi  Citras. 

Bismuthi  et  Ammonii  Citras. 

Butyl-Chloral  Hydras. 

Caffeina. 

Caffeince  Citras. 

Calamina  Preparata. 

Calcii  Sulphas. 

Calx  Sulphurata. 

Chrysarobinum. 

Cimiciiugaa  Bhizoma. 

Cinchonidina  Sulphas. 

Cinchoninffi  Sulphas. 

Coca. 

Cocaine  Hydrochloras. 

Codeina. 

Collodium  Vesicans. 

Cupri  Nitras. 

Elaterinum. 

Ergotinum. 

Extractum  Belladonna?  Alcoholicum. 

Extractum  Cascarse  Sagradse. 


Extractum  Cascare  Sagradas  Liquidum. 

Extractum  Cimicifugse  Liquidum. 

Extractum  Cocse  Liquidum. 

Extractum  Gelsemii  Alcoholicum. 

Extractum  Jaborandi. 

Extractum  Bhamni  Frangule. 

Extractum  Bhamni  Frangulffi  Liquidum. 

Extractum  Taraxaci  Liquidum. 

Gelsemium. 

Glycerinum  Aluminis. 

Glycerinum  Plumbi  SubaCetatis. 

Glycerinum  Tragacanthas. 

Inf  usum  Jaborandi. 

Injectio  Apomorphinse  Hypodermica. 

Injectio  Ergotini  Hypodermica. 

Iodoformum. 

Jaborandi. 

Lamella;  Atropine. 

Lamella?  Cocaine. 

Lamellse  Physostigmine. 

Liquor  Acidi  Chromici. 

Liquor  Ammonii  Acetatis  Fortior. 

Liquor  Ammonii  Citratis  Fortior. 

Liquor  Arsenii  et  Hydrargyri  Iodidi. 

Liquor  Calcii  Chloridi. 

Liquor  Ferri  Acetatis. 

Liquor  Ferri  Acetatis  Fortior. 

Liquor  Ferri  Dialysatus. 

Liquor  Morphine  Bimeconatis. 

Liquor  Sodii  Ethylatis. 

Lupulinum. 

Menthol. 

Morphine  Sulphas. 

Oleatum  Hydrargyria 

Oleatum  Zinoi. 

Oleo-Besina  Cubebe. 

Oleum  Eucalypti. 

Oleum  Pini  SyWestris. 

Oleum  Santali. 


XX 


AETICLES  ADDED  AND   OMITTED. 


Paraffinum  Durum. 

Paraffinum  Molle. 

Physostigmina. 

Pilocarpine  Hydrochloras. 

Potassii  Cyanidum. 

Quininas  Hydrochloras. 

Ehamni  Frangulas  Cortex. 

Ehamni  Purshiani  Cortex. 

Salicinum. 

Sodii  Bromidum. 

Sodii  Iodidum. 

Sodii  Salicylas. 

Sodii  Sulphis. 

Sodii  Sulphocarbolas. 

Sodium. 

Spiritus  ^Etheris  Compositus. 

Spiritus  Cinnamomi. 

Staphisagrias  Semina. 

Suppositoria  Iodoform!. 

Tabellaj  Nitroglycerin!. 


Thymol. 

Tinctura  Chloroformi  et  Morphinsa. 

Tinctura  Cimicifugse. 

Tinctura  Gelsemii. 

Tinctura  Jaborandi. 

Tinctura  Podophylli. 

Trochisci  Acidi  Benzoici. 

Trochisci  Santonini. 

Unguentum  Acidi  Borici. 

TJnguentum  Acidi  Carbolici. 

Unguentum  Acidi  Salicylici. 

Unguentum  Calamines. 

Unguentum  Chrysarobini. 

Unguentum  Eucalypti. 

UnguentumHydrargyriNitratisDilutum. 

Unguentum  Iodoformi. 

Unguentum  Staphisagrise. 

Unguentum  Zinci  Oleati. 

Vapor  Olei  Pini  Sylvestris. 

Zinci  Sulphocarbolas. 


Articles  and  Preparations  included  in  the  British  Pharma- 
copeia or  1867  or  in  the  '  Additions  '  of  1874,  but 
omitted  in  the  British  Pharmacopoeia  of  1885. 


Areca. 

Cadmii  Iodidum. 

Castoreum. 

Decoctum  Ulmi. 

Digitalmum. 

Dulcamara. 

Enema  Tabaci. 

Ferri  Iodidum. 

Ferri  Oxidum  Magneticum. 

Ferri  Peroxidum  Humidum. 

Hydrargyri  Iodidum  Viride. 


Infusum  Dulcamaras. 
Liquor  Atropia. 
Mistura  Gentianse. 
Pilula  Quinias. 
Ehamni  Succus. 
Sodas  Acetas. 
Stramonii  Folia. 
Syrupus  Bhamni. 
Tinctura  Castorei. 
Ulmi  Cortex. 
Unguentum  Cadmii  Iodidi. 


Articles  and  Preparations  the  Names  of  which  have 
been  altered. 


Former  Names,  1867  or  1874. 
Aconitia 

Albumen  Ovi        .        . 
Ammonias  Benzoas        . 
Ammoniae  Carbonas 
AmmonisB  Nitras  . 
Ammoniae  Phosphas 
Arnicas  Badix 


Present  Names,  1885. 
Aconitina. 
Ovi  Albumen. 
Ammonii  Benzoas. 
Ammonii  Carbonas. 
Ammonii  Nitras. 
Ammonii  Phosphas. 
Arnicas  Bhizoma. 


ALTERATIONS  OF  NAME. 


xxi 


Former  Names,  1867  or  1874. 
Assafostida    . 
Atropia 

Atropias  Sulphas  . 
Berberies  Sulphas 
Calcis  Carbonas  Prsecipitata 
Calcis  Hydras 
Calcis  Hypophospliis     . 
Calcis  Phosphas    . 
Calx  Chlorata 
Canellas  Alba?  Cortex    . 
Caidp.momura 
Cataplasma  Sodas  Chloratas 
Catechu  Pallidum 
Cinchonas  Flavas  Cortex 
Cinchonas  Pallidas  Cortex 
Decoctum  Cinchonas  Flavas 
Ecbalii  Fructus     . 
Emplastrum  Cerati  Saponis 
Enema  Assafoetidas 
Enema  Magnesia?  Sulphatis . 
Extractum  Cinchonas  Flavas 
Ferri  et  Ammonia  Citras 
Ferri  et  Quinias  Citras  . 
Hydrargyri  Sulphas 
Infusum  Cinchonas  Flavas 
Liquor  Ammonias  Acetatis 
Liquor  Ammonias  Citratis 
Liquor  Atropias  Sulphatis 
Liquor  Bismuthi  et  Ammonias  Citratis 
Liquor  Calcis  Chlorates 
Liquor  Magnesias  Carbonatis 
Liquor  Magnesias  Citratis 
Liquor  Morphias  Acetatis 
Liquor  Morphias  Hydrochloratis 
Liquor  Potasses  Pcrmanganatis 
Liquor  Sodas  Arseniatis 
Liquor  Sodas  Chloratas  . 
Liquor  Strychnias 
Lithias  Carbonas  . 
Lithias  Citras 


Liquidum 


Magnesias  Carbonas 
Magnesias  Carbonas  Levis 
Magnesias  Sulphas 
Morphias  Acetas    . 
Morphias  Hydrochloras 
Physostigmatis  Faba    . 
Pilula  Aloes  et  Assafoetidas 
Pilula  Assafcetidas  Composita 
Podophylli  Badix 
Potasses  Acetas 
Potassas  Bicarbonas 
Potassee  Bichromas 


Present  Names,  1883. 
Asafostida. 
Atropina. 
Atropines  Sulphas. 
Beberinas  Sulphas 
Calcii  Carbonas  Precipitata. 
Calcii  Hydras. 
Calcii  Hydrophosphis, 
Calcii  Phosphas. 
Calx  Cblorinata. 
Canellas  Cortex. 
Cardamomi  Semina. 
Cataplasma  Sodas  Chlorinates. 
Catechu. 

Cinchonas  Cortex. 
Cinchonas  Cortex. 
Decoctum  Cinchonas  [Bubras], 
Ecballii  Fructus. 
Emplastrum  Saponis  Fuscum. 
Enema  Asafostidas. 
Enema  Magnesii  Sulphatis. 
Extractum  Cinchonas  [Bubras]  Liquidum. 
Ferri  et  Ammonii  Citras. 
Ferri  et  Quinines  Citras. 
Hydrargyri  Persulphas. 
Infusum  Cinchonas  [Bubras]  Acidum. 
Liquor  Ammonii  Acetatis. 
Liquor  Ammonii  Citratis. 
Liquor  Atropines  Sulphatis. 
Liquor  Bismuthi  et  Ammonii  Citratis. 
Liquor  Calcis  Chlorinates. 
Liquor  Magnesii  Carbonatis. 
Liquor  Magnesii  Citratis. 
Liquor  Morphinas  Acetatis. 
Liquor  Morphines  Hydrochloratis. 
Liquor  Potassii  Permanganatis. 
Liquor  Sodii  Arseniatis. 
Liquor  Sodas  Chlorinate. 
Liquor  Strychninas  Hydrochloratis. 
Lithii  Carbonas. 
Lithii  Citras. 
Magnesia  Ponderosa. 
Magnesii  Carbonas  Ponderosa. 
Magnesii  Carbonas  Levis. 
Magnesii  Sulphas. 
Morphinas  Acetas. 
Morphinas  Hydrochloras. 
Phosostigmatis  Semen. 
Pilula  Aloes  et  Asafcetidte. 
Pilula  Asafoetidas  Composita. 
Podophylli  Bhizoma. 
Potassii  Acetas. 
Potassii  Bicarbonas. 
Potassii  Bichromas. 


xxii  ALTERATIONS  AND  SUBSTITUTIONS. 

Former  Names,  1867  or  1874.  Present  Names,  1885. 

Potasss  Carbonas         ....  Potassii  Carbonas. 

Potassse  Chloras Potassii  Chloras. 

Potassae  Citras Potassii  Citras. 

Potassse  Nitras      .....  Potassii  Nitras. 

Potasss  Permanganas  ....  Potassii  Permanganas. 

Potassse  Prussias  Flava         .        .        .  Potassii  Ferrocyanidum. 

Potassse  Sulphas Potassii  Sulphas. 

Potassse  Tartras Potassii  Tartras. 

Potassse  Tartras  Acida  ....  Potassii  Tartras  Acida. 

Quinife  Sulphas Quininse  Sulphas. 

Serpentarise  Radix        ....  Serpentarise  Ehizoma. 

Sodre  Arsenias Sodii  Arsenias. 

Sodffi  Bicarbonas Sodii  Bicarbonas, 

Sodas  Carbonas      ...         .         .         -  Sodii  Carbonas. 

Sodas  Carbonas  Exsiccata     .        .        .  Sodii  Carbonas  Exsiccata. 

Sodse  Citro-tartras  Efiervescens    .         .  Sodii  Citro-tartras  Effervescens. 

Sodas  Hypophosphis      ....  Sodii  Hypophosphis. 

Sodse  Nitras Sodii  Nitras. 

Sodas  Phosphas Sodii  Phosphas. 

Sodas  Sulphas Sodii  Sulphas. 

Sodas  Valerianas Sodii  Valerianae. 

Strychnia Strychnina., 

Suppositoria  Morphia;  ....  S.uppositoria  Morphinse. 

Suppositoria  Morphise  cum  Sapone      .  Suppositoria  Morphinse  cum  Sapone. 

Tinctura  Assafoetidas     ....  Tinctura  Asafoetidas. 

Tinctura  Quinise Tinetirra  Quininse. 

Tinctura  Quinise  Ammoniata        .        .  Tinctura  Quininas  Ammoniata. 

Trochisci  Morphiaa        ....  Trochisci  Morphinae. 

Trochisci  Morphias  et  Ipecacuanha      .  Trochisci  Morphinse  et  Ipecacuanb.se. 

Trochisci  Potassse  Chloratis .         .         .  Trochisci  Potassii  Chloratis. 

Trochisci  Sodse  Bicarbonatia         .        .  Trochisci  Sodii  Biearbonatis. 

Unguentum  Aconitiae    ....  Ungue,ntum  Aconitinas. 

Unguentum  Atropise     ....  Unguentum  Atropines. 

Unguentum  Veratrise    ....  Unguentum  Veratrinse. 

Valerianse  Radix Valeriana}  Rhizoma. 

Vapor  Conise Vapor  Coninse. 

Veratria Veratrina. 

Veratri  Viridis  Radix    ....  Veratri  Viridis  Rhizoma. 

Vinum  Quinise      .....  Vinum  Quininse., 


Substitutions.   • 


Antimonium  Nigrum  Purificatum  for        Antimonfum  Nigrum. 
Cinchonas  Rubral  Cortex )  f  Cinchonas'  Flavas  Cortex. 


(in  preparations)  [  "       t 

Pulvis  Elaterini  Compositus  „ 

Tinctura  Cinchonas  [Rubra]  „ 
Unguentum  Glycerini  Plumbi )  f 

Subacetatis  J  "       \ 


Cinehonse  Pallidas  Cortex. 
Pulvis  Elaterii  Compositus. 
Tinctura  Cinehonse  Flavse. 
Unguentum  Plumbi  Subacetatis  Com- 
positum. 


ALTERATIONS. 


xxiu 


Pkepabations  the  Composition  op  which  has  been  altered. 


(Minor  alterations  are  not  included.) 


Acidum  Sulphurosum. 

Alumen. 

Antimqnium  Sulphuratum. 

Extractum  Cinchona  Liquidum. 

Infusum  Cinchonas  Acidum. 

Injectio  Morphine  Hypodermica. 

Liquor  Epispasticus. 

Liquor  Iodi. 

Oleum  Phosphoratum. 

Pilula  Phosphori. 

Pulvis  Glyoyrrhizse  Compositus. 


Tinctura  Quininse. 

Unguentum  Hydrargyri  Ammoniati. 

The  fatty  basis  of  the  four  suppositories 

of  B.P.  1867  is  now  oil  of  theobroma 

only. 
In  some  of  the  ointments  paraffins  have 

been  substituted  for  lard. 
Scammony  Besin  has  been  substituted 

for  Scammony  in  most  preparations 

of  Scammony. 


The  strengths  of  the  following  preparations  have  been  altered  from  1  in  109 

to  1  m  100. 


Liquor  Arsenicalis. 
Liquor  Arsenici  Hydrochloricus. 
Liquor  Atropine  Sulphatis. 
Liquor  Morphine  Acetatis. 


Liquor.  Morphine  Hydrochloratis. 
Liquor  Potassii  Permanganatis. 
Liquor  Sodii  Arseniatis. 
Liquor  Strychnine  Hydrochloratis. 


CONTENTS. 


PAGE 

INTRODUCTION 3 


SECTION  I. 
GENEKAL  PHAEMACOLOGY  AND  THEEAPEUTICS. 

CHAPTER  I. 

General  Relations  between  the  Okganish  and  Substances  Affecting:  it, 

pp.  9-32. 

List  of  Elements . , 9 

Nature  of  Elements 11 

Classification  of  Elements        .        .        .        .        .        ...        .        •        .15 

Mendelejeff's  Classification  of  the  Elements 19 

Organic  Radicals 20 

Chemical  Reactions  and  Physiological  Reactions 24 

Relation  between  Isomorphism  and  Physiological  Action        ....  26 

„            „       Spectroscopic  Characters  and  Physiological  Action .        .    .  27 

„           „      Atomic  Weight  and  Physiological  Action     .        ...  28 

Connection  between  Chemical  Constitution  and  Physiological  Action         .   .  30 

CHAPTER  H. 

Circumstances  which  Affect  the  Action  of  Dbuos  on  the  Obganism, 
pp.  33-56. 

Local  and  Remote  Action         .        .        . 33 

Interaction  of  Various  Functions 33 

Direct  and  Indirect  Action '     .  -     . 34 

Selective  Action  of  Drugs     .        . 34 

Primary  and  Secondary  Action  -     .  • 35 

Relation  of  Effect  to  Quantity  of  the  Drag 36 

Homoeopathy    ....  ........       36 

Dose     ...-.■ .37 

Size ..  •'.*..        •»«••■«        .37 

Mode  of  Administration    "', 38 

Absorption  of  Drugs         .        .        .        >        .        .        .        .        .        .        .39 

Duration  of  Action      •       .       .-•<>.        . 41 


xxyi  CONTENTS. 

PAGE 

Cumulative  Action 41 

Effect  of  Different  Preparations 42 

„        Fasting 43 

„        Conditions  of  the  Stomach 43 

Habit 43 

„        Temperature '44 

„        Climate 48 

Time  of  Day 48 

„        Season 48 

„        Disease 49 

Use  of  Experiments         .  • 49 

Comparative  Pharmacology 50 

Idiosyncrasy 51 

Experiments  upon  Healthy  Men 51 

Fallacies  of  Experiment  upon  Man 52 

Experiments  in  Disease 52 

Objections  to  Experiment 53 

Erroneous  Deductions  from  Experiments 55 


CHAPTEE  HI. 

Action  op  Dhugs  on  Protoplasm,  Blood,  and  Low  Organisms,  pp.  57-108. 

Action  of  Drugs  on  Albumin 57 

„             „             Protoplasmic  Movements 59 

Method  of  Experimentation     .  ■      .  •      .        .        .  ^      .  -      .  -      .        .        .  59 

Amoeba        .        . .      . .       .        .        .  •      .  -      .  -      . .      .  •      .        .        .    .  60 

Leucocytes       .■.>.-,        .  •      .        .  • 61 

Effect -of  Drugs  on  leucocytes     .  ■               61 

Movements  of  Leucocytes  in  the  Blood-vessels 62 

,i             Bed  Blood  Corpuscles 63 

Action'  of  Drugs  on  Infusoria 63 

Relations  of  Motion  and  Oxidation 65 

Oxidation  of  Protoplasm 67 

Oxygen-carrying  Power  of  Protoplasm    • 68 

Ozonising  Power  of  Protoplasm 69 

Aotion  of  Drugs  on  Oxidation 69 

Seduction  by  Protoplasm 70 

Action  of  Drugs  on  Blood 70 

Catalysis— Fermentation— Inorganic  Ferments 73 

Ferments,  Organic  and  Organised    .        . '  * ' 74 

Action  of  Drugs  on  Enzymes  .        .        . 76 

^yjnogens 80 

Organised  Ferments         .._..,.,., 80 

leasts  .        .        ....  ^     .,     ...  , 81 

Moulds     .        .,.,.,.,;>..,.. 82 

Bacteria               ..,.,.,., 82 

Struggle  for. Existence, between  the  Organism  and  Microbes    •  ,     .       ..        .  85 

Action  of  Drugs  on  the  Movenjents.of  Bacteria   ■  ..,.,.,.,.,.  88 

■    „  „        ,    Reproduction  of  Bacteria  .,.,.,.,.        .        .89 

it            »            ,        .  »t     .        ,        ii        Mode  of  Experimenting  on   .    .  89 

„    ,       i,        ,   Particular  Species, of  Bacilli ,.,.,.        .  .92 

l',n    .       >•            .        ,  ii     .        ,        .«          Mode  of, Experimenting  on    .  92 


CONTENTS.  xxvii 

PAGE 

Action  of  Drugs  on  Development  and  Growth  of  Bacilli 95 

Influence  on  Antiseptics  of  the  Solvent 96 

„              „              „        Admixture 96 

„              „              „        Temperature        .        .        •        .        .        .    .  96 

.  Alterations  in  Bacteria  by  Heat  and  Soil 96 

Possible  Identity  of  different  Forms,  of  Bacteria 97 

Action  of  Bacteria  and.  their  Products  on  the  Animal  Body    ....  98 

Alkaloids  formed  by  Putrefaction — Ptomaines 99 

,,                „                  „              Leucomaines 101 

Effect  of  Drugs  on  the  Action  of  Bacteria  in  the  Animal  Body    .        .        .    .  102 

Antiseptics — Antizymotics— Disinfectants — Deodorizers         ....  103 

Uses  of  Antiseptics 104 

Disinfectants 106 

,  Deodorizers 106 

Antiperiodics 107 


CHAPTER  IV. 

Action  of  Drugs  on  Invertebbata,  pp.  109-116. 

Action  of  Drugs  on  Medusae 109 

„.    .       „  Mollusca 114 

„•        ■  „  Ascidians 114 

,  Annnlosa 114 


.     CHAPTEB  V. 
Action  of  Drugs  on  Muscle,  pp.  117-143. 

Action  of  Drugs  on  Voluntary  Muscle 117 

Irritability  of  Muscle        .        .' 119 

Contraction  of  Muscle .        .        ; 119 

Latent  Period  of  Muscle  . 120 

Summation  of  Stimuli 122 

Contraction  of  Muscle 122 

Fatigue         .....        f 123 

Contracture 124 

Tetanus        :                         12S 

'Muscular  Poisons     .'       .'        .'        .        .'        .'        .'        .'        ."    '    .        .        .  126 

Massage 131 

Propagation  of  the  Contraction  Wave  in  Muscle  ; 131 

Rhythmical  Contraction  of  Muscle      .        .        . 131 

Pathology  of  Tremor .        .        .        .  133 

Treatment  of,  Tremcr  .,        ..        ..        ..        ..        . 13ft 

Connection  between.  Chemical  Constitution  and   Physiologjpal  Action  on, 

Muscle  .".*,.' .        *        .        .        .13.4 

Action  of  Drugs,  on  Muscle  is  Relative  and  not  Absolute      .        .        .        .    .  136 

„           „         on  Involuntary  Muscular  Fibre .  137 

Effect  of  Stimuli .138 

Relation  of  Contractile  Tissue  to  the  Nerves    .......  139 

Propagation  of  Contraction  Waves .    .  139 

Artificial  Bhvthm,   .......        . 140 

Hypothetical  Considerations  regarding  the  Action  of  Drugs  on  Muscle       .   .  141 


xxviii  CONTENTS. 

CHAPTER  VI. 
Action  op  Drugs  on  Nerves,  pp.  144-158* 

FAGS 

General  Action  of  Drugs  on  the  Nervous  System 144 

Action  of  Drugs  on  Motor  Nerves 146 

Methods  of  Experiment ....  147 

Paralysis  of  Motor  Nerve-Endings  by  Drugs 147 

Advantage  of  the  Method  of  Local  Protection 149 

Paralysers  of  Motor  Nerves 150 

Exact  Localisation  of  the  Action  of  Curare 1S1 

Action  of  Drugs  in  Increasing  Excitability  of  Motor  Nerves        .        .        .    .  153 

Irritation  of  Motor  Nerve-Endings    .        .                154 

Action  of  Drugs  on  the  Trunks  of  Motor  Nerves 154 

,,             „             Sensory  Nerves 155 

Local  Sedatives  and  Local  Ansssthetics 157 

Stimulating  Action  of  Drugs  on  the  Peripheral  Ends  of  Sensory  Nerves .        .  157 

CHAPTER  VII. 
Action  of  Drugs  on  the  Spinal  Cord,  pp.  159-182. 

Action  on  the  Conducting  Power  of  the  Cord 159 

Action  of  Drugs  on  Reflex  Action    . 163 

Direct,  Indirect,  and  Inhibitory  Paralysis  of  the  Spinal  Cord  by  Drugs       .    .  164 

Indirect  Paralysis 164 

Direct           ,,                 164 

Spinal  Depressants  and  their  Uses 165 

Inhibitory  Paralysis 165 

Nature  of  Inhibition 167 

Interference  in  Nervous  Structures 169 

Effect  of  Altered  Rate  of  Transmission 169 

Opposite  Conditions  produce  Similar  Effects 170 

The  Same  Conditions  may  cause  Opposite  Effects 170 

Stimulation  and  Inhibition  merely  Consequences  of  Relation      .        .        .    .  170 

Test  of  the  Truth  of  the  Author's  Hypothesis  regarding  Inhibition         .        .  171 

Explanation  of  the  Action  of  Certain  Drugs  on  this  Hypothesis  .        .        .    .  171 

Stimulating  Action  of  Drugs  on  the  Reflex  Powers  of  the  Cord        .        .        .  177 

Localisation  of  the  Action  of  Strychnine  by  Magendie 177 

Spinal  Stimulants    .        .        .        . 181 

CHAPTER  VHI. 

Action  op  Drugs  on  the"  Brain,  pp.  183-215. 

Functions  of  the  Brain  in  the  Frog 183 

„  „  „  Mammals .184 

Depressant  Action  of-  Drugs  on  Motor  Centres  in  the  Brain         .        .        .    .  187 

Irritant             „                             „                            „                    ....  188 

Convulsions 188 

Action  of  Drugs  on  the  Sensory  and  Psychical  Centres  in  the  Brain        .        .  191 

Drugs  which  Increase  the  Functional  Activity  of  the  Brain         .        ,        .    .  192 

Nerve  Stimulants 192 

Cerebral  Stimulants     ....                 192 

Drugs  which  Lessen  the  Functional  Activity  of  the  Brain      .                       .  195 


CONTENTS.  xxix 

PAGE 

Hypnotics  or  Soporifics 196 

Narcotics 200 

Anodynes  or  Analgesics 201 

Adjuncts  to  Anodynes 203 

Anaesthetics 203 

Stages  of  their  Action 206 

Uses  of  Anaesthetics 207 

Dangers  of  Anesthetics 207 

Mode  of  Administering  Anesthetics 209 

Anesthesia  in  Animals 210 

History  of  the  Discovery  of  Anesthesia        .        .        . 21] 

Antispasmodics 212 

Action  of  Drugs  on  the  Cerebellum 215 

CHAPTBE   IX. 
Action  of  Drugs  on  the  Okoans  of  Special  Sense,  pp.  216-231. 

Action  of  Drugs  on  the  Eye 216 

„            „            „     Conjunctiva 216 

„            „            „     Lacrimal  Secretion 217 

Projection  of  the  Eyeball 217 

Action  of  Drugs  on  the  Pupil 217 

„            „            „     Accommodation 223 

„            „            „     Intra-ocular  Pressure  .        , 224 

Uses  of  Mydriatics  and  Myotics 225 

Action  of  Cocaine 226 

Action  of  Drugs  on  the  Sensibility  of  the  Eye 227 

„            „       in  Producing  Visions 228 

„             „       on  Hearing: 228 

„            „       on  Smell 280 

„             „       on  Taste   .         .         ...         . 230 

CHAPTEB  X. 
Action  of  Dbucs  on  Respiration,  pp.  232-261. 

Eespiratory  Stimulants  and  Depressants 232 

Comparative  Anatomy  of  the  Eespiratory  Centre 232 

Action  of  Drugs  on  the                   „                „ 240 

„            „            „      Eespiratory  Nerves 244 

Sternutatories  or  Errhines 245 

Pulmonary  Sedatives 246 

Pathology  of  Cough 247 

Eemedies  which  Lessen  Irritation 249 

Pulmonary  Sedatives 250 

Expectorants .  250 

Action  of  Drugs  on  the  Bronchial  Secretion .  252 

„             „             „      Expulsive  Mechanism      ......  254 

Adjuncts .        .  255 

Arrest  of  Colds     .        . '.        .        .    .  '256 

Selection  of  Eemedies  in  Treatment  of  Cough 257 

Action  of  Drugs  on  the  Bronchi '259 

Pathology  of  Bronchial  Asthma 259 

Treatment  of        „              „                 . 260 


xxx  CONTENTS. 

CHAPTER  XI. 
Action  of  Detjos  on  the  Circulation,  pp.  262-339. 

FAGB 

Arteries  and  Veins •  262 

Blood-pressure 263 

Painting  and  Shock ' 264 

Scheme  of  the  Circulation 265 

Circulation  in  the  Living  Body 267 

Mode  of  Ascertaining  the  Blood-pressure 268 

Fallacies 269 

Alterations  in  Blood-pressure       .        .     — 270 

Belation  of  Pulse-rate  and  Arterioles  to  Blood-pressure 271 

Effect  of  the  Arterioles  on  Pulse  Curves 275 

Investigation  of  the  Action  of  Drugs  on  the  Arterioles     .....  277 

Method  of  Measurement  by  Bate  of  Flow 281 

Action  of  Drugs  on  Vaso-motor  and  Vaso-dilating  Nerves       ....  283 

Action  of  Other  Parts  on  the  Blood-pressure 285 

Keflex  Contraction  of  Vessels  .        .        .        .' 285 

Action  of  Drugs  on  Reflex  Contraction  of  Vessels 286 

.  Comparative  Effect  of  Heart  and  Vessels  on  Blood-pressure  in  Different 

Animals 287 

Influence  of  Nerves  on  Blood-pressure 289 

Action  of  the  Heart  on  Blood-pressure 292 

Causes  of  Alteration  in  Blood-pressure  and  Pulse-rate 293 

Effect  of  Drugs  on  the  Pulse-rate •        .        .        .  295 

Action  of  Drugs  on  the  Cardio-inhibitory  Action  of  the  Vagus     .        .        .    .  295 

Keflex  Stimulation  of  the  Vagus 296 

Causes  of  Quickened  Pulse 297 

Action  of  Drugs  on  Vagus-Koots 297 

Action  on  Accelerating  Nerves 298 

Stimulating  Effect  of  Asphyxial  Blood  on  the  Medulla 298 

Stimulation  of  the  Heart  by  Increased  Blood-pressure 298 

Palpitation 299 

The  Heart  of  the  Frog 299 

Action  of  Drugs  on  the  Heart  of  the  Frog 301 

„              „          its  Muscular  Substance 305 

Differences  between  the  Heart  Apex  and  the  Heart 308 

Action  of  Drugs  on  the  Vagus  of  the  Frog 310 

Action  of  Drugs  on  Inhibition  of  the,  Heart 310 

Theories  Regarding  the  Mode  of  Action  of  Drugs  on  the  Heart   .        .        .    .  312 

Drugs  which  Act  on  the  Cardiac  Muscle 316 

„            „            „       Motor  Ganglia .  316 

„             „             .,       Inhibitory  Ganglia 317 

„            „            „       Vagus-Ends  in  the  Heart 317 

„            „            .,       Vagus-Centre 317 

„            „            „       Accelerating  Centre 318 

,,            »            ..       Capillaries 318 

„            „            „       Vaso-motor  Nerves 318 

>•             ..             ..                ..           Centre     .                  319 

Stannius's  Experiments ...  319 

General  Considerations  regarding  the  Heart    .                 322 

Regulating  Action  of  the  Nervous  System    .                                         v  324 


CONTENTS.'  xxxi 

l'AGE 

Hypothesis  regarding  the  Action  of  .the  Vagus 325 

Inhibition  in  the  Heart        *        ..        .  -.    .  326 

Therapeutic  Uses  of  Drugs  acting  on  the  Circulation      .....  328 

Cardiac  Stimulants      .  328 

Vascular 330 

Cardiac  Tonics 331 

Bisks  attending  the  Administration  of  Digitalis  and  other  Cardiac  Tonics      .  335 

Vascular  Tonics   . 335 

Pathology  of  Dropsy 336 

Cardiac  Sedatives         . 338 

Vascular       „ 339 

CHAPTER  XII. 
Remedies  Acting  on  the  Surface  op  the  Body,  pp.  340-351. 

Irritants  and  Counter-irritants 340 

Bubefacients 344 

Vesicants 345 

Pustulants 346 

Caustics 346 

Emollients  and  Demulcents 347 

Astringents 349 

Styptics   .  350 

CHAPTEE  XHI. 
Action  op  Dbugs  on  the  Digestive  System,  pp.  352-409. 

Action  of  Drugs  on  the  Teeth 352 

„  „  „      Salivary  Glands 353 

Sialagogues 353 

„      Keflex 357 

„      Mixed 357 

„      Specific 357 

Excretion  by  the  Saliva 358 

Refrigerants 360 

Pathology  of  Thirst 360 

Anti-sialics 360 

Action  of  Drugs  on  the  Stomach 361 

Gastric  Tonics 361 

Appetite • 362 

Action  of  Drugs  on  Secretion  in  the  Stomach  . 363 

„  „  the  Movements  of  the  Stomach 365 

Absorption  from  the  Stomach 368 

Antacids 369  ^ 

Emetics 370 

Anti-emetics  and  Gastric  Sedatives 376 

Carminatives 378 

Action' of  Drugs  on  the  Intestines     .  .        .        .        .        .        .    .  379  V 

Intestinal  Movements  and  Secretion 379 

Paralytic  Secretion 380 

Constipation 384 

Action  of  Drugs  On  Absorption  from  the  Intestines      .        .        .        .        .    .  386 

Intestinal  Astringents 387 


xxxii  CONTENTS. 

PAGB 

Purgatives 389 

Action  of  Purgatives 390 

Uses  of  Purgatives 394  ' 

Action  of  Irritant  Poisons 395 

Peculiarities  in  the  Action  of  different  Irritant  Poisons       ,  .        .    .  397 

Secondary  Effects  of  Irritant  Poisoning 398 

Action  of  Drugs  on  the  liver .  399 

Hepatic  Stimulants 402 

Cholagogues 404 

Adjuncts  to  Cholagogues 406 

Uses  of  Hepatic  Stimulants  and  Cholagogues 407 

Hepatic  Depressants 407 

Action  of  Drugs  on  the  Pancreas 407 

Anthelmintics 408 


CHAPTER   XIV. 
Drugs  Acting  on  Tissue-Change,  pp.  410-421. 

Tonics 410 

Hasmatinics 412 

Alteratives 413 

Antipyretics — Febrifuges '.  ....  416 

CHAPTER  XV. 
Action  or  Drugs  on  Excretion,  pp.  422-446. 

Action  of  Drugs  on  the  Kidneys         .         .         . 422 

Circumstances  Modifying  the  Secretion  of  Urine 427 

Mode  of  Action  of  Diuretics         .  , 431 

Adjuvants  to  Diuretics 434 

Action  of  Drugs  on  Albuminuria 434 

Lithontriptics 436 

Action  of  Drugs  on  the  Skin 437 

Diaphoretics  and  Sudorifics .        .        .  437 

Excretion  by  the  Sweat  Glands    .  , 439 

Relation  between  Sweat  Glands  and  Kidneys  .    ,  ...  439 

Action  of  the  Skin  in  Regulating  Temperature  .        .  .    .  440 

Antihidrotics  or  Anhidrotics 441 

Pathology  of  Night  Sweats  .  ...  442 

Action  of  Drugs  on  the  Bladder 443 

Urinary  Sedatives  and  Astringents 445 


CHAPTER  XVI. 
•  Action  of  Drugs  on  the  Generative  System,  pp.  447-456. 

Aphrodisiacs  and  Anaphrodisiacs 447 

Aphrodisiacs 449 

Anaphrodisiacs 457 

Emmenagogues 452 

Ecbolics 454 

Action  of  Drugs  upon  the  Mammary  Glands 455 


CONTENTS.  xxxiii 

43HAPTBE  XVTT. 
Methods  of  AnMiNisiEEiNa  Dkugs,  pp.  457-485. 

RAGE 

Application  of  Drugs  by  the  Skin 457 

Epidermic  Application       " 457 

Baths      .        . ' 459 

Cold  Bath    .                       * 460 

»    Pack 463 

„    Sponging 463 

„    Douches                            .    ' 463 

Local  Application  of  Cold  •  .■  .     .        .        .        .        .        .        .'-      .        .    .  464 

Cold  Sitz  Bath 464 

„    Foot  Bath 464 

„    Compresses      .        .        .     ' 464 

Tepid  Baths         .        .        .        .....        .- 466 

Warm 466 

Hot        „              467 

„    Foot  Bath 467 

„    Sitz  Bath 467 

Poultices 468 

Medicated  Baths  .        .      - 469 

Sea-bathing     .        .        .'       .        . 469 

Carbonic-acid  Bath 469 

Acid  Bath 469 

Alkaline  Bath 470 

Sulphurous  Bath 470 

Mustard  Bath , 470 

Pine  Bath 470 

Vapour  Baths 470 

Calomel  Fumigation , .        .        .        .  471 

Air  Baths— Turkish  Bath 471 

Friction  and  Inunction 472 

Massage 472 

Inunction 473 

Endermic  Application  of  Drugs 474 

Hypodermic  Administration  of  Drugs 474 

Objections  to  Hypodermic  Injections .        .    .  476 

Application  of  Drugs  to  the  Eye      .        .       . .        .       . .        .        .        .        .  477 

Ear, 477 

<>                   >•                 Nose 478 

1.                   »                 Larynx 479 

»                   „                 Lungs  . 481 

„                  „                Mouth  and  Pharynx       . . 482 

Masticatories — Gargles 482 

Application  of  Drugs  to  the  Stomach  .        .        ...        .        .        .        .    .  482 

Stomach-pump 483 

Gastric  Syphon 483 

Application  of  Drugs  to  the  Intestine 484 

Enemata      . .        .        .        .        .    .  484 

Suppositories 484 

Application  of  Drugs  to  the  Urethra 484 

„                  „                Vagina  and.Uterus       .        .     '  .        .        .        .  485 

b 


xxxiv  CONTENTS. 

CHAFTEB  XVHL 

Antidotes,  pp.  486-491. 

PASS 

Antidotes  to  Poisonous  Gases 486 

Acids 487 

Alkalies 487 

„  Alkaloids,  &e. 488 


CHAPTEK  XIX. 

Antagonistic  Action  or  Deugs,  pp.  492-496. 

OHAPTEE  XX. 
Dosage,  p.  497. 


SECTION  n. 

GENEEAL  PHAEMACY. 

CHAPTEE  XXI. 

Pharmaceutical  Peepaeations,  pp.  501-534. 

Abstracta — Abstracts .  503 

Aceta  —Vinegars 503 

Alkaloidea — Alkaloids 503 

Aquffi — Waters .  505 

Gataplasmata — Poultices 506 

Cerata — Cerates .        .        .        .        .        .    .  506 

Chartse  —Papers 506 

Collodia — Collodions 507 

Confectiones — Confections— Electuaries  ........  507 

Decocta — Decoctions 507 

Elixiria— Elixirs 508 

Emplastra— Plasters 508 

Enemata — Injections — Enemas — Clysters 508 

Essentia — Essences 509 

Extracta — Extracts 509 

Glycerina— Glycerita — Glycerines 513 

Infusa — Infusions 513 

Injectiones  Hypodermics — Hypodermic  Injections 514 

Lamellte— Gelatine  Discs 515 

Linimenta — Liniments — Embrocations 515 

Liquores— Solutions         .        , 517 

Lotiones — Lotions 518 

Masses— Masses 518 

Mellita — Honeys 518 

Misturse — Mixtures .  513 

Mueilagines — Mucilages       .        .        ...        .        ...         .        .    ,  519 


.-CONTENDS. 


•  XXXV 


TAUK 


Olea— Oils,  Fixed  and  Volatile 61!) 

Oleata — Oleates  ...  621 

Oleoresinffi — Oleoresins 521 

Oxymel .    .  521 

PilulsB— Pills 521 

Pulveres — Powders .    .  524 

Resinae — Eesins       .•.-...        . -  524 

Spiritus — Spirits ,    .  525 

Suppositoria — Suppositories 526 

Succi — Juices       .        .        .        »   , 526 

Syrupi — Syrups 527 

Tfcbellffl— Tablets 528 

TifcctursB — Tinctures 528 

Triturationes — Triturations 531 

Troehisci — Lozenges 531 

Unguent  a — Ointments 532 

Vapores — Vapours — Inhalations 533 

Vina— Wines 534 


■     SECTION  m. 

INOEGANIC  MATEEIA  MEDICA. 

CHAPTER  XXn. 
Hydhooen,  Oxygen,  Ozone,  OABBoiir,  Sulphur,  and  the  Halogens,  pp.  537-564. 

Hydrogen         .■ 537 

Oxygen 537 

Ozone      .        .  ■       .        .        ...        .        .  -       .        .        .        .        ,        .  539 

Peroxide  of  Hydrogen  .                 540 

Carbon 541 

Sulphur .543 

Sulphuretted  Hydrogen 545 

Halogen  Elements — General  Source  and  Characters    ....            .  547 

Mode  of  Preparation 548 

General  Action 549 

Chlorine • 549 

Chlorinated  Lime  -       .        .•               550 

„            Soda 551 

Bromine 552 

Bromide  of  Potassium 553 

„            Sodium 555 

„            Ammonium 556 

„            Lithium     .        .        .     ■ 556 

„           Calcium ,  556 

„            Zirio  (vide  p.  678)      .        .        .        . 556 

Iodine .        .        .        .        .  56? 

Iodide  of  Sulphur         .        » ,.        .        .        .    .  557 

Action  of  Iodine       . .        .  558 

Iodide  of  Potassium ...        .                .    .  559 


xxxvi 


CONTENTS. 


Iodide  of  Sodium ,  563 

Ammonium  .  •    •  "63 

Zinc  (vide  p.  673) 564 

Silver  (vide  p.  680) 564 

Mercury,  Bed  (vide  p.  696) 564 

„        Green  (rede  p.  ,696) fi64 

Lead  (vide  p.  705) 564 


CHAPTEB  XXHI. 
Acids,   pp.  565-591. 


General  Characters  of  Acids 
„       Preparations  of  Acids . 
„       Action  ,        „ 

Sulphuric  Acid 

Sulphurous  „ 

Hydrochloric  Acid   .     , 

Hydrobromic    „ 

Hydriodic  Acid  (Syrup) 

Nitric  „ 

Nitro-hydrochloric  Acid 

Acetic 

Phosphorio 

Tartaric 

Citric 

Oxalic 

Boric  or  Boracic 

Chromic 

Carbonic 

Hydrocyanic 

Lactic 

Oleic 

Arsenious  „     (vide  p.  719) 

Benzoic  „    ,(vide.-p.  964) 

Carbolic  „     (vifie  p.  .813). 

Chrysophanic  „    (vide  p.  909) 

Gallic  „     (vide  p.  1033) 

Pyrogallic  „    .(vide/p.  819) 

Salicylic  „     (vide  p..819) 

Tannio         „  .(vide.?.  10,31) 


565 
565 
567 
570 
571 
572 
573 
574 
574 
575 
576 
578 
580 
580 
581 
581 
582 
583 
586 
589 
590 
591 
591 
591 
591 
591 
591 
591 
591 


CHAPTER  XXIV. 
Metals,  pp.  592-643. 


General  Classification  of  the  Metals         .... 
General  Tests  fqr  Acid  Badicals  in  Metallic  Salts 
Metals  .of  the  Alkalis.    Their  Characters  and  Reactions 
General  Physiological  Action  of  the  Alkalis         .  . 

„  „  „  Alkaline,  Group  of  .Salts 

.1  ii  ,.  Chlorides    „  „ 

„  „  „  Sulphates   „  „ 


592 
593 
596 
596 
597 
599 
602 


CONTENTS. 


xxxvn 


Comparative  Action  of  the  Alkaline  Metals 

Monad  Metals,  Group  I.,  Potassium,  Sodium,  Lithium    . 

Potassium,  General  Sources  and  Eeactions  of  its  Salts 

Preparation  of  Potassium  Salts 

General  Action  of    „    *       „i 

Characters,  Actions  and  Uses  of  Offieinal  Potassium  Salts 
Sodium,  General  Sources  and  Beactions  of  its  Salts 

Preparations  of  its  Salts  . -       r 

General  Impurities,  Tests  and  Action  . 
Characters,  Actions  and  Uses  of  Sodium  Salts 
Lithium,  Sources  and  Eeactions -of  its  Salts      .        , 
Impurities,  Tests  and  General  Action  of  Lithium  Salts  . 
Characters,  Actions  and  Uses  of  Officinal  Lithium  Salts 
Monad  Metals,  Group  II.,  Ammonium  , 

Nature  of  Ammonium  Salts 

Sources  and  Beactions 

Impurities  and  Tests 

Preparation      .        .. ,. 

General  Action 

Characters,  Actions  and  Uses  of  Officinal  Ammonium  Salts 


PAGE 

.    .    602 

.    603 

.    .    603 

604 

.    .    605 

007-617 

.    .    617 

.    618 

.    .     619 

619-630 

.    .     630 

.     630 

631-633 

.     633 

.    .     633 

.     634 

.    .    634 

.     635 

635 

037-643 


CHAPTEB  XXV. 

Metals  {continued),  Class  II.,  Dyad  Metals — Gboups  I.  and  II.,  Metals  op 
the  Alkaline  Earths  and  op  the  Earths,  pp.  644-661. 

Beactions  of  the  Metals-  in  Class  H 645 

Class  II.,  Group  I.,  Metals  of  the  Alkaline  Earths 645 

General  Action  of  „     -    „  „  „        .        .        .        .        .    645 

Calcium,  Beactions,  Preparation,  Impurities  and  Tests  of  its  Salts  .         646,  647 
Characters,  Action  and  Uses  of  Officinal  Calcium  Salts  ....     647-653 

Class  II.,  Group  I.,  Appendix — Aluminium 654 

General  Sources,  Preparation,  Beactions,  Impurities  and  Tests  of  Aluminium 

Salts 654 

Characters,  Actions  and  Uses  of  Officinal  Aluminium  Salts         .        .         654-657 

Cerium,  Action  and  Uses  of  its  Oxalate 657 

Class  II.,  Group  II.,  Magnesium 658 

Sources,  Beactions  and  Preparations  of  Magnesium  Salts        ....    658 

Impurities,  Tests  and  Action  „  „  , 659 

Characters,  Actions  and  Uses  „  „  „  .        .        .     659-661 


CHAPTEB  XXVI. 

Met-als  (continued)?  The  Heavy  Metals,  Class  II.,  Gboups  lH.  and  IV., 
and  Class  IV.,  pp.  662-706. 

General  Actions  of  Heavy  Metals 662 

„  „  Class  II.,  Group  III.,  Zinc,  Copper,  Cadmium  and  Silver  .     665 

Zinc,  its  Sources,  General  Beactions  and  Preparations  of  Zinc  Salts      .        .     667 

Impurities,  Tests  and  Action  of  Zinc  Salts 668 

Characters,  Action  and  Uses  of  Officinal  Zinc  Salts         ....    669-674 

Copper,  its  Sources,  Beactions,  Impurities  and  Tests 674 

Characters,  Action  and  Uses  of  Officinal  Salts  of  Copper        .        .        .     674-676 


xxxviii  .CONTENTS. 

PAGE 

Silver,  Characters,  Action  and  Uses  of  its  Salts          ....         676-680 
Class  II.,  Group  IT.,  Mercury 680 

General  Sources  and  Eeactions  of  Salts  of  Mercury     , 

„       Impurities,  Tests  and  Action  of  Salts  of  Mercury 
Characters,  Actions  and  Uses  of  Officinal     ,,  ,,  . 

Class  IV.,  Tetrad  Metals,  Lead  and  Tin 

General  Actions 

lead,  its  Sources,  Eeactions,  Impurities         .... 

Tests  and  Action  of  Lead     ....... 

Characters,  Actions  and  Uses  of  Officinal  Salts  of  Lead . 


.    .    680 

.    681 

686-697 

.     698 

.  .  698 
.    698 

.    .    699 

702-705 


Tin,  Action  and  Uses  of  its  Chloride 706 


CHAPTER  XXVII. 

Class  V.,  Pentad  Elements — Nitrogen,  Phosphorus,  Arsenic,  Antimont, 
and  Bismuth,  pp.  707-734. 

Nitrogen  and  its  Compounds 707 

Nitrous  Oxide 708 

Phosphorus,  its  Preparation,  Characters  and  Action    ....     709,  710 

Uses  of  Phosphorus 712 

Arsenic,  its  Sources  and  Tests 712 

General  Action  of  Arsenic    . 713 

Probable  Mode  of  Action  of  Arsenic  in  Phthisis       , 717 

Characters,  Actions  and  Uses  of  Officinal  Preparations  of  Arsenic      ,         719-721 

Antimony,  its  Sources  and  Eeactions 721 

General  Action  and  Uses 722 

Characters,  Action  and  Uses,  of  its  Offioinal  Preparations        .        .        .     727-730 

Bismuth,  its  Sources  and  Eeactions 730 

General  Action  and  Uses  of  its  Salts 731 

Character,  Action  and  Uses  of  its  Officinal  Preparations      .        .        .         732-734 


CHAPTER  XXVIII. 
Metals  {contMVUed),  Class  VIII.,  Iron,  Manoanese,  pp.  735-755. 

Iron,  its  Sources  and  Eeactions 735 

Impurities,  Tests  and  Preparation  of  its  Salts 736 

General  Action               ■  .    ■    .        .        .                 .        t        t  733 
Character,  Action  and  Uses  of  its  Officinal  Preparations     .        .        .         740-752 

Manganese _  irgg 

Class  VIII.,  Group  II.,  Gold  and  Platinum _  753 

Gold,  Preparation  and  Characters  of  its  Chloride   ......  754 

Platinum,  Preparation,  Uses  and  Action  of  its  Chloride    .        ,       .        754  755 


CONTENTS.  aureix 

SECTION  IV. 
OEGANIC  MATEELA  MEDIOA. 

OHAPTEB  XXIX. 
Cabbon  Compounds — Fatty  Sebies,  pp.  759-806. 

PAGE 

Series  of  Carbon  Compounds 759 

General  Action  of  Carbon  Compounds •  760 

Bisulphide  of  Carbon 760 

Hydro-Carbons 761 

Benzin 762 

Petrolatum  (Vaseline) 763 

Paraffin,  Hard 763 

Soft ,    .  764 

Alcohols  of  the  Series  C2H,n+1OH 764 

General  Action ,    .  764 

Methyl  Alcohol 766 

Ethyl  Alcohol :  General  Sources,  Preparation  and  General  Impurities       .   .  767 

Tests  and  General  Action 767 

Effect  of  Impurities  on  its  Action ,    .  770 

Chronic  Alcoholic  Poisoning .  770 

Causes  and  Treatment  of  Alcoholism .  772 

Uses  of  Alcohol 773 

Alcohol  as  a  Stimulant        .        . 774 

Officinal  Alcoholic  Preparations 775-778 

Aldehydes,  Acetic  aldehyde  and  Paraldehyde 778 

Ketones,  Hypnone 779 

Simple  Ethers,  Ether 780-783 

Saline  Ethers  .'...' 783 

Ethereal  Oil  and  Hoffman's  Anodyne 783 

Acetic  Ether     .        .        .'.'.' 783 

Nitrites  of  Ethyl  and  Amyl .        „ 784 

Nitro-Glycerine— Tablets  of  Nitro-Glycerine 788 

Liquor  Sodii  Ethylatis  (vide  p.  619) 789 

Haloid  Compounds 789 

Bromide  of  Ethyl 789 

Iodide  of  Ethyl        .                        790 

Chloral  Hydrate,  its  Preparations  and  Characters       .        .        .        .        .   ,  790 

Its  Action .  791 

Treatment  of  Chloral  Poisoning .   .  793 

Butyl-Chloral  Hydrate 794 

Bromal  Hydrate 794 

Bichloride  of  Methylene 795 

Chloroform,  its  Preparation,  Characters,  Impurities  and  Tests    .        .        .    .  795 

Action  of  Chloroform       .        .        .        .        . 796 

Bangers  of        „ 799 

Precautions  in  using  Chloroform     . 800 

Uses  of  Chloroform      ...        .        ...        .        .        ,        .    .  802 

Iodoform . 804 

Methylal  (vide  Appendix) <•  .  806 

Urethane  (vide  Appendix) ,        .  806 

Iodol  (vide  Appendix) .    .  806 


xl  CONTENTS.' 

CHAPTER  XXX. 
Cabbon  ..Compounds — Aromatic  Sebies,  pp.  807-826. 

PAGB 

General  Chemistry  of  the  Aromatic  Series 807 

General  Action           „             „            » 811 

Carbolic  Acid 812 

Its  Action 813 

Uses   - 815 

Sodii  Sulpho-carbolas  (vide  p.  626) 817 

Zinci  Sulpho-carbolas  (vide  p.  671)          .        .        ......        •        .        •  817 

Creasote .        .    .  817 

Eesorcin 818 

Hydroquinone       .        .  •      . 818 

Pyrocatechin 819 

Pyrogallic  Acid    .        .        . 819 

Salicylic  Acid 819 

Naphthalin  .        .        . 821 

i-  aphthol.        .        .        .        i .        .        .822 

Eydrochlorate  of  Bosaniline 822 

Pyridine 823 

Chinoline 823 

Kairin 824 

Antipyrin 824 

Antifebrin        .        ...        .        .        .        .        .  , 825 

Saccharine 825 


SECTION  V. 
VEGETABLE  MATEKIA.  MEDICA, 

InteoductioN 829 

CHAPTER  XXXI. 

Sub-Kingdom  I.,  Phanebogamje. 

DlTISIOH  I.,  ANGIOSPEBMiE  ;    CLASS  I.,  I)lOOTpaiDO.NES  PoLTPETAIJE  ; 
.  SuB-J&iASS  I.,  THAT.AMTTI.OBa!,  pp.  831-875. 

Xanunculacese 831 

Aconite     .                         831 

Staphisagria .       .        .        .        . 836 

Pulsatilla 836 

Adonis  Vernalis 837 

Cimicifuga 837 

Podophyllum 838 

Hydrastis.       .        .       .      "^ 839 

Tttagnoliaceae 840 

Star-Anise — Illicium 840 

Oil  of  Anise • 840 

IHenlspermaceae 840 

Menispenmrm 840 

Calumba 840 

Pareira 841 

Picrotoxin 842- 


CONTENTS.  xli 

PACK 

Berberidaceee  .        .     *  .     •. •. 842 

Caulophyllum 842 

Papaveraceae 843 

Eoppy  Capsules 843 

Opium .         .    .  844 

Preparations  of  Opium 844 

Meconic  Aeid 846 

Morphine 846 

Apomorphine 848 

Codeine 0 849 

Action  of  Opium 851 

Diagnosis  of  Opium  Poisoning 852 

Treatment        „              „               853 

Circumstances  Modifying  the  Action  of  Opium 856 

Action  of  the  Alkaloids  of  Opium .     •  .        . 858 

Uses  of  Opium • 859 

Khceas— Bed  Poppy 862 

Sanguinaria— Blood  Boot 863 

Chelidonium — Celandine 863 

Cruciferee      .        .     • 864 

Sinapis — Mustard 864 

Armoracia — Horseradish  .     ,. 866 

Vlolarleee 866 

Viola, — Pansy ■ 866 

Canellaceae ■ 867 

CanellaAlba - 867 

Polygalaoeae     . 867 

Senega       ...     - 867 

Krameria — Bhatany 868 

Guttlferae 869 

Cambogia — Gamboge    . 869 

TernstromlacesB 869 

Tea        .      • 869 

Caffeine  .  .        .... 870 

Malvaceae 872 

Gossypiuzn — Cotton 873 

Pyroxylin— Gun  Cotton .        .    .  874 

Collodion 874 

Althaea — Marshmallow .    .  875 

Steroullaceae  (Byttneriacese) 875 

Theobroma — Cacao 875 


CHAPTBB  XXXII. 

PHANEEOGAMa:  (continued). 

Class  I.,  Dicotyledones  Poltpetal^e  ;  Sub-Class  II.,  DiscrpLORa:,  pp.  876-898. 

Xlneee    .        .        .        .    ■' 876 

Linseed— Flaxseed .        .        .    .    876 

Erytbroxyleee 877 

Coca — ^Erythroxylum - .        .        .    .    877 

Cocaine .        .        .        .        .        .        .  -  877 

Action  of  Cocaine  .        .        .        .        .        .        .        .        ,        .    .    878 


xlii  CONTENTS. 

FAGB 

Zjrgophyllaceee 880 

Guaiacum 880 

Geranlaceee •         ■  881 

Geranium — Cranesbill 881 

Rutacese ■        •  881 

Eutese 881 

Oil  of  Rue 881 

Cusparia 881 

DiosmesB 882 

Buchu    .............  882 

Xanthoxylinas 883 

Xanthoxylum — Prickly  Ash 883 

Jaborandi — Pilooarpua 883 

Pilocarpine 883 

Action  of  Pilocarpine 884 

Aurantiese 887 

Orange 887 

Oil  of  Bergamoi 889 

Lemon 890 

Bael  Fruit 891 

Simarubaceae 892 

Quassia 892 

Bnrseraceee  or  Amyridacee 893 

Myrrh ,893 

Elemi        .....'...,,...  893 

JHellaceae 894 

Azedarach 894 

lUclnese  (Aquifoliaceae) 894 

Prinos— Black  Alder         .                         894 

Celastrinae 894 

Euonymus — Wahoo 894 

Rbamnese 895 

Cascara  Sagrada — Bhamnus  Purshianus  .......  895 

Rhamuus  Frangula — Buckthorn ,  .        .    .  895 

Ampelldse  (Vitaceue) 896 

TJvse — Raisins ,  .        .        .        .        .    .  896 

Vinum  Xericum 896 

VinumRubrum .        .                 .    .  896 

Saplndaceee  ...,....•..,..  897 

Guarana , 897 

Anaoardlacese  (Torobinthacote)    .        .        .        .      , 897 

Mastiohe 897 

Rhus  Glabra — Sumach 898 

Rhus  Toxicodendron — Poison  Ivy 898 


CHAPTER  XXXIII. 

,  Phanerogams,  (continued). 

Class  I.,  Dicottledones  Polypetal^:  ;  Sub-Class  III.,  CALYorrLORai,  pp.  899-938. 

lefuminosee         .         .         .        ....        ...        .        ,         .         .     899 

Papilionacese         .        .        .        ...        .....,.,.        .    .    899 

Glycyrrhiza— Liquorice     .       .,,..,.       ,       ,        ,        .899 


CONTENTS.  xliii 

PAUE 

Scoparius — Broom 900 

Tragacanth 900 

Pterooarpus — Santalum— Bed  Sandal-wood  or  Bed  Saunders       .    .  901 

Kino 902 

Balsam  of  Peru 902 

Balsam  of  Tolu 903 

Abrus — Jequirity 903 

Physostigma — Calabar  Bean 904 

Hamatoxylon — Logwood 908 

Chrysarobinum— Chrysophaoic  Acid — Goa  Powder  ....  908 

Cffisalpinte ' 909 

Senna 909 

Cassia — Purging  Cassia 911 

Tamarind 911 

Copaiba — Copaiva 912 

Pi  scidia  Erythrina — Jamaica  Dogwood 913 

Mimoseas 913 

Acacia 913 

Catechu     , ,        .        .    .  914 

Erythrophloeum — Casca — Sassy 915 

Indigo 915 

Jtosaeese        ,         .         .         ( 915 

Prunes; 915 

Amygdala  Dulcis-^Sweet  Almond 915 

.  -    Amygdala  Amara — Bitter  Almond        ,....,.  915 

Prunum — Prune 917 

Frunus  Virginiana — Wild  Cherry 917 

Laurocerasus— Cherry  Laurel 917 

QuillajesB 918 

Quillaia— Soap  Bark 918 

Bubete 919 

Eubus— Blackberry 919 

Bubus  Idseus — Baspberry 919 

Boseae 920 

Oil  of  Bose 920 

Bosa  Centifolia — Cabbage  Bose— Pale  Bose 920 

Bosa  Gallica— Bed  Bose 920 

Bosa  Canina — Dog  Bose 920 

Cusso— Brayera     .        .        .        .        .        .    - 921 

PomesB 921 

Cydonium — Quince 921 

Myrtaceee 922 

Caryophyllus — Cloves .    .  922 

Pimenta — Allspice 923 

Cheken 923 

Oleum  Myrti— Oil  of  Myrtle 924 

Oleum  Cajuputi — Oil  of  Cajuput 924 

Eucalyptus — Oil  of  Eucalyptus 925 

Granatum — Pomegranate 926 

Papayaceae 927 

Papayotin — Papain - 927 

Cucurbltacese 927 

Colocynth 927 


xliv  CONTENT'S. 

PAGB 

Eoballium — JUlaterium •        •  928 

Pepo — Pumpkin 930 

Bryonia — Bryony 930 

Vmbelliferae 930 

Campylospermje 930 

Conium ...  931 

Orthospermae 932 

Asafcetida^Asafetida 932 

Galbanum 933 

Ammoniacum        . 933 

Eoeniculum — Fennel 934 

Anisum — Anise 935 

Anethum— DUl 936 

Carum — Caraway 936 

Sumbul 937 

Ccelospermse 937 

Coriander 937 

Cornaceee          .        .        .        .    > 938 

Cornusrr-Dogwood    .        . 938 


CHAPTEE  XXXIV. 

Phanerogams  (continued). 

Class  II.,  Dicotsledones  G-amofetal.s  (ConojjjrhORm),  pp.  939-1008. 

Caprifoliacese 939 

Sambucus 939 

Viburnum 939 

Rubiaceee  (Cinchonaoese) 939 

Cinohonese ,  939 

Cinchona  Flava — Yellow  Cinchona 940 

„        Bubra — Bed  „ 940 

Quinine  and  its  Salts 942 

Cinchonine 943 

Ixorese  (Coffere) 948 

Ipecacuanha      .        .        . 948 

Caffea — Coffee 950 

Catechu  (Pale) _ 951 

Valerianaceae 951 

Valerian 951 

Composites „ 952 

Pyrethrum        . 952 

Absinthium — Wormwood 953 

Tanacetum — Tansy 953 

Santonica — Santonin 954. 

Anthemis — Chamomile 955 

Matricaria — German  Chamomile 956 

Eupatorium — Thoroughwort 955 

Taraxacum — Dandelion ggg 

Lactuca — Lettuce 957 

Arnica 957 

Calendula — Marygold 959 


CONTENTS,  xlv 


PAGE 


Grindelia                                , 959 

Inula — Elecampane          ......        .  ■     ,        .  959 

Lappa-^Burdock 960 

Campanulaceae  (Lobeliacea) 960 

Lobelia ,        .    .  960 

Ericaceae 961 

Uva  TJrsi — Bearberry    ...........  961 

Chimaphila — Pipsissewa 962 

Oleum  Gualtherise — 9il  of  Wintergreen        .                962 

Sapotaceae     .                           963 

Gutta-percha 963 

Styraeaceae  . 963 

Benzoin — Benzoic  Acid 963 

OleacesB         ...... 965 

Olive  Oil 965 

Hard  Soap 966 

Soft  Soap     .        .        .      „v       .        •        ■     ; 966 

Glycerin 966 

Manna - 968 

Apocynaceee         . ,  968 

Apocynum — Canadian  Hemp 968 

Quebracho 969 

Asclepladaceee 970 

AsclepiaB — Pleurisy  Boot 970 

Asclepias  Incarnata — White  Indian  Hemp 970 

Hemidesmus 970 

Condurango 970 

Xoganiaceae 971 

Nux  Vomica 971 

Ignatia 971 

Strychnine 972 

Curare- , 976 

Gelsemium 977 

Spigelia — Pinkroot — Maryland  Pink 978 

Gentlanaceae 979 

Gentian .        .        .  979 

Chiretta 979 

Convolvulaceae 980 

Scammony 980 

Jalap 982 

Solanaceae .    .  983 

Dulcamara 983 

Capsicum 984 

Atropeae  • 984 

Belladonna — Atropine 984 

Hyoscyamus 990 

Stramonium 991 

Tobacco ,      .        .        .        .992 

Scrophulariaceae 994 

Digitalis   .  • 994 

Leptandra 1001 

Pedalineae 1002 

-Oleum  Sesami — Benne  oil    .        .        .        .        .        .        .       .,        .    .  1002 


xlvi  CONTENTS^ 

PASS 

Verbenaeeee  . 1002 

Lippia  Mexicana »    •  1002 

Lablatee        »»...... 1002 

Rosemary      >         » 1002 

Lavender .        > 1003 

Peppermint — Menthol. 1004 

Spearmint         »•.........••  1005 

•Thymol 1005 

Hedeoma — Pennyroyal 1006 

Marrubium — Horehound 1007 

Melissa— Balm «        •  1007 

Origanum — Wild  Marjoram         .........  1007 

Salvia— Sage    .  »  1008 

Scutellaria— Skull-cap 1008 


CHAPTEB  XXXV. 

Phanekogajde  (continued). 
Class  III.,  Dicotyledones  Monoohlamydej3  (Apeial2e),  pp.  1009-1035. 

Cnenopodlaceae 1009 

Chenopodium— Amerioan  Wormseed >  1009 

Oleum  Chenopodii 1009 

Pbytolaccaoeae 1009 

Phytolacca— Poke  berry 1009 

Polygonaceae 1010 

Eheum— Ehubarb 1010 

Eumex— Yellow  Dock 1011 

Arlstolochiaceee 1012 

Serpentary 1812 

Asarabacca 1012 

Piperaceae 1012 

Pepper— Piperine 1012 

Cubebs          .                 1013 

Matico 1014 

Myristlcacese 1015 

Myristica — Nutmeg 1015 

Macis — Mace 1016 

Xiaurlnese 1016 

Cinnamon 1016 

Goto 1017 

Parocoto 1017 

Camphor 1018 

Monobromated  Camphor      .        .        , 1019 

Sassafras 1020 

Nectandra— Bebeeru .        .  1021 

Santalacese iQ'21 

Oleum  Santali ,    .  102I 

Tbymelaceee 1022 

Mezereon 1022 

Euphorbiaceee 1022 

Cascarilla     ...  - .        .        .        ,  1022 


GOftttEKt&'  xltii 

PAGK 

Stillingia  .        .  ■     .        .        .        . 1022 

Croton  Oil -     .        .        .        .    .  1023 

Castor  Oil         .        . .  1024 

Kamala         .        . <  1025 

Vrtlcaceee 1025 

Ulmeee 1025 

TJlmua  , 1025 

Cannabineffi . ,         .         ,         .    ,  1026 

■    Cannabis  Indica — Indian  Hemp        .        .        .        ...        .        .  1026 

i    Cannabis  Americana — American  Cannabis   .        .        .        .        ,    .1026 

Hamulus — Lupulus — Hop 1027 

Mores , 1028 

Morus-^Mulberry 1028 

Artocarpeie   ...        .        .        . 1028 

Kcus— .Fig »        .  1028 

Juglandaceae    .„.„.„...  , .1029 

Juglans — Butternut 1029 

Hqmamelaceae 1029 

Hamamelis 1029 

Balsamiflorae  .         .         .■<*;.         *      ,■•         •         •         •         •    •  1030 

Styrax      .        .        .        .""'  .        /      .        '/      .  ...  1030 

Cupullferee        .........  ....  1030 

Querous— Oak  .        . 1030 

Galls    .        .        .        .        V 1031 

Tannic  Acid     .  1031 

Gallic  Acid  ' 1033 

Castanea — Chestnut .        .  1034 

Sallcaceee  .  .    .  1034 

Salix— Salioin 1034 


CHAPTEE  XXXVl. 

PniNEKOQAM^:  (continued). 

Glass  IV.,  Monocotyledones,  pp.  1036-1056. 

Orchldaceae 1036 

Vanilla 1036 

Cypripedium ,      .        .        ...        .        .  1036 

Scltamnaceee  (Zingiberaceas)   .        .        .  1036 

Zingiber — Ginger ,     .  .  .  1036 

Turmeric 1037 

Cardamoms 1038 

Zrldeae 1038 

Crocus— Saffron 1038 

Iris 1038 

Ullaceae 1039 

Allium— Garlic     . 1039 

Convallaria .        .  1040 

Squill 1049 

Aloe 1041 

Veratrum  Viride .    .  .1045 


xlviii  CONTENTS. 

PASS 

Cevadilla— Sabadjlla— rYeratrine .  .  .  ,  .  ...  .  •  •  1046 
Colehicum , 1049 

MUacese  (Smilaceso)     .   , , 1051 

Sarsaparilla 1051 

Palmacese    •        ......■        ...*-■  1052 

Areea 1052 

Aroldese 1052 

Calamus^Sweet  Flag - 1052 

Gramlneee ^ 1053 

Wheat— Flours-Bread— Starch 1053 

Conch  Grass 1054 

Pearl  Barley. 1054 

Malt 1054 

Sugar 1055 

Treacle 1055 

Oatmeal 1056 


CHAPTEE  XXXVH. 

Phaneboouix  (continued). 

Division  II.,  GraxospEiiKS,'  pp.  1057-1065. 

Conlferee ,    .  1057 

Terebinthina  Canadensis — Canada  Balsam 1057 

Thus  Americanum — Common  Frankincense 1057 

Turpentine 1057 

Oil  of  Turpentine .        .    .  1058 

Oil  of  Scotch  Fir "...  1059 

Terebene 1060 

Sanitas 1060 

Oleum  Succini — Oil  of  Amber 1060 

Besin        .        .        . 1061 

Larch  Bark 1061 

Burgundy  Pitch 1062 

Canada  Pitch 1062 

Tar 1062 

Oil  of  Tar ....  1063 

Thuja— Arbor  Vital 1063 

'  Juniper 1063 

Savin       » ....  1064 


CHAPTEE  XXXVIII. 

Sub-Kingdom  II.,  Cryptogams,  pp.  1066-1073. 

Fllices  . 1066 

Male  Fern 1066 

Mchenes 1067 

Cetraria — Iceland  Moss        .       .        .        . 1067 

Litmus     .       .        .  .        .        .........       ,        .  1067 


CONTENTS.  xlix 

PAGE 

rung*         .......                1067 

Muscarine        ............  1067 

Agaricus  Albus     . 1068 

ErgOt— Ergotin 1068 

TJstilago 1073 

Beer  Yeast 1073 

Aleas 1073 

Chondrus—  Irish  Moss 1073 


SECTION  VI. 

ANIMAL  KINGDOM. 

CHAPTER  XXXIX.,  pp.  1077-1099. 

Class  Mammalia 1077 

Order  Bodentia 1077 

Castor 1077 

Order  Buminantia 1077 

Musk 1077 

Suet 1078 

Lanolin .  1078 

Curd  Soap 1079 

Milk— Koumiss— Kephir 1079,  1080 

Milk  Sugar 1080 

Pepsin 1081 

Ox  Gall ...  1081 

Keratin 1083 

Order  Pachydermata 1084 

Lard 1084 

Order  Cetacese 1085 

Spermaceti 1085 

Class  Aves         .  - 1085 

Order  Gallinse 1085 

Egg-Albumen  and  Yolk 1085 

Class  Pisces 1086 

Order  Sturiones 1086 

Isinglass — Ichthyocolla 1086 

Order  Teleosteas— Family  Gadidse 1087 

Cod  Liver  Oil 1087 

Class  Inseeta 1089 

Order  Hymenoptera 1089 

Honey 1089 

Wax  ....  1089 

Order  Hemiptera 1090 

Coccus — Cochineal 1090 

Order  Coieoptera 1091 

Cantharis — Spanish  Flies 1091 

Class  Annelida 1095 

Hirudo — the  Leech 1095 

c 


CONTENTS. 


APPENDIX. 

PAO» 

Methylal 1097 

Urethane 1097 

Iodol 1099 

Strophanthus  hispidus— Strophanthin 1099 

Dead  Space 1100 

GENEEAL  INDEX 1103 

INDEX  OF  DISEASES  AND  BEMEDIES 1177 

BIBLIOGBAPHICAL.  INDEX    .       .       9       ......   .  1239 


ADDITIONS  MADE  IN  1890 
TO  THE  BRITISH  PHARMACOPOEIA  OP  1885. 

PAGE 

Acetanilidum  (Antifebrin)  (of.  p.  825) [1110] 

Acetnm  Ipecacuanb.se  (cf.  p.  949) [1114] 

Adeps  LansB  (Anhydrous  Lanolin)  (cf.  p.  1078) [1116] 

Adeps  Lanse  Hydrosus  (Lanoline) [1116] 

'  Antifebrin.'     See  Acetanilidum 

'  Antipyrine '  (p.  824).     See  Phenazonum 

'  Blaud's  Pill.'     See  Pilula  Ferri 

Emplastrum  Menthol  (cf.  p.  1004) [1116] 

Eucalypti  Gummi  (cf.  p.  925) [1116] 

Euonymi  Cortex  (cf.  p.  894) [HOG] 

'  Euonymin.'     See  Extractum  Euonymi  Siccum. 

Extractum  Euonymi  Siccum  (cf.  p.  403) [1106] 

Extractum  Hamamelidis  Liquidum  (cf.  p.  1029) [1108] 

Extractum  Hydrastis  Liquidum  (cf.  p.  839) [1107] 

'  Fehling's  Solution.'     See  Solution  of  Potassio-Cupric  Tartrate 

Gelatinum  (cf.  p.  1086) [1106] 

Glonoine,  Solution  of.     See  Liquor  Trinitrini 

Glusidum  (cf.  Saccharin,  p.  825) [1112] 

Hamamelidis  Cortex [1108] 

Hamamelidis  Folia  (cf.  p.  1029) [1108] 

Homatropinae  Hydrobromas  (cf.  p.  219) [1114] 

'  Huile  de  Cade.'     See  Oleum  Cadinum 

Hydrastis  Ehizoma  (cf.  p.  839) [1107] 

'  Lanoline.'     See  Adeps  Lanse  Hydrosus 

Liquor  Cocainte  Hydrochloratis  (cf.  p.  877) [1113] 

Liquor  Morphinffl  Sulphatis  (cf.  p.  848) [1113] 

Liquor  Trinitrini  (cf.  p.  788) [1115] 

Magnesii  Sulphas  Effervescens  (cf.  p.  659) [1105] 

Mistura  Olei  Bicini [1105] 

Nitroglycerine,  Solution  of.     See  Liquor  Trinitrini 

Oleum  Cadinum [1117] 

Paraldehydum  (cf.  p.  778) [1113] 

Phenacetinum [1110] 

Phenazonum  (Antipyrine)  (cf.  p.  824) [1111] 

Picrotoxinum  (cf.  p.  842) [1114] 

Pilula  Ferri [1115] 

Pulvis  Sods  Tartaratse  Effervescens [1104] 

■  Saccharin.'    See  Glusidum 


lii 


CONTENTS. 


'  Seidlitz  Powder.'    See  Pulvis  Sodte  Tartaratas  Effervescens 

Sodii  Benzoas  (of.  pp.  78  and  964) 

Sodii  Nitris  (cf.  pp.  331  and  788)     . 

Sodii  Phosphas  Effervescens  (of.  pp.  626  and  403) 

Sodii  Sulphas  Effervescens  (cf.  pp.  625  and  403 

Solution  of  Potassio-Cupric  Tartrate 

Stramonii  Folia  (cf.  p.  991)     . 

Strophantus  (cf.  p.  1099)  . 

Sulphonal 

Suppositoria  Glycerini         . 
Syrupus  Ferri  Subchloridi 
Tinctura  Hamamelidis 
Tinctura  Hydrastis  (cf.  p.  403) 
Tinctura  Strophanthi  (cf.  p.  1099) 
Trochisci  Sulphuris  (cf .  p.  547) 
Unguentum  Conii  (cf.  p.  932) 
Unguentum  Hamamelidis  (cf.  p.  1029) 


[1109] 
[1115] 
[1105] 
[1105] 
[1117] 
[1114] 
[1115] 
[1113] 
[1106] 
[1116] 
[1108] 
[1107] 
[1115] 
[1104] 
[1108] 
[1108] 


MATERIA  MEDICA  AND  THERAPEUTICS. 


B 


INTRODUCTION. 


By  Materia  Medica  we  understand  a  knowledge  of  the 
remedies  employed  in  medicine.  This  knowledge  may  be  sub- 
divided into  several  divisions :  Materia  Medica  proper,  Pharmacy, 
Pharmacology,  and  Therapeutics. 

By  Materia  Medica  proper  we  mean  an  acquaintance  with 
the  remedies  used  in  medicine,  the  places  whence  they  come,  the 
crude  substances,  plants  or  animals  which  yield  them,  the  methods 
by  which  they  are  obtained,  and  the  means  of  distinguishing  their 
goodness  or  purity,  or  of  detecting  fraudulent  adulteration. 

By  Pharmacy  we  mean  the  methods  by  which  drugs  are 
prepared  and  combined  for  administration. 

By  Pharmacology  we  mean  a  knowledge  of  the  mode  of 
action  of  drugs  upon  the  body  generally,  and  upon  its  various 
parts.  It  is  of  comparatively  recent  growth,  but  is  now  one  of  the 
most  important  subdivisions  of  Materia  Medica. 

By  Therapeutics  we  understand  a  knowledge  of  the  uses 
of  medicines  in  disease. 

Therapeutics  may  be  either  etnpirical  or  rational.  By  em- 
pirical we  mean  that  drugs  are  tried  haphazard,  or  with  little 
knowledge  of  their  action  in  some  cases,  and,  being  found  success- 
ful, are  again  administered  in  other  cases  which  seem  to  be  similar. 

Perhaps  the  best  example  of  the  empirical  use  of  a  remedy  is 
that  of  quinine  in  ague.  We  do  not  know  with  certainty  what 
the  pathological  conditions  are  in  this  disease,  nor  how  quinine 
acts  upon  them  ;  all  we  know  is  that  it  has  proved  useful  in  cases 
of  ague  before,  and  therefore  we  give  it  again. 

Rational  therapeutics  consists  in  the  administration  of  a 
drug  because  we  know  the  pathological  conditions  occurring  in 
the  disease,  and  know  also  that  the  pharmacological  action  of 
the  drug  is  such  as  to  render  it  probable  that  it  will  remove  or 
counteract  these  conditions. 

Bational  therapeutics  is  the  highest  branch  of  medicine.  Its 
advance  is  necessarily  slow,  because  it  is  based  upon  pathology 
on  the  one  hand  and  pharmacology  on  the  other,  and  both 
of  these  rest  upon  physiology,  which  in  its  turn  rests  upon 
physics  and  chemistry.     It  is  only  with  the  development  of  the 

B  2 


4  INTRODUCTION. 

fundamental  sciences  that  those  which  rest  upon  them  can  grow ; 
and  when  we  consider  that  chemistry  as  a  science  is  not  much 
more  than  a  hundred  years  old,  and  when  we  see  the  advances 
it  has  already  made,  we  cannot  but  be  hopeful  for  the  future  of 
therapeutics. 

occasionally  we  hear  the  question  asked,  '  What  is  the  use  of 
knowing  the  action  of  all  sorts  of  drugs  upon  the  different  parts 
of  the  animal  body,  and  what  is  the  use  of  knowing  the  altera- 
tions in  the  muscles,  vessels,  or  nerves  which  occur  under  patho- 
logical conditions,  seeing  that  in  many  instances  such  a  know- 
ledge cannot  be  utilised  for  the  treatment  of  disease  ? '  As  well 
might  we  ask,  on  seeing  a  half-built  bridge,  '  What  is  the  use  of 
laying  the  foundations  and  building  the  piers,  seeing  -no  one  can 
walk  across  from  one  end  to  the  other  ?•' 

As  an  example  of  rational  therapeutics,  we  may  take  the  use 
of  nitrite  of  amyl  in  certain  forms  of  angina  pectoris.  The 
obvious  symptoms  in  this  disease  are  intense  pain  in  the  region 
of  the  heart,  and  fear  of  impending  death.  Sphygmographic 
tracings  of  .the  pulse  taken  during  this  condition  show  that  the 
tension  within  the  heart  and  vessels  begins  to  increase  as  the 
pain  comes  on,  and  reaches  such  a  height  that  the  heart  can 
barely  empty  itself.  Observations  on  animals  have  shown  that 
nitrite  of  amyl  lessens  the  tension  of  the  blood  in  the  vessels  ; 
and  we  therefore  give  it  in  angina  pectoris  with  the  expectation 
that  it  will  dimmish  the  tension  and  remove  the  pain,  and  we  find 
that  it  succeeds. 

But  this  example  shows  us  only  the  first  stage  of  rational 
therapeutics.  We  have  removed  by  a  remedy  the  pathological  con- 
dition which  immediately  gives  rise  to  the  pain  and  danger  of  the 
patient,  but  the  antecedent  alterations  of  the  heart,  bloodvessels,' 
and  nervous  system,  which  led  to  the  occurrence  of  the  pain,  are 
unaltered  by  the  remedy.  In  order  that  our  therapeutics  should 
be  completely  successful,  we  must  seek  still  further  for  something 
which  will  restore  the  circulation  and  nervous  system  to  its 
normal  condition  and  bring  the  patient  back  to  a  state  of  perfect 
health. 

Sometimes  we  are  able  to  do  this.  For  example,  we  oc- 
casionally meet  with  a  kind  of  pain  in  the  cardiac  region  which 
closely  resembles  angina  pectoris,  and  is  probably  a  form  of 
it.  Acting  on  the  general  principle  that  pain  is  due  to  irritation 
somewhere,  though  not  necessarily  at  the  place  where  the  pain 
is  felt,  we  seek  for  the  irritant.  We  find  swelling  and  tenderness 
over  the  sternum  at  the  junction  of  the  manubrium  and  the 
body,  and  we  look  upon  this  as  the  irritant  which  is  exciting 
the  cardiac  pains.  Judging  this  swelling  to  be  syphilitic, 
we  give  iodide  of  potassium ;  the  swelling  subsides,  and  the 
angina-like  pain  completely  disappears. 

But  sometimes  it  is  impossible  to  remove  the  cause  of  the 


INTRODUCTION.  5 

disease,  and  all  that  we  can  do  is  to  alleviate  symptoms. 
The  organic  changes  which  have  occurred  in  the  course  of  the 
disease  may  be  so  great  that  we  can  hardly  hope  that  any  remedy 
will  ever  be  discovered  sufficiently  powerful  to  remove  them.  We 
must  therefore  try  to  prevent  them. 

Preventive  medicine,  or  prophylaxis,  is  daily  becoming 
more  important,  and,  possibly  before  the  end  of  this  century, 
medical  men  will  be  employed  more  to  prevent  people  from 
becoming  ill  than  to  cure  them  when  disease  has  become  fairly 
established. 

This  may  at  least  be  the  case  in  regard  to  the  contagious  and 
infectious  diseases,  which  attack  people  as  it  were  by  accident, 
and  are  totally  unconnected  with  their  ordinary  work  or  pleasure. 
It  is  too  much  to  hope  that  other  diseases  which  depend  upon 
hereditary  tendencies,  overwork,  or  over-indulgence,  will  disappear., 
for  there  can  be  little  doubt  that  men  in  the  future  will,  as  in  the 
past,  knowingly  sacrifice,  not  only  their  health,  but  their  life,  to 
ambition,  duty,  or  pleasure. 

The  advance  of  this  branch  of  medicine  has  been  greatly 
aided  by  the  recent  increase  in  our  knowledge  of  the  life-history 
of  microbes  and  their  action  in  causing  disease.  Our  power  to 
prevent  disease  will  become  greater  when  we  know  accurately 
the  action  of  various  drugs  in  destroying  these  microbes  or 
preventing  their  growth. 

Pharmacology  has  made  such  rapid  advances  of  late  years 
that  it  is  exceedingly  difficult  for  many  men  who  are  engaged  in 
practice  to  understand  thoroughly  either  the  methods  by  which 
it  is  studied,  or  its  results.  Many  students  also,  although  they 
may  be  able  to  pass  a  good  examination  in  physiology,  find  it 
difficult  to  apply  their  physiological  knowledge  to  pharmacology ; 
and  therefore  in  discussing  the  action  of  drugs  upon  the  various 
functions  of  the  body,  I  have  sometimes  entered  more  fully  into 
the  physiology  of  those  functions  than  may  seem  to  some  at  all 
either  necessary  or  advisable. 

In  discussing  pharmacological  questions,  we  are  accustomed 
to  speak  of  the  action  of  a  drug  on  the  body  or  on  its  various 
parts ;  but  we  must  remember  the  effect  produced  is  not  due 
to  a  one-sided  action — that  what  we  actually  mean  is  the 
re-action  between  the  drug  and  the  various  parts  of  the  body. 

In  some  instances  we  know  that  the  drug  itself  is  changed  in 
the  body,  as  well  as  the  function  of  the  body  modified  by  the 
drug ;  and  even  in  those  cases  where  the  drug  itself  is  eliminated 
from  the  body  apparently  unaltered,  it  is  probable  that  it  has 
entered  into  various  chemical  combinations  within  the  body 
while  circulating  in  the  blood  or  present  in  the  tissues. 


SECTION  I. 

GENERAL  PHARMACOLOGY  AND 
THERAPEUTICS. 


OHAPTEE  I. 

GENEEAL  EELATIONS  BETWEEN  THE  OEGANISM  AND 
SUBSTANCES  AFFECTING  IT. 


In  discussing  the  inter-action  between  the  animal  organism  and 
the  substances  which  act  upon  it,  it  may  be  well  to  take  a  slight 
glance  first  at  the  substances  which  compose  its  environment, 
although  these  will  be  afterwards  considered  more  in  detail. 

Of  the  elements  composing  the  earth  on  which  we  live  we 
at  present  know  about  seventy-two  whose  existence  appears  well- 
established.  They  are  given  in  the  accompanying  table.  The 
atomic  weights  assigned  to  them  cannot  be  regarded  as  absolutely 
correct.  There  are  sometimes  considerable  discrepancies  between 
those  given  by  different  authorities,  and  those  which  are  accepted 
to-day  may  require  to  be  altered  again  in  accordance  with  the 
more  exact  knowledge  which  future  observations  may  supply. 
There  are  slight  differences  between  several  of  them  as  given  in 
the  British  and  United  States  Pharmacopoeias. 


TABLE  OF  ELEMENTS. 

Element 

Symbol 

Valency  or 
Atomicity 

Atomic 

Weight, 

B.P. 

Atomio 
Weight, 

r.s.  P. 

Atomic  Weight 

very  accurately 

determined ' 

♦Aluminium         • 

Al.       . 

II.  &  IV. 

27-0 

27-0 

27-009 

♦Antimony         \ 
(Stibium)/ 

*  Arsenicum . 

Sb. 

in.  &  v. 

120-0 

120-0 

119-555 

As. 

III.  &  V. 

75;0 

74-9 

74-918 

•Barium 

Ba.       . 

ii. 

137-0 

136-8 

136-763 

Beryllium  or    "1 
Glueinumj 

Be  or  G . 

ii. 

9-0 

9-0 

9-085 

♦Bismuth     . 

Bi. 

UI.&V. 

209-0 

210-0 

207-523 

*Boron 

. 

B  . 

— 

11-0 

11-0 

10-941 

'  *Bramme 

. 

Br 

i. 

80-0 

79-8 

79-768 

Cadmium 

. 

Cd 

ii. 

111-8 

111-8 

111-835 

Caesium 

, 

Cs. 

i. 

133-0 

132-6 

132-583 

♦Calcium 

. 

Ca 

n. 

40-0 

40-0 

39-99 

*Cwrbon 

• 

C  . 

n.  &  iv. 

120 

120 

11-9736 

♦Cerium 

, 

Ce. 

IV. 

141-0 

141-0 

140-424 

*Chlorme 

, 

CI. 

i. 

35-5 

35-4 

35-37 

♦Chromium 

. 

Cr. 

n.  &  iv. 

52-S 

52-4 

52-009 

Cobalt 

• 

Co. 

n.  &  iv. 

58-9 

58-9 

58-887 

Those  marked  with  ♦  are  contained,  either  simply  or  in  combination,  in  the 
British  Pharmacopoeia.  Those  printed  in  italics  are  non-metallic  elements.  Their 
atomio  weights  are  given  as  in  the  B.  P. 

1  From  Ira  Bemsen's  Principles  of  Theoretical  Chemistry. 


10  PHABMACOLOGY  AND   THEEAPEUTICS.     [sect.  i. 

TABLE  OF  ELEMENTS— continued. 


Valency  or 
Atomicity 

Atomic 

Atomic 

Atomic  Weight 

Element 

Symbol 

Weight, 
B.P. 

Weight, 
U.S.  V. 

very  accurately 
determined 

Columbium  vide 

Niobium 

"Copper  (Cuprum) 

Cu. 

II. 

63-4 

63-2 

63-173 

Didymium  . 

Di. 

rv. 

145-4 

144-6 

145-4 

Erbium 

ErorEb1 
orE 

F  . 

— 

166-0 

165-9 

165-891 

Fluorine     . 

i. 

19-0 

19-0 

18-984 

Gallium 

Ga 

IV. 

70-0 

68-8 

69-9 

♦Gold  (Aurum)     . 

Au 

i.  &  in. 

196-5 

196-2 

196-155 

Glueinum      vide 

Beryllium 

Holmium    . 

.               . 



— 





*Hydrogen   . 

B  . 

i. 

1-0 

1-0 

1-0 

Indium 

In. 

i.  &  in. 

113-4 

113-4 

113-398 

*Iodime 

I   . 

i. 

127-0 

126-6 

126-557 

Iridium 

Ir  . 

II.  &  IV. 

192-7 

192-7 

192-651 

♦Iron  (Ferrum)     . 

Fe. 

II.  &  IV. 

56-0 

55-9 

55-913      ■ 

Lanthanum 

La. 

IV. 

139-0 

138-5 

138-526 

*Lead  (Plumbum) 

Pb. 

II.  &  IV. 

207-0 

206-5 

206-471      ' 

*Lithium 

Li. 

I. 

7-0 

7-0 

7-0073    ■ 

♦Magnesium 

Mg 

II. 

24-0 

24-0 

23-959 

*Manganese 

Mn 

II.  &  IV. 

55-0 

54-0 

53-906 

^Mercury           \ 
(Hydrargyrum)  / 

Hg 

II. 

200-0 

199-7 

199-712 

Molybdenum 

Mo 

95-5 

95-5 

95-527 

Nickel 

Ni. 

II.  &  IV. 

58-0 

58-0 

57-928      i 

Niobium  or       "1 
Columbium/ 

Nb 

V. 

94-0 

94-0 

*Nitrogen     . 

N  . 

III.  &  V. 

14-0 

14-0 

14-021 

Osmium 

Os. 

II.  &  IV. 

198-5 

198-5 

198-494 

*  Oxygen 

0  . 

II. 

16-0 

16-0 

15-9633 

Palladium  . 

Pd. 

II.  &  IV. 

105-7 

105-7 

105-737 

*Phosphorus 

P  . 

III.  &  V. 

31-0 

31-0 

30-958 

♦Platinum    . 

Pt. 

II.  &  IV. 

195-0 

194-4 

194-415 

♦Potassium        1 
(Ealium)  / 

K  . 

I. 

39-0 

39-0 

39-019 

Bhodium    . 

Eh 

H.  &  IV. 

104-0 

104-1 

104-055 

Bubidium  . 

Bb 

I. 

85-3 

85-3     ' 

85-251 

Buthenium 

Eu 

II.  &  IV. 

104-2 

104-2 

104-217 

Samarium  . 

Sm 

— 

150-0 

150-021 

Scandium  . 

Sc. 

— 

44-0 

44-0     ' 

43-98 

Selenium    . 

Se. 

II. 

78-8 

78-8 

78-797 

Silicon 

Si. 

IV. 

28-0 

28-0 

28-195 

♦Silver  (Argentum) 

Ag.        . 

I.  (?  II.) 

108-0 

107-7 

107-7 

♦Sodium(Natrium) 

Na 

I. 

23-0 

230 

22-998 

Strontium  . 

Sr. 

II. 

87-4 

87-4 

87-374 

*Sulphur     . 

S  . 

II. 

32-0 

32-0 

31-984 

Tantalum  . 

Ta. 

III.  &  V.  ' 

182-0 

182-0 

182-144 

Tell/wrium  . 
Terbium     . 

Te. 

n. 

128-0 

128-0 

127-96 

Thallium    . 

Tl  or  Th' 

III. 

203-7 

203-7 

203-715 

Thorium     . 

Th 

IV. 

233-0 

233-0 

233-414 

Thulium     . 

• 

—          1 

— 

1  Er,  Boscoe  and  Schorlemmer,  Treatise  on  Chemistry,  vol   i   p    54     Eb 
PbWneB,  edited  by  Watts,  12th  ed.  vol.  i.  p.  401.    E,  Ira  Bemsen's  Principles  of 
Theoretical  Chemistry. 


CHAP.  I.] 


GENEEAL  EELATIONS. 


11 


TABLE   OF  ELEMENTS— continued. 

Element 

Symbol 

Valency  or 
Atomicity 

Atomic 

Weight, 

B.P. 

Atomic 
Weight, 
U.S.  P. 

Atomic  Weight 

very  accurately 

determined 

*Tin  (Stannum)   . 
Titanium    . 
Tungsten    ■ 
Uranium    . 
Vanadium  .        . 
Ytterbium  . 
Yttrium      , 
*Zinc          .        . 
Zirconium .        . 

Sn. 
Ti. 
W. 
U  . 
V  . 
Yb. 

y  . 

Zn 
Zr. 

II.  &  IV. 
IV. 
VI. 

IV.  &  VI. 

III.  &  V. 

IV. 

II. 

IV. 

118-0 
49-8 

184-0 

240-0 
51-3 

172-8 
89-8 
65-0 
90-0 

117-7 
48-0 

183-6 

238-5 
51-3 

172-7 
89-8 
64-9 
90-0 

117-698 
49-846 

183-61 

239-8 
51-256 

172-761 
89-816 
64-9045 
89-367 

Nature  of  the  Elements. 

Considerable  additions  have  been  made  to  the  number  of  elements  during 
late  years.  The  reason  of  this  is  that  the  spectroscope  has  indicated  the 
presence  of  metals  previously  unknown,  and  by  the  use  of  proper  means  they 
have  been  obtained  in  a  separate  condition.  These  substances  are  termed 
elements  because  we  do  not  at  present  know  how  to  split  them  up  in  such  a 
manner  as  to  prove  that  they  are  compounds.  But  it  is  not  improbable  that 
they  are  compounds,  just  as  we  now  know  that  potash  and  soda  are  com- 
pounds ;  although  before  Sir  Humphry  Davy  split  them  up  into  oxygen  and 
a  metal  they  were  supposed  to  be  elements.  Indeed,  recently  much  evidence 
has  been  brought  to  show  that  the  substances  which  we  call  elements  are 
really  compounds. 

It  is  from  an  examination  of  the  spectroscopic  character  of  the  elements 
at  different  degrees  of  temperature  that  Lockyer  has  been  able  to  obtain 
sufficient  data  to  justify  the  definite  formulation  of  the  hypothesis  that 
all  the  elements  we  know  are  really  compounds,  or,  to  speak  perhaps  more 
precisely,  are  really  different  forms  of  aggregation  of  one  kind  of  matter.1 
According  to  this  hypothesis  the  matter  of  which  the  universe  is  composed 
was  at  one  time  equally  distributed  through  space,  and  uniform  in  kind. 
The  atoms  then  coalesced  in  various  groups  of  two,  three,  or  more;  and 
these,  again  grouping  themselves  together  still  further,  formed  aggregates  of 
more  and  more  complex  composition.  These  aggregates  are,  it  is  supposed, 
the  elements  with  which  we  are  acquainted.  Most  of  those  complex  mole- 
cules are  perfectly  stable  at  ordinary  temperatures ;  and  so  their  composition 
remains  constant  under  the  conditions  usual  at  the  surface  of  this  earth. 

But  when  they  are  subjected  to  increased  temperatures  in  the  laboratory, 
rising  from  that  of  the  Bunsen  lamp  to  the  electric  arc,  and  then  to  the 
electric  spark  or  to  still  higher  temperatures  in  the  sun,  their  spectroscopic 
appearances  give  evidence  of  decomposition  into  simpler  molecules.  When 
the  elements  are  subjected  to  cold  and  pressure  the  molecules  which  compose 
them  come  closer  together,  and  we  get  them  forming  a  solid  substance.  Heat 
tends,  by  communicating  vibrations  to  them,  to  shake  the  molecules  further 
apart,  and  to  produce  a  liquid  condition.  Still'  greater  heat  shakes  the 
molecules  further  apart  still,  and  produces  a  gaseous  condition. 

In  all  those  conditions  the  molecules  of  the  element  become  more  complex 
by  reduction  of  temperature  or  increase  of  pressure,  and  simpler  by  increase 
in  temperature  or  reduction  in  pressure.2  Exceedingly*  great  heat  or  elec- 
tricity appears  to  shake  apart  still  further  the  constituents  of  the  element,  so 
as  to  resolve  it  into  simpler  combinations  of  the  elementary  substance  of 
which,  according  to  the  hypothesis,  it  is  composed. 

This  shaking  apart  of  the  component  elements  is  known  to  exist  in  com- 

1  Lockyer,  Phil.  Trans.  1874,  p.  492  et  seq. 

2  According  to  another  hypothesis,  bodies  are  supposed  to  have  molecules  of  one 
degree  of  complexity,  and  the  difference  between  solid,  liquid,  and  gaseous  bodies  is 


12 


PHAKMACOLOGY  AND  THEBAPEUTTCS.     [sect.  i. 


pounds,  and  to  it  the  name-  of  dissociation  has  been  given.  Thus  when 
chalk  or  limestone  is  exposed  to  the  action  of  heat  it  becomes  dissociated 
into  carbonic  acid  and  lime,  CaCOs  =  CaO  +  C02.  This  process  is  readily  re- 
versible by  reversing  the  conditions.  Thus  the  Erne  and  carbonic  acid  which 
are  dissociated  by  heat  readily  recombine  in  the  cold  CaO  +  C04  =  CaCOs. 

When  matter  is  solid  the  molecules  of  which  it  is  composed  are  sup- 
posed to  be  large  and  close  together.  When  in  the  state  of  vapour  or  gas, 
these  molecules  are  smaller  and  much  further  apart. 

Solid,  liquid,  or  densely  gaseous  matter,  when  its  molecules  are  agitated 
by  heat,  gives  a  continuous  spectrum.  Gaseous  and  vaporous  matters,  when 
their  molecules  are  agitated  at  lower  pressures  or  higher  temperatures  by 
heat  or  electricity,  give  a  discontinuous  spectrum  consisting  of  bands  or  lines. 

Between  those  extremes  we  have,  as  a  rule,  three  other  intermediate 
kinds  of  spectra :  first,  a  continuous  spectrum  in  the  red ;  next,  a  continuous 
spectrum  in  the  blue ;  next,  a  fluted  spectrum,  and  after  thatthe  line  spectrum 
already  mentioned. 

In  all  those  kinds  of  spectrum,  however,  we  are  supposing  that  the  ele- 
mentary molecules  are  still'  intact ;  they  are  only  more  or  less  separated. 

Compound  bodies,  like  simple  bodies,  give  definite  spectra.  The 
spectrum  of  a  simple  metal  consists  of  lines  which  increase  in  number  and 
thickness  as  the  pressure  of  the  vapour  or  its  quantity  in  a  given  space  is 
increased.  The  spectrum  of  a  compound  body  consists  chiefly  of  channelled 
spaces  and  bands  which  increase  in  the  same  manner.  The  greater  the  number 
of  molecules  in  a  cubic  inch  or  cubic  millimetre,  and  the  more  violently  they 
are  agitated,  the  more  complex  is  the  spectrum  until  it  becomes  continuous. 

The  smaller  the  number  of  molecules  in  a  given  space,  the  more  simple  is 
the  spectrum,  which  then  consists  of  a  few  lines  only. 

When  a  compound  is  exposed  to  heat,  so  as  to  dissociate  it  into  its  com- 
ponent parts  the  spectroscopic  bands  characteristic  of  the  compound  become 
thinner,  and  the  lines  of  the  metal  increase  in  number,  as  shown  in  the 
accompanying  diagram  where  the  bands  exhibited  by  calcium  chloride  in  the 
flame  of  a  Bunsen's  burner,  disappear,  and  are  replaced  by  lines  only,  when 


4      - 

11 

'  III  III 

Fia.  1.— Spectrum  of  calcium  chloride.  (1)  In  the  flame  of  a  Bunsen's  burner,  showing  the 
channelled  spaces  and  bands  of  a  oompound.  (2)  In  an  electric  spark,  showing  the  lines  of 
the  element  calcium.    (After  Roscoe.) 

an  electric  spark  is  used.  When  an  element  is  treated  with  more  and  more 
heat  and  electricity  it  likewise  gives  exactly  the  same  kind  of  evidence  of 
dissociation— bands  disappearing,  and  lines  becoming  thinner.  Besides  this, 
new  lines  make  their  appearance  with  every  large  increase  of  temperature. 

This  behaviour  of  the  element  appears  to  show  that  it  also  is  a  compound, 
but  that  it  is  stable  under  ordinary  conditions,  and  is  only  dissociated  at  a 
high  temperature. 

,  Other  proofs  of  this  hypothesis  are  derived  from  a  comparison  of  the  spectra 
of  the  elements  as  observed  in  our  laboratories  with  their  spectra  in  the  sun. 

A  comparison  «of  the  two  hypotheses  shows  us  that  as  on  the  old 
hypothesis  each  element  represents  a  specjes  and  is  unvariable,  its  spec- 
trum ought  to  be  always  the  same  in  our  laboratories  and  in  the  sun :  and 
the  same  in  sun-spots  as  in  prominences,  and  the  same  at  all  periods  of  the 
sun's  activity. 

supposed  to  depend  on  the  difference  in  the  free  path  of  the  molecule.  But  accord- 
ing to  the  new  view,  the  difference  in  the  complexity  of  the  molecule  itself  is  sufficient 
to  explain  the  phenomena. 


qhat.  i.]  GENEEAL  RELATIONS.  13' 

Under  the  new  hypothesis  the  spectra  off  metals  in  our  laboratories  and 
in  the  sun  should  not  resemble  each  other ;  they  should  be  different  in  sun- 
spots  and  in  prominences,  because  the  spot  is  cooler  than  the' prominence; 
and  they  should  vary  at  the  time  of  the  sun's  activity  because  the  sun  is 
hotter  at  the  maximum  of  the  sun-spot  period,  and  therefore  there  should  be 
a  greater  amount  of  dissociation  amongst  the  elements  at  that  period. 

As  a  matter  of  fact  we  find  that  the  spectra  in  our  laboratories  and  in  the 
sun  do  not  resemble  each  other  (Fig.  2) ;   that  those  of  the  same  element 


m 


B 


FEEBLE  SPARK 


Fig.  2. — Diagram  of  the  spectrum  of  lithium  under  various  conditions  of  temperature. 
(After  Lockjer,  Boy.  Sac.  Proa.  Deo.  12, 1878.) 

m  the  sun-spot  and  prominences  are  as  dissimilar  as  of  any  two  elements ; 
and  that  the  spectra  of  the  elements  in  the  sun  do  vary  with  the  maximum ? 
of  the  sun-spot  period. 

On  the  old  hypothesis  the  spectra  of  prominences  should  also  consist  of 
lines  familiar  to  us  in  our  laboratories,  because  solar  and  terrestrial  elements 
are  the.  same,  while,  according  to  the  new  hypothesis,  the  spectra  of  promi- 
nences should  be  unfamiliar,  because  the  prominences  represent  outpourings 
from  a  body  hot  enough  to  prevent  the  atoms  of  which  our  elements  are 
composed  from  coming  together. 

As  a  matter  of  fact,  the  lines  in  the  prominences,  with  the  exception  of 
those  of  hydrogen,  magnesium,  calcium,  and  sodium,  are  either  of  unknown 
origin,  or  are  feeble  lines  in  the  spectra  of  known  elements.  Spectroscopic 
observation,  therefore,  leads  to  the  belief  that  the  so-called  elements  are 
really  compounds,  the  component  parts  of  which  are  kept  apart  by  high 
temperatures  in  the  sun  and  stars,  but  unite  when  the  temperature  decreases. 

By  the  powerful  vibrations  imparted  to  them  by  the  electric  spark,  they 
may  be  dissociated  in  the  laboratory ;  but,  as  no  means  has  yet  been  devised 
of  separating  the  components,  they  again  unite  to  form  the  original  body, 
just  as  hydrogen  and  oxygen,  into  which  steam  is  dissociated  by  passing  it 
through  a  strongly  heated  tube,  almost  instantly  combine  again  to  form  water 
unless  they  are  separated  by  means  of  the  more  rapid  diffusion  of  hydrogen 
through  a  porous  tube. 

The  difficulty  in  accepting  this  evidence  lies  in  the  fact  that  we  have 
hitherto  been  unable  to  isolate  the  substances  into  which  the  elements  are 
supposed  to  be  dissociated:  as  these  after  their  dissociation  at  once  recombine 
and  again  form  the  original  substance. 

One  proof,  however,  that  the  supposed  components  of  the  element  calcium 
may  remain  permanently  separated,  is  afforded  by  the  fact  that  in  the 
spectra  of  two  stars,  Sirius  (Fig.  3)  and  a  Lyrse,  which  are  very  bright,  and 
probably  very  hot,  only  one  of  the  ultra-violet  lines  of  calcium  is  represented. 


1AFU 
FLfl 


Fig.  3. — Diagram  of  the  speotrum  of  calcium  under  various  conditions  of  temperature.    In  the 
spectrum  of  Sirius  the  line  K  is  absent,  while  it  is  very  strongly  marked  in  the  solar  spectrum. 

But  we  have  also  other  evidence  of  the  compound  nature  of  the  elements, 
which,  although  it  was  not  sufficient  of  itself  to  force  us  to  abandon  our  old 
ideas  of  their  simple  nature,  is  yet  strongly  corroborative  of  the  spectroscopic 
evidence.  Thus  we  find  that  oxygen  is  broken  up  by  electricity,  and  that 
the  atoms  of  which  its  molecules  are  composed,  rearrange  themselves 
so  as  to  form  what  is  to  all  intents  and  purposes  a  new  element,  ozone, 
having  a  much  closer  resemblance  to  chlorine  than  to  oxygen  in  its  activity, 


14 


PHARMACOLOGY  AND  THEEAPEUTICS.     [sect.  i. 


although  its   compounds  with  metals  appear   to   be   identical   with   those 
of  oxygen.  • 


Fig.  4. — Diagram  to  Illustrate  the  formation  of  ozone  by  electricity,  a  represents  oxygen,  through 
which  a  spark  is  passing ;  &  after  it  has  passed.  The  double  rings  are  intended  to  represent 
molecules  of  oxygen,  each  containing  two  atom3.  As  the  electric  spark  passes  through  the 
oxygen  it  breads  up  the  first  molecule,  carrying  one  atom  on  to  join  the  second  molecule  of 
oxygen,  and  form  one  of  ozone.  The  atom  which  is  left  joins  another  molecule  of  oxygen,  and 
also  forms  ozone.    (After  Lockyer.) 

At  a  high  temperature  its  atoms  are  again  dissociated,  and  recombine  to 
form  ordinary  oxygen.  When  it  combines  with  other  substances,  the  heat 
of  combination  appears  to  be  sufficient  to  dissociate  the  atoms  of  ozone  (Oj), 
so  that  in  the  compound  we  meet  with  simple  oxygen,  O. 

When  sulphur  is  simply  melted  and  cooled,  it  solidifies  as  a  yellow 
brittle  substance,  but  if  it  is  heated  to  200°  it  becomes  brownish  and  thick, 
and  if  it  be  suddenly  cooled,  by  throwing  it  into  water,  it  solidifies  as  a  trans- 
parent reddish  plastic  and  elastic  substance.  The  ordinary  brittle  and 
yellow,  and  the  reddish  plastic  sulphur,  appear  to  be  quite  different  sub- 
stances. But  if  the  plastic  sulphur  be  left  for  some  hours,  it  becomes  re- 
converted into  ordinary  sulphur ;  and  if  either  ordinary  or  plastic  sulphur 
be  volatilised,  the  vapour  condenses  in  the  form  of  ordinary  sulphur ;  but  if 
the  vapour  is  quickly  cooled,  the  sulphur,  while  retaining  its  ordinary  appear- 
ance, may  yet  undergo  a  certain  change  evidenced  by  its  becoming  insoluble 
in  bisulphide  of  carbon.  On  the  new  hypothesis  we  explain  these  phenomena 
by  supposing  that  the  different  forms  of  sulphur  are  'different  compounds,  or 
perhaps  we  should  rather  say  different  aggregates,  for  their  components  may 
not  differ  in  kind  like  those  of  calcium,  but  only  in  number  like  those  of 
oxygen  or  ozone. 

Indeed  we  are  almost  driven  to  such  a  conclusion  by  the  behaviour  of 
sulphur  in  regard  to  its  vapour  density,  for  only  at  very  high  temperatures  does 
the  specific  gravity  of  the  vapour  follow  the  general  rule,  and  at  lower  tem- 
peratures it  is  three  times  as  great  as  it  ought  to  be,  indicating  that  at  these 
lower  temperatures  the  molecule  of  sulphur  contains  six  atoms  instead  of  two. 

Phosphorus  also  affords  us  an  example  of  an  element  which  occurs  in 
two  forms,  so  different  that  we  should  call  them  distinct  bodies,  were  it  not 
that  we  find  that  one  can  be  transformed  into  the  other. 

The  two  forms,  red  and  yellow  phosphorus,  differ  from  each  other,  not 
only  in  their  colour,  but  in  their  density,  specific  heat,  readiness  of  com- 
bustion, and  heat  of  combustion.  They  differ  also  in  the  fact  that  yellow 
phosphorus  is  exceedingly  poisonous,  whereas  the  red  phosphorus  is  not 
poisonous.  They  are  in  many  respects,  then,  different  bodies,  but  we  have 
hitherto  been  content  to  call  them  allotropic  forms  of  the  same  element. 

In  combination  we  find  that  phosphorus  is  sometimes  pentad  and  sometimes 
triad ;  that  its  compounds  with  oxygen  are  sometimes  poisonous,  at  other  times 
not.  Thus  orthophosphoric  acid,  H3P04,  is  not  poisonous ;  pyrophosphorio 
acid,  H4P20,,  and  metaphosphoric  acid,  HPOs,  are  both  poisonous. 

The  most  striking  example,  however,  is  carbon,  which  we  not  only  find 


chap,  i.]  GENEEAL  EELATIONS.  15 

in  three  forms,  differing  enormously  from  each  other,  as  diamond,  charcoal, 
and  graphite,  but  which  we  find  in  various  compounds  playing  the  most 
varied  parts.    This  we  at  present  explain  by  saying  that  carbon  unites  with 
itself  in  the  formation  of  the  various  radicals ;  and  thus  comes  to  form  what ' 
are  practically  new  elements. 

Another  example  is  afforded  us  by  ammonia,  the  salts  of  which  are  just  as 
well  characterised  as  those  of  potash  or  soda.  The  amalgam  which  it  forms 
with  mercury  possibly  indicates  that  we  have  in  it  also  a  real  metal, 
ammonium,  corresponding  to  sodium  or  potassium,  though  thiB  is  uncertain. 

The  three  metals,  sodium,  potassium,  and  ammonium  (if  it  exist),  agree  in 
the  readiness  with  which  they  are  oxidised,  so  that  it  is  difficult  to  preserve  the 
•.tire  metal,  although  the  oxide  is  stable.  They  differ,  however,  in  the  oxides 
of  potassium  and  sodium  being  solid,  and  that  of  ammonium  gaseous. 
Ammonium  has  not  been  isolated,  and  it  is  put  down  in  the  text-books  as  a 
hypothetical  substance,  but  ammonium  salts  are  tangible  enough,  and  the 
question  which  we  have  to  keep  before  us  is,  whether  potassium,  sodium, 
and  all  the  other  so-called  elements,  are  not  in  reality  compounds  like 
ammonium. 

Some  people  still  regard  species  as  immutable,  and  look  upon  Darwin's 
hypothesis  of  evolution  as  unproven. 

The  evidence  in  favour  of  the  evolution  of  elements  from  one  simple  form 
of  matter,  is  as  yet,  perhaps,  much  less  strong  than  that  in  support  of  the 
evolution  of  species  ;  but  the  hypothesis  has  this  advantage,  that  it  explains 
certain  phenomena  which  have  hitherto  been  very  perplexing. 

It  may  be  at  least  convenient  in  discussing  the  physiological  action  of 
drugs  to  bear  this  hypothesis  in  mind,  and  to  remember  that  what  we  have 
hitherto  been  accustomed  to  call  elements  may  be  really  constituted  like  the 
so-called  organic  radicals,  with  this  difference,  that  we  can  split  up  organic 
radicals  with  tolerable  facility,  while  we  cannot  do  this — at  least  to  any  great 
extent — with  elements. 

It  also  shows  us  that  we  must  as  pharmacologists  pay  attention  to 
molecular  as  well  as  to  empirical  composition,  and  take  into  consideration 
crystalline  form  and  physical  aggregation  in  all  observations  regarding  the 
relations  between  elements  or  compounds  and  living  organisms.  It  is  not 
sufficient,  for  example,  to  speak  of  the  action  of  phosphorus  on  the  organism 
as  if  this  were  invariable,  for.it  varies  with  the  molecular  composition  of 
the  body  in  the  red  or  yellow  form,  and  isomeric  organic  substances  may  be 
utterly  different  in  action. 

Classification  of  the  Elements. 

The  vegetable  and  animal  kingdoms  are  divided  into  various  groups. 
Formerly,  men  tried  to  arrange  them  in  linear  succession  so  that  there  should 
be  an  unbroken  line  from  the  lowest  to  the  highest  members  of  the  vegetable 
kingdom,  thence  to  the  lowest  member  of  the  animal,  and  onwards  up  to  the 
highest  member  of  the  animal  kingdom.  Such  an  arrangement  as  this, 
however,  was  found  to  be  unnatural.  Instead  of  the  highest  members  of  the 
vegetable  kingdom  being  connected  with  the  lowest  members  of  the  animal 
kingdom,  it  is  found  that  the  lowest  members  of  each  kingdom  are  closely 
connected  and  that  the  divergence  becomes  greater  as  development  proceeds 
towards  the  highest  members  in  each  kingdom.  The  doctrine  of  evolution 
at  once  rendered  this  arrangement  natural  and  easily  understood. 

Starting  from  one  common  point  of  origin  in  structureless  protoplasm, 
the  various  organisms  became  more  and  more  unlike  in  each  successive  stage 
of  development,  their  resemblance  being  only  recognisable  at  all  in  their 
embryonic  condition. 

Various  attempts  have  been  made  to  arrange  inorganic  substances  in 
natural  orders.  One  mode  of  arrangement  is  according  to  their  atomic 
weight — as  in  the  following  table : — ' 

1  In  this  and  the  following  Tables  the  atomic  weights  have  been  corrected. 


10 


PHARMACOLOGY  AND  THEEAPEUTICS.     [sect.  i. 


a 

ft 

1 

1 

1 

0 

!s 

a 

a 
1 

d 

M 

0) 

a 

t 

a) 

1 

s 

1 

1 

W 
P 

13 

1 

<a 

1 

a 
Si 

a 

1 
a 

! 

5 

o 

a 

V 
-M 

w 

5 

H 

l 

K 

39 

3-5 

Y 

89-8 

2-4 

Ce 

141 

2 

Li 

7' 

6 

Ca 

40 

1 

Zr 

90 

0-2 

Di 

145-4 

3-6 

Gor, 
Be  ! 

Ti 

49-8 

9-8 

Nb 

94 

4 

Ta 

182 

36-6. 

9 

2 

V 

51-3 

1-5 

Mo 

95-5 

1-5 

W 

184 

2 

B 

11 

2 

Cr 

62-5 

1-2 

Eh 

104 

8-5 

Ir 

192-7 

8-7 

0 

12 

1 

Mn 

'55 

2-5 

Eu 

104-2 

0-2 

Pt 

195 

2-3 

N 

14 

2 

Fe 

56 

1 

Pd 

105-7 

1-5 

Au 

196-5 

1-5 

0 

16 

2 

Ni 

58 

2 

Ag 

108 

2-3 

Os 

198-5 

2 

m 

19 

3 

Co 

58-9 

0-9 

Cd 

111-8 

3-8 

Hg 

200 

1-5 

Na 

23 

4 

Cu 

63-4 

4-5 

Sn 

118 

6-2 

Tl 

203-7 

3-7 

Mg 

24 

1 

Zn 

65 

1-6 

Sb 

120 

2 

Pb 

207 

4 

Al 

27 

3 

As 

75 

10 

I 

127 

7 

Bi 

209 

3 

Si 

28 

1 

Se 

78-8 

3-8 

Te 

128 

1 

Th 

233 

24 

P 

31 

3 

Br 

80 

1-2 

Cs 

133 

5 

U 

240 

V 

S 

32 

1 

Bb 

85-3 

5-3 

Ba 

137 

4 

CI 

35-5 

3-5 

Sr 

87-4 

2-1 

La 

139 

2    1 

1 

From  this  it  will  be  seen  that  the  atomic  weights  of  the  different  elements 
form  a  series,  the  members  of  which  in  most  cases  differ  from  one  another  by 
1,  2,  3,  or  4.  There  are  few  exceptions  in  which  the  differences  are  much 
greater,  and  these  probably  represent  blanks  which  may  yet  be  Med  up  as  our 
knowledge  of  the  elements  increases.  This  mode  of  classification,  however, 
reminds  us  of  the  Linnsean  system  in  plants,  and  is  artificial  rather  than 
natural.  In  it,  the  elements  which  are  placed,  close  together  possess  very 
different  properties,  whereas  those  which  are  separated  from  each  other 
present  considerable  resemblances. 

Newlahd's  Tablb. 


Difference 

Member  of  a  Group 
having  Lowest  Equivalent 

One  immediately  above 
the  preceding 

H  =  I 

0  =  1 

Magnesium      .    24 

Calcium  .        .    40 

16 

1 

Oxygen    .        .     16 

Sulphur  .        .    32 

16 

1 

Lithium  .        .      7 

Sodium    .        .    23 

16 

1 

Carbon     .        .    12 

Silicon     .        .    28 

16 

1 

Fluorine  .        .    19 

Chlorine  .        .    35-5 

16-5 

1-031 

Nitrogen  .        .    14 

Phosphorus      .    31 

17 

1-062 

Lowest  term  of  Triad 

Highest  term  of  Triad 

Lithium  .        .      7 

Potassium        .    39 

32 

2 

Magnesium      .    24 

Cadmium         .  112 

88 

5-5 

Molybdenum    .    96 

Tungsten         .  184 

88 

5-5 

Phosphorus      .    31 

Antimony         .  120 

89 

5-687 

Chlorine  .        .    35-5 

Iodine      .        .  127 

91-5 

5-718 

Potassium        .    39 

Caesium   .        .141 

102 

5-875 

Sulphur  .        .    32 

Tellurium        .  128 

96 

6-062 

Calcium  .        .    40 

Barium    .        .  137 

97 

6-062 

CHAP.  I.j 


GENERAL  RELATIONS. 


17 


The  first  important  attempt  at  a  natural  classification  of  the  elements 
•was  made  by  Newlands  in  1864.1  He  then  arranged  them  in  groups,  be- 
tween the  members  of  which  there  was  a  close  connection  in  regard  to  their 
chemical  properties,  and  a  curious  relation  in  regard  to  their  atomic  weights. 
These  presented  differences  which  were  generally  multiples  of  the  atomic 
weight  of  hydrogen,  and  generally  equal  to,  or  multiples  of,  that  of  oxygen. 

A  curious  relationship  had  also  been  pointed  out  by  M.  Dumas  2  between 
the  members  of  the  potassium  group,  their  atomic  weights  being  equal  to 
multiples  of  those  of  lithium  and  potassium  added  together. 

7  +    39  =    46 

7  +     78  =    85 


Li  +    K  =  2Na,    or  in 

Li  +  2K  =    Eb 
2Li  +  3K  =    Cs  (133) ' 

Li  +  5K  =    Tl  (203-7) 
3Li  +  5K  =  2Ag 


14  +  117  =  131 

7  +  195  =  202 

21  +  195  =  216 


A  similar  relation  was  also  pointed  out  by  Mr.  Newlands  between  lithium 
and  the  calcium  group ;  as  follows : — 

Li  +    Ca  =  2Mg  (48),  or  in  figures,  7  +    40  =    47 

Li  +  2Ca  =    Sr  „  7  +    80  =    87 

2Li  +  3Ca  =    Ba  (137)        „  14  +  120  =  134 

Li  +  5Ca  =    Pb  „  7  +  200  =  207 

But  Mr.  Newland's  most  important  table  is  the  following  one,  in  which 
he  has  arranged  the  elements  in  ten  series  : — 


Triad 

Lowest 

Mean 

Highest 

term 

term 

I. 

Li     7 

+  17     =Mg24 

Zn   65 

Cd  111-8 

II. 

B    11 

Au  196 

III. 

C    12 

+  16    =Si  28 

Snll8 

IV. 

N    14 

+  17    =  P    31 

As    75 

Sb  120 

+  88=Bi  210 

V. 

O    16 

+  16    =S    32 

Se    78-8 

Tel28 

+  70  =  Os  199 

VI. 

F    19 

+  16-5  =  C1  35-5 

Br    80 

I    127 

VII. 

Li  7 

+  16  =  Na  23 

+  16    =K   39 

Bb   85-3 

Cs  133 

+  70  =  T1  203 

VIII. 

Li  7 

+  17  =  Mg24 

+  16    =Ca40 

Sr    87-4 

Bal37 

+  70  =  Pb  207 

IX. 

V    51-3 

W  184 

X. 

Mo  95-5 
Pdl05-7 

Pt  195 

Seven  of  these  series  nearly  correspond  in  their  first  members  with  those 
of  Mendelejeff,  to  whom  and  to  Lothar  Meyer  we  owe  the  complete  develop- 
ment of  this  mode  of  classification.  Mr.  Newlands  also  pointed  out  that  the 
eighth  element  starting  from  a  given  one,  was  a  kind  of  repetition  of  the  first, 
like  the  eighth  note  of  an  octave  in  music.4 

Mendelejeff  has  not  only  greatly  developed  this  system  of  classification, 
but  has  afforded  convincing  proof  of  its  value  by  not  only  predicting  the 
existence  of  an  unknown  element,  but  actually  describing  its  physical  cha- 
racters and  chemical  reactions — a  prediction  the  correctness  of  which  was 
proved  by  the  discovery  of  gallium,  and  by  the  agreement  of  its  characters 
and  reactions  with  those  which  Mendelejeff  had  foretold. 

The  various  members  of  the  animal  kingdom  can  all  be  arranged  in  a  few 
series  :  Protozoa,  Coelenterata,  Annuloida,  Annulosa,  Molluscoida,  Mollusca, 
and  Vertebrata.    These  series  all  differ  more  or  less  from  one  another,,  but  a 

1  Newlands,  Chemical  News,  July  30,  1864. 
s  Dumas,  quoted  by  Newlands,  op.  cit. 

*  The  newer  atomic  weights  of  Cs,  Fl,  Mg,  and  Ba  do  not  correspond  so 
exactly  as  their  old  ones  with  the  sum  of  the  other  elements. 

*  Chem.  News,  Aug.  20, 1864,  p.  94. 

C 


18  PHAKMACOLOGY  AND  THEBAPEUTICS.     [sect,  u 

certain  agreement  is  observed  between  their  members,  and  similarly  the 
elements  may  be  arranged  in  series. 

Mendelejeff  points  out,  that  if  we  take  those  elements  having  the  lowest 
atomic  weight,  and  omit  hydrogen,  between  which  and  lithium  there  is  a  great 
gap,  the  seven  elements,  lithium,  glucinum,  boron,  carbon,  nitrogen,  oxygen, 
and  fluorine,  may  be  regarded  as  typical  elements  forming  a  series  repre- 
senting the  lowest  members  of  seven  groups.  The  next  seven  elements  may 
be  arranged  in  a  similar  way : — 

Li  =  7  :  G  =  9-4  :  B  =  11 :  C  =  12  :  N  =  14  :  0  =  16  :  F  =  19  : 
Na  =  23  :  Mg  =  24  :  Al  =  27  :  Si  =  28  :  P  =  31  :  S  =  32  :  CI  =  35-5. 

To  each  group  of  seven  elements  Mendelejeff  gives  the  name  of  a  small 
period  or  series.  In  each  series  the  characters  of  the  elements  vary  gra- 
dually and  regularly  as  their  atomic  weights  increase.  This  variation  is 
periodical,  i.e.  varies  in  the  same  way  in  each  series,  so  that  the  elements 
which  have  corresponding  places  in  each  series,  correspond  also  to  a  certain 
extent  in  their  properties,  and  form  similar  compounds.  The  atomicity  is 
least  in  the  first,  and  greatest  in  the  last  members  of  each  series.  Thus  the 
first  members  of  the  series  form  monochlorides,  the  second  dichlorides,  the 
third  trichlorides,  and  so  on. 

In  the  accompanying  table  B  represents  radical  or  element,  and  B'  indi- 
cates that  the  element  is  monatomic,  so  that  one  atom  combines  with  one  of 
CI  to  form  a  monochloride,  BC1.  E"  indicates  that  the  element  is  diatomic, 
and  so  on. 

But  a  difference  is  to  be  observed  between  the  even  and  the  uneven  series. 
Corresponding  members  of  even  series,  such  as  the  fourth  and  sixth,  agree 
with  each  other,  and  members  of  uneven  series  like  the  fifth  and  seventh  agree. 
This  agreement  is  greater  than  between  the  members  of  an  even  series,  such 
as  the  fourth,  and  those  of  an  uneven  series  like  the  fifth,  although  the  fifth 
is  more  closely  placed  to  the  fourth  than  the  sixth  is.  Thus  Ca  and  Sr 
belonging  to  the  fourth  and  sixth  series  have  a  greater  resemblance  to  each 
other  than  they  have  to  Zn  or  Cd,  which  belong  to  the  fifth  and  seventh  series, 
and  these  metals  on  the  other  hand  have  a  greater  resemblance  to  each  other 
than  they  have  to  Ca  or  Sr.  The  members  of  even  series  are  less  metalloidal 
or  more  metallic  than  those  of  uneven  series,  e.g.  Mn  of  the  fourth  series  is 
less  metalloidal  than  Br  of  the  fifth  series.  In  the  even  series  the  metallic 
or  basic  character  predominates,  whilst  the  corresponding  members  of  the 
uneven  series  rather  exhibit  acid  properties.  The  members  of  the  even  series, 
so  far  as  we  know,  form  no  volatile  compounds  with  hydrogen  or  alcohol 
radicals,  while  the  corresponding  members  of  the  uneven  series  do  form  such 
compounds. 

<  The  last  members  of  the  even  series  resemble  in  many  respects  (in  their 
lower  oxides,  etc.),  the  first  members  of  the  uneven  series;  thus  chromium 
and  manganese  in  their  basic  oxides  are  analogous  to  copper  and  zinc.  But 
there  are  great  differences  between  the  last  members  of  the  uneven  series 
(haloids),  and  the  first  members  of  the  next  even  series  (alkali  metals).  Now 
between  the  last  members  of  the  even  series  there  occur,  according  to  the 
order  of  atomic  weights,  all  those  elements  which  cannot  be  included"  in  the 
small  periods.  Thus  between  Cr  and  Mn  in  the  one  series,  and  Cu  and  Zn 
in  the  next,  there  come  the  elements  Fe,  Co,  Ni,  and  in  a  similar  way  after 
the  sixth  series  come  Eu,  Eh,  Pd,  and  after  the  tenth  Os,  Ir,  Pt.  Mendelejeff 
gives  the  name  of  a  long  period  to  two  such  series  with  three  intervening 
members,  forming  seventeen  in  all. 

From  the  difficulty  of  arranging  all  the  elements  in  this  system,  it  cannot 
be  regarded  as  yet  perfect,  but  the  fact  that  Mendelejeff  was  able  so  correctly 
to  foretell  the  properties  of  gallium,  shows  that  it  must  contain  a  large  ele- 
ment of  truth.  At  the  time  that  he  drew  up  his  table  there  was  a  blank  in 
the  third  group  of  the  fifth  series. 

The  relationships  of  the  metal  which  Mendelejeff  believed  would  fill  this 


CHAP.  I.] 


GENEBAL  RELATIONS. 


19 


jiff 

g     Stf 

S 

Fe  =  56  Co  =  54 
Ni  =  59  Cu*  =  63 

Eu  =  104  Eh  =  104 
Pd  =  106  Ag*  =  108 

Os  =  199  Ir  =  193 
Pt  =  195  Au*=  196 

S 

rH 

ft 

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29  PHAEMACOLOGY  AND  THEEAPEUTICS.     [sect.  i. 

gap  will  be  more  easily  seen  by  omitting  the  even  series  on  either  side  of  it, 
and  taking  only  the  odd  series  with  which  it  will,  as  already  mentioned,  the 
more  closely  correspond. 


Series. 

Group  IT. 

Group  III. 

Group  IV. 

Group  T 

3 

Mg 

Al 

Si 

P 

5 

Zn 

— . 

— 

As 

7 

Cd 

In 

Sn 

Sb 

.As  it  stands  between  zinc  with  an  atomic  weight  of  sixty-five,  and  arsenic 
with  one  of  seventy -five,  while  it  is  separated  from  the  latter  by  a  blank,  its 
atomic  weight  must  be  about  sixty-eight.  As  it  is  atom -analogous  with  Al, 
its  salts  should  have  a  similar  constitution.  It  should  form  an  oxide  x203, 
and  a  sulphide  x2Ss.  It  will  be  precipitated  from  its  solution  by  ammonium 
sulphide.  The  metal  should  be  easily  reduced  by  carbon  or  sodium,  it  should 
have  a  specific  gravity  of  5'9,  and  decompose  water  at  a  red  heat.  As  it  be- 
longs to  an  odd  series,  it  should,  like  zinc,  form  volatile  compounds  with 
organic  radicals,  and  form  also  anhydrous  chlorides. 

On  the  discovery  of  the  metal  gallium,  it  was  found  to  agree  in  almost 
every  respect  with  the  prediction  of  Mendelejeff,  and  this  fact  is  not  interest- 
ing to  chemists  only,  but  also  to  pharmacologists.  For  the  great  object  of 
pharmacology  is  to  obtain  such  a  knowledge  of  the  relations  between  the 
physical  and  chemical  characters  of  bodies,  and  their  actions  upon  the  living 
organism,  that  we  may  be  able  to  predict  their  actions  with  certainty,  and 
to  know  the  modifications  which  alterations  in  their  physical  and  chemical 
characters  will  produce  on  their  physiological  action. 

Mendelejeff  s  present  classification  is  imperfect,  because  we  find  that  by 
it  the  members  of  some  natural  groups,  such  as  those  of  the  earthy  metals,  are 
separated  from  one  another,  although  they  agree  in  their  chemical  characters. 

We  find  also  that  metals  having  similar  pharmacological  actions,  as 
copper,  zinc  and  silver,  do  not  fall  naturally  together  in  this  arrangement. 
But,  on  the  other  hand,  we  find  also  that  by  this  classification,  elements  are 
brought  .together  which  do  not  at  first  seem  to  have  any  resemblance  to  each 
other,  and  are  yet  found  by  recent  investigations  to  have  a  physiological  con- 
nection. Thus  mercury  and  calcium  do  not  appear  to  resemble  one  another, 
yet  Prevost  has  shown  that,  in  acute  poisoning  by  mercury,  the  calcareous 
matter  disappears  from  the  bones,  and  in  the  process  of  elimination  by  the 
kidneys  produces  calcification  of  these  organs.1 

Organic  Radicals.— Whether  the  so-called  elements  be 
compounds  or  not,  it  is  certain  that  several  of  them  have  the 
power  of  uniting  with  themselves  and  with  others  in  such  a 
way  as  to  form  bodies  called  compound  radicals  which  resemble 
elements  in  many  respects.  These  groups  of  atoms  may  enter 
into  and  again  pass  out  of  combination  with  other  substances, 
just  as  elements  do. 

For  example,  when  compounds  of  the  elements  unite,  an 
interchange  of  elements  takes  place.  Thus  when  calcium  oxide 
(CaO)  and  hydrochloric  acid  (HC1)  combine,  the  oxygen  leaves 
the  calcium  to  combine  with  the  hydrogen  and  form  water,  while 
the  chlorine  leaves  the  hydrogen  and  combines  with  the  calcium 
to  form  calcium  chloride. 

CaO  +  2HCl  =  CaCl2  +  H20. 


1  Prevost,  Eevuo  MMicale  de  la  Suisse  Bomande,  p.  553,  Nov.  15  •  t>    605 
Dec.  15,  1882  ;  p.  5,  Jan.  15,  1883.  '  *"        ' 


CHAP.  I.] 


GENEEAL  EELATIONS. 


21 


But  when  ethylic  alcohol  (C?H60)  is  treated  with  hydrochloric  acid 
(HC1),  it  is  not  oxygen  which  leaves  the  alcohol  and  is  replaced 
by  chlorine.  The  alcohol  does  not  split  up  into  the  group  C2H6 
and  the  element  oxygen,  but  into  the  two  groups  OH  and  C.JIS. 

C2H60  +  HC1  =  C2HaCl  +  H20 ; 
or,  as  it  may  also  be  represented — 

(^^)@)  +  hci = C5?T) ci+H  ©■ 

To  the  group  OH  the  name  of  hydroxyl  has  been  given,  and 
to  the  group  C2H5  that  of  ethyl. 

Similarly,  when  acetic  acid  (C2H402)  is  treated  with  phos- 
phorus trichloride  (PC13)  the  three  atoms  of  chlorine  leave  the 
phosphorus,  and  are  replaced  by  three  hydroxyl  (OH)  groups. 

3  C2H402  +  PC13  =  3  C2H3O01  +  PO3II3 ; 

or,  as  it  might  be  represented — 


+© 


+    P 


OH" 

oih 


This  mode  of  representation  is  awkward  and  cumbrous,  although 
it  is  clear,  and  the  same  reactions  may  be  represented  more 
shortly,  thus : 

3  C2H30.  0H  +  PC13  =  3  C2H30.  Cl  +  P  .  (0H)3. 

Here  again  it  is  not  oxygen,  but  hydroxyl  (OH),  which 
breaks  off  from  the  acetic  acid,  just  as  it  did  from  alcohol ;  but 
instead  of  the  group  C2H6  (ethyl)  being  left  behind,  we  have 
another  group,  C2H30  (acetyl). 

It  is  evident  that  such  groups  of  atoms  or  radicals,  as  they 
are  termed,  as  hydroxyl,  ethyl,  acetyl,  &c,  behave  in  combina- 
tion just  like  elements.     They  are  not  known  in  a  free  state. 

In  order  to  exhibit  the  valency  and  probable  relationships  of 
radicals,  they  are  sometimes  expressed  by  graphic  formulas,  in 
which  the  affinities  are  shown  by  a  — ,  as  well  as  in  the  ways 
already  shown. 

As  the  position  of  the  radicals  in  some  compounds,  e.g.  in 
the  organic  alkaloids,  is  probably  of  great  importance  in  regard 
to  their  action,  although  the  subject  is  not  well  understood  at 
present,  the  most  important  radicals  are  given  below,  with  their 
graphic  as  well  as  their  ordinary  formula. 

Hydroxyl,  OH,  or  —  0— H.  This  is  a  monad  radical, 
consisting  of  one  atom  of  dyad  oxygen,  —0—,  with  one  of  its 


22  PHAEMACOLOGY  AND  THEEAPEUTICS.     [sect.  i. 

two  affinities  saturated  by  an  atom  of  hydrogen,  and  the  other 
affinity  free.  It  was  at  one  time  called  water-residue,  as  it  is 
the  residue  left  after  the  removal  of  one  atom  of  hydrogen  from 
water,  which  may  be  regarded  as  the  hydride  of  the  radical. 

Hydroxyl  is  an  important  constituent  of  alcohols,  regarding 
the  chemical  constitution  of  which  two  views  may  be  taken. 
They  may  either  be  looked  on  as  water  in  which  one  atom  of 
hydrogen  is  replaced  by  organic  radicals,  or  as  compounds 
of  the  radicals  with  hydroxyl.  Tbe  constitution  of  water  and 
alcohol  may  be  represented  graphically,  K  standing  for  a  monad 
organic  radical — 

H-O-H  water; 

E-O-H  alcohol,  e.g.,    (Ethyl}  -O-H  ;    (Phenyl)  -O-H 

Ethyl-alcohol.  Phenyl-alcohol,  or 

Phenol. 

The  presence  of  the  hydroxyl  group  in  certain  substances, 
and  also  its  position  in  them,1  appear  to  be  of  great  importance 
in  regard  to  their  physiological  action.2    , 

By  replacing  the  hydrogen  in  one  atom  of  hydroxyl  by  a 
monad,  or  in  two  atoms  by  a  dyad  element,  other  radicals  are 
formed,  e.g. 

Potassoxyl,  KO,  or  —  0— K. 

Zincoxyl,  OZnO,  or  —  0\ 

_o>n- 

When  united  to  carbonyl,  hydroxyl  forms  a  very  important 

radical  carboxyl. 

* 

Carbonyl,    CO   or    —  C  — ,  is  a  dyad  radical  consisting  of 

II 

0 
tetrad  carbon,  in  which  two  affinities  are  saturated  by  dyad 
oxygen,  and  two  left  free.  It  exists  in  aldehydes,  ketones,  and 
acids,  although  in  aldehydes  it  is  combined  with  hydrogen,  and 
in  acids  with  hydroxyl,  to  form  other  radicals.  In  ketones  both 
its  free  affinities  are  saturated  by  organic  radicals,  which  may 
either  be  of  the  same  kind  or  of  different  kinds. 


E-C-E,e.£r.(Methyl)-C-(iJethyl)  (Thenyh-C-(MethyT) 

II  ^ ^      II     V ^ ^     II        

0  0  0 

Acetone.  Phenyl-methyl-acetone. 

Aldehyde  Group,  CHO,  or  -C-H.    When  the  free  affinity 

II 
0 

1  Efron,  PflUger's  Arcfoiv,  xxxvi.  p.  467. 

8  Stolnikow,  Zeitschr.f.physiol.  Ohem.,  1884,  viii.  pp.  235  and  271. 


chap,  i,]  GENEEAL  EELATIONS.  23 

of  this  group  is  saturated  by  a  monatomic  radical,  we  get  alde- 
hydes; thus — 

(JthyT)-C-H  ,  (^nyj)  -C-H 


0 

0 

Ethyl-aldehyde. 

Benzoic  aldehyde 

(oil  of  bitter  almonds). 

Carboxyl,    CO.OH,   or    Ci}}  0,  or  -C-O-H.    This  is 

HI  j 

0 

a  monad  radical.  When  its  free  affinity  is  saturated  by  an 
organic  radical,  it  forms  monad  organic  acids,  in  which  the 
hydrogen  of  the  hydroxyl  is  readily  replaced  by  a  basic  element. 

E_C-H-0,e.^.(lSethyl)  -C-O-H  (fhlnyT) -C-O-H 

II  ^ ^      II  II 

0  0  0 

Acetic  acid.  Benzoic  acid. 


rMeti^l)_C-0-Na    (Ph^nyT)-C-0-Na 

^     II  II 

0  0 

Sodium  acetate.  Sodium  benzoate. 

Carbon  forms  an  immense  number  of  radicals  by  union 
with  itself  and  with  hydrogen,  e.g. 

H    H 
H  H    H  || 

I  I      I  /C-C\ 

H   C-  H-C-C-    h-c/      nyc- 

I  I      I  ,". 

H  HH  H    H 

Methyl.  Ethyl.  Phenyl. 

Nitrogen  gives  origin  also  to  a  number  of  most  important 
radicals. 


Nitroxyl,  NOa. 

2,  or 
•H 


/H 
Amidogen,  NH2,  or  —  N^     • 


Imidogen,  NH  or  N^ 


24  PHARMACOLOGY  AND  THERAPEUTICS,     [sect.  i. 

Phosphorus,  arsenic,  and  antimony  give  origin  also  to  a 
number  of  radicals  similar  to  those  of  nitrogen. 

PH2,  or  -P^;   SbHa,  or  -Sb^;  AsH2,  or  -As<^H 

/H  /H  /H 

PH,  or  -P/     ;    SbH,  or  -Sb^     ;   AsH,   or  -As<^ 

Sulphur  also  gives  origin  to  some  important  radicals. 


0  /yO 

;a\    I  ;  Sulphin,  SO,  or  -Sf 


Sulphuryl  (sulphon),  S02,  or  J>S<    I  ;  Sulphin,  SO,  or  -S<f 


Chemical    Reactions    and    Physiological    Reactions.— 

Each  element  and  each  of  its  compounds  has  chemical  re- 
actions special  to  itself,  by  which  it  can  be  recognised  and  dis- 
tinguished from  all  others.  The  number  of  these  chemical 
reactions  is  therefore  very  great,  but  there  are  a  few  reactions 
which  are  common  to  a  great  number  of  the  elements.  We 
shall  find  that  something  similar  occurs  in  their  physiological 
reactions. 

The  number  of  possible  actions  which  may  be  exerted  on  the 
body  by  the  elements  and  their  compounds  is  very  great,  yet  we 
shall  find  that  there  are  certain  physiological  reactions  which  are 
common  to  so  many  that  their  repetition  under  the  head  of  each 
drug  becomes  monotonous. 

Chemical  Reactions. — Although  the  chemical  reactions 
of  the  metallic  elements  are.  numerous  and  varied,  yet  there 
are  certain  reactions  which  are  common  to  a  very  large  number, 
and  by  these  the  class  of  metallic  elements  may  be  subdivided 
into  sub-classes.  Other  reactions  again  are  common  to  a  few 
elements  only,  and  by  these  the  sub-classes  may  be  subdivided 
into  groups.  Other  reactions  again  are  peculiar  to  each 
individual  element,  and  by  them  it  may  be  distinguished  from 
all  others. 

Thus,  by  the  use  of  hydrogen  sulphide,  or  ammonium 
sulphide,  we  at  once  divide  the  class  of  metallic  elements  into 
two  sub-classes : 

A.  Metals  which  give  a  precipitate  with  one  or  other  of  these 
reagents. 

B.  Metals  which  give  no  precipitate  with  either. 

Physiological  Reactions.— It  is  probable  that,  if  our  know- 
ledge of  physiological  chemistry  were  sufficient,'  we  might  be 
able  to  classify  physiological  reactions  according  to  the  chemical 
relation  between  substances  introduced  into  the  organism  and 
the  various  constituents  of  the  organism  itself.    At  present  we 


chap,  i.]  GENERAL  RELATIONS.  25 

are  quite  unable  to  do  this ;  but,  as  albuminous  substances  form 
an  essential  part  of  all  living  organisms,  we  may  roughly  divide 
the  elements  physiologically,  by  their  relation  to  albumen,  just 
as  we  do  it  chemically,  by  their  relation  to  sulphur,  into  two 
sub- classes: 

A.  Those  which  precipitate  albumen. 

B.  Those  which  do  not. 

Just  as  in  the  case  of  sulphides,  we  might  further  sub-divide 
sub-class  A  into  two  sections : 

(a)  Those  which  precipitate  albumen  in  acid  solutions. 

(&)  „  „  „  in  neutral  or  alkaline 

solutions. 

Section  (b)  may  be  further  sub-divided  into  groups  according 
to  the  kind  of  albuminous  bodies  which  its  members  precipitated, 
e.g.,  myosin,  globulin,  serum-albumen,  albumoses,  peptones,  &c. 

We  might  also  divide  sub-class  B  in  two  sections : 

(a)  Substances  which,  though  they  do  not  precipitate  albu- 
men, have  a  marked  affinity  for  fatty  substances  or  other  con- 
stituents of  the  organism,  and  especially  of  the  nervous  system 
(p.  144). 

(b)  Substances  having  no  such  action. 

It  is  evident  that  such  a  classification  as  this,  although  it 
might  form  the  groundwork  of  a  system  to  be  perfected  at  some 
future  time,  is  at  present  so  imperfect  that  it  is  generally  more 
convenient  to  divide  physiological  reactions  according  to  the 
organs  affected :  e.g.,  muscles,  nerve-centres,  respiration,  circu- 
lation, secretion,  &c. 

A.  This  group  contains  substances  which  paralyse  muscles 
and  motor  nerves.  The  number  of  these  substances  is  very  great 
(p.  126  et  seq.,  p.  150). 

This  large  group  can  again  be  subdivided  into  those  which 
(a)  paralyse  muscle,  while  affecting  the  nerves  but  slightly,  or 
(6)  paralyse  the  nerves  and  leave  the  muscle  uninjured. 

B.  Another  large  group  is  that  which  acts  specially  on  nerve- 
centres,  and  has  little  effect  either  on  muscles  or  motor  nerves. 
This  contains  sub-groups  of  substances  which  affect  the  brain, 
medulla,  or  spinal  cord  by  exciting,  paralysing,  or  disturbing  the 
functions  of  each. 

C.  Another  group  is  that  which  affects  the  secretions,  with 
sub-groups  of  substances  affecting  the  secretions  from  the  sweat 
and  mammary  glands,  salivary,  gastric,  or  intestinal  glands,  liver, 
or  kidneys. 

D.  Another  group  still  is  that  which  acts  chiefly  upon  the 
circulation. 

These  groups  are  all  more  or  less  distinct,  although  they,  tp 
a  certain  extent,  may  run  into,  or  overlap,  each  other. 

Individual  members  of  the  same  group  may  differ  very  widely 
in  their  physiological  action,  even  when  they  all  finally  paralyse 


2(1  PHABMACOLOGY  AND  THEEAPEUTICS.      [sect.  i. 

muscle,  nerves,  and  nerve-centres.  For  while  they  may  pro- 
duce the  same  final  result,  the  course  of  their  action  will  be 
different,  and  the  symptoms  they  occasion  will  depend  very 
greatly  upon  the  part  of  the  organism  which  they  affect  first. 
Thus  atropine  and  curare  both  completely  paralyse  motor  or 
efferent  nerves,  but,  while  a  very  large  dose  of  curare  is  required 
to  paralyse  the  cardiac  and  vascular  nerves,  a  very  small  dose 
paralyses  those  going  to  the  muscles,  and  produces  increasing 
weakness,  gradually  passing  into  death.  On  the  other  hand, 
an  enormous  dose  of  atropine  is  required  to  paralyse  the 
motor  nerves  of  muscles,  but  very  small  doses  are  sufficient 
to  affect  the  nerves  of  the  heart  and  other  involuntary  muscles, 
and  thus  we  get  rapid  circulation,  dilated  pupil,'  and  restless 
delirium. 

The  physiological  action  of  any  drug  depends  to  a  great 
extent,  not  merely  on  its  general  affinities  for  classes  of  tissues, 
but  upon  its  particular  affinity,  or  power  of  acting  on  one  tissue 
or  organ  first.  The  organ  first  affected  may,  through  its  func- 
tional activity,  greatly  alter  the  effects  of  the  drug  upon  the 
others. 

As  an  example  of  this  we  may  take  the  effects  produced  by 
very  large  and  by  moderate  doses  of  veratrine  on  the  frog.  A 
moderate  dose  will  produce  great  stiffness  of  the  muscles,  while 
a  very  large  dose  may  have  comparatively  little  effect.  Yet  if 
the  large  dose  were  applied  directly  to  the  muscles  it  would  act 
more  powerfully  than  the  moderate  dose.  The  reason  that  it 
does  not  do  so  in  the  living  body  is  that  the  large  dose  paralyses 
the  heart  so  quickly  that  the  circulation  stops,  and  therefore  the 
poison,  not  being  conveyed  to  the  muscles,  has  no  action  upon 
them. 

Relation  between  Isomorphism  and  Physiological 
Action. — From  a  number  of  experiments  made  by  Dr.  Blake, 
he  concluded  that  when  inorganic  salts  were  injected  directly 
into  the  circulation,  the  intensity  of  their  physiological  action 
increased  in  proportion  to  their  molecular  weight,  but  only  in 
those  groups  of  elements  where  the  salts  were  isomorphic,  or  in 
other  words,  crystallised  in  the  same  forms.  Thus  groups  whose 
salts  were  crystallised  in  different  forms  had  quite  different 
physiological  actions.  He  adopts  Mitscherlich's  division  of  the 
elements  into  nine  groups,  and  considers  that  the  physiological 
action  of  the  different  groups  differs  in  kind,  whilst  that  of  the 
individual  members  of  the  same  group  agrees  in  kind  but  differs 
in  degree.  Thus  he  states '  that  the  salts  of  the  first  group 
increase  in  activity  in  the  order  mentioned,  silver  being  the  most 
active,  and  lithium  the  least. 

1  Blake,  American  Journal  of  Science  and  Arts,  vol.  vii.,  March  1874  (corrected 

reprint). 


chap,  i.]  GENERAL  EELATIONS.  27 

These  groups  are  as  follows : — 

Group  1.  Lithium,  sodium,  rubidium,  thallium,  caesium,  and  silver. 
According  to  him  they  produce  death  by  acting  on  the  lungs  and  impeding 
the  pulmonary  circulation.  None  of  them  affect  the  nervous  system  excepting 
cassium ;  nor  do  any  affect  the  pulmonary  circulation  excepting  silver. 

Group  2.  Magnesia,  ferrous  salts,  manganous  salts,  nickel,  cobalt,  copper, 
zinc,  and  cadmium  are  increasingly  lethal  in  the  order  mentioned.  They 
kill  by  arresting  the  action  of  the  heart. 

Group  3.  Beryllium,  alumina,  yttria,  cerium,  and  ferric  salts  both  impede 
the  systemic  and  pulmonary  circulation. 

Group  4.  Calcium,  strontium,  barium,  and  lead  salts  kill  by  paralysing 
the  ventricles  of  the  heart. 

Group  5.  Palladium,  platinum,  osmium,  and  iridium  act  on  the  heart, 
respiration,  circulation,  and  blood. 

Group  6.  Ammonia  and  potash  paralyse  the  heart  and  cause  convulsions. 

Group  7.  Hydrochloric,  hydriodic,  bromic,  and  iodic  acids  impede  the 
circulation  and  kill  by  arresting  the  circulation. 

Group  8.  Phosphoric  acid,  arsenic  acid,  and  antimony  kill  by  arresting 
the  pulmonary  circulation. 

Group  9.  Sulphuric  and  selenic  acid  impede  the  pulmonary  circulation. 

The  author's  statements  regarding  the  mode  of  action  of  the 
elements  show  that  their  physiological  action  has  not  been  fully 
investigated,  and  his  results  as  to  the  lethal  dose  are  probably 
only  approximate  and  may  want  re-investigation ;  but  while  we 
cannot  accept  at  present  all  his  results  or  conclusions  as  final, 
yet  his  last  and  chief  conclusion  is  one  of  great  interest — viz., 
that  in  living  matter  we  possess  a  reagent  capable  of  aiding  us 
in  our  investigations  on  the  molecular  properties  of  substances. 

Relation  between  Spectroscopic  Characters  and 
Physiological  Action. 

The  quickness  with  which  a  pendulum  oscillates  is  less  or  greater  accord- 
ing to  its  length,  a  long  one  oscillating  slowly,  and  a  short  one  quickly.  The 
vibrations  of  a  string  or  pipe  are  also  slow  or  quick,  and  the  note  which  it 
yields  is  low  or  high,  according  as  it  is  long  or  short. 

Similarly,  according  to  Lecoq  de  Boisbaudran,  the  rate  of  vibrations  of 
molecules,  and  the  wave-lengths  of  the  light  which  they  emit,  are  determined 
by  their  weight.  When  the  molecular  weight  is  high,  the  vibrations  of  the 
molecules  are  slow,  and  the  light  which  they  emit  has  long  wave-lengths,  and 
is  situated  towards  the  red  end  of  the  spectrum.  When  the  weight  is  low 
the  vibration  of  the  molecules  is  rapid ;  and  the  light  they  emit  lies  towards 
the  violet  end  of  the  spectrum. 

In  the  same  family  of  elements  the  mean  length  of  the  wave  of  light 
which  they  emit  is  a  function  of  their  atomic  weight,  so  that  for  bodies  of  the 
same  chemical  type  the  general  form  of  the  spectrum  persists,  but  is  gradually 
modified  by  the  mass  of  the  molecules.  As  the  atomic  weight  diminishes, 
the  spectrum  will  tend  to  ascend  towards  the  violet,  and  as  it  increases  the 
spectrum  will  tend  to  descend  towards  the  red. 

Until  recently,  our  observations  on  the  spectra  of  bodies  were  limited  to 
the  visible  spectrum,  but  the  application  of  photography  now  enables  us 
to  extend  our  observations  both  above  and  below  the  visible  spectrum,  and 
to  ascertain  the  presence  of  definite  spectra  in  the  ultra-red  and  ultra-violet, 
when  nothing  of  the  sort  is  visible  to  the  eye.  In  most  musical  sounds 
besides  the  fundamental  note  we  have  a  number  of  harmonics  having  a  much 
greater  rapidi,ty  of  vibration  than  it.  Similarly,  in  the  spectrum  there  appear 
harmonics  as  well  as  the  fundamental  spectral  lines,  and  so  instead  of  one 


28  PHAEMACOLOGY  AND  THEEAPEUTICS.     [sect.  r. 

line  or  band  there  may  be  a  number.  According  to  the  author  already  quoted, 
the  corresponding  harmonics  in  a  series  of  analogous  spectra  have  mean 
wave-lengths  which  increase  in  proportion  to  the  weight  of  the  molecules. 

It  might  appear,  therefore,  that  a  relation  might  be  observed  between  the 
spectroscopic  characters  and  physiological  action  of  an  element,  and  this 
idea  was  propounded  by  Papillon.  His  idea  was,  however,  to  a  great  extent 
based  on  the  experiments  of  Eabuteau  referred  to  later  on,  and  just  as  no 
definite  relation  can  be  at  present  traced  between  the  atomic  weight  and  the 
toxic  action  of  a  metal,  so  no  definite  relation  can  be  observed  between  its 
spectroscopic  characters  and  its  physiological  action. 

Further  consideration,  however,  will  show  us  that  this  is  not  at  all  to  be 
wondered  at,  for  in  physiological  experiments  we  are  not  working  with  the 
same  molecules  which  yield  the  spectrum. 

In  spectrum-analysis,  when  line  spectra  are  in  question,  according  to  one 
view  we  are  in  presence  of  phenomena  produced  by  the  chemical  atom, 
whereas  this  atom  exists  only  molecularly  combined  at  lower  temperatures. 
According  to  another  view,  that  put  forward  by  Lockyer,  we  are  in  presence 
of  phenomena  produced  by  a  series — possibly  a  long  series — of  simplifications, 
brought  about  by  the  temperature  employed,  and  this  simplification  can 
begin  at  very  low  temperatures,  and  is  indeed  indicated  by  Dalton's  law  of 
multiple  proportions. 

Such  molecular  simplifications  and  differences  are  represented  by  ozone 
and  oxygen,  ordinary  and  amorphous  phosphorus,  the  various  forms  of  sul- 
phur and  so  on,  and  it  is  therefore  at  this  lower  range  of  temperature — where 
the  phenomena  are  to  be  studied  by  absorption,  and  not  by  radiation — that 
we  must  look  for  connections  between  molecular  structure  and  physiological 
action  if  any  such  connection  exists.1 

Some  of  the  absorption  bands  which  occur  in  the  spectra  of  bodies  at 
ordinary  temperatures  may  be  in  the  visible  spectrum,  like  those  observed  in 
alcoholic  and  aromatic  substances  ; 2  but  others  may  be  quite  invisible,  and 
only  recognisable  by  the  aid  of  photography  in  the  ultra-red  or  ultra-violet.3 

Relation  between  Atomic  Weight  and  Physiological 

Action. 

From  experiments  made  on  the  toxic  action  of  the  chloride,  bromide,  and 
iodide  of  potassium,  Bouchardat  and  Stewart  Cooper  came  to  the  conclusion 
that  a  relation  existed  between  the  physiological  activity  of  elements  and 
their  atomic  weight,  the  activity  being  inversely  as  their  atomic  weight,  e.g. 
fluorine  (atomic  weight,  19)  being  more  active  than  chlorine  (atomic  weight, 
35-5). 

In  1867,  Kabuteau  made  a  number  of  experiments  from  which  he  con- 
cluded that  Bouchardat  was  correct  in  saying  that  the  physiological  activity 
of  the  monatomic  metalloids  was  in  inverse  proportion  to  their  atomic  weight, 
while  that  of  the  diatomic  metalloids  increased  directly  with  their  atomic 
weight :  selenium  being  more  active  than  sulphur. 

He  considered  also  that  he  had  discovered  a  new  law  regarding  the  re- 
lation between  the  atomic  weight  and  the  physiological  activity  of  metals : 
viz.,  that  the  activity  of  metals  increases  with  their  atomic  weight.  He 
afterwards  qualified  this  statement  by  saying  that  the  poisonous  action  in- 
creased with  the  atomic  weight  amongst  elements  belonging  to  the  same 
group.  Thus  potassium  (atomic  weight,  39)  is  more  poisonous  than  sodium 
(23),  and  barium  (137)  than  calcium  (40).  But  it  has  been  shown  by  Huse- 
mann  that  lithium  is  much  more  poisonous  than  sodium,  and  his  results 
have  been  confirmed  by  Bichet. 

In  the  following  table  the  lethal  activity  of  various  metals  is  given  aa 

1  See  Hartley,  Phil.  Trams.,  Part  II.  1885. 

'  Eussell  and  Lapraik,  Journ.  Chetn.  Soc,  April  1881. 

•  Abney  and  Testing,  Phil.  Trans.,  1882,  p.  887. 


CHAP.  I.] 


GENERAL  RELATIONS. 


29 


determined  by  Bichet,  and  of  the  metals  belonging  to  the  groups  of  the  alkalis 
and  earths  as  determined  by  Bichet,  by  Cash  and  myself,  and  by  Botkin,  jun. 
Where  the  position  of  the  metals  in  the  tables  is  different  the  symbols  are 
printed  in  italics.  The  most  active,  Hg,  is  first ;  the  least  active,  Na  or  Ca,  last. 


Kichet 

Brunton 

Botkin, 

Atomic 

Kichet 

Brunton 

Botkin, 

Atomic 

and  Cash 

junr. 

Weight 

and  Cash 

junr. 

Weight 

Hg 





200 



Cs 

Cs 

133 

Cu 

— 

— 

63-4 

Li 

Li 

Li 

7 

Zn 

— 

— 

65 

Mn 

— 



55 

Fe 

— 

— 

56 

Ba 





137 

Cd 

— 

— 

111-2 

Mg 

— 

— 

24 

NSt 

— 

— 

18 

— 

La 

— 

139 

K 

K 

K 

39 

— 

Di 

— 

145-4 

— 

Be 

— 

9 

— 

Er 



163 

— 

Bb 

Bb 

85-3 

Sr 

Sr 



87-4 

Ni 

— 

— 

58 

— 

Yt 

— 

89-8 

Co 

_ 

— 

58 

Ca 

Na 

— 

40123 

— 

Ba 

— 

137 

Na 

Ca 

— 

23|40 

— 

NHt 

— 

18 

Eichet's  experiments  were  made  upon  fish,  and  the  substances  were 
added  to  the  water  in  which  the  animals  were  swimming.  The  experiments 
of  Cash  and  myself  were  made  upon  frogs,  and  the  substances  were  injected 
subcutaneously.  Botkin's  experiments  '  were  made  upon  dogs,  and  the  sub- 
stances were  injected  directly  into  the  circulation. 

It  is  possible  that  the  differences  observed  were  due  to  the  differences  in 
the  animals  on  which  the  experiments  were  made,  or  in  the  way  of  applying 
the  poison.  Botkin's  table,  so  far  as  it  goes,  agrees  perfectly  with  Cash's  and 
mine,  and  there  is  a  general  correspondence  also  between  Eichet's  results  and 
ours,  although  there  are  several  differences  in  particulars. 

It  is  thus  evident  that  the  relationship  between  atomic  weight  and  physio- 
logical action  is  no  simple  one.  But  indeed,  on  looking  into  the  matter  more 
closely,  we  could  hardly  expect  it  would  be.  For  the  toxic  action  of  an 
element  may  depend  upon  its  effect  on  the  muscles,  nerves,  nerve-centres, 
blood,  or  on  the  digestive  or  excretory  systems.  These  differ  from  one 
another  in  their  composition,  and  while  it  is  possible  that  the  elements 
belonging  to  a  certain  group  may  have  relations  varying  with  their  atomic 
weight  to  individual  organs  or  structures,  we  can  hardly  expect  those  rela- 
tionships to  be  the  same  to  all  organs. 

Thus  an  element  with  one  atomic  weight  may  prove  fatal,  by  affecting 
the  muscular  power  of  an  animal,  while  another  with  an  atomic  weight  either 
higher  or  lower,  may  be  still  more  deadly  by  affecting  the  nervous  system  or 
heart. 

What  we  want,  therefore,  is  not  a  general  relationship  between  atomic 
weight  and  toxic  action,  but  a  knowledge  of  the  particular  relationships  ot 
each  group  of  elements  to  each  organ  and  tissue  of  the  body. 

Relation  of  Atomic  Weight  and  Smell. 

The  idea  has  been  put  forward  by  Eamsay  that  the  sense  of  smell  is 
excited  by  vibrations  of  a  lower  period  than  those  which  give  rise  to  the 
sense  of  light  or  heat.    These  vibrations  are  conveyed  by  gaseous  molecules 


1  S.  Botkin,  junr. :  '  Zur  Frage  fiber  den  Zusammenhang  der  physiologischen 
Wivkung  mit  den  chemischen  Eigenschaften  der  Alkalimetalle  der  ersten  Grappa 
nach  Mendelejeff,'  Centralb.  filr  die  med,  WissenscJiaft.  No.  48  1885. 


30  PHARMACOLOGY  AND  THERAPEUTICS,     [sbot.i.- 

to  the  surface  network  of  nerves  in  the  nasal  cavity.  The  difference  of 
smells  is  caused  by  the  rate  and  by  the  nature  of  such  vibrations,  just  as 
difference  in  tone  of  musical  sounds  depends  upon  the  rate  and  on  the  nature 
of  the  vibration— the  nature  being  influenced  by  the  number  and  pitch  of  the 
harmonics.  Just  as  the  eye  and  ear  are  capable  only  of  appreciating  sight  or 
sound  vibrations  occurring  within  a  limited  range,  bo  the  nose  is  unable  to 
appreciate  a  smell  the  result  of  the  rapid  vibrations  produced  by  substances  of 
low  molecular  weight.  Hydrocyanic  acid  appears  to  be  at  the  lowest  limit,  as 
one  in  five  are,  according  to  him,  unable  to  detect  its  odour.  It  is  fifteen  times 
the  molecular  weight  of  hydrogen,  and  he  concludes  that  to  produce  the  sensa- 
tion of  smell  a  substance  must  have  a  molecular  weight  at  least  fifteen  times 
that  of  hydrogen.  The  intensity  of  smell  in  bodies  of  similar  constitution  in- 
creases with  the  molecular  weight ;  thus,  methyl-alcohol  is  odourless,  but  the 
intensity  of  smell  increases  with  the  molecular  weight  of  each  succeeding 
member  of  the  alcohol  group,  until  the  limit  of  volatility  is  reached,  and 
they  become  changed  into  solids  with  such  a  low  vapour  tension  that  they 
give  off  no  appreciable  amount  of  vapour  at  the  ordinary  tension.1 

Relation  of  Atomic  Weight  to  Taste. 

Haycraft  considers a  that  '  quality '  in  taste  depends  upon  the  nature  of 
the  atoms  found  in  the  sapid  molecule.  A  study  of  the  periodic  law  demon- 
strates that  similar  tastes  are  produced  by  combinations  which  contain 
elements  such  as  lithium,  sodium,  potassium,  which  show  a  periodic  recur- 
rence of  ordinary  physical  properties.  Among  the  carbon  compounds,  those 
which  produce  similar  tastes  are  found  to  contain  a  common  'group'  of 
elements.  Thus  organic  acids  contain  the  group  CO.OH,  the  sweet  sub- 
stances CHe.OH.  There  is  no  relation  between  quality  of  sensation  and 
gross  molecular  weight,  except  that  substances  of  either  very  small  or  very 
great  molecular  weight  are  not  tasted  at  all. 

Connection  between  Chemical  Composition  and 
Physiological  Action. 

In  considering  this  subject  and  other  subjects  allied  to  it, 
we  must  carefully  distinguish  between  chemical  composition  and 
chemical  constitution ;  between  the  mere  elements  of  which  a  com- 
pound is  formed  and  the  manner  in  which  these  elements  are  put 
together.  Thus  the  cyanides,  or  nitriles,  and  the  isonitriles,  or 
carbamines,  both  contain  carbon  and  nitrogen,  and  contain  them 
in  equal  proportions ;  but  the  manner  in  which  the  carbon  is 
united  with  the  nitrogen  probably  differs  in  the  two  classes,  and 
their  physiological  action  is  different.  Tneir  chemical  composition 
is  the  same,  but  their  chemical  constitution  is  different. 

It  was  pointed  out  by  Blake  in  1841  that  a  close  connection 
exists  between  the  chemical  constitution  and  physiological  action 
of  salts ;  their  physiological  action  on  animal  organisms  appear- 
ing to  depend  chiefly  on  the  base.  Yet  the  physiological  action 
of  any  salt  is  not  dependent  entirely  upon  the  base\  It  may  be, 
and  sometimes  is,  modified  to  a  very  great  extent  by  the  acid  ; 
moreover,  we  find  that  the  salts  which  the  same  inorganic  base 

1  Nature,  June  22,  1S82,  p.  187. 

2  Ibid.,  Oct.  8,  1885,  p.  562. 


CHAP.  I.] 


GENERAL  RELATIONS. 


31 


may  form  with  different  acids  may  present  very  different  physio- 
logical actions,  as  in  the  case  of  the  carbonate,  bromide,  and 
cyanide  of  potassium.  The  same  is  the  case  with  organic  bases, 
and  Richardson,  in  1865,  drew  attention  to  an  example  of  the 
relation  between  the  action  of  the  base  and  acid  in  the  amyl 
compounds.  He  found  that  amyl-hydride  had  an  anaesthetic 
effect ;  the-  introduction  of  oxygen,  as  in  amyl-alcohol  or  amyl- 
acetate,  added  spasm  to  this  action ;  amyl-iodide  produced  a 
large  excretion  of  fluid  from  the  body,  while  amyl-nitrite  had 
a  great  effect  on  the  circulation.  Thus,  the  base  remaining 
the  same,  different  acid  radicals  modified  the  action  of  the  com- 
pound.1 

The  fact  is  that  sometimes  the  action  is  determined  chiefly 
by  the  base  (whether  it  be  inorganic  or  organic),  and  sometimes 
chiefly  by  the  acid.  The  action  of  the  whole  salt  may  differ  to  a 
great  extent  from  that  of  the  substances  composing  it,  and  it 
may  agree  to  some  extent  with  other  salts,  which  differ  from  it 
both  in  regard  to  the  base  and  acid  composing  them ;  thus — the 
sulphate  of  magnesium  and  the  sulphate  of  sodium  are  both  pur-, 
gative,  and  in  this  property  they  agree  not  only  with  the  sulphate 
of  potassium,  in  which  the  base  is  different  although  the  acid  is 
the  same,  but  with  the  bitartrate  of  potassium,  in  which  both 
the  base  and  the  acid  are  different.  This  fact  confirms  what  has 
already  been  said  regarding  the  necessity  for  taking  into  con- 
sideration crystalline  form  and  physical  aggregation,  as  well  as 
chemical  composition  (p.  15). 

Physiological  Action  of  the  Constituents  of  a  Drug. — In 
the  case  of  acids  and  bases,  the  physiological  action  of  each  is 
modified  by  their  union,  e.g.  when  caustic  soda  and  hydrochloric 
acid  unite,  the  caustic  action  of  each  is  destroyed,  and  we  obtain 
sodium  chloride  and  water,  which  have  different  physiological 
actions,  as  well  as  different  chemical  characters,  from  either  the 
acid  or  the  base. 

But  if  we  examine  a  series  of  salts  of  the  same  base  with 
different  acids,  or  of  the  same  acid  with  different  bases,  we  find 
that  both  the  acid  and  the  base  modify  the  physiological  action 
of  the  compound. 


Different  Acids.                                          Different  Bases. 

Sodium 

hydrate 

caustic.                         Sodium     ichloride 

neutral  in  action. 

» 

bicarbonate 

antacid.                        Potassium 

ii 

muscular  poison. 

i) 

sulphate 

purgative.                     Zinc 

ii 

caustic. 

i) 

benzoate 

antilitMc.                     Barium 

ii 

muscular  poison. 

„ 

salicylate 

antipyretic.                   Silver 

>» 

inert. 

it 

cyanide 

powerful  poison.          Iron 

ii 

astringent, 

hcematinic. 

Mercuric 

ii 

corrosive,     anti- 
septic. 

This  modification  is  in  some  cases  due  to  a 

change  in  the 

Brit.  Assoc.  Reports,  1865,  p.  280. 


32  PHAEMACOLOGY  AND   THERAPEUTICS,     [sect.  I. 

physical  conditions,  and  especially  in  the  soluhility  of  the  com- 
pound. Thus  the  chloride  of  silver  is  inert  so  long  as  it  remains 
in  the  form  of  a  chloride,  because  it  is  insoluble.  It  thus  differs 
much  from  the  corrosive  chloride  of  zinc,  while  if  we  were  to 
compare  the  action  of  the  nitrate  of  silver  and  zinc  we  should 
find  considerable  similarity. 

Another  cause  of  difference  is  the  different  proportion  of  the 
acid  to  the  base. 

Thus  the  proportion  of  sodium  (Na=23)  to  the  acid  radical 
in  the  following  sodium  salts  is  as  follows :  in  the  hydrate 
as  23  to  18 ;  in  the  bicarbonate  as  23  to  61 ;  in  the  sulphate  as 
23  to  96 ;  in  the  benzoate  as  23  to  121 ;  in  the  salicylate  as  23 
to  137. 

In  this  connection,  too,  the  degree  of  saturation  of  the  acid 
by  the  base  must  be  considered.  If,  for  example,  the  acid  is  not 
saturated,  part  of  the  action  of  the  compound  is  due  to  its  acid 
chemical  properties ;  and  if,  on  the  other  hand,  a  weak  acid  be 
combined  with  a  strong  base,  this  action  is  partly  due  to  the 
alkaline  chemical  property. 

Relation  between  Physiological  Action  and  Chemical 
Constitution. 

An  immense  step  has  been  made  of  late  years  in  our 
knowledge  of  the  relation  between  chemical  constitution 
and  physiological  action  by  the  discoveries  of  Crum-Brown, 
Fraser,  and  Schroff,  who  have  shown  that  by  modifying  artifi- 
cially the  chemical  constitution  of  a  drug  it  is  possible  to  modify, 
also  its  physiological  action.  And  not  only  so,  but  they  have 
shown  that  similar  modifications  in  the  chemical  constitution 
of  various  drugs  induce  similar  modifications  in  the  action  of 
their  derivatives ;  thus  they  have  found  that  by  introducing 
methyl  into  the  molecule  of  strychnine,  brucine,  and  thebaine, 
the  convulsive  action  exerted  by  these  substances  on  the  spinal 
cord  was  changed  into  a  paralysing  one  exerted  on  the  ends  of 
the  motor  nerves.  Other  alkaloids,  also,  which  do  not  exhibit 
a  convulsive  action,  nevertheless  exhibit  a  paralysing  one  when 
their  constitution  is  altered  by  means  of  methyl ;  thus  methyl- 
codeine,  methyl-morphine,  methyl-nicotine,  methyl-atropine, 
methyl-quinine,  methyl-veratrine,  and  several  others,  all  exhibit 
this  paralysing  action  (p.  150). 

As  a  general  rule,  most  of  the  compound  radicals  formed  by 
the  union  of  amidogen  with  the  radicals  of  the  marsh-gas  series 
possess  a  paralysing  action  on  motor  nerves. 

The  subject  of  the  connection  between  chemical  constitution 
and  physiological  action  is  the  most  important  one  in  phar- 
macology, and  we  shall  have  to  return  to  it  in  considering  the 
actions  of  various  groups  of  organic  substances. 


33 


CHAPTEE  IL 

CIRCUMSTANCES  WHICH  AFFECT  THE  ACTION  OF 
DRUGS  ON  THE   ORGANISM. 

One  of  the  most  important  circumstances  affecting  the  action  of 
any  drug  is  the  mode  in  which  it  is  brought  into  contact  with 
the  various  parts  of  the  organism. 

Local  and  Remote  Action. — The  local  action  of  a  drug  is 
that  which  it  exerts  on  the  part  to  which  it  is  applied.  Thus 
sulphuric  acid  has  a  direct  irritant  or  destructive  action,  and 
when  applied  to  the  skin  or  mucous  membrane  will  produce 
local  redness,  inflammation,  or  sloughing.  When  swallowed, 
it  produces  weakness  of  the  circulation,  stoppage  of  the  heart, 
and  death. 

This  effect  on  the  circulation  is  not  due  to  the  direct  action 
of  the  acid  upon  the  heart,  the  vessels,  or  the  nervous  system, 
after  its  absorption :  it  is  due  to  the  reflex  action  exerted  upon 
them  by  the  irritation  of  the  nerves  of  the  stomach  which 
the  sulphuric  acid  produces.  This  action  on  different  parts 
through  the  nervous  system  is  termed  its  remote  action,  in 
contradistinction  to  the  local  action  of  the  acid  upon  the  gastric 
mucous  membrane. 

The  Interaction  of  various  functions  in  the  body  is  one 
of  the  greatest  difficulties  in  the  way  of  our  readily  understanding 
the  action  of  drugs. 

One  function  alters  another,  and  the  second  reacts  upon  the 
first,  so  that  in  some  cases  it  is  almost  impossible  to  say  precisely 
how  far  the  alteration  in  any  function  is  due  to  the  direct  effect 
of  the  drug  upon  it,  and  how  far  to  some  indirect  action.  Thus 
curare  when  applied  to  a  wound  usually  kills  without  producing 
any  convulsion  whatever.  It  paralyses  the  ends  of  the  motor 
nerves,  so  that  all  the  muscles  in  the  body  become  powerless. 
But  when  it  is  given  by  the  stomach,  and  excretion  through 
the  kidneys  prevented,  death  is  preceded  by  convulsions.  These 
convulsions  are  not  caused  by  any  direct  irritating  action. of  the 
curare  itself  upon  the  nerve-centres ;  they  are  due  to  irritation  of 
these  centres  by  a  venous  condition  of  the  blood.  This  venosity 
of  the  blood  is  due  to  imperfect  respiration,  produced  by  paralysis 


34  PHAEMACOLOGY   AND  THEEAPEUTICS.      [sect.  i. 

of  the  respiratory  muscles  through  the  action  of  curare  on  the 
motor  nerves.1 

The  effect  of  curare  is  a  purely  paralysing  one,  both  when 
the  animal  dies  quietly  and  when  it  dies  with  convulsions.  In 
both  cases  it  paralyses  the  motor  nerves  of  the  respiratory 
muscles  and  of  the  extremities.  In  both  cases  it  causes  death 
by  arresting  the  respiration  and  producing  asphyxia.  But  in 
the  latter  case  the  motor  nerves  of  the  extremities  being  only 
partially  paralysed  when  asphyxia  occurs,  they  respond  by  con- 
vulsive movements  to  the  irritation  of  the  nerve-centres,  which 
the  venous  blood  produces.  In  the  former,  the  paralysis  of  the 
limbs  being  complete,  the  muscles  remain  perfectly  quiet,  not- 
withstanding the  irritation  of  the  nerve-centres. 

Convulsions  also  sometimes  occur  previous  to  death  from 
narcotic  poisons:  and  in  a  description  of  the  action  of  these 
poisons  we  frequently  meet  with  the  phrase,  '  coma,  convulsions, 
and  death.'  In  such  cases  the  convulsions  are  also  caused  by 
the  irritation  of  the  nerve-centres  by  asphyxial  blood. 

The  drug  causes  the  coma;  the  coma  causes  imperfect  re- 
spiration ;  imperfect  respiration  renders  the  blood  venous ;  and 
tne  venous  blood  causes  convulsions. 

Direct  and  Indirect  Action. — The  direct  action  of  a  drug 
is  the  effect  it  produces  on  any  organ  with  which  it  comes  in 
contact.  Thus  sulphuric  acid  applied  to  the  skin,  or  taken 
into  the  stomach,  will,  according  to  its  degree  of  concentration, 
irritate  or  destroy  the  mucous  membrane  which  it  touches. 
Its  direct  action  upon  them  is  therefore  that  of  an  irritant  or 
caustic. 

Curare,  when  applied  to  the  ends  of  a  motor  nerve  in  a 
muscle,  paralyses  them.  It  does  this  either  when  the  muscle 
is  soaked  in  a  solution  of  curare,  or  when  the  curare  is  carried 
through  the  substance  of  the  muscle  by  means  of  the  blood 
circulating  in  it. 

Paralysis  is  therefore  the  direct  effect  of  curare  on  the  motor 
nerves. 

The  convulsions  which  sometimes  occur  in  poisoning  by 
curare  are  caused  by  its  indirect  action.  It  has  no  stimulating 
effect  on  the  nerve-centres,  when  applied  to  them  directly  or 
caried  to  them  by  the  blood,  but  by  paralysing  the  muscles  of 
respiration,  and  thus  causing  asphyxia,  it  indirectly  irritates  the 
nerve-centres,  and  causes  convulsions. 

Selective  Action  of  Drugs. — Drugs  sometimes  seem  to 
affect  only  one  part  of  the  body  and  to  leave  the  other  organs 
unaffected ;  although  the  drugs  may  be  carried  equally  by  the 
blood  to  every  part  of  the  body,  they  appear  to  combine  with 
some  and  not  with  others.     Many  dye-stuffs  will  not  attach 

■  Hermann,  Arch.}.  Aitat.  U.  Physiol,  1807,  64,  650. 


Chap,  ii.]    ACTION  OF  DBTJGS  ON  THE  ORGANISM.  85 

themselves  to  cotton  fabrics,  but  will  do  so  readily  to  wool  or 
silk ;  and  we  find  that  different  tissues,  and  even  different  parts 
of  the  same  tissue,  have  very  unequal  attractions  for  stains : 
thus  some  anilin  colours  will  deeply  stain  a  nucleus,  while 
leaving  the  cell  in  which  it  is  contained  entirely  uncoloured. 
Although  the  different  organs  of  the  body  contain  many  sub- 
stances in  common,  yet  their  chemical  composition  varies  within 
wide  limits,  and  the  products  of  the  tissue-waste  are  also  differ- 
ent. Even  in  the  same  organs  the  cells  may  have  different 
properties,  and  even  individual  parts  of  the  same  cell  may  differ. 
Some  have  a  reducing,  and  others  an  oxidising  action ;  some  an 
alkaline,  and  others — as  may  be  ascertained  from  their  action  on 
anilin  colours l — an  acid,  reaction  (p.  70) .  We  would  therefore 
expect  that,  just  as  the  tissues  exert  a  selective  action  upon  dye- 
stuffs  which  we  are  able  to  see,  they  will  also  have  a  selective 
action  on  many  organic  substances,  although  this  action  may 
not  be  visible  to  our  senses. 

Primary  and  Secondary  Action. — I  have  already  stated 
(p.  5)  that  the  so-called  action  of  a  drug  is  not  one-sided :  it 
is  the  reaction  between  the  drug  and  the  organism.  While 
drugs  are  circulating  in  the  body  they  may  modify  the  chemical 
nature  and  the  physiological  functions  of  various  organs.  In 
some  cases  the  drug,  after  doing  this,  may  again  leave  the  organs 
and  be  eliminated  without  undergoing  any  essential  change ;  but 
in  other  cases  the  chemical  character  of  the  drug  itself  under- 
goes an  essential  change  during  its  sojourn  in  the  body.  Some 
organic  substances  undergo  complete  combustion,  and  are  con- 
verted into  carbonates,  while  others  are  converted  into  substances 
having  a  powerful  physiological  action,  but  perfectly  different 
from  that  of  the  substance  originally  introduced  into  the  body. 
These  products  of  the  decomposition  of  the  drug  may  then, 
while  circulating  in  the  blood,  or  during  the  process  of  excretion, 
exert  upon  the  organism  a  marked  physiological  action  quite 
different  from  that  of  the  original  substance.  Perhaps  one  of 
the  most  marked  examples  of  this  is  to  be  found  in  morphine. 
Morphine  lessens  the  irritability  of  nerve-centres,  producing 
sleep,  and  having  a  marked  sedative  action  upon  the  stomach 
in  allaying  vomiting,  either  when  introduced  directly  into  the 
stomach  or  injected  into  the  circulation.  This  is  its  primary 
action ;  but  in  the  body  morphine  undergoes  certain  alterations 
and  becomes  partly  converted  into  oxy-dimorphine,  which 
appears  to  counteract  the  soporific  action  of  morphine,  and 
probably  either  oxy-dimorphine  or  some  other  product  of  the 
decomposition  of  morphine  has  an  emetic  action.  The  effect  of 
these  secondary  products  will  manifest  itself  after  the  original 

'  P.  Ehrlioh,  '  Ueber  die  Methylenblaureaotion  der  lebenden  Nervensubstanz.' 
Deutsche  med.  Wochenschrift,  1886,  No.  4.    Ibid.  1885. 

D  2 


86  PHARMACOLOGY  AND  THERAPEUTICS,     [sect,  ft 

dose  of  morphine  has  either  been  eliminated  or  undergone  con- 
version into  the  products  already  mentioned;  and  thus  the 
secondary  action  -will  be  quite  different  from  the  primary,  and 
instead  of  narcosis  and  quietness  of  the  stomach,  there  will  be 
excitement,  and  nausea  or  vomiting,  which  may  require  to  be 
again  counteracted  by  a  larger  dose  of  the  original  drug. 

It  is  evident  that  the  relation  between  the  primary  and 
secondary  effects  of  a  drug  will,  if  this  explanation  be  correct, 
vary  very  much  according  to  the  relative  solubility  of  the  drug 
originally  administered,  and  of  the  products  of  its  decomposition. 
If  the  products  of  decomposition  be  more  soluble,  and  more 
readily  eliminated,  than  the  drug  itself,  they  will  leave  the 
organism  before  it,  and  their  action  will  hardly  appear ;  but  if 
they  are  less  soluble,  and  more  slowly  eliminated,  their  action 
may  persist  for  a  considerable  length  of  time. 

Relation  of  Effect  to  Quantity  of  the  Drug.  —The  effect 
of  drugs  varies  very  much  according  to  the  quantity  employed. 
Sometimes  this  is  due  to  the  interaction  of  different  parts  of 
the  body  on  one  another,  as  already  mentioned  in  regard  to 
veratrine  (p.  26).  Sometimes  it  is  due  to  the  different  effects 
upon  individual  cells  or  tissues.  Thus  we  find,  very  generally, 
that  any  substance  or  form  of  energy,  whether  it  be  acid  or 
alkali,  heat  or  electricity,  which  in  moderate  quantity  increases 
the  activity  of  cells,  destroys  it  when  excessive. 

But  varying  doses  do  not  always  produce  opposite  effects. 
We  sometimes  find  that  exceedingly  small  and  exceedingly 
large  doses  have  a  similar  effect,  which  differs  from  that  pro- 
duced by  moderate  doses.  Thus  very  minute  quantities  of 
atropine  render  the  pulse  somewhat  slow ;  larger  quantities 
make  it  exceedingly  rapid,  and  very  large  quantities  again 
render  it  slow. 

Moderate  quantities  of  digitalis  slow  the  pulse,  larger  quan- 
tities quicken  it,  and  still  larger  quantities  render  it  slow 
again.  We  find  a  similar  effect  produced  by  variation  in  tem- 
perature. Great  cold  disturbs  the  mental  faculties,  so  that 
men  exposed  to  it  present  symptoms  which  cannot  be  dis- 
tinguished from  those  of  intoxication.  Ordinary  temperatures 
do  not  disturb  the  functions  of  the  brain,  but  high  temperatures 
do,  as  we  see  in  the  delirium  of  fever,  which  in  many  cases  im- 
mediately ceases  when  the  temperature  of  the  patient  is  reduced 
by  cold  baths. 

Homoeopathy. — This  opposite  action  of  large  and  small 
doses  seems  to  be  the  basis  of  truth  on  which  the  doctrine  of 
homoeopathy  has  been  founded.  The  irrational  practice  of  giving 
infinitesimal  doses  has  of  course  nothing  to  do  with  the  principle 
of  homoeopathy—  similia  similibus  curantur:  the  only  requisite  is 
that  mentioned  by  Hippocrates,  when  he  recommended  man- 
drake in  mania ;   viz.  that  the  dose  be  smaller  than  would  be 


chap,  ii.]    ACTION  OF  DEUGS  ON  THE  OEGANISM.  87 

sufficient  to  produce  in  a  healthy  man  symptoms  similar  to 
those  of  the  disease.  Now  in  the  case  of  some  drugs  this  may 
be  exactly  equivalent  to  giving  a  drug  which  produces  symptoms 
opposite  to  those  of  the  disease ;  and  then  we  can  readily  see 
the  possibility  of  the  morbid  changes  being  counteracted  by  the 
action  of  the  drug,  and  benefit  resulting  from  the  treatment. 
For  example,  large  doses  of  digitalis  render  the  pulse  extremely 
rapid,  but  moderate  ones  slow  it.1  The  moderate  administration, 
when  there  is  a  rapid  pulse,  is  sometimes  beneficial :  this 
might  be  called  homoeopathic  treatment,  inasmuch  as  the  dose 
administered  is  smaller  than  that  which  would  make  the  pulse 
rapid  in  a  healthy  man ;  but  it  might  also  be  called  antipathic, 
inasmuch  as  the  same  dose  administered  to  a  healthy  person 
would  also  slow  the  pulse. 

Homoeopathy  can  therefore  not  be  looked  upon  as  a  universal 
rule  of  practice,  and  the  adoption  of  any  such  empirical  rule 
must  certainly  do  harm  by  leading  those  who  believe  in  it  to 
rest  content  in  ignorance  instead  of  seeking  after  a  system  of 
rational  therapeutics. 

Dose. — The  amount  of  a  drug,  which  actually  comes  in  con- 
tact with  and  affects  the  tissues,  depends  upon  several  conditions 
— (1)  the  quantity  actually  given ;  (2)  its  proportion  to  the 
body-weight;  (3)  the  rapidity  of  its  absorption  by  the  blood 
from  the  place  of  introduction ;  (4)  the  condition  of  the  circula- 
tion in  various  parts  of  the  body,  which  determines  the  quantity 
of  the  drug  carried  to  each ;  (5)  the  rate  of  its  absorption  by  the 
tissues ;  (6)  the  rapidity  of  excretion. 

The  word  dose,  as  employed  in  medicine,  usually  means  the 
quantity  given  at  one  time,  but  sometimes  this  may  be  very 
different  from  what  actually  produces  any  effect.  It  is  the 
amount  of  the  drug  existing  in  the  blood  at  any  given  time, 
or  rather  the  proportion  of  it  that  actually  comes  in  contact 
with  or  is  absorbed  by  the  tissues,  which  really  acts.  We  must 
therefore  consider  more  in  detail  the  circumstances  which  affect 
this  proportion. 

Size. — As  the  action  which  a  drug  has  on  the  body  is  not 
dependent  on  its  absolute  amount,  but  on  the  proportion  it  bears 
to  the  body  on  which  it  is  to  act,  an  amount  which  is  a  small 
dose  for  one  person  is  a  very  large  one  for  another.2  Thus  if  a 
grain  of  some  active  substance  be  injected  at  the  same  time  into 
the  veins  of  a  full-grown  man  and  into  those  of  a  boy  of  only 
half  his  weight,  it  will  be  distributed  through  twice  as  much 
blood  in  the  man  as  in  the  boy,  and  each  tissue  will  only  receive 
half  as  much  of  it.  The  dose  of  a  drug  must  therefore  be  re- 
gulated by  the  weight  of  the  patient;  and  thus  women,  being 

1  Vide  Traube,  Med,  Centr.  Ztg.  xxx.  p.  94,  1861,  and  Brunton  On  Digitalis,  p.  21. 
2  Buchheim,  Arznevrmttellehre,  3rd  edit.  p.  54. 


38  PHARMACOLOGY  "AND  THERAPEUTICS,     [sect.  I* 

lighter,  require  a  smaller  amount  than  men,  and  children  less 
than  adults.  Though  it  would  be  more  exact,  it  is  not  always 
convenient,  to  weigh  patients;  but  in  experiments  on  animals 
we  usually  weigh  the  animal  carefully,  and  describe  the  dose  in 
terms  of  the  body-weight.  For  example,  in  describing  the  lethal 
dose  of  physostigmine  we  do  not  say  that  it  is  so  many  grains  for, 
an  animal,  but  that  it  is  0*04  grain  per  pound  weight  of  a  rabbit. 
This  relation,  however,  is  not  always  an  exact  one,  and  other 
circumstances  must  be  taken  into  account.  Thus  the  species 
of  the  animal  must  be  considered,  for  the  same  dose  which 
would  kill  one  kind  of  animal  will  not  kill  another.  In  animals 
of  the  same  species  the  state  of  nutrition  must  be  taken  into 
account,  for  two  animals  of  the  same  species,  which  would  be 
nearly  of  the  same  size  when  equally  nourished,  may  have  very 
different  weights  if  the  one  is  fat  and  the  other  is  lean.  But  the 
fat  is  a  comparatively  inert  tissue,  and  if  we  give  to  each  animal 
a  dose  regulated  by  its  body-weight,  the  vital  organs,  brain, 
heart,  and  spinal  cord  of  the  fat  animal  will  get  a  larger  share 
in  proportion  than  those  of  the  lean  one. 

In  testing  the  action  of  poisons  on  frogs,  also,  it  must  be 
remembered  that  a  female  frog  with  a  quantity  of  spawn  will  be 
very  heavy,  but  the  spawn,  like  the  fat,  is  not  to  be  reckoned  as 
tissue  ;  so  that  a  dose  given  in  proportion  to  the  actual  weight 
would  be  much  larger  than  the  same  proportion  given  to  the 
frog  after  spawning. 

Mode  of  Administration. — If  a  substance  be  injected  into 
the  veins,  the  whole  of  it  mixes  with  the  blood  and  becomes 
active  immediately,  and  the  maximum  effect  is  thus  at  once 
obtained  and  will  again  diminish  as  the  substance  is  excreted. 
But  the  case  is  different  if  it  be  injected  subcutaneously,  and  if 
it  be  given  by  the  stomach  or  any  other  mucous  cavity  the 
difference  is  still  greater ;  for  as  soon  as  some  of  it  is  absorbed 
excretion  begins,  and  thus  one  portion  of  the  drug  is  passing  out 
of  the  blood  while  another  portion  is  being  taken  in.  The 
amount  in  the  blood  is,  then,  only  the  difference  between  that  ab- 
sorbed and  that  excreted  in  a  given  time  (Fig.  6).  Absorption  may 
be  so  slow,  or  excretion  so  quick,  that  there  is  never  a  sufficient 
amount  of  the  substance  in  the  blood  to  produce  any  effect. 
Thus  Bernard  found  that  a  dose  of  curare  which  would  certainly 
paralyse  an  animal  when  injected  into  the  veins,  or  even  sub- 
cutaneously, would  have  no  effect  when  introduced  into  the 
stomach ;  '  and  showed  that  this  was  due  to  the  kidneys  ex- 
creting the  poison  as  fast  as  it  was  absorbed  from  the  stomach, 
oy  extirpating  the  kidneys,2  when  the  animal  became  paralysed 
art  surely  as  if  the  poison  had  been  introduced  at  once  into  the 


1  Bernard,  Leqons  sur  les  Effeta  des  Substances  Toxigv.es,  p.  2S2. 
1  Bernard,  Revue  des  Cows  Scientifiques,  1865. 


chap,  ii.]    ACTION  OF  DEUGS  ON  THE  OBGANISM. 


39 


veins,  though  not  so  quickly.  Hermann  also  discovered,  without 
being  acquainted  with  Bernard's  observations,  that  curare  taken 
into  the  stomach  would  produce  paralysis  if  excretion  were  pre- 
vented by  ligature  of  the  renal  vessels. 


Pulmonary  arteries.  >• 
(Absorption.) 

Veins  of  general  surface  of  - 
body.     (Absorption,) 


Liver.  m 

(Destruction  of  drugs.) 

Veins  of  stomach., 

X  Absorption  from  stomach.) 

Biliary  circulation.  ,-..— 
(Excretion  into  intestine.) 

Veins  of  intestine.  — *"" 
(Absorption  from 
intestine.) 


Arteries  going  to  nerve- 
centres. 

Pulmonary  veins. 
(Excretion.) 

Arteries  to  muscles. 


Arteries  to  stomach. 
(Excretion  into  stomach.) 


Arteries  to  intestines. 
(Excretion  into  intestines.) 
Kidney. 


Excretion  by  kidney. 


Fig.  5.— Diagram  to  illustrate  absorption  and  excretion.  The  arrows  show  the  direction  of  the  cur- 
rents. The  absorbents  from  which  the  blood  passes  directly  into  the  general  circulation  are 
represented  diagrammatically  by  the  veins  of  the  lungs  and  of  the  general  body  surface  in  the 
figure.  The  absorbents  by  which  the  drug  must  pass  through  the  liver,  and  possibly  be  partly 
excreted  or  destroyed,  are  represented  by  the  veins  of  the  stomach  and  intestine.  The  exereting 
channels  by  which  the  drug  may  pass  directly  from  the  body  without  re-absorption  occurring 
are  represented  by  the  vessels  of  the  lung  and  by  the  ureter.  Those  by  which  excretion  takes 
place  into  cavities  from  which  much  re-absorption  may  occur  are  represented  by  the  arteries  to 
the  intestine  and  the  stomach. 

The  absorption  of  drugs  from  the  stomach  and  intestines 
may  be  considerably  retarded,  and  their  action  diminished,  by 
the  liver.  Before  reaching  the  general  circulation,  drugs  ab- 
sorbed from  the  intestinal  canal  must  all  pass  through  the  liver 
(Fig.  5).  In  their  passage  they  may  be  partly  arrested  and  ex- 
creted again  into  the  intestine  along  with  the  bile.  They  may 
be  also  partially  destroyed.  A  larger  quantity  of  a  drug  may  thus 
be  necessary  to  produce  similar  effects  when  introduced  by  the 
stomach  than  when  injected  directly  into  the  circulation  or  under 
the  skin — (1)  because  it  may  be  absorbed  more  slowly  by  the 
vessels  of  the  gastric  or  intestinal  mucous  membrane ;  (2)  because 
a  part  of  it  may  be  arrested  in  the  liver  and  excreted  into  the 
intestine  along  with  the  bile ;  (3)  because  a  part  of  it  may  be 
actually  destroyed  in  the  liver. 

The  more  rapid  the  absorption,  or  the  slower  the  excretion, 
of  any  drug,  the  greater  will  be  its  effect.  Thus  the  effect  pro- 
duced by  the  same  dose  of  a  medicine  will  be  in  proportion  to 
the  rapidity  of  its  absorption  from  the  different  parts  to  which  it 
has  been  applied,  unless  the  differences  be  so  slight  that  there 
has  not  been  time  for  the  excretion  of  any  considerable  quantity 
from  the  blood  during  the  process.  On  this  account  we  must 
diminish  the  dose  of  a  medicine  in  order  to  obtain  the  'same 
effect,  according  to  the  rapidity  of  absorption  from  the  place  to 
which  we  apply  it.  Absorption  is  quickest  from  serous  mem- 
branes, next  from  intercellular  tissue,  and  slowest  from  mucous 


10 


PHARMACOLOGY  AND  THERAPEUTICS,     [sect. 


membranes.     The  vascularity  and  rate  of  absorption  from  inter- 
cellular tissue  is  greater  on  the  temples,  breast,  and  inner  side 


Pig.  6.— Diagram  to  illustrate  the  differences  produced  in  the  amount  of  a  drug  present  in  the 
organism  by  alterations  in  the  rate  of  absorption  and  excretion.  The  lower  funnel  represents 
the  organism.  A  represents  the  condition  when  a  drug  is  rapidly  introduced,  as  by  injection 
into  a  vein.  In  this  case  the  drug,  e.g.  curare,  comes  to  be  present  in  large  quantities  in  the 
organism,  and  produces  its  full  physiological  effect.  This  is  represented  by  the  fulness  of  the 
lower  funnel.  And  it  does  this  notwithstanding  the  rapidity  of  excretion,  which  causes 
the  drug  to  be  quickly  eliminated  and  to  appear  copiously  in  the  urine,  as  represented  by  tbe 
fulness  of  the  beaker  into  which  the  fluid  flows  from  the  lower  funnel.  B  represents  the  con- 
dition when  a  drug  is  slowly  absorbed  and  rapidly  excreted,  as  when  curare  is  given  by  the 
stomach.  In  this  case  the  quantity  present  in  the  hlood  at  any  one  time  is  very  minute,  as 
represented  by  the  empty  condition  of  the  lower  funnel.  0  represents  the  condition  when 
absorption  is  rather  quicker  than  excretion,  as  when  a  dose  of  morphine  is  given  by  the  stomach. 
D  represents  the  condition  where  absorption  is  moderate  but  excretion  is  interfered  with,  lead- 
ing to  accumu!  ation  in  the  blood,  as  where  an  active  drug  is  given  by  the  mouth  and  the  kidneys 
are  much  degenerated. 

of  the  arms  and  legs  than  on  their  outer  surfaces,  or  on  the  back.1 
It  should  not  be  forgotten  that  any  drug  introduced  into  the 
stomach,  but  not  absorbed  into  the  blood,  is  as  much  outside 
the  body  as  if  it  were  in  the  hand,  for  any  effect  it  will  have  on 


too.  7,— Diagrammatio  representation  of  the  body,  A  is  a  box  to  represent  the  tissues.  B  is  an 
inner  tube  to  represent  the  intestinal  canal.  It  is  obvious  that  anything  which  is  merely  in  the 
inner  tube  is  outside  the  box,  and,  similarly,  anything  which  is  merely  in  the  intestinal  canal  is 
outside  the  body. 

the  system,  provided  always  it  have  no  local  action  on  the  gastric 
walls.  But  if  it  act  directly  on  the  walls  of  the  stomach,  it  may 
have  an  effect  which  it  would  not  have  when  held  in  the  hand 


Eulenburg,  Hypodermatische  Injection  der  Arzneimittel,  3rd  edit.  p.  65. 


chap.  ii.]    ACTION  OF  DEUGS  ON  THE  OEGANISM.  41 

or  applied  to  the  skin.  Thus  mustard,  which  would  produce 
redness  and  burning  of  the  skin,  will  cause  vomiting  when 
swallowed;  but  opium,  which  does  not  act  on  the  stomach 
itself,  except  by  diminishing  its  sensibility,  produces  no  apparent 
effect  until  after  it  has  been  absorbed. 

By  the  difference  between  absorption  and  excretion  under 
different  circumstances  or  in  different  individuals,1  the  cumu- 
lative action  of  drugs,  the  effect  of  idiosyncrasy,  habit,  climate, 
condition  of  body,  as  fasting,  &c,  disease,  and  form  of  adminis- 
tration, can,  to  a  certain  extent,  though  not  entirely,  be  explained; 
but  experiments  on  some  of  these  points  are  deficient,  and  the 
explanations  now  given  are  to  some  extent  theoretical. 

Duration  of  Action  of  Drugs. — When  a  soluble  drug  is 
introduced  into  the  stomach,  it  will  undergo  absorption,  and  the 
whole  of  it  may  possibly  be  absorbed  without  any  portion  of  it 
even  passing  into  the  intestine.  After  absorption  into  the  blood 
it  will  either  remain  in  the  plasma  or  form  a  compound  with  the 
corpuscles.  It  will  thus  be  carried  to  the  liver,  where  part  of  it 
may  be  retained  (vide  p.  39).  Such  portions  as  pass  through 
the  liver  will  then  be  carried  to  the  right  side  of  the  heart,  to 
the  pulmonary  circulation,  and  then,  passing  to  the  left  side  of 
the  heart,  will  be  distributed  to  all  parts  of  the  body.  As  ab- 
sorption continues,  the  quantity  of  the  drug  in  the  stomach  will 
gradually  diminish,  while  that  in  the  circulation  will  increase  to 
a  certain  extent ;  this  extent,  however,  will  depend  upon  the 
activity  of  the  eliminating  organs.  The  drug  will  be  carried  to 
all  parts  of  the  body,  both  to  the  eliminating  organs  and  to  those 
connected  with  the  other  functions  of  the  organism.  It  will  enter 
into  combination,  more  or  less  firm,  with  all  those  organs  which 
have  any  attraction  for  it,  and  will  more  or  less  modify  their 
functional  activity.  In  the  processes  of  tissue-change,  which  are 
constantly  going  on,  the  combination  between  the  drug  and  the 
organs  will  be  gradually  destroyed  ;  and,  being  again  returned  to 
the  circulation,  it  will  undergo  gradual  elimination.  The  method 
in  which  elimination  occurs  will  also  depend,  to  a  certain  extent, 
on  the  selective  action  of  the  eliminating  organs  ;  thus  soluble  sub- 
stances are  usually  eliminated  most  readily  by  the  kidneys,  while 
salts  of  the  heavy  metals,  which  form  insoluble  compounds  with 
albumen,  are  eliminated  to  a  great  extent  by  mucous  membranes. 

Cumulative  Action. — If  a  substance  be  naturally  so  slowly 
excreted  from  the  body  that  the  whole  of  the  dose  in  ordinary 
use  is  not  excreted  before  another  is  given,  the  amount  present 
in  the  body  will  gradually  increase,  just  like  the  curare  in  Her- 
mann's experiment,  and  will  produce  an  increasing  or  cumulative 
effect.   Examples  of  this  are  to  be  found  in  metallic  preparations, 

1  Children  absorb  more  quickly  than  adults,  so  opium  is  more  dangerous  to 
them.    Marx,  Lehre  von  den,  Qi/ten,  vol.  ii.p.  117. 


42  PHABMACOLOGY  AND  THEEAPEUTICS.     [sect,  i., 

such  as  those  of  mercury  or  lead,  -which  are  excreted  very  slowly ; 
or  in  some  of  the  organic  alkaloids,  if  given  in  sufficiently  large 
and  frequent  doses.  The  sparingly  soluble  alkaloids  which 
form  stable  compounds  with  the  tissues  and  are  thus  slowly 
eliminated  are  more  liable  to  prove  cumulative.  The  size  of 
the  dose  and  the  frequency  with  which  it  must  be  repeated  in 
order  to  produce  a  cumulative  effect  will  differ  according  to  the 
rapidity  with  which  the  drug  is  excreted ;  for,  if  excretion  be 
rapid,  a  larger  dose  or  more  frequent  repetition  will  be  required. 

Sometimes  the  symptoms  of  the  physiological  action  of  a  drug 
instead  of  increasing  gradually  may  do  so  suddenly,  and  it  is  to 
this  kind  of  action  that  the  term  cumulative  action  is  most, 
usually  applied.  This  may  sometimes  be  due  to  a  sparingly 
soluble  drug  accumulating  in  the  intestinal  canal,  and  being 
suddenly  dissolved  and  absorbed  on  account  of  some  change 
occurring  in  the  intestinal  contents ;  at  other  times  it  may  be  due 
to  arrest  of  excretion,  as  in  the  case  of  the  two  vegetable  active 
principles,  digitalin  and  strychnine,  to  which  an  especial  cumu- 
lative action  is  ascribed.  After  moderate  doses  of  these  drugs 
have  been  taken  for  some  time,  it  is  found  that  instead  of  the 
effects  they  produce  increasing  gradually,  as  we  would  expect' 
from  a  gradual  accumulation  in  the  blood,  the  symptoms  of 
poisoning  become  suddenly  developed,  in  somewhat  the  same 
way  as  if  the  dose  had  been  suddenly  increased.  It  is  evident 
that  a  diminution  in  the  quantity  excreted  will  produce  this 
effect  as  readily  as  an  increase  in  the  quantity  taken,  and  this 
is  probably  the  true  cause  of  the  phenomenon.  "When  digitalin 
has  been  taken  for  some  time  and  accumulated  to  a  certain 
extent  in  the  blood,  it  causes  a  diminution  in  the  amount  of 
urine  excreted,  and  this  diminution  is  either  accompanied  or 
quickly  followed  by  the  other  symptoms  of  poisoning.1  The 
effect,  indeed,  seems  exactly  the  same  as  Hermann  would  have 
obtained  in  his  experiment  if  he  had  only  partially  compressed 
the  renal  arteries  instead  of  ligaturing  them  completely.  For 
digitalin  appears  to  diminish  the  secretion  of  urine  by  causing  a 
powerful  contraction  of  the  renal  vessels,2  and  in  large  doses  may 
completely  arrest  the  secretion  of  urine,3  and  probably  also  the 
circulation  through  the  kidneys.  Strychnine  has  a  similar  action 
on  the  vessels.4 

Effect  of  different  Preparations. — When  a  drug  is  given  in 
a  soluble  form,  and  in  small  bulk,  it  is  more  quickly  absorbed 
and  will  have  greater  effect  than  when  given  in  a  less  soluble 


1  Brunton,  On  Digitalis,  p.  39. 

2  Brunton  and  Power,  Proceedings  of  Royal  Soc,  1874,  No.  153,  and  Central- 
blattf.  d.  Med.  Wiss.,  1874,  p.  497. 

8  Chriatison,  Edin.  Med.  Journ.,  vii.  149. 

*  Grfitzner,  PflUger's  Arohiv,  1876,  Bd.  xi.  p.  601.     Gartner,  Separat-Abdruck 
a.  d.  lxxx.  Bd.  d.  k.  Akad.  d.  Wiss.  III.  Abt.,  Deo.  Heft,  Jahrg.  1879. 


chap,  ii.]    ACTION  OF  DRUGS  ON  THE  ORGANISM.  48 

form  or  much  diluted.  Thus  drugs  given  in  solution  as  tinctures 
will  act,  as  a  rule,  more  quickly  than  when  given  in  the  form  of 
pill  or  powder. 

Effect  of  Fasting. — When  a  drug  is  given  upon  an  empty 
stomach,  it  is  usually  absorbed  much  more  rapidly.  Thus  the 
same  quantity  of  alcohol  which  would  have  no  effect  on  a  man 
if  taken  during  or  after  dinner,  might  intoxicate  him  if  taken 
on 'an  empty  stomach,  and  especially  if  he  were  thirsty,  so  that 
absorption  occurred  rapidly.  Curare,  although  it  is  usually 
inert  when  placed  in  the  stomach,  is  sometimes  absorbed  so 
rapidly  from  an  empty  stomach  as  to  produce  a  certain  amount 
of  paralysis. 

Besides  the  alterations  in  absorption  we  have  to  consider  also 
the  local  action  on  the  stomach  itself,  and  the  reflex  effects  which 
may  be  produced  through  the  gastric  nerves  on  other  organs.  Thus 
where  we  give  a  drug  for  its  local  action  on  the  stomach  itself,  it 
is  administered  with  the  greatest  effect  during  fasting,  as  it  will 
come  in  contact  with  all  parts  of  tbe  gastric  mucous  membrane. 
An  example- of  this  is  the  use  of  a  small  dose  of  arsenic  for 
gastric  neuralgia  or  lientery. 

But  when  we  wish  to  prevent  local  action  on  the  stomach — as, 
for  example,  when  we  give  arsenic  for  its  general  effect  on  the 
system,  in  cases  of  skin-disease — we  administer  it  after  meals,  so 
that  it  may  be  diluted  by  the  food,  and  not  irritate  the  stomach 
too  much. 

Effect  of  Conditions  of  the  Stomach. — In  some  conditions 
of  the  nervous  system,  absorption  takes  place  much  more  slowly 
than  others ;  indeed,  both  digestion  and  absorption  appear  to  be 
sometimes  totally  arrested.  Thus  in  persons  in  whom  a  sick 
headache  comes  on  some  time  after  a  meal  the  contents  of  the 
-stomach  are  vomited  after  a  while  and  the  food  is  found  to  have 
undergone  digestion  but  not  absorption.  If  the  meal  be  taken 
after  the  headache  has  come  on  it  will  be  found,  in  some  persons 
at  least,  that  the  food  is  vomited  almost  unchanged,  both  diges- 
tion and  absorption  appearing  to  be  arrested.  This  condition 
exists  also  in  delirium  tremens,  and  in  a  case  of  this  disease  I 
have  seen  pieces  of  food  thrown  up  in  an  undigested  condition 
although  they  have  been  swallowed,  as  the  patient  has  informed 
me,  three  or  four  days  before.  It  is  probable  that  in  these  con- 
ditions drugs  are  also  not  absorbed,  and  I  think  it  is  not  im- 
probable that  the  harmlessness  of  large  doses  of  digitalis  given 
in  cases  of  delirium  tremens  is  due  to  the  non-absorption  of  the 
drug. 

Effect  of  Habit. — The  tissues  seem  to  have  a  certain  power 
of  adapting  themselves  to  changes  in  their  surroundings.  Thus 
salt-water  amcebaB  will  die  when  placed  at  once  in  fresh  water, 
but  if  the  fresh  water  be  added  very  gradually,  they  may  by-and- 
,by  become  accustomed  to  live  in  it.. .  Fresh-water  amoebae  also 


44  PHAKMACOLOGY  AND  THEEAPEUTICS.     [sect,  u 

have  the  power  of  becoming  gradually  accustomed  to  increasing 
quantities  of  salt  gradually  added  to  the  water  in  which  they 
live,  and  which  would  at  once  kill  them  if  added  suddenly.  A 
similar  power  seems  to  be  possessed  by  the  tissues  of  the  higher 
animals,  in  regard  to  some  drugs  at  least.  Thus  the  arsenic- 
eaters  of  Styria  are  able  to  consume — not  only  without  injury, 
but  with  apparent  benefit  to  themselves — a  quantity  of  arsenic 
Which  would  prove  fatal  to  one  unaccustomed  to  it.  The  same  is 
the  case  wiih  opium  and  morphine.  With  these  latter  drugs  there 
seems  to  be  hardly  any  limit  to  the  quantity  which  can  be  taken 
after  the  habit  has  been  once  established,  and  after  a  certain 
dose  has  been  exceeded. 

It  is  possible,  however,  that  in  addition  to  a  process  of  ac- 
commodation going  on  in  the  tissues,  there  is  a  slower  absorption, 
and  perhaps  more  rapid  excretion,  going  on  at  the  same  time  ; 
for  it  is  observed  in  the  case  of  opium  that  sometimes  the  effect 
is  not  only  diminished,  but  the  time  which  elapses  before  it 
occurs  is  lengthened  when  persons  have  become  accustomed  to 
the  drug. 

In  regard  to  the  possibility  of  very  slow  absorption  we  must 
remember  the  power  of  the  liver  to  arrest  and  excrete  or  to 
destroy  poisons,  especially  as  it  is  chiefly  in  the  case  of  vegetable 
poisons  that  their  power  is  lessened  by  habit,  which  has  much 
less  influence  on  the  effect  of  inorganic  substances.  The  toler- 
ance of  some  inorganic  drugs,  and  especially  of  tartar  emetic  in 
disease  or  after  repeated  doses,  may  be  due  to  fever  or  the 
drug  itself  lessening  the  acidity  of  the  stomach,  and  consequently 
the  action  of  the  drug,  which  acts  most  strongly  in  presence  of 
an  acid. 

The  Effect  of  Temperature. — Chemical  reactions,  as  a  rule, 
go  on  more  rapidly  the  higher  the  temperature,  excepting  when 
very  high  temperatures  are  reached  and  dissociation  occurs. 
The  effect  of  drugs  upon  living  organisms  may  be  regarded  as 
being  to  a  great  extent  due  to  chemical  union  between  the  drugs 
and  the  organism,  and  therefore  we  should  expect  that  alterations 
in  temperature  would  greatly  affect  the  action  of  drugs  and  that, 
as  a  rule,  we  should  find  that  they  would  act  with  greater  quick- 
ness when  the  temperature  is  high  unless  some  other  factor 
should  be  brought  into  operation  by  the  increasing  temperature. 
Experience  confirms  this  expectation,  and,  as  a  matter  of  fact, 
the  effect  of  temperature  on  the  action  of  drugs  is  very  great. 
At  different  temperatures  the  administration  of  the  same  drug 
may  be  followed  by  different  results,  and  it  is  probable  that  a 
great  number  of  the  contradictory  observations  which  we  find 
in  works  on  Pharmacology  are  due  to  this  most  important  factor 
having  been  neglected  in  making  the  experiments.  It  is  of  the 
greatest  importance  to  the  physician  also,  as  many  of  the  cases 
of  disease  which  he  has  to  treat  are  accompanied  by  a  rise  in 


chap,  ii.]    ACTION  OF  DRtJGS  ON  THE  ORGANISM.  45 

temperature  which  may  have  a  very  important  effect  upon  the 
action  of  the  drugs  which  he  administers. 

•  The  alteration  produced  in  the  effect  of  drugs  by  warmth,  was 
first  noticed  by  Alexander  von  Humboldt,  who  observed  that 
warmth  not  only  acted  as  a  stimulant  to  the  heart  in  increas- 
ing the  power  and  rapidity  of  its  contractions,  but  noticed  that 
warmth  increased  the  rapidity  with  which  alcohol  destroyed  the 
irritability  of  a  nerve,  and  potassium  sulphide  that  of  a  muscle. 
Bernard  observes  generally  that  poisons  act  slightly  on  frogs 
.when  cooled  down,  and  become  more  active  the  higher  the  tem- 
perature. The  effect  of  warmth  in  stimulating  the  movements 
of  protoplasmic  structures,  such  as  amoebae  and  cilia,  was  in- 
vestigated by  Kiihne ;  and,  in  an  important  research,  Luchsinger 
experimented  on  the  influence  of  warmth  on  the  action  of  poisons 
on  many  organs,  and  found  that  the  ciliary  motion  in  the 
pharynx  of  the  frog  became  paralysed  by  chloral,  potassium 
carbonate,  and  tartrate  of  copper  and  sodium  more  and  more 
quickly  in  proportion  to  the  rise  in  temperature.  On  cooling 
down  the  ciliary  movement  again  returned. 

Dr.  Cash  and  I  have  found  that  the  action  of  veratrine  or 
barium  on  muscle  is  very  much  altered  by  heat  and  cold.  At 
ordinary  temperatures  contraction  is  greatly  prolonged,  but  under 
the  influence  of  either  great  heat  or  great  cold  the  contraction 
again  becomes  nearly  or  quite  normal. 

Many,  if  not  all,  muscular  poisons  act  more  quickly  with 
increased  temperature ;  and  frogs  poisoned  with  chloral,  copper, 
manganese,  potash,  and  zinc  are  paralysed  more  quickly  when 
the  temperature  is  high,  than  when  it  is  low,  whether  the  alter- 
ations be  produced  artificially,  or  be  due  to  differences  in  the 
season  at  which  the  experiments  are  made. 

Eabbits  poisoned  with  copper  or  potash  also  die  more  quickly 
when  placed  in  a  warm  chamber  than  when  left  at  the  ordinary 
temperature. 

The  terminations  of  motor  nerves  in  the  muscles  are  also 
greatly  affected  by  temperature. 

Guanidine  produces  in  the  frog  fibrillary  twitchings  of  the 
muscles,  which  persist  even  in  excised  muscles,  but  are  removed 
by  curare,  and  are  therefore  in  all  probability  dependent  on  an 
affection  of  the  terminal  ends  of  the  motor  nerves  in  the  muscle. 
Luchsinger  found  that  when  four  frogs  are  poisoned  in  this 
way,  and  one  is  placed  in  ice- water,  another  in  water  at  18°,  a 
third  at  25°,  and  a  fourth  at  32°,  the  fibrillary  twitchings  soon 
disappear  from  the  muscles  of  the  frog  at  0°,  and  only  return 
when  its  temperature  is  raised  to  about  18°.  In  the  one  at  18° 
convulsions  occur,  which  are  still  greater  in  the  one  at  25°.  In 
the  frog  at  32°,  on  the  other  hand,  no  abnormal  appearance  is 
to  be  remarked,  and  five  times  the  dose  may  be  given  without 
doing  it  any  harm. 


46  .PHARMACOLOGY  AND  THERAPEUTICS,     [sect.  V 

This  poison  then  resembles  veratrine  in  acting  only  at  ordi- 
nary temperatures,  and  in  its  action  being  abolished  by  excess  of 
heat  or  cold. 

The  effect  of  temperature  on  secreting  nerves  is  well  marked. 
When  the  sciatic  is  stimulated  in  an  animal,  the  corresponding 
foot  usually  begins  to  sweat,  but  the  sweating  is  very  much  less 
if  the  foot  is  cooled  down  than  if  it  is  warm.  A  similar  action 
is  exerted  by  temperature  upon  the  sweating  produced  by  pilo- 
carpine— a  drug  which  appears  to  act  by  stimulating  the  ends 
of  the  secreting  nerves.  When  the  animal  is  cooled,  this  drug 
is  much  less  powerful  than  when  it  is  warm. 

Overheating  appears  to  have  an  opposite  action,  and  when 
the  foot  is  heated  up  to  a  certain  temperature  it  does  not  secrete 
nearly  so  readily,  even  though  the  glands  themselves  are  not  in- 
jured, and  secretion  may  commence  after  the  lapse  of  a  little  time. 

The  influence  of  poisons  on  the  heart  of  the  frog  is  also 
modified  by  temperature.  Kronecker  found  that  its  beats  were . 
arrested  by  ether  easily  and  quickly  when  the  temperature  was 
high,  but  with  great  difficulty  when  it  was  low.  Kinger  found 
that  a  small  dose  of  veratrine  greatly  affects  the  ventricle  at  a 
moderate  or  high  temperature,  but  at  a  low  temperature  produces 
no  effect.1 

Luchsinger  noticed  that  when  the  frog's  heart  had  been 
arrested  by  passing  dilute  solutions  of  chloral,  copper,  or  potas- 
sium carbonate  through  at  25°  C,  the  pulsations  again  began 
when  the  temperature  was  reduced  to  15°  C.  When,  on  the 
contrary,  the  heart  had  been  arrested  in  a  similar  manner,  at  a 
temperature  of  5°  C,  pulsations  could  then  be  induced  by  warm- 
ing it  to  15°. 

Some  extraordinary  observations  on  the  effect  of  temperature 
upon  the  action  of  drugs  on  the  spinal  cord  have  been  made  by 
Kunde  and  Poster,  who  have  found  that,  in  a  number  of  frogs 
poisoned  with  strychnine  and  exposed  to  different  temperatures, 
raising  the  temperature  diminishes  the  convulsions,  while  cold 
increases  them  if  small  doses  are  employed.  Baising  the  tem- 
perature, indeed,  may  not  only  diminish  but  entirely  abolish  the 
convulsions,  while  putting  a  frog  in  ice  may  bring  them  on  when 
they  would  not  otherwise  appear,  and  cause  them  to  last  for  no 
less  than  twenty-four  hours.  When  large  doses  are  employed 
the  opposite  effect  is  produced;  raising  the  temperature  then 
increases  the  convulsions,  while  cooling  the  frog  down  to  0° 
abolishes  them. 

An  observation  similar  in  some  respects,  though  differing  in 
others,  has  been  made  on  the  effect  of  temperature  on  the  action 
of  picrotoxin  by  Luchsinger.2   When  this  poison  is  given  to  three 


1  Ringer,  Archives  of  Medicine,  vol.  vii.  Feb.  1882,  p.  5. 
!  Luchsinger,  Physiologische  Studien,  Leipzig,  18S2. 


chap,  ii.]    ACTION  OF  DEUGS  ON  THE  OEGANISM.  47 

frogs,  and  they  are  then  placed  in  water  at  0°,  15°,  and  32°, 
in  a  few  minutes  the  convulsions  occur  in  the  one  at  32°,  shortly 
afterwards  in  that  at  15°,  while  the  one  at  0°  remains  for  a  long 
time  completely  unaffected,  and  only  exhibits  signs  of  convulsion 
when  the  dose  has  been  very  great  indeed,  or  when  it  is  taken 
out  of  the  cold  bath. 

The  effect  of  warmth  in  accelerating  death  from  muscular 
poisons  has  already  been  mentioned. 

The  power  of  warmth  to  preserve  life  in  narcotic  poisoning 
was  observed  by  Hermann  in  relation  to  alcohol,  which  rabbits 
bear  better  when  they  are  somewhat  warmed.1  Its  extraordinary 
effect  in  preventing  death  in  animals  poisoned  with  chloral  was 
noticed  by  Strieker,  and  more  thoroughly  worked  out  by  myself 
at  his  suggestion.2  Death  by  chloral  appeared  from  my  ex- 
periments to  be  in  a  great  measure  due  to  continued  loss  of  heat 
from  the  animal.  This  seems  to  be  the  case  also  in  metallic 
poisoning  by  copper,  manganese,  mercury,  platinum,  potassium, 
thallium,  tungsten,  and  zinc.  Its  cause  appears  to  be  twofold : 
(1)  the  poisons  lessen  combustion  in  the  body,  and  the  amount 
of  heat  produced,  as  is  shown  by  their  diminishing  the  amount 
of  carbonic  acid  excreted ;  (2)  besides  disturbing  the  production 
they  also  disturb  the  regulation  of  heat,  so  that  animals  poisoned 
by  them  have  less  power  of  resisting  the  influence  of  external 
temperature,  and  therefore  the  temperature  rises  more  quickly 
when  they  are  put  in  a  warm  chamber,  as  well  as  sinks  more 
quickly  when  they  are  exposed  to  cold. 

All  these  observations  show  that  the  definition  of  the  action 
of  a  drug,  already  given  (p.  5),  must  be  still  further  modified, 
and  we  must  define  it  as  the  reaction  between  the  drug  and  the 
various  parts  of  the  body  at  a  certain  temperature. 

Thomas 3  found  that  digitalis  has  sometimes  no  action  on  the 
pulse  in  pneumonia.  As  the  slowing  of  the  pulse  produced  by 
this  drug  is  to  some  extent  effected  through  the  vagi,  it  occurred 
to  me  that  its  want  of  action  in  this  disease  might  be  due  to  the 
paralysis  of  these  nerves  by  heat.  On  testing  the  action  of  heat, 
however,  on  the  vagus,  in  rabbits  deeply  chloralised,  I  found  that 
it  was  not  paralysed  at  a  temperature  just  sufficient  to  kill  the 
animal.4  Cash  and  I,  however,  have  found  that  though  the 
peripheral  ends  of  the  vagi  are  not  completely  paralysed  by  high 
temperature,  the  roots  of  the  vagus  in  the  medulla  appear  to  be  • 
so,  and  probably  the  want  of  action  of  digitalis,  when  the  tem- 
perature is  high,  is  due  to  this  paralysis  {vide  Digitalis). 

The  abnormal  effect  which  opium  has  in  some  cases  of  fever 
— causing  excitement   instead   of    sleep — is  occasionally  most 

1  Hermann,  Arch.f.  Anat.  u.  Physiol.  1867,  p.  64. 

"  Lauder  Brunton,  Journal  of  Anatomy  and  Physiology,  vol.  viii. 

•  Arch.f.  Heilk.,  vol.  iv.  329,  1865. 

*  St.  Bartholomew's  Hospital  Reports,  1871,  p.  216. 


48  PHAEMACOLOGY  AND  THEEAPEUTICS.     [sect,  u 

distressing  to  the  physician.  It  is  possible  that  this  may  be 
partly  due  to  the  temperature,  and  that  the  combination  of 
tartar  emetic  with  the  opium  may  owe  some  of  its  utility  to  its 
effect  in  lowering  temperature,  although  not  improbably  both  it 
and  another  useful  combination  with  chloral  also  act  more  per- 
fectly on  account  of  the  depressing  action  on  the  circulation. 
These  are  points,  however,  on  which  further  observations  are 
greatly  needed. 

Climate. — It  is  said  that  the  action  of  narcotic  drugs  is 
greater  in  warm  climates  than  in  cold,  and  that  smaller  doses 
are  therefore  required  to  produce  a  similar  effect.  If  this  state- 
ment be  true,  it  may  be  due  to  the  higher  temperature,  for 
Crombie  has  shown  that  in  India  the  average  temperature  of  the 
body  is  about  half  a  degree  higher  than  in  England.  It  may, 
however,  be  due  to  the  slower  elimination  of  the  drug  by  the 
urine ;  because  in  hot  climates  the  secretion  of  the  skin  is  apt 
to  be  much  greater,  and  the  secretion  of  urine  and  elimination 
by  it  consequently  less. 

Time  of  Day. — In  healthy  persons  fluctuations  of  the  body- 
temperature  occur.  The  lowest  temperatures  occur  at  night 
between  10  p.m.  and  1  a.m.,  and  in  the  early  morning  between 
6  and  8  a.m.  The  highest  temperature  occurs  between  4  and  5 
in  the  afternoon. 

The  action  of  drugs  may  be  partially  altered  by  the  slight 
variations  in  temperature  which  occur  within  the  body,  and 
perhaps  still  more  by  the  variations  in  tissue-change,  of  which 
these  fluctuations  of  temperature  are  the  indication.  Thus  tbe 
necessity  for  great  attention  to  the  administration  of  stimulants 
in  the  early  hours  of  the  morning  in  cases  of  threatening  collapse 
has  long  been  recognised. 

Effect  of  Season. — The  action  of  drugs  is  altered  by  the 
changes  in  temperature  due  to  the  seasons.  Galen  supposed 
that-  the  quantity  of  blood  in  the  body  was  increased  in  spring, 
and  in  this  country,  till  within  recent  years,  it  was  a  common 
custom  for  people  to  be  regularly  bled  every  spring.  Purgatives 
were  not  unfrequently  administered  also  at  the  same  time. 
There  are,  no  doubt,  changes  corresponding  with  the  seasons  in 
the  human  organisation,  although  these  are  better  marked  in 
the  lower  animals ;  e.g.  deer,  in  which  the  antlers  bud  regularly 
in  spring  and  reach  perfection  just  at  the  breeding  season.  It  is 
possible  that  the  abolition  of  the  practice  of  bleeding  in  spring 
and  the  changes  in  other  plans  .of  treatment  formerly  adopted, 
may  not  be  altogether  due,  as  some  suppose,  to  increased  know- 
ledge on  our  part,  but  rather  to  the  occurrence  of  a  change  of 
type  not  only  in  diseases  but  also  in  slight  ailments,  and  to  the 
need  for  such  treatment  having  disappeared.  Formerly,  before 
the  introduction  of  coaches,  and  still  more  of  railways,  locomotion 
was  difficult  and  transportation  was  expensive ;   in  consequence 


chap,  ii.]    ACTION  OF  DRUGS  ON  THE  ORGANISM.  49 

of  this,  the  food  consumed  by  the  generality  of  people  was  differ- 
ent in  character,  loaf  bread  being  very  little  used,  and  salt  meat 
often  used  for  weeks  and  months  together  during  the  winter, 
with  comparatively  few  vegetables.  Such  a  diet  might  naturally 
lead  to  a  condition  of  body  which  would  be  benefited  by  bleeding 
and  purgatives. 

Effect  of  Disease. — The  direct  and  indirect,  the  local  and 
remote  action  of  drugs  upon  the  complicated  mechanism  of  a 
mammalian  body  is  so  perplexing  that  the  attempt  to  ascertain 
the  precise  mode  of  action  of  a  drug  by  its  mere  administration, 
either  to  a  healthy  man  or  to  healthy  animals,  and  observation 
of  its  effect  upon  them,  is  hopeless. 

Moreover,  the  object  that  we  really  wish  to  attain  is  the 
power  to  relieve  human  suffering,  and  to  avert  the  premature 
death  due  to  disease.  But  in  disease  we  have  new  factors; 
changes  are  produced  by  it  in  the  functions  of  the  body,  and 
the  reaction  of  the  diseased  organism  to  the  drugs  which  we  ad- 
minister is  oftentimes  different  from  that  of  a  healthy  one.  To  a 
man  suffering  from  cholera,  for  example,  enormous  doses  of  drugs 
have  been  given  without  the  least  effect ;  and,  in  the  wakefulness 
of  fever,  the  opium  which  ought  to  produce  sleep  may  simply 
cause  excitement  and  delirium. 


Use  of  Experiments. 

As  we  have  seen,  the  problems  put  before  us  are  too  com- 
plicated to  be  solved  directly,  and  we  must  therefore  simplify 
them. 

This  is  done  in  four  ways : — 

1st,  by  observation  of  the  effects  of  drugs  on  animals  with 
a  simpler  organism  than  our  own,  such  as  amoebae 
or  frogs ; 

2ndly,  by  applying  the  drug  to  some  part  of  an  animal 
body  more  or  less  completely  separated  from  the  rest, 
such  as,  for  example,  the  muscle  and  nerve,  or  the 
heart  of  a  frog  separated  from  the  body ;  and 

3rdly,  by  preventing  the  drug  from  reaching  one  part  of 
the  body  while  it  acts  on  the  others,  as  by  ligaturing 
an  artery,  as  in  Bernard's  or  Kolliker's  experiments  on 
curare. 

4thly,  by  producing  artificial  changes  in  the  relations  of 
the  various  parts  of  the  body  of  higher  animals, 
either  before  or  after  administration  of  a  drug,  as, 
for  example,  by  dividing  the  vagi,  in  order  to  ascer- 
tain how  far  the  change  produced  in  the  beats  of  the 
heart  by  a  drug  is  due  to  its  action  upon  it  through 
these  nerves. 


50  PHARMACOLOGY  AND  THERAPEUTICS,     [sect.  i. 

Comparative  Pharmacology. — It  may  seem  almost  absurd 
to  those  unacquainted  with  the  subject,  that  so  much  attention 
should  be  devoted  to  experiments  on  the  effect  of  drugs  on  the 
lower  animals,  when  our  object  is,  as  we  have  just  stated,  to 
ascertain  their  action  upon  human  beings,  and  their  mode  of 
employment  in  the  diseases,  of  man. 

But  in  the  study  of  Pharmacology,  just  as  in  Histology,  very 
much  is  to  be  learned  by  comparative  studies.  In  his  lectures, 
Ranvier  admirably  defines  General  Anatomy  as  Comparative 
Histology  limited  to  a  single  organism.  He  illustrates  this  by 
showing  that  the  different  modes  of  movement  which  occur  in 
some  of  the  lower  classes  of  the  animal  kingdom  are  to  be  found 
united  in  the  highest.  Thus  leucocytes  of  the  blood  move  about 
like  amoebae.  The  epithelium  of  the  respiratory  passages  is  pro- 
vided, like  infusoria,  with  cilia ;  and  while  some  muscles  have  the 
power  of  rapid  contraction,  others  contract  slowly,  like  those  of 
some  invertebrata.1 

We  have  thus  in  certain  parts  of  the  bodies  of  the  higher 
animals  and  of  man,  anatomical  elements  whose  functions  are 
performed  in  a  way  resembling  that  of  organisms  low  in  the 
scale  of  existence,  and  by  examining  the  effects  of  drugs  upon 
these  low  organisms  we  acquire  knowledge  which  aids  us  in  deter- 
mining the  action  of  drugs  upon  similar  anatomical  elements  in 
the  human  body. 

In  his  admirable  lecture  on  Elemental  Pathology,  Sir  James 
Paget  draws  attention  to  the  distinction  between  the  conditions 
of  life  and  the  essential  properties  of  living  things ;  and  to  the 
fact  that,  while  the  various  parts  of  a  complicated  organism  like 
the  human  body  are  closely  connected  together,  and  made  to 
work  in  harmony  for  the  common  good  of  the  organism  in 
health,  yet  each  part  retains  its  own  mode  of  life,  and  may 
sometimes  develop  to  an  excessive  extent  at  the  expense  of  the 
rest,  and  may  destroy  the  organism,  and  itself  as  well.  We  see 
the  power  which  each  part  possesses  of  carrying  on  individual 
life  apart  from  the  rest  best  in  lower  organisms  or  in  inorganic 
substances,  where  the  parts  are  less  dependent  on  the  welfare  of 
the  whole. 

Thus,  in  crystals,  a  chip  which  has  been  broken  off  is  re- 
placed, and  the  form  of  the  crystal  restored,  by  putting  it  in  a 
solution  which  will  yield  it  the  proper  kind  of  material  required. 
When  a  hydra  is  cut  in  two,  each  part  grows  into  a  perfect  in- 
dividual :  a  tail  growing  to  the  head  part,  and  a  head  growing 
to  the  tail  part.  When  a  claw  has  been  broken  off  a  crab  or 
lobster,  a  new  one  will  by-and-by  grow ;  but  if  the  animal  be 
divided  in  two,  unlike  the  hydra  it  will  die. 


1  Legons  d'anatomie  ginirale  sur  le  systime  musculaire,  par  L.  Ranvier     Paris, 
18S0,  p.  46. 


ceap.  ii.]    ACTION  OF  DEUGS  ON  THE  OBGANISM.  51 

As  we  ascend  in  the  scale  of  existence  the  power  of  repair 
becomes  less  perfect.  But  even  in  the  human  being  we  see  that 
the  different  parts  retain  their  individual  life,  and  if  put  into 
proper  conditions  may  live,  although  the  original  body  from 
which  they  were  obtained  were  to  die.  Teeth,  for  example, 
which  have  been  extracted  from  one  person  have  been  trans- 
planted and  grown  in  the  jaws  of  another ;  and  the  transplanta- 
tion of  hair,  skin,  or  of  periosteum  is  perfectly  practicable. 

Idiosyncrasy. — -In  then-  onward  development  from  the 
lowest  forms  of  life,  man  and  the  higher  animals  have  not 
only  permanently  retained  in  their  bodies  certain  parts  which 
resemble  organisms  low  in  the  scale  of  existence,  but  every 
now  and  again  a  tendency  to  reversion  appears  in  certain 
individuals,  and  we  thus  get  anatomical  abnormalities  and 
malformations. 

These  were  formerly  inexplicable,  but  the  doctrine  of  evolution 
has  thrown  much  light  on  their  probable  causation. 

Now  and  again  we  also  meet  with  peculiarities  in  the  re- 
action between  drugs  and  parts  of  the  human  body  in  certain 
individuals. 

Some  persons,  for  example,  are  like  pigeons — only  slightly 
affected  by  opium — and  can  take  enormous  doses  of  it  without 
any  apparent  effect.  Others,  again,  are  peculiarly  sensitive  to 
the  action  of  certain  medicines,  and  a  dose  of  a  mercurial 
preparation,  which  would  have  but  a  slight  purgative  action  on 
one,  will  produce  intense  salivation  in  another. 

These  personal  peculiarities  in  regard  to  the  action  of  drugs, 
or  idiosyncrasies,  as  they  are  termed,  have  been,  _  and  are  still, 
very  perplexing  td  the  medical  practitioner.  It  is  probable,  how- 
ever, that  a  more  complete  study  of  comparative  pharmacology 
will  enable  us,  to  some  extent  at  least,  to  recognise  these,  and 
thus  to  avoid  the  inconvenience  which  they  occasion. 

Experiments  upon  Healthy  Man. — As  the  action  of  drugs 
upon  animals  is  to  a  certain  extent  different  from  that  on  man, 
it  is  undoubtedly  desirable  to  ascertain  the  action  of  drugs  by 
experiments  upon  healthy  man.  This  is  all  the  more  necessary 
because  by  experiments  upon  animals  we  are  able  to  discover 
only  the  ruder  differences  between  drugs,  and  we  cannot  ascer; 
tain  the  finer  shades  of  action,  both  because  it  is  in  man  alone 
that  these  finer  differences  occur,  and  because  it  is  he  alone  who 
can  give  information  regarding  slight  changes  which  he  can  per- 
ceive in  his  own  organism,  but  which  are  imperceptible  to  others 
who  may  be  observing  him.  There  is  no  doubt  that  many  ob- 
servers of  this  sort,  several  of  whom  have  been  homceopathists, 
have  done  good  service  to  medicine  by  carefully  noting  and  care- 
fully comparing  the  symptoms  produced  by  various  drugs.  These 
observations,  however,  are  liable  to  fallacies,  as  I  will  presently 
mention. 

E  2 


52  PHARMACOLOGY   AND   THERAPEUTICS,      [sect.  i. 

Fallacies  of  Experiment  upon  Man.— But  the  high  de- 
velopment of  the  nervous  system  in  man,  its  susceptibility  to 
various  influences,  and  the  power  of  expression  which  man 
possesses— the  very  qualities  which  render  him  such  a  valuable 
subject  for  experiment  make  experiments  upon  him  all  the  more 
liable  to  fallacy.  Thus  we  find  that  in  the  experiments  of  Hein- 
rich  and  Dworzak  aconite  was  found  to  cause  neuralgic  pains 
in  the  face ;  but  unfortunately  these  observers  have  not  mentioned 
whether  any  carious  teeth  were  present,  and  so  we  cannot  ascer- 
tain whether  the  neuralgia  was  due  to  the  action  of  the  aconite 
itself  upon  healthy  nerves,  or  to  alterations  in  the  circulation  of 
the  alveoli  lodging  decayed  teeth. 

One  of  the  most  marked  examples  of  the  fallacies  occurring 
in  experiments  upon  man,  and  of  the  errors  to  which  such 
fallacies  may  lead,  is  to  be  found  in  the  provings  which  Hahne- 
mann made  of  cinchona  bark,  and  which  led  him  to  formulate 
the  doctrine  of  homoeopathy.  Hahnemann,  who  had  suffered 
from  ague,1  for  the  sake  of  experiment,  took  for  several  days 
4  drachms  of  good  cinchona  bark  twice  a  day,  and  then  began  to 
suffer  from  all  the  ordinary  symptoms  of  intermittent  fever.  On 
leaving  off  the  drug  he  soon  became  quite  well.  He  therefore 
concluded  that  cinchona  bark,  which  was  well  known  to  be  a 
remedy  for  ague,  could  also  produce  it. 

Everyone  who  has  an  extended  experience  of  ague  knows 
well  that  even  when  patients  have  been  free  from  any  symptoms 
of  the  disease  for  a  considerable  length  of  time,  they  may  be 
caused  to  reappear  by  various  conditions,  and  more  especially  by 
anything  that  irritates  the  stomach  or  intestines.  I  have  not 
myself  seen  a  case  of  ague  brought  on  by  the'  administration  of 
cinchona  bark,  but  I  have  seen  it  occur  after  a  succession  of 
heavy  dinners  in  a  patient  who  had  been  long  free  from  it. 
Powdered  cinchona  is  certainly  irritant,  and  Jorg  found  that 
in  two-drachm  doses  it  might  cause  flatulence,  irritation,  and 
nausea.  Hahnemann  took  it  in  double  this  dose,  and  in  all 
probability  the  ague  which  it  brought  on  was  simply  due  to 
gastric  irritation,  and  not  to  any  specific  action  of  the  cinchona. 
Had  Hahnemann  taken  any  other  irritant  which  disagreed  with 
him — say  tartar  emetic,  or  perhaps  even  pork-pie — he  might 
have  suffered  in  the  same  way,  and  yet  pork-pie  could  hardly  be 
said  to  be  a  specific  for  ague. 

Experiments  in  Disease. — In  the  present  state  of  medicine 
every  attempt  which  we  make  to  treat  disease  by  the  administra- 
tion of  medicine  partakes  more  or  less  of  the  nature  of  experi- 
ment, because  we  can  rarely  be  absolutely  certain  that  the  drug 


1  History  of  Homccopathy.  By  Wilhelm  Ameke,  M.D.  Translated  by  Alfred  E. 
Drysdale,  M.B.  Edited  by  B.  E.  Dudgeon,  M.D.  London.  Published  for  the 
British  Homeopathic  Society,  by  E.  Gould  &  Son,  59  Moorgate  Street.     1S85 


chap,  n.]    ACTION  OP  DBUGS  ON  THE  ORGANISM.  53 

will  have  precisely  the  effect  which  we  desire.  As  the  phrase  is, 
'We  try  one  medicine,  and  then  we  try  another.'  If  human 
life  were  not  so  valuable,  we  might  pursue  a  series  of  systematic 
experiments,  and  gain  valuable  information  ;  but  it  is  impossible 
for  a  physician  to  treat  the  patient  who  calls  upon  him  for  aid  in 
any  other  way  than  that  which  seems  likely  to  be  the  best  for 
the  patient's  welfare.  Here  again  the  homceopathists  have  done 
good  service,  because  by  administering  to  the  patient  medicines 
in  which  they  believed,  but  which  could  neither  do  good  nor 
harm,  they  have  taught  us  the  natural  course  of  some  diseases, 
which  we  could  not  otherwise  have  learned. 

Objections  to  Experiment. — Some  people  object  entirely 
to  experiments  upon  animals.  They  do  this  chiefly  on  two 
grounds.  The  first  is  that  such  experiments  are  useless,  and 
the  second  is  that,  even  if  they  were  useful,  we  have  no  right  to 
inflict  pain  upon  animals. 

The  first  objection  is  due  to  ignorance.  Almost  all  our  exact 
knowledge  of  the  action  of  drugs  on  the  various  organs  of  the 
body,  as  well  as  the  physiological  functions  of  these  organisms 
themselves,  has  been  obtained  by  experiments  on  animals. 

The  second  objection  is  one  which,  if  pushed  to  its  utmost 
limits  and  steadily  carried  out,  would  soon  drive  man  off  the  face 
of  the  earth. 

The  struggle  for  existence  is  constantly  going  on,  not  only 
between  man  and  man,  but  between  man,  the  lower  animals  and 
plants,  and  man's  very  being  depends  upon  his  success. 

We  kill  animals  for  food.  We  destroy  them  when  they  are 
dangerous  like  the  tiger  or  cobra,  or  destructive  like  the  rat  or 
mouse.  We  oblige  them  to  work  for  us,  for  no  reward  but  their- 
food ;  and  we  urge  them  on  by  whip  and  spur  when  they  are 
unwilling  or  flag.  No  one  would  think  of  blaming  the  messenger 
who  should  apply  whip  and  spur  to  bring  a  reprieve,  and  thus 
save  the  life  of  a  human  being  about  to  die  on  the  scaffold,  even 
although  his  horse  should  die  under  him  at  the  end  of  the 
journey.  Humane  people  will  give  an  extra  shilling  to  a  cab- 
man in  order  that  they  may  catch  the  train  which  will  take  them 
to  soothe  the  dying  moments  of  a  friend,  without  regarding  the 
consequences  to  the  cab-horse.  Yet  if  one-tenth  of  the  suffering 
which  the  horse  has  to  endure  in  either  of  the  cases  just  men- 
tioned were  to  be  inflicted  by  a  physiologist  in  order  to  obtain 
the  knowledge  which  would  help  to  relieve  the  suffering  and 
lengthen  the  life,  not  of  one  human  being  only,  but  of  thousands, 
many  persons  would  exclaim  against  him.  Such  objections  as . 
these  are  due  either  to  want  of  knowledge  or  want  of  thought  on 
the  part  of  the  people  who  make  them.  They  either  do  not  know 
the  benefits  which  medicine  derives  from  experiment,  or  they 
thoughtlessly  (sometimes,  perhaps,  wilfully)  ignore  the  evidence 
regarding  the  utility  of  experiment. 


54:  PHAEMACOLOGY  AND   THEEAPEUTICS.      [sect.  i. 

One  of  the  most  important  objections  that  has  been  raised  to 
this  mode  of  experiment  is  that  the  action  of  drugs  on  the' lower 
animals  is  quite  different  from  their  action  on  man.  This 
objection  has  a  certain  amount  of  truth,  but  is  in  the  main 
groundless.  The  action  of  drugs  on  man  differs  from  that  on  the 
lower  animals  chiefly  in  respect  to  the  brain,  which  is  so  much 
more  greatly  developed  in  man. 

Where  the  structure  of  an  organ  or  tissue  is  nearly  the  same 
in  man  and  in  the  lower  animals,  the  action  of  drugs  upon  it  is 
similar.  Thus  we  find  that  carbonic  oxide  and  nitrites  produce 
similar  changes  in  the  blood  of  frogs,  dogs,  and  man,  that  curare 
paralyses  the  motor  nerves  alike  in  them  all,  and  veratrine  exerts 
upon  the  muscles  of  each  its  peculiar  stimulant  and  paralysing 
action. 

Where  differences  exist  in  the  structure  of  the  various  organs, 
we  find,  as  we  would  naturally  expect,  differences  in  their  re- 
action to  drugs.  Thus  the  heart  of  the  frog  is  simpler  than  that 
of  dogs  or  men,  and  less  affected  by  the  central  nervous  system. 
We  consequently  find  that  while  such  a  drug  as  digitalis  has 
a  somewhat  similar  action  upon  the  hearts  of  frogs,  dogs,  and 
men,  there  are  certain  differences  between  its  effect  upon  the 
heart  of  a  frog  and  that  of  mammals.  In  all  it  seems  to  affect 
the  muscular  substance  and  cause  increased  contraction.  But 
while  the  frog  almost  invariably  dies  with  the  heart  in  a  state  of 
tetanic  contraction,  this  is  not  the  case  with  dogs  or  men,  where 
the  heart  sometimes  is  found  in  diastole  after  death. 

Ipecacuanha  or  tartar  emetic  will  cause  vomiting  in  man,  but 
does  not  do  so  in  rabbits.  The  reason  of  this  is  that  the  position 
of  the  stomach  in  the  rabbit  is  different  from  that  in  man,  and 
is  such  that  the  animal  cannot  vomit.  In  dogs,  however,  the 
position  of  the  stomach  agrees  with  that  of  man,  and  tartar 
emetic  or  ipecacuanha  causes  vomiting  in  both.  Belladonna 
offers  another  example  of  apparent  difference  in  action — a  con- 
siderable dose  of  belladonna  will  produce  almost  no  apparent 
effect  upon  a  rabbit,  while  a  smaller  dose  in  a  dog  or  a  man 
would  cause  the  rapidity  of  the  pulse  to  be  nearly  doubled.  Yet 
in  all  three — rabbits,  dogs,  and  men — belladonna  paralyses  the 
power  of  the  vagus  over  the  heart.  The  difference  is,  that  in 
rabbits  the  vagus  normally  exerts  but  little  action  on  the  heart, 
and  the  effect  of  its  paralysis  is  consequently  slight  or  hardly 
appreciable,  the  pulse  being  normally  almost  as  quick  as  it  is 
after  the  vagus  is  paralysed.  In  dogs  and  men,  on  the  contrary, 
the  vagus  is  constantly  exerting  considerable  restraining  power 
over  the  heart,  and  the  effects  of  its  paralysis  at  once  attract 
attention. 

An  example  of  the  apparent  difference  in  the  effect  of  a  drug 
on  different  animals  is  afforded  by  nitrite  of  amyl.  If  we  measure 
the  pressure  of  the  blood  in  the  arteries  of  a  rabbit  and  of  a  dog. 


chap,  ii.]    ACTION  OF  DEUGS  ON  THE  OKGANISM.  55 

and  then  cause  them  to  inhale  nitrite  of  amyl,  we  find  that  the 
small  vessels  have  become  widened  and  allow  the  blood  to  pass 
easily  out  of  the  arterial  system  into  the  veins,  so  that  the 
pressure  sinks  considerably  in  the  rabbit,  whereas  it  sinks  only 
slightly  in  the  dog.  The  action  seems  at  first  sight  different ; 
but  when  we  examine  it  more  closely,  we  find  that  the  heart  of 
the  dog  is  no  longer  beating  slowly,  but  very  quickly,  so  as  to 
keep  up  the  pressure,  notwithstanding  the  rapid  flow  of  the 
blood  through  the  widened  vessels,  while  the  heart  of  the  rabbit 
was  going  so  fast  before  that  it  could  not  go  much  more  quickly. 
If  we  cut  the  vagi  in  the  dog,  so  that  the  heart  goes  as  quickly 
as  in  the  rabbit  before  it  begins  to  inhale,  the  blood-pressure 
sinks  during  the  inhalation,  just  as  it  does  in  the  rabbit.1 

One  of  the  most  marked  differences  between  the  action  of  a 
drug  upon  lower  animals  and  upon  man  is  to  be  found  in  the 
effect  of  morphine  upon  frogs  and  upon  pigeons.  In  frogs  it 
causes  convulsions ;  on  pigeons,  even  in  large  doses,  it  produces 
no  apparent  effect.  But  although  its  effects  are  not  appreciable 
to  the  eye,  they  exist  nevertheless,  and  on  applying  the  thermo- 
meter it  is  found  that  morphine  lowers  the  temperature  of  pigeons 
many  degrees.  On  comparing  the  effect  of  the  drug  on  frogs 
with  its  effect  on  man,  we  see  that  in  the  frog  the  cerebral  hemi- 
spheres are  very  slightly  developed  indeed  as  compared  with 
man,  and  in  the  latter  the  effects  of  the  drug  upon  the  spinal 
cord  are  usually  completely  concealed  by  the  narcotic  effect  of 
the  drug  upon  the  brain.  In  children,  however,  and  in  some 
races  of  man  where  the  cerebral  hemispheres  are  less  developed 
than  in  Europeans,  the  convulsant  action  of  morphine  manifests 
itself.  Occasionally  we  find  individuals  who  are  almost  proof 
against  the  action  of  morphine,  and  who  take  large  doses  of  it 
without  any  apparent- effect.  Whether  in  these  persons  it  lowers 
the  temperature  as  it  does  in  pigeons  is  a  point  which  remains 
to  be  ascertained. 

By  means  of  experiments  upon  animals,  then,  we  are  able  to 
ascertain  the  action  of  drugs  upon  those  organs  of  the  body 
which  are  alike  in  man  and  animals ;  and  the  very  differences 
which  exist  between  the  various  sorts  of  animals,  help  us  to 
understand  the  action  of  drugs  more  thoroughly. 

Erroneous  Deductions  from  Experiments. — A  great  fault 
— and  one  which  is  only  too  common  in  the  works  of  experi- 
mental pharmacologists — is  that  of  drawing  general  conclusions 
from  limited  data. 

One  experimenter  tries  the  effect  of  a  drug,  let  us  say  tartar 
emetic,  upon  rabbits.  He  finds  that  they  do  not  vomit,  and  in- 
stead of  drawing  the  only  warrantable  conclusion,  viz.  that  tartar 

1  Lauder  Brunton, '  Action  of  Nitrite  of  Amyl  on  the  Circulation,'  Journal  of 
Anatomy  and  Physiology,  vol.  v.  p.  95. 


56  PHAEMACOLOGY  AND   THEEAPEUTICS.      [sect.  i. 

emetic  does  not  cause  vomiting  in  rabbits,  he  draws  the  general 
one — that  tartar  emetic  does  not  cause  vomiting  in  animals. 
Another  tries  it  upon  dogs,  and  he  finds  they  all  vomit.  Instead 
of  the  limited  conclusion  that  tartar  emetic  makes  dogs  vomit, 
he  draws  the  general  conclusion  that  it  makes  animals  in  general 
vomit.  The  two  observers  are  equally  positive  in  regard  to  their 
facts — each  is  assured  that  he  himself  is  right,  and  that  the  other 
is  totally  wrong.  The  reason  of  the  discrepancy  is  simply  that 
the  conditions  under  which  the  experiments  have  been  performed 
were  different,  but  the  observers  have  not  taken  these  differences 
into  account  when  drawing  their  conclusions.  A  third  observer 
then  comes,  perhaps,  and  by  further  experiments  reconciles  the 
apparently  contradictory  statements.  Thus  one  experimenter 
tries  the  effect  of  caffeine  upon  frogs  ;  he  finds  that  it  produces 
rigor  mortis  in  the  muscles.  Another  tries  the  same  drug,  and 
finds  no  such  result.  These  two  observations  are  completely 
contradictory,  until  a  third  tries  the  effect  of  the  drug  upon  two 
species  of  frog,  and  finds  that  while  the  muscles  of  the  rana 
esculenta  are  but  slightly  affected,  those  of  the  rana  temporaria 
are  rendered  rigid.1 

These  apparent  contradictions  in  the  results  of  different  ob- 
servers are  exceedingly  puzzling  to  the  student,  but  nothing  is 
more  instructive  to  those  who  are  actually  working  at  the  subject. 

The  utility  of  apparent  exceptions  was  fully  recognised  by 
Claude  Bernard,  who  says :  '  In  physiological  studies  we  must 
always  carefully  note  any  fact  which  does  not  accord  with  re- 
ceived ideas.  It  is  always  from  the  examination  and  the  dis- 
cussion of  this  exceptional  fact  that  a  discovery  will  be  made,  if 
there  is  one  to  make.' 2 

1  Schmiedeberg,  Arch.  f.  exper.  Path.  u.  Pharmalc,  Bd.  ii.  p.  C2. 
*  Bernard,  Ligwides  de  Vorgawisme,  torn.  i.  p.  258. 


57 


CHAPTEE  m. 

ACTION  OF  DEUGS  ON  PEOTOPLASM,  BLOOD,  AND  LOW 

OBGANISMS. 

Action  of  Drugs  on  Albumin. 

In  all  living  bodies  we  find  that  the  protoplasm  is  of  a  more  or 
less  albuminous  nature. 

Albuminous  substances  possess  a  very  complex  inter-mole- 
cular grouping,  and  very  high  atomic  weights.  Many  different 
forms  are  found  in  animals,  and  along  with  albumins  we  must 
associate  bodies  like  mucin,  which  probably  have  a  very  im- 
portant relation  to  it,  inasmuch  as  a  body  nearly,  if  not  quite, 
identical  with  mucin  forms  the  nucleus  of  the  red  blood-cor- 
puscles in  fowls,1  and  a  substance  of  an  allied  nature  also  occurs 
in  the  circulating  fluid  which  represents  the  blood  in  the  echino- 
dermata.2  The  albumin  of  serum  may  be  taken  as  a  representa- 
tive of  such  substances ;  it  is  soluble  in  water,  but,  at  a  certain 
temperature,  is  coagulated  and  precipitated.  It  is  coagulated 
also  by  alcohol,  but  if  the  coagulum  is  quickly  placed  in  water  it 
redissolves ;  if  allowed  to  remain  for  some  time  exposed  to  the 
action  of  the  alcohol  it  becomes  permanent  and  insoluble.  An 
insoluble  precipitate  also  falls  on  the  addition  of  tannic  acid, 
both  lead  acetates,  and  mercuric  chloride.  The  reagents  just 
mentioned  precipitate  all  the  albumins,  even  from  somewhat 
dilute  solutions ;  in  strong  solutions  precipitates  are  also  formed 
by  silver  nitrate,  copper  sulphate,  and  zinc  chloride. 

When  these  are  added  to  albumin  containing  only  a  small 
quantity  of  water,  as,  for  example,"  the  white  of  an  egg,  they 
form  with  it  a  solid  mass  of  albuminate.  A  small  quantity  of 
strong  potash  added  to  the  white  of  egg  produces  a  solid  trans- 
parent jelly  of  albuminate  of  potash,  and  a  similar  but  opaque 
jelly  is  formed  by  the  use  of  caustic  lime  or  baryta  in  the  place 
of  potash  :  these  albuminates  are,  however,  soluble  in  water. 

Albumin  dissolves  in  alkalies,  and  may  be  partly  precipitated 
by  neutralising.  The  alkaline  solution  is  not  coagulated  by  heat, 
and,  in  fact,  the  substance  present  in  the  solution  is  no  longer 
serum  albumin,  but  a  compound  of  the  albumin  with  the  alkali, 
or  alkali-albuminate. 

1  Lauder  Brunton  after  Kuhne,  Journ.  of  Anat.  and  Physiol.  Nov*  1869. 
*  Sehafer,  Proc.  Boy.  Soc,  vol.  xxxiv.,  p.  370. 


58  PHAKMACOLOGY  AND  THEEAPEUTICS.      [sect.  i. 

Albumin  is  precipitated  by  a  small  quantity  and  dissolved 
by  excess  of  most  mineral  acids,  forming  witb  tbem  acid-albu- 
minates ;  thus  a  watery  solution  of  albumin  is  precipitated  by 
concentrated  nitric,  sulphuric,  or  hydrochloric  acid.  It  is  also 
precipitated  by  acetic  acid  along  -with  a  considerable  quantity  of 
a  neutral  salt  of  an  alkali  or  alkaline  earth,  or  of  gum  arabic  or 
dextrin.  This  precipitation  is  perhaps  best  marked  with  nitric 
acid,  but  it  only  occurs  with  moderate  quantities  of  nitric  acid. 
When  a  minute  quantity  only  of  the  acid  is  added,  no  precipita- 
tion takes  place,  and  the  solution  remains  clear ;  but  a  nitric- 
acid-albuminate  containing  a  small  quantity  of  acid  is  formed, 
and  if  the  solution  is  now  boiled  no  coagulum  will  form.  On  the 
addition  of  more  acid,  however,  a  second  nitric-acid-albuminate, 
insoluble  in  water,  is  produced,  and  a  precipitate  falls.  On  the 
addition  of  more  acid  still,  the  precipitate  is  redissolved,  and  a 
third  nitric-acid-albuminate  is  formed,  soluble  in  water,  and  not 
precipitated  on  boiling. 

The  temperature  at  which  albumin  coagulates  is  altered  by 
acids  and  alkalies.  Alkalies  generally  tend  to  raise  the  tempera- 
ture of  coagulation,  and  when  added  in  large  quantities  prevent 
it  altogether. 

Very  dilute  acetic  and  phosphoric  acid,  on  the  other  hand, 
tend  to  lower  the  coagulating  point,  although  large  quantities 
may  interfere  with  coagulation. 

Neutral  salts,  such  as  sodium  chloride  or  sulphate,  also  lower 
the  coagulating  point. 

The  organic  alkaloids  which  have  such  a  powerful  action  on 
the  animal  body  appear  to  resemble  acids  rather  than  alkalies 
in  their  effect  upon  albumin,  because,  according  to  Eossbach, 
they  lower  considerably  instead  of  raising  the  point  of  coagula- 
tion. 

Albumin  undergoes  an  extraordinary  change  in  consequence 
of  the  action  of  ozone,  and  becomes,  after  exposure  to  it,  un- 
coagulable  by  boiling,  and  by  acids,  excepting  in  large  quantities, 
and  by  metallic  salts,  with  the  exception  of  basic  acetate  of  lead, 
and  of  alcohol. 

The  action  of  alkaloids  upon  this  ozonised  albumin  is  even 
more  remarkable  than  upon  ordinary  albumin,  for  when  mixed 
with  it  in  Bmall  quantity,  they  restore  its  coagulability  to  the 
albumin,  and  cause  it  to  coagulate  far  under  the  boiling-point. 
When  added  to  the  albumin  before  exposure  to  a  stream  of  ozone, 
they  prevent  the  albumin  being  altered  by  it,  in  the  way  which 
it  would  otherwise  be,  and  it  remains  coagulable  by  heat,  in  the 
same  way  as  if  it  had  not  been  exposed  to  the  action  of  ozone  at 
all.  It  is  therefore  evident  that  the  alkaloids  not  only  increase 
the  coagulability  of  ordinary  albumin  at  a  high  temperature,  but 
that  they  act  upon  it  at  ordinary  temperatures  (S0°-40°  C.)  and 
destroy  its  affinity  for  ozone.   This  action  will  naturally  interfere 


ohap.  in.]    ACTION  OF  DEUGS  ON  PEOTOPLASM,  ETC.      59 

with  the  processes  of  oxidation  in  protoplasm ;  but  the  methods 
of  examining  this  action  will  be  described  later  on  (p.  69). 

When  a  solution  of  pure  albumin  is  added  to  a  mixture  of 
guaiac  and  vegetable  protoplasm,  it  greatly  lessens  the  blue 
colour,  which  would  otherwise  be  produced.  The  cause  of  this 
appears  to  be  that  albumins  or  albuminous  substances  have 
such  an  affinity  for  ozone  that  they  take  it  up  instead  of  allowing 
it  to  act  on  the  guaiac.  This  affinity  for  ozone  is  diminished  by 
the  action  of  alkaloids. 

This  is  shown  by  taking  several  tubes  containing  an  albuminous  solution 
of  a  certain  strength.  .Reserving  one  as  a  standard,  the  alkaloids  are  added 
to  the  others,  and  after  a  certain  time  has  elapsed,  so  as  to  allow  the  alkaloid 
to  affect  the  albumin,  a  small  quantity  of  lettuce  water  is  mixed  with  each, 
and  then  a  little  guaiac.  In  the  standard  one  the  colour  will  he  least,  because 
the  albumin  not  having  been  acted  upon  by  the  alkaloids  will  interfere  with 
the  reaction  of  the  lettuce  water  and  the  guaiac  upon  each  other.  In  the 
others  a  blue  colour  will  appear  with  greater  or  less  intensity,  according  as 
the  albumin  has  been  more  or  less  affected  by  the  alkaloid.  This  experi- 
ment, however,  is  not  free  from  fallacy,  because  there  is  to  be  considered  not 
merely  the  action  of  the  alkaloid  upon  the  albumin,  but  its  action  on  the 
protoplasm  as  well,  and  it  is  therefore  advisable  to  use  it  in  a  quantity  which 
is  small  as  compared  with  the  amount  of  albumin  employed.1 

Action  of  Drugs  on  Protoplasmic  Movements. 

The  amoeba  consists  of  a  small  mass  of  structureless  proto- 
plasm, without  any  distinct  cell-wall. 

It  contains  numerous  granules  and  nucleus,  with  nucleolus, 
as  well  as  one  or  more  vacuoles,  which  appear  to  be  small  spaces 
filled  with  fluid. 

Some  amcebse  live  in  salt  water,  others  in  fresh  water  ;  and, 
although  it  may  be  impossible  with  the  microscope  to  detect  any 
marked  difference  between  them,  they  exhibit  a  great  difference 
in  their  reactions  to  drugs — the  salt-water  amcebse  being  only 
slightly  affected  by  them,  while  fresh-water  amcebse  are  readily 
susceptible  to  their  action. 

The  amceba  is  nourished  by  simply  adhering  to  any  particle 
of  food,  closing  over  it  and  digesting  it,  and  afterwards  opening 
and  ejecting  the  residue. 

This  protoplasmic  mass  is  almost  constantly  altering  in 
shape,  pushing  out  projections  at  one  point,  and  drawing  them 
in  at  another.  By  this  means,  also,  it  moves  about  from  place 
to  place, 

Method    of    Experimentation    on    Amoebae    and    leucocytes. — In 

experimenting  on  amcebse,  take  a  drop  of  slimy  sediment,  such  as  is 
found  in  the  tanks  of  hothouses,  and  place  it  on  the  covering-glass  of  a 
microscope  ;  this  may  then  either  be  put  on  an  object-glass,  and  the  excess 
of  water  removed  by  filter -paper,  or,  still  better,  it  may  be  inverted  over  the 
opening  of  a  Strieker's  warm  stage. 

1  Bossbach,  Yerhandl.  d.  phys.  med,  Oes.  zu  Wilrzburg,  N.P.,  Band  iii.  p.  346. 


60  PHABMACOLOGY  AND  THERAPEUTICS,     [sect.  i. 

"When  it  is  simply  laid  on  the  object-glass,  a  solution  of  the  drug  is  added 
by  putting  a  drop  across  the  edge  of  the  covering-glasB,  and  allowing  it  to  be 
drawn  gradually  underneath  by  capillary  attraction. 

Gases  are  best  applied  by  means  of  a  Strieker's  stage,  which  is  also  con- 
venient for  experiments  on  solutions. 

In  experimenting  on  leucocytes  with  the  aid  of  this  stage,  a  covering-glass 
is  applied  to  the  cut  surface  of  a  newt's  tail,  or  to  the  surface  of  a  drop  of 
blood,  so'  that  a  very  minute  quantity  of  blood  adheres  to  it. 

The  drug  to  be  tested  is  kept  dissolved  in  a  -65--75  per  cent,  solution  of 
common  salt  (Na  CI).  The  salt  solution  of  this  strength  is  often  called 
simply  normal  salt  solution,  and  is  used  instead  of  water,  because  water  itself 
has  a  very  destructive  action  on  those  forms  of  protoplasm,  which  are  usually 
nourished  by  saline  solutions,  like  blood  or  serum. 

A  drop  of  the  salt  solution  containing  the  drug  is  placed  over  the  blood  on 
the  covering-glass,  and  inverted  over  the  warm  stage  as  already  described. 
If  the  experiment  is  to  continue  long,  a  rim  of  oil  should  be  drawn  around 
the  edge  of  the  covering-glass  with  a  camel-hair  pencil,  so  as  to  prevent 
evaporation. 

The  advantage  of  using  such  a  small  quantity  of  blood  is,  first,  that  it 
mixes  rapidly  and  perfectly  with  the  solution  ;  and  secondly,  that  it  does  not 
dilute  the  solution  of  the  drug,  and  we  thus  know  the  strength  of  the  drug  used. 

If  we  used  a  large  drop  of  blood,  we  should  have  to  employ  a  solution  of 
the  drug  twice  the  strength  we  desire,  so  that  when  a  drop  of  equal  size 
was  added  to  the  blood,  the  mixture  would  contain  the  proper  proportion. 

Amoebae. — The  effect  of  heat  and  cold  upon  the  movements 
is  very  marked,  cold  rendering  them  slow,  or  arresting  them 
altogether.  Heat  at  first  greatly  quickens  their  movements,  but 
when  raised  to  35°  C.  it  causes  them  to  fall  into  a  state  of  tetanic 
contraction  and  assume  a  spherical  form. 

This  state  is  one  of  heat-tetanus,  and  if  the  temperature  be 
now  reduced,  the  movements  will  again  reappear. 

At  a  temperature  of  40°  C.  they  also  become  spherical  and 
motionless.  But  their  movements  do  not  return  when  the  tem- 
perature is  reduced ;  they  are  in  a  state  of  heat-rigor,  the  high 
temperature  having  coagulated  the  protoplasm. 

Slight  electrical  shocks  from  a  coil  increase  the  rapidity  of 
the  protoplasmic  movements ;  stronger  ones  cause  tetanic  con- 
traction ;  and  numerous  or  powerful  ones  produce  coagulation. 

Common  salt  in  very  small  quantity  (a  drop  of  1  per  cent, 
solution  slowly  added)  first  quickens  the  protoplasmic  movements 
and  then  causes  sudden  tetanic  contraction,  and  the  expulsion  of 
any  food  they  may  contain  at  the  moment,  and  sometimes  even 
expulsion  of  the  nucleus. 

When  water  is  added  so  as  again  to  dilute  the  mixture  the 
amoebae  resume  their  movements. 

Both  acids  and  alkalies,  when  very  dilute,  increase  the  proto- 
plasmic movements  and  afterwards  arrest  them. 

Hydrochloric  acid  has  a  more  powerful  action  than  a  solution 
of  potash  of  a  similar  strength.  It  causes  the  amoeba  to  contract 
and  form  a  ball  with  a  sharp  double  contour.  In  it,  twitching 
movements  first  occur,  which  expel  any  food  present.  It  then 
becomes  pale  and  lumpy,  and  breaks  up. 


chap,  in.]    ACTION  OF  DEUGS  ON  PEOTOPLASM,  ETC.      61 

Potash  causes  them  to  swell  up  and  assume  the  form  of  large 
pale  vesicles,  which  quickly  burst. 

A  constant  current  of  electricity  causes  contraction  and 
imperfect  tetanus ;  and,  if  powerful  and  long  kept  up,  the  posi- 
tive pole  produces  in  the  amoebae  near  it  the  same  changes  as 
dilute  hydrochloric  acid,  and  the  negative  pole  the  same  changes 
as  are  produced  by  an  alkali  such  as  potash. 

Oxygen  appears  to  be  necessary  for  their  life ;  its  removal 
by  means  of  hydrogen  deprives  the  amoebae  of  their  power  of 
motion,  and  finally  causes  contraction  and  coagulation. 

Carbonic  acid  alone  has  a  similar  action  to  removal  of  oxy- 
gen and  produces  this  effect  both  in  the  presence  and  absence 
of  oxygen,  but  takes  a  longer  time  to  do  so  when  oxygen  is 
present.1 

Leucocytes. — In  their  appearance  and  movements  leucocytes 
strongly  resemble  amoebae :  they  are  affected  in  a  similar  manner 
by  heat,  electricity,  and  drugs.  Their  resistance  to  the  action 
of  drugs  varies  somewhat  in  different  animals.  Those  obtained 
from  the  blood  of  the  newt,  for  example,  are  more  resistant  than 
those  of  the  guinea-pig,  and  those  of  the  female  newt  more  re- 
sistant than  those  of  the  male,  to  the  action  of  quinine.2  Heat 
and  cold  affect  the  movements  of  leucocytes  in  very  much  the 
same  way  as  those  of  amoebae. 

The  movements  of  leucocytes,  like  those  of  amoebae,  are  of 
two  kinds,  viz.  movements  of  the  protoplasmic  pseudopods, 
while  the  leucocyte  remains  in  situ.  The  pseudopods  in  this 
instance  are  generally  of  a  waxy  look  and  knoblike  form. 

Secondly,  movements  of  migration  from  place  to  place ;  these 
movements  are  accompanied,  or  accomplished,  through  the 
projection  of  numerous  fine  filaments. 

Effect  of  Drugs.—  Cinchona  alkaloids — quinine,  quinidine, 
cinchonine,  and  cinchonidine  have  a  remarkable  power  of  arrest- 
ing these  movements  in  the  proportion  of  1  in  1,500.  They 
quickly  stop  the  migratory  movements  of  leucocytes  from  the 
newt,  and  in  a  much  larger  proportion  will  arrest  the  movements 
of  the  knoblike  pseudopods. 

No  very  marked  difference  is  observed  in  the  strength  of  the 
cinchona  alkaloids,  though  quinine  seems  to  be  somewhat  the 
most  powerful. 

Sulphate  of  bebeerine  is  almost  as  powerful  as  the  cinchona 
alkaloids. 

Strychnine  is  very  much  less  powerful  than  any  of  the  alka- 
loids mentioned. 

Potassium  picrate  and  aesculin  have  but  little  action,3 


1  Kuhne,  Protoplasma  wnd  Contractilitat,  pp.  28-53. 

2  Geltowsky,  Practitioner,  vol.  viii.  pp.  325-330. 
*  Buchanan  Baxter,  Practitioner,  vol.  xi.  n.  321. 


62  PHAEMACOLOGY  AND  THEEAPEUTICS.     [sect.  i. 

Movements  of  Leucocytes  in  the  Blood-vessels. — In  the 

processes  of  inflammation  leucocytes  pass  in  great  numbers 
through  the  walls  of  the  capillaries. 

The  effect  of  quinine  in  arresting  their  movements,  when 
mixed  with  them  directly,  naturally  leads  one  to  expect  that  it 
may  arrest  their  migration  from  the  capillaries,  when  injected 
into  the  blood,  and  this  anticipation  has  been  realised  in  the 
experiments  of  Professor  Binz. 

To  observe  this  phenomenon  the  brain  of  a  frog  is  to  be  destroyed,  and 
a  little  curare  injected  under  the  skin,  in  order  to  abolish  any  spinal  reflex 
movements.  It  is  then  laid  on  »  piece  of  cork,  such  as  that  shown  in 
Fig.  8,  with  a  hole  at  one  side,  over  which  a  piece  of  glass  is  fastened  about 


Fig.  8. — Apparatus  for  examining  the  mesentery  of  the  frog  under  the  microscope. 

half  an  inch  higher,  by  means  of  two  other  pieces  of  cork  and  some  sealing- 
wax.  On  this  a  piece  of  sheet  cork  of  the  form  shown  in  the  figure,  and  a 
round  piece  of  glass  are  cemented  so  as  to  form  a  channel,  in  which  the 
intestine  lies.  The  body  of  the  frog  is' fixed  to  the  cork,  the  abdomen 
opened,  the  intestines  drawn  out,  and  the  mesentery  •  fastened  with  very 
fine  pins  over  the  aperture.  In  half  an  hour,  or  two  hours,  the  leucocytes 
pass  rapidly  through  the  walls  of  the  capillaries,  and  afterwards  wander 
through  the  tissues. 

The  drug  may  then  be  injected  into  the  lymph-sac,  or  locally  applied  to 
the  mesentery. 

When  quinine  is  applied  locally  to  the  mesentery  in  this 
condition  it  arrests  the  movements  of  the  leucocytes,  which  have 


Fig.  9.— Diagram  to  illustrate  the  action  of  quinine  on  leucocytes,  modified  from  Binz  (Das  Wesen 
del-  Chininmrkung.  Berlin,  1868).  The  thick  lines  represent  the  walls  of  the  blood-vessel,  and 
numerous  leucocytes  are  shown  both  inside  it  and  outside  distributed  through  the  adjoining 
tissues,  a  represents  the  vessel  before,  aud  6  after,  the  local  application  of  quinine.  The  leuco- 
cytes outside  the  vessel  have  their  movements  arrested,  and  cannot  wander  on  through  the 
tissues,  while  those  inside  are  not  affected  and  continue  to  emigrate,  c  represents  the  effect  of 
quinine  injected  into  the  circulation  or  lymph-sac.  The  leucocytes  inside  the  vessel  are  here 
affected  first,  and  their  emigration  stopped,  while  those  outside  still  continue  to  travel  onwards. 

already  emerged,  but  does  not  prevent  those  which  are  still 
within  the  vessels  from  going  out ;  they  therefore  form  a  dense 
accumulation  around  the  vessel  (Fig.  9,  b).    When  injected  into 


chap,  in.]    ACTION  OF  DEUGS  ON  PEOTOPLASM,  ETC.      63 

the  circulation,  on  the  contrary,  the  leucocytes  which  are  in  the 
vessels  are  prevented  from  passing  from  the  capillaries,  while 
those  which  have  already  passed  out  continue  to  wander  on- 
wards, and  thus  a  dear  space  is  left  outside  the  vessel  (Fig.  9,  c). 

The  quantity  of  quinine  necessary  to  produce  this  effect  is 
a5Soi)^  *°  io'oo^  °f  the  animal's  weight. 

If  quinine  were  given  to  stop  the  exit  of  leucocytes  from  the 
vessels  in  peritonitis,  three  or  four  grammes  would  be  required 
to  be  given  within  a  short  time,  to  a  man  weighing  150  lbs. 

In  guinea-pigs  a  dose  of  quinine  sufficient  to  kill  the  animal 
does  not  stop  the  movements  of  the  leucocytes  in  its  blood, 
which  are  seen  to  go  on,  when  a  drop  of  it  is  examined  after 
death. 

Red  Blood  Corpuscles. — The  size  of  the  red  corpuscles  is 
diminished  by  carbonic  acid,  by  morphine,  or  by  warmth,  either 
applied  locally  on  the  hot  stage  of  a  microscope,  or  acting  on 
them  in  the  vessels  of  an  animal  suffering  from  fever. 

It  is  increased  by  oxygen,  hydrocyanic  acid,  quinine,  or  cold ; 
and  an  increase  occurs  also  in  eases  of  anaemia.1 

The  red  corpuscles  pass  out  of  the  capillaries  like  the  white, 
but  they  do  so  very  slowly  indeed,  and  in  small  numbers,  under 
ordinary  circumstances.  Excess  of  sodium  chloride  in  the  blood 
causes  them  to  pass  out  much  more  quickly  ; 2  and  rattle-snake 
poison,  when  locally  applied,  produces  such  sudden  extravasation 
that  it  is  impossible  to  follow  the  process :  the  whole  field  of  the 
microscope  becoming  suddenly  covered  with  blood.3 

Action  of  Drugs  on  Infusoria. 

Among  the  infusoria,  like  the  amcebse,  each  individual  consists  of  a  single 
mass  of  protoplasm,  and  not  of  a  number  of  distinct  cells ;  but  the  proto- 
plasm is  differentiated.  Kound  the  greater  part  of  the  animal  it  seems  to 
be  somewhat  harder,  so  as  to  form  a  sort  of  skin,  excepting  at  one  place 
which  is  softer  than  the  rest,  serving  for  the  ingress  of  food  and  the  egress 
of  egesta. 

Instead  of  throwing  out  pseudopods,  the  body  is  either  covered  entirely 
with  cilia  or  they  are  arranged  round  the  mouth.  Once  it  has  entered  by 
the  mouth,  the  food  finds  its  way  all  through  the  protoplasm  of  the  body. 

A  contractile  vesicle  exists,  which  pulsates  rhythmically. 

Mode  of  Experimentation.  —  For  the  purpose  of  examining  the 
action  of  drugs  upon  infusoria  an  infusion  of  hay  ia  prepared  some  days 
previously.  Two  small  pipettes  are  then  made,  which  will  deliver  drops 
of  equal  size. 

This  is  done  by  heating  a  piece  of  glass  tubing  in  the  middle,  drawing 
it  out,  and  cutting  it  across  by  a  scratch  with  a  triangular  file  (Fig.  10). 
With  one  of  these  a  drop  of  hay-infusion  is  placed  on  the  covering-glass, 
which  is  inverted  on  a  Strieker's  stage  and  examined.    In  order  to  ascertain 

1  Manassein,  Ueber  die  Dimensioned,  der  Blutlcorperchen  writer  verschiedenen 
Einflussen.    Tubingen,  1872. 

2  Prussak,  Wiener  Akad.  SiUungsber.l\i.,  1876  (Abth.  2),  p.  13. 
'  Brunton  and  Fayrer,  Proc.  Roy.  Soc,  February  1875,  p.  271. 


64  PHAKMACOLOGY  AND   THEKAPEUTICS.      [sect.  I. 

the  lethal  strength  of  a  drug,  a  drop  of  a  solution  of  the  poison  of  a  definite 
strength  is  then  mixed  with  it,  and  the  infusoria  are  examined  again  after  a 


certain  time. 


Fig.  10. — Diagram  to  show  the  way  o£  making  small  pipettes. 

If  they  continue  moving,  another  experiment  is  made  with  a  stronger 
solution  ;  but  if  they  have  completely  stopped,  it  is  repeated  with  a  weaker 
one  until  the  solution  is  of  such  »  strength  that  the  movements  become 
very  slight  and  cease  almost  immediately  after  mixing,  and  cannot  be 
restored  by  the  addition  of  water.  As  the  two  drops  of  fluid  were  of 
equal  size,  the  lethal  strength  of  the  solution  is  just  one  half  of  that  which 
was  last  added.  By  repeating  the  experiments  in  exactly  the  same  way 
with  different  drugs,  their  relative  poisonous  properties  are  ascertained. 

Heat  increases  the  rapidity  both  of  the  rhythmical  contrac- 
tions of  the  vesicle  and  of  the  ciliary  motion  and  consequently  of 
the  movements  from  place  to  place  of  the  infusoria.  It  seems  as 
if  the  cilia  were  not  equally  affected  by  heat,  those  which  pro- 
duce a  longitudinal  movement  appearing  to  be  acted  upon  more 
quickly  than  those  which  cause  a  movement  of  rotation.  Both 
kinds  are  first  stimulated  and  then  paralysed. 

At  temperatures  between  25°  and  30°  G.  the  contractions  of 
the  vesicle  are  greatly  quickened,  and  the  animal  moves  with 
great  rapidity  in  the  longitudinal  direction. 

Between  30°  and  35°  its  movements  are  still  very  rapid,  but  it  seems  to 
have  lost  the  power  of  direction ;  all  the  cilia  seem  in  full  action,  and  the 
movements  of  the  individual  are  determined  simply  by  their  anatomical 
arrangement. 

Above  40°  the  cilia,  which  act  longitudinally,  appear  to  have  stopped  and 
the  animal  rotates,  at  first  very  rapidly,  then  slower  and  slower  until  all 
movements  cease,  and  the  protoplasm  appears  to  become  fluid ;  but  when 
the  heat  is  still  further  raised  it  coagulates.1 

Cold  lessens  the  quickness  of  the  rhythmical  contractions  of 
the  vesicle,  of  the  ciliary  motion  and  of  the  movements  from 
place  to  place.  Weak  electrical  currents  first  quicken  the  ciliary 
motion  and  cause  movements  of  rotation,  then  swelling  of  the 
protoplasm,  slower  movements,  and  finally  apparent  solution  of 
the  protoplasm. 

Moderate  currents  produce  a  tetanic  contraction  of  the  proto- 
plasm and  of  the  cilia,  while  the  contractile  vesicle  is  unaffected. 

Strong  currents  cause  liquefaction  of  the  protoplasm. 

Saline  solutions  appear  rather,  if  we  may  say  so,  to  alter 
the  conditions  under  which  the  infusoria  live  than  to  affect  the 
protoplasm  itself.      Strong  solutions  cause  them  to  shrivel  and 


1  Eossbach, '  Die  rhythmischen  Bewegungserscheinungen  der  einf achsten  Organ- 
ismen,'Verh.  d.Wursburgerphysik.  med.  Gesellsch.  A.N.P.,  Bd.  ii.,  Separat-Abdruck 
S.  23.  This  work  contains  a  number  of  exceedingly  interesting  and  valuable 
observations  on  the  subject. 


chap,  m.]    ACTION  OF  DEUGS  ON  PEOTOPLASM,  ETC.      65 

then  to  swell  up  and  become  motionless.  This  effect  appears  to 
be  due  to  the  solution  altering  the  quantity  of  water  which  the 
protoplasm  contains. 

Weaker  saline  solutions,  on  the  contrary,  quicken  their  move- 
ments, and,  instead  of  causing  them  to  shrivel,  make  them  swell 
up  at  once.  Chloride  of  sodium,  chloride,  bromide,  and  chlorate 
of  potassium,  as  well  as  alum,  all  have  this  effect. 

Acids  in  minute  quantities  cause  contraction  both  of  the 
body  and  of  the  vesicle.  The  ciliary  motion  is  at  first  quickened 
and  then  retarded ;  the  rate  of  contraction  of  the  vesicle  is  at 
once  diminished. 

Moderate  quantities  cause  coagulation  of  the  protoplasm  with 
swelling  and  liquefaction  after  death. 

Strong  acids  at  once  destroy  the  protoplasm. 

Alkalies  in  minute  quantities  cause  swelling  of  the  proto- 
plasm, dilatation  and  slowness  of  the  contractile  vesicle. 

Moderate  quantities  at  once  arrest  the  movements,  cause 
liquefaction  of  the  protoplasm,  and  destroy  its  differentiation, 
the  contractile  vesicles  and  vacuoles  disappearing.  They  then 
cause  swelling,  and  finally  solution. 

In  large  quantities  they  produce  immediate  liquefaction  of  the 
whole  body. 

Other  drugs  appear  to  affect  the  protoplasm  itself,  a*id 
arrest  its  movements  without  producing  any  apparent  change 
in  it. 

The  most  active  are  chlorine,  bromine,  corrosive  sublimate, 
iodine,  permanganate  of  potassium,  and  creasote. 

Quinine  is  much  less  powerful  than  these,  though  it  is  much 
more  so  than  most  other  organic  alkaloids.  Strychnine  has  only 
one-fourth  the  power  of  quinine. 

Cobra  poison  at  first  greatly  quickens  the  movements  of 
infusoria  and  then  arrests  them,  causing  just  before  death  a  con- 
traction of  the  protoplasm,  which  then  expands  to  its  ordinary 
size. 

Relations  of  Motion  and  Oxidation. 

All  animals,  from  the  lowest  to  the  highest,  evidence  their 
life  by  motion  at  one  time  or  another  ;  and  the  energy  required 
for  this  motion  is  maintained  by  processes  of  combustion. 

The  materials  for  this  combustion,  viz.  oxygen,  and  fuel  of 
some  sort,  or  food,  are  derived  from  the  external  medium  in 
which  the  animal  lives ;  and  in  order  to  enable  these  substances 
to  be  available  for  each  part  of  the  animal  body,  we  must  have 
some  kind  of  respiration  and  circulation  going  on  in  it. 

In  unicellular  organisms,  consisting  of  a  single  mass  of  proto- 
plasm, the  oxygen  is  derived  from  the  water  in  which  they  swim, 
and  both  it  and  the  nutritive  material  derived  from  the  digestion 


•66  PHAEMACOLOGY  AND  THEEAPEUTICS.     [sect.  i. 

of  enclosed  masses  are  circulated  through  the  protoplasm  by 
contractile  vacuoles. 

In  sponges,  where  the  organism  no  longer  consists  of  one  but 
of  several  cells  united  into  a  community,  some  of  these  are  fur- 
nished with  cilia,  in  order  to  send  a  current  containing  oxygen 
and  food  to  the  other  cells  having  a  less  favoured  position. 

In  higher  animals,  where  many  cells  are  built  up  to  form  one 
organism,  we  find  a  circulatory  and  respiratory  apparatus  fully 
developed. 

The  medium  in  which  unicellular  organisms  live  is  the  water 
in  which  they  swim.  The  medium  in  which  the  cells  composing 
the  main  parts  of  the  bodies  of  higher  animals,  such  as  man, 
live,  is  not  the  air  which  surrounds  the  body,  but  the  intercellular 
fluid  in  which  the  cells  themselves  are  bathed. 

As  Claude  Bernard  points  out  with  his  usual  clearness,  the 
cells  of  the  human  body  and  the  lowest  unicellular  organisms 
alike  live  in  a  liquid  medium.  From  the  layer  of  fluid  surround- 
ing it,  the  cell  takes  up  the  oxygen  and  food  which  this  layer  can 
yield.  The  supply  being  exhausted,  a  unicellular  organism  can 
move  on  elsewhere,  but  the  cells  in  higher  animals,  being  fixed 
and  unable  to  move,  require  fresh  portions  of  oxygen  and  of 
aiutritive  fluid  to  be  brought  to  them. 

•  This  is  effected  by  the  slow  circulation  of  the  lymph  in  which 
the  cells  themselves  are  bathed  and  by  the  supply  to  the  lymph 
<of  oxygen  and  nutritive  material  from  the  blood. 

The  circulation  of  the  lymph  is  aided  in  many  lower  or- 
ganisms by  the  motion  of  cilia,  and  this  is  found  persisting  in 
:some  parts  of  the  higher  animals,  e.g.  the  central  canal  of  the 
spinal  cord. 

Between  the  blood  and  the  lymph  an  interchange  goes  on, 
oxygen  passing  from  the  blood  to  the  lymph  or  intercellular  fluid, 
and  carbonic  acid  from  the  lymph  to  the  blood. 

This  interchange  of  gases  between  the  blood,  the  intercellular 
fluid,  and  the  cells  is  termed  internal  respiration. 

In  order  to  maintain  this,  a  constant  current  of  blood  must 
take  place ;  and  when  its  circulation  is  locally  arrested  it  becomes 
deprived  of  oxygen  and  loaded  with  carbonic  acid,  so  that  the 
•cells  in  the  district  in  which  the  stagnation  occurs  suffer  from 
local  asphyxia,  while  the  other  parts  of  the  body  may  be  perfectly 
healthy. 

When  the  general  circulation  is  arrested  by  stoppage  of  the 
heart,  by  obstruction  of  the  pulmonary  arteries,  or  by  the  rup- 
ture of  an  aneurism  draining  the  blood  away,  the  whole  body 
suffers  in  a  similar  manner  from  general  asphyxia  by  the  cessa- 
tion of  internal  respiration. 

If  oxygen  were  simply  dissolved  in  the  blood,  the  quantity 
which  would  be  conveyed  to  the  tissues  would  be  too  small  for 
their  wants,  and  we  therefore  have  as  an  oxygen-carrier  a  sub- 


chap,  in.]    ACTION  OP  DRUGS  ON  PROTOPLASM,  ETC.      67 

stance  capable  of  taking  up  a  large  quantity  of  oxygen,  of  readily 
forming  a  loose  compound  with  it>  and  of  again  giving  it  off 
readily  to  oxidisable  substances. 

In  man  and  mammals  and  many  of  the  lower  animals  this 
substance  is  haemoglobin  containing  iron.  In  some  annelids  it  is 
a  green  substance,  chlorocruorin ;  and  in  the  octopus  and  some 
crustaceans  it  is  a  blue  body,  hsemocyanin,  containing  copper.1 

In  order  to  remove  carbonic  acid  taken  up  from  the  tissues 
and  obtain  a  fresh  supply  of  oxygen,  an  interchange  takes  place 
between  the  blood  and  the  external  air  in  the  lungs;  this  is 
external  respiration.  Without  any  direct  influence  being  ex- 
erted upon  the  cells  of  the  animal  body  themselves,  they  may  be 
affected  and  their  nutrition  greatly  modified  by : 

1st.  Alterations  in  the  circulation  of  the  intercellular  fluid  or 
lymph  in  which  they  are  bathed. 

2nd.  In  the  greater  or  less  rapidity  of  circulation  of  blood 
locally. 

3rd.  In  the  circulation  generally,  from  changes  in  the  heart 
and  blood-vessels  generally. 

4th.  Changes  in  the  oxygen-carrying  power  of  the  blood, 
either  from  alterations  in  its  power  to  take  up  or  give  off  oxygen. 

5th.  Changes  in  the  external  respiration. 

All  these  conditions  may  be  altered  by  drugs,  or  at  least  by 
therapeutic  measures.  Thus  the  circulation  of  lymph  in  a  part 
may  be  increased  by  shampooing,  and  its  accumulation  in  a 
case  of  dropsy  may  be  removed  by  incision,  by  puncture,  or  by 
drainage. 

The  circulation  of  blood  may  be  arrested  locally  and  gangrene 
induced  by  the  continuous  use  of  ergot.  It  may  be  increased  by 
the  use  of  local  stimulants  or  irritants. 

The  circulation  generally  may  be  affected  by  the  large  class  of 
vascular  stimulants  and  depressants,  to  be  afterwards  discussed, 
and  sometimes  by  stoppage  of  the  pulmonary  circulation  through 
minute  emboli. 

Alterations  in  the  oxygen-carrying  power  of  the  blood  will 
be  discussed  presently,  and  those  in  the  external  respiration 
subsequently. 

Oxidation  of  Protoplasm. — The  movements  of  protoplasm 
are  intimately  connected  with  processes  of  oxidation  going  oh , 
in  it. 

By  these  processes  chemical  energy  is  converted  into  the 
mechanical  energy  exhibited  in  the  movements,  and  this  is 
sometimes  very  considerable. 

The  oxygen  which  takes  part  in  these  processes  is  not  always 
derived  from  the  surrounding  medium  at  the  exact  moment  when 

1  For  further  details  see  Physiological  Chemistry,  by  A.  Gamgee,  vol.  i.,  1880, 
p.  130. 

f  2 


68  PHAEMACOLOGY  AND  THEEAPEUTICS.      [sect.  i. 

"the  movements  take  place ;  it  may  have  been  obtained  some  time 
before,  and  the  movements  may  continue  for  a  little  while  after 
all  oxygen  has  been  removed. 

It  therefore  appears  that  protoplasm  has  the  power  of  ab- 
sorbing and  storing  up  within  itself,  in  some  manner  or  other, 
oxygen,  which  it  can  afterwards  utilise  for  the  purpose  of  liberat- 
ing mechanical  energy. 

This  storage  of  oxygen  takes  place  not  only  in  the  proto- 
plasm of  unicellular  organism,  but  also  in  the  tissues  of  the 
higher  animals,  e.g.  the  muscles. 

The  exact  way  in  which  storage  occurs  is  not  known,  but  it 
has  been  well  compared  by  Professor  Ludwig  to  the  storage  of 
oxygen  in  gunpowder.  The  oxygen  is  there  contained  in  the 
nitrate  of  potassium,  a  compound  which  is  readily  decomposable 
by  the  application  of  heat,  and  then  gives  rise  to  the  evolution  of 
mechanical  energy ;  and  this  it  does  perfectly  well  in  an  enclosed 
Bpace,  like  a  gun-barrel,  where  no  air  is  present. 

The  power  of  storing  up  oxygen  is  very  limited,  and  although 
protoplasmic  movements  continue  for  a  little  while  after  all  ex- 
ternal oxygen  has  been  removed,  yet  they  will  not  continue  long. 

A  convenient  way  of  ascertaining  this  fact  has  been  devised  by  Ktihne, 
•who  adds  a  small  quantity  of  blood  or  of  haemoglobin  solution  to  a  drop  of 
water  containing  protoplasmic  organisms  or  cells  placed  on  a  covering-glass. 
This  is  then  observed  with  a  micro-spectroscope.  The  haemoglobin  solution 
exhibits  the  two  bands  characteristic  of  oxy-hsemoglobin.  When  all  the 
oxygen  is  removed  by  means  of  a  stream  of  hydrogen,  kept  up  for  some 
time,  the  spectrum  of  oxy -haemoglobin  passes  into  that  of  reduced  haemo- 
globin. 

The  occurrence  of  this  change  indicates  the  moment  when  all  the  oxygen 
has  disappeared  from  the  liquid.  By  reckoning  from  this  moment  onwards, 
we  are  able  to  estimate  the  length  of  time  during  which  the  movements 
continue  in  the  absence  of  oxygen. 

Oxygen-carrying  Power  of  Protoplasm. — Not  only  does 
protoplasm  possess  the  power  of  taking  up  oxygen  readily  and 
assimilating  it  to  itself,  but  it  has  also  the  power  of  taking  up 
and  giving  off  oxygen  to  other  substances  when  these  substances 
would  be  unable  to  take  it  themselves. 

We  may  understand  this  action  better  by  comparing  it  in  a 
very  rough  way  with  that  of  a  man  whose  greater  strength 
enables  him  to  seize  fruit  or  break  off  pieces  of  sweatmeat  and 
give  them  to  his  child,  which  thus  enjoys  what  it  could  not  have 
obtained  for  itself,  however  desirous  of  them  it  might  be. 

.Method  of  Experimenting'. — Guaiae  resin,  when  finely  divided  and 
oxidised,  becomes  of  a  blue  colour.  It  has,  however,  only  a  slight  power 
of  attracting  oxygen  to  itself  from  the  air,  or  from  water  in  which  the 
oxygen  is  dissolved,  and  thus  the  blue  colour  is  developed  slowly. 

On  the  addition  of  protoplasm  to  the  water  containing  the  guaiae,  the 
blue  colour  is  developed  rapidly.  The  reason  of  this  possibly  is,  that  the 
protoplasm  has  taken  up  oxygen  from  the  water  and  given  it  over  to  the 
guaiae.  This  process  reminds  us  of  the  action  of  spongy  platinum  in  causing 
oxidation  of  hydrogen  or  formic  acid. 


chap,  iii.]    ACTION  OF  DEUGS  ON  PROTOPLASM,  ETC.      69 

Ozonising  Power  of  Protoplasm.— It  has  been  supposed 
that,  in  addition  to  its  power  of  oxidising  such  substances  as 
guaiac  by  giving  to  them  oxygen  which  it  has  already  taken  up, 
protoplasm  has  the  power  of  actually  breaking  up  the  molecules 
of  oxygen  and  forming  ozone. 

The  rapid  oxidation  which  protoplasm  causes  has  been  at- 
tributed to  this  power.  A  similar  action  to  this  is  observed 
during  the  slow  oxidation  of  phosphorus.  Phosphorus  appears 
to  break  up  the  molecule  of  oxygen,  taking  to  itself  one  atom 
and  freeing  another,  which  unites  with  two  more  in  order  to 
form  ozone. 

Action  of  Drug's  on  Oxidation. — A  convenient  way  of  testing  the 
effect  of  drugs  upon  oxidation  is  to  use  the  protoplasm  of  potato,  of  lettuce, 
or  of  dandelion.  The  most  active  part  of  the  potato  lies  just  under  the 
skin,  as  is  seen  by  pouring  some  freshly  prepared  tincture  of  guaiac  over 
its  cut  surface.  A  ring  of  blue  first  forms  close  to  the  skin,  and  is  always 
darkest  there,  although  it  may  extend  over  the  whole  of  the  cut  surface.  The 
ammoniated  tincture  of  the  British  Pharmacopoeia  will  not  answer.  The 
tincture  must  be  made  with  spirit  only.  When  potato  is  used,  the  whole  of 
the  potato  may  be  pounded  with  water,  or,  still  better,  the  peel  alone  may  be 
cut  off  and  rubbed  up  with  water  in  a  mortar  and  then  filtered  through 
linen.    When  lettuce  or  dandelion  is  used,  the  fresh  leaves  are  triturated 


Pig.  11.— Test-glasses  for  examining  the  action  of  drags  on  oxidation. 

in  a  mortar  with  five  or  ten  times  their  bulk  of  water,  and  the  solution  is 
then  filtered.  A  row  of  test-tubes  or  test-glasses  having  been  prepared, 
a  measured  quantity  of  water  is  put  into  the  first.  In  this  glass  the 
protoplasm  is  not  mixed  with  any  foreign  substance,  and  it  therefore 
serves  as  the  standard  with  which  to  compare  the  others ;  and  into  the 
others  is  put  a  similar  quantity  of  solutions  of  the  drugs  to  be  tested. 
Each  test-glass  is  distinguished  by  a  label  bearing  either  a  number  or  the 
name  of  the  drug  which  it  contains  attached  to  it.  To  each  glass  a  mea- 
sured quantity  of  the  lettuce-water  is  added  and  the  contents  mixed  by 
shaking.  All  are  allowed  to  stand  for  a  period  varying  from  a  few  minutes 
to  some  hours.  Then  a  small  drop  of  freshly-prepared  tincture  of  guaiao 
is  added  to  each,  mixed  by  shaking,  and  allowed  to  stand  for  one  or  two 
minutes ;  the  glasses  are  then  arranged  in  the  order  of  depth  of  colour. 

In  this  way  it  is  found  that  many  drugs  greatly  lessen  or  almost  com- 
pletely abolish  the  oxidising  power  of  protoplasm,  so  that  while  the  lettuce- 
water  in  the  standard  glass  assumes  a  dark-blue  colour,  that  in  the  others 
exhibits  varying  shades  of  blue,  or  may  even  retain  the  creamy-white 
colour  caused  by  the  guaiac  without  showing  any  blue  whatever. 

The  colour  is  deeper  and  the  reaction  is  more  readily  obtained  when 
the  tincture  of  guaiac  is  mixed  with  some  substance  capable  of  giving  off 
oxygen  readily,  such  as  a  solution  of  peroxide  of  hydrogen  in  ether,  usually 
called  ozonic  ether. 

A  number  of  experiments  made  with  potato-water  by  Cash  and  myself 
showed  that  oxidation  in  potato  solution  was  diminished  most  powerfully  by 
strychnine,,  then  by  quinine  and  coniine;  next  by  morphine,  codeine,  cin- 
chonine,  and  atropine,  each  of  which  had  almost  exactly  the  same  action ; 


70  PHAEMACOLOGY  AND  THEKAPEUTICS.     [sect.  I. 

next  by  nicotine,  and  then  veratrine.  Aconitine  seemed  neither  to  retard 
nor  accelerate  oxidation,  and  presented  exactly  the  same  degree  of  coloration 
as  the  standard  solution.  Caffeine,  picrotoxin,  and  digitalin  appeared  some- 
what to  hasten  oxidation.1 

Reduction  by  Protoplasm. — Ehrlich 2  has  shown,  in  an 
interesting  manner,  the  properties  of  oxidation  and  reduction 
possessed  by  protoplasm.  Methylene-blue,  alizarin-blue,  and 
indo-phenol  are  coloured  bodies  which  become  colourless  on 
being  reduced.  After  injecting  methylene-blue  into  the  veins,  he 
found  that  most  of  the  parenchymatous  tissues  became  coloured, 
the  heart,  brain,  cortex  of  kidney,  the  voluntary  muscles,  &c, 
while  the  lungs  and  the  liver  were  normal  and  only  a  small 
amount  of  colouring  matter  could  be  obtained  by  prolonged 
exposure  to  the  air.  Ehrlich  concluded  that  the  indifferent 
paraplasma  of  the  cells  excretes  the  unchanged  matter,  while 
the  protoplasm,  which  is  greedy  for  oxygen,  excretes  the  reduced 
colouring  stuff. 

Action  of  Drugs  on  Blood. 

The  haemoglobin  of  blood  has  also  the  power  of  taking  up 
oxygen  readily  and  giving  it  freely  off  again.  Haemoglobin  free 
from  oxygen,  or,  as  it  is  sometimes  called,  reduced  haemoglobin, 
is  recognised  by  the  simple  band  which  it  gives  between  D  andE, 
when  examined  spectroscopically. 

Hemoglobin  combined  with  oxygen,  or  oxyhemoglobin,  gives 
two  bands,  situated  in  nearly  the  same  portion  of  the  field  of  the 
spectroscope.  These  are  separated  from  one  another  by  a  clear 
space,  and  are  more  sharply  defined  and  darker  than  the  spec- 
trum of  haemoglobin. 

The  oxygen  of  oxyhemoglobin  may  be  replaced  by  other 
gases.  Thus: — Carbonic  oxide  drives  out  the  oxygen  from 
oxyhaemoglobin  and  forms  carbonic  oxide  haemoglobin  (CO- 
haemoglobin).  This  is  a  comparatively  stable  compound.  It 
presents  spectroscopic  bands  nearly  the  same  as  those  of  oxy- 
haemoglobin, but  which  are  slightly  nearer  to  the  violet  end  of 
the  spectrum.  This  compound,  being  stable,  circulates  in  the 
blood  without  performing  the  functions  of  respiration.  It 
neither  takes  up  oxygen  in  the  lungs  nor  gives  off  oxygen  to  the 
tissues. 

Animals  poisoned  by  CO  therefore  die  of  asphyxia,  the  in- 
ternal respiration  being  arrested,  and  their  blood  remains  for  a 
long  time  of  a  florid  colour. 

Hydrocyanic  acid  appears  also  to  form  a  compound  with 
haemoglobin,  which  is  much  less  stable  than  that  of  carbonic 
oxide.     There  has  been  a  good  deal  of  discussion  about  this 

1  St.  Bartholomew's  Hospital  Reports,  1882. 

2  Ehrlich,  '  Zur  biologischen  Verweitung  des  Methylen-Blau,'  Centralblatt  f. 
die  med.  Wissenscha/t.   1885,  No.  8. 


chap,  in.]    ACTION  OF  DBUGS  ON  PEOTOPLASM,  ETC.      71 

compound,  and  its  existence,  indeed,  has  been  denied.  The 
spectrum  of  this  compound  consists  of  a  single  band  resembling 
reduced  haemoglobin,  but  nearer  the  violet  end  of  the  spectrum. 

Solutions  of  haemoglobin  when  boiled  are  completely  decom- 
posed into  haematin  and  a  proteid  body  or  bodies. 

Haematin  gives  a  single  band,  which  differs  according  as  the 
solution  is  alkaline  or  acid,  and  according  as  the  solvent  is  water 
or  ether. 

Acids  split  up  haemoglobin  into  haematin  and  a  proteid.  It  is 
sometimes  possible  to  get  these  to  recombine  and  to  again  form 
haemoglobin,  but  this  is  far  from  being  always  the  case. 

Methaemoglobin  appears  either  to  be  a  product  of  the  in- 
complete decomposition  of  haemoglobin  or  of  its  excessive  oxida- 
tion. Some  think  that  it  contains  more  oxygen  than  haemoglobin, 
but  less  than  oxyhaemoglobin.  Others  think  that  it  is  a  per- 
oxyhaemogldbin  containing  more  oxygen  than  oxyhaemoglobin. 
At  all  events  the  oxygen  is  more  firmly  combined  in  methaemo- 
globin than  it  is  in  oxyhaemoglobin. 

This  body  is  distinguished  by  a  spectroscopic  band  nearly  in 
the  same  place  as  that  of  the  acid  haematin. 

When  the  solution  is  made  alkaline  by  ammonia  this  band 
disappears,  and  is  replaced  by  another  fine  one  near  D. 

Methaemoglobin  appears  to  be  converted  again  into  haemo- 
globin by  the  action  of  reducing  agents  and  subsequent  oxidation. 
When  its  solution  is  treated- with  reducing  agents,  it  shows  the 
spectrum  of  reduced  haemoglobin  ;  and  on  shaking  this  with  air 
oxyhaemoglobin  is  formed,  as  shown  by  the  appearance  of  its 
characteristic  bands. 

When  blood  is  allowed  to  stand  for  a  length  of  time,  it 
assumes  a  brownish  colour  and  gives  the  bands  of  methaemo- 
globin. When  nitrites  are  mixed  with  freshly-drawn  blood,  they 
impart  to  it  a  chocolate  colour,  and  it  then  exhibits  the  bands  of 
methaemoglobin. 

As  the  oxygen  in  methaemoglobin  is  more  firmly  combined 
with  it  than  in  oxyhaemoglobin,  substances  such  as  the  nitrites 
interfere  with  internal  respiration,  and  thus  in  large  doses  will 
cause  symptoms  of  asphyxia ;  but  their  action  differs  from  that 
of  carbonic  oxide  in  one  very  important  particular,  viz.,  that  it 
is  altered  by  asphyxia;  whilst  that  of  carbonic  oxide  is  not. 
Eeducing  substances  are  constantly  present  in  the  blood  and 
tissues,  and  these  accumulate  to  a  greater  extent  during  the  pro- 
cess of  asphyxia.  Carbonic-oxide  haemoglobin,  being  a  stable 
compound,  remains  unaffected  by  these,  and  the  blood  continues 
to  circulate  unchanged. 

But  methaemoglobin,  which  is  produced  by  the  action  of  the 
nitrites,  becomes  reduced  by  these  substances  and  forms  the 
normal  reduced  haemoglobin  ordinarily  present  in  venous  blood. 
When  this  reaches  the  lungs  it  again  takes  up  oxygen,  forming 


72  PHARMACOLOGY  AND  THEEAPEUTICS.     [sect.  I. 

normal  arterial  blood,  by  which  the  internal  respiration  is  again 
restored.  Thus,  unless  new  supplies  of  nitrites  are  constantly- 
added  to  the  blood,  the  asphyxia  they  occasion  quickly  passes 
away.  That  caused  by  carbonic  oxide,  on  the  contrary,  is  much 
more  permanent.  It  is  not  removed  by  artificial  respiration,  and 
in  order  to  save  the  life  of  the  animal  or  person  poisoned  by  it,  a 
quantity  of  the  poisoned  blood  must  be  withdrawn  from  the  veins 
and  healthy  blood  introduced  by  transfusion. 

Oxyhemoglobin 

Haemoglobin 

Carbonic-oxide      hsemo- 1 
giobin j 

Sulphsemoglobin 

Ditto,  oxygenated 

Methaemoglobin 

Bloodtreatedwithnitrite  ] 
of  amyl  and  alcohol ...  J 

Acid  hrematin  (alcoholic  ] 

solution) J 

Alkaline    hsematin    (al-  ] 

coholic  solution) ) 

Blood       treated       with 

cyanide  of   potassium 

or  hydrocyanic  acid. . . 
Ditto,  oxidised 

C  D  B  5       V 

Fig.  12.— Chart  showing  the  spectroscopic  absorption-bands  of  haemoglobin  and  its  derivatives. 

(After  McMunn.) 

A  method  of  ascertaining  the  effect  of  drugs  on  oxidation  in 
the  blood  consists  in  estimating  the  rate  at  which  acid  is  de- 
veloped in  it  after  its  removal  from  the  body. 

In  this  way  Binz  and  his  scholars,  Zuntz,  Scharrenbroich, 
and  Schulte,  have  found  that  both  quinine  and  sodium  nitro- 
picrate  stop  the  formation  of  acid ;  cinchonine  lessened  it.1 

The  alterations  effected  in  the  interchange  between  blood 
and  the  air  have  also  been  observed  by  simply  allowing  the  blood 
mixed  with  the  drug  to  stand  for  a  certain  time  in  a  closed 
receiver,  partially  filled  with  air,  and  afterwards  analysing  the 
gases  which  the  receiver  contains  at  the  end  of  the  experiment. 

By  this  mode  of  experimentation,  Harley 2  found  that  hydro- 
cyanic acid  diminished  or  arrested  the  processes  of  oxidation 
in  the  blood.  Alcohol,  chloroform,  quinine,  morphine,  nicotine, 
strychnine,  and  brucine,  all  had  a  similar  action,  though  varying 
in  extent,  all  of  them  diminishing  both  the  amount  of  oxygen 
absorbed  and  of  carbonic  acid  given  out. 

Uric  acid  and  snake  poison  had  a  contrary  effect,  increasing 

1  A  very  complete  list  of  the  literature  of  this  subject  is  given  by  Binz  in  his 
work,  Das  Chinin,  Berlin,  1875. 

2  Harley,  Phil.  Trans.,  1805,  p.  678. 


"BHflTT 1 ' ■ 

Sf     9HRnr 

■      I "'" ; 
..       . 

Hi_ H 

III,!.  I      .lil 

EH  II    s 


chap,  in.]    ACTION  OF  DEUGS  ON  PEOTOPLASM,  ETC.      73 

the  absorption  of  oxygen  and  the  evolution  of  carbonic  acid. 
Curare  appeared  to  lessen  the  absorption  of  oxygen,  but  in- 
creased the  evolution  of  carbonic  acid.  Mercuric  chloride 
lessened  the  •  carbonic  acid,  but  increased  the  absorption  of 
oxygen.  Arsenious  acid  and  tartar  emetic  diminished  the  ab- 
sorption of  oxygen,  but  arsenious  acid  appeared  also  to  lessen 
the  evolution  of  carbonic  acid,  while  tartar  emetic  appeared  to 
increase  it. 

Catalysis. — Fermentation. — Inorganic  Ferments. 

There  are  many  examples  of  chemical  reactions  which  only 
occur  between  two  bodies  when  a  third  is  present,  which  may 
nevertheless  be  found  unchanged  at  the  end  of  the  process. 
Notwithstanding  the  fact  that  the  third  body  is  found  unchanged 
at  the  end  of  the  process,  it  may  have  undergone  changes  during 
the  continuance  of  the  process.  Thus  alcohol  is  not  converted 
into  ether  and  water  by  boiling  alone,  but  it  does  undergo  this 
conversion  by  boiling  with  sulphuric  acid.  The  acid  is  found 
unchanged  at  the  end  of  the  process,  but  is  changed  during  it 
into  ethyl- sulphuric  acid,  which,  combining  with  alcohol,  again 
yields  sulphuric  acid  along  with  ether. 

In  other  cases,  however,  we  cannot  show  that  the  substance 
has  undergone  change.  Thus  starch  is  converted  into  dextrin 
and  sugar  and  cane-sugar  into  grape  sugar  by  boiling  with  acids, 
but  we  do  not  at  present  know  that  the  acid  has  undergone  any 
change  during  the  process  as  it  does  in  the  preparation  of  ether. 
Peroxide  of  hydrogen  is  rapidly  decomposed  by  finely  divided 
platinum  or  silver,  and  finely  divided  platinum  will,  on  the  other 
hand,  cause  oxygen  and  hydrogen  to  unite  rapidly.  Such 
actions,  where  the  third  substance  seems  to  act  by  its  mere  con- 
tact with  the  other  substances,  and  without  undergoing  change 
itself,  are  called  catalytic.  They  are  probably  due  to  an  attrac- 
tion of  some  kind  bordering  both  on  chemical  and  physical 
between  the  molecules. 

Thus  some  organic  substances  would  resist  the  oxidising 
action  of  the  air  for  a  considerable  time,  but  they  are  readily 
oxidised  by  charcoal.  It  is  usually  said  that  the  charcoal  has 
the  power  of  attracting  oxygen  and  condensing  this  gas  upon  its 
surface.  It  does  not  unite  with  the  oxygen  chemically  so  as  to 
form  C02,  but  merely  attracts  it,  holds  it  for  a  while,  and  then 
gives  it  off  readily  to  any  oxidisable  substance.  Platinum, 
palladium,  rhodium,  and  iron  absorb  hydrogen,  palladium  doing 
*  so  to  an  enormous  extent,  especially  when  it  is  in  a  spongy  form. 
The  hydrogen  is  supposed  by  some  to  be  simply  condensed 
within  the  metal,  while  others  think  that  the  hydrogen  and 
metal  unite  to  form  a  hydride.  The  hydrogen  is  given  off  from 
the  metal  in  a  nascent  form,  and  has  very  strong  affinities. 


74  PHAEMACOLOGY  AND   THEEAPEUTICS.     [sect,  i, 

Thus  palladium-hydrogen  readily  reduces  ferric  to  ferrous  salts, 
the  hydrogen  taking  oxygen  from  the  ferric  salt  and  forming 
water.  But  when  the  hydrogen  is  liberated  from  palladium  or 
rhodium  in  presence  of  oxygen,  it  appears  to  convert  the  oxygen 
into  ozone,  and  greatly  increases  its  oxidising  power.  Thus 
palladium-hydrogen  with  oxygen  colours  a  mixture  of  potassium 
iodide  and  starch  paste  blue,  and  oxidises  hemoglobin  to  met- 
haemoglobin  and  ammonia  to  nitric  acid.  Spongy  rhodium,  or 
iridium  saturated  with  hydrogen,  cause  formic  acid  to  be  oxidised 
to  carbonate,  calcium  formate  being  changed  into  calcium  car- 
bonate. Exactly  the  same  action  is  possessed  by  an  organic 
ferment,  and  in  the  conversion  of  the  formic  into  carbonic  acid 
the  ferment  and  the  spongy  rhodium  or  iridium  are  alike  un- 
changed. Spongy  platinum,  palladium,  rhodium,  and  iridium 
may  thus  be  regarded  as  inorganic  ferments.1 

Ferments  Organic  and  Organised. 

The  mechanical  energy  displayed  in  the  movements  of  proto- 
plasm is  supplied  by  processes  of  chemical  change,  and  chiefly  of 
oxidation. 

By  these  processes  some  of  the  substances  contained  in  the 
protoplasm  are  destroyed,  and  their  place  must  be  supplied  by 
fresh  material.  This  material  is  obtained  from  the  food,  but,  in 
order  to  render  it  available  for  the  protoplasm,  its  atoms  must 
be  more  or  less  disintegrated  in  order  that  they  may  again  be 
assimilated.  As  Hermann  very  well  puts  it,  the  bricks  of  which 
the  old  house  is  built  must  be  pulled  asunder  before  they  can  be 


Pig.  13. — An  amoeba  figured  at  two  different  periods  during  movement, 
n,  nucleus  ;  i,  ingested  bacillus. 

built  up  again  into  the  new.  In  the  present  case,  the  bricks 
are  the  atoms  of  protoplasm  in  some  other  organism  living  or 
dead,  which  is  being  used  as  food  by  some  larger  mass  of  proto- 
plasm, as,  for  example,  a  bacillus  which  has  been  absorbed  by 
an  amoeba.     (Fig.  13.)  , 

In  order  to  render  the  protoplasm  in  the  bacillus  available 
for  the  nutrition  of  the  amoeba,  the  atoms  of  which  it  is  composed 

1  Hoppe-Seyler,  Ber.  d.  deutsch.  chem.  Gcscllsck.,  1883,  Feb.  12,  p.  117. 


chap,  in.]    ACTION  OF  DRUGS  ON  PEOTOPLASM,  ETC.      75 

must  be,  to  some  extent,  decomposed.  This  process  appears  to 
be  effected  by  enzymes  or,  as  they  are  sometimes  called,  organic 
ferments. 

Ferments  are  bodies  which  split  up  carbon  compounds  at 
moderate  temperatures  and  lead  to  the  formation  of  other  carbon 
compounds,  most  of  which  are  of  a  simpler  constitution  than  the 
first. 

In  this  definition  we  require  to  introduce  the  term  '  moderate 
temperature,'  because  excessive  heat  alone  will  cause  the  atoms 
of  a  complex  carbon  compound  to  fly  asunder  and  form  simpler 
compounds,  as  in  the  process  of  dry  distillation.  A  less  heat 
than  this,  but  aided  by  the  action  of  powerful  chemicals,  will 
also  produce  the  same  effect.  For  example,  fibrine  heated  with 
diluted  hydrochloric  acid  under  pressure  yields  peptones;  but 
the  same  change  is  effected  at  the  temperature  of  the  mammalian 
body  by  the  aid  of  pepsin.  Trypsin  from  the  pancreas  effects  a 
similar  change  when  mixed  with  water  alone  without  the  aid  of 
an  acid,  though  its  action  is  certainly  aided  by  alkalies.  Neither 
pepsin  nor  trypsin  are  alive,  but  they  contain  carbon,  and  are 
therefore  called  organic  ferments.  But  this  term  easily  leads 
to  confusion  with  ordinary  living  or  organised  ferments,  and  so 
the  term  enzymes  has  been  lately  introduced  to  signify  ferments 
such  as  diastase,  ptyalin,  and  pepsin,  which,  though  they  con- 
tain carbon  and  are  therefore  called  organic,  are  not  alive  and 
have  no  definite  structure,  or,  in  other  words,  are  not  organised. 
The  term  unformed  ferments  has  also  been  applied  to  them. 

By  organised  ferments  we  mean  minute  living  organisms, 
which  in  the  course  of  their  life-processes  cause  decomposition  of 
the  substances  in  which  they  live.  They  have  also  been  called 
formed  ferments.    Examples  of  these  are  yeast  and  bacteria. 

The  processes  of  fermentation  have  been  divided  by  Hoppe- 
Seyler  into  two  kinds : — 

(1)  Those  in  which  water  is  taken  up;  and  (2)  those  in  which 
oxygen  is  transferred  from  the  hydrogen  to  the  carbon  atom. 

The  hydration  in  the  first  case  is  produced  by  the  ferment 
acting  either  (a)  like  a  dilute  mineral  acid  at  a  high  temperature, 
as  in  diastatic  and  invertive  ferments  and  in  the  decomposition 
of  glucosides;  or  (b)  like  caustic  alkalies  at  a  high  tempera- 
ture, as  in  the  splitting  up  of  fats  or  the  decomposition  of  amide 
compounds.  These  processes  of  fermentation  by  hydration  are 
chiefly  carried  on  by  enzymes. 

The  second  class  of  fermentative  changes  by  the  transference 
of  oxygen  from  the  hydrogen  to  the  carbon,  as  in  lactic  and 
alcoholic  fermentation  and  in  putrefactive  processes,  are  chiefly 
produced  through  the  agency  of  organised  ferments.  The  action 
of  the  latter  may  be  to  a  certain  extent  imitated  by  spongy 
platinum,  which  absorbs  oxygen  readily,  and  readily  gives  it  off 
again  to  oxidisable  substances.   Thus  acetic  fermentation  usually 


7C 


PHAEMACOLOGY  AND  THEEAPEUTICS.     [sect,  i. 


produced  by  an  organised  ferment  may  be  also  brought  about  by 
spongy  platinum. 

The  products  formed  by  the  action  of  organised  ferments 
on  the  media  in  which  they  live  are  poisonous,  to  them;  and 
when  these  products  accumulate  above  a  certain  proportion, 
they  kill  the  ferments.  Just  as  a  fire  will  be  smothered  in 
its  own  ashes,  or  an  animal  in  a  confined  space  will  be 
poisoned  by  the  carbonic  acid  which  it  has  itself  produced,  so 
the  yeast  plant,  when  living  in  a  solution  of  sugar,  is  killed  by 
the  alcohol  which  it  produces,  as  soon  as  this  amounts  to  20  per 
cent. ;  and  other  organised  ferments  have  their  lives  limited  in 
a  similar  way. 

Action  of  Drugs  on  Enzymes. — Although,  with  the  ex- 
ception of  a  kind  of  pepsin  in  the  naked  protoplasm  of  JEthalium 
septicum,  a  species  of  myxomycetes,1  enzymes  have  not  been 
shown  to  be  present  in  the  protoplasm  of  the  lowest  organisms, 
it  is  probable  that  the  processes  of  life  in  all  living  beings  from 
the  lowest  to  the  highest  are  carried  on  by  their  means.  A 
ferment,  which  is  evidently  of  the  greatest  importance  in  the 
animal  economy,  has  been  recently  discovered  in  the  blood  by 
Schmiedeberg.  He  has  given  to  it  the  name  of  Histozyme, 
and  he  believes  that  its  function  is  to  split  up  nitrogenous  sub- 
stances preparatory  to  their  oxidation.2  The  chief  enzymes  are 
the  following : — 

I  i  Diastase  from  malt. 

Ptyalin  from  saliva. 

Diastatic  ob  J      amyloids  into  maltose  A  ^?yloPsin  fr°m  P^creas. 
Aklolytic   1  Other  ferments  having  a  similar  action 

.     from  other  parts  of  the  body. 

From  small  intestine. 


Inveksive 

Fekments 


Which  convert  starch  and 
amyloids  into  maltose  . 

Which    convert    maltose 
into  glucose  . 

I  Which  convert  cane  sugar 
into  dextros*  and  levu- 
lose       .        .        .        . 
Which  decompose  gluco- 
sides      .... 
Decomposing  sugar  . 


'  Invertin  from  the  intestinal  juice. 

„  „       mucus  of  the  mouth. 

„  „       tissue  of  the  testis. 

Emulsin  from  bitter  almonds. 
Myrosin  from  mustard. 
.Rennet, 
f  From  stomaoh. 

n 


Proteolytic 

Fekments 


(Which  decompose  proteids 
and  form  peptones 


Decomposing  fats     ,        .  ,  ..,  ,„J  .  . 

1  From  pancreas  (Stearopsin). 

Pepsin  from  stomach. 

Trypsin  from  pancreas. 

Others  from  saliva. 

Histozyme. 

The  action  of  drugs  on  enzymes  is  ascertained  by  taking  two  portions  of 
a  solution  containing  the  enzyme  and  the  substance  to  be  acted  upon.  To 
one  of  these  a  quantity  of  the  drug  to  be  tested  is  added,  the  other  acts  as  a 
standard  with  which  to  compare  it.  If  the  drug  is  in  solution,  a  correspond- 
ing quantity  of  water  must  be  added  to  the  standard  solution  in  order  that 
both  may  be  alike.  _  They  are  then  placed  in  a  warm  chamber  and  the 
rapidity  of  digestion  is  noted. 


1  Krukenberg,  Untersuch.  a.  d.  physiol.  Inst.  d.  Univ.  Heidelberq,  Bd  II    1878, 
p.  273. 

8  Schmiedeberg,  Arch.f.  exyer.  Path.  u.  Pharm.,  Bd.  xiv.  S.  379. 


chap,  in.]    ACTION  OF  DEUGS  ON  PKOTOPLASM,  ETC.      77 

The  effect  of  some  of  the  more  important  drugs  on  the  action 
of  enzymes  will  be  readily  seen  from  the  following  table  from 
Wernitz,  quoted  by  Meyer.1  In  it  the  proportion  is  shown  of 
the  drugs  which  arrest  in  watery  solution  the  action  of  enzymes ; 
thus,  one  part  of  chlorine  in  8,540  parts  of  a  watery  solution  will 
arrest  the  action  of  ptyalin  upon  starch  paste,  while  creasote  has 
.no  action  on  it  even  in  saturated  solution,  and  corrosive  sublimate 
is  so  enormously  destructive  as  to  arrest  its  action,  even  in  one 
part  in  52,000. 

1  Hermann  Meyer,  '  Ueber  das  Milchsaureferment  u.  sein  Vernal  ten  gegen 
Antiseptica,'  Inaug.  Diss.  Dorpat,  1880. 


78 


PHAEMACOLOGY  AND  THERAPEUTICS,     [sect.  i. 


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chap,  hi.]    ACTION  OF  DEUGS  ON  PEOTOPLASM,  ETC. 


The  different  action  which  the  same  drug  exerta  upon  formed 
and  unformed  ferments  is  of  great  importance,  because  upon  it 
depends  our  power  to  use  the  drug  in  the  practice  of  medicine. 
Thus  creasote,  which  appears  from  the  preceding  table  not  to 
destroy  the  digestive  power  of  ptyalin  and  to  have  but  a  weak 
action  upon  that  of  pepsin,  has  been  found  by  Werneke  to  destroy 
yeast  in  a  dilution  of  one  part  to  500  of  water ;  and  by  Bucholtz 
to  kill  bacteria  in  a  dilution  of  one  part  to  1,000  of  water.  This 
difference  enables  us  to  arrest  fermentation  in  the  stomach  de- 
pending on  the  presence  of  low  organisms,  while  the  digestive 
action  of  the  pepsin  is  not  interfered  with,  or  only  very  slightly. 
The  following  diagram  shows  the  action  of  drugs  on  enzymes 
and  on  the  lactic  ferment,  which  is  a  bacillus. 


Fig.  14.— Diagram  to  show  the  different  action  of  drags  on  different  enzymes.    The  nature  of  the 
line  showing  the  action  of  each  drug  is  shown  under  its  name. 


80  PHABMACOLOGY  AND  THEEAPEUTICS.      [sect.  i. 

Zymogens. 

As  several  enzymes  act  readily  in  neutral  or  slightly  alkaline 
fluids,  it  is  evident  that  if  they  existed  free  in  every  part  of  the 
animal  body,  they  would  soon  lead  to  its  speedy  destruction. 
Accordingly,  we  find  that  they  do  not  normally  exist  free,  except 
at  the  times  and  places  they  are  required. 

This  fact  was  first  discovered  by  Kiihne  in  relation  both  to  the  stomach 
and  pancreas,  and  was  announced  by  him  in  the  course  of  lectures  which  he 
delivered  at  Amsterdam  in  1868-69,  which  I  attended.  In  my  note-books  of 
those  lectures  I  find  that  he  stated  that  there  seems  to  exist  '  a  pepsin-giving 
substance,'  because  if  a  '  slice  of  stomach  is  thrown  directly  into  dilute  HC1 
of  4  parts  to  1,000  of  water  at  40°  C.  no  digestion  takes  place,' '  a  fact  which 
shows  that  pepsin  is  not  always  present  in  it.  In  regard  to  the  pancreas,  he 
not  only  recognised  the  existence  of  a  ferment-yielding  body,  but  described  a 
mode  of  obtaining  ferment  from  it  in  the  following  words  : — '  Glands  which 
have  no  action  on  fibrine  can  be  made  active  by  digesting  in  very  dilute  acid 
and  then  neutralising  or  alkalising,  there  seeming  to  exist  a,  ferment-forming 
substance  in  the  pancreas.' 

Kuhne's  discovery  of  the  existence  of  ferment-yielding  bodies  does  not 
seem  to  have  become  widely  known,  and  it  was  again  made  independently  by 
Liversedge  2  in  regard  to  the  amylolytic  ferment  of  the  pancreas,  and  by 
Heidenhain  in  regard  to  trypsin.  These  observers  found  that  when  glands 
which  did  not  contain  ferment  were  exposed  to  the  air  ferments  were  formed. 

Heidenhain3  also  investigated  more  fully  these  ferment- 
forming  substances,  and  gave  to  them  the  name  of  zymogens. 

The  methods  by  which  we  obtain  ferments  from  zymogens 
are,  therefore,  exposure  to  air  and  treatment  with  acids. 


Organised  Ferments. 

The  chief  organised  ferments  are  the  yeast-plant,  which 
produces  alcohol  and  carbonic  acid  from  grape  sugar,  and 
various  kinds  of  bacteria,  one  of  which  produces  butyric, 
another  lactic,  and  another  acetic  fermentation.  Both  yeast  and 
bacteria  belong  to  the  lowest  class  of  plants,  the  protophytes. 
To  this  class  also  belong  moulds,  the  action  of  drugs  upon  which 
is  sometimes  important,  inasmuch  as  moulds  give  rise  to  some 
skin  diseases. 

Yeasts,  moulds,  and  bacteria  have  been  variously  classified 
by  different  authors,  and  the  classification  is  apt  to  undergo 
changes  as  our  knowledge  of  the  life-history  of  these  different 
organisms  increases. 

At  present  it  is  not  certainly  known  whether  the  various 

1  Just  after  this  there  is  unfortunately  a  blank  in  my  notes,  but  Professor 
Kiihne  has  kindly  supplied  the  deficiency,  and  informs  me  that  he  was  then  speak- 
ing of  slices  taken  from  the  external  surface  of  the  stomach,  and  therefore  containing 
the  lower  ends  only  of  the  gastric  glands. 

2  Liversedge  (Nov.  1872),  Journ.  of  Anat.  and  Physiol.,  Nov.  1873,  p.  23. 
•  Heidenhain,  Pflilger's  Archiv,  Bd.  xi.  p.  557. 


chap.  in.].  ACTION  OF  DRUGS  ON  PROTOPLASM,  ETC.      81 

kinds  of  bacteria,  for  example,  are  generically  or  specifically  differ- 
ent, or  whether  they  can,  by  altered  cultivation,  be  transformed 
into  one  another  or  not. 

Koch,  who  has  cultivated  them  by  the  dry  process  on  gelatine 
instead  of  in  liquid,  and  has  thus  been  able  to  avoid  admixture 
of  different  kinds  of  bacteria,  has  come  to  the  conclusion  that 
each  kind  possesses  distinctive  characters ;  but  Klein  has  shown 
that,  even  when  cultivated  in  this  way,  bacteria  may  vary  much 
in  form.  Thus  the  bacillus  anthracis  may  form  torula-like  cells, 
from  which  ordinary  bacilli  are  again  produced, 

The  numerous  names  used  in  treatises  on  the  subject  of 
organised  ferments  are  apt  to  lead  to  confusion,  hence  some  of 
the  names  are  given  here  simply  for  the  purpose  of  reference. 
Thus  Brefeld's  classification  is  : — 

(1)  '  Phycomycetes  =  algoid  fungi ;  (2)  Mycomycetes  =  true 
higher  fungi ;  (3)  Myxomycetes  =  gelatinous  fungi ;  (4)  Blasto,- 
mycetes  =  yeast  fungi ;  (5)  Schizomycetes=bacteria. 

The  classification  into  yeasts,  moulds,  and  bacteria  which  I 
have  followed  may  not  be  botanically  correct,  but  it  is  convenient 
for  our  present  purpose. 

"  Yeasts. — The  yeast-plant,  to  which  various  names  have  been 
given,  as  torula  cerevisiae,  saccharomyces,  consists  of  ovoid  cells, 
which  multiply  by  budding.  The  buds  may  remain  attached, 
forming  torula-chains,  but  when  they  attain  the  size  of  the  parent 
cell  they  fall  off  and  begin  to  multiply  anew.  When  placed  in 
saccharine  solutions  the  plant,  during  the  process  of  growth, 
decomposes  the  sugar  and  forms  alcohol  and  carbonic  acid, 

In  this  process  oxygen  is  usually  absorbed  from  the  air  in 
considerable  quantities,  but  fermentation  can  occur  in  saccharine 
solutions  even  when  oxygen  is  excluded,  though  under  such  con- 
ditions the  torula  grows  slowly.  When  plenty  of  oxygen  is 
present,  and  the  layer  of  fluid  shallow,  the  torula  grows  luxuri- 
antly, but  there  is  very  little  fermentative  change ;  while,  on  the 
other  hand,  when  free  oxygen  is  excluded  the  torula  grows 
slowly,  but  there  is  marked  fermentation. 

Another  plant  nearly  allied  to  yeast  is  the  mycoderma  vini, 
the  ferment  which  changes  alcohol  into  acetic  acid.  The  myco- 
derma is  not  regarded  by  Naegeli  as  a  species  distinct  from 
torula,  and  it  is  considered  by  Grawitz  to  be  the  same  as  the 
fungus  found  in  the  aphthous  patches  which  occur  about  the 
mouth  and  throat  of  children  suffering  from  thrush,  although 
this  fungus  is  usually  said  to  be  an  oi'dium. 

To  teat  the  action  of  drugs  on  alcoholic  fermentation,  equal  quantities  of 
a  solution  of  grape  sugar  with  yeast  are  introduced  into  two  test-tubes,  and 
to  one  of  them  a  little  of  the  substance  to  be  tried  is  added.  These  are  then 
inverted  over  mercury  and  kept  in  a  warm  place  for  several  days.  The 
amount  of  gas  developed  is  then  measured,  and  the  power  of  the  drug  to 
prevent  fermentation  is  estimated  by  the  diminution  in  the  amount  of 
carbonic  acid  produced,  as  compared  with  the  standard. 

a 


'82  PHAEMACOLOGY  AND  THEEAPEUTICS.     [sect.  i. 

Mould  Fungi,  or  Hyphomycetes. — These  form  long  fila- 
ments or  hyphse,  which  become  agglomerated  into  a  mycelium 
or  mass  of  compact  tufts.  They  multiply  not  only  by  gemmation, 
but  by  the  formation  of  spores. 

These  moulds  vary  considerably  according  to  the  soil  in 
which  they  grow,  and  the  amount  of  oxygen  present.  Thus,  if 
the  spores  of  the  common  white  mould,  Mucor  mucedo,  are  sown 
in  a  liquid  containing  sugar  and  exposed  to  the  air,  they  grow  on 
the  surface,  forming  branched  hyphss  without  septa,  and  the 
liquid  absorbs  oxygen.  But  if  the  mycelium  be  immersed,  or  the 
oxygen  withdrawn,  septa  develop  in  the  hyphse,  and  they  break 
up  into  segments  which  multiply  by  budding,  forming  a  kind  of 
yeast  with  large  cells,  and,  like  the  true  yeast,  decomposing  sugar 
into  alcohol  and  carbonic  acid. 

They  may  be  trained  to  thrive  on  substances  on  which  they 
do  not  usually  grow  by  gradually  altering  the  composition  of 
the  soil.  Thus,  the  commonest  of  all  moulds,  Penicilliwm 
glaucum,  although  it  does  not  usually  grow  on  blood,  may  be 
trained  to  do  so  by  transplanting  it  from  bread  to  peptone,  and 
then  to  blood. 

Heat  destroys  these  fungi,  but  a  much  higher  temperature  is 
required  to  kill  the  spores  than  the  perfect  plant,  and  in  order  to 
destroy  the  spores  a  temperature  of  110D-115°  C,  kept  up  for 
an  hour,  is  requisite. 

The  mould-fungi  cause  some  local  diseases  in  the  body,  and 
especially  skin  diseases  such  as  favus,  tinea  tonsurans,  tinea 
versicolor,  tinea  sycosis,  onychomycosis,  and  the  madura-foot  or 
fungus-foot  of  India.     They  also  occur  in  the  fur  of  the  tongue. 

Bacteria,  or  Schizomycetes. — Bacteria  are  every  day  be- 
coming more  and  more  important  on  account  of  the  relation  in 
which  they  are  found  to  stand  to  various  diseases.  Anthrax, 
diphtheria,  phthisis,  and  typhoid  fever,  are  probably  all  due  to 
various  species  of  bacteria  introduced  into  the  body,  and  affecting 
various  organs  in  it.  It  is,  therefore,  of  the  greatest  possible 
importance  that  their  life-history  should  be  learned,  and  that  we 
should  know  what  the  conditions  are  under  which  they  thrive 
best,  and  what  the  conditions  are  which  will  destroy  their  life 
and  prevent  their  development. 

_  They  appear  to  increase  in  two  ways  :  first,  by  simple  multi- 
plication of  their  parts,  and  secondly,  by  forming  spores. 

Bacteria  require  water,  organic  matter,  and  salts,  for  then- 
life.  Some  of  them  also  require  the  presence  of  free  oxygen; 
others  do  not;  hence  they  have  been  divided  by  Pasteur  into 
two  classes  :  aerobious  and  anaerobious.  To  the  anaerobious 
bacteria  oxygen  is  not  merely  unnecessary  but  hurtful,  and 
even  the  _  aerobious  bacteria,  although  they  require  oxygen 
in  a  certain  quantity,  are  injured  or  destroyed  by  it  when  it  is 
in  excess. 


chap,  in.]    ACTION  OF  DRUGS  ON  PROTOPLASM,  ETC.      83 


Blastomycetes,  01    ) 
Yeasts  .    / 


Fie.  15. 


(Tornla, 
or  Saccharomyces  (Fig.  151 
01  Mycoderma. 


Hyphomycetes,  or    1 
Moulds    .        .     ) 


Fig.  16. 


/Mucor. 
Penicillium. 
Oldium. 
Achorion. 
Trichophyton 
Microsporcm. 


iWX 


*\\ 


FIG.  17. 


Schizomycetes, 
Bacteria . 


/  Sphaerdbacteria 
(globular  cells) 
Microbacteria,      or 
Bacteria        proper 
(smallj  rod-like  cells) 

Desmobacteria,  or 
Filobacteria  (larger 
rod-like  or  thread- 
like cells) 


1  Micrococcus  (1  (a  &  6)  &  2,  Kg- 16). 
J  Sarcina  (3). 


Bacterium 


Bacillus  (straight) 


Spirobacteria 
(twisted  or   spiral 
cells)       .       .       • 


( Bacterium  termo  (4). 
(B.  llneola(5). 

IB  subtilis(6). 
B.  anthracis  (7). 
B.  septicemia. 
B.  malaria?  (8). 
B.  tuberculosis  (12). 
B.  lepra?. 
Vibrio  (wavy)    .  Vibrio  serpens  (9). 

Spirocha?ta(Iong,flex-  ]  gpirochasta.    Ober- 
ible,      close-wound  f     meyeri(10). 
spirals)    .       .       .  I 
Spirillum  (short,  stiff,  1  s_  T0iutans  (11). 
open  spirals).  .  J 

e  2 


84  PHAEMACOLOGY  AND  THEEAPEUTICS.      [sect.  r. 

The  soil  which  is  most  favourable  to  different  classes  of 
bacteria  varies  with  each  class.  A  struggle  for  existence  goes 
on  between  bacteria  and  other  organised  ferments,  and  between 
different  kinds  of  bacteria  themselves,  in  the  same  way  as  amongst 
higher  plants.  Just  as  an  abundant  crop  of  one  kind  of  higher 
plants  will  occupy  a  whole  field  and  choke  other  plants,  so  that 
kind  of  bacterium  which  grows  most  readily  in  a  particular  soil 
will  choke  others  and  prevent  them  growing  at  the  same  time 
with  itself.  During  their  growth  they  alter  the  soil  or  substance 
in  which  they  grow,  either  by  exhausting  the  nutriment  it 
affords,  or  by  forming  in  it  new  substanaes  which  are  injurious 
to  themselves,  and  thus  they  gradually  die  out. 

But  the  soil  which  is  no  longer  suitable  for  one  kind  of 
bacterium  then  becomes  suitable .  for  another,  and  their  spores, 
which  may  have  lain  without  germinating  during  the  time  the 
first  kind  was  growing,  now  begin  to  grow  actively. 

Thus,  if  a  number  of  germs  of  different  classes  of  fungi  be 
added  at  the  same  time  to  a  saccharine  solution,  the  bacteria 
only  will  grow  and  set  up  lactic  fermentation.  If  a  small  quan- 
tity of  tartaric  acid  be  now  added  (J  per  cent.)  the  yeast  alone 
will  grow  and  alcoholic  fermentation  begins.  If  more  tartaric 
acid  be  added  (4-5  per  cent.)  the  alcoholic  fermentation  stops, 
and  mould  begins  to  grow.  In  this  process  neither  the  bacteria 
nor  the  yeast  are  killed  by  the  addition  of  tartaric  acid,  which,  in 
different  proportions,  merely  renders  the  liquid  more  favourable 
for  the  growth  of  the  yeast  and  mould  respectively,  and  enables 
them  to  flourish  best,,  although  the  others  are  still  present. 

In  fresh  grape-juice  many  germs  are  present,  but  the  compo- 
sition of  the  liquid  being  more  favourable  to  the  growth  of.  the 
yeast-plant  than  to  other  fungi,  it  alone  grows.  When  it  has 
converted  the  sugar  into  alcohol  its  growth  stops,  and  bacteria 
may  then  multiply  and  convert  the  alcohol  into  acetic  acid. 
This  in  turn  checks  the  growth  of  the  bacteria,  and  mould-fungi 
then  find  the  soil  favourable.  In  their  growth  they  consume  the 
lactic  acid,  and  the  liquid  once  more  affords  a  favourable  soil  for 
bacteria,  which  may  then  grow  and  cause  putrefaction. 

The  same  struggle  for  existence  occurs  between  the  different 
species  of  bacteria  themselves.  Thus  micrococci  may  be  pre- 
vented from  growing  by  micro-bacteria,  and  bacilli  may  be  killed 
by  bacterium  termo  when  the  supply  of  oxygen  is  insufficient  for 
both.1 

It  is  to  be  noted,  however,  that  in  the  struggle  for  existence 
the  formation  of  poisonous  products  by  bacteria-  may  be,  and 
probably  is,  beneficial  to  them.  No  doubt  these  poisonous 
products  check  their  own  growth  and  finally  destroy  them ;  but 

1  Ziegler's  Pathological  Anatomy,  translated  and  edited  by  MacAlister,  p.  272. 
This  work  contains  a  very  lucid  and  complete  account  of  disease  germs. 


chap,  in.]  ,  ACTION.  OF  DRUGS  ON  PROTOPLASM,  ETC.      85 

in  the  struggle  for  existence  between  bacteria  and  living  tissues 
these  poisons  may  be  beneficial  to  the  bacteria  by  killing  the 
tissues,  and  thus  giving  the  bacteria  a  more  ample  supply  of 
nutriment. 

In  investigating  any  problem  it  is  always  best  to  take  the 
simplest  case,  and  if  we  look  at  the  struggle  for  existence 
between  bacilli  and  an  amoeba,  or  white  blood-corpuscle,  we  shall 
see  that  the  formation  of  poisonous  products  by  the  bacteria  may 
enable  them  to  destroy  the  amoeba  or  leucocyte  instead  of  their 
being  destroyed  by  it  (Fig.  25,  p.  87). 

These  poisonous  products  in  fact  may  prepare  the  soil  for 
bacteria,  and  this  supposition  is  confirmed  by  the  observations 
of  Eossbach  and  Eosenberger.  Eossbach  found  that  when  papain 
was  injected  into  the  vessels,  micrococci  developed  in  the  blood 
with  extraordinary  rapidity,  the  ferment  seeming  to  have  altered 
the  blood  to  such  an  extent  that  it  became  an  exceptionally 
favourable  soil  for  the  micrococci.  A  similar  result  was  observed 
by  Eosenberger  from  the  injection  of  sterilised  septic  blood.  In 
tbis  blood  the  bacteria  themselves  were  destroyed,  but  the 
poisonous  substances  which  they  had  formed  were  present,  and 
these  seemed  to  have  a  similar  action  to  the  papain. 

The  struggle  for  existence  between  the  Organism  and 
the  Microbes  which  invade  it.— This  has  been  found  by 
Metschnikoff  to  occur  both  in  the  blood  and  the  tissues.  In  the 
daphne,  or  water-flea,  where  the  tissues  are  transparent,  he  has 
been  able  to  observe  the  spores  of  a  kind  of  yeast  passing  from 
the  intestinal  canal  into  the  body-cavity  (Figs.  18,  19).  As  they 
pass  through  they  are  attacked  by  leucocytes — sometimes  by  one, 
sometimes  by  many.  These  leucocytes  occasionally  coalesce 
so  as  to  form  a  Plasmodium.  When  they  are  sufficiently  power- 
ful they  digest  and  destroy  the  spores  (Figs.  19,  20,  and  21). 
Sometimes  the  spores  may  be  left  sufficiently  long  intact  to 
germinate  and  give  off  buds,  which  become  free  in  the  body- 
cavity,  and  may  also,  like  the  parent  spores,  be  attacked  and 
digested  by  leucocytes. 

When  there  are  many  spores  they  destroy  the  leucocytes 
instead  of  being  destroyed  by  them  (Fig.  25). 

The  connective-tissue  cells  also  take  up  and  destroy  the 
microbes,  and,  from  the  property  the  cells  possess  of  eating  up 
the  microbes,  Metschnikoff  names  them  phagocytes.1  He  finds 
that  bacillus  anthracis  is  eaten  up  in  a  similar  way  by  white 
blood-corpuscles  ; 2  and  Fodor 3  has  observed  that  various  kinds  of 
bacteria,  viz.  bacterium  termo,  bacillus  subtilis,  and  bacterium 
megatherium,  as  well  as  the  spores  of  the  latter,  disappear  in 
four  hours  after  they  are  injected  into  the  blood  of  living  rabbits; 

1  Virchow's  ArcMv,  vol.  xcvi.,  p.  177.  z  Idem,  vol.  xcvii.,  p.  502. 

»  Arch,  far  Hygiene,  Bd.  34,  p.  129. 


86 


PHAEMAOOLOGY  AND  THEEAPEUTIOS.     [sect.  i. 


Pig.  18.— A  piece  of  the  anterior  part  of  the  body  of  a  Daphne,  with  a  number  of  spores,  some  of 
which  are  still  in  the  intestinal  canal,  others  are  penetrating  the  intestinal  wall,  and  others 
are  free  in  the  abdominal  cavity,  where  they  are  attacked  by  leucocytes. 


Pw.  19. 

1.  A  spore  which  has  penetrated  the  intestinal  wall  and  entered  the  abdominal  cavity,  where  font 

leucocytes  have  surrounded  its  end.  m,  the  muscular  layer  of  the  intestine  ;  e,  epithelial  layer ;  *, 
the  serous  layer. 

2.  A  spore  surrounded  by  leucocytes  from  the  abdominal  cavity  of  a  Daphne. 

3.  Confluent  leucocytes  enveloping  a  spore. 

4.  A  spore,  of  which  one  end  is  being  digested  by  a  leucocyte. 


Fig.  20.— Different  stages  of  the  changes  undergone  by  spores  through  the  action  of  phagocytes. 


Pia.  21.— A  germinating  spore  with  leucocyte  adherent  to  It, 


chap.  iij.J    ACTION  OF  DKUGS  ON  PEOTOPLASM,  ETC.      87 


/"* 


Fig,  22.— A  spore  germinating  and  forming  conidia,  which  drop  ofE  and  become  free  la 
the  abdominal  cavity. 


Fig.  23.— (i  and  6,  two  stages  in  the  process  of  Fig.  24.— A  leucocyte  enclosing  conidla. 

leucocyte  eating  up  two  conidia. 


Flo.  26.— A  group  of  conidia  which  have  caused  the  leucocytes  surrounding  a  spore  to  dissolve, 
leaving  only  an  empty  vesicle  and  fine  detritus. 


Fig.  26.— A  connective-tissue  phagocyte,  containing  three  fungi-cells. 


Fig.  27.— Leucocyte  of  a  frog  from  the  neighbourhood  of  a  piece  of  the  lung  of  a  mouse  infected  with 
antnrax  about  forty-two  hours  after  the  piece  of  lung  had  been  placed  under  the  skin  of  the 
frog's  back.    The  leucocyte  is  in  the  act  of  eating  up  an  anthrax  bacillus. 


Fig.  28.— The  same  leucocyte,  a  few  minutes  later,  after  It  has  completely  enveloped  the  baoillnv 


88  PHARMACOLOGY  AND  THERAPEUTICS,     [sept.  i« 

but  if  the  animals  are  weak,  or  depressed  by  hunger  or  cold, 
they  have  much  less  power  of  destroying  the  foreign  organisms, 
and  so  a  longer  time  elapses  before  the  bacteria  disappear. 

When  only  a  small  number  of  pathogenic  bacteria,  such  as 
the  bacillus  anthracis,  is  injected  into  the  blood  at  once,  they 
are  destroyed  in  the  organism;  but  when  they  are  in  larger 
numbers,  they  have  the  best  of  the  struggle,  and  the  organism 
itself  is  destroyed.  It  is  probable  that  bacteria  are  constantly 
entering  the  organisms  of  men  and  animals  from  the  lungs  and 
digestive  canal,  but  unless  they  are  excessive  in  number,  and 
virulent  in  their  nature,  they  are  quickly  destroyed.1 

The  septic  poisoning  which  occurs  from  wounds  is  not  due 
merely  to  bacteria  entering  the  blood  from  them,  but  is  due 
chiefly  to  the  absorption  of  the  poisons  which  the  bacteria 
have  formed  in  the  wound.  The  dead  or  enfeebled  tissues 
which  occur  in  the  wound  afford  a  soil  favourable  to  the  growth 
of  the  bacteria,  and  for  the  formation  of  their  deadly  products. 
When  these  are  absorbed  they  not  only  poison  the  tissues 
generally,  but,  by  doing  so,  convert  the  whole  body  into  a  soil 
suitable  for  the  growth  and  development  of  bacteria,  as  is  shown 
by  the  fact  that  the  tissues  of  animals  killed  by  the  injection  of 
sepsin  decompose  very  quickly,  and  swarm  with  bacteria  shortly 
after  death. 

Action  of  Drugs  on  the  Movements  of  Bacteria. 

Mode  of  Experimenting-. — In  order  to  test  the  effect  of  a  drug  on 
the  movements  of  bacteria  already  developed,  a  drop  of  the  solution  contain- 
ing bacteria  may  be  mixed,  under  the  microscope,  .with  a  drop  of  the  solution 
of  a  drug  in  the  way  already  described  at  page  63,  and  the  strength  of 
solution  necessary  to  destroy  their  movements  estimated  in  the  same  manner. 

In  order  to  combine  experiments  on  the  movements,  and  on  the  reproduc- 
tion, so  as  to  ascertain  whether  the  bacteria  which  have  been  rendered 
motionless  by  heat  or  drugs  are  really  dead,  or  are  only  torpid,  the  covering- 
glass  in  the  experiment  just  described  is  taken  up  with  a  pair  of  sterilised 
forceps,  and  dropped  into  some  sterilised  Cohn's  solution  (vide  p.  72).  It  i3 
then  put  along  with  the  standard  solution  into  a  warm  chamber,  and  left  for 
a  day  or  two.  If  the  bacteria  have  been  destroyed,  it  will  remain  clear  like 
the  standard  solution,  but  if  they  have  only  become  torpid,  it  will  be  more  or 
less  opalescent  or  milky. 

In  performing  this  experiment,  great  care  must  be  taken  that  the  solution 
of  the  drug  has  been  sterilised  by  boiling ;  and  that  the  covering-glass,  glass 
slide,  all  the  instruments,  and  indeed  everything  used  in  the  experiments, 
have  been  also  thoroughly  sterilised  by  heating. 

A  temperature  of  66°  to  70°  0.  usually  arrests  the  move- 
ments of  bacteria,  and  if  continued  for  an  hour  destroys  adult 
organisms,  though  not  the  spores.  A  temperature  of  100°  C. 
usually  destroys  the  spores  as  well,  but  this  is  not  always  the  case. 

If  the  bacteria  are  moist,  this  temperature  generally  kills 
them,  but  not  if  they  happen  to  be  dry,  and  a  much  higher  tem- 

1  Fodor,  op.  cifc.  p.  147. 


chap,  in.]    ACTION  OP  DEUGS  ON  PROTOPLASM,  ETC.      89 

perature  is  then  required.  They  may  become  dry,  before  being 
killed,  by  a  little  solution  containing  them  having  flowed  or 
spurted  into  the  higher  part  of  the  tube  or  flask,  where  the  water 
evaporates  and  leaves  them  dry  before  the  temperature  has  been, 
sufficiently  raised  to  destroy  them. 

The  bacteria  grown  in  different  fluids  are  not  all  equally 
sensitive  to  drugs. 

The  most  destructive  substances  to  bacteria  are  corrosive  sub- 
limate, chlorine,  bromine,  and  iodine.  Quinine  and  the  other 
cinchona  alkaloids  also  destroy  bacteria,  their  power  diminishing' 
in  the  following  order :— quinine,  quinidine,  cinchonidine,  and; 
lastly  cinchonine. 

Bebeerine  is  nearly  as  powerful,  and  potassium  picrate  is  even 
superior  to  quinine  when  used  with  Conn's  solution.  When 
bacteria  are  cultivated  in  beef-tea  instead  of  Cohn's  solution, 
potassium  picrate  is  less  powerful. 

Sulphocarbolates  and  strychnine  have  considerable  power, 
though  a  good  deal  less  than  quinine ;  berberin  and  assculin  have 
hardly  any  power  to  destroy  bacteria  at  all.  Sodium  hyposulphite 
has  very  little  action ;  sodium  sulphate  has  a  destructive  action, 
but  is  about  ten  times  less  strong  than  quinine.1 


Action  of  Drugs  on  the  Reproduction  of  Bacteria  in 

general. 

The  spores  of  bacteria  have  an  enormous  power  of  resisting 
agents  destructive  to  their  vitality,  very  much  greater  than  that 
of  the  fully-developed  bacteria.  Thus  it  happens  that  a  quantity 
of,  an  antiseptic,  which  is  quite  sufficient  not  only  to  prevent  the 
spores  of  bacteria  from  developing  so  long  as  they  remain  in  it, 
but  to  destroy  fully-formed  bacteria,  will  not  destroy  the  vitality 
of  the  spores  or  hinder  them  from  germinating  as  soon  as  they 
are  removed  from  the  influence  of  the  antiseptic  and  transferred 
to  a  proper  soil.  < 

Yet  the  power  to  destroy  the  vitality  of  the  spores  completely 
is  what  is  required  in  an  antiseptic,  for  we  wish  to  destroy  the 
infectious  material,  and  prevent  it  from  causing  disease,  rather 
than  to  administer  substances  to  an  animal  which  will  hinder 
the  germs  from  developing  in  the  blood  after  their  introduction 
into  it ;  although  this  may  be  desirable  when  infection  has 
already  taken  place. 

It  is  therefore  necessary  to  test  the  effect  of  drugs  in  destroy- 
ing the  germs  completely. 

Method  of  Experimenting. — This  is  done  by  adding  to  a  fluid,  con- 
taining bacteria  and  their  spores,  varying  quantities  of  an  antiseptic,  and 
allowing  the  mixture  to  stand  for  a  longer  or  shorter  time.    A  drop  jf  this 

1  Buchanan  Baxter,  Practitioner,  vol.  i.  pp.  343,  350. 


90  PHAEMACOLOGY  AND  THEEAPEUTICS.      [sect.  i. 

fluid  is  then  introduced  by  a  sterilised  platinum  wire  or  glass  pipette  into 
some  sterilised  Cohn's  fluid  or  beef-tea.  This  is  -watched,  to  see  whether 
bacteria  will  develop  in  it  or  not.  If  they  do  develop,  it  is  clear  that  the 
spores  have  not  been  killed  by  the  admixture  with  the  disinfectant  in  the 
original  fluid ;  if  they  do  riot  develop,  then  the  disinfectant  has  been  sufficiently 
powerful  to  destroy  them. 

The  plan  usually  employed  is  to  take  a  number  of  test-tubes,  plug  their 
orifices  with  cotton-wool,  and  destroy  any  germs  that  may  be  attached  to 
them  by  thoroughly  heating  them  to  about  300°  P.  in  a  hot  chamber,  or  in 
the  flame  of  a  Bunsen's  lamp.  They  are  then  allowed  to  cool,  and  a  small 
quantity  of  a  liquid  (about  5  cc.)  in  which  bacteria  readily  grow  is  placed  in 
each.  This  also  must  be  previously  thoroughly  boiled,  in  order  to  destroy 
any  germs  which  may  be  present  in  it.  The  liquid  recommended  by  Cohn 
consists  of  ammonium  tartrate  one  gramme,  potassium  phosphate  and 
magnesium  sulphate  of  each  five  grammes,  calcium  phosphate  "05  gramme, 
distilled  water  100  cc.  This  is  filtered  and  boiled  before  use.  To  the  tubes 
the  different  agents  to  be  tested  are  added,  the  solutions  of  each  having  been 
carefully  sterilised  by  boiling,  and  the  pipette  used  being  superheated  in  each 
case  before  it  is  employed.  If  the  drugs  are  added  in  solution,  a  similar 
quantity  of  boiled  water  must  be  added  to  the  first  tube,  which  is  to  serve  as 
a  standard.  To  each  of  them  is  then  added  a  single  drop  of  a  liquid  contain- 
ing bacteria. 

The  mouths  of  the  tubes  are  then  stopped  with  the  cotton- wool  and  placed 
for  a  few  days  in  a  warm  chamber  at  about  40°  C.  The  standard  liquid  will 
then  be  found  to  be  opalescent  or  milky.  The'  degree  of  the  opalescence  in 
the  other  tubes  will  be  less  according  to  the  effect  of  the  drug  which  has 
been  added,  in  preventing  the  development  of  bacteria. 

Where  it  has  completely  hindered  the  development,  the  solution  will 
remain  quite  clear,  and  as  its  strength  diminishes,  the  opalescence  will  become 
greater  until  it  is  equal  to  that  of  the  standard. 

In  performing  this  experiment  it  is  best  to  use  one  definite  form  of  bac- 
terium, instead  of  a  mixture  of  several  unknown  kinds.  This  is  referred  to 
again  in  speaking  of  the  experiments  of  Dr.  Koch,  who  generally  employs 
the  micrococcus  prodigiosus  as  an  example  of  an  organism  easily  acted  upon, 
and  the  spores  of  bacillus  anthracis,  or  of  a  bacillus  found  in  earth,  as 
examples  of  resistant  organisms. 

It  is  found  by  this  mode  of  experiment  that  a  smaller  quantity 
of  poison  will  prevent  the  development  of  bacteria  than  will 
destroy  them  after  they  are  developed. 

By  experiments  on  the  comparative  action  of  different  drugs 
on  bacteria  the  results  contained  in  the  following  table  have  been 
obtained  by  N.  de  la  Croix,  and  these  have  been  to  a  considerable 
extent  confirmed  by  Koch. 

It  will  be  seen  by  looking  at  the  table  that  the  exact  limit  of 
the  power  of  each  drug  to  destroy  bacteria  is  not  determined, 
but  that  two  concentrations  of  each  antiseptic  are  given,  one  of 
which  is  sufficient  to  do  it,  and  the  other  is  insufficient.  The 
disinfecting  limit  therefore  lies  between  the  two  experiments. 
But  the  limit  of  disinfection  is  not  an  invariable  one  for  each 
'drug,  as  its  power  to  destroy  bacteria  is  modified  not  only  by  the 
concentration  of  the  solution  employed,  but  by  the  length  of  time 
during  which  it  acts,  and  by  the  temperature. 


chap,  in.]    ACTION  OP  DRUGS  ON  PROTOPLASM,  ETC.      91 


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8)2  PHAKMACOLOGY  AND  THEEAPEUTICS.     [sect.  i„ 


Action  of  Drugs  on  particular  species  of  Bacilli. 

In  these  experiments  of  De  la  Croix,  however,  the  nature  of 
the  bacteria  experimented  on  was  not  determined,  and  there 
might  be  a  mixture  of  several  sorts.  Koch  has  therefore  sought 
to  ascertain  the  action  of  disinfectants  upon  definite  forms  of 
microzymes  by  cultivating  them  in  pure  crops  before  applying 
the  disinfectant.  Those  which  he  has  chiefly  experimented  on 
are  the  red  micrococcus  prodigiosus,  the  bacteria  of  blue  pus,  and 
the  bacillus  anthracis. 

The  first  two  do  not  form  spores,  and  are  easily  destroyed 
by  disinfectants.  The  bacillus  anthracis  forms  spores,  and  was 
therefore  employed  to  test  the  action  of  disinfectants  upon  them. 

mode  of  Experimenting-  on  the  Action  of  Drugs  on  Reproduction 
of  Bacilli. — In  order  to  avoid  admixture  with  other  species,  Koch  culti- 
vated the  first  two  on  slices  of  potato,  instead  of  in  a  solution.  Upon  one 
piece  of  potato  the  unaltered  microzymes  were  sown  (control  specimen),  and 
upon  the  others  similar  microzymes  which  had  been  exposed  to  the  action  of 
disinfectants.  If  the  microzymes  had  been  destroyed  by  the  disinfectants, 
no  result  occurred,  but  if  not,  then  a  crop  was  obtained  which,  in  comparison 
with  the  control  specimen,  was  more  or  less  abundant,  according  as  the  action 
of  the  disinfectant  had  been  less  or  more  complete. 

For  the  cultivation  of  the  anthrax  bacillus,  Koch  used  as  a  soil  gelatine 
mixed  with  some  other  nutritive  substance,  usually  meat  infusion  and  peptone 
sterilised  and  spread  upon  a  slip  of  purified  glass,  and  exposed  to  such  a  heat 
as  just  to  solidify  it.  Koch  did  not  use  his  solidified  blood-serum  in  these 
experiments.  This  could  be  placed  under  the  microscope,  and  the  growth  of 
bacilli  observed  from  day  to  day.  Middle-sized  test-tubes  were  then  par- 
tially filled  with  the  disinfecting  solutions,  and  silk  threads,  steeped  in  a 
fluid  containing  bacilli  and  then  dried,  were  placed  in  them  ;  from  time  to 
time  a  thread  was  removed  from  the  tubes  by  means  of  a  previously  heated 
platinum  wire  arid  placed  on  the  slide,  which  was  then  subjected  to  micro- 
scopical observation.  In  this  way  it  was  easy  to  determine  what  strength  of 
solution,  and  what  time  of  exposure  to  its  action,  were  required  to  destroy  the 
spores. 

The  results  of  experiments  made  in  this  way  with  carbolic 
acid  were  very  surprising.  It  was  to  be  expected  that  carbolic 
acid  would  readily  destroy  the  spores,  but  this  was  not  the  case. 
A  1  per  cent,  watery  solution  had  almost  no  action  upon  them 
even  after  they  had  been  exposed  to  it  for  15  days ;  2  per  cent, 
slightly  retarded  their  growth,  but  it  did  nothing  more ;  3  per 
cent,  killed  the  spores  in  7  days ;  4  per  cent,  in  3  days ;  and  5 
per  cent,  in  1  day. 

This  comparatively  slight  action  of  carbolic  acid  on  spores 
and  the  long  time  that  it  requires  to,  destroy  them  show  that  it 
cannot  be  relied  upon  as  a  universal  disinfectant.  But  it  has 
nevertheless  great  power  in  destroying  microzymes  which  have 
not  formed  spores. 

The  fresh  blood  of  an  animal  which  has  died  from  anthrax' 
contains  only  bacilli  and  no  spores.  When  it  is  mixed  with  its 
own  bulk  of  a  1  per  cent,  solution  of  carbolic  acid,  it  can  very 


<3hap.  in.]    ACTION  OF  DEUGS'ON  PEOTOPLASM,  ETC. 


98 


soon  afterwards  be  injected  into  an  animal  without  producing 
any  marked  symptoms.  A  |  per  cent,  solution  will  not  do  this, 
so  that  the  limit  lies  between  *5  and  -25  per  cent,  of  the  mixture 
(v.  p.  97). 

The  action  of  carbolic  acid  on  other  fully-developed  microzymes, 
or  on  the  spores,  is  almost  j;he  .same  as  on  the  anthrax  bacilli. 

The  following  table  gives  the  result  of  Koch's  experiments 
with  other  substances,  the  figures  indicating  the  number  of 
days  during  which  the  spores  had  been  submitted  to  the  action 
of  the  antiseptic  previous  to  cultivation.  The  black- faced  figures 
indicate  that  the  spores  were  destroyed,  and  their  germination 
prevented  by  exposure  to  the  disinfectant  for  that  number  of 
days ;  a  *  indicates  that  their  vitality  was  diminished,  and  that 
the  crop  from  them  was  scanty ;  a  f  indicates  that  their  growth 
was  retarded;  *t  that  it  was  .both  scanty  and  retarded.  The 
disinfectants  are  divided  into  three  groups.  The  first  contains 
the  group  of  fluids ;  the  second  of  solutions  in  water ;  and  the 
;  third  of  solutions  in  alcohol,  ether,  or  oil. 


Geoup  I.^FLUIDS. 


.  Distilled  water   . 

.Alcohol  (absolute) 

'  Alcohol  (1  to  1  of  water) 

Alcohol  (1  to  2  of  water) 

Ether 

Acetone 

Glycerine   . 

Butyric  acid 

French  salad  oil 

Bisulphide  of  carbon  . 

Chloroform 

Benzol 

Petroleum  ether 
^'Turpentine  oil    . 


7    15    20    35    90 

1      3      5    10-  12    20     30    40    50    65     110 

3    20    30    40    50    65  110 

3    20    30    40    50    65  110 
8*  30 


10    20    30    40    50    65  110 


5 
5' 
3 
5 
30    90 
5     10    20 
3     10    20.100 
5    10    20. 
5 


1*    5    10 


Group  II.— SOLUTIONS  IN  WATEE. 


Chlorine  water  (freshly  made)  . 
Bromine  (2  p.  c.  in  water) 
Iodine  water  (1  in  7,000)  . 
Hydrochloric  acid  (2  p.  c.  in  water) 
Ammonia  .... 

:  Ammonium  chloride  (5  p.  c.  in  water) 
Common  salt  (saturated  solution) 
Calcium  chloride  (saturated  solution), 

'  Barium  chloride  (5  p.  c.  in  water) 
Ferric  chloride  (5.  p.  c.  in  water) 
Potassium  bromiie  (5  p.  c.  in  water) 
Potassium  iodide  (5  p.  c.  in  water) 
Corrosive  sublimate  (1  p.  c.  in  water) 
Arsenic  (1  p.  c.  in  water)  . 

,  Lime  water 

Chloride  of  lime  (5  p.  c.  in  water) 
Sulphuric  aeid  (1  p.  c.  in  water) 

•  Zinc  sulphate  (5  p.  c.  in  water) 
Copper  sulphate  (5  p.  c.  in  water) 
Ferrous  sulphate  (5  p.  c.  in  water) 
Sulphate  of  aluminium  (5  p.  o.  in.water) 


1 
1 
1 

1 
1 
1 
1 
1 
5 

at 

5 
5 
1 
1 
o 

It 

1 

1 

1 

2 

1 


5 

5 

5 
10 

6 
10 
10 

2 

6 
10 

2*t 

3 

5* 

5* 

6 

5 


10 

10 
10 
10 

20 
45 

25 
25 

10 

15* 
5 
10* 
10* 
10* 

12- 


25 
20 

40 
100 


80 


20*t 
20* 


94 


PHAEMACOLOGY  AND  THEEAPEUTICS.     [sect.  i. 


Alum  (4  p.  e.  in  water)      .    _    .        . 
Potassium  chromate  (5  p.  e.  in  water) 
Potassium  bichromate  (5  p.  o.  in  water) 
Chrome  alum  (5  p.  c.  in  water) 
Chromic  acid  (1  p.  a.  in  water)      _    . 
Potassium  permanganate  (5  p.  c.  in  water) 
Do.  do.  (1  p.  o.  in  water) 

Potassium  chlorate  (5  p.  c.  in  water) 
Osmic  acid  (1  p.  c.  in  water)      .        •     _  . 
Boracic  acid  (5  p.  c.  in  water)  not  quite  dissolved 
Boras  (S  p.  c.  in  water)     . 
Sulphuretted  hydrogen  water    . 
Ammonium  sulphide 
Oil  of  mustard  with  water 
Formic  acid  (sp.  gr.  1-120) 
Acetic  acid  (5  p.  c.  in  water)     .     _  . 
Potassium  acetate  (saturated  solution) 
lead  aoetate  (5  p.  c.  in  water)  . 
Soft  (potash)  soap  (2  p.  c.  in  water)  . 
Lactic  acid  (5  p.  c.  in  water)     . 
Tannin  (5  p.  c.  in  water)  . 
Trimethylamine  (5  p.  c.  in  water)     . 
Chloropicrin  (5  p.  c.  in  water)   .  _     . 
Benzoic  acid  (saturated  solution  in  water 
Benzoate  of  sodium  (5  p.  u.  in  water) 
Cinnamio  acid  (2  p.  c.  in  water  60  and  alcohol 

40  parts)      .... 
Indol  (in  excess  in  water) . 
Skatol  (in  excess  in  water) 
Leucin  (A  p.  c.  in  water)    . 
Quinine  (2  p.  c.  in  water  and  40  alcohol  60  parts) 
Quinine  (1  p.  c.  in  water  with  HC1)  . 

Gboot  III— SOLUTIONS  IN  ALCOHOL 

Iodine  (1  p.  e.  in  alcohol) 

Valerianic  acid  (5  p.  c.  in  ether) 

Palmitic  acid  (5  p.  c.  in  ether)  . 

Stearic  acid  (5  p.  c.  in  ether)     . 

Oleic  acid  (5  p.  c.  in  ether) 

Xylol  (5  p.  c.  in  alcohol)    . 

Thymol  (5  p.  c.  in  alcohol) 

Salicylic  acid  (5  p.  c.  in  alcohol) 

Salicylic  acid  (2  p.  c.  in  oil)      .... 

Oleum  animale  (Dippel's  oil,  5  p.  o.  in  alcohol) 

Oleum  menthse  piperita  (5  p.  c.  in  alcohol) 

From  this  table  it  appears  that  the  ordinary  method  of  sepa- 
rating between  formed  and  unformed  ferments  by  precipitation 
with  alcohol  and  solution  in  glycerine  cannot  be  relied  upon  as  a 
trustworthy  means  of  separating  them,  since  neither  alcohol  nor 
glycerine  destroys  the  activity  of  formed  ferments. 

It  is  remarkable  that  ether  and  turpentine  oil,  which  are  both 
ozone  carriers,  should  have  such  a  marked  action  in  comparison 
with  other  fluids.  This  is  in  harmony  with  some  recent  observa- 
tions of  Paul  Bert  and  Eegnard,  who  found  that  oxygenated  water 
in  sufficient  quantity  destroys  the  bacteria  of  anthrax. 

The  spores  of  anthrax  bacilli  resist  in  an  extraordinary  way 
the  action  of  certain  substances  which  usually  are  fatal  to  life,  as 
hydrochloric  acid  (2  per  cent.),  salicylic  acid  (1  per  cent.),  cgp 


1          5 
1         2 

12 

1          2 

1          2 

1          2 

1          2 

2          6 

1          2 

6t 

10f 

5        10 

15 

1          5* 

1          2 

5 

1          5 

10* 

1          2 

4 

10 

1          5 

1         4 

10 

1          5 

12 

1         5 

12 

1          2 

5 

1         6 

10 

1         5 

12 

1         2 

6 

12 

1          5 

10 

45 

90 

1         2 

5 

10 

1         3 

5 

10 

1          5 

10 

25 

80 

1          5 

10 

25 

80 

1         5 

10 

l*t      5*t 

1         5 

10 

j,  OB  BTHEE,  OB  OIL. 

1*        2* 

1          5 

1          5 

1          5 

1          5 

1          5 

30 

60 

90 

1          6 

10 

15 

1          6 

10 

15 

5        10 

20 

80 

1      v  "5 

12 

1          5 

12 

chap,  in.]    ACTION  OF  DEUGS  ON  PEOTOPLASM,  ETC.      95 


centrated  solutions  of  chloride  of  sodium,  chloride  of  calcium, 
metallic  solutions,  borax,  boric  acid,  chloride  of  potassium, 
benzoic  acid,  benzoate  of  sodium,  cinnamic  acid,  and  quinine. 

Action  of  Drugs    on  the    Development    and    Growth  of  Bacilli. — 

In  order  to  test  the  action  of  disinfectants  on  the  development  and  growth 
of  bacteria,  Koch  put  into  a  number  of  small  watch-glasses,  or  rather 
crystallisation-glasses  with  flat  bottoms,  a  few  drops  of  blood-serum,  or  a 
solution  of  extract  of  meat  and  peptone,  mixed  with  varying  quantities  of 
the  disinfectant.  Into  each  of  these  a  silk  thread,  which  had  been  dipped 
in  the  fluid  containing  bacteria  and  dried,  was  placed.  In  one  glass  serum 
alone,  without  any  disinfectant,  was  placed,  in  order  to  ascertain,  by  com- 
parison with  the  growth  which  takes  place  in  it,  how  the  disinfectant  in  the 
other  glasses  had  interfered  with  the  growth  of  the  bacilli. 

In  experiments  of  this  sort  a  difference  was  found  between 
anthrax  bacilli  and  other  microzymes.  A  dilution  of  carbolic 
acid,  1  in  1,250  and  1  in  850,  sufficed  to  prevent  the  growth  of 
anthrax  bacilli,  while  a  strength  of  1  in  500  was  required  to 
prevent  the  growth  of  others. 

Other  species  are  therefore  more  resistant  than  anthrax 
bacilli  to  the  action  of  carbolic  acid.  The  following  table  shows 
the  strength  of  various  disinfectants  required  to  hinder  or  entirely 
prevent  the  development  of  anthrax  bacilli : — 

Solution 
Iodine       .... 
Bromine  .... 
Chlorine  .... 
Osmic  acid 

Permanganate  of  potassium 
Corrosive  sublimate . 
.    AUyl  alcohol    . 
Oil  of  mustard . 
Thymol    .... 
Peppermint  oil. 
Oil  of  turpentine 
Oil  of  cloves 
Arsenite  of  potassium 
Chromic  acid    . 
Picric  acid 
Hydrocyanic  acid     . 

The  following  are  abor 

Fluid 
Boric  acid 
Borax 

Hydrochloric  acid 
Salicylic  acid    . 
Benzoic  acid     . 
Camphor  . 
Eucalyptol 
Soft  soap  . 
Quinine    . 
Hydrate  of  chloral 
Chlorate  of  potassium 
Acetic  acid 
Benzoate  of  sodium 
Alcohol     . 
Acetone    . 
Chloride  of  sodium 


Hinders 

Prevents 

1  to  5,000 

— 

1  to  1,500 

— 

1  to  1,500 

— 

1  to  1,500 

— 

1  to  3,000 

— 

1  to  1,000,000 

1  to  300,000 

1  to  167,000 

— 

1  to  330,000 

1  to  33,000 

1  to  80,000 

— 

1  to  33,000 

— 

1  to  75,000 

— 

1  to  5,000 

— 

1  to  100,000 

1  to  10,000 

1  to  10,000 

1  to  5,000 

1  to  10,000 

— 

1  to  40,000 

1  to  8,000 

the  same  strength 

as  carbolic  acid 

Hinders 

Prevents 

1  to  1,250 

1  to  800 

1  to  2,000 

1  to  700       • 

1  to  2,500 

1  to  1,700 

1  to  3,300 

1  to  1,500 

1  to  2,000 

— 

1  to  2,500 

— 

1  to  2,500 

— 

1  to  500 

1  to  5,000 

1  to  830 

1  to  625 

1  to  1,000 

— 

1  to  250 

.                 — 

1  to  250 

— 

1  to  200 

,                 — 

1  to  100 

1  to  12-5 

1  to  50  No  action  . 

— 

1  to  64 

.                *™~ 

96  PHAEMACOLOGY  AND  THEEAPEUTICS.     [sect.  i. 

Influence  of  the  Solvent.— Although  a  5  per  cent,  solution 
of  carbolic  acid  in  water  has  a  well-marked  destructive  action  on 
the  spores,  and  a  strong  destructive  action  on  fully-developed 
anthrax  bacilli,  a  solution  of  the  same  strength  in  oil  or  alcohol 
has  not  the  least  disinfectant  action.  A  similar  influence  with 
regard  to  iodine  is  observable  in  the  previous  tables. 

Effect  of  the  Fluid  with  which  Disinfectants  are  mixed. 
— This  is  sometimes  very  marked,  especially  in  the  case  of  free 
iodine,  bromine,  or  chlorine.  These  in  watery  solutions  are 
powerful  disinfectants,  but  when  mixed  with  fluids  which  contain 
alkalies,  e.g.  blood-serum,  they  are  converted  into  bromides, 
iodides,  and  chlorides,  and  their  action  is  very  greatly  diminished. 
The  action  of  corrosive  sublimate,  however,  and  of  ethereal  oils 
is  not  altered. 

Influence  of  Temperature  on  the  Action  of  Antiseptics.— 
The  action  of  antiseptics  is  greatly  increased  by  a  high  tempera- 
ture. Spores  of  anthrax  bacilli  exposed  to  the  vapour  of  carbolic 
acid  at  15°-20°  C.  remain  unchanged  even  after  45  days'  expo- 
sure. When  exposed  to  the  vapour  of  carbolic  acid  at  a  tem- 
perature of  55°  C.  the  case  is  very  different.  Half  an  hour's 
exposure  does  not  seem  to  harm  them  at  this  temperature,  but 
many  are  destroyed  by  an  exposure  of  an  hour  and  a  half,  and 
very  few  will  stand  3  hours'  exposure,  so  that  probably  an  exposure 
of  5  or  6  hours  would  destroy  the  whole  of  them. 

Alterations  in  Bacteria  by  Heat  and  Soil.— By  careful 
cultivation  through  successive  generations  of  a  slip  taken  from 
a  wild  fruit-tree,  the  chemical  processes  of  growth  may  be  so 
modified  in  it  that  the  fruit  will  lose  its  acrid  character  and 
become  edible  and  pleasant.  What  is  true  of  higher  plants  is 
true  also  of  lower  in  this  respect,  and  bacilli  are  much  modified 
by  the  conditions  under  which  they  are  cultivated ;  for  example, 
Pasteur  has  found  that  the  bacilli  of  anthrax  develop  and  multiply 
in  beef-tea  best  at  25V40°  C.  Their  development  is  retarded  at 
lower  or  higher  temperatures  than  these,  and  is  completely  ar- 
rested at  15°  or  43°  C.  When  cultivated  at  a  temperature  where 
development  occurs  with  difficulty,  such  as  42°-43°,  the  bacilli 
no  longer  form  resting  spores,  but  only  grow  into  long  threads. 

Fresh  bacilli  injected  into  an  animal  rapidly  cause  death 
from  anthrax,  but  the  longer  they  have  been  previously  kept  at 
this  high  temperature  the  more  does  their  virulence  decrease, 
and  at  the  end  of  four  or  six  weeks  they  die. 

When  some  of  the  first  crop  of  bacilli  are  put  into  fresh  beef- 
tea,  the  second  crop  retains  the  degree  of  virulence  of  the  first, 
and  the  third  crop  taken  from  the  second,  and  again  grown  in 
fresh  beef-tea,  has  exactly  the  same  morbific  power,  and  so  on. 

When  the  bacilli  are  cultivated  at  35°,  the  microzymes  not 
only  multiply  quickly,  but  they  form  spores  of  a  definite  degree 
of  virulence,  and  these  spores  may  be  kept  unaltered  for  years  in 


chap,  in.]    ACTION  OF  DBUGS  ON  PEOTOPLASM,  ETC.      97 

sealed  tubes,  whereas  the  threads  of  developed  bacilli  die  when 
air  is  excluded. 

When  an  animal  is  inoculated  with  anthrax  bacilli  whose 
virulence  has  been  diminished  by  cultivation  at  a  high  tempe- 
rature, they  produce  merely  temporary  illness  instead  of  death. 
By  the  growth  of  these  non-virulent  bacteria  in  the  body,  its 
constitution  appears  to  undergo  some  alteration,  and  virulent 
bacteria  subsequently  injected  have  a  much  less  powerful  action 
on  it.  If  the  first  injection  be  made  with  bacteria  having  a  very 
slight  amount  of  virulence,  the  animal  may  still  die  if  injected  a 
second  time  with  virulent  bacteria,  but  if  inoculated  first  with 
non-virulent  bacteria  and  a  second  time  with  bacteria  rather 
more  powerful,  a  slight  disturbance  is  produced  by  each  inocu- 
lation, and  a  subsequent  injection  of  virulent  bacteria  no  longer 
causes  death. 

The  changes  which  are  produced  by  inoculation  with  modified 
anthrax  or  with  vaccine  matter  in  the  blood  and  tissues,  although 
probably  very  slight,  are  sufficient  to  confer  on  the  organism 
immunity  from  further  infection.  This  is  usually  permanent, 
although  the  immunity  may  dimmish  with  the  course  of  years, 
unless  the  advancing  age  of  the  animal  in  itself  tends  to  lessen 
its  liability  to  infection. 

A  similar  immunity  against  infection  with  different  bacilli  is 
sometimes  conferred  by  age.  Thus  young  dogs  are  easily  infected 
with  anthrax,  but  old  ones  are  not. 

A  difference  of  species  also  confers  immunity.  Thus  rats 
and  field-mice  are  not  liable  to  infection  with  anthrax,  while 
house-mice  are  highly  so.  Algerian  sheep  also  resist  infection 
with  anthrax,  while  French  sheep  do  not. 

The  experiments  of  Cash  seem  to  show  that  it  may  be  possible 
by  the  action  of  drugs  to  alter  the  blood  and  tissues  in  such  a 
way  as  to  render  the  animal  proof  against  infection  by  pathogenic 
bacteria ;  for  he  has  found  that  by  the  continued  administration 
of  minute  doses  of  corrosive  sublimate  to  animals  he  can  render 
them  capable  of  resisting  the  lethal  effects  of  anthrax  subse- 
quently inoculated.1  This  is  a  direction  in  which  further  research 
is  likely  to  yield  interesting  results. 


Possible  Identity  of  Different  Forms  of  Bacteria. 

It  has  already  been  mentioned  that  we  are  not  quite  certain 
whether  all  the  species,  genera,  or  even  orders  of  bacteria  are 
natural  divisions,  or  whether  the  same  organism  under  various 
conditions  of  nutrition  and  development  may  not  present  such 
different  appearances  as  to  be  included  in  different  orders  and 

1  Cash :  Proceedings  of  the  Physiological  Society,  Dec.  12,  1885.     Journal  of 
Physiology,  vol.  vii. 


98  PHAEMACOLOGY   AND   THEEAPEUTICS.      [sect.  i. 

under  different  names.  Yet  this  is  a  matter  of  very  great  im- 
portance in  regard  to  the  causation  of  disease,  for  if  it  be  true 
that  organisms  which  are  usually  innocuous  may  undergo  an 
opposite  process  to  that  which  occurs  in  anthrax  bacilli  by  cul- 
tivation, and  may  in  certain  conditions  of  soil  be  changed  from 
innocuous  into  pathogenous  forms,  we  can  understand  how 
diseases  may  appear  to  originate  de  novo. 

It  has  been  stated  by  Naegelithat  bacteria  may  be  so  modified 
by  cultivation  as  to  form  entirely  different  fermentative  products. 
Thus  he  says  that  the  bacterium  which  produces  lactic  acid 
fermentation  in  milk  may  be  changed  by  cultivating  it  in  extract 
of  meat  and  sugar,  so  that  it  will  no  longer  produce  a  lactic  but 
an  ammoniacal  decomposition  in  milk.  He  considers  also  that 
innocuous  may  be  transformed  into  virulent  bacteria,  and  back 
again  into  an  innocuous  form,  and  Buchner  thinks  that  he  has 
succeeded  in  transforming  the  ordinary  hay -bacillus  (bacillus  sub- 
tilis)  into  anthrax  bacillus  by  cultivating  it  for  a  number  of 
generations  in  Liebig's  meat  extract,  peptone,  and  sugar.  This 
observation  is  denied  by  Klein '  and  others,  but  observations 
which  partly  support  Buchner  and  partly  Klein  have  been  made 
by  P.  Kohler,2  who  finds  that  while  the  ordinary  hay -bacillus 
(bacillus  subtilis)  is  not  altered  in  its  appearance  by  repeated 
cultivations,  it  acquires  a  progressive  virulence  which  renders  it 
so  fatal  to  animals  as  to  resemble  the  anthrax  bacillus  in  its 
deadly  properties. 

H.  C.  Wood  and  Formad 3  have  also  come  to  the  conclusion 
that  the  micrococci  found  in  diphtheria  resemble  those  on  furred 
tongues  in  all  respects  excepting  in  their  greater  tendency  to  grow. 
When  cultivated  successively,  they  lose  their  contagious  power 
and  grow  less  readily.  These  authors,  therefore,  consider  that 
circumstances  outside'  the  body  are  capable  of  converting  the 
slower  growing  or  common  micrococcus  into  the  rapidly  growing 
micrococcus  of  diphtheria,  which,  when  cultivated  again,  reverts 
to  the  common  type. 

Action  of  Bacteria  and  their  Products  on  the  Animal 
Body. — When  bacteria  are  injected  into  the  animal  body,  they 
produce  different  effects  according  to  the  original  nature  of  the 
bacteria  or  bacilli,  the  conditions  under  which  they  have  been 
cultivated,  and  the  quantity  introduced.  There  is  probably 
another  factor  of  no  less  importance,  which,  however,  still  re- 
quires to  be  investigated,  viz.  the  condition  of  the  body  (p.  97) 
into  which  they  are  introduced.  In  considering  the  effect  of  an 
injection  into  the  living  body  of  a  solution  containing  bacilli,  we 
must  be  careful  to  distinguish  between  the  effect  of  the  bacilli 
themselves,  after  their  introduction  into  the  circulation,  upon  the 

'  Klein,  Quarterly  Journ.  of  Microscopic  Science,  Jan.  1883. 

2  Inaugural  Dissertation  (Gottingen),  1881. 

*  National  Board  of  Health  Bulletin,  Siipplement  No.  17,  Jan.  21,  18f>2. 


chap.  iii.J    ACTION  OP  DEUGS  ON  PEOTOPLASM,  ETC.      99 

tissues  and  organs  of  the  body,  and  the  effect  of  the  substances 
which  they  have  already  formed  in  the  solution  before  their 
injection. 

We  must  distinguish  between  those  two  things  in  the  same 
way  as  we  would  have  to  distinguish  between  the  effects  of  the 
particles  of  the  yeast-plant  and  the  effects  of  the  alcohol  which 
it  had  formed,  if  we  were  to  inject  a  solution  in  which  yeast  was 
growing  into  the  veins  of  an  animal.  The  yeast  or  the  bacteria 
would  have  one  effect  upon  the  animal,  the  alcohol  or  the  septic 
products  of  the  bacteria  would  have  another. 

Solutions  of  putrid  organic  matter  containing  numerous 
bacteria  cause  high  fever  and  often  death. 

The  course  of  the  fever  depends  on  the  specific  nature  of  the 
bacteria,  e.g.  septic  bacteria,  anthrax  bacilli,  &c. 

It  is  difficult  at  present  to  ascertain  exactly  how  far  all  the 
following  diseases  are  due  to  the  presence  of  microbes  or  their 
products  ;  but  it  has  been  found  that  micrococci  cause  erysipelas, 
acute  necrosis,  gonorrhoea,  gonorrhceal  ophthalmia,  contagious 
ophthalmia,  ophthalmia  neonatorum,  and  are  present  in  pyaemia, 
puerperal  fever,  ulcerative  endocarditis,  infective  myositis,  and 
contagious  pneumonia.  When  malignant  oedema  or  traumatic 
gangrene  occur,  bacilli  are  usually  found.  Micrococci  are  also 
supposed  by  some  to  be  the  cause  of  vaccinia  and  of  diphtheritic 
inflammation.  The  bacillus  anthracis  produces  anthrax  ;  bacillus 
septicaemiae,  blood-poisoning ;  bacillus  malariae,  ague  and  mala- 
rious diseases ;  bacillus  tuberculosis,  phthisis ;  bacillus  leprae, 
leprosy ;  and  another  bacillus  is  the  cause  of  glanders.  In  re- 
lapsing fever  the  spirochaeta  Obermeyeri  is  found  in  the  blood, 
and  is  probably  the  cause  of  the  disease. 

Alkaloids  formed  by  Putrefaction.  Ptomaines. — From 
decomposing  organic  matter  substances  can  be  separated  which 
have  all  the  characters  of  alkaloids. 

The  alkaloids  produced  by  putrefaction  are  usually  known 
by  the  name  of  ptomaines.  It  was  at  one  time  supposed  that 
they  were  different  in  their  chemical  nature  from  the  alkaloids 
which  occur  in  plants,  and  they  were  supposed  to  have  a  much 
greater  reducing  power  than  the  latter.  It  was  therefore  pro- 
posed to  distinguish  between  ptomaines  and  other  alkaloids  by 
the  addition  of  potassium  ferricyanide :  if  the  alkaloid  changed 
this  into  ferrocyanide,  so  that  a  precipitate  of  prussian  blue  was 
obtained  on  the  addition  of  ferric  chloride,  it  was  supposed  to 
belong  to  the  class  of  ptomaines ;  whereas  non-reduction  was 
supposed  to  show  that  it  belonged  to  the  vegetable  alkaloids. 
It  was  soon  found,  however,  that  this  test  was  not  trustworthy, 
for  such  important  alkaloids  as  morphine  and  veratrine  produced 
reduction.  Later  researches,  especially  those  of  Brieger,  have 
shown  that  some  at  least  of  the  so-called  ptomaines  are  identical 
with  vegetable  alkaloids. 

H  2 


100  PHAEMAC0LOGY  AND   TSBEAPEUTICS.     [sect.  i. 

We  may  indeed  now  regard  alkaloids  as  products  of  albu- 
minous decomposition,  whether  'their  albuminous  precursor  be 
contained  in  the  cells  of  plants  and  altered  during  the  pro- 
cess of  growth,  or  whether  the  albuminous  substances  undergo 
decomposition  from  the  presence  of  microbes,  either  outside  or 
inside  the  animal  body,  or  by  the  pimple  process  of  digestion  by 
unorganised  ferments  such  as  pepsine. 

The  alkaloidal  products  formed  by  the  putrefaction  of  albu- 
minous substances,  vary  according  to  the  stage  of  decay  at  which 
they  are  produced.  At  first  the  poisonous  action  of  these  pro- 
ducts may  be  slight.  As  decomposition  advances,  the  poisons 
become  more  virulent ;  but  after  a  longer  period  they  appear  to 
become  broken  up  and  lose  to  a  great  extent  their  poisonous 
power. 

Muscarine,  which  is  the  poisonous  alkaloid  of  some  mush- 
rooms, has  been  made  synthetically  by  Schmiedeberg  and  Har- 
nack  from  choline ;  and  Brieger  has  obtained  from  decomposing 
albuminous  substances  several  well-defined  chemical  bodies— 
dimethylamine,  trimethylamine,  triethylamine,  ethylenediamine, 
choline,  neurine,  neuridine,  muscarine,  gadinine,  cadaverine, 
putrescine,  saprine,  and  mydaleine,  as  well  as  some  substances  to 
which  he  has  given  no  name.  Muscarine,  neurine,  and  choline 
all  have  a  similar  action,  their  power  diminishing  in  the  order 
just  mentioned,  choline  being  much  weaker  than  the  other  two. 
They  all  produce  salivation,  diarrhoea,  vomiting,  dyspnoea,  para- 
lysis, and  death.  Muscarine  and  neurine  in  frogs  produce  com- 
plete stoppage  of  the  heart  in  diastole  ;  in  mammals  they  only 
weaken  its  action.  Neurine,  cadaverine,  putrescine,  and  saprine 
have  no  marked  physiological  action ;  but  one  alkaloid  which 
Brieger  has  isolated  from  human  cadavers  in  an  advanced  stage 
of  decomposition  appears  to  affect  the  intestine,  causing  enormous 
peristalsis,  continuous  diarrhoea,  lasting  for  days,  and  extreme 
weakness.  Mydaleine,  obtained  from  a  similar  source,  is  interest- 
ing, inasmuch  as  it  causes  a  rise  of  temperature  ;  for  frequently 
we  find  in  cases  of  acute  disease  that  the  rise  of  temperature 
coincides  with  the  constipation,  and  is  removed  by  purgation,  so 
that  the  question  arises  how  far  the  rise  of  temperature  in  such 
cases  may  be  due  to  the  absorption  of  poison  from  the  intestine. 
Mydaleine  causes  dilatation  of  the  pupil,  enormous  secretion  of 
tears,  saliva,  and  sweat,  vomiting,  diarrhoea,  paralysis,  convulsions, 
twitching,  dyspnoea,  coma,  and  death. 

Sepsine,  which  was  isolated  by  Bergmann  and  Schmiedeberg 
from  putrefying  yeast,  causes  vomiting,  diarrhoea,  and  bloody 
stools ;  but  Nicati  and  Kietsch '  have  produced  choleraic  symptoms 
in  animals  by  cultivations  of  Koch's  comma  bacillus  from  which 
the  organisms  themselves  had  been  removed;  and  somewhat 

5 

1  Compt.  rend.,  xo.  928. 


chap,  in.]    ACTION  OF  DEUGS  ON  PROTOPLASM,  ETC.    101 

similar  results  were  obtained  several  years  ago  by  Lewis  and 
Douglas  Cunningham  with  cholera  stools  in  which  any  organisms 
present  had  been  destroyed  by  boiling. 

The  extract  from  putrefied  maize  has  a  tetanic  and  narcotic 

,  action,  which  appears  to  be  due  to  two  different  substances. 

These  are  not  present  in  the  same  proportion,  so  that  sometimes 

the  tetanising  action,  and  at  other  times  the  narcotic  action,  is 

most  marked. 

Another  alkaloid,  resembling  atropine  in  its  action,  has  been 
separated  by  Sonnenschein  and  Zuelzer  from  decomposing  animal 
matter ;  and  this  has  also  been  found  in  the  bodies  of  persons 
dying  from  typhus  fever. 

Another  which  resembles  curare  in  its  action  has  been  separated 
by  Guareschi  and  Mosso '  from  putrefying  brain. 

Another  substance  causing  tetanic  symptoms  has  also  been 
obtained  from  animal  matter. 

Leucomaines. — Gautier,  to  whom  much  of  our  knowledge 
regarding  alkaloids  produced  by  albuminous  decomposition  is 
due,  has  given  the  name  of  leucomaines  to  alkaloids  which  are 
not  produced  by  putrefaction  due  to  bacteria,  but  are  formed  by 
the  decomposition  of  albuminous  matters  in  the  normal  processes 
of  waste  in  the  living  animal  tissues.  Amongst  these  he  reckons 
various  substances  formed  in  muscles  and  allied  to  xanthine  and 
creatine.2 

Brieger  has  shown  that  during  the  digestion  of  fibrin  by 
pepsin  an  alkaloid  has  been  formed,  to  which  he  gives  the  name 
of  peptotoxin. 

Absorption  and  Elimination  of  Ptomaines  and  Leuco- 
maines.— It  is  probable  that  a  considerable  production  of  alkaloids 
takes  place  in  the  intestine,  both  when  the  digestive  processes 
are  normal  and  more  especially  when  they  are  disordered ;  at  the 
same  time  alkaloids  are  being  formed  in  the  muscles,  and  pos- 
sibly also  in  other  tissues.  Were  all  the  alkaloids  to  be  retained 
in  the  body,  poisoning  would  undoubtedly  ensue,  and  Bouchard 
considers  that  the  alkaloids  formed  in  the  intestine  of  a  healthy 
man  in  twenty-four  hours  would  be  sufficient  to  kill  him  if  they 
were  all  absorbed  and  excretion  stopped.  He  finds  that  the 
poisonous  activity  of  even  healthy  human  faeces  is  very  great, 
and  a  substance  obtained  from  them  by  dialysis  produced  violent 
convulsions  in  rabbits.  When  the  funcdons  of  the  kidney  are  im- 
paired, so  that  excretion  is  stopped,  uraemia  occurs,  and  Bouchard 
would  give  the  name  of  stercoraemia  to  this  condition,  because  he 
believes  it  to  be  due  to  alkaloids  absorbed  from  the  intestines 
He  also  thinks  that  the  nervous  disturbance  which  occurs  in 
cases  of  dyspepsia  is  due  to  poisoning  by  ptomaines.     That 

1  Les  Ptomaines,  Turin,  1883. 
Sur  les  alcalcfides  dirivis  de  la  ctestruoticn  hacU.-ienne  ou  physiologig^ue  des 

animaux.    Paris :  G.  Masson.     1886. 


102  PHARMACOLOGY   AND   THERAPEUTICS,      [sect.  i. 

alkaloids  are  excreted  by  the  urine  has  been  shown  by  Bocci, 
■who  has  found  in  the  urine  a  substance  having  an  action  like 
that  of  curare. 

Effect  of  Drugs  on  the  Action  of  Bacteria  in  the  Animal 

Body. 

So  long  as  bacteria  are  outside  the  body,  we  may  use  drugs 
of  any  strength  we  please  to  destroy  them,  but  the  case  is  quite 
different  when  they  have  once  gained  entrance  and  are  no  longer 
outside  but  inside  the  body,  because  then  the  nature  of  the  drug 
and  the  amount  we  can  employ  is  limited  by  its  effect  on  the 
organism  itself,  and  we  cannot  administer  very  large  doses  of 
antiseptics  leBt  we  should  injure  or  kill  the  patient  at  the  same 
time  that  we  destroy  the  bacteria  which  are  causing  the  disease. 
All  that  we  can  hope  to  do  is  to  turn  the  scale,  if  possible,  in 
favour  of  the  organism  in  the  struggle  for  existence  between  the 
cells  which  compose  it  and  the  bacteria  which  have  invaded  it 
(vide  pp.  86  and  89). 

Our  hope  of  doing  this  rests  on  the  fact  that  drugs  which 
may  be  injurious  both  to  the  tissue  and  to  the  bacteria  are  not 
equally  so  to  each.  Thus  excess  of  temperature  is  injurious  to  the 
organism,  but  it  is  also  destructive  to  bacteria ;  and,  as  Fokker ' 
has  pointed  out,  the  febrile  reaction  which  occurs  on  the  intro- 
duction of  bacteria  into  the  blood  may  be  a  means  of  destroying 
the  mierobes  and  preserving  the  animal.  There  is  often  a  germ 
of  truth  in  apparently  foolish  plans  of  treatment,  and  the  old 
practice  of  treating  scarlet  fever,  small-pox,  and  measles  by  warm 
drinks,  hot  rooms,  and  abundant  clothing  may  have  been  a  blind 
effort  to  aid  the  natural  processes  of  cure,  just  as  the  irritating 
ointment  of  the  Middle  Ages  seems  to  have  been  an  attempt  at 
antiseptic  surgery.  The  extraordinary  destructive  power  of  cor- 
rosive sublimate,  and  the  fact  that  it  continues  to  act  in  blood- 
serum  just  as  it  does  in  distilled  water,  seem  to  indicate  that 
it  might  be  used  to  destroy  bacilli  in  the  body,  especially  as 
Schlesinger  has  found  that  it  may  be  injected  subcutaneously 
into  rabbits  and  dogs  daily  for  several  months  without  doing 
them  any  harm,  even  in  doses  of  5  milligrammes,  1  cc.  of  a  \  per 
cent,  solution.  Koch's  experiments  on  this  point,  by  the  adminis- 
tration of  sublimate  after  inoculation  with  anthrax,  led  to  a 
negative  result,  the  animals  inoculated  with  anthrax  dying  of  the 
disease,  notwithstanding  the  injection  of  the  sublimate.  On  the 
other  hand,  Cash  has  succeeded  in  preventing  death  from  anthrax 
by  administering  corrosive  sublimate  for  some  time  previous  to 
inoculation  (p.  97). 

The  extraordinary  effect  of  allyl  alcohol,  and  the  less  power- 

1  International  Medical  Congress,  1881. 


chap,  in.]    ACTION  OF  DEUGS  ON  PEOTOPLASM,  ETC.     103 

ful  but  still  great  action  of  ethereal  oils,  indicate,  however,  that 
we  may  look  forward  with  hope  to  the  discovery  of  some  organic 
substances  which  may  so  hinder  the  development  of  bacteria  in 
the  body  after  their  inoculation,  as  to  allow  of  their  gradual  de- 
struction in  the  organism,  and  prevent  the  sickness  or  death 
which  they  would  otherwise  have  occasioned. 

In  relation  to  this,  the  observations  of  the  late  Dr.  W.  Farr 
in  his  Keport  are  very  interesting :  '  Alcohol  appears  to  arrest 
the  action  of  zymotic  diseases,  as  it  prevents  weak  wines  from 
fermenting ;  like  camphor,  alcohol  preserves  animal  matter — this 
is  not  now  disputed.  But  may  it  not  do  more?  May  it  not 
prevent  the  infection  of  some  kinds  of  zymotic  disease  ? ' 

Experiments  have  shown  that  alcohol  itself  has  but  a  slight 
power  in  destroying  bacilli,  but  it  is  possible  that  even  the  slight 
traces  of  the  ethers  which  are  present  in  wine  or  spirits  may 
have  some  beneficial  action  in  cases  of  septic  poisoning. 

Antiseptics,  Antizymotics,  Disinfectants,  Deodorizers. 

These  classes  of  remedies  are  often  confounded  together.  It 
is  well,  however,  to  distinguish  their  meanings : — 

Antizymotics  are  remedies  which  arrest  fermentation. 

It  has  already  been  mentioned  (p.  73etseq.)  that  fermentative 
processes  may  depend  upon  either  enzymes  or  organised  ferments, 
and  that  organised  ferments  maybe  subdivided  into  several  classes, 
such  as  those  consisting  of  yeast,  innocuous  bacteria,  and  patho- 
genic bacteria. 

The  class  of  antizymotics  includes  all  substances  which  arrest 
fermentative  processes  due  to  these  bodies.  It  contains  two  sub- 
classes :  antiseptics  and  disinfectants. 

Antiseptics  are  remedies  which  arrest  putrefaction.  They 
do  this  by  preventing  the  development,  or  completely  destroying 
the  bacilli  on  which  septic  decomposition  depends. 

Disinfectants  are  remedies  which  destroy  the  specific  poisons 
of  communicable  diseases.  Many  of  those  poisons,  perhaps  all 
of  them,  belong  to  the  class  of  microbes,  and  so  disinfectants 
may  be  regarded  as  a  sub-class  of  antizymotics. 

Deodorizers  or  deodorants  are  remedies  which  destroy  dis- 
agreeable smells.  Such  smells  often  accompany  the  decomposi- 
tion of  various  organic  substances,  which  septic  organisms  cause. 
These  foul-smelling  products  may  be  injurious  to  health  in  them- 
selves by  acting  as  poisons ;  but  they  are  not  to  be  confounded 
with  the  bacteria  which  produce  them.  Moreover,  the  disagree- 
able nature  of  the  smell  is  not  always  to  be  relied  upon  as  an 
index  of  its  poisonous  nature.  M.  Gustav  le  Bon  made  some 
experiments  with  hashed  meat  and  water,  over  which  he  put 
some  small  animals.  As  the  meat  decomposed,  the  liquid  teemed 
with  organisms,  was  very  fatal  when  injected  into  an  animal, 


104  PHAEMACOLOGY  AND   THEBAPEUTICS.      [sect.  I. 

and  emitted  a  very  foul  smell,  which,  however,  did  not  seem  to 
be  very  injurious.  Afterwards  the  organisms  present  in  the 
liquid  died,  and  the  foul  smell  became  much  less  disagreeable ; 
but  the  emanations  from  the  liquid  appeared  to  become  much 
more  poisonous,  although  the  liquid  itself,  when  injected  into  an 
animal,  had  no  longer  the  same  virulent  power  as  at  first. 

Uses  of  Antiseptics. — Antiseptics  are  employed  externally 
in  order  to  destroy  microbes  before  their  entrance  into  the  body, 
and  are  administered  internally  with  a  like  object,  or  for  the 
purpose  of  at  least  preventing  the  free  development  and  multi- 
plication of  the  microbes. 

They  are  employed  externally  in  surgical  operations,  with 
the  object  of  destroying  any  organisms  which  might  find  a  nidus 
in  the  wound,  and  there  give  rise  to  the  formation  of  poisonous 
substances.  Both  these  substances  and  the  bacteria  themselves 
will  not  only  have  an  injurious  local  action  in  the  wound,  but  by 
undergoing  absorption  may  prove  injurious  or  fatal  to  the  or- 
ganism as  a  whole.  The  antiseptic  plan  of  treatment  has  been 
empirically  practised  in  a  limited  manner  for  a  very  long  period 
without  its  principle  being  recognised :  for  the  well-known  Friar's 
balsam  has  antiseptic  properties.  It  is  to  Lister  that  we  owe 
the  introduction  of  such  a  mode  of  treatment,  not  based  upon 
mere  empiricism,  but  upon  scientific  knowledge.  The  reason 
why  it  had  fallen  into  disuse  probably  was  that  some  of  the  anti- 
septic substances  used  for  dressing  wounds  in  the  Middle  Ages 
were  irritants  as  well  as  antiseptics.  Those  who  employed  them 
did  not  know  the  reason  why  they  were  beneficial,  and  supposed 
that  their  virtue  was  due  to  their  irritating  properties.  The  oint- 
ments were  accordingly  made  more  and  more  irritating :  and 
thus  more  harm  than  good  was  done,  until  they  were  discarded 
by  Ambrose  Pare.  The  antiseptic  most  commonly  employed  is 
carbolic  acid.  Not  only  are  all  the  instruments  to  be  employed 
disinfected  by  a  watery  solution,  but  the  operation  itself  is  con- 
ducted under  a  spray  of  the  dilute  acid,  so  as  to  render  innocuous 
any  organisms  which  may  be  present  in  the  air.  The  wound 
is  then  covered  with  an  antiseptic  dressing.  Whenever  this 
requires  to  be  removed  it  must  always  be  done  under  the  spray. 
The  reason  of  these  great  precautions  is  obvious  :  if  any  germs, 
however  few,  gain  an  entrance  they  will  soon  multiply  and  prove 
as  deadly  as  a  great  number,  the  only  difference  being  one  of  time. 

The  great  danger  which  may  arise  from  an  exceedingly 
minute  portion  of  septic  matter  renders  great  caution  necessary 
on  the  part  of  those  who  might,  by  a  little  indiscretion,  convey  it 
from  one  to  another.  Thus  a  number  of  years  ago  a  medical 
man  was  nearly  driven  mad  by  an  epidemic  of  puerperal  fever 
which  he  had  in  his  practice :  one  patient  dying  after  the  other. 
In  order  to  get  rid  of  any  infection,  he  burnt  all  his  clothes  and 
went  away  for  three  months.     During  his  absence  everything 


chap,  in.]    ACTION  OP  DEUGS  ON  PEOTOPLASM,  ETC.    105 

went  well.  On  his  return  the  epidemic  again  broke  out :  on 
careful  investigation  he  found  the  only  thing  he  had  forgotten  to 
burn  was  his  gloves,  and  these  had  acted  as  a  reservoir  of  in- 
fection. The  hands,  imperfectly  cleansed  in  the  first  instance, 
had  coiiveyed  the  septic  matter  into  the  gloves,  and  there  it  re- 
mained, re- infecting  the  hands  every  time  the  gloves  were  put  on. 
In  the  same  way  a  thermometer  may  prove  a  cause  of  continual 
infection  unless  the  thermometer  be  carefully  washed,  and,  if 
necessary,  disinfected,  each  time  it  is  used  and  before  it  is  put 
into  the  case.  In  a  similar  manner  it  has  been  found  tna,t 
gonorrhceal  matter  may  remain  in  the  vagina  and  infect  several 
persons  without  the  woman  herself  ever  suffering.  One  of  the 
best  antiseptics  for  disinfection  in  such  cases  is  permanganate  of 
potassium.  This  may  be  used  to  wash  out  abscesses,  if  there 
is  any  fear  of  danger  from  absorption  of  carbolic  acid  ;  and  also 
as  a  lotion  for  ulcers  or  wounds  about  the  mouth,  the  urethra, 
or  anus,  where  the  carbolic  acid  might  be  too  irritating ;  as  is 
evident  from  Koch's  experiment,  however  (vide  p.  92),  a  solution 
of  the  strength  ordinarily  used — one  per  cent.,  i.e.  four  grains  to 
the  ounce — is  not  sufficient  to  destroy  the  septic  organism, 
although  one  of  five  times  the  strength  will  do  so. 

Another  way  in  which  septic  poisoning  may  be  produced  is 
,by  the  introduction  of  a  catheter  into  the  bladder,  where  this 
cannot  be  completely  emptied  naturally  on  account  either  of 
paralysis,  enlarged  prostate,  or  stricture.  So  long  as  the  con- 
tents of  the  bladder  have  not  come  in  contact  with  any  foreign 
matter  they  may  remain  in  the  bladder  for  some  time  without 
undergoing  decomposition,  but  if  a  dirty  catheter  should  be 
passed,  and  thus  a  few  organisms  introduced  into  the  bladder, 
decomposition  may  set  up  in  the  urine  and  septic  poisoning 
ensue.  A  solution  of  carbolic  acid  in  oil  is  sometimes  trusted 
to  for  the  disinfection  of  catheters,  but,  as  Koch's  experiments 
(p.  96)  show  that  such  a  solution  has  little  or  no  antiseptie 
power,  the  catheters  should  be  disinfected  by  a  strong  solution 
of  carbolic  acid  in  water,  and  afterwards  oiled  before  their 
introduction. 

The  use  of  antiseptics  internally  is  limited  by  the  resistance 
of  the  organism  itself,  as  already  mentioned  (p.  102).  In  the 
stomach  antiseptics  are  used  for  the  purpose  of  preventing  decom- 
position, and  by  thus  lessening  the  production  of  irritating  pro- 
ducts they  diminish  irritation  of  the  stomach  and  arrest  vomiting. 
Tbose  which  are  chiefly  employed  for  this  purpose  are  creasote, 
carbolic  acid,  sulpho-carbolates,  salicylic  and  sulphurous  acids. 
In  the  intestine  antiseptics  are  useful  in  arresting  putrefaction, 
and  thus  preventing  the  harm  caused  locally  to  the  intestine 
by  the  products  of  decomposition  as  well  as  the  injury  due  to 
their  subsequent  reabsorption.  They  therefore  tend  to  check 
diarrhcea  and  dysentery.    It  is  probably  to  its  antiseptic  action 


106  PHAEMACOLOGY  AND   THEKAPEUTICS.      [sect.  i. 

that  currosive  sublimate  owes  its  curative  power  in  cases  of  in- 
fantile dysentery,  and  it  is  not  improbable  that  the  beneficial 
action  of  calomel  is  due  to  a  similar  action,  for  it  has  been  found 
by  Wassilieff  greatly  to  retard  the  decomposition  due  to  low 
organisms . 

The  beneficial  action  of  mercurials  in  such  cases  may  be 
partly  due  to  their  antiseptic  power  not  being  as  greatly  diminished 
by  admixture  with  fecal  matters  as  that  of  other  antiseptics. 
After  absorption  into  the  blood,  antiseptics  are  chiefly  employed  in 
febrile  conditions,  in  order,  if  possible,  both  to  lessen  the  growth 
o'f  the  septic  organism  and  to  remove  the  danger  to  the  individual 
which  the  fever  itself  would  occasion.  The  principal  antiseptics 
used  for  this  purpose  are  alcohol,  eucalyptol,  quinine,  salicin, 
salicylic  acid,  and  salicylates.  Carbolic  acid  and  creasote  can 
hardly  be  used,  as  their  action  on  the  organism  is  too  poisonous, 
but  hydroquinone,  cresotinic  acid,  kairin,  pyrocatechin,  anti- 
pyrin,  and  resorcin  are  not  markedly  poisonous,  and  are  antir 
pyretic.  They  may  thus  be  useful,  and  antipyrin  is  now  largely 
employed  (vide  also  Antipyretics).  Eucalyptol  has  sometimes 
appeared  to  me  to  be  more  beneficial  in  cases  of  septic  poisoning 
ihan  quinine  ;  at  any  rate,  I  have  seen  patients  recover  under  its 
use  who  had  not  been  benefited  by  quinine. 

Disinfectants. — These  are  generally  employed  in  order  to 
destroy  the  germs  of  disease  in  the  excreta  of  a  patient  suffering 
from  an  infectious  disease,  or  those  germs  which  may  be  adhering 
to  articles  of  clothing  or  to  furniture  or  to  the  walls  of  a  room  in 
which  the  patient  has  been  lying.  Probably  the  most  efficient 
and  generally  applicable  to  articles  of  clothing  is  heat.  The  heat 
employed  is  usually  from  230°  to  250°  P.,  but  as  a  general  rule 
it  should  be  as  hot  as  the  fabrics  will  bear  without  injury,  and 
should  be  continued  as  long  as  is  necessary  to  raise  the  central 
parts  of  the  articles  to  be  disinfected  to  the  temperature  of  the 
chamber  in  which  they  are  placed.  As  the  presence  of  moisture  aids 
the  destructive  action  of  heat  upon  septic  organisms,  superheated 
steam  appears  to  be  the  best  disinfectant  under  ordinary  circum- 
stances. The  only  disinfectant  that  seems  to  be  really  trust- 
worthy for  destroying  septic  organisms  when  it  is  simply  washed 
over  them  is  corrosive  sublimate  :  even  in  a  dilution  of  one  to  a 
thousand  it  appears  to  destroy  microzymes  and  their  spores  by  a 
single  application  for  a  few  minutes. 

Deodorizers. — Deodorizers  are  mainly  strong  oxidizing  and 
deoxidizing  substances,  as  chlorine  and  its  oxides,  sulphurous 
acid,  nitrous  acid,  ozone,  peroxide  of  hydrogen,  permanganate  of 
potassium.  Charcoal,  in  addition  to  oxidizing,  absorbs  and  con- 
denses the  foul-smelling  gas.  Those  which  are  most  commonly 
used  as  deodorizers  for  the  air  of  rooms  are  chlorine  or  its  oxides 
set  free  from  chlorinated  lime. 

For  removing  smells  from  the  hands,  carbolic  acid  is  to  be 


chap,  in.]    ACTION  OF  DEUG8  ON  PROTOPLASM,  ETC.    107 

preferred  to  others,  and  for  deodorizing  faecal  matters,  perman- 
ganate of  potassium,  carbolic  acid,  or  charcoal.  A  mixture  of 
eight  or  nine  parts  calcined  dolomite  (magnesia  and  lime)  with 
one  or  two  of  peat  or  wood  charcoal  is  not  only  an  excellent 
deodorizer,  but  increases  the  value  of  the  faecal  matters  as  manure. 


Antiperiodics. 

These  are  remedies  which  lessen  the  severity  or  prevent 
the  return  of  attacks  of  certain  diseases  which  tend  to  recur 
periodically. 

The  chief  of  these  are : — 

Cinchona  bark  and  its  alkaloids : — 

Quinine.  Arsenic. 

Cinchonine.  Salicylic  acid. 

Quinidine.  Salicylates. 

Cinchonidine.  Salicin. 

Bebeeru  bark  and  its  alkaloid  : — 

Bebeerine.  Eucalyptol. 

Action. — The  mode  in  which  antiperiodics  act  is  not  at 
present  definitely  ascertained,  nor  indeed  is  the  pathology  of 
the  diseases  which  they  prevent.  Bemittent  fever,  however,  has 
been  shown  to  depend  upon  the  presence  of  a  spirillum  in  the 
blood,  and  there  is  considerable  evidence  for  considering  that 
malarious  conditions  are  connected  with  the  presence  of  a  bacillus. 
The  periodical  return  of  the  attacks  in  such  diseases  would  ap- 
pear, then,  to  be  associated  with  the  growth  of  successive  crops 
of  these  protophytes,  and  the  action  of  antiperiodics  might  be 
explained  by  supposing  that  they  interfere  with  the  development 
of  these  pathogenic  organisms. 

Uses. — Quinine  and  cinchona  bark  are  often  regarded  as 
almost  specific  in  the  various  affections  due  to  malarious  poison- 
ing, i.e.  intermittent  fevers,  periodic  headaches,  neuralgias,  etc. 
In  tropical  remittent  fever  of  malarious  origin,  quinine  is  also 
the  best  remedy  we  possess.  It  must  be  given  in  very  large  doses, 
however,  and  is  less  certainly  curative  than  in  intermittent  fever. 
The  other  cinchona  alkaloids  have  a  similar  action  to  quinine^ 
but  are  not  quite  so  powerful :  they,  as  also  quinine,  may  be  used 
as  prophylactics  in  order  to  prevent  the  recurrence  of  ague  in 
persons  travelling  through  or  living  in  malarious  districts  as 
well  as  for  the  purpose  of  curing  malarious  conditions  already 
present. 

Arsenic  is  sometimes  even  more  powerful  than  quinine,  but  as 
a  rule  it  answers  best  in  malarious  conditions  which  are  some- 


108  PHAEMACOLOGY  AND  THEEAPEUTICS.     [sect.  i. 

times  known  as  masked  or  latent  malaria,  and  which  manifest 
themselves  in  neuralgia  and  nervous  or  digestive  disturbance 
rather  than  in  well-marked  ague  fits. 

Adjuncts. — Emetics  and  purgatives  aid  the  action  of  anti- 
periodics,  and  sometimes,  indeed,  can  replace  them  and  cure  ague 
without  their  aid.  Antiperiodics  rarely  succeed  if  the  functions 
of  the  liver  are  disturbed  unless  they  are  aided  by  emetics  or 
purgatives,  and  especially  by  cholagogues. 


109 


CHAPTEE  IV. 
ACTION  OF  DEUGS  ON  INVEETEBEATA. 

The  study  of  the  action  of  drugs  on  invertebrata  has  not  been 
carried  out  methodically  to  any  great  extent,  but  it  offers  a  very 
promising  field  for  investigation,  and  probably  in  the  course  of  a 
few  years  may  yield  very  valuable  results. 

Action  of  Drugs  upon  Medusa. 

This  subject  has  been  worked  at,  almost  exclusively  by  Eomanes '  and 
Krukenberg.8  At  present  it  has  little  practical  bearing,  but  it  promises  to  be 
of  great  service  by  enabling  us  to  understand  better  the  action  of  drugs  on 
contractile  structures  generally,  and  on  the  heart  in  particular. 

In  medusae  the  swimming  organ  consists  of  a  bell-shaped  mass  of  con- 
tractile substance,  within  which  the  polyp  hangs  like  the  clapper.  Around 
the  margin  of  this  bell  are  a  number  of  ganglia  connected  with  one  another 
by  nervous  filaments,  and  forming  a  peripheral  ring. 


Lithocvst  and  ganglion  M         ;;  HPolypite. 

Tentacles   9|    9IUII 


Flo.  29.— Medusa  (Sarsia),  natural  size. 


In  the  normal  state  of  the  animal,  the  bell  alternately  contracts  and  dilates 
rhythmically,  so  that  the  animal  is  propelled  through  the  water. 

When  the  marginal  strip  containing  the  ganglia  is  removed,  the  bell 
becomes  entirely  motionless.  The  bell  thus  resembles,  as  we  shall  see  after- 
wards, the  ventricle  of  the  frog's  heart,  both  in  the  relation  of  ganglia  to  it, 
and  in  its  rhythmical  movements.  Oxygen  accelerates,  and  carbonic  acid 
slows  and  finally  stops,  the  rhythmical  movements. 

When  the  bell,  paralysed  by  the  removal  of  the  ganglia  which  supply  its 
normal  stimulus  to  motion,  is  momentarily  stimulated  by  a  single  induction 
shock,  it  invariably  responds  by  a  single  contraction. 

1  Eomanes,  Phil.  Trans,  vol.  clxvi.  part  1,  and  vol.  clxvii.  part  2, 1866  and  1867. 
!  Krukenberg,  Vergleichend.  physiologische  Studien,  Heidelberg,  1880. 


110  PHAEMACOLOGY  AND   THEKAPEUTICS.      [sect.  i. 

When  successive  shocks  are  employed  at  regular  intervals  the  effect  of 
each  increases  until  the  maximum  is  reached  (Fig.  30,  cf.  pp.  122  and  123). 


Fig.  30. — Shows  the  increasing  contractions  of  the  tissue  of  the  medusa  whien  stimulated  by  repeated 
weak  induction  shocks  of  the  same  intensity.  The  first  two  shocks  had  no  apparent  effect,  and 
the  first  feeb'e  contraction  seen  in  the  figure  was  caused  by  the  third  shock.  (From  a  paper  by 
Bomanes  in  Phil,  Trans.) 

But  if  an  additional  constant  stimulus  is  supplied  to  it  by  the  addi- 
tion of  acid  to  the  water  in  which  it  is  floating ;  by  the  passage  of  a  constant 
or  of  an  interrupted  electrical  current  through  it ;  or  by  alcohol  or  glycerine 
dropped  upon  its  surface,  it  commences  to  beat  regularly,  rhythmically,  and 
continuously.  When  rhythmical  action  is  thus  artificially  induced  in  the 
paralysed  bell,  its  rate  is  increased  by  raising  the  temperature,  and  re- 
duced by  cooling  it.     Temperatures  below  20°  or  above  85°  arrest  the  rhythm. 

When  the  marginal  strip  containing  the  ganglia  is  cut  off  and  left  attached 
only  at  one  point,  a  stimulus  applied  to  its  end  travels  along  the  strip  and 
finally  causes  the  bell  to  contract.     The  stimuli  which  pass  along  may  be 


Strip  of  contractile  tissue  witS  ■  WHmm/M9    ' 

fringe  of  tentacles H  t' 

Fro.  31.— Diagram  of  a  medusa  (tiaropsis),  about  one-third  natural  size,  with  a  strip  of  contractile 
tissue  cut  from  the  bell,  but  left  attached  at  one  end. 

of  two  kinds — they  may  occur  separately  or  together.  The  first  kind  is  a 
wave  of  contraction  in  the  contractile  tissue  of  the  strip  itself.  If  the  stimulus 
is  applied  to  a  portion  of  the  strip  the  contraction  will  pass  along  like  a  wave 
until  it  reaches  the  bell,  which  it  excites  to  contraction.  The  second  is  a 
rudimentary  form  of  nervous  activity.  This  may  occur  along  with  the  con- 
traction wave,  and  when  this  is  the  case  it  is  seen  to  pass  along  in  front  of 
the  contractile  wave.  But  it  may  also  occur  when  no  wave  of  contraction 
takes  place.  _  Its  occurrence  is  rendered  visible  by  the  movements  of  the 
tentacles  which  fringe  the  strip  and  are  much  more  sensitive  than  the  con- 
tractile tissue  of  the  strip  itself.  This  wave  of  stimulation  without  contraction 
passing  along  the  strip  will  cause  the  bell  to  contract  on  reaching  it,  provided 
there  is  a  marginal  ganglion  in  the  bell,  but  not  if  the  bell  is  paralysed.  The 
wave  of  stimulation  is  more  easily  excited  than  that  of  contraction,  so  that 
it  may  occur  from  stimuli  too  weak  to  excite  a  wave  of  contraction.  The 
passage  of  stimuli  along  the  strip  may  be  impeded  or  prevented  altogether  by 
compressing  the  strip,  by  making  transverse  incisions  into  it  so  as  to  narrow 
the  band  of  tissue  by  which  the  wave  is  transmitted,  or  by  injuring  the  tissue. 


chap,  iv.]     ACTION '  OF  DEUGS  ON  INVEETEBEATA.  Ill 

by  straining.  Sometimes  the  contraction  wave  may  be  blocked  by  the  injury 
before  the  stimulus  wave,  and  sometimes  the  stimulus  wave  may  be  blocked 
before  the  contraction  wave.  When  the  block  is  only  partial  it  frequently 
happens  that  two  or  three  waves  will  pass  along  the  strip  up  to  the  block 
without  being  able  to  cross  it,  but  after  a  long  time  their  effect  appears  to 
penetrate  so  that  a  wave  at  last  crosses  it. 

As  Gaskell  has  shown,  a  similar  occurrence  takes  place  in  the  frog's 
heart,  and  stimuli  proceeding  from  the  auricle  to  the  ventricle  may  also  be 
blocked  by  compression. 

The  influence  of  poisons  can  be  studied  either  upon  the  bell  containing' 
the  ganglia,  or  upon  this  marginal  strip. 

In  healthy  medusae  chloroform  first  arrests  the  spontaneous  movements 
of  the  bell.  When  now  irritated  it  answers  by  a  single  contraction,  instead 
of  by  a  series,  to  such  stimulation. 

After  the  bell  has  ceased  to  respond,  nipping  its  margin  causes  the  polyp 
to  contract. 

After  stimulation  of  any  part  of  the  bell  ceases  to  produce  response  in  any 
part  of  the  organism,  the  polyp  will  respond  to  stimuli  directly  applied  to  it. 
Nitrite  of  amyl  also  produces  effects  which  in  many  respects  are  similar  to 
those  of  chloroform.  There  are,  however,  certain  exceptions;  the  first  is 
that,  before  the  spontaneous  movements  are  abolished,  the  rhythm  becomes 
quickened,  and  the  strength  of  the  pulsations  is  diminished.  The  move- 
ments also  die  out  more  gradually  than  under  chloroform,  and  before  they 
entirely  cease  they  become  localised  to  the  muscular  tissue  close  to  the 
margin.  "When  the  dose  is  large,  spasmodic  contractions  are  produced  which 
obliterate  the  gradual  paralysing  action  of  the  drug. 

Caffeine  first  causes  an  increase  in  the  rate  of  pulsation,  and  diminishes  its 
strength  after  a  few  seconds.  This  condition  passes  off,  and  the  spontaneous 
movements  become  gradually  abolished.  They  still  remain  for  a  long  time 
sensitive  to  stimulation,  and  at  first  respond  by  several  feeble  contractions 
to  each  stimulus ;  afterwards  by  a  single  response ;  and  afterwards  they  do 
not  respond  at  all. 

As  medusas  paralysed  by  removal  of  the  ganglia  never  respond  to  a  single 
stimulus  with  more  than  a  single  contraction,  the  increased  number  of  con- 
tractions which  at  first  appear  after  the  application  of  the  stimulus,  are  pro- 
bably due  to  increased  reflex  irritability. 

Caffeine  causes  the  tentacles  and  polypi  to  lose  their  tonus,  and  become 
relaxed,  which  is  not  the  case  with  chloroform.     Medusas  anaesthetised  with  , 
chloroform  when  put  into  a  solution  of  caffeine  also  lose  their  tonus,  but  their 
irritability  is  restored,  though  their  spontaneity  is  not. 

The  effects  of  strychnine  differ  in  different  species  of  medusae.  In  Sarsia 
it  accelerates  the  rhythmical  contractions  which  occur  in  groups  separated  by 
intervals  of  quiescence.  This  quiescence  finally  becomes  continuous,  and 
during  it  the  animal  does  not  respond  to  irritation  of  the  tentacle,  but  does  so 
to  direct  muscular  stimulation. 

Veratrine  first  increases  the  number  and  power  of  the  contractions ;  after- 
wards it  diminishes  both. 

Digitalin  first  quickens  them,  then  renders  them  regular,  causes  persistent 
spasms,  and  produces  death  in  strong  systole. 

Atropine  causes  first  acceleration,  then  convulsions,  then  feeble  contractions, 
and  finally  death  in  systole. 

Nicotine  causes  violent  and  continuous  spasm,  with  numerous  minute 
rapid  contractions  superimposed  upon  it.  These  latter  soon  die  away,  leaving 
the  bell  in  strong  systole. 

After  spontaneous  movements  have  disappeared,  the  bell  no  longer 
responds  to  stimulation  of  the  tentacles,  but  responds  to  direct  stimulation. 

Alcohol  first  greatly  increases  the  rapidity  of  the  contractions,  so  much  so 
that  the  bell  has  no  time  to  expand  properly  between  them,  and  they  are  in 
consequence  feeble  and  gradually  die  out.  The  reflex  stimulation  shortly 
ceases  to  produce  any  effect,  but  muscular  irritability  is  longer  maintained. 


112  PHABMACOLOGY  AND   THERAPEUTICS,     [sect,  i.,. 

Cyanide  of  potassium  first  quickens  and  then  enfeebles  the  contractions ; 
spontaneous  movements  rapidly  cease,  and  the  bell  soon  becomes  irresponsive 
either  to  irritation  of  the  tentacles,  or  to  direct  irritation.  For  a  long  time 
after  it  has  become  irresponsive,  the  nervous  connections  between  the  tentacles 
and  polyp  remain  intact,  as  also  do  the  nervous  connections  of  these  organs 
with  all  parts  of  the  bell.  The  sensory  organs  are  therefore  not  paralysed  by 
this  drug. 

The  effects  of  poisons  on  medusae  were  localised  by  Eomanes  in  two  ways. 
One  way  was  to  divide  the  medusa  almost  into  two  halves,  connected  only  by 
a  narrow  strip  of  tissue.  These  halves  were  plunged  into  two  beakers  filled 
with  sea-water,  pure  in  one  and  poisoned  in  the  other.     The  connecting  strip 


Fig.  32.— Diagrammatic  representation  of  the  method  of  localising  the  action  of  poisons  on  medusa. 
One  vessel  contains  normal  sea-water  ;  another  contains  poisoned  sea-w&ter,  which  is  shaded  in 
order  to  distinguish  it. 

rested  upon  the  edges  of  the  beaker.  When  curare  was  employed  as  a  poison 
in  this  way,  it  was  found  to  have  an  action  similar  to  that  which  it  exerts  on 
mammals  :  apparently  paralysing  the  motor  nerves,  while  it  left  the  sensory 
nerves  capable  of  action.  Thus,  on  nipping  the  half  of  a  medusa  which  was 
plunged  in  the  curare  solution,  it  remained  absolutely  motionless,  while  the 
other  half  at  once  responded  by  a  peculiar  contraction  to  the  stimulus.  Here, 
also,  however,  just  as  in  mammals,  the  sensory  fibres  are  also  paralysed  by  a 
large  dose,  so  that  if  much  poison  be  used,  irritation  of  the  poisoned  part  will 
have  no  effect  either  upon  it  or  upon  the  unpoisoned  part.  "When  experiment- 
ing in  this  way  with  strychnine,  Krukenberg  found  that  the  excitability  of 
the  poisoned  part  was  increased,  so  that  when  he  touched  the  connecting  strip 
lightly  with  a  needle  no  effect  was  produced  on  the  unpoisoned  half,  but  the 
poisoned  half  responded  by  several  energetic  contractions.  Veratrine  had  a 
similar  action  to  that  of  curare,  so  that  irritation  of  the  poisoned  half  caused 
no  movement  in  it,  but  caused  movement  in  the  unpoisoned  half.  The  irrita- 
bility of  the  contractile  tissue  is  also  diminished  so  that  it  no  longer  reacts  so 
readily  in  the  poisoned  half  to  electrical  stimuli. 

Nicotine  appears  to  paralyse  the  ganglionic  structures  and  not  the  nerves. 

It  has  already  been  mentioned  that  the  rhythmical  movements  of  medusse 
depend  upon  the  ganglia :  when  these  are  all  cut  off  the  movements  cease, . 
but  if  only  one  be  left  the  movements  continue.  In  the  medusa  divided  into 
two  halves,  as  already  described,  it  is  evident  that  if  the  ganglia  are  removed 
from  one  half,  or  one  half  rendered  functionally  inactive  by  poison,  that  half 
will  still  continue  to  contract,  so  long  as  it  remains  connected  with  the  other 
half,  but  will  cease  to  move  when  it  is  completely  divided  from  the  half 
which  still  contains  ganglia.  The  effect  of  nicotine  is  such  as  one  would 
expect  if  the  poison  paralyses  the  ganglia,  for  it  is  found  that  when  one  half 
of  a  medusa  is  steeped  in  water  containing  nicotine,  both  halves  still  continue 
to  pulsate  rhythmically ;  so  soon  as  the  connecting  band  of  tissue  is  divided, 
the  poisoned  half  at  once  ceases  to  move,  while  the  other  half  continues  to 
pulsate. 

The  second  way  in  which  Eomanes  localised  the  action  of  poisons  on 
medusae  was  by  applying  them  to  a  strip  of  contractile  tissue.  He  found 
that  various  poisons  applied  to  the  strip,  or  injected  into  it,  caused  a  blockage 
of  contractile  waves,  preceded  by  a  progressive  slowing  of  the  rate  of  trans- 
mission along  the  poisoned  part.  Chloroform,  ether,  alcohol,  morphine, 
strychnine,  and  curare,  all  have  this  effect. 


chap,  iv.]    ACTION  OF  DEUGS  ON  INVEETEBEATA.  113 

General  Results. — The  most  marked  results  of  experiments 
on  medusse  are,  that  the  contractile  tissue  contracts  rhythmi- 
cally when  stimulated  by  ganglia.  It  ceases  to  do  so  when  the 
ganglia  are  removed  and  the  contractile  tissue  left  under  ordinary 
conditions,  hut  a  constant  stimulus,  either  chemical  or  electrical, 
applied  to  it  after  the  removal  of  the  ganglia,  will  cause  it  to 
beat  rhythmically  just  a's  if  the  ganglia  were  present.  This 
appears  to  show  that  the  rhythmical  contractile  power  is  a  func- 
tion of  the  contractile  tissue  and  not  merely  of  the  ganglia. 
Besides  its  power  of  contracting  once  on  the  application  of  a 
single  stimulus,  or  rhythmically  from  continued  stimulation,  the 
contractile  tissue  also  possesses  the  power  to  conduct  stimuli. 
This  is  seen  in  the  passage  of  the  contraction  wave  along  a  strip 
of  medusa  which,  on  reaching  the  bell,  causes  it  to  contract. 
When  two  contraction  waves  travelling  along  the  contractile 
strip  in  opposite  directions  meet  one  another  they  arrest  each 
other.  This  mutual  extinction  may  be  regarded  either  as  a 
process  of  inhibition  or  interference,  or  as  a  consequence  of  ex- 
haustion of  the  tissue  which  possibly  may  be  unable  to  contract 
twice  with  such  a  short  interval  between. 

The  power  of  the  contractile  tissue  to  transmit  stimuli  is 
diminished  or  destroyed  by  cutting  it  more  or  less  completely 
across,  by  compression,  by  stretching,  by  very  high  or  low  tem- 
peratures, and  by  poisons  such  as  chloroform,  morphine,  nitrite 
of  amyl,  caffeine,  strychnine,  curare,  and  indeed  almost  any 
foreign  substance  added  to  the  water  in  which  the  strip  is  im- 
mersed. 

There  are,  however,  two  conducting  channels,  along  which 
stimuli  may  be  transmitted ;  the  first,  already  mentioned,  is  the 
contractile  tissue;  the  second  is  the  nervous  tissue.  The 
passage  of  stimuli  along  the  second  is  rendered  evident  by  the 
movements  of  the  tentacles.  These  nervous  or  tentacular  waves 
and  the  contractile  waves  may  exist  either  together  or  separately. 
The  nervous  waves  are  excited  by  stimuli  which  are  too  weak  to 
excite  contraction  waves,  and  it  is  to  be  particularly  remarked 
that  when  this  is  the  case  they  only  travel  at  half  the  rate  at 
which  a  contraction  wave  travels,  although,  when  the  stimulus 
is  strong  enough  to  excite  a  contraction  wave  also,  both  the 
nervous  and  the  contractile  wave  travel  at  the  same  rate,  the 
nervous  one  being  a  little  ahead  of  the  other.  The  passage  of 
nervous  stimuli  may  also  be  diminished  or  completely  blocked 
by  section  or  compression  just  as  in  the  case  of  contraction  waves. 

The  transmission  of  stimuli  along  nerves  is  also  affected  by 
poisons.  It  appears  to  be  destroyed  by  anaesthetics,  though 
more  slowly  than  that  of  the  contractile  tissue.  The  ganglia  may 
be  paralysed,  e.g.  by  nicotine,  before  the  transmission  of  nervous 
stimuli  from  them  is  diminished.  The  contractile  tissue  alone 
may  be  paralysed. 


Ill     PHAEMACOLOGY  AND  THEKAPEUTICS.  [sect.!.* 


Action  of  Drugs  on  Mollusca. 

In  the  lameiiibranchlata,  instead  of  a  chain  of  ganglia,  as  in  the 
medusae,  we  have  three  pairs  of  ganglia  :  cerebral  at  the  mouth,  pedal  in  the 
foot,  and  parietal-splanchnic  supplying  the  bronchial  apparatus  and  viscera. 
The  heart  has  distinct  chambers,  but  apparently  consists  of  protoplasmic 
substance  without  distinct  nerves  or  ganglia.*  The  application  to  it  of  an 
interrupted  current  will  arrest  the  rhythmical  pulsation  and  cause  stoppage 
in  diastole.1  This  effect  is  prevented  by  atropine.  Warmth  up  to  104° 
quickens  the  heart ;  when  raised  higher  it  destroys  reflex  movement  in  the 
animal,  and  afterwards  arrests  the  heart  also.  Pure  water  without  salts 
quickly  paralyses  the  muscles  and  causes  death  in  salt-water  molluscs. 
Curare  in  small  doses  has  no  effect,  large  doses  quicken,  but  do  not  abolish 
movement,  and  do  not  affect  the  heart.  Strychnine  somewhat  stimulates 
movement,  and  may  cause  some  local  contractions,  but  never  any  general 
tetanus.  Nicotine  acts  in  a  similar  way,  but  in  large  doses  appears  to  para- 
lyse the  muscles  and  cause  death ;  it  also  appears  to  cause  contraction  ot 
the  vessels,  so  that  the  heart  becomes  more  bulky  and  beats  more  quickly. 
Veratrine  has  a  similar  action.  Digitalis  has  no  action,  excepting  when 
applied  to  the  heart  directly,  and  then  it  renders  the  beats  slower  and  some- 
times stops  them.  Antiarine,  like  digitalis,  has  no  general  action,  but  stops 
the  heart  if  applied  to  it  directly.  Muscarine  generally  causes  muscular 
contractions  in  the  body :  first  acceleration,  quickly  followed  by  retardation 
of  the  cardiac  beats.  Sulphocyanide  of  potassium  diminishes  reflex  action, 
but  has  little  effect  on  the  excitability  of  the  nerves.  A  small  dose  somewhat 
quickens  the  cardiac  action ;  a  large  dose  stops  the  heart  in  diastole,  and  if  it 
is  directly  applied  to  the  heart  the  stoppage  is  permanent. 

Action  of  Drugs  on  Ascidians. 

The  heart  in  ascidians  consists  of  a  tube  open  at  both  ends,  and  which,  by 
its  contraction,  drives  the  visceral  fluid  alternately  towards  the  viscera  and 
away  from  them.  Its  action  does  not  seem  to  depend  on  the  nervous 
ganglion  lying  between  the  oral  and  anal  sac,  or  indeed  upon  nervous 
influence  at  all. 

The  application  of  an  induced  current  causes  it  to  beat  for  some  time  in 
one  direction  instead  of  alternately,  but  does  not  arrest  its  pulsations.2  Ac- 
cording to  Krukenberg  it  is  not  affected  either  by  atropine  or  muscarine.  It 
is  paralysed  by  veratrine,  quinine,  and  strychnine :  these  poisons  rendering 
the  beats  gradually  weaker  and  more  irregular.  No  evidences  of  tetanus  are 
to  be  seen  from  the  action  of  strychnine.  The  mode  of  action  of  the  heart  is 
affected  by  helleborin  and  nicotine :  helleborin  increases  the  number  of  the 
advisceral  beats  while  nicotine  diminishes  them.  Camphor  and  strychnine 
have  possibly  an  action  in  this  respect  resembling  helleborin. 

Action  of  Drugs  on  Annulosa. 

In  annulosa  the  nervous  system  consists  of  ganglia  in  each  segment 
united  together  by  nervous  bundles.  These  bundles  in  general  appearance 
correspond  with  the  gangliated  cord  of  the  sympathetic  in  higher  animals. 
The  spinal  cord  is  absent :  we  might  therefore  expect  that  drugs  which 
act  specially  on  the  spinal  cord  in  vertebrates  would  not  have  the  same 


1  M.  Poster,  Pfliiger's  Archiv,  v.  191. 

*  Dew-Smith,  Proc.  Boy.  Soc,  March  18, 1875,  p.  336. 


chap,  iv.]    ACTION  OF  DEUGS  ON  INVEETEBEATA. 


115 


marked  action  on  annelida,  and  this  appears  to  be  the  case.  It  was  found  by 
Moseley  that  strychnine  had  no  action  on  cockroaches ; '  and  leeches,  when 
placed  in  water  containing  strychnine,  become  elongated  but  do  not  exhibit 
signs  of  tetanus.  Some  years  ago  I  noticed  that  ants  sprinkled  with  insect- 
powder  died  in  violent  convulsions,  and  it  occurred  to  me  that  possibly  sub- 
stances which  excite  movements  of  the  intestine  in  the  higher  animals  might 
have  a  somewhat  convulsant  action  on  invertebrates.  I  therefore  tried  the 
effect  of  oil  of  peppermint  on  ieeches,  and  it  produced  in  them  violent  excite- 
ment. This  appears  to  be  of  a  somewhat  convulsant  nature  :  the  animal  at 
first  flying  rapidly  hither  and  thither  through  the  water,  and  afterwards,  when 
it  becomes  quiet  and  nearly  exhausted,  there  is  a  constant  rhythmical  twitch- 
ing movement  in  the  body  which  appears  to  last  nearly  until  death.  But  if  my 
idea  had  been  correct,  all  carminatives  should  excite  convulsions  in  annulosa. 
This  is  not  the  case,  for  the  oils  of  peppermint,  caraway,  and  anise  have  no 
apparent  effect  on  black-beetles  other  than  that  of  making  them  sluggish. 

Chloroform,  ether,  and  other  substances  belonging  to  the  alcohol  group, 
act  as  anaesthetics  on  mammals,  temporarily  abolishing  the  functional 
activity  of  the  brain,  spinal  cord,  and  medulla.  On  annulosa  they  have  a 
similar  action,  although  Krukenberg 2  supposed  they  had  a  different  effect, 
coagulating  the  muscular  substance  and  rendering  it  stiff  and  hard  before 
affecting  the  nerves.      The  experiment  by  which   he   thought  this    was 


Fig.  33.— Krukenberg's  apparatus  for  investigating  the  action  of  chloroform,  &c.,  on  annifosa. 
a  is  a  shallow  vessel  containing  a  little  water.  6  is  a  beaker  containing  water,  saturated  with 
chloroform,  or  ether,  and  covered  with  a  piece  of  millboard  c,  in  which  are  two  holes.  Through 
these  holes  the  head  and  tail  of  a  leech,  d,  are  drawn  and  fastened  by  ligatures  held  by  two 
clamps,   e  is  a  bell-jar  covering  the  whole. 

proved  consisted  in  applying  chloroform  to  the  middle  part  of  a  leech 
while  the  two  ends  of  the  animal  were  protected  from  the  action  of  the 
vapour.  The  middle  part  then  became  stiff  and  rigid,  but  the  movements 
of  the  two  ends  of  the  animal  were  perfectly  co-ordinated,  so  that  its 
actions  were  that  of  a  single  animal  having  a  stiff  girdle  surrounding  its 
middle.  Ether  and  alcohol  had  a  similar  result.  The  co-ordination  of 
the  two  ends  showed  that  although  the  muscles  had  been  rendered  rigid 
by  chloroform,  the  nerves  which  passed  through  the  middle  part  of  the 
body  were  still  functionally  active.  When  the  middle  part  of  the  body  was 
coagulated  by  the  application  of  hot  water,  the  muscles  became  rigid  but 
the  nerves  were  also  destroyed,  and  the  movements  of  the  two  ends  of  the 
animal  were  no  longer  co-ordinated,  so  that  they  appeared  like  two  dis- 
tinct animals  connected  by  a  rigid  cylinder.  Luchsinger s  repeated  Kruken- 
berg's experiments,  and  found  that  although  the  muscles  were  affected  by 
the  chloroform,  yet  the  nervous  system  was  still  more  sensitive  than  the 
muscles. 


1  Moseley,  unpublished  experiment  made  in  C.  Ludwig's  laboratory. 

*  Krukenberg,  Vergleicliend.  physiologische  Sttidien,  Abtg.  I.,  p.  77. 

*  Luchsinger  und  Guillebeau,  PflUger's  Archill,  xxviii.,  p.  61. 

i  2 


116  PHAEMACOLOGY  AND  THERAPEUTICS,     [sect,  i.' 

Atropine  has  a  similar  action  to  chloroform,  ether,  and  alcohol,  on  the 
muscles  of  the  leech.  Veratrine  appears  to  some  extent  to  affect  the  muscles, 
30  that  after  contraction  they  relax  slowly.  It  appears  also,  however,  to 
affect  the  nerve-centres,  and,  according  to  Krukenberg,  paralyses  more 
especially  the  sensory  centres.  Camphor,  strychnine,  morphine,  caffeine, 
copper  sulphate,  and  mercuric  chloride  act  chiefly  on  the  nervous  system  of 
leeches,  although  they  also  affect  the  muscles  when  applied  for  a  length  of 
time.     Caffeine  renders  the  muscles  in  the  leech  also  rigid. 


117 


CHAPTEE  V. 
ACTION  OP  DKUGS  ON  MUSCLE. 

Action  of  Drugs  on  Voluntary  Muscle. 

In  the  bodies  of  animals  we  find  the  protoplasmic  masses  or  cells 
of  which  they  are  composed  variously  modified,  in  order  to  per- 
form special  functions. 

In  some  the  power  of  nutrition  is  chiefly  developed :  and 
this  we  find  in  glands.  In  others  the  power  of  contractility 
is  developed:  and  this  we  find  in  muscles,  striated  and  non- 
striated. 

In  the  course  of  special  development  towards  the  fulfilment 
of  a  particular  function,  the  protoplasm  of  the  muscular  cells 
undergoes  marked  changes.  But  it  must  always  be  borne  in 
mind  that  the  protoplasmic  elements  of  the  body,  however  dif- 
ferent from  one  another,  always  tend  more  or  less  to  retain  all 
the  functions  which  are  seen  in  an  organism  consisting  of  a 
single  cell,  a  reference  to  which  may  sometimes  throw  much 
light  upon  the  mode  of  life  of  the  more  highly  organised  tissues. 

In  amoebae  or  leucocytes  the  protoplasm  contracts  in  any 
direction  and  when  strongly  contracted  in  tetanus  they  become 
spherical. 

In  muscle  the  protoplasm  is  specially  modified  and  contracts 
chiefly  in  one  direction,  viz.  that  of  its  length,  and,  indeed,  it  is 
usually  assumed  that  muscular  fibre,  either  voluntary  or  in- 
voluntary, contracts  in  the  direction  of  its  length  only. 

But  the  probability  of  its  contraction  in  a  transverse  direction 
also  is  to  be  borne  in  mind,  and  there  are  some  phenomena 
which  it  is  very  hard  to  explain  except  on  the  supposition  that 
muscle  contracts  transversely  as  well  as  longitudinally.1 

We  distinguish  in  muscle  its  elasticity,  a  physical  property ; 
and  its  contractility,  a  vital  property. 

1  Thus  Weber  found  that  when  a  muscle  is  loaded  with  a  weight  too  great  for 
it  to  lift,  instead  of  shortening,  it  elongates.  The  usual  explanation  of  this  is  that 
the  elasticity  of  the  muscle  then  becomes  diminished ;  but  according  to  Wundt 
the  elasticity  is  not  changed.  If  we  suppose  that  stimulation  tends  to  make  the 
muscle  contract  transversely  as  well  as  longitudinally,  the  explanation  is  easy,  for 
in  this  case,  longitudinal  contraction  being  prevented,  the  transverse  contraction 
tends  to  elongate  the  muscle. 


118  PHAEMACOLOGY  AND  THEEAPEUTICS.     [sect.  i. 

The  word  elasticity  is  applied  to  the  tendency  of  the  body 
both  to  resist  change  of  its  form,  and  to  regain  it  when  this 
change  has  been  effected  :  so  that  ivory  may  be  taken  as  the 
type  of  a  very  strongly  elastic  body.  Indiarubber,  on  the  other 
hand,  is  regarded  as  a  feebly  elastic  body,  because  it  does  not 
strongly  resist  changes  of  form,  although  it  tends  very  strongly 
to  regain  its  original  form  after  such  changes.  It  is,  however, 
popularly  regarded  as  the  perfect  type  of  an  elastic  body.  In 
talking  of  the  elasticity  of  muscle,  confusion  is  apt  to  occur ;  it 
is  better,  then,  to  avoid  the  term  elasticity  and  to  use  the  words 
suggested  by  Marey — extensibility  and  retractility.  The  exten- 
sibility of  muscle  is  of  two  kinds — immediate  and  supplementary. 
When  a  weight  is  attached  to  it,  it  extends  considerably ;  this  is 
its  immediate  extensibility ;  it  then  goes  on  slowly  and  gradually 
lengthening  for  a  considerable  time,  and  this  is  supplementary 
.  extensibility.  When  the  weight  is  removed  the  retractile  power 
of  the  muscle  again  becomes  evident,  and  there  is  immediate 
retractility  and  supplementary  retractility,  the  muscle  at  once 
contracting  to  a  considerable  extent,  and  then  continuing  to  do 
so  slowly  and  gradually  for  some  time  afterwards. 

The  extensibility  of  a  muscle  is  increased  by  stimulation,  so 
that  if  a  weight  be  hung  on  a  muscle  while  it  is  contracted  in 
consequence  of  stimulation,  it  will  produce  a  greater  extension 
than  it  would  if  applied  to  the  same  muscle  in  a  state  of  rest ; 
and  if  a  muscle  be  loaded  with  a  weight  too  great  for  it  to  raise, 
stimulation,  instead  of  causing  contraction,  causes  elongation.1 
Heat  renders  the  muscle  less  extensible  and  more  retractile; 
cold  has  an  opposite  effect,  rendering  it  more  extensible  and  less 


Fig.  34.— Ehows  the  fiction  on  muscle  ot  caustic  &utia,  1  in  z.uuu,  once  renewed  in  25  minutes,  followed 
by  the  action  of  lactic  acid,  1  in  600,  once  renewed  in  25  minutes.    (Eruiitou  and  Cash.) 


Fig.  35.— Shows  the  action  on  muscle  of  caustic  potash,  1  in  2,6ou,  twice  renewed  for  13  minutes, 
succeeded  by  the  aotion  of  lactic  acid,  1  in  600,  for  18  minutes,  and  this  by  the  action  of  caustic 
potash  for  17'5  minutes.    (Ct  Fig.  60,  p.  132.)    (Brunton  and  Cash.) 

retractile.     Section  of  the  nerve  has  a  similar  effect  to  that  of 
cold.    Fatigue  increases  the  extensibility.     Alkalis  (potash  or 

1  Vide  footnote, ».  117. 


chap.  v.J        ACTION  OF  DEUGS  ON  MUSCLE.  119 

soda),   in   very  dilute  solutions,  diminish  extensibility;  dilute 
acids  (lactic  acid)  increase  it.    By  the  alternate  application  of 


Fig.  36.— Shows  the  action  01  caustic  potash,  1  in  1,600,  on  muscle  for  18  minutes,  succeeded  by  the 
action  of  lactic  acid  for  24  minutes.  1  is  the  contraction  of  normal  muscle ;  2,  3, 4,  contractions 
of  alkali-muscle ;  5,  6,  7,  contractions  of  acid-muscle  on  stimulation.    (Brunton  and  Cash.) 

alkalis  and  acids  the  muscle  may  be  made  to  yield  curves  which, 
■  when  recorded  on  a  very  slowly-revolving  cylinder,  are  similar  in 
form  to  the  normal  contraction  curve  recorded  on  a  rapidly- 
revolving  cylinder.1     Fig.  34. 

Irritability  of  Muscle. — In  order  to  ascertain  the  irrita- 
bility of  muscle  itself  or  the  readiness  with  which  it  responds 
to  various  stimuli  independently  of  the  nerves  within  it,  the 
muscle  is  first  jpoisoned  by  curare,  and  then  exposed  to  various 
conditions,  or  to  the  action  of  drugs.  The  muscle  thus  poisoned 
by  curare,  woorara,  woorali,  or  urari  (for  the  poison  has  all 
these  names),  is  much  less  sensitive  to  the  action  of  fara- 
daic  currents.  The  readiest  way  of  testing  its  excitability  is  by 
the  making  and  breaking  of  a  constant  current,  the  strength 
of  which  can  be  estimated  very  exactly  by  using  du  Bois  Bey- 
mond's  rheochord.  The  excitability  of  muscles  is  increased  by 
heat  and  diminished  by  cold.  It  is  increased  by  physostigmine 
and  diminished  by  most  poisons  which  paralyse  muscle.2 

Contraction.— "When  the  ends  of  the  muscle  are  not  kept 
apart  by  force  too  great  for  it  to  overcome,  and  it  is  stimulated 
by  heat,  mechanical  injury,  chemical  irritants,  or  electricity,  it 
contracts  and  then  relaxes. 

The  form  of  this  contraction  varies  according  to  the  species 
of  animal,  and  the  particular  muscle  tested. 

In  cold-blooded  animals,  as  a  rule,  the  contraction  is  slower 
than  in  warm-blooded  animals.  It  is  not  alike  in  all  the  muscles 
of  the  body  of  mammals.  Thus  in  the  rabbit  there  are  two 
kinds  of  muscles — red  and  white ;  the  white  muscles  contract 
more  quickly  and  relax  more  quickly  than  the  red  ones.  The 
muscle  usually  employed  in  experiments  is  the  gastrocnemius  of 
the  frog,  freshly  prepared,  with  the  nerve  and  end  of  the  femur 
attached  to  it. 

1  Brunton  and  Cash,  Phil.  Trans.,  1884,  p.  197. 

1  Harnack  and  Witkcrwski,  Arch.  f.  exp.  Path.  u.  Pharm.  v.  1876,  p.  402. 


120 


PHAEMACOLOGY  AND  THEEAPEUTICS.     [sect.  i. 


The  femur  is  fixed  in  a  clamp,  and  the  lower  end  of  the 
muscle  is  attached  to  a  writing  lever  usually  loaded  with  a 
weight  (Fig.  37).     The  end  of  this  lever  writes  upon  a  revolving 


if 

i 

— 

Fig.  37. — Apparatus  for  registering  muscular  contraction.  It  consists  of  an  upright  stand  on  which 
two  horizontal  bars  may  be  moved  by  a  rack  and  pinion.  The  upper  bar  ends  in  a  clamp,  the 
lower  carries  a  delicate  lever,  the  part  near  the  hinge  being  of  metal,  and  the  part  beyond  of 
light  wood  tipped  with  quill  or  tinfoil,  a,  a,  wires  for  exciting  muscle ;  &,  muscle  ;  c,  writing 
lever.  In  the  figure  no  arrangement  is  shown  for  exciting  the  nerve,  and  for  the  sake  of  sim- 
plicity the  weight  is  shown  directly  under  the  muscle.  In  actual  experiment,  however,  the 
weight  should  be  applied  close  to  the  axle,  or  on  it,  so  as  to  lessen  oscillation  due  to  the  inertia 
of  the  lever. 

cylinder  (Fig.  38),  which  is  made  to  rotate  with  greater  or  less 
rapidity.  The  rate  of  revolution  is  usually  ascertained  by 
marking  the  time  upon  it  by  means  of  an  electro-magnet  (Fig. 
39)  communicating  with  a  clock  or  metronome,  or,  when  the 
revolution  is  quick,  with  a  large  tuning-fork  vibrating  100  times 
or  more  per  second.  "When  the  cylinder  is  not  in  motion  each  ■ 
contraction  of  the  lever  makes  a  straight  line  upon  it  (Figs.  40  a 
and  46) ;  when  the  cylinder  is  moving,  the  lever  describes  a 
curve  which  is  more  or  less  elongated,  according  to  the  rapidity 
of  the  cylinder's  rotation  (Figs.  40  and  41). 

Latent  Period  of  the  Muscle. — The  mechanical  energy 
developed  by  muscle  during  its  contraction  is  derived  from 
chemical  energy  liberated  by  changes  in  the  constituents  of  the 
muscle  itself.  These  are  of  the  nature  of  oxidation,  and  during 
them  oxygen  is  used  up,  and  carbonic  acid  is  liberated.  But 
the  oxygen  is  not  necessarily  present  either  around  the  muscle, 
or  in  the  blood  circulating  through  the  muscle  ;  it  is  stored  up  in 
some  loose  form  of  combination  within  the  muscle.1 

1  It  would  appear  that  this  force-yielding  substance,  or  muscle-dynamite,  as  we 
may  call  it,  is  not  present,  at  least  in  large  quantity,  in  the  muscles  in  a  form  in 
which  it  can  be  at  once  fired  off.  There  appears  rather  to  exist  a  substance  yielding 
it,  or  dynamogen,  which  may  be  looked  upon  as  corresponding  to  the  zymogen  of  the 
glands,  while  the  muscle-dynamite  may  be  regarded  as  corresponding  to  the  fer- 
ments of  glands.    Irritation  of  a  nerve  appears  both  to  liberate  muscle-dynamite 


chap,  v.]         ACTION  OP  DEUGS  ON  MUSCLE. 


121 


The  form  in  which  it  is  stored  up  has  been  compared  by  Lud- 
wig  to  gunpowder,  a  small  quantity  of  which  is  fired  off  at  each 
contraction. 

One  of  the  final  products  is  carbonic  acid ;  but  there  are 
intermediate  products,  one  of  them  being  sarcolactic  acid ;  and 
these  products  tend  to  cause  muscular  fatigue. 

Screw 


Brass  pin 


Framework 


Clockwork 


Fig.  38.— Revolving  cylinder  for  recording  movements.    The  screws  at  the  top  are  for  fixing  ttte-^ 
cylinder  in  position.    The  brass  pin  is  for  making  or  breaking  a  current  at  a  given  time  in  the 
revolution.    It  does  this  by  striking  against  a  small  key.    The  curve  is  described  by  the  lever, 
Fig.  37.    The  abscissa,  or  zero  line,  is  drawn  by  a  fixed  point,  and  serves  to  show  the  height  of 
the  contraction. 

When  they  are  washed  out  of  the  muscle  by  a  current  of 
blood,  or  of  simple  saline  solution,  the  fatigue  of  the  muscle  is 
removed ;  and  this  removal  is  effected  even  more  perfectly  when 
the  internal  oxidation  is  rendered  more  complete  by  adding  per- 
manganate of  potassium  to  the  solution,  or  by  the  addition  of 
minute  quantities  of  potash.  A  mere  trace  of  veratrine  has  also 
a  similar  effect  in  restoring  the  muscle  after  fatigue. 

and  to  explode  it,  if  we  may  so  term  it.  The  passage  of  a  constant  current  through 
the  muscle  appears  to  liberate  the  muscle-dynamite  from  the  dynamogen,  but 
causes  no  expulsion  except  at  the  moment  when  the  current  is  made  or  broken,  or 
its  strength  altered.  It  must  be  carefully  borne  in  mind  that  the  idea  of  a  muscle- 
dynamogen  is  at  present  simply  theoretical,  and  must  be  looked  upon  not  as  a  fact 
but  rather  as  a  means  of  remembering  facts.  According  to  A.  Schmidt,  however, 
the  contraction  and  relaxation  of  muscle  is  closely  connected  with  the  formation 
and  destruction  of  a  ferment. 


122  PHARMACOLOGY  AND   THERAPEUTICS,     [sect.  i. 

•  We  find  that  the  muscle  does  not  immediately  respond  to  a 
stimulus,  but  that  a  period  elapses  between  the  stimulus  and  the 
commencement  of  the  contraction,  which  is  on  the  average  about 
the  100th  of  a  second.     This  is  termed  the  latent  period. 

During  this  period  a  chemical  change  is  probably  going  on  in 
the  muscle,  and  it  is  evidenced  by  an  electrical  change  known 
as  the  negative  variation,  or  diminution  in  the  natural  current 
which  passes  from  the  longitudinal  to  the  transverse  section  of 
the  muscle. 

The  latent  period  is  altered  by  fatigue.  Loading  the  muscle 
shortens  the  latent  period,  until  the  load  is  just  sufficient  to 
extend  the  muscle.  An  increase  of  load  above  this,  lengthens 
the  latent  period.  Cold  lengthens  it ;  heat  shortens  it.  Small . 
doses  of  strychnine  or  veratrine  shorten  the  latent  period.  Large 
doses  of  strychnine  or  veratrine,  and  also  curare,  lengthen  it. 

Summation  of  Stimuli. — During  the  latent  period,  the 
stimulus  applied  to  a  muscle  excites  chemical  changes  which 
result  in  contraction ;  but  if  the  stimulus  be  very  small,  the 


Electro-magnet. 

(Indiarubber  thread  to  draw 
back  the  -writing-point  when 
released  by  the  magnet. 

Fio.  39.— Electro-magnet  (aiter~"Marey)  for  recording  time  on  a  cylinder.  When  used  to  record 
time,  the  current  is  made  and  broken  alternately  by  clockwork  or  by  a  tuning-fork.  It  may  be 
used  also  to  record  the  time  of  irritating  or  dividing  a  nerve,  or  of  injecting  a  poison,  &c. 

chemical  changes  may  be  so  slight  that  contraction  does  not 
occur.  If  the  stimulus,  however,  be  repeated  several  times,  the 
changes  which  it  induces  in  the  muscle  become  sufficient  to  pro- 
duce at  first  a  slight  contraction,  and  then  one  greater  and 
greater,  until  the  maximum  effect  is  produced — this  is  called 
summation.  It  occurs  not  only  in  voluntary  muscles,  but  in 
other  contractile  tissues,  such  as  those  of  the  medusa  (vide 
Fig.  30,  p.  110).  A  similar  phenomenon  occurs  also  in  the  heart, 
and  has  there  received  the  name  of  '  the  staircase.' 

Contraction  of  Muscle. — In  the  muscular  curve  we  notice 
(1)  the  rapidity  of  its  rise,  which  indicates  the  rapidity  of  con- 
traction of  the  muscle  ;  (2)  its  length,  indicating  the  duration  of 
contraction  ;  (3)  its  height,  indicating  power  of  contraction ;  and 
(4)  slowness  of  fall,  indicating  the  condition  of  extensibility. 

The  muscular  contraction  is  modified  by  numerous  conditions. 

One  of  these  is  the  strength  of  stimulus. 

The  stimulus  usually  applied  is  electricity,  as  its  strength  can 
be  more  easily  regulated,  and  it  does  not  destroy  the  muscle  so 
readily  as  mechanical  or  chemical  irritants. 


chap,  v.]         ACTION  OF  DEUGS  ON  MUSCLE. 


123 


"With  a  weak  current,  making  (closing)  has  no  action  on  the 
muscle,  but  breaking  (opening)  causes  contraction. 


Fig.  40. — Muscle  curves,  showing  the  different  appearances  they  present  according  to  the  rate  at 
which  the  recording  cylinder  revolves,  a  is  a  curve  with  a  very  slowly  revo'viug  cylinder ;  6,  e, 
and  d  are  curves  with  increasing  speed  of  rotation,  c  is  written  with  a  lever  pointiug  in  the 
opposite  direction  from  that  with  which  a  and  b  are  recorded,  and  the  curve  therefore  inclines 
to  the  other  side. 

A  moderate  current  gives  contraction  both  in  making  and 
breaking,  but  that  of  making  is  comparatively  small  (Fig.  41). 
With  a  strong  current  no  difference  is  observed. 


Fig.  41. — Shows  effect  of  making  and  breaking  shocks.  These  are  normal  muscle  curves  with  a 
still  quicker  rotating  cylinder  than  in  Fig.  40a*.  The  first  is  caused  by  irritating  the  muscle  by 
making  (closing)  a  constant  current,  and  the  second  by  breaking  (opening)  it. 


The  more  intense  the  stimulus,  the  higher  and  longer  is  the 
curve.    The  increase  in  height  is  shown  in  Fig.  42. 


Fig.  42.— Tracing  of  the  contractions  of  a  muscle  with  stimuli  of  varying  strength.  The  numbers 
indicate  the  distance  in  centimetres  of  the  secondary  from  the  primary  coil  in  the  induction 
apparatus.    As  and  Des  indicate  the  ascending  and  descending  direction  of  the  current. 

Cold  renders  contraction  slower,  lower,  and  more  prolonged 
(Pig.  48  6). 

Heat  renders  it  quicker,  higher,  and  shorter  (Fig.  43  a). 

Fatigue. — Fatigue  makes  the  ascent  slow,  the  height  less, 
and  the  descent  slow  (Fig.  44). 

Exhaustion  of  the  animal  has  a  similar  action ;  and  dilute 
acids  applied  to  the  muscle  produce  the  same  effect  (Fig.  36). 


124  PHAEMACOLOGY  AND  THEEAPEUTICS.     [sect.  r. 

The  effect  of  fatigue  is  probably  due  in  a  considerable  mea- 
sure to  the  accumulation  of  acid  products  of  muscular  waste. 


Fia.  43. — Effeot  of  heat  and  cold.    In  a  the  muscle  has  been  artificially  warmed,  and  in  b  it  has 

been  cooled. 

When  these  are  washed  out  by  passing  a  weak  solution  of 
chloride  of  sodium  through  the  vessels  of  the  muscle,  or  partially 
removed  by  kneading,  it  regains  to  a  great  extent  its  normal 
power  of  contraction. 


Fig.  44 Effect  ol  fatigue. 

Oxidising  agents,  such  as  permanganate  of  potassium,  added 
to  the  salt  solution,  increase  its  power,  and  restore  the  muscle 
even  more  quickly  and  completely.1 

Deprivation  of  blood  has  a  similar  action  on  the  muscle  to 
fatigue ;  and  free  circulation  of  blood  tends  to  remove  the  effects 
Of  fatigue. 

Contracture. — When  the  stimulation  is  exceedingly  strong, 
the  relaxation  after  contraction  may  become  very  slow,  and  the 
descent  of  the  curve  may  be  divided  into  two  parts.  At  first  it 
descends  for  a  short  time  pretty  quickly,  and  then  falls  very 
slowly  indeed.  This  long  contraction  of  the  muscle  is  known  as 
contracture.  It  is  very  strongly  marked  in  muscles  poisoned  by 
veratrine  or  barium.  It  occurs,  though  to  a  less  extent,  in 
muscles  poisoned  by  salts  of  calcium  and  strontium,  by  ammonia, 
and  by  the  chloride,  iodide,  nitrite,  nitrate,  and  cyanide  of 
ammonium.2 

The  cause  of  contracture  is  not  known ;  it  is  considered  not 
to  be  a  tetanic  contraction,  because  unlike  an  ordinary  tetanised 
muscle  it  does  not  give  rise  to  secondary  tetanus  in  another 
frog's  muscle,  when  the  nerve  of  the  latter  is  placed  upon  it.  It 
is,  however,  an  active  contraction,  not  a  mere  alteration  in  the 
elasticity  of  the  muscle  preventing  its  relaxation ;  for,  as  Fick 
and  Boehm  have   shown,   a  much  greater  amount  of  heat  is 

1  Kroneoker,  Ludwig's  Arbeiten,  1871,  p.  183. 
*  Bruntor.  and  Cash,  Proc.  Boy.  Soc,  1883. 


chap,  vj         ACTION  OF  DEUGS  ON  MUSCLE.  125 

developed  during  the  long-continued  contracture  than  in  an 
ordinary  contraction.  Sometimes,  and  indeed  not  unfrequently, 
the  contracture,  instead  of  consisting  of  a  single  prolonged  con- 
traction, appears  in  the  form  of  a  prolonged  contraction  added 
on  to  an  ordinary  contraction  before  relaxation  has  had  time  to 
occur.  This  gives  rise  to  a  peculiar  hump  in  the  curve,  as  is 
well  seen  in  the  middle  curve  in  Fig.  49.  This  appears  to  show 
that  the  contracture  is  really  a  double  phenomenon,  like  the  two 
contractions  observed  after  a  single  stimulation  in  the  muscle  of 


Flo.  45.— Secondary  contraction  in  the  muscle  of  a  crayfish.  The  thick  part  of  the  lower  line  shows 
the  time  during  which  the  muscle  was  irritated  fay  a  tetanising  current.  It  will  be  noticed  that 
the  secondary  contraction  occurs  after  the  irritation  has  ceased,  and  after  the  tetanus  Caused  by 
it  has  relaxed.  It  is  not  a  simple  continuous  rise,  but  exhibits  several  wares  indicative  of  a 
kind  of  rhythm.    (After  Bichet.) 

the  crayfish  by  Eichet  (Fig.  45).  How  far  the  contracture  may 
depend  upon  irritation  of  the  muscle  by  its.  own  current  has  yet 
to  be  determined. 

Tetanus. — If  instead  of  a  single  stimulation  a  number  of 
stimuli  rapidly  succeeding  each  other  are  applied  either  directly 
to  the  muscle  itself  or  to  its  motor  nerve,  we  get,  in  place  of  a 
single  contraction,  a  continued  contraction  or  tetanus.  As  this 
is  due  to  a  fresh  contraction  of  the  muscle  occurring  before  the 
previous  one  has  had  time  to  relax,  it  is  evident  that  the  number 
of  stimuli  requisite  to  produce  this  will  vary  with  the  length  of 
each  single  contraction  in  a  muscle.  Thus  in  the  muscles  of  the 
tortoise,  which  contract  and  relax  very  slowly,  tetanus  may  be 
produced  by  3  stimuli  per  second,  while  in  the  white  muscles  of 
rabbits  20  may  be  necessary,  and  in  some  muscles  of  birds  70 
stimuli  per  second  are  insufficient.  It  has  been  said  that  with 
as  rapid  stimuli  as  250  per  second  the  tetanus  ceases,  and  after 
a  single  initial  contraction  a  muscle  goes  to  rest  just  as  if  a  con- 
stant instead  of  an  interrupted  current  had  been  used.  Kro- 
necker  and  Stirling  have  shown  that,  with  no  less  than  22,000 
interruptions  per  second,  tetanus  is  still  obtained ;  but  when  such 
extremely  rapid  stimuli  are  applied,  the  muscle  still  contracts 
about  the  ordinary  rate  of  20  per  second ;  and  this  is  also  the 


126  PHAEMACOLOGY  AND  THERAPEUTICS,     [sect.  i. 

case  when  chemical  stimuli  are  applied  to  the  nerve,  or  when  the 
muscle  is  irritated  by  the  nerve-centres,  either  voluntarily  or  by 
artificial  stimuli  applied  to  them.  It  seems  therefore  probable 
that  the  number  of  contractions  of  the  muscles  in  tetanus  are 
not  due  to  the  number  of  stimuli  sent  down  from  the  nerve 
centres,  but  that  the  rate  is  determined  either  by  the  ends  of  the 
nerve  in  the  muscle  or  by  the  muscle  itself.1 

The  form  of  a  tetanus  curve  may  be  modified  very  consider- 
ably by  the  action  of  drugs :  thus  substances  which  diminish 
the  contractile  power  of  muscle  cause  the  tetanus  curve  to  fall 
very  rapidly  notwithstanding  the  continued  application  of  stimuli 
either  to  the  muscle  itself  or  to  its  nerve  (vide  Ammonia). 

Muscular  Poisons. — We  may  distinguish  several  groups  of 
muscular  poisons,  but  at  present  the  classification  is  difficult, 
and  the  division  into  six  groups  based  on  that  of  Kobert,  which  I 
have  adopted,  although  it  possesses  some  advantages,  is  far  from 
satisfactory,  and  can  only  be  regarded  as  temporary. 

Geoup  I. — Leaves,  the  irritability  of  the  muscle  unaffected,  but 
diminishes  the  total  amount  of  work  it  is  able  to  do. 

Group  II. — Diminishes  the  excitability  of  the  muscle  as  well  as 
its  capacity  for  work. 

Group  III. — Diminishes  the  capacity  for  work,  and  produces 
majked  irregularity  in  its  excitability. 

Group  IV. — Alters  the  form  of  the  muscular  curve. 

Group  V. — Increases  the  excitability. 

Group  VI.- — Increases  the  capacity  for  work. 


Fig.  46.— Tracings  showing  the  gradual  loss  of  contractile  power  from  fatigue  in  a  normal  muscle, 
a,  and  in  one  poisoned  by  carbolio  acid,  6.  Bach  section,  V—l',  4>c,  shows  the  contractions  in 
one  minute.    (After  Gies.) 

The  poisons  in  Group  I.  do  not  alter  the  muscle  curve,  so 
that  if  the  action  of  the  poison  were  tested  by  a  single  contrac- 
tion only,  it  would  be  supposed  that  the  muscle  was  unaffected ; 
they  lessen,  however,  the  amount  of  work  which  the  muscle  can 
yield. 

The  amount  of  work  is  estimated  by  the  weight  which  a 
muscle  raises  multiplied  into  the  number  of  times  it  is  lifted 
and  the  height  it  is  raised  each  time.     These  are  ascertained  by 

1  Wedenskii,  Archivf.  Anat.  u.  Physiol.  Phys.  Abthlg.  1883,  p.  325. 


chap,  v.]         ACTION  OF  DEUGS  ON  MUSCLE.  127 

registering  the  contractions  on  a  slowly  revolving  drum,  as  in 
Fig.  46,  which  shows  the  rapid  exhaustion  of  a  muscle  poisoned' 
by  carbolic  acid  as  compared  with  a  normal  one.  The  rapid 
exhaustion  of  muscles  may  also  be  observed  in  the  form  of  the 
tetanus  curve  which,  under  the  influence  of  such  poisons,  falls 
much  more  rapidly  in  height  than  that  of  the  normal  muscle. 

This  group  contains  a  number  of  drugs  having  an  emetic 
action.1  These  are :  apomorphine,  asclepiadine,  cyclamine,  del- 
phinine,  sanguinarine,  and  saponine,  copper,  zinc,  and  cadmium. 
Antimony  has  a  somewhat  similar  action,  but  only  in  large  doses, 
and  after  a  great  length  of  time.  Arsenic,  platinum,  and  pro- 
bably mercury,  act  in  the  same  way  as  antimony.2  Tin,  nickel,8 
cobalt,3  manganese,2  aluminium,  and  magnesium,  have  little  or 
no  action  on  muscle.  Large  doses  of  iron  are  nearly  as  powerful 
as  arsenic,  but  in  small  doses  it  rather  increases  the  amount  of 
work  the  muscle  can  do. 

Carbonic  oxide  at  the  atmospheric  pressure  does  not  affect 
muscular  contractility,  but  abolishes  it  at  a  pressure  of  five 
atmospheres. 

Perhaps  we  may  take  as  a  subdivision  of  this  group  those 
poisons  which  lessen  the  contractile  power  of  the  muscle  without 


Pitt.  47. — (After  Harnack.)  Shows  the  action  of  lead  on  muscle,  a  shows  the  contraction  of  a  normal 
muscle  after  eighty  stimulations ;  &,  the  irregular  contractions  of  a  muscle  poisoned  by  lead 
after  ten  to  fifty  stimulations ;  c  shows  the  slow  relaxation  of  the  muscle  after  contraction  in  a 
muscle  poisoned  by  lead  after  numerous  stimulations. 

altering  its  irritability.  When  a  muscle  poisoned  by  one  of  these 
is  stimulated,  it  may  contract  quite  as  readily  as  a  normal 
muscle,  provided  the  weight  that  it  has  to  raise  is  but  slight, 
but  it  cannot  raise  such  a  heavy  weight  as  a  normal  muscle. 
This  is  tested  by  loading  it  with  a  given  weight,  and  the  slightest 
contraction  is  ascertained  by  adjusting  the  lever  of  the  myograph 
in  such  a  way  that  if  raised  in  the  very  least  it  breaks  a  connec- 
tion in  an  electrical  current  and  causes  a  bell  to  ring.  By  this 
means  contractions  quite  imperceptible  to  the  eye  are  readily 
appreciated.  Digitalis  has  an  action  of  this  sort,  as  I  found  in 
some  experiments  carried  on  under  the  direction  of  Professor  J. 
Eosenthal  in  1868,  but  not  published. 

Group  II.  contains  salts  of  potassium,  lithium,  ammonium, 

1  Harnack,  Archie  f.  exp.  Path.  u.  Pharm.,  Bd.  ii.  p.  299,  and  iii.  p.  44. 

*  Kobert,  Arch.  f.  exp.  Path.  u.  Pharm.,  Bd.  xv.  p.  22,  and  xvi.  p.  361. 

*  Anderson  Stuart,  Journ.  of  Aruxt.  and  Physiol.,  vol.  xvii.  p.  89. 


128  PHAKMACOLOGY  AND  THERAPEUTICS,     [sect.  i. 

quinine,  cinchonine,  oil  of  mace,  alcohol  in  large  doses,  chloro- 
form, &c. 

Chloral,  chloroform,  and  ether  also  belong  to  this  group,  but 
they  might  also  be  reckoned  as  belonging  to  Group  IV.,  for  they 
slow  the  ascent,  lessen  the  height,  and  prolong  the  descent  of  the 
curve.     Curare  has  a  similar  action. 

It  is  usually  stated  that  curare,  while  it  paralyses  motor 
nerves,  leaves  the  excitability  of  the  muscles  unaffected,  but  this 
appears  not  to  be  quite  correct,  for,  when  very  weak  currents  are 
employed,  the  muscle  loses  its  excitability  by  them  before  the 
nerve,  and  the  contractions  of  the  muscle  at  the  same  time 
become  unequal.  It  is  perhaps  not  yet  perfectly  certain  how  far 
these  appearances  are  due  to  the  curare,  and  how  far  to  the 
gradual  death  of  the  muscle.1 

Group  III.  contains  poisons  of  which  lead  is  a  typical 
example.  These  poisons  cause  the  muscular  contractions  to  be- 
come very  unequal,  although  the  stimuli  are  equal  and  regular. 
Emetine  and  cocaine  have  a  similar  action  to  lead.  This 
action  is  probably  due  only  to  the  gradual  death  of  the  muscle. 
It  is  produced  also  by  ptomaines,  and  it  may  occur  in  muscles 
which  are  simply  dying  without  being  poisoned  at  all.2 

Group  IV.  contains  poisons  which  alter  the  form  of  the  curve 
to  a  marked  extent. 

The  action  of  veratrine  is  very  peculiar :  it  does  not  lessen 
the  rapidity  of  contraction,  and  even  increases  the  height  of  the 
curve,  but  it  prolongs  the  descent  to  an  enormous  extent. 


Fig.  48.— Tracing  of  the  contraction  curve  of  a  muscle  poisoned  by  veratrine,  showing  enormous 
prolongation  of  the  contraction,  the  recording  cylinder  making  many  complete  revolutions 
before  the  muscle  is  completely  relaxed. 

This  action  of  veratrine  is  most  marked  at  moderate  tem- 
peratures. 

It  is  much  diminished,  and  sometimes  entirely  removed,  by 
cold ;  and  it  disappears  also  when  the  temperature  of  the  muscle 
is  considerably  raised.  When  the  muscle  which  has  been  cooled 
or  heated  is  again  brought  back  to  a  moderate  temperature,  the 
contracture  sometimes  returns,  but  occasionally  does  not,  the 

1  Marey,  Travaux  du  Laboratoire,  1878,  p.  157. 
»  Mosso,  Les  Ptomaines,  Turin,  1883. 


chap,  v.]         ACTION  OF  DEUGS  ON  MUSCLE. 


129 


effect  of  veratrine  on  the  muscle  appearing  to  be  sometimes,  but 
by  no  means  always,  destroyed  by  the  heat  or  cold  to  which  the 
muscle  has  been  exposed.1 

The  result  of  this  exceedingly  prolonged  contraction  is  that  a 
frog  poisoned  with  veratrine  is  able  to  jump  with  considerable 
power,  but  the  extensor  muscles,  by  which  the  movement  is 
executed,  remain  contracted  instead  of  relaxing.  The  animal 
•  therefore  lies  extended  and  "stiff,  and  is  only  able  very  slowly  to 
draw  its  legs  up  towards  the  body.  After  they  have  been  drawn 
up,  the  flexors  in  their  turn  remain  contracted  for  a  while,  and 
so  the  animal  is  unable  to  jump  until  some  time  further  has 
elapsed. 

Another  remarkable  point  about  the  action  of  veratrine  on 
f  muscle  is,  that  although  a  single  contraction  lasts  so  long  as 
seriously  to  interfere  with  the  power  of  co-ordinated  movement, 
jet,  if  the  muscle  is  made  to  contract  a  few  times  in  rapid, 
succession,  the  effect  of  the  veratrine  disappears,  and  it  again 
:  acts  normally.  After  a  short  rest  the  effect  of  veratrine  again 
,  reappears.     . 

A  similar  action  to  that  of  veratrine  is  exerted  by  salts  of 
.  .barium,  which,  when  locally  applied,  cause  the  muscle  to  describe 


,  Fig.  49.— Tracing  of  the  contraction  curves  of  a  muscle  poisoned  by  veratrine,  showing  the 
peculiarly  elongated  curve  at  a  moderate  temperature,  and  its  restoration  nearly  to  the  normal 
.  by  cooling  and  heating. 

a  curve  resembling  that  of  veratrine,  not  only  in  its  form,  but  in 
the  alterations  produced  by  temperature  and  in  its  temporary 
disappearance  after  repeated  contractions.  A  similar  action 
is  exerted  also,  though  to  a  less  extent,  by  strontium  and 
calcium.  Salts  of  potassium  may  at  first  increase  the  height 
of  contraction,  but  afterwards  both  moderate  and   large   doses 

1  Brunton  and  Cash,  Joum.  of  Physiol.,  vol.  iv.  p.  1,  and  Centralblatt  f.  d.  med. 
Wiss.,  1S83,  No.  6. 


130  PHARMACOLOGY  AND  THERAPEUTICS,     [sect.  7. 

shorten  the  muscular  curve,  and  lessen  its  height,  so  as  finally 
to  abolish  its  contractile  power  altogether.  When  applied  to  a 
muscle  poisoned  by  veratrine,  barium,  strontium,  or  calcium, 
salts  of  potassium  remove  the  excessive  prolongation  of  the  con- ' 
traction  which  these  drugs  occasion,  and  "restore  the  muscular 
curve  again  to  its  normal.1 

Although  veratrine  alters  the  form  of  the  muscular  curve 
so  greatly,  it  does  not  (excepting  in  large  doses)  paralyse  the 
muscle,  so  that  when  a  poisoned  muscle  is  made  to  contract  at 
regular  intervals  for  a  length  of  time,  it  is  able  to  do  as  much 
work  as  a  normal  one. 

Nearly  allied  to  this  is  another  group  of  muscular  poisons, 
some  of  which  have  already  been  mentioned  as  a  sub-division  of 
Group  I.  It  contains :  digitalin,  digitalein,  digitaleresin,  digitoxin, 
toxiresin,  scillain,  helleborein,  oleandrin,  adonidin,  neriodorin, 
and  neriodorein.  Tanghinia,  thevetin,  and  frynin,  or  toad 
poison,  probably  also  belong  to  this  class. 

These  drugs  do  not  lessen  the  irritability  of  muscle,  but 
appear  to  alter  somewhat  the  form  of  the  muscle  curve,  some- 
what in  the  same  way,  but  to  a  less  extent  than  substances  of 
the  veratrine  group.  Some  of  them  when  applied  in  a  concen-  • 
trated  form  directly  to  the  muscle  cause  a  condition  of  rigor. 
This  is  especially  the  case  with  caffeine  and  digitalin.  This  rigor 
is  well  marked  in  the  rana  temporaria,  and  only  to  a  compara- 
tively slight  extent  in  the  rana  esculenta.  Although  caffeine  in 
concentrated  solution  produces  rigor  mortis  in  the  muscle,  yet  in 
very  dilute  solutions  it  is  a  muscular  stimulant,  and  as  such  is 
included  in  the  sixth  group. 

Group  V.  contains  physostigmine,  which  increases  the  ex- 
citability of  muscle  to  slight  stimuli,  but  does  not  increase  the 
amount  of  work  it  can  do ;  on  the  contrary,  in  large  doses  it 
diminishes  it. 

Group  VI. — Poisons  belonging  to  this  group  in  small  doses 
increase  muscular  work,  and  cause  the  muscle  to  recover  rapidly 
after  exhaustion.  Greatin  has  this  power  to  a  great  extent;  - 
hypoxanthin  has  it  also,  though  less  powerfully.  The  effect  of 
these  substances  is  very  interesting,  because  they  are  products 
of  muscular  waste.  They  also  occur  in  beef-tea,  and  their  action 
appears  to  show  that  beef-tea  assists  muscular  power,  as  well  as 
acts  as  a  nervous  stimulant. 

Other  members  of  this  group  are  caffeine  and  glycogen: 
these  have  great  power  to  increase  muscular  work.  The  relation 
of  caffeine  to  hypoxanthin  is  very  interesting.  Xanthin,  which 
is  another  substance  derived  from  muscles,  differs  from  hypo- 
xanthin in  containing  one  atom  more  oxygen.  Theobromine,  the 
active  principle  of  cocoa,  is  dimethylxanthine ;  and  caffeine,  the 

1  Brunton  and  Cash,  Proc.  Roy.  Soc,  1883- 


chap,  v.]         ACTION   OP  DEUGS  ON  MUSCLE.  131 

active  principle  of  tea  and  coffee,  is  trimethylxanthine.  The 
restorative  effects  of  beef-tea,  coffee,  tea,  and  cocoa  have  long 
been  recognised  empirically,  although  their  action  could  not  be 
explained.  It  now  seems  not  at  all  improbable  that  it  may  be 
partly  due  to  their  restorative  effect  on  the  muscle. 

Massage. — The  effect  of  kneading  a  muscle  so  as  to  remove 
the  waste  products  from  it  is  very  extraordinary. 

When  the  muscles  of  an  uninjured  frog  are  stimulated  to 
contraction  by  the  rhythmic  application  of  maximal  induction 
currents  until  they  are  exhausted  and  no  longer  contract,  knead- 
ing them,  or  massage,  restores  their  contractility  so  that  their 
contractions  are  nearly  as  powerful  as  at  first,  while  simple  rest 
without  massage  has  very  little  restorative  effect.  In  man  also, 
while  a  rest  of  fifteen  minutes  after  exhausting  labour  had 
very  little  restorative  action,  massage  during  the  same  period 
increased  double  the  work  that  could  be  done.  Massage  has  a 
similar  action  to  very  complete  and  perfect  circulation  through 
the  muscle,  in  removing  the  waste  products  and  restoring  its 
power.1 

Propagation  of  the  Contraction  Wave  in  Muscle. — When 
a  muscle  is  irritated  at  one  point,  the  contraction  wave  which 
occurs  at  that  point  is  conducted  along  the  muscle  in  both 
directions. 

This  contraction  wave,  like  that  which  occurs  in  the  con- 
tractile tissue  of  the  medusa,  is  independent  of  the  nervous 
system.  The  completeness  with  which  it  is  conducted,  and  the 
quickness  with  which  it  subsides  at  each  point,  are  closely  con- 
nected with  the  rapidity  of  the  conduction,  and  they  are  also 
injuriously  affected  by  anything  which  impairs  it.  It  diminishes 
during  the  death  of  the  muscle,  and  it  is  lessened  also  by 
fatigue,  by  cold,  and  by  injury,  such  as  excessive  stimulation. 
Certain  poisons  also  lessen  it,  as  cyanide  of  potassium,  veratrine, 
and  upas  antiar.2 

Heat  increases  the  rapidity  of  the  conduction. 

Rhythmical  Contraction  of  Muscle. —  Ehythmical  con- 
traction is  frequently  regarded  as  a  function  of  involuntary 
muscular  fibre  only ;  this,  however,  is  not  the  case,  for  it  is 
observed  also  in  voluntary  muscles.  Ehythmical  contraction 
of  involuntary  muscle  is  seen  in  the  trachea,3  and  is  well 
marked  in  the  heart  and  blood-vessels.  It  is  very  distinct 
in  the  intestines  and  bladder,  and  becomes  still  more  marked 
after  the  influence  of  the  central  nervous  system  has  been 
destroyed.  In  the  case  of  the  sphincter  ani,  for  example,  the 
rhythm  is  strong  and  regular,  especially  after  the  nerves  have 

1  Zabludowski,  Central,  f.  d.  med.  Wiss.,  1883,  No.  14,  p.  241. 
1  Aeby,  XJntersuchungen  aber  die  Forlpflanzungsgeschwindigkeit  der  Reizungen 
der  quergestreiften  Muskclfaser.    Braunschweig,  1862,  p.  52. 
3  Honvath,  Pfliiger's  Archiv,  1875,  vol.  xiii.  p.  508. 

k  2 


132 


PHAEMACOLOGY   AND   THEEAPEUTICS.      [sect.t 


been  divided  and  the  muscle  subjected  to  some  mechanical 
distension  by  tbe  introduction  of  the  finger. 

In  voluntary  muscle  the  tendency  to  large  rhythmical  pul- 
sations is  slight,  although  we  see  rapid  contractions  occurring 
in  tetanus. 

The  number  of  impulses  sent  down  to  the  muscles  along  the 
motor  nerves,  from  the  spinal  cord,  is  about  10  per  second  in 
the  dog.  If  more  numerous  impulses  are  sent  down  from  the 
cerebral  cortex,  or  corona  radiata,  or  if  more  numerous  stimuli 
are  applied  to  the  spinal  cord  itself,  summation  appears  to  occur 
in  the  cells  of  the  spinal  cord,  and  only  10  impulses  per  second 
are  sent  out.1 

From  the  observations  of  Wedenskii,  that  irritation  of  the 
motor  nerve  of  a  muscle  by  exceedingly  rapid  stimuli  still  pro- 
duces the  same  number  of  contractions  in  the  muscle,  it  seems 
probable  that  this,  rate  of  contraction  is  due  to  the  constitution 


Fio.  50.— Tracing  of  the  contraction  curve  of  a  muscle  poisoned  by  veratrine  and  exposed  to  a  high 
temperature.  The  poison  tends  to  cause  prolonged  contraction,  and  the  high  temperature  to 
cause  rapid  relaxation  of  the  muscle.  The  result  is  a  somewhat  rhythmical  spontaneous  con- 
traction.   The  muscle  was  only  irritated  at  the  very  beginning  of  the  first  contraction. 

either  of  the  muscle  itself,  or  of  the  nerve-endings  within  it. 
Under  certain  circumstances,  however,  the  voluntary  muscle 
may  be  made  to  contract  with  a  slow  rhythmical  movement  of 
considerable  extent,  and  closely  resembling  that  of  involuntary 
muscular  fibre. 

Thus  voluntary  muscle  treated  by  veratrine  tends  to  renjain 
contracted  for  a  length  of  time  like  an  involuntary  muaole: 
heat  has  a  tendency  to  cause  its  relaxation,  and  sometimes,,  as 
is  seen  in  the  accompanying  figure  (Fig.  50),  these  contending 
influences  produce  in  the  voluntary  muscle  a  tendency  to  marked 
rhythmical  contraction. 

A  still  more  remarkable  phenomenon  has  been  noticed  by 
Kuhne,2  who  finds  that  when  the  uninjured  sartorius  of  a  frog 
is  placed  in  a  solution  of  5  grammes  NaCl,  and  2-5  grammes  of 
common  alkaline  crystallised  phosphate  of  sodium  in  a  litre  of 


1  Horsley  and  Schafer,  Proc.  Roy.  Soc,  vol.  xxxix.  p.  40G. 
=  Unters-uchungen  cms  dem  Phr/siologisclien  Institute  der  Universitttt  Heidek 
berg.    Sonderabclruck,  1879,  p.  16. 


chap,  v.]         ACTION  OF  DEUGS  ON  MUSCLE.  133 

water,  it  begins  to  contract  at  once,  and  after  it  has  been  trans- 
versely divided  it  beats  with  the  regularity  of  the  heart. 

The  effect  of  various  substances  on  the  rhythmic  action  of 
muscle  treated  in  this  way  has  been  investigated  by  Biedermann. 
He  finds  that  the  best  fluid  for  the  sartorius  is  5  grammes 
NaCl,  2-2"5  grammes  of  Na2HP04,  -04--05  gramme  of 
Nia2C03.  A  low  temperature,  not  rising  above  10°  C,  is 
best.  The  lower  the  temperature  the  slower  is  the  rhythm  and 
the  more  extensive  the  contraction.  Heat  quickens  the  rhythm 
and  lessens  the  contraction.  At  about  18°  to  20°  C.  the  con- 
tractions become  rapid  and  indistinct.  When  caustic  soda  is 
used  instead  of  carbonate,  the  effect  is  similar,  but  the  muscle 
dies  much  more  quickly.  Potassium  carbonate  and  other 
potassium  salts  only  cause  pulsations  when  greatly  diluted. 
Lactic  acid  stops  the  pulsations;"  alkaline  NaCl  solution  again 
restores  them.  Veratrine  and  digitalin  in  a  solution  of  NaCl 
also  cause  pulsations.1 

Schonlein  finds  that,  with  a  certain  strength  of  current  inter- 
rupted about  880  times  in  a  second,  the  muscles  of  the  water 
beetle  are  not  tetanised,  but  contract  rhythmically  from  two  to 
six  times  in  a  second.2 

Biedermann  has  succeeded  in  making  a  voluntary  muscle, 
such  as  the  sartorius,  contract  rhythmically  by  applying  a 
solution  of  sodium  bicarbonate  (2  per  cent.)  to  the  tibial  end, 
and  then  passing  a  constant  ascending  current  through  the 
muscle.3 

Pathology  of  Tremor. 

Bapid  alternation  of  contraction  and  relaxation,  or  tremor, 
may  be  observed  to  affect  either—  (a)  a  few  bundles  of  muscular 
fibres,  (6)  a  single  muscle,  or  (c)  groups  of  muscles. 

The  tremors  affecting  a  few  bundles  of  fibres,  or  fibrillary 
twitchings,  may  occur  in  excised  muscles,  and  are  probably  due 
to  some  conditions  of  the  muscular  fibre  allied  to  those  which 
have  already  been  considered  (p.  132).  They  may  occur  also  in 
muscles  which  still  remain  in  the  living  animal  after  the  nerve 
has  been  cut,  more  especially  in  the  muscles  of  the  tongue  after 
section  of  the  hypoglossal  nerve,  or  in  the  muscles  of  the  face 
after  section  of  the  facial  nerve.4 

Tremors  affecting  groups  of  muscles  occur,  in  some  cases, 
when  the  limbs  are  at  rest,  and  cease  during  voluntary  move- 
ment, as  in  paralysis  agitans ;  or  may  cease  entirely  when  the 
limb  is  at  rest,  and  only  come  on  when  the  muscles  are  put  in 

1  Sitzungsber.  d.  Wiener  Akad.,  Abth.  lxxxii.  p.  257-275. 
!  Schonlein,  du  Bois  Beymond's  Archiv,  1882,  p.  357. 
'  Sitzungsber.  d.  Wien.  Akad.,  Bd.  lxxxvii.,  Abt.  iii.,  March  1883. 
4  They  may  possibly  be  regarded  as  due  to  disturbance  of  the  normal  relations 
letween  longitudinal  and  transverse  contraction  in  muscular  substance. 


134  PHARMACOLOGY   AND   THERAPEUTICS,      [sect,  i.' 

action,  as  in  disseminated  sclerosis  and  in  mercurial  tremor. 
As  already  mentioned,  a  certain  number  of  motor  impulses  per 
second  are  required  to  keep  a  muscle  steadily  contracted. 

It  is  evident  that,  if  the  stimuli  proceeding  to  the  muscles 
from  the  nerve-centre  should  be  too  few,  tremor,  and  not  steady 
contraction,  of  the  muscle  will  occur.  And  the  same  will  be  the 
case  if  any  change  in  the  muscle  itself  should  render  the  duration 
of  each  single  contraction  less  than  usual. 

But  in  all  co-ordinated  movements  a  number  of  muscleB,  the 
actions  of  which  are  antagonistic  to  each  other,  are  brought  into 
play ;  and  it  is  by  the  proper  adjustment  of  these  antagonistic 
actions  that  the  performance  of  delicate  movements  becomes 
possible.  Unless  the  amount  of  contraction  of  each  of  these 
muscles  is  exactly  graduated,  there  will  be  a  tendency  to  oscilla- 
tory movement.  As  the  amount  of  contraction  in  each  muscle, 
or  group  of  muscles,  is  regulated  by  the  stimuli  sent  down  to 
it  from  the  nerve-centres,  it  is  evident  that  if  the  motor  cells 
supplying  one  group  of  muscles  be  affected  more  than  those 
which  supply  the  antagonistic  or  regulating  muscles,  inco-ordi- 
nation,  and  possibly  tremor,  will  occur.  The  pathology  of  tremor 
is  still,  however,  very  obscure. 

Treatment  of  Tremor. — If  tremor  should  depend  upon  in- 
sufficient rapidity  of  the  stimuli  passing  to  the  muscles  from  the 
nerve-centres,  it  is  evident  that  any  drug  which,  like  veratrine, 
will  increase  the  duration  of  each  individual  contraction,  is  likely 
to  be  of  use.  Acting  upon  this  idea,  Dr.  Ferris  has  used  vera- 
trine in  cases  of  tremor  due  to  alcoholism,  disseminated  sclerosis,  -' 
and  weakness  after  typhoid  fever.  Although  this  treatment  was 
successful  in  all  these  diseases,  it  does  not  seem  quite  certain 
that  the  utility  of  the  medicine  may  not  be  partially  due  to  its 
action  on  the  spinal  cord  as  well  as  on  the  muscles  themselves. 
In  one  case  of  tremor,  occurring  at  the  commencement  of  general 
paralysis,  I  have  given  salts  of  calcium  with  the  same  object  with 
the  apparent  result  of  arresting  the  tremor.  I  had  intended 
to  use  barium,  but  the  tremor  ceasing  for  many  months  with 
calcium,  I  have  not  proceeded  to  use  anything  else. 

Connection  between  Chemical  Constitution  and 
Physiological  Action  on  Muscle. 

I  have  already  mentioned  (p.  29)  that  one  can  hardly  look 
for  a  general  relation  between  the  atomic  weights  of  metals  and 
their  lethal  activity,  so  that  what  we  want  is  really  a  knowledge 
of  the  particular  relationship  of  each  group  of  elements  to  the 
organs  and  tissues  of  the  body. 

In  such  an  investigation  it  seems  natural  to  take  the  muscles 
first,  then  the  motor  nerves,  afterwards  the  nerve-centres  and 
individual  organs.    A  number  of  experiments  have  been  made  by 


chap.  v.J         ACTION   OF  DEUGS  ON  MUSCLE. 


135 


Cash  and  myself  in  order  to  do  this  for  the  alkalis  and  alkaline 
earths,  and  we  have  found  that  the  contractile  power  of  muscle, 
as  shown  hy  the  height  of  the  curve,  is  increased  by  rubidium, 
ammonium,  potassium,  and  caesium.  It  is  slightly  increased  or 
unaffected  by  sodium,  excepting  in  large  doses,  and  is  almost 
invariably  diminished  by  lithium. 

The  duration  of  contraction,  as  shown  by  the  length  of  the 
curve,  is  increased  by  rubidium  in  large  doses,  ammonium, 
sodium,  and  cesium.  It  is  shortened  by  ammonium,  lithium, 
rubidium  in  small  doses,  and  by  potassium. 

The  contracture,  or  viscosity,  is  increased  by  rubidium  in 
large  doses,  ammonium,  lithium,  and  sodium.  It  is  diminished 
by  rubidium  in  small  doses,  ammonium,  caesium,  and  potassium. 

Both  ammonium  and  rubidium  have  two  actions  on  muscle 
of  an  opposite  character,  sometimes  increasing  and  sometimes 
diminishing  both  the  duration  of  the  contraction  and  of  the  con- 
tracture, or  viscosity,  which  remains  after  the  ordinary  contraction 
has  ceased.  In  the  case  of  rubidium  this  appears  to  depend  upon 
the  dose,  but  we  were  not  satisfied  that  it  was  so  entirely  in  the 
case  of  ammonium  salts. 

In  regard  to  the  action  of  the  alkaline-earths  and  earths, 
we  found  that  the  contractile  power  "of  muscle  is  increased  by 
barium,  erbium,  and  lanthanum.  It  is  sometimes  increased  and 
sometimes  diminished  by  yttrium  and  calcium.  It  is  diminished 
by  didymium,  strontium,  and  beryllium. 

The  duration  of  contraction  is  increased  by  barium,  calcium, 
strontium,  yttrium,  and  erbium.  It  is  unaffected,  or  slightly 
diminished,  by  beryllium,  didymium,  and  lanthanum. 

Contracture  is  increased  by  barium,  calcium,  strontium, 
yttrium,  and  beryllium. 

The  contracture  produced  by  barium  is  enormous,  resembling 
that  produced  by  veratrine.  It  is,  like  that  of  veratrine,  dimin- 
ished by  heat,  cold,  and  potash,  and  may  be  abolished  by  these 


Increase  or  diminish 

afteraction  or  contracture. 

Increase.   0    Diminish. 


Increase  or 

diminish  altitude. 

Diminish.    0   Increase. 


Shorten  or 
lengthen  curve. 
Lengthen.   0   Shorten. 


Rb  (in  small  doses) 
Li  — 

Na(in  moderate  doses) . 

.  Sr  

Ca  

Rb  (large  doses)  ~— — 
Ba  — — 

NH4  (HC1)  — 


agents.  It  is  by  no  means  so  well  marked  when  the  drug 
is  injected  into  the  circulation  as  when  locally  applied  to  the 
muscle. 

The  action  of  some  of  the  more  important  of  those  drugs  can 


136  PHABMACOLOGY  AND  THERAPEUTICS,    ^sbct.i, 

be  graphically  represented  by  a  spiral,  the  terminal  members-of 
which  are  potassium  and  barium,  and  these  two  are,  to  a  certain 
extent,  connected  by  ammonium  as  an  intermediate  link. 

The  effect  of  one  member  of  one  of  these  groups  may  be 
diminished  or  increased  by  the  subsequent  application  of  another. 
Potassium  shortens  the  elongated  curves  caused  by  barium, 
calcium,  sodium  in  large  doses,  and  lithium,  and  reduces  the  con- 
tracture which  these  substances  cause.  The  veratrine-like  curve 
of  barium  is  counteracted  by  almost  all  the  substances  which 
produce  a  shorter  curve  than  itself. 

Action  of  Drugs  on  Muscle  is  Relative  and  not  Absolute. 

In  considering  the  action  of  drugs  on  muscle,  the  first  point 
which  comes  clearly  out  is  that  the  action  of  a  drug  on  the 
muscle  is  not  absolute,  but  merely  relative.  Thus  veratrine  and 
salts  of  barium  are  not  to  be  regarded  as  absolute  muscle- 
poisons — they  are  only  poisons  under  certain  conditions  of 
quantity  and  of  temperature.  An  exceedingly  small  dose  of 
veratrine,  instead  of  acting  as  a  poison  to  muscle,  acts  rather 
as  a  food,  and  restores  it  .when  exhausted.  Caffeine  likewise  in 
small  doses  has  a  restorative  action,  while  in  large  doses  it  is 
a  powerful  poison.  Veratrine  and  barium  in  moderate  doses 
and  at  moderate  temperatures  are  powerful  muscular  poisons, 
but  at  low  temperatures  and  at  high  temperatures  their  action 
is  to  a  great  extent,  or  even  completely,  abolished.  Nay  more, 
moderate  quantities  of  barium  salts  at  moderate  temperatures 
are  poisonous  to  the  normal  muscle,  but  they  are  restorative  to 
the  muscle  whose  composition  and  functions  have  been  already 
altered  by  rubidium.  Acids  and  alkalis  also  produce  an  effect 
on  muscle,  but  their  effect  depends  upon  whether  they  are  applied 
to  the  normal  muscle  or  to  one  previously  treated  with  a  substance 
having  an  opposite  reaction. 

It  is  evident,  then,  that  the  whole  question  of  the  action  of 
drugs  on  muscle  is  one  involving  the  relation  of  the  drug  to  the 
muscle  at  the  time  of  application,  and  we  must  expect  that  if  the 
temperature  is  different  from  the  normal,  or  if  the  composition 
of  the  muscle  should  vary,  the  action  of  the  drug  will  vary  like- 
wise. Now  the  composition  of  all  the  muscles  in  the  body  is  not 
the  same,  as  has  been  shown  by  Toldt  and  Nowak,1  and  the 
composition  of  the  ash  obtained  by  the  combustion  of  different 
animals  is  also  different,  as  has  been  shown  by  Lawes  and 
Gilbert.1  We  may  therefore  expect  that  muscular  poisons  will 
not  act  alike  at  the  normal  temperature  and  in  febrile  condi- 
tions, nor  alike  upon  all  the  muscles  of  an  animal ;  nor  will  they 

1  Quoted  by  Seegen,  Wien.  Akad.  Ber.  lxiii.  Abt.  ii.,  11-43. 
'  Proc.  Boy.  Soc,  xxxv.,  p.  344. 


chap,  v.]         ACTION  OP  DEUGS  ON  MUSCLE.      ,  137 

always  have  the  same  action  upon  different  animals— the 
relations  being  different,  the  effects  will  be  different.  The  effect 
of  poisons  upon  muscles  will  also  vary  according  to  the  chemical 
composition  of  the  tissue  at  the  time.  This  composition  may 
probably,  to  a  certain  extent,  be  altered  by  feeding— at  least  as 
far  as  regards  the  proportions  of  inorganic  ingredients.  We  know 
that  the  quantity  of  sodium  chloride  in  the  body  can  be  increased, 
for  if  an  animal  be  fed  with  a  larger  quantity  of  salt  than  usual, 
it  does  not  at  once  begin  to  excrete,  but  stores  it  up  for  two  or 
three  days,  and  then  the  excretion  increases.  After  the  ad-* 
ministration  of  the  salt  has  been  stopped  the  excretion  continues 
large  for  two  or  three  days,  and  then  returns  again  to  the  lower 
standard.  It  seemed  probable  that  similar  retention  would 
take  place  with  potash,  and  if  this  were  so,  we  might  expect  to 
counteract  to  a  great  extent  the  effect  of  barium  by  feeding  an 
animal  on  potash  for  some  time  before  administering  the  barium. 
On  trying  this,  Cash  and  I  have  found  that  this  is  the  case  to 
a  certain  extent,  and  although  we  have  not  been  able  com- 
pletely to  counteract  the  effect  of  a  large  dose  of  barium  so 
as  to  prevent  death  from  a  lethal  dose,  we  have  been  able  to 
modify  and  diminish  its  action  by  the  administration  of  potash 
for  several  days  previously,  so  that  the  characteristic  symptoms 
of  barium  poisoning  do  not  occur  until  some  hours  after  they 
would  otherwise  do  so,  and  thus  life  is  prolonged  though  not 
preserved. 

Action  of  Drugs  on  Involuntary  Muscular  Fibre. 

Contraction. — Involuntary  muscles,  with  the  exception  of 
the  heart,  differ  from  voluntary  not  only  in  their  anatomical 
structure  but  in  their  functional  activity :  instead  of  contracting 
or  relaxing  rapidly,  both  their  contraction  and  relaxation  are  slow. 
We  have  seen  that  although  voluntary  muscle  occasionally  ex- 
hibits spontaneous  rhythmical  contractions,  yet  these  occur  only 
under  exceptional  circumstances,  and  but  rarely.  Involuntary 
muscle,  on  the  other  hand,  has  a  much  greater  tendency,  to 
rhythmical  contraction,  although  it  may  be  regarded  as  doubtful 
whether  some  stimulus,  however  slight,  is  not  required  to  induce 
this  rhythm  even  in  involuntary  muscle.  It  has  been  already 
mentioned  that  the  contractile  tissue  of  medusa  will  beat  rhyth- 
mically so  long  as  it  is  connected  with  motor  ganglia.  When 
these  ganglia  are  removed,  the  contractions  cease,  but  will  again 
reappear,  notwithstanding  the  absence  of  the  ganglia,  if  a  con- 
stant stimulus  be  applied  to  the  contractile  tissue  itself.  This 
shows  that  the  conditions  for  rhythm  are  contained  in  contractile 
tissue  itself — that  the  rhythm  may  be  independent  of  the  ganglia 
with  which  the  contractile  tissue  is  connected  (p.  113).  The  same 
appears  to  be  the  case  with  involuntary  muscular  fibre  generally. 


138  PHAKMACOLOGY  AND  THEEAPEUTICS.     [sect.  i. 

The  ventricle  of  the  frog's  heart,  containing  ganglia,  will 
beat  rhythmically  for  a  length  of  time  after  its  removal  from  the 
body.  If  the  ganglia  which  lie  close  to  the  auriculo- ventricular 
groove  be  cut  off,  the  rhythmical  action  will  cease  just  as  in  the 
medusa  when  the  marginal  ganglia  are  removed;  but  if  a  constant 
stimulus  be  applied  to  the  apex  of  the  heart,  as  for  example  by 
passing  a  constant  current  through  it,  or  by  distending  it  with 
serum,  its  rhythmical  movement  will  again  commence,  mechani- 
cal distension  appearing  to  have  upon  it  the  same  exciting  action 
that  a  little  acid  added  to  the  water  has  upon  the  nerveless  bell 
of  the  medusa. 

The  excitability  of  involuntary  muscular  fibre  appears  to  be 
increased  by  small  doses  of  atropine ;  for  when  the  ganglia  of 
the  frog's  heart  are  removed  the  apex,  instead  of  stopping  im- 
mediately, will  give  a  few  beats  before  it  stops  if  atropine  has 
been  previously  given,  and  mechanical  stimuli  cause  more  beats 
in  the  atropinised  than  in  the  normal  apex.1 

Effect  of  Stimuli. — Mechanical  distension  appears  to  be  one 
of  the  most  powerful  of  all  stimuli  to  excite  rhythmical  contraction 
in  involuntary  muscular  fibre. 

Luchsinger  observed  distinct  pulsation  in  the  veins  of  a  bat's 
wing  twenty  hours  after  the  death  of  the  animal,  if  artificial  cir- 
culation was  kept  up.  This  appears  to  show  that  the  power  of 
rhythmical  contraction  resides  in  the  muscular  fibres  of  the  veins, 
as  it  does  in  the  nerveless  apex  of  the  frog's  heart,  and  the  con- 
tractile tissue  of  the  medusa ;  but  here  also  an  external  stimulus 
appears  to  be  required  to  induce  contraction.  "When  the  pressure 
by  which  artificial  circulation  was  maintained  fell  to  zero,  the 
pulsation  stopped,  but  if  it  were  raised  to  forty  or  fifty  centi- 
metres of  water,  so  as  to  distend  the  vascular  wall,  rhythmical 
pulsation  again  commenced.  It  appears  possible,  however,  that 
when  involuntary  muscular  fibre  is  perfectly  healthy  and 
possesses  the  highest  degree  of  irritability,  it  may  contract 
rhythmically  without  any  extra  stimulus.  Thus  Engelmann2 
observed  that  the  ureter,  in  which  he  could  find  no  nerves  at  all, 
contracted  rhythmically  when  freshly  exposed,  although  it  was 
not  distended  or  subjected  to  any  mechanical  irritation ;  but  if 
artificial  respiration  has  been  long  kept  up,  and  the  animal  is 
exhausted,  so  that  the  excitability  of  the  ureter  is  diminished, 
then  the  effect  of  minimum  distension  in  increasing  its  rhythm 
becomes  very  evident. 

Cold  causes  the  isolated  non-striated  muscles  of  animals  to 
relax.     Heat  causes  them  to  contract.3 

The  influence  of  heat  and  cold,  however,  does  not  seem  to  be 
constant,  and  in  the  non-striated  muscle  of  frogs  they  have  an 

1  Langendorff,  Arehwf.  Anat.  u.  Phys.  Physiolog.,  Abtg.  1886,  p.  267. 

»  PflUger's  Archiv,  1869,  Bd.  11,  p.  251. 

'  Luchsinger  and  Sokolofl,  PflUger's  Archiv,  Bd.  26,  p.  465.      ■ 


eHAP.  v.]         ACTION  OF  DEUGS  ON  MUSCLE.  189 

opposite  connection  to  thai;  just  described.  It  is  probable  that 
the  different  results  may  depend  to  a  great  extent  upon  the 
amount  of  heat  or  cold  applied,  and  its  relation  to  the  condition 
of  the  tissues  at  the  time  of  application  ;  for  mechanical  stimu- 
lation has  also  an  opposite  effect,  according  to  its  amount ;  and 
while  gentle  stimulation  of  involuntary  muscular  fibre,  such  as 
that  of  the  small  blood-vessels,  causes  dilatation,  more  powerful 
irritation  produces  contraction.1 

The  influence  of  various  drugs  upon  involuntary  muscular 
fibre,  as  seen  in  the  contraction  of  the  blood-vessels,  will  be 
described  when  considering  the  circulation. 

The  Relation  of  the  Contractile  Tissue  to  the  Nerves 
is  different  in  voluntary  and  involuntary  muscular  fibre.  In  the 
latter  there  are  no  end  plates,  but  the  terminal  twigs  form 
a  plexus  around  the  fibres.  The  motor  nerves  of  involuntary 
muscular  fibre  appear  to  be  affected  by  atropine  and  its  con- 
geners in  a  similar  way  to  those  of  voluntary  muscle  by  curare. 
There  appears  also  to  be  a  certain  relationship  between  the  atro- 
pine and  curare  group.  Small  doses  of  atropine  paralyse  the 
motor  nerves  of  involuntary  muscle,  while  very  large  doses  of 
curare  are  required.  The  converse  is  the  case  with  voluntary 
muscle.  These  effects  are  usually  supposed  to  be  due  to  a 
definite  paralysing  action  on  the  nerves  themselves.  There  are 
difficulties,  however,  in  the  way  of  this  hypothesis,  and  a  more 
probable  one,  perhaps,  is  that  these  drugs  disturb  the  relations 
between  the  nerves  and  the  muscular  fibres  which  they  excite. 
On  the  idea  of  a  specific  action  it  seems  hard  to  explain  the 
results  obtained  by  Szpilman  and  Luchsinger,2  who  found  that 
atropine  produces  paralysis  of  the  motor  fibres  of  the  vagi  sup- 
plying the  oesophagus,  only  in  those  parts  of  it  where  involuntary 
muscular  fibre  is  present.  Thus  the  oesophagus  of  the  frog  and 
the  crop  of  birds  consist  of  involuntary  muscular  fibre,  and 
atropine  destroys  the  motor  power  of  the  vagus  over  them.  The 
oesophagus  of  the  dog  and  rabbit  contains  striated  muscular 
fibre,  and  atropine  does  not  paralyse  the  motor  nerves.  The 
oesophagus  of  the  cat  contains  striated  muscular  fibres  in  its 
upper  three-fourths,  and  non-striated  in  its  lower  fourth ;  atro- 
pine destroys  the  motor  action  of  the  vagus  upon  the  lower 
fourth,  but  not  upon  the  upper  part.3 

Propagation  of  Contraction  Waves. — Although  involuntary 
muscular  fibre  consists  of  short  cells  and  not  of  long  fibres  like 
voluntary  muscle,  yet  the  contraction  wave  may  be  propagated 
along  a  strip  of  involuntary  muscular  tissue  in  both  directions 
from  the  point  of  irritation,  just  as  in  voluntary  muscle  or  in 
the  contractile  tissue  of  medusae.     This  wave  is  transmitted 

1  Sigmund  Meyer,  Hermann's  Handb.  d.  Physiol.,  Bd.  5,  Theil  ii.,  p.  476. 
8  Szpilman  and  Luchainger,  PflUger's  ArcMv,  Bd.  26,  p.  459. 
•  Ibid.  p.  249. 


2 


140  PHARMACOLOGY  AND  THERAPEUTICS,     [sect.  i.. 

more  slowly  in  involuntary  than  in  voluntary  muscle ;  and 
its  rate  in  the  involuntary  muscle  of  the  heart,  though  slower 
than  in  ordinary  striated  muscle,  is  quicker  than  iri  unstriated 
muscle,  so  that  in  this  respect  the  heart  is  intermediary  between 
the  two.1 

The  passage  of  contraction  waves  in  involuntary  muscular 
fibre  is  affected  by  the  same  conditions  as  voluntary  muscle, 
the  conduction  of  the  contractile  wave  being  rendered  slower  by 
fatigue  and  cold,  while  it  is  quickened  by  heat. 

Cold  and  fatigue  also  render  the  rhythmical  pulsations  smaller, 
and  longer,  while  heat  has  an  opposite  effect.  The  passage  of 
the  contraction  wave  may  also  be  diminished  or  arrested  by 
section  or  pressure,  just  as  in  the  contractile  tissue  of  medusae, 
so  that  instead  of  each  contraction  wave  passing  the  block  pro- 
duced by  the  sections  or  compression,  only  one  out  of  several, 
or  none  at  all,  may  pass.  The  proportion  passing  the  block 
depends  upon  its  completeness.  If  the  tissue  forming  the 
bridge  be  dry  as  well  as  narrow,  the  block  becomes  more  com- 
plete, and  may  be  again  diminished  by  moistening.  Variations 
in  the  strength  of  the  stimulus  do  not  affect  the  passage  of  the 
contraction  wave  over  the  block,  so  that  it  would  appear  that 
the  injury  caused  by  the  section,  along  with  the  narrowing  of  the 
conduction  path,  retards  the  re-establishment  of  the  conductive 
power. 

In  experiments  made  upon  the  heart  of  a  tortoise  cut  into  a 
strip,  it  has  been  found  by  Gaskell  that  stimulation  of  the  vagus 
removes  the  block,  quickens  the  recovery  of  the  tissue,  and  causes 
every  contraction  wave  to  pass.  The  effect  upon  the  muscle 
therefore  seems  to  be  trophic. 

A  weak  interrupted  current  applied  to  the  muscle  directly 
has  the  same  action  as  stimulation  of  the  vagus,  i.e.  it  increases 
the  conducting  power  of  the  muscle.  Sometimes,  however,  both 
the  vagus  and  a  weak  interrupted  current  have  an  opposite  effect, 
and  diminish  instead  of  increasing  the  conducting  power. 

An  artificial  rhythm  may  be  induced  in  a  strip  of  involuntary 
muscular  fibre  cut  from  the  heart  of  the  tortoise  by  passing  a  weak 
interrupted  current  through  it  and  then  stimulating  it  at  one  end 
by  induction  shocks,  at  intervals  of  about  five  seconds.  After  a 
while,  if  the  induction  shocks  are  discontinued,  the  muscle  still 
continues  to  contract  rhythmically  at  the  same  rate.  These  con- 
tractions, at  first  weak,  afterwards  become  strong,  and  may  last 
for  many  hours.  Both  the  conducting  and  the  contractile  power 
of  the  muscle  are  diminished  by  muscarine.  When  a  strip  of  it 
is  stimulated  by  induction-shocks  applied  to  one  end,  the  con- 
traction wave  passes  quickly  along ;  but  muscarine  appears  to 

1  Hermann's  Handbuch  d.  Physiologie,  Bd.  1,  p.  56. 

2  Engelmann,  Pflilger's  Archiv,  1875,  Bd.  11,  p.  465 ;   Gaskell,  Journal  of 
Physiology,  vol.  iii.  p.  367. 


chap.  v:j         ACTION  OF  DEUGS  ON  MUSCLE.  141 

block  its  transmission,  so  that  while  the  part  of  the  muscle 
between  the  electrodes  contracts  at  every  shock,  the  rest  of  the 
muscle  contracts  only  at  every  second  one.  A  weak  interrupted 
current  then  sent  through  the  muscle  may  lower  its  conducting 
power  and  still  further  reduce  the  force  of  the  contractions,  and 
not  only  block  the  passage  of  most  of  the  contraction  waves  from 
the  point  of  excitation,  but  may  even  prevent  the  contraction  of 
the  excited  part  itself. 

Atropine  has  an  opposite  action  and  appears  to  increase  the 
conducting  power  of  involuntary  muscle,  so  that  when  applied 
to  a  strip  of  the  heart,  the  conducting  power  of  which  has  been 
diminished  by  muscarine,,  the  contractility  is  at  once  increased^ 
and  each  contraction  wave  pass'es  over  the  whole  muscular  strip 
each  time  that  a  single  point  is  irritated.  Large  doses,  however,1 
appear  to  have  a  depressant  action  on  the  muscle. 

Hypothetical  Considerations  regarding  the  Action  of 
Drugs  on  Muscle. 

The  modifications  which  drugs  produce  in  the  functions  of  the  animal 
body  and  of  its  parts  are  so  numerous  and  varied  that  we  are  unable  fully 
to  explain  them  on  the  basis  of  our  present  physiological  knowledge.  The 
results  of  pharmacological  experiments  furnish  us  indeed  with  a  number  of 
additional  facts  regarding  the  functions  of  organs  and  tissues  which  will  ultl* 
mately  lead  us  to  a  more  correct  and  thorough  knowledge  of  their  physiology'. 
At  present,  however,  we  can  only  explain  them  hypothetically,  and,  indeed,  in 
many  cases  we  can  do  little  more  than  guess  at  the  explanation. 

The  advantage  to  be  gained  from  hypothetical  explanations  is  that 
hypotheses  not  only  lead  to  further  experiment,  but  serve  as  guides  for 
experiments,  by  which,  if  false,  they  may  be  soon  disproved,  or,  if  true,  may 
be  maintained. 

The  disadvantage  of  hypotheses  is  that  they  are  sometimes  apt  to  be 
taken  for  facts,  and  being  made  use  of  as  bases  for  further  speculation,  may 
lead  more  and  more  astray  from  the  truth.  While  bearing  in  mind  the 
danger  of  speculation,  it  may  be  useful  to  make  some  guesses  at  the  mode  of 
action  of  drugs  upon  the  muscle  as  guides  to  further  research. 

The  most  striking  point  about  muscle  is  the  motor  function  which  it 
exercises  by  contracting,  and  the  nature  of  its  contraction  must  engage  our 
attention.  Throughout  the  universe  we  find  that  motion  of  nearly  all  sorts 
resolves  itself  into  a  series  of  vibrations,  and  the  question  arises  whether  the 
motion  of  muscle  cannot  be  explained  in  the  same  way. 

When  a  muscle  is  stimulated  it.  contracts  and  relaxes  once,  describing  a 
wave-like  curve  upon  the  revolving  cylinder.  Frequently  this  first  wave  is 
followed  by  a  second,  and  sometimes  even  by  a  third,  which  are  usually 
ascribed  to  the  simple  elasticity  of  the  muscle.  Sometimes  we  can  notice 
that  the  single  contraction  wave  appears  really  to  consist  of  two  or  moie  par- 
tially superimposed  on  each  other,  and  sometimes  we  may  find  two  distinct 
waves  arise  from  one  stimulation. 

When  a  muscle  is  in  a  state  of  tetanic  contraction  it  appears  to  the  eye  to 
be  perfectly  quiet,  yet  we  know  that  during  this  period  of  apparent  rest  the 
muscle  is  in  a  state  of  vibration,  alternately  tending  to  contract  and  elongate. 
These  vibrations  may  succeed  one  another  with  a  rapidity  such  that  the 
muscle  appears  to  the  eye  to  be  motionless,  while  a  tracing  taken  upon  the 
revolving  cylinder  shows  distinct  successive  waves.  If  the  vibrations  are 
still  more  rapid,  the  waves  may  disappear,  and  we  get  the  muscle  describing 
a  straight  line.     But  even  when  a  muscle  is  entirely  relaxed,  its  parts  may 


142  PHAEMACOLOGY  AND  THEEAPEUTICS.     [sect.  i. 

be  in  a  state  of  vibration  quite  as  continuous  as  in  tetanic  contraction.  This 
is  seen  by  examining  muscular  fibre  under  the  microscope.  The  phenomenon 
which  then  presents  itself  was  described  by  Porret  and  is  often  known  by  his 
name.  On  passing  a  constant  current  through  a  thin  muscular  slip  a  con- 
traction is  seen  when  the  current  is  closed.  During  the  whole  time  of  the 
passage  of  the  current,  the  muscle,  to  the  naked  eye,  appears  to  be  perfectly 
at  rest,  but  under  the  microscope  its  parts  are  seen  to  be  in  constant  motion, 
presenting  an  appearance  almost  exactly  similar  to  the  waving  of  a  field  of 
corn  on  a  windy  day,  or  to  the  motion  of  rows  of  cilia.  At  the  same  time  an 
actual  transference  of  material  takes  place  in  the  muscle :  the  end  next  the 
positive  pole  growing  smaller,  and  the  end  next  the  negative  pole  growing 
larger.  When  the  current  is  suddenly  reversed,  a  sudden  contraction  of  the 
whole  muscle  takes  place,  and  it  then  returns  to  apparent  rest ;  but  micro- 
scopic observation  shows  the  same  cilia-like  motion  as  before,  but  in  an 
opposite  direction. 

This  phenomenon  reminds  one  very  strongly  of  the  crowding  together  of 
carriages  in  a  railway  train  when  it  is  set  in  motion  or  stopped  by  the 
locomotive  pushing  behind  or  stopping  in  front.  Wo  know  that  the  apparent 
steady  movement  of  the  train  is  due  to  the  backward  and  forward  vibration 
of  the  piston  in  the  cylinders  of  the  locomotive,  and  the  question  occurs 
whether  the  contraction  of  the  muscle  as  a  whole  at  the  moment  of  opening 
and  breaking  the  current,  is  not  due  to  an  interference  with  the  rhythmical 
vibration  of  its  parts.  The  question  also  arises  whether  these  vibrations  are 
not  to  a  great  extent  dependent  upon  the  molecular  weight  of  its  constituents. 
This  seems  to  a  certain  extent  to  be  indicated  by  the  curious  relations  between 
the  effects  of  the  alkalis,  alkaline  earths,  and  certain  metals  upon  muscle. 
Thus  Cash  and  I  have  found  that  potassium  and  calcium  neutralise  the  action 
of  each  other  upon  muscle,  and  if  the  hypothesis  just  expressed  be  correct 
we  should  expect  that  metals  having  a  similar  molecular  weight  to  a  mixture 
of  calcium  and  potassium  would  have  no  action  upon  muscle.  This  appears 
to  be  the  case.  In  researches  made  in  Professor  Schmiedeberg's  laboratory, 
Anderson  Stewart  found  that  nickel  and  cobalt  had  no  action  upon  muscle, 
and  White  found  that  tin  also  had  little  or  none.  On  comparing  then  the 
atomic  weights  of  potassium  (39),  calcium  (40),  nickel  (59),  cobalt  (59),  and 
tin  (118),  we  get  the  following  relationships : 

K2  (78)  +  Ca  (40)  =  Ni2  (118),  or,  Co,  (118),  or,  Sn  (118.) 
Sodium  in  large  doses  lengthens  the  curve  and  increases  the  contracture 
when  applied  to  a  normal  muscle.  It  adds  to  the  length  of  the  long  curves 
caused  by  calcium  and  strontium.  Eubidium  in  large  doses  produces  a  long 
curve  with  enormous  contracture  almost  like  that  of  barium.  One  would 
naturally  have  expected  that  the  rubidium  and  barium  would  have  increased 
each  other's  effect  like  sodium,  calcium,  or  strontium ;  but  the  reverse  is  the 
case,  for  the  abnormal  curve  caused  by  rubidium  is  reduced  to  the  normal  by 
the  application  of  barium.  If  barium  be  applied  to  a  greater  extent  than  is 
sufficient  to  antagonise  rubidium,  it  first  abolishes  the  prolonged  rubidium 
curve,  reducing  it  to  the  normal,  and  then  again  elongates  it,  producing  its 
own  characteristic  curve.  Calcium  and  strontium,  which  also  prolong  the 
curve,  though  to  a  less  extent  than  barium,  do  not  antagonise  one  another's 
effect — they  rather  increase  it ;  but  calcium  reduces  the  barium  curve  to  the 
normal  before  causing  its  own  peculiar  curve.  At  first  sight  these  results 
seem  to  be  independent  of  any  rule,  but  a  curious  relation  is  to  be  observed 
between  the  atomic  weights  of  these  substances.  Thus  we  have  seen  that 
rubidium  in  large  doses  has  the  same  effect  as  barium  in  causing  a  veratrine- 
like  curve,  but  barium  destroys  the  effect  of  rubidium  before  producing  its 
own  effect.  On  comparing  the  atomic  weights  of  these  elements  we  find  that 
eight  atoms  of  rubidium  have  nearly  the  same  weight  as  five  of  barium,  and 
by  subtracting  one  from  the  other  we  get  almost  no  remainder.    Thus, 

Ba  137    x  5  =  685 

Eb  85-4  x  8  =  683'2 


chap,  v.]         ACTION  OF  DEUGS  ON  MUSCLE.  14y 

Potassium  is,  as  we  know,  an  important  constituent,  of  muscle,  and  it 
seems  possible  that  the  reduction  in  the  barium-curve  which  calcium  causes 
may  be  due  to  their  union  having  resulted  in  a  substance  whose  molecular 
weight  is  a  multiple  of  that  of  potassium.    Thus, 

Ba  137  x  2  =  274  -  Ca  40  =  234 
K     39  x  6=  234 

The  alterations  which  occur  in  voluntary  muscle  from  the  action  of  such 
substances  as  calcium  or  barium  appear  to  approximate  it  to  some  extent  to 
involuntary  muscle.  Voluntary  muscle  is  chiefly  characterised  by  sudden  and 
rapid  contraction  and  relaxation.  Involuntary  muscle  usually  contracts  and 
relaxes  slowly.  In  the  slowness  of  its  relaxation,  at  least,  the  muscle  poisoned 
by  barium  or  calcium  approaches  involuntary  muscle.  , 

The  power  of  summation  which  contractile  tissues  possess  is  strongly  sug- 
gestive of  the  idea  that  rhythmical  vibrations  of  gradually  increasing  intensity 
are  going  on  within  the  tissue  even  before  any  movement  becomes  visible.  A 
pendulum  very  gently  struck  at  proper  intervals  will  gradually  begin  to 
oscillate  through  a  larger  and  larger  arc.  If  touched  on  one  side  while 
oscillating,  the  effect  of  the  touch  will  depend  upon  the  time  at  which  the 
touch  is  applied,  for  at  one  period  of  oscillation  it  will  tend  to  impede,  and  at 
another  to  assist  the  oscillation.  Possibly  some  unseen  rhythm  in  the  muscle 
itself  may  be  the  cause  of  the  curious  variations  in  excitability  observed  in 
dying  muscles  and  in  muscles  poisoned  by  lead.  Two  pendulums  connected 
together  will  swing  harmoniously  if  their  rate  of  oscillation  is  the  same,  but 
if  one  be  loaded  so  as  to  alter  its  rate  of  oscillation  they  will  interfere  with 
each  other.  Possibly  the  effect  of  poisons  in  paralysing  nerves  may  be  due 
rather  to  alteration  in  the  relative  rhythms  of  the  nerve  and  muscle  than  to 
any  specific  destructive  power  on  the  terminations  of  the  nerve  itself. 

The  opposite  effects  which  Gaskell  has  noticed  the  vagus  nerve  and  a  weak 
induced  current  to  produce  upon  the  conducting  power  of  the  cardiac  muscle, 
sometimes  increasing  and  sometimes  diminishing  it,  may  be  due  to  the  inter- 
ference or  coincidence  of  rhythm  such  as  are  discussed  more  fully  farther  on 
under  the  head  of  Inhibition. 

It  is  impossible  to  say  at  present  what  the  true  cause  of  the  curious 
rhythmical  contractions  of  voluntary  muscle  is,  but  if  we  suppose  that  there 
is  a  transverse  as  well  as  a  longitudinal  contraction  in  muscle,  we  might 
regard  the  rhythmical  contractions  as  resulting  from  the  action  of  these  two 
opposing  forces. 

It  must  be  borne  in  mind  that  the  considerations  contained  in  this  section 
are  purely  hypothetical,  and  their  only  use  is  to  indicate  the  direction  in 
which  we  may  possibly  look  for  an  explanation  of  the  action  of  medicines  on 
muscle. 


IU  PHARMACOLOGY  AND  THERAPEUTICS.     Tsect.  u 


CHAPTEE   VI. 
'      ACTION  OF  DRUGS  ON  NERVES. 

General  Action  of  Drugs  on  the  Nervous  System. 

In  low  organisms  the  contractile  protoplasm  fulfils  the  func- 
tions of  both  nerve  and  muscle,  but  as  we  ascend  in  the  scale 
differentiation  becomes  more  and  more  complete.  From  their 
original  common  origin,  however,  we  might  expect  that  the 
poisons  which  act  on  the  muscles  would  also  act  on  the  motor 
nerves,  and  vice  versa,  and  we  should  hardly  expect  any  poison 
to  act  entirely  on  the  one  without  affecting  the  other.  This 
is  to  a  considerable  extent  the  case,  for  very  many  substances 
paralyse  them  both.  But,  as  one  would  also  expect  from  the- 
differentiation  they  have  undergone,  muscle  and  nerve  are  not 
equally  affected  in  the  higher  animals.  Thus  we  find  that 
although  most  of  the  salts  of  ammonium,  and  the  iodides, 
chlorides,  and  sulphates  of  the  compound  ammonias  into  which 
methyl  and  ethyl  enter,  paralyse  both  muscle  and  nerve,  yet 
they  paralyse  the:  nerve  before  the  muscle.  In  some  cases  the 
nerve  is,  affected  so  much  before  the  muscle  that  at  first  sight  it 
might  appear  that  the  nerve  alone  was  paralysed  and  the  muscle 
left  unaffected.  More  careful  observation,  however,  shows  us. 
that  most  of  the  compound  ammonias,  and  probably  most  of 
the  organic  alkaloids,  affect  muscle,  motor  nerves,  and  nerve-; 
centres,  and,  if  their  action  can  be  continued  long  enough,  will 
paralyse  all  three.  The  symptoms  they  produce  may,  however, 
be  entirely  different,  because  these  depend  upon  the  order  in 
which  the  different  parts  of  the  nervous  system  are  affected,  as 
has  already  been  pointed  out  at  p.  26.  The  symptoms  pro- 
duced, for  example,  by  strychnine  and  methyl-strychnine  ara 
utterly  different,  the  former  causing  tetanic  convulsions,  and 
the  latter  gradually-increasing  torpor,  weakness,  and  paralysis. 
Strychnine  stimulates  the  spinal  cord,  and  methyl-strychnine 
paralyses  the  motor  nerves ;  yet  if  their  action  continue  long 
enough  it  is  found  that  both  of  them  will  ultimately  cause 
paralysis  of  both  spinal  cord  and  motor  nerves.  The  final  result 
is  thus  the  same  in  both  cases,  but  the  order  in  which  the 
various  parts  of  the  nervous  system  are  affected  is  different. 


chap,  vi.]         ACTION  OF  DEUGS  ON  NERVES. 


145 


In  the  example  just  given,  the  drugs  appear  to  exert  a 
selective  influence  on  the  spinal  cord  and  motor  nerves  respect- 
ively, and  consequently  produce  very  different  symptoms.  But 
we  find  that  a  number  of  drugs  appear  to  act  upon  muscles, 
motor  nerves,  and  nerve-centres,  in  a  given  order,  although  there 
may  be  slight  variations  in  the  action  of  the  individual  drugs. 
These  substances  are  .generally  found  to  act  as  protoplasmic 
poisons,  arresting  the  movements  of  amoeba  and  white  blood- 
corpuscles,  as  well  as  proving  fatal  to  higher  animals. 

In  the  protoplasm  of  these  minute  organisms  we  are  unable 
at  present  to  distinguish  any  evidences  of  differentiation.  As  we 
ascend  in  the  animal  kingdom  we  find  a  differentiation  between 


Brain 


Medulla 


Respiratory  nerved 


Heart 


spinal  cord 


Centre  for 
sphincter* 


Sensory  and  motor  nerves 


Pig.  51. — Diagram  to  illustrate  Hughlings  Jackson's  views  of  the  nervous  sj'stem. 

muscle,  nerve,  and  nerve-centre ;  and  the  higher  up  we  ascend 
in  the  scale  the  more  complex  do  the  nerve-centres  become.  As 
Hughlings  Jackson  has  well  put  it,  '  evolution  is  a  passage  from 
the  most  simple  to  the  most  complex,  from  the  lowest  to  the 
highest  centres.'  It  is  a  passage  from  the  most  automatic  to  the 
most  voluntary ;  but  the  lowest  centres  are  at  the  same  time  the 
most  stable,  or,  as  Jackson  calls  it,  the  '  most  organised  centres ' ; 
while  the  highest  centres  are  the  most  unstable  or  least  organ- 
ised. This  is  represented  diagrammatically  in  Fig.  51,  where 
the  centres  for  the  heart  and  respiratory  apparatus  and  for  the 

L 


146  PHAKMACOLOGY  AND  THERAPEUTICS.  '  [sect,  u 

sphincters  are  represented  as  very  simple  in  their  organisation, 
but  very  stable,  as  indicated  by  the  size  of  the  ganglia  and  thick- 
ness of  the  nerves  in  the  diagram.  The  spinal  cord  is  represented 
as  more  complex,  but  with  thinner  lines,  in  order  to  show  its 
lesser  stability ;  while  the  high  complexity  and  small  stability  of 
the  cerebral  cortex  is  indicated  by  the  great  number  and  thin- 
ness of  the  lines  in  the  figure.  According  to  Jackson,  the  lowest 
nervous  centre  extends  from  the  aqueduct  of  Sylvius  to  the  lower 
end  of  the  spinal  cord ;  and  in  this  all  parts  of  the  body  are 
directly  represented,  so  that  a  discharge  of  nervous  energy  from 
any  part  of  it  only  requires  to  overcome  the  resistance  in  the 
motor  nerves .  and  the  muscles,  themselves.  What  he  regards 
as  the  middle  motor  centres  are  evolved  out  of  the  lowest,  and 
re-represent  all  parts  of  the  body  in  more  complex  and  special 
combinations.  The  highest  centres  evolved  out  of  the  middle 
re-re-represent  all  parts  of  the  body  in  still  more  complex  and 
special  combinations.  A  discharge  from  the  highest  centres,  in 
order  to  act  on  the  periphery,  has  to  overcome  the  resistance  of 
the  middle,  and  lowest  centres,  as  well  as  of  the  muscles. 

In  the  action  of  such  poisons  as  alcohol,  the  nervous  system 
appears  to  be  paralysed  in  inverse  order  of  its  development :  the 
highest  centres  going  first,  next  the  middle,  and  then  the  lowest. 
After  this  comes  paralysis  of  the  motor  nerves,  and  lastly  of  the 
muscles  themselves.  In  the  ease  of  alcohol,  the  dose  required  to 
paralyse  motor  nerves  and  muscles  is  so  great  that,  as  a  rule,  we 
can  only  observe  its  effect  by  directly  applying  the  drug  to  the 
nerves  and  muscles  themselves.  To  such  a  process  of  paralysis 
as  this,  Jackson  applies  the  term  of  dissolution. 

In  the  case  of  drugs  which  excite  nervous  centres,  we  also 
notice  a  certain  similarity  of  action.  Thus  strychnine  not  only 
causes  convulsions  by  its  stimulating  action  on  the  medulla 
spinalis,  but  stimulates  also  the  nerve-centres  for  the  respiration 
and  circulation  in  the  medulla  oblongata  and  in  the  heart  itself. 

Action  of  Drugs  on  Motor  Nerves. 

The  readiness  with  which  a  muscle  responds  to  a  stimulus 
depends  both  on  the  condition  of  the  muscle  itself,  and  on  the 
terminations  of  motor  nerves  within  it.  A  faradaic  current 
readily  stimulates  the  nerve-endings,  but  does  not  act  at  all 
readily  on  the  muscle.  The  making  and  breaking  of  a  constant 
current,  on  the  other  hand,  has  comparatively  slight  action  on 
the  nerves,  but  a  powerful  action  on  the  muscle.  One  of  the 
questions  which  arises  most  constantly  in  connection  with  the 
action  of  drugs  is :— whether  or  not  they  paralyse  the  end  of 
the  motor  nerves  in  muscle.  This  question  was  fully  worked 
out  by  -Bernard,  and  also  independently  by  Kolliker,  in  relation 
to  curare. 


chap,  vi.]         ACTION  OF  DEUGS  ON  NEEVES.  147 

The  same  methods  of  experiment  were  adopted  by  both. 
They  were  twofold,  and  consisted : 

1.  In  applying  the  poison  to  that  part  of  the  body  alone  which 
seemed  affected  by  it,  and  seeing  whether  it  produced  its  usual 
action. 

2.  In  preventing  it  from  reaching  that  part,  and  seeing 
whether  its  usual  effect  was  then  absent. 

The  first  of  these  methods  consisted  in  the  local  application 
of  the  drug  to  the  muscles  and  motor  nerves  themselves  (Pigs.  52 
and  53).  The  second  consisted  in  ligaturing  the  artery  of  one 
leg  in  a  frog,  so  as  to  prevent  the  poison  from  reaching  the 
muscles  and  motor  nerves  in  that  leg  (Pig.  54) . 

The  advantage  of  the  first  method,  viz.  that  of  local  appli- 
cation, is  that  it  allows  us  to  deal  with  only  one  organ  at  a 
time,  and  the  results  are  therefore  less  complicated  than  those 
of  the  second  method.  In  some  respects  it  is  better  to  begin  with 
the  second  method  and  work  back  to  the  simpler  from  the  more 
complex  organs  (p.  149). 

Paralysis  of  Motor  Nerve  -  endings. —  Curare  produces 
symptoms  of  paralysis.  Paralysis  may  be  due  to  the  action 
of  the  drug  on  the  muscles  themselves,  on  the  motor  nerves 
which  set  them  in  action,  or  on  the  nerve-centres  which  originate 
motor  impulses.  In  order  to  decide  this,  Bernard  applied  elec- 
tricity to  the  nerves  and  to  the  muscles  of  a  frog  poisoned  by 
curare  administered  subcutaneously.  He  thus  found  that  when 
the  nerve  was  irritated  no  effect  was  produced  on  the  muscles ; 
but  that  when  the  muscle  itself  was  stimulated,  it  contracted 
readily.  In  order  to  decide  whether  this  loss  of  irritability  in 
the  nerve  was  due  to  a  change  in  the  nerve-trunk,  or  in  the  ter- 
minations within  the  muscle,  Bernard  employed  the  first  method, 
that  of  local  application.  He  placed  a  solution  of  curare  in  two 
watch-glasses.    In  one  he  immersed  the  trunk  of  the  nerve  (Fig. 


Fig.  52. — Shows  the  method  of  applying  a  drug  in  solution  locally  to  the  trunk  of  a  nerve. 

52),  and  in  the  other  the  muscle,  so  that  the  solution  penetrating 
between  the  fibres  could  reach  the  nerve-endings  (Fig.  53).    He 


FiQ.  53.— Shows  the  method  of  applying  a  drug  in  solution  locally  to  a  muscle  and  the  ends 
of  motor  nerves  within  it. 

then  irritated  the  nerve  attached  to  both  muscles,  and  found 
that  irritation  caused  contraction   readily  enough  in  the  case, 

l2 


148 


PHARMACOLOGY  AND  THEEAPEUTICS.     [sect.  i. 


Where  the  nerve-trunk  had  been  steeped  in  the  solution  of  curare, 
but  had  no  effect  when  the  curare  had  been  allowed  to  reach  the 
nerve-ends  by  immersion  of  the  muscle  in  the  solution.  The 
irritability  of  the  muscle  itself  to  mechanical  stimuli,  or  to  the 
making  and  breaking  of  a  constant  current  directly  applied  to 
it,  remained  quite  unaltered,  so  that  the  muscular  fibre  had 
evidently  not  been  affected  by  the  action  of  the  poison. 

The  second  mode  of  testing  the  action  of  drugs  upon  motor 
nerves,  viz.  that  of  local  protection,  consists,  as  has  been  stated, 
in  allowing  the  drug  to  be  carried  to  the  muscles  and  nerve-endings 


3FIG.'  54.— Diagram  of  the  mode  of  experimenting  on  motor  and  sensory  nerves  in  the  frog. — The 
shaded  part  shows  where  the  poison  has  been  carried  by  the  cumulation.  The  unshaded  left  leg 
shows  where  the  tissues  have  been  protected  from  the  poison  by  ligature  of  the  artery  just 
above  the  knee.  The  unbroken  lines  with  arrows  pointing  to  the  spinal  cord  indicate  the 
sensory  nerves.  The  broken  line  with  arrows  pointing  outwards  indicates  the  motor  nerve  to 
the  unpoisoned  leg. 

by  the  circulating  blood  in  one  leg  of  a  frog,  while  it  is  prevented 
from  reaching  the  other  either  by  ligaturing  (Fig.  54)  the  blood- 
vessels alone,  or  ligaturing  tbe  whole  leg  with  the  exception  of  the 
sciatic  nerve.  After  some  time  has  elapsed,  the  sciatic  nerve  is 
stimulated  on  eacb  side.  If  the  muscles  of  the  poisoned  limb  do 
not  contract  at  all  or  do  so  more  feebly  than  in  the  unpoisoned 
limb,  it  is  evident  that  the  poison  has  paralysed  either  them  or 
the  motor  nerves.  In  order  to  .decide  whether  the  nerves  or  the 
muscles  are  paralysed  the  muscle  is  next  stimulated  directly ;  if 
it  then  contracts  normally  it  is  evident  that  the  paralysis  ob- 
served when  the  nerve  was  irritated  is  due  to  the  action  of  the 


chap,  vi.]         ACTION  OF  DRUGS  ON  NERVES.  149 

drug  on  the  nerve-endings.  If  the  muscle  is,  completely  para- 
lysed, no  definite  conclusion  can  be  drawn  regarding  the  nerve- 
endings,  but  if  the  muscle  shows  only  partial  paralysis,  and  the 
paralysis  is  greater  when  the  nerve  is  stimulated  than  when  the 
muscle  is  stimulated  directly,  we  conclude  that  the  drug  has 
acted  upon  both  the  muscular  substance  itself  and  the  motor 
nerve-endings  within  it. 

The  effect  of  drugs  in  paralysing  motor  nerves  is  chiefly  in- 
vestigated in  frogs  as  the  action  comes  out  much  more  distinctly 
in  them. 

Warm-blooded  animals  may  die  from  paralysis  of  the  motor 
nerves  while  the  nerves  still  respond  readily  to  faradaic  stimuli 
.applied  to  them,  the  faradaic  stimulus  being  much  greater  than 
that  normally  sent  along  the  nerves  from  the  nerve-centres. 
Thus  after  an  animal  has  been  killed  by  paralysing  it  with 
curare,  its  muscles  will  still  respond  readily  to  electrical  stimu- 
lation of  the  motor  nerves. 

A  fallacy  to  be  guarded  against  in  experiments  on  the  results 
of  preventing  a  poison  from  reaching  one  part  of  the  body  is 
that  caused  by  diffusion.  Even  when  the  circulation  is  stopped 
in  a  frog's  leg  by  ligature  of  the  artery,  poison  introduced  into 
the  dorsal  lymph-sac  may  pass  down  the  limb  by  diffusion  and 
affect  the  parts  below  the  ligature.  This  may  be  to  a  great 
extent  prevented  by  ligaturing  the  whole  limb  en  masse,  at  the 
same  time  carefully  excluding  the  sciatic  nerve  from  the  ligature. 
Diffusion  may  also  occur  although  the  circulation  has  been  stopped 
throughout  the  whole  body  by  removal  of  the  heart  and  other 
viscera,  and  the  anterior  part  of  the  spinal  cord  may  be  affected 
before  the  posterior  when  the  poison  is.  injected  into  the  dorsal 
lymph-sac. 

Advantage  of  the  Method  of  Local  Protection.:— The 
advantage  of  this  method  is  that  it  affords  information  regarding 
the  action  of  the  poison  upon  other  parts  of  the  nervous  system,. 
viz.  the  nerve-centres  and  sensory  nerves,  as  well  as  upon.  the 
motor  nerves.  It  also  gives  the  order  in  which  the  poison  affects 
the  various  nervous  structures,  and  shows  whether  the  quantity 
of  poison  conveyed  to  the  nerves  by  the  circulation  is  sufficient 
to  paralyse  them  or  not.  For  some  substances,  directly  applied 
to  the  ends  of  the  motor  nerves,  may  paralyse  them,  although 
they  do  not  have  this  effect  when  injected  into  the  blood : 
the  reason  being  that  the  quantity  applied  to  the  nerves  directly 
may  be  much  greater  than  that  which  reaches  them  through  the 
circulation. 

The  muscles  and  ends  of  the  motor  nerves  being  protected 
in  the  ligatured  leg  from  the  action  of  the  poison,  while  it  still 
remains  in  connection  with  the  nerve-eentres  by  means  of  the 
sciatic  nerve,  this  method  serves  as  an  index  to  show  what  is 
going  on  in  the  nerve-centres..     Thus  in  a  frog  poisoned  by 


150 


PHAEMACOLOGY  AND  THEEAPEUTICS.     [sect.  i. 


curare  it  is  found  that  the  ligatured  leg  moves  on  irritation 
of  the  sensory  nerves,  while  all  the  poisoned  parts  remain  per- 
fectly still.  This  shows  that  the  afferent  nerves  are  still  capable 
of  conveying  impressions  to  the  spinal  cord,  and  the  cord  itself 
of  reflex  action,  although  the  poisoned  limbs  give  no  indication 
of  the  changes  which  are  occurring  in  the  nerve-centres.  By- 
and-by  irritation  of  a  sensory  nerve  or  root  ceases  to  produce 
any  movement  even  in  the  ligatured  limb.  This  effect  is  shown 
to  be  due  to  paralysis  of  the  nerve-centres  by  observing  the 
effect  of  irritation  of  the  nerves  in  the  ligatured  limb,  for  the 
muscles  still  respond  readily  to  irritation  of  .the  nerve  by  a 
moderate  stimulus.  We  may  conclude  with  tolerable  certainty 
that  the  motions  have  ceased  in  the  limbs  because  the  nerve- 
centres  have  become  paralysed. 

Paralysers  of  Motor  Nerves.— Many  other  drugs  have 
an  action  somewhat  similar  to  that  of  curare  upon  the  motor 
nerves : — 


ammonium 
ammonium 
ammonium 


Ammonium  cyanide.1 

„  iodide. 

Ethyl  ammonium  chloride.1 
Amyl  ammonium  chloride.1 

„  „  iodide.1 

Amyl  ammonium  sulphate.1 
Phenyl  -  di  -  methyl  -  ethyl 

iodide.13 
Phenyl  -  di  -  methyl  -  amyl 

iodide.13 
Phenyl  -  di  -  methyl  -  amyl 

hydrate.13 
Phenyl-tri-ethyl  ammonium  iodide.13 
Tri-methyl  ammonium  iodide.2 
Tri-ethyl  „  chloride, 

iodide. 
„  „  sulphate. 

Methyl-tri-ethyl  stibonium  iodide.14 
Methyl-tri-ethyl         „         hydrate.14 
Toluyl-tri-ethyl  ammonium  iodide.13 
Di-toluyl-di-ethyl        „  „    13 

Toluyl-di-ethyl-amyl  „ 
Toluyl-tri-ethyl  „ 

Tetra-methyl  „ 

Tetra-ethyl  „ 

Tetra-methyl  „ 

Tetra-amyl  „  „     " 

Tetra-ethyl  phosphonium  iodide.1* 
Tetra-ethyl  arsonium  iodide.1' 
Tetra-ethyl  arsonium  and  zinc  double 

iodide.14 


hydrate.13 
iodide. 

r      » 

iodide.13 


and    cadmium 


Tetra-ethyl    arsonium 
double  iodide." 

Anchusa. s 

Methyl  anilin.4 

Ethyl        „      4 

Amyl         „      4 

Methyl-atropine.2 

Methyl-brucine.2 

Ethyl-brucine.3 

Camphor. 

Methyl-cinchonine.* 

Amyl  „         » 

Chloroxethylene. 

Methyl-codeine.2 

Collidine. 

Conime. 

Di-methyl-coniine.! 

Cotarnine.3 

Cynaglossine.5 

Di-methyl  ammonium  chloride.' 
iodide.1 
sulphate.1 


Di-ethyl 


Curarine." 

Curare.' 

Dita'ine.8 

Methyl-delphinine.' 

Echium.3 

Erythrina  corallodendron.* 


chloride.1 

iodide.1 

sulphate.1 


1  Brunton  and  Cash,  Proc.  Boy.  Soc. 

2  Crum-Brown  and  Fraser,  Trans,  of  Roy.  Soc.  of  Edinburgh. 
8  Buchheim  and  Loos,  Eckhard's  Beitrage,  Bd.  v. 

4  Jolyet  and  Cahours,  Compt.  Bend.,  lxvi.  p.  1181. 

*  Diediilin,  Med.  Centralbl.,  1868,  p.  211. 

i  Preyer,  QBttmger  Ztschr.  f.  Chemie,  1,  p.  381. 

'  Bernard  and  Kolliker. 

'  Hamack,  Arch.f.  exp.  Path.  u.Pharm.,  vii.  p.  126. 


chap,  vi.]         ACTION  OF  DEUGS  ON  NERVES.  151 


Guachamacha.10 
Lobeline. 

Methyl-morphine.2 
Methyl-nicotine.2 
Ethyl  „       ' 

Ptomaines." 
Methyl-quinine.3 
„      quinidine.2 


Methyl-piperidine. 
Saponine. 
Sparteine. 

Methyl-strychnine.2,  12 
Ethyl  „         2 

Methyl-thebaine.2 
Methyl-veratrine.' 
Amyl  „      3 


Although  the  substances  mentioned  in  the  above  list  have  all 
the  power  of  paralysing  motor  nerves,  they  do  not  possess  the 
same  power  as  curare.  In  the  case  of  the  salts  of  ammonium 
and  the  compound  ammonias,  the  curare-like  action  is  accom- 
panied by  a  paralysing  effect  upon  the  muscular  substance  and 
on  the  nerve-centres.  When  salts  of  these  substances  are  em- 
ployed, their  effect  is  somewhat  modified  by  their  acid  radical, 
although  this  is  not  the  case  to  the  same  extent  in  the  salts  of 
the  compound  ammonias,  and  in  the  salts  of  ammonium  itself. 
Thus  the  iodide  of  ammonium  has  a  much  stronger  paralysing 
action  on  the  nerves  than  bromide,  chloride,  sulphate,  or  phos- 
phate, and  this  is  observed  also,  though  to  a  less  extent,  in  the 
salts  of  the  compound  ammonias.1 

Exact  Localisation  of  the  Action  of  Curare. 

The  experiments  already  described  have  shown  that  curare 
does  not  paralyse  the  trunks  of  motor  nerves  (p.  148),  nor  the 
muscular  substance  (p.  148),  and  does  paralyse  the  peripheral 
terminations  of  the  motor  nerves  within  the  muscles :  but  they 
do  not  show  what  the  exact  part  of  the  peripheral  terminations  is 
on  which  the  drug  exerts  its  action. 

When  a  nerve  enters  a  muscle  it  divides  and  subdivides 
dichotomously  until  the  fibres  become  single,  and,  losing  their 
myelin  sheath,  the  axis-cylinders  enter  the  muscular  fibres. 
There  they  end  in  the  nerve-plates,  from  which  the  ultimate 
branches  pass  to  the  muscular  substance. 

The  paralysis  produced  by  curare  may  be  due  to  its 
action  on : 

(a)  The  single  nerve-fibrillae  before  they  completely  lose  their 
myelin  sheath ; 

(b)  The  axis-cylinders ; 

(c)  The  end  plates ; 

(d)  The  ultimate  branches. 

As  curare  acts  so  much  more  readily  on  the  nerves  passing 

•  Harnack,  Buchheim's  Pharmacologic,  3rd  ed.  p.  615. 

10  Sachs,  Archivf.  Physiol.,  1877,  p.  91 :  Schiffer,  Deutsch.  med.  .Wochenschr., 
1882,  No.  28. 

"Several  authors  quoted  by  Guareschi  and  Mosso,  Les  Ptomaines,  1883. 

12  Schroff,  Wochenblatt  d.  Ztschr.  d.  Aertze  zu  Wien,  No.  14,  1866. 

"  Kabuteau,  TraiU  ilimentaire  de  Thirapeutique,  4me  ed.  p.  530  et  seq. 

lt  Vulpian;  Arch.de Physiologie,  1868.  i    --    : -  ...  . 


152  PHABMACOLOGY  AND  THEEAPEUTICS.     Isect.  i. 

to  voluntary  than  on  those  passing  to  involuntary  muscles,  and 
the  most  marked  anatomical  difference  between  these  two  kinds  of 


Tig.  55".— Curve  stowing  tlie  excitability  in  different  pirts  of  the  sartorial  of  a  frog  in  a  normal  and 

curarised  muscle, 

muscles  consists  in  the  termination  of  the  former  in  end  plates, 
it  is  natural  to   suppose  that  curare  acts  upoa  these  plates. 


Pig.  56.— Shows  the  distribution  of  the  nerves  in  the  gastrocnemius  of  the  froff  and  the  curve  of 
excitabi.ity  in  different  parts  of  the  muscle.  It  will  be  observed  that  the  excitability  is  greatest 
in  those  parts  where  there  ane  most  nerve-endings. 

Moreover,  this  supposition  appears  to  receive  confirmation  from 
the  observation  of  Kiihne — that  the  end  plates  undergo  a  certain 
alteration  in  poisoning  by  curare,  their  outlines  becoming  more 


chap,  vi.]         ACTION  OF  DRUGS  ON  NERVES.  158 

distinct  than  in  the  normal  condition.  This  slightly  increased 
sharpness  of  outline  may  be  regarded  as  indicating  a  slight 
physical  change,  which  might,  however,  be  associated  with  such 
profound  chemical  changes  in  the  end  plates  as  to  destroy  their 
power  of  conducting  stimuli  from  the  nerve  to  the  muscle. 

But  recent  researches  by  Kiihne  and  one  of  his  pupils, 
Politzer,  appear  to  render  it  probable  that  some  of  the  nerve- 
structures  within  the  muscle  retain  their  functional  activity  even 
in  profound  poisoning  by  curare ;  and  Politzer  supposes  that  the 
part  of  the  nerve  which  is  acted  on  by  curare  is  the  nerve-fibril 
before  it  has  quite  lost  its  medullary  sheath,  and  that  the  poison 
destroys  the  conducting  power  of  the  nerve  by  acting  on  the 
cement-substance  at  Ranvier's  nodes.  The  grounds  on  which 
this  supposition  is  based  are  that,  even  in  profound  poisoning  by 
curare,  those  parts  of  the  sartorius  of  the  frog  which  contain 
nerve-endings  are  more  irritable  than  those  which  contain  none 
(Fig.  56),  and  that  the  irritability  increases  or  diminishes  in 
proportion  to  the  number  of  nerve-endings,  just  as  it  does  in 
the  normal  muscle,  although  the  excitability  of  all  the  parts 
containing  nerves  is  less  than  normal  in  curare-poisoning. 

That  this  variation  in  irritability  in  different  parts  of  the 
muscle  is  due  to  nervous  structures,  and  not  to  variations  in  the 
muscular  fibres  themselves,  is  shown  by  the  fact  that,  when  the 
excitability  of  the  nerve  is  depressed  by  throwing  it  into  a  state  of 
anelectrotonus,  these  variations  in  the  excitability  of  the  muscle 
disappear. 

It  is  just  possible  that  the  nervous  structures  which  retain 
a  certain  amount  of  excitability  in  curare-poisoning  may  be  the 
ultimate  terminations  which  pass  from  the  motor  plate  to  the 
muscular  fibre :  but  Politzer  appears  to  throw  this  possibility 
aside,  and  considers  that  the  amount  of  nervous  excitability  re- 
tained shows  that  all  the  parts  beyond  the  last  node  of  Ranvier 
still  possess  their  functions. 

Should  Politzer' s  supposition — that  curare  paralyses  motor 
nerves  by  acting  on  the  cement  at  Ranvier's  nodes — be  correct, 
it  may  perhaps  serve  to  explain,  not  only  the  difference  between 
jts  action  on  motor  nerves  going  to  voluntary  and  those  going  to 
involuntary  muscular  fibre,  but  also  the  difference  between  the 
action  of  curare,  or  poisons  having  a  similar  action,  and  of 
atropine  on  the  inhibitory  fibres  of  the  vagus. 

Action  of  Drugs  in  Increasing  Excitability  of  Motor  Nerves. 

It  is  not  so  easy  to  prove  positively  that  a  drug  has  increased 
'as  that  it  has  diminished  the  excitability  of  motor  nerves.  The 
fact  that  the  nerves  of  the  poisoned  leg  are  found  to  be  more 
excitable  than  those  of  the  ligatured  one  in  such  experiments  as 
those  just  described,  does  not  prove  it,  for  it  must  be  borne  in 


154  PHAEMACOLOGY  AND  THEEAPEUTICS.     LSect.  r. 

mind  that  the  arrest  of  the  circulation  in  the  ligatured  leg 
lessens  the  excitability  of  the  muscles  and  the  nerves  in  it. 
This  effect  of  the  ligature  strengthens  the  proof  that  a  drug  has 
produced  paralysis  when  we  find  that,  in  spite  of  the  freer  circu- 
lation, the  poisoned  leg  is  less  irritable  than  the  ligatured  one ; 
but  it  prevents  our  concluding  that  the  drug  has  increased  ex- 
citability when  we  find  that  the  poisoned  leg  responds  more 
readily  to  stimuli  than  the  ligatured  one. 

To  try  whether  a  drug  increases  excitability  we  treat  two 
muscles  with  saline  solution,  and  after  ascertaining  that  their 
excitability  is  alike  we  add  the  drug  to  be  tested  to  the  saline 
solution  in  which  one  muscle  is  steeped,  and  after  some  time  test 
the  excitability  again.  If  the  muscle  in  the  poisoned  saline  solu- 
tion becomes  more  excitable  than  the  other,  we  conclude  that  the 
increase  is  due  to  the  action  of  the  drug. 

Irritation  of  Motor  Nerve-endings  by  Drugs. — The  peri- 
pheral terminations  of  motor  nerves  in  muscle  appear  to  be 
irritated  by  certain  poisons,  so  that  the  excised  muscle  exhibits 
fibrillary  twitchings.  This  might  be  due  to  irritation  of  the 
muscular  structure  itself,  but  as  they  are  gradually  abolished 
by  curare  they  are  supposed  to  depend  upon  irritation  of  the 
terminations  of  motor  nerves.  The  poisons  which  produce  this 
effect  are :  aconitine,  camphor,  guanadine,  nicotine,  pilocarpine, 
pyridine.  Physostigmine  produces  it  most  markedly  in  warm- 
blooded animals,  but  does  not  seem  to  cause  it  in  frogs. 

Action  of  Drugs  on  the  Trunks  of  Motor  Nerves. — Nerve- 
trunks  are,  as  a  rule,  very  much  less  affected  by  poisons  than  the 
end-plates ;  but  they  may,  nevertheless,  be  also  acted  upon  by 
strong  solutions  of  a  poison.  It  appears  necessary  to  apply  the 
poison  locally  to  them,  and  they  are  probably  little  if  at  all 
affected  by  poisons  introduced  into  the  system  generally.  The 
action  of  poisons  is  tested  by  placing  a  small  piece  of  gutta- 
percha tissue  under  the  nerve-trunk,  usually  the  sciatic  of  the 
frog,  and  applying  the  poison  directly  to  it,  or  dipping  the  nerve 
into  a  weak  solution  of  common  salt,  or  of  sodium  phosphate,  to 
which  the  poison  has  been  added,  and  comparing  the  poisoned 
nerve  with  one  dipped  into  a  similar  saline  solution  without  the 
poison. 

There  are  two  methods  of  comparison.  The  first  consists 
in  using  the  contraction  of  the  corresponding  muscle  as  an 
index  of  the  functional  power  of  the  nerve;  the  second  in 
ascertaining  the  effect  of  the  poison  on  the  normal  electrical 
current  in  the  nerve. 

The  motor  fibres  of  a  nerve  appear  to  have  their  excitability 
abolished  more  readily  than  that  of  sensory  nerves  by  changes 
in  the  body  generally,  and  sometimes  also  by  the  local  application 
of  drugs  to  them.  Thus  in  wounded  nerves  the  motor  function 
may  be  destroyed,  while. the  sensory  function  is  little  alteredj 


ttup.  vi.]         ACTION  OF  DEUGS  ON  NEEVES.  155 

and  where  both  sensibility  and  motion  have  been  destroyed  by 
a  bruise  of  the  nerve-trunk,  tbe  sensibility  may  reappear,  while 
the  motor  power  does  not.  In  rheumatic  neuralgia  there  is  not 
unfrequently  motor  paralysis  with  exaggerated  sensibility.  When 
a  solution  of  physostigmine  is  applied  locally  to  the  nerve-trunk 
for  a  while,  and  the  nerve  is  then  irritated  beyond  the  point  of 
application,  it  is  found  tbat  it  will  produce  reflex  movements  of 
the  body  after  it  has  ceased  to  do  so  in  the  limb  supplied  by  the 
nerve,  which  shows  that  the  sensory  fibres  can  still  conduct  im- 
pressions, though  the  motor  fibres  cannot.  Longer  application 
of  the  poison  will  destroy  the  sensory  fibres  also.  When  a  paste 
of  theine  is  applied  to  the  sciatic  nerve,  or  the  nerve  is  dipped 
in  a  solution  of  opium,  similar  results  are  observed. 

By  dipping  nerves  in  a  solution  of  the  poison  Mommsen  finds 
that  atropine  diminishes  the  irritability  of  the  nerves,  affecting 
first  the  intramuscular  endings,  and  afterwards  the  trunks. 
Alcohol,  ether,  and  chloroform  first  increase  and  then  diminish 
the  irritability. 

Action  of  Drugs  on  Sensory  Nerves. 

The  general  action  of  a  drug  on  sensory  nerves  is  much 
more  difficult  to  ascertain  with  precision  than  its  effect  upon 
motor  nerves,  because  the  evidences  of  sensation  we  have  in  the 
lower  animals  are  cries,  and  movements  either  of  the  limbs  or 
involuntary  muscles,  such  as  the  iris,  arteries,  or  bladder,  which 
ensue  on  irritation  of  sensory  nerves. 

In  the  production  of  these  movements  or  cries,  many  struc- 
tures are  concerned,  viz.  sensory  nerves,  nerve-centres,  spinal  or 
cerebral  motor  nerves,  and  muscles.  It  is  comparatively  easy 
to  ascertain  the  local  action  of  the  drug  upon  sensory  nerves,  for 
in  this  case  these  other  structures  are  not  affected.  By  applying 
the  substance  to  one  part  of  the  body,  either  by  painting  it  upon, 
or  injecting  it  under,  the  skin,  and  then  comparing  the  effect  of 
stimulation  produced  by  pinching  or  by  the  application  of  heat 
or  electricity  upon  that  and  other  parts  of  the  surface,  we  can 
see  whether  or  not  the  sensibility  of  the  sensory  nerves  has  been 
affected  by  the  drug. 

But  when  the  drug  is  absorbed  into  the  circulation,  it  may 
affect  all  the  other  structures  already  mentioned,  as  well  as  the 
sensory  nerves,  and  thus  it  may  be  impossible  to  decide  with 
certainty  whether  these  nerves  are  affected  or  not.  But  even 
here  definite  results  are  sometimes  obtainable,  as  in  the  case  of 
curare.  The  method  of  experimenting  is  that  of  local  protection, 
arresting  the  circulation  in  one  leg  of  a  frog  by  applying  a  ligature 
to  the  sciatic  artery.  The  animal  is  then  poisoned  with  curare, 
or  any  drug  the  action  of  which  is  to  be  ascertained.  The 
poison  is  carried  by  the  circulation  to  all  other  parts  of  the  body 
excepting  the  ligatured  leg. 


156  PHAEMACOLOGY  AND  THEBAPEUTICS.     [sect.  i. 

In  the  case  of  curare  the  motor  nerves  are  paralysed  by  the 
drug,  and  it  would  be  impossible  to  ascertain  whether  irritation 
of  the  sensory  nerve  produced  any  effect  at  all,  were  it  not  that 
the  ligatured  limb,  retaining  its  irritability,  serves  as  an  index 
to  the  condition  of  the  nerve-centres.  At  first  it  is  found  that 
pinching  the  poisoned  foot  will  cause  movements  in  the  non- 
poisoned  leg.  This  shows  that  the  sensory  nerves  retain  their 
irritability  and  transmit,  the  stimulation  up  to  the  spinal 
cord,  whence  it  is  reflected  down  the  motor  nerves  to  the  non- 
poisoned  foot. 

As  the  poisoning  becomes  deeper,  however,  pinching  the 
poisoned  leg  produces  much  less  effect. 

This  might  be  due  to  paralysis  of  the  spinal  cord,  but  it  is 
shown  that  this  is  not  the  case  by  pinching  the  ligatured  leg  just 
above  and  below  the  ligature. 

It  is  found  that  a  pinch  just  below  the  ligature  causes  marked 
reaction,  while  a  pinch  just  above  has  little  or  no  effect. 

In  this  experiment  all  the  structures  concerned  in  the  move- 
ment have  been  alike  subjected  to  the  action  of  curare  with  the 
exception  of  the  ends  of  the  sensory  nerves  below  the  ligature. 
It  is  thus  evident  that  the  diminished  reaction  from  pinching 
above  the  ligature  is  due  to  paralysis  of  the  ends  of  the  sensory 
nerve,  in  the  part  of  the  body  to  which  the  poison  has  had  access, 
and  which  is  shaded  dark  in  the  engraving  (Pig.  54). 

In  the  experiment  just  mentioned,  the  second  of  the  two 
methods  already  described  (p.  147)  in  the  reference  to  motor  nerves 
is  employed,  and  the  action  of  the  drug  on  the  ends  of  sensory 
nerves  is  ascertained  by  preventing  the  poison  from  reaching 
them;  but  the  first  method  may  also  be  employed  and  the 
action  ascertained  by  applying  the  poison  to-  the  ends  of  the 
sensory  nerves,  while  the  nerve-trunks  and  nerve-centres  are 
protected  from  its  action.  Thus,  in  the  experiments  of  Liegeois 
and  Hottot  upon  the  action  of  aconitine  on  the  sensory  nerves, 
they  ligatured  the  vein  and  injected  the  poison  into  the  artery  of 
a  frog's  leg;  the  poison  was  thus  carried  to  the  ends  of  the 
sensory  nerves  in  the  skin,  while  it  was  prevented  from  reaching 
the  nerve-centres.  In  this  way  they  found  that  irritation  of  the 
poisoned  skin  ceased  to  produce  any  reflex  action,  while  stimula- 
tion of  the  trunk  of  the  nerve  distributed  to  that  leg  still  caused 
well-marked  reflex  action.  Normally  the  terminations  of  a  sensory 
nerve  in  the  skin  are  much  more  sensitive  than  the  trunk  of 
the  nerve;  and  this  experiment  therefore  proves  that -aconitine 
paralyses  the  ends  of  the  sensory  nerves. 

The  local  action  of  drugs  on  the  sensory  nerves  in  man  is 
ascertained  by  producing,  when  applied  locally,  either  diminution 
in  pain  which  may  be  present  at  the  time,  or  insensibility,,  which 
is  usually  ascertained  by  the  sesthesiometer.  This  instrument 
is  simply  a  pair  of  compasses  with  blunt  points  and  a  scale 


chap,  vi.]         ACTION  OP  DEUGS  ON  NEEVES.  157 

by  which  the  distance  of  the  points  from  one  another  can  be 
read  off. 

"When  the  sensation  is  acute,  the  points  are  distinctly  felt  as 
two,  even  when  they  are  but  slightly  separated  from  one  another  ; 
but  when  the  sensation  is  blunt,  they  are  felt  as  one  when  they 
are  at  a  considerable  distance  apart. 

In  frogs  the  local  action  on  sensation  is  ascertained  by  dipping 
one  leg  for  some  time  in  the  solution  to  be  tested,  and  then 
comparing  the  effect  of  irritating  corresponding  points  in  the  two 
feet  or  legs  by  pinching,  by  the  application  of  acids,  or  by  a  faradaic 
current.  In  this  way  it  has  been  ascertained  that  hydrocyanic 
acid  has  a  powerful  local  action  in  paralysing  sensory  nerves. 
Where  the  drug  is  very  powerful,  its  action  on  the  nerve-centres 
might  complicate  the  result,  if  a  sufficient  quantity  should  be 
absorbed  into  the  blood.  This  fallacy  may  be  avoided  by  arresting 
the  circulation  entirely  through  excision  or  ligature  of  the  heart. 

Local  Sedatives  and  Local  Anaesthetics. — Local  sedatives 
are  substances  which  diminish,  and  local  anaesthetics  are 
substances  which  destroy,  the  sensibility  of  the  skin  for  the  time 
being. 

Local  Sedatives.  Local  Anaesthetics. 

Aconite.  Extreme  cold. 

Atropine.  Ice. 

Belladonna.  Ether  spray. 

Carbolic  acid.  Carbolic  acid. 

Chloroform.  Cocaine. 

Chloral.  Kawa-resin.1 
Morphine. 
Opium. 
Veratrine. 

Action. — Their  effect  in  some  degree  is  due  to  a  paralysing 
action  upon  the  terminal  branches  of  the  cutaneous  nerves.  It 
is  probably,  to  some  extent,  also  due  to  an  effect  upon  the  vessels 
and  tissues  analogous  to  that  which  is  produced  by  rubbing  or 
scratching,  which,  as  everyone  knows,  gives  temporary  relief  to 
itching.  Sweating  also  relieves  the  itching,  which  is  sometimes 
felt  just  before  it  begins. 

Uses. — Local  sedatives  are  employed  to  relieve  itching  and  to 
lessen  pain,  whether  it  be  due  to  neuralgia  or  inflammation.  Local 
anaesthetics  are  employed  temporarily  to  abolish  the  sensibility 
of  the  skin,  and  allow  slight  incisions  or  operations  to  be  made 
painlessly. 

Stimulating  Action  of  Drugs  on  the  Peripheral  Ends 
of  Sensory  Nerves. —  The  peripheral  terminations  of  sensory 
nerves  appear  to  become  more  sensitive  when  the  supply  of  blood 

1  Lewin,  Ueber  Piper  methysiicum  (Kawa).    Berlin,  1886. 


158  PHARMACOLOGY  AND  THERAPEUTICS,     [sect.  i. 

to  the  part  is  increased.  This  is  markedly  seen,  not  only  in 
inflammation,  where  the  part  becomes  exceedingly  tender,  but  in 
cases  where  turgescence  of  the  vessels  occurs  under  physiological 
conditions.  Besides  the  class  of  irritants  which  act  on  the  peri- 
pheral terminations  of  sensory  nerves  so  as  to  cause  pain  when 
locally  applied,  there  are  several  drugs  which  appear  to  have  a 
special  irritant  action  on  the  ends  of  sensory  nerves  when  intro- 
duced into  the  circulation :  these  are  aconite  and  aconitine,  which 
give  rise  to  a  peculiar  tingling  and  numbness  in  the  tongue,  lips, 
cheeks,  and  indeed  in  all  parts  supplied  by  the  fifth  nerve.  Vera- 
trine  also  causes  peculiar  sensations  in  the  sensory  nerves  when 
taken  internally,  but  these  are  felt  more  in  the  fingers  and  toes, 
and  in  the  joints,  than  in  the  tongue.1 

1  Von  Schroff,  Pharmacologic,  4th  ed.  p.  584. 


CHAPTEE  VII. 
ACTION  OP  DRUGS  ON  THE  SPINAL  COED. 

In  the  spinal  cord  we  have  to  distinguish  three  functions  :  that 
of  conduction,  that  of  reflex  action,  and  that  of  origination  of 
nerve-force!  as  in  the  sweat-centres,  &c,  contained  in  it. 

The  spinal  cord  transmits  sensory  or  afferent  impulses 
upwards  to  the  medulla  and  brain ;  and  motor  impulses  down- 
wards to  the  muscles,  as  well  as  other  efferent  impulses  to  the 
glands.  It  transmits  reflex  impulses  across,  either  from  behind 
forwards,  or  laterally  from  one  half  of  the  cord  to  the  other. 
Transmission  from  behind  forwards  occurs  when  the  impulse 
passes  from  the  sensory  to  the  motor  columns  on  the  same  side, 
as  in  the  case  of  reaction  of  a  sensory  stimulus  on  the  same  side 
of  the  body.  It  occurs  laterally  when  the  sensory  stimulus  pro- 
duces motion,  not  on  the  same  side,  but  on  the  opposite  side  of 
the  body. 

Action  on  the  Conducting  Power  of  the  Cord. — Its  con- 
ducting power  for  motor  impulses  is  assumed  to  be  impaired 
when  it  is  noticed  that  any  drug  causes  partial  paralysis  of  the 
hinder  extremities  of  an  animal  before  the  anterior  extremities. 

It  is  usually  tested  by  irritating  the  spinal  cord  at  its  upper  end,  either 
mechanically  with  the  point  of  a  needle,  or  by  a  galvanic  or  faradaic  current 
passed  through  electrodes  inserted  into  it  close  together,  and  observing 
whether  irritation  of  the  cord  itself  in  this  way  causes  contraction  in  the 
muscles  of  the  legs. 

When  no  contraction  is  produced  by  irritation  of  the  cord 
itself,  while  direct  irritation  of  the  motor  nerves  can  still  produce 
vigorous  contraction,  it  is  evident  that  the  cause  of  the  paralysis 
must  be  that  the  spinal  cord  has  lost  its  power  to  conduct  motor 
impulses. 

These  experiments  may  be  made  in  a  frog,  the  cerebrum  of  which  has 
been  previously  destroyed;  and  they  may  be  confirmed  in  warm-blooded 
animals  where  sensibility  has  been  destroyed  by  a  section  of  the  cord,  just 
below  the  medulla,  and  respiration  is  kept  up  artificially.  The  spinal  cord  is 
then  exposed,  and  the  anterior  columns  are  irritated  in  the  ways  already 
mentioned. 

The  power  of  the  cord  to  conduct  sensory  impressions  is 
ascertained  by  exposing  it  under  anaesthetics  and  allowing  their 
influence  to  pass  so  far  off  that  the  animal  is  capable  of  giving 


160  PHAEMACOLOGY  AND  THEEAPEUTICS.      [sect.  r. 

evidence  of  sensation.  The  posterior  roots  are  then  irritated 
before  and  after  the  injection  of  the  poison  into  the  circulation. 

When  it  is  found  that  after  the  poison  is  injected  the  irrita- 
tion of  the  posterior  roots  which  previously  caused  evidence  of 
sensation  no  longer  produces  any  effect,  while  irritation  of  the 
anterior  columns  still  produces  motion,  the  conclusion  appears  to 
be  just,  that  the  poison  has  paralysed  the  conducting  power  of 
the  sensory  columns  of  the  cord. 

This  action  appears  to  be  possessed  by  caffeine,  for  Bennett 
found  that  while  irritation  of  the  posterior  roots  of  the  cord 
caused  violent  struggles  and  loud  cries  in  a  rabbit  before  the  in- 
jection of  caffeine  into  the  circulation,  similar  irritation,  after  the 
injection,  caused  only  a  slight  quiver.  That  this  effect  was  not 
due  to  motor  paralysis  was  shown  by  the  fact  that  irritation  of 
the  anterior  columns  caused  violent  muscular  contractions  after, 
the  injection  as  well  as  before  it.' 


FIBRE  IN 
LATERAL 
COLUMNS 


SENSORY 
ROOT 


Fig.  57.— Diagram  to  show  the  effect  of  chloroform,  chloral,  and  other  anaesthetics  on  conduction  of 
painful  impressions  in  the  spinal  cord. 

Ordinary  impressions  of  touch,  temperature,  and  muscular 
action  are  transmitted  through  the  posterior  roots  of  the  spinal 
cord  to  the  ganglia  of  the  posterior  horn  of  the  grey  substance, 
and  thence  upwards  by  the  fibres  of  the  lateral  columns.  Painful 
sensations,  however,  appear  to  be  transmitted  upwards  through 
the  grey  substance  of  the  cord.  The  afferent  nerves,  which  trans- 
mit impressions  from  one  part  of  the  cord  to  another,  so  as  to 
produce  co-ordinated  reflex  movement,  are  contained  in  the 
posterior  columns  of  the  cord. 

It  is  evident  that  any  injury  or  poison  which  chiefly  affects 
the  grey  matter  so  as  to  diminish  its  conducting  power  may 
abolish  pain  while  reflex  action  still  persists.  This  condition  may 
be  produced  by  division  of  the  grey  matter  of  the  cord,  and  it 
occurs  also  at  a  certain  stage  of  the  action  of  anaesthetics  such  as 
chloroform  and  ether. 

The  action  of  drugs  on  the  power  of  the  spinal  cord  to  con- 
duct reflex  stimuli  both  transversely  and  longitudinally  has 
been  carefully  investigated  by  Wundt.     He  first  ascertains  the 

1  Hughes-Bennett,  Edin.  Med.  j'ourn.,  Oct.  1873. 


chap,  vn.]  ACTION  OF  DEUGS  ON  THE  SPINAL  COED.    1G1 

time  which  elapses  between  the  application  of  a  stimulus  to  a 
motor  nerve  and  the  contraction  of  a  muscle,  the  nerve  used 
being  the  sciatic,  and  the  muscle  the  gastrocnemius  of  a  frog. 
This  time,  which  includes  that  requisite  for  the  stimulus  to 
travel  down  the  motor  nerve  and  to  set  the  muscle  in  action,  he 
terms  the  direct  latency.  He  next  stimulates  a  sensory  root  of 
the  spinal  nerve  at  the  same  level  and  on  the  same  side  as  the 
motor  nerve,  taking  care  that  the  stimulus  does  not  act  on  the 
motor  nerve  directly,  but  only  reflexly  through  the  cord.  The  time 
between  the  application  of  the  stimulus  and  the  commencement 
of  contraction  he  terms  the  total  latency.  By  deducting  the 
direct  latency  from  the  total  latency,  he  ascertains  the  time  re- 
quired for  the  stimulus  to  pass  through  the  grey  matter  of  the 
cord  from  the  posterior  to  the  anterior  horn  of  the  same  side. 
This  he  calls  the  reflex  time. 

The  time  required  for  transverse  conduction  is  ascertained 
by  applying  the  stimulus  to  a  posterior  root  on  the  other  side  and 
comparing  the  latency  with  that  of  stimulation  to  a  posterior  root 
on  the  same  side. 

The  time  required  for  longitudinal  conduction  is  ascertained 
by  applying  a  stimulus  to  the  brachial  nerve,  so  that  it  has  to 
travel  down  the  greater  part  of  the  length  of  the  spinal  cord 
before  it  can  excite  the  sciatic  nerve.    By  comparing  the  latent 


POSTERIOR 
ROOT       o 


\V/A  SECTION  Of 
;  „  n    SPINAL 
U^Uy      CORD 


I    )  MUSCLE 


Pig.  58.— Diagram  to  show  the  method  of  investigatinjrreflexand  transverse  conduction  In  the  spinal 
cord.  The  motor  nerve  is  first  irritated.it  1.  As  the  cylinder  revolves  at  a  known  rate,  ai  d  a 
mark  is  made  upon  it  by  an  electro-magnet  at  the  instant  the  nerve  is  irritated,  the  distance 
between  this  mark  and  the  commencement  of  the  muscle  curve  indicates  the  time  required  for 
the  irritation  to  travel  down  the  motor  nerve  to  the  muscle  and  set  it  in  action.  The  irritation 
is  next  applied  to  the  posterior  root  on  the  same  side  (  2 ).  The  distance  between  the  commence- 
ment of  contraction  in  this  case  and  in  that  where  the  motor  nerve  was  irritated  gives  the  time 
required  for  simple  reflex  transmission  of  the  stimulus  from  the  posterior  to  the  anterior  horn 
of  the  cord.  The  stimulus  is  then  applied  1  o  the  posterior  root  on  the  opposite  side  at  3,  and 
the  distance  between  the  commencement  of  the  consequent  contraction  and  that  of  the  curve 
obtained  by  irritating  at  2  gives  the  time  required  for  transmission  across  the  cord. 

period  of  excitation  in  the  brachial  nerve  with  that  of  the  sciatic 
on  the  same  side l  the  length  of  time  required  for  longitudinal 

1  For  convenience  sake  both  the  sciatic  and  the  brachial  nerves  are  taken  in 
this  experiment  on  the  opposite  side  from  the  muscle,  so  that  the  time  of  longi- 

M 


1C2  PHARMACOLOGY  AND  THERAPEUTICS,     [sect,  t, 

transmission  of  stimuli  in  the  cord  is  ascertained.  The  mode  of 
ascertaining  the  time  of  ordinary  reflex  and  transverse  trans- 
mission in  the  cord  is  shown  diagrammatically  in  Fig.  58. 

The  differences  in  the  latent  period  and  in  the  form  of  the 
muscle  curve  obtained  by  irritation  of  the  motor  nerve,  and  by 
simple  transverse,  and  longitudinal  reflex  stimulation,  are  shown 
diagrammatically  in  Fig.  59.     Wundt  found  that  when  a  motor 


Win  59  — Diagram  to  show  tlie  difference  between  the  length  of  the  latent  period  and  form  ot  the 
carve  in  contraction  induced,  B,  by  direct  irritation  of  the  motor  nerve ;  o,  by  simple  reflex  from 
irritation  of  the  cord  on  the  same  side  ;  and  D,  by  cross  reflex  from  irritation  of  the  cord  on  the 
oonosite  side  to  that  from  which  the  motor  nerve  proceeds,  as  shown  in  Pig, ,58  i  shows  com- 
bined transverse  and  longitudinal  reflex ;  A  indicates  the  moment  at  which  the  stimulus  was 
applied  in  each  case. 

nerve  was  irritated  at  a  point  distant  from  the  muscle  the  xe- 
sulting  contraction  had  not  only  a  longer  latent  period,  but  was 
less  in  height  and  longer  in  duration  than  when  the  nerve  was 
irritated  close  to  the  muscle.  From  a  comparison  of  the  curves 
it  will  be  seen  that  a  small  portion  of  grey  matter  has  a  similar 
effect  upon  the  stimulus  which  passes  through  it  that  a  great 
length  of  nerve-fibre  would  have.  In  all  reflex  actions,  there- 
fore, in  the  normal  animal,  the  contraction  of  the  muscle  has  a 
longer  latent  period,  less  height,  and  longer  duration  than  that 
produced  by  direct  irritation  of  the  motor  nerve.  The  increase 
in  the  latent  period,  diminution  in  height,  and  longer  duration 
are  greater  in  the  case  of  transverse  than  of  simple  reflex,  and 
greater  still  in  the  case  of  combined  transverse  and  longitudinal 
reflex. 

In  the  normal  frog  a  stronger  stimulus  is  necessary  to  pro- 
duce reflex  contraction  than  would  be  sufficient  if  it  were  applied 
directly  to  the  motor  nerve,  and  strong  and  weak  stimuli  will 
produce  strong  and  weak  muscular  contractions.  The  spinal  cord 
has  a  power  of  summation  similar  to  that  already  referred  to  in 
the  case  of  contractile  tissue  of  medusae,  so  that  a  stimulus  which 
would  be  powerless  to  produce  a  reflex  contraction  if  applied 
once  to  a  posterior  root  or  to  a  sensory  nerve  will  be  effectual  if 
repeated  several  times  in  close  succession. 

Strychnine  has  an  effect  on  the  conducting  power  of  the 
spinal  cord  which  we  should  hardly  expect,  and  so  have  other 
convulsant  poisons.  It  increases  the  excitability  so  much  that 
slighter  stimuli  than  before  will  produce  reflex  action,  and  it 
destroys  to  a  considerable  extent  the  power  of  summation,  so 
that  instead  of  each  stimulus  producing  a  contraction  in  propor- 

tudinal  conduction  is  ascertained  by  deducting  the  transverse  from  the  combined 
transverse  and  longitudinal  conduction. 


chap,  vii.]  ACTION  OF  DEUGS  ON  THE  SPINAL  COED.    1G8 

tion  to  its  strength,  all  have  the  same  effect — a  weak  one,  which 
is  just  strong  enough  to  produce  an  effect  at  all  causing  as  great 
a  contraction  as  the  most  powerful.  The  time  required  for  the 
transmission  of  stimuli  through  the  cord  is  enormously  increased, 
so  that  the  latent  period  of  ordinary  reflex,  and  still  more  of 
transverse  and  longitudinal  reflexes,  is  greatly  increased,  some- 
times, indeed,  to  as  much  as  ten  times  the  normal.  The  retarda- 
tion of  transverse  conduction  is  not  absolutely  greater  than  of 
longitudinal  conduction  ;  but,  as  the  distance  through  which  the 
stimulus  has  to  pass  in  the  former  case  is  much  less  than  in 
the  latter,  it  follows  that  strychnine  increases  the  resistance  more 
transversely  than  longitudinally.  Morphine  in  small  doses  has 
no  very  marked  action  upon  the  cord,  but  larger  doses  have  an 
action  almost  exactly  like  that  of  strychnine,  causing  increased 
reflex  irritability,  tetanic  contractions,  and  prolonged  latency. 
Veratrine  has  a  similar  action.  Nicotine  and  coniine  in  small 
doses  have  a  similar  action  to  strychnine,  but  this  is  quickly 
masked  by  the  rapid  appearance  of  paralysis.  When  large  doses 
are  used,  paralysis  occurs  almost  immediately,  and  is  usually 
accompanied  by  fibrillary  twitchings.  Atropine  has  at  first  an 
action  similar  to  strychnine  in  causing  increased  excitability, 
prolonged  latency,  and  tetanic  contraction.  It  differs  from 
strychnine  in  causing  more  rapid  diminution  in  the  irritability 
of  the  grey  substance  of  the  spinal  cord  and  in  diminishing  the 
conducting  power  of  peripheral  nerves.  In  consequence  of  this, 
irritation  of  the  sciatic  nerve  in  a  frog  poisoned  by  atropine 
causes  two  contractions,  one  direct  and  one  reflex,  separated  from 
each  other  by  a  distinct  interval,  whereas,  in  a  frog  poisoned  by 
strychnine,  these  two  contractions  begin  almost  at  the  same 
moment  and  appear  superimposed  upon  each  other.1 

Effect  of  Drugs  on  the  Reflex  Action  of  the  Cord. — The 
effect  of  drugs  upon  the  reflex  action  of  the  spinal  cord  is  usually 
estimated  by  the  time  which  elapses  between  the  application  of 
a  stimulus  and  the  occurrence  of  reflex  action,  before  and  after 
the  administration  of  a  drug.  Longer  time  indicates  diminished, 
and  shorter  time  increased,  excitability  of  the  cord. 

Method  of  Experimenting:. —  Since  the  spinal  cord  in  mammals  quickly 
loses  its  excitability  when  deprived  of  oxygenated  blood  (as  shown  by 
Stenson's  experiment,  p.  164),  frogs  are  used  for  experiment.  The  method 
usually  employed  is  called  Tiirck's  method.  The  cerebral  lobes  in  a  frog  are 
destroyed,  and  after  sufficient  time  has  elapsed  ib  allow  it  to  recover  from 
the  shock,  it  is  suspended  either  by  the  head  Or  fore -legs,  so  that  the  hind- 
legs  hang  down.  A  very  dilute  solution  of  sulphuric  acid,  the  acid  taste  of 
which  can  be  little  more  than  perceived  by  the  tongue,  is  put  in  a  small 
beaker  and  raised  until  one  foot  of  the  frog  is  completely  immersed  in  it. 

1  According  to  W.  Stirling,  the  latent  period  of  reflex  action  in  the  spinal  cord 
is  increased  by  the  chloride  and  bromide  of  potassium  and  ammonium,  by  lithium 
salts,  and  by  chloral  and  butyl-chloral ;  it-  is  decreased  by  the  chloride,  bromide, 
and  iodide  of  sodium. — Stirling  and  London'  Physiology,  2nd  ed.,  vol;  ii.  p.  909. 


164  PHAEMACOLOGY  AND  THERAPEUTICS,     [sect.  i. 

The  time  is  then  counted  by  means  of  a  metronome,  between  the  immersion 
of  the  foot  in  the  acid  solution  and  the  time  when  the  leg  is  drawn  up  out  of 
it.  As  soon  as  the  foot  is  drawn  up,  the  acid  is  carefully  washed  off  with 
some  fresh  water  in  order  to  prevent  any  injury  to  the  skin,  and  after  a 
minute  or  two,  the  experiment  may  be  repeated.  When  the  time  seems 
constant  the  drug  is  injected  into  the  lymph-sac,  and  the  experiment  is 
repeated  again.  The  greater  or  less  time  which  is  required  for  the  withdrawal 
of  the  foot  from  the  acid  after  the  injection  of  the  poison,  as  compared  with 
the  time  required  before,  shows  the  extent  to  which  the  reflex  action  of  the 
spinal  cord  has  been  diminished  or  increased  by  the  poison. 

Direct,  Indirect,  and  Inhibitory  Paralysis  of  the  Spinal 
Cord  by  Drugs. — When  it  is  found  that  the  reflex  action  of 
the  cord  is  greatly  diminished  or  apparently  entirely  abolished, 
it  must  not  be  at  once  concluded  that  this  is  necessarily  due  to 
the  direct  paralysing  action  of  the  drug  itself  upon  the  nervous 
substance  of  the  cord.  This  may  be  the  case,  and  is  so  when 
methyl-coniine  is  employed,  but  it  may  be  due  to  the  indirect 
action  of  the  drug  upon  the  heart,  weakening  the  circulation,  and 
lessening  the  function  of  the  cord  by  interfering  with  its  blood- 
supply. 

In  order  to  ascertain  whether  this  is  the  case  or  not,  it  is  usual  to  take  two 
frogs  as  nearly  alike  as  possible,  to  destroy  the  brain  in  each,  and  after 
waiting  until  they  have  recovered  from  the  immediate  shock  of  the  operation, 
to  inject  into  one  the  drug  to  be  tested,  and,  at  the  moment  when  it  stops  the 
beating  of  the  heart,  to  tie  a  ligature  around  the  heart  of  the  other.  The 
persistence  of  reflex  action  is  then  tested  in  the  usual  manner,  and  if  it  is 
found  that  it  disappears  much  sooner  in  the  poisoned  frog  than  in  the  other  one 
in  which  the  heart  has  been  ligatured,  it  is  concluded  the  drug  has  paralysed 
the  substance  of  the  cord  itself. 

Indirect  Paralysis. — The  spinal  cord  is  very  rapidly  para- 
lysed in  mammals  if  the  blood-supply  to  it  is  stopped.  This  is 
readily  shown  by  Stenson's  experiment  of  gently  compressing 
the  abdominal  aorta  in  a  rabbit  with  the  thumb  or  finger,  so  as 
to  arrest  the  circulation  for  four  or  fire  minutes.  On  releasing 
the  animal  its  hinder  extremities  are  found  to  be  paralysed,  and 
this  paralysis,  though  it  may  be  partly  due  to  interference  with 
the  blood-supply  of  the  muscles  and  nerves  of  the  lower  extremi- 
ties themselves,  is  chiefly  due  to  the  arrest  of  circulation  in  the 
spinal  cord.  The  spinal  cord  in  frogs  is  less  rapidly  affected,  but 
if  the  circulation  be  arrested  for  half  an  hour  or  so  symptoms 
of  paralysis  usually  begin  to  appear,  the  time  varying,  however, 
with  the  temperature  and  other  conditions.  Indirect  paralysis 
is  produced  by  aconitine,  digitalin,  and  large  doses  of  quinine, 
which  arrest  the  circulation.  It  is  frequently  difficult  to  decide 
how  far  paralysis  is  due  to  the  action  of  a  drug  on  the  circulation, 
and  how  far  to  its  direct  action  on  the  spinal  cord  itself. 

Direct  Paralysis.— Paralysis  of  reflex  movement  is  produced 
by  a  number  of  substances,  some  of  which  produce  little  or  no 
previous  excitement ;  others,  however,  markedly  increase  the  ex- 
citability of  the  spinal  cord  first,  and  are  thus  classed  as  spinal 
stimulants. 


chap,  vii.]  ACTION  OP  DEUGS  ON  THE  SPINAL  CORD.    165 

Spinal  Depressants.— The  following  drugs  belong  to  this 
class : — 

Depress  without  marked  previous  Excite  first  and  afterwards  paralyse, 

excitement. 

Antimony.  Ammonia. 

Emetin.  Apomorphine. 

Ergot.  Alcohol  (through  circu- 

Hydrocyanic  acid.  lation. 

Methylconiine.  Arsenic. 

Saponine.  Camphor. 

Physostigmine.  Morphine  group.1 

Turpentine.  Carbolic  acid. 

Zinc,  Chloral. 

Silver.  Nicotine. 

Sodium.  Potassium  salts. 

Lithium.  Veratrine. 

Caesium.  Mercury. 

Alcohol  group1  (action    on 

nervous  substance). 

Uses  of  Spinal  Depressants. — Such  substances  as  morphine, 
chloral,  &c,  which  diminish  the  conducting  power  of  the  grey 
matter  of  the  cord  for  painful  impressions,  are  useful  as  anodynes, 
though  their  action  in  lessening  pain  is  probably  often  due  to 
their  effect  on  the  brain  as  well  as  on  the  spinal  cord.  Spinal 
depressants  which  lessen  reflex  action  are  employed  in  diseases 
where  there  seems  to  be  increased  excitability  of  various  parts  of 
the  cord,  as  evidenced  by  spasm,  either  tonic  or  clonic.  They 
are  therefore  employed  in  tetanus,  trismus  neonatorum,  chorea, 
writer's  cramp,  and  paralysis  agitans.  The  pathology  of  many 
nervous  diseases  is  imperfectly  known,  and  as  the  action  of  spinal 
depressants  is  frequently  a  complex  one  of  combined  stimulation 
and  depression,  some  of  the  drugs  included  in  this  class  are 
used  in  paraplegia  due  to  myelitis,  locomotor  ataxy,  and  general 
paralysis. 

They  are  also  used  as  antagonists  in  cases  of  poisoning  by 
spinal  stimulants  like  strychnine. 

Inhibitory  Paralysis.  —  The  higher  parts  of  the  nervous 
system  have  the  power  of  lessening  the  action  of  the  lower,  and 
in  the  frog  this  power  seems  to  be  especially  marked  in  the  optic 
lobes.  Irritation  of  these  either  mechanically  by  a  needle,  chemi- 
cally by  a  grain  of  salt  laid  upon  them,  or  electrically,  will  lessen 
or  entirely  abolish  the  reflex  action  in  the  cord ;  but  this  again 
returns  when  the  irritation  is  removed,  or  when  its  influence  is 
destroyed  by  cutting  the  cord  across,  below  the  point  of  irritation. 
Tbis  fact  was  discovered  by  Setschenow,  and  thus  parts  of  the 

1  Schmiedeberg,  Arzneimitlellehre,  p.  34. 


166  PHAEMACOLOGy  AND  THEEAPEUTICS.     [sect.  i. 

optic  lobes  concerned  in  this  inhibitory  action  are  known  as 
Setschenow's  centres. 

An  inhibitory  action  appears  to  be  exerted  by  the  cranial 
centres  in  higher  animals  also,  for  McKendrick  observed  that  on 
decapitating  a  pigeon  the  body  lies  comparatively  still  for  a 
second  or  two,  and  then  violent  convulsions  set  in.  If  the  body 
be  held  firmly  during  these  convulsions,  and  a  moderately  strong 
faradaic  current  be  applied  to  the  upper  part  of  the_  spinal  cord, 
the  convulsions  may  be  altogether  arrested  while  it  continues, 
again  commencing  when  it  stops.  In  this  experiment  the  appli- 
cation of  the  current  to  the  cut  end  of  the  cord  is  regarded  as 
supplying  a  stimulus  in  place  of  that  which  would  normally  pass 
downwards  from  the  brain. 

Quinine  causes  great  depression  of  reflex  excitability,  and 
this  was  stated  by  Chaperon  to  be  due  to  the  action  of  the  drug 
on  Setschenow's  centres. 


Fig.  60.  —Nervous  system  of  a  frog,  shoving  the  cerebral  and  optic  lobes,  the  medulla  oblongata, 
and  the  spinal  cord  with  nerre-roots.    The  brain  is  shown  on  a  larger  scale  at  p.  184. 

Almost  immediately  after  injection  of  quinine  into  the  dorsal 
lymph-sac,  the  reflex  excitability  of  the  frog  becomes  very  greatly 
reduced  or  almost  entirely  abolished,  but  if  the  spinal  cord  be  now 
cut  across  at  its  upper  part  just  below  the  medulla  oblongata,  the 
reflex  excitability  becomes  as  great,  or  even  greater,  than  the 
normal. 

This  loss  of  excitability  has  been  ascribed  by  Binz  to  the 
action  of  quinine  on  the  heart,  causing  weakening  of  the  circula- 
tion, and  thus  indirectly  producing  paralysis  of  the  cord.  This 
kind  of  paralysis  does  occur  with  large  doses  and  after  consider- 
able time,  but  it  is  quite  different  from  the  inhibitory  paralysis 
described  by  Chaperon,  which  comes  on  almost  immediately  after 
the  injection  of  the  drug  into  the  lymph-sac,  and  disappears 
immediately  on  section  of  the  cord  below  the  medulla. 

I  have  repeated  Chaperon's  experiments,  and  can  fully  confirm 
their  accuracy.  In  doing  so,  however,  it  struck  me  that  the  result 
was  most  marked  when  a  solution  of  quinine  was  concentrated 
and  somewhat  strongly  acid.  It  therefore  appeared  probable  that 
the  inhibition  was  not  due  to  the  direct  action  of  the  quinine 
upon  Setschenow's  centres  after  it  had  been  carried  to  them  by 
the  blood,  but  only  to  its  reflex  action  upon  them.  It  irritates 
locally  the  sensory  nerves  of  the  lymph-sac  into  which  it  is  in- 


chap,  vii.]  ACTION  OF  DEUGS  ON  THE  SPINAL  CORD.    167 

jected,  and  this  stimulus  being  transmitted  to  the  optic  lobes' 
excites  them  so  that  they  produce  inhibition  of  that  reHex  action 
which  would  usually  occur  in  the  cord  when  the  foot  is  irritated 
by  acid.  On  testing  this  hypothesis  by  injecting  acid  alone  into 
the  lymph-sac,  Mr.  Pardington  and  I  found  that  it  also  caused 
reflex  inhibition  like  that  produced  by  quinine.  We  may  there- 
fore conclude  that  there  is  nothing  special  in  the  action  of  quinine 
upon  the  inhibitory  centres ;  it  merely  acts  like  other  irritants 
on  sensory  nerves.1  Probably  digitalis  and  sanguinaria  also  act 
in  a  similar  way. 

NATURE   OP  INHIBITION. 

Inhibition  and  the  action  of  drugs  on  inhibitory  centres  play 
a  very  important  part  indeed  in  pharmacology,  and  on  the  pre- 
sent hypothesis  they  are  very  puzzling. 

By  inhibition  we  mean  the  power  of  restraining  action  which 
some  parts  of  the  nervous  centres  possess.  At  present  it  is  usually 
supposed  that  certain  parts  of  the  nerve-centres,  instead  of 
having  a  sensory  or  motor  function,  have  an  inhibitory  one 
peculiar  to  themselves.  It  is  found,  however,  that  inhibitory 
powers  are  not  confined  to  Setsehenow's  centres,  already  men- 
tioned (p.  166),  but  that  almost  any  part  of  the  nervous  system 
may  have  an  inhibitory  action  on  other  parts,  so  that  it  becomes 
almost  necessary  to  abandon  the  old  hypothesis.  It  is  found,  for 
example,  that  not  only  is  reflex  action  more  active  in  the  frog 
when  the  optic  lobes  are  removed,  but  that  when  the  spinal  cord  is 
taken  away  in  successive  slices  from  above  downwards,  the  reflex 
action  in  the  part  below  goes  on  increasing.  On  the  old  hypo- 
thesis we  are  almost  obliged  to  assume  that  each  nerve-cell  has 
two  others  connected  with  it,  one  of  which  has  the  function  of 
increasing  or  stimulating,  and  the  other  of  inhibiting  its  action. 
Most  of  the  phenomena  which  we  find  can  be  explained  in  a 
much  simpler  way  by  supposing  that  nervous  stimuli  consist  of 
vibrations  in  the  nerve-fibres  or  nerve-cells,  just  as  sound  cqnsists 
of  vibrations. 


Fig.  61. — Diagram  to  show  increased  intensity        Fig.  62. — Diagram  to  show  abolition  of  vibratiua 
of  vibration  by  coincidence  of  waves.  by  interference  of  waves. 

Interference. — In  the  case  of  both  sound  and  light  we  find 
that  if  two  waves  should  fall  upon  one  another  so  that  their  crests 

1  St.  Bartholomew's  Hospital  Beports,  1876,  p.  155. 


1G8 


PHAEMACOLOGY  AND  THEEAPEUTICS.     [sect.  i. 


coincide,  the  intensity  of  the  sound  or  light  is  increased  (Fig.  61), 
•while  if  they  fall  on  each  other  so  that  the  crest  of  one  wave  fills 
up  the  trough  of  the  other,  they  interfere  so  as  to  destroy  each 
other's  effect  (Fig.  62) ;  and  thus  two  sounds  produce  silence,  or 
two  waves  of  light  darkness.  This  is  shown  in  the  case  of  sound 
by  a  tube  (Fig.  63),  which  divides  into  two  branches,  and  these 
again  re-unite.     The  length  of  one  branch  may  be  altered  at 


il= 


— s 

E 


Fhj.  C3. — Diagram  of  apparatus  for  demonstrating  the  interference  of  waves  of  sound.  A  and  B, 
branches  of  a  tube  ;  c,  sliding  piece  by  which  the  branch  B  can  be  lengthened  or  shortened  at 
will ;  d,  tuning-fork ;  B,  the  ear. 

will,  so  that  the  sound  travelling  through  one  branch  has  further 
to  go  than  the  other.  It  may  thus  be  retarded  so  far  as  to  throw 
it  half  a  wave-length  behind  the  other,  and  silence  is  produced. 
If  lengthened  still  further,  so  as  to  throw  the  one  sound  a  whole 
wave-length  behind  the  other,  the  crests  again  coincide,  and  the 
sound  is  again  heard.  Increasing  the  length  still  further,  so  that 
the  one  sound  is  thrown  a  wave-length  and  a  half  behind  the 
other,  they  again  interfere,  and  silence  is  again  a  second  time 
produced.  This  may  be  repeated  ad  infinitum,  silence  occurring 
whenever  Ihe  one  sound  falls  behind  the  other  by  an  odd  number 
of  half  wave-lengths. 


I'ig.  64.— Diagram  showing  the  beats  or  alternate  increase  and  diminution  of  the  wave-heights  by 
the  interaction  of  two  systems  of  waves  of  different  wave-lengths.  At  A,  two  systems,  having  a 
relation  to  each  other  of  3  to  1,  are  indicated  separately  by  dotted  and  complete  lines.  AtB  the 
resultant  of  the  interaction  of  the  two  systems  is  shown.  With  such  a  relation  as  that  shown  in 
the  diagram,  and  with  those  of  a  vibrating  rod  generally,  such  as  n,  Sn,  5n,  &c,  the  interference 
i.f  the  systems. is  not  complete,  and  silence  cannot  be  produced  by  the  interference  of  sounds. 
(iTom  Ganot's  Physics.) 

In  the  case  just  mentioned,  the  waves  are  of  the  same  length, 
but  if  they  are  of  different  lengths,  instead  of  constantly  rein- 


chap,  vii.]  ACTION  OF  DKUGS  ON  THE  SPINAL  COED.    169 

forcing  and  interfering  with  others,  they  may  sometimes  strengthen 
and  sometimes  weaken  each  other.  The  result  is  more  or  less 
rhythmical  increase  and  diminution  of  action,  or  as  it  is  termed 
'  beats.'   This  is  shown  in  the  accompanying  diagram  (Pig.  64). 

Instances  of  rhythm  occur  in  the  body,  which  strongly  remind 
us  of  this  condition ;  for  example,  the  different  rhythms  of  the 
heart  under  various  conditions. 

Interference  in  Nervous  Structures.— Supposing  nervous 
stimuli  to  consist  of  vibrations  like  those  of  light  or  sound,  the 
action  which  any  nerve-cell  would  have  upon  the  others  connected 
with  it  would  he  stimulant  or  inhibitory  according  to  its  position 
in  relation  to  them.  If  its  relation  be  such  that  a  stimulus 
passing  from  it  to  another  cell  will  there  meet  with  a  stimulus 
from  another  quarter  in  such  a  way  that  the  waves  of  which  they 
consist  coincide,  the  nervous  action  will  be  doubled  ;  but  if  they : 
interfere  the  nervous  action  will  be  abolished.  If  they  meet  so 
as  neither  completely  to  coincide  nor  to  interfere,  the  nervous 
action  will  be  somewhat  increased,  or  somewhat  diminished,  ac- 
cording to  the  degree  of  coincidence  or  interference  between  the 
crests  of  the  wave. 

Thus  if  the  relations  of  the  nerve-cells  s,  s'  and  m,  m'  in  the 
diagram  (Fig.  65)  are  such  that  when  a  stimulus  passes  fromja 


Fig.  65.— Diagram  to  illustrate  inhibition  in  the  spinal  cord,  t,  s?,  and  j"  are  sensory  nerves,  m,  m\ 
and  m"  are  motor  nerves,  8,  s',  and  8"  are  sensory  cells,  m,  M',  and  M"  are  motor  cells  in  the  spinal 
cord,  sb  is  a  sensory,  and  MB  a  motor  cell  in  the  brain. 

sensory  nerve  s  to  a  motor  nerve  m,  o"ne  part  of  it  travels  along 
the  path  s,  s,  m,  m,  and  another  along  s,  s,  s',  m, m,  or  s,  s,  s',m',  m,  m, 
at  such  a  rate  that  the  crests  of  the  waves  coincide  at  the  motor 
cell  m,  they  will  increase  each  other's  effect.  If  they  interfere, 
the  effect  of  both  will  be  diminished  or  destroyed,  i.e.  inhibition 
will  occur. 

Effect  of  Altered  Rate  of  Transmission. — But  it  is  evident 
that  the  coincidence  or  interference  of  nervous  stimuli  travelling 
along  definite  nerve-paths,  will  vary  according  to  the  rate  at 
which  they  travel,  so  that  when  stimuli  which  ordinarily  interfere 
with  one  another,  are  made  to  travel  more  slowly,  one  may  be 


170  PHARMACOLOGY  AND  THERAPEUTICS,     [sect,  l 

thrown  a  whole  wave-length,  instead  of  half  a  wave-length,  behind 
the  other  :  and  thus  we  get  coincidence  and  stimulation,  instead 
of  interference  and  inhibition.  "When  stimuli,  whose  waves 
ordinarily  coincide  and  strengthen  each  other's  action,  are  made 
to  travel  more  slowly,  one  may  be  thrown  half  a  wave-length  be- 
hind the  other,  and  thus  we  shall  have  interference  and  inhibition 
instead  of  stimulation. 

On  the  other  hand,  when  the  stimuli  travel  more  quickly,  the 
one  which  was  half  a  wave-length  behind  the  other,  and  interfered 
with  it,  may  be  thrown  only  a  small  fraction  of  a  wave-length 
behind  it.  It  will  thus,  to  a  great  extent,  coincide  and  cause 
stimulation,  while  the  one  which  normally  coincides  with  and 
helps  another  may,  by  travelling  with  increased  rapidity,  get 
half  a  wave-length  in  front  of  the  other,  and  cause  inhibition. 

Opposite  Conditions  produce  Similar  Effects.  —  We  see 
then  that  results,  apparently  exactly  the  same,  may  be  produced 
by  two  opposite  conditions,  increased  rapidity  or  greater  slowness 
of  transmission  of  stimuli. 

The  Same  Conditions  may  cause  Opposite  Effects. — We 
see  also  that  the  same  conditions  may  produce  entirely  opposite 
effects,  by  acting  more  or  less  intensely.  Thus,  the  application 
of  cold,  or  of  any  agent  which  will  render  the  transmission  of 
stimuli  along  nervous  channels  slower  than  usual,  may  throw 
one  which  ordinarily  coincided  with  another  a  small  fraction  of 
a  wave-length  behind  it,  then  half  a  wave-length,  then  three- 
quarters,  next  a  whole  wave-length,  and  then  in  addition  to  the 
whole  wave-length  it  will  throw  it,  as  at  first,  a  small  fraction  or 
a  half  wave-length  behind,  and  so  on. 

We  shall  thus  have  the  normal  stimulation  passing  into  partial, 
then  into  complete  inhibition,  which  will  gradually  pass  off  as 
the  crests  of  the  waves  come  more  nearly  together,  until  they 
coincide,  when  we  shall  again  have  stimulation  as  at  first.  As 
the  action  proceeds,  this  second  stimulation  will  again  pass  into 
inhibition.  In  the  same  way  a  gradual  retardation  of  trans- 
mission will  cause  impulses,  which  normally  interfere,  gradually 
to  coincide  until  inhibition  gives  place  to  complete  stimulation, 
and  this  again  passes  into  inhibition.  By  quickening  the  trans- 
mission and  throwing  one  wave  more  or  less  in  advance  of 
another,  various  degrees  of  heat  will  likewise  produce  opposite 
effects. 

Stimulation  and  Inhibition  on  this  Hypothesis  are  merely 
Consequences  of  Relation.— Stimulation  and  Inhibition  are 
not  due  to  any  particular  stimulating  or  inhibitory  centres ;  they 
are  merely  dependent  on  the  wave-length  of  nervous  stimuli  or 
the  rapidity  of  transmission,  and  on  the  lengths  of  the  paths 
along  which  they  have  to  travel.  Any  nerve-cell  may  therefore 
exercise  an  inhibitory  or  stimulating  action  on  any  other  nerve- 
cell,  and  the  nature  of  this  action  will  be  merely  a  question  of 


chap,  vii.]  ACTION  OF  DRUGS  ON  THE  SPINAL  COED.    171 

the  length  and  arrangement  of  its  connections,  and  the  rapidity 
with  which  stimuli  travel  along  them. 

Test  of  the  Truth  of  the  Hypothesis.— If  the  hypothesis 
be  true  we  ought  to  be  able  to  convert  inhibition  into  stimulation, 
and  vice  vend,  by  either  quickening  or  slowing  the  transmission 
of  stimuli.  We  can  quicken  transmission  by  heat,  and  we  can 
render  it  slower  by  cold. 

On  this  hypothesis  we  would  expect  to  find  that  either  ex- 
cessive quickening  or  excessive  slowing  of  the  passage  of  stimuli 
between  the  cells  of  the  nerve-centres  might  cause  a  number  of 
stimuli  which  would  ordinarily  interfere  to  coincide  and  produce 
convulsions.  This  is  what  actually  does  occur,  for  extreme  heat 
and  extreme  cold  both  cause  convulsions.  But  it  is  unsafe  to 
lay  too  much  stress  upon  this  point,  as  the  cause  of  convulsion 
may  be  very  complex.  We  find,  however,  as  we  should  expect 
on  this  hypothesis,  that  the  inhibitory  action  of  the  vagus  is 
destroyed  by  cold,1 


Explanation  of  the  Actions  of  Certain  Drugs  on  this 
Hypothesis. 

There  are  certain  phenomena  connected  with  the  action  of 
drugs  on  the  spinal  cord  which  are  almost  inexplicable  on  the 
ordinary  hypothesis,  but  which  are  readily  explained  on  that 
of  interference.  Thus  belladonna  when  given  to  frogs  causes 
gradually  increasing  weakness  of  respiration  and  movement,  until 
at  length  voluntary  and  respiratory  movements  are  entirely 
abolished,  and  the  afferent  and  efferent  nerves  are  greatly 
weakened.  Later  still,  both  afferent  and  efferent  nerves  are 
completely  paralysed,  and  the  only  sign  of  vitality  is  an  occasional 
and  hardly  perceptible  beat  of  the  heart,  and  retention  of  irrita- 
bility in  the  striated  muscles.  The  animal  appears  to  be  dead, 
and  was  believed  to  be  dead,  until  Fraser  made  the  observation 
that  if  allowed  to  remain  in  this  condition  for  four  or  five  days, 
the  apparent  death  passed  away  and  was  succeeded  by  a  state  of 
spinal  excitement.  The  fore-arms  pass  from  a  state  of  complete 
flaccidity  to  one  of  rigid  tonic  contraction.  The  respiratory 
movements  reappeared ;  the  cardiac  action  became  stronger,  and 
the  posterior  extremities  extended.  In  this  condition  a  touch 
upon  the  skin  caused  violent  tetanus,  usually  opisthotonic,  lasting 
from  two  to  ten  seconds,  and  succeeded  by  a  series  of  clonic 
spasms.  A  little  later  still  the  convulsions  change  their  character 
and  become  emprosthotonic.  These  symptoms  are  due  to  the 
action  of  the  poison  upon  the  spinal  cord  itself,  for  they  continue 
independently  in  the  parts  connected  with  each  segment  of  the 
cord  when  it  has  been  divided. 

*  Horwath,  Pfillger's  Archiv,  1876,  xii.  p.  278. 


112  PHAKMACOLOGY  AND  THE  KAPEU  TICS,     [sect.  i. 

This  action  may  be  imitated  by  a  combination  of  a  drug  which 
will  paralyse  the  motor  nerves  with  one  which  will  excite  the 
spinal  cord.  Fraser  concludes  that  the  effects  of  large  doses  of 
atropine  just  described  are  due  to  a  combined  stimulant  action  of 
this  substance  on  the  cord,  and  a  paralysing  one  on  the  motor 
nerves.  The  stimulant  action  on  the  cord  is  masked  by  the 
paralysis  of  the  motor  nerves,  and  only  appears  after  the  para- 
lysis has  passed  off.  He  thinks  that  the  difference  in  the  rela- 
tions of  these  effects  to  each  other,  which  are  seen  in  different 
species  of  animals,  may  be  explained  by  this  combination  acting 
on  special  varieties  of  organisation.  In  support  of  his  views  he 
administered  to  frogs  a  mixture  of  strychnine  which  stimulates 
the  spinal  cord,  and  of  methyl-strychnine,  which  paralyses  the 
motor  nerves,  and  found  that  the  mixture  produced  symptoms 
similar  to  thoBe  of  atropine.  Notwithstanding  this  apparently 
convincing  proof,  it  would  appear  that  the  paralysis  in  the  frog 
is  due  to  the  action  of  the  atropine  on  the  spinal  cord,  and  not 
to  a  paralysing  effect  on  the  motor  nerves.  For  Einger  and 
Murrell  have  found  that  when  the  ends  of  the  motor  nerves  in 
one  leg  are  protected  from  the  action  of  the  poison  by  ligature  of 
the  artery  there  is  no  difference  between  it  and  the  unpoisoned 
leg,  while  if  Fraser's  ideas  were  correct  the  unpoisoned  leg  ought 
to  be  in  a  state  of  violent  spasm. 

A  condition  very  nearly  similar  to  that  caused  by  atropine  is 
produced  by  morphine.  "When  this  substance  is  given  to  a  frog, 
its  effects  are  exactly  similar  to  those  produced  by  the  successive 
removal  of  the  different  parts  of  the  nervous  system  from  above 
downwards.  Goltz  has  shown  that  when  the  cerebral  lobes  are 
removed  from  the  frog  it  loses  the  power  of  voluntary  motion, 
and  sits  still ;  when  the  optic  lobes  are  removed  it  will  spring 
when  stimulated,  but  loses  the  power  of  directing  its  movements. 
When  the  cerebellum  is  removed,  it  loses  the  power  of  springing 
at  all ;  and  when  the  spinal  cord  is  destroyed,  reflex  action  is 
abolished. 

Now  these  are  exactly  the  effects  produced  by  morphine,  the 
frog  poisoned  by  it  first  losing  voluntary  motion,  next  the  power 
of  directing  its  movements,  next  the  power  of  springing  at  all, 
and  lastly,  reflex  action.  But  after  reflex  action  is  destroyed  by 
morphine,  and  the  frog  is  apparently  dead,  a  very  remarkable 
condition  appears,  the  general  flaccidity  passes  away,  and  is 
succeeded  by  a  stage  of  excitement,  a  slight  touch  causing 
violent  convulsions  just  as  if  the  animal  had  been  poisoned  by 
strychnine.1 

The  action  of  morphine  here  appears  to  be  clearly  that  of  de- 
stroying the  function  of  the  nerve-centres  from  above  downwards, 
causing  paralysis  first  of  the  cerebral  lobes,  next  of  the  optic 

1  Marshall  Hall,  Memoirs  on  the  Nervous  System,  p.  7  (London,  1837).    Wit- 
kowski,  Archivfiir  exper.  Path,  und  Pharm.,  Band  vii.  p.  247. 


chap,  vii.]  ACTION  OF  DEUGS  ON  THE  SPINAL  COED.    173 

lobes,  next  of  the  cerebellum,  and  next  of  the  cord.  But  it  seems 
probable  tbat  the  paralysis  of  the  cord  first  observed  is  only  ap- 
parent and  not  real ;  and  in  order  to  explain  it  on  the  ordinary 
hypothesis  we  must  assume  that  during  it  the  inhibitory  centres 
in  the  cord  are  intensely  excited,  so  as  to  prevent  any  motor 
action,  tbat  afterwards  they  become  completely  paralysed,  and 
thus  we  get  convulsions  occurring  from  slight  stimuli. 

Ammonium  bromide  also  causes,  first,  complete  loss  of  volun- 
tary movement  and  reflex  action,  but  at  a  later  stage  in  the 
poisoning  convulsions. 

On  the  hypothesis  of  interference,  the  phenomena  produced 
both  by  atropine  and  by  morphine  can  be  more  simply  explained. 
These  drugs,  acting  on  the  nervous  structures,  gradually  lessen 
the  functional  activity  of  the  nerve-fibrils  which  connect  the 
nerve-cells  together ;  the  impulses  are  retarded,  and  thus  the 
length  of  nervous  connection  between  the  cells  of  the  spinal  cord, 
which  is  calculated  to  keep  tbem  in  proper  relation  in  the  normal 
animal  just  suffices  at  a  certain  stage  to  throw  the  impulses 
half  a  wave-length  behind  the  other,  and  thus  to  cause  complete 
inhibition  and  apparent  paralysis. 

As  the  action  of  the  drug  goes  on,  the  retardation  becomes 
still  greater,  and  then  the  impulses  are  thrown  very  nearly,  but 
not  quite,  a  whole  wave-length  behind  the  other,  and  thus  they 
coincide  for  a  short  time,  but  gradually  again  interfere,  and 
therefore  we  get,  on  the  application  of  a  stimulus,  a  tonic  con- 
vulsion followed  by  several  clonic  ones,  and  then  by  a  period  of 
rest.  This  explanation  is  further  borne  out  by  the  fact  observed 
by  Fraser,  that  the  convulsions  caused  by  atropine  occurred  more 
readily  during  winter,  when  the  temperature  of  the  laboratory  is 
low,  and  the  cold  would  tend  to  aid  the  action  of  the  drug  in 
retarding  the  transmission  of  impulses.1 

The  effect  of  strychnine  in  causing  tetanus  is  very  remark- 
able ;  a  very  small  dose  of  it  administered  to  a  frog  first  renders 
the  animal  most  sensitive  to  reflex  impulses,  so  that  slight  im- 
pressions which  would  normally  have  no  effect,  produce  reflex 
action.  As  the  poisoning  proceeds,  a  slight  stimulus  no  longer 
produces  a  reflex  action  limited  to  a  few  muscles,  but  causes  a 
general  convulsion  throughout  all  the  body,  all  the  muscles  being 
apparently  put  equally  on  the  stretch.  In  man  the  form  assumed 
by  the  body  is  that  of  a  bow,  the  head  and  the  heels  being  bent 
backwards,  the  hands  qlenched,  and  the  arms  tightly  drawn  to 
the  body. 

My  friend  Dr.  Ferrier  has  shown  that  this  position  is  due  to 
the  different  strengths  of  the  various  muscles  in  the  body.  All 
being  contracted  to  their  utmost,  the  stronger  overpower  the 
weaker,  and  thus  the  powerful  extensors  of  the  back  and  muscles 

1  Transactions  of  the  Royal  Society  of  Edinburgh,  vol.  xxv.  p.  467. 


174  PHABMACOLOGY  AND  THEEAPEUTICS.     [sect.  i. 

of  the  thighs  keep  the  hody  arched  backwards  and  the  legs  rigid, 
while  the  adductors  and  flexors  of  the  arms  and  fingers  clench 
the  fist  and  bend  the  arms,  and  draw  them  close  to  the  body.1 
The  convulsions  are  not  continuous,  but  are  clonic ;  a  violent 
convulsion  coming  on  and  lasting  for  a  while,  and  then  being 
succeeded  by  an  interval  of  rest,  to  which  after  a  little  while 
another  convulsion  succeeds.  The  animal  generally  dies  either 
of  asphyxia  during  a  convulsion,  or  of  stoppage  of  the  heart 
during  the  interval. 

When  the  animal  is  left  to  itself,  the  convulsions—at  least 
in  frogs— appear  to  me  to  follow  a  certain  rhythm,  the  intervals 
remaining  for  some  little  time  of  nearly  the  same  extent. 

A  slight  external  stimulus,  however,  applied  during  the  in- 
terval—or at  least  during  a  certain  part  of  it — will  bring  on  the 
convulsion.  But  this  is  not  the  case  during  the  whole  interval. 
Immediately  after  each  convulsion  has  ceased  I  have  observed  a 
period  in  which  stimulation  applied  to  the  surface  appears  to 
have  no  effect  whatever. 

It  is  rather  extraordinary,  also,  that  although  touching  the 
surface  produces  convulsions,  irritation  of  the  skin  by  acid  does 
not  do  so.2 

The  cause  of  those  convulsions  was  located  in  the  spinal  cord 
by  Magendie  in  an  elaborate  series  of  experiments,  which  will  be 
described  later  on  (p.  177). 

Other  observers  have  tried  to  discover  whether  any  change 
in  the  peripheral  nerves  also  took  part  in  causing  convulsion  ; 
but  from  further  experiments  it  appears  that  the  irritability  of 
the  sensory  nerves  is  not  increased.3 

According  to  Eosenthal,  strychnine  does  not  affect  the  rate  at 
which  impulses  are  transmitted  in  peripheral  nerves ;  he,  how- 
ever, states  that  it  lessens  the  time  required  for  reflex  actions. 
Wundt  came  to  the  conclusion  that  the  reflex  time  was  on  the 
contrary  increased. 

In  trying  to  explain  the  phenomenon  of  strychnine-tetanus 
on  the  hypothesis  of  interference,  one  would  have  been  inclined 
by  Eosenthal's  experiments  to  say  that  strychnine  quickened  the 
transmission  of  impulses  along  those  fibres  in  the  spinal  cord 
which  connect  the  different  cells  together. 

The  impulses  which  normally,  by  travelling  further  round, 
fell  behind  the  simple  motor  ones  by  half  a  wave-length,  and 
thus  inhibited  them,  would  now  fall  only  a  small  fraction  of  a 
wave-length  behind,  and  we  should  have  stimulation  instead  of 
inhibition. 

Wundt's  conclusion,  on  the  other  hand,  would  lead  to  the 

1  Brain,  vol.  iv.  p.  313. 

2  Eckhard,  Hermann's  Handb.  d.  Physiol.,  Band  ii.  Th.  2,  p.  43. 

3  Bernstein,  quoted  by  Eckhard,  op.  cit.  p.  40.  Walton,  Ludwia's  Arbeiten, 
1882. 


chap,  vn.]  ACTION  OF  DEUGS  ON  THE  SPINAL  COED.    175 

same  result  by  supposing  that  the  inhibitory  wave  was  retarded 
so  as  to  fall  a  whole  wave-length  behind  the  motor  one.  On  the  as- 
sumption, however,  that  the  fibres  which  pass  transversely  across 
from  sensory  to  motor  cells,  and  those  that  pass  upwards  and 
downwards  in  the  cord  connecting  the  cells  of  successive  strata 
in  it,  are  equally  affected,  we  do  not  get  a  satisfactory  explana- 
tion of  the  rhythmical  nature  of  the  convulsions.  By  supposing, 
however,  that  these  are  not  equally  affected,  but  that  the  re- 
sistance in  one— let  us  say  that  in  the  transverse  fibres — is  more 
increased  than  in  the  longitudinal  fibres,  we  shall  get  the  im- 
pulses at  one  time  thrown  completely  upon  each  other,  causing 
intense  convulsion,  at  another  half  a  wave-length  behind,  causing 
complete  relaxation,  which  is  exactly  what  we  find. 

This  view  is  to  some  extent  borne  out  by  the  different  effect 
produced  by  a  constant  current  upon  these  convulsions,  accord- 
ing as  it  is  passed  transversely  or  longitudinally  through  the 
spinal  cord.  Eanke  found  that  when  passed  transversely  it  has 
no  effect,  but  when  passed  longitudinally  in  either  direction 
it  completely  arrests  the  strychnine  convulsions,  and  also  the 
normal  reflexes  which  are  produced  by  tactile  stimuli. 

Eanke's  observations  have  been  repeated  by  others  with 
varying  result,  and  this  variation  may,  I  think,  be  explained  by 
the  effect  of  temperature. 

The  effect  of  warmth  and  cold  upon  strychnine-tetanus  is 
what  we  would  expect  on  the  hypothesis  of  interference.  With 
small  doses  of  strychnine,  warmth  abolishes  the  convulsions, 
while  cold  increases  them.  When  large  doses  are  given,  on  the 
contrary,  warmth  increases  the  convulsions,  and  cold  abolishes 
them.1 

We  may  explain  this  result  on  the  hypothesis  of  interference 
in  the  following  manner : — 

If  a  small  dose  of  strychnine  retard  the  transmission  of  ner- 
vous impulses  so  that  the  inhibitory  wave  is  allowed  to  fall  rather 
more  than  half  a  wave-length,  but  not  a  whole  wave-length, 
behind  the  stimulant  wave,  we  should  have  a  certain  amount  of 
stimulation  instead  of  inhibition.  Slight  warmth,  by  quickening 
the  transmission  of  impulses,  should  counteract  this  effect,  and 
should  remove  the  effect  of  the  strychnine.  Cold,  on  the  other 
hand,  by  causing  still  further  retardation,  should  increase  the 
effect.  With  a  large  dose  of  strychnine,  the  transmission  of  the 
inhibitory  wave  being  still  further  retarded,  the  warmth  would 
be  sufficient  to  make  the  two  waves  coincide,  while  the  cold 
would  throw  back  the  inhibitory  wave  a  whole  wave-length,  and 
thus  again  abolish  the  convulsions. 

The  effect  of  temperature  on  the  poisonous  action  of  guanidine 
is  also  very  extraordinary,  and  is  very  hard  to  explain  on  the 

1  Kunde  and  Virchow,  quoted  by  Eckhard,  op.  cit.  p.  44 ;  Foster,  Journal  of 
Anatomy  and  Physiology,  November  1873,  p.  45. 


176  PHAEMACOLOGY  AND  THERAPEUTICS,     [sect.  I. 

ordinary  hypothesis,  although  the  phenomena  seem  quite  natural 
when  we  look  at  them  as  cases  of  interference  due  to  alterations 
in  the  rapidity  with  which  the  stimuli  are  transmitted  along 
nervous  structures. 

Another  cause  of  tetanus  that  is  difficult  to  understand  on 
the  ordinary  hypothesis  of  inhibitory  centres  is  the  similar  effect 
of  absence  of  oxygen  and  excess  of  oxygen.  When  an  animal  is 
confined  in  a  closed  chamber  without  oxygen,  it  dies  of  convul- 
sions ;  when  oxygen  is  gradually  introduced  before  the  convulsions 
become  too  marked,  it  recovers.  But  when  the  pressure  of  oxygen 
is  gradually  raised  above  the  normal,  the  animal  again  dies  of 
convulsions.  This  is  evidently  not  the  effect  of  mere  increase  in 
atmospheric  pressure,  but  the  effect  of  the  oxygen  on  the  animal, 
inasmuch  as  twenty -five  atmospheres  of  common  air  are  required 
to  produce  the  oxygen-convulsions,  while  three  atmospheres  of 
pure  oxygen  are  sufficient.  This  effect  is  readily  explained  on 
the  hypothesis  of  interference  by  supposing  that  the  absence 
of  oxygen  retards  the  transmission  of  impulses  in  the  nerve- 
centres  ;  so  that  we  get  those  which  ought  ordinarily  to  inhibit 
one  another  coinciding  and  causing  convulsions.  Increased  supply 
of  oxygen  gradually  quickens  the  transmission  of  impulses  until 
the  waves  first  reach  the  normal  relation,  and  then,  the  normal 
rate  being  exceeded,  the  impulses  once  more  nearly  coincide, 
and  convulsions  are  produced  a  second  time.1 

The  effect  of  various  agents  also  in  arresting  or  inhibiting 
muscular  action  suggests  the  possibility  that  such  inhibition  is 
due  to  interference  with  vibrations  in  muscle.  The  vibrations 
of  the  parts  which  occur  in  the  muscle  during  the  passage  of  a 
constant  current  have  already  been  mentioned.  When  a  constant 
current  is  passed  for  a  length  of  time  and  then  stopped,  tetanic 
contraction  of  the  muscle  occurs  and  lasts  for  some  time,  but  it 
can  be  at  once  arrested  by  again  passing  the  constant  current 
through  the  muscle. 

The  idea  that  coincidence  or  interference  of  contractile  waves 
in  muscle  have  much  to  do  with  the  presence  or  absence  of  con- 
traction of  a  muscle  has  been  advanced  by  Kiihne,  in  order  to 
explain  the  phenomenon  observed  by  A.  Ewald.  When  the 
sartorius  of  a  frog  is  stimulated  at  each  end  by  electric  currents 
passing  transversely  through  the  ends,  the  secondary  contraction 
which  can  be  obtained  from  it  is  strongest  in  the  middle  of  the 
muscle,  while  the  points  exactly  intermediate  between  the  middle 
and  the  end  do  not  produce  any  secondary  contraction  at  all. 
This  absence  of  secondary  contraction  Kiihne  thinks  is  due  to 


1  For  other  observations  on  interference  as  a  cause  of  inhibition,  vide  Wundt, 
Untersuchtmgen  sur  Mechanik  cler  Nerven  und  Nervencentren.  1876.'  (Stuttgart : 
T.  Enke) ;  Eanvier,  Lemons  d'Anatomie  Ginerale.  Annie  1877-78.  (Paris  •  J  B." 
Bailliere  et  Fils) ;  and  Lauder  Brunton  '  On  the  Nature  of  Inhibition  and  the' 
Action  of  Drugs  upon  it '  (Nature,  March  1883,  and  reprint). 


chap,  vii.]    ACTION  OP  DEUGS  ON  THE  SPINAL  COED.    177 

interference^  and  the  powerful  secondary  contraction  from  the 
middle  to  coincidence  of  waves.1 

Inhibition  may  also  be  produced  by  direct  irritation  of  in- 
voluntary muscular  fibre.  Thus  I  have  noticed,  under  Ludwig's 
direction,  that  stimulation  of  veins  as  a  rule  very  frequently 
causes  dilatation  at  the  point  of  irritation,  and  if  the  mus- 
cular fibre  of  a  frog's  heart  be  injured  by  pinching  at  one 
point,  that  point  is  apt  to  remain  dilated  when  the  rest  is  con- 
tracted. Protoplasmic  structures  appear  to  be  similarly  affected, 
and  the  passage  of  an  interrupted  current  through  the  heart  of 
a  snail  will  arrest  its  rhythmical  pulsations,  although  the  heart  in 
this  animal  appears  to  be  a  continuous  protoplasmic  structure 
and  destitute  of  nerves.2 

Stimulating  Action  of  Drugs  on  the  Reflex  Powers  of 

the  Cord. 

The  reflex  action  of  the  cord  is  greatly  increased  by  certain 
drugs,  more  especially  by  ammonia  and  by  strychnine.  The 
action  of  strychnine  was  first  investigated  by  Magendie,  and  his 
research  is  not  only  the  first  example  of  the  systematic  investi- 
gation of  the  physiological  action  of  a  drug  leading  to  its  thera- 
peutical employment,  but  is  such  a  model  of  this  method  of 
research  that  it  is  worth  giving  in  detail. 

He  first  introduced  a  little  of  the  upas  poison,  of  which 
strychnine  was  the  essential  ingredient,  under  the  skin  of  the 
thigh  of  a  dog,  and  found  that  for  the  first  three  minutes  no 
symptoms  at  all  were  produced.  Then  the  action  of  the  poison 
began  to  manifest  itself  by  general  malaise,  succeeded  by  marked 
symptoms.  The  animal  took  shelter  in  a  corner  of  the  labora- 
tory ;  and  almost  immediately  afterwards  convulsive  contraction 
of  all  the  muscles  of  the  body  occurred,  the  for.e-feet  quitting  the 
ground  for  a  moment  on  account  of  the  sudden  extension  of  the 
spine.  This  contraction  was  only  momentary,  and  almost  imme- 
diately afterwards  ceased ;  the  animal  remained  calm  for  several 
seconds,  and  was  then  seized  with  a  second  convulsion,  more 
marked  and  prolonged  than  the  first.  These  convulsions  suc- 
ceeded each  other  at  short  intervals,  gradually  becoming  more 
severe.  The  respiration  was  hurried,  the  pulse  quick,  and  it  was 
observed  that  each  time  the  animal  was  touched  a  convulsion 
immediately  followed.  Finally,  death  occurred  at  an  interval 
increasing  with  the  age  and  strength  of  the  animal. 

These  symptoms  suggested  to  Magendie  the  following  ex- 
planation of  the  action  of  the  poison. 

It  was,  he  thought,  absorbed  from  the  wound  into  the  blood, 

1  Untersuchungen  a.  d.  Physiolog.  Inst.,  Heidelberg,  1879.     Sonderabdruck, 
p.  40. 

,2  M.  Foster,  Pflilger's  Archiv. 

■  N 


178  PHARMACOLOGY  AND   THEEAPEUTICS.     [sect.  I. 

by  which  it  was  carried  to  the  heart,  and  thence  to  all  the  organs 
of  the  body.  On  arriving  at  the  spinal  cord,  it  acted  upon  it  as 
a  violent  excitant,  producing  the  same  symptoms  as  mechanical 
irritation  or  the  application  of  electricity.  Magendie  was  not 
content  until  he  had  tested  his  theory  by  experiment.  The  first 
question  to  be  settled  was  whether  the  poison  was  absorbed 
or  not. 

To  test  this  supposition  he  applied  the  poison  first  to  the 
serous  membranes,  the  peritoneum  and  pleura,  from  which,  as 
he  had  learned  by  previous  experience,  absorption  takes  place 
with  extreme  rapidity.  The  result  showed  that  his  supposition 
was  correct.  The  symptoms  appeared  almost  immediately  after 
the  injection  of  the  poison  into  the  pleura,  and  within  twenty 
seconds  after  it  had  been  injected  into  the  peritoneum.  In  order 
to  ascertain  whether  absorption  took  place  from  mucous  as  well 
as  from  serous  surfaces,  he  isolated  a  loop  of  small  intestine  by 
means  of  two  ligatures,  and  injected  a  little  of  the  poison  into 
the  part  between  them.  In  six  minutes,  symptoms  of  poisoning 
appeared,  showing  that  absorption  had  occurred,  but  they  were 
less  intense  than  when  the  poison  was  applied  to  the  serous 
surface. 

Further  experiments  showed  that  absorption  took  place  from 
the  large  intestine,  from  the  bladder,  and  from  the  vagina ;  but 
that  it  was  comparatively  feeble  and  slow.  When  introduced 
into  the  stomach  along  with  food,  upas  invariably  caused  death  ; 
but  the  symptoms  did  not  appear  until  half  an  hour  after  it  had 
been  taken.  This  delay  might  have  been  due  either  to  absorp- 
tion from  the  stomach  having  taken  place  very  slowly  or  not 
at  all,  so  that  the  drug  had  passed  on  to  the  small  intestine,  and 
thence  been  absorbed  into  the  blood.  To  determine  this  point, 
he  isolated  the  stomach  by  ligatures  applied  to  its  cardiac  and 
pyloric  orifices,  and  then  injected  a  little  poison  into  its  cavity. 

Under  such  conditions,  symptoms  of  poisoning  were  only 
observed  after  the  lapse  of  an  hour.  This  showed  that  while 
absorption  from  the  stomach  did  occur,  it  was  much  slower  than 
from  the  small  intestine. 

The  second  question  was,  Does  the  poison  act  through  the 
circulation  ?  If  so,  reasoned  Magendie,  the  first  symptoms  of 
the  action  of  the  poison  will  come  on  more'  slowly  when  it  has 
far  to  travel  to  the  spinal  cord  from  the  point  of  introduction, 
and  vice  versd.  On  testing  this  by  experiment,  he  found  that 
when  the  poison_  was  injected  into  the  jugular  vein,  tetanus 
occurred  almost  instantaneously,  and  death  took  place  in  less 
than  three  minutes,  for  the  upas  had  only  to  pass  through  the 
pulmonary  circulation  and  heart  to  the  arteries  of  the  cord. 
When  injected  into  the  femoral  artery  (at  D,  Fig.  66)  the  dis- 
tance to  be  travelled  before  reaching  the  cord  would  be  greatly 
increased,  for  the  poison  must  first  pass  through  the  artery  itself, 


chap,  vii.]    ACTION  OF  DRUGS  ON  THE  SPINAL  COED.    179 

through  the  capillaries,  and  along  the  vena  cava,  traversing  the' 
whole  distance  marked  D  A  B  in  Pig.  66  before  it  reached  the 
point  where  it  entered  the  circulation  when  it  was  injected  into 
the  jugular.  Under  these  conditions  the  action  should  be  slow, 
and  experiment  showed  this  to  be  actually  the  case,  for  no 
symptoms  appeared  until  seven  minutes  after  the  injection- 
Although  these  experiments  of  Magendie's  appear  to  prove  com- 
pletely that  the  upas  poison  acts  through  the  circulation,  a 
number  of  persons  nevertheless  considered  that  the  symptoms 
were  produced  through  the  nervous  system  by  means  of  so-called 
sympathy.  In  order  to  remove  their  doubts,  Magendie  narcotised 
a  dog  by  means  of  opium,  and  then  divided  all  the  structures  of 
one  leg  with  the  exception  of  the  artery  and  vein.     Into  this 


Eig.  66. — Diagram  illustrating  Magendie's  method  of  investigating  the  mode  of  action  of  upas 
(strychnine).  A,  femoral  vein ;  B,  peritoneum ;  c,  pleura;  D,  femoral  artery;  E,  f,  g,  spinal 
cord,  to  which  small  arteries  are  seen  passing  from  the  aorta.  At  p  is  indicated  a  point  of 
section  of  the  cord. 


almost  isolated  limb  he  then  introduced  a  little  of  the  poison. 
This  was  followed  by  the  usual  symptoms  almost  exactly  as  if 
the  limb  had  been  intact.  By  pressing  upon  the  vein  which 
passed  from  the  limb  to  the  body  when  the  symptoms  of  tetanus 
appeared  he  was  able  to  arrest  their  further  development,  and  by 
releasing  the  vessel  and  allowing  the  circulation  to  have  free 
course  the  symptoms  reappeared.  Lest  by  any  chance  the 
poison  might  have  acted  through  nerves  or  lymphatics  contained 
in  the  walls  of  the  artery  and  vein,  he  divided  these  structures 
also,  connecting  their  several  ends  by  means  of  quills  through 
which  circulation  then  took  place.  When  the  poison  was  applied 
to  the  severed  limb  connected  with  the  body  only  by  these  quills, 
the  same  succession  of  phenomena  occurred  as  when  the  limb 
was  uninjured.  Tho  possibility  of  the  action  being  due  to 
sympathy  between  the  nervous  system  and  the  point  of  applica- 
tion of  the  poison  was  thus  completely  excluded,  and  the  opera- 
tion of  the  poison  through  the  circulation  triumphantly  demon- 
strated. 

The  next  question   was    whether  the   convulsions    were 
caused  by  the  action  of  the  drug  on  the  brain  or  the  cord. 

N   2 


180  PHAEMACOLOGY  AND  THEEAPEUTICS.      [sect.  r. 

To  ascertain  its  action  upon  the  brain,  a  little  of  the  solution 
was  injected  into  the  carotid  artery.  The  effects  produced  were 
the  same  as  those  of  any  irritating  liquid.  The  intellectual 
faculties  disappeared,  the  head  was  laid  between  the  paws,  and 
the  animal  rolled  over  and  over  like  a  ball.  These  effects  passed 
off  as  the  circulating  blood  removed  a  quantity  of  the  drug  from 
the  brain,  and  were  succeeded  by  the  ordinary  tetanic  convulsions 
when  sufficient  time  had  elapsed  for  it  to  reach  the  spinal  cord. 
The  question  whether  it  really  acted  upon  the  cord  still  remained 
to  be  put  to  a  crucial  test.  If  its  effects  were  really  due  to  its 
action  upon  the  spinal  cord  they  ought  to  cease  upon  the  de- 
struction of  that  part  of  the  nervous  system,  and  to  occur  when 
the  drug  was  applied  to  it  alone.  Tbe  cord  was  therefore  de- 
stroyed by  running  a  piece  of  whalebone  down  the  vertebral 
canal  at  the  moment  of  injection.  When  this  was  done,  no 
tetanus  occurred.  In  another  experiment,  Magendie  waited 
until  the  tetanic  spasms  had  been  induced  by  the  upas,  and  then 
destroyed  the  spinal  cord  by  slowly  pushing  the  whalebone  down 
the  vertebral  canal.  As  the  whalebone  advanced,  the  tetanus 
disappeared,  first  in  the  fore-legs,  when  the  dorsal  part  of  the 
cord  was  destroyed,  and  then  in  the  hind-legs,  when  the  whale- 
bone had  reached  the  lumbar  vertebrae. 

In  another  experiment,  an  animal  was  narcotised  by  means 
of  opium,  and  the  spinal  canal  laid  freely  open.  The  upas  was 
then  directly  placed  on  a  part  of  the  spinal  cord.  Tetanus  im- 
mediately occurred  in  that  part  of  the  body,  and  in  that  part 
only  to  which  the  nerves  arising  from  this  portion  of  the  cord 
were  distributed.  When  the  poison  was  successively  applied  to 
other  parts  of  the  cord,  the  convulsions  spread  to  the  correspond- 
ing regions  of  the  body. 

The  question  whether  a  drug  exercises  a  convulsant 
action  through  the  brain  or  spinal  cord  is  now  frequently 
tested,  not  by  destroying  the  whole  cord  as  Magendie  did,  but 
simply  by  dividing  the  spinal  cord  transversely  between  the  occi- 
put and  the  atlas.  Convulsions  depending  upon  stimulation  of 
the  motor  centres  in  the  brain  and  medulla  oblongata  then 
cease  after  section,  while  those  dependent  upon  the  spinal  cord 
do  not. 

The  experiment  of  dividing  the  spinal  cord  transversely  about 
its  middle  is  also  sometimes  performed  in  order  to  test  whether 
the  convulsions  are  of  really  spinal  origin.  If  they  are,  they 
should  persist  in  both  the  anterior  and  posterior  parts  of  the 
body,  but  if  they  are  of  cerebral  origin,  they  occur  in  the  anterior 
but  not  in  the  posterior  part. 

The  effect  of  strychnine  and  allied  substances  upon  the  cord 
is  usually  ascribed  to  increased  excitability  of  the  nerve-cells,  but 
it  is  not  improbably  due  partly  to  alteration  in  the  comparative 
rate  at  which  stimuli  are' transmitted  from  one  cell  to  another  • 


chap.vii.]    ACTION  OF  DEUGS  ON  THE  SPINAL  CORD.    181 

but  this  subject  has  already  been  more  fully  discussed  under 
'  Inhibition '  (q.v.,  p.  173  et  seq.). 

Some  curious  results  obtained  by  Dr.  A.  J".  Spence  may  be 
explained  on  the  latter  hypothesis  which  would  be  inexplicable  on 
the  former.  After  removing  the  blood  from  the  body  of  a  frog, 
and  exposing  the  brain,  he  placed  some  nux  vomica  upon  it,  so 
that  it  could  gradually  diffuse  along  the  spinal  cord.  As  it  passed 
downwards  he  observed  that,  at  first,  irritation  of  the  fore-feet 
caused  spasm  only  in  them ;  later  it  caused  spasm  of  both  front 
and  hind-feet,  while  irritation  of  the  hind-feet  still  produced  the 
ordinary  reflex ;  and  later  still  irritation  of  the  fore-feet  caused 
no  spasm  in  the  hind-legs  while  irritation  of  the  hind-feet  would 
still  cause  spasm  in  the  fore-legs.1 

The  action  of  strychnine  on  the  conducting  power  of  the 
spinal  cord  has  already  been  discussed.  It  diminishes  or 
abolishes  the  power  of  summation,  but  increases  the  reflex 
excitability,  so  that  stimuli  will  produce  reflex  action  which  are 
too  feeble  to  do  so  when  the  spinal  cord  is  in  its  normal  condition. 
The  difference  between  the  reaction  to  strong  and  weak  stimuli 
is  also  to  a  great  extent  abolished,  and  both  produce  tetanic  con- 
tractions. This  condition,  however,  is  absent  for  a  short  time 
after  the  application  of  each  stimulus,  and  then  strong  and  weak 
stimuli  produce  corresponding  strong  and  weak  action,  much  as 
in  the  normal  cord.2 

The  effect  of  nicotine  as  a  spinal  stimulant  is  very  extra- 
ordinary ;  for  Freusberg  found  that  when  frogs  had  been  decapi- 
tated for  twenty-four  hours,  and  reflex  action  was  almost  entirely 
gone,  the  injection  of  a  small  quantity  of  the  poison  increased 
the  reflex  excitability  so  much  that  irritation  of  the  skin  caused 
well-marked  movements.  This  increase  lasted  from  one  to  three 
days,  and  the  bodies  of  frogs  poisoned  by  nicotine  retained  a 
fresh  appearance  for  a  long  time. 

Spinal  Stimulants. 

Spinal  stimulants  are  remedies  which  increase  the  functional 
activity  of  the  spinal  cord. 

Ammonia.  Thebaine. 

Strychnine.  Gelsemine. 

Erucine.  Buxine. 

Absinthe.  Calabarine. 

Nicotine.  Caffeine. 

The  most  marked  of  these  are  strychnine,  brucine,  and  the- 
baine, which  in  small  and  moderate  doses  greatly  increase  the 

1  Edm.  Med.  Journ.,  July  1866. 

*  Ludwig  and  Walton,  Ludwig's  Arbeiten,  1882. 


182  PHARMACOLOGY  AND  THERAPEUTICS.      [sect.  i. 

reflex  excitability,  and  in  large  doses  cause  tetanic  convulsions. 
Besides  these  there  are  some  others,  such  as  opium,  morphine, 
and  belladonna,  which,  although  they  appear  at  first  to  have  a 
sedative  action,  when  given  in  very  large  doses  produce  convul- 
sions. 

Uses. — The  want  of  an  exact  knowledge  of  the  intimate 
pathology  of  diseases  of  the  spinal  cord  renders  the  rational  use  of 
spinal  stimulants  difficult.  They  are  employed  in  the  cases  of 
general  debility  without  any  evidence  of  distinct  disease,  and  in 
paralysis  where  there  is  no  evidence  of  inflammation :  this 
paralysis  may  be  local,  or  affect  the  whole  side  of  the  body,  as  in 
hemiplegia,  or  the  lower  half,  as  in  paraplegia. 

When  strychnine  is  given  in  cases  of  paralysis  until  it  begins 
to  exhibit  its  physiological  action  in  slight  muscular  twitches, 
these  twitches  begin  soooner  and  are  more  marked  in  the  para^ 
lysed  than  the  healthy  parts. 


183 


CHAPTER  VIII. 
ACTION  OF  DEUGS  ON  THE  BRAIN. 

We  are  able  to  judge  to  a  certain  extent  of  the  order  and  kind  of 
action  of  drugs  upon  the  different  parts  of  the  nerve-centres  by 
watching  their  effect  upon  the  movements  of  animals  after  their 
injection. 

Functions  of  the  Brain  in  the  Frog. 

By  removal  of  successive  portions  of  the  nervous  system 
in  the  frog,  Goltz  has  shown  that  the  cerebral  lobes  have  the 
function  of  voluntary  movement,  so  that  when  they  ar.e  removed, 
the  animal  lies  quiet,  unless  acted  upon  by  some  external 
stimulus. 

The  optic  lobes,  which  correspond  to  the  corpora  quadri- 
gemina  of  the  higher  animals,  have  the  function  of  directing  and 
co-ordinating  movements,  but  not  of  originating  them,  so  that  a 
frog  in  which  they  are  uninjured,  but  from  which  the  cerebral 
lobes  have  been  removed,  will  remain  perfectly  quiet,  except  on 
the  application  of  an "  external  stimulus,  when  it  will  leap  like  a 
normal  frog. 

As  the  optic  lobes  have  the  power  of  directing  and  co-ordinat- 
ing movements,  when  they  are  destroyed  the  animal  will  jump, 
but  will  be  unable  to  direct  its  movements. 

The  cerebellum  has  also  the  power  of  co-ordination,  so  that 
when  it  is  removed  the  animal  cannot  jump  at  all,  although  one 
leg  may  answer  by  a  kick  or  other  motion  to  the  application  of  a 
stimulus.  But  even  when  all  those  parts  have  been  removed, 
the  frog  will  still  recover  its  ordinary  position  after  it  has  been 
laid  upon  its  back. 

The  co-ordination  requisite  for  this  power  of  retaining  or 
recovering  its  ordinary  position  appears  to  be  situated  in  the 
medulla  oblongata,  for  when  this  is  removed  the  frog  will  lie 
upon  its  back,  and  will  not  attempt  to  recover  its  ordinary 
position. 

The  legs  will  still  respond  by  movements  to  irritation  applied 
to  the  foot,  but  when  the  spinal  cord  is  now  destroyed  these 
reflex  movements  also  cease. 

In  frogs  poisoned  by  opium,  the  movements  are  gradually 


184  PHARMACOLOGY   AND   THEEAPEUTICS.       [sect.  i. 

abolished  in  the  order  just  mentioned,  and  we  therefore  conclude 
that  opium  affects  the  nerve-centres  in  the  order  of  their  deve- 
lopment, the  highest  being  paralysed  first,  and  the  lowest  last 
(p.  172).  This  order  is  usually  not  quite  the  same  in  higher 
animals,  inasmuch  as  the  last  centre  to  be  paralysed  by  opium 
or  other  anaesthetics  is  usually  the  medulla  oblongata,  and  more 
especially  that  part  of  it  which  keeps  up  the  respiratory  move- 
ments. As  we  shall  afterwards  see,  however,  the  respiratory 
centre  is  really  a  lower  or  more  fundamental  centre  than  either 
the  brain  or  spinal  cord. 

Functions  of  the  Brain  in  Mammals. 

In  higher  animals,  such  as  rabbits  and  guinea-pigs,  the  cere- 
bral hemispheres  are  comparatively  much  more  developed  than 
in  the  frog,  and  their  removal  interferes  very  much  with  the 
animal's  motions.  At  first  it  is  utterly  prostrate,  but  after  some 
time  its  power  of  movement  returns  to  some  extent,  though  it 


Effects  of  removing  the  part  of 
brain  included  in  brackets. 


Voluntary  motion  lost  . 


Cannot  direct  movements 


Cannot  jump   

Cannot  recover  position  when  laid 
on  its  back 


Olfactory  nerves. 
Olfactory  lobes. 


Cerebral  lobes. 
Pineal  gland. 
Optic  thalamus. 
Optic  lobes. 
Cerebellum. 

Rhomboid  sinus. 
Medulla  oblongata. 


Fig.  67. — Diagram  of  the  higher  nerve-centres  of  the  frog. 

remains  much  less  than  in  the  normal  animal.  As  we  should 
expect,  the  weakness  is  most  marked  in  those  parts  of  the  body 
that  are  most  under  the  control  of  the  cerebrum,  and  least  in 
those  whose  movements  are  regulated  by  the  lower  centres. 
Thus  in  rabbits  the  fore-paws  are  capable  of  being  used  for  com- 
plex motions  at  the  will  of  the  animal,  such  as  washing  the  face, 
holding  food,  and  so  on,  and  in  them  the  weakness  caused  by 
removal  of  the  cerebrum  is  much  more  marked  than  in  the  hind 
limbs,  which  are  simply  used  for  progression.  After  the  opera- 
tion the  animal  can  still  stand,  although  it  is  unsteady,  and  the 
fore-legs  tend  to  sprawl  out.  When  pinched  it  bounds  forward, 
but,  unlike  the  frog,  it  is  unable  to  avoid  any  obstacle  in  its  path. 


chap,  viii.]    ACTION  OF  DEUGS  ON  THE  BEAIN. 


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m         -PHARMACOLOGY  AND  THERAPEUTICS,      [sect.  r. 

If  it  be  pinched  at  all  severely,  it  not  only  moves,  but  will  cry 
loudly  and  plaintively,  and  this  condition  is  frequently  noticed  m 
rabbits  under  chloroform,  although  they  have  received  no  injury 
whatever.  The  pupils  contract  on  the  stimulus  of  light,  and  the 
eyes  wink  if  the  finger  is  brought  near  them.  Bitter  substances 
cause  movements  of  the  tongue  and  mouth,  and  ammonia  applied 
to  the  nostrils  may  cause  the  head  to  be  drawn  back,  or  the  animal 
to  rub  its  nostrils  with  its  toes.1 

Where  the  cerebral  hemispheres  are  still  more  developed,  as 
in  cats,  dogs,  and  monkeys,  their  removal  causes  so  much  pro- 
stration, and  interferes  so  greatly  with  motor  power  as  almost 
entirely  to  destroy  equilibrium  and  co-ordinated  progression. 

The  motor  and  sensory  centres  of  the  brain  have  been  more 
exactly  localised  in  monkeys  by  Ferrier,  Fritsch,  Hitzig,  and 
others,  and  the  results  of  their  experiments,  especially  those  of 
Ferrier,  agree  so  well  with  those  of  pathological  observation  in 
men  that  we  may  assume  that  there  is  a  general  agreement 
between  the  position  of  the  centres  in  man  and  monkey. 

The  motor  centres  are  arranged  along  the  two  sides  of  the 
fissure  of  Rolando,  the  order  of  their  arrangement  being  exactly 
what  is  required  for  the  purpose  of  (1)  seeing  food ;  (2)  conveying 
it  to  the  mouth ;  (3)  masticating  it ;  (4)  throwing  away  the 
refuse ;  and  (5)  advancing  to  get  more 2  (vide  Fig.  68,  brain  of 
monkey). 

The  sensory  centres  he  in  the  posterior  and  lower  parts  of 
the  brain.  The  centre  for  sight  is  situated  in  the  angular  gyrus 
and  is  marked  14  and  15  in  the  diagram;  that  for  hearing  is 
situated  in  the  superior  temporo-sphenoidal  and  is  marked  16  in 
the  diagram ;  those  for  smell  and  taste  lie  at  the  tip  of  the 
temporo-sphenoidal  lobe,  and  the  centre  for  general  sensation 
appears  to  be  towards  the  interior  of  the  brain,  in  the  hippo- 
campal  region. 

When  the  motor  centres  in  the  monkey  are  slightly  irritated 
by  a  faradaic  current,  a  single  co-ordinated  movement  is  produced, 
but  if  the  irritation  be  continued  longer,  and  especially  if  a 
strong  current  be  used,  epileptiform  convulsions  may  occur,  suc- 
ceeded by  choreic  movements  after  the  current  has  ceased. 
Epileptic  convulsions  are  easily  produced  by  irritation  of  the 
cerebral  cortex  in  the  cat  and  dog  as  well  as  the  monkey.  It  is 
difficult  to  produce  them  by  cortical  irritation  in  the  guinea-pig 
or  rabbit,  and  impossible  in  birds,  frogs,  and  fishes.3 

1  Ferrier,  Functions  of  the  Brain,  p.  38. 

*  Lauder  Brunton  '  On  the  Position  of  the  Motor  Centres  in  the  Brain  in  regard 
to  the  Nutritive  and  Social  Functions,'  Brain,  vol.  iv.  p.  1. 

*  Francois -Franok  and  Pitres,  Arch,  de  Physiol.,  July  1883,  p.  39. 


chap,  vm.]    ACTION  OF  DRUGS  ON  THE   BKAIN^  187 

Depressant  Action  of  Drugs  on  the  Motor  Centres. 

The  excitability  of  the  brain  may  be  altered  either  by 
conditions  which  modify  the  nerve-cells  or  the  circulation.  A 
deficient  circulation  greatly  depresses  the  excitability,  and  it  is 
very  low  when  much  haemorrhage  has  occurred. 

One  method  of  investigating  the  action  of  drugs  on  the  excita- 
bility of  the  brain  consists  in  trephining  so  as  to  expose  the 
cortical  substance  and  then  stimulating  it  by  a  faradaic  current 
before  and  after  the  administration  of  a  drug  either  by  inhalation 
or  injection.  Another  method  has  been  employed  by  Albertoni, 
who  first  trephines  on  one  side,  and  having  estimated  the 
strength  of  current  sufficient  to  produce  an  epileptic  convulsion 
when  applied  to  a  motor  centre,  he  allows  the  wound  to  heal, 
and  then  gives  for  a  length  of  time  the  drug  on  which  he  wishes 
to  experiment.  He  then  exposes  the  corresponding  motor  area 
on  the  other  side  and  observes  whether  the  strength  of  current 
required  to  produce  an  epileptic  convulsion  is  greater  or  less 
than  before. 

The  excitability  of  the  motor  centres  is  greatly  lowered  by 
anaesthetics,  so  that  as  anaesthesia  becomes  deeper,  irritation  of 
the  motor  centres  has  less  and  less  effect,  and  when  anaesthesia  is 
very  profound,  such  irritation  has  no  action  whatever.1  The 
motor  centres,  however,  are  less  affected  than  the  sensory  ones 
by  anaesthetics,  so  that  they  will  still  react  to  faradaic  irritation 
when  the  sensation  of  pain  has  been  completely  abolished. 

Alcohol  also  diminishes  the  excitability  of  the  motor  centres, 
so  that  the  epileptic  convulsions  which  usually  follow  the  appli- 
cation of  strong  currents  to  the  cortex  are  less  readily  produced 
after  its  administration,  as  well  as  after  ether  and  chloroform.2 
Chloral  for  a  time  diminishes  the  excitability  of  the  brain, 
lengthening  the  latent  period,  so  that  stronger  currents  or  more 
numerous  stimuli  must  be  used  to  produce  a  result :  it  will  tem- 
porarily abolish  the  excitability.  Cold  (not  freezing)  greatly 
lowers  or  destroys  excitability,  and  this  may  be  followed  'by  a 
period  of  increased  excitability  with  a  shorter  latent  period.3 

Bromide  of  potassium,  according  to  Albertoni,  when  given  for 
several  weeks  together,  greatly  diminishes  the  excitability  of  the 
motor  centres,  so  that  when  dogs  are  thoroughly  under  its  in- 
fluence it  is  almost  impossible  to  produce  epileptic  convulsions  by 

1  This  was  observed  in  the  case  of  ether  by  Hitzig,  Vntersuchungen  ilber  das 
GeMrn,  Berlin,  1874.  I  have  had  several  opportunities  of  observing  the  same 
thing  in  regard  to  chloroform  when  assisting  my  friend  Dr.  Ferrier  in  experiments 
on  the  brain. 

2  Francois-Francis  and  Pitres,  op.  cit. 

'  De  Varigny,  Becherches  expirimentaUs  sv/r  I'excitabiUti  ilectrique  des  eircon- 
volutiom  ceribrales  et  sur  lapiriode  d 'excitation  latente  du  cerveau.  Paris,  1884, 
p.  138. 


188     PHARMACOLOGY  AND  THERAPEUTICS.   [sect.i. 

irritation  of  the  cortical  substance.  Atropine  in  small  doses 
increases  the  excitability  of  the  brain  in  monkeys,  but  in  large 
doses  paralyses  it.  It  greatly  increases  the  tendency  to  epileptic 
convulsions  in  dogs,  so  that  they  can  be  produced  by  very  much 
slighter  stimuli  than  usual,  and  strychnine,  absinthe,  and  canna- 
bin  have  a  similar  action  in  this  respect.1  Physostigmine  appears 
to  increase  the  excitability  of  motor  centres  in  the  brain ;  for 
when  guinea-pigs  have  been  rendered  epileptic  by  section  of  a 
sciatic  nerve,  the  administration  of  physostigmine  greatly  in- 
creases the  number  of  fits. 

Irritant  Action  of  Drugs  on  Motor  Centres  in  the 

Brain. 

.Certain  drugs  when  administered  to  animals  or  taken  by 
man  produce  convulsions.  The  muscular  actions  which  occur 
in  these  convulsive  movements  may  be  induced  by  (a)  irritation 
of  the  motor  centres  in  the  spinal  cord,  (b)  the  motor  centres  in 
the  medulla  oblongata  and  pons  Varolii,  or  (c)  cerebral  cortex. 
These  centres  may  be  irritated  directly  by  the  action  of  the  drug 
upon  them,  or  they,  may  be  stimulated  indirectly  by  the  drug 
causing  the  blood  in  them  to  become  venous  through  its  action 
on  the  respiratory  or  circulatory  organs.  Convulsions  of  this 
sort,  although  caused  by  the  administration  of  a  poison,  are 
really  asphyxial,  and  are  similar  in  character  to  those  produced 
by  suffocation. 

Convulsions  are  usually  ascertained  to  be  of  spinal  origin  by 
dividing  the  cord  either  at  the  occiput  or  lower  down  in  its  course 
and  finding  that  they  still  persist  in  those  parts  of  the  body  which 
derive  their  innervation  from  the  spinal  cord  below  the  point  of 
section.  If  they  cease  in  parts  of  the  body  innervated  by  the 
spinal  cord  alone,  but  continue  in  the  parts  which  retain  their 
nervous  connection  with  the  brain,  they  are  regarded  as  of  cerebral 
origin  (v.  p.  179). 

It  has  already  been  mentioned  that  irritation  of  the  motor  areas 
in  the  cortex  of  the  brain  will  produce  epileptic  convulsions,  but 
it  is  probable  that  such  cortical  irritation  acts  through  lower  gan- 
glionic centres  and  especially  through  the  medulla  oblongata  and 
pons  Varolii.  Epileptic  convulsions  can  be  still  more  readily  pro- 
duced by  irritation  of  this  part  of  the  brain  than  by  irritation  of 
the  cerebral  cortex,  and  may  be  induced  by  a  slight  lesion  of  the 
pons  and  medulla  by  a  needle.  It  is  to  irritation  of  this  part  of 
the  brain  by  venous  blood  that  asphyxial  convulsions  are  due,  for 
they  can  still  be  induced  by  suffocation  or  by  ligature  or  compres- 
sion of  all  the  arteries  leading  to  the  brain  after  all  the  parts  of  the 
brain  above  the  pons  have  been  removed,  and  they  cease  when  the 
spinal  cord  is  divided  just  below  the  medulla,  or  the  medulla  itself 

1  Franijois-Franck  and  Pitres,  op.  cik 


ghap.viii.J    ACTION  OF  DEUGS  ON  THE  BEAIN.  189 

divided  at  its  lower  end.  It  is  evident  that,  if  the  spinal  cord  be 
paralysed,  the  convulsions  will  not  occur  though  the  medulla  and 
pons  be  irritated ;  and  it  has  been  found  that,  if  its  blood-supply 
is  stopped  at  the  same  time  as  the  circulation  in  the  pons  by 
ligaturing  the  aorta  in  place  of  the  cerebral  vessels  alone,  convul- 
sions do  not  occur.  Probably  the  absence  of  convulsions  in  slow 
asphyxia  is  due,  at  least  in  some  degree,  to  gradual  paralysis 
of  the  cord  by  the  long-continued  circulation  of  venous  blood 
through  it. 

The  centre  for  convulsions  in  the  frog  appears  to  be  in  the 
medulla  oblongata. 

Asphyxial  convulsions  are  usually  of  an  opisthotonic  charac- 
ter, because,  all  the  muscles  being  stimulated  at  once  by  the  action 
of  the  venous  blood  on  the  motor  centres,  the  stronger  overpower 
the  weaker,  and  the  extensor  muscles  of  the  back  being  more 
powerful  than  the  flexors  bend  the-  spine  backwards.  Asphyxial 
convulsions  only  occur  in  warm-blooded  animals  and  not  in  frogs, 
where  the  respiratory  processes  are  slow,  and  entire  stoppage  of  the 
respiration  for  a  length  of  time  does  not  render  the  blood  suffi- 
ciently venous  to  act  as  a  powerful  irritant.  If  any  drug  therefore 
produces  convulsions  in  the  higher  animals  and  not  in  frogs,  the 
probability  is  that  its  convulsive  action  is  indirect  and  the  convul- 
sions it  produces  are  asphyxial. ..  If,  on-  the  other  hand,.it  produces 
convulsions  in  frogs  as  well  as  higher  animals,  its  convulsive  action 
is  in  all  probability  due  to  the  direct  effect  of  the  drug  upon  the 
nerve-centres.  In  order  to  ascertain  this  definitely,  however,  the 
usual  plan  is  to  see  (1)  whether  the  convulsions  which  occur  after 
the  drug  has  been  injected  disappear  when  artificial  respiration 
is  commenced,  and  (2)  whether  these  convulsions  are  prevented 
by  artificial  respiration  begun  before  the  injection  of  the  drug  and 
kept  up  during  its  action.  But  even  this  does  not  entirely  show 
whether  the  convulsive  action  of  a  drug  is  direct  or  indirect,  for 
artificial  respiration  will  not  prevent  asphyxial  convulsions .  if 
these  should  depend  upon  the  action  of  the  drug  in  stopping  the 
heart  and  thus  arresting  the  circulation.  If  it  is  found  that  the 
convulsions  occur  very  shortly  after  the  heart  stops,  the  usual 
plan  is  -  to  paralyse  the  vagus  in  the  heart  by  atropine,  and 
ascertain  whether  the  convulsive  action  then  occurs.  If  the  drug 
still  produces  convulsions  when  respiration  is  kept  up  and  the 
heart  is  not  stopped,  it  is  almost  certain  that  its  action  is  direct 
upon  the  nerve-centres. 

Experiments  to  ascertain  whether  convulsions  are  asphyxial 
or  not  may  be  conveniently  made  upon  fowls,  for  the  venous  or 
arterial  condition  of  the  blood  is  readily  ascertained  by  the  colour 
of  the  comb. '  Thus,  in  fowls  killed  by  cobra  poison,  the  convul- 
sions come  oh  at  the  moment  the  comb  becomes  livid,  and  when 
artificial  respiration  is  begun  the  convulsions  disappear  as  the 
comb  again  regains  its  normal  colour.     It  is  evident  that  the 


190  PHARMACOLOGY  AND   THERAPEUTICS.      [sect,  i, 

eolour  of  the  comb  will  indicate'  the  condition  of  the  blood  supply- 
ing the  brain,  even  though  a  venous  condition  of  it  should  be  due 
to  stoppage  of  the  heart  and  not  to  failure  of  the  circulation. 

Camphor  has  a  curious  exciting  action  both  upon  the  brain 
and  upon  the  medulla.  It  produces  first  rapid  succession  of  ideas, 
great  desire  to  move,  hallucinations  which  are  generally  agreeable, 
and  a  wish  to  dance  and  laugh.  In  animals  it  has  a  similar 
action,  causing  wild  excitement  and  constant  motion,  succeeded 
by  clonic  epileptiform  convulsions,  during  which  death  often  occurs. 
Usually,  if  they  survive  the  convulsions,  they  recover ;  but  in  man 
the  convulsive  stage  may  be  succeeded  by  paralysis,  coma,  and 
death,  the  parts  of  the  nervous  system  which  are  first  excited 
being  apparently  finally  paralysed.  The  action  upon  frogs  is 
different  from  that  on  warm-blooded  animals,  for  in  them  it  proT 
daces  such  rapid  paralysis  both  of  the  spinal  and  motor  nerves 
that  convulsions  do  not  occur. 

Among  other  drugs  having  a  powerful  convulsant  action  due 
to  irritation  either  of  the  eortical  centres  or  of  the  medulla  and 
pons  are  picrotoxin  (the  active  principle  of  Anamirta  cocculus  or 
Cocculus  indicus),  cicutoxine  (the  active  principle  of  Cicutavirosa), 
and  the  active  principle  of  the  nearly-allied  (Enanthe  crocata, 
coriamyrtin  (from  Coriaria  myrtifolia) ,  digitaliresin  and  toxiresin, 
which  are  products  of  the  decomposition  of  the  active  principles 
of  digitalis. 

The  method  of  localising  the  parts  of  the  brain  upon  which 
certain  drugs  exert  a  convulsant  action,  consists  in  extirpating 
some  of  the  motor  centres  and  then  giving  these  drugs,  such  as 
picrotoxin,  cinchonidine,  and  quinine,1  which  produce  epileptic 
convulsions.2  The  results  of  these  experiments  are  that  the 
epileptic  convulsions  produced  by  these  poisons  appear  to  have  a 
twofold  origin,  (a)  in  the  brain,  and  (b)  in  the  medulla,  the  centre 
in  the  brain  being  the  most  sensitive  to  the  action  of  the  poison. 
In  consequence  of  this,  when  the  poison  is  given  after  the  destruc- 
tion of  the  motor  centres  on  one  side  in  such  quantities  as  not 
to  cause  general  convulsions,  the  weakness  of  the  opposite  side, 
due  to  the  lesions,  becomes  still  more  evident,  probably  from 
the  motor  excitability  of  the  sound  side  being  increased.  When 
convulsions  are  produced  they  are  unsymmetrical.  Those  of  the 
sound  side  are  much  stronger,  are  generally  clonic,  and  appa- 
rently arise  from  irritation  of  the  cerebral  centres.  Those  of  the 
paralysed  side  are  much  weaker,  are  more  tonic,  and  apparently 
arise  from  irritation  of  the  medulla. 


'I  have  seen  a  case  in  which  an  epileptic  convulsion  appeared  to  be  caused  by 
medicinal  doses  of  quinine. 

«  Rovighi  e  Santini,  Publicazioni  del  R.  Inslit.  di  stud,  superiori  in  Firenze 
Sezwne  di  scienze  fisiche  natur.    1882,  s.  1. 


CHAP.vrii.]    ACTION  OF  DEUGS  ON  THE  BRAIN.  191 


ACTION  OF  DRUGS  ON  THE  SENSORY  AND  PSYCHICAL 
CENTRES  IN  THE  BRAIN. 

'The  effect  of  drugs  upon  the  higher  mental  functions  can  only 
be  ascertained  satisfactorily  in  man.  These  functions  vary  in 
complexity  from  simple  choice  to  the  highest  efforts  of  genius. 

The  effect  of  drugs  upon  the  time  required  for  mental  pro- 
cesses is  observed  by  ascertaining,  first,  the  time  required  for 
the  performance  before  and  after  the  administration  of  a  drug, 
and  comparing  these  two  times  with  one  another. 

The  processes  generally  investigated  are,  (a)  the  time  required 
for  simple  reaction ;  (b)  for  discrimination ;  (c)  for  decision.  The 
simple  reaction  is  ascertained  by  marking  on  a  chronograph  the 
time  when  a  signal  is  made,  such  as,  for  example,  the  exhibition 
of  a  coloured  flag.  As  soon  as  this  is  seen  by  the  individual 
experimented  upon  he  marks  the  time  upon  the  same  chronograph 
by  placing  a  finger  upon  a  key  which  is  connected  with  the 
registering  electro-magnet.  The  difference  of  time  between  the 
exhibition  of  the  flag  and  the  time  registered  by  the  electro-magnet 
is  equal  to  the  time  required  for  the  transmission  of  the  sensory 
impulse  to  the  brain,  for  its  transmission  from  the  sensory  to  the 
motor  tracts  of  the  brain,  for  its  passage  down  the  motor  nerves, 
and  the  latent  period  of  the  muscles. 

The  time  required  for  selection  is  ascertained  in  the  same 
way,  but  either  a  red  or  blue  flag  may  be  shown,  and  the  person 
experimented  upon  has  to  discriminate  between  them,  and  only 
to  press  when  the  one  previously  agreed  upon  is  shown.  The 
difference  between  the  time  of  this  experiment  and  the  former 
gives  the  time  required  for  discrimination. 

The  time  required  for  decision  is  ascertained  in  the  same  way 
as  the  previous  one,  excepting  that  a  different  signal  is  to  be  made 
on  the  appearance  of  the  red  and  of  the  blue. 

Simple  reaction  has  been  found  by  Kraepelin '  to  be  little 
affected  by  nitrite  of  amyl :  sometimes  it  is  a  little  quicker  and 
sometimes  a  little  slower  than  normal.  It  is  rendered  slower  by 
aether  and  much  slower  by  chloroform,  although  exceptionally  it 
may  be  quickened  by  chloroform,  probably  when  used  in  small 
doses. 

The  time  required  for  discrimination  is  not  definitely  affected 
by  nitrite  of  amyl,  being  sometimes  increased  and  sometimes 
diminished.  It  is  generally  increased,  though  it  may  be  dimi- 
nished, by  small  doses  of  ether  and  also  by  chloroform. 

The  time  for  decision  is  sometimes  increased  and  sometimes 
diminished  by  nitrite  of  amyl.     It  is  increased  by  ether  and  also 

1  Kraepelin,  Ueber  die  Einwirkung  einiger  medicamentosen  Staff e  auf  die  Dauer 
hinfacher  psychischer  Vprgange,  1882.  Abstract  in  Rivista  Spepmentale  di 
iPrerriatria,  anno  ix.  1888,  p.  124. 


192  PHARMACOLOGY  AND   THERAPEUTICS.       [sect.  i. 

by  chloroform  ;  and  if  the  quantity  given  be  great,  the  increase 
may  be  very  large. 

■  The  influence  of  alcohol  upon  psychical  processes  is  curious  ; 
for  while  it  renders  them  much  slower,  the  individual  under  its 
influence  believes  them  to  be  much  quicker  than  usual. 

Drugs  which  increase  the  Functional  Activity  of  the 

Brain. 

Nerve  Stimulants. 

These  are  remedies  which  increase  the  nervous  activity  of 
the  cerebro-spinal  system.  They  are  subdivided  into  those  which 
act  on  the  cerebrum,  or  cerebral  stimulants,  and  those  which 
affect  the  spinal  cord,  or  spinal  stimulants.  Spinal  stimulants 
have  been  already  discussed  (p.  181) . 

Cerebral  Stimulants. 

In  popular  language,  the  name  of  stimulant  is  generally 
applied  to  drugs  which  have  the  power  to  increase  the  activity  of 
the  brain.  From  their  producing  a  feeling  of  comfort  and  mirth 
they  are  also  called  exhilarants.  The  functional  activity  of  the 
brain,  like  that  of  other  organs,  depends  upon  the  tissue-change 
which  goes  on  in  the  cells  and  fibres  which  compose  it,  and  the 
amount  of  tissue-change  is  regulated  to  a  great  extent  by  the 
quantity  and  quality  of  the  blood  supplied  to  the  organ.  A  free 
supply  of  blood  to  the  brain  may  be  obtained  by  general  excite- 
ment of  the  circulation,  i.e.  more  powerful  and  rapid  action  of 
the  heart  and  contraction  of  the  vessels  in  other  parts  of  the 
body  driving  blood  into  the  brain,  or  by  local  dilatation  of  the 
cerebral  arteries  allowing  blood  more  ready  access  to  the  brain, 
or  by  a  combination  of  these  factors. 

Free  circulation  through  the  cerebral  arteries  may  be  in- 
duced to  some  extent  by  posture  :  thus,  some  men  can  think  best 
when  the  head  is  low,  and  almost  everyone  naturally  assumes 
the  sitting  posture  with  the  head  bowed  down  and  held  between 
the  hands  when  suffering  from  the  effects  of  mental  depression. 
This  posture  is  not,  as  is  often  supposed,  merely  consequent  on 
the  depressed  condition  of  the  nerve-centres,  it  is  voluntarily 
assumed  because  it  affords  an  actual  sense  of  relief.  In  eager 
conversation  also  the  body  generally  stoops  forward  and  the  head 
is  held  low  so  as  to  allow  of  a  free  supply  of  blood  to  the  brain.1 

This  effect  of  posture  on  the  human  brain  is  admirably  shown2 

1  Lauder  Brunton  on  the  Physiological  Action  of  Alcohol,  Practitioner,  1876. 
vol.  xvi.  p.  127. 

*  Francois-Franck  et  Brissaud,  Marty's  Travaux,  1877,  tome  iii.  p.  147. 


chap,  vm.]    ACTION   OP  DRUGS  ON  THE   BRAIN.  198 

by  a  tracing  taken  from  a  patient  with  an  aperture  in  the  skull 
by  b  rancois-Franck  and  Brissaud  (Fig.  69). 


FlG- 69-- Tracing  sh^ig  the  inorease(J  circulation  in  the  brain  caused  bv  inclining  the  head  and 
body  forwards  The  tracing  was  taken  by  Brissaud  and  Francois-Franck,  from  the  parietal  regton 
of  a  woman  who  had  lost  a  large  piece  of  bone  from  syphilis?  "•"<«" ""»  parietal  regum 

Local  dilatation  of  the  arteries  of  the  brain  appears  to  be  pro- 
duced in  animals  by  the  movements  of  mastication  (Fig.  70)  and 
probably  also  by  savoury  food  or  irritating  substances  in  the  mouth. 


AAA 

jOURINC   MASTICATION 


Fio.  70.    Tracing  to  show  the  increased  rapidity  of  circulation  in  the  carotid  of  a  horse  dnrlni. 
mastication..   (After  Marey.)  ^" 

It  is  probably  on  this  account  that  so  many  substances  are  chewed 
for  their  stimulant  action,  such  as  tobacco,  betel  nut,  cola  nut 
and  raisins.  The  effect  of  smoking  is  probably  to  a  great  extent 
due  also  to  its  action  on  the  cerebral  circulation  through  the 
stimulating  effect  of  the  smoke  on  the  nerves  of  the  mouth  and 
nares,  and  so  is  the  use  of  alcohol  in  sips  by  men,  such  as  jour- 


Fig.  71.— Pulsations  of  the  fontanelle  (F)  in  an  inlant  aix  weeks  old  while  sucking,  ti  shows  a 
simultaneous  tracing  of  the  thoracic  respiration.  The  breast  was  offered  to  the  child  at  the 
beginning  of  the  tracing.  At  the  time  indicated  by  the  third  respiratory  wave,  which  has  a 
flattened  top,  the  child  began  to  take  the  breast.  It  will  be  noticed  that  the  line  of  the  tracing 
F  rises,  indicating  increased  circulation  on  the  brain.    (After  Salathc.)a 

nalists,  who  are  engaged  in  writing.     It  is  probable  that  tea  and 
coffee  also  cause  local  dilatation  of  the  arteries  supplying  the 


1  Mareifs  Travaux  for  1877,  p.  147. 

•  SalathS,  Marey's  Travaux,  1876,  p.  354. 


1U  PHARMACOLOGY  AND  THERAPEUTICS,      {sect.  1. 

brain.     Suction  also  causes  an  increased  supply  of  blood  to  the 

brain  (Fig.  71). '  .  ,     ,  ,   •  « 

The  effect  of  local  dilatation  of  the  cerebral  vessels  is  very  greatly 
increased,  if  in  addition  to  it  the  general  circulation  is  increased 
and  the  blood-pressure  raised  by  contraction  of  the  arterioles  in 
the  body  generally,  or  by  more  vigorous  action  of  the  heart. 

General  excitement  of  the  circulation  is  induced  by  exercise 
short  of  fatigue,  and  a  brisk  walk  will  sometimes  remove  a  con- 
dition of  low  spirits.  Sometimes  the  supply  of  blood  to  the  bram 
is  but  slightly  increased  during  continuous  exercise,  as  a  large 
portion  of  the  blood  is  then  diverted  to  the  muscles,  but  after 
the  exertion  is  over  the  excitement  of  the  circulation  continues 
for  some  time,  and  then  the  supply  to  the  brain  is  increased.  In 
some  persons  a  cold  wind  acts  as  an  exhilarant,  causing  con- 
traction of  the  vessels,  with  consequent  increase  in  the  general 
blood-pressure  and  increased  circulation  in  the  brain.  In  persons 
who  are  debilitated  and  feeble,  on  the  contrary,  the  cold  may 
have  an  opposite  effect,  by  depressing  the  action  of  the  heart. 

Some  men  can  think  best  when  walking  about,  on  account  of 
the  excitement  in  the  circulation  which  the  exertion  produces ; 
but  many  such  people,  when  they  come  to  a  very  difficult  point, 
will  stand  still  or  sit  down,  so  as  to  allow  the  blood  to  flow  more 
to  the  head  and  less  to  the  muscles. 

Where  the  circulation  is  feeble,  so  that  the  heart  is  not  much 
stimulated  by  walking  about,  men  often  find  that  they  can  think 
better  when  lying  down,  or  sitting  with  their  head  in  their  hands 
(Fig.  69),  so  as  to  gain  the  advantage  of  the  greater  flow  of  blood 
to  the  head  in  these  positions. 

Stimulation  of  the  mucous  membrane  of  the  nose  by  smelling 
the  vapour  of  strong  ammonia,  carbonate  of  ammonium,  or  acetic 
acid,  raises  the  blood-pressure  generally  throughout  the  body  by 
reflexly  stimulating  the  vaso-motor  centre,  and  thus  increases 
the  circulation  of  blood  in  the  brain.  Smelling  salts  or  aromatic 
vinegar  are  therefore  frequently  employed,  not  only  to  enable 
people  to  attend  more  readily  to  any  subject  in  which  they  are 
engaged,  and  to  prevent  them  from  falling  asleep,  but  also  to 
arouse  them  from  syncope. 

The  action  of  sipping  is  a  powerful  stimulant  to  the  circu- 
lation, for,  as  Kronecker  has  shown,  the  inhibitory  action  of  the 
vagus  on  the  heart  is  abolished  while  the  sipping  continues,  and 
the  pulse-rate  is  very  greatly  increased.  A  glass  of  cold  water 
slowly  sipped  will  produce  greater  acceleration  of  the  pulse  for  a 
time  than  a  glass  of  wine  or  spirits  taken  at  a  draught.  Sipping 
cold  water  has  been  recommended  to  allay  the  craving  for  alcohol 
in  drunkards  endeavouring  to  reform,  and  probably  its  use  is 
owing  to  this  stimulant  action  on  the  heart.  It  is  sometimes 
said  that  a  single  glass  of  ale  sucked  through  a  straw  will  intoxi- 

1  Salathi,  op.  cit. 


chap,  vni.]    ACTION   OF  DEUGS  ON  THE   BBAIN.  195 

cate  a  man,  although  three' times  the  quantity  would  not  do  so  if 
taken  in  large  draughts.  If  this  be  true,  the  more  rapid  intoxi- 
cation caused  by  sucking  is  probably  due  to  the  conjoined  effects 
of  the  alcohol  and  of  temporary  paralysis  of  the  vagus  caused  by 
the  suction,  possibly  aided  by  the  direct  effect  of  suction  on  the 
cerebral  circulation  (Fig.  71,  p.  193). 

One  of  the  most  typical  stimulants  is  alcohol.  In  small 
quantities  it  increases  the  arterial  tension  by  locally  stimulating, 
first  the  sensory  nerves  of  the. mouth,  and  afterwards  those  of 
the  stomach,  and  thus  causing  reflex  contraction  of  the  vessels 
and  reflex  acceleration  of  the  beats  of  the  heart.  This  effect 
occurs  before  its  absorption,  and  is  best  marked  when  the  alcohol 
is  strong,  and  is  but  slightly  marked  when  it  is  diluted.  It  is 
possible  that  by  inducing  local  dilatation  of  the  cerebral  arteries 
while  the  heart  still  continues  active,  it  may  have  a  stimulant 
■  action  on  the  cerebral  functions,  besides  that  which  it  induces  by 
merely  exciting  the  circulation  generally. 

Any  stimulant  action  on  the  brain  beyond  what  may  be 
explained  in  this  way  is  very  slight,  if  indeed  it  exist  at  all. 
Its  further  actions  are  those  of  paralysis  exerted  on  the  nerve- 
centres  in  the  order  of  their  development,  the  higher  centres 
being  paralysed  first  (see  p.  146) . 

At  or  about  this  point  the  stimulating  action  ceases  and  the 
narcotic  action  commences.  The  exhilarating  effect  of  alcohol, 
however,  may  be  most  marked  just  at  this  point,  because  just  here, 
while  the  circulation  in  the  brain'generally  remains  increased,  the 
restraining  or  inhibitory  parts  of  it  begin  to  be  paralysed.  Thus, 
imagination  and  emotion  are  more  readily  excited  and  expression 
is  free  and  unrestrained ;  external  circumstances  are  less  attended 
to,  and  a  boyish  or  childish  hilarity  occurs. 

It  is  probable  that  some  substances,  such  as  strychnine,  in- 
crease the  mental  powers  by  a  direct  action  on  the  brain-tissue 
itself,  and  possibly  caffeine  may  do  so  also. 

Drugs  which  lessen  the  Functional  Activity  of  the 

Brain. 

These  drugs  are  soporifics  or  hypnotics ;  narcotics ;  anodynes 
or  analgesics ;  and  ansesthetics. 

Most  of  the  substances  belonging  to  those  classes  have  a 
certain  resemblance  to  one  another  in  their  action.  Most  of  them 
stimulate  the  mental  functions  when  given  in  very  small  doses. 
In  larger  doses  they  have  also  a  stimulating  action  at  first,  i.e. 
while  a  small  quantity  only  has  been  absorbed,  but  later  on  they 
diminish  or  abolish  the  mental  faculties.  The  same  drug— as, 
for  example,  opium  or  alcohol— in  different  doses  may  thus  act  as 
a  stimulant,  narcotic,  soporific,  and  anesthetic. 

In  a  certain  stage  of  their  action  opium  and  alcohol  do  not 

»  2 


196  PHAKMACOLOGY  AND   THERAPEUTICS.       [sect.  I. 

merely  lessen  the  functional  activity  of  the  brain,  but  they 
disturb  the  normal  relations  of  one  part  to  another,  so  as  to 
produce  disorder  of  the  mental  functions.  Bromide  of  potassium, 
on  the  other  hand,  appears  simply  to  lessen  the  functional  activity 
of  the  brain  without  disturbing  the  relation  of  one  part  to  another. 
We  do  not  know  what  the  causes  of  this  difference  in  their  action 
are,  but  with  some  degree  of  probability  we  may  consider  that  such 
substances  as  bromide  of  potassium,  or  the  normal  products  of 
tissue-waste,  such  as  lactic  acid,  simply  diminish  the  functional 
activity  of  the  nerve-cells  without  disturbing  the  nervous  paths 
by  which  they  communicate  with  one  another,  so  that  we  have 
merely  a  general  and  even  diminution  of  the  mental  faculties,  as 
in  natural  sleep.  Such  substances  as  alcohol,  on  the  other  hand, 
may  be  supposed  not  only  to  diminish  the  functional  activity  of 
the  cells,  but  also  to  disturb  the  rate  at  which  the  impulses  pass 
from  one  cell  to  another,  or  to  alter  the  direction  in  which  these 
impulses  are  sent,  so  that  instead  of  the  mental  activity  being 
lessened  in  degree  but  natural  in  kind,  as  after  the  administration 
of  bromide  of  potassium,  we  have  a  disturbance  of  the  functions 
resembling  that  which  we  find  in  delirium  or  madness. 

Hypnotics  or  Soporifics. 

These  are  remedies  which  induce  sleep.  Although  many  of 
them  are  also  narcotic,  yet  we  may  distinguish  between  hypnotics 
and  narcotics.  Pure  hypnotics  are  substances  which  in  the  doses 
necessary  to  produce  sleep  do  not  disturb  the  normal  relationship 
of  the  mental  faculties  to  the  external  world. 

In  sleep  the  cerebro-spinal  system,  with  the  exception  of  the 
medulla  oblongata,  is  to  a  great  extent  functionally  inactive,  and 
even  the  respiratory  centre  and  the  vaso-motor  centre  in  the 
medulla,  undergo  a  diminution  in  their  functional  activity,  so 
that  the  respiration  becomes  slower,  the  vessels  of  the  surface 
dilate,  and  the  arterial  tension  falls. 

Certain  parts  of  the  nervous  system  may  still  remain  func- 
tionally active,  so  that,  for  example,  when  the  nose  is  tickled 
with  a  hair,  reflex  movements  of  the  face  or  hand  may  occur 
without  awakening  the  sleeper ;  and  certain  parts  of  the  brain 
may  also  be  active  so  that  dreams  occur,  which  may  be  afterwards 
remembered  as  distinctly  as  real  occurrences,  or  may  produce  at 
the  time  various  movements  of  the  body. 

But  while  individual  parts  may  be  active,  the  whole  cerebro- 
spinal system  is  not  active  together,  and  thus  any  co-ordina- 
tion which  may  occur  between  either  sensations  or  motions  is 
incomplete ;  the  dreams  are  incoherent,  and  the  motions  do  not 
affect  the  whole  body,  as  is  seen  in  sleeping  dogs,  where  the  legs 
make  a  movement  of  running,  but  the  animal  continues  to  lie  on 
its  side.     The  functional  inactivity  of  the  whole  or  of  the  greater 


chap,  viii.]    ACTION  OF  DEUGS  ON  THE   BEAIN.  197 

part  of  the  cerebro-spinal  system  is  associated  with  a  condition  of 
anaemia,  and  probably  depends  to  a  certain  extent  upon  it.  At 
the  same  time  it  is  probable  that  sleep  depends  also  on  functional 
inactivity  of  the  cerebral  cells  due  to  accumulation  of  the  products 
of  tissue- waste  in  or  around  them. 

,  The  arteries  of  the  brain  during  sleep  are  contracted,  the  brain 
is  anaemic,  and  its  bulk  is  small.  On  awakening,  the  arteries 
become  dilated,  the  circulation  becomes  rapid,  and  the  brain 
increases  in  bulk.  Where  parts  of  the  brain  are  active,  as  in 
dreaming,  increased  circulation  occurs,  but  probably  this  is  local 
and  not  general. 

In  considering  the  circulation  of  the  brain,  however,  a 
marked  distinction  must  be  drawn  between  the  condition  of  the 
arteries  and  veins.  So  long  as  the  blood  is  in  the  arteries  it  is 
available  for  the  nutrition  of  the  nervous  structures ;  but  once  it 
is  in  the  veins  it  is  no  longer  available,  and  its  accumulation 
there  will  tend  to  impair  nutrition,  both  by  the  pressure  it  exerts 
on  the  nervous  structures,  and  by  its  interference  with  the  supply 
of  arterial  blood. 

In  normal  sleep  the  arteries  and  veins  are  both  contracted, 
and  the  brain  appears  anaemic.  In  the  very  act  of  waking  the 
brain  may  slightly  contract,  and  this  has  been  thought  by  Mosso, 
to  whom  we  owe  the  observation,  to  show  that  sleep  does  not  depend 
upon  anaemia  of  the  brain  ;  but  this  contraction  may  be  due  to 
the  removal  of  venous  blood,  preparatory  to  further  arterial  supply. 

Observations  on  the  brain  by  trephining  appear  to  show  that 
during  ordinary  sleep,  whether  it  has  come  on  naturally,  or  has 
been  induced  by  narcotics,  such  as  a  small  dose  of  opium,  the 
brain  is  anaemic.  During  functional  activity,  either  of  the  whole 
or  of  its  parts,  there  is  arterial  dilatation,  with  a  free  supply  of 
blood.  During  coma  the  veins  become  dilated  and  the  brain  con- 
gested.1 This  congestion,  however,  is  utterly  different  from  the 
arterial  congestion  of  functional  activity,  for  in  coma  the  blood, 
though  abundant  in  quantity,  is  stagnating  in  the  veins,  and 
useless  for  the  tissues. 

In  order  to  produce  sleep,  then,  two  things  are  necessary  : — 

1st.  To  lessen  the  circulation  in  the  brain  as  much  as  possible 
by  diverting  blood  from  it  or  quieting  cardiac  action. 

2nd.  To  lessen  the  functional  activity. of  the  organ. 

Blood  may  be  diverted  from  the  brain  by  dilating  the  vessels 
elsewhere.  In  weak  conditions  of  the  body,  with  feeble  vascular 
tone,  this  may  occur  simply  from  position,  and  such  persons 
become  drowsy  when  standing  or  walking  about,  or  when  sitting. 
As  soon  as  they  lie  down,  however,  the  cerebral  vessels  having 
little  or  no  tone,  the  blood  floods  the  brain,  and  they  are  unable 
to  sleep.    In  such  persons,  sleep  may  be  sometimes  obtained  by 

•  Hammond,  On  Wakefulness,  1866,  p.  20. 


1U8  PHAEMACOLOQY  AND  THEEAPEUTICS.  ;     [seot.u 

raising  the  head  with  high  pillows.  In  such  cases,  also,  vascular 
tonics,  such  as  digitalis,  by  increasing  the  contractile  power  of 
the  arteries  leading  to  the  brain,  may  enable  them  to  resist  the 
increased  pressure  in  the  recumbent  position,  and  thus  prevent 
the  brain  being  flooded  with  blood  and  allow  sleep  to  be  obtained. 


3?ig.  72. — Tracings  from  the  brain  of  a  dog  after  trephining,  showing  the  innuence  of  position  on 
the  cerebral  circulation.  In  the  upper  tracing  the  vertical  line  shows  when  the  head  of  the 
dog  was  lowered,  and  in  the  lower  tracing  when  the  head  was  raised.    (Salathe./  - 

The  largest  vascular  area  into  which  the  blood  may  be  drawn 
away  from  the  brain  is  that  of  the  intestinal  canal.  When  the 
vessels  in  the  intestine  are  contracted,  it  is  almost  impossible  to' 
obtain  sleep.  Consequently  both  man  and  animals,  when  ex- 
posed to  cold,  which  acting  through  the  thin  abdominal  walk 
would  cause  contraction  of  the  intestinal  vessels  and  drive  the 
blood  to  the  brain,  instinctively  keep  the  intestines  warm  by 
curling  themselves  up  before  going  to  sleep,  and  thus  covering 
the  abdomen  with  the  thick  muscles  of  the  thighs. 

Warmth  to  the  abdomen  by  means  of  a  large  poultice  out-; 
side  will  also  tend  to  produce  sleep ;  or,  in  place  of  a  poultice,  a .' 
wet  compress,  consisting  of  linen  or  flannel  wrung  out  of  cold 
water,  and  covered  with  oil-silk,  and  with  two  thicknesses  of  dry 
flannel  placed  above  it,  tends  greatly  to  induce  sleep  and  is  most 
useful  for  this  purpose,  especially  in  children. 

Warmth  to  the  interior  of  the  stomach  has  a  somewhat 
similar  action,-  but  it  differs  from  warmth  to  the  exterior  in 
this,  that  it  may,  to  a  certain  extent,  stimulate  the  heart  as 
well  as  dilate  the  abdominal  vessels.  Stimulation  of  the  heart ' 
is  of  course  objectionable,  as  it  tends  to  maintain  the  activity 
of  the  brain. 

On  this  account  the  food  or  drink  should  be  tolerably  warm, 
but  not  very  hot.  Warm  milk,  either  alone,  or  with  bread 
soaked  in  it,  warm  gruel,  thin  corn-flour,  or  ground  rice,  sago, 
or  tapioca,  warm  beef-tea  or  soup,  or  a  glass  of  hot  wine  and 
water  or  spirits  and  water  at  bed-time,  may  all  act  as  soporifics 
by  withdrawing  the  blood  from  the  brain  to  the  stomach.  In  the 
sleeplessness  of  fever  a  wet  pack,  by  restraining  the  movements 
and  by  diverting  blood  from  the  brain  to  the  body  generally,  is 
often  an  efficient  soporific. 


Marey's  Travaux,  1876,  p.  397. 


chap,  vin.]    ACTION  OP  DEUGS  ON  THE  BEAIN.  199 

Cold  feet  also  tend  to  keep  up  the  tension  in  the  vessels 
and  prevent  sleep,  and  therefore  they  ought  to  be  warmed  either 
by  the  use  of  an  india-rubber  bag  filled  with  hot  water,  and 
covered  with  flannel,  or  by  rubbing  them  briskly  in  cold  water 
and  drying  them  thoroughly  before  going  to  bed,  or  by  both 
means  combined. 

Cardiac  excitement  may  be  lessened  by  sedatives,  one  of 
the  most  useful  of  which  is  cold.  After  hours  of  weary  tossing 
sleep  may  sometimes  be  induced  by  walking  about  in  a  night- 
dress until  cool,  or  by  sponging  the  surface  either  with  cold  or 
hot  water. 

The  chief  hypnotics  or  soporifics  are — 

Opium.  Hypnone. 

.  Morphine.  Bromide  of  potassium. 

Chloral-hydrate.  Bromide  of  sodium. 
Butyl-chloral-hydrate  (croton-     Bromide  of  calcium. 

chloral) .  Bromide  of  zinc. 

Hyoscyamus.  Monobromo-camphor. 

Cannabis.  Hop. 

Paraldehyde.  Lettuce. 

Urethane.  Lactic  acid. 

The  most  powerful  hypnotics  that  we  possess  are  undoubtedly 
opium  and  morphine,  and  they  seem  to  act  by  depressing  the 
functional  activity  of  the  brain  itself,  although  along  with  this 
depression  an  anaemic  condition  of  the  organ  sets  in.  Besides 
their  action  in  producing  sleep,  even  in  health  opium  and  mor- 
phine have  the  power  of  lessening  pain  and  thus  removing  the 
effect  which  painful  stimuli  have  in  maintaining  a  wakeful  con- 
dition.. Bromide  of  potassium  and  bromide  of  ammonium  in 
large  doses  have  also  a  hypnotic  action,  and  even  in  smaller 
doses,  when  they  would  not  of  themselves  produce  sleep,  they 
appear  to  lessen  cerebral  excitement,  and  allow  sleep  to  come  on 
when  other  conditions  are  favourable.  Chloral  probably  causes 
sleep  both  by  acting  on  the  brain  itself  and  by  causing  dilatation 
of  the  vessels  generally.  It  is  therefore  a  useful  hypnotic  in 
persons  suffering  from  Bright 's  disease,  in  which  there  is  high 
tension  of  the  vessels  and  consequently  a  tendency  to  sleeplessness. 

A  combination  of  hypnotics  sometimes  answers  much  better 
than  any  one  singly.  Thus  morphine  or  opium  alone  some- 
times simply  cause  excitement ;  but  when  chloral  is  given,  either 
along  with,  or  after  them,  the  excitement  is  quieted  and  sleep 
occurs. 

A  combination  also  of  small  quantities,  such  as  five  or  ten 
minims,  of  solution  of  opium  or  morphine  with  five  grains  of 
chloral  and  ten  to  thirty  of  bromide  of  potassium,  is  sometimes 
more  useful  than  any  one  of  the  three  used  alone. 

Indian  hemp  also  is  sometimes  used  to  procure  sleep,  and 


200  THAKMACOLOGY  AND   THEEAPEUTICS.       [sect.  I; 

lettuce  and  lactucarium  are  also  said  to  have  a  hypnotic  action. 
Lettuce  certainly  does  seem  to  have  such  an  action,  hut  how 
much  of  it  depends  upon  the  juice  and  how  much  upon  the 
mechanical  effect  of  the  indigestible  fibres  of  the  lettuce  upon 
the  stomach,  in  drawing  blood  to  it,  it  would  be  hard  to  say. 
Hops  are  said  to  be  hypnotic,  and  their  combination  with  lettuce 
in  the  form  of  a  supper  consisting  chiefly  of  beer  and  salad  has 
sometimes  a  very  marked  soporific  action. 

Narcotics. 

Narcotics  are  substances  which  lessen  our  relationships  with 
the  external  world.  They  are  closely  related,  as  I  have  already 
stated,  to  stimulants ;  and  alcohol  in  the  various  stages  of  its 
action  affords  us  a  good  example  of  both  stimulant  and  narcotic 
action.  Alcohol  at  first  excites  the  cerebral  circulation  and  then 
begins  to  paralyse  various  parts  of  the  brain  in  the  inverse  order 
of  their  development. 

But  this  order  differs  in  different  individuals ;  for  in  watching 
the  growth  of  children  we  find  that  the  order  of  development  of 
the  nerve-centres  in  them  is  not  always  the  same :  some  talking 
before  they  can  walk,  and  others  walking  before  they  can  talk. 
In  all,  however,  the  powers  of  judgment  and  self-restraint  are 
among  the  last  to  be  completely  developed. 

While  the  circulation  of  the  brain  is  still  active,  the  restrain- 
ing or  depressing  effect  of  present  external  circumstances,  and 
the  restraining  effect  of  training,  during  previous  life,  which  are 
stored  up  as  it  were  in  the  inhibitory  centres,  are  lessened.  The 
fancy  is  thus  allowed  free  play  and  a  condition  of  joyousness  and 
volubility  like  that  of  a  child  occurs.  The  imagination  and 
memory  fail  next  in  some,  while  the  emotions  become  prominent, 
and  to  this  follows  paralysis  or  paresis  of  the  power  of  co-ordina- 
tion. In  others  the  power  of  co-ordination  is  impaired  before 
the  mental  faculties  are  much  affected,  the  speech  becomes  thick 
and  the  walking  becomes  staggering  and  uncertain.  At  this 
stage  reflex  action  still  persists,  but  afterwards  it  is  diminished, 
then  abolished,  and  finally  paralysis  of  the  respiratory  centre 
occurs.  The  effect  of  other  drugs,  such  as  ether  and  chloroform, 
is  much  the  same  as  that  of  alcohol. 

In  the  case  of  opium  and  Indian  hemp,  however,  there  is  but 
little  excitement  of  the  circulation,  and  their  effects  appear  to  be 
due  more  to  alterations  in  the  relative  functions  of  the  different 
parts  of  the  brain. 

Belladonna,  hyoscyamus,  stramonium,  and  their  allies,  have 
a  curious  effect.  They  produce  delirium  of  an  active  character, 
the  patient  having  a  constant  desire  to  speak,  move  about,  or  be 
doing  something,  while  at  the  same  time  he  feels  great  languor. 
It  is  probable  that  this  effect  is  due  to  the  combined  stimulant 


chap,  viii.]     ACTION  OF  DKUGS  ON   THE   BKAIN. 


201 


action  of  these  drugs  on  the  nerve-centres  in  the  brain  and 
spinal  cord  and  their  paralysing  action  on  tjie  peripheral  ends  of, 
motor  nerves. 

Anodynes  or  Analgesics. 

Anodynes  are  remedies  which  relieve  pain  by  lessening  the 
excitability  of  nerves  or  of  nerve-centres.  They  are  divided  into 
local  or  general : — 

Local  Anodynes.  General  Anodynes. 


Anaesthetics  in  small  doses. 

Atropine. 

Belladonna. 

Butyl-chloral. 

Chloral. 

Conium. 

Coniine. 

Gelsemium. 

Hyoscyamus. 

Hyoscyamine. 

Lupulus. 

Lupulin. 

Morphine. 

Opium. 

Stramonium. 


Cold- 
Cold  water. 
Ice-bags. 

Warmth — 
Poultices. 
Fomentations. 

Aconite. 

Acupuncture. 

Atropine. 

Belladonna. 

Blood-letting — 
Leeches. 
Cupping. 

Carbolic  acid. 

Carbonic  acid. 

Cocaine. 

Conium. 

Creasote. 

Gelsemium. 

Hydrocyanic  acid. 

Morphine. 

Opium. 

Veratrine. 

Action. — The  sensation  of  pain  is  due  to  a  change  in  some 
part  of  the  cerebrum,  and  is  usually  excited  by  injury  to  some 
part  of  the  body. 

According  to  Ferrier  the  hippocampal  region  is  the  seat  of 
sensation.  Pain  may  be  of  central  origin ;  for  if  these  convo- 
lutions should  from  any  cause  undergo  changes  similar  to  what 
.usually  take  place  in  them  on  the  application  of  a  painful 
stimulus  to  a  nerve,  pain  will  be  felt,  even  although  no  injury 
whatever  has  been  done  to  the  body.  Something  of  this  sort 
appears  to  occur  in  certain  cases  of  hysteria. 

Conversely,  if  the  changes  which  ordinarily  occur  in  these 
.convolutions  on  severe  irritation  of  a  sensory  nerve  are  prevented 
from  taking  place,  pain  will  not  be  felt,  however  great  the 
stimulus  to  the  nerve  may  be. 

The  sensory  nerves  of  the  head  pass  directly  to  the  brain,  but 


202  PHAEMACOLOGY  AND  THERAPEUTICS.      [sect.  x. 

all  other  sensory  nerves  have  to  pass  fora  greater  or  less  distance 
along  the  spinal  cord  before  they  reach  the  brain. 

The  transmission  of  painful  impressions  along  the  spinal  cord 
occurs  in  the  grey  matter,  and  the  effect  of .  anaesthetics  in  pre- 
venting the  transmission  of  painful  impressions  while  tactile 
stimuli  are  still' conducted  has  been  already  discussed, 
i  •  Pain  may  be  occasioned  by  irritation  applied  to  nerves  any* 
where  between  the  brain  and  the  periphery ;  and  whatever  its 
point  of  application  may  be,  it  is  usually  referred  to  the 
peripheral  distribution  of  the  nerve.  Sometimes  irritation 
of  a  nerve,  instead  of  being  referred  by  the  brain  to  the  proper 
spot,  is  referred  to  a  branch  of  the  same  nerve  going  to  a 
different  point. 

Pain  may  be  caused  by  violent  stimulation  of  the  peripheral 
distribution  of  a  nerve,  of  its  trunk,  of  the  spinal  cord  through 
which  the  fibres  pass  to  the  brain,  or  of  the  encephalic  centres 
themselves. 

Pain  may  be  relieved  by  (a)  removing  the  source  of  irritation, 
(b)  by  preventing  the  irritation  from  affecting  the  cerebrum. 
Thus,  if  necrosis  of  the  jaw  should  give  rise  to  intense  pain,  the 
pain  will  at  once  cease  on  dividing  the  sensory  nerve  by  which 
the  impulses  are  transmitted  to  the  brain.  It  may  be  relieved, 
also,  while  the  source  of  irritation  still  remains,  by  lessening  the 
excitability  of  the  peripheral  terminations  of  the  sensory  nerves 
which  receive  the  painful  impression ;  or  of  the  nerve-trunks ;  or 
of  the  spinal  cord  along  which  the  impression  travels ;  or  of  the 
cerebral  centres  in  which  it  is  perceived. 

Opium  probably  acts  on  them  all,  diminishing  the  excitability 
of  the  cerebral  centre,  of  the  spinal  cord,  and  of  the  sensory 
nerves ;  and  bromide  of  potassium  is  also  supposed  to  affect  all 
these  structures,  though  to  a  much  less  degree  than  opium. 

Chloral,  butyl-chloral,  lupulin,  gelsemium,  and  cannabis 
indica  probably  act  on  the  cerebral  centres. 

Belladonna  and  atropine  lessen  the  excitability  of  the  sensory 
nerves,  and  probably  this  is  effected  also  by  hyoscyamus,  stra- 
monium, aconite,  aconitine,  and  veratrine. 

Uses.— It  is  evident  that  if  the  nerve-centre  by  which  pain  is 
perceived  is  deadened,  the  pain  will  cease  wherever  its  seat  may 
be ;  and  therefore  opium  and  morphine  are  used  to  relieve  pain 
Whatever  may  be  its  cause.  Cannabis  indica  and  bromide  of 
potassium,  having  likewise  a  central  action,  may  also  be  em- 
ployed, but  they  are  very  much  less  efficient  than  opium. 
Chloral  and  butyl-chloral  have  an  anaesthetic  action  when  given 
in  very  large  doses,  but  in  moderate  doses  their  power  to  relieve 
pain  is  not  so  marked  as  their  hypnotic  action.  Butyl-chloral, 
however,  seems  to  have  a  special  sedative  action  on  the  fifth 
nerve,  and  so  has  gelsemium :  consequently  both  of  them  are 
used  in  the  treatment  of  facial  neuralgia. 


chap,  viii.]    ACTION  OF  DRUGS  ON  THE   BRAIN.  203 

As  cocaine,  belladonna,  aconite,  and  veratrine  have  a  local 
action  on  the  peripheral  ends  of  the  sensory  nerves,  they  are 
usually  applied  directly  to  the  painful  part  in  the  form  of  lotion, 
ointment,  liniment,  or  plaster.  Local  injections  of  cocaine,  mor- 
phine, atropine,  or;  ether,  in  the  neighbourhood  of  the  painful 
part,  are  often  of  the  greatest  service. 

Adjuncts  to  Anodynes.— As  pain  depends  on  the  condition 
of  the  cerebral  centre  by  which  it  is  perceived,  as  well  as  on 
irritation  of  sensory  nerves,  it  is  obvious  that  it  may  vary  with 
the  condition  of  these  centres,  although  the  irritation  remains. 
Thus  a  decayed  tooth  does  not  always  cause  toothache,  and  when 
the  toothache  comes  on,  it  may  frequently  be  removed  by  means 
of  a  brisk  purgative,  even  although  the  tooth  be  not  extracted. 
It  is  possible  that  the  purgative  may  act  partly  by  lessening  con- 
gestion around  the  tooth,  but  partly.also  by  altering  the  condition 
of  the  cerebral  centres.  When  the  attention  is  fixed  upon  other 
things,  also,  the  pain  may  be  to  a  great  extent,  or  even  com- 
pletely, abolished,  as  in  mesmerism  or  hypnotism.  The  sensory 
stimuli,  also,  which  would  usually  produce  pain  may  be  diverted 
voluntarily  or  involuntarily  into  motor  channels.  Thus,  during 
the  heat  of  action,  the  pain  of  a  wound  is  not  felt ;  and  the  pain 
felt  during  the  extraction  of  a  tooth  is  lessened  by  the  employ- 
ment of  violent  muscular  effort,  as  in  grasping  the  arms  of  the 
dentist's  chair.  Other  most  powerful  adjuncts  are  electricity 
applied  along  the  course  of ,  the  nerves,  and  counter-irritation, 
especially  by  means  of  the  actual  cautery  to  the  painful  part, 
and,  when  other  means  fail,  stretching  the  nerve  may  succeed. 

Cold  also,  applied  to  the  surface  over  a  painful  part,  will 
relieve  pain,  and  so  may  dry  heat,  applied  by  a  sand-bag  or  hot 
cloth,  or  moist  heat  in  the  form  of  a  poultice ;  for  the  mode  of 
action  of  these  vide  '  Action  of  Iebitants.' 

Pain  has  been  ascribed  by  Mortimer  Granville  to  vibrations 
of  nerves  or  of  the  sheaths;  and,  in  order  to  lessen  it,  he  pro- 
poses to  produce  vibrations  of  a  different  nature :  this  he  does  by 
percussing  over  the  painful  nerve  with  a  small  hammer,  worked 
either  by  clockwork  or  electricity.  For  a  dull  heavy  pain  he 
uses  quick  and  short  vibrations  of  the  hammer,  and  for  a  sharp 
lancinating  pain  he  uses  large  and  slow  vibrations. 

Anaesthetics. 

Anaesthetics  are  remedies  which  destroy  sensation. 

It  has  already  been  mentioned  that  both  sensation  and  pain 
require  for  their  perception  a  certain  condition  of  the  cerebral 
centres  and  of  the  sensory  nerves  and  spinal  cord,  by  which 
impressions  are  conveyed  to  these  centres. 

The  difference  between  anaesthetics  and  anodynes  is  to  a  great 
extent  one  of  degree.     Anodynes  affect  more  particularly  the 


204  PHAKMACOLOGY  AND   THEBAPEUTICS.  ,     [sect.  i. 

cerebral  centres  by  which  pain  is  perceived,  or  the  conducting 
paths  by  .which  painful  impressions  are  transmitted,  and  thus 
in  moderate  doses  lessen  pain  without  destroying  reflex  action. 
They  only  affect  the  ordinary  centres  for  reflex  action  when  the 
dose  is  considerably  increased.  Anaesthetics,  on  the  other  handi 
affect  the  cerebral  and  spinal  centres  more  equally,  and  so  abolish 
pain,  ordinary  sensation,  and  reflex  excitability  more  nearly  at 
the  same  time,  though  their  abolition  is  by  no  means  completely 
simultaneous. 

According  to  Eulenberg,  in  chloroform-narcosis  the  patellar 
reflex  is  abolished  first,  then  reflex  from  the  skin,  then  from  the 
conjunctiva,  and  lastly  from  the  nose.  As  the  anaesthesia  passes 
off  they  return  in  the  inverse  order,  patellar  reflex  being  the  last 
to  reappear.  A  stage  of  excitement  generally  precedes  the  dis- 
appearance of  patellar  reflex,  both  in  man  and  animals. 

Narcosis  by  ether  differs  from  that  of  chloroform  in  the  much 
greater  increase  of  patellar  and  other  tendon  reflexes,  both  in 
extent  and  duration. 

Chloral  hydrate  and  potassium  bromide  have  an  action  like 
chloroform,  but  much  weaker.  Like  chloroform,  they  paralyse  the 
patellar  reflex  before  the  corneal  reflex,  but  butyl-chloral  (croton- 
chloral)  paralyses  the  corneal  reflex  before  the  patellar. 

In  ordinary  sleep,  reflexes  disappear  in  the  same  order  as  in 
chloroform  narcosis,  but  in  mesmeric  sleep  the  reflexes  are  in- 
creased as  in  narcosis  from  ether.  In  hysterical  conditions 
diminution  of  the  cerebral  reflexes  from  the  nose  and  cornea 
with  persistence  of  the  patellar  reflex  has  been  observed. 

The  reflex  power  of  the  vaso-motor  centre  is  very  quickly 
paralysed  by  chloroform,  so  that  irritation  of  a  sensory  nerve 
will  no  longer  raise  the  blood-pressure.  Its  reflex  power  is  much 
less  affected  by  ether.1 

Anaesthetics  may  be  divided  into  local  and  general.  The 
local  are  those  which  abolish  the  sensibility  of  the  peripheral 
nerves  of  a  particular  area.  The  general  are  those  which  act 
on  the  central  nervous  system  in  the  way  already  described,  and 
abolish  sensation  throughout  the  whole  body. 

The  chief  local  anaesthetics  are  cold,  cocaine,  carbolic  acid, 
iodoform. 

For  the  purpose  of  producing  local  anaesthesia,  cold  is  generally 
applied  by  means  of  ether  spray,  until  the  part  is  all  but  frozen 
and  is  insensible,  when  slight  operations  may  be  made  without 
the  patient  feeling  any  pain.  The  ether  may  perhaps  have  itself 
a  certain  amount  of  physiological  effect  in  diminishing  sensibility 
when  applied  in  this  manner.  Carbolic  acid  painted  over  the  sur- 
face also  causes  it  to  become  white  and  to  lose  its  sensibility,  and 
may  thus  be  used  to  lessen  the  pain  of  opening  an  abscess. 


*  H.  P.  Bowditoh  and  C.  S.  Minot,  Boston  Med.  and  Swg.  Journ.,  May  21, 1874. 


chap,  vin,]    ACTION   OF  DEUGS   ON   THE   BRAIN.  205 

General  anaesthetics  are- 
Nitrous  oxide.  Trichlorhydrin. 
Ether.  Bi-chloride  of  methylene. 
Chloroform.  Paraldehyde. 
Bromoform.  Bi-chloride  of  ethidene. 
Tetrachloride  of  carbon.  Bromide  of  ethyl. 

With  the  exception  of  nitrous  oxide  they  all  belong  to  the 
class  of  alcohols  and  ethers,  and  the  substitution-compounds 
having  an  anaesthetic  action  are  probably  almost  indefinite  in 
number.  Even  alcohol  itself  produces  general,  anaesthesia  when 
volatilised  and  inhaled. 

General  Anaesthetics  may  destroy  the  sensibility  of  the 
nerve-centres  indirectly  or  directly.  Anaesthesia  is  induced  in- 
directly by  stopping  the  circulation  in  the  brain  and  thus  arrest- 
ing the  process  of  oxidation  and  tissue-change  in  the  nerve-cells 
which  are  necessary  for  their  functional  activity. 

This  result  may  be  produced  by  draining  the  blood  from  the 
head  into  other  parts  of  the  body.  Thus  in  some  of  the  hospitals 
at  Paris,  before  anaesthetics  were  introduced,  a  plan  was  some- 
times employed  of  rendering  a  patient  insensible  before  an  opera- 
tion, by  laying  him  flat  on  the  ground,  and  then  lifting  him 
very  suddenly  to  a  standing'  posture  by  the  united  efforts  of  six 
or  eight  men  (c/.  pp.  193,  198). 

Local  arrest  of  the  circulation  to  the  brain  by  ligatures  or  by 
compression  of  the  arteries  has  a  similar  effect.  Waller  has 
recommended  diminution  of  the  cerebral  circulation,  by  the 
combined  effects  of  simultaneous  pressure  on  the  carotid  arteries 
and  vagus  nerves,  as  an  easy  means  of  producing  anaesthesia  for 
short  operations. 

Slight  anaesthesia,  usually  accompanied  by  some  giddiness, 
may  be  produced  by  taking  a  number  of  deep  breaths  in  rapid 
succession.  This  may  be  used .  in  order  to  lessen  the  irritability 
of  the  pharynx  in  laryngoscopy  examinations,  and  to  lessen  the 
pain  of  opening  boils  or  abscesses.  The  anaesthesia  thus  pro-, 
duced  may  perhaps  depend  on  anaemia  of  the  brain,  although 
this  is  not  certain. 

Anaesthesia  may  also  be  produced  by  diminishing  the  internal 
respiration  of  the  nerve-cells  through  a  gradually  increasing 
venous  condition  of  the  blood.  Thus  gradual  suffocation  by 
charcoal  fumes  or  carbon  monoxide  causes  complete  insensibility, 
and  the  inhalation  of  nitrogen  and  of  nitrous  oxide  has  a  similar 
action. 

Anaesthesia  may  be  caused  by  the  direct  action  of  drugs  on 
the  nerve-cells  themselves.  Chloroform,  ether,  and  other  allied 
substances  belonging  to  the  alcohol  series  appear  to  act  in  this' 
way.  Although  their  action  is  generally  exerted  through  the 
blood  by  which  they  are  conveyed  to  the  brain  when  inhaled,  yet 


206  PHARMACOLOGY  AND  THERAPEUTICS.       [sect:  i.> 

they  will  also  produce  a  similar  action  if  locally  applied  to  the 
nerve-centres.  Thus  Prevost1  found  that  chloroform  applied 
directly  to  the  brain  of  a  frog  narcotises  it  when  the  aorta  is  tied- 
When  the  aorta  is  again  unligatured,  so  that  the  current  of  blood 
can  again  wash  the  chloroform  away,  the  narcosis  disappears. 
Chloroform  and  ether  when  inhaled  appear  to  act. like  alcohol, 
producing  paralysis  of  the  nerve-centres,  commencing  with  the 
highest  and  proceeding  downwards.  The  rate  of  paralysis,  though 
the  same  in  order,  is  more  rapid  than  that  caused  by  alcohol. 

These  anaesthetics  are,  however,  not  nerve-poisons  only ;  they 
are  protoplasmic  poisons  affecting  simple  organisms,  such  as 
amoebae  and  leucocytes,  and  destroying  also  the  irritability  of 

muscular  fibre. 

This  action  of  anaesthetics  and  especially  that  of  chloroform 
upon  muscular  fibre  is  one  of  considerable  importance  in  reference 
to  the  occasional  stoppage  of  the  heart  and  consequent  death 
during  the  administration  of  anaesthetics. 

The  action  of  anaesthetics  may  be  divided  into  four 
stages : — 

1st.  The  stimulant  stage. 

2nd.  The  narcotic  and  anodyne  stage. 

3rd.  Anaesthetic  stage. 

4th.  Paralytic  stage. 

Stimulant  Stage.— Chloroform  and  ether,  as  already  men- 
tioned, resemble  alcohol  in  their  action,  and,  like  it,  in  small, 
doses  will  produce  a  condition  of  stimulation  and  acceleration  of 
the  circulation  passing  gradually  into  one  of  narcosis,  in  which, 
the  action  of  the  higher  nervous  centres  is  more  or  less  abolished, 
while  that  of  the  lower  centres  still  remains. 

In  small  quantities  chloroform  and  ether  are  sometimes  taken, 
either  internally  or  by  inhalation,  for  their  stimulant  effect.  They 
are  useful  in  lessening  pain  and  spasm,  as  in  neuralgia,  and 
biliary,  renal,  or  intestinal  colic,  when  given  till  the  stimulant  is 
just  passing  into  the  narcotic  stage. 

Narcotic  Stage. — When  pushed  still  further,  sensibility 
becomes  more  impaired,  reflex  action  still  continues,  and  some- 
times, just  as  in  drunkenness,  there  is  a  form  of  wild  delirium 
and  great  excitement.  This  is  much  less  marked  in  feeble  or 
debilitated  persons  than  in  strong  men.  In  the  latter,  the 
struggles  which  occur  in  this  condition  are  sometimes  exceed- 
ingly violent,  the  patient  raising  himself  forcibly  from  the  couch, 
his  muscles  being  in  a  state  of  violent  contraction,  the  face  livid, 
the  veins  turgid,  and  eyeballs  protruding.  Usually  this  condition 
quickly  subsides  and  passes  into  the  third  stage — that  of  complete- 
anaesthesia.  ; 

1  Prevost,  Practitioner  July  1881.  ■ 


cHAP.vii.]    ACTION  OF  DEUGS  ON  THE  BEAIN.  207 

In  order  to  lessen  the  pains  of  labour,  anaesthesia  is  usually 
carried  to  the  commencement  of  the  second  stage. 

Anaesthetic  Stage.— The  third  stage  diners  from  the  second 
in  the  function  of  the  spinal  cord  being  abolished,  as  well  as  those 
of  the  brain ;  ordinary  reflex  is  consequently  abolished,  and  the 
most  common  way  of  ascertaining  whether  this  stage  has  set  in' 
or  not  is  by  drawing  up  the  eyelid  and  touching  the  conjunctiva. 
If  no  reflex  contraction  of  the  eyelid  occurs,  the  anaesthesia  is 
complete.  By  careful  and  judicious  administration  of  the  anaes- 
thetic this  condition  may  be  kept  up  for  a  length  of  time  even 
for  hours,  or  days ;  but  if  the  inhalation  be  carried  too  far,  the 
anaesthetic  passes  into  the  fourth  stage. 

The  third  stage  is  the  one  employed  for  surgical  operations. 

Paralytic  Stage.  —  In  the  fourth  the  respiratory  centre 
becomes  paralysed,  respiration  ceases,  and  the  beats  of  the  heart 
become  feebler  and  may  cease  altogether. 


Uses  of  Anaesthetics. 

Anaesthetics  are  used  not  only  to  lessen  pain  but  to  relax 
muscular  action  and  spasm.  They  are  chiefly  employed  to  lessen 
pain  in  surgical  operations,  in  labour,  and  in  biliary  and  renal  colic. 
They  are  used  to  lessen  muscular  action  and  spasm  in  tetanus, 
in  poisoning  by  strychnine,  in  hydrophobia,  and  in  the  reduction 
of  dislocations,  fractures,  and  hernia.  They  are  also  of  assistance 
in  diagnosis,  by  allowing  careful  examination  to  be  made  of  parts 
which  are  too  tender  or  painful  to  be  examined  without  it,  and 
by  causing  the  phantom  tumours  due  to  spasmodic  contraction 
of  the  muscles  to  disappear. 

Dangers  of  Anaesthetics. — (1)  One  danger  is  that  just  men- 
tioned, of  paralysis  of  the  respiration  from  an  overdose.  This, 
however,  is  one  of  the  least  of  the  dangers,  and  if  the  enfeeble- 
ment  of  the  respiration  be  observed  in  time,  it  is  generally  pos- 
sible to  save  the  patient  by  stopping  inhalation,  and  keeping  up 
artificial  respiration  for  a  little  while  if  necessary. 

(2)  Another  danger  is  from  paralysis  of  the  heart  by  a  too, 
concentrated  chloroform  vapour.  This  is  indicated  by  a  sudden 
stoppage  of  the  heart,  paleness  of  the  face,  and  dilatation  of  the 
pupil  while  the  respiration  may  continue. 

If  this  accident  should  occur,  the  body  of  the  patient  should 
be  inclined  so  that  the  head  should  be  lower  than  the  feet,  and, 
artificial  respiration  should  be  kept  up  briskly  but  regularly,  the 
expiratory  movements  being  made  by  pressure  on  the  thorax  and 
especially  over  the  cardiac  region,  so  that  the  mechanical  pressure; 
should  stimulate  the  heart,  if  possible,  to  renewed  action.  The. 
vapour  of  nitrite  of  amyl  may  also  be  administered  by  holding  a 
piece  of  blotting-paper  or  cloth  on  which  a  few  drops  have  been 
sprinkled  before  the  nose,  while  artificial  respiration  is  kept  up. 


208  PHARMACOLOGY   AND   THERAPEUTICS.       [sect.  t. 

The  inspiratory  movements  may  be  made  by  crawing  the  arms 
backwards  over  the  head,  as  in  Sylvester's  plan. 

(3)  A  third  danger  arises  from  stoppage  of  the  heart  by  a 
combination  of  chloroform-narcosis  and  shock.  This  is  one  of 
the  most  dangerous  conditions.  It  may  occur  even  during  full 
chloroform-narcosis  in  animals  from  operations  on  the  stomach ; 
but  it  is  much  more  common  in  men  from  imperfect  anaesthesia. 
In  very  many  cases  of  so-called  death  from  chloroform  during 
operations,  we  find  it  noted  as  a  matter  of  surprise  that  death 
should  have  occurred  as  the  quantity  of  chloroform  given  was  so 
small.  The  reason  that  death  occurred  probably  was  because 
the  quantity  of  chloroform  given  was  so  small.  Had  the  patient 
been  completely  anaesthetised,  the  risk  would  have  been  very  much 
less.  The  reason  why  imperfect  anaesthesia  is  so  dangerous  is, 
that  chloroform  does  not  paralyse  all  the  reflexes  at  the  same 
time.  A  very  large  proportion  of  the  deaths  from  chloroform 
occur  during  the  extraction  of  teeth,  and  we  may  take  this 
operation  as  a  typical  one  in  regard  to  the  mode  of  action,  both 
of  the  sensory  irritation  and  of  the  chloroform.  When  a  tooth  is 
extracted  in  a  waking  person,  the  irritation  of  the  sensory  nerve 
produced  by  the  operation  has  two  effects  : — 1st,  it  may,  acting 
reflexly  through  the  vagus,  cause  stoppage  of  the  heart  and  a 
consequent  tendency  to  syncope.  2nd,  it  causes  reflex  contrac- 
tion of  the  arterioles,  which  tends  to  raise  the  blood-pressure  and 
counteract  any  tendency  to  syncope  which  the  action  of  the 
vagus  might  have  produced. 

In  complete  anaesthesia  all  these  reflexes  are  paralysed,  and 
thus  irritation  of  the  sensory  nerves  by  the  extraction  of  the 
teeth  has  no  effect  either  upon  the  vagus  or  upon  the  arterioles. 
In  imperfect  anaesthesia,  however,  the  reflex  centre  for  the  arte- 
rioles may  be  paralysed  {ride  p.  204),  while  the  vagus  centre  is 
still  unaffected.  The  irritation  caused  by  the  extraction  of  the 
tooth  may  then  cause  stoppage  of  the  heart,  and  there  being 
nothing  to  counteract  the  tendency  to  faint,  syncope  occurs  and 
may  prove  fatal. 

With  nitrous  oxide  there  is  very  much  less  danger,  inasmuch 
as  the  nitrous  oxide  causes  a  venous  condition  of  the  blood,  with 
consequent  contraction  of  the  arterioles  and  rise  in  the  blood- 
pressure,  so  that  any  tendency  to  syncope  through  vagus-irrita- 
tion is  efficiently  counteracted. 

With  ether,  also,  the  danger  is  very  much  less,  probably  be- 
cause it  has  a  more  equal  effect  on  the  centres  (vide  p.  204) . 

(4)  Another  danger  is  that  of  suffocation  from  blood  passing 
into  the  trachea  in  operations  about  the  mouth  or  nose,  or  from 
the  contents  of  the  stomach  being  drawn  into  the  larynx  when 
vomiting  has  occurred  during  partial  anaesthesia.  In  consequence 
of  this,  it  is  better,  instead  of  giving  chloroform  or  ether  during 
the  whole  of   an   operation  on  the  mouth  or  nose,  to  give  it 


chap,  vni.]    ACTION  OF  DEUGS  ON  THE   BEAIN.  209 

only  at  the  commencement,  and  to  administer  along  with  it,  or 
before  it,  a  hypodermic  injection  of  one-sixth  to  one-third  of  a 
grain  of  morphine.  The  chloroform  anaesthesia  thus  passes  into 
the  morphine  narcosis,  and  the  operation  can  be  finished  without 
pain,  and  without  danger. 

To  prevent  the  occurrence  of  vomiting,  it  is  advisable  not  to 
give  solid  food  for  some  hours  before  an  operation,  though  if 
necessary  a  little  beef-tea  or  stimulant  may  be  given  half  an  hour 
or  so  before  the  administration  of  the  anassthetic. 

Mode  of  administering  Anaesthetics. — In  order  to  obtain 
the  first  stages  of  the  action  of  anaesthetics,  as  in  cases  of  in- 
testinal, biliary,  or  renal  colic,  intense  neuralgia,  or  in  parturition, 
the  best  means  of  administration  is  one  for  the  account  of  which 
I  am  indebted  to  Mr.  W.  J.  Image,  of  Bury  St.  Edmunds.  It 
consists  of  a  tumbler,  at  the  bottom  of  which  is  placed  a  piece  of 
blotting-paper  or  linen  thoroughly  wetted  with  chloroform  or 
ether.  The  patient  holds  the  tumbler  to  the  nose  with  his,  or 
her,  own  hand.  On  account  of  the  form  of  the  tumbler,  sufficient 
air  always  gets  in  at  the  sides,  and  the  patient  cannot  inhale  the 
vapour  in  too  concentrated  a  condition.  As  soon  as  the  anaes- 
thetic begins  to  take  effect,  the  hand  drops,  and  the  inhalation 
ceases.  As  the  effect  again  passes  off,  the  patient  resumes  the 
inhalation.  In  employing  anaesthetics  in  this  way,  however, 
great  care  must  be  taken  that  the  bottle  containing  the  chloro- 
form is  never  entrusted  to  the  patient,  but  is  always  kept  on  a 
table  at  some  little  distance  from  the  bed,  and  that  the  blotting- 
paper  or  lint  in  the  tumbler  is  supplied  with  fresh  chloroform  by 
an  attendant.  If  the  bottle  itself  be  entrusted  to  the  patient, 
as  the  anaesthetic  takes  effect  and  produces  stupidity,  the  stopper 
may  fall  out,  the  whole  contents  of  the  bottle  may  be  sucked  up 
by  the  pillow,  bolster,  bed,  or  bedclothes,  and  the  vapour  being 
inhaled,  fatal  suffocation  may  ensue. 

Another  method  of  administering  chloroform,  which  is  very 
convenient  when  complete  anaesthesia  is  required  for  a  length  of 
time,  and  when  the  supply  of  chloroform  is  limited,  was  devised 
by  Sir  James  Simpson:  it  consists  of  either  a  cup-shaped  in- 
haler, formed  of  a  wire  framework  covered  with  flannel,  or  else 
simply  of  a  single  fold  of  a  pocket-handkerchief  thrown  over  the 
face  :  the  chloroform  is  dropped  upon  the  flannel  or  handkerchief 
just  under  the  nostrils  in  single  drops  at  a  time.  Another  plan 
is  to  pour  some  chloroform  on  to  a  folded  towel  or  pocket-hand- 
kerchief, and  then  place  it  over  the  patient's  face,  taking  care 
that  it  does  not  come  so  close  over  the  nose  as  to  interfere  with  a 
free  admixture  of  air  with  the  chloroform  vapour.  There  is  this 
difference  between  ether  and  chloroform,  that  whereas  it  is  highly 
inadvisable  to  give  chloroform  vapour  in  a  concentrated  condi- 
tion, it  is  requisite  to  give  the  ether  vapour  very  strong,  in  order 
to  produce  an  anaesthetic  effect.     A  combined  administration  of 


210  PHAEMACOLOGY   AND   THEEAPEUTICS.       [sect,  l 

nitrous  oxide  and  ether  is  now  used  to  a  considerable  extent : 
the  nitrous  oxide  producing  rapid  anesthesia,  which  is  kept  up 
by  the  ether. 

Anaesthesia  in  Animals. 

In  the  course  of  many  investigations  into  the  action  of  druga 
on  animals  it  is  necessary  to  perform  experiments  which  would 
be  painful  unless  the  animals  were  anaesthetised.  The  easiest 
way  of  doing  this  with  frogs  or  small  animals,  such  as  mice,  rats, 
or  rabbits,  is  to  put  them  under  a  bell-jar  with  an  opening  at  the 
top.  Into  this  opening  a  piece  of  cotton-wool  or  blotting-paper  is 
put,  and  chloroform  dropped  on  it.  The  vapour  being  heavier 
t;han  air  falls  to  the  bottom,  and  the  animal  soon  becomes  in- 
sensible. The  best  way  of  anaesthetising  cats,  small  dogs,  or  very 
large  rabbits,  is  to  put  them  into  a  wooden  box  or  tin  pail,  and 
stretch  a  towel  tightly  over  the  top.  An  assistant  then  pours 
some  chloroform  on  the  towel  and  anaesthesia  is  quickly  pro- 
duced. Eats  are  most  readily  anaesthetised  by  completely  cover- 
ing the  cage,  in  which  they  are,  with  a  towel,  and  dropping 
chloroform  upon  it. 

Babbits  may  be  very  quickly  anaesthetised  by  the  plan  em- 
ployed by  Pasteur.  It  consists  in  putting  a  piece  of  cloth  or 
blotting-paper  soaked  in  chloroform  round  the  animal's  nose  so 
as  to  exclude  air.  At  once  the  rabbit  ceases  to  breathe,  and  re- 
mains without  breathing  for  about  a  minute.  It  then  begins 
to  struggle,  and  if  the  anaesthetic  be  kept  closely  applied  the 
respiratory  movements  shortly  become  steady  and  regular  and 
the  animal  completely  insensible. 

For  very  large  or  savage  dogs  an  old  packing-case  without  a 
lid  may  be  simply  placed  over  the  animal  and  held  firmly  down, 
or  one  of  the  sides  may  be  furnished  with  hinges  so  as  to  convert 
the  case  into  a  sort  of  kennel.  After  the  dog  is  safely  housed 
large  pieces  of  blotting-paper  or  of  cloth  on  which  chloroform  is 
pourea  are  pushed  through  cracks  in  the  top  of  the  case  or  holes 
specially  made  for  the  purpose.  The  outer  ends  of  the  blotting- 
paper  or  cloth  remaining  outside,  fresh  quantities  of  chloroform 
can  be  introduced  as  required  until  complete  anaesthesia  is  pro- 
duced. Anaesthesia  may  be  maintained  for  almost  any  length  of 
time  that  is  required,  by  putting  a  piece  of  cloth  loosely  round 
the  animal's  nose  and  dropping  chloroform  upon  it.  This  re- 
quires careful  attention,  however,  in  order  to  prevent  danger  from 
an  overdose  on  the  one  hand,  or  partial  recovery  on  the  other. 
I  find  the  most  convenient  way  of  maintaining  the  anaesthesia 
induced  by  chloroform  in  the  way  already  mentioned  is  to  put  a 
cannula  in  the  trachea  and  connect  it  with  a  flask  containing  ether, 
so  that  the  inspired  air  passes  over  the  surface  of  the  ether,  and 
carries  a  quantity  of  the  vapour  with  it  into  the  lungs  of  the 


chap,  viii.]    ACTION  OP  DEUGS  ON  THE  BRAIN.  211 

animal.^  By  means  of  a  peculiar  stopcock,  the  construction  of 
which  is  indicated  in  the  diagram  (Fig.  73),  pure  air  or  air 
loaded  with  ether  vapour  or  a  mixture  of  both  may  be  given. 

The  advantages  of  employing  this  method  and  of  using  ether 
rather  than  chloroform  are  that  complete  anaesthesia  may  be  kept 


Flo.  73. — Diagram  of  a  stopcock  by  which  air  or  vapour,  or  two  kinds  of  gas,  may  be  given 
alone,  or  mixed  together  in  any  proportion. 

up  for  hours  together  with  little  or  no  attention  on  the  part  of 
the  operator,  and  without  the  respiration  or  blood-pressure  being 
seriously  affected  by  the  anaesthetic. 

Another  plan  of  maintaining  anaesthesia  for  a  length  of  time 
is  to  inject  some  laudanum  or  liquid  extract  of  opium  into  a  vein 
after  anaesthesia  has  been  induced  by  chloroform.  Before  the 
effect  of  the  chloroform  has  passed  off,  such  complete  narcosis  is 
produced  by  the  opium  that  no  procedure,  however  painful  it 
might  otherwise  be,  will  produce  the  slightest  evidence  of  sensa- 
tion. "When  the  effect  of  the  anaesthetic  or  of  the  opium  would 
interfere  with  the  investigation  of  the  action  of  a  drug  on  the 
circulation  or  reflex  action,  the  animal  may  be  anaesthetised  by 
chloroform,  and  the  crura  cerebri  divided.  The  channels  by 
which  painful  impressions  are  conveyed  to  the  brain  being  thus 
destroyed  no  pain  can  be  felt,  although  the  reflex  action  of  the  cord 
again  returns  after  the  effects  of  the  chloroform  have  passed  off. 

History  of  the  Discovery  of  Anesthesia. 

This  is  a  subject  of  considerable  interest,  and  has  given  rise 
to  much  discussion.  The  starting-point  of  the  discovery  seems 
to  have  been  Sir  Humphry  Davy's  observations  on  the  pro- 
perties of  nitrous  oxide,  regarding  which  he  said,  '  as  nitrous 
oxide  in  its  extensive  operation  seems  capable  of  destroying 
physical  pain,  it  may  probably  be  used  with  advantage  during 
surgical  operations.'  The  property  of  this  gas  and  also  of  ether 
vapour  to  produce  excitement  when  inhaled,  caused  these  sub- 
stances to  be  used  in  sport,  and  during  their  action  bruises 
were  frequently  received,  but  not  felt.  This  circumstance  excited 
the  attention  of  Dr.  Crawford  W.  Long,  of  Athens,  Georgia,  and, 
in  1842,  he  anaesthetised  a  patient  with  ether  in  order  to  re- 
move a  tumour.  He  was  encouraged  to  do  this  by  the  fact  that 
Dr.  Wilhite,  in  a  frolic,  had  rendered  a  negro  boy  completely 
insensible  without  any  bad  results.     Mr.  Horace  Wells,  without 

p  2 


212  PHARMACOLOGY  AND   THEEAPEUTICS.       [sect.  i. 

knowing  what  Dr.  Long  had  done,  used  nitrous  oxide  as  an 
anesthetic  in  1844.  His  pupil,  Mr.  Morton,  wishing  to  use  it 
also,  asked  him  how  to  make  it,  and  was  referred  to  a  scientific 
chemist,  Dr.  Jackson.  Jackson  advised  Morton  to  use  sulphuric 
ether,  a's  it  had  similar  properties  to  nitrous  oxide  and  was  easier 
to  get.  Acting  on  this  suggestion  Morton  used  ether  in  dentistry, 
and  induced  Drs.  Warren,  Haywood,  and  Bigelow  to  perform 
important  surgical  operations  on  patients  whom  he  anaesthetised 
by  it.  From  this  time  onwards  anaesthesia  has  been  regularly 
used  in  medical  operations.  Shortly  afterwards,  Sir  J.  Y.  Simp- 
son discovered  the  use  of  chloroform  as  an  anaesthetic,  and  it  has 
been  chiefly  employed  in  Great  Britain,  but  in  America  ether  has 
always  retained  its  original  place. 

Antispasmodics. 

These  are  remedies  which  prevent  or  relieve  spasm. 

Spasm  is  contraction  of  voluntary  or  involuntary  muscles, 
in  a  way  that  is  unnecessary  or  injurious  to  the  organism 
generally.  The  spasmodic  contraction  of  muscles  may  sometimes 
be  excessive  in  degree,  as  in  the  calves  of  the  legs  in  cramp,  or 
in  the  fibres  of  the  intestinal  walls  in  colic.  Sometimes  it  is  not 
excessive  in  degree,  but  are  merely  out  of  place,  as,  for  example, 
in  the  slight  twitchings  of  the  face  or  fingers  which  occur  in  mild 
cases  of  chorea. 

Spasm  may  affect  single  muscles,  or  it  may  affect  groups  of 
muscles  and  the  nerve-centres  by  which  they  are  set  in  action  5 
these  centres  may  sometimes  be  very  limited  in  extent,  but  some- 
times a  great  number,  or  indeed  most  of  the  motor  centres  in 
the  body,  may  be  involved,  as  in  the  convulsions  of  hysteria. 
Spasm  is,  indeed,  a  kind  of  insubordination  in  which  the 
individual  muscles  or  nerve-centres  act  for  themselves  without 
reference  to  those  higher  centres  which  ought  to  co-ordinate  their 
action  for  the  general  good  of  the  organism.  It  may  be  due,  there- 
fore, either  to  excess  of  action  in  the  muscles  or  local  centres,  or 
diminished  power  of  the  higher  co-ordinating  centres.  As  a  rule 
it  is  due  to  diminished  action  of  the  co-ordinating  or  inhibitory 
centres,  rather  than  to  excess  of  action  in  the  motor  centres ;  it  is, 
therefore,  a  disease  rather  of  debility  and  deficient  co-ordination 
than  of  excessive  strength. 

Cramps  in  the  muscles  may  come  on  from  their  exhaustion  by 
excessive  exertion,  the  waste  products  of  their  functional  activity 
appearing  to  act  as  local  irritants.  This  is  relieved  by  the  removal 
of  these  waste  products ;  as,  for  example,  by  shampooing.  In  the 
intestine,  cramp  may  be  due  to  the  presence  of  a  local  irritant, 
which  ought'  in  the  normal  condition  to  produce  increased 
peristalsis,  and  thus  ensure  the  speedy  removal  of  the  offending 
substance.    From  some  abnormal  condition  the  muscular  fibres 


chap,  vin.]    ACTION  OF  DRUGS  ON  THE  BRAIN.  213 

around  the  irritant  contract  excessively,  and  do  not  pass  on  the 
stimulus  to  those  adjoining.  Prom  this  want  of  co-ordination 
painful  and  useless  spasm  occurs.  In  order  to  remove  it  we  apply 
warmth  to  the  abdomen  so  as  to  increase  the  functional  activity, 
both  of  the  muscular  fibres  and  of  the  ganglia  of  the  intestine 
(pp.  138,  140).  Peristalsis  then  occurring  instead  of  cramp,  the 
pain  disappears,  and  the  offending  body  is  passed  onwards  and 
removed.  Or  we  give  internally  aromatic  oils,  which  will  have  a 
tendency  to  increase  the  regular  peristalsis ;  or  yet  again,  we 
may  give  opium  for  the  purpose  of  lessening  the  sensibility  of 
the  irritated  part,  or  the  nerves  connected  with  it,  and  thus  again 
bringing  it  into  relationship  with  other  parts  of  the  body. 
General  antispasmodics  may  act  either 

(1)  By  increasing  the  power  of  the  higher  nervous  centres 
to  keep  the  lower  ones  and  the  muscles  in  proper  subordina- 
tion, or — 

(2)  By  lessening  the  activity  of  over-excited  muscles  or  lower 
nervous  centres. 

On  this  account  we  find  stimulants  and  antispasmodics  very 
much  classed  together.  Those  drugs  which  stimulate  the 
circulation  and  increase  the  nutrition  of  the  higher  nerve-centres 
and  the  co-ordinating  power,  tend  to  prevent  spasm.  Thus, 
small  quantities  of  alcohol  and  ether,  by  acting  in  this  way,  tend 
to  prevent  general  spasm,  as  in  hysteria,  nervous  agitation,  or 
trembling,  or  remove  local  spasm,  as  in  colic. 

Camphor,  which  is  frequently  used  as  an  antispasmodic,  has 
a  stimulant  action  on  the  brain,  spinal  cord,  circulation,  and 
respiration.  It  is  probable  that  such  antispasmodic  powers  as 
it  possesses  are  due  to  its  exciting  the  higher  centres,  and  in- 
creasing their  inhibitory  powers  over  the  lower  (p.  214).  Bromo- 
camphor  has  a  somewhat  similar  action. 

Valerian,  asafoetida,  musk,  castor,  and  other  aromatic  sub- 
stances, have  an  antispasmodic  action  which  we  do  not  under- 
stand. It  is  possible  that  they  affect  some  part  of  the  brain 
particularly,  so  as  to  increase  its  regulating  power,  in  much  the 
same  way  as  camphor. 

Other  antispasmodics,  such  as  bromide  of  potassium,  lessen 
the  irritability  of  motor  centres.  Borneol  and  menthol  have  a 
depressing  and  finally  paralysing  effect  upon  motor,  sensory,  and 
reflex  centres  in  the  brain  and  spinal  cord.  In  this  respect  they 
differ  greatly  from  ordinary  camphor,  which  has  an  exciting 
action  upon  these  structures,  though  they  may  perhaps  be  still 
more  useful  as  antispasmodics. 

Other  antispasmodics,  instead  of  lessening  the  irritability  of 
nerve-centres,  may  paralyse  the  structures  through  which  the 
nerves  act.  Thus,  nitrite  of  amyl  appears  to  arrest  the  spasm  of 
the  vessels  in  angina  pectoris,  by  causing  paralysis  of  the  vessels 
themselves  or  of  the  peripheral  ends  of  the  vaso-motor  nerves. 


214 


PHAEMACOLOGY  AND   THEEAPEUTICS.       [sect.  t. 


Adjuvants. — As  spasm  is  usually  an  indication  of  deficient 
nervous  power,  tonics,  as  quinine,  iron,  cod-liver  oil,  arsenic, 
sulphur,  cold  baths,  and  moderate  exercise,  are  useful  as  adju- 
vants. 

It  has  already  been  mentioned,  that  a  healthy  condition  of 
the  various  parts  of  the  body  depends  on  proper  nutrition  and 
proper  removal  of  waste.  Therefore,  when  there  is  a  tendency 
to  spasm,  the  diet  should  be  plain,  but  nutritious.  Those  condi- 
tions which  tend  to  cause  excessive  waste  should  be  avoided,  such 
as  exciting  emotions,  excessive  bodily  or  mental  work,  a  close 
atmosphere,  and  late  hours.  Attention  must  be  paid  also  to  the 
proper  removal  of  all  waste,  by  the  use  of  purgatives,  cholagogues, 
or  diuretics  if  necessary. 

Great  irritability  of  the  nervous  system  is  usually  observed 
in  gouty  subjects  before  an  attack  of  gout  comes  on.  It  is  uncer- 
tain to  what  this  irritability  is  due,  but  it  may  not  improbably  be 
caused  by  the  retention  within  the  body  of  the  products  of  tissue- 
waste.  Some  years  ago  there  was  considerable  discussion  regard- 
ing the  active  ingredient  of  bromide  of  potassium,  some  attribut- 
ing its  antispasmodic  action  to  the  bromine,  and  others  to  the 
potassium.  It  occurred  to  me  that  possibly  its  action  might  be 
partly  due  simply  to  its  action  as  a  saline  leading  the  patient 
to  drink  more  water,  and  thus  assisting  the  elimination  of  the 
products  of  tissue-waste.  I  accordingly  tried  30-grain  doses  of 
chloride  of  sodium  in  cases  of  epilepsy.  In  some  it  did  little  or 
no  good,  but  in  a  few  it  appeared  to  have  nearly  as  powerful  an 
action  as  bromide  of  potassium. 

Uses. — Antispasmodics  are  used  in  convulsive  diseases. 

The  antispasmodics  used  in  hysteria  may  be  divided  into 
substances  which  exert  on  the  higher  nerve-centres  a  sedative, 
tonic,  or  stimulant  action,  thus  : 


I.  Sedatives 


.   Alkaline  bromides. 
Zinc  salts. 


Castor      . 

Sumbul    . 
►  Valerian  . 

Asafoetida 
Ammoniac  um 
Galbanum 


Derived  from  the  genital  organs  of 

animals. 
Similar  in  the  nature  of  their  odour 

to  the  above,  though  derived  from 

plants. 

I  Containing  sulphur  oils. 


II.  Tonics 
III.  Stimulants, 
whichhaveapower-\  Musk 
ful  odour,  and  pro- 
bably  act    on    the 
higher  centres 

through  the  olfac- 
tory organs,  either 
by  direct  applica- 
tion or  during  their^ 
elimination  (p.  41). 

In  epilepsy,  laryngismus  stridulus,  and  infantile  convulsions, 
bromides  of  potassium,  sodium,  ammonium,  and  calcium,  nitrite 
of  sodium,  salts  of  silver,  zinc,  and  copper. 

In  chorea,  arsenic,  conium,  the  salts  of  copper  and  zinc. 

In  spasmodic  asthma,  lobelia,  stramonium. 

In  spasm  of  the  blood-vessels,  nitrite  of  amyl  and  other 
itrites. 


chap,  viii.]    ACTION  OP  DKUGS  ON  THE  BEAIN.  215 


Action  of  Drugs  on  the  Cerebellum. 

The  chief  function  of  the  cerebellum  appears  to  be  the  main- 
tenance of  equilibrium.  Symmetrical  lesions  on  both  sides  of  the 
organ  or  division  of  it  down  the  centre  from  before  backwards, 
cause  very  little  disturbance  of  the  equilibrium,  but  when  a  lesion 
is  unsymmetrical  the  equilibrium  is  disordered. 

According  to  Ferrier,  if  the  lesion  affects  the  whole  of  a  lateral 
lobe,  there  is  a  tendency  for  the  animal  to  roll  over  towards  the 
affected  side.  In  an  animal  standing  on  all  fours  or  lying  on  the 
ground,  we  regard  the  centre  of  the  back  as  the  point  of  move- 
ment, but  in  a  man  standing  upright  we  usually  take  the  face,  and 
therefore  what  we  should  regard  in  an  animal  as  rolling  towards 
the  affected  side,  would  be  equivalent  hi  man  to  a  rotation 
towards  the  sound  side.  If  the  lesion  is  limited  to  one  part  of 
the  lateral  lobe,  it  may  not  cause  rotation,  but  only  falling  to- 
wards the  opposite  side.  When  the  anterior  part  of  the  middle 
lobe  of  the  cerebellum  is  injured,  the  animal  tends  to  fall  forward, 
and  in  walking  usually  stumbles,  or  falls  on  its  face.  When  the 
posterior  part  of  the  middle  lobe  of  the  cerebellum  is  injured,  the 
head  is  drawn  backwards  and  there  is  a  continual  tendency  to 
fall  backwards  when  moving.' 

Injuries  of  the  cerebellum  are  frequently  associated  with  a 
certain  amount  of  nystagmus,  and  in  all  probability  the  com- 
plete or  partial  inability  to  walk  or  stand  which  alcohol  produces, 
is  due  to  its  action  on  the  cerebellum. 

Different  kinds  of  spirit  appear  to  have  a  tendency  to  affect 
different  parts  of  the  cerebellum,  for  good  wine  or  beer  is  said  to 
make  a  man  fall  on  his  side,  whisky,  and  especially  Irish  whisky, 
on  his  face,  and  cider  or  perry  on  his  back.2  These  disturbances 
of  the  equilibrium  correspond  exactly  with  those  caused  by  injury 
to  the  lateral  lobes,  and  to  the  anterior  and  posterior  part  of  the 
middle  lobe  of  the  cerebellum  respectively.  Apomorphine  in 
large  doses  appears  also  to  have  an  action  on  the  cerebellum  or 
corpora  quadrigemina,  as  the  animal  poisoned  by  it  does  not 
vomit,  but  moves  round  and  round  in  a  circle. 

The  action  of  alcohol  on  frogs  is  peculiar  and  differs  from 
that  of  other  narcotics,  inasmuch  as  it  appears  to  affect  unequally 
the  two  sides  of  the  nervous  apparatus  by  which  the  equilibrium 
is  maintained,  so  that  in  a  certain  stage  of  alcohol-poisoning 
they  excite  similar  manege  movements  to  those  which  occur  after 
division  of  the  corpora  quadrigemina  on  one  side.3 

1  Ferrier,  Functions  of  the  Brain,  p.  94. 

2  Shorthouse,  Baily's  Magazine  of  Sports,  1880,  vol.  xxxv.  p.  396. 

s  Wilhelm  Wundt :   Untersuchungen  zur  Mechanik  der  Nerven  und  Nerven- 
centren.     Zweite  Abtheilung,  1876.     Stuttgart. 


216  PHAKMACOLOGY  AND  THEKAPEUTICS.     {sect. 


CHAPTEE  IX. 

ACTION  OF  DBUGS  ON  THE  OEGANS  OF  SPECIAL  SENSE. 

Action  of  Drugs  on  the  Eye. 

Action  on  the  Conjunctiva.  —  Before  light  can  reach  the 
retina,  it  has  to  pass  through  the  cornea,  which  is  covered  by 
epithelium  continuous  with  that  of  the  conjunctiva.  Alterations 
in  either  or  both  of  these  textures  are  therefore  very  important 
in  regard  to  the  integrity  of  vision.  The  chief  drugs  employed  in 
the  local  treatment  of  diseases  of  the  cornea  and  conjunctiva  are 
warmth,  moist  and  dry,  anaesthetics,  anodynes,  antiphlogistics, 
antiseptics,  and  astringents.  The  chief  astringents  are  per- 
chloride  of  mercury,  oxide  of  mercury,  and  nitrate  of  silver.  The 
chief  antiseptics  are  perehloride  of  mercury,  quinine,  boric  acid,  • 
and  sulphocarbolate  of  sodium.  The  chief  sedatives  are  hydro- 
cyanic acid,  opium,  belladonna,  atropine,  and  cocaine.  There 
are  two  astringents  in  common  use  which  ought  to  be  avoided, 
these  are  solutions  of  lead  and  of  alum.  Lead  salts  are  objection- 
able, because  if  there  is  any  ulceration  on  the  cornea  they  may 
form  an  insoluble  albuminate  and  cause  permanent  opacity. 
Salts  of  alum  are  said  by  Tweedy  to  be  perhaps  still  more  objec- 
tionable, because  alum  has  the  power  of  dissolving  the  cement  by 
which  the  fibrillae  of  the  cornea  are  held  together,  and  this  is 
very  apt  to  give  rise  to  perforation  of  the  cornea  whenever  the 
epithelium  is  removed  by  injury  or  inflammation.  Tweedy  also 
thinks  that  strong  solutions  of  common  salt,  ten  per  cent,  or 
more,  and  solution  of  permanganate  of  potassium  also  dissolve 
the  corneal  cement  and  should  therefore  be  avoided  in  inflamma- 
tion of  the  conjunctiva  or  of  the  cornea.  He  considers  that  sul- 
phate of  zinc  should  be  avoided,  for  the  same  reason,  but  it  is 
largely  used  by  others.  The  best  astringent  is  probably  perehloride 
of  mercury,  -Jjth  to  -J^-th  of  a  grain  to  an  ounce  of  water,  and 
coloured  with  cochineal.  The  next  best  is  an  aqueous  solution 
of  boric  acid,  containing  3  to  8  grains  of  it  with  3  to  10  grains  of 
sulphocarbolate  of  sodium  per  ounce. 

The  chief  effects  which  drugs  produce  on  the  eye,  besides 
those  just  described,  are  alterations  in  the  size  of  the  pupil,  in 


chap,  ix.}    ACTION  OF  DEUGS  ON  SPECIAL  SENSE.         217 

the  power  of  accommodation,  in  the  intra-ocular  pressure,  in  the 
sensitiveness  of  the  retina  to  impressions,  and  in  the  apparent 
colour  of  objects. 

Action  of  Drugs  on  the  Lacrimal  Secretion.— The  great 
power  of  certain  volatile  oils,  such  as  those  of  onion  or  mustard, 
to  irritate  the  eyes  and  cause  secretion  of  tears  is  well  known. 
The  prolonged  action  of  atropine  diminishes  the  secretion.  Ese- 
rine  abolishes  the  action  of  atropine,  and  quickly  increases  the 
secretion.1 

Projection  of  the  Eyeball.— The  non-striated  muscular  fibres 
which  are  contained  in  the  orbital  membrane  and  in  both  eyelids 
push  the  eyeball  forward  and  draw  the  eyelids  back  when  they 
contract.  Like  the  dilator  pupillae  they  are  innervated  by  the 
sympathetic,  and  consequently  some  degree  of  protrusion  of  the 
eyeball  is  frequently  produced  by  such  substances  as  dilate  the 
pupil,  and  especially  by  cocaine.  Excessive  pain,  or  an  asphyxial 
condition  of  the  blood,  has  a  powerful  action  in  producing  this 
effect,  so  that  in  men  subjected  to  torture  in  the  Middle  Ages  pro- 
trusion of  the  eyeballs  was  noticed;  and  both  in  animals  and  men 
dying  from  rapid  asphyxia  the  eyeballs  may  seem  as  if  starting 
from  the  head. 

Action  on  the  Pupil. — The  iris  is  usually  said  to  consist  of 
two  muscles,  the  sphincter,  which  has  circular  fibres  and  contracts 
the  pupil,  and  the  dilator,  which  has  radial  fibres  and  dilates  the 
■  pupil.  All  observers  are  agreed  regarding  the  sphincter  muscle 
of  the  eyes,  but  some  deny  the  existence  of  the  dilator  muscle; 
In  the  following  description,  however,  I  shall  take  the  view  which 
is  usually  accepted.2 

The  sphincter  receives  its  motor  nervous  supply  from  the 
third  nerve,  and  the  dilator  from  the  cervical  sympathetic.  The 
nervous  centre  for  the  contraction  of  the  pupil  probably  lies  in 
the  corpora  quadrigemina ;  the  nerve-centre  for  the  dilatation 
of  the  pupil  lies  in  the  medulla  oblongata,  but  there  seems  to 
be  another  dilating  centre,  situated  in  the  floor  of  the  front  part  of 
the  aqueduct  of  Sylvius.3  The  contracting  -nerves  are  contained 
in  the  third  nerve,  and  pass  to  the  ciliary  ganglion,  and  thence 
to  the,  eye.  Along  with  them  motor  fibres  pass  also  to  the  ciliary 
muscle.  This  muscle  when  contracted  lessens  the  tension  of  the 
suspensory  ligament  on  the  lens,  allowing  the  latter  to  become 


1  Maynard,  Vmshoto's  Archiv,  vol.  lxxxix.  p.  258. 

2  At  present  it  is  generally  assumed  that  muscular  fibres,  either  voluntary  or 
involuntary,  contract  only  in  the  direction  of  their  length.  If  we  suppose  that  they 
can  contract  either  in  the  direction  of  their  length  or  their  width,  the  movements 
of  the  iris  might  be  more  readily  explained.  At  present  we  assume  the  presence 
of  a  dilator  muscle,  which  is  almost  certainly  absent  in  many  animals,  in  order  to 
explain  phenomena  which  might  be  explained  just  as  readily  by  the  supposition  that 
the  muscular  fibres  which  are  present  can  contract  in  two  directions  {see  p.  117). 

•  Foster's  Physiology,  4th  ed. 


318  PHAEMACOLOGY  AND  THEEAPEUTICS.      [sect,  i, 

more  spherical,  and  thus  accommodating  the  eye  for  near  objects, 
Such  accommodation  and  contraction  of  the  pupil  generally  ac- 
company one  another.  The  arrangement  of  the  nerves  of  the  eye 
is  very  diagrammatically  shown  in  Fig.  74.  A  few  of  the  dilating 
fibres  are  contained  in  the  fifth  nerve,  but  most  of  them  pass 
down  the  spinal  cord  to  the  cilio-spinal  region  in  the  lower  cervical 
and  upper  dorsal  part  of  the  cord,  and  thence  through  the  second 
dorsal  nerve  in  monkeys  and  probably  in  man,  or  through  the 
inferior  cervical  and  superior  dorsal  nerves  in  the  rabbit,  into 
the  cervical  sympathetic,  in  which  they  again  ascend  to  the  eye. 


Ciliary  ganglion  

Muscle  for  accommodation 

Lens 

Sphincter  iridis    

Dilator  pupil  he 

Vesselsofeye   


Nucleus  of  third  nerve. 
Central  origin  of  sympathetic. 

Sympathetic  centre  in  medulla. 
Sympathetic  fibres. 


IjlQ.  *  4.— uiagram  to  show  the  nervous  supply  of  the  eye.  a,  nerves  to  the  ciliary  muscle  regu- 
lating accommodation  ;  6,  nerves  to  the  contracting  fibres,  and  c,  nerves  to  the  dilating  fibres  of 
the  iris ;  d,  vaso-motor  nerves  to  the  vessels  of  the  eye.  The  iris  is  put  apparently  behind 
instead  of  in  front  of  the  lens  for  convenience  in  showing  the  passage  of  nerves  to  it. 


Along  with  the  dilating  fibres  others  pass  to  supply  the  orbital 
muscle  at  the  back  of  the  orbit,  which  causes  protrusion  of  the 
eyeball,  as  already  mentioned.  There  are  also  other  fibres  from 
the  sympathetic  (vaso-motor)  which  supply  the  muscular  coats 
of  the  arteries  of  the  ciliary  vessels. 

The  dilating  centre  may  be  stimulated  directly  by  venous 
blood  circulating  in  it.  In  consequence  of  this  the  pupils  usually 
dilate  much  when  the  respiration  is  imperfect,  as  during  dyspnoea; 
but  when  the  asphyxia  becomes  complete  the  centre  again  be- 
comes paralysed  and  the  size  of  the  pupil  diminishes.  It  may  be 
stimulated  reflexly  by  irritation  of  sensory  nerves,  so  that  dilata- 
tion of  the  pupil  has  been  used  as  an  indication  of  sensation  in 
animals  paralysed  by  curare.  It  seems  to  be  readily  stimulated 
by  irritation  of  the  genital  organs.  This  is  probably  the  reason 
why  dilatation  of  the  pupil  frequently  occurs  in  persons  suffering 
from  irritation  of  the  genital  organs.  It  is  probably  also  readily 
stimulated  by  irritation  of  the  intestinal  canal,  and  such  irritation 
may  be  the  cause  of  dilatation  of  the  pupil  in  children  suffering 
from  worms,  and  in  cases  of  poisoning  by  drugs  which  irritate 
the  gastro-intestinal  canal,  like  aconite. 

The  drugs  which  act  upon  the  iris  are  divided  into  two  classes : 
Mydriatics  which  dilate,  and  Myotics  which  contract  the  pupil. 
The  most  important  of  these  are  such  drugs  as  have  a  local  action 


chap,  ix.]    ACTION  OF  DEUGS  ON  SPECIAL  SENSE.         219 

on  the  eye,  and  they  alone  are  used  in  ophthalmic  medicine.   They 
are  indicated  in  the  following  list  by  an  *. 

Mydriatics.  Myotics. 

General  anesthetics —  General  anesthetics— 
chloroform,  ether,  &c.  chloroform,  ether,  &c. 

*Atropine.  *Calabar  bean. 
*Belladonna. 

Belladonnine. 

Benzoyltropine. 

Cocaine. 

Daturine. 
*Duboisine. 

Gelsemine  locally.  Gelsemine  internally. 

*Homatropine  (oxytoluylic-  Jaborandi. 

acid-tropine).  Lobeline  internally. 

Hyoscyamine.  Morphine  internally. 

Muscarine  locally  (?).  Muscarine  internally. 

„         locally. 

Narcissine.  Nicotine  locally. 

Piturine.  Opium. 

Scopalein.  *Physostigmine  (eserine). 

Stramonium.  Pilocarpine. 

Thebaine. 

Ansesthetics  occur  in  both  classes,  because  they  cause  con- 
traction towards  the  commencement  of  their  action,  while  later 
on  they  cause  dilatation.  The  probable  reason  of  this  is  that  at 
first  they  lessen  reflex  action,  so  that  the  reflex  dilatation  of  the 
pupil  by  stimulation  of  sensory  nerves  is  abolished.  Later  on, 
when  they  begin  to  paralyse  the  respiration,  the  accumulation  of 
venous  blood  causes  irritation  of  the  dilating  centre  and  widens 
the  pupil.  Dilatation  of  the  pupil  during  the  administration  of 
ansesthetics  is  therefore  to  be  regarded  as  a  sign  of  imperfect 
aeration  of  the  blood,  due  either  to  embarrassed  or  failing 
respiration  (p.  218)  or  failing  circulation  (p.  207). 

The  contraction  caused  by  morphine  is  also  central,  and  pro- 
bably due  to  a  similar  cause. 

It  is  possible  that  the  local  application  of  drugs  to  the  eyes 
may  have  an  action  on  the  pupil  due  merely  to  their  effect  as 
irritants,  and  independent  of  any  special  action  on  the  iris,  for 
E.  H.  Weber  '  found  that  local  irritation  at  the  margin  of  the 
cornea  causes  partial  dilatation.  Irritation  in  the  middle  of  the 
cornea  causes  rather  contraction  of  the  pupil.  Localised  irrita- 
tion at  the  margin  of  the  iris  may  cause  dilatation  at  that  part. 

The  reason  why  muscarine  has  been  found  by  Binger  and 

1  Quoted  by  Landois.  Physiologic,  1880,  p.  799. 


220  PHAKMACOLOGY  AND   THERAPEUTICS,      [sect.  i. 

Morshead  to  dilate  the  pupil  when  applied  locally  is  probably  that 
the  solution  they  used  was  very  irritating,  either  from  its  strength 
or  for  some  other  reason,  while  Schmiedeberg  and  Harnack  found 
it  to  contract  the  pupil  both  when  given  internally  and  applied 
locally. 

The  contraction  of  the  pupil  noticed  by  Eossbach  in  rabbits 
immediately  after  the  application  of  atropine,  may  also  have  been 
due  to  local  irritation.  The  occurrence  of  dilatation  in  one  case 
and  of  contraction  in  the  other  may  possibly  have  been  due  to  the 
solution  being  dropped  into  the  eye  in  a  different  way  in  the  two 
cases. 

The  commonest  and  most  important  local  mydriatic  and 
myotic  are  respectively  atropine  and  physostigmine  (eserine). 

From  ten  to  twenty  minutes  after  a  solution  of  atropine  has 
been  dropped  on  the  eye,  the  pupil  dilates  and  the  ciliary  muscle 
becomes  paralysed,  so  that  the  accommodation  for  near  objects  is 
no  longer  possible,  and  the  eye  remains  focussed  for  distant  ob- 
jects. When  a  solution  of  physostigmine  is  dropped  into  the  eye, 
the  pupil  contracts  and  the  ciliary  muscle  becomes  spasmodically 
contracted,  so  that  the  eye  is  accommodated  for  near  objects. 

It  is  very  difficult  to  explain  the  mode  of  action  of  these 
drugs  satisfactorily,  and  authorities  are  by  no  means  agreed 
regarding  it.  That  the  action  is  local  is  shown  by  the  fact  that 
when  either  atropine  or  physostigmine  is  applied  to  one  eye  its 
action  is  limited  to  it  and  the  other  remains  unaffected.  If  care 
be  taken  to  limit  the  application  of  a  solution  of  atropine  to  one 
side  of  the  margin  of  the  cornea,  local  dilatation  of  the  corre- 
sponding part  of  the  pupil  may  be  produced. 

Dilatation  of  the  pupil  may  be  due  to 

(1)  Paralysis  of  the  sphincter,  or 

(2)  Excessive  action  of  the  dilator,  or 

(3)  Both  conditions  combined. 

Paralysis  of  the  sphincter  may  be  due  to  (a)  imperfect  action 
or  paralysis  of  the  oculo-motor  centre  in  the  corpora  quadri- 
gemina,  (b)  to  paralysis  of  the  ends  of  the  third  nerve  in  the 
sphincter  iridis,  or  (c)  to  the  action  of  the  drug  upon  the  mus- 
cular fibres  of  the  sphincter  itself,  or  to  a  combination  of  two  or 
more  of  these  factors. 

Along  with  the  factors  just  mentioned  might  be  associated 
excessive  contraction  of  the  dilator  muscle,  which  may  be  due  to 
stimulation  (1)  of  the  sympathetic  centre  in  the  medulla,  (2)  of  the 
ends  of  the  sympathetic  in  the  dilator  muscle,  or  (3)  of  the  dilator 
muscle  itself. 

Excluding  for  the  present  the  question  of  excessive  action  of  the 
dilator  muscle  and  confining  ourselves  to  the  causes  of  paralysis, 
we  see  that  paralysis  of  the  cerebral  oculo-motor  centre  as  a 
factor  in  dilatation  of  the  pupil  by  atropine  is  excluded  by  the 
local  action  of  the  drug,  by  the  experiments .  of  Bernard  and 


chap,  ix.]    ACTION  OF  DEUGS  ON  SPECIAL  SENSE.         221 

others,  which  show  that  dilatation  occurs  from  the  local  action  of 
atropine  when  the  ciliary  ganglion  is  extirpated  and  all  the  nerves 
of  the  eye  have  been  divided,  and  by  the  mydriatic  action  of  atro- 
pine even  in  the  exsected  eye.  We  can  now  limit  its  action  either 
to  paralysis  of  the  ends  of  the  oculo-motor  nerve,  or  paralysis 
of  the  muscular  fibres  of  the  sphincter. 

That  the  ends  of  the  oculo-motor  nerve  in  the  sphincter  iridis 
are  paralysed  is  shown  by  the  experiment  that  when  the  pupil  is 
under  the  full  action  of  atropine,  irritation  of  the  third  nerve  will 
not  produce  a*ny  contraction  in  it,  although  the  sphincter  will  still 
contract  when  stimulated  directly. 

Here  also  we  find  the  same  relation  between  the  action  of 
atropine  on  nerves  supplying  striated  and  non-striated  muscle 
that  we  have  already  noticed  in  the  case  of  the  oesophagus  (p.  139), 
for  in  most  animals  the  iris  consists  of  unstriated  muscular  fibre, 
and  atropine  causes  dilatation  ;  but  in  birds  the  iris  consists  of 
striated  muscular  fibre,  and  atropine  causes  no  dilatation.  Para- 
lysis of  the  ends  of  the  oculo-motor  nerve  in  the  iris  itself  may  be 
looked  upon  as  one  of  the  factors  in  dilatation  by  atropine,  and 
similar  paralysis  of  the  fibres  supplying  the  ciliary  musele  may 
be  regarded  as  the  cause  of  loss  of  accommodation. 

In  addition  to  this,  however,  when  the  dose  of  atropine  is 
large,  the  muscular  fibres  of  the  sphincter  themselves  become 
paralysed,  and  fail  to  contract  even  when  directly  irritated. 

The  question  now  arises  whether  in  addition  to  paralysis  of 
the  oculo-motor  nerve  there  is  not  also  excessive  action  of  the 
dilator  muscle.  That  such  action  of  the  dilator  is  actually  pre- 
sent appears  to  be  shown  by  the  following  fact,  viz.  that  the 
dilatation  caused  by  atropine  does  not  appear  to  be  merely  pas- 
sive, but  occurs  with  such  force  as  to  tear  the  iris  away  from  the 
lens,  and  break  down  inflammatory  adhesions  which  may  have 
formed  between  them.  This  conclusion  has  been  considered  to 
be  supported  also  by  the  facts  : — (a)  That  when  the  oculo-motor 
nerve  is  divided  the  pupil  does  not  dilate  nearly  to  the  same 
extent  as  it  does  from  the  application  of  atropine.  This  is  shown 
both  by  a.  comparison  of  measurements  of  the  eye  under  the  two 
conditions  and  by  the  observation  that  after  the  nerves  have  been 
divided  and  partial  dilatation  produced,  atropine  causes  the  pupil 
to  dilate  still  more.  And  similarly  in  dilatation  due  to  paralysis 
atropine  increases  the  mydriasis.  (6)  When  the  pupil  is  dilated 
by  atropine,  section  of  the  sympathetic  in  the  neck  lessens  the 
dilatation. 

We  may  consider,  then,  with  tolerable  certainty,  that  dilata- 
tion caused  by  atropine  is  due  to  increased  action  of  the  dilator 
as  well  as  diminished  action  of  the  sphincter  muscles  of  the  iris. 

Contraction  of  the  pupil  may  be  due  to 

(1)  Excessive  action  of  the  sphincter,  or 

(2)  Paralysis  of  the  dilator. 


222  PHAEMACOLOGY  AND   THEEAPEUTICS.      [sect.  i. 

That  the  contraction  caused  by  physostigmine  is  not  due  to 
paralysis  of  the  dilator  is  shown  by  the  pupil  dilating  somewhat 
when  shaded,  even  when  the  drug  is  exerting  a  well-marked 
action.  Excessive  action  of  the  sphincter  must  therefore  be  re- 
garded as  the  cause  of  the  myosis.  Such  action  may  be  due  to 
stimulation  (1)  of  the  oculo-motor  cerebral  centre,  (2)  of  the  ends 
of  the  oculo-motor  nerve  in  the  sphincter,  or  (3)  to  increased 
action  of  the  muscular  fibres  in  the  sphincter  from  the  direct 
effect  of  the  drug  upon  them.  The  local  action  of  physostigmine 
upon  the  eye  excludes  the  cerebral  centre,  and  leaves  for  our  con- 
sideration stimulation  of  the  ends  of  the  nerves  and  of  the  mus- 
cular fibres  themselves. 

These  two  structures  seem  to  be  specially  affected  by  differ- 
ent drugs— so  that  local  myotics  may  be  divided  into  two 
classes — 

1st.  Those  which  act  upon  the  peripheral  ends  of  the  oculo- 
motor nerve. 

2nd.  Those  which  affect  the  muscular  fibre  of  the  sphincter 
iridis. 

The  first  class  includes  muscarine,  pilocarpine,'  and  nicotine, 
wbereas  physostigmine  belongs  to  the  second. 

Muscarine,  pilocarpine,  and  nicotine,  when  applied  to  the 
eye,  cause  contraction  of  the  pupil  and  spasm  of  accommodation. 
Atropine,  as  we  have  already  seen,  not  only  paralyses  the  ends 
of  the  oculo-motor  nerve,  which  these  drugs  stimulate,  but  has 
also  an  action  on  the  muscular  fibre  itself.  Its  subsequent  ap- 
plication will  therefore  remove  the  effect  of  these  drugs,  and  they 
will  not  act  when  atropine  has  been  applied  first.  As  physo- 
stigmine stimulates  the  muscular  fibre  itself,  it  will  cause  con- 
traction in  an  eye  which  is  dilated  by  atropine  unless  the  action 
of  the  atropine  has  been  carried  to  such  an  extent  as  to  paralyse 
the  muscular  fibre. 

The  contraction  produced  by  muscarine  in  the  eye  of  the  cat 
is  so  great  as  to  reduce  the  pupil  to  a  mere  slit,  and  is  much 
greater  than  that  caused  by  physostigmine,  for  muscarine,  acting 
only  on  the  ends  of  the  oculo-motor,  produces  spasm  in  the 
sphincter  without  affecting  the  dilator,  while  physostigmine,  act- 
ing on  the  muscular  fibres,  is  said  to  stimulate  those  of  the 
dilator  as  well  as  the  sphincter,  and  thus  to  render  the  contrac- 
tion less  complete.2 

It  has  already  been  pointed  out,  however,  that  the  action  of 
atropine  is  not  confined  to  the  ends  of  the  oculo-motor  nerve,  but 
affects  the  muscular  fibre  itself,  and  thus  it  will  counteract  the 
effect  of  physostigmine,  which  it  would  not  do  if  it  acted  only  on 
the  nerves. 

Atropine  consists  of  the  combination  of  a  base,  tropine,  with 

1  Schmiedeberg,  Arzneimittellchre,  p.  71.        2  Schmiedeberg,  op.  cit. 


chap,  ix.]    ACTION  OF  DRUGS  ON  SPECIAL  SENSE.         223 

tropic  acid.  Tropine  itself  has  no  mydriatic  action,  but  when  an 
atom  of  hydrogen  in  it  is  displaced  by  an  acid  residue  it  acquires 
this  action.  A  number  of  combinations  of  tropine  with  different 
acids  have  been  artificially  prepared  by  Ladenberg,  who  terms 
them  tropeines.  Amongst  these  are  homatropine,  in  which  the 
tropine  is  combined  with  oxytoluylic  acid,  and  also  benzoyl-tropine. 
Atropine  appears  to  be  identical  with  daturine.  Hyoscyamine  is 
also  a  combination  of  tropine  with  tropic  acid,  but  it  appears  to 
be  only  isomeric  with  and  not  identical  with  atropine,  though  it 
seems  to  be  identical  with  duboisine. 

Action  of  Drugs  on  Accommodation. — The  accommodation 
of  the  eye  depends  upon  the  ciliary  muscle.  When  the  eye  is  at 
rest  the  lens  is  flattened  by  the  elastic  tension  of  the  zonule  of 
Zinn.  During  accommodation  for  near  objects  the  ciliary  muscle 
draws  the  zonule  forward  and  allows  the  lens  to  become  more 
convex.  The  ciliary  muscle  is  innervated  by  the  third  nerve : 
the  centre  for  it  appears  to  be  in  the  posterior  part  of  the  floor  of 
the  third  ventricle.  Those  drugs  which  affect  the  iris,  also  affect 
the  power  of  accommodation.  Their  action  on  the  iris  and  on 
accommodation  do  not,  however,  always  begin  at  the  same  time, 
nor  have  they  the  same  duration.  The  action  of  physostigmine 
and  atropine  on  accommodation  usually  begins  after,  and  passes 
away  long  before,  the  affection  of  the  pupil. 

Action  on  intra-ocular  pressure. — The  intra-ocular  pressure 
depends  greatly  on  the  amount  of  fluid  contained  in  the  vitreous, 
and  this  in  turn  is  determined  by  two  factors  : — 

(1)  The  amount  of  fluid  secreted  by  the  ciliary  body. 

(2)  The  freedom  with  which  fluid  escapes  at  the  angle  of  the 
anterior  chamber. 

The  aqueous  humour  and  the  fluid  which  nourishes  the 
vitreous  and  crystalline  lens  are  chiefly  secreted  by  the  ciliary 
processes.  It  ultimately  passes  out  from  the  anterior  chamber  of 
the  eye  by  a  number  of  small  openings  (/,  Pig.  75)  close  to  the 
junction  of  the  cornea  and  iris  into  the  canal  of  Schlemm 
(c,  s,  Fig.  75),  thence  into  the  anterior  ciliary  veins.  Some  of 
it  also  passes  into  the  perichoroidal  space,  and  out  through  the 
lymphatics. 

The  intra-ocular  pressure  may  be  increased  by  (a)  more  rapid 
secretion  from  the  ciliary  processes,  or  (b)  interference  with  its 
outward  flow  from  the  eye,  or  (c)  by  increased  quantity  of  blood 
in  the  vessels  of  the  iris.  It  may  be  diminished  by  the  contrary 
conditions. 

More  rapid  secretion  from  the  ciliary  process  probably  takes 
place  under  nervous  conditions  which  are  not  at  present  well 
known.  Interference  with  the  flow  of  the  aqueous  humour^  out 
of  the  anterior  chamber  may  occur  in  aquo-capsulitis,  in  which 
the  openings  from  the  anterior  chamber  into  the  spaces  of 
Fontana  are  occluded  by  a  coating  of  inflammatory  lymph  ;  also 


224  PHAKMACOLOGY  AND  THEEAPEUTICS.      [sect.  i. 

in  glaticoma  where  these  openings  are  shut  by  the  iris  being  pressed 
forward  against  the  cornea,  as  in  Fig.  75,  and  in  iritis  where  the 
iris  is  much  congested  and  the  communication  between  the 
posterior  and  anterior  chambers  is  interrupted  by  complete  ad- 
hesion of  the  pupillary  edge  of  the  iris  to  the  anterior  capsule 
of  the  lens  (total  posterior  synechia).  The  secretion  is  probably 
diminished  by  the  action  of  atropine.  In  glaucomatous  states 
where  the  periphery  of  the  iris  lies  in  contact  with  the  cornea 
the  outward  flow  through  the  spaces  of  Fontana  may  often  be 
increased  by  Calabar  bean,  which,  by  causing  contraction  of  the 
circular  fibres  of  the  iris,  flattens  the  arch  of  the  iris  and,  drawing 
it  away  from  the  cornea,  reopens  the  contracted  angle  between 
the  cornea  and  iris,  and  permits  the  passage  of  fluid  through  the 
spaces  of  Fontana.1 

There  are  few  or  no  experiments  on  the  tension  in  the  vitreous 
humour  of  the  eye,  though  by  the  term  intra-ocular  tension  is 
usually  intended  the  pressure  in  the  vitreous  humour.      The 


Fig.  76.— This  diagram  (  vhich  I  owe  to  the  kindness  of  Mr.  J.  Tweedy)  represents  a  section  througu- 
tlie  corneo-scleral  region,  ciliary  body  and  iris,  of  a  healthy  eye  (left  side),  and  of  a  glaucomatous 
eye  (right  side)  :  A,  cornea  ;  s,  sclerotica ;  i,  iris  ;  /,  spaces  of  Fontana  ;  c  s,  canal  of  Schlemm.  In 
the  glaucomatous  eye  the  ciliary  body  is  atrophied,  and  the  iris  lies  against  the  cornea,  prevent, 
ing  the  escape  of  fluids  through  the  spaces  of  Fontana  and  canal  of  Schlemm. 

degree  of  intra-ocular  tension  is  usually  ascertained  by  pressing 
the  finger  secundum  artem  upon  the  eye  and  observing  whether  it 
is  harder  or  softer  than  usual,  or  by  pressing  upon  the  sclerotic 
with  an  ivory  point  attached  to  a  registering  spring,  and  noticing 
the  pressure  required  to  produce  an  indentation.  These  methods 
of  experiment  are  valuable  clinically,  but  the  tension  can  be 
more  exactly  ascertained  in  animals  by  passing  a  small  trocar 
into  the  anterior  chamber  and  connecting  it  with  a  manometer. 
The  results  of  experiments  even  by  this  method  are  not  entirely  in 
accordance.  The  most  recent  ones  by  Graser 2  appear  to  show  that 
the  tension  depends  to  a  great  extent  upon  the  height  of  the 
blood-pressure  generally :  contraction  of  the  pupil  diminishes, 
and  dilatation  increases  the  intra-ocular  tension.  Eserine  causes 
temporary  increase  at  first,  but  after  contraction  of  the  pupil 
comes  on,  the  tension  is  diminished.    Atropine  in  doses  sufficient 


J.  Tweedy,  Practitioner,  Nov.  1883,  vol.  xxxi.  p.  321. 
Graser,  Archiv  f.  exp.  Path.  u.  Pharm.,  Bd.  xvii.  Heft  5. 


chap,  ix.]     ACTION  OP  DBUGS  ON  SPECIAL  SENSE.         225 

to  dilate  the  pupil  increases  the  tension.  The  precise  effect  of 
atropine  on  intra-ocular  tension  in  man  is  disputed.  From 
clinical  observation  the  truth  would  seem  to  be  that  in  a  per- 
fectly healthy  eye  and  in  ordinary  iritis  atropine  and  other 
mydriatics  diminish  tension,  whereas  they  increase  the  tension 
when  the  anterior  chamber  is  shallow  from  narrowing  of  the 
iridic  angle.  In  glaucomatous  states  atropine  and  other  my- 
driatics almost  always  rapidly  increase  tension.  This  action  of 
atropine  and  its  allies  not  only  makes  them  dangerous  in  cases 
of  glaucoma,  but  where  this  disease  has  been  impending  it  has 
been  at  once  brought  on  by  their  use.  From  its  power  to 
diminish  tension  eserine  is  useful  in  glaucoma. 

Uses  of  Mydriatics  and  Myotics. — Belladonna  is  employed 
locally  for  its  sedative  action,  to  relieve  pain  and  allay  irritation 
and  inflammation  in  the  conjunctiva,  cornea,  choroid,  or  iris. 

Mydriatics  and  myotics  are  used  not  only  for  their  action 
upon  the  pupil  but  for  their  action  upon  accommodation  and 
intra-ocular  pressure. 

Mydriatics  are  employed  to  dilate  the  pupil  for  the  purpose 
of  facilitating  ophthalmoscopic  examination,. assisting  the  detec- 
tion of  cataract  commencing  in  the  periphery  of  the  lens,  or 
allowing  the  patient  to  see  past  the  edge  of  a  cataract  or  corneal 
opacity  when  this  is  central  in  position,  and  obstructs  the  vision 
with  a  pupil  of  normal  size.  They  are  used  to  prevent  prolapse 
of  the  iris,  or  to  restore  it  to  its  normal  position  when  already 
prolapsed  in  cases  of  perforating  ulcer  or  mechanical  lesion  of 
the  cornea.  They  are  employed  in  iritis  to  afford  rest  to  the 
inflamed  tissues  of  the  eye,  and  to  keep  the  iris  as  far  as  possible 
off  the  surface  of  the  lens  and  prevent  adhesions  of  its  posterior 
surface  to  the  anterior  surface  of  the  lens. 

Mydriatics  are  employed  to  paralyse  the  ciliary  muscle,  and 
thus  destroy  the  power  of  accommodation  in  order  to  test  the 
condition  of  the  refractive  media  of  the  eye  in  cases  of  astig- 
matism, or  in  cases  where  the  patients  either  suffer  from  spasm 
of  the  ciliary  muscle  or  are  unable  voluntarily  to  relax  the 
accommodation . 

Myotics  are  used  to  counteract  the  effect  of  mydriatics  which 
have  been  previously  employed,  or  in  mydriasis  following  a  blow 
or  paralysis  of  the  third  nerve.  They  are  used  also  to  counteract 
deficiency  in  tone  of  the  ciliary  muscle,  as  in  paralysis  of  ac- 
commodation consequent  on  diphtheria,  asthenopia,  a  blow  on 
the  eye,  &c. 

Myotics  are  useful  in  cases  of  threatening  and  commencing 
glaucoma  and  often  even  in  more  advanced  cases  of  glaucoma, 
from  their  power  to  lessen  intra-ocular  tension.  As  a  temporary 
expedient  they  are  often  of  the  greatest  service  in  cases  of  acute 
glaucoma.  So,  also,  if  perchance  the  instillation  of  atropine 
have  induced  glaucoma,  myotics  will  not  only  counteract  the 

Q 


226  PHARMACOLOGY  AND   THERAPEUTICS,      [sect.  I. 

mydriasis,  but  often  rapidly  restore  the  intra-oeular  tension  to 
the  normal  standard.1 

Mydriatics  and  myotics  may  be  employed  alternately  in  order 
to  ascertain  the  presence  of  any  adhesions  of  the  iris,'  and  to 
break  them  down  if  present. 

In  glaucoma  the  intra-ocular  tension  within  the  anterior 
chamber  is  greatly  increased,  and  the  increase,  according  to 
Tweedy,  is  due  to  the  natural  channel  of  escape  for  the  aqueous 
humour  through  the  spaces  of  Fontana  and  the  canal  of  Schlemm 
being  obstructed  by  the  iris  lying  against  the  cornea.  This 
condition  is  relieved  by  myotics,  which,  by  causing  contraction 
of  the  pupil,  draw  the  iris  away  from  the  cornea,  and  thus  allow 
the  fluid  to  escape  through  the  spaces  of  Fontana.  When  the 
anterior  chamber  of  the  eye  is  shallow  and  the  iris  is  lying  close  to 
the  cornea,  so  as  nearly,  though  not  quite,  to  obstruct  the  spaces  of 
Fontaaia,  atropine  may  induce  an  attack  of  glaucoma  by  dilating 
the  pupil  and  thus  packing  the  tissue  of  the  iris  into  the  angle 
between  it  and  the  cornea,  so  as  to  render  the  obstruction  to  the 
spaces  of  Fontana  complete. 

Action  of  Cocaine. — Cocaine,  when  applied  locally  to  the  eye, 
has  several  actions.  It  produces  local  anaesthesia,  dilatation  of 
the  pupil,  and  relaxation  with  more  or  less  complete  paralysis 
of  the  ciliary  muscle.  When  two  to  three  drops  of  a  4-per  cent, 
solution  are  applied  to  the  eye  at  intervals  of  five  minutes,  such 
complete  local  anaesthesia  of  the  cornea,  conjunctiva,  and  his  is 
produced  in  twenty  to  thirty  minutes  as  to  allow  operations  to  be 
performed  on  the  eye.  At  the  same  time  the  cocaine  causes  con- 
striction of  the  superficial  vessels,  producing  blanching  of  the 
conjunctiva.  The  dilatation  of  the  pupil  is  great,  is  quickly 
attained,  and  differs  from  that  produced  by  atropine  in  the  fact 
that  the  cocainised  pupil  reacts  to  light  and  accommodation.  The 
mydriasis  is  probably  due  to  stimulation  of  the  ends  of  the  sympa- 
thetic in  the  iris,  for  cocaine  will  not  produce  any  mydriatic  effect 
after  the  cervical  sympathetic  has  'been  cut  for  such  a  length  of 
time  as  to  allow  degeneration  of  the  peripheral  ends  to  occur, 
nor  has  stimulation  of  the  cervical  sympathetic  any  effect  in 
increasing  the  ad  maximum  cocaine  mydriasis.  That  the  third 
nerve  is  not  paralysed  is  shown  by  the  fact  that  stimulation  of 
it  produces  contraction  in  the  cocainised  pupil.  A  similar  effect 
follows  local  stimulation  of  the  sphincter  pupillse.  That  the 
action  of  cocaine  is  exerted  on  the  peripheral  ends  and  not  on  the 
centres  of  the  sympathetic  is  shown  by  the  fact  that  section  of  the 
cervical  sympathetic  does  not  alter  the  pupil  which  is  fully  dilated 
by  cocaine,  and  cocaine  induces  mydriasis  in  an  exsected  eye.2 

Action  of  Drugs  on  the  Retina.— By  a  comparison  of  the 
retina  of  a  frog  kept  in  darkness  with  one  exposed  to  light,  it  has 


Tweedy,  loc.  cii.  '  Jessop,  Proc.  Roy.  Soc,  1885. 


cSap.  ix-1    ACTION  OF  DEUGS  ON  SPECIAL  SENSE.         227 

been  found  that  light  causes  not  only  the  internal  segments  of 
the  cones  •  and  rods 2  but  also  the  pigment-cells  of  the  retina  to 
contract,  so  that  the  external  parts  of  the  rods  and  cones  as  well 
as  the  pigment  are  drawn  away  from  the  external  towards  the 
internal  limiting  membrane  of  the  retina  (Fig.  766).  A  similar 
effect  is  produced  by  heat.2  The  retina  of  a  frog  which  has  been 
tetanised  by  strychnine  in  complete  darkness  has  an  appearance 


Pig.  76.— Shows  the  position  of  the  rods  and  pigment-cells  in  the  retina  of  the  frog :  a,  after  the 
animal  has  been  kept  in  complete  darkness  for  one  or  two  days ;  6,  after  it  has  been  exposed  to 
diffused  daylight  for  five  or  ten  minutes,  after  being  kept  in  darkness  for  twenty-four  hours ; 
c,  after  exposure  to  light  as  in  b,  but  for  half  an  hour  instead  of  a  few  minutes.  This  also  repre- 
sents the  position  of  the  rods  and  pigment-cells  in  strychnine  tetanus. 

similar  to  that  of  a  retina  which  has  been  exposed  to  full  day- 
light, the  strychnine  haying  caused  extreme  contraction  of  the 
rods,  cones,  and  pigment-cells  (Fig.  76c).  A  similar  effect  is 
produced  by  tetanising  the  eye  itself  either  by  induced  currents 
in  the  dark,  or  while  it  is  still  in  the  head  or  immediately 
after  its  excision.  Curare  neither  hinders  this  action  nor  pro- 
duces it. 

Action  of  Drugs  on  the  Sensibility  of  the  Eye. — The 
sensitiveness  of  the  eye  to  impressions  is  increased  by  strychnine, 
the  field  of  vision  becoming  larger,  and  the  sight  more  acute,  so 
that  objects  can  be  distinctly  observed  at  a  greater  distance,  and 
the  field  of  colour  is  increased  for  blue.  This  action  appears  to 
be  to  a  certain  extfent  local,  as  it  occurs  more  distinctly  on  that 
side  where  the  strychnine  has  been  injected  hypodermically. 
The  sense  of  colour  is  affected  in  a  remarkable  way  by  santonin, 
which  at  first  causes  objects  to  appear  somewhat  violet  and  after- 
wards of  a  greenish-yellow.  The  yellow  colour  has  been  ascribed 
to  staining  of  the  media  of  the  eye  by  santonin,  as  it  becomes 
yellow  when  exposed  to  the  light ;  others  again  have  supposed 


1  Engelmann  (and  von  Genderen  Stort),  Pflilger's  Archiv,  xxxv.  p.  498. 
1  Gradenigo,  jun.,  Allg.  Wiener  med.  Ztg.,  1885,  No.  29. 

«  2 


228 


PHAEMACOLOGY  AND  THEKAPEUTICB.      (sect.  i. 


the  alteration  in  the  apparent  colour  of  objects  to  be  due,  first  to 
a  stimulation,  and  then  to  a  paralysis  of  those  constituents  of  the 
retina  by  which  the  violet  colour  is  perceived. 

The  sensibility  of  tbe  eye  for  red  and  green  appears  to  be 
sometimes  diminished  by  physostigmine. 

Action  of  Drugs  in  Producing  Visions.— It  may  be  well 
here  to  mention  the  effect  of  some  drugs  in  causing  subjective 
sensations  of  sight,  although  these  probably  depend  rather  upon 
the  action  of  the  drugs  on  the  brain,  than  on  the  eye  itself.  The 
centres  for  sight,  according  to  Ferrier,  are  the  angular  gyrus 
(14  and  15,  Fig.  68,  p.  185),  and  the  occipital  lobes.  In  delirium 
tremens  arising  from  alcoholic  excess  the  patients  often  complain 
much  of  visions  of  the  most  disagreeable  character,  which  often 
take  the  form  of  demons  or  of  animals. 

Cannabis  indica  produces  in  some  persons,  though  not  in  all, 
visions  which  may  be  pleasant  or  laughable.  These  chiefly  occur 
just  'before  sleep.1 

Salicylate  of  sodium  in  some  persons  tends  to  cause  most 
disagreeable  visions  whenever  the  eyes  are  shut,  and  I  have  seen 
it  have  this  effect  even  in  such  a  small  dose  as  five  grains. 
Large  doses  of  digitalis  may  cause  subjective  sensations  of  light, 
and  after  taking  nearly  one  grain  of  digitalin  in  the  course  of 
forty-eight  hours  I  suffered  from  the  centre  of  the  field  of  vision 
being  occupied  by  a  bright  spot  surrounded  by  rainbow  colours. 
Digitalin  when  introduced  into  the  eye  locally  causes  at  first 
smarting  and  lacrimation,  which  soon  passes  off,  but  after  four 
or  five  hours,  when  a  light  is  looked  at,  a  halo  is  seen  surround- 
ing it,  which  is  not  improbably  due  to  some  opalescence  in  the 
cornea.2 

Toxic  Amblyopia. — Belladonna  taken  internally  in  sufficient 
quantity  causes  dilatation  of  the  pupil  and  misty  vision.  Alcohol, 
tobacco,  quinine,  and  lead  all  cause  failure  of  the  power  of  vision 
for  form  and  for  certain  colours,  as  well  as  limitation  of  the  field 
of  vision  either  in  the  centre  or  the  periphery.  These  symptoms 
are  at  first  functional,  but  if  not  relieved  they  may  be  the  pre- 
cursors of  actual  anatomical  changes. 

Action  of  Drugs  on  Hearing. 

The  sense  of  hearing  depends  on  the  transmission  of  sonorous 
vibrations  from  the  air  to  the  auditory  nerve  by  means  of  the 
membrana  tympani  and  the  ossicles  of  the  ear,  and  upon  the 
perception  of  those  vibrations  by  the  brain. 

The  centre   for    hearing,   according  to  Ferrier,   is   in  the 


1  Compare  Sohrofi,  Pharmacologie,  4th  ed.  p.  535,  and  Wood,  Materia  Medica, 
3rd  ed.  p.  236. 

2  Lauder  Brunton,.  On  Digitalis,  &c. 


chap,  nc]    ACTION  OP  DEUGS  ON  SPECIAL  SENSE.  229 

superior  temporo-sphenoidal  convolution  (16,  Fig.  68,  p.  185). 
It  is  probable  that  subjective  sounds  not  depending  on  disturb- 
ance of  the  auditory  apparatus,  such  as  the  sounds  of  voices,  &c, 
heard  in  delirium  or  mania,  or  as  the  prodromata  of  an  epileptic 
fit  in  certain  individuals,  or  during  intoxication  by  cannabis 
indica,  are  due  to  irritation  of  these  eentres. 

The  sense  of  hearing  may  be  dulled  by  any  interference  with 
the  passage  of  the  sound  into  the  ear,  as  by  wax  in  the  auditory 
meatus,  by  disease  of  the  auditory  nerve  or  of  the  brain  itself. 

The  hearing  may  be  rendered  more  acute  by  the  removal  of 
any  obstacle  in  the  way  of  transmission  of  sound  to  the  auditory 
nerve,  or  by  drugs  which  increase  the  excitability  of  the  auditory 
nerve  or  of  the  brain ;  thus  the  wax  may  be  removed  by  simply 
syringing ;  thickness  and  catarrh  of  the  Eustachian  tube  which 
interfere  with  vibrations  in  the  middle  ear  may  be  lessened  by 
the  inhalation  of  camphor  and  ammonia,  or  by  the  application 
of  a  solution  of  ammonium  chloride  and  sodium  bi-carbonate  to 
the  posterior  nares  either  by  the  spray  or  nasal  douche.  The 
excitability  of  the  auditory  nerve  or  of  the  brain  is  increased  by 
strychnine,  which  renders  the  hearing  more  acute. 

Subjective  noises  in  the  ear,  such  as  humming,  buzzing,  or 
ringing,  are  often  very  troublesome.  Bubbling  noises  may  be 
due  to  mucus  in  the  Eustachian  tube.  Buzzing  or  humming 
are  probably  generally  caused  by  vascular  congestion  either  of 
the  external  meatus,  of  the  middle  ear,  or  of  the  Eustachian 
tube.  Where  the  bubbling  noises  are  due  to  the  presence  of 
mucus  they  may  be  to  a  considerable  extent  removed  by  washing 
out  the  mucus  with  a  solution  of  carbonate  of  sodium  applied  by 
a  nasal  douche.  Noises  in  the  ears  due  to  hyperemia  may  be 
lessened  or  removed  by  cholagogue  purgatives  and  by  hydro- 
bromic  acid.  Where  chronic  thickening  of  the  membrane  is 
present,  relief  is  usually  afforded  by  iodide  of  potassium  or 
iodide  of  ammonium,  both  applied  locally  and  taken  internally. 
Subjective  noises  in  the  ears  are  caused  by  quinine  in  large 
doses,  and  also  by  salicylate  of  sodium.  Both  of  these  drugs 
have  their  effect  upon  the  ear  to  a  great  extent  neutralised  by 
hydrobromic  acid,  and  ergot '  is  said  to  have  a  similar  power 
to  prevent  or  remove  the  unpleasant  singing.  It  is  uncertain 
whether  the  singing  caused  by  quinine  and  salicylates  is  due  to 
their  action  on  the  auditory  apparatus,  or  the  cerebral  centres ; 
but  the  fact  that  in  larger  doses  they  may  cause  delirium  in- 
dicates that  even  the  earlier  symptom  of  buzzing  in  the  ears 
may  be  due,  in  part  at  least,  to  their  action  on  the  cerebral 
centres. 

1  Schilling;  Aertzl.  Intelligenzblalt,  1883. 


230  PHAEMACOLOGY  AND  THERAPEUTICS,      [sect.  i. 


Action  of  Drugs  on  Smell. 

Many  drugs,  such  as  musk  and  ethereal  oils,  have  a  marked 
and  characteristic  smell,  due  to  their  effect  upon  the  terminal 
branches  of  the  olfactory  nerve.  This  nerve  is  soon  exhausted, 
so  that  in  a  very  short  time  the  smell  is  no  longer  perceived  with 
anything  like  the  intensity  it  was  at  first.  Such  smells  as  these 
just  mentioned  cannot  be  perceived  by  persons  suffering  from 
anosmia,  but  certain  drugs,  such  as  ammonia  or  acetic  acid, 
can  be  recognised  by  them.  The  reason  of  this  is  that  although 
such  persons  are  incapable  of  perceiving  any  true  smell,  the 
nasal  branches  of  the  fifth  nerve  are  irritated  by  pungent  vapours, 
and  thus  produce  a  certain  kind  of  sensation.  The  power  of 
distinguishing  smells  seems  to  be  increased  by  strychnine ;  which 
appears  at  the  same  time  to  render  such  disagreeable  odours  as 
those  of  asafcetida,  garlic,  and  valerian  agreeable.  This  effect 
may  be  due  to  the  action  of  strychnine  on  the  olfactory  apparatus, 
but  it  is  very  probably  due  rather  to  the  action  of  the  drug  on 
the  cerebral  centre  for  smell,  which,  according  to  Ferrier,  is 
situated  at  the  tip  of  the  temporo-sphenoidal  lobe.  The  power 
•  to  distinguish  smells  is  diminished  by  such  drugs  as  lessen  the 
sensibility  of  the  brain,  or  by  those  which  cause  alterations  in 
the  nasal  mucous  membrane,  as,  for  example,  iodide  of  potassium 
given  in  such  doses  as  to  produce  coryza. 

Action  of  Drugs  on  Taste. 

Most  of  the  substances  used  in  medicine  have  a  strong  taste, 
and  many  a  very  unpleasant  taste. 

What  is  usually  termed  taste  frequently  depends  on  a  mixture 
of  taste  and  smell,  and  if  the  sense  of  smell  is  abolished  for  the 
time  being,  the  characteristic  taste  of  the  substance  cannot  be 
distinguished.  This  is  the  reason  why  castor-oil,  which  owes  its 
nauseous  taste  almost  entirely  to  its  odour,  can  be  swallowed 
without  being  so  readily  distinguished  if  the  nose  is  held  during 
the  act  of  swallowing.  In  addition  to  the  taste  they  produce  in 
the  mouth,  certain  substances  leave  an  impression  termed  '  after 
taste '  on  the  tongue  after  they  have  been  swallowed  or  ejected ; 
and  this  is  sometimes  quite  different  from  that  of  the  taste  of 
the  substance  itself :  thus  bitters  leave  a  sweet  after-taste  in  the 
mouth.  If  quinine  is  taken  in  a  nearly  neutral  solution,  it 
leaves  a  persistent  bitter  taste  from  the  sparingly  soluble  alka- 
loid being  precipitated  on  the  tongue  and  remaining  there  for  a 
length  of  time,  but  if  the  quinine  be  taken  with  excess  of  acid, 
so  as  to  keep  it  entirely  in  solution,  and  washed  out  of  the 
mouth  immediately  with  a  draught  of  water,  it  leaves  a  sweet 
after-taste. 


chap,  ix.]    ACTION  OF  DEUGS  ON  SPECIAL  SENSE.  231 

Some  substances  after  their  entrance  into  the  blood  are 
excreted  by  the  saliva  and  may  cause  a  somewhat  persistent 
taste  in  the  mouth ;  this  is  observable  in  the  case  of  iodide  of 
potassium. 

Iodine  appears  also  to  have  the  power  of  causing  other  sub- 
stances to  be  excreted  by  the  saliva,  when  they  are  combined 
with  it,  and  thus  Bernard  found  that  iodide  of  iron  was  secreted 
by  the  saliva,  though  lactate  of  iron  was  not ;  and  I  have  some- 
times thought  that  iodine  has  a  similar  effect  upon  quinine, 
because  I  have  very  frequently  noticed  patients  complain  of  a 
persistent  bitter  taste  in  their  mouth  when  I  have  given  quinine 
combined  with  iodide  of  potassium,  although  they  did  not  com- 
plain of  this  when  either  of  the  drugs  has  been  given  without 
the  other. 


232  PHARMACOLOGY  AND  THERAPEUTICS,      [seot.i. 


CHAPTER  X. 
ACTION  OF  DRUGS  ON  RESPIRATION. 

Respiratory  Stimulants  and  Depressants. 

It  is  usually  supposed  by  naturalists  that  in  the  descent  of  man 
from  some  organism  low  in  the  scale  of  existence,  he  has  passed, 
at  a  remote  period,  through  a  stage  resembling  the  Ascidians  or- 
Tunicata.  In  these  animals  respiration  is  maintained  by  water 
being  driven  through  a  perforated  sac  in  the  meshes  of  which 
the  nutritive  fluids  of  the  animal  circulate.  The  contractile 
motions  of  the  sac  by  which  the  circulation  of  fluid  is  maintained 
probably  depend  on  a  nervous  ganglion  situated  between  the 
oral  and  anal  apertures  as  represented  in  the  diagram  (Fig.  77). 
We  do  not  know  whether  or  not  this  ganglion  may  influence  the 
circulation  which  is  maintained  by  the  rhythmical  contractions  of 
the  simple  tube  which  serves  as  a  heart.  These  drive  the  fluid 
first  in  one  direction,  and  then  after  a  while  the  action  of  the 
tube  is  reversed,  and  its  contractions  drive  the  fluid  in  the  oppo- 
site direction.  This  ganglion  in  its  functions  would  correspond 
with  the  medulla  oblongata  in  the  vertebrata,  and  thus  the 
medulla  oblongata  may  be  looked  upon  as  a  lower  and  more 
fundamental  centre  than  the  brain  or  spinal  cord. 

We  see  this  more  distinctly  perhaps  by  looking  at  the  two 
diagrams  (Figs.  78  and  79)  representing  an  amphioxus  and  a 
fish.  In  the  amphioxus  respiration  is  kept  up  in  much  the  same 
way  as  in  the  ascidian,  the  water  passing  from  the  pharyngeal 
to  the  atrial  sac  and  through  the  atrial  aperture  or  abdominal 
pore.  There  is  no  head  and  no  organs  of  special  sense,  and  so 
we  have  no  brain  whatever.  But  the  body  is  elongated  so  as  to 
remind  us  of  an  ascidian,  having  its  ganglion  and  the  part  of  the 
body-wall  containing  it  so  much  extended  as  to  remove  the  anal 
considerably  from  the  oral  aperture.  The  muscles  of  this 
elongated  body  require  innervation,  and  thus  the  ganglionic  mass 
is  elongated  into  a  cord  called  the  myelon,  which  represents  the 
spinal  cord  as  well  as  the  medulla  oblongata.  In  ascidians  then 
we  have  a  mass  corresponding  to  the  medulla ;  in  the  amphioxus 
we  have  a  mass  corresponding  to  medulla  and  spinal  cord. 


chap,  x.]      ACTION  OF  DEUGS  ON  EESPIEATION.  '233 

In  a  fish  the  pharyngeal  or  branchial  sac,  instead  of  opening 
into  the  atrial  sac,  opens  directly  into  the  surrounding  water. 


Body  wall 

Serves  passing  from  the 
ganglion 


Pharyngeal  sao 

General  body-cavity 
Heart 


'  Oral  aperture. 

Part  of  body  wall    containing 

ganglion. 
Branchio-anal  or  atrial  aperture. 

1  Branchial  openings  in  the  sep- 
tum between  the  pharyngeal 
and  anal  sac. 


Intestine \-J. 


Fig.  77.— Diagram  of  an  Ascidian. 


Oral  aperture  — — 


Branchial  openings  | 

3/   — — . 


or  pharyngeal  sac 
Pharyngeal  sac 


Branchial  aperture  or 
abdominal  pore 

Ana}  aperture 


Mr Nose. 

Orrl 
aperture  "-"" 
Branchial 
apertures 

il 
>4 

wi               Brain. 

Nervous 
myelon. 

i 

[Ktf    \          cord 

Anal 

apertuie  — 

w, 

Fig.  78. — Diagram  of  Amphioxus.  'riie  water  enters  the 
oral  aperture,  passes  through  the  openings  in  the 
pharyngeal  sac  into  another  cavity,  whence  it 
escapes  by  the  abdominal  pore. 


Tia.  79.— Diagram  of  fish. 


We  have  a  head  and  organs  of  special  sense,  and  therefore  we 
have  a  large  nervous  mass  or  brain. 

In  these  three  members  of  the  animal  kingdom,  therefore,  we 
have  the  medulla  as  the  lowest  or  fundamental  centre,  next  the 
spinal  cord,  and  lastly  the  brain.  We  might  therefore  expect 
that  notwithstanding  the  apparently  higher  position  and  greater 
nearness  of  the  medulla  to  the  brain  than  to  the  spinal  cord, 
the  medulla  would  be  less  readily  affected  by  many  drugs  than 
the  cord  or  the  brain,  and  this  is  what  we  find  in  the  case 
of  such  drugs  as  alcohol,  ether,  or  morphine,  which  appear  to 
paralyse  the  nervous  centres  in  the  inverse  order  of  their  de- 
velopment— the  brain  first,  spinal  cord  next,  and  medulla  last. 

There  are  some  drugs,  however,  e.g.  aconite,  gelsemium,  and 


234  PHAEMACOLOGY  AND  THEEAPEUTICS.      [sect.  I. 

hydrocyanic  acid,  which  seem  to  have  a  special  paralysing  action 
on  the  respiratory  centre. 

If  we  look  at  the  ganglionic  mass  in  an  ascidian,  represented 
in  the  diagram,  we  shall  see  that  it  sends  some  fibres  to  the 
pharyngeal  sac  and  some  to  the  anal  sac.  If  these  two  sacs  were 
to  contract  together  they  would  oppose  each  other's  action,  and 
thus  the  passage  of  water  through  the  branchial  apertures  would 
be  stopped,  and  respiration  consequently  arrested.  They  must 
therefore  act  alternately,  and  this  alternate  action  is  regulated 
by  the  ganglion.  This  ganglion  consists  of  numerous  nerve-cells 
and  fibres.  As  some  of  these  have  a  more  special  connection 
with  the  pharynx,  the  group  which  they  form  may  be  called  the 
pharyngeal  centre  or  inspiratory  centre. 

Similar  arrangements  occur  in  higher  animals,  and  the  terms 
used  in  regard  to  their  nervous  system  may  lead  to  some  confu- 
sion of  thought ;  thus  we  speak  of  the  respiratory,  of  the  inspi- 
ratory, of  the  expiratory,  and  of  the  vomiting  centres. 

By  nerve-centres  we  simply  mean  the  groups  of  cells  and 
fibres  which  are  concerned  in  the  performance  of  certain  acts. 
They  are  not  necessarily  entirely  distinct  from  one  another,  and  the 
same  group  of  ganglionic  cells  may  form  a  part  of  several  centres. 
Thus  in  the  accompanying  diagram  (Fig.  80),  the  respiratory 
centre  includes  both  inspiratory  and  expiratory  centres,  and 
the  vomiting  centre  includes  some  ganglionic  groups  which  form 
part  of  the  inspiratory,  and  others  forming  part  of  the  expiratory 
centres,  besides  other  ganglion  groups  which  are  concerned  with 
the  simultaneous  dilatation  of  the  cardiac  orifice  of  the  stomach. 
On  analysing  this  subject  still  further  we  find  also  that  the 
inspiratory  centre  affects  many  muscles,  and  that  it  does  not 
always  affect  them  to  the  same  extent.  Thus  in  men  the  dia- 
phragm takes  a  more  active  share  in  inspiration  during  the  day 
than  the  thoracic  muscles.  During  sleep  the  diaphragm  takes 
a  much  less  active  part,  and  may  be  entirely  quiet,  while  the 
thoracic  muscles  are  more  active,  and  the  chest  rises  and  falls 
more  than  during  walking. 

The  inspiratory  centre  might  be  thus  still  further  divided 
into  thoracic  inspiratory  centre,  and  diaphragmatic  inspiratory 
centre. 

Such  subdivisions  appear  absurd  if  we  imagine  that  each 
centre  represents  a  distinct  nervous  mass,  and  we  become  puzzled 
to  understand  how  the  medulla  oblongata  can  contain  so  many 
distinct  centres  in  a  small  bulk.  But  if  we  remember  that  the 
word  '  centre '  simply  indicates  a  group  of  cells  and  fibres 
connected  with  the  performance  of  a  particular  act,  and  that  two 
centres  may  be  formed  by  the  same  ganglionic  groups  and  differ 
from  one  another  only  by  having  a  few  ganglion  cells  more  or 
less  which  alter  the  function  they  perform,  no  harm  is  done  by 
the  use  of  the  term. 


chap,  x.]      ACTION  OF  DEUGS  ON  EESPIEATION.  233 

The  act  of  respiration  consists  in  the  alternate  enlargement 
and  diminution  of  the  thoracic  cavity,  so  that  the  air  is  alter- 
nately inspired  and  expired. 


Vomiting  centre. 


Bespiratory  centre. 


Fig.  80.— Diagrammatic  representation  of  various  groups  of  ganglion  cells,  or  'centres'  in  the 
medu  la  oblongata.  The  arrows  indicate  the  directions  in  which  the  nerve-currents  pass  Those 
pointing  to  the  cells  indicate  sensory,  those  pointing  from  the  cells  indicate  motor  nerves 

I 

The  muscles  by  which  this  is  effected  in  ordinary  respiration 
are  the  diaphragm  and  intercostal  and  scaleni  muscles.  The 
diaphragm  descends,  and  the  intercostal  and  scaleni  muscles  raise 
the  ribs  during  inspiration. 

Expiration  is  normally  a  passive  act,1  and  is  not  performed 
by  muscular  action,  but  simply  by  the  tendency  of  the  dia- 
phragm and  thoracic  walls  to  return  to  the  position  of  the  equi- 
librium from  which  they  had  been  removed  during  inspiration, 
and  by  the  contraction  of  the  elastic  walls  of  the  air- vesicles  dis- 
tended by  inspiration. 

When  the  supply  of  oxygen  is  deficient,  other  muscles  are 
called  in  to  aid  the  inspiration.  Expiration  appears  to  be  a 
passive  act,  not  merely  in  ordinary  respiration,  but  even  in  dys- 
pnoea caused  by  the  absence  of  oxygen.  In  some  experiments 
by  Bernstein2  the  inspiration  and  expiration  were  equally 
increased  in  a  rabbit,  when  the  air  which  it  had  breathed  was 
replaced  by  hydrogen.  But  expiratory  efforts  are  required  both 
for  the  production  of  voice,  and  for  the  removal  of  irritants  from 
the  air-passages  by  coughing  or  sneezing ;  and  forcible  expira- 


1  Bernstein,  Archiv  f.  Anat.  u.  Physiol.,  1882,  p.  322. 
*  Ibid.,  op.  cit. 


236  PHARMACOLOGY  AND   THERAPEUTICS,      [sect.!, 

tion  is  produced  when  an  irritant  is  applied  to  the  mucous  mem- 
brane of  the  nose,  of  the  larynx,  trachea,  or  bronchi.  As  every 
one  who  has  drunk  a  bottle  of  soda-water  knows,  carbonic  acid  is 
an  irritant  of  considerable  power  to  these  mucous  membranes, 
and  when  it  is  breathed  instead  of  air  or  hydrogen  the  expiration 
becomes  much  more  powerful,  and  is  no  longer  a  passive  action, 
but  an  active  one,  performed  by  active  muscular  exertion. 

The  chief  respiratory  centre  is  situated  in  the  medulla  ob- 
longata close  to  the  end  of  the  calamus  scriptorius,  at  the  point 
designated  nceud  vital  by  Flourens,  because  destruction  of  this 
point  arrests  the? respiration  and  causes  death. 

It  extends  equally  on  both  sides  of  the  middle  line  in  the 
medulla,  each  half  regulating  the  breathing  on  the  same  side  of 
the  body.  It  has  been  supposed  to  be  double,  and  to  consist  of 
inspiratory  and  expiratory  centres  which  act  alternately,  but  it 
would  appear  that  in  ordinary  respiration  the  inspiratory  centre 
only  is  active. 

When  the  centre  is  injured  by  a  puncture,  as  in  Flourens' 
experiment,  or  when  one  half  of  it  is  destroyed,  breathing  usually 
stops  entirely,  but  if  the  respiration  be  kept  up  artificially  for 
several  hours,  the  normal  breathing  again  becomes  established ; 
and  the  prolonged  continuance  of  artificial  respiration  has  been 
recommended  by  Schiff  in  apoplexy. 

When  the  connection  between  this  centre  and  the  respira- 
tory muscles  is  cut  off  by  dividing  the  spinal  cord  just  below 
the  medulla,  respiration  usually  ceases  entirely,  so  that  at  first 
sight  it  would  seem  that  the  respiratory  centre  is  limited  to  the 
medulla. 

The  effects  of  strychnine  show  that  this  is  not  the  case.  This 
drug  greatly  increases  the  excitability  of  the  respiratory  centre, 
and  when  it  is  injected  into  the  blood  before  division  of  the  spinal 
cord,  the  respiratory  movements  still  continue  to  some  extent 
after  the  cord  has  been  divided.  When  it  is  injected  after  section 
of  the  cord,  the  respiratory  movements  which  had  ceased  again 
recommence  to  a  slight  degree. 

The  reason  appears  to  be  that  the  respiratory  centre  is  not 
limited  to  the  medulla,  but  extends  to  the  upper  part  of  the 
spinal  cord,  though  the  spinal  portion  is  of  itself  too  weak  to 
keep  up  the  respiratory  movements,  except  when  stimulated  by 
strychnine. 

The  amount  of  respiratory  work  which  this  centre  excites 
appears  to  depend  to  a  great  extent,  though  not  entirely,  upon 
the  condition  of  the  centre  itself. 

The  distribution  of  the  work  is  chiefly  determined  by  the 
irritation  of  one  or  other  of  the  afferent  nerves,  and  these  nerves 
also  influence  the  amount  of  work. 

The  centre  is  stimulated,  and  the  amount  of  work  it  does 
increased  by  a  venous  condition  of  the  blood  circulating  in  it. 


chap,  x.]      ACTION  OF  DEUGS.ON  EESPIEATION.  287 

An  arterial  condition  of  its  blood  lessens  or  completely  abolishes 
its  activity,  so  that  when  the  blood  is  highly  aerated  by  forced 
artificial  respiration,  a  condition  of  apncea  is  produced,  in  which 
no  spontaneous  respiratory  movements  occur. 

_  This  condition  is  much  more  readily  induced  when  the  excit- 
ability of  the  respiratory  centre  is  lessened  by  drugs.  In  an 
animal  poisoned  by  chloral,  for  example,  it  is  very  easy  to  induce 
it,  and  it  lasts  for  a  long  time. 

When  the  respiratory  centre  is  excited,  as  by  the  injection 
of  emetine  or  apomorphine  into  the  circulation,  it  is  difficult  or 
impossible  to  produce  this  condition. 

It  is  uncertain  whether  the  stimulation  which  the  venosity  of 
the  blood  produces  is  due  chiefly  to  the  absence  of  oxygen  or  to 
the  presence  of  carbonic  acid.  Possibly  it  may  also  be  due  to  the 
products  of  imperfect  combustion  in  the  venous  blood.  Or  all 
these  three  causes  may  share  in  the  stimulation,  though  to  what 
extent  each  does  so  is  not  known. 

According  to  Bernstein,  want  of  oxygen  appears  to  stimulate 
the  inspiratory  and  the  presence  of  carbonic  acid  to  stimulate  the 
expiratory  centre.1 

As  the  blood  becomes  venous  the  activity  of  the  respiratory 
centre  increases,  the  respirations  becoming  quicker  and  deeper,  and 
the  accessory  respiratory  muscles  are  thrown  into  action.  This 
condition  is  called  dyspnoea.  Finally  the  excitement  extends 
to  all  the  muscles  of  the  body  and  we  get  general  convulsions, 
which  have  usually  an  opisthotonic  character.  The  eyeballs 
very  often  protrude  during  these  convulsions,  and  the  blood- 
pressure  rises  greatly  from  stimulation  of  feympathetic  and  vaso- 
motor centres  in  the  medulla. 

After  the  convulsions  cease,  the  animal  usually  lies  motion- 
less, and  the  heart  as  a  rule  continues  to  beat  for  a  short  time 
after  the  respirations  have  ceased. 

The  excessive  venosity  of  the  blood  in  this  condition  has 
paralysed  the  nerve-centres,  but  if  artificial  respiration  be  now 
commenced  and  the  blood  becomes  gradually  aerated,  the  condi- 
tions just  described  are  again  passed  through  in  the  reverse 
order  :  convulsions  first  reappearing,  then  dyspnoea,  next  normal 
breathing,  and,  if  the  respiration  be  pushed  far  enough,  apncea'. 

Asphyxial  convulsions  only  occur  in  warm-blooded  animals, 
and  not  in  frogs,  and  when  we  find  that  any  drug  produces  con- 
vulsions in  mammals  and  not  in  frogs  we  usually  assume  that 
the  convulsions  are  due  to  asphyxia  produced  by  the  action  of  the 
drug  on  the  respiration  or  circulation,  and  not  to  a  direct  irri- 
tant action  upon  the  motor  centres.  If,  on  the  other  hand,  we 
find  that  the  convulsions  occur  in  frogs  as  well  as  in  mammals, 
the  presumption  is  in  favour  of  their  being  due  to  the  direct 
irritant  action  of  the  drug  on  motor  centres. 

1  Bernstein,  op.  cit.  p.  324. 


23S  PHAEMACOLOGY  AND  THERAPEUTICS,     [sect,  u 

Blood  becomes  venous  when  the  external  respiration  or  inter- 
change of  gases  between  it  and  the  external  air  is  arrested  while 
internal  respiration  continues. 

Internal  respiration  or  interchange  of  gases  occurs  between 
tbe  blood  and  the  tissues  outside  the  vessels  which  are  consuming 
oxvgen  and  deriving  it  from  the  blood.  But  the  blood  although 
fluid  is  itself  a  tissue  and  likewise  consumes  oxygen,  so  that  it 
will  become  venous  if  left  to  itself  in  a  thoroughly-stoppered  glass 

bottle. 

External  respiration  may  be  arrested  or  diminished  by — 

(1)  Interfering  with  the  access  of  air  to  the  blood ;  or 

(2)  „  „      „        ,,      ,,  blood  to  the  air ;  or 

(3)  „  „      „    power  of  the  blood  to  take  up 

and  give  off  oxygen. 
The  access  of  air  to  the  blood  may  be  prevented  by  obstruction 
to  the  air-passages  or  alteration  in  the  structure  of  the  lung ;  thus 
anaesthetics  may  obstruct  respiration  by  allowing  vomited  matters 
to  enter  the  trachea  and  plug  it  mechanically.  Apomorphine  may 
lead  to  obstruction  of  the  bronchi  by  profuse  secretion  from  the 
mucous  membrane,  and  large  doses  of  antimony  may  cause  con- 
solidation of  the  lung. 

Air  may  be  prevented  from  reaching  the  blood  by  any  obstruction  in  the 
respiratory  passages. 

The  respiratory  passages  may  be  obstructed  by  spasmodic  closure  of  the 
glottis  or  of  the  nostrils  in  rabbits  when  an  irritating  vapour  is  inspired. 
This  source  of  obstruction  is  easily  avoided  by  putting  a  cannula  into  the 
trachea  and  allowing  the  vapour  to  be  inspired  through  it.  Another  source  of 
obstruction  is  the  formation  of  plugs  of  mucus  or  clots  of  blood  in  the  trachea 
or  in  the  cannula,  which  has  been  introduced  into  it.  Occasionally  a  plug  of 
mucus,  and  sometimes  a  clot  of  blood,  forms  in  the  tracheal  cannula  and 
seriously  impedes  the  respiration,  whether  natural  or  artificial,  without 
being  perceived  by  the  experimenter.  In  order  to  be  sure  that  such  an  oc- 
currence has  not  taken  place  and  vitiated  the  results,  it  is  always  advisable, 
on  removing  the  cannula  from  the  trachea  at  the  end  of  an  experiment,  to 
blow  through  it  and  see  that  its  lumen  is  perfectly  unobstructed. 

Access  of  air  to  the  blood  may  be  prevented  also  by  paralysis 
of  the  muscles  of  respiration;  thus  curare  will  produce  it  by 
paralysing  the  ends  of  the  motor  nerves,  hydrocyanic  acid 
by  paralysing  the  respiratory  centre,  and  snake  poison  by 
paralysing  both. 

The  blood  may  be  prevented  from  reaching  the  lungs  by  arrest 
of  the  circulation  either  local  or  general,  and  may  thus  become 
venous,  either  locally  or  generally. 

The  venosity  of  the  blood  circulating  in  the  medulla  may  be 
altered  locally  without  any  change  in  the  rest  of  the  body. 
Thus  if  the  carotid  and  vertebral  arteries  are  tied,  the  blood 
stagnates  in  the  vessels  of  the  medulla,  and  there  becoming  venous 
causes  dyspnoea  and  convulsions,  which  again  disappear  when  the 
ligatures  are  loosened  and  the  circulation  re-established. 


chap.  x.j     ACTION  OF  DEUGS  ON  EESPIEATION.  239 

Dyspnoea  and  convulsions  are  likewise  produced  by  alteration 
in  the  general  circulation,  e.g.  by  loss  of  blood,  as  is  seen  when 
an  animal  is  bled  to  death,  or  when  the  supply  of  blood  in  the 
arteries  is  greatly  diminished  by  ligature  of  the  portal  vein,  which 
causes  the  blood  to  accumulate  and  stagnate  in  the  capacious 
veins  of  the  intestine. 

Stoppage  of  the  heart,  either  by  ligature  directly  applied  to 
it  or  by  the  action  of  drugs  upon  it,  causes  asphyxia  and  convul- 
sions. 

Arrested  circulation  through  the  pulmonary  vessels  by  emboli 
has  a  similar  action.  This  sometimes  leads  to  error  in  regard  to 
the  action  of  drugs  when  these  are  injected,  as  is  often  done,  into 
the  jugular  vein. 

If  they  contain  solid  particles,  these  mav  give  rise  to  embolism 
in  the  pulmonary  arteries  and  lead  to  the  belief  that  the  drug  has 
a  tetanising  action,  when,  as  a  matter  of  fact,  it  has  nothing  of 
the  kind.  Thus,  in  making  an  experiment  on  condurango,  I 
injected  an  infusion  into  the  jugular  vein  of  a  rabbit,  and  it 
rapidly  died  with  symptoms  resembling  those  of  strychnine-poison- 
ing. The  cause  of  this,  however,  was  simply  embolism  of  the 
pulmonary  vessels,  due  to  undissolved  particles  in  the  infusion, 
and  when  this  was  avoided  by  injecting  the  drug  into  the  peri- 
toneal cavity,  no  symptom  whatever  was  produced.  Gianuzzi, 
in  his  experiments  on  this  drug,  appears  to  have  fallen  into  the 
same  error  as  I  did  at  first. 

Altered  condition  of  the  blood  also  gives  rise  to  dyspnoea,  as 
is  seen  in  the  breathlessness  of  anaemia,  where  the  blood  is  unable 
to  take  up  the  quantity  of  oxygen  necessary  for  any  exertion,  and 
the  patient  pants  violently  after  any  quick  movement,  such  as 
going  up  stairs. 

Dyspnoea  and  even  convulsions  are  also  caused  by  nitrites,  e.g. 
nitrite  of  amyl  or  sodium,  which  lessen  the  power  of  the  blood  to 
give  off  oxygen,  and  by  carbonic  oxide,  which  replaces  the  oxygen 
in  the  blood. 

It  must  be  remembered,  however,  that,  whatever  may  be  the 
remote  cause  of  dyspnoea,  its  direct  cause  is  the  condition  of  the 
nerve-cells  in  the  medulla,  and  if  these  are  unable  to  take  up 
oxygen,  and  give  off  carbonic  acid  to  the  blood,  dyspnoea  may 
occur,  although  the  blood  itself  circulating  in  the  medulla  con- 
tains abundance  of  oxygen. 

In  the  case  of  carbonic-oxide  poisoning  the  blood  cannot  take 
up  oxygen  from  the  lungs,  although  there  is  abundance  of  oxygen 
present ;  and  in  a  similar  way  the  nerve-cells  of  the  medulla  may 
possibly  be  rendered  by  certain  drugs  unable  to  take  up  oxygen 
from  the  blood  circulating  through  the  medulla. 

In  simple  suffocation  the  internal  respiration  of  the  nerve- 
cells  in  the  medulla  is  arrested  by  the  general  venous  condition  of 
the  blood ;  in  carbonic-oxide  poisoning  by  the  oxygen  being  absent 


240  PHAEMACOLOGY  AND  THEEAPEUTICS.      [sect.  i. 

from  the  haemoglobin ;  in  nitrite  poisoning  by  the  oxygen  being 
locked  up  in  methasinoglobin.  In  all  those  cases  the  condition  of 
the  blood  is  betrayed  to  the  eye  by  the  appearance  of  the  mucous 
membranes,  which  in  suffocation  and  in  nitrite  poisoning  become 
dark  and  livid,  and  in  carbonic-oxide  poisoning  of  a  cherry-red 
colour.  Perhaps  the  change  is  most  conveniently  seen  in  the 
comb  of  a  cock  poisoned  by  these  substances ;  in  it  the  altera- 
tion in  the  colour  of  the  blood  produced  by  artificial  respiration  is 
readily  observed.  The  dependence  of  convulsions  upon  the  blood, 
is  also  easily  observed  :  the  convulsions  appearing  as  the  comb 
becomes  livid,  and  again  disappearing  when  artificial  respiration 
has  been  employed,  and  the  colour  of  the  comb  becomes  bright. 
In  poisoning  by  hydrocyanic  acid,  however,  I  have  observed  that 
convulsions  come  on  while  the  mucous  membranes  are  still  of  a 
bright  colour,  so  that  we  may  conclude  that  they  are  not  due  to 
a  venous  condition  of  the  blood,  as  in  ordinary  suffocation.  They 
might  be  due  to  the  formation  of  a  compound  between  the  hydro- 
cyanic acid  and  the  blood,  as  in  poisoning  by  nitrites  or  carbonic 
oxide ;  but  accurate  analyses  have  shown  that  hydrocyanic  acid 
does  not  displace  the  oxygen  in  haemoglobin  like  carbonic  acid; 
nor  lock  it  up  in  the  form  of  methsemoglobin  like  the  nitrites. 
We  are  therefore  obliged  to  consider  the  possibility  that  the 
dyspnoea  and  convulsions  produced  by  hydrocyanic  acid  are  not 
due  so  much  to  its  effect  upon  the  blood  circulating  in  the 
medulla  as  to  an  action  on  the  cells  of  the  medulla  itself,  by 
which  it  prevents  the  ordinary  internal  respiration  taking  place 
in  them. 

Action  of  Drugs  on  the  Respiratory  Centre. 

A  useful  method  of  testing  the  action  of  the  drug  itself  on  the  respiratory 
centre  is  to  perform  artificial  respiration  vigorously  so  as  to  produce  apnoea, 
to  allow  the  respiration  to  become  normal  again,  then  to  inject  the  drug  and 
again  try  to  produce  apncea.  If  the  drug  has  excited  the  respiratory  centre, 
apnoea  ■will  be  much  more  difficult  to  produce  after  its  injection  than  before, 
and  will  last  a  shorter  time  ;  if  it  has  depressed  it,  apnoea  will  be  more  easily 
produced,  and  will  last  longer. 

Apnoea  lasting  for  a  short  time  may  be  readily  produced  by  taking  five  or 
six  very  deep  breaths,  and  the  effect  of  drugs  on  the  respiratory  centre  may 
be  readily  tried  by  anyone  in  the  following  way.  Laying  a  watch  before 
him,  shutting  his  mouth  and  holding  his  nose,  let  him  first  ascertain  how 
many  seconds  he  can  hold  his  breath  after  previous  ordinary  respiration. 
Next  let  him  produce  a  certain  amount  of  apnosa  by  six  or  more  deep  respira- 
tions, and  again  ascertain  how  long  he  can  hold  his  breath.  After  repeating 
these  observations  several  times,,  let  him  take  the  drug  to  be  tested  and 
repeat  them  again,  taking  care  that  all  the  circumstances  should  be  the  same 
as  before. 

The  activity  of  the  respiratory  centre  is  augmented  by 
heat,  so  that  the  respirations  become  both  quicker  and  deeper, 
and  more  respiratory  work  is  done.  Strychnine,  ammonia, 
atropine,  duboisine,   brucine,  thebaine,  apomorphine,  emetine,, 


ghap.  x.]     ACTION  OF  DRUGS  ON  EESPIRATION.  241 

members  of  the  digitalis  group,  salts  of  zinc  and  copper,  have  a 
similar  action. 

It  appears  to  be  first  excited  and  then  depressed  by  caffeine, 
colchicin,  nicotine,  quinine,  and  saponine. 

It  is  diminished  by  cold,  so  that  the  respirations  become 
slow  and  shallow.  Chloral,  chloroform,  ether,  alcohol,  opium, 
pbysostigrnine,  muscarine,  gelsemine,  aconite,  and  veratrine  in 
large  doses,  all  have  a  similar  action. 

The  action  of  drugs  on  the  respiratory  centre  is  one  of  great 
importance,  not  only  as  giving  us  a  definite  basis  on  which  to 
found  a  plan  of  treatment  in  respiratory  diseases,  but  as  helping 
us  to  preserve  life  in  cases  of  poisoning — drugs  which  stimulate 
being  antagonised  by  those  which  depress  the  respiratory  centre, 
and  vice  versa. 

The  chief  afferent  nerves,  by  which  the  distribution  of  the 
respiratory  movements  is  altered,  may  be  divided  into  two  classes 
— those  having  an  inspiratory  and  those  having  an  expiratory 
action. 

The  expiratory  are  the  nasal  branches  of  the  fifth,  the  supe- 
rior laryngeal,  the  inferior  laryngeal,  and  the  cutaneous  nerves, 
especially  of  the  breast  and  belly. 

The  chief  inspiratory  are  the  branches  of  the  vagus. going  to 
the  lung,  but  all  sensory  nerves  when  slightly  stimulated  appear 
also  to  have  an  inspiratory  action. 

The  vagus  appears,  however,  to  contain  both  expiratory  and 
inspiratory  fibres,  which  are  alternately  stimulated  by  the  con- 
dition of  the  lung.  Expansion  of  the  lung  appears  to  stimulate 
mechanically  the  inhibitory  or  expiratory  fibres;  while  its  collapse 
stimulates  the  accelerating  or  inspiratory  fibres. 

When  the  expiratory  nerves  are  stimulated,  the  respiratory 
movements  become  slower  and  deeper ;  and  if  the  stimulation  be 
strong  they  may  stop  altogether  in  expiration,  with  the  diaphragm 
in  complete  relaxation. 

Stimulation  of  the  inspiratory  nerves  causes  the  respiration 
to  become  quicker  and  shallower,  and  at  length  to  stop  in 
inspiration,  the  diaphragm  being  in  a  state  of  tetanic  contraction. 

These  are  the  general  results,  but  they  are  not  quite  con- 
stant. The  reason  for  this  inconstancy  may  be  either  that  all 
the  nerves  contain  both  inspiratory  and  expiratory  fibres,  or  that 
the  same  fibres  may  stimulate  either  the  inspiratory  or  expiratory 
centres,  according  to  the  strength  of  the  stimulus  and  the  con- 
dition of  the  animal.  Thus,  when  the  vagus  is  divided,  the 
stimulus  which  is  conveyed  to  the  respiratory  centre  being  re- 
moved, the  respirations  usually  become  very  slow;  when  the 
central  end  of  the  divided  nerve  is  irritated  they  become  quick, 
and  a  very  strong  current  may  stop  them  in  inspiration.  But  this 
is  not  always  so  :  when  the  nerve  is  very  much  exhausted,  irri- 
tation by  a  strong  current  may  have  an  entirely  opposite  effect, 


242 


PHAEMACOLOGY  AND  THERAPEUTICS,      [sect,  u 


and  cause  the  respiration  to  stop  in  expiration  instead  of  inspira- 
tion. 

The  probability  that  the  same  nervous  fibres  may,  under  dif- 
ferent conditions,  excite  either  inspiration,  expiration,  or  the 
two  alternately,  is  rendered  still  greater  when  we  consider  some 
other  experiments ;  and  the  contradictory  results  which  have  been 
obtained  by  various  observers  in  regard  to  the  action  of  druga 
may  depend  to  a  great  extent  on  the  strength  of  the  stimulus 
they  have  used  and  the  state  of  exhaustion  of  the  animal.  Thus 
Langendorf  has  found  that  all  sensory  nerves  in  the  body  when 
slightly  stimulated  have  an  inspiratory,  but  when  stimulated 
more  strongly  have  an  expiratory  action.  Eosenthal  found  that 
irritation  of  the  crural  nerves  caused  alternately  deep  inspiration 
and  expiration  in  animals  which  were  not  narcotised.  In  nar- 
cotised animals,  Langendorf,  on  slight  irritation,  observed  an 
inspiratory  effect,  indicated  by  quickening  of  the  respiration  or 
slight  inspiratory  tetanus ;  but  when  the  experiment  was  con- 
tinued long,  or  the  irritation  was  increased,  the  contrary  or 
expiratory  effect  was  observed,  indicated  by  a  slowing  of  the  re- 
spiration. 

On  the  hypothesis  that  the  various  actions  of  respiration 
depend  upon  individual  centres,  inspiratory,  expiratory,  and  in- 


Inspiratory  and  Expiratory  Fibres) 
for  voluntas  alterations  in  Hespi-  \ 
ration J) 


Cutaneous  Nerves  of  Pace 

■g      ("Nasal  Branch  of  Fifth  Nerve..! 


Superior  Laryngeal  Nerve  . . .. 
Inferior  Laryngeal  Nerve 
Larynx ...*.••■.. 


b      (.Cutaneous  Nerves  of  the  Chest 

Expiratory  Fibres  of  Vagus  excited  by 
distension  of  Lung 


Inspiratory  Fibres  of  Vagus  excited  by 
collapse  of  Lung 


Respiratory  Centre  In 
Medulla  and  Cord 


Spinal  cord 


Fig.  81.— Diagram  showing  the  position  of  the  respiratory  centre,  and  the  afferent  nerves  which 
influence  it.    Inspiratory  nerves  are  indicated  by  plain,  aud  expiratory  by  dotted,  lines. 

hibitory,  it  is  exceedingly  difficult,  or  impossible,  to  understand 
the  contradictory  results  of  various  experimenters ;  but  the  ques- 
tion seems  much  less  intricate  when  we  regard  it  as  due  to  the 


chap,  x.]     ACTION  OP  DRUGS  ON  RESPIRATION. 


243 


interference  of  stimuli  passing  at  different  rates  in  different 
directions,  or  to  different  distances,  according  to  the  strength  of 
the  stimulus  and  the  irritability  or  exhaustion  of  the  nervous 
system. 

In  regard  then  to  inhibitory  or  slowing,  and  to  stimulating  or 
accelerating  nerves  or  fibres,  it  must  be  carefully  borne  in  mind 
that  the  same  fibres  may  possibly  have  either  the  one  or  the  other 
action,  according  to  the  conditions  under  which  they  are  acting. 

If  we  keep  this  carefully  in  view  we  may  continue  to  use  the 
terms  accelerating  and  slowing  or  inspiratory  and  expiratory 
nerves  as  convenient  means  of  expression.  These  are  shown 
in  the  accompanying  diagram  (Fig.  81). 

The  movements  of  respiration  are  most  easily  counted,  and  their  depth 
and  the  relation  of  inspiration  to  expiration  are  best  noted  by  causing 
them  to  register  themselves  on  a  revolving  cylinder.  Various  means  of 
doing  this  have  been  suggested  by  different  authors.  One  of  the  simplest 
consists  of  a  needle  pushed  into  the  diaphragm,  and  connected  by  a 
thread  with  one  of  Marey's  levers.  Marey's  pneumograph  consists  of  a 
cylinder  of  soft  indiarubber,  enclosing  a  spiral  spring,  whose  extremities 
are  connected  with  two  pieces  of  metal  which  form  the  ends  of  the 
cylinder.  A  band  is  passed  round  the  thorax  of  the  animal,  and  attached 
to  the  ends  of  the  cylinder.  The  interior  of  the  cylinder  is  brought  into 
communication  with  one  of  Marey's  levers,  and  as  each  respiratory  move- 
ment draws  the  ends  of  the  cylinders  wider  apart,  or  allows  them  to  approach, 
the  air  is  rarefied  or  compressed,  and  a  corresponding  movement  is  trans- 
mitted to  the  lever.  Bert  has  modified  this,  and  made  it  more  sensitive  by 
making  the  cylinder  itself  of  metal,  and  its  ends  of  indiarubber.  Another 
method — one  more  ordinarily  employed — is  to  introduce  one  limb  of  a 
T-tube  into  the  nostril  or  trachea  of  an  animal,  or  connect  it  with  a  tracheal 
cannula.  The  respired  air  passes  through  the  other  end,  and  the  third  limb 
is  connected  with  one  of  Marey's  levers. 

In  the  attempt  to  find  out  whether  the  alteration  in  respira- 
tion produced  by  any  drug  is  due  to  its  action  on  the  respiratory 
centre,  or  on  some  of  the  nerves  which  influence  it,  we  may 
find  the  following  table  useful  by  showing  at  a  glance  the  chief 
ways  in  which  the  respirations  may  be  rendered  quicker  or 
slower : — 


{Excitement  of  nerves. 
Greater  excitement  of 
respiratory  centre, 


Stimulation  of  the  vagus. 
Stimulation  of  optic  nerve. 
Stimulation  of  acoustic  nerve. 
Action  of  brain  (voluntary). 
Increased  temperature  of  blood. 
Increased  venosity  of  blood. 
Action  of  drugs. 


Diminished       excite-  f  Diminished  venosity  of  blood. 


The  respiratory 
movements  may< 
be  rendered  slow 
by 


ment  of  respiratory 
centre. 


Nervous  influences. 


Action  of  drugs. 
,  Action  of  brain  (voluntary), 
f  Paralysis  of  vagi. 

Stimulation  of  superior  laryngeal  nerves. 

Stimulation  of  inferior  laryngeal  nerves. 

Stimulation  of  nasal  nerves. 

Stimulation  of  cutaneous  nerves. 
iStimulation  of  splanchnic  nerves. 

r  2 


244  PHAEMACOLOGY  AND  THERAPEUTICS.,    [sect.  r. 

If  the  drug  to  be  experimented  on  be  injected  subcutaneously 
or  into  the  veins,  the  actions  on  the  respiratory  centre  and  on 
the  vagi  are  the  chief  points  which  require  attention ;  but  if  we 
are  experimenting  with  a  vapour,  its  local  action  on  the  nasal,, 
laryngeal,  and  possibly,  also,  on  the  pharyngeal  nerves  '  must  be 
carefully  attended  to,  as  it  may  greatly  modify  its  general  action 
on  the  respiratory  centres.  Thus  Kratschmer  has  found  that 
tobacco-smoke  inhaled  by  a  rabbit  through  its  nostrils,  or  blown 
upward  into  the  nasal  cavity  from  an  aperture  in  the  trachea, 
will  cause  arrest  of  breathing  in  a  state  of  expiration  from  the 
irritating  effect  of  the  vapour  of  the  nasal  branches  of  the  fifth, 
while  it  has  no  such  effect  when  blown  into  the  lungs.  Ammonia, 
when  inhaled,  also  arrests  the  respiratory  movements  in  the 
same  way ;  but  Knoll 2  has  observed  that  if  it  be  blown  into  the 
lungs  while  the  nostrils  are  carefully  protected  from  its  influence, 
it  causes  accelerated  and  shallow  breathing,  alternating  with  slow 
and  deep  respirations,  and  occasional  stoppages  in  the  position 
of  expiration,  obviously  from  its  action  on  the  different  fibres  of 
the  vagi. 


Action  of  Drugs  on  the  Respiratory  Nerves. 

In  experiments  regarding  the  effect  of  drugs  upon  the  re- 
spiration, the  voluntary  influence  of  the  brain  is  excluded  by  the 
use  of  ether,  chloroform,  opium,  or  chloral,  or  by  section  of  the 
crura  cerebri.  In  the  case  of  such  poisons  as  cause  sickness 
allowance  must  be  made  for  the  effect  of  gastric  irritation.  It 
will  usually  be  found  that  before  vomiting  occurs  the  respiratory 
movements  are  very  rapid,  but  they  become  slower  after  vomiting 
has  taken  place.  As  the  chief  afferent  fibres  from  the  stomach 
are  contained  in  the  vagus,  the  effect  of  irritation  of  the  gastric, 
as  well  as  of  other  fibres  contained  in  these  nerves,  is  prevented 
by  their  division.  Sometimes  the  action  of  a  drug  on  the 
peripheral  ends  of  the  vagus  and  upon  its  roots  in  the  medulla 
may  produce  exactly  opposite  effects  upon  the  respiration.  Thus 
atropine  appears  to  lessen  the  excitability  of  the  respiratory 
fibres  of  the  vagus,  while  it  stimulates  the  respiratory  centre. 
Such  an  action  may  be  to  a  certain  extent  inferred  from  the 
respiration  becoming  slower  almost  immediately  after  the  injec- 
tion of  the  drug  into  the  jugular  vein,  and  while  it  is  still  passing 
through  the  lungs,  and  by  this  slowing  being  quickly  succeeded 
by  acceleration  when  the  drug  begins  to  circulate  through  the 
medulla. 

There  are  two  kinds  of  experiment  by  which  such  a  conclu- 
sion may  be  tested.     The  one  is  to  apply  the  drug  first  to  the 


Brown-SSquarcl,  Archives  of  Scientific  and  Practical  Medicine,  p.  94. 
Sitzungsber.  der  Wien.  Acad.,  vol.  lxviii.  Abt.  3,  p.  255. 


chap,  x.]      ACTION  OF  DEUGS  ON  EESPIEATION.  245 

medulla  by  injecting  it  into  the  carotid  artery,  and  seeing  whether 
acceleration  occurs  at  once  and  afterwards  becomes  less  when 
the  drug  has  had  time  to  pass  round  again  to  the  lungs.  The 
other  way  is  to  divide  the  vagi  before  the  injection  and  observe 
the  effect.  Any  alteration  in  the  respiration  in  the  way  of  either 
quickening  or  slowing  which  the  drug  produced  in  the  uninjured 
animal  should  remain  the  same  after  division  of  the  vagi  if 
its  effect  were  due  to  its  action  on  the  medulla,  but  will  be 
absent  if  it  were  due  to  an  action  upon  the  peripheral  ends  of 
the  vagi. 

This  method  was  introduced  into  pharmacological  research 
by  Von  Bezold  in  his  admirable  research  on  atropine,  and  it  is 
the  one  usually  employed. 

There  is  one  fallacy,  however,  which  must  not  be  entirely  lost  sight  of, 
which  is,  that  after  division  of  the  vagi  the  nerves  which  remain  in  con- 
nection with  the  respiratory  centre  have  chiefly  a  slowing  action  on  the 
respiration;  and  thus  a  drug  which  really  renders  the  respiratory  centre 
more  susceptible  to  reflex  influences  might  seem  to  have  a  depressing  action 
upon  it. 

While  atropine  injected  into  the  jugular  vein  seems  to  pro- 
duce first  a  slowing  of  the  respiration,  due  to  its  paralysing 
action  on  the  vagus  ends,  and  afterwards  a  progressive  quickening 
as  more  of  it  is  carried  out  of  the  lungs  into  the  medulla,  phy- 
sostigmine,  muscarine,  and  veratrine  have  an  opposite  action, 
quickening  the  respiration  at  first  by  their  stimulating  action  on 
the  vagus  ends,  and  afterwards  slowing  it  by  their  action  on  the 
medulla. 

In  the  action  of  veratrine  upon  the  pulmonary  branches  of 
the  vagus  we  may  notice  a  resemblance  to  the  stimulant  action 
which,  as  already  mentioned,  it  exerts  upon  the  nerves  of  or- 
dinary sensation.  If  the  sensory  branches  of  the  vagus  are 
affected  by  drugs  in  a  somewhat  similar  way  to  those  of  ordinary 
sensation,  as  the  action  of  veratrine  might  lead  us  to  imagine, 
we  should  expect  them  to  be  much  stimulated  also  by  aconite, 
and,  indeed,  according  to  Boehm  and  Ewers,  this  is  the  case. 
The  respiratory  changes  produced  by  aconite  are  regarded  by 
them  as  due,  in  part,  to  irritation  of  the  peripheral  ends  of  the 
vagus,  and  disappear  on  section  of  the  vagi  or  the  administra- 
tion of  atropine. 

Sternutatories  or  Errhines. 

These  are  drugs  which  cause  sneezing  and  increased  secre- 
tion from  the  nose  when  locally  applied  to  it.  The  drugs  must 
be  in  a  pulverised  condition.     The  chief  are ; — 

Tobacco  (snuff).  Euphorbium. 

Veratrum  album.  Sassy  bark. 

Ipecacuanha.  Saponine. 


246  PHARMACOLOGY  AND  THERAPEUTICS,      [sect.  I. 

Irritation  applied  to  the  nose  is  transmitted  by  the  nasal 
branches  of  the  fifth  to  the  respiratory  centre  in  the  medulla 
oblongata,  and  excites  the  sudden  and  forcible  expiratory  move- 
ments of  sneezing.  At  the  same  time,  however,  the  stimulus  is 
transmitted  to  the  vaso-motor  centre,  and  the  blood-pressure 
becomes  considerably  increased  by  the  contraction  of  small  vessels 
throughout  the  body,  even  when  no  sneezing  occurs.  When 
sneezing  takes  place,  the  pressure  is  still  further  increased  by 
the  muscular  efforts  which  occur  in  the  act.  It  is  probable  that 
there  is  not  only  general  rise  in  blood-pressure  but  also  that 
local  dilatation  of  the  cerebral  vessels  is  reflexly  produced  by 
the  nasal  irritation,  and  thus  a  stimulant  effect  is  produced  on 
the  brain.  Snuff  is  therefore  employed  as  a  luxury  giving  a 
feeling  of  comfort  and  enabling  the  snuff-taker  to  think  more 
clearly — '  clearing  the  head  '  as  it  is  often  termed  (vide  p.  193). 

Uses. — Though  comparatively  little  used  now,  sternutatories 
were  formerly  employed  in  failure  of  memory,  deafness,  and 
severe  persistent  headache.  From  the  violent  expulsive  efforts 
which  they  induce,  they  were  given  also  to  cause  the  expulsion 
of  foreign  bodies  from  the  air-passages,  and  to  hasten  the  ex- 
pulsion of  the  child  in' cases  of  lingering  labour  where  no  ob- 
struction was  present,  but  where  expulsive  force  was  deficient. 
They  were  given  also  in  order  to  try  and  check  diseases  at  the 
commencement,  by  what  was  termed  '  shock  to  the  system.' 

One  curious  thing  is  to  be  remarked,  that  stimulation  of  one 
part  of  the  respiratory  tract  may  arrest  abnormal  actions  in 
another.  Thus  Marshall  Hall  has  shown  that  actual  sneezing 
may  frequently  be  prevented,  after  the  inspiration  by  which  it 
is  usually  preceded  has  occurred,  by  forcibly  rubbing  the  end  of 
the  nose  or  by  tightly  compressing  the  nostrils.  In  a  similar 
way  irritation  of  the  interior  of  the  nose  by  snuff  will  sometimes 
arrest  obstinate  hiccough. 

Contraindications. — On  account  of  the  high  blood-pressure 
which  they  produce  their  use  is  by  no  means  free  from  danger 
in  persons  affected  with  atheroma  or  a  tendency  to  pulmonary 
haemorrhage  or  apoplexy,  as  they  may  cause  rupture  of  a  vessel, 
and  in  those  who  suffer  from  hernia  or  from  prolapsus  of 
the  uterus,  they  may  seriously  increase  the  gravity  of  these 
affections. 


Respiratory  Sedatives. 

These  are  substances  which  diminish  cough  and  spasmodic 
difficulty  of  breathing. ' 

They  may  be  divided  into  drugs  which — 

(1)  Tend  to  remove  the  irritation  which  acts  as  the  exciting 
cause  of  the  cough. 


chap,  x.]     ACTION  OF  DRUGS  ON  RESPIRATION. 


247 


(2)  Tend  to  lessen  f  (a)  the  afferent  nerves  in  the  lungs ; 
irritability  of  |  (6)  the  respiratory  centre. 

Pathology  of  cough. — Cough  consists  in  a  deep  inspiration 
followed  by  a  forcible  expiration  with  closed  glottis,  so  that  the  air 
is  driven  rapidly  through  the  larynx,  carrying  with  it  foreign  sub- 
stances, liquid  or  solid,  which  may  be  present  in  the  air-passages. 
As  it  is  a  modified  respiratory  act,  the  nerve-centre  by  which  the 
muscles  employed  in  it  are  co-ordinated  is  situated  in  the  medulla 
oblongata. 

The  afferent  fibres  by  which  cough  may  be  excited  are  chiefly 
branches  of  the  vagus.    One  of  the  most  powerful  is  the  superior 


Pharynx  \  Cough  very  vio- 
I  lent.ofteuaccom- 
[  panied  by  retch- 

CEsophagus  j  ing  or  vomiting. 


Liver 


Fig.  82.— Diagram  of  the  afferent  nerves  by  which  cough  may  be  excited.  These  nerves  are  shown 
passing  to  the  respiratory  centre  in  the  following  order  from  above  downward— from  the  audi- 
tory meatus,  pharynx,  upper  part  of  oesophagus,  larynx  and  trachea,  bronchi,  lung,  costal 
pleura,  liver  and  spleen. 

laryngeal  nerve  distributed  to  the  glosso-epiglottidean  folds  and 
to  the  whole  of  the  interior  of  the  larynx,  and  this  being  a 
special  expiratory  nerve  we  find  that  irritation  of  the  larynx  and 
also  of  the  trachea  is  usually  characterised  by  a  cough  with  very 
violent  expulsive  efforts.  Irritation  of  the  mucous  membrane  of 
the  trachea  especially  at  the  bifurcation  of  the  bronchi,  and 
irritation  of  the  substance  of  the  lung,  also  give  rise  to  cough  ; 
and  irritation  of  the  costal  pleura  and  of  the  oesophagus  does  so 
also.1  Irritation  of  the  auditory  meatus  at  the  point  to  which 
the  auricular  branch  of  the  vagus  is  distributed  will  also  cause 
coughing ;  and  cough  appears  to  be  also  induced  by  irritation  of 
certain  parts  of  the  interior  of  the  nose.  These  are  the  surfaces 
of  the  inferior  and  middle  turbinated  bones,  the  most  sensitive 


Kohts,  Virchow's  Archiv,  66, 191. 


248  PHAEMACOLOGY  AND  THERAPEUTICS,      [sect.  & 

part  being  the  posterior  end  of  the  inferior  turbinated  bone  and 
the  portion  of  the  septum  immediately  opposite.1  The  sudden 
application  of  cold  to  the  skin  on  various  parts  of  the  body  will 
sometimes  cause  coughing.  Probably  the  cough  in  this  case  is 
not  due  to  the  stimulus  being  conveyed  directly  to  the  respiratory 
centre  by  the  cutaneous  nerves,  but  to  its  causing  congestion 
of  the  air-passages,  as  in  Eossbach's  experiments  (p.  252).  The 
congestion  then  causes  irritation  of  the  sensory  nerves  of  the 
bronchi,  and  occasions  cough. 

T  have  seen  irritation  of  the  liver  and  spleen,  induced  by 
percussion  over  them,  in  a  man  suffering  from  chronic  enlarge- 
ment due  to  malaria,  likewise  cause  coughing.2  In  addition  to 
those  nerves,  however,  it  appears  that  irritation  of  the  glosso- 
pharyngeal branches  distributed  to  the  pharynx,  where  the 
digestive  and  respiratory  tracts  coincide  as  they  cross  one  an- 
other, may  not  only  excite  coughing,  but  may  also  act  as  an 
auxiliary  to  irritation  of  the  branches  of  the  vagus.  The  com- 
bined action  of  the  two  may  thus  induce  cough,  when  irritation 
of  the  vagus  alone  would  not  do  so.  Thus  we  find  that  many 
persons  begin  to  cough  as  soon  as  they  lie  down,  but  that  some- 
times by  lying  round  partially  on  the  face,  the  cough  ceases.  In 
these  persons  the  uvula  is  often  found  to  be  long  and  much  con- 
gested, and  the  tickling  which  it  produces  as  it  rests  upon  the 
pbarynx  or  pillars  of  the  fauces  seems  to  aid  the  irritation  in 
the  respiratory  passages,  and  produce  cough. 

Cough  due  to  irritation  of  those  parts  of  the  respiratory 
tract  where  the  nerves  are  chiefly  expiratory,  as  the  pharynx, 
larynx,  trachea,  and  large  bronchi,  is  usually,  as  might  be  ex- 
pected, loud,  explosive,  and  prolonged ;  while  cough  due  to  irri- 
tation of  those  parts  where  the  nerves  are  chiefly  inspiratory  is 
short  and  hacking  (Pig.  82). 

Cough  produced  by  irritation  of  the  pharynx  where  the, re- 
spiratory and  digestive  passages  cross  one  another,  is  not  only 
violent,  noisy,  and  barking,  but,  as  we  would  naturally  expect, 
is  not  unfrequently  accompanied  by  retching  or  vomiting. 

Pharyngeal  irritation  may  accompany  dyspepsia,  and  it  is 
probably  the  origin  of  the  so-called  stomach-cough.  Irritation 
of  the  stomach  itself,  or  of  its  nerves,  causes  vomiting,  but  does 
not  produce  cough. 

Nevertheless  there  is  a  rationale  for  the  common  expression 
'  stomach-cough.'  In  some  experiments  on  the  reflex  origin  of 
cough,  E.  Meyer 3  has  noticed  that  when  some  part,  from  which 

1  On  Nasal  Cough,  by  John  N.  Mackenzie,  M.D.,  reprint  from  The  American 
Journal  of  the  Medical  Sciences,  July  1883. 

2  These  observations  were  made  in  January  and  April  1879,  but  not  published. 
Naunyn,  in  a  paper  published  in  the  Deutsch.  Archw  f.  Mm.  Med.  in  March  1879 
recorded  similar  observations. 

■  E.  Meyer,  Correspondenzblatt  d.  Schweiser  Aerate,  No.  1, 1876. 


chap,  x.]     ACTION  OP  DRUGS  ON  RESPIRATION.  249 

cough  can  be  reflexly  induced,  is  already  in  a  state  of  irritation, 
cough  can  be  brought  on  with  great  ease  by  irritation  of  a  neigh- 
bouring part  which  would  not  by  itself  cause  cough.  Something 
of  this  kind  appears  to  occur  with  the  stomach,  for  although 
irritation  of  the  stomach  alone  will  not  cause  coughing,  yet  it 
will  do  so  if  irritation  of  the  larynx  and  trachea  are  already 
present.  Thus  I  have  observed  violent  spasms  of  coughing  occur, 
along  with  acidity  and  heartburn,  some  time  after  a  meal,  in  a 
person  suffering  from  congestion  of  the  pharynx,  larynx,  or 
trachea.  The  connection  between  the  cough  and  the  acidity  was 
shown  by  the  cough  ceasing  as  soon  as  the  acidity  was  relieved 
by  a  dose  of  alkali  and  the  consequent  removal  of  the  irritation 
to  the  stomach,  which  the  acidity  had  produced. 

Remedies  which  Lessen  Irritation. 

Soothing  remedies  applied  to  the  pharynx  greatly  relieve 
cough,  although  they  do  not  reach  so  far  down  as  the  epiglottis. 
Mucilaginous  remedies  are  very  useful  for  this  purpose,  and  they 
may  either  be  employed  alone  or  as  vehicles  for  the  local  appli- 
cation of  sedatives  such  as  morphine.  Thus,  a  piece  of  extract 
of  liquorice  allowed  to  dissolve  in  the  mouth,  a  marsh-mallow 
lozenge,  a  gum-jujube,  or  a  sip  of  linseed-tea,  by  covering  the 
back  of  the  throat  with  a  mucilaginous  coating,  will  lessen  cough 
to  a  great  extent.  Such  remedies  are  especially  useful  where  the 
cough  depends  on  congestion  of  the  pharynx  and  trachea.  '>  In 
such  cases  no  abnormal  sound  at  all  may  be  heard  in  ausculta- 
tion, and  the  cough  being  due  to  irritation  of  the  parts  supplied 
by  the  superior  laryngeal  nerve,  has  a  peculiarly  convulsive 
expiratory  character  often  termed  '  barking.' 

Other  remedies  lessen  cough  by  diminishing  congestion  of 
the  respiratory  passages,  and  thus  lessening  the  irritation  which 
causes  the  cough.  Many  of  these  also,  however,  come  under  the 
class  of  expectorants  (p.  250),  inasmuch  as  the  diminished 
congestion  is  frequently  associated  with  increase  of  the  ex- 
pectoration. Others,  again,  although  they  diminish  cough,  are 
included  rather  under  the  head  of  '  cardiac  tonics,'  or  sedatives. 
Digitalis  is  an  example  of  this.  In  the  congestion  due  to 
cardiac  disease,  and  even  in  that  due  to  bronchitis,  digitalis,  by 
strengthening  the  heart  and  by  contracting  the  vessels,  may 
lessen  the  congestion  in  the  lungs,  and  give  the  patient  relief. 
Squill  and  a  number  of  other  drugs  have  an  action  on  the  blood- 
vessels similar  to  that  of  digitalis. 

Other  remedies,  such  as  the  vapour  of  hydrocyanic  acid, 
conium,  stramonium,  and  tobacco,  have  a  local  sedative  action 
on  the  lung,  and  may  lessen  cough ;  they  also  are  used  in  order- 
to  diminish  local  spasm  of  the  bronchioles,  and  thus  to  relieve 
spasmodic  asthma. 


250  PHABMACOLOGY  AND  THEEAPEUTICS.      [sect.  i. 


Pulmonary  Sedatives. 

These  are  remedies  which  lessen  the  irritability  of  the  respira- 
tory centre  or  of  the  nerves  connected  with  it.  The  chief  drugs 
which  diminish  the  excitability  of  the  respiratory  centre  are 
opium  and  its  principal  alkaloid,  morphine.  Morphine  and 
opium  have  a  double  action  in  lessening  cough :  they  not  only 
lessen  the  excitability  of  the  respiratory  centre,  but  they 
diminish  the  secretion  of  mucus  in  the  bronchial  tubes,  and 
probably  thus  also  lessen  the  irritation.  Hydrocyanic  acid  has 
also  a  sedative  action  on  it,  but  it  is  by  no  means  so  powerful  as 
the  others. 

Belladonna  and  stramonium  have  a  rather  peculiar  action, 
stimulating  the  respiratory  centre,  and  at  the  same  time  appear- 
ing to  lessen  the  excitability  of  the  ends  of  the  vagi  in  the  lungs. 
Atropine  has  but  a  very  slight  and  uncertain  action  on  the 
respiratory  centre  in  preventing  cough,  if  indeed  it  has  any  at 
all.  It  has,  however,  a  powerful  effect — much  more  powerful 
than  that  of  opium, — in  completely  arresting  the  secretion 
from  the  bronchial  tubes.  The  cases  in  which  it  is  useful  are 
therefore  those  where  the  cough  depends  upon  excessive  secre- 
tion; In  cases  where  the  mucous  membrane  is  already  too  dry, 
it  would  be  injurious  rather  than  beneficial. 

When  apomorphine  and  morphine  are  given  together  they  do 
not  destroy  each  other's  action,  so  that  from  the  combination  we 
get  increased  secretion  from  the  mucous  membrane,  with  dimin- 
ished irritability  of  the  respiratory  centre,  and  consequently 
lessened  cough.  The  cases  in  which  this  combination,  then,  is 
useful,  are  those  where  there  is  difficulty  of  breathing,  continual 
cough,  and  thick  tenacious  mucus.  When  morphine  and  atropine 
are  given  together,  also,  they  do  not  destroy  each  other's  action ; 
and  thus  dryness  of  the  mucous  membrane  is  produced,  along 
with  diminished  irritability  of  the  centre  for  coughing.  This 
combination  is  therefore  useful  in  cases  of  catarrh,  emphysema, 
and  phthisis,  where  there  is  copious  secretion  of  mucus.  In 
phthisis  it  is  especially  indicated  on  account  of  the  beneficial 
action  of  atropine  in  also  lessening  sweating.  Where  the  copious 
expectoration  depends  upon  the  presence  of  a  cavity,  and  not  on 
excessive  secretion  from  the  bronchi,  it  will  not  be  much  affected 
by  the  use  of  these  remedies. 

Expectorants. 

Expectorants  are  remedies  which  facilitate  the  removal  of 
secretions  from  the  air-passages.  The  secretion  may  be  ren- 
dered more  easy  of  removal,  either  by  an  alteration  in  its 
character  rendering  it  less  adhesive  and  more  easily  detached 


chap,  x.]     ACTION  OF  DEUGS  ON  EESPIEATION.  251 

from  the  air-passages,  or  by  increased  activity  of  the  expulsive 
mechanism. 

Our  knowledge  of  the  use  of  expectorants  is  founded  chiefly 
on  empiricism.  We  are  almost  entirely  indebted  to  the  recent 
experiments  of  Eossbach  for  any  precise  information  as  to  their 
mode  of  action.1 

The  secretion  from  the  air-passages,  like  other  secretions, 
depends  partly  upon  the  condition  of  the  circulation,  and  partly 
on  the  secreting  cells  themselves. 

•  In  healthy  conditions  the  increased  secretion  and  increased 
circulation  of  blood  in  the  mucous  membrane  go  together,  but 
just  as  in  the  case  of  the  sweat-glands,  these  two  factors  may 
occur  independently  of  each  other,  and  secretion  may  take  place 
rapidly  when  the  circulation  is  diminished  and  the  mucous  mem- 
brane is  anaemic,  and,  on  the  other  hand,  it  may  stop  altogether 
when  the  vessels  are  dilated  and  the  mucous  membrane  is  con- 
gested. The  latter  happens  both  in  cases  of  disease  and  in 
animals  poisoned  by  atropine. 

The  secretion  from  the  normal  respiratory  mucous  membrane 
consists  of  a  thin  solution  of  mucin  which  dries  very  slowly,  and 
is  only  secreted  in  sufficient  quantity  to  keep  the  mucous  mem- 
brane moist.  It  is  slightly  adhesive,  and  any  particles  of  dust, 
&c,  which  may  have  found  their  way  into  the  trachea,  will  stick 
to  the  walls  of  the  air-passages,  and  will  be  gradually  moved  up 
towards  the  mouth  by  the  cilia  with  which  the  cells  of  the  mucous 
membrane  are  furnished.  Any  excess  of  mucus  secreted  in 
consequence  of  irritation  will  also  be  moved  upwards  by  the  cilia 
in  a  similar  manner.  In  the  ciliated  cells  of  the  mucous  mem- 
brane we  recognise  a  structure  which  is  frequently  met  with  in 
animals  lower  down  the  scale  of  existence,  and  the  mucous  mem- 
brane of  the  respiratory  passages  appears  to  resemble  the  parts 
of  lower  organisms,  in  being  very  slightly  controlled  by  the 
central  nervous  system.  When  not  irritated  it  secretes  slowly 
and  regularly ;  when  irritated  locally  the  secretion  is  increased, 
but  irritation  of  the  nerves  passing  to  it,  such  as  the  vagus,  the 
superior  or  inferior  laryngeal,  or  the  sympathetic,  does  not  cause 
any  increase  as  it  does  in  the  case  of  the  submaxillary  gland. 
These  nerves,  however,  can  influence  it  indirectly  through  the 
circulation,  for  when  they  are  divided  an  increased  dilatation 
of  the  vessels  occurs  in  the  mucous  membrane  of  the  trachea,  a 
freer  circulation  of  blood  occurs,  and  increased  secretion  is  thus 
indirectly  produced.  When  they  are  irritated,  however,  and 
anaemia  of  the  trachea  produced,  the  secretion  is  not  arrested* 
but  continues. 

The  circulation  in  the  mucous  membrane  is  readily  affected 
reflexly  by  irritation  of  other  parts  of  the  body.    When,  for 

1  Festschrift  der  Julius-Maximilian-  Universitat  eu  Wiirzburg,  Leipzig. 


252  PHAEMACOLOGY  AND  THEEAPEUTICS.     [bect.  i. 

example,  a  warm  poultice  is  laid  for  five  or  ten  minutes  on  the  - 
belly  of  an  animal,  and  then  afterwards  replaced  by  ice,  the 
mucous  membrane  of  the  trachea  and  larynx  becomes  m  halt  a 
minute  deadly  pale  from  the  contraction  of  its  vessels.  Though 
the  ice  is  still  allowed  to  remain  on  the  belly,  the  tracheal  mucous 
membrane  quickly  changes  colour,  and  to  the  paleness  succeeds 
first  slight  redness,  then  deep  red  congestion,  and  m  five  or  ten 
minutes  lividity.  This  lividity  shows  that  the  congestion  is  not 
arterial  but  venous,  and  that  the  circulation,  instead  of  being 
quicker  is  really  slower.  Along  with  the  increase  of  congestion 
in  the  mucous  membrane,  the  amount  of  mucus  secreted  in- 
creases. When  the  ice  is  removed  for  half  an  hour,  and  again 
replaced  by  the  warm  poultice,  the  bluish-red  colour  of  the 
mucous  membrane  almost  immediately  disappears  and  gives  place 
to  a  rosy  colour  which  is,  however,  redder  than  normal.  Ice 
again  applied  will  cause  a  second  contraction  of  the  vessels  and 
paleness,  though  much  less  than  before.  These  experiments 
show  how  sensitive  is  the  mucous  membrane  of  the  trachea  to 
reflex  stimulation  of  other  parts  of  the  body  by  heat  or  cold,  and 
enable  us  to  understand  more  readily  how  a  draught  of  cold  air 
on  some  part  of  the  body  should  cause  inflammation  of  the 
respiratory  organs.  » 

Action  of  Drugs  on  the  Secretion.— Alkalies,  such  as  car- 
bonate of  sodium,  injected  into  the  blood,  lessen,  or  in  large 
quantity  completely  arrest,  the  secretion  of  mucus  from  the 
trachea. 

This  experimental  result  is  in  contradiction  to  the  teaching 
of  clinical  experience,  which  shows  us  that  alkalies  increase  the 
amount  of  secretion,  and  render  it  more  fluid.  The  results  of 
clinical  observation  are  quite  as  certain  as  those  of  Eossbach's 
experiments,  for  we  may  not  only  remark  the  greater  quantity  of 
expectoration,  and  its  greater  fluidity  in  persons  taking  alkalies, 
but  we  may  note  the  alteration  which  they  occasion  in  the 
amount  and  nature  of  the  moist  rales  heard  within  the  lungs. 
This  can  be  observed  most  readily  in  persons  suffering  from 
phthisis,  especially  round  the  margin  of  the  cavity.  After  catch- 
ing a  slight  cold  an  extension  of  consolidation  may  be  remarked, 
in  which  moist  rales  readily  occur  on  the  administration  of  dilute 
alkalies.  When  these  are  continued  until  the  expectoration  has 
been  free  for  a  day  or  two  and  the  rales  diminish,  acids  may  be 
given  with  advantage,  so  as  to  dry  up  the  expectoration  still 
more.  But  if  the  acid  is  given  too  soon  the  expectoration  dimi- 
nishes, but  the  cough  increases  and  becomes  troublesome  to  the 
patient. 

In  all  probability  the  difference  between  the  results  of  clinical 
observation  and  Eossbach's  experiments  depends  upon  the  dif- 
ference of  dose,  the  quantity  usually  given  to  a  patient  being 
proportionately  much  smaller  than  that  which  he  employed.    We 


chap,  x.]      ACTION  OP  DEUGS  ON  EESPIEATION.  253 

are  able  to  observe  a  similar  difference  between  tbe  effects  of 
small  and  large  doses  in  the  case  of  iodide  of  potassium ;  a  small 
dose  of  a  grain  and  a  half,  taken  by  a  healthy  man  three  times 
a  day,  will  almost  certainly  cause  the  nose  to  run  freely,  while  if 
the  dose  be  increased  to  ten,  twenty,  or  thirty  grains  the  .excessive 
secretion  will  almost  certainly  be  arrested. 

The  local  application  of  one  to  two  per  cent,  solution  of 
sodium  carbonate  has  very  little  action.  The  local  application  of 
strong  liquor  ammoniee  causes  both  congestion  and  increased 
secretion  of  mucus.  Very  strong  solutions  cause  a  croupous 
exudation  from  the  surface  of  the  mucous  membrane.  The  local 
application  of  dilute  acetic  acid  (three  per  cent,  solution)  has  a 
similar  action  to  weak  solutions  of  ammonia  :  the  mucous  mem- 
brane becoming  redder  and  secreting  more  mucus. 

When  acetic  acid  was  given  internally,  Eossbach  observed  in 
one  case  that  the  mucus,  which  was  before  watery  and  clear, 
became  gelatinous  and  opalescent.  This  result  agrees  with  what 
one  finds  clinically,  that  acids  dry  up  the  secretion  and  make  it 
harder  to  expectorate. 

Among  astringents  Eossbach  tried  tannin,  alum,  and  nitrate 
of  silver;  the  first  two" when  locally  applied  made  the  mucous 
membrane  appear  paler  by  altering  the  epithelium  and  rendering 
it  opaque,  so  that  the  vessels  underneath  could  hardly  be  seen  ; 
at  the  same  time  they  arrested  the  secretion  of  mucus  almost 
entirely.  A  four  per  cent,  solution  of  nitrate  of  silver  also  caused 
opacity  of  the  epithelium,  arrest  of  secretion,  and  dryness  of  the 
mucous  membrane.  There  appears  to  be  a  difference  in  the 
action  of  nitrate  of  silver  on  the  mucous  membrane  of  the  nose 
and  on  the  trachea,  as  when  the  inside  of  the  nose  is  touched 
by  it,  it  causes  a  profuse  secretion,  whereas  it  causes  dryness  in 
the  trachea. 

The  vapour  of  oil  of  turpentine  mixed  with  air  arrests  the 
secretion  of  mucus,  whilst  a  current  of  air  alone,  without  admix- 
ture with  oil  of  turpentine,  will  act  as  an  irritant  to  the  mucous 
membrane  and  increase  secretion.  Here  again,  however,  a 
marked  difference  is  to  be  seen  in  the  effect  of  small  and  large 
doses,  for  when  a  watery  solution  containing  from  one  to  two 
per  cent,  of  oil  of  turpentine  was  dropped  directly  on  the  mucous 
membrane,  it  became  less  vascular,  but  the  secretion  was  at 
once  increased,  instead  of  being  diminished,  as  it  was  by  the 
vapour. 

This  action  of  oil  of  turpentine  is  of  great  cherapeutical 
importance,  inasmuch  as  in  many  cases  of  bronchitis  we  have 
profuse  secretion  with  vascular  congestion,  a  condition  likely  to 
be  removed  by  the  vapour  of  oil  of  turpentine. 

Apomorphine,  emetine,  and  pilocarpine,  when  given  internally, 
all  cause  a;  great  increase  of  the  secretion  of  mucus,  but  they 
do  not  alter  the  vascularity  of  the  mucous  membrane.     The., 


254  PHARMACOLOGY  AND  THERAPEUTICS,     [sect.  i. 

most  powerful  of  all  these  is  pilocarpine,  and  after  it  come  apo^ 
morphine  and  emetine.  One  would  therefore  expect  that  pilo- 
carpine would  be  the  best  remedy  in  catarrhal  conditions,  but 
this  is  not  the  case,  for  its  other  actions  on  the  salivary  and 
sweat  glands  and  on  the  heart  render  its^  administration  un- 
pleasant for  the  patient.  Sometimes  also  hi  children  oedema  of 
the  lungs  has  followed  its  use.  Apomorphine,  on  the  contrary, 
has  been  found  by  Rossbach  to  be  of  the  greatest  service  in 
catarrh  of  the  larynx,  trachea,  and  bronchi,  both  in  adults  and 
in  children.  Ipecacuanha  has  long  been  recognised  as  one  of  the 
most  useful  expectorants,  but  the  dose  given  is  often  too  small. 

Rossbach's  experiments  have  shown  that  the  consequence  of 
sudden  changes  of  heat  and  cold  applied  to  a  part  of  the  body  is 
congestion  of  the  respiratory  mucous  membrane  with  diminished. 
circulation  and  stagnation  of  blood  in  the  veins.  A  similar  con- 
dition occurs  in  many  cases  of  chronic  bronchitis,  and  in  them 
we  not  unfrequently  find  great  benefit  from  vascular  tonics  such 
as  digitalis,  which,  in  addition  to  stimulating  the  vaso-motor 
centre,  increase  the  activity  of  the  heart,  and  thus  tend  to  main- 
tain the  pulmonary  circulation. 

In  what  way  cod-liver  oil  affects  the  bronchial  mucous  mem- 
brane it  is  perhaps  hard  to  say,  but  there  is  no  doubt  whatever 
that  it  is  one  of  the  most  efficient  expectorants  that  we  possess, 
and  in  cases  of  chronic  bronchitis  it  affords  more  relief  than 
any  of  the  ordinary  expectorants.  It  is  possible  that,  being  a 
form  of  fat  which  is  readily  assimilated,  it  is  taken  up  by  the 
young  epithelial  cells  of  the  respiratory  mucous  membrane,  and 
thus  enables  them  to  grow  and  maintain  their  attachment  to  the 
mucous  membrane,  instead  of  being  at  once  shed  in  an  unde- 
veloped form  as  pus-cells  in  the  expectoration. 

Action  of  Drugs  on  the  Expulsive  Mechanism.— The 
expectorants  which  act  by  increasing  the  activity  of  the  expulsive 
apparatus  may  be  divided  into — 

(1)  Those  which  increase  the  rapidity  of  the  ciliary  motion 
in  the  tracheal  mucous  membrane. 

(2)  Those  which  increase  the  activity  of  the  respiratory 
centre. 

We  have  no  direct  experiments  or  observations  on  the  rapidity 
of  the  ciliary  motion  in  the  bronchial  mucous  membrane  of  the 
higher  animals,  but  ammonia  has  been  found  to  increase  its 
rapidity  in  the  mucous  membrane  of  the  frog. 

The  remedies  which  increase  the  activity  of  the  respiratory 
centre  are :  strychnine,  ammonia,  emetine,  ipecacuanha,  bella- 
donna, atropine,  senega,  and  saponine.  They  are  used  more 
especially  in  cases  of  bronchitis  where  the  expectoration  is 
imperfect. 

The  chief  expectorants  have  been  divided  into  depressant  and 
stimulant.     Thoy  are  as  follows :— 


chap,  x.]      ACTION  OP  DKUGS  ON  EESPIEATION. 


255 


Depeessant  Expectorants.         Stimulating  Expectoeants. 


Generally  tending  to  depress 
the  heart,  lessen  blood-pressure, 
and  increase  secretion. 

Antimonial  preparations, 

Tartar  emetic. 
Alkalies. 
Ipecacuanha. 

Emetine, 
Lobelia. 

Lobeline. 
Jaborandi. 

Pilocarpine, 
Apomorphine. 
Quebracho. 

Quebrachine 
Potassium  iodide, 


Balsams 


Terebin- 
thinates 


Generally     stimulating      the 
heart,  increasing  blood-pressure, 
and  diminishing  secretion. 
Acids. 

(chloride, 
carbonate, 
hydrate 
(Ammonia). 
Nux  vomica. 

Strychnine. 
Senega. 

Saponine. 
Squill. 

Benzoin. 
Benzoic  acid. 
Balsam  of  Tolu. 
.Balsam  of  Peru. 
/Wood  tar. 
Terebene. 
Turpentine. 
( Oleum  Pini 

Sylvestris. 
Oleum  Pini 
VPumilionis. 
Sulphur. 

Saccharine    j  Syrups, 
substances  I  Liquorice. 

Adjuncts. — One  of  the  most  powerful  adjuncts  to  expectorants 
is  an  emetic,  which  frequently  will  clear  the  lungs  and  save  life 
in  cases  of  chronic  bronchitis  with  impending  suffocation,  when 
ordinary  expectorants  have  completely  failed. 

One  of  the  emetics  most  commonly  employed  in  such  cases  is 
ipecacuanha,  either  alone  or  combined  with  squill,  e.g.  half  a  fluid 
ounce  each  of  ipecacuanha  wine  and  oxymel  of  squills.  When 
there  is  great  depression,  however,  and  the  circulation  is  very 
feeble,  carbonate  of  ammonium  is  to  be  preferred. 

Another  powerful  adjunct  is  warmth  and  moisture  in  the 
room  in  which  the  patient  is  living,  and  this  is  best  secured  by 
means  of  steam  brought  well  into  the  room  from  a  kettle  placed 
upon  the  hob.  The  kettle  used  should  either  be  furnished  with  a 
very  long  spout,  as  in  the  case  of  the  ordinary  bronchitis  kettle, 
or  a  long  tube  made  of  a  piece  of  stout  brown  paper  tied  around 
with  a  string  may  be  used  to  convey  steam  into  the  room  from 
the  nozzle  of  an  ordinary  kettle. 


256     PHARMACOLOGY  AND  THERAPEUTICS,  [seot.i. 

Respirators  are  also  serviceable,  by  preventing  the  entrance 
of  cold  air  into  the  trachea.  Many  persons,  forgetting  that  the 
mouth  is  part  of  the  digestive  tract,  and  that  the  nose  is  the 
proper  entrance  to  the  respiratory  tract,  breathe  through  their 
mouth ;  the  consequence  is,  that  the  cold  air  passes  down  the 
trachea  without  being  previously  warmed.  In  the  nose  we  bave 
a  special  arrangement  for  warming  the  air.  The  turbinated 
bones  present  an  enormous  warming  surface,  like  some  recently- 
invented  stoves,  and  moreover,  a  special  arrangement  is  made  for 
allowing  a  free  flow  of  blood  through  this  mucous  membrane  by 
its  being  loosely  instead  of  firmly  attached  to  the  turbinated  bones. 
Its  vessels  are  therefore  capable  of  great  and  rapid  distension, 
so  as  to  allow  the  air  to  be  readily  warmed  in  cold  weather. 

Most  respirators  are  made  simply  to  go  over  the  mouth,  and 
their  advantage  is  that  they  force  people  to  breathe  through 
their  nose,  or  warm  the  air  if  they  cannot  do  so,  and  continue  to 
breathe  through  the  mouth.  In  many  persons  the  same  end  may 
be  gained  by  forcing  them  to  wear  an  invisible  respirator.  An 
instrument  is  sold  bearing  this  name,  consisting  of  a  thin  plate 
of  metal ;  but  what  is  perhaps  quite  as  good,  or  better,  is  a  sove- 
reign or  half-sovereign  placed  between  the  lips  and  teeth.  Patients 
are  thus  forced  to  keep  the  mouth  shut  in  order  to  prevent  it  from 
falling  out,  and  its  value  makes  them  careful  about  losing  it. 

It  is  often  forgotten  too  that  passages  and  disused  rooms  are 
nearly  as  cold  as  the  external  air,  and  many  delicate  people  who 
would  never  dream  of  going  outside  in  cold  weather  will,  without 
thinking,  walk  through  cold  passages  and  in  rooms  without  fires. 
Warm  clothing,  especially  over  the  shoulders,  neck,  and  chest, 
is  very  useful,  and  its  utility  is  recognised  by  the  common  employ- 
ment of  so-called  chest  protectors  made  of  chamois  leather  and 
red  flannel. 

Other  adjuncts  are  friction  to  the  chest  with  stimulating 
liniments ;  mustard  leaves,  warm  poultices  and  the  application  of 
plasters  ;  the  emplastrum  calefaciens  (B.P.)  or  emplastrum  picis 
cum  cantharide  (U.S.P.)  is  especially  useful  in  chronic  bronchitis. 

Arrest  of  Colds. — Catarrhal  affections  of  the  respiratory 
passages  may  be  excited  by  irritants  of  various  kinds,  and  it  is 
probable  that  these  irritants  are  frequently  living  organisms. 
The  form  of  coryza  usually  called  hay-fever  is  probably  due  to 
irritation  of  the  nasal  mucous  membrane  by  pollen-grains  com- 
mencing to  grow  on  it  and  sending  pollen-tubes  into  its  substance. 

Other  forms  of  respiratory  catarrh,  e.g.  measles  and  influenza, 
are  probably  associated  with  specific  microbes. 

When  the  respiratory  mucous  membrane  is  perfectly  healthy 
it  is  probable  that  the  invading  organisms  are  quickly  expelled 
or  destroyed  (p,  85)  so  that  no  injury  results.  But  when  the 
resisting  power  of  the  mucous  membrane  is  weak,  either  on 
account  of  general  constitutional  tendencies,  or  from  local  anil 


chap.x:]      ACTION  OF  DEUGS  ON  EESPIEATION.  257 

temporary  condition  of  congestion  due  to  a  chill  (p.  252),  the 
microbes  may  begin  to  grow  and  cause  great  irritation. 

Among  the  remedies  useful  in  arresting  colds  we  may  recog- 
nise antiseptics,  which  destroy  microbes,  and  also  sedatives, 
which  remove  congestion. 

_  Hay-fever  has  been  treated  by  Binz  with  a  watery  solution  of 
quinine  in  order  to  stop  the  growth  of  organisms  in  the  nose.  In 
some  cases  this  treatment  is  successful.  There  is  a  form  of  cold 
sometimes  known  as  influenza-cold.  Like,  true  influenza  it  is 
extremely  infectious  and  is  easily  communicated,  not  only  by  one 
member  of  a  family  to  another,  but  even  by  casual  visitors.  It 
sometimes  begins  as  a  cold  in  the  head,  passes  down  the  throat 
to  the  trachea  and  bronchi,  leading  to  severe  bronchitis  with 
much  depression  and  occasionally  also  to  gastro-intestinal  catarrh. 
Sometimes  it  begins  in  the  throat  and  spreads  upwards  into  the 
nostrils  and  downwirds  into  the  air-passages.  It  may  frequently 
be  arrested  or  rendered  less  severe  by  the  use  of  dilute  carbolic 
acid  applied  to  the  nostrils  in  the  form  of  spray  or  by  a  syringe 
or  rasal  douche  when  the  cold  begins  in  the  head.  When  the  cold 
begins  in  the  throat  it  may  be  arrested  by  the  use  of  a  carbolic 
acid  gargle,  and  such  a  gargle  is  also  useful  when  the  cold  begins 
in  the  head  and  is  spreading  down  the  throat. 

Inhalations  of  carbolic  acid  and  ammonia  appear  to  be  fre- 
quently useful  in  arresting  colds.  It  seems  probable  that  their 
effect  may  be  due  partly  to  an  antiseptic  action  and  partly  to  their 
lessening  congestion.  Carbolic  acid  inhalations  appear  to  be,, 
useful  in  whooping-cough,  probably  from  an  antiseptic  action. 

Camphor  inhaled  and  also  taken  internally  is  useful  in  arrest- 
ing colds,  though  it  may  be  rather  hard  to  give  an  explanation  of 
its  modus  operandi. 

The  sedatives  which  remove  congestion  of  the  nasal  mucous 
membrane  may  be  either  general  or  local.  Amongst  the  local  may 
be  mentioned  bismuth,  bismuth  and  morphine,  and  cocaine ;  and 
amongst  the  general,  preparations  of  opium,  especially  Dover's 
powder,  and  aconite. 

Selection  of  Remedies  in  the  Treatment  of  Cough. 

Cough,  as  I  have  already  said,  is  a  reflex  act  which  is  per- 
formed hy  means  of  a  reflex  mechanism,  and  is  adopted  for  the 
purpose  of  expelling  foreign  bodies  from  the  air-passages.  It  is 
evident  that,  when  the  source  of  irritation  may  be  removed  by 
efforts  at  coughing,  these  efforts  are  useful,  and  require  to  be  sus- 
tained rather  than  prevented ;  but  if  the  irritant  cannot  be  re- 
moved, the  effort  of  coughing  is  injurious  rather  than  beneficial, 
and  the  same  is  the  case  when  the  amount  of  effort  is  dispro- 
portionately great  to  the  good  that  it  effects.  In  these  cases  we 
must  try  to  lessen  the  cough. 


258  PHAKMACOLOGY  AND  THERAPEUTICS,     [sect.  I. 

The  source  of  irritation  in  the  respiratory  passages  may  either 
he  free  in  the  lumen  of  the  bronchial  tuhes,  or  may  he  situated 
in  the  mucous  membrane  lining  the  bronchi,  or  in  the  substance 
of  the  lung  itself.  Thus  we  may  have  foreign  substances,  such 
as  dust,  which  have  been  inhaled,  or  mucus  secreted  from  the 
bronchi,  resting  on  the  surface  of  the  mucous  membrane,  and 
leading  to  irritation.  Such  foreign  matter  may  be  expelled  by 
coughing,  and  so  may  purulent  matter  lying  in  a  cavity,  and  the 
cough  may  be  useful  by  expelling  them. 

But  if  the  irritation  be  simply  due  to  a  congested  condition  of 
the  bronchial  mucous  membrane  ;  to  congestion  or  consolidation 
of  the  lung-tissue  itself;  to  a  caseous  or  calcareous  nodule  which 
is  firmly  embedded  in  the  lung ;  or  to  inflammation  of  the  pleura, 
it  is  evident  that  the  efforts  at  coughing  will  not  remove  the 
irritant,  but  will  rather  tend  to  produce  exhaustion;  and  con- 
sequently we  must  either  try  to  remove  the  source  of  irritation 
by  other  means,  or  to  lessen  the  irritability  of  the  nervous  me- 
chanism by  which  coughing  is  produced.  Where  the  cough  is 
due  to  irritation  caused  by  indigestion  we  may  give  alkalies  to  re- 
lieve acidity,  but  we  sometimes  find  that  a  blue  pill  and  a  black 
draught  are  amongst  the  most  efficient  remedies  for  coughs  of 
this  character,  by  the  permanently  beneficial  action  they  exert  on 
the  digestion.  When  there  is  irritation  of  the  pharynx,  as  well 
as  of  the  trachea,  mucilaginous  substances,  such  as  jujubes  or 
linseed  tea,  are  exceedingly  useful. 

Where  cough  depends  on  congestion  of  the  mucous  mem- 
brane of  the  trachea  or  bronchi,  we  not  unfrequently  find  that  the 
inhalation  of  cold  air,  by  causing  contraction  of  the  vessels,  and 
lessening  the  congestion,  will  arrest  the  cough,  so  that  patients 
are  able  to  walk  out  on  a  cold  frosty  morning  for  a  length  of  time 
without  coughing.  On  coming  into  a  warm  room  the  vessels  of 
the  respiratory  mucous  membrane  again  dilate :  the  mucous 
membrane  becomes  congested,  and  the  congestion  leads  to  violent 
and  prolonged  efforts  at  coughing.  In  such  cases  counter-irrita- 
tion over  the  neck,  upper  part  of  the  chest,  and  between  the 
shoulders  is  useful,  probably  by  causing  contraction  of  the  vessels 
(p.  252),  and  thus  lessening  congestion.  But  congestion,  not 
only  of  the  trachea  and  bronchi,  but  also  of  the  smaller  bronchial 
tubes,  may  be  relieved,  not  only  by  counter-irritation,  but  by  in- 
ducing secretion.  Congestion  of  the  smaller  bronchi  indicated 
by  loud  whistling  rales  all  over  the  chest,  is  often  accompanied 
by  great  shortness  of  breath.  The  inhalation  of  hot  aqueous 
vapour  tends  to  relieve  the  congestion  by  inducing  secretion,  but 
more  powerful  agents  still  are  antimony,  ipecacuanha,  and  apo- 
morphine.  In  such  a  condition  as  the  one  just  mentioned,  where 
secretion  is  absent  and  congestion  is  great,  one  or  other  of  these 
drugs  should  be  given  frequently  until  secretion  occurs  freely,  as 
indicated  by  abundant  moist  rales  in  the  chest. 


chap,  x.]      ACTION  OF  DEUGS  ON  EESPIEATION.  259 

Along  with  these  depressant  expectorants,  some  preparation 
of  opium  should  be  given,  in  order  to  lessen  the  cough,  which  at 
this  stage  is  of  no  advantage.  It  is  advisable  not  to  stop  the 
administration  of  these  expectorants  immediately  on  the  occur- 
rence of  secretion,  but  to  continue  them  for  some  time  longer, 
and  gradually  to  lessen  their  amount.  "When  secretion  has  be- 
come copious,  either  from  the  administration  of  depressant  ex- 
pectorants or  from  the  natural  course  of  the  disease,  we  have 
resort  to  such  drugs  as  will  tend  to  cause  its  expulsion,  and  also 
to  lessen  its  formation.  Amongst  those  which  tend  to  lessen  its 
formation  are  balsams  and  terebinthinates  (p.  255),  and  those 
which  tend  to  assist  expulsion  have  already  been  mentioned  (p. 
254).  Along  with  these  we  generally  combine  some  preparation 
of  opium  if  the  cough  is  disproportionately  severe,  and  in  chronic 
bronchitis  cod-liver  oil  (p.  254)  is  perhaps  the  most  efficient  of 
all  remedies. 

Action  of  Drugs  on  the  Bronchi. —  The  bronchi  contain 
muscular  fibres  in  their  walls,  which  appear  to  maintain  a  state 
of  tonic  contraction  similar  to  that  of  the  arteries.  The  motor 
fibres  which  supply  these  muscles  are  contained  in  the  vagi. 
When  one  vagus  is  cut  the  bronchi  of  the  corresponding  lung  ex- 
pand, and  when  the  peripheral  end  of  the  cut  vagus  is  stimulated, 
the  bronchi  contract  so  much  as  sometimes  almost  to  close  com- 
pletely ;  but  the  vagi  appear  to  contain  bronchial-dilating  fibres, 
as  well  as  bronchial-constricting,  so  that  irritation  of  the  peripheral 
end  of  a  cut  vagus  may  sometimes  cause  marked  dilatation  instead 
of  contraction,  and  sometimes  primary  contraction  followed  by 
dilatation.  The  vagi  also  contain  afferent  fibres,  passing  from 
the  bronchi  to  the  nerve-centres,  and  these  afferent  fibres  have 
also  a  twofold  action,  so  that  when  the  central  end  of  one  cut 
vagus  is  irritated,  the  irritation  may  cause  either  reflex  contrac- 
tion or  reflex  dilatation  of  the  bronchi  in  the  other  lung.  It  is 
probable  that  there  are  two  cerebro- spinal  centres  :  one  produc- 
ing dilatation  and  the  other  contraction.  Atropine  completely 
paralyses  either  the  constricting  fibres  of  the  vagus  or  their  ter- 
minations in  the  bronchi,  so -that  after  a  very  small  dose  stimu- 
lation of  the  peripheral  end  of  the  cut  vagus  no  longer  causes 
contraction.  Ether  probably  paralyses  the  cerebro-spinal  centre 
for  contraction,  so  that  irritation  of  the  central  ends  of  a  divided 
vagus  causes  expansion  instead  of  contraction  in  the  bronchi  of 
the  other  lung.  Small  doses  of  nicotine  have  a  powerful  effect 
in  expanding  the  bronchi,  but  the  mode  of  action  of  the  drug  has 
not  been  determined.1 

Pathology  of  Bronchial  Asthma.— The  attacks  of  dyspnoea 
which  occur  in  spasmodic  asthma  in  all  probability  depend  upon 
spasmodic  contraction  of  the  unstriped  muscular  fibres  in  the 


'  Eov  and  Graham  Brown,  Journ  of  Phys.  vol.  vi, 

s2 


266  PHAEMACOLOGY  AND  THBEAPEUTICS.      [sect.  r. 

bronchi.  In  some  cases  no  definite  cause  can  be  assigned  for 
the  occurrence  of  these  attacks,  though  a  gouty  tendency  in  the 
patient,  or  the  imperfect  elimination  of  waste  products,  as  in 
renal  diseases,  increases  the  tendency  to  their  occurrence.  In 
other  eases  they  appear  to  be  occasioned  by  irritation,  either  in 
the  mucous  membrane  of  the  respiratory  tract  or  irritation  of 
some  other  part  of  the  body.  Thus  they  appear  sometimes  to 
be  brought  on  reflexly,  by  irritation  of  the  nose  by  polypi,  by 
certain  odours,  or  the  inhalation  of  irritating  dust,  especially 
pollen  of  ,grass,  or  by  congestion  of  the  mucous  membrane  in 
ordinary  coryza.  Sometimes  irritation  of  the  pharynx  by  en- 
larged tonsils  appears  to  bring  them  on,  and  they  frequently 
arise  from  bronchial  catarrh.  At  other  times  they  may  occur  in 
consequence  of  indigestion,  constipation,  of  worms  in  the  intes- 
tine, of  disease  of  the  uterus  or  ovaries,  or  of  pregnancy. 

Treatment  of  Asthma. — In  cases  where  the  cause  of  the 
attacks  can  be  ascertained,  the  cause  is  to  be  removed.  Thus  in 
gouty  patients  the  free  use  of  water  as  a  beverage,  and  the  ad- 
ministration of  iodide  and  bromide  of  potassium  or  of  salicylate 
Of  sodium  may  be  useful.  In  renal  asthma  the  diet- must  be  chiefly 
•farinaceous  and  fatty,  meat  and  beef-tea  being  sparingly  given, 
>so  as  to  avoid  the  accumulation  of  waste  products  in  the  system, 
•and  caffeine  (pp.  433,  434)  may  be  given  to  aid  their  elimination. 
The  asthma  of  dyspepsia,  and  also  that  of  constipation,  may 
possibly  be  due  partly  to  the  presence  of  abnormal  digestive  pro- 
ducts in  the  blood,  as  well  as  to  irritation  of  the  mucous  mem- 
brane of  the  stomach  or  intestine.  In  dyspeptic  asthma  pepsin 
has  proved  very  useful;  emetics  are  sometimes  of  service,  pro- 
Jbably  by  removing  irritating  substances  (p.  255),  and  ipecacu- 
anha may  possibly  have  some  special  action  of  its  own  on  the 
mucous  membrane,  in  addition  to  its  emetic  action.  Constipation 
is  to  be  treated  by  laxatives  (p.  388)  and  cholagogues  (p.  404),  and 
worms  by  vermifuges  (p.  408).  Polypi  in  the  nose  and  enlarged 
tonsik  are  to  be  removed,  and  for  congestion  of  the  mucous  mem- 
brane of  the  nose  or  throat,  carbolic  acid  lotion  may  be  used 
(p.  257). 

The  medicine  most  usually  employed  to  prevent  recurrence 
of  the  attack  is  lobelia  inflata.  The  exact  mode  of  action  of  this 
drug  is  not  known,  but  the  general  symptoms  produced  by  it  so 
closely  resemble  those  of  tobacco  that  it  is  often  known  as  Indian 
tobacco,  and  possibly  its  action  on  the  bronchial  tubes  may  be 
somewhat  the  same  as  those  of  nicotine.  During  the  attacks  of 
■spasmodic  asthma  more  relief  is  usually  afforded  by  the  inhala- 
tion of  smoke  of  various  kinds  than  by  any  other  means.  The 
smoke  of  tobacco,  of  the  leaves  of  various  species  of  datura:,  of 
paper  impregnated  with  potassium  nitrate,  or  with  a  mixture  of 
potassium  nitrate  and  chlorate ;  of  pastiles  and  of  various  powders, 
which  probably  are  principally  composed  of  powdered  datura- 


chap,  x.]      ACTION  OF  DEUGS  ON  EESPIEATION.  261 

leaves,  mixed  with  powdered  nitre,  and  perhaps,  also,  with  ipe- 
cacuanha, all  prove  useful.  The  action  of  all  these  smokes  is 
probably  the  same  as  that  of  nicotine,  for  Vohl  and  Eulenberg1 
have  shown  that  the  active  principles  in  tobacco-smoke  really 
are  not  nicotine  alone,  but  are  the  products  of  the  dry  distilla- 
tion of  tobacco-leaves,  consisting  chiefly  of  pyridine,  collidine* 
and  allied  substances,  which  resemble  nicotine  in  action,  and  are 
present  along  with  it  in  the  smoke.  The  same  products,  but  in 
different  proportions,  are  obtained  by  the  dry  distillation  of  other 
organic  bodies.  The  proportion  in  which  the  different  bases  are 
present  depends  both  on  the  nature  of  the  substances  subjected 
to  dry  distillation,  and  on  the  amount  of  oxygen  present  during 
the  process.  When  much  oxygen  is  present,  bodies  of  higher 
atomic  weight  and  less  volatile  than  those  lower  in  the  series 
are  formed,  much  collidine  being  produced  when  tobacco  is 
smoked  as  a  cigar,  while  pyridine  is  the  chief  product  when  it  is 
smoked  in  a  pipe.  It  is  probable  that  the  admixture  of  nitre 
with  paper  or  with  powdered  leaves  acts  beneficially  by  producing 
a  different  mixture  of  organic  bases  than  would  be  produced  by 
burning  the  paper  or  the  leaves  alone,  and  that  we  must  look  to 
bodies  allied  to  collidine  for  the  relief  of  asthma. 

'Arch.  Pharm.  (2),  1873,  vol.  cxlvii.  130-166. 


2G2  PHAEMACOLOGY  AND  THEEAPEUTICS.      [sect.  i. 


CHAPTEE  XI. 
ACTION  OF  DEUGS  ON  THE   CIECULATION. 

It  has  already  been  mentioned  that  the  cells  of  which  higher 
organisms  are  composed  live  in  the  intercellular  fluid  or  lymph 
which  bathes  them. 

This  nutritive  fluid  is  continually  being  renewed  by  fresh 
supplies  exuding  from  the  blood-vessels  into  the  lymph-spaces 
which  surround  the  cells,  the  excess  being  removed  by  absorption 
either  by  the  veins  or  by  the  lymphatics.  Besides  this,  an  inter- 
change of  gases  (internal  respiration)  and  of  solids  takes  place 
by  diffusion  between  the  lymph  and  the  blood. 

Wben  the  circulation  stops,  internal  respiration  is  arrested, 
and  the  cells  die.  But  they  do  not  all  die  at  the  same  time,  for 
some  are  able  to  live  longer  without  fresh  supplies  of  oxygen 
than  others.  The  order  in  which  they  die  is  (1)  the  cells  of  the 
initiative  nerve-centres,  as  the  brain  ;  (2)  those  of  the  automatic 
and  reflex  centres ;  (3 )  nerve-fibres  (which  are  modified  nerve- 
cells)  ;  (4)  unstriated  muscles  {  (5)  striated  muscles. 

Arteries  and  Veins. — It  is  important  in  this  respect  to  re- 
member tbat  it  is  only  so  long  as  blood  is  in  the  arteries  that  it 
is  available  for  the  nutrition  of  cells.  Once  in  the  veins  it  is 
useless  for  nutrition ;  and  were  it  not  that  it  readily  passes  from 
the  veins  into  the  arteries  again,  it  might  as  well  be  outside  the 
body  for  any  purposes  of  nutrition. 

The  veins  are  very  capacious,  and  when  dilated  to  their 
utmost,  they  can  alone  hold  all  the  blood  the  body  contains, 
and  more.  During  life  they  are  constantly  kept  more  or  less  in 
a  state  of  contraction  by  the  action  of  the  nervous  system,  but 
when  they  become  completely  dilated,  as  after  death,  all  the 
blood  flows  into  them,  leaving  the  arteries  empty.  It  is  there- 
fore possible,  as  Ludwig  has  well  expressed  it,  to  bleed  an  animal 
into  its  own  veins.  Schiff  has  shown  that  when  the  blood-vessels 
relax  as  they  do  after  section  of  the  medulla  oblongata,  the  whole 
of  the  blood  of  another  animal  as  large  as  the  one  experimented 
upon  must  be  introduced  in  addition  to  its  own,  in  order  to  raise 
the  pressure  within  the  vessels  to  the  normal.  Even  this  is  in- 
sufficient to  keep  up  the  pressure,  for  the  vessels  go  on  still 
dilating,  and  the  pressure  falls,  notwithstanding  the  large  quan* 


chap,  xi.]    ACTION  OF  DEUGS  ON  THE  CIRCULATION.     263 

tity  of  blood  which  is  present  in  them.  It  is  therefore  evident 
that  the  normal  action  of  the  vasomotor  centres  is  more  than 
equivalent,  for  .the  purposes  of  circulation,  to  as  much  blood 
again  as  the  animal  possesses.  "Weakened  power  of  these  centres 
is  to  a  certain  extent  equivalent  to  bleeding,  and  increased  power 
has  a  similar  effect  to  an  increase  in  the  quantity  of  blood  in  the 


Blood-pressure.— The  continuity  of  the  circulation  of  blood 
through  the  capillaries  is  not  maintained  by  the  heart  alone : 
the  elastic  pressure  of  the  arteries  on  the  blood  within  them  plays 
ajnost  important  part,  and  indeed  during  the  cardiac  diastole  the 
circulation  is  maintained  entirely  by  this  elastic  pressure. 

If  the  arterioles  or  capillaries  through  which  the  arterial 
system  empties  itself  into  the  veins  are  much  contracted,  so  that 
the  blood  can  flow  only  slowly  through  them,  the  heart  may  stop, 
and  yet  the  blood-pressure  may  remain  for  many  seconds  almost 
Unchanged.  But  if  the  arterioles  or  capillaries  are  dilated,  the 
arteries  quickly  empty  themselves  into  the  veins,  arterial  pres- 
sure rapidly  falls,  and  circulation  soon  stops. 


tm.  83.— Diagram  to  illustrate  the  effects  of  the  horizontal  and  vertical  position  on  the  circulation 
of  the  frog  in  shock,  a,  normal  ciiculation  in  the  upright  position.  6,  circu'ation  after  dilata- 
tion of  the  veins  has  been  produced  by  a  blow  on  the  intestines.  The  blood  does  not  reach  the 
heart,  and  it  beats  empty,  so  that  the  circulation  stops,  c  shows  the  circulation  ina  horizontal 
position  after  the  veins  have  been  dilated,  as  in  b.  The  veins  are  still  dilated,  but  the  .blood 
reaches  the  heart,  and  the  circulation  is  carried  on.  Fig.  c  is  perhaps  too  diagrammatic,'  as  it 
appears  to  show  an  empty  space  or  air  in  the  veins.  In  reality  the  veins,  being  very  thic- 
walled,  collapse.  Fig.  6  is  open  to  the  same  objection,  but  if  we  suppose  ourse  ves  to  be  look- 
ing at  the  vein  from  the  front  instead  of  in  section,  6  represents  almost  exactly  what  I  have 
myself  seen  in  repeating  Goltz's  experiment. 

I  use  the  words  arterioles  and  capillaries  as  synonymous, 
because  it  is  almost  certain  that  the  capillaries  do  contract.  In 
most  cases  where  contraction  has  occurred  in  the  peripheral 
vessels,  it  is  difficult  or  impossible  to  say  whether  its  seat  is  in 
the  capillaries  or  arterioles. 

The  action  of  the  heart  is  to  pump  the  blood  out  of  the  veins 
into  the  arteries,  and  this  it  can  only  do  when  the  blood  reaches 
it.  If  the  veins  are  much  dilated  and  the  animal  is  in  an  up- 
right position,  no  blood  may  reach  the  heart,  or  so  little  blood 
that  its  pulsations  are  practically  useless.  This  is  seen  in  the 
frog  when  dilatation  of  the  large  veins  has  been  renexly  pro- 
duced by  striking  the  intestines  (Fig.  836).  When  the  animal  is 
laid  flat,  the  blood  flows  into  the  heart,  and  then  it  works  nor- 
mally. It  is  probable  that  a  similar  condition  occurs  in  man,  as 
one  of  the  factors  in  shock ;  and  in  this  condition,  as  well  as  in 
fainting,  or  failure  of  the  heart's  action  from  the  effect  of  drugs, 


264 


PHARMACOLOGY  AND  THEEAPEUTICS.      [sect,  i. 


as  chloroform,  or  other  causes,  the  person  should  be  laid  flat, 
with  the  limbs  raised  so  that  the  blood  may  flow  out  of  them 
into  the  heart,  and  with  the  head  low  (either  perfectly  level  with 
the  body  or  depressed  below  it),  in  order  to  permit  of  an  in-, 
creased  supply  of  blood  to  the  intra-cranial  nerve-centres. 

Fainting  and  Shock. — In  fainting  there  is  sudden  uncon- 
sciousness, which  appears  to  be  caused  by  sudden  arrest  of  the 
supply  of  blood  to  the  brain.  This  arrest  may  be  due  to  a  rapid 
fall  in  blood-pressure,  either  from  stoppage  of  the  heart,  rapid 
dilatation  of  the  arterioles,  or  sudden  removal  of  pressure  from 
the  larger  vessels.  It  is  possible  that  these  conditions  may  be  as- 
sociated with  spasmodic  contraction  not  only  of  the  vessels  of  the 
face  and  surface  generally,  but  of  those  supplying  the  brain  itself. 
Tbe  effect  of  sudden  change  from  a  horizontal  to  an  upright  pos- 
ture in  producing  syncope  has  already  been  mentioned  (p.  205). 
Sudden  removal  of  external  pressure  from  the  great  vessels  acts 
upon  both  arteries  and  veins.  It  removes  external  support  from 
the  arteries,  and  allows  them  to  yield  more  readily  to  the  in- 
fluence of  the  blood-pressure,  and  by  their  dilatation  to  lessen  it. 
It  allows  the  large  veins  also  to  dilate,  and  blood  to  stagnate  in 
them.  Its  influence  is  readily  seen  when  fluid  is  removed  too 
suddenly  from  the  abdomen,  and  external  pressure  by  a  bandage 
hot  supplied  in  its  place,  as  in  cases  of  ascites. 

It  is  seen,  perhaps,  even  more  strikingly,  where  the  bladder 
*has  been  allowed  to  become  distended  and  is  suddenly  emptied. 
The  effect  of  this  is  shown  in  Fig.  84.   In  a  the  bladder  is  repra- 


Carotid  artery  (full) 


Aorta  tense 

Veins  tense  and  mode- 1 
ratelyfullf 


Bladder  (full) 


e-~ 


"  Carotid  artery  (empty). 


Aorta  las. 

Veins  lax  and  full. 


Bladder  (empty). 


]?ig.  84.— Diagram  to  show  the  effects  on  the  cerebral  circulation 'of  rapidly  emptying  the  bladder. 

sented  as  full,  and,  the  pressure  within  the  abdomen  being  con- 
siderable, the  veins  are  prevented  from  dilating,  the  heart  is  well 
supplied  with  blood,  and  the  circulation  in  the  brain  is  active. 
In  b,  the  bladder  is  represented  as  empty,  and  the  abdominal 
contents  being  diminished,  so  that  the  intra-abdominal  pressure 
is  lessened,  not  only  do  the  aorta  and  other  vessels  become  lax 
from  loss  of  the  external  pressure,  but  the  veins  dilate,  the  hear$ 


chap,  xi.]    ACTION  OF  DEUGSON  THE  CIECULATION.     265 

is  imperfectly  supplied  with  blood,  the  cerebral  circulation  fails, 
and  syncope  ensues.  This  occurs  more  readily  just  after  waking, 
before  the  vaso-motor  centre  has  recovered  its  usual  tone,  so  that 
one  of  the  most  favourable  conditions  for  its  occurrence  is  when 
a  man  jumps  suddenly  into  the  upright  position  and  empties  his 
bladder  immediately  on  waking.  The  consequence  of  this  some- 
times is  that  he  falls  down  suddenly,  quite  insensible,  during  the 
act  of  micturition.  I  have  seen  one  case  in  which  the  tendency 
appeared  to  be  increased  by  the  practice  of  opium-eating,  pro- 
bably from  the  diminished  excitability  of  the  vaso-motor  centre 
produced  by  the  drug.  It  is  evident  that  the  danger  will  be  in- 
creased if  the  intervals  between  the  systoles  of  the  heart  are  pro- 
longed, and  it  is  the  combination  of  the  natural  tendency  to 
syncope,  produced  by  large  doses  of  digitalis,  with  that  caused  by 
the  sudden  assumption  of  the  upright  posture,  and  by  the  rapid 
emptying  of  the  bladder,  which  renders  micturition  in  the  upright 
posture  so  excessively  dangerous  in  persons  under  the  action  of 
digitalis,  and  leads  so  frequently  to  death. 

It  is  evident  that  fainting  may  be  prevented  by  increasing  the 
blood-pressure  in  the  brain  locally,  or  throughout  the  body  gene- 
rally. To  increase  it  locally  the  head  of  a  fainting  person  should 
be  allowed  to  lie  level  with  the  body,  or  a  little  below  it,  and  on 
no  account  raised  even  by  pillows.  A  fainting  fit  may  indeed 
often  be  prevented  by  sitting  with  the  head  hanging  between  the 
knees.  It  may  also  be  prevented  or  removed  by  such  conditions 
as  raise  the  general  blood-pressure,  e.g.  a  draught  of  cold  water, 
which  causes  contraction  of  the  gastric  vessels,  or  a  sniff  of  am- 
monia or  acetic  acid,  which  stimulates  the  nasal  nerves,  and 
causes  reflex  contraction  of  the  vessels  generally.  In  some  parts 
of  India  the  natives  are  accustomed  to  bring  persons  round  from 
a  faint  by  compressing  the  nostrils  and  holding  the  hand  over 
the  mouth,  so  as  completely  to  stop  respiration.  The  accumula- 
tion of  carbonic  acid  in  the  blood  irritates  the  vaso-motor  centre, 
raises  the  blood-pressure,  and  thus  probably  tends  to  bring  the 
person  round. 

In  shock  there  is  no  unconsciousness,  but  the  failure  of  the 
circulation  is  even  more  profound  than  in  syncope.  Its  pathology 
is  not  perhaps  exactly  ascertained,  but  it  probably  depends  to  a 
great  extent  on  a  paralytic  distension  of  the  great  veins,  as  in 
Goltz's  experiments.  I  have  found  that  in  shock  produced  in  a 
similar  manner  in  a  rabbit  the  blood-pressure  could  be  raised 
from  two  inches  up  to  two  and  a  half  by  the  inhalation  of  am- 
monia. 

Schema  of  the  circulation. — In  order  to  understand  the  action  of  drugs 
on  the  circulation  it  is  absolutely  necessary  to  have  a  clear  idea  regarding  the 
effect  of  the  heart  and  capillaries  in  maintaining  the  blood-pressure.  This 
is  best  obtained  by  using  a  schema  which  can  be  easily  made  from  a  spray- 
apparatus  (Pig.  85).    By  removing  the  glass  or  metal  tube  from  one  of  these, 


266 


PHAKMACOLOGY  AND  THEEAPEUTICS.      [sect.  t. 


and  attaching  a  nozzle  with  a  small  stopcock  to  the  india-rubber  tube  in  its 
stead,  we  obtain  a  very  good  schema  of  the  circulation ;  and,  by  imitating  on 
it  the  changes  which  occur  in  the  heart  and  vessels,  we  may  form  a  much 
clearer  idea  of  them  than  we  could  otherwise  do.  The  india-rubber  ball 
will  represent  the  heart ;  the  elastic  bag,  surrounded  by  netting,  will  repre- 
sent the  elastic  aorta  and  larger  arteries;  and  the  stopcock,  which  regulates 
the  size  of  the  aperture  through  which  the  air  escapes,  will  represent  the 
small  arteries  and  capillaries,  whose  contraction  or  dilatation  regulates  the 
flow  of  blood  from  the  arteries  into  the  veins.  We  may  judge  of  the  tension 
in  the  arteries  by  the  distension  of  the  bag,  or  still  better,  we  may  connect 
the  tube  between  it  and  the  stopcock  with  a  mercurial  manometer,  and 
estimate  the  tension  by  the  height  of  the  mercurial  column  which  it  sustains. 
If  we  turn  the  stopcock  so  as  to  present  some  resistance  to  the  escape  of  air, 
and  then  compress  the  india-rubber  ball,  very  little  air  will  issue  from  the 


Fig.  85.— Simple  schema  of  the  circulation,  consisting  oi  a  spray-prodncer,  Dladder,  and  mercurial 
manometer.  The  elastio  ball  represents  the  heart ;  the  elastic  bag,  covered  with  netting  to 
prevent  too  great  distension,  represents  the  aorta  and  arterial  system,  and  the  bladder  represents 
the  venous  system. 

stopcock  even  while  we  are  squeezing  the  ball ;  the  greater  part  of  it  goes  to 
distend  the  bag ;  and,  when  we  cease  to  compress  the  ball,  very  little  air 
passes  through  the  stopcock.  At  the  next  squeeze,  the  bag  becomes  a  little 
more  distended ;  and  a  little  more  air  passes  through  the  stopcock,  not  only 
while  we  are  compressing  the  ball,  but  even  when  we  relax  our  grasp.  At 
each  squeeze  of  the  ball,  the  elastic  bag  becomes  tighter,  till  it  is  so  tense, 
and  contracts  so  strongly  on  the  air  inside,  that  it  can  press  all  the  extra 
amount  of  air,  forced  into  it  when  the  ball  was  compressed,  through  the 
stopcock  during  the  time  when  the  ball  is  relaxed.  When  this  is  the  case, 
every  time  we  squeeze  the  ball  we  see  the  bag  become  a  little  fuller,  and  air 
issue  more  quickly  from  the  nozzle.  At  each  relaxation,  while  the  ball  is 
refilling,  the  bag  gets  a  little  slacker,  and  the  air  passes  out  of  the  nozzle  a 
little  more  slowly,  but  never  stops  entirely.  During  the  time  the  ball  is 
filling,  the  valves  between  it  and  the  bag  and  nozzle  are  closed,  and  cut  it 
off  from  any  connection  with  them.  All  this  time,  then,  the  stream  of  air 
from  the  nozzle  must  be  entirely  independent  of  the  ball ;  it  is  produced  by 
the  contraction  of  the  elastic  bag,  and  by  it  alone.  The  bag  may  be  stretched, 
and  the  tension  of  its  walls  increased  in  consequence,  in  two  ways :  first,  by 
working  the  ball  more  quickly  or  compressing  it  more  completely ;  second, 
by  lessening  the  opening  of  the  nozzle,  and  thus  hindering  the  passage  of  air 
through  it.  One  trial  will,  I  think,  be  enough  to  show  how  much  easier  it  is 
to  alter  the  pressure  by  changing  the  size  of  the  nozzle  than  by  any  altera- 
tion in  the  working  of  the  ball,  and  to  prove  that  alterations  in  blood-pressure 


chap.  xi/J    ACTION  OP  DEUGS  ON  THE  CIRCULATION.     267 

probably  depend  much  more  on  alterations  in  the  lumen  of  the  small 
arteries  than  on  changes  in  the  action  of  the  heart. 

But  our  schema,  as  it  at  present  exists,  is  not  a  perfect  representation  of 
the  heart  and  vessels ;  for  it  draws  its  air  from  an  inexhaustible  reservoir, 
the  atmosphere,  and  is  not  obliged  each  time  to  use  that  amount  alone  which 
it  had  previously  driven  through  the  nozzle  ;  while  the  heart  can  only  use 
the  blood  which  has  been  forced  by  it  through  the  capillaries  and  returned 
to  it  by  the  veins.  In  order  to  make  our  schema  complete,  we  must  connect 
its  two  ends  by  tying  them  into  a  bladder  or  large  thin  caoutchouc  bag  (such 
as  is  used,  after  inflation,  as  a  toy  for  children),  so  that  the  air  shall  pass 
into  it  from  the  nozzle  and  be  sucked  out  of  it  by  the  elastic  ball.  This  will 
represent  the  veins.  If  we  then  repeat  the  experiment  just  described,  we 
shall  find  that,  when  we  begin  to  work  the  ball  and  stretch  the  elastic  bag 
representing  the  arteries,  the  bladder  representing  the  veins  becomes  empty 
and  collapsed ;  and  just  in  proportion  as  we  fill  the  bag  do  we  empty  the 
bladder.  If  we  now  stop,  the  air  will  gradually  escape  from  the  bag  to  the 
bladder,  till  the  air  in  both  is  of  equal  tension,  as  at  first. 

Circulation  in  the  Living  Body. — The  phenomena  of  the 
circulation  in  the  heart  and  vessels  are  very  much  the  same  as 
in  the  schema.  "When  the  heart  stands  still  (as  when  the  vagus 
is  strongly  galvanised),  the  blood  flows  from  the  arteries  into- 
the  veins  until  the  arteries  are  nearly  empty  and  the  pressure 
■within  them  falls  to  zero.  If  the  heart  now  begin  to  beat,  it 
forces  blood  into  the  elastic  aorta  and  arteries  at  each  systole, 
and  distends  them,  just  like  the  elastic  bag  of  the  schema  ; 
while  at  the  same  time  it  takes  blood  from  the  veins,  and  they 
become  empty  in  proportion  as  the  arteries  become  full.  During 
every  diastole  of  the  heart,  the  distended  aorta  and  other  arteries, 
in  virtue  of  their  elasticity,  contract  on  the  blood  they  contain, 
and  keep  it  flowing  on  through  the  capillaries  till  another  systole 
occurs ;  the  heart,  meanwhile,  being  completely  shut  off  from 
the  aorta  by  the  sigmoid  valves  (just  as  the  ball  of  the  schema 
was  shut  off  ifrom  the  elastic  bag).  In  general,  the  diastole  is 
longer  than  the  systole ;  so  that  for  the  greater  part  the  circula- 
tion through  the  capillaries  is  carried  on  by  the  elasticity  of  the 
arteries,  and  not  directly  by  the  heart.  The  arteries,  which  we 
have  supposed  to  be  at  first  empty,  gradually  become  distended 
by  the  heart,  just  as  the  elastic  bag  was  by  the  ball,  and  exert 
more  and  more  pressure  on  the  blood  in  them  (so  that  it  would 
spout  higher  ana  higher  if  one  of  them  were  cut),  till  they  are 
able  during  the  diastole  to  press  the  same  amount  of  blood 
through  the  capillaries  into  the  veins  as  had  been  pumped  into 
them  during  the  systole.  The  more  tensely  they  are  stretched, 
the  greater  is  the  pressure  they  exert  on  the  blood  they  contain  ; 
and  the  amount  of  this  is  termed  the  arterial  tension  or  blood- 
pressure.  These  two  terms  mean  the  same  thing,  and  we  use 
one  or  other  just  as  the  fancy  strikes  us.  At  each  systole,  the  fresh 
Supply  of  blood  pumped  in  by  the  heart  stretches  them  more ; 
that  is,  the  arterial  tension  rises.  Luring  each  diastole,  the 
blood  escapes  into  the  wide  and  dilatable  veins,  and  the  arteries 


268  PHAEMACOLOGY  AND  THEEAPEUTIGS.    ■  [sect.  i. 

become  less  stretched ;  that  is,  the  arterial  tension  falls.  This 
alternation  of  rise  and  fall  constitutes  the  pulse. 

Besides  the  oscillations  which  take  place  in  the  Hood- 
pressure  at  each  beat  of  the  heart,  a  rise  and  fall  in  the  form 
of  a  long  wave  occurs  at.  each  respiration..  The  wave  begins  to 
rise  just  after  inspiration  has  begun,  reaches  its  maximum  just 
after  the  beginning  of  expiration,  and  then  begins  to  fall  again 
till  a  new  wave  succeeds  it.  The  heart-beats  are  generally  quicker 
during  inspiration,  and  slower  during  expiration. 

The  blood -pressure  thus  oscillates  up  and  down  at  each 
heart-beat  and  rises  and  falls  with  each  respiration,  and  the 
average  between  the  highest  and  lowest  points  is  called  the  mean 
arterial  tension  or  mean  blood-pressure. 

Besides  the  oscillations  in  blood-pressure  due  to  the  pulse 
and  to  the  respiration,  there  are  slowly  rising  and  falling  waves 
to  which  the  name  of  Traube's  curves  is  given.  These  are  due 
to  alternate  contraction  and  relaxation  of  the  arterioles  and 
capillaries.  Bhythmical  contraction  of  the  arterioles  has  been 
observed  in  almost  all  parts  of  the  body  of  rabbits,  and  probably 
occurs  both  in  the  lower  animals  and  in  man. 

The  blood-pressure  is  not  equal  throughout  the  whole  arte- 
rial system.  It  is  greater  in  the  large  and  less  in  the  smaller 
arteries,  in  which  it  becomes  diminished  by  the  friction  between 
the  blood  and  the  arterial  walls.  It  is  also  modified  by  gravity, 
so  that  the  position  of  a  limb  may  alter  the  pressure  in  its 
arteries. 


Method  of  ascertaining  the  Blood-Pressure. 

The  blood-pressure  is  usually  estimated  in  animals  by  connecting  a  large 
artery,  such  as  the  carotid  or  femoral,  with  a  bent  tube  containing  mercury 
by  means  of  a  connecting  tube,  which  is  filled  with  a  solution  of  carbonate  of 
sodium  to  prevent  coagulation.  The  pressure  is  estimated  by  the  height  at 
which  the  mercury  stands  in  the  outer  limb  of  the  tube.  The  height  may 
either  be  read  off  with  the  eye,  or,  what  is  much  better,  it  may  be  registered 
on  a  revolving  cylinder  by  means  of  a  long  float  which  rests  upon  the  surface 
of  the  mercury,  and  bears  on  its  upper  end  a  brush  or  pen.  This  method, 
which  is  important  both  in  itself  and  as  being  the  introduction  of  the  graphio 
method  into  physiology,  we  owe  to  C.  Ludwig.  The  apparatus  is  known  as 
the  kymograph. 

Tracings  may  be  taken  upon  paper  with  a  varying  speed :  it  is  usual  to 
take  them  upon  paper  travelling  rapidly,  so  that  quick  and  small  oscillations 
due  to  the  cardiac  beats  may  not  be  lost  or  obscured  by  fusion.  The  great 
disadvantage  of  this  is  that  it  is  impossible  to  use  the  curves  directly :  they 
must  be  reduced,  and  this  is  a  work  requiring  much  time  and  labour.  When 
taken  on  a  slowly  revolving  cylinder  we  get  the  general  results  of  the  action 
of  a  drug  on  the  blood-pressure  shown  us  at  a  glance ;  and  its  effects  on  the 
form  and  rapidity  of  the  pulse  may  by  a  little  arrangement  be  recorded  from 
time  to  time  on  another  cylinder  revolving  more  rapidly. 

This  method  gives  us  both  the  blood-pressure  and  the  oscillations  which 
it  undergoes  on  account  of  the  cardiac  pulsations  and  respiration.  If  we 
wish  to  get  the  mean  blood-pressure  unaffected  by  these  oscillations,  it  is 


chap,  xi.]    ACTION  OF  DRUGS  ON  THE  CIRCULATION.     269 

done  by  simply  narrowing  at  one  point  the  calibre  of  the  tube  containing  the 
mercury,  either  by  a  stopcock,  or  by  reducing  the  tube  to  a  capillary  bore. 

Fallacies  of  Mercurial  Manometers.— The  oscillating  mercurial 
(.column  does  not  give  the  variations  in  blood-pressure  quite  truly,  because 
the  oscillations  are  compounded  of  these  variations  and  of  the  oscillations 
due  to  the  inertia  of  the  mercury  itself.  In  order  to  obtain  the  exact  form  of 
variation  we  employ  Fick's  kymograph  (Pig.  86),  or  Eoy's  tonometer,  in 
which  the  apparatus  is  made  very  light,  and  all  oscillations  due  to  its  own 
inertia  are  as  far  as  possible  avoided. 


Writing-point ' 


Piston  to  lessen  oscil- 
lation of  point. 

Tube      filled      with 
glycerine 


Eyringe  for    altering 
the  pressure  in  the 
I  manometer. 


—flat  metal  tube  form- 
ing the  manometer. 


(Tube  to  connect  the 
manometer  and  ar- 
tery. 


Fig.  86.— Pick's  kymograph.  It  consists  of  a  fiat  metal  tube,  bent  into  a  nearly  ciroular  form,  filled 
with  alcohol,  and  connected  with  the  artery  by  means  of  a  leaden  tube,  filled  with  a  solution  of 
sodium  carbonate.  When  the  pressure  increases  within  it,  the  tube  straightens,  and  when  the 
pressure  diminishes  it  bends.  These  changes  are  magnified  and  recorded  on  a  cylinder  by  a 
light  lever.  The  vibrations  of  the  lever  are  lessened  by  a  piston,  which  works  in  a  tube  rilled 
with  glycerine. 

Fallacies  from  Anaesthetics. — Even  if  the  instrument  be  free  from 
fallacy,  we  still  have  difficulty  in  ascertaining  the  real  action  of  the  drug  on 
the  circulation,  inasmuch  as  the  blood-pressure  is  much  affected  by  move- 
ments, and  by  anaesthetics.  If  the  animal  is  not  anaesthetised  we  may  get 
untrustworthy  results  from  the  straining  or  movements  it  may  make,  and  if 
it  is  anaesthetised,  the  anaesthetic  may  greatly  alter  the  power  of  the  heart,  or 
the  sensibility  of  the  nerve-centres  either  to  the  direct  action  of  the  drug 
upon  them,  or  to  its  reflex  action  through  the  afferent  nerves.  In  order  to 
get  rid  of  movement,  and  at  the  same  time  to  prevent  the  vascular  centres 
from  being  much  depressed,  curare  is  sometimes  used  instead  of  an  anaesthetic. 
Perhaps,  almost  equally  good  results  may  be  obtained  by  using  ether  as  the 
anaesthetic,  carefully  regulating  the  supply  so  as  to  abolish  sensation  without 
greatly  affecting  the  medulla.  The  reasons  why  this  is  possible  are  discussed 
at  p.  204.  In  order  to  regulate  the  supply  of  ether,  we  use  a  stopcock,  by 
which  pure  ether,  or  pure  air,  or  an  admixture  of  both  in  any  desired  propor- 
tion, can  be  passed  into  the  lungs  (Fig.  73,  p.  211). 

Other  fallacies  arise  from  the  mode  of  injecting  the  drug,  and  this  has 
Sometimes  led  to  false  results  :  thus  drugs  are  not  unfrequently  injected  into 
the  jugular  vein,  as  it  is  very  conveniently  situated  for  the  purpose.  In  this 
way,  however,  they  are  carried  directly  to  the  heart,  and  act  much  more 
strongly  upon  it,  than  they  would  do  if  absorbed  from  other  parts  of  the 
body.  In  the  case  of  irritant  salts,  for  example,  time  is  not  afforded  for  their 
irritant  properties  becoming  lessened  by  chemical  combination  with  the  con- 
stituents of  the  blood.     If  the  solution  injected  contain  particles  which  will 


270  PHAEMACOLOGY  AND  THEKAPEUTICS.      [sect,  i, 

not  pass  through  the  pulmonary  capillaries,  or  if  it  is  likely  to  cause  coagu- 
lation of  the  blood,  it  may  plug  up  the  pulmonary  vessels  and  give  rise  to 
dyspnoea  and  convulsions. 

Both  these  objections  are  avoided  when  the  drug  is  injected  under  the 
skin,  or  into  the  peritoneal  cavity.  Absorption  from  the  skin  is  slower  than 
from  the  peritoneum.  In  some  experiments  this  is  a  disadvantage :  in  others, 
however,  it  is  an  advantage. 

Another  fallacy  sometimes  arises  from  the  solution  of  carbonate  of  sodium 
used  to  prevent  coagulation.  In  order  to  prevent  the  blood  from  passing  too 
far  into  the  tube  connecting  the  artery  with  the  kymograph,  it  is  usual  to 
introduce  the  solution  of  carbonate  of  sodium  into  the  tube  by  a  syringe  (vide 
Fig.  86)  or  otherwise,  under  a  pressure  very  little  less  than  the  usual  blood- 
pressure  of  the  animal  experimented  on.  If  the  blood-pressure  be  lowered 
much  by  stoppage  of  the  heart  or  dilatation  of  the  vessels,  the  solution  of 
carbonate,  or  bicarbonate  of  sodium,  runs  into  the  arteries  and  may  cause 
convulsions  and  death.  Thus  stoppage  of  the  heart  by  irritation  of  the  vagus, 
or  by  the  action  of  a  drug,  may  sometimes  appear  to  be  followed  by  results  - 
which  are  not  really  due  to  it,  but  only  to  the  conditions  under  which  the 
experiment  has  been  made. 


Alterations  in  Blood-pressure. 

In  speaking  of  "blood-pressure,  arterial  blood-pressure  is  always 
meant,  unless  otherwise  stated. 

As  the  blood-pressure  depends  on  the  difference  between  the 
quantity  pumped  into  the  arterial  system  by  the  heart  at  one 
end,  and  the  quantity  flowing  out  through  the  arterioles  into  the 
veins  at  the  other  in  a  given  time,  it  is  evident  that — 

The  blood-pressure  will  remain  constant  when  these  quan- 
tities remain  equal  to  each  other. 

It  will  rise  when — 

(a)  More  blood  is  pumped  in  by  the  heart. 

(b)  When  less  flows  out  through  the  arterioles  in  a  given 

time. 
It  will  fall— 

(a)  When  less  is  pumped  in  by  the  heart ;  or, 

(b)  More  flows  out  through  the  arterioles ;  or,  to  look  at  it 

another  way : — - 

Heart  jmore  active-     Blood-pressure  rises. 
Uess        „  „  „       falls. 

Arterioles  {^tract  „  „       rises. 

ldllate  „  „       falls. 

The  heart  may  throw  more  blood  into  the  arteries,  either  by 
pulsating  more  rapidly,  or  by  pulsating  more  vigorously  and 
more  completely,  so  that  at  each  contraction  a  larger  amount  of 
blood  is  expelled.  But  increased  activity  can  only  affect  the 
blood-pressure  so  long  as  there  is  a  free  supply  of  blood  entering 
the  heart.  If  there  exist  any  obstruction  to  its  entrance  the 
increased  cardiac  action  will  have  no  effect.  Hence  obstruction 
of  the  pulmonary  circulation  will  also  lower  the  blood-pressure. 


-chap,  xi.]    ACTION  OF  DEUGS  ON  THE  CIECULATION.     271 

The  causes  of  alteration  in  the  blood-pressure  may  be  tabulated 
as  follows  :— 

Blood-Pressuve 


May  be  raised — 

1.  By  the  heart  beating 
more  quickly. 

2.  By  the  heart  beating 
more  vigorously  and  more 
completely,  and  sending  more 
blood  into  the  aorta  at  each 
beat. 

3.  By  contraction  of  the 
arterioles,  retaining  the  blood 
in  the  arterial  system. 


May  be  lowered — 

1.  By  the  heart  beating 
more  slowly. 

2.  By  the  heart  beating 
less  vigorously  and  completely, 
and  sending  less  blood  into  the 
aorta  at  each  beat. 

3.  By  dilatation  of  the 
arterioles,  allowing  the  blood 
to  flow  more  quickly  into  the 
Veins. 

4.  By  deficient  supply  of 
blood  to  the  left  ventricle,  as 
from  contraction  of  the  pul- 
monary vessels,  or  obstruction 
to  the  passage  of  blood  through 
them,  or  from  stagnation  of 
blood  in  the  large  veins,  e.g., 
in  shock. 

The  influences  on  the  pressure  exerted  by  (a)  the  number  of 
beats,  and  (b)  by  the  amount  of  blood  sent  out  by  the  heart  at 
each  beat,  to  a  certain  extent,  though  by  no  means  completely, 
counteract  each  other ;  for,  when  the  heart  is  beating  quickly, 
it  has  not  time  to  fill  completely,  and  so  sends  out  little  blood 
at  each  beat :  but,  when  beating  slowly,  it  becomes  quite  full 
during  each  diastole,  and  sends  out  a  larger  quantity  of  blood 
at  each  contraction. 

It  is  evident  that  the  amount  of  blood  which  the  heart  can 
send  into  the  arteries  at  each  beat  will  depend  also  upon  the 
completeness  with  which  the  ventricle  relaxes  during  diastole. 
If  the  relaxation  be  incomplete  very  little  blood  will  enter  the 
ventricle,  and  thus  a  drug  which  increases  the  contractile  power 
of  the  heart  may,  by  unnecessarily  prolonging  the  systole,  lower 
the  blood-pressure  as  much  as  a  drug  which  paralyses  the  heart 
and  prevents  the  ventricle  from  expelling  its  contents. 


Relation  of  Pulse-rate  and  Arterioles  to  Blood-pressure. 

Although  we  are  unable,  from  the  mere  fact  that  the  blood- 
pressure  rises  or  falls  after  the  administration  of  a  drug,  to  say 
whether  the  result  is  due  to  the  action  of  the  drug  on  the  heart 
or  on  the  arterioles,  yet  we  can  come  to  some  general  conclusion 
regarding  its  mode  of  action  by  comparing  the  alterations  which 


272  PHARMACOLOGY  AND  THERAPEUTICS,      [sect.  I. 

it  has  produced  in  the  blood-pressure  with  those  which  occur  m 
the  pulse-rate.  For  in  the  normal  condition  of  an  animal*  when 
all  the  nerves  are  intact,  a  rise  in  the  blood-pressure  renders  the 
pulse  slow  by  increasing  the  normal  tone  of  the  vagus  centre  in 
tbe  medulla,  and  a  fall  of  blood-pressure  quietens  the  pulse  by 
diminishing  the  tone.  This  mechanism  tends  in  the  normal 
animal  to  keep  the  blood-pressure  more  or  less  constant. 

We  find,  therefore,  that  when  alterations  in  blood-pressure 
and  pulse-rate  are  depicted  graphically,  so  that  a  rise  in  one 
curve  indicates  a  rise  in  blood-pressure,  and  a  rise  in  the  other 


Fig.  87.— Diagram  of  a  pulse  and  blond-pressure  curve,  where  tbe  alterations  are  due  at  first  to  the 
action  of  a  drug  on  the  heart,  as  in  tbe  case  of  atropine.  The  unbroken  line  indicates  tbe  blood- 
pressure,  and  the  dotted  line  the  pulse.  After  the  injection  shown  by  the  vertical  line  the  vagus 
is  paralysed,  the  pulse  becomes  very  rapid,  and  the  blood-pressure  rises.  At  A  the  vaso-motor 
centre  becomes  paralysed,  the  arterioles  dilate,  and  the  pressure  falls.  From  a  to  6  the  action 
of  the  heart  continues  nearly  uniform,  notwithstanding  the  fall  in  blood-pressure,  but  at  6  the 
heart  begins  to  become  paralysed,  and  the  pulse-rate  and  blood-pressure  both  continue  to  fall 
steadily  till  death. 

indicates  quickening  of  the  pulse,  the  two  curves  run  in  oppo- 
site directions  if  the  alteration  in  blood-pressure  is  due  to  the 
arterioles,  but  they  run  parallel  when  the  alteration  is  due  to 
the  heart  (Fig.  87).  Thus,  if  the  vagi  be  cut,  we  find  that  the 
pulse-rate  rises,  and  in  consequence  of  this  the  blood-pressure  also 
rises.  Here  the  alteration  in  pressure  is  due  to  the  heart,  and 
the  two  curves  are  therefore  parallel.  If  the  vagi  be  irritated  the 
pulse-rate  falls,  and  in  consequence  of  this  the  blood-pressure  also 
falls.  Here  again  the  alteration  is  due  to  the  heart,  and  the  two 
curves  are  parallel. 


Fig.  88.— Diagram  of  pulse  and  blood-pressure  curves,  where  the  alterations  are  lue  at  first  to  the 
action  of  a  drug  on  the  arterioles.  The  unbroken  line  indicates  the  blood-pressure,  the  dotted 
line  indicates  the  pulse.  The  upright  line  indicates  the  time  of  iujectiun  of  the  poison.  This 
is  followed  by  contraction  of  the  arterioles  and  consequent  rise  of  blood-pressure.  This  rise 
stimulates  the  vagus  roots,  and  causes  slowness  of  the  pulse.  At  6  the  vagus  becomes  paralysed, 
the  pulse  becomes  quick,  and  the  pressure  rises  still  higher  between  A  and  B.  At  B  the  vaso- 
motor centre  becomes  paralysed,  the  arterioles  dilate,  and  the  pressure  falls,  notwithstanding 
the  rapidity  of  the  pulse.  At  c  the  heart  itself  begins  to  be  paralysed,  its  beats  become  slow, 
and  both  pulse  and  pressure  fall  steadily  till  death. 

If,  on  the  other  hand,  the  arterioles  are  made  to  contract  the 
pressure  rises,  but  the  increased  pressure  stimulates  the  vagus 
roots  in  the  medulla  and  the  pulse-rate  falls,  so  that  the  curves 


chap,  xi.]    ACTION  OF  DEUGS  ON  THE  CIECULATION.     273 

run  in  opposite  directions.  If  the  arterioles  dilate  the  pressure 
falls,  and  the  vagus  tone  being  lessened  the  pulse-rate  rises ;  so 
the  curves  are  again  in  opposite  directions  (Fig.  88). 

An  example  of  this  is  seen  in  the  accompanying  curve  (Fig.  89), 
which  illustrates  the  action  of  erythrophloeum — a  substance  similar 
in  action  to  digitalis— on  the  circulation.  After  the  injection  of 
the  drug  the  vessels  contract,  and  the  blood-pressure  consequently 
rises  and  produces  some  slowness  of  the  pulse.  In  a  little  while 
the  vagus  becomes  paralysed,  the  pulse  becomes  quicker,  and 


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Jia.  89.— Curve  of  the  pulse  and  blood-pressure  in  a  cat  after  division  uf  the  spinal  cord  at  the  atlas 
and  injection  of  erythrophloeum.    (Prom  a  paper  by  Brunton  and  Pye,  Phil.  Trans,  vol.  167.) 

the  pressure  rises  still  further.  At  a  later  stage  the  heart  be- 
comes slow,  apparently  from  the  action  of  the  drug  upon  it,  and 
the  blood-pressure  then  falls  again.  At  first  then,  where  the 
alteration  of  pressure  depends  upon  the  state  of  the  vessels,  we 
have  the  two  curves  running  in  opposite  directions,  but  when 
the  alterations  depend  upon  the  condition  of  the  heart  we  have 
them  running  parallel.1  It  will  be  noticed  that  in  the  latter  part 
of  the  curve,  although  the  blood-pressure  and  the  pulse  sink 

1  Although  the  rise  in  blood-pressure  which  accompanies  that  of  the  pulse  ia 
partly  due  to  the  heart,  it  is  very  probable  that  the  contraction  of  the  arterioles 
which  caused  the  rise  at  first  is  not  only  continuing  but  increasing. 


274     .       PHARMACOLOGY  AND  THEEAPEUTICS.     [sect.  I. 

together,  they  do  hot  sink  quite  parallel ;  the  pulse  falling  very 
rapidly  and  the  blood-pressure  very  slowly.  Prom  this  fact  we 
may  conclude  that  the  arterioles  are  still  contracted,  and  this 
affords  an  illustration  of  another  way  in  which  we  judge  of  the 
effect  of  drugs  upon  the  arterioles.  This  conclusion  would  not 
be  warranted  by  the  data  contained  in  Fig.  89  alone.  For  the 
slowness  with  which  the  blood-pressure  falls  in  this  experiment 
might  possibly  be  due  to  the  heart  beating  more  perfectly,  at  the 
same  time  that  it  begins  to  beat  more  slowly.  An  examination 
of  the  original  tracings  of  the  blood-pressure  shows  that  this  is 
not  the  case  and  that  the  beats  of  the  heart  became  feeble  at  the 
same  time  that  they  became  slow. 

The  mutual  regulating  power  of  the  pulse  and  blood-pressure 
only  exists  when  the  vagi  are  working  normally.  If  they  should 
be  paralysed,  either  by  section  or  by  the  action  of  a  drug,  in- 
creased arterial  pressure  will  no  longer  slow  the  pulse ;  it  may 
even  quicken  it,  and  therefore  the  pulse-rate  and  blood-pressure 
may,  in  such  a  condition,  run  parallel  even  though  the  increased 
pressure  should  be  dependent  upon  alterations  in  the  arterioles. 

But  if  the  vagi  are  not  paralysed,  and  we  find  on  comparing 
the  curves  of  blood-pressure  and  pulse-rate  that  they  run  parallel, 
a  fall  in  the  blood-pressure  and  slowness  of  pulse  occurring 
together,  or  a  rise  in  pressure  and  quickness  of  pulse  accom- 
panying each  other,  we  may  conclude  that  the  alterations  in 
such  a  case  are  due  to  changes  in  the  action  of  the  heart. 

If,  however,  we  find  that  the  curves  run  in  opposite  directions, 
the  pressure  rising  and  the  pulse  falling,  it  is  highly  probable 
that  the  rise  is  due  to  contraction  of  the  arterioles,  and  that  the 
fall  of  the  pulse  is  caused  by  the  rise  of  pressure  acting  as  a 
stimulus  to  the  vagus  roots.  This  is,  however,  not  quite  certain, 
as  it  might  be  due  to  the  action  of  the  drug  upon  the  vagus,  and 
the  proper  method  of  ascertaining  this  would  be  that  employed 
by  Ludwig,  of  allowing  a  quantity  of  blood  to  flow  out  into  a 
bladder  connected  with  a  blood-vessel,  so  that  the  pressure, 
should  fall.  If  the  pulse  still  continued  slow  in  spite  of  the  fall 
of  pressure,  it  would  be  evident  that  the  slowness  was  due  to  the 
action  of  the  drug  upon  the  vagus,  and  not  to  indirect  action 
through  the  blood-pressure.  By  employing  a  bladder  in  this 
manner  the  blood  can  be  quickly  introduced  again  into  the 
vessels  after  the  effect  of  its  withdrawal  has  been  ascertained. 

We  not  unfrequently  find  that,  owing  to  the  action  of  a  drug 
the  pulse,  which  has  become  slow  during  the  rise  of  the  blood- 
pressure,  suddenly  becomes  very  rapid  notwithstanding  that  the 
pressure  continues  high.  This  is  usually  due  to  paralysis  of  the 
vagus-ends  in  the  heart,  and,  when  this  occurs,  the  correctness 
of  the  conclusion  which  we  draw  from  the  occurrence  mav  be 
ascertained  by  stimulating  the  vagus  in  the  neck  by  a  faradaic 
current,  and  seeing  whether  any  slowing  or  stoppage  of  the  heart 


chap,  xi.]    ACTION  OF  DEUGS  ON  THE  CIRCULATION.     275  _• 

occurs.  Frequently  we  find  that  after  the  pulse  has  become 
quick  from  paralysis  of  the  vagus,  the  pressure  which  the  quick- 
pulse  had  raised  begins  to  fall  again  from  paralysis  of  the 
arterioles.  The  pulse  may  continue  quick  and  weak  almost  till 
death  and  then  cease  suddenly,  or  it  may  become  gradually  slow 
as  well  as  weak  from  paralysis  of  the  heart  itself. 

Effect  of  the  Arterioles  on  Pulse-curves. — The  influence  of 
the  arterioles  upon  the  blood-pressure  in  a  living  animal  can  be 
to  a  great  extent  ascertained  by  the  rapidity  or  slowness  of  the , 
fall  of  the  blood  pressure  during  the  diastole  of  the  heart.  When 
the  heart  is  beating  slowly  the  diastole  may  be  long  enough  to 
show  distinctly  the  curve  which  the  blood-pressure  describes  dur- 
ing its  descent ;  but  if  the  heart  is  beating  quickly  the  diastole 
may  be  so  short  that  this  curve  cannot  be  exactly  obtained.  It  is 
then  necessary  to  prolong  the  diastole  artificially  by  stimulation 
of  the  vagi. 

The  reason  why  the  part  which  the  arterioles  play  in  main- 
taining the  blood-pressure  can  be  ascertained  by  the  way  in 
which  it  falls  during  cardiac  diastole,  natural  or  artificial,  is  that 
in  the  healthy  heart  the  aortic  valves  close  during  the  diastole  so 
as  to  separate  the  aorta  completely  from  the  ventricle. 

In  considering  the  blood-pressure  during  the  diastole,  we  may 
therefore  disregard  the  heart  entirely,  and  look  upon  the  aorta 
and  its  branches  as  an  elongated  elastic  bag  closed  at  its  cardiac 
end,  but  open  at  its  capillary  end.  This  bag  is  distended  with 
blood,  which  in  consequence  of  the  elastic  pressure  exerted  upon 
it  by  the  arterial  walls  tends  to  flow  out  into  the  veins.  The 
rate  at  which  it  does  this  will  depend — 

1st,  on  the  elastic  pressure  or  arterial  tension ;  and, 

2ndly,  on  the  size  or  degree  of  contraction  of  the  arterioles  or 
capillaries. 

If  we  connect  a  manometer  with  this  elongated  bag  as  in 
Fig.  90,  and  place  on  the  mercurial  column  a  float  by  which  its 


Fig.  90.— Diagram  of  the  circulation,  a,  the  heart,  completely  shut  off  by  the  valves  during 
diastole  from  b,  the  arteries,  e,  the  capillaries,  d,  the  veins,  e,  mercurial  manometer.  /,  a 
float,    g,  a  recording  cylinder. 

height  can  be  recorded  on  a  revolving  cylinder,  it  is  evident  that 
the  pressure-curve  will  fall  more  quickly  to  zero  when  the  capil- 
laries are  dilated,  and  more  slowly  when  they  are  contracted. 
With  capillaries  of  the  same  size,  the  rate  of  flow  will  vary 

T  2 


276  PHAKMACOLOGY  AND  THERAPEUTICS,      [sect.  i. 

with  the  arterial  pressure.  If  the  pressure  be  high  the  curve 
will  fall  more  rapidly  than  when  it  is  low,  for  the  greater  blood- 
pressure  will  drive  the  blood  more  rapidly  through  the  open 
arterioles.  If  we  find  that  with  a  normal  pressure  the  pressure- 
curve  falls  more  slowly  than  usual  during  the  diastole,  we  may 
conclude  that  the  arterioles  are  contracted ;  and  if  we  find  that 
the  fall  is  slower,  notwithstanding  that  the  pressure  is  higher 
than  usual,  the  proof  that  the  arterioles  are  contracted  is  so 
much  the  stronger. 

This  is  what  Meyer  and  I  *  observed  in  the  case  of  digitalis, 
where  we  found,  as  in  the  accompanying  figure  (Fig.  91),  that 
the  fall  of  the  blood-pressure  during  the  cardiac  diastole  hi  a 
dog  is  much  slower  after  than  before  the  injection  of  digitalis 
into  the  circulation. 

In  observations  of  this  sort  it  must  always  be  borne  in  mind 
that  a  great  difference  exists  between  the  vessels  of  the  intestines 


2?ig.  91.— Tracing  showing  tlie  blood-pressure  and  form  of  the  pulse-wave  before  and  after  the  in- 
fection of  digitalis  -in  the  dog.  The  thin  line  shows  the  blood-pressure  before,  and  the  thick 
one  after,  the  injection.  The  curve  sinks  more  slowly  after  the  injection,  notwithstanding  the 
greater  pressure  in  the  vessels. 

on  the  one  hand,  and  those  of  the  muscles  on  the  other.  The 
former  are  readily  controlled  by  the  vaso-motor  centre,  and 
when  this  is  stimulated  they  contract  greatly.  Those  of  the 
muscles  appear  to  be  but  slightly  influenced  by  the  vaso-motor 
centre,  so  that  when  it  is  stimulated  they  hardly  contract  at  all, 
and  indeed  the  flow  of  blood  through  them  becomes  accelerated 
on  account  of  the  contraction  of  the  vessels  elsewhere.  When 
the  vaso-motor  centre  is  stimulated  at  the  same  time  that  the 
vagus  is  irritated,  the  blood-pressure  appears  to  fall  nearly  as 
quickly  as  when  the  vagus  alone  is  irritated.  It  seems  possible, 
however,  that  this  result  may  be  really  due  to  some  extent  to 
actual  dilatation  of  the  vessels  in  the  muscles,  for  stimulation  of 
the  motor  nerves  of  muscle  appears  to  produce  a  vaso-dilating 
effect  on  their  blood-vessels  (Gaskell  and  others) . 

The  want  of  power  of  the  vaso-motor  centre  over  the  vessels 

1  Brunton  and  Meyer,  Journal  of  Anatomy  and  Physiology,  vol.  vii.  1872,  p.  134. 
The  experiments  described  in  the  paper  were  performed  in  1868. 


chap,  si.]    ACTION  OF  DEUGS  ON  THE  CIECULATION.     277 

of  the  muscles  is  probably  of  considerable  pathological  import- 
ance. John  Hunter  *  noticed,  when  he  was  bleeding  a  lady  from 
a  vein  in  the  arm,  that  the  blood,  which  previously  had  been 
dark  and  venous,  became  bright  scarlet,  like  arterial  Wood,  when 
she  fainted,  and  remained  so  during  the  continuance  of  the  faint. 
This  seems  to  indicate  that  during  syncope,  although  the  super- 
ficial vessels  are  empty  and  contracted,  the  arterioles  of  the 
muscles  are  dilated  like  those  of  an  actively  secreting  salivary 
gland. 

If  we  find,  then,  that  after  the  injection  of  a  drug  the  blood- 
pressure  remains  constantly  high,  during  stoppage  of  the  heart, 
we  may  conclude  that  the  vessels  of  the  muscles  are  contracted 
as  well  as  those  of  the  intestine.  Such  a  condition  occurs  after 
the  injection  both  of  digitalin  and  of  erythrophlceum,  in  which 
the  pressure  sometimes  remains  high  for  many  seconds,  or  even 
for  a  minute  or  more,  after  the  heart  has  finally  ceased  to  beat 
(Fig-  89). 

Investigation  of  the  Action  of  Drugs  on  the  Arterioles. 

The  arterioles  become  contracted  by  the  action  of  the  involun- 
tary muscular  fibre  contained  in  their  walls ;  they  dilate  partly 
by  their  own  elasticity  and  partly  by  the  pressure  of  fluid  within 
them; 

The  capillaries  also  appear  to  have  the  power  of  contraction. 
Both  arterioles  and  capillaries  are  induced  to  contract  by  the 
effect  upon  them  of  the  nerves  which  pass  to  them  from  vaso- 
motor centres.  The  blood-vessels  may  also  dilate  actively  from 
irritation  of  vaso-inhibitory  nerves.  The  exact  mode  of  action 
of  these  nerves  is  not  ascertained;  they  are  generally  looked 
upon  as  entirely  separate  from  vaso-motor,  but  it  seems  not  im- 
probable that  here  also  the  difference  between  vaso-motor  and 
vaso-inhibitory  nerves  is  a  mere  question  of  relation,  and  some 
nerves  produce  contraction  and  dilatation  according  to  the  point 
where  they  are  stimulated.  Thus  Dastre  and  Morat  have  found 
that  the  cervical  sympathetic,  which  produces  contraction  of  the 
vessels  in  the  rabbit's  ear  when  irritated  between  the  ear  and  the 
first  thoracic  ganglion,  causes  dilatation  instead  of  constriction 
when  it  is  irritated  at  a  point  below  the  ganglion,  in  which  case 
the  stimulus  has  to  pass  through  the  ganglion  before  it  reaches 
the  ear. 

In  considering  the  action  of  drugs  on  the  vessels,  we  have, 
therefore,  to  examine — 

1.  Their  direct  effect  upon — 

a.  The  contractile  walls  of  the  vessels  themselves  with  their 
a,  muscular  fibres, 
o,  motor  ganglia ; 

1  John  Hunter's  works,  edited  by  Palmer,  1837,  vol.  iii.  p.  91, 


273  PHAEMACOLOGY  AND  THEEAPEUTICS.      [sect.  i. 

B.  Nerve-fibres 

a,  vaso-motor, 

b,  vasodilating ; 
c.  Nerve-centres 

a,  vaso-motor, 

b,  vaso-dilating. 

2.  Their  reflex  effect  on  the  nerve-centres  just  mentioned. 

There  are  two  modes  of  estimating  the  contraction  of  the 
arterioles  :  1st,  by  direct  observation  and  measurement  under  the 
microscope ;  2nd,  by  ascertaining  the  quantity  of  blood  or  other 
fluid  which  will  pass  through  them  in  a  given  time. 

Each  of  these  methods  may  be  used  in  several  ways,  accord- 
ing as  we  wish  to  ascertain  the  action  of  a  drug— 1st,  on  the 
contractile  walls  of  the  vessels  alone  ;  2nd,  on  the  walls  together 
with  the  vascular  nerves  but  without  the  nerve-centres ;  and  3rd, 
on  the  vessels  in  connection  with  the  nerve-centres. 

The  method  of  direct  observation  of  the  arterioles  may 
be  practised  in  either  frogs  or  mammals. 

The  part  of  the  frog  usually  selected  is  the  web,  the  mesen- 
tery, the  mylo-hyoid  muscle,  the  tongue,  or  the  lung.  The  parts 
usually  observed  in  mammals  are  the  wing  of  the  bat  and  the 
ear  of  the  rabbit.1 

In  observing  the  effect  of  various  conditions  on  the  lung,  it 
is  necessary  to  inflate  it.  This  is  easily  done  by  means  of  a 
small  cannula  with  a  bulging  end  which  is  tied  into  the  larynx. 
Over  the  other  end  is  slipped  a  small  piece  of  india-rubber 
tubing,  and  by  clamping  this  after  the  lung  has  been  inflated, 
the  escape  of  air  is  prevented. 

An  apparatus  for  this  purpose  is  described  by  Holmgren.2 
The  accompanying  engraving  (Fig.  92)  shows  one  which  I  used 
in  1870  for  the  purpose  of  investigating  the  action  of  heat  and 
cold  upon  the  lung.3 

By  means  of  the  india-rubber  ball  I  directed  upon  the  lung 
a  stream  of  air  which  was  previously  passed  either  through  hot 
water  or  through  iced  water.  The  pulmonary  capillaries,  when 
treated  in  this  way,  contract  under  the  influence  of  cold  by  one- 
third  of  their  diameter.  McKendrick,  Coats,  and  Newman,  in 
an  investigation  on  the  action  of  anaesthetics  on  the  pulmonary 
circulation,  found  that  chloroform,  ethidene,  and  ether,  all  stop 
the  pulmonary  circulation,  the  action  of  chloroform  being  greatest 
■and  that  of  ether  least.4 

In  observing  the  effects  of  drugs  on  the  vessels  alone,  it  is 
necessary  to  destroy  the  influence  of  the  nerve-centres  over  them. 

1  For  observing  the  vessels  of  the  rabbit's  ear  one  of  Bracke's  lenses  is  very- 
convenient.    It  resembles  a  telescope  in  its  construction,  but  has  a  very  short  focus. 

2  Ludwig's  Festgabe. 

s  British  Medical  Journal,  Feb.  13,  1875,  p.  204. 
4  Ibid.  Dee.  18,  1880. 


chap,  xi.]    ACTION  OF  DKUGS  ON  THE  CIRCULATION.    279 

This  is  usually  done  in  a  frog  by  destroying  the  brain  and  spinal 
cord.  In  the  rabbit's  ear  it  is  done  by  dividing  as  far  as  possible 
all  the  nerves  going  to  one  ear,  then  injecting  the  drug  into  the 
general  circulation  and  comparing  its  effect  upon  the  two  ears. 


Piu,  y2. — Apparatus  for  ascertaining  the  effect  of  heat  and  cold  on  the  vessels  of  the  frog's  lungs. 
A,  a  piece  of  cork  to  which  the  frog  is  fastened,  is  iaid  on  b,  the  stage  of  a  microscope,  and 
attached  by  an  india-rubber  strap,  c.  D  is  a  small  ring  of  cork  covered  witha  thin  circle  of  glass. 
e  is  the  inflated  frog's  lung,  p  is  a  tube  by  which  a  current  of  air  can  be  directed  on  the  frog's 
lung.  It  is  held  in  position  by  a  piece  of  wire,  o,  which  can  be  bent  to  any  position,  z  isanask 
containing  ice  and  water.  H,  a  flask  containing  hot  water.  K  is  a  three-way  stopcock,  by  which 
a  current  of  air  may  be  sent  from  the  spray-producer,  L  and  M,  through  either  I  or  H  at  will,  and 
thus  cold  or  hot  air  may  be  applied  alternately  to  the  lung. 

It  is  evident,  however,  that  such  experiments  are  not  free  from 
fallacy,  because  in  them  the  circulation  is  dependent  on  the 
condition  of  the  heart  as  well  as  that  of  the  vessels ;  and  both  of 
these  may  be  affected  by  the  drug. 

A  better  plan,  therefore,  is  to  obviate  this  fallacy  by  keeping 


280  PHAKMACOLOGY  AND  THEKAPEUTICS.      [sect,  i. 

up  the  circulation  artificially,  either  in  the  body  of  the"  frog,  of 
in  the  ear  of  the  rabbit. 

A  method  of  maintaining  artificial  circulation  in  the  rabbit's 
ear  while  the  calibre  of  the  vessels  is  being  measured  was  in- 
vented by  Ludwig,  and  described  by  me  in  the, British  Medical 
Journal,  1871. 

In  the  frog  artificial  circulation  is  kept  up  by  putting  a 
cannula  into  the  aorta,  and  another  into  the  vena  cava  or  abdo- 
minal vein  after  destruction  of  the  brain  and  spinal  cord.  The 
aortic  cannula  is  connected  with  two  funnels  or  bottles,  such  as 
are  used  for  artificial  circulation  through  the  intestine  (p.  382). 
These  contain  either  a  saline  solution  or  a  mixture  of  saline  solu- 
tion with  defibrinated  blood.  To  one  of  them  the  drug  is  added. 
The  circulation  can  be  rendered  quicker  or  slower  at  will,  by  in- 
creasing the  pressure  under  which  the  fluid  flows  into  the  aorta. 
A  suitable  part  of  the  frog  is  then  put  under  the  microscope,  and 
the  vessels  measured  wbile  unpoisoned  blood  flows  through  them. 
The  poisoned  blood  is  then  allowed  to  circulate  under  exactly  the 
same  conditions  of  pressure  and  the  vessels  are  measured  again. 
By  this  method  of  observation  (iraskell  ascertained  that  very 
dilute  alkalies  cause  great  contraction  of  the  vessels,  so  as  some- 
times almost  entirely  to  occlude  them  and  arrest  any  flow  of 
blood  through  them.  Dilute  acids  counteract  this  effect  and 
cause  the  vessels  again  to  dilate. 

Cash  and  I  have  observed  that,  in  addition  to  this  action, 
dilute  acids  have  a  tendency  to  increase  the  exudation  of  fluid 
from  the  vessels  and  produce  oedema  of  surrounding  tissues. 

In  many  experiments  which  have  been  made  on  the  action  of 
drugs  on  the  blood-vessels  by  direct  microscopic  measurement  of 
their  size,  before  and  after  the  application  of  the  drug,  no  ac- 
count has  been  taken  of  the  effect  which  the  application  of  the 
drug  may  produce  by  its  local  irritating  action  on  the  nerves  or 
tissues  of  the  part  to  which  it  is  applied,  and  by  its  reflex  action 
through  the  nerves,  quite  independently  of  any  special  action 
which  it  may  have  on  the  vessels.  Thus,  irritation  by  the  appli- 
cation of  alcohol,  either  alone  or  as  a  solvent  in  tinctures,  or  by 
a  strong  saline  solution,  has  an  effect  similar  to  that  of  simple 
irritation  by  pressure  or  scratching,  and  usually  causes  tempo- 
rary contraction,  followed  by  dilatation  of  the  capillaries.  This 
contraction  may  be  more  or  less  prolonged,  according  to  the 
strength  of  the  irritant  which  is  applied.  Unless  these  condi- 
tions are  taken  into  account,  observations  on  the  effect  of  drugs 
applied  locally  to  the  web,  mesentery,  or  tongue,  are  very  un- 
satisfactory and  generally  worthless. 

Perhaps  a  somewhat  better  result  may  be  obtained  by  in- 
jecting the  drug  into  the  lymph-sac  of  a  frog,  and  then  observing 
the  web.  But  here  also  we  have  the  same  difficulty,  because  the 
sensory  nerves  of  the  lymph-sac  being  irritated,  reflex  stimulation 


chap,  xi.]    ACTION  OF  DRUGS  ON  THE  CIRCULATION.     281 


of  the  vaso-motor  centre  and  consequent  contraction  of  the  vessels 
may  be  induced. 

Method  of  Measurement  by  Rate  of  Flow.— Another 
method  of  ascertaining  the  effect  of  drugs  on  the  vessels  is  to 
measure  the  amount  which  flows  out  of  them  in  a  given  time. 
This  method  may  be  employed  either  in  the  frog  or  in  the  higher 
animals.  The  method  of  employing  it  in  the  frog  is  to  destroy 
the  brain  and  spinal  cord,  and  tie  one  cannula  into  the  heart  or 
aortic  bulb,  and  another  into  the  inferior  vena  cava.  The  aortic 
cannula  is  connected  with  a  reservoir  containing  saline  solution,  or 
defibrinated  blood,  which  can  be  made  to  pass  into  the  aorta  and 
circulate  through  the  vessels  at  any  desired  pressure  by  simply 
raising  or  lowering,  the  reservoir ;  the  fluid  flows  out  through  the 
cannula  in  the  vena  cava,  and  the  quantity  is  registered  upon  a 
revolving  cylinder. 

By  this  method  Cash  and  I  have  found  that  potassium 
chloride,  contrary  to  our  expectation,  causes  great  contraction 
of  the  vessels ;  that  barium  and  calcium  and  strontium  do  so 
also,  but  to  a  less  extent.  The  instrument  used  for  this  purpose 
consists  of  a  light  lever,  one  end  of  which  is  depressed  each  time 
that  a  drop  falls  upon  it.  An  electric  circuit  is  thus  broken,  and 
the  fall  of  each  drop  is  readily  recorded  by  means  of  an  electro- 
magnetic marker ;  at  the  same  time  the  pressure  under  which  the 
circulation  is  going  on  is  also  recorded  by  means  of  a  manometer. 
Slowing  of  the  flow  indicates  of  course  contraction  of  the  vessels, 
and  acceleration  indicates  dilatation  of  the  vessels. 

The  general  results  of  our  experiments  with  several  metallic 
salts  are  shown  in  the  accompanying  table.  Most  of  the  drugs 
experimented  on  cause  contraction  of  the  blood-vessels,  but  we 
are  unable  at  present  to  arrange  them  in  the  exact  order  of  their 
strength  of  action. 

Lithium  causes  slight  contraction.  Iron    causes  slow  contraction. 

Potassium  (very  dilute  solutions)  causes 
dilatation. 
Ditto  (solutions  of  j^g)  causes  con- 
traction. 

Barium    causes  rapid  contraction. 

Calcium        „    gradual        „ 

Strontium     „    gradual        „ 

Magnesium  „    slight  „ 

Aluminium  (much  diluted)  has  no  effect. 
1  per  cent,  needed  to  produce  any 
effect. 

In  experiments  made  by  such  methods  as  that  just  described 
we  reduce  the  problem  of  the  action  of  drugs  on  the  blood-vessels 
to  a  very  simple  form,  although  we  have  still  to  distinguish 
whether  the  drug  acts  directly  on  the  contra1  ctile  walls  of  the 
blood-vessel  or  on  the  nervous  elements  contained  in  them. 
There  is  at  present  no  means  of  absolutely  separating  those  two 
factors,  but  it  is  probable  that  the  nerves  die  sooner  than  the 


Copper 

,    powerful  , 

Zinc         , 

»           11         * 

Tin 

i          »»         » 

Cadmium 

,     slight       , 

Nickel 

i        j»           i* 

Cobalt 

ti        "           i) 

Platinum 

,    powerful  , 

but  none 
is  produced  by  solutions  weaker  than 

i 
Eooo* 


282  PHARMACOLOGY  AND  THEEAPEUTICS.      [sect.  i. 

muscular  fibres,  and  that  if  the  experiments  are  carried  on  for 
some  time  the  effect  of  the  drug  is  chiefly,  if  not  entirely,  exerted 
upon  the  muscular  fibres.  This  is  probably  the  explanation  of 
the  different  effects  of  chloral  on  the  vessels  of  the  kidney  observed 
by  Ludwig  and  Mosso  (p.  283). 

In  experiments  on  the  flow  of  blood  through  the  vessels  of 
warm-blooded  animals,  the  circulation  is  kept  up  in  much  the 
same  way  as  in  the  frog.  The  blood  may  be  used  cold,  or  may 
be  kept  at  the  temperature  of  the  body.  The  cannula  is  usually 
inserted  either  into  the  artery  supplying  an  organ  such  as  the 
kidney,  or  supplying  a  single  muscle,  or  it  may  be  put  into  the 
descending  aorta,  so  that  the  blood  passes  through  the  whole  of 
both  lower  extremities.  The  flow  is  measured  by  the  rate  at 
which  the  blood  issues  from  the  corresponding  vein. 

This  method  we  owe  to  Ludwig,  who,  along  with  his  pupil 
Mosso,  made  a  number  of  experiments  on  the  circulation  through 
the  kidney.  The  conclusions  arrived  at  were : — that  venous  blood 
causes  contraction,  and  oxygenated  blood,  dilatation  of  the  ves- 
sels; but  the  dilatation  which  richly  oxygenated  blood,  circulating 
after  venous  blood,  causes  in  the  vessels  is  only  temporary,  and 
they  soon  return  to  their  normal  calibre.  Mosso's  experiments 
have  been  repeated  by  Severini,  who  used  the  lung  instead  of  the 
kidneys.  He  finds  that  the  alternate  circulation  of  oxygenated 
and  of  venous  blood  acts  in  the  manner  described  by  Mosso, 
but  that  when  oxygenated  blood  is  passed  through  steadily  the 
vessels  contract  and  the  flow  through  them  is  diminished ;  venous 
blood,  on  the  contrary,  when  circulated  for  a  length  of  time  causes 
the  vessels  to  dilate  and  the  flow  through  them  to  increase.  The 
action  of  venous  blood  upon  the  arterioles  appears  indeed  to  be 
similar  to  its  action  upon  other  tissues.  A  small  or  moderate 
quantity  of  carbonic  acid  acts  as  a  stimulus  and  causes  contrac- 
tion, but  great  interference  with  the  natural  process  of  oxidation 
produces  paralysis. 

Nicotine,  in  the  proportion  of  1  in  10,000,  causes  contraction 
of  tbe  vessels ;  but  this  is  also  temporary.  One  per  cent.,  on 
the  contrary,  immediately  causes  dilatation. 

Atropine  has  a  very  powerful  action ;  but  this  differs  com- 
pletely according  to  the  dose.  One  part  in  100,000  causes  tem- 
porary contraction  of  the  vessels,  which  soon  passes  off.  One 
in  10,000  causes  contraction,  which,  instead  of  returning  simply 
to  the  normal,  passes  into  dilatation,  and  then  returns  to  the 
normal.  One  in  5,000  has  a  similar  action,  but  instead  of  the 
dilatation  passing  away,  and  the  vessels  returning  to  their  normal 
size,  the  dilatation  persists,  and  the  kidney  soon  dies. 

Chloral  causes  the  vessels  to  contract  and  then  to  dilate ;  but 
besides  this  it  has  a  peculiar  action,  either  increasing  rhythmical 
contraction  and  dilatation  of  the  vessels,  when  such  movements 
are  already  present,  or  inducing  them  when  they  are  absent.    It 


chap,  xi.]    ACTION  OF  DRUGS  ON  THE  CIRCULATION.     283 

only  acts  upon  the  vessels  when  the  blood  contains  oxygen ;  and 
when  the  blood  is  saturated  with  carbonic  acid,  it  has  no  action 
on  them  at  all.  Its  action  is  also  altered  by  the  condition  of  tbe 
kidney.  When  this  organ  has  been  kept  for  twenty-four  hours 
in  a  cool  place,  its  vessels  still  retain  their  irritability  ;  but  small 
doses  of  chloral,  instead  of  causing  contraction  followed  by  dila- 
tation, only  produce  contraction,  and  a  much  larger  dose  is 
required  to  produce  dilatation.  This  alteration  is  due  to  a 
change  in  the  vessels— either  in  their  muscular  walls,  or  more 
probably  in  the  ends  of  the  vaso-motor  nerves — and  not  to  any 
change  in  the  blood ;  for  it  occurs  when  serum  instead  of  blood 
is  passed  through  the  kidneys.  When  the  kidney  is  dead,  chloral 
mixed  with  the  blood,  instead  of  increasing  the  rapidity  of  the 
current  as  in  the  living  organ,  or  leaving  it  unaltered,  as  one 
would  expect,  greatly  diminishes  it.  Chloral  also  alters  the  effect 
of  artificial  stimulation  of  the  kidney.  Faradaic  currents  or  in- 
duction-shocks do  not  seem  to  affect  the  normal  vessels,  but 
constant  currents  cause  dilatation,  which  continues  while  the 
currents  are  passing  and  diminishes  after  they  cease.  When 
chloral  is  added  to  the  circulating  blood,  however,  the  vessels 
contract  during  the  passage  of  the  current  instead  of  dilating, 
and  dilate  slightly  after  the  current  has  ceased.  When  the 
chloral  has  acted  so  far  upon  the  vessels  as  to  dilate  them  greatly, 
the  constant  current  causes  no  alteration  while  it  is  passing,  but, 
after  it  ceases,  dilatation  increases  still  further. 

Action  of  Drugs  on  Vaso-motor  and  Vaso-dilating  Nerves. 

The  effect  which  irritation  of  the  vascular  nerves  produces 
in  the  living  body  is  also  altered  by  the  action  of  drugs.  This 
effect  is  of  two  kinds — vaso-motor  or  vaso-contracting,  and  vaso- 
dilating. Fibres,  having  these  two  different  actions  on  the  vessels 
of  a  part,  appear  frequently  to  run  together  in  the  same  nerve- 
trunk,  so  that  sometimes  we  get  dilatation,  at  other  times  con- 
traction of  the  vessels  on  irritation  of  a  nerve,  and  not  unfre- 
quently  we  get  contraction  followed  by  dilatation.  Such  fibres, 
however,  are  not  contained  in  equal  proportions  in  different 
nerve-trunks.  The  splanchnics,  for  example,  chiefly  contain 
vaso-motor  fibres,  so  that  irritation  of  these  nerves  causes  great 
contraction  of  the  vessels  in  the  intestine,  and  a  rise  of  blood- 
pressure.  The  motor  nerves  of  the  muscles,  on  the  contrary, 
appear  to  contain  chiefly  vaso-inhibitory  fibres,  so  that  stimulation 
of  the  nerve  causes  dilatation  of  the  vessels  in  the  muscle  to 
which  it  is  distributed.  Similarly,  irritation  of  nerves  distri- 
buted to  glands  usually  causes  dilatation  of  the  vessels  in  them. 
The  chorda  tympani  affords  a  marked  example  of  this,  though 
the  same  thing  is  noticed  also  in  the  case  of  the  sweat-glands  in 
the  foot  on  irritation  of  the.  sciatic  nerve. 


284  PHABMACOLOGY  AND  THEKAPEUTICS.      [sect.  i. 

Most  of  these  vaso-motor  or  vaso-inhibitory  nerves  can  be 
stimulated  reflexly  by  irritation  of  a  sensory  nerve,  as  well  a8 
directly  by  irritants  applied  to  the  nerves  themselves. 

We  are  not  acquainted  with  many  drugs  which  have  the 
power  of  paralysing  the  ends  of  the  vaso-motor  nerves  in  the 
vessels  apart  from  an  action  upon  the  contractile  walls  of  the 
vessels,  or  the  central  nervous  system.  Arsenic,  however,  appears 
to  be  a  drug  of  this  kind,  and  in  acute  poisoning  by  arsenic 
Bohm  has  observed  that  neither  irritation  of  the  splanchnic 
nerves  nor  of  the  medulla  raises  the  pressure  in  the  way  it 
usually  does.  Prom  this  effect  Bohm  concludes  that  the  motor 
nerves  contained  in  the  splanchnics  are  paralysed,  but  some  other 
observers  have  not  obtained  similar  results.  Hay  has  found  that 
potash  has  a  similar  action.  The  method  is  not  free  from  fallacy, 
for  it  is  obvious  that  if  the  vessels  in  the  intestine  should  happen 
to  be  already  contracted  either  from  the  effect  of  a  drug  upon 
them  or  from  any  other  cause,  neither  stimulation  of  the  splanch- 
nics nor  of  the  medulla  can  have  any  further  effect  upon  them 
or  on  the  blood-pressure  through  them.  For  when  the  vessels  of 
the  intestine  are  contracted  the  blood  pours  into  the  veins  from 
the  aortic  system,  through  the  arterioles  and  capillaries  of  the 
voluntary  muscles,  and  these  are  only  to  a  very  slight  extent  under 
the  control  of  the  vaso-motor  centre  in  the  medulla.  Irritation 
of  it  will  therefore  have  little  effect  on  the  general  blood-pressure 
when  the  arterioles  of  the  intestine  are  already  contracted,  and 
irritation  of  the  splanchnics  is  also  prevented  from  having  much 
effect. 

It  seems  probable  that  curare  and  poisons  which,  like  it,  not 
only  paralyse  the  ends  of  the  motor  nerves,  but  also  the  ends  of 
the  vagus  in  the  heart,  also  paralyse  vaso-motor  nerves,  though 
larger  doses  are  required  for  this  purpose. 

Vaso-dilating  fibres  appear  also  to  be  paralysed  by  curare, 
for  irritation  of  the  motor  nerve  of  a  muscle  does  not  cause 
dilatation  '  of  the  vessels  in  a  muscle  of  an  animal  deeply  poi- 
soned by  curare.  Stimulation  of  the  spinal  cord  produces  con- 
traction of  the  vessels  of  the  penis  instead  of  erection  in  an 
animal  poisoned  by  curare,2  and  stimulation  of  the  chorda  tym- 
pani  does  not  cause  the  same  amount  of  dilatation  in  a  poisoned 
as  in  a  non-poisoned  animal,  even  when  the  dose  of  curare  is 
small.3  Small  doses  of  curare,  however,  and  even  large  doses 
of  opium,  do  not  appear  to  paralyse  the  vaso-dilating  nerves  of 
muscles. 

In  some  experiments  which  I  made  on  the  chorda  tympani,  I 
got  a  different  result  from  the  usual  one  in  an  animal  thoroughly 
under  the  influence  of  opium.     The  vessels  appeared  to  contract 

1  Gaskell,  Journ.  of  Physiol  1878-9,  vol.  i.  p.  273. 

s  Eokhard,  BeitrOge,  vol.  vii.  p.  67. 

*  V.  Frey,  Ludwig's  Arbeiten,  1876,  p.  98. 


chap,  xi.]    ACTION  OF  DRUGS  ON  THE  CIRCULATION.     285 

instead  of  dilating  on  irritation  of  the  chorda  tympani,  so  that 
instead  of  the  blood  gushing  out  of  the  vein,  it  flowed  slowly, 
drop  by  drop. 

Action  of  other  parts  on  the  Blood-pressure. —  It  has 
already  been  mentioned  that  the  blood-pressure  rises  during 
muscular  exertion,  as,  for  example,  during  the  struggles  of  an 
animal.  The  cause  of  this  has  not  been  definitely  ascertained, 
but  it  is  probably,  to  a  great  extent,  due  to  the  flow  of  blood 
through  the  muscles  being  mechanically  obstructed  by  the  con- 
traction of  the  muscular  fibres  and  to  a  more  rapid  action  of  the 
heart. 

The  flow  of  blood  through  those  organs  which  consist  of  in- 
voluntary muscles,  e.g.  the  intestine,  may  be  also  obstructed. 

When  physostigmine  is  given  to  an  animal,  the  blood-pressure 
is  sometimes  noticed  to  rise  considerably,  and  this  rise  of  pres- 
sure was  at  first  attributed  to  contraction  of  the  arterioles. 
According  to  Von  Bezold  and  Gotz,  however,  this  is  due,  to  a 
great  extent,  not  to  the  contraction  of  the  arterioles  themselves, 
but  to  mechanical  obstruction  of  the  intestinal  vessels  by  the 
tetanic  contraction  of  the  muscular  walls  of  the  intestine.1 

Reflex  Contraction  of  Vessels. — Experiments  on  the  out- 
flow of  blood  from  divided  vessels,  while  the  nervous  system  is 
intact,  are  sometimes  made  on  frogs  for  the  purpose  of  ascer- 
taining the  direct  effect  of  drugs  on  the  arterioles  themselves ; 
but  this  method  is  faulty,  for  the  alterations  consequent  on  the 
injection  of  the  drug  may  be  simply  due  to  its  local  irritant 
action  producing  reflex  contraction. 

Such  experiments  are  usually  made  by  snipping  off  the  toe 
of  a  frog,  then  injecting  the  drug  into  the  lymph-sac  and  observ- 
ing how  many  drops  of  blood  exude  in  a  given  time  from  the  toe 
before  and  after  the  injection. 

It  is  obvious  that  if  no  change  occur  in  the  heart,  and  the 
openings  of  the  divided  vessels  do  not  beeome  obstructed  by  clots 
or  otherwise,  these  experiments  may  give  some  indication  re- 
garding the  contraction  of  the  vessels ;  but  the  results  are  not 
trustworthy  unless  we  can  ascertain  the  condition  of  the  heart. 
A  modification  of  this  experiment  enables  us  to  some  extent  to 
do  this.  The  end  of  a  toe  on  each  foot  having  been  snipped  off, 
the  nerve  in  one  leg  is  divided  and  then  the  drug  is  injected  into 
the  lymph-sac.  If  it  be  then  found  that  the  flow  of  blood  from 
the  foot,  whose  vaso-motor  supply  has  been  destroyed  by  division 
of  the  nerve,  continues  unchanged  or  is  even  increased  after  the 
injection  of  the  drug,  while  that  from  the  other  foot  is  diminished, 
we  may  conclude  that  the  diminution  is  due  to  contraction  of 
the  vessels  caused  by  the  injection  of  the  drug. 

But  it  is  incorrect  to  assume,  as  has  sometimes  been  done, 

1  Centralblatt  f.  d.  med.  Wiss.,  April  G,  1867,  p.  234.  • 


286  PHARMACOLOGY  AND  THERAPEUTICS,      [sect,  i., 

that  this  contraction  is  due  to  any  specific  action  of  the  drug, 
either  upon  the  muscular  walls  of  the  blood-vessels  or  upon  the. 
vaso-motor  centre.  There  is  here  a  fallacy  similar  to  that  already, 
mentioned  in  respect  to  direct  observation  of  the  size  of  blood- 
vessels. Any  irritation  of  a  sensory  nerve  by  pinching,  scratch-, 
ing,  heat,  &c,  may  cause  reflex  stimulation  of  the  vaso-motor 
centre  and  produce  contraction  of  the  vessels,  and  injection  of 
strong  saline  solutions  into  the  lymph-sac,  having  a  local  irritant 
action,  will  produce  a  similar  effect. 

As  an  example  of  this  fallacy  we  may  mention  certain  experi- 
ments with  bromide  of  potassium.  In  such  experiments  it  was 
found  that  injections  into  the  lymph-sac  were  followed  by  con- 
traction of  the  vessels  of  the  toes,  so  that  much  less  blood  flowed 
after  the  injection.  When  the  sciatic  nerve  was  divided  on  one 
side  the  flow  was  not  lessened  but  rather  increased  in  the  corre- 
sponding foot,  at  the  same  time  that  it  was  much  diminished  on 
the  other  side  where  the  nerve  was  intact.  This  result  clearly 
shows  that  after  the  injection  the  vessels  in  one  foot  contracted, 
and  that  this  contraction  was  due  to  the  effect  of  the  injection  on 
the  vaso-motor  centre,  inasmuch  as  it  did  not  occur  in  the  foot 
whose  vessels  had  been  withdrawn  from  the  influence  of  this 
centre  by  division  of  the  nerves.  From  this  fact  the  conclusion 
has  been  drawn  that  bromide  of  potassium  has  a  special  power 
of  contracting  blood-vessels  generally,  and  on  this  conclusion 
theories  of  its  action  upon  the  nervous  system  have  been  based. 
Such  theories,  however,  rest  on  a  very  untrustworthy  foundation; 
for  though  contraction  of  the  vessels  no  doubt  followed  the  in-, 
jection  of  a  strong  solution  of  bromide  into  the  lymph-sac,  this 
contraction  was  probably  not  at  all  due  to  any  specific  action  of 
the  bromide,  but  only  to  the  reflex  stimulation  of  the  vaso-motor 
centre  caused  by  its  local  irritant  action  at  the  place  of  applica-. 
tion.  If  introduced  in  a  dilute  solution  into  the  mouth  instead 
of  in  a  concentrated  form  into  the  lymph-sac,  this  local  irritant, 
action  would  be  absent  and  probably  no  contraction  of  the  blood-; 
vessels  would  be  produced. 

Action  of  Drugs  on  Reflex  Contraction  of  Vessels. — 
Irritation  of  a  sensory  nerve  usually  produces  reflex  stimulation, 
of  the  vaso-motor  centre  and  consequent  contraction  of  the  ves- 
sels and  rise  in  the  blood-pressure  both  in  the  frog  and  higher 
animals.  The  chief  vaso-motor  centre  is  situated  in  the  medulla 
oblongata,  but  it  is  probable  that  there  are  many  subsidiary 
centres  throughout  the  body.  It  is  probable  also  that  these 
vary  in  strength  and  in  the  amount  of  independent  action  they 
possess  in  different  animals.  When  the  influence  of  the  chief 
vaso-motor  centre  upon  the  body  is  destroyed  by  section  of  the 
spinal  cord  just  below  the  medulla,  the  vessels  dilate  and  the 
blood-pressure  falls  greatly.  This  is,  however,  not  always  the 
case,  for  in  some  dogs  I  have  noticed  that  after  section  of  the 


chap,  xi.]    ACTION  OF  DEUGS  ON  THE  CIECULATION.     287 

medulla,  the  blood-pressure  remained  so  high  that  I  was  under 
the  impression  that  the  cord  had  been  imperfectly  divided,  yet 
after  death  examination  of  the  cord  showed  that  section  was 
complete. 

The  vaso-motor  centre  is  paralysed  by  numerous  drugs, 
especially  in  the  final  stages  of  their  action,  so  that  its  ordinary 
tonic  action  is  destroyed  and  the  blood-pressure  falls  greatly. 
Its  action  of  responding  to  a  reflex  stimulation  is  also  abolished, 
and  irritation  of  a  sensory  nerve  no  longer  raises  the  pressure. 
The  tonic  and  reflex  action  of  the  centre  do  not  always  appear 
to  be  effected  pari  passu, — chloral,  for  example,  appearing  to 
have  a  greater  power  to  diminish  its  reflex  action  than  its  tone, 
so  that  stimulation  of  a  sensory  nerve  has  little  or  no  effect  even 
when  the  blood-pressure  has  not  as  yet  fallen  very  low.  Some- 
times, indeed,  an  opposite  effect  to  the  usual  one  may  be  pro- 
duced and  the  blood-pressure  be  lowered  still  further  instead  of 
raised  by  the  stimulation.  Alcohol  also  paralyses  very  markedly 
both  the  reflex  power  and  the  direct  excitability  of  the  vaso- 
motor centre,  so  that  neither  stimulation  of  a  sensory  nerve,  nor 
even  stimulation  of  the  centre  of  suffocation,  will  raise  the  blood- 
pressure.1  Both  the  normal  tone  and  the  reflex  excitability  of 
the  vaso-motor  centre  are  greatly  increased  by  strychnine.  The 
general-  blood-pressure  greatly  rises  after  the  injection  of  this 
drug,  and  the  effect  of  irritation  of  a  sensory  nerve  upon  it  is 
increased.  It  has  already  been  mentioned  that  in  ordinary 
circumstances  the  subsidiary  vaso-motor  centres  in  the  cord 
when  separated  from  the  medulla  cannot  of  themselves  maintain 
the  blood-pressure.  After  the  injection  of  strychnine,  however, 
their  action  is  so  much  increased  that  they  may  keep  the  blood- 
pressure  at  a  high  average  and  may  also  cause  it  to  rise  on 
irritation  of  a  sensory  nerve. 

Comparative  Effect  of  the  Heart  and  Vessels  on  Blood- 
pressure  in  different  Animals. — The  influence  of  these  two 
factors — the  heart  and  the  vessels — on  the  blood-pressure  varies 
in  different  animals,  and  under  different  conditions;  and  a 
number  of  the  discrepancies  observed  by  various  investigators 
are  probably  due  to  this  circumstance.  Thus,  in  dogs  the  effect  of 
the  heart  is  very  considerable,  and  when  its  beats  are  quickened 
by  division  of  the  vagi  the  pressure  rises ;  in  rabbits,  on  the  other 
hand,  the  heart,  instead  of  working  well  under  its  power  as  in  the 
dog,  beats  very  rapidly  in  the  normal  condition,  and  when  the 
vagi  are  divided  the  pressure  does  not  rise  much,  although  when 
they  are  stimulated  the  pressure  falls  both  in  the  dog  and  in  the 
rabbit.  This  different  action  of  the  vagus  in  the  dog  and  rabbit 
is  well  seen  when  these  animals  are  poisoned  by  atropine.  This 
drug  completely  destroys  the  inhibitory  action  of  the  vagus  on 

1  Dogiel,  Pfliiger's  Archiv,  1874,  Bd.  viii. 


288  PHARMACOLOGY  AND  THERAPEUTICS,      [sect.  i. 

the  heart ;  and  when  the  inhibitory  power  is  completely  removed 
we  find  that  only  a  slight  increase  in  the  number  of  beats  takes 
place  in  the  rabbit,  the  pulse-rate  rising  one  quarter :  for  ex- 
ample, perhaps  from  100  to  125.  In  the  dog,  on  the  contrary, 
the  pulse-rate  will  rise  to  three  times,  or  even  four  times,  what 
it  was  before. 

In  man  the  effect  of  the  vagus  on  the  heart  is  intermediate 
between  that  of  the  rabbit  and  dog :  so  that  if  the  normal  pulse 
is  between  70  and  80  in  the  minute,  it  rises  to  between  140  and 
180  when  the  vagus  is  paralysed  by  atropine  (Von  Bezold). 

This  difference  between  the  effect  of  the  vagus  on  the  heart 
alters  the  effect  of  drugs  on  the  blood-pressure  in  different 
animals. 

The  difference  in  the  action  of  drugs  on  the  dog  and  rabbit 
is  well  shown  in  the  case  of  nitrite  of  amyl.  If  this  be  given 
by  inhalation  to  a  rabbit,  the  blood-pressure  falls  immediately 
and  rapidly.  If  given  to  a  dog  the  fall  may  be  very  slight,  at 
least  if  a  small  quantity  only  is  used.  On  counting  the  pulse  in 
the  dog  we  discover  at  once  the  cause  of  the  apparent  difference 
in  the  action  of  the  drug  on  the  two  animals.  Before  inhalation 
the  pulse  of  the  dog  was  slow,  but  alter  inhalation  its  pulse 
became  almost  as  quick  as  that  of  the  rabbit.  In  both  animals 
the  nitrite  causes  dilatation  of  the  vessels,  but  in  the  dog  the 
heart  begins  to  beat  so  much  more  rapidly  than  usual  that  it 
maintains  the  blood-pressure  nearly  at  the  normal,  notwith- 
standing this  dilatation ;  while  the  heart  of  tbe  rabbit  beats  so 
quickly,  normally,  that  it  cannot  maintain  the  pressure  by 
increased  rate  of  pulsation.  If  the  vagi  be  cut  in  the  dog,  so 
ihat  the  heart  beats  rapidly  like  that  of  the  rabbit  before  inhala- 
tion, the  nitrite  causes  as  sudden  a  fall  as  in  the  rabbit.1 

The  numerous  factors  which  have  to  be  taken  into  considera- 
tion in  regard  to  the  blood-pressure,  the  action  and  the  inter- 
action of  different  parts  of  the  body  upon  one  another,  render 
it  by  no  means  easy  to  understand  the  effect  of  drugs  on  the 
circulation.  The  differences  which  we  find  in  the  action  of  drugs 
on  different  animals  seem  at  first  to  make  matters  still  worse ; 
but  it  is  through  these  differences  of  action  that  we  learn  the 
exact  mode  in  which  the  various  factors  of  the  circulation  are 
affected  by  the  drug. 

There  are  at  least  two  other  factors  which  must  be  borne  in 
mind  in  relation  to  the  difference  between  rabbits  and  dogs : 
these  are  (1)  the  much  greater  sensitiveness  of  the  inhibitory 
nerves  of  the  heart  to  reflex  stimulation  from  the  nose  as  well  as 
to  stimulation  by  venous  blood,  in  the  rabbit  than  in  the  dog ; 
and  (2)  the  proportionately  much  greater  length  of  the  intestinal 
tube  in  the  rabbit,  which  causes  the  vessels  of  the  intestines,  on 

1  Lauder  Bruntcn,  Joum.  of  Anat.  and  Physiol.,  Nov.  1870,  p.  95. 


Chap.  xi.J    ACTION  OP  DRUGS  ON  THE  CIRCULATION.     289 

account  of  their  number,  to  exercise  a  greater  action,  on  the 
blood-pressure  in  it  than  in  the  dog.  Thus,  in  the  rabbit,  a 
slightly  irritating  vapour  will  cause  the  animal  to  close  its  nos- 
trils ;  and  almost  immediately  the  vagus  will  be  excited  and  the 
heart  will  stop.  This  stoppage  is  probably  chiefly  due  to  reflex 
action  on  the  heart  through  the  nasal  nerves,  though  it  may  be 
partly  due  to  accumulation  of  carbonic  acid  in  the  blood.  When 
the  spinal  cord  is  divided  in  the  rabbit  just  below  the  medulla, 
the  pressure  sinks  enormously:  in  the  dog  it  also  sinks,  but 
not  to  the  same  extent;  and  in  some  cases  it  sinks  so  little 
that  it  is  almost  impossible  to  believe  that  the  cord  has  been 
divided,  until  examination  after  death  shows  that  the  section 
has  really  been  completed.  This  effect  may  be  partially  due 
to  the  less  power  which  the  dilatation  of  the  intestinal  vessels, 
consequent  upon  the  section,  has  in  the  dog.  It  may  also, 
however,  be  partly  due  to  greater  development  of  extra-cranial 
vaso-motor  centres  in  the  spinal  cord  and  elsewhere,. than  in  the 
rabbit. 

Influence  of  Nerves  on  Blood-pressure. — Both  the  quick- 
ness of  the  heart's  beat  and  the  contraction  of  the  arteries  are 
regulated  by  the  nervous  system  ;  and  it  is  generally  by  their 
action  on  it  that  drugs  alter  the  blood-pressure,  though  it  must 
be  constantly  borne  in  mind  that  they  may  also  do  so  by  acting 
directly  on  the  muscular  walls  of  the  heart  and  arteries  them- 
selves. The  parts  of  the  nervous  system  chiefly  concerned  in 
regulating  the  circulation  are  : 

I.  The  motor  cardiac  ganglia  which  lie  in  the  walls  of  the 
heart,  and  are  under  ordinary  circumstances  the  cause  of  its 
rhythmical  action. 

II.  Inhibitory  nerves,  which  render  the  heart's  action  slow, 
and,  if  irritated  very  strongly,  may  stop  its  beatipg  altogether, 
and  produce  quiescence  in  diastole.  The  inhibitory  fibres  have 
their  origin  or  roots  in  the  medulla,  and  proceed  in  the  vagi  to 
the  heart.  In  probably  all  the  higher  animals  they  are  normally 
in  more  or  less  constant  action.  In  men  and  dogs  they  main- 
tain a  well-marked  action ;  and,  after  they  are  cut  or  paralysed, 
the  heart  beats  in  the  dog  three  or  four  times  as  quickly,  and  in 
man  twice  as  quickly,  as  before.  In  rabbits  and  cats  they  act 
less,  and  their  division  only  makes  the  heart  go  one-half  or  one- 
fourth  faster.  In  frogs  they  are  not  in  constant  action,  so  that 
their  section  does  not  usually  quicken  the  beats  of  the  heart  in 
these  animals. 

A  drug  may  irritate  them,  and  render  the  heart's  action 
slow — 

1.  By  acting  directly  on  (a)  their  roots  in  the  medulla,  (b) 
their  ends  in  the  heart  ; 

2.  Indirectly,  through  its  action  on  other  parts,  producing 
(a)  increased  blood-pressure,  or  (b)  accumulation  of  carbonic 

u 


290  PHAEMACOLOGY  AND  THEEAPEUTICS.      [sect.  I. 

acid  in  the  blood,  both  of  which  act  as  irritants  to  the  vagus 
roots ; 

3.  Reflexly,  through  irritation  of  sensory  nerves,  e.g.  irrita- 
tion of  the  intestines ;  of  the  sympathetic  nerve ;  of  the  depres- 
sor ;  or  of  certain  afferent  fibres  in  the  vagus.  Eeflex  irritation  is 
only  likely  to  be  caused  by  drugs  having  a  powerful  local  action. 

Drugs  may  also  paralyse  the  inhibitory,  or  the  ends  of  in- 
hibitory, nerves  in  the  heart,  and  thus  quicken  the  heart. 

Inhibitory  ganglia  have  been  supposed  to  exist  in  the  heart, 
and  certain  drugs,  such  as  muscarine,  are  supposed  to  slow  its 
pulsations  by  their  action  on  these  ganglia.  They  have  been 
supposed  to  be  distinct  from  the  ends  of  the  vagus  (p.  313), 
although  generally  when  the  ends  of  inhibitory  nerves  in  the 
heart  are  spoken  of,  the  inhibitory  ganglia  are  included  in  the 
term. 

III.  Quickening  Nerves. — These  belong  to  the  sympathetic 
system.  They  have  their  origin  in  the  brain  or  medulla,  pass 
down  through  the  cervical  part  of  the  spinal  cord  to  the  last 
cervical  and  first  dorsal  ganglion  (which  in  many  animals  are 
united),  and  thence  through  the  third  branch  of  the  ganglion  to 
the  heart.  Quickening  fibres  are  said  by  some  to  run  also  in 
the  cervical  part  of  the  sympathetic  cord.  In  the  frog  the 
accelerating  fibres  pass  from  the  spinal  cord  in  the  anterior  root 
of  the  third  nerve  into  the  ganglion  on  the  trunks  of  the  glosso- 
pharyngeal and  vagus  and  thence  in  the  vagus  trunk  to  the 
heart  (Gaskell).  Unlike  the  inhibitory  nerves,  the  quickening 
nerves  are  not  normally  in  constant  action  in  mammals. 

The  accelerating  centres  may  be  stimulated — 

1.  By  the  direct  action  of  drugs  upon  them. 

2.  Indirectly  by  the  drugs  producing  a  diminution  in  the 
blood-pressure.     Such  a  diminution  acts  as  a  stimulus  to  them. 


do.  93.—  Diagram  to  show  tlie  supposed  rel  ation  of  motor  ganglia  In  the  heart  to  accelerating  fibres. 
A,  accelerating  fibres  proceeding  from  the  cerebrospinal  or  sympathetic  nervous  systems  to  the 
motor  ganglia  of  the  heart,  tt,  motor  ganglion,  a,  accelerating  fibres  passing  from  the  endo- 
cardium to  the  motor  ganglion,  m,  motor  fibres  to  the  cardiac  musole.  h,  the  cardiac  muscle. 
tPor  the  sake  of  simplicity  in  this  diagram  all  hypotheses  regarding  separate  motor  and 
accelerating  ganglia  have  been  disregarded.] 

It  is  probable  that  accelerating  fibres  also  pass  to  the  cardiac 
ganglia  from  the  endocardium,  for  irritation  of  the  interior  of  the 
heart,  either  mechanically  or  by  the  injection  of  irritating  drugs 


chap,  xx.]    ACTION  OF  DEUGS  ON  THE  CIKCULATION.     291 

into  it,  causes  acceleration.  The  supposed  relationship  of  the 
various  accelerating  fibres  to  the  cardiac  ganglia  is  shown  in  the 
accompanying  figure  (Fig.  93). 

IV.  Vaso-motor  Nerves,  which  cause  the  smaller  arteries, 
and  probably  also  the  capillaries,  to  contract.  These  belong  to 
the  sympathetic  system ;  and  the  most  important  of  them  are 
contained  in  the  splanchnics,  which  when  stimulated  produce 
contraction  of  the  intestinal  vessels.  As  these  vessels  can,  under 
certain  circumstances,  hold  a?'  the  blood  in  the  body,  the  in- 
fluence of  the  splanchnics  over  the  blood-pressure  is  very  great ; 
and  division  of  them  can  lower  it,  or  stimulation  of  them  increase 
it,  very  much.  The  intestine  being  much  longer  in  herbivora 
than  carnivora,  the  splanchnics  have  a  greater  influence  over 
the  blood-pressure  in  the  former.  The  chief  centre  of  the  wbole 
vaso-motor  system  seems  to  be  in  the  medulla  oblongata ;  and 
it  is  generally  in  constant  action,  keeping  up  a  certain  amount 
of  contraction  or  tone  in  the  vessels.  There  are  also,  however, 
subsidiary  centres  in  the  spinal  cord,  and  possibly  also  in  the 
ganglia  of  the  sympathetic  system. 

The  activity  of  the  vaso-motor  centres  may  be  increased 
(cf.  p.  276),  and  the  vessels  made  to  contract — 

1.  By  direct  irritation  of  these  centres. 

2.  By  reflex  irritation  through  (a)  the  cervical  sympathetic, 
(b)  the  vagus,  when  the  brain  is  intact,  and  the  animal  not  nar- 
cotised, (c)  sensory  nerves,  including  the  splanchnics  themselves. 
When  the  medulla  is  separated  from  the  rest  of  the  body  by 
dividing  the  spinal  cord  at  the  atlas,  it  can,  of  course,  no  longer 
exert  any  influence  over  the  vessels ;  they  consequently  become 
dilated  throughout  the  whole  body,  and  the  blood-pressure 
usually  sinks  very  low.  If  the  lower  end  of  the  divided  cord  be 
then  irritated,  the  vaso-motor  nerves  which  pass  through  it  from 
the  medulla  to  the  body  are  stimulated,  and  the  blood-pressure 
rises. 

It  is  probable  that  the  peripheral  ends  of  the  vaso-motor 
nerves  in  the  vessels  themselves  may  be  either  stimulated  or 
paralysed  by  the  action  of  drugs  conveyed  to  them  by  the  general 
circulation. 

V.  Depressor  nerves. — Irritation  of  these  nerves  is  con- 
ducted to  the  vaso-motor  centres,  and  acts  on  them  in  such  a 
way  as  to  cause  a  reflex  dilatation  of  the  small  vessels,  either 
(1)  generally  throughout  the  whole  body,  or  (2)  locally  in  one 
particular  part  of  it. 

1.  The  chief  nerve  which  causes  dilatation,  especially  affect- 
ing the  intestinal  vessels,  is  one  which  runs  from  the  heart  to 
the  medulla,  and  is  called,  from  its  power  of  diminishing  blood- 
pressure,  the  depressor  nerve.  Its  fibres  seem  to  be  included  in 
the  vagus  in  the  dog;  but  in  the  rabbit  it  generally  runs  separate 
from  the  heart  to  the  level  of  the  thyroid  cartilage;   here  it 


292  PHAEMACOLOGY  AND  THEEAPEUTICS.      [sect.  i. 

divides  into  two  so-called  roots,  one  root  going  to  the  superior 
laryngeal,  and  the  other  to  the  vagus  nerve.  These  are  generally 
called  roots,  though,  as  the  nerve  conveys  impressions  from  the 
heart  to  the  brain,  they  are,  physiologically,  really  branches. 
There  seem  to  be  also  depressor  fibres  in  the  vagus  itself;  but 
the  vagus  contains  fibres  of  many  kinds,  and,  among  others, 
some  which  cause  reflex .  contraction  of  the  vessels  and  rise  of 
blood-pressure — hence  called  pressor-fibres.  The  depressor-fibres 
of  the  vagus  seem  to  act  on  the  vaso-motor  system  through  the 
medulla  itself,  while  the  pressor-fibres  affect  it  through  a  centre 
in  the  brain,  so  that,  when  the  brain  is  perfect,  irritation  of  the 
central  end  of  the  vagus  causes  increased  contraction  of  the 
vessels  and  raised  blood-pressure ;  but,  when  the  brain  is  re- 
moved or  its  functions  abolished  by  opium,  it  causes  dilatation 
of  vessels  and  diminished  pressure. 

2.  When  a  sensory  nerve  is  irritated,  the  action  of  the  vaso- 
motor pentre  is  suspended  in  the  part  supplied  by  the  nerve, 
and  in 'those  which  immediately  adjoin  it,  so  that  their  vessels 
become  dilated,  while  at  the  same  time  contraction  of  the  vessels 
in  other  parts  of  the  body  is  produced.  The  blood-pressure  is 
thus  increased  generally,  and  produces  in  the  locally  dilated 
vessels  a  very  rapid  stream  of  blood.  This  fact  was  first  dis- 
covered, and  its  therapeutics  indicated,  by  Ludwig  and  Loven. 

The  causes  of  alteration  in  blood-pressure  as  well  as  in  the 
pulse-rate,  will  perhaps  be  more  easily  seen  from  the  table  on 
the  next  page. 

Action  of  the  Heart  on  Blood-pressure. — I  have  already 
mentioned  that  we  can  to  a  certain  extent  ascertain  whether  a 
rise  or  fall  in  blood-pressure  is  due  to  the  heart  or  arterioles,  by 
comparing  the  pressure-curve  with  the  pulse-curve  (p.  271  et 
seq.).  If  they  run  parallel  the  effect  may  be  attributed  in  great 
measure  to  the  heart. 

But  the  effect  of  the  heart  on  the  blood-pressure  is  not  so 
simple  as  that  of  the  arterioles.  In  the  case  of  the  arterioles 
we  have  to  consider  only  the  rate  at  which  the  blood  will  flow 
through  them  when  they  are  more  or  less  contracted ;  but  in  the 
case  of  the  heart  we  have  to  consider  not  only  the  rapidity  of 
its  pulsations,  but  the  amount  of  blood  which  is  sent  into  the 
arterial  system  at  each  beat.  We  judge  of  the  amount  of  blood 
chiefly  by  the  extent  to  which  the  blood-pressure  oscillates  with 
each  pulsation.  A  large  quantity  of  blood  will,  as  a  rule,  cause 
an  extensive,  and  a  small  quantity  only  a  slight  oscillation. 
When,  the  heart  is  beating  slowly,  so  that  it  has  time  to  fill 
completely  during  each  diastole,  the  oscillations  are  large,  and 
when  it  is  beating  quickly  the  oscillations  are  small. 

It  is  evident  that  although  quick  pulsations  tend  to  raise  the  Hood- 
pressure,  they  only  do  so  up  to  a  certain  point,  as  beyond  that,  the  heart  does 
not  get  properly  filled,  and  so  sends  but  little  blood  into  the  aorta  at  each 


chap,  xi.]    ACTION  OF  DEUGS  ON  THE  CIRCULATION.     293 

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294  PHARMACOLOGY  AND  THERAPEUTICS,      [sect.  i. 

beat.  But  the  heart  may  sometimes  be  imperfectly  filled  even  when  it  is 
beating  slowly ;  this  has  been  shown  to  occur  in  the  case  of  the  frog  by 
Goltz.  When  a  blow  or  two  is  struck  on  the  intestines  the  veins  dilate  and 
the  blood  accumulates  in  them,  so  that  the  heart,  which  is  also  stopped  at 
first,  receives  no  blood  when  it  does  begin  to  beat  again.  It  can  therefore 
send  none  into  the  aorta,  and  the  circulation  remains  completely  arrested, 
although  the  heart  is  beating. 

If  the  pulmonary  capillaries  also  are  contracted  the  left  ventricle  will 
receive  little  blood,  and  so  will  send  little  blood  into  the  arteries,  although 
the  right  ventricle  may  be  much  distended.  This  appears  to  occur  during 
poisoning  with  muscarine,  which  causes  the  lungs  to  become  blanched,1  the 
right  ventricle  distended,  and  the  left  ventricle  and  the  arterial  system  empty: 
so  that  little  blood  flows  from  a  wound.2 


a  ■  im  c 

Fjg.  84. — For  description  vide  p.  263. 

It  is  difficult,  however,  to  estimate  precisely  the  quantity  of  blood  sent 
into  the  arteries  at  each  beat,  and  its  relation  to  the  rapidity  of  the  pulse,  so 
as  to  ascertain  directly  how  much  the  rise  or  fall  of  blood-pressure  is  due  to 
the  heart ;  and  therefore  this  is  sometimes  estimated  indirectly  by  ascertain- 
ing first  how  much  of  the  effect  of  the  drug  on  the  blood-pressure  is  due  to 
the  arterioles,  and  then  attributing  to  the  heart  what  is  not  accounted  for  by 
their  action. 

Sometimes  also  we  may  get  useful  information  by  compressing  the  abdo- 
minal aorta  as  near  the  diaphragm  as  possible  before  and  after  injection.  We 
thus  dimmish  so  greatly  the  number  of  capillary  outlets  by  which  the  blood 
may  flow  from  the  arteries  into  the  veins  that  we  greatly  lessen,  though  we 
do  not  quite  destroy,  the  effect  of  the  arterioles  on  the  blood-pressure.  We 
can  thus  estimate  more  precisely  the  action  of  the  heart  upon  it. 

Section  of  the  spinal  cord  below  the  medulla  oblongata,  by  destroying  the 
effect  of  the  vasomotor  centre  upon  the  vessels,  also  aids  us  in  estimating 
the  action  of  the  heart. 

Another  method  of  ascertaining  what  share  in  alterations  of  the  circula- 
tion locally  is  due  to  the  heart  and  arterioles  respectively,  consists  in  the 
combined  use  of  the  manometer  and  Ludwig's  stromuhr  or  Marey's  hsemo- 
dromometer.  The  manometer  shows  the  general  blood-pressure  while  the 
hffimodromometer  shows  the  rate  of  circulation  in  the  particular  artery 
experimented  upon.  If  the  rate  of  flow  increases  while  the  blood-pressure 
remains  constant  or  sinks,  it  is  evident  that  the  arterioles  of  the  particular 
vascular  district  to  which  the  artery  is  distributed  have  become  dilated.  If, 
on  the  other  hand,  the  rate  of  circulation  diminishes  while  the  pressure 
remains  constant  or  rises,  it  is  clear  that  the  arterioles  have  become  con- 
tracted. 

This  method  is  only  capable  of  being  applied  to  large  arteries  such  as  the 
carotid  or  femoral.  By  placing  the  stromuhr  in  the  femoral  artery,  Dogiel 
and  Kowalewsky  found  that  during  suffocation  the  rapidity  of  the  blood-flow 
diminished  while  the  pressure  rose,  showing  that  the  peripheral  vessels  were 
contracted.3 

1  Lauder  Brunton,  Brit.  Med.  Joum.,  Nov.  14, 1874. 

2  Schmiedeberg  and  Eoppe,  Das  Muscarin,  p.  57. 
»  Pflilger's  Archvo,  1870,  p.  489. 


chap,  xi.]    ACTION  OF  DRUGS  ON  THE  CIRCULATION.     295 

By  the  use  of  the  stromuhr,  Dogiel  •  haa  found  that  the  rapidity  of  the 
flow  of  blood  m  the  carotid  is  first  increased  and  then  diminished  by  alcohol, 
the  greatest  diminution  occurring  during  complete  narcosis. 

Effect  of  Drugs  on  the  Pulse-rate.— The  pulse-rate,  i.e.  the 
rapidity  of  the  heart's  beats,  is  chiefly  regulated  by  the  inhibitory 
fibres  of  the  vagus,  although  it  is  affected  also  by  accelerating 
fibres.  In  the  frog  the  latter,  excepting  those  which  pass  to  the 
motor  ganglia  of  the  heart  from  the  endocardium,  also  run  mainly 
in  the  vagus,  which  is  really  the  vago-sympathetic  (Gaskell).  In 
the  higher  animals  they  run  chiefly  through  sympathetic  channels, 
though  to  a  slight  extent  also  in  the  vagus. 

If  we  find  that  the  administration  of  a  drug  quickens  the 
pulse,  we  next  try  to  discover  the  mode  in  which  it  has  done  so. 
A  glance  at  the  table  (p.  293)  will  show  that  there  are  several 
ways  in  which  acceleration  may  occur,  though  the  most  important 
is  either  paralysis  of  the  vagus  or,  at  least,  cessation  of  its  action. . 
The  usual  stimulus  to  the  vagus-roots  in  the  medulla  which  calls 
the  nerve  into  action  is  the  pressure  of  blood  within  the  medulla ; 
when  this  is  high  the  vagus-rootB  are  stimulated,  and  the  pulse 
becomes  slow ;  when  the  pressure  is  low,  the  stimulus  is  removed, 
and  the  pulse  again  becomes  quick. ,  Alterations  in  the  blood- 
pressure  will  therefore  alter  the  pulse,  and  drugs  which  affect  the 
arterioles  may  quicken  or  slow  the  pulse-rate  without  any  marked 
action  of  their  own  on  the  heart  or  vagus.  This  has  already  been 
mentioned  when  speaking  of  nitrite  of  amyl,  which,  by  lowering 
the  blood-pressure,  and  thus  lessening  the  normal  stimulus  to  the 
vagus-roots,  greatly  quickens  the  heart  in  the  dog  (p.  288). 

In  order  to  ascertain  whether  irritation  of  the  vagus  has  been 
caused  reflexly  or  not,  we  may  divide  the  nerves  through  which 
we  may  expect  the  reflex  to  have  occurred,  or  we  may  abolish 
their  action  on  the  medulla  to  a  great  extent  by  the  use  of  large 
doses  of  chloral. 

Action  of  Drugs  on  the  Cardio-inhibitory  Functions  of 
the  Vagus. 

When  speaking  in  the  following  pages  of  the  inhibitory  action 
of  the  vagus  on  the  heart  I  mean  its  power  to  affect  the  rhythm 
of  the  heart  so  as  to  render  its  pulsations  slow  or  stop  them  en- 
tirely, and  I  do  not  include  under  the  term  inhibition,  the  power 
which  the  vagus  also  possesses  of  enfeebling  the  cardiac  contrac- 
tions, unless  when  this  is  expressly  stated. 
.  We  distinguish  between  (a)  stimulation  of  the  vagus-roots  by 
any  cause  whatever,  and  (b)  stimulation  of  its  ends  in  the  heart 2 

1  Pflilger's  Archiv,  1874,  vol.  viii.,  p.  606. 

*  We  use  the  term  vagus-ends  here  for  the  sake  of  convenient  distinction  between 
the  central  cardio-inhibitory  systems  in  the  medulla  oblongata  and  the  peripheral 
one  in  the  heart.  A  fuller  explanation  of  the  peripheral  cardio-inhibitory  apparatus 
will  be  given  further  on. 


296  PHAEMACOLOGY  AND  THEEAPEUTICS.      [sect.  I. 

by  dividing  both  vagi.  Sometimes  we  inject  the  drug  first,  and 
see  whether  any  slowing  of  the  heart  which  it  has  produced  dis- 
appears on  section,  or  we  may  divide  them  before  injecting  the 
drug,  and  see  whether  any  change,  either  in  the  way  of  slowing 
or  acceleration,  occurs  after  the  injection.  If  the  effect  of  a  drug 
in  slowing  the  heart  is  removed  by  dividing  the  vagi,  we  conclude 
that  its  action  has  been  exerted  on  the  vagus-roots :  if  it  should 
still  persist  after  their  division,  we  conclude  that  it  has  acted  on 
the  vagus-ends  in  the  heart  or  on  the  heart  itself. 

Thus  aconitine,1  veratrine,2  erythrophkeum,3  and  probably  all 
members  of  the  digitalis 4  group  stimulate  the  vagus-roots,  so 
that  the  slowing  of  the  pulse  they  produce  is  much  lessened  or 
completely  abolished  by  section  of  the  vagi,  and  takes  place  to  a 
much  less  extent  when  the  vagi  are  divided  before  the  injection. 
That  the  slowing  does  not  always  completely  disappear  after 
section  of  the  vagi,  or  is  not  always  completely  prevented  by 
their  previous  section,  is  due  to  the  fact  that  most  of  these  drugs 
have  also  an  action  either  on  the  ends  of  the  vagus  in  the  heart, 
or  on  the  nervous  mechanism  or  muscular  fibre  of  the  heart  itself. 
Nicotine  resembles  the  substances  already  mentioned  in  so  far  that 
the  slowing  which  it  would  otherwise  produce  is  somewhat  less- 
ened by  section  of  the  vagi,  but  only  to  a  slight  extent,  its  action 
being  chiefly  exerted  on  the  peripheral  cardio-inhibitory  system.5 
Physostigmine  chiefly  affects  the  heart  itself,  and  so  the  slowing 
of  the  pulse  it  causes  is  not  abolished  by  section  of  the  vagi.6 

Reflex  Stimulation  of  the  Vagus.— The  vagus-centre  may 
be  also  stimulated  reflexly,  and  slowing  or  stoppage  of  the  heart 
produced  by  irritation  of  sensory  nerves.  This  stimulation  occurs 
most  readily  through  the  nasal,  dental,  or  other  branches  of  the 
fifth  nerve,  the  nucleus  of  which  is  closely  connected  with  that 
of  the  vagus,  or  through  the  sensory  branches  of  the  vagus  itself, 
but  it  may  also  be  induced  through  almost  any  sensory,  and 
some  sympathetic  nerves,  if  the  stimulus  be  strong. 

The  vagus-centre  in  rabbits  appears  to  be  very  readily 
stimulated  through  the  nasal  nerves,  for  the  application  of  any 
strong  vapour  such  as  ammonia  or  chloroform  to  the  nose  not 
only  induces  closure  of  the  nostrils  and  stoppage  of  respiration, 
but  also  complete  arrest  of  the  heart's  pulsations. .  It  appears 
also  to  be  very  sensitive  to  venous  blood.  Stoppage  of  the  heart 
may  occur  in  man  from  irritation  of  a  sensory  nerve,  even  under 

1  Vide  Dissertation  on  Aconitine  under  Bshm's  direction,  by  C.  Ewers,  Dorpat, 
1873. 

»  Von  Bezold  and  Hirt,  Wilrebwrger  physiol.  XJntersuch.  i.  p.  103. 

8  Brunton  and  Pye,  Phil.  Trans.,  1877,  p.  627. 

*  Traube  and  others. 

8  Traube,  Med.  Centralstg.  1862  and  1863,  No.  9;  Centralblatt  f.  d.  med.  Wiss. 
1863,  pp.  Ill  and  159;  Bosenthal,  Centralblatt  f.  d.  med.  Wiss.,  1863,  p.  737. 

8  Fraser,  Trans,  of  Boy.  Soc.  of  Edinburgh,  1867,  reprint,  p.  39;  for  other 
literature  vide  Harnack,  Arch.f.  exjp.  Path.  u.  Pharm.,  Bd.  v.  p.  446. 


chap,  xi.]    ACTION  OF  DRUGS  ON  THE  OIECULATION.     297 

chloroform  anaesthesia,  and  indeed  I  believe  that  in  excision  of 
the  eyeball  the  heart  usually  misses  one  beat  at  the  moment  the 
nerves*  are  divided. 

In  dogs,  stoppage  of  the  heart  and  death  may  occur  from 
irritation  of  the  stomach,  even  when  complete  anaesthesia  has 
been  produced  by  chloroform.  Some  years  ago,  when  making 
a  gastric  fistula  in  a  dog,  the  animal,  which  was  in  a  state  of 
profound  anaesthesia  from  chloroform,  suddenly  died  when  the 
stomach  was  laid  hold  of  with  forceps.  This  occurred  in  a  second 
case  just  as  the  cannula  was  being  introduced.  On  mentioning 
the  subject  to  Professor  Schiff,  he  informed  me  that  he  had 
had  several  cases  of  a  similar  sort  when  using  chloroform  as  an 
anaesthetic,  but  had  none  after  he  began  to  use  ether  instead. 
I  found  also  on  using  ether  that  no  further  death  occurred. 

Causes  of  Quickened  Pulse. — If,  instead  of  causing  a  slow- 
ness of  the  pulse,  the  drug  produces  quickening,  it  may  be  due 
to  paralysis  of  the  vagi,  to  stimulation  of  the  accelerating  nerves, 
or  to  direct  action  on  the  heart  itself.  We  ascertain  whether  the 
drug  has  paralysed  the  ends  of  the  vagus  in  the  heart  by  inject- 
ing it,  and  then  irritating  the  vagi  in  the  neck  by  a  faradaic 
current.  If  we  find  that  we  are  no  longer  able  to  slow  or  stop 
the  heart  by  stimulation  of  the  vagi,  we  conclude  that  the  drug 
has  paralysed  these  nerves.  This  action  is  well-marked  in  the 
case  of  atropine. 

Action  of  Drug's  on  Vagus-roots. — We  may  wish  to  know,  however, 
what  the  action  of  the  drug  has  been  on  the  vagus-roots,  and  it  is  evident 
that  if  the  ends  in  the  heart  are  paralysed,  no  action  on  the  vagus-centre 
could  alter  the  pulsations  of  the  heart  any  more  than  nervous  stimuli  pro- 
ceeding from  the  cord  could  move  the  legs  of  an  animal  poisoned  by  curare. 
Nor  can  we  separate  the  vagus-centre  from  the  heart  by  ligature  of  the 
vessels  so  readily  as  one  isolates  the  frog's  leg.  It  can  be  done  no  doubt  by 
tying  the  carotid  and  vertebral  arteries  and  keeping  up.an  artificial  stream 
of  blood  through  the  head.  Instead  of  this,  however,  the  simpler  method  is 
generally  adopted  of  injecting  the  drug  to  be  tested  into  the  carotid  artery,  so 
that  it  will  reach  the  vagus-centre  before  it  gets  to  the  heart,  instead  of 
injecting  it  as  usual  into  the  subcutaneous  tissue  or  veins,  whence  it  will  be 
carried  to  the  heart  before  it  can  reach  the  vagus-centre. 

By  experimenting  in  this  way  it  is  shown  that  atropine  stimulates  the 
vagus-roots  so  that  when  injected  into  the  carotid  it  causes  slowing  of  the 
heart's  action.  When  it  has  passed  through  the  cerebral  vessels,  and  returns 
with  the  blood  to  the  heart  it  paralyses  the  ends  of  the  vagus  in  the  heart, 
and  therefore  the  pulse  again  becomes  very  rapid,  notwithstanding  the  con- 
tinued stimulation  of  the  vagus-roots. 

We  cannot  always  conclude  with  certainty  that  a  drug  has  excited  the 
vagus-roots  merely  because  it  has  caused  the  pulse  to  become  slower  and  has 
had  no  action  after  the  vagi  have  been  divided,  for  it  is  possible  that  the  ter- 
minations of  the  vagus  in  the  heart  may  be  rendered  more  sensitive  than 
usual  by  a  drug,  so  that  they  may  respond  to  a  slighter  stimulus  than  usual 
or  with  greater  energy  to  a  normal  stimulus.  Such  an  action  appears  to  be 
exerted  by  physostigmine,  which  in  a  certain  stage  of  poisoning  renders  the 
vagus  more  excitable,  so  that  when  irritated  in  the  neck  by  a  faradaic  current 
a  slighter  stimulus  suffices  to  stop  the  heart  after  the  administration  of  the 
drug  than  before. 


298  PHAEMACOLGGY  AND  THEEAPEUTICS.      [sect.  i. 

Action  on  Accelerating  Nerves. — We  ascertain  whether  a  drug  has  a 
stimulating  action  on  the  accelerating  nerves  of  the  heart  by  cutting  both 
vagi  and  then  injecting  the  drug.  If  it  quickens  the  heart  still  further,  we 
assume  that  it  does  so  by  stimulation  of  the  accelerating  nerves.  This 
experiment,  however,  does  not  enable  us  to  decide  whether  the  stimulation 
has  affected  the  accelerating  nerves  passing  to  the  cardiac  ganglia  from  the 
central  nervous  system  or  those  passing  from  the  endocardium. 

Stimulating'  Effect  of  Asphyxial  Blood  on  the  Medulla. — In  order  to 
prevent  fallacies  arising  from  stimulation  of  the  vagus-roots  by  an  asphyxial 
condition  of  the  blood  due  to  the  action  of  the  drug  upon  respiration,  it  is 
usual  to  maintain  artificial  respiration  through  a  cannula  placed  in  the 
trachea.  This  acts  perfectly  well  in  some  cases,  but  if  the  drug  should  cause 
violent  convulsive  actions  it  may  prevent  the  movements  of  the  thorax 
occurring  regularly,  and  therefore  it  is  sometimes  necessary  to  paralyse  them 
by  means  of  curare. 

Moreover,  it  must  be  remembered  that  prolonged  stoppage  of  the  heart 
itself  will  allow  the  blood  in  the  medulla  to  become  venous  and  will  thus 
irritate  the  vagus-roots.  Prolonged  arrest  of  the  heart,  therefore,  tends  by 
this  action  to  prolong  it  still  further,  and  functional  inactivity  tends  to  pass 
into  death.  This  mechanism  would  render  every  intermission  of  the  pulse 
very  dangerous  were  it  not  that  the  same  venous  condition  of  the  blood 
which  stimulates  the  vagus-roots  stimulates  also  the  vaso-motor  centre  and 
the  respiratory  centre.  The  vaso-motor  centre  by  contracting  the  arterioles 
maintains  the  blood-pressure  during  the  prolonged  diastole,  and  excitation  of 
the  respiratory  centre  tends  to  restore  the  arterial  character  of  the  blood. 
The  venous  condition  of  the  blood  also  stimulates  accelerating  centres  in  the 
medulla  (Dastre  and  Morat). 

Stimulation  of  the  Heart  by  increased  Blood-pressure. — 

It  has  already  been  mentioned  that  increased  blood-pressure 
usually  renders  the  beats  of  the  heart  slower  by  the  stimulating 
action  it  exerts  on  the  vagus-roots.  When  the  vagi  are  divided, 
however,  its  effect  is  usually  quite  different,  and  a  rise  in  blood- 
pressure  after  division  of  the  vagi  renders  the  pulse-  quicker 
instead  of  slower,  at  least  generally.  An  opposite  result  has  been 
found  by  Marey  in  the  heart  of  the  tortoise,  where  increased 
pressure  rendered  the  beats  slower.  The  reason  of  the  difference 
observed  between  the  mammalian  heart  and  that  of  the  tortoise 
is  probably  due  to  the  different  development  of  the  nervous  and 
muscular  structures.  The  tortoise  heart  acts  more  like  a  single 
simple  muscle,  and  the  more  resistance  it  has  to  overcome  the 
more  slowly  does  it  work. 

In  the  mammalian  heart  the  increased  pressure  appears  to 
stimulate  the  nerves,  so  that  the  more  resistance  it  has  to  over- 
come the  more  quickly  does  it  work — that  is,  if  the  vagi  have 
been  cut.  The  sensibility  of  the  nervous  system  in  the  heart  to 
increased  pressure  appears  to  be  diminished  by  atropine,  for  Schiff ' 
has  found  that  a  quantity  of  this  poison  slightly  larger  than  will 
dilate  the  pupil  lessens  the  sensibility  of  the  heart  to  changes  in 
blood-pressure  so  much  that  the  pressure  may  be  first  increased 
to  three  times  the  normal  and  then  diminished  to  one-half,  or  even 
one-third,  without  any  change  in  the  pulse-rate  being  produced. 

1  La  Nazione,  1872,  No.  235. 


chap,  xi.]    ACTION  OF  DRUGS  ON  THE  CIRCULATION.     299 

Such  an  observation  suggests  that  atropine  would  be  useful  in 
lessening  pain  or  palpitation  of  the  heart  .in  persons  with  high 
blood-pressure  or  suffering  from  the  effects  of  cardiac  strain  con- 
sequent on  violent  muscular  exertion.  I  have  tried  it  in  such 
cases  sometimes  with  apparently  great  benefit,  at  other  times 
with  little  result.  The  cases  of  failure  may,  however,  have  been 
due  to  the  remedy  not  being  pushed  far  enough,  as  in  them  the 
pupil  was  not  markedly  dilated. 

Palpitation. — In  what  I  have  just  said  regarding  the  effect 
of  blood-pressure  on  the  heart  I  have  spoken  of  the  total  work, 
including  in  it  both  the  rapidity  of  pulsation  and  the  amount  of 
work  done  by  each  beat.  This  is,  perhaps,  fair  enough ;  but  at 
the  same  time  we  must  not  forget  that  there  is  a  distinction  be- 
tween the  total  amount  of  work  done  and  the  nature  of  the  indi- 
vidual contraction,  either  in  the  heart  of  tortoises  or  mammals, 
or  in  voluntary  muscles.  Both  voluntary  muscles  and  the  heart 
tend  to  contract  rapidly  if  they  have  little  resistance  to  overcome,. 
In  patients  suffering  from  anaemia  and  debility,  where  the  blood- 
pressure  is  low  and  the  resistance  to  the  ventricular  contractions 
is  consequently  small,  they  are  apt  to  take  place  with  great  quick- 
ness, giving  rise  to  a  short  flapping  first  sound  and  a  short  but 
unsustained  apex-beat,  while  the  patient  complains  of  much  pal- 
pitation. In  such  cases  increased  blood-pressure  will  tend  to 
lessen  the  palpitation,  and  digitalis,  which  contracts  the  vessels, 
will  be  useful ;  iron  also  is  serviceable  by  increasing  the  nutrition 
of  the  circulatory  apparatus  of  the  body  generally.  The  low 
blood-pressure,  however,  while  it  increases  the  tendency  to  pal- 
pitation, is  not  the  only  factor,  and  is  usually  accompanied  by  a 
tendency  to  disturbance  of  the  cardiac  innervation,  which  is  to  be 
met  by  sedatives  such  as  the  bromides,  or  by  remedies  directed  to 
the  stomach  or  other  organs  from  which  the  disturbing  stimulus 
may  proceed. 

The  Heart  of  the  Frog. 

This  is  a  very  convenient  object  on  which  to  study  the  action  of  drugs. 
Their  effects  upon  it  are  somewhat,  though  not  absolutely,  the  same  as  their 
effects  on  the  mammalian  heart ;  and  the  frog's  heart  being  simpler  in  its 
construction  it  is  easier  to  analyse  the  exact  mode  in  which  drugs  act  upon 
it.  The  frog's  heart  consists  of  three  chambers,  one  ventricle  and  two  auri- 
cles. But  in  addition  to  these,  there  is  what  might  almost  be  called  a  fourth 
chamber,  the  venous  sinus  or  sac  into  which  the  vense  cavse  open. 

There  are  three  vense  cavse,  two  superior  and  one  inferior,  which  open 
into  the  venous  sinus. 

The  venous  sinus  itself  opens  into  the  right  auricle,  the  opening  being 
covered  during  the  auricular  systole  by  a  small  fold  which  acts  as  a  valve. 

The  left  auricle  receives  the  pulmonary  veins  and  discharges  into  the 
single  ventricle  the  arterial  blood  which  enters  it  from  them,  while  the  right 
auricle  does  the  same  with  the  venous  blood  it  receives  from  the  sinus. 

The  septum  between  the  auricles  ends  inferiorly  in  two  triangular  flaps, 
which  act  as  valves  between  the  auricles  and  ventricle. 


r300 


PHARMACOLOGY  AND  THEEAPEUTICS.      [sect.  i. 


Prom  the  ventricle  issues  the  common  aorta,  or  aortic  bulh,  which  has  at 
its  origin  from  the  ventricle  a  spiral  valve  to  prevent  the  return  of  the  blood. 
The  two  auricles  beat  together,  and  the  aortic  bulb  and  ventricle  usually  beat 
together,  though  the  bulb  is  capable  of  independent  pulsation. 


Left  auricle  and  pulmonary  veins 

Aortic  bulb 
Bidder's  ganglia 


Superior  venas  cavse  and  vagi  nerves. 
Venous  sinus  and  Remak's  ganglion. 

Inferior  vena  cava. 

Ventricle. 


JTIG.  95. — Diagram  of  the  frog's  heart. 

The  usual  rhythm  is  the  following:  first  the  venous  sinus,  next  the 
auricles,  then  the  ventricle  and  bulb. 

The  pulsations  of  the  venous  sinus  and  ventricle  alternate  with  those  of 
the  auricle.  The  heart  continues  to  pulsate  rhythmically  after  it  has  been 
completely  removed  from  the  body,  so  that  the  motor  power  of  rhythmical 
contraction  is  evidently  contained  within  itself.  Its  rhythm  is,  however, 
regulated  by  the  vagi  nerves.  These  pass  along  behind  the  two  superior 
cavse  to  the  junction  of  the  venous  sinus  with  the  auricle.    At  this  spot,  or 


Fig.  96.— View  df  the  auricular  septum  in  the  frog  (seen  from  the  left  side).  The  nerves  are  stained 
with  osmic  acid,  n  is  the  posterior,  and  n'  the  anterior  cardiac  nerve ;  Ms  a  horizontal  portion 
of  thel  atter  nerve  ;  6  is  the  posterior,  and  B'  the  anterior  auriculo- ventricular  ganglion  ;  m  is 
a  projecting  muscular  fold.  [This  figure  is  taken  by  the  kind  permission  of  my  friend,  M. 
Ran vier,  from  his  Lemons  d'Anatomie  ghdrale,  Annee  1877-78,  '  Appareils  nervous  terminaux,' 
t.  6,  p.  79.] 

just  over  the  auricles,  between  the  superior  cavse  and  the  pulmonary  veins, 
they  anastomose  to  form  a  single  or  double  ganglion,  or  a  plexus  containing 
ganglionic  cells,  sometimes  known  as  Bemak's  ganglion.  From  hence  two 
nerves  pass  down  in  the  auricular  septum,  to  the  base  of  the  ventricle,  where 
they  end  in  two  ganglia,  known  as  Bidder's  ganglia  (Fig.  95).  These  are 
situated  at  the  junction  of  the  wall  of  the  ventricle  with  the  two  valvularflaps 
in  which  the  septum  ends.  They  are  connected  with  one  another  by  fibres 
which  run  transversely,  nearly  in  a  line  with  the  auriculo-ventricular  groove. 

The  posterior  or  dorsal  nerve  comes  chiefly  from  the  left  vagus ;  and  the 
anterior  or  ventral  from  the  right  vagus. 

Both  of  these  nerves  grow  thicker  as  they  pass  down  towards  Bidder's 


chap,  xi.]    ACTION  OF  DEUGS  ON  THE  CIRCULATION.     801 

ganglia  from  the  presence  in  them  of  numerous  ganglionic  cells ;  they  also 
send  off  several  branches  to  the  auricle. 

The  ventricle  itself  has  not  been  shown  to  contain  either  nerve-fibres  or 
ganglionic  cells,  excepting  just  at  its  base,  where  Bidder's  ganglia  already 
mentioned  are  situated,  and  where  branches  from  them  proceed  to  the 
ventricle. 

Action  of  Drugs  on  the  Heart  of  the  Frog. 

The  effect  of  drugs  may  be  observed  by  simply  destroying  the  brain, 
exposing  the  heart,  and  either  injecting  the  drug  subcutaneously,  or  into  the 
dorsal  lymph-sac,  or  even  laying  it  upon  the  heart  itself.  Changes  in  the  rate 
of  the  pulse  and  in  the  mode  of  contraction  of  the  different  cavities  of  the 
heart  are  thus  readily  observed.  By  exposure  and  irritation  of  the  vagi  the 
effect  of  drugs  upon  their  action  can  also  be  observed.  Even  when  com- 
pletely excised,  the  heart  of  the  frog  continues  to  pulsate  for  a  length  of 
time,  and  the  action  of  heat,  cold,  and  poisons  upon  it  can  be  readily  demon- 
strated.   A  simple  apparatus  for  this  purpose  is  shown  in  Fig.  97. 


Fig.  97. — Instrument  for  showing  the  Action  of  heat  and  cold  and  of  poisons  on  the  frog's  heart.  It 
consists  of  a  piece  of  tin  plate  or  glass  three  or  four  inches  long  and  two  or  three  wide,  at  one 
end  of  which  an  ordinary  cork  cut  square  is  fastened  with  sealing-wax  in  such  a  manner  that  it 
projects  half  an  inch  or  more  beyond  the  edge  of  the  plate.  This  serves  as  a  support  to  a  little 
wooden  lever  about  three  inches  long,  a  quarter  of  an  inch  broad,  and  one-eighth  of  an  inch 
thick.  A  pin  is  passed  through  a  hole  in  the  centre  of  this  lever,  and  runs  into  the  cork,  so  that 
the  lever  swings  freely  about  upon  it  as  on  a  pivot.  The  easiest  way  of  making  a  hole  of  the 
proper  size  is  simply  to  heat  the  pin  red  hot,  and  then  to  burn  a  hole  in  the  lever  with  it.  To 
prevent  the  lever  from  sliding  along  the  pin,  a  minute  piece  of  cardboard  is  put  at  each  side  ol 
it,  and  oiled  to  prevent  friction.  A  long,  fine  bonnet-straw,  or  section  of  one,  is  then  fastened 
by  sealing-wax  to  one  end  of  the  lever,  and  to  the  other  end  of  the  straw  a  round  pi?ce  of  white 
paper,  cut  to  the  size  of  a  shilling  or  half-crown,  according  to  convenience,  is  also  fixed  by  a 
drop  of  sealing-wax.  The  pin,  which  acts  as  a  pivot,  should  be  just  sufficiently  beyond  the  edge 
of  the  plate  to  allow  the  lever  to  move  freely,  and  the  lever  itself  should  lie  flat  upon  the  plate. 
Its  weight,  too,  increased  as  it  is  by  the  straw  and  paper  flag,  would  now  be  too  great  for  the 
heart  to  lift,  and  so  it  must  be  counterpoised.  This  is  readily  done  by  clasping  a  pair  of  bulldog 
forceps  on  the  other  end.  By  altering  the  position  of  the  forceps  the  weight  of  the  lever  can  be 
regulated  with  great  nicety.  If  the  forceps  are  drawn  back  as  ate,  the  flagis  more  than  counter- 
balanced, and  does  not  rest-on  the  heart  at  all,  while  the  position  a  brings  the  centre  of  gravity 
of  the  forceps  in  front  of  the  pivot,  and  increases  the  pressure  of  the  lever  on  the  heart.  The 
isolated  frog's  heart  is  laid  under  the  lever  near  the  pivot,  and  as  it  beats  the  lever  oscillates 
upwards  and  downwards.  When  used  for  demonstrating  the  action  of  poisons  the  wooden  lever 
should  be  covered  with  sealing-wax,  so  as  to  allow  every  particle  of  the  poison  to  be  washed  off! 
it,  and  thus  prevent  any  portion  from  being  left  behind  and  interfering  with  a  future  experi- 
ment. By  attaching  a  small  point  to  the  end  of  the  straw  in  place  of  the  paper  flag,  tracings 
may  be  taken  upon  smoked  paper  fixed  on  a  revolving  cylinder. 

The  fact  that  heat  accelerates  and  cold  retards  the  pulsations 
of  the  heart  is  one  of  fundamental  importance,  both  in  regard  to 
a  right  understanding  of  the  quick  pulse,  which  is  one  of  the  most 
prominent  symptoms  of  fever,  and  to  a  correct  knowledge  of  the 
proper  treatment  to  apply  when  the  heart's  action  is  failing. 

It  may  be  shown  with  the  apparatus  just  described  by  placing 
a  piece  of  ice  under  the  tin  plate.  The  pulsations  will  become 
slower  and  slower,  and  if  the  room  be  not  too  warm  the  heart  may 
stand  completely  still  in  diastole.  On  removing  the  ice  from  the 
plate  the  pulsations  of  the  heart  become  quicker.   If  a  spirit-lamp 


802 


PHAEMACOLOGY  AND  THEEAPEUTICS.      [sect.  t. 


be  now  held  at  some  distance  below  it  the  heart  beats  quicker  and 
quicker  as  the  heat  increases,  until  at  last  it  stands  still  in  heat- 
tetanus.  On  again  cooling  it  by  the  ice,  its  pulsations  recommence. 


Pi8.  98— Ludwig  and  Coats'  frog-heart  apparatus,  a  Is  a  reservoir  for  serum.  B,  a  stopcock  to 
regulate  the  supply  to  the  heart.  0,  a  piece  of  caoutchouo  tubing  connecting  a  and  d.  d  a 
glass  cannula  in  the  vena  cava  inferior,  d',  another  in  the  aorta,  a,  a  manometer  f  a'  piece 
of  tubing  closed  by  a  clip,  to  al low  of  the  escape  of  serum,  a,  a  fine  pen,  floating  on  the  mercurv 
in  k.  h,  the  frog's  heart.  J,  a  sealed  glass  tube  passed  through  the  oesophagus,  k,  and  firml  v 
held  by  a  holder,  L.  H,  a  second  holder  to  support  a.  p,  a  stand  with  upright  rod  a  a  nan 
of  akin  to  coyer  the  heart  and  prevent  drying.    The  vaguB  nerve  is  seen  oassing  to  the  heart 


chap,  xi.]    ACTION  OF  DRUGS  ON  THE  CIRCULATION.     303 


At  first  they  are  quick,  but  they  gradually  become  slower  and 
slower.  On  again  applying  the  spirit-lamp  they  become  quicker, 
and  by  raising  the  temperature  sufficiently  the  heat-tetanus  is 
converted  imto  heat-rigor.  In  this  condition  no  application  of 
cold  has  the  slightest  effect  in  restoring  pulsation. 

Not_  only  the  effects  of  heat  and  cold,  but  the  effect  of 
separating  the  venous  sinus  or  the  auricles  from  the  ventricle  can 
readily  be  shown  with  this  apparatus,  as  well  as  the  action  of 
various  poisons.  The  best  for  the  purpose  of  class  demonstration 
is  muscarine.  A  drop  of  saline  solution  containing  a  little  of  the 
alkaloid  being  placed  on  the  heart,  it  ceases  to  beat  entirely.  If 
a  drop  of  atropine  solution  be  now  added  the  beats  recommence. 
I  have  seen  them  do  so  on  one  occasion  after  they  had  entirely 
ceased  for  four  hours. 

For  the  purpose  of  observing  alterations  in  the  strength  of  the  cardiac 
pulsations  as  well  as  their  rhythm,  a  convenient  piece  of  apparatus  is  the  one 
devised  by  Ludwig  and  used  under  his  directions  by  Coats  (Fig.  98). 

One  objection  to  this  apparatus  as  shown  in  the  engraving  is,  that  the 
blood  does  not  circulate  freely  through  the  heart,  but  this  can  be  overcome 
by  closing  the  tube  at  f  only  partially  instead  of  completely,  and  according 
to  the  amount  of  closure  the  pressure  under  which  the  heart  worts  may  be 
regulated.  Or  the  tube  f  may  be  lengthened  and  made  to  empty  itself  into 
the  reservoir  a.  The  pressure  under  which  the  heart  works  may  be  regulated 
by  the  height  at  which  the  tube  is  allowed  to  discharge. 

Another  apparatus  is  that  used  by  Williams  in  his  researches  on  digitalin 
(Fig.  99).'    It  consists  of  a  Y-shaped  cannula  whose  stem  is  divided  by  a 


Flask  containing 

nutrient  fluid 


Valve  opening 

towards  heart 


Valve  opening ) 
from  heart ) 


Valve  with  slit. 


•  Recording  cylinder. 


— -— i|b~ Manometer. 

SI 


Fig.  99. — Diagram  of  Williams's  apparatus  for  investigating  the  action  of  drugs 
on  the  heart  of  the  frog. 

longitudinal  septum  into  two  halves,  each  of  which  is  continuous  with  the  fork 
on  its  own  side.  The  stem  is  inserted  through  the  aorta  into  the  ventricle  of 
■  the  heart,  which  is  kept  moist  by  being  dipped  in  a  vessel  containing  serum  or 
a  dilute  saline  solution.  One  fork  of  the  Y  is  connected  with  a  flask  containing 
blood-serum  or  other  nutritive  fluid,  and  the  other  with  a  manometer.  By 
means  of  valves  these  fluids  are  made  to  flow  only  in  one  direction.  These 
valves  consist  of  a  piece  of  glass  tubing  with  a  slit  on  one  side ;  over  this  slit 
is  loosely  tied  a  piece  of  thin  membrane  (gold-beater's  skin)  which  covers  about 
three-quarters  of  the  circumference  of  the  tube.  This  membrane  allows  fluid 
to  pass  readily  out  of  the  tube  from  within  outwards,  but  not  from  without 
inwards,  any  external  pressure  causing  the  membrane  to  become  tightly 
applied  to  the  slit  and  to  close  it. 

1  Arch.  f.  exp.  Path.  u.  Pliarm.,  Bd.  xiii.  p.  1. 


304  PHARMACOLOGY  AND  THEEAPEUTICS.      [sect.  i. 

A  very  useM  form  of  apparatus  for  investigating  the  action  of  drugs 
on  the  frog's  heart  and  on  the  effect  of  the  vagus  upon  it  is  made  by  com- 
bining the  valves  in  Williams's  apparatus  with  the  apparatus  of  Ludwig  and 
Coats.1 

The  apex  (as  the  lower  two-thirds  of  the  ventricle  is  com- 
monly called)  contains,  as  has  been  mentioned,  no  nerves,  and 
when  separated  from  the  rest,  either  by  cutting  or  by  tight  liga- 
ture, usually  lies  perfectly  quiet  without  contracting.  When 
irritated  by  a  single  induced  shock,  it  answers  by  a  single  con- 
traction, just  like  any  other  muscular  fibre. 

But  though  the  muscular  fibres  contained  in  the  apex  cease 
to  contract  rhythmically,  when  the  nervous  stimulus  usually 
supplied  by  Bidder's  ganglia  is  removed,  they  still  retain  a  ten- 
dency to  rhythmical  contraction ;  and  when  subjected  to  a  con- 
stant stimulus  of  another  kind  they  again  commence  to  pulsate. 
This  is  seen  when  the  apex  is  stimulated  by  supplying  it  with 
oxygenated  blood  through  a  cannula  under  pressure  (the  pressure 
supplying  the  necessary  stimulus),  or  by  passing  through  it  a 
constant  or  interrupted  current,  or  by  adding  a  trace  of  del- 
phinine  to  the  nutritive  fluid  with  which  it  is  supplied.  This 
phenomenon  is  similar  to  that  which  occurs  in  the  bells  of 
medusae  already  described  (p.  110),  which  cease  to  contract  rhyth- 
mically when  their  marginal  ganglia  are  removed,  but  recom- 
mence when  an  additional  stimulus  is  applied  to  the  bell  itself, 
by  putting  it  into  acidulated  water. 

A  curious  point  has  been  made  out  by  Bowditch  regarding 
the  excitability  of  the  heart-apex.  It  has  already  been  men- 
tioned that  the  amount  of  compaction  of  voluntary  muscle  varies 
with  the  intensity  of  the  stimulus,  and  that  this  is  also  the  case 
with  the  reflex  contraction  produced  by  irritation  of  sensory 
nerves.  The  apex  when  fed  with  serum  usually  stands  still  for 
a  long  time  before  it  begins  to  beat,  but  when  in  this  condition 
may  be  made  to  contract  by  the  application  of  an  induction 
shock.  The  difference  between  the  reaction  of  an  ordinary 
striated  muscle  and  of  the  apex  to  such  a  shock  is,  that  the 
heart,  instead  of  responding  by  a  strong  or  weak  contraction  to 
a  strong  or  weak  stimulus,  either  does  not  contract  at  all  or  con- 
tracts with  as  much  force  as  it  can  exert.  The  weakest  stimulus 
which  will  act  at  all  and  the  strongest  have  thus  exaetly  the  same 
action,  or,  in  other  words,  a  minimum  is  also  a  maximum  stimu- 
lus. This  condition  does  not  correspond  to  that  which  obtains 
in  the  normal  striated  muscle  when  stimulated  either  directly  or 
reflexly.  We  find,  however,  a  corresponding  condition  in  the 
reflex  contraction  of  the  muscle  produced  by  stimulation  of 
sensory  nerves  in  an  animal  poisoned  by  strychnine  (p.  181). 
We  noted,  however,  in  discussing  the  action  of  strychnine  on  the 

1  Harnack  and  Hoffmann,  Arch.  f.  exp.  Path.  u.  Pharm.,  Bd.  xvii.  p.  159. 


chap,  xi.]    ACTION  OF  DEUGS  ON  THE  CIECULATION.     805 

spinal  cord,  that,  just  after  exhaustion  had  occurred  from  a 
spasm,  strong  and  weak  stimuli  produced  strong  and  weak  con- 
tractions in  the  muscle.  A  somewhat  similar  condition  appears 
to  occur  in  the  heart,  for  Mays  has  noticed  that,  when  the  apex 
is  supplied  with  blood  which  has  stood  three  or  four  days  instead 
of  with  fresh  blood,  strong  and  weak  stimuli  produce  strong 
and  weak  contractions.1 

It  is  obvious  that,  although  the  contractions  of  voluntary 
muscle  on  reflex  stimulation  may  be  analogous  to  the  contrac- 
tions of  the  apex,  yet,  in  the  former  case,  the  alterations  occur 
in  the  nervous  centres,  while  in  the  apex  the  changes  occur  in 
the  muscular  substance. 

Action  of  Drugs  on  the  Muscular  Substance  of  the  Heart. 

'  Since  the  lower  two-thirds  of  the  ventricle  or  apex,  as  it  is 
usually  termed,  contains  no  nerves,  it  forms  a  convenient  object 
for  ascertaining  the  action  of  drugs  upon  the  muscular  substance 
of  the  heart  itself  and  has  been  much  used  for  this  purpose. 

Tube  for  allow-  Jr^  ^^%. 

ing   escape  of  W  ^ 

fluid  from  the  GL  ^S^^^^^ 

heart >S-  ^^^0*^  "m.          " 


_End  for  intro- 
duction into 
the  heart. 


1TI8. 100.— Perfusion  cannula,  with  the  anterior  part  removed  so  as  to  show  the  septum. 

The  apparatus  usually  employed  (Fig.  100)  consists  of  a  small  cannula 
introduced  into  the  ventricle,  which  is  attached  to  it  by  a  ligature  tightly  tied 
round  it  at  the  junction  of  its  upper  third  with  its  lower  two-thirds.  The 
interior  of  the  cannula  is  divided  into  two  by  a  septum  which  runs  longi- 
tudinally, and  the  one  half  is  connected  with  a  flask  containing  the  nutritive 
fluid  with  which  it  is  to  be  supplied,  and  the  other  with  a  small  mercurial 
manometer  provided  with  a  float  to  register  its  oscillations  upon  a  revolving 
cylinder. 

At  first  the  nutritive  fluid  is  supplied  pure  to  the  apex,  and 
after  a  normal  tracing  has  been  obtained  the  substance  to  be 
investigated  is  added  to  it.  #  . 

When  saline  solution,  a  -65  per  cent,  solution  of  NaU,  is 
employed,  the  apex  usually  stops  in  diastole  for  a  period  varying 
from  a  few  minutes  to  an  hour  and  a  half.  It  then  begins  to 
pulsate  (Fig.  101,  a),  getting  gradually  weaker  and  weaker  (Fig. 
101,  b  and  c),  and  finally  stops  in  diastole.  When  the  heart  is 
in  this  condition  its  pulsations  may  be  restored  by  the  addition 

>  Separat-Abdk.  a.  d.  7erhandl.  d.physiol.  Gesellsch.  zu  Berlin,  Jan.  12,  1883. 


306  PHAEMACOLOGY  AND  THEEAPEUTICS.      [sect,  i.' 

to  the  chloride  of  sodium  solution  of  1  to  10  per  cent,  of  blood,  or 
of  serum,  or  of  a  solution  of  the  ashes  of  serum. 

Minute  quantities  of  several  poisons  such  as  delphinine  or 
quinine,  or  a  mixture  of  atropine  and  muscarine,  also  restore  the 


FIG  101  —After  Ringer.  Tracings  showing  the  effect  of  simple  NaCl  solution  in  weakening  the 
pulsations  of  the  apex  of  the  frog's  heart.  The  tracing  a  was  taken  soon  after  the  blood  was 
replaced  by  NaCl  solution  ;  6,  after  a  longer  period  ;  and  c  after  a  still  longer  time. 

rhythmical  pulsations  after  they  have  ceased  in  a  heart-apex 
supplied  with  NaCl  solution.  A  minute  quantity  of  Na2C03  or 
■005  per  cent,  of  NaHO  restores  or  increases  the  beats  for  a  time ' ; 
afterwards  the  pulsations  become  again  weaker  and  the  heart 
stops  a  second  time,  but  it  stops  in  systole  and  not  in  diastole. 

Singer  has  made  the  remarkable  discovery  that  when  the 
saline  solution  is  made  with  ordinary  tap-water  the  beats  become 
prolonged,  but  the  addition  of  a  trace  of  potash  causes  them  at 
once  to  assume  their  normal  character,  and  a  frog's  heart  may 
be  kept  beating  for  hours  together  with  saline  solution  made  in 
this  way  and  containing  a  trace  of  potash,  although  the  saline 
solution  never  does  this  when  made  with  distilled  water.     The 


S"> 


Fig.  102.— After  Ringer.  Shows  the  effect  produced  upon  the  beat  of  the  frog's  heart  fed  with  NaCl 
solution  by  the  addition  of  a  trace  of  calcium  chloride.  The  beats  in  this  case  are  induced  by  an 
induction  shock. 

addition  of  a  minute  trace  of  calcium  salt  to  distilled  water  pro- 
duces the  same  effect  as  tap-water — the  contractions  become 
larger  and  longer  (Fig.  102) .  When  potash  is  then  added,  the 
length  of  the  contractions  becomes  diminished  to  the  normal 
without  their  strength  becoming  affected,  and  thus  a  pure  saline 
solution  made  with  distilled  water  and  with  the  addition  of 
minute  traces  of  calcium  and  potassium  will  keep  the  heart 
beating  perfectly  for  hours  together. 

Dilute  alkalies  added  to  the  saline  solution  have  been  shown 
by  Gaskell  to  cause  a  tonic  contraction  of  the  muscular  fibre  of 
the  apex,  so  that  it  may  gradually  cease  to  beat.  This  con- 
traction may  occur  whether  the  apex-  is  pulsating  or  not.     If  it 

1  Gaule,  Archiv  f.  Anat.  u.  Phys.,  1878,  p.  295. 


chap,  xi.]    ACTION  OF  DEUGS  ON  THE  CIRCULATION.     307 

remains  at  rest,  a  manometer  connected  with  it  simply  shows  a 
gradual  rise  in  the  mercury  until  the  contraction  of  the  apex  is 
complete.  If  it  is  heating,  the  duration  of  full  contraction  at 
each  systole  becomes  longer,  and  relaxation  during  diastole  less 
complete,  until  no  diastolic  relaxation  occurs  and  the  ventricle 
remains  perfectly  still  in  a  condition  of  complete  contraction. 

Dilute  acids  have  an  opposite  action  to  dilute  alkalies,  and 
when  very  dilute  acid,  e.g.  lactic  acid,  is  mixed  with  the  saline 
solution,  it  produces  a  condition  of  complete  relaxation. 

Instead  of  increasing  the  duration  of  the  systole  like  alkalies, 
acids  first  shorten  it  and  then  render  it  less  and  less  powerful, 
until  contractions  cease  altogether  and  the  ventricle  remains  at 
rest  in  diastole. 

Dilute  acids  and  alkalies  counteract  each  other's  effects  on 
the  heart,  so  that  after  the  beats  have  been  very  much  lowered 
in  force  by  acids,  an  alkali  will  first  restore  it  to  its  original  con- 
dition, and  then  produce  its  own  characteristic  effect.  The  sub- 
sequent application  of  an  acid  will  undo  the  effect  of  the  alkali, 
again  weakening  the  beats  and  again  producing  dilatation  instead 
of  contraction.1 

The  three  alkalies,  potash,  soda,  and  ammonia,  have  all  a 
somewhat  similar  tendency  to  increase  the  tonic  contraction  of 
the  ventricle.  When  large  doses  are  given  they  tend  to  para- 
lyse the  muscle,  so  that  it  again  dilates  after  a  period  of  tonic 
contraction.  The  paralysing  action  of  potash  is  much  more 
powerful,  and  manifests  itself  much  sooner  than  that  of  the 
other  two. 

The  excitability  of  the  muscular  fibre  is  also  altered  by  alkalies. 
Soda  and  ammonia  increase  it,  so  that  a  faradaic  stimulus  ap- 
plied to  the  ventricle  has,  much  more  effect  after  the  application 
of  soda  and  ammonia  than  before.  Potash  has  a  different  effect 
and  diminishes  the  excitability  of  the  ventricle,  although  some- 
times the  diminution  may  be  preceded  by  a  stage  of  increased 
excitability.2 

A  number  of  poisons  act  on  the  muscular  fibre  of  the  ventricle 
like  alkalies,  others  act  like  acids. 

Antiarine,  digitalin,  helleborin,  veratrine,  physostigmine, 
barium,  and  probably  all  the  substances  belonging  to  the  digitalin 
group,  act  like  alkalies. 

Muscarine 3  acts  like  an  acid,  and  so  apparently  do  also  pilo- 
carpine,4 saponine,5  and  apomorphine. 

Neutral  double  salts  of  copper,  chloral,  iodal,  and ,  other 
members  of  the  chloral  group,6  are  probably  to  be  classed  along 

1  Gaskell,  Jowrn.  of  Physiol.,  vol.  iii.  p.  48. 

*  Binger,  Ibid.,  vol.  iii.  p.  193. 

*  Gaskell,  Jowrn.  of  Physiol.,  vol.  iii.  p.  61. 

*  Ibid.,  op.  cit. 

*  Schmiedeberg,  Ludwig's  Festgabe.  p.  127. 

"  Harnack,  Archivf.  cxp.  Path.  u.  Biwurm..  Bd.  xvii.  p.  185. 

x  2 


308  PHAKMACOLOGY  AND  THEEAPEUTICS.     [sect.  i. 

-with  salts  of  potassium,  first  exciting  and  then  paralysing  the 
cardiac  muscle. 

In  classifying  cardiac  poisons,  when  we  say  that  some  act 
like  acids  and  others  like  alkalies,  it  must  be  borne  in  mind  that 
the  action  though  similar  is  not  identical.  Although  the  actions 
may  be  generally  like  one  another,  they  may  vary  very  consider- 
ably even  in  kind,  and  they  certainly  vary  enormously  in  degree. 
Thus  the  action  of  barium  and  veratrine  may  be  very  similar,  but 
veratrine  is  much  the  more  powerful.  We  find  a  similar  condition 
in  other  structures.  Thus  iodide  of  ammonium  and  curarine 
both  paralyse  the  ends  of  motor  nerves,  but  an  enormously 
larger  amount  of  the  former  is  required  to  produce  the  effect. 

That  there  is  considerable  similarity  in  kind,  however,  be- 
tween the  action  of  the  vegetable  alkaloids  and  inorganic  salts  is 
shown  by  the  fact  that  the  action  of  veratrine  may  be  neutralised 
by  potassium  chloride.1 

The  irritability  of  the  heart  is  preserved  for  very  different' 
lengths  of  time  in  different  gases.  Thus  Castell 2  found  that  the 
frog's  heart  continued  to  beat  in  oxygen  for  12  hours,  in  nitrogen 
for  1  hour,  in  hydrogen  for  1£  hour,  in  carbonic  acid  for  10 
minutes,  in  nitrous  oxide  for  5  or  6  minutes,  in  carbonic  oxide  for 
40  minutes,  and  in  chlorine  for  2  minutes. 

Differences  between  the  Heart-Apex  and  the  Heart. 

When  the  heart  is  tied  on  to  a  cannula  in  the  same  way  as 
the  apex,  by  a  ligature  round  the  auricles  or  even  the  sinus,  so 
that,  instead  of  containing  no  ganglia  at  all,  it  contains  either 
Bidder's  or  Bidder's  and  Kemak's  ganglia,  it  also  remains  motion- 


FiG.  103. — Diagram  to  Bhowthe  differ  nee  in  the  mode  of  experimenting  with  the  heart  and  with  the 
apex  alone.  In  a  the  apex  alone  its  attached  to  the  cannu'a.  In  o  the  heart,  consisting  of 
ventricle  and  auricles,  or  of  the  venous  sinus  also,  is  attached  to  the  cannula. 

less  in  the  same  way  as  the  apex  when  supplied  with  chloride  of 
sodium  solution,  but  its  rhythmical  power  is  restored  by  the 
addition  of  defibrinated  blood,  of  serum,  of  solution  of  the  ashes 
of  serum,  by  a  trace  of  Na2C03,  or  still  better  by  the  addition  of 
•005  per  cent,  of  NaHO  and  a  trace  of  peptone  or  serum-albumin. 
When  supplied  with  pure  serum,  it  does  not  beat  regularly, 
but  its  pulsations  occur  in  groups  separated  by  long  intervals 
(Fig.  104)  .3    When  a  little  haemoglobin  or  blood  is  added  to  the 

1  Binger,  Practitioner,  vol.  xxx.  p.  17. 

2  Hermann's  Handb.  d.  Phys.,  iv.  1,  p.  357. 
*  Luciani,  Ludwig's  Arbeiten,  1872,  p.  120, 


chap,  xi.]    ACTION  OF  DEUGS  ON  THE  CIKCULATION.     809 

serum,   this  grouping  disappears,   and  the  pulsations  become 
regular.1 

When  the  heart  has  been  supplied  with  haemoglobin  or  blood 
and  is  beating  regularly,  the  addition  of  a  little  veratrine  causes 


Fig.  104. — Periodio  rhythm  of  the  heart,  the  pulsations  occurring  in  groups  separated 
by  intervals  of  complete  quiescence. 

the  groups  to  appear,  and  a  similar  effect  is  produced  if  the 
blood  is  not  renewed,  but  allowed  to  remain  in  the  heart  till  it 
becomes  venous.2 

This  periodic  stage  does  not  occur  immediately  after  the  heart  has  been 
tied  on  the  cannula  and  supplied  with  serum.  It  is  preceded  by  an  initial 
stage,  in  which  the  beats  are  at  first  very  quick,  then  slow,  and  these  are 
separated  by  long  pauses.  Next  comes  the  periodic  stage  in  which  the 
groups  occur.  It  is  succeeded  by  the  stage  of  crisis  in  which  the  groups  are 
replaced  by  single  pulsations  slower  and  smaller  than  the  normal. 

Atropine  and  nicotine  do  not  prevent  the  occurrence  of  groups.  Both  of 
them  make  the  groups  longer  and  the  pauses  shorter.  Atropine,  however, 
even  in  small  doses,  soon  kills  the  heart  before  it  even  enters  on  the  stage  ot 
crisis.  Nicotine,  on  the  other  hand,  shortens  the  pauses,  and  rapidly  induces 
the  stage  ot  crisis  without  destroying  the  energy  of  the  heart,  which  is  quite 
as  great  after  poisoning  by  nicotine  as  in  the  normal  condition. 

Moderate  doses  of  muscarine  make  the  pulsations  smaller  and  slower,  the 
groups  shorter,  and  the  pauses  longer.  Sometimes  the  heart  becomes  ex- 
hausted before  the  stage  of  crisis  appears,  at  other  times  it  does  not.  Large 
doses  of  muscarine  arrest  the  movements  of  the  heart. 

The  activity  of  the  heart  which  has  been  stopped  by  muscarine  is  again 
restored  by  atropine,  but  muscarine  can  render  the  beats  smaller  and  slower, 
even  after  the  previous  application  of  atropine. 

The  occurrence  of  groups  appears  to  be  most  probably  due  to 
interference  of  rhythms — of  the  ganglionic  rhythm  with  that  of 
muscular  fibre. 

We  find  an  indication  of  alternate  interference  and  coinci- 
dence of  two  rhythms  in  the  alterations  which  sometimes  occur 
in  the  beats  of  a  ventricle  containing  its  ganglia,  but  separated 
from  the  auricles.  At  first  all  the  beats  are  of  equal  strength, 
but  soon  each  alternate  beat  gets  longer  and  shorter,  till  some 
disappear  and  others  get  much  stronger  than  before  (Fig.  105  ;  cf. 
Fig.  64,  p.  168). 

1  Bossbach,  Ludwig's  Arbeiten,  1874,  p.  92. 
*  Ibid.,  p.  93. 


310  PHARMACOLOGY  AND   THERAPEUTICS,      [sect.  i. 

Action  of  Drugs  on  the  Vagus  in  the  Frog. — When  the 
vagi  are  stimulated  by  an  induced  current,  the  heart  usually 
stops  in  diastole. 


Fig.  105.— Tracing  of  the  pulsations  of  a  ventricle  separated  from  the  auricles  by  section  at  the 
auriculo-ventricular  groove.    After  Kanvier,  Lesons,  1877-78. 

The  effect  of  stimulation  may  be  observed  either  on  the  heart 
simply  exposed  or  by  means  of  Ludwig  and  Coats'  apparatus. 
The  action  of  both  vagi  is  not  always  alike.  The  right  vagus 
has  usually  a  greater  power  to  arrest  the  heart  than  the  left.  The 
action  of  the  Vagus  varies  also  according  to  the  condition  of  the 
heart,  and  may  produce  different  effects.  It  may  cause,  1st, 
stoppage  of  the  heart's  beats,  followed  after  an  interval  by  slow 
pulsations  or  by  small  rapid  pulsations,  gradually  becoming 
larger  and  stronger ;  2nd,  it  may  cause  them  to  become  small 
and  slow  without  actual  stoppage — -this  is  the  usual  effect  of 
irritation  of  the  vagus  in  the. living  body ;  3rd,  it  may  cause  the 
pulsations  to  become  simply  small  and  rapid  without  any  stop- 
page ;  4th,  it  may  cause  them  to  become  rapid ;  5th,  it  may 
cause  them  to  become  more  powerful  (Figs.  112  to  115,  p.  324). 

It  may  also  act  differently  on  the  auricles  and  ventricle,  pro- 
ducing still-stand  of  the  ventricle  and  rapid  pulsation  of  the 
auricles.  These  differences  are  probably  due  to  a  great  extent 
to  the  vagus  of  the  frog  being  really  the  combined  vagus  and 
sympathetic.  At  present  the  chief  point  upon  which  I  wish  to 
insist  is  that  irritation  of  the  vagus  usually  causes  still-stand  of 
the  heart. 

When  the  venous  sinus  is  stimulated,  still-stand  of  the  heart 
is  produced,  which  is  even  more  complete  and  permanent  than 
that  which  follows  irritation  of  the  vagus. 

Action  of  Drugs  on  Inhibition  of  the  Heart. — The  effect 
of  certain  drugs  upon  the  still-stand  produced  by  irritation  of 
the  vagus  or  of  the  venous  sinus  is  very  remarkable.  A  large 
number  of  drugs,  more  especially  atropine,  curare,  coni'ine,  and 
nicotine,  when  injected  into  the  circulation  have  the  power  of 
completely  destroying  the  inhibitory  power  of  the  vagi  as  far  as 
the  rate  of  rhythm  is  concerned,  so  that  when  their  fibres  are 
stimulated  the  heart  is  not  arrested,  nor  are  its  beats  rendered 
slower,  but  they  are,  on  the  contrary,  quickened. 

These  poisons  again  may  be  divided  into  two  classes : 
Class  I.  containing  atropine  and  its  congeners. 
Class  II.  containing  curare,  connne,  nicotine,  &c. 


chap,  xi.]    ACTION  OF  DEUGS  ON  THE  CIRCULATION.     311 

These  two  classes  agree  in  destroying  the  inhibitory  power 
of  the  vagus  nerve,  so  that  irritation  of  its  trunk  will  no  longer 
produce  still-stand  or  slowing  of  the  heart.  They  differ  in  their 
action  on  the  still- stand  produced  by  irritation  of  the  venous 
sinus.  Atropine  and  its  allies  prevent  any  inhibition  occurring 
when  the  venous  sinus  is  stimulated,  or  when  muscarine  is 
applied  to  the  heart  directly.  This  action  affects  chiefly  the 
rhythm  of  the  heart,  for  muscarine  can  still  reduce  the  force  of 
the  cardiac  contractions  after  the  application  of  atropine. 

Poisons  of  the  second  class  do  not  prevent  the  still-stand  of 
the  heart  occurring  on  irritation  of  the  sinus,  nor  do  they  pre- 
vent muscarine  from  arresting  the  beats  of  the  heart.  This 
antagonism  of  atropine  and  muscarine  has  hitherto  been  explained 
on  the  supposition  that  muscarine  greatly  stimulates  inhibi- 
tory centres  in  the  sinus  or  auricle,  while  atropine  paralyses 
them. 

These  two  classes  also  agree  in  leaving  unaffected  the 
accelerating  nerves  of  the  heart.1 

These  complicated  effects  are  very  hard  to  explain  on  the 
ordinary  hypothesis. 

It  is. still  more  strange  that  although  atropine  and  muscarine 
have  such  apparently  opposite  effects,  they  both  agree  in  ulti- 
mately paralysing  the  inhibitory  function  of  the  vagus. 

Muscarine,  as  I  have  already  mentioned,  arrests  the  move- 
ments of  the  heart;  but,  if  the  circulation  be  carried  on,  this 
arrest  is  only  temporary,  and  is  succeeded  by  a  period,  first  of 
slowness,  then  of  irregularity,  and  then  of  return  to  the  normal ; 
the  stage  of  irritation  of  the  inhibitory  centre  by  the  muscarine 
gradually  passing  into  that  of  complete  paralysis.  During  the 
time  when  the  pulse  is  still  slow  in  consequence  of  the  action  of 
muscarine,  irritation  of  the  vagus  itself  has  no  power  to  arrest 
it,  or  even  to  increase  the  slowness,  while  at  that  very  time 
irritation  of  the  accelerating  nerves  quickens  its  pulsations  just 
as  it  would  those  of  a  normal  heart.2  When  the  accelerating 
nerves  are  thus  irritated,  there  is  often  not  only  an  increase  in 
the  number  but  also  in  the  size  of  the  pulsations,  very  much  as 
Gaskell  has  observed  under  other  conditions  from  irritation  of 
the  vagus  in  the  frog.  This  action  is  only  to  be  observed  in 
moderate  conditions  of  poisoning.  When  the  poisoning  is  very 
profound,  irritation  of  the  accelerating  nerves  has  a  very  peculiar 

1  In  the  frog  the  accelerating  nerves  appear  to  run  along  with  the  inhibitory 
fibres  in  the  vagus  trunk.  In  warm-blooded  animals  these  fibres  run  in  separate 
nerves  which  pass  out  from  the  spinal  cord  along  the  vertebral  artery  and  reach 
the  heart  through  the  sympathetic  system.  Although  the  chief  accelerating  fibres 
pass  in  these  nerves,  some  are  also  contained  in  the  vagus  trunk,  both  in  warm- 
blooded animals  and  in  frogs.  In  animals  poisoned  by  atropine,  irritation  of  the 
vagus  usually  produces  acceleration  of  the  pulse. 

,     "  Weinzweig.    From  experiments  in  Yon  Basch's  laboratory.    Archiv  f.  Amt. 
U.  Phys.,  Phys.  Abt.,  1882,  p.  527. 


812  PHAKMACOLOGY  AND  THEEAPEUTICS.      [sect.  i. 

effect,  sometimes  producing  so-called  staircases,  and  sometimes 
a  prolonged  condition  of  still-stand,  half  in  systole  and  half  in 
diastole. 

A  marked  difference  is  seen  between  the  action  of  the 
accelerating  nerves  and  the  inhibitory  fibres  of  the  vagus, 
as  the  inhibitory  action  follows  very  shortly  after  the  irritation 
of  the  vagus,  and  usually  ceases  very  shortly  after  the  irritation 
is  removed,  whereas  that  of  the  accelerating  nerves  does  not 
occur  until  some  time  after  the  irritation  has  been  applied,  and 
often  lasts  a  good  while  after  the  irritation  has  been  removed. 
The  two  sets  of  fibres  also  appear  to  influence  a  different  period 
of  the  heart's  action,  the  inhibitory  affecting  the  pause  or  relaxa- 
tion, wbile  the  accelerating  affect  the  systole  or  contraction.  This 
condition  renders  it  not  improbable  that  we  may  have  to  do  here 
with  an  action  of  these  nerves  on  two  different  parts  of  the  heart 
— the  ganglia  and  the  cardiac  muscle. 

It  is  quite  clear  that,  in  order  to  get  any  satisfactory  ex- 
planation of  these  phenomena,  we  must  take  into  consideration 
not  only  the  rhythmical  actions  going  on  in  the  cardiac  ganglia 
and  those  in  the  cardiac  muscle  separately,  but  also  the  relation 
to  one  another  of  these  rhythms  both  as  regards  their  energy 
and  rate. 


Theories  regarding  the  Mode  of  Action  of  Drugs  upon 

the  Heart 

In  order  to  explain  the  effects  of  various  poisons  upon  the 
heart,  a  hypothetical  view  of  its  nervous  system  has  been  proposed 
by  Professor  Schmiedeberg,1  and  I  have  endeavoured  to  represent 
this  in  the  accompanying  diagram  (Fig.  106)  .2  It  consists  of  a 
ganglion,  m,  which  keeps  up  a  rhythmical  contraction  of  those 
muscular  fibres  of  the  heart  to  which  it  is  connected  by  the  fine 
nervous  filaments,  e.  This  ganglion  is  connected  by  an  inter- 
mediate apparatus  with  an  inhibitory  ganglion,  i,  which  can 
retard  or  stop  the  muscular  contractions  which  m  produces ;  and 
by  another  apparatus,  c,  with  another  ganglion,  Q,  which  quickens 
the  contractions,  i  is  connected  by  an  intermediate  apparatus, 
a  with  the  retarding  fibres,  v,  of  the  vagus,  and  d  with  the 
quickening  nerve,  s,  of  the  heart. 

This  schema  has  been  adopted  by  Professor  Harnack.3 
'It  has  been  supposed  that  motor  ganglia  are  present  because 
the  apex  of  the  heart  of  the  frog,  which  contains  no  ganglia,  will 


1  Schmiedeberg,  Ltulwig's  Arbeiten,  1870,  p.  41. 

2  'Experimental  Investigations  of  the  Action  of  Medicines,'  Lauder  Brunton, 
British  Medical  Journal,  December  16,  1871. 

•  Pharmakologische  Thatsachen  fiir  die  Physiologic  des  Froschlmsem,  Halle, 
1881. 


chap,  xi.]    ACTION  OP  DEUGS  ON  THE  CIRCULATION.     813 

not  contract  rhythmically  if  left  entirely  to  itself,  whereas  the 
ventricle  containing  ganglia  will  do  so.1 

It  has  been  supposed  that  inhibitory  ganglia  are  present, 
because  when  a  little  muscarine  is  applied  to  the  heart  it  causes 


Fig.  106.— Diagram  of  the  hypothetical  nervous  apparatus  in  the  heart,  m,  motor  ganglion,  r,  in- 
hibitory ganglion.  Q,  quickening  ganglion,  v,  inhibitory  fibres ;  and  s,  quickening  fibres  from 
the  head,  a,  a',  b,  and  c,  intermediate  apparatus,  e,  fibres  passing  from  the  motor  ganglia,  m, 
to  the  muscular  substance,  v.  [For  simplicity's  sake  only  one  set  of  motor  ganglia  has  been 
represented,  but  other  similar  ones  are  supposed  to  be  present  in  other  parts  of  the  heart,  and 
so  connected  with  this  set  that  they  all  work  in  unison.  Zt  must  he  remembered  that  this 
diagram  is  purely  hypothetical :  but  if  this  be  carefully  borne  in  mind,  the  sketch  will  be  found 
of  service  in  remembering  and  comparing  the  action  of  different  poisons  on  the  heart.] 

it  to  stop  in  diastole.  This  effect  is  not  developed  all  at  once, 
but  goes  on  gradually  increasing,  and  its  action  in  this  respect 
seems  rather  to  point  to  its  effect  upon  ganglia  than  upon  nerve 
fibres. 

It  has  been  supposed  that  the  vagus  acts  through  tbis  in- 
hibitory ganglion  or  ganglia  because  irritation  of  the  vagus 
arrests  the  heart  in  diastole,  just  as  muscarine  does ;  but  it  has 
been  supposed  to  be  connected  by  some  intermediate  apparatus 
with  the  inhibitory  ganglia,  because  we  find  that  when  nicotine 
is  applied  to  the  heart  irritation  of  the  vagus  will  no  longer 
arrest  its  beats,  but  that  irritation  of  the  venous  sinus,  in  which 
the  inhibitory  ganglia  have  been  supposed  to  be  situated,  will  do 
so  at  once. 

It  has  been  supposed  that  the  inhibitory  apparatus,  I,  was  connected  by 
an  intermediate  structure  with  the  motor  ganglia,  m,  becausephysottigmine 
does  not  produce  the  extraordinary  still-stand  which  muscarine  does,  but  it 
counteracts  to  a  certain  extent  the  effects  of  atropine  which  muscarine  does 
not.  Physostigmine  in  small  doses  increases  the  excitability  of  the  vagus,  so 
that  a  slight  stimulus  applied  to  that  nerve,  so  slight  that  it  would  under  ordi- 
nary circumstances  be  insufficient  to  affect  the  heart,  will  stop  it.s  In  large 
doses  it  appears  to  paralyse  the  vagus.  The  difference  of  action  between 
muscarine  and  physostigmine  seemed  to  show  that  they  acted  on  different 
nerve  structures ;  while  the  mutual  power  of  atropine  and  physostigmine 

*  The  recent  researches  of  Gaskell  have  shown  that  the  musoular  fibre  of  the 
heart  of  the  tortoise  will  contract,  although  it  contains  no  ganglia.  The  question  of 
muscular  rhythm  independent  of  ganglia  will  be  considered  further  on. 

8  Arnstein  and  Sustsohinsky,  Wilrzburger  physiol.  JIntemcch.  iii. 


314  PHAEMACOLOGY  AND  THERAPEUTICS,     [sect.  i. 

to  neutralise  each  other's  effects  within  certain  limits  indicated  that  atropine 
acted  on  the  same  nerve  structure  as  physostigmine  and  consequently  on  a 
different  one  from  muscarine.1 

When  atropine  is  applied  to. the  heart  it  completely  removes 
the  effect  of  muscarine  and  totally  prevents  any  arrest  being 
produced  either  by  irritation  of  the  vagus  or  the  venous  sinus. 
It  has  therefore  been  supposed  that  nicotine  acts  upon  the  in- 
termediate apparatus,  a,  but  that  atropine  acts  either  upon  i  or 
upon  b. 

The  reason  why  it  has  been  supposed  that  quickening 
ganglia  exist  is,  that  when  irritation  is  applied  to  the  vagus 
after  its  inhibitory  power  has  been  destroyed  by  the  administra- 
tion of  nicotine  or  atropine  it  no  longer  produces  slowness  or 
still-stand  of  the  heart,  but,  on  the  contrary,  quickens  its  pulsar 
tions.  But  the  quickening  does  not  take  place  immediately,  it 
only  occurs  some  timje  after  the  application  of  the  stimulus.  If 
it  is  applied  only  for  a  short  time,  no  quickening  may  take  place 
until  after  its  removal,  but  the  quickening  once  induced  remains 
for  a  considerable  time.  This  seems  to  indicate  that  the  stimulus 
does  not  act  through  nerve-fibres,  as  these  would  conduct  the 
stimulus  directly  to  the  muscle,  but  rather  through,  some 
ganglionic  apparatus.  It  has  been  supposed  that  this  apparatus 
is  not  identical  with  the  motor  ganglia  themselves,  because  if 
the  heart  is  irritated  directly,  its  pulsations  at  once  become 
quickened,  and  the  quickening  does  not  last  long  after  the 
irritation  is  removed. 

It  is  evident,  however,  that  though  this  hypothetical  schema 
allows  us  to  explain  in  a  fairly  satisfactory  manner  the  action  of 
many  drugs,  yet  it  can  only  be  looked  upon  in  the  same  light  as 
the  hypothesis  of  cycles  and  epicycles  in  astronomy,  which  was 
useful  for  a  time,  and  enabled  astronomers  not  only  to  recollect 
but  to  predict  facts.  Its  use  was  only  temporary,  and  the  hypo- 
thesis just  at  the  time  of  its  greatest  complication  gave  place  to 
one  of  the  greatest  simplicity. 

It  is  probable,  indeed  almost  certain,  that  the  same  thing 
will  occur  in  regard  to  the  action  of  drugs  upon  the  heart,  and 
that  the  whole  complication  of  motor  ganglia,  inhibitory  ganglia, 
accelerating  ganglia,  vagus  endings,  and  intermediate  fibres, 
may  resolve  themselves  simply  into  a  question  of  the  mutual 
relationships- between  the  rate  of  rhythm  and  rapidity  of  con- 
duction in  the  muscular  fibres,  nervous  ganglia,  and  nerve-fibrea 
respectively.  Schmiedeberg's  hypothetical  schema  has  been 
most  useful  for  several  years,  but  facts  which  it  will  not  explain 
are  beginning  to  accumulate,  and  we  must  look  in  another 
direction  for  their  explanation.  The  whole  question  of  the  action 
of  drugs  upon  the  heart  is  far  from  being  completely  solved, 

■  Lauder  Brunton,  op.  cit. 


chap,  xi.]    ACTION  OP  DRUGS  ON  THE  CIRCULATION.     815 

but  I  shall  try,  if  possible,  to  indicate  the  direction  in  which 
pharmacology  is  at  present  looking  for  an  explanation. 

±  or  this  purpose  it  will  be  necessary  to  go  still  more  fully  into 
the  physiology  of  the  heart  than  we  have  already  done 

Before  doing  so,  however,  it  may  be  advantageous  to  put  in 


Inhibitor;  ganglia., 
Motor  ganglia 


Cardiao  muscle  .... 


Pig.  107.— Diagram  of  the  heart  and  vessels  to  illustrate  the  aotion  of  drugs  on  the  various  paHs  of 
the  circulatory  apparatus  as  given  in  the  following  tallies,     a,  indicates  accelerating  ganglia. 

a  tabular  form  the  action  of  the  most  important  drugs  on  the 
various  parts  of  the  circulatory  apparatus,  according  to  the 
prevalent  opinions  at  present.1 


'  In  drawing  up  this  table  [see  pp.  316-319]  I  have  been  greatly  aided  by  the 
admirable  paper  of  Professor  Boehm,  read  before  the  International  Congress  in 
London  in  1881. 


816 


PHAEMACOLOGY  AND  THEEAPEUTICS.     [sect. 


Cardiac  Muscle. 


STIMULATED   BY. 


[Stimulation  is  shown  by  increased 
energy  of  contraction,  the  rate  of  pulsa- 
tion remaining  the  same  or  becoming 
slower.] 
So-called    car-  /Digitalin. 


diac  poisons 
With  a  larger 
dose  the  stage 
of  stimulation 
is    followed  by, 

— e    c 

staltic  action, 
and  final  ar- 
rest in  sys- 
tole.1 


Digitale'in. 

Digitoxin. 

Erythrophloeum. 

Hellebore'in. 

Nerein  (Oleander). 

Scillam. 

Antiarin. 

Strophanthus. 

Thevetine. 

,Theveresine. 

Yeratrine. 

Barium  salts. 

Caffeine  (produces  rigor). 


These  do  not' 
cause  peristal- 
sis, nor  arrest 
in  systole. 
They  excite  the 
heart  to  pulsate 
rhythmically, 
after  it  has 
been  made  to 
stand  com- 
pletely still  in 
diastole  by  the 
application  of 
muscarine. 


Potassium  salts, 
Copper  double  salts. 
Zinc  double  salts. 


In  small 


DEPBESSED   OE  PARALYSED   BY. 

[Depression  is  shown  by  diminished 
energy  of  contraction  with  final  stoppage 
in  diastole.  The  cardiac  muscle  is  shown 
to  be  paralysed  by  no  longer  contracting 
on  stimulation,  either  mechanical  or 
electrical.] 

Salicylic  acid.  1 

Potassium  salts.  In  large 

Copper  double  salts,     doses. 

Zinc  double  salts.     , 

Quinine  (?). 

Saponin  (removes  the  systolic  still- 
stand  produced  by  digitalin). 

Apomorphine. 

Emetine. 

Muscarine. 

Pilocarpine. 

Veratrum  viride  (veratroidine  and 
jervine). 


Guanidine. 

Physostigmine. 

Camphor. 

Monobromocamphor. 

Eorneol. 

Arnica-camphor. 

Anilin  sulphate. 

Cumarine. 


Motor 


[Stimulation  is  shown  by  increased 
rapidity  and  energy  of  contraction,  which 
is  observed,  not  only  when  the  drug  is 
given  to  an  animal,  but  when  it  is 
applied  directly  to  the  heart.] 

.Alcohol. 
Ether. 
Chloroform. 
Chloral. 

Anaesthetics  generally. 
Cyanogen. 
Arsenic. 
Quinine. 
Guanidine. 


Alcohol 
group. 


Ganglia. 

[Depression  is  evidenced  by  slower  and 
less  powerful  pulsations,  with  final  stop- 
page in  diastole.  This  stoppage  is  shown 
to  be  due  to  the  action  of  the  drug  on 
the  ganglia,  and  not  on  the  cardiac 
musole,  by  the  heart  contracting  on  sti- 
mulation, either  mechanical  or  electrical, 
after  spontaneous  pulsation  has  ceased.] 

Ergot. 

Antimony  (?).     The  stoppage  in 
diastole  caused  by  antimony  is 
converted     into     stoppage     in 
systole  by  helleboreiin. 
Hydrocyanic  acid. 
The  same  drugs  that  stimulate  in 
small  doses  depress  when  used  in  larger 
quantity,  or  at  a  later  stage  of  their 
action. 


1  This  stoppage  of  the  heart  in  systole  occurs  in  frogs,  but  in  higher  animals 
the  heart  may  stop  in  diastole. 


chap,  xi.]    ACTION  OP  DRUGS  ON  THE  CIRCULATION.    317 


Inhibitory  Ganglia. 


STIMULATED  BY. 

[Stimulation  is  shown  by  the  direct 
application  of  the  drug  to  the  heart, 
stoppingits  spontaneous  pulsations  com- 
pletely, while  it  still  contracts  on  the 
application  of  a  stimulus  either  mechan- 
ical or  electrical.] 

Muscarine. 

Pilocarpine. 


DEPRESSED   OB   PAEA1YSED   BY. 

[Depression  or  paralysis  is  shown  by 
stimulation,  not  only  of  the  vagus  trunk, 
but  of  the  venous  sinus  itself,  having 
lost  all  power  to  slow  or  stop  the  heart ; 
and  by  the  direct  application  of  musca- 
rine also  having  no  action.] 

Atropine. 

Hyoscyamine. 

Daturine. 

Duboisine. 

Cocaine. 

Sparteine. 

Saponin. 


Vagus-ends  in  the  Heart. 


'  [Stimulation  either  of  the  ends  of  the 
vagus  in  the  heart  or  of  the  inhibitory 
ganglia  is  shown  by  the  injection  of  a 
drug  rendering  the  pulse  slow  after 
previous  division  of  the  trunks  of  the 
vagi.] 

Physostigmine  (7). 

It  is  said  to  render  the  peripheral 
ends  of  the  vagus  more  sensitive, 
so  that  a  slighter  stimulus  will 
stop  the  heart  applied  to  the 
trunk. 


[Depression  or  paralysis  is  shown  by 
irritation  of  the  vagus  trunk  no  longer 
producing  slowness  or  stoppage  of  the 
pulsations  of  the  heart,  while  the  appli- 
cation of  muscarine,  or  irritation  of  the 
venous  sinus,  will  still  cause  stoppage.] 

Nicotine. 

Saponin. 

Lobeline. 

Curare,  methyl-strychnine,  and 
probably  large  doses  of  all  drugs 
which  have  the  power  of  paralys- 
ing the  ends  of  motor  nerves. 


Vagus  Centre. 


[Stimulation  is  evidenced  by  slowing 
of  the  pulse,  disappearing  on  section  of 
the  vagi.] 

Increased  blood-pressure. 
Venous  blood. 
Ammonia  (in  frogs). 
Carbonic  oxide. 
Chloroform. 
Chloral  hydrate. 
Butyl-chloral. 
Belladonna  (atropine). 
Hyoscyamus  (hyoscyamine). 
Stramonium  (daturine). 
Aconite  (acomtine). 
Veratrum  viride  (veratroidine). 
Tobacco  (nicotine). 
Digitalis  (digitalin). 
Hydrocyanic  acid. 


[Depression  is  evidenced  by  a  quick 
pulse,  which  is  not  rendered  slow  by  irri- 
tation of  sensory  nerves  which  usually 
produce  slowing  of  the  pulse,  e.g.  the 
central  end  of  one  vagus.] 

Diminished  blood-pressure  and 
substances  which  produce  it, 
e.g.  nitrite  of  amyl  and  other 
nitrites. 

Large  doses  of  such  substances  as 
stimulate  it  in  small  doses,  vide 
adjoining  list. 


318 


PHARMACOLOGY  AND  THERAPEUTICS,      [sect,  u 


Accelerating  Centre. 


STIMULATED   BY. 

[Stimulation  is  evidenced  by  the  injec- 
tion of  the  drug  after  previous  section  of 
the  vagi  rendering  the  pulse  still  more 
rapid  than  before.] 

{Venous  blood. 
Ammonia. 
Cicutoxine. 
Caffeihe. 
Delphinin. 
Picrotoxin. 


DEPRESSED    OB   PARALYSED   BY. 

[Little  or  nothing  is  known  about  the 
depression  of  the  accelerating  centres.] 

Saponin     paralyses     accelerating 
nerves. 


Capillaries. 


[Stimulation  is  shown  by  a  rise  in 
blood-pressure  which  remains  after  sec- 
tion of  the  spinal  cord  at  the  occiput, 
and  is  produced  by  the  injection  of  the 
drug  after  previous  division  of  the  cord. 
It  is  also  ascertained  by  the  rate  of  flow 
through  the  vessels  being  diminished  by 
the  drug  when  circulation  is  kept  up 
artificially  in  a  frog  whose  nerve-centres 
have  been  destroyed,  or  in  a  single  limb 
of  a  warm-blooded  animal.] 

Alkalies. 

Digitalis  and  its  allies. 

Barium  salts. 

Potassium  salts. 

Copper. 

Zinc,  &c. 


[Depression  is  shown  by  a  fall  of  blood- 
pressure  to  a  slight  extent,  even  after 
the  spinal  cord  has  been  divided,  and  by 
increased  rapidity  of  flow  when  artificial 
circulation  is  kept  up.] 

Acids. 
Nitrites. 
Quinine  (?) 


Vaso-motor  Nerves. 


[It  is  very  doubtful  whether  they  are 
stimulated  by  drugs,  and  at  any  rate  it 
is  very  difficult  to  ascertain  whether 
any  stimulation  which  may  occur  in  the 
arterioles  or  capillaries  is  in  the  termi- 
nations of  the  vaso-motor  nerves  or  in 
the  muscular  walls.] 


[Paralysis  is  shown  by  the  vessels  not 
contracting  on  stimulation  of  the  vaso- 
motor nerves,  while  they  still  contract 
on  direct  stimulation.  This  has  been 
chiefly  observed  in. the  vessels  of  the 
intestines  after  irritation  of  the  splanch- 
nic nerves.  The  effect  of  irritation  is 
ascertained  by  the  alterations  in  colour 
of  the  intestines,  and  also  by  the  altera- 
tionsin  the  general  blood-pressure  which 
occur  after  irritation,] 

Potassium  salts. 

Arsenic. 

Antimony. 

Mercury, 

Iron, 


chap.-xi.J    ACTION  OF  DEUGS  ON  THE  CIRCULATION.     319 


Vaso-motor  Centre. 


STIMULATED  BY. 

[Stimulation  is  evidenced  by  a  rise  of 
blood-pressure,  which  disappears  on  sec- 
tion of  the  spinal  cord  below  the  medulla, 
and  doeB  not  occur  if  the  cord  has  been 
divided  before  the  injection  of  the  drug. 
This  rule  is  only  partially  true,  because 
subsidiary  vaso-motor  centres  occur  is 
the  spinal  cord  itself.] 

Salts  of  ammonium.' 
Potassium  (?) 
Caffeine  (?) 
Cicutoxine. 
Delphinin. 
Picrotoxin. 
Strychnine. 
Sanguinaria. 
Ergot  (cornutine). 
Thebaine. 
Veratrine. 

Belladonna  (atropine). 
Hyoscyamus  (hyoscyamine). 
Stramonium  (daturine). 
Carbolic  acid  (?) 
Salicylic  acid. 
Turpentine. 

Camphor  (rhythmically). 
Oil  of  rosemary,  and  other  ethereal 
oils. 


-Convulsants. 


Digitalin  (?) 
Ether  (?) 
Chloroform  (?) 
Chloral  (?) 
Butyl-chloral  (?) 


Stimulant  action 
doubtful;  slight, 
and  transient. 


DEPRESSED   OR   PARALYSED   BY. 

[Depression  is  evidenced  by  fall  in  the 
blood-pressure  not  depending  on  failure 
of  the  heart's  action.  It  is  also  shown 
by  the  absence  of  rise  in  blood-pressure 
on  irritation  of  a  sensory  nerve.] 

Carbolic  acid. 

Lobelia. 

Large  doses  of  most  drugs,  such  as 
those  in  the  adjoining  column, 
which  stimulate  in  small  doses. 

Depression  usually  occurs  in  the 
later  stages  of  the  action  of  such 
drugs  even  in  moderate  doses. 


Stannius's  Experiments. 


Some  of  the  most  important  experiments  relating  to  the  action  of  the 
various  cavities  of  the  frog's  heart  were  first  performed  by  Stannius,  and  bear 
his.  name. 

"When  the  venous  sinus  is  separated  from  the  rest  of  the  heart  by  cutting  it 
off  with  a  sharp  razor,  or  by  a  ligature  tightly  drawn  round  it  at  its  junction 


f& 


9 


Ca»W 


few* 


Fig.  108.— «,  diagram  of  frog's  heart  ligatured  at  the  junction  of  the  venous  sinus  with  the  auricles. 
The  vena?  caT«  and  sinus  are  represented  with  a  crenated  outline  resembling  the  tracing  which 
their  beats  might  give  if  recorded  on  a  revolving  cylinder.  The  auricle  and  ventricle  being 
motionless  would  only  trace  a  straight  line  if  connected  with  a  recording  apparatus.  Their  out- 
.  line  is  therefore  represented  by  a  straight  line,  b,  diagram  of  a  frog's  heart  in  which  sections 
have  been  made  at  the  junction  of  the  sinus  with  the  auricles,  and  at  the  auriculo-ventricu  ar 
groove.  The  sinus  and  ventricles  pulsate,  whilst  the  auricles  remain  motionless.  The  beats  of 
the  ventricle  should  have  been  represented  as  slower  than  those  of  the  auricle,  as  in  /,  Fig.  109. 
c,  the  same  as  6,  but  with  the  parts  of  the  heart  separated  by  ligature  instead  of  section. 

with  the  auricle,  it  continues  to  pulsate,  but  the  auricle  and  ventricle  stand 
perfectly  still  (a,  Fig.  108).  If  now  the  auricle  is  separated  from  the  ventricle 


820  PHARMACOLOGY  AND  THERAPEUTICS,      [sect.  r. 

by  another  out  (6,  Fig.  108),  or  another  ligature  be  applied  (c,  Fig.  108),  at  the 
auriculb-ventrioular  groove,  the  auricles  remain  motionless,  but  the  ventricle 
begins  to  beat,  so  that  the  venous  sinus  and  ventricle  are  both  pulsating,  while 
the  auricles  are  at  rest.  The  venous  sinus  and  the  ventricle,  however,  ho 
longer  beat  with  the  same  rhythm,  and  the  rate  of  the  ventricular  beatB  is 
usually  much  slower  (/,  Fig.  109).  In  this  remarkable  experiment  the  com- 
plete  stoppage  of  the  auricles  and  ventricle  which  follows  the  removal  of  the 
venous  sinus  has  been  supposed  to  show  that  the  motor  centres  for  the  entire 
heart  reside  in  the  sinus,  and  that  from  them  the  motor  impulses  originate 
which  keep  up  the  rhythmical  pulsations  of  the  organ.  But  the  fact  that  the 
ventricles  begin  to  pulsate  on  their  own  account  when  separated  by  another 
cut  from  the  auricle  seems  to  show  that  they  also  contain  motor  centres. 
The  hypothesis  has  therefore  been  advanced  that  both  venous  sinus  and 
ventricles  contain  mt>tor  centres,  while  the  auricles  contain  inhibitory  centres. 

So  long  as  the  auricles  are  in  connection  both  with  the  venous  sinus  and 
the  ventricle,  the  motor  centres  in  the  latter  two  cavities  are  supposed  to  be 
sufficiently  powerful  to  overcome  the  resistance  offered  by  the  inhibitory 
centres,  and  thus  the  cardiac  rhythm  is  maintained.  When  the  motor 
centres  of  the  sinus  are  removed,  the  inhibitory  centres  of  the  auricle  are 
supposed  to  be  so  powerful  as  to  keep  both  it  and  the  ventricle  in  a  state 
of  rest. 

"When  the  ventricle  is  separated  from  the  auricles  and  their  inhibitory  in- 
fluence removed,  it  again  begins  to  pulsate  rhythmically.  In  order  to  obtain 
a  clearer  idea  of  the  mechanism  of  the  heart,  many  variations  of  the  above 
fundamental  experiments  have  been  made. 

The  chief  results  of  these  are  the  following  : — 

First,  section  or  ligature  of  the  venae  cavse  or  of  the  venous  sinus  at  any 
point  before  its  junction  with  the  ventricle  does  not  affect  the  action  of  the 
heart  (d,  Fig.  109). 

Second,  section  or  ligature  of  the  auricles  at  any  point  above  the  auriculo- 
ventricular  groove  arrests  the  movements  of  the  part  below  them,  while  that 
connected  with  the  venous  sinus  still  continues  to  pulsate  (e,  Fig.  109). 


Pig.  109.— d,  diagram  of  heart  with  ligature  round  the  venous  sinus,  e,  diagram  of  heart  with  liga- 
ture round  middle  of  auricles.  /,  diagram  of  heart  with  ligature  in  the  auriculo-ventricular 
groove.  The  pulsations  of  the  ventricle  are  much  slower  than  those  of  the  auricle  and  venous 
sinus.    This  is  indicated  by  the  larger  dentation  of  the  outline  of  the  ventricle. 

Third,  irritation  of  the  vagus  nerves  usually  produces  stoppage  of  the 
heart-beats. 

Fourth,  ligature  or  section  of  the  vagi  before  their  entrance  into  the  heart 
prevents  their  having  any  action  upon  it  when  they  are  stimulated. 

Fifth,  ligature  or  section  of  the  venous  sinus  or  auricles  prevents  any  action 
of  the  vagi  upon  the  part  of  the  heart  below  the  ligature  or  section. 

It  is  evident  that  section  or  ligature  of  the  heart  at  any  point  between  the 
junction  of  the  sinus  and  auricles  and  the  auriculo-ventricular  groove  has 
the  same  action  on  the  movements  of  the  part  below  it  as  irritation  of  the 
vagus. 

But  more  than  this ;  although,  as  we  have  seen,  the  motor  ganglia  of  the 
heart  appear  to  be  situated  chiefly  in  the  venous  sinus,  yet  irritation  of  tne 
sinus  produces  complete  still-stand  of  the  heart,  even  more  perfect  and 
prolonged  than  irritation  of  the  vagus.  Strong  stimulation  of  the  venous 
sinus  has  therefore  the  same  effect  as  its  removal.  The  parts  whose  motions 
have  been  arrested  by  section  or  by  irritation,  in  the  experiment  just  de 


chap,  xi]    ACTION  OF  DKUGS  ON  THE  CIBCULATION.     821 

scribed,  are  not  paralysed :  this  is  shown  by  the  effect  of  stimulation  upon 
them. 

"When  the  auricles  and  ventricle  are  standing  still  after  section  or  ligature 
of  the  venous  sinus,  irritation  of  the  outside  of  the  ventricle  with  a  needle  has 

9  »  k 

Fig.  110.— gr,  diagram  of  heart  stopped  by  a  ligature  at  the  junction  of  the  sinus  and  auricles.  The 
o  ill  side  of  the  ventricle  is  irritated  by  a  needle,  and  the  even  outline  indicates  that  no  contraction 
occurs^  A,  diagram  similar  to  g,  but  with  the  inside  of  the  ventricle  irritated  by  a  needle.  The 
projections  on  the  outline  of  the  heart  indicate  that  one  contraction  of  the  ventricle  and  three 
or  four  of  the  auricles  occur.  *,  diagram  similar  to  g  and  A,  but  with  the  outside  of  the  auricle 
stimulated  by  a  needle.  The  projections  indicate  that  one  contraction  of  the  auricle  and  one  of 
the  ventricle  occur. 

no  action  (gr,  Pig.  110) ;  but  if  its  interior  be  irritated  by  a  needle  (h,  Fig.  110) 
the  auricle  contracts  first,  then  the  ventricle,  then  the  auricle  again  two  or 
three  times,  but  the  ventricle  does  not  respond.  When  the  auricle  is  irritated 
by  a  needle  applied  to  its  outside,  contraction  both  of  the  auricle  and  ventricle 
ensues  (k,  Pig.  110).  When  the  auriculo-ventricular  groove  is  irritated  by  a 
needle  there  are  usually  eight  or  ten  contractions  in  response.  When  the 
outside  of  the  auricle  is  irritated  by  an  interrupted  current,  numerous  and 
rhythmical  contractions  both  of  auricle  and  ventricle  ensue. 

To  sum  up  these  results  shortly,  we  find  that  either  removal  of  the  normal 
stimuli  which  pass  in  the  direction  of  the  circulation  from  the  venous  sinus 
to  the  auricle  and  then  to  the  ventricle,  or  abnormally  strong  stimulation, 
produces  arrest  of  the  rhythmical  movements  of  the  heart,  or,  as  it  is 
usually  termed,  inhibition. 

Some  exceedingly  instructive  experiments  have  been  made 
by  Gaskell,  who,  instead  of  separating  the  cavities  of  the  frog's 
heart  from  each  other  by  sections  or  by  a  ligature,  compresses 
more  or  less  completely  the  point  of  junction,  so  as  to  impede  or 
block  (as  it  is  termed)  to  a  certain  extent  the  transmission  of 
stimuli  from  one  cavity  to  another  (Fig.  111). 


1 1  r  tt  t  m  ** 


Fig.  111. — Diagram  to  illustrate  Gaskell's  experiment.    At  a  the  jaws  of  the  clamp  hold  the  heart 
without  compressing  it,  and  each  beat  of  the  auricle  is  succeeded  by  one  of  the  ventricle  as 

shown  by  the  figure  -I .     At  6  the  heart  is  compressed,  and  its  rhythm  disturbed,  so  that  one 
beat  of  the  ventricle  only  occurs  for  several  of  the  auricles. 

He  does  this  by  a  clamp  the  two  limbs  of  which  are  placed  one  on  each 
side  of  the  heart.  By  means  of  a  micrometer  screw  their  edges  can  be 
approximated  so  as  either  simply  to  hold  the  heart  without  pressure  or  to 
compress  it  to  any  desired  extent.  When  the  clamp  is  placed  in  the  auriculo- 
ventricular  groove,  the  beats  of  the  auricles  and  ventricle  are  registered 
separately  by  levers  above  and  below  the  clamp  with  which  the  auricles  and 
ventricle  are  connected  by  threads. 

When  the  heart  is  simply  held  by  the  clamp  without  compression,  each 
beat  of  the  auricle  is  followed  by  one  of  the  ventricle ;  but  when  the  auriculo- 
ventricular  groove  is  compressed  the  transmission  of  stimuli  from  the  auricle 

Y 


322  PHAEMACOLOGY  AND  THEEAPEUTICS.      [sect.  x. 

to  the  ventricle  appears  to  be  blocked  in  somewhat  the  same  way  as  it  is  by 
compression  in  the  contractile  tissue  of  medusae,  and  one  beat  of  the  ventricle 
then  occurs  with  every  second,  third,  fourth,  or  more  auricular  beats,  accord- 
ing to  the  degree  of  pressure,  and  if  this  be  very  great  the  ventricle  will  cease 
beating  altogether. 

The  beats  of  the  ventricle  are  shown  in  this  experiment  to  be  diminished 
or  arrested  by  hindering  or  blocking  the  transmission  of  stimuli  to  it  from 
the  venous  sinus  and  auricle.  But,  as  one  might  expect,  a  diminution  of 
the  stimuli  themselves  has  a  similar  effect  as  a  block  to  their  passage. 
Thus,  if  the  auricle  and  sinus  are  heated,  but  not  the  ventricle,  their  rhythm 
is  markedly  quickened,  but  the  ventricle  now  beats  only  once  for  every  two 
or  even  more  pulsations  of  the  auricle,  the  heat  appearing  to  render  the 
impulses  proceeding  from  the  auricle  and  sinus  more  rapid  but  more  weak, 
If  the  ventricle  be  heated  as  well,  it  will  respond  to  each  beat  of  the  auricle, 
so  that  the  whole  heart  beats  more  quickly,  but  if  the  ventricle  alone  be 
heated  its  rhythm  remains  unchanged. 

Experiments  which  are  likely  to  give  useful  information  in  regard  to  the 
action  of  various  drugs  on  the  cardiac  muscle  and  nerves  have  been  made  by 
Gaskell  by  the  aid  of  the  clamp  already  described. 


General  Considerations  regarding  the  Heart. 

In  ascidians  the  heart  is  a  mere  contractile  sac  open  at  both  ends,  and 
drives  the  fluid  alternately  in  opposite  directions.  In  snails  it  is  a  simple 
sac  of  protoplasm  without  differentiated  nerves,  but  it  drives  the  nutritive 
fluid  in  one  direction.  In  the  amphioxus  there  is  no  special  heart,  but  only 
numerous  contractile  dilatations  in  the  chief  blood-vessels.  In  fishes  the 
heart  may  be  said  to  consist  of  three  parts — the  auricle,  ventricle,  and 
arterial  bulb.  The  heart  of  the  frog  has  already  been  described,  and  that  of 
mammals  requires  no  description. 

Even  the  complicated  mammalian  heart  may  be  regarded  as  a  special 
development  of  the  simple  contractile  tube  endowed  with  the  power  of 
peristaltic  contraction.  The  direction  in  which  the  contraction  occurs  is 
probably  determined  at  first  by  slight  differences  in  the  stimuli  to  which  the 
two  ends  of  the  tube  are  subjected,  and  the  direction  may  be  altered  by 
altering  the  stimulus.  Thus  in  the  heart  of  a  fish  the  contraction  usually 
proceeds  from  the  auricle  to  the  ventricle  and  bulb,  but  by  irritating  the  bulb 
the  direction  may  be  reversed  so  that  the  bulb  contracts  first  and  the  auricle 
last,  and  this  reversal  of  rhythm  may  persist  for  some  time.1  In  the  mam- 
malian heart  it  is  not  perhaps  so  easy  to  reverse  the  rhythm  by  simple 
irritation,  and  probably  some  interference  with  the  cardiac  nervous  system  is 
also  requisite,  but  by  introducing  tincture  of  opium  into  the  mammalian 
ventricle  the  rhythm  may  be  reversed  so  that  the  beats  of  the  auricle  follow 
instead  of  preceding  those  of  the  ventricle.8 

The  cause  of  rhythmical  pulsation  in  the  heart  is  usually  supposed  to 
be  the  motor  ganglia  which  it  contains.  Of  late  years  numerous  researches 
have  shown  that,  although  these  are  very  important  indeed,  yet  they  are  not 
to  be  looked  upon  as  the  exclusive  originators  of  the  rhythm.  The  heart  of 
the  snail,  although  it  consists  of  simple  protoplasm  without  nerves,  beats 
rhythmically,  and  when  a  ligature  is  tied  across  the  venous  sinus  in  the  frog 
the  venae  cavse  and  upper  part  of  the  sinus  continue  to  beat  although  they 
possess  no  special  ganglia,  while  the  rest  of  the  heart  remains  motionless 
although  it  contains  both  Eidder's  and  Retnak's  ganglia.  From  this  experi- 
ment one  would  be  inclined  at  first  to  say  that  the  Initiation  of  rhythm 
in  the  heart  is  due  to  the  muscular  tissue  of  the  venae  cavae  and  sinus, 


'  Gaskell,  Journ.  of  Physiol.,  vol.  iv.  p.  78. 
•  Ijudwig,  Physiologie,  1801,  vol.  ii.  p.  88. 


chap.  xi.].   ACTION  OF  DEUGS  ON  THE  CIRCULATION.     823 

and  might  be  inclined  to  regard  the  nervous  system  of  the  heart  as  an 
apparatus  for  merely  conducting  stimuli  from  the  sinus  to  the  auricles  and 
ventricle. 

Other  experiments  would  seem  to  deprive  the  nerves  even  of  this  function, 
for  Engelmann  l  and  Gaskell  have  shown  that  when  Bidder's  ganglia  are 
excised,  or  the  nerves  cut  through  as  they  traverse  the  auricles,  contractions 
still  pass  from  the  venous  sinus  to  the  ventricle,  and  continue  to  do  so  wh.eji 
the  nerves  have  not  only  been  divided  but  most  of  the  muscular  tissue  of  the 
auricle  has  been  cut  through  and  only  a  narrow  bridge  remains  behind. 
This  may  seem  to  prove  that  the  muscular  tissue  of  the  heart  conducts  the 
motor  stimuli  from  the  venous  sinus  to  the  auricle  and  ventricle,  which 
cause  them  to  contract,  and  may  appear  to  show  that  the  cardiac  nerves  are 
entirely  superfluous.  A  similar  mode  of  reasoning,  however,  would  lead  us 
to  say  that  the  ganglia  in  medusae  are  also  superfluous  because  the  contractile 
tissue  will  pulsate  rhythmically  after  they  have  been  cut  off,  if  it  be  placed  in 
acidulated  water. 

In  regard  to  the  conduction  of  stimuli,  the  fact  probably  is  that  under 
favourable  conditions  they  may  be  conveyed  by  the  muscular  tissue  alone 
from  the  sinus  to  the  ventricle,  but  under  ordinary  circumstances  they  are 
Conveyed  in  part,  at  least,  by  the  nerves. 

Ganglionic  tissue  is  more  sensitive  than  contractile  tissue,  and  the  stimuli 
which  act  on  the  ganglia  of  the  medusa,  under  the  conditions  in  which  it 
lives,  are  insufficient  to  excite  contractile  tissue.  When  the  ganglia  are 
paralysed  by  a  poison,  the  effect  is  the  same  as  if  they  were  cut  off,  and 
pulsation  is  arrested.  A  similar  condition  appears  to  occur  in  the  ventricle. 
The  muscular  tissue  forming  the  apex  of  the  frog's  heart  under  ordinary 
circumstances  will  not  beat  when  separated  from  the  rest  unless  an  extra 
stimulus  be  applied  to  it.  The  ventricle  containmg  Bidder's  ganglia  will 
usually  pulsate  rhythmically,  and  if  its  apex  be  dipped  in  a  solution  of  chloral 
no  effect  is  produced,  but  if  its  base  be  dipped  in  the  solution  so  that  the 
drug  acts  upon  the  ganglia,  the  pulsations  are  arrested  apparently  by  paralysis 
of  the  ganglia  (Harnack). 

We  may  consider,  then,  that  ganglia  are  more  susceptible  to  stimuli  than 
muscular  fibre,  and  have  the  function  of  making  it  pulsate  rhythmically 
when  it  otherwise  would  not. 

It  is  probable  also  that  they  serve  to  prevent  the  occurrence  of  blocks  at 
the  junction  between  the  different  cavities  of  the  heart  which  might  occur  if 
the  stimuli  were  transmitted  from  each  cavity  by  muscular  tissue  alone. 

When  the  heart  is  dying,  and  when  we  may  fairly  assume  that  its  nerves 
are  losing  their  functional  activity,  such  blocks  actually  take  place,  and  the 
ventricle  may  beat  only  once  for  every  two  or  three  or  more  beats  of  the 
auricle. 

The  cardiac  muscle  is  also  without  doubt  losing  its  functional  activity, 

yet  it  still  retains  it  to  such  an  extent  that  each  cavity  can  contract  power- 

•  fully.    The  same  thing  occurs  when  the  heart  is  poisoned  with  chloral,  iodal, 

or  other  members  of  the  same  group,  which,  as  already  mentioned,  paralyse 

the  cardiac  ganglia.2 

In  the  present  state  of  our  knowledge  it  is  difficult  to  make  any  absolute 
statement  regarding  the  function  of  the  cardiac  ganglia,  but  I  think  we 
may  fairly  assume  them  to  have  two  functions,  (1)  to  originate  rhythmical 
pulsations  in  the  heart  when  the  muscular  fibre  alone,  although  capable  of 
independent  rhythmical  pulsation,  would  not  pulsate  under  the  conditions 
which  may  be  present ;  (2)  to  transmit  and  receive  stimuli  from  one  cavity 
of  the  heart  to  the  other,  and  thus  prevent  the  occurrence  of  blocks  at  the 
junction  of  the  cavities  and  consequent  irregular  action  which  might  occur  if 
the  stimuli  were  transmitted  only  by  the  muscular  fibre. 

1  Pfluger's  Archiv,  xi.  p.  465. 

s  Harnack  and  Witkowski,  Arch.  f.  exp.  Path,  und  Pharm.,  vol.  xi.  p.  15, 

y  2 


324  PHARMACOLOGY  AND  THERAPEUTICS.      [sEcr.  r. 


Regulating  Action  of  the  Nervous  System. 

The  necessity  of  some  means  for  regulating  the  action  of  the  heart  ia 
accordance  with  the  wants  of  the  hody  is  obvious,  and  in  the  heart  we  find 
that  such  an  arrangement  exists  in  relation  both,  to  the  strength  and  rate  of 
pulsation. 

The  action  of  the  vasru8  upon  the  heart  has  long  been  a  matter  of  great 
dispute,  some  physiologists  holding  it  to  be  the  motor  nerve  of  the  heart, 
while  the  majority  regard  it  as  inhibitory.  The  reason  of  this  disagreement 
probably  is  that  the  right  and  left  vagi  have  frequently  different  effects  upon 
the  heart,  and  that  the  effects  even  of  the  same  vagus  may  vary  according  to 
the  state  of  nutrition  of  the  heart,  and  other  circumstances.  We  find  for 
example  in  rabbits  that  both  the  right  and  left  vagi  can  usually  slow  or  stop  the 
heart ;  but  sometimes  the  right  has  much  greater  power  in  this  respect  than  the 
left,  and  in  some  species  of  tortoise  the  left  vagus  has  no  inhibitory  action 
upon  the  heart  at  all,  and  in  the  frog  during  the  breeding  season  the  action 
of  the  vagi  is  very  uncertain.  The  cause  of  these  different  results  appears  to 
be  that  the  vagus  is  a  very  complex  nerve,  and  contains  accelerating  and 
strengthening  fibres  which  are  derived  from  the  sympathetic,  as  well  as  in- 
hibitory fibres  which  are  derived  from  the  spinal  accessory,  and  sensory  fibres 
which  belong  to  the  vagus  proper.  The  results  of  stimulating  the  vagus 
trunk  will  vary  according  to  the  proportion  of  these  different  fibres  which  it 
contains,  and  on  the  activity  of  each  kind  at  the  time  of  stimulation. 

A  number  of  experiments  made  by  Gaskell  on  the  heart  in  situ,  and  with 
the  clamping  apparatus  already  mentioned,  by  which  the  beats  of  the  auricle 
and  ventricle  may  be  simultaneously  recorded,  have  led  him  to  divide  the 
effects  produced  on  the  heart  by  irritation  of  the  vagi  into  two  types :  (a) 
affections  of  the  rate  of  rhythm ;  and  (6)  affections  of  the  strength  of  the 
contractions. 

The  effect  of  vagus  stimulation  on  the  heart  of  the  frog  may  be  divided 
into  five  classes. 

The  1st  class  is  that  which  occurs  with  the  heart  of  the  tortoise  or  frog 
in  situ  or  just  after  removal  from  the  body.  The  vagus  here  causes  arrest 
by  slowing:  the  rate  of  rhythm ;  and,  in  consequence,  the  first  beats  which 
occur  after  the  heart  again  begins  to  beat  are  slower  than  those  preceding 
the  stimulation. 

In  the  next  classes  the  vagus  produces  its  effect  by  weakening:  the  strength 
of  the  contractions  so  that  they  may  become  invisible  and  the  heart  remains 
still,  but  after  it  begins  to  beat  their  rate  is  as  quick  or  quicker  than  before. 


Pig.  112.— After  Gaskell.  Tracing  showing  the  action  of  tlie  vagus  on  the  heart.  Aur.  Indicatesthe 
auricular,  and  Vent,  the  ventncu'ar  tracing.  The  part  inc  lided  between  the  upright  lines  indi- 
cates the  time  during  which  the  vagus  was  stimulated.  C.  8  indicates  that  the  secondary  coil 
used  for  stimu'ation  was  eight  centimetres  distant  from  the  primarv.  The  part  of  the  tracing 
tothe  left  hand  shows  the  regu'ar  contractions  of  moderate  height  before  stimu'ation  During 
stimulation,  and  for  some  time  after,  the  movements  of  bith  auricle  and  ventricle  are  entirely 
arrested.  After  they  again  commence  tliev  are  small  at  first,  but  soon  acquire  a  much  greater 
amplitude  thau  before  the  application  of  the  stimulus. 

The  2nd  class  is  an  example  of  this.   In  it  irritation  of  the  nerve  produces 
complete  stoppage  of  both  auricles  and  ventricles.     This  is  followed  by  -con- 


chap,  xi.]    ACTION  OF  DRUGS  ON  THE  CIRCULATION.     825 

tractions,  which  are  at  first  so  small  as  to  be  hardly  visible,  but  quickly  grow 
larger  until  they  are  much  greater  than  the  normal ;  from  this  they  gradually 
decrease  to  the  normal  size  (Fig.  112). 

The  two  types  of  action  may  occur  together,  the  rhythm  becoming  slower 
and  the  contractions  smaller.    This  is  seen  in  Fig.  113. 


Flu.  118.— After  Gaskell.    Tracing  showing  diminished  amplitude  and  slowing  of  the  pulsations 
without  complete  stoppage,  during  irritation  of  the  va^us. 

The  3rd  class  is  where  irritation  produces  no  still- stand  of  either  auricles 
or  ventricles,  but  only  great  diminution  in  the  size  of  the  beats,  followed  by  a 
gradual  increase  and  subsequent  fall  similar  to  that  just  described.  This  curve 
is  like  the  first,  but  differs  from  it  in  the  absence  of  the  complete  arrest 
(Fig.  H4). 


Fig.  114. — After  Gaskell.  Tracing  showing  diminished  amplitude  of  contraction  without  slowing  op 
stoppage  during  irritation  of  vagus. 

The  4th  is  that  where  there  is  no  primary  diminution,  but  gradual  in- 
crease in  the  size  of  the  beats,  which  again  sink  to  the  normal  (Fig.  115). 

The  5th  is  where  irritation  of  the  vagus  does  not  stop  the  beats  of  the 
venous  sinus  but  causes  both  auricles  and  ventricle  to  stop. 

The  ordinary  inhibitory  effect  of  the  vagus  is  the  one  which  is  noticed 
best  in  well-nourished  hearts,  and  as  the  heart  becomes  more  exhausted,  and 
is  dying,  the  motor  power  of  the  vagus  becomes  more  and  more  pronounced. 
We  find  a  similar  occurrence  in  the  case  of  the  splanchnics,  which  lose  their 
inhibitory  power  as  the  intestine  dies.  Nervous  structures  as  a  rule  die 
sooner  than  muscle,  and  the  conclusion  is  not  unwarranted  that  the  dis- 
appearance of  the  inhibitory  action  of  the  vagus  is  due  to  a  gradual  death  of 
the  nervous  structures  upon  which  it  acts  in  the  healthy  heart,  while  its 
action  on  the  muscular  tissue,  which  has  a  more  prolonged  vitality,  still 
remains.  The  actual  increase,  indeed,  in  its  motor  action  we  may  attribute 
to  the  removal  of  nervous  interference. 

Hypothesis  regarding  the  Action  of  the  Vagus. — Nervous  inter- 
ference as  a  cause  of  inhibition  was  clearly  pointed  out  by  Bernard,  and  in 
the  case  of  the  heart  has  been  discussed  by  Banvier  with  his  usual  clearness. 

In  the  grey  matter  of  ifae  spinal  cord  there  is  ample  room  for  the  slowing 


326 


THAEMACOLOGY  AND  THEEAPEUTICS.      [sect.*. 


of  nervous  stimuli  "by  transmission  along  paths  of  different  lengths  (p.  169), 
more  especially  as  a  small  length  of  grey  matter  is  equivalent  to  a  great 
length  of  ordinary  nerve-fibre  (p.  162).  _  . 

In  the  heart  we  might  suppose  there  was  no  such  provision,  hut,  as  Kanvier 
points  out,  the  ganglion  cells  in  the  auricle  have  one  of  their  fibres  wound 


Pio.  IIS.— After  Gaskell.  Tracing  showing  increased  cardiac  contractions  from  irritation  of  the 
vagus.  [In  this  figure  the  upper  tracing  shows  the  ventricular  and  the  lower  the  auricular 
contractions.] 

spirally,  so  as  to  give  a  great  length  in  small  space,  and  thus  provide  for  retarda- 
tion and  interference  of  stimuli  (Pigs.  116,  117).  If  we  suppose  that  some  of 
the  nerve-fibres  contained  in  the  vagus  trunk  pass  through  these  spiral 
ganglia  while  others  pass  on  directly  to  the  heart,  we  can  understand  that 
the  different  rates  of  transmission  may  lead  to  interference  and  stoppage  *of 
pulsation.  Alterations  in  the  rate  of  transmission  along  the  spiral  fibre  may 
again  convert  interference  into  coincidence  of  waves  and  cause  acceleration 
and  increased  action.  If  these  spiral  fibres  are  affected  by  drugs  so  that  the 
rate  of  transmission  of  stimuli  along  them  is  altered,  we  can  understand  that 
the  interference  may  in  some  cases  be  increased,  in  others  diminished, 
and  that  an  increase  of  interference  may  readily  pass  into  the  opposite 
condition,  so  that  the  irritation  of  the  vagus  no  longer  produces  stoppage  but 
acceleration  of  the  heart,  such  as  actually  occurs  on  irritation  of  the  vagus 
after  its  inhibitory  power  has  been  paralysed  by  atropine. 

"Wo  can  understand  also  how  curare  and  the  large  class  of  drugs  which 
paralyse  the  motor  nerves  may  destroy  the  inhibitory  power  of  the  vagus. 

Inhibition  in  tbe  Heart. — But  it  is  probable  that  interference  between 
the  nervous  structures  is  not  the  sole  cause  of  inhibition  in  the  heart ;  we 
must  look  also  to  the  relationship  between  nervous  and  muscular  rhythms. 
Thus  distension  of  the  ventricle  frequently  diminishes  or  abolishes  the  action 
of  the  vagus,  the  stimulus  which  the  pressure  within  the  heart  exerts  on  the 
muscular  fibre  appearing  to  more  than  counteract  the  inhibitory  action  of 
the  nerve.  The  condition  of  the  muscular  fibre  too  is  probably  very  im- 
portant. Thus,  feeding  the  frog's  heart  with  a.  solution  containing  soda 
appears  to  paralyse  the  power  of  the  vagus,  which  is  again  restored  by 
potash.1     (Compare  their  action  on  the  cardiac  muscle,  p.  307.) 

It  is  indeed  to  an  action  on  the  muscle  rather  than  on  the  nerve  that  we 
must  probably  look  for  the  explanation  of  the  action  of  atropine.  For  the 
heart  in  snails,  though  apparently  destitute  of  both  ganglia  and  nerves,  is 
arrested  by  an  interrupted  current.    This  effect  is  prevented  by  atropine. 

1  lowit,  Pflilger's  Archiv,  xxv.  p.  466. 


chap,  xi.]    ACTION  OF  DRUGS  ON  THE  CIRCULATION. 


327 


Flo.  1 1 6.— rart  of  the  posterior  cardiac  nerve,  highly  magnified,  showing  the  ganglia.' 


Fig.  117.— Spiral  ganglion  cell  from  the  pneumogastric  of  the  frog.  This  figure  is  not  taken  from  the 
cells  in  the  cardiac  nerves,  as  in  them  the  connection  between  the  spiral  and  straight  fibres  has 
not  been  clearly  made  out,  but  it  is  probable  that  these  cells  hare  a  structure  similar  to  theone 
figured  ( Ran  vier,  op.  dt.  pp.  114- 120).  a  is  the  oell-bodv,  n  the  nucleus,  r  the  nucleolus,  d  nucleus 
of  the  capsule, /the  straight  fibre,  g  Henle's  sheath,  sp  spiral  fibre,  g'  its  game,  n'  nucleus  of 
Henle's  sheath." 


1  Ranvier,  Leq(m$  d'Anatomie  G&nfrale,  anii^e  1877-78,  p.  106, 
1  Ibid.,  p.  114. 


328  PHARMACOLOGY  AND  THERAPEUTICS,      [sect.  t. 

It  is  exceedingly  difficult,  or  perhaps  impossible,  with  the 
physiological  data  which  we  at  present  possess,  to  give  a  complete 
and  satisfactory  explanation  of  the  action  of  drugs  on  the  heart, 
but  it  is  evident  that  while  all  new  discoveries  tended  for  a  while 
to  render  our  ideas  regarding  the  cardiac  mechanism  more  and 
more  complicated,  our  increasing  knowledge  now  tends  to  render 
them  more  simple.  Before  long  we  may  hope  that  systematic 
investigations  into  the  action  of  drugs  on  the  excitability, 
rhythm,  and  power  to  conduct  stimuli  of  the  cardiac  muscle 
itself,  on  the  action  of  drugs  upcn  the  rhythm  of  the  ganglia, 
and  on  the  rate  of  transmission  by  the  nerves,  as  well  as  on  the 
mutual  relations  of  these  various  factors,  will  at  last  give  us  a 
clear  understanding  of  this  very  difficult  and  complicated  subject. 

Therapeutic  Uses  of  Drugs  acting  on  the  Circulation. 

The  drugs  which  act  on  the  circulation  have  been  divided 
according  to  their  action  into  stimulants,  tonics,  and  sedatives. 
Each  of  these  classes  has  been  further  subdivided  into  cardiac 
and  vascular,  according  as  its  members  act  on  the  heart  and 
vessels.  There  are  thus  six  subdivisions  in  all :  cardiac  stimu- 
lants, vascular  stimulants,  cardiac  tonics,  vascular  tonics,  cardiac 
sedatives,  and  vascular  sedatives. 


Cardiac  Stimulants. 

These  are  substances  which  rapidly  increase  the  force  and 
frequency  of  the  pulse  in  conditions  of  depression.  The  most 
important  are  ammonia,  and  alcohol  in  its  various  forms,  but 
there  are  also  other  substances  which  are  sometimes  useful. 

Heat. 

Liquor   ammoniaa.  B.P.  Aqua    Ether. 

ammoniae.    U.S. P.  Chloroform. 

Ammonium  carbonate.  Spirit  of  chloroform. 
Sal  volatile  (spiritus  ammonias     Spirit  of  ether. 

aromaticus).  Camphor. 

Alcohol.  Aromatic  volatile  oils. 

Brandy.  Oil  of  turpentine. 

Whisky.  Heat  and  counter-irritants  to 

Eau  de  Cologne.  the  prsecordium. 
Gin. 

Liqueurs. 
Strong  wines 
Atropine. 

Cardiac  stimulants  are  used  to  prevent  or  counteract  sudden 
failure  of  the  heart's  action  in  syncope  or  shock  due  to  mental 


chap,  xi.]    ACTION  OP  DKUGS  ON  THE  CIECULATION.     329 

emotion,  physical  injury,  or  poisoning  by  cardiac  depressants,  or 
by  the  bite  of  snakes,  or  when  the  action  of  the  heart  becomes 
much  depressed  in  the  course  of  fevers  or  other  diseases. 

Although  alcohol  after  its  absorption  stimulates  the  heart, 
yet  its  effect  on  the  heart  is  probably,  to  a  considerable  extent, 
due  to  a  reflex  action  on  it  through  the  nerves  of  the  mouth, 
gullet,  and  stomach.  Its  action  is  consequently  very  rapid,  and 
begins  before  there  has  been  time  for  much  of  it  to  be  absorbed. 
On  this  account,  however,  it  must  be  given  in  a  somewhat  con- 
centrated form,  and  if  much  dilated,  as  in  the  form  of  weak 
wine  or  beer,  which  has  little  or  no  local  action  and  can  exert 
no' reflex  action,  it  has  little  or  no  power  as  an  immediate  stimu- 
lant. When  given  in  disease  it  is  best  to  administer  it  in  small 
quantities  frequently,  and  the  rule  by  which  to  ascertain  whether 
it  is  doing  good  or  not  is :  Does  it  bring  the  circulation  more 
nearly  to  the  normal  or  not  ?  If  it  does  so,  it  is  beneficial ;  if  it 
does  not,  it  is  harmful.  Thus,  if  the  pulse  be  too  quick,  alcohol 
should  render  it  slower;  if  already  abnormally  slow,  alcohol 
should  make  it  quicker.  If  too  small,  soft,  and  compressible, 
alcohol  should  render  it  larger,  fuller,  and  more  resistant.  There 
are  other  rules  connected  with  the  effect  of  alcohol  on  other 
organs  which  also  regulate  its  use  in  disease,  but  these  will  be 
given  further  on. 

Ether  alone  or  mixed  with  alcohol  has  a  stimulant  action 
almost  more  rapid  than  alcohol  itself;  and  chloroform  in  small 
doses,  and  especially  when  mixed  with  alcohol,  is  also  a  powerful 
stimulant. 

Ammonia  has  not  only  a  reflex  action  on  the  heart  like  that 
of  alcohol,  but  has  powerful  stimulating  action  on  the  vaso-motor 
centre.  Its  action  when  applied  to  the  nose  in  syncope  has 
already  been  discussed.  In  cases  of  snake-bite  thirty  minims  of 
liquor  ammonise  have  been  injected  directly  into  the  veins.  The 
immediate  stimulating  effect  appears  to  be  beneficial,  although 
it  is  doubtful  whether  life  can  really  be  saved  by  this  means. 

Camphor  is  useful  as  a  cardiac  stimulant  in  febrile  conditions 
with  a  tendency  to  failure  of  the  circulation,  as  in  typhus  and 
typhoid  fevers ;  in  exanthemata,  when  the  rash  does  not  appear  ; 
in  asthenic  pneumonia,  and  in  the  typhoid  condition  depending 
on  other  diseases. 

Aromatic  volatile  oils  and  substances  containing  them  have 
also  been  used  in  similar  but  less  severe  conditions. 

One  of  the  most  powerful  of  all  cardiac  stimulants  is  heat,  and 
when  the  heart's  action  threatens  to  fail  it  may  be  frequently 
restored  by  warm  fluid  taken  into  the  stomach,  or  by  the  appli- 
cation of  an  indiarubber  bag l  or  bottle  filled  with  hot  water,  or 

1  An  indiarubber  bag  for  holding  hot  water  is  one  of  the  most  useful  things  an 
invalid  can  carry  about  with  him;  It  should  have  a  flannel  case  fastened  by  buttona 


880  PHAEMACOLOGY  AND   THEEAPEUTICS.      [sect.i, 

of  a  bag  filled  with  hot  sand  or  salt,  or  of  a  hot  poultice  to  the 
cardiac  region. 

It  must  be  remembered  that  the  high  temperature  of  the  body 
in  febrile  conditions  acts  as  a  cardiac  stimulant;  and  if  this 
stimulus'  be  removed  by  the  temperature  falling,  either  in  the 
natural  course  of  the  disease  or  in  consequence  of  the  adminis- 
tration of  antipyretics,  the  heart  may  fail  and  collapse,  and  death 
ensue,  unless  it  be  stimulated  either  by  medicines  or  by  the 
application  of  heat  to  the  cardiac  region. 


Vascular  Stimulants, 

These  are  substances  which  cause  dilatation  of  the  peripheral 
vessels,1  and  thus  render  the  flow  of  blood  through  them  more 
^jrapid.     The  most  important  are : 

Heat. 

Alcohol  in  its  various  forms.        Dover's  powder. 
Ether.  Acetate  of  ammonium. 

Nitrous  ether. 

Alcohol  and  ether,  by  stimulating  the  heart  at  the  same  time 
that  they  dilate  the  vessels,  render  the  peripheral  circulation 
very  vigorous.  From  its  stimulant  action  on  the  vaso-motor 
centre,  ammonia  is  less  useful  than  alcohol. 

Vascular  stimulants  are  useful  in  equalising  the  circulation 
and  preventing  congestion  of  internal  organs.  Thus,  from  expo- 
sure to  cold  generally  so  that  the  whole  surface  of  the  body  is 
chilled,  or  from  a  local  chill  due  to  a  draught,  or  to  the  combined 
action  of  cold  and  moisture,  as  in  wet  feet,  congestion  of  the 
respiratory  tract,  or  of  the  stomach,  intestines,  or  pelvic  organs 
may  occur.  This  frequently  evidences  itself  immediately  either 
by  rigors  or  by  localised  pain.  If  the  congestion  be  not  relieved 
inflammation  may  occur,  but  if  alcohol  be  taken  either  in  a  con- 
centrated form  or  diluted  with  boiling  water,  the  vessels  of  the 
surface  dilate,  a  warm  glow  is  felt  throughout  the  body,  the 
shivering  and  pains  disappear,  and  frequently  all  injurious  results 
of  the  chill  are  averted.  If  the  external  cold,  however,  is  very 
excessive,  and  the  exposure  is  to  be  prolonged,  alcohol  must  be 

go  that  it  can  easily  be  removed.  This  allows  the  heat  to  come  gradually  through 
■without  burning  the  skin.  For  a  small  gratuity  the  engine-driver  or  stoker  is 
usually  willing  to  fill  the  bag  with  hot  water,  and  the  bag  can  be  refilled  if  necessary 
at  each  station  where  there  is  a  sufficiently  long  stoppage.  This  is  sometimes  a 
very  great  boon  to  invalids  on  long  railway  journeys  such  as  they  are  often  com- 
pelled to  make  on  their  way  to  winter  health  resorts. 

1  From  this  definition  it  will  be  observed  that  while  cardiac  stimulants  increase 
the  functional  activity  of  the  heart,  vascular  stimulants  do  not  increase  the  con« 
tractile  power  of  the  vessels,  nor  the  aotivity  of  the  vaso-motor  centre,  but,  on  the 
contrary,  diminish  the  contraction  of  the  vessels. 


chap,  xi.]    ACTION  OF  DRUGS  ON  THE  CIRCULATION.     831 

used  with  great  care,  as  the  blood  becomes  much  more  rapidly 
cooled  when  the  cutaneous  vessels  are  dilated  than  when  they 
are  contracted ;  and  in  arctic  temperatures  a  person  is  much  more 
readily  frozen  to  death  after  the  free  use  of  alcohol.  Dover's 
powder  is  also  a  useful  vascular  stimulant,  though  less  powerful 
and  rapid  than  alcohol.  It  is  of  use  in  similar  cases  to  those 
just  described,  and  may  be  given  after  the  alcohol  to  supplement 
and  continue  its  action. 

Slighter  cases  of  chill  may  be  treated  by  Dover's  powder  alone, 
and  ten  grains  of  it  taken  at  night  will  often  cut  short  commencing 
coryza,  and  will  frequently  prevent  slight  increase  of  consolidation 
occurring  round  a  cavity  after  a  chill  in  persons  suffering  from 
phthisis.  Patients  suffering  from  this  disease  should  not  omit  to 
take  a  Dover's  powder  or  some  other  vascular  stimulant  at  night 
whenever  they  feel  as  if  they  had  caught  cold,  and  before  any 
local  mischief  can  be  detected. 

All  nitrites  dilate  the  blood-vessels  and  thus  act  as  vascular 
stimulants.  The  one  most  commonly  employed  is  nitrite  of  ethyl 
in  the  form  of  spirits  of  nitrous  ether.  This  remedy,  taken  in 
hot  water  or  along  with  acetate  of  ammonium,  is  a  useful  vascular 
stimulant,  and  is  often  used  for  the  same  purposes  as  Dover's 
powder. 

Camphor  is  frequently  used  as  a  popular  remedy  instead  of 
alcohol  or  Dover's  powder  in  order  to  cut  short  coryza  or  catarrh, 
about  ten  drops  of  the  tincture  being  taken  on  a  piece  of  sugar. 
Local  vascular  stimulation  is  useful  in  removing  chronic  inflam- 
mation or  consolidation.  For  a  more  detailed  account  of  its  action 
and  uses,  vide  Irritants  and  Counter-irritants  (p.  343). 


Cardiac  Tonics. 

These  are  drugs  which  have  no  perceptible  immediate  action 
on  the  heart,  but  when  given  for  a  little  while  render  its  beats 
much  more  powerful,  although  usually  much  slower.  The  most 
important  of  them  are  : — 

Digitalis.  Convallaria  majalis. 

Digitalin.  Convallamarin. 

Digitalein.  Adonis  vernalis. 

Digitoxin.  Adonidin. 

Erythrophlceum    (Casca)  Squills. 

Erythrophlcein.  Scillain. 

St'rophanthus      bispidus.         Helleborein. 
Strophanthin.  Antiarin. 

Caffeine. 
Nux  vomica. 
Strychnine. 


332  PHAKMACOLOGY  AND  THEEAPEUTICS.      [sect.  t. 

All  these  drugs,  as  already  mentioned,  stimulate  the  cardiac 
muscle  and  render  its  contractions  slower  and  stronger.  Although 
in  large  doses  they  tend  themselves  to  produce  irregular  and  peri- 
staltic contraction  of  the  heart,  yet  in  moderate  doses  they  tend  to 
remove  irregularity  already  present.  The  cases  in  which  they  are 
most  useful  are  those  in  which  the  left  ventricle  is  unable  to  drive 
the  blood  with  sufficient  force  into  the  aorta.  It  is  evident  that 
this  inability  may  depend  on  simple  weakness  of  the  ventricle 
without  any  valvular  lesion,  or  upon  irregular  action  of  the  various 
cavities,  or  upon  valvular  lesions,  or  on  a  combination  of  two  or 
more  of  these  conditions. 

Weakness  of  the  heart  may  occur  in  cases  of  general  mal- 
nutrition, as  anaemia  and  chlorosis,  or  in  consequence  of  acute 
disease  such  as  fevers.  It  is  not  necessarily  accompanied  by 
dilatation,  but  if  it  continues  for  some  time  the  cavities  are  apt  to 
dilate.  A  considerable  amount  of  dilatation  may  sometimes  occur 
without  leading  to  valvular  incompetence,  but  if  it  proceeds  be- 
yond a  certain  point  the  cusps  of  the  tricuspid  and  mitral  valves 
become  insufficient  to  close  the  dilated  orifices,  and  mitral  or 
tricuspid  regurgitation  is  the  result.  For  it  must  be  remembered 
that  in  the  healthy  heart  the  tricuspid  and  mitral  orifices  are 
much  diminished  in  size  by  the  contraction. of  the  muscular  tissue 
of  the  heart  at  the  moment  of  systole. 

In  cases  where  the  mitral  valve  is  thus  affected,  a  systolic 
murmur  may  be  heard  at  the  apex  during  life,  but,  should  death 
occur,  the  valves  may  be  found  perfectly  competent  to  close  the 
mitral  orifice  in  the  heart,  which  is  then  in  a  state  of  more  or  less 
complete  rigor.  In  all  such  cases  of  weakness  of  the  heart,  either 
with  or  without  dilatation  and  functional  incompetence  of  the 
valves,  digitalis  is  of  the  greatest  possible  service.  I  have  also 
found  erythrophlceum  give  most  satisfactory  results  in  simple 
dilatation  without  incompetence. 

The  form  of  valvular  disease  in  which  cardiac  tonics  are  es- 
pecially useful  is  mitral  regurgitation.  In  all  forms  of  valvular 
disease  there  is  a  tendency  to  the  occurrence,  of-  compensatory 
hypertrophy,  which  will  enable  the  heart  to  do  its  work  in  spite 
of  the  hindrance  caused  by  the  disease.  Wherever  this  is  suffi- 
cient, so  that  the  circulation  is  well  carried  on,  notwithstanding 
the  valvular  defect,  cardiac  tonics  are  useless  and  likely  to  be 
injurious.  Nor  should  they  be  given  when  the  compensatory 
hypertrophy  is  just  beginning  to  take  place.  But  when  compen- 
sation is  insufficient,  cardiac  tonics  are  of  the  very  highest  value. 
In  mitral  regurgitation  the  blood,  instead  of  being  driven  entirely 
onwards  by  the  left  ventricle  into  the  aorta,  is  partially  driven 
backwards  into  the  left  auricle  at  the  very  moment  that  the 
right  ventricle  is  driving  the  blood  into  the  pulmonary  artery  and 
lungs.  Hence  there  is  a  tendency  to  pulmonary  congestion,  which 
may  lead  to  haemoptysis.     The  right  ventricle  having  to  work 


cnAP.  xi.]    ACTION  OF  DEUGS  ON  THE  CIRCULATION.     333 

against  greatly  increased  pressure  tends  to  dilate,  the  blood 
accumulates  in  the  venous  system  generally,  and  venous  con- 
gestion of  the  stomach  leads  to  loss  of  appetite,  of  the  kidneys  to 
albuminuria,  and  of  the  limbs  to  anasarca.  While  the  venous 
system  is  gorged,  the  arterial  is  correspondingly  empty,  and  it  is 
not  only  the  stomach,  kidneys,  and  limbs  which  suffer  by  the 
stagnation  of  the  circulation,  for  a  similar  condition  exists  in 
the  heart  itself.  In  consequence  of  this  its  action  may  become 
not  only  weak  but  irregular,  and  matters  go  on  from  bad  to 
worse. 

In  such  a  condition  cardiac  tonics  are  of  the  greatest  possible 
service.  By  increasing  the  strength  of  the  cardiac  muscle  they 
not  only  enable  the  left  ventricle  to  drive  a  larger  proportion  of 
blood  into  the  aorta,  but  tbey  actually  tend  to  lessen  the  opening 
of  the  mitral  orifice  in  the  same  way  as  in  functional  incom- 
petence. By  rendering  the  pulse  less  frequent  they  allow  the 
ventricle  to  become  more  completely  filled  during  each  diastole. 
The  pressure  on  the  lungs,  right  side  of  the  heart,  and  venous 
system  is  diminished,  the  arterial  system  becomes  correspond- 
ingly filled,  the  congestion  of  the  various  organs  is  diminished 
and  their  function  correspondingly  improved. 

The  consequence  of  this  is,  that  in  the  stomach  we  have  in- 
creased appetite,  in  the  kidneys  diminished  albumen,  and  in  the 
limbs  removal  of  anasarca.  The  heart  also  benefits  by  the 
improved  circulation  in  it,  its  pulsations  are  more  regular  and 
powerful,  and  it  will  often  continue  to  act  well  and  carry  on  the 
circulation  satisfactorily  even  after  the  tonics  which  first  enabled 
it  to  do  so  have  been  discontinued. 

In  mitral  stenosis  cardiac  tonics  probably  are  beneficial  both 
by  lengthening  the  diastole,  and  thus  allowing  more  time  for  the 
blood  to  run  out  of  the  auricle  into  the  ventricle,  and  by  strength- 
ening the  auricle  itself.  Besides  this,  mitral  stenosis  is  usually 
accompanied  by  mitral  regurgitation,  which  will  be  benefited  by 
cardiac  tonics  in  the  way  just  described. 

In  aortic  stenosis  digitalis  is  of  little  or  no  use  when  there  is 
sufficient  compensatory  hypertrophy,  but  may  be  useful  if  the 
heart  is  becoming  feeble. 

There  has  been  considerable  difference  of  opinion  regarding 
the  use  of  digitalis  in  aortic  regurgitation,  some  holding  it  to 
be  useful  and  unattended  with  any  risk,  while  others  regard  its 
administration  as  attended  with  considerable  danger.  In  con- 
sidering this  question  we  must  bear  in  mind  that  the  risks  which 
a  patient  runs  from  aortic  regurgitation  are  not  the  same  in  all 
stages  of  the  disease.  While  the  aortic  regurgitation  is  uncom- 
plicated, and  the  ventricle  strong  enough  to  carry  on  the  circu- 
lation, the  risk  to  the  patient  is  that  of  sudden  death  by 
Byncope. 

It  is  easy  to  understand  how  this  should  be  the  case.    When 


834 


PHAEMACOLOGY  AND  THEEAPEUTICS.      [sect.  r. 


the  aortic  valves  are  healthy  the  arterial  system  may  be  regarded 
as  a  large-branched  tube  open  only  at  one  end— the  capillaries— 
and  through  these  the  blood  flows  so  slowly  that  there  is  no  risk 
of  syncope  from  the  blood-pressure  falling  too  low  (Fig.  118,  a). 

In  a  case  of  aortic  regurgitation,  on  the  contrary,  the  arterial 
system  is  open  at  both  ends,  and  during  the  cardiac  d'iastole  the 
blood  is  not  only  running  through  the  capillaries,  but  is  running 
backwards  into  the  left  ventricle,  so  that  the  conditions  are  favour- 
able for  the  blood-pressure  falling  so  low  as  to  induce  syncope  (Fig. 
118,  b).  It  is  evident  that  anything  which  prolongs  the  diastole, 
and  thus  allows  more  time  for  the  arterial  system  to  empty  itself 
through  the  capillaries  at  one  end  and  into  the  ventricle  at  the 
other,  will  increase  the  risk  of  syncope,  and  for  this  reason  digi- 
talis cannot  be  regarded  as  free  from  danger  in  aortic  regurgita- 
tion,   The  danger  may,  however,  be  very  considerably  diminished 


Fig.  118. — Diagram  to  illustrate  the  tendency  to  syncope  in  aortic  regurgitation.  In  a  the  aortio 
valves  are  healthy  and  prevent  regurgitation.  The  carotid  and  its  branches  are  shown  as  full. 
In  b  there  is  aortio  regurgitation,  the  blood  flows  out  of  the  arterial  system  through  the  capil- 
laries and  into  the  heart.  The  carotid  and  its  branohes  are  shown  as  empty.  In  c  the  condition 
is  the  same  as  In  b,  but  the  patient  is  supposed  to  be  in  the  recumbent  posture,  and  the  carotid 
and  Its  branohes  remain  full. 

by  keeping  the  patient  in  a  recumbent  posture  with  the  head 
low.  The  column  of  blood  above  the  aortic  valves  being  lower, 
there  will  be  somewhat  less  tendency  to  regurgitation ;  and  even 
should  the  arterial  pressure  fall  much,  the  brain  may  still  receive 
sufficient  blood  supply  to  prevent  syncope. 

In  cases  of  aortic  disease,  where  compensatory  hypertrophy  is 
insufficient,  or  where  the  hypertrophied  heart  is  becoming  en- 
feebled and  dilated  so  that  the  mitral  valves  no  longer  close  the 
orifice,  the  most  urgent  risk  to  the  patient  is  no  longer  that  of 
sudden  syncope,  but  of  pulmonary  embarrassment,  dropsy,  and 
all  the  other  consequences  of  mitral  regurgitation.  In  such  cases, 
as  well  as  in  those  where  organic  disease  of  both  mitral  and 
aortic  valves  exist  simultaneously,  we  must  treat  the  urgent 
symptoms  and  give  digitalis  or  other  cardiac  tonics. 


ghap.  xi.]    ACTION  OP  DEUGS  ON  THE  CTKCULATION.     885 

In  dilatation  of  the  right  heart  due  to  bronchitis  or  emphy- 
sema, digitalis  is  frequently  useful,  though  its  benefit  is  less 
marked  than  in  mitral  disease. 

Risks  attending  the  Administration  of  Digitalis  and 
other  Cardiac  Tonics.— The  great  risk  attending  the  use  of 
these  drugs  is  sudden  death  from  syncope.  Whenever  it  is 
necessary  to  push  them  to  any  extent,  the  patient  should  be  kept 
strictly  in  the  recumbent  posture,  and  not  allowed  to  raise  him- 
self quickly  even  into  a  sitting  position  on  any  pretence  what- 
ever, even  when  there  is  no  aortic  complication.  The  effects  of 
sudden  change  from  the  lying  to  the  standing  position  in  produc- 
ing syncope  have  already  been  mentioned  (p.  205),  and  when  the 
patient  is  allowed  to  sit  up  he  should  be  helped  up  slowly  and 
with  care.  A  change  from  the  lying  to  the  standing  position  by 
the  patient  getting  out  of  bed  is,  of  course,  still  more  danger- 
ous than  simply  sitting  up  in  bed,  and  the  most  dangerous  thing 
of  all  is  for  him  to  get  up  for  the  purpose  of  micturition.  The 
reason  of  this  has  been  already  explained  (p.  264). 

Such  strict  precautions  are,  of  course,  not  required  excepting 
when  the  cardiac  tonics  have  to  be  given  in  full  doses.  But 
when  it  is  necessary  to  do  this  they  should  on  no  account  be 
neglected. 

As  digitalis  is  cumulative  in  its  action,  it  is  often  advisable 
after  continuing  it  for  several  days  to  leave  it  off  for  a  day  or  two, 
and  then  recommence;  and  this  is  a  useful  precaution  when 
giving  digitalis  to  out-patients  who  are  seen  at  an  interval  of 
a  week  or  more,  even  when  the  dose  is  comparatively  small. 
Another  difficulty  in  the  administration  of  cardiac  tonics  is  the 
gastric  disturbance,  loss  of  appetite,  and  vomiting  which  they  are 
apt  to  produce. 

In  cases  where  the  arterial  tension  is  already  abnormally 
high — e.g.  in  cases  of  contracting  kidney — and  the  heart  seems 
unable  to  drive  the  blood  into  the  aorta,  the  proper  treatment,  of 
course,  is  to  reduce  the  abnormally  high  blood-pressure  by  purga- 
tives, diuretics,  and  diaphoretics,  and  not  to  attempt  to  strengthen 
the  heart  by  the  use  of  cardiac  tonics.  If  this  be  done  the  pres- 
sure may  be  raised  still  further  and  burst  the  vessels,  giving  rise 
to  apoplexy. 


Vascular  Tonics. 

Vascular  tonics  are  substances  which  cause  increased  contrac- 
tion of  the  arterioles  or  capillaries.  They  not  only  raise  the 
blood-pressure,  but  influence  to  a  considerable  extent  the  quantity 
of  lymph  poured  out  into  the  tissues  or  absorbed  from  them,  and 
thus  modify  tissue  change.  They  are  of  special  importance  in 
the  treatment  of  dropsy. 


336 


PHAEMACOLOGY  AND  THERAPEUTICS,      [sect.  i. 


The  most  important  vascular  tonics  are :— " 

Digitalis. 

Iron. 

Strychnine. 

Pathology  of  Dropsy.  —Dropsy  consists  in  the.  accumulation 
of  lymph,  either  in  small  lymph  spaces  in  the  tissues  (oedema, 
anasarca)  or  large  serous  cavities  (ascites,  pleural  or  pericardial 
effusions).  The  accumulation  is  caused  by  more  lymph  being 
poured  out  from  the  capillaries  than  can  be  removed  by  the 
lymphatics  and  veins. 

The  chief  causes  of  dropsy  are — (1)  Diminished  removal  of 
lymph  from  the  lymph  spaces  or  serous  cavities.     This  may  be 


Vaso-motor- — 

NERVES  > 


Eight  leg. 


Left  leg. 


Fig.  119. — Diagram  of  Ranvier's  experiment  on  dropsy.  The  vena  cava  is  ligatured,  and  in  the  left 
leg  the  trunk  of  the  sciatic  has  been  divided  so  that  hoth  the  motor  and  vaso-motor  nerves  con- 
tained in  it  are  paralysed.  On  the  right  side  the  motor  roots  of  the  sciatic  alone  are  divided  and 
the  vaso-motor  left  uninjured.  There  is  thus  motor  paralysis  on  both  sides,-but  vaso-motor 
paralysis  and  dropsy  only  on  the  left  side. 

due  to  (a)  obstruction  of  the  veins,  or  (b)  of  the  lymphatics.  (2) 
Increased  exudation  of  lymph  from  the  capillaries.  This  increased 
exudation  may  be  due  to  (a)  changes  in  the  walls  of  the  capillaries 
themselves  rendering  them  more  permeable.  This  appears  to  be 
the  only  condition  which  by  itself  can  produce  oedema.  There 
are  two  others,  however,  which,  although  by  themselves  incapable 
of  producing  oedema,  yet,  along  with  others,  are  of  the  utmost 


chap,  xi.]    ACTION  OF  DRUGS  ON  THE  CIRCULATION.      337 

importance ;  these  are  (b)  a  watery  condition  of  the  blood,  and 
(c)  vaso-motor  paralysis.  In  many,  indeed  in  most  cases  of 
dropsy,  two  or  three  of  these  factors  are  combined. 

Obstruction  to  the  veins,  or  lymphatics  alone,  will  rarely 
cause  dropsy,  unless  at  the  same  time  there  is  increased  transu- 
dation from  the  capillaries.  Thus  Ranvier  found  that  ligaturing 
the  vena  cava  of  a  dog  did  not  produce  dropsy  in  the  legs,  the 
lymph  being  removed  either  by  the  collateral  venous  circulation 
or  by  the  lymphatics.  On  dividing  the  sciatic  nerve  on  one  side, 
however,  after  ligature  of  the  vena  cava,  dropsy  appeared  in  the 
corresponding  leg,  while  it  remained  absent  from  the  other.  He 
showed  that  the  dropsy  was  caused  by  paralysis  of  the  vaso- 
motor, and  not  of  the  motor  fibres  contained  in  the  sciatic,  by 
dividing  the  motor  roots  of  the  sciatic  on  the  other  side,  leaving 
the  vaso-motor  roots  uninjured.  When  this  was  done  motor 
paralysis  occurred  equally  in  both  legs,  but  dropsy  only  appeared 
in  the  one  where  the  vaso-motor  nerves  had  been  divided  (Fig. 
119).  This  experiment  shows  what  an  important  factor  the 
loss  of  vascular  tone  is  in  the  production  of  oedema,  and  we  may 
legitimately  infer  from  it  that  vascular  tonics,  by  increasing  the 
contractility  of  the  vessels,  will  tend  to  prevent  oedema,  or  remove 
it  when  it  is  already  present. 

A  watery  condition  of  the  blood  does  not  of  itself  increase  the 
exudation  of  lymph,  nor  does  it  produce  oedema,  yet  in  cases  of 
anaemia  or  chlorosis  we  very  frequently  find  a  tendency  to  cedetna 
of  the  ankles,  and  experiments  in  Cohnheim's  laboratory  have 
shown  that,  although  a  watery  condition  of  the  blood  alone  causes 
no  increased  exudation  of  lymph  so  long  as  the  vaso-motor  nerves 
are  intact,  yet  it  does  so  to  a  very  great  extent  when  the  vaso- 
motor nerves  are  paralysed.1 

Alteration  of  the  capillaries  by  inflammation  causes  increased 
exudation  of  lymph,  and  tends  to  produce  a  local  oedema.  This 
oedema  is  greatly  increased  if  the  vaso-motor  nerves  are  paralysed, 
not  only  attaining  a  much  greater  extent,  but  appearing  more 
quickly  and  lasting  longer.  I  have  already  mentioned  that,  in 
experiments  on  artificial  circulation,  acids  added  to  the  circulating 
fluid  not  only  caused  dilatation  of  the  vessels,  but  increased 
transudation  through  them,  and  tended  to  render  the  tissues 
cedematous.  It  is  not  improbable  that  some  alterations  of  the 
blood-vessels  of  the  living  body  which  tend  to  render  them  more 
permeable  may  be  connected  with  imperfect  oxidation  and  the 
formation  of  sarco-lactic  instead  of  carbonic  acid. 

Arsenic  has  this  power  of  lessening  oxidation,2  and  it  seems 
not  improbable  that  the  tendency  to  produce  oedema  of  the  eyelids 
which  it  possesses  may  be  due  to  this  peculiar  action. 

1  Jankowski,  Virchow's  Archiv,  xciii.  p.  259. 
*  Feitelberg,  Inaug.  Diss.  Dorpat,  1883. 


838  PHAEMACOLOGY  AND  THEEAPEUTICS.      [sect.i. 

It  is  evident  that  whatever  tends  to  increase  oxidation  will 
have  an  opposite  effect,  and  will  tend  to  prevent  any  excessive  exu- 
dation from  the  capillaries.  In  cases  of  anajmia  iron  is  there- 
fore serviceable,  and  as  the  condition  of  the  blood  improves  the 
tendency  to  cedema  disappears. 

What  has  just  been  said  regarding  the  action  of  acids  may 
seem  to  be  in  contradiction  to  the  usually  received  opinion  that 
the  mineral  acids  act  as  vascular  tonics.  It  is  quite  true  that 
small  doses  of  dilute  acids,  especially  when  given,  as  they  usually 
are,  along  with  bitters,  frequently  impart  a  feeling  of  strength 
and  tone,  whereas  alkalies  are  frequently  felt  to  be  depressing, 
but  in  the  case  of  both  these  classes  of  remedies  this  effect  is 
probably  not  due  to  any  direct  action  on  the  vessels  themselves 
(vide  Acids). 


Cardiac  Sedatives. 

Cardiac  sedatives  are  substances  which  lessen  the  force  and 
frequency  of  the  heart's  action. 

They  are  chiefly  used,  either  for  the  purpose  of  lessening 
violent  action  or  palpitation  of  the  heart,  or  of  rendering  the 
pulse  slower  in  febrile  conditions,  especially  those  consequent  on 
local  inflammation.  It  has  already  been  mentioned  that  bella- 
donna diminishes  the  sensibility  of  the  heart  to  changes  of  pres- 
sure, and  that  sometimes  it  is  useful  in  palpitation  consequent  on 
cardiac  strain.  Simple  pressure  over  the  cardiac  region  appears 
to  have  the  power  of  lessening  palpitation,  so  that  when  this 
occurs  in  consequence  of  any  sudden  emotion,  there  is  a  natural 
tendency  to  press  the  hand  over  the  region  of  the  heart.  It  is 
impossible  to  say  whether  the  relief  which  such  pressure  certainly 
affords  is  simply  mechanical,  or  is  due  to  reflex  action  on  the 
heart  through  the  cutaneous  nerves.  Plasters  applied  to  the 
cardiac  region  have  a  beneficial  action  upon  palpitation  similar 
to  that  of  the  hand,  and  one  of  the  most  commonly  used  and 
beneficial  is  belladonna  plaster.  In  irritable-heart  of  soldiers 
Dr.  Da  Costa  found  digitalis  better  than  any  other  remedy.1 

In  palpitation  depending  on  indigestion,  hydrocyanic  acid  is 
useful.  In  palpitation  due  to  aortic  disease,  senega  has  been 
recommended.  It  is  probable  that  its  efficacy  depends  upon  the 
diminished  action  of  the  cardiac  ganglia  and  muscle  which  its 
active  principle,  saponine,  produces. 

An  active  circulation  of  blood  is  usually  advantageous  both 
for  functional  activity  and  for  the  repair  of  damage  to  an  organ, 
but  sometimes  it  may  become  excessive,  and  relief  may  be  afforded 
by  diminishing  it  (vide  p.  342) . 

1  Amer.  Journ.  Med.  Sci.,  Jan.  1871. 


CttiP.  xi.]    ACTION  OF  DEUGS  ON  THE  CIRCULATION.      839 

The  chief  cardiac  sedatives  employed  for  this  purpose  are : — 

Aconite. 

Veratrum  viride. 
Antimonial  preparations. 

It  is  questionable  whether  in  extensive  inflammation  of  in- 
ternal organs  cardiac  sedatives  are  of  much  service  or  not.  They 
seem,  however,  to  give  relief  in  the  feverish  condition  which  accom- 
panies more  limited  inflammation,  such  as  tonsillitis,  otitis, 
&c.  In  such  cases  the  tincture  of  aconite  is  best  employed  in 
very  small  doses  (one  drop)  frequently  repeated.  The  introduc- 
tion of  this  method  of  using  the  drug  in  divided  doses  is  due  in 
great  measure  to  Einger,  and  it  has  the  very  great  advantage 
that  the  desired  effect  can  be  produced  with  greater  certainty  and 
with  less  risk  of  an  overdose  being  given. 

Vascular  Sedatives. 

Vascular  sedatives  are  substances  which,  by  increasing  the 
contraction  of  the  vessels,  lessen  the  flow  of  blood  through  them. 
They  are  chiefly  used  to  lessen  local  inflammation  or  prevent 
haemorrhage.  One  of  the  most  powerful  of  all  vascular  sedatives 
is  cold.  For  its  use  in  local  inflammation  vide  p.  343.  It  is  not 
only  a  vascular  but  a  cardiac  sedative,  and  ice  swallowed  in  con- 
siderable quantity  will  tend  to  lessen  the  action  of  the  heart.  It 
is  therefore  one  of  tire  means  to  which  we  chiefly  trust  in  cases  of 
haemoptysis.  In  haematemesis  it  has  the  double  action  of  lessen- 
ing the  activity  of  the  heart,  and  of  contracting  the  vessels  in 
the  stomach. 

The  remedies  which  are  chiefly  employed  in  addition  to  cold 
are  :— 

Digitalis. 

Ergot. 

Hamamelis. 

Lead  acetate. 

Opium. 


B  2 


840  PHARMACOLOGY  AND  THERAPEUTICS,      [sect.  i. 


CHAPTEE  XII. 
REMEDIES  ACTING  ON  THE  SURFACE  OF  THE  BODY. 

Irritants  and  Counter-irritants. 

Irritants  are  substances  which,  when  applied  to  the  skin, 
cause  a  greater  or  less  degree  of  vascular  excitement  or  inflam- 
mation. They  are  employed  for  the  sake  of  their  local  action, 
to  produce  increased  circulation  in  the  part  to  which  they  are 
applied,  and  thus  to  remove  abnormal  conditions  already  present 
in  it. 

When  irritants  are  employed  for  the.  purpose  of  affecting 
reflexly  a  part  remote  from  the  seat  of  application  they  are  named 
Counter-irritants. 

Irritants  are  subdivided,  according  to  the  amount  of  effect 
produced,  into  rubefacients,  vesicants,  pustulants,  and  escharotics. 

Rubefacients  produce  simply  congestion  and  redness,  which 
may  be  merely  temporary,  passing  off  in  a  few  minutes,  or  may 
be  more  permanent,  remaining  for  several  days. 

When  more  powerful,  so  as  to  cause  exudation  between  the 
true  skin  and  epidermis,  giving  rise  to  vesicles,  they  are  called 
vesicants,  or  epispastics. 

Wben  they  do  not  affect  the  whole  skin  alike,  but  do  so  un- 
equally, and  irritate  isolated  parts  in  it,  such  as  the  orifices  of 
the  sudoriferous  glands,  so  powerfully  as  to  give  rise  to  pustules, 
they  are  called  pustulants. 

When  they  destroy  the  tissues  altogether,  forming  a  slough, 
they  are  called  caustics  or  escharotics. 

The  difference  between  these  sub-classes  is  chiefly  one  of 
degree,  and  not  of  kind.  The  weaker  ones  produce  the  higher 
degrees  of  action  when  applied  for  a  long  time,  and  the  stronger 
ones  produce  the  slighter  kinds  of  action  when  applied  for  a 
short  time. 

It  must  be  remembered  that,  although  inflammation  is  usually 
associated  with  increased  circulation,  the  two  things  are  essentially 
different. 

Inflammation  is  the  injury  to  the  tissue ;  the  increased  circu- 
lation is  the  attempt  to  repair  it. 

Increased   circulation   occurs  wherever   we   have   increased 


chap,  xii.]      REMEDIES  ACTING  ON  THE  BODY.  841 

functional  activity,  whether  this  be  for  the  purpose  of  performing 
a  normal  function,  as  in  glands  during  the  process  of  secreting, 
and  in  muscles  during  contraction,  or  for  the  purpose  of  repair. 
When  repair  is  going  on  slowly,  the  process  may  be  frequently 
quickened  by  increasing  the  supply  of  blood  to  the  part,  and  this 
is  the  reason  for  using  friction,  and  liniments  and  blisters  of 
various  kinds,  in  cases  of  chronic  inflammation  in  joints  or  in 
ulcers. 

Sometimes  irritation  fails  to  cause  absorption,  from  being  too 
weak.  In  a  case  of  rheumatic  gout  which  I  saw  some  years  ago, 
irritating  liniments  had  been  applied  for  some  time  in  vain,  until, 
by  mistake  on  the  patient's  part,  so  much  iodine  liniment  was 
put  on  at  once  as  to  cause  vesication  over  the  whole  back  of  the 
hand,  when  recovery  began  immediately. 

In  acute  inflammation,  however,  the  greatly  increased  circu- 
lation, along  with  the  heightened  sensibility  of  the  sensory  nerves 
in  the  inflamed  part,  causes  much  pain,  and  this  is  relieved  when 
the  tension  of  the .  blood  in  the  inflamed  part  is  lessened.  We 
notice  this  very  clearly  when  the  finger  is  inflamed  in  consequence 
of  a  prick  from  a  thorn,  a  bruise,  or  other  injury.  When  it  is 
allowed  to  hang  by  the  side,  the  throbs  of  pain,  coincident  with 
every  pulse-beat,  become  excruciating,  while,  if  raised  above  the 


Fig.  120. — Tracings  from  the  radial  artery  at  the  Wrist  :  A  before  and  B  after  the  application  of  a 
cloth  dipped  in  cold  water  round  the  arm.    (After  Winternitz.) 

head,  so  that  the  pressure  Of  blood  in  the  vessels  is  less,  the  pain 
becomes  greatly  diminished.  The  tension  in  the  vessels  may  be 
relieved  likewise  by  causing  contraction  of  the  arteries  leading  to 
the  part  by  a  cold  compress  around  the  arm  (Fig.  120),  or  by 
dipping  the  finger  in  cold  water ;  but  relief  is  also  afforded  by  a 
warm  poultice  applied  to  the  finger.  At  first  sight  it  seems  strange 
that  heat  and  cold  should  both  relieve  the  pain,  but  a  little 
consideration  will  show  that  they  both  relieve  the  tension  in  the 
vessels  of  the  inflamed  part.  Cold  does  so  by  causing  a  reflex 
Contraction  of  the  afferent  arteries,  and  thus  diminishing  the 
quantity  of  blood  going  to  the  inflamed  part.  Warmth,  on  the 
other  hand,  dilates  the  capillaries  of  the  collateral  circulation, 
and  thus  diverts  the  current  away  from  the  inflamed  vessels. 

The  use  of  counter-irritation  as  a  remedial  measure  depends 
on  the  fact  that  similar  alterations  to  those  produced  by  heat  and 
cold  on  the  finger  may  be  produced  on  the  circulation  in  internal 
organs  reflexly  through  the  nervous  system. 

When  an  irritant  is  applied  to  any  part  of  the  skin,  it  causes 


812 


PHAEMACOLOGY  AND  THERAPEUTICS,      [sect. 


a  local  dilatation  of  the  vessels  and  redness  of  that  part,  but 
contraction  of  the  vessels  in  other  parts  of  the  body.  Probably 
this  contraction  takes  place  with  the  greatest  force  in  certain  or- 
gans having  a  definite  nervous  relation  to  that  part  of  the  surface 


FIG.  121. Diagram  to  show  the  effects  of  heat  and  cold  in  lessening  the  pain  of  inflammation.    The 

diagram  is  supposed  to  represent  the  end  of  the  finger.  The  small  star  indicates  the  point  of 
irritation,  e.g.  a  prick  by  a  thorn.  The  line  in  the  centre  of  each  figure  is  intended  to  represent 
the  nerve'  going  to  the  injured  part ;  and  at  the  side  of  each  figure  is  an  artery  and  vein  con- 
nected by  a  capillary  network.  In  a  the  capillary  network  around  the  seat  of  irritation  is  seen 
to  be  much  congested ;  the  nerve-filaments  are  thus  pressed  upon  and  pain  is  occasioned,  h  re- 
presents the  condition  of  the  finger  after  the  application  of  cold  to  the  arm  or  hand.  In  conse- 
quence of  the  contraction  of  the  afferent  arteries  the  finger  becomes  ansemic ;  no  pressure  is 
exerted  on  the  nervous  filaments,  and  pain  is  alleviated,  c  represents  the  finger  after  it  has 
been  encased  in  a  warm  poultice ;  the  capillary  network  at  the  surface  of  the  finger  is  dilated, 
and  the  blood  is  thus  drawn  away  from  the  seat  of  irritation  and  the  pain  therefore  relieved. 


which  is  irritated.  Ziilzer  found  that  when  cantharides-collodion 
was  painted  repeatedly  over  the  back  of  a  rabbit  for  fourteen  days, 
the  vessels  underneath  the  skin,  and  the  superficial  layers  of 


Vessels  of  thoracic  wall 


Vessels  of  body  generally. 


Dilated  vessels  of  lung. 


Fig.  122. — Diagram  to  show  congestion  of  the  lung.    The  pulmonary  vessels  are  shown  dilated,  and 
those  of  the  thoracic  wall  contracted. 


muscles,  were  congested.  The  deeper  layers  of  the  muscles,  the 
thoracic  wall,  and  even  the  lung  itself,  were  much  paler  and  more 
ansemic  than  those  of  the  other  side. 

It  is  probable  that  a  similar  condition  occurs  in  man,  and  that 
when  we  apply  a  blister  to  the  side  we,  sometimes  at  least,  cause 
contraction  of  the  vessels  in  the  pleura  and  lung  below,  and  thus 
relieve  pain  in  the  chest  in  much  the  same  way  as  when  we  apply 
cold  to  an  inflamed  finger.  It  has  been  supposed  that  the  action 
of  a  poultice  or  blister  was  simply  to  draw  away  blood  from  the 


chap,  xn.]       EEMBDIES  ACTING  ON  THE  BODY.  843 

inflamed  part.  We  have  seen  that  the  poultice  does  this  in  the 
case  of  an  inflamed  finger,  but  in  an  inflamed  lung  or  pleura  the 
quantity  which  comes  to  the  skin  is  insufficient  to  explain  the 
relief.  It  is  quite  possible,  however,  that  the  vessels  in  the  lung 
and  pleura  adjoining  the  inflamed  district  may  be  dilated  by  the 
application  of  a  poultice  or  blister  to  the  side,  and  thus  relief  is 
afforded  in  the  same  way  as  by  the  application  of  a  poultice  to  the 
finger.    It  is  not  easy  to  say  in  which  of  these  ways  a  poultice  or 


Dilated  vessels  of  thoracic  wall 


Blister 


Taso-motor  centre. 


Vessels  of  body  generally. 


Contracted  vessels  of  lung. 


Fig.  123. — Diagram  to  explain  the  action  of  counter -irritation.  A  blister  or  other  counter-irritant 
is  shown  applied  to  the  chest-wall.  The  stimulus  which  it  causes  is  transmitted  up  the  afferent, 
nerves  to  the  vaso-motor  centre ;  it  is  thence  reflected  down  the  vaso-motor  nerves  to  the  pul- 
monary vessels,  causing  them  to  contract,  while  it  is  reflected  down  vaso-dilating  fibres  to  the 
vessels  of  the  thoracic  wall  and  probably  of  other  parts  of  the  body  also,  causing  them  to  dilate, 
and  thus  lessening  the  pulmonary  congestion  by  withdrawing  blood  from  the  lungs.  (Compare 
with  Kg.  122.) 

blister  acts  in  any  particular  case.  Clinical  experience  seems  to 
show  that  sometimes  the  blisters  relieve  acute  inflammation  by 
causing  contraction  of  the  afferent  vessels  (as  represented  in  the 
accompanying  diagram,  Fig.  123)  and  thus  lessening  the  tension 
in  the  vessels  of  the  inflamed  part.  If  the  blister  is  too  near 
to  the  inflamed  part,  it  may  increase  instead  of  diminishing  the 
congestion,  and  thus  do  harm  instead  of  good. 

As  a  matter  of  practice,  the  rule  is  usually  insisted  upon,  that 
in  a  case  of  pericarditis,  for  instance,  the  blister  should  not  be 
put  immediately  over  the  pericardium,  but  at  some  little  distance 
from  it. 

Counter-irritation  is  not  only  used,  however,  as  a  means  of. 
lessening  congestion  and  pain  in  acute  inflammation,  it  is  also 
employed  with  much  advantage  to  cause  the  re-absorption  of  in- 
flammatory products.  The  use  of  the  increased  circulation  which 
a  blister  causes  in  a  chronic  ulcer  is  unquestionable,  and  the  rapid 
aosorption  of  the  thickened  margins  of  the  ulcer  is  perceptible  to 
the  eye.  A  similar  absorption  appears  to  occur  in  deeper-seated 
organs,  such  as  the  lung,  on  the  application  of  counter-irritation 
to  the  chest,  and  painting  with  iodine  liniment  is  useful  in  pro- 
moting absorption  of  liquid  effused  into  the  pleural  cavity  or  of 
the  product  of  chronic  inflammation  of  the  lung.  The  mode  in 
which  the  irritation  acts  is  probably  the  same  both  in  the  chronic 


344 


PHABMACOLOGY  AND  THEEAPEUTICS.      [sect.  i. 


ulcer  and  in  the  lung,  i.e.  by  increasing  the  circulation  through 
the  part  affected.  Where  the  blister  is  applied,  as  in  acute  peri- 
carditis, to  lessen  congestion,  it  is  usually  placed  at  a  little  distance 
from  the  inflamed  part,  but  where  we  wish  to  increase  absorption, 
as  in  consolidation  of  a  part  of  the  lung,  we  apply  the  counter--' 
irritant  directly  over  the  consolidated  part. 


Rubefacients. 

Mechanical,  as  friction. 

Ammonia. — Solution  of  am- 
monia, compound  camphor 
liniment. 

Alcohol  (prevented  from  evapo- 
rating by  oil-silk  or  a  watch- 
glass). 

Arnica. 

Cajeput  oil. 

Camphor. 

Capsicum. 

Chloroform  (prevented  from 
evaporating,  like  alcohol) ; 
chloroform  liniment. 

Ether  (like  chloroform). 

Iodine  and  its  preparations. — 
Iodide  of  cadmium,  iodide  of 
lead. 

Menthol. 

Mustard. 

Oil  of  turpentine,  of  nutmeg, 
and  many  other  volatile  oils. 

Vesicants. 

Acetic  acid  (glacial). 
Heat  of : 

Boiling  water. 

Corrigan's  hammer. 
-Cantharides. — Solutions,   plas- 
ter, cantharidin. 
Euphorbium. 
Mezereon. 

Volatile  oil  of  mustard. 
Ehus  toxicodendron. 


Pustulants. 

Croton  oil. 
Tartarated  antimony. 

Caustics. 

Actual  cautery. 

Acids : — Acetic  (glacial). 

Carbolic. 

Chromic. 

Hydrochloric. 

Lactic. 

Nitric. 

Osmic. 

Sulphuric. 
Alkalies  :— 

Lime. 

London  paste  (p.  346). 

Vienna  paste  (p.  346). 

Potash. 

Soda. 

Ethylate  of  sodium. 

Alum  (burnt). 
Antimony  (chloride). 
Arsenic. 
Bromine. 
Soluble    compounds    of     the 

heavier  metals ;  as : 
Copper  sulphate. 
Mercuric  chloride. 

„        nitrate. 
Silver  nitrate. 
Zinc  chloride. 
Zinc  sulphate. 


Rubefacients.—  One  oi"  the  simplest  rubefacients  is  mere 
friction.  This  may  be  made  either  with  the  hand,  or  more 
effectually  still,  with  a  rough  cloth  or  a  flesh-brush.  Friction  also 
greatly  aids  the  action  of  many  of  the  slighter  rubefacients. 

Bubefacients  may  be  used  for  their  action  upon  the  skin  itseH: 


Chap,  xn.]      REMEDIES  ACTING  ON  THE  BODY.  845 

to  relieve  itching.  They  may  also  be  used  for  their  effect  on 
deeper-seated  structures. 

Friction,  with  firm  pressure,  is  used  in  shampooing.  Upward 
friction  in  the  limbs  will  diminish  the  tension  in  dropsy,  by 
removing  part  of  the  fluid  from  them.  It  also  aids  the  circula- 
tion of  the  lymph,  and  by  accelerating  the  passage  of  the  pro- 
ducts of  muscular  waste  from  the  muscles  themselves  into  the 
general  circulation,  it  removes  to  a  great  extent  the  sense  of 
fatigue  after  over-exertion  (p.  131).  When  applied  along  the  back 
it  soothes  conditions  of  nervous  excitement,  and  tends  to  produce 
sleep.  Friction,  along  with  stimulating  liniments,  applied  to  the 
joints  after  active  inflammation  has  subsided  in  them,  tends  to 
remove  the  swelling  and  to  restore  their  function. 

Neuralgic  pains  are  frequently  relieved  by  the  application  of 
rubefacients  such  as  ammonia,  chloroform  applied  by  a  watch- 
glass,  or  a  mustard-plaster  to  the  painful  spot.     • 

Conditions  of  nervous  debility  are  sometimes  benefited  by 
mustard  liniment  applied  over  the  spine,  and  a  mustard-plaster 
to  the  nape  of  the  neck  is  sometimes  useful  in  nervous  irritability 
with  sleeplessness.  In  addition  to  the  action  which  the  mustard 
has  on  the  vessels,  it  produces  a  sharp  pain,  so  that  it  is  employed 
also  to  rouse  persons  suffering  from  narcotic  poisoning,  or  from 
coma. 

Mustard-leaves  or  iodine  liniment  applied  over  consolidated 
parts  of  the  lung  tend  to  cause  absorption  of  inflammatory 
products,  and  are  used  for  this  purpose  in  cases  of  effusion  into 
the  pleura  or  pericardium,  of  chronic  consolidation  remaining  after 
an  attack  of  pleurisy  or  pneumonia,  or  in  commencing  phthisis. 

Vesicants. — Vesicants  are  employed  locally  in  chronic  ulcers 
and  to  cause  absorption  of  effusions  into  joints,  or  chronic 
thickening  about  them.  When  applied  around  the  inflamed 
joints  in  acute  rheumatism,  they  not  only  relieve  the  local  affec- 
'  tion,  but  appear  to  have  a  curative  action  on  the  general  febrile 
condition. 

In  neuralgia,  blisters  over  the  painful  point  are  useful,  and 
sometimes,  when  neuralgia  is  in  the  side,  or  in  the  breast,  it  may 
be  relieved  by  applying  the  blister  over  the  corresponding  part 
of  the  spine  where  there  is  usually  a  spot  which  is  tender  on 
pressure.  In  sciatica,  the  relief  is  often  greater  when  the  blister 
is  applied  to  the  heel,  than  over  the  nerve  itself. 

In  neuralgia  also  it  not  unfrequently  happens  that  a  slight  ap- 
plication of  the  actual  cautery  is  more  efficacious  than  a  blister. 
The  most  convenient  form  of  this  is  Paquelin's  thermocautery. 

In  inflammation  of  the  pericardium  or  pleura,  a  blister 
frequently  relieves  the  pain,  and  it  sometimes  lessens  or  cuts 
short  the  inflammation.  Applied  over  the  epigastrium,  blisters 
relieve  vomiting  arising  from  various  causes. 

In  cerebral  affections,  such  as  obstinate  headache,  in  menin- 


346  PHAEMACOLOGY  AND  THERAPEUTICS,      [sect.  i. 

gitis  and  hydrocephalus,  blisters  to  the  nape  of  the  neck  or 
under  the  mastoid  process  are  useful. 

Hysterical  paralysis  of  the  limbs  sometimes  yields  to  blistef  s 
locally  applied ;  and  hysterical  aphonia  is  sometimes  removed  by 
a  blister  over  the  larynx. 

Pustulants. — Pustulants  are  employed  for  the  purpose  of 
keeping  up  a  continuous  moderate  irritation  in  chronic  inflam- 
mations :  tartar  emetic  ointment,  and  croton-oil  liniment,  seem 
sometimes  to  be  of  considerable  advantage  in  chronic  inflamma- 
tion of  joints  or  synovial  membranes,  in  chronic  bronchitis  and 
in  pleurisy ;  perhaps  sometimes  in  phthisis.  They  have  been 
used  also  as  an  application  to  the  spine  in  paralysis  and  hysteria, 
and  to  the  head  in  tubercular  meningitis,  and  to  the  nape  of  the 
neck  in  chronic  headache  or  giddiness.  They  were  much  em- 
ployed formerly,  but  of  late  years  iodine  liniment  or  small  blisters 
have  to  a  great  extent  taken  their  place. 

Caustics. — Caustics  are  used  to  destroy  excrescences  on  the 
surface  of  the  skin  and  mucous  membranes :  warts,  condylomata, 
or  polypi ;  to  destroy  exuberant  and  unhealthy  granulations  in 
ulcers  and  fungating  sores :  thus,  a  slight  touch  with  nitrate  of' 
silver,  sulphate  of  copper,  or  with  nitric  acid,  will  sometimes 
cause  the  tissues  in  an  unhealthy  wound  after  an  operation  to 
become  less  exuberant,  and  take  on  a  healthy  healing  action. 

Caustics  may  be  used  to  destroy  malignant  growths.  Gene- 
rally a  surgical  operation  is  preferable  for  this  purpose,  but  some- 
times patients  have  such  a  horror  of  the  knife  that  they  will  not 
submit  to  an  operation,  and  in  such  cases  caustics  are  occasionally 
employed.  For  this  purpose  one  of  the  following  may  be  applied : 
Vienna  paste  consisting  of  caustic  potash  and  caustic  lime  moist- 
ened with  water,  or  London  paste,  which  consists  of  caustic  soda 
and  lime  moistened  with  alcohol.  Sulphuric  acid  mixed  with  saw- 
dust has  sometimes  also  been  used,  but  it  is  exceedingly  painful. 
Arsenious  acid  made  with  various  inert  substances  into  a  paste 
is  not  unfrequently  employed  with  considerable  success  by  char- 
latans, who  sometimes  succeed  in  removing  cancerous  growths 
by  its  application  in  apparently  hopeless  cases,  but  the  risk 
attending  its  use  is  considerable. 

Caustics  are  sometimes  employed  also  to  open  abscesses, 
especially  abscesses  of  the  liver,  if  it  is  thought  advisable  to  cause 
adhesions  between  the  viscus  and  the  abdominal  wall  before  the 
abscess  is  opened,  so  as  to  avoid  any  risk  of  pus  finding  its  way 
into  the  abdominal  cavity.  The  substance  usually  employed  fof 
this  purpose  is  caustic  potash. 

Caustics  are  also  used  to  keep  up  chronic  irritation,  as  in 
chronic  headache  or  epilepsy,  a  wound  being  first  made  by  the 
use  of  the  caustic,  and  prevented  from  healing  by  the  introduc- 
tion of  a  foreign  body  into  it,  or  by  the  continued  application  of 
some  irritating  ointment,  such  as  savine  ointment. 


chap,  xii.]      EEMEDIES  ACTING  ON  THE  BODY.  347 

Caustics  are  also  used  as  an  application  to  the  bites  of  veno- 
mous serpents,  or  of  rabid  dogs,  in  order  to  destroy  the  virus 
and  prevent  its  general '  action  on  the  organism.  The  weaker 
caustics  are  of  no  use  for  this  purpose.  I  have  seen  a  boy  die  of 
hydrophobia  six  weeks  after  he  was  bitten  by  a  mad  dog,  although 
the  wound  had  been  thoroughly  cauterised  by  nitrate  of  silver 
five  minutes  after  the  bite.  In  all  cases  the  parts  around  the 
Dite  should  be,  if  possible,  excised  and  then  cauterised  with  a 
red-hot  iron,  a  ligature  being,  if  possible,  placed  between  the 
bitten  part  and  the  heart  until  the  operation  has  been  effected, 
so  as  to  prevent  any  absorption  of  the  virus. 


Emollients  and  Demulcents. 

Emollients  are  substances  which  soften  and  relax,  while 
Demulcents  are  substances  which  protect  and  soothe  the  parts 
to  which  they  are  applied. 

Many  substances  exercise  both  of  these  actions,  and  so  no 
very  sharp  line  of  distinction  is  drawn  between  them.  Emol- 
lients, however,  are  more  generally  spoken  of  in  relation  to 
their  application  to  the  skin,  and  demulcents  to  the  mucous 
membranes. 

Demulcents.  Emollients. 

Bread.  Moist  warmth — bathing    with 

Collodion.  warm  water,  hot  sponge,  hot 

Cotton-wool  (for  external  fomentations,  steam. 

use  only).  Poultices  made   of  substances 

Figs.  which  retain  heat  and  mois- 

Fuller's  earth.  ture — bran,  bread,  figs,  flour, 

Gelatine.  linseed-meal,  oatmeal,  &c. 

Iceland  moss.  Gelatinous  substances. 

Isinglass.  Fats  —  almond-oil,      glycerin, 

Glycerin.  lard,   linseed-oil,   neat's-foot 

Gum.  oil,  olive-oil,  spermaceti,  suet, 

Honey.  lanolin. 

Linseed.  Paraffin — petrolatum,  vaseline, 

Linseed-tea.  and  unguentum  petrolei. 

Marsh-mallows.  Soap  and  other  liniments. 
Almond-oil. 
Olive-oil. 
Starch. 
White  of  egg. 

The  Action  of  Demulcents  is  chiefly  mechanical.  They 
form  a  smooth,  soft  coating  to  an  inflamed  mucous  membrane, 
pr  to  a  skin  deprived  of  its  epidermis,  and  they  thus  protect  the 
eurface  from  external  irritation,  and  allow  the  process  of  repair 


348  PHAEMACOLOGY  AND  THERAPEUTICS,      [sect,  i 

to  go  on.  They  are  used  externally  in  cases  of  irritating  skin 
diseases,  where  the  epidermis  from  one  cause  or  another  has 
been  broken  or  removed,  as  by  friction,  exposure  to  cold,  &c. 
Internally  they  are  employed  when  the  mucous  membranes  have 
been  irritated,  as,  for  example,  in  the  after-treatment  of  cases  of 
irritant  poisoning. 

Mucilaginous  substances  are  also  used  to  relieve  pain  and 
irritation  in  the  throat,  and  to  lessen  the  irritable  cough  which 
frequently  depends  on  congestion  of  the  pharynx  and  upper  parts 
of  the  respiratory  passages. 

Such  substances  as  figs,  prunes,  and  even  cabbage,  are  em- 
ployed to  protect  the  intestines  from  injury  by  hard  and  pointed 
substances  which  have  been  accidentally  swallowed.  They  do 
this  by  leaving  a  bulky  indigestible  residue  in  which  the  pointed 
article  becomes  embedded,  and  thus  passes  along  the  intestine 
without  lacerating  it. 

The  Action  of  Emollients  is  to  relieve  the  tension  and  pain 
in  inflamed  parts ;  warmth  and  moisture  do  this  by  dilating 
the  collateral  blood-vessels  in  the  manner  already  described 
(p.  342).  They  also  relax  the  tissues  themselves  and  lessen  the 
pressure  upon  the  nerves  of  the  part. 

Fatty  emollients  soften  the  skin  and  thus  render  it  softer 
and  more  flexible.  These  emollients  also  aid  the  immediate 
effect  of  friction  upon  the  skin,  enabling  it  to  be  applied  with 
greater  advantage,  and  to  act  on  the  more  deeply-seated  tissues, 
as,  for  example,  in  cases  of  stiffness  in  joints. 

Therapeutic  Uses. — Warmth  and  moisture  are  almost  in- 
variably used  to  relieve  spasm  and  the  pain  attending  it,  as  well 
as  to  relieve  pain  in  all  cases  of  inflammation,  whether  super- 
ficial or  deep-seated,  and  they  relieve  so  much  that,  with  many 
people,  the  connection  between  pain  and  poultice  has  come  to  be 
a  household  word.  When  poultices  are  intended  to  act  directly 
on  the  part  to  which  they  are  applied,  the  linseed,  bran,  or 
bread  should  be  applied  to  the  skin  with  nothing  between,  or  at 
most  with  only  a  thin  piece  of  muslin,  but  when  intended  to  act 
on  deep-seated  organs,  a  considerable  thickness  of  flannel  should 
be  interposed,  so  that  the  heat  may  come  gradually  through,  and 
allow  an  excessively  hot  poultice  to  be  applied  without  burning 
the  skin. 

In  cases  of  disease  of  the  respiratory  passages  the  warmth  is 
usually  applied  by  means  of  inhalation. 

Fatty  emollients,  by  softening  the  skin  or  mucous  mem- 
branes, such  as  those  of  the  lips,  prevent  them  from  cracking, 
and  are  used  by  persons  with  a  delicate  skin  to  prevent  cracks 
forming  on  exposure  to  cold. 

They  are  also  used  to  prevent  friction  between  surfaces  of 
skin  constantly  in  contact,  as  between  the  nates  and  inner  joints 
in  children,  and  to  prevent  bed-sores. 


CHAP,  xii.]      REMEDIES  ACTING  ON  THE  BODY.  349 

Astringents. 

These  are  substances  which  cause  contraction  of  the  tissues 
to  which  they  are  applied  and  lessen  secretion  from  mucous 
membranes. 

Acids.  Gallic  acid. 

Alcohol.  Tannic  acid. 

Alum.  Vegetable  substances  contain- 

Chalk  and  Lime.  ing  these  acids,  e.g. — 

Salts  of  the  heavier  metals,  Catechu, 

e.g. —  Galls. 

Bismuth  subnitrate,  &c.  Kino. 

Cadmium  sulphate.  Oak-bark. 

Copper  sulphate.  Uva-Ursi. 

Ferric  chloride.  Arbutin. 

Lead  acetate. 

Silver  nitrate. 

Zinc  sulphate. 

Astringents  are  usually  divided  into  local  and  remote. 

Local  astringents  are  those  which  affect  the  part  to  which 
they  are  applied.  Remote  are  those  which  act  on  internal 
organs  after  their  absorption  into  the  blood. 

With  the  exception  of  gallic  acid  and  ergot  they  all  coagu- 
late or  precipitate  albumen.  Dilute  mineral  acids  do  not 
coagulate  albumen,  but  precipitate  albuminous  substances  from 
the  alkaline  fluids  in  which  they  are  naturally  dissolved  in  the 
body. 

When  applied  to  a  surface  from  which  the  epidermis  has 
been  removed,  the  other  astringents  combine  with  the  albumi- 
nous juices  which  moisten  this  surface,  as  well  as  with  the 
tissues  themselves,  and  form  a  pellicle  more  or  less  thick  and 
dense,  which  in  some  measure  protects  the  structures  beneath 
it  from  external  irritation,  at  the  same  time  that  they  cause  the 
structures  themselves  to  become  smaller  and  more  dense.  On  a 
mucous  membrane  they  have  a  similar  action,  and  they  lessen 
its  secretion.  It  was  formerly  supposed  that  their  action  was 
partly  due  to  their  causing  the  blood-vessels  going  to  a  part  of 
the  body  to  contract,  thus  lessening  the  supply  of  fluid  to  it,  as 
well  as  to  their  effect  on  the  tissues  themselves.  But  experiment 
has  shown  that,  while  nitrate  of  silver  and  acetate  of  lead  possess 
this  power,  perchloride  of  iron  and  alum  do  not,  and  that  tannic 
and  gallic  acids  actually  'dilate  the  vessels.  The  astringent 
action  of  these  latter  drugs  must  therefore  be  exerted  upon  the 
tissues.     (Rossbach.) 

Uses. — Astringents  may  be  employed  locally  in  various 
forms.    In  the  solid  form,  as  a  powder,  or  in  various  prepara- 


850  PHARMACOLOGY  AND  THERAPEUTICS,      [sect.  i. 

tions,  such  as  lotions,  ointments,  plasters,  glycerines,  &c,  they 
are  applied,  especially  the  metallic  astringents,  to  wounds  and 
ulcers  for  the  purpose  of  reducing  the  size  and  increasing  the 
firmness  of  exuberant  granulations,  as  well  as  of  protecting  the 
surface  by  forming  a  pellicle  over  it.  They  are  used  to  lessen 
congestion  and  diminish  the  secretion  of  the  various  mucous 
membranes — as  a  lotion  to  the  eye  and  mouth  ;  as  a  gargle  or  a 
spray  to  the  throat ;  in  the  form  of  an  injection  to  the  nose, 
urethra,  and  vagina ;  and  of  suppositories  to  the  rectum.  Ad- 
ministered internally,  several  astringents  have  a  powerful  effect 
in  checking  diarrhoea,  and  certain  of  them  may  have  a  local 
action  upon  the  stomach  and  intestines. 

The  remote  action  of  such  astringents  as  acetate  of  lead  and 
gallic  acid,  when  absorbed  into  the  blood,  in  lessening  haemor- 
rhage, is  made  available  in  the  treatment  of  haemoptysis, 
hsematemesis,  hsematuria,  and  loss  of  blood  from  other  parts  of 
the  body. 

Styptics. 

Styptics  are  substances  which  arrest  the  flow  of  blood  from 
broken  or  wounded  surfaces  or  vessels.  They  may  do  this  either 
by  aiding  the  rapid  formation  of  a  coagulum  which  will  plug  up 
the  wounded  vessels,  or  by  causing  the  vessels  themselves  to 
contract  so  much  as  to  check  the  flow  of  blood  out  of  them. 
They  are  closely  connected  with  astringents,  which,  as  we  have 
already  mentioned,  nearly  all  coagulate  albuminous  substances. 

Acids.  Collodion, 

Actual  cautery.  Matico, 

Alum.  Spider's- web, 

Ferric  chloride. 

Tannin. 

Lead  acetate. 

Substances  acting  on  the  blood-vessela : — 

Cold  (Ice). 

Digitalis. 

Ergot. 

Action. — Matico  and  cobwebs  act  mechanically  in  aiding 
the  formation  of  a  clot  around  the  fibres.  Collodion  also  acts 
mechanically  by  exerting  pressure  over  the  surface,  and  thus 
preventing  the  blood  from  issuing. 

Alum,  lead  acetate,  and  ferric  chloride  cause  coagulation  of 
the  blood. 

Pressure  to  the  surface,  cold  sponges  or  ice,  cause  the  vessels 
to  contract,  and  thus  prevent  the  blood  from  running  out  of 
them  in  superficial  haemorrhage. 

Lead  acetate  and  gallic  acid,  when  absorbed  into  the  blood, 


acting 
mechanically. 


chap,  xii.]      EEMEDIES  ACTING  ON  THE  BODY.  351 

not  only  tend  to  lessen  secretion  from  the  mucous  membranes, 
but  arrest  haemorrhage  from  internal  organs.  This  is  probably 
partly  due  to  their  effect  in  increasing  the  coagulability  of  the 
blood,  and  possibly  partly  also  to  their  power  of  causing  contrac- 
tion of  the  arterioles.  Ergot  and  digitalis  also  lessen  or  arrest 
haemorrhage,  although  they  have  little  or  no  action  on  coagula- 
tion, and  their  action  probably  depends  on  their  power  to  cause 
contraction  of  the  arterioles. 

A  dependent  position  increases  the  pressure  of  blood  locally 
in  the  part,  and  thus  tends  to  increase  haemorrhage.  It  is 
therefore  advisable  to  keep  the  bleeding  part  as  much  raised  as 
possible. 

Powerful  action  of  the  heart  tends  to  increase  the  blood- 
pressure  generally.  In  cases  of  severe  haemorrhage  it  is  there- 
fore of  the  greatest  importance  that  the  patient  should  keep 
absolutely  quiet,  and  that  all  the  food  should  be  taken  cold. 

Cold  to  the  surface  is  a  powerful  agent  in  checking  internal 
as  well  as  superficial  haemorrhage.  It  probably  acts  by  causing 
reflex  contraction  of  the  vessels  (compare  Eossbach's  experi- 
ments, p.  252).  A  cold  key  to  the  back  of  the  neck  and  cold 
water  to  the  nose  are  frequently  useful  in  epistaxis,  and  ice-bags 
to  the  chest  or  epigastrium  are  useful  in  haemoptysis  and  hsema- 
temesis.  It  is  probable  that  other  stimuli  to  the  surface  act  on 
the  vessels  in  a  similar  way,  and  probably  this  is  the  explanation 
of  the  fact  that  menorrhagia  and  metrorrhagia  are  sometimes 
successfully  treated  by  placing  a  plug  of  cotton  wool  soaked  in 
a  mixture  of  vinegar  and  brandy  in  the  vagina,  or  applying  the 
same  mixture  either  on  cotton  wool  or  on  a  napkin  to  the  vulva. 

The  powerful  action  of  hot  water  injected  into  the  vagina 
and  uterus  in  arresting  post  partum  haemorrhage  (p.  455)  is 
probably  due  partly  to  its  causing  a  reflex  contraction  of  the 
vessels  and  of  the  uterus  itself,  and  probably  also  to  its  direct 
stimulating  action  on  the  muscular  walls  of  the  uterus. 


352  PHAEMACOLOGY  AND  THEEAPEUTICS.     [sect.  I. 


chaptee  xnr. 

ACTION  OF  DEUGS  ON  THE  DIGESTIVE  SYSTEM. 

ACTION  OF  DRUGS  ON  THE  TEETH. 

Although  the  hurry  and  bustle  of  modern  life  is  apt  to  make 
people  forget  it,  mastication  is  a  most  important  part  of  the 
digestive  process.  During  early  life  the  stomach  and  intestines 
may  be  able  to  digest  imperfectly-masticated  food,  but  as  years 
advance  they  cease  to  do  so,  and  imperfect  mastication  becomes 
a  fruitful  source  of  dyspepsia. 

If  the  teeth  are  entirely  or  almost  entirely  gone,  the  person 
may  chew  with  his  gums,  but  if  they  are  only  partially  gone  it 
frequently  happens  that  those  which  remain  oppose  one  another 
only  sufficiently  to  prevent  the  gums  from  closing,  while  they  do 
not  help  mastication. 

The  decay  of  teeth  is  chiefly  due  to  the  dentine  being  attacked 
by  the  acid  products  of  the  decomposition  of  food  in  the  mouth. 
This  decomposition  is  to  a  great  extent  due  to  bacteria,  and 
antiseptics  are  therefore  useful  in  preventing  decay. 

By  cleaning  the  teeth  with  a  soft  brush  at  night  before  going 
to  bed,  particles  of  food  sticking  between  them  may  be  removed, 
and  thus  its  decomposition  and  consequent  injurious  action  on 
the  teeth  may  be  avoided.  Chalk  is  employed  as  a  basis  of  most 
dentifrices,  as  its  mechanical  action  is  sufficient  to  clean  the  teeth 
without  injuring  their  polish,  and  at  the  same  time  it  neutralises 
any  acid  which  may  be  present.  Charcoal  has  also  a  useful 
mechanical  action  greater  than  that  of  chalk,  but  it  is  more  liable 
to  scratch  the  enamel. 

The  antiseptics  which  are  usually  employed  to  cleanse  the 
teeth  are  borax,  qiiinine,  and  carbolic  acid.  Dilute  solutions  of 
permanganate  of  potassium  are  also  very  useful,  but  have  a  very 
disagreeable  taste.  Where  the  gums  are  soft  and  spongy  and  are 
apt  to  leave  the  fang  of  the  tooth  more  or  less  exposed,  vegetable 
astringents,  such  as  areca  nut,  catechu,  kino,  and  rhatany  are 
useful.  Mineral  acids  when  given  medicinally  cause  an  unplea- 
sant feeling  of  the  teeth  being  on  edge,  and  are  also  injurious  to 
the  teeth ;  they  are  therefore  usually  sucked  up  by  means  of  a 
glass  tube  or  quill,  instead  of  being  simply  swallowed.  When 
used  as  gargles  for  the  throat,  their  injurious  action  on  the  teeth 


chap,  xiii.]    ACTION  OF  DEUGS  ON  DIGESTIVE  SYSTEM.    353 

may  be  to  a  considerable  extent  prevented  by  previously  rubbing 
the  teeth  with  oil,  butter,  or  lard,  and  washing  out  the  mouth  or 
brushing  the  teeth  with  a  weak  solution  of  alkaline  bicarbonate 
or  soap.  Soluble  preparations  of  iron,  especially  persalts,  are 
apt  to  stain  the  teeth,  and  they  are  therefore  also  given  by  means 
of  a  tube ;  alum  appears  also  to  have  a  very  injurious  action  on 
the  teeth  ;  alum  gargles  should  therefore  not  be  employed  for  a 
length  of  time  together,  and  the  same  precautions  should  be  used 
as  with  acid  gargles. 

When  the  gums  have  receded  somewhat  from  the  crown  of 
the  teeth,  pain  or  a  soreness  is  not  unfrequently  felt  in  the  teeth, 
although  no  definite  caries  is  present.  This  soreness  appears  to 
be  due  to  the  irritant  action  of  acid  secretions  in  the  mouth  upon 
the  exposed  fang,  and  it  may  be  often  to  a  great  extent  removed 
by  washing  the  mouth  out  with  a  weak  solution  of  bicarbonate  of 
sodium,  or  rubbing  finely-powdered  chalk  or  magnesia  along  the 
gums.  When  toothache  occurs  in  consequence  of  caries,  it  may 
sometimes  also  be  relieved  by  holding  some  brandy  in  the  mouth,  or 
by  placing  a  small  pledget  of  cotton-wool  dipped  in  tincture  or 
liquid  extract  of  opium  with  a  little  bicarbonate  of  sodium  in  the 
cavity  of  the  tooth.  A  pledget  of  cotton-wool  dipped  in  creasote 
or  oil  of  cloves  is  often  used  for  a  similar  purpose,  and  one  of  the 
most  effectual  remedies  is  to  dip  a  small  pledget  of  cotton-wool 
in  pure  carbolic  acid  liquefied  by  heat,  and  place  it  in  the  cavity 
of  the  tooth,  taking  care  to  cover  it  well  with  clean  cotton-wool 
so  as  to  prevent  the  carbolic  acid  coming  in  contact  with  the 
tongue  or  cheeks.  Chlorate  of  potassium  often  lessens  toothache 
if  due  to  inflammation  of  a  large  open  carious'  cavity.  Phosphate 
of  calcium  frequently  relieves  toothache  occurring  during  preg- 
nancy or  lactation  and  is  sometimes  useful  also  in  toothache 
unconnected  with  either  of  these  conditions. 

ACTION   OF  DRUGS  ON  THE   SALIVAEY  GLANDS. 
Sialagogues. 

These  are  remedies  which  increase  the  secretion  of  saliva. 

Anything  which  is  chewed,  or  even  turned  about  in  the  mouth, 
such  as  a  pebble,  will  increase  the  secretion  of  saliva ;  but  the 
chief  sialagogues  have  a  stimulating  action  of  their  own. 

Action. — In  the  secretion  of  saliva  there  are  two  factors — 
first,  the  activity  of  the  secreting  cells ;  secondly,  the  supply  of 
new  material  to  them,  from  which  they  may  manufacture  the 
secretion.     This  depends  on  the  circulation. 

Secreting  cells  do  not  derive  the  new  material  from  which 
they  form  the  secretion  directly  from  the  blood.  They  obtain 
it  from  the  lymph  which  fills  the  adjacent  lymph-spaces.  Hence 
they  may  continue  to  secrete  for  a  short  while  after  the  circula- 

A  A 


854 


PHAEMACOLOGY  AND  THEKAPEUTICS.      [sect.  i. 


tion  has  ceased,  as  in  the  sweat-glands  of  an  amputated  limb,  or 
in  the  salivary  glands  after  the  head  of  the  animal  has  been  sepa- 
rated from  the  body.  But  the  supply  of  lymph  soon  becomes 
exhausted  unless  a  supply  of  fresh  lymph  in  the  spaces  is  kept 
up  by  exudation  from  the  blood-vessels.  We  therefore  find  that 
abundant  secretion  is  usually,  though  not  invariably,  associated 
■with  an  abundant  blood-supply.  If  the  flow  of  blood  is  not  rapid 
the  secretion  must  soon  diminish  or  come  to  a  stop,  for,  although 
it  may  occur  rapidly  at  first,  the  lymph  which  has  accumulated 
in  the  lymph-spaces  supplying  the  cells  soon  becomes  exhausted. 


VEsrgLaj"  Gl*nd 


"«*e 


Fig.  124. — Diagram  representing  the  general  relation  of  nerves  to  the  secreting  cells  and  vessels  of  a 
g.and.  For  the  sake  of  simplicity  only  one  afferent  nerve  and  one  nerve-centre  and  one  set  of 
secreting  and  vascular  nerves  are  here  represented. 

In  the  salivary  gland,  when  the  secretion  is  going  on,  the 
arteries  usually  dilate,  and  the  blood  flows  rapidly  through  them. 
I' he  submaxillary  gland,  in  which  secretion  has  been  best  studied, 
appears  to  receive  four  kinds  of  nerves — two  sets  being  contained 
in  the  chorda  tympani  and  two  in  the  sympathetic. 

The  chorda  contains  some  fibres  which  act  on  the  blood- 
vessels, causing  them  to  dilate  and  allow  the  blood  to  flow  freely 
through  the  gland,  and  others  which  stimulate  the  cells  of  the 
gland  to  secrete  a  thin,  watery  saliva.  These  two  kinds  are  spoken 
of  as  vaso-dilating  and  secreting,  or  secretory,  fibres  (Fig.  124). 

At  present  the  usually  accepted  theory  is  that  the  secretory 
nerves  have  a  direct  influence  upon  the  tissue-change  in  the  cells 
of  the  gland.  During  secretion  the  granules  in  the  cell  decrease 
in  number  and  generally  in  size,  the  hyaline  substance  increases, 
and  the  network  within  the  cell  grows.1  It  is  not  at  all  impro- 
bable, however,  that  in  addition  to  their  action  upon  secreiing 
nerves  some  drugs  influence  the  amount  of  fluid  poured  out  from 
the  vessels.  For  if  we  inject  a  solution  of  quinine  into  the  duct 
of  the  gland  and  thus  destroy  its  secreting  power,  and  afterwards 
irritate  the  chorda  tympani,  the  lymph  poured  out  from  the 
blood-vessels  will  accumulate  in  the  gland  and  render  it  cedema- 

1  Langley,  Proc.  Camb.  Phil.  Soc,  Nov.  12,  1883. 


chap,  xiii.]  ACTION  OP  DEUGS  ON  DIGESTIVE  SYSTEM.    355 


tons ;  but  if  an  animal  be  poisoned  witb  atropine  the  gland  does 
not  become  oedematous  when  the  chorda  tympani  is  stimulated — 
although  the  blood-vessels  going  to  it  are  dilated  and  its  power  of 
secretion  is  completely  destroyed.  We  might  suppose  that  the 
gland  did  not  become  oedematous  because  the  lymph,  although 
not  used  up  by  the  gland,  had  been  carried  away  by  the  cervical 
lymphatics.  But  this  is  not  the  case,  for  Heidenhain  has  found 
that  the  flow  of  cervical  lymph  is  not  increased  under  these  cir- 
cumstances. 

It  appears  to  me  that  the  circumstance  can  hardly  be  ex-, 
plained  otherwise  than  by  supposing  that  atropine  not  only  para- 
lyses the  secreting  fibres  of  the  chorda,  but  acts  upon  the  vessels 
in  such  a  manner  as  to  greatly  diminish  or  prevent  the  exudation 
which  would  usually  take  place  from  them  into  the  lymph- spaces 
on  irritation  of  the  chorda. 

The  sympathetic  contains  some  fibres  which  cause  the  vessels 
of  the  gland  to  contract  and  the  blood  to  flow  slowly  through  it, 
and  otherB  which  stimulate  the  cells  to  secrete  a  thick  and  viscid 
saliva. 

Besides  the  ordinary  secretion  of  saliva  regulated  by  the  action 
of  the  nerves,  there  is  a  secretion  which  is  usually  termed  para- 
lytic, because  it  occurs,  not  after  irritation,  but  after  paralysis  of 
the  nerves  going  to  the  salivary  gland.     It  occurs  in  the  sub- 


TOUGUB 


SALlVAFtr 
CLAND 
VESSELS 
OFGLANQ 


Pia.  125. — Diagram  to  show  the  afterent  nerves  by  which  the  secretion  ot  salira  may  be  reflexly 

excited. 

maxillary  gland,  when  its  nerves  have  either  been  paralysed  by 
the  injection  of  small  doses  of  curare  into  the  artery  going  to  the 
gland,  or  by  a  section  of  the  combined  lingual  nerve  and  chorda 
tympani,  or  extirpation  of  the  submaxillary  ganglion.  It  is  not 
improbable  that  morphine  also,  like  curare,  produces  it,  because 

A  A  2 


850  PHAKMACOLOGY  AND   THERAPEUTICS,      [bbot.i. 

in  moderate  doses  it  causes  dryness  of  the  mouth,  but  in  enormous 
doses  causes  excessive  salivation. 

The  secretion  of  saliva  may  be  stimulated  by  the  direct  action 
of  drugs  upon  secreting  nerves  in  the  gland  itself,  or  reflexly 
through  the  sensory  nerves  of  the  mouth,  stomach,  eye,  or  nose 
(Fig.  125).  The  mere  smell,  or  sight,  of  appetising  food,  causes 
secretion  of  saliva,  which  is  probably  due  to  the  nerves  of  smell 
and  taste  acting  through  the  brain  upon  the  medulla.  The  brain, 
•when  excited  by  mere  recollection,  may  also  stimulate  the  secretion 
of  saliva. 

Increased  salivation  is  a  common  accompaniment  of  sickness 
or  nausea.  The  afferent  nerve  here  appears  to  be  the  gastric 
branches  of  the  vagus. 

The  nerve-centre  which  regulates  the  secretion  of  the  thin 
chorda-saliva  is  probably  the  nucleus  of  the  seventh  nerve  situated 
in  the  medulla  oblongata. 

Efferent  fibres  pass  out  along  the  chorda  tympani  and  reach 
the  gland,  some  directly,  and  some  after  passing  through  the  sub- 
maxillary ganglion. 

The  afferent  fibres,  which  convey  stimuli  from  the  mouth  to 
the  medulla  are  contained  in  the  lingual  branch  of  the  fifth,  and 
the  glosso-pharyngeal  nerves.  Those  which  convey  stimuli  from 
the  stomach,  and  excite  the  salivation  which  accompanies  nausea, 
are  contained  in  the  vagus.  The  salivary  centre  may  also  be 
stimulated  by  impulses  sent  down  from  the  brain,  and  the  nerves 
of  sight  and  smell  may  act  as  afferent  nerves  to  the  salivary 
centre  indirectly  through  the  brain  (,Fig.  125). ' 

Besides  the  nerve-centre  in  the  medulla  oblongata  there  are 
subsidiary  nerve-centres.  These  are  the  submaxillary  gan- 
glion and  small  ganglionic  masses  in  the  submaxillary  gland 
itself. 

Sialagogues  have  been  divided  into  two  classes  :  1st,  topical, 
or  direct ;  and  2nd,  specific,  remote,  or  indirect.  The  names 
■direct  and  indirect  are  complete  misnomers,  and  ought  not  to  be 
used ;  inasmuch  as  the  so-called  direct  sialagogues  are  those 
which  act  directly  on  the  mouth,  but  do  not  act  directly  on  the 
substance  of  the  gland,  or  on  the  nervous  structures  contained 
within  it  or  immediately  connected  with  it. 

Sialagogues  are  better  divided  according  to  their  mode  of 
action  into  reflex  sialagogues,  specific  sialagogues,  and  those 
which  act  both  reflexly  and  specifically,  and  may  be  called  mixed 
sialagogues.  * 


1  The  nasal  branches  of  the  fifth  nerve  probably  also  act  as  afferent  nerves  for 
the  salivary  secretion,  for  I  have  noticed  that  on  dipping  the  tip  of  the  nose  into  hot 
water  containing  a  little  compound  tincture  of  benzoin,  salivation  occurred,  ceased 
when  the  nose  was  withdrawn,  and  again  occurred  regularly  whenever  the  nose  was 
again  introduced  into  the  mixture.  The  mere  inhalation  of  the  vapour  had  no 
effect. 


chap,  xm.]  ACTION  OF  DEUGS  ON  DIGESTIVE  SYSTEM.    357 

Reflex  Sialagogues.  Specific  Sialagogues. 

Acids,  mineral  and  vegetable.        Jaborandi.  (Pilocarpine.) 

Acid  salts.  Muscarine. 

Alkalies.  Physostigma.  (Physostigmine.) 

Ethereal  bodies —  Tobacco. 

Ether.  Compounds  of  Iodine. 

Chloroform,  &c.  Mercury  and  its  compounds. 

Pungent  substances- 
Mustard. 

Horseradish. 

Ginger. 

Pyrethrum. 

Mezereon. 

Tobacco,  &c. 

Ehubarb. 

Cubebs. 

Nauseants. 

Tartar  emetic,  &c. 

Reflex  Sialagogues. — Acids,  ether,  ginger,  horseradish, 
mezereon,  mustard,  pyrethrum  and  rhubarb,  all  produce  salivation 
by  stimulating  the  salivary  glands  reflexly  through  the  nerves  of 
the  mouth. 

The  effect  produced  by  reflex  or  topical  sialagogues  is  not  the 
same  for  each.  Ether  and  dilute  acids  produce  a  thin,  watery 
saliva,  but  alkalies  cause  the  secretion  of  a  thicker  and  more 
viscid  saliva :  the  former  appearing  to  affect  chiefly  the  chorda 
tympani,  and  the  latter  the  sympathetic. 

Nauseants,  such  as  tartar  emetic,  stimulate  the  glands  reflexly 
through  the  vagus. 

Mixed  Sialagogues. — Mercury  probably  acts  partly  upon 
the  gland  structures  and  partly  reflexly  through  the  nerves  of 
the  mouth.  Tobacco,  when  smoked  or  chewed,  probably  acts  both 
reflexly  and  specifically.  Iodide  of  potassium  may  act  partially 
as  a  reflex  sialagogue,  for  it  is  secreted  in  the  saliva,  and  it  there- 
fore comes  to  be  present  in  the  mouth  more  or  less  persistently. 
It  is  probable,  however,  that  it  acts  also  upon  the  gland-struc- 
tures, though  it  has  not  been  determined  whether  the  secreting 
cells  or  the  nerves  are  chiefly  affected. 

Specific  Sialagogues. — The  peripheral  ends  of  the  secret- 
ing nerves  in  the  gland  itself  are  stimulated  by  pilocarpine  or  jabo- 
randi, muscarine,  nicotine  and  physostigmine,  so  that  secretion  is 
induced  by  the  injection  of  these  substances  into  the  blood  even 
after  all  the  nerves  going  to  the  gland  have  been  cut. 

In  large  doses  these  substances  paralyse  the  ends  of  the 
secreting  nerves,  so  that  irritation  of  the  chorda  tympani  will 
no  longer  cause  secretion.  Physostigmine  and  nicotine,  besides 
acting  on  the  peripheral  terminations  of  the  secretory  nerves, 


358  PHAEMACOLOGY  AND  THEEAPEUTICS.      [sect.  I. 

stimulate  the  central  ends  of  those  nerves  so  that  section  of  the 
chorda  tympani  greatly  lessens  the  secretion  which  these  sub- 
stances cause,  although  it  may  still  persist  from  the  effect  of  the 
drug  upon  the  peripheral  terminations. 

The  peripheral  action  of  physostigmine  and  nicotine  is,  how- 
ever, much  less  marked  than  that  of  muscarine  and  pilocarpine, 
so  that  the  secretion  caused  by  the  two  former  after  the  nerves 
have  been  divided  is  very  much  less  than  that  produced  by  the 
latter. 

Physostigmine  acts  also  on  the  sympathetic  nerves,  produc- 
ing contraction  of  the  vessels  at  the  same  time  that  it  is  stimu- 
lating the  secreting  centre  in  the  medulla.  In  consequence  of 
this  double  action,  secretion  is  rapid  at  first;  it,  however, 
diminishes  very  quickly  or  ceases  entirely,  the  circulation  being 
so  much  lessened  by  the  contraction  of  the  vessels  that  the  glands 
do  not  get  sufficient  supply  of  new  material  to  go  on  secreting. 


Excretion  by  the  Saliva. 

Iodide  of  potassium  is  very  quickly  excreted  by  the  kidneys, 
so  that  the  great  bulk  of  it  passes  out  of  the  body  in  a  short  time 
after  it  has  been  taken.  But  a  little  of  it  is  retained  very 
persistently  for  a  length  of  time.  There  may  be  more  than  one 
reason  for  this.  It  is  possible  that  it  becomes  combined  with 
albuminous  matters  of  the  blood  and  tissues,  and  this  combination 
being  only  slowly  broken  up,  the  elimination  of  the  drug  continues 
for  a  length  of  time.  Another  reason  appears  to  be  that  it  is 
excreted  even  more  readily  by  the  salivary  glands  than  by  the 
urine.  The  saliva  in  which  it  is  contained  is  swallowed,  the 
iodide  is  again  absorbed  from  the  stomach  and  carried  by  the 
circulation  to  the  salivary  glands.  It  thus  goes  on  in  a  continual 
round  from  mouth  to  stomach  and  from  stomach  to  mouth 
(Fig.  126).  Iodide  of  iron,  and  probably  other  iodides,  are  elimi- 
nated by  the  saliva  in  the  same  way.  Iodide  of  iron  occurs  in  the 
saliva  either  when  injected  into  the  artery  of  the  gland  or  when 
absorbed  from  the  stomach.  When  lactate  of  iron  and  iodide  of 
potassium  are  introduced  simultaneously,  or  at  a  short  interval 
after  each  other,  into  the  stomach,  so  that  iodide  of  iron  is 
formed  there  by  their  combination,  iodide  of  iron  is  found  in 
the  saliva.1  But  if  they  are  injected  separately  into  the  blood, 
iodine  of  potassium  alone  without  any  iron  appears  in  the  saliva. 
Iodine  probably  causes  other  substances  besides  potassium  and 
iron  to  appear  in  the  saliva  when  they  are  combined  with  it.  It 
probably  does  so  to  quinine,  for  when  iodide  of  potassium  and 
quinine  are  given   together    in  a  mixture,  patients    frequently 

'  Bernard,  Physiologie  Experimentale,  torn.  ii.  p.  99, 


chap,  xiii.]  ACTION  OP  DEUGS  ON  DIGESTIVE  SYSTEM.    859 

complain  of  a  very  persistent  bitter  taste  in  the  mouth  much 
more  marked  than  when  the  quinine  is  given  in  simple  solution 
with  acid. 


Fig.  126. — Diagram  of  the  gaatro-salivary  circulation. 

Uses. —  Saliva  is  useful  in  keeping  the  mouth  moist,  and  thus 
facilitating  mastication,  solution,  deglutition,  and  the  movement 
of  the  tongue  in  speaking.  By  moistening  the  fauces,  it  also 
prevents  or  lessens  thirst.  A  pebble  placed  under  the  tongue,  or 
masticated,  will  keep  up  a  slight  flow  of  saliva,  and  may  be  useful 
for  these  purposes.  Where  this  is  insufficient,  dilute  acids  are 
employed.  As  the  flow  of  blood  to  the  glands  is  greatly  increased 
through  secretion,  sialagogues  have  been  used  as  derivatives  to 
lessen  inflammation,  congestion,  and  pain,  in  other  parts  of  the 
head,  as  in  toothache,  earache,  and  inflammation  of  the  ear,  nose, 
or  scalp. 

Saliva  has  also  a  digestive  action  on  starch,  and  increase  of 
the  flow  may  be  advantageous  in  imperfect  digestion  of  this  sub- 
stance. When  swallowed,  the  saliva  stimulates  the  secretion  of 
gastric  juice,  and  increased  salivary  secretion  therefore  tends  to 
aid  the  gastric  digestion  of  proteids.  To  obtain  this  object  it  is 
best  to  chew  a  piece  of  ginger,  pellitory,  or  rhubarb. 


360  PHAEMACOLOGY  AND  THEEAPEUTICS.      [btcct.l 

Refrigerants. 

■Refrigerants  are  remedies  which  allay  thirst,  and  give  a  feel- 
ing of  coolness. 

There  appear  to  be  two  kinds  of  thirst :  one  of  which  is 
general,  the  other  of  which  is  local.  Local  thirst  is  occasioned 
by  dryness  of  the  mouth  and  fauces.  It  may  be  quenched  by 
washing  the  mouth  and  gargling  the  throat  with  water,  although 
none  of  it  be  swallowed,  or  by  anything  which  will  increase  the 
flow  of  saliva,  and  thus  keep  the  mouth  and  fauces  moist.  _  Thus, 
a  pebble  under  the  tongue,  or  chewed,  will  lessen  thirst  by 
increasing  the  secretion  of  saliva  ;  and  acids,  both  mineral  and 
vegetable,  as  well  as  effervescing  drinks  containing  carbonic  acid 
and  the  juices  of  fruits,  which  contain  either  free  vegetable  acid 
or  acid  salts,  acetates  and  tartrates,  have  a  similar  effect.  When 
the  secretion  from  the  mouth  and  throat  is  very  scanty,  it  is 
dried  up  by  the  passage  of  air  to  and  fro  in  the  process  of  re- 
spiration. The  evaporation  thus  occasioned  may  be  lessened, 
and  the  feeling  of  thirst  diminished  by  the  use  of  mucilaginous 
substances,  which  will  form  a  thin  coating  over  the  mucous 
membrane  of  the  mouth  and  pharynx.  Thus,  the  addition  of 
oatmeal  to  water  will  increase  its  power  to  quench  thirst,  and  a 
very  little  milk  added  to  water  has  a  similar  effect. 

General  thirst  depends  upon  the  condition  of  the  organism 
generally,  which  appears  to  be  due  either  to  deficiency  of  water 
or  excess  of  soluble  and  especially  saline  substances  in  the 
circulation. 

General  thirst  is  very  often  accompanied  by  local  thirst,  and 
may  be  partially  alleviated  by  the  means  already  described,  but 
cannot  be  removed  excepting  by  the  introduction  of  water  into 
the  organism,  or  removal  from  it  of  the  saline  or  other  substances 
which  are  present  in  excess,  or  by  lessening  the  excitability  of 
that  part  of  the  nervous  system  by  which  the  sensation  of  thirst 
is  perceived. 

This  part  of  the  nervous  system,  or  thirst  centre  as  Nothnagel 
calls  it,  is  probably  situated,  according  to  him,  in  the  occipital  lobes 
of  the  brain,  and  it  is  possible  that  it  may  be  irritated  directly 
by  mechanical  injury,  or  by  the  condition  of  the  blood  circulating 
in  it,  as  well  as  reflexly  from  mucous  membranes,  such  as  that 
of  the  mouth  and  throat,  and  possibly  also  from  the  kidneys.  Its 
excitability  is  lessened  by  opium,  and  this  may  be  used  to  dimmish 
thirst  in  cases  where  other  remedies  fail  to  relieve. 

Anti-sialics. 

Anti-sialics  are  Bubstances  which  lessen  the  salivary  secre- 
tion.    They  may  do  this  : 

First,  by  removing  the  stimulus  to  secretion. 


chap,  xin.]  ACTION  OF  DEUGS  ON  DIGESTIVE  SYSTEM.    861 

Second,  by  lessening  the  excitability  of  the  efferent  nerves  or 
reflex  centres. 

Third,  by  paralysing  the  efferent  nerves,  such  as  the  chorda 
tympani. 

Fourth,  by  acting  on  the  circulation  through  the  gland. 

Fifth,  by  acting  on  the  gland-structures  themselves. 

Borax  and  chlorate  of  potassium  are  useful  in  the  first  of  these 
ways  by  inducing  a  healthy  condition  of  the  mucous  membrane 
of  the  mouth,  and  thus  lessening  the  irritation  which  gives  rise 
to  salivation ;  opium  and  morphine  diminish  the  reflex  excitability 
of  the  nerve-centre,  and  are  thus  powerful  anti-sialics. 

Physostigma  in  large  doses  greatly  lessens  the  supply  of  blood 
to  the  gland,  and  thus  diminishes  its  secretion,  and  quinine,  hydro- 
chloric acid,  and  alkalies  injected  directly  into  the  duct  of  the 
gland  arrest  secretion  by  affecting  the  secretory  cells  themselves. 
These  latter  drugs,  however,  cannot  be  used  as  anti-sialics. 

The  most  powerful  of  all  anti-sialics  is*,  however,  atropine,  which 
paralyses  the  peripheral  terminations  of  secreting  nerves.  It  does 
not  affect  the  vaso-dilating  nerves,  so  that  in  an  animal  poisoned 
by  atropine  electrical  stimulation  of  the  chorda  tympani  will  cause 
dilatation  of  the  vessels  and  a  free  flow  of  blood  through  the 
gland  as  usual,  but  not  a  drop  of  saliva  will  be  secreted.  That 
this  absence  of  secretion  is  due  to  paralysis  of  secretory  nerves 
and  not  of  the  secreting  cells  appears  to  be  shown  by  the  fact 
that  at  the  time  when  the  power  of  the  chorda  to  induce  secretion 
is  completely  paralysed,  stimulation  of  the  sympathetic  will  still 
induce  secretion. 

Very  large  doses  of  atropine,  however,  paralyse  the  secreting 
power  of  the  sympathetic  in  the  cat,  although  this  has  not  been 
noticed  in  the  dog. 

The  paralysing  action  of  atropine  can  be  counteracted  by 
physostigmine.  This  is  shown  by  poisoning  an  animal  with 
atropine,  and  then  injecting  physostigmine  into  the  gland  of  one 
side  through  the  submental  artery.  It  is  then  found  that  irrita- 
tion of  the  chorda  causes  salivation  in  the  gland  which  has  re- 
ceived physostigmine,  while  it  causes  no  secretion  in  the  other. 

Iodide  of  ethyl-strychnine  and  cicutine  have  an  action  like 
that  of  atropine  on  the  secreting  and  not  on  the  vaso-dilating 
fibres  of  the  chorda  tympani.1 

ACTION  OF  DEUGS   OX  THE  STOMACH. 
Gastric  Tonics. 

These  are  substances  which  increase  the  appetite  and  aid 
gastric  digestion. 

From  observations  made  on  the  stomach  in  persons  or  animals 

1  Jolyet,  Qaz.  Mid.  de  Perns,  1877 


362 


PHAEMACOLOGY  AND  THEEAPEUTICS.      [sect.  r. 


where  a  gastric  fistula  has  been  present,  it  has  been  found  that, 
in  the  normal  condition,  when  the  stomach  is  empty  and  quiet, 
the  mucous  membrane  is  of  a  pale  rose  colour.  When  stimulated 
mechanically,  by  rubbing  it  gently  with  a  feather  or  glass  rod, 
the  mucous  membrane  becomes  redder,  and  such  abundant 
secretion  of  gastric  juice  occurs  that  it  runs  down  in  drops  along 
the  walls  of  the  stomach. 

When  the  irritation  is  greater — as,  for  example,  when  the 
mucous  membrane  is  rubbed  roughly  instead  of  gently — an  op- 
posite effect  is  produced.  The  vessels  then  contract,  the  mucous 
membrane  becomes  pale,  and  the  secretion  of  gastric  juice  stops, 
secretion  of  mucus  commences,  and  if  the  irritation  be  carried 
still  further,  vomiting  occurs. 

Almost  all  substances  which,  when  applied  to  the  skin,  act  as 
irritants,  as  arsenic  and  salts  of  copper,  silver,  or  zinc,  and  those 
also  which,  without  irritating  the  skin,  irritate  the  nerves  of  taste, 


<*  ofSto 


Fio.  127.— Diagram  to  illustrate  the  supposed  nervous  connections  of  the  stomach.  A  gentle  stimnlns 
applied  to  the  walls  of  the  stomach  is  transmitted  hy  the  afferent  nerves,  A,  to  a  nerve-centre, 
B,  and  thence  along  the  vase-dilating  nerves,  c,  and  the  secreting  nerves,  D,to  the  vessels  of  the 
mucous  membrane  and  the  cells  of  the  gastric  follicles.  A  stronger  stimulus  is  transmitted  up 
to  the  nerve-centre,  B,  and  thence  along  the  vaso-constricting  fibres.  F,  and  the  secreting  fibres, 
a,  of  the  mucous  follicles.  A  still  stronger  stimulus  is  transmitted  to  h,  and  thence  along  the 
motor  nerves  to  the  abdominal  walls,  K.K,  causing  them  to  contract  and  produce  retching  or 
vomiting. 


as  bitters,  produce  a  feeling  of  appetite  in  the  stomach,  but  they 
only  do  this  in  certain  conditions  of  the  stomach,  and  in  certain 
quantities.  The  appetite  appears  to  be  associated  with  gentle 
stimulation  of  the  gastric  walls ;  stronger  stimulation  destroys 


chap,  xiii.]   ACTION  OF  DKUGS  ON  DIGESTIVE  SYSTEM.    363 

the  appetite,  still  greater  irritation  causes  nausea  and,  lastly, 
vomiting. 

In  cases  of  atonic  dyspepsia,  where  the  stomach  is  below  par, 
as,  for  instance,  in  anaemia  and  debility,  slight  stimulants  or  irri- 
tants produce  appetite. 

In  such  cases,  where  the  tongue  is  usually  smooth  and  flabby, 
bitters  and  metallic  salts  are  useful.  But  when  the  stomach  is 
already  too  irritable,  and  the  tongue  is  red  with  enlarged  papillae, 
such  substances  are  likely  to  irritate  still  more,  and  thus,  instead 
of  increasing  the  appetite,  to  diminish  it,  and  produce  nausea. 
The  increased  irritability  of  the  stomach  which  precedes  a  bilious 
attack  is  often  signalised  by  an  unusually  good  appetite,  which 
continues  during  the  meal,  so  that  food  is  eaten  with  relish.  A 
still  greater  irritability  is  characterised  by  a  great  appetite  before 
meals,  which  disappears,  giving  place  to  anorexia  as  soon  as  a 
few  mouthfuls  have  been  swallowed,  and  the  gastric  irritation 
heightened  by  the  increased  circulation  consequent  on  the  intro- 
duction of  the  food.  In  such  cases,  bitters  are  likely  to  do  harm, 
and  gastric  sedatives,  such  as  bismuth,  are  required. 

The  stomach  has  not  merely  to  receive  food,  it  has  to  digest 
it,  and  in  the  process  of  digestion  there  are  three  factors  :  1st, 
secretion  of  the  gastric  juice  which  is  to  render  the  food  capable 
of  absorption  and  of  assimilation ;  2ndly,  movements  of  the 
stomach  to  break  up  the  food  and  mix  it  thoroughly  with  the 
solvent  juice  ;  and  3rdly,  absorption  of  the  products  of  digestion. 


Action  of  Drugs  on  Secretion  in  the  Stomach. 

The  secretion  of  the  gastric  juice  is  stimulated  by  gentle 
mechanical  and  chemical  irritation,  as  by  dilute  alkalies  and 
alcohol. 

The  name  of  peptogens  is  given  to  substances  which  increase 
the  gastric  secretions.  Schiff  has  examined  these,  and  states  the 
most  important  of  them  to  be  dextrine  (toasted  bread),  soups, 
peptones,  &C.1 

In  order  to  obtain  gentle  mechanical  stimulation,  it  is  often 
advisable  to  make  patients  who  are  suffering  from  atonic  dyspepsia 
commence  their  meals,  and  especially  their  breakfast,  with  solids, 
instead  of  commencing  with  a  large  draught  of  liquid. 

Dilute  alkalies  given  before  meals  increase  the  secretion  ot 
gastric  juice ;  so  much  so,  that  the  alkali  is  not  only  rapidly 
neutralised,  but  a  large  amount  of  acid  gastric  juice  remains 
Over. 

The  alkaline  saliva  has  a  powerful  stimulant  action  on  the 


1  Boberts,  Digestive  Ferments. 


364  PHAKMACOLOGY  AND  THEEAPBUTICS.      [sect.  i. 

secretion  of  gastric  juice,  and  as  its  quantity  is  much  increased 
both  by  savoury  food  and  by  the  movements  of  mastication,  it  is 
important  that  the  food  should  not  only  be  well  cooked,  but  slowly 
and  perfectly  masticated.  Alcohol  is  one  of  the  most  powerful 
stimulants  that  we  know,  and  is  probably  surpassed  only  by  ether. 
In  persons  suffering  from  weak  digestion,  therefore,  a  little  dilute 
alcohol  with  meals  is  sometimes  very  beneficial. 

Thorough  mastication  is  also  of  the  greatest^  importance  in 
ensuring  perfect  digestion,  inasmuch  as  the  gastric  juice  penetrates 
with  difficulty,  and  only  slowly  dissolves  the  masses  of  albuminous 
matter,  while  it  would  digest  them  very  quickly  if  they  were 
thoroughly  broken  up. 

In  children  and  young  people,  the  stomach  may  be  able  to  do 
more  than  its  fair  share  of  work,  but  it  cannot  do  this  in  persons 
above  middle  age,  and  in  them,  imperfect  mastication,  either  from 
deficient  or  decayed  teeth,  or  from  the  habit  of  eating  quickly,  is 
one  of  the  most  common  causes  of  dyspepsia. 

When  the  stomach  is  too  much  debilitated  to  secrete  a  suffi- 
ciency of  gastric  juice,  even  when  stimulated,  as  in  the  weakness 
consequent  upon  acute  disease,  general  debility,  or  old  age,  we 
may  supply  artificially  the  digestive  substances  in  the  form  of 
acids  and  of  pepsin.  Acids  should  be  given  for  this  purpose  im- 
mediately after  meals,  or  two  hours  after  meals.  Pepsin  should 
be  given  either  with,  or  immediately  after,  those  meals  which 
contain  albuminous  substances.  As  pepsin  has  no  action  on 
farinaceous  food  or  salts,  it  is  of  no  use  to  give  it  after  meals 
containing  these  only. 

Pancreatin,  given  two  hours  after  meals,  along  with  a  little 
bicarbonate  of  sodium,  appears,  in  some  cases,  to  complete  diges- 
tion, and  to  give  great  relief  and  comfort.  When  given  before 
meals  it  is  not  of  much  service,  since  it  is  rendered  inactive  by 
the  gastric  juice. 

Action  of  Bitters. — There  can  be  no  doubt  whatever  that  in- 
fusions of  vegetable  bitter  substances  are  exceedingly  useful  in 
dyspepsia.  They  not  only  increase  the  appetite  so  that  more  food 
is  taken  by  the  patient,  but  they  really  appear  to  assist  digestion 
and  prevent  discomfort  and  flatulence.  Their  beneficial  action 
is  usually  supposed  to  be  due  to  their  causing  an  increased  secre- 
tion of  digestive  juices  and  having  an  antiseptic  action  on  the  con- 
tents of  the  stomach  and  intestine,  thus  preventing  decomposition 
and  flatulence.  This  explanation  has  recently  been  contradicted, 
and  experiments  with  a  number  of  bitter  substances  appear  to 
show  that  they  tend  rather  to  assist  than  to  prevent  fermentation 
and  putrefaction,  and  to  lessen  the  digestive  power  of  the  gastric 
and  pancreatic  juices.  When  given  in  small  quantities  to  animals 
they  cause  a  slight  increase  of  the  gastric  juice.  They  have  no 
action  on  the  secretion  of  the  pancreas ;  some  of  them  increase 
slightly  the  secrotion.of  bile,  but  not  more  than  could  be  accounted 


chap,  xin.]  ACTION  OF  DKUGS  ON  DIGESTIVE  SYSTEM.   365 

for  by  the  water  in  which  they  are  dissolved.  Extract  of  absinthe 
appears  to  increase  tissue-change,  so  that  more  nitrogen  is  ex- 
creted both  in  the  urine  and  fasces,  while  extract  of  quassia  lessens 
tissue-change  by  diminishing  the  amount  of  food  absorbed  from 
the  intestine.  These  experiments  would  appear  to  show  that 
bitters  instead  of  being  useful  are  injurious,  but  the  evidence  of 
clinical  experience  in  regard  to  their  utility  is  so  strong  that  it 
is  evident  either  that  the  experiments  have  been  imperfectly 
conducted,  or  that  we  must  look  to  some  other  organ  than  the 
stomach  for  an  explanation  of  the  beneficial  action  of  bitters  in 
dyspepsia.  I  have  just  mentioned  that  the  condition  of  the  liver 
is  one  of  the  most  important  factors  in  digestion,  and  this  organ 
appears  to  be  specially  acted  upon  by  a  number  of  bodies  belong- 
ing to  the  aromatic  series  (p.  403).  As  a  great  number  of  the 
vegetable  bitters  belong  to  this  series,  it  is  possible  that  their 
beneficial  action  in  dyspepsia  may  be  due  to  changes  which  they 
induce  in  the  liver  (p.  368)  rather  than  in  the  stomach. 


Action  of  Drugs  on  the  Movements  of  the  Stomach. 

Digestion  is  greatly  aided  by  the  movements  of  the  stomach, 
which  assist  it  by  breaking  up  the  food  and  mixing  it  thoroughly 
with  the  gastric  juice.  When  these  are  deficient,  it  is  probable 
that  they  are  stimulated  by  nux  vomica,  or  strychnine,  and  also 
by  bitters. 

A  number  of  experiments  have  lately  been  made  by  Schiitz1 
on  the  influence  of  drugs  upon  the  movements  of  the  stomach. 
These  experiments  are  interesting  as  showing  an  analogy  between 
the  action  of  drugs  on  the  stomach  and  other  organs,  such  as  the 
heart ;  but  the  doses  applied  were  so  large  that  the  effects  are 
not  to  be  considered  the  same  as  those  arising  from  medicinal 
doses.  These  experiments  were  made  by  observing  the  move- 
ments of  the  viscus,  after  removing  it  from  the  body  and  placing 
it  in  a  moist  chamber.  Various  drugs  were  administered  to 
dogs ;  and  after  the  symptoms  of  poisoning  became  well-marked, 
the  animals  were  killed,  and  the  movements  of  their  stomachs 
in  the  moist  chamber  were  compared  with  those  of  normal 
animals. 

The  movements  of  the  isolated  stomach  depend  upon : 

(a)  The  muscular  fibres  contained  in  its  walls. 

(b)  The  motor  nerve-endings  by  which  the  muscular  fibres 
are  excited  to  action. 

(c)  The  ganglionic  cells  of  Auerbach's  plexus,  by  which  the 
rhythmical  movements  of  the  organ  are  maintained. 


1  Arch.f.  exp.  Path.  u.  Pharm.,  xxi.,  p.  341. 


3G6  PHARMACOLOGY  AND  THEEAPEUTICS.      [sect.  i. 

(d)  The  sensory  nerves,  by  which  those  ganglia  may  be 
reflexly  excited. 

The  occurrence  of  spontaneous  movements  in  the  stomach 
shows  that  both  the  ganglia  and  muscular  fibres  retain  their 
functional  power.  This  is  shown  also  by  the  occurrence^  of 
reflex  contractions,  when  the  stomach  is  distended  by  inflation 
and  by  the  production  of  extensive  undulating  contractions  on 
local  irritation  by  a  weak  electrical  stimulus.  As  the  stomach 
dies,  the  nervous  apparatus  loses  its  irritability  before  the  muscles, 
so  that  spontaneous  movements  cease,  reflex  contraction  no 
longer  occurs  on  inflation,  and  the  strength  of  electrical  stimuli 
requires  to  be  greatly  increased  in  order  to  produce  undulatory 
movements  extending  beyond  the  part  actually  stimulated. 

"When  the  excitability  of  the  nervous  apparatus  is  quite  gone, 
that  of  the  muscular  fibres  still  remains.  Electrical  stimuli 
cause  localised  contractions  corresponding  to  the  bundles  of 
muscular  fibres  directly  excited  by  the  current. 

It  is  evident  that  this  result  will  be  nearly  the  same  if  the 
ganglia  themselves  are  paralysed,  or  if  the  motor  nerve-fibres, 
through  which  they  act  on  the  muscular  fibres,  are  paralysed. 
At  present,  these  actions  have  not  been  distinguished  experi- 
mentally in  the  stomach,  and  therefore  conclusions  regarding 
the  mode  of  action  of  some  drugs  are  based  to  some  extent  upon 
analogy.  Thus,  ether  and  atropine  both  produce  the  effect  men- 
tioned above ;  but  we  know  that  ether  tends  to  act  on  nerve- 
centres,  such  as  those  of  the  brain  and  spinal  cord,  while  atro- 
pine tends  to  paralyse  peripheral  nerves  ending  in  involuntary 
muscular  fibre.  The  conclusion  is  that  in  the  stomach  also  the 
effects  of  ether  are  due  to  its  action  on  the  ganglionic  cells,  while 
those  of  atropine  are  due  to  its  action  on  motor  nerves. 

When  the  muscular  fibres  are  paralysed  as  well  as  the 
nerves,  electrical  stimuli  cause  no  contractions  at  all,  or  local 
contractions,  which  are  more  or  less  feeble  according  to  the 
completeness  of  the  paralysis. 

The  results  of  Schiitz's  experiments  are  as  follows  : — 

Muscular  irritability  is  increased,  so  that  finally  general 
persistent  contraction  of  the  stomach  occurs,  by  : — 

Physostigmine.  Scillain. 

Digitalin.  Helleborein. 

Motor  nerve-endings  in  the  stomach  are 

Excited  by  Paralysed  by 

Muscarine.  Atropine. 

The  excitation  by  muscarine  is  shown  by  general  contraction  of 
the  stomach.  The  symptoms  of  paralysis  by  atropine  have  been 
already  discussed. 


chap,  xin.]   ACTION  OF  DEUGS  ON  DIGESTIVE  SYSTEM.    867 

Automatic  nerve-centres  in  the  stomach  are  excited,  so  that 
the  spontaneous  movements  become  brisker  and  assume  a  cha- 
racter differing  from  the  normal — 


Strongly  by — 
Emetine. 
Tartar  emetic. 
Apomorphine. 


Less  marked  by — 

Strychnine. 
Caffeine. 
Veratrine. 
Barium  chloride. 
Nicotine       )  in  small 
Pilocarpine  )    doses. 
Cocaine  (?) l 

Automatic  nerve-centres  are  partially  paralysed,  so  that  the 
movements  are  weakened,  though  not  completely  abolished,  by — 

Chloral.  Arsenic. 

Urethane.  Nicotine     . )  .    ,  , 

Morphine.  Pilocarpine  |  in  lar§e  doseB- 
Pyrophosphate  of  zinc. 

The  whole  nervous  mechanism  of  the  stomach  is  paralysed  by 
exposure  to  the  vapour  of 

Chloroform.  Ether. 

This  paralysis  is  transient,  and  only  lasts  during  exposure.    The 
administration  of  chloroform  or  ether  to  animals  so  as  to  pro- 


Fig.  128. — Action  of  tartar  emetic  on  the  stomach  in  producing  active  contraction  of  an 
antiperistaltic  character.    The  dotted  line  shows  the  shape  of  the  stomach  at  rest. 

duce  ordinary  anaesthesia  seems  to  have  no  action  on  the  move- 
ments of  the  stomach.  It  must  be  borne  in  mind  that  while 
exposure  to  the  vapour  of  ether  or  chloroform  may  paralyse 
the  stomach, .  and  that  while  this  action  is  unimportant,  as  it 
may  occur  from  an  overdose  of  these  substances,  smaller  doses 
probably  increase  the  movements  of  the  stomach  and  act  as 
carminatives. 


1  Cocaine  at  first  causes  greatly  increased  movement  of  the  stomach,  but  its 
subsequent  efforts  are  similar  to  those  of  atropine. 


868 


PHAEMACOLOGY  AND  THEEAPEUTICS.     [sect.  r. 


Absorption  from  the  Stomach. 

We  know  at  present  very  little  regarding  the  effect  of  drugs 
in  stimulating  absorption  from  the  stomach,  but  it  is  probable 
that  this  is  very  greatly  influenced  by  the  condition  of  other 
organs. 

All  the  processes  'which  go  on  in  the  stomach — secretion, 
peristaltic  action  and  absorption — are  much  influenced  by  the 
condition  of  the  circulation. 

All  the  blood  which  circulates  in  the  stomach  has  to  pass 
through  the  liver  before  it  gets  into  the  general  circulation 


Longs 


Veins  from  the  stomach 


Veins  from  the  intestines 


Vena  cava 

Superior     hemorrhoidal 

vein  

Middle      and      inferior 
hemorrhoidal  veins . . 


Arteries  to  the  brain. 


Aorta. 

Arteries  to  the  stomach. 


Arteries  to  the  small 
intestine. 


Arteries  to  the  large 
intestine. 


Kidney. 


HEemorrhoidal  plexus. 
Ureter. 


RECTUM  AND   H.EMOItimoIDAL  PLEXUS. 

PlG.  129.— Diagram  of  the  veins  forming  part  of  the  portal  circulation.    The  pancreatic  and  splenic 
veins,  although  most  important,  have  been  omitted  for  the  sake  of  clearness. 

(Fig.  129),  and  thus  the  condition  of  the  stomach  is  necessarily 
much  modified  by  the  condition  of  the  liver.  If  there  is  any  ob- 
struction to  the  free  flow  of  blood  through  the  liver,  the  circula- 
tion in  the  stomach  will  necessarily  be  impeded,  and  absorption 
probably  diminished. 


chap,  xm.]  ACTION  OF  DEUGS  ON  DIGESTIVE  SYSTEM.  .369 

Not  only  the  blood  from  the  stomach,  but  that  from  the 
intestines  also,  passes  through  the  liver,  and  we  may  naturally 
expect  that  the  liver  itself  will  be  influenced  by  the  condition  of 
the  blood  which  passes  to  it  from  the  intestinal  canal. 

In  Dr.  Beaumont's  observations  on  Alexis  St.  Martin,  in  whom 
a  gastric  fistula  existed,  he  found  that  after  the  stomach  had 
been  deranged  by  various  articles  of  food,  including  fat  pork,  there 
was  distress  in  the  stomach,  headache,  costiveness,  and  a  coated 
tongue.  In  the  stomach  there  were  numerous  white  and  pustular- 
looking  spots.  Half  a.  dozen  calomel  pills  produced  catharsis, 
^removed  the  symptoms,  and  restored  the  mucous  membrane  of 
the  stomach  to  its  normal  condition.  Whether  this  effect  was 
due  to  the  action  of  the  pills  on  the  liver,  or  on  the  intestines, 
.we  cannot  perhaps  positively  say,  but  at  all  events  the  improve- 
ment was  readily  evident  to  the  observer's  eye. 

Purgatives  and  Cholagogues  may  thus  act  as  indirect 
gastric  tonics,1  and  the  effect  of  bitters  (p.  364)  may  be  due  to 
their  action  on  the  liver. 

Absorption  from  the  stomach  is  probably  also  much  influenced 
by  the  condition  of  the  nervous  system.  Bouley  found  that  when 
the  vagi  were  divided  in  a  horse,  strychnine  no  longer  produced 
poisoning,  the  reason  being  that  the  absorption  took  place  so 
slowly  after  a  division  of  the  nerves  that  the  poison  was  excreted 
as  fast  as  it  was  absorbed.  The  retarded  absorption,  however, 
he  considers  to  be  due,  not  to  any  alteration  in  the  absorptive 
power  of  the  stomach  itself,  but  to  diminished  movement  in  its 
walls,  so  that  its  contents  are  not  so  quickly  poured  out  into  the 
intestine.  Absorption  normally  goes  on  more  slowly  from  the 
stomach  than  from  the  intestine,  and  so  while  the  poison  re- 
mains in  the  stomach  it  is  not  absorbed  quickly  enough  to  cause 
poisoning. 

Antacids. 

Antacids  are  remedies  employed  to  lessen  or  counteract 
acidity.  The  excessive  acidity  for  which  antacids  are  given  may 
be  present  in  the  stomach,  intestines,  or  urine. 

Antacids  are  divided  into  direct  and  indirect  or  remote. 
Direct  antacids  lessen  the  acidity  in  the  stomach,  to  which  they 
are  directly  applied.  Bemote  antacids  lessen  the  acidity  of  the 
urine.  Some  substances  have  both  actions,  such  as  potash  and 
soda,  or  the  carbonates  and  bi-carbonates.  Other  substances, 
such  as  the  citrates,  tartrates,  arid  acetates  of  these  bases,  have 
no  power  to  lessen  acidity  in  the  stomach,  but,  after  absorption 
into  the  blood,  they  appear  to  undergo  combustion,  and  become 
converted  into  carbonates.  In  this  form  they  are  excreted  in  the 
urine,  and  lessen  its  acidity. 

1  Beaumont,  Physiology  of  Digestion,  Burlington,  1847,  p.  118. 

B  B 


370  PHARMACOLOGY  AND  THEEAPEUTICS.      [sect.  i. 

Ammonia  and  its  carbonate  are  direct  antacids,  but  not  re- 
mote antacids.  They  lessen  acidity  in  the  stomach  or  intestines, 
'  but  after  absorption  they  undergo  change,  and  are  eliminated  in 
the  form  of  urea,  and,  according  to  some,  of  nitric  acid,  so  that 
they  do  not  lessen  the  acidity  of  the  urine. 

Direct  Antacids. —Liquor  potassae,  potassium  carbonate, 
potassium  bi-carbonate,  liquor  sodae,  sodium  carbonate,  sodium  bi- 
carbonate, liquor  lithiae,  lithium  carbonate,  lithium  bi-carbonate, 
•magnesia,  magnesium  carbonate,  magnesium  bi-carbonate,  lime- 
water,  saccharine  solution  of  lime,  chalk. 

Direct  but  not  Remote  Antacids.— Ammonium  carbonate, 
aromatic  spirit  of  ammonia. 

Remote  Antacids.— Potassium  acetate,  potassium  citrate, 
•potassium  tartrate,  potassium  bi-tartrate,  sodium  acetate,  sodium 
citrate,  tartarated  soda,  lithium  citrate. 


Emetics. 

These  are  remedies  which  produce  vomiting. 

Action. — The  act  of  vomiting  consists  in  compression  of  the 
stomach  by  the  simultaneous  spasmodic  contraction  of  the  dia- 
phragm and  abdominal  muscles,  while  at  the  same  time  relaxa- 
tion of  its  cardiac  orifice  is  produced  by  contraction  of  the  fibres 
which  radiate  out  from  the  lower  end  of  the  oesophagus  along  the 
gastric  walls.  By  their  contraction  these  fibres  draw  the  stomach 
up  towards  the  diaphragm  and  pull  the  walls  of  the  oesophagus 
apart  at  its  lower  end  so  as  to  open  the  cardia.  When  the  cardiac 
orifice  dilates  at  the  same  moment  that  the  stomach  is  compressed 
between  the  diaphragm  and  the  abdominal  muscles,  its  contents 
are  expelled  and  vomiting  occurs ;  but  when  the  compression 
of  the  stomach  and  dilatation  of  the  cardiac  orifice  do  not  take 
place  simultaneously,  the  contents  of  the  stomach  are  retained 
and  the  efforts  are  then  termed  retching. 

The  nerve-centre  which  regulates  the  movements  of  vomiting 
is  situated  in  the  medulla  oblongata.  The  movements  of  vomit- 
ing are  modified  respiratory  actions;  and  the  respiratory  centre 
appears  to  be  closely  connected  with  the  vomiting  centre.  In- 
deed some  groups  of  ganglion  cells  probably  take  part  both  in 
respiration  and  vomiting,  or  in  other  words  form  part  of  both  the 
respiratory  and  vomiting  centres  (Fig.  80,  p.  235). 

The  reason  for  this  supposition  is  not  merely  that  the  move- 
ments of  vomiting  consist  of  modified  respiratory  movements, 
but  that  drugs  which  cause  vomiting  also  increase  the  respiratory 
activity.  Emetics  usually  quicken  the  respiration  considerably 
before  they  produce  vomiting,  and  if  injected  into  the  veins  they 
not  only  quicken  the  respiration,  but  prevent  the  condition  of 
apncea  being  produced  by  vigorous  artificial  respiration. 

On  the  other  hand,'  the  desire  to  vomit  mav  be  lessened  to 


chap.  xm.j  ACTION  OF  DEUGS  ON  DIGESTIVE  SYSTEM.   871 

some  extent  by  taking  frequent  and  deep  inspirations,  and  nar- 
cotics which  diminish  the  excitability  of  the  respiratory  centre 
also  lessen  the  tendency  to  vomit. 

The  motor  impulses  from  the  vomiting  centre  are  sent  to  the 
abdominal  muscles,  diaphragm,  stomach  and  oesophagus  by  the 
intercostal,  phrenic,  and  vagus  nerves  respectively.  Section  of 
the  vagi  generally,  though  not  always,  destroys  the  power  to 
vomit,  because  it  disturbs  the  co-ordination  of  the  cardia  and  the 
abdominal  muscles  and  diaphragm,  so  that  they  no  longer  act 
simultaneously,  and  vomiting  does  not  occur,  although  retching 
may  continue. 

The  vomiting  centre  is  usually  excited  by  stimulation  of 
afferent  nerves  passing  upwards  to  it  from  the  body,  or  by  im- 
pulses sent  down  to  it  from  the  brain. 

The  brain  may  be  stimulated  so  as  to  act  on  the  vomiting 
centre  in  the  medulla  through  impressions  on  the  nerves  of 
special  sense,  such  as  a  disgusting  sight,  stench,  or  taste,  or  by 
the  recollection  of  such  subjects.  Irritation  of  the  brain  itself 
or  of  its  membranes  by  inflammation,  tubercle,  haemorrhage, 
softening,  or  cancer  may  also  excite  vomiting.  The  afferent 
nerves  are  shown  in  the  accompanying  diagram  (Fig.  130). 
Those  chiefly  concerned  with  the  action  of  emetics  are : — 

1.  Branches  of  the  glosso-pharyngeal  nerve  to  the  soft  palate, 
the  root  of  the  tongue,  and  the  pharynx.  Tickling  these  parts 
with  the  finger  or  with  a  feather  is  one  of  the  readiest  means  of 
inducing  vomiting.  Vomiting  also  occurs  when  the  soft  palate, 
tonsils,  or  pharynx  are  inflamed,  especially  in  children. 

2.  The  nerves  of  the  stomach.  These  are  chiefly  branches 
of  the  pneumogastric,  but  they  are  contained  also  in  the  sym- 
pathetic system. 

3.  Mesenteric  nerves  causing  vomiting  in  hernia. 

4.  Nerves  of  the  liver  and  gall-duct. 

5.  Nerves  of  the  kidney  and  ureter. 

6.  Vesical  nerves. 

7.  Uterine  nerves. 

8.  Pulmonary  branches  of  the  vagus  causing  vomiting  in 
phthisis. 

There  are  also  a  number  of  other  nerves  which  produce  vomit- 
ing, but  are  more  important  in  connection  with  pathological 
vomiting  than  with  the  action  of  emetics. 

When  less  was  known  regarding  the  action  of  the  nervous 
system  in  vomiting,  Emetics  were  divided,  according  to  their 
relation  to  the  stomach,  into  direct  and  indirect.  Direct  emetics 
were  those  which  acted  only  when  introduced  into  the  stomach. 
Indirect  were  those  which  acted  when  injected  into  the  blood.  * 

Their  relation  to  the  vomiting  centre  is  of  course  the  reverse. 
Drugs  which  are  applied  directly  to  the  stomach  act  reflexly  or 
bdirectly  on  the  vomiting  centre,  while  those  injected  into  the 

b  b  a 


-S72  PHAEMACOLOGY  AND  THEEAPEUTICS.      [sec*,  r. 

blood  may  be  carried  by  the  circulation  to  the  medulla  and  act 
directly  upon  it.  _  _  .  . 

It  is  to  be  noted,  however,  that  drugs  injected  mto  the  circula- 
tion are  carried  not  only  to  the  nerve-centres  but  to  the  stomach, 


■Central  afferent  paths  \ 
through  which  vomiting  l 
may  he  excited ) 


^Pharyngeal  branches  of  the  1 
^jlosso-pharyngeal  nerve    j 


Liver  and  gall-bladder,  with  \  . — 
nerves  going  to  them  ....]" 

Stomach  and   gastric)  

branches  oi  the  vagus. . . .  ) 


Kidney  and  ureter 


f  Nervous  centre  of  vomiting  in 
t     the  medulla  oblongata. 


— Spinal  cord; 

.--—-Vagus  nerve. 

I Pulmonary  branches  of  vagus. 

.—  J  Splanchnics    giving  fibres  to 
1     liver  and  intestines, 
Gall-duct. 


Renal  nerves. 

.Mesenteric  nerves. 
Uterine  nerves. 


Intestine 

Uterus 

Bladder 

Vesical  nerves*__. 

Fig.  150. — Diagram  showing  the  afferent  nerves  by  which  the  vomiting  centre  may  be  excited  to 

action. 

and  may  be  excreted  by  the  gastric  mucous  membrane.  They 
may  thus  irritate  the  (afferent  nerves  of  the  stomach  and  stimu- 
late the  vomiting  centre  reflexly  just  as  they  do  when  given  by  the 
mouth.  Thus  it  has  been  shown  by  Brinton  that  tartar  emetic 
injected  into  the  veins  of  a  dog  is  excreted  in  a  few  minutes 
:into  the  stomach,  and  may  be  found  on  testing  its  contents. 

It  is  therefore  evident  that  the  action  of  drugs  in  causing 
vomiting  may  be  complex,  and  that  drugs  injected  into  the  blood 
or  under  the  skin  may  cause  vomiting,  both  by  (1)  irritating  the 
vomiting  <oentre  in  the  medulla  directly  when  conveyed  to  it  by 
the  circulation ;  and  (2)  by  irritating  it  reflexly  from  the  stomach, 
whither  they  have  also  been  conveyed  by  the  blood. 

It  is  frequently  very  difficult  to  determine  in  which  of  these 
two  ways  a  drug  has  acted,  and  sometimes  almost  impossible  to 
decide  with  certainty. 

The  reasons  for  believing  that  any  drug  injected  into  the 
circulation  has  caused  vomiting  by  irritating  the  medulla  reflexly 
through  the  stomach,  and  not  by  acting  directly  upon  it,  are : 


chap,  xiii.]  ACTION  OF  DRUGS  ON  DIGESTIVE  SYSTEM.    873 

(a)  When  the  vomiting  does  not  take  place  immediately  on 
injection,  but  only  after  sufficient  time  has  elapsed  to  allow  of 
excretion  of  the  drug  into  the  stomach. 

(b)  When  the  quantity  of  a  drug  required  to  produce  vomit- 
ing by  injection  into  the  veins  is  greater  than  that  which  is 
sufficient  to  produce  a  similar  effect  if  introduced  into  the 
stomach.  It  is  probable  that  some  drugs,  as  tartar  emetic,  act 
in  both  ways,  because,  as  has  already  been  mentioned,  it  is  ex- 
creted into  the  stomach  and  will  there  act  as  an  irritant. 

But  it  will  also  produce  vomiting  when  the  stomach  has  been 
excised  and  replaced  by  a  bladder,  as  in  Magendie's  celebrated 
experiment.  Even  this  experiment,  however,  does  not  prove  that 
tartar  emetic  acts  directly  on  the  vomiting  centre,  inasmuch  as 
it  is  possible  that  it  may  be  excreted  by  the  oesophagus  or  intes- 
tines and  irritate  the  vomiting  centre  reflexly  through  them.  As 
tartar  emetic,  however,  appears  to  act  as  an  irritant  chiefly  in 
those  parts  of  the  body  where  there  is  an  acid  secretion,  it  seems 
doubtful  whether  it  would  produce  irritation  in  the  oesophagus 
and  intestines  such  as  it  does  in  the  stomach.  It  therefore  seems 
not  improbable  that  the  vomiting  which  it  occasions  after  ex- 
cision of  the  stomach  is  due  to  its  direct  action  on  the  medulla 
oblongata,  but  this  cannot  be  regarded  as  quite  proved.  In 
order  to  avoid  the  confusion  which  the  terms  direct  and  indirect 
emetics  are  likely  to  produce  with  regard  to  their  relations  to  the 
stomach  and  vomiting,  it  is  better  to  describe  them  as,  and  to 
employ  the  terms,  topical  or  local  and  general  emetics. 

Topical,  or  local,  are  such  as  produce  vomiting  by  acting 
locally  on  the  pharynx,  oesophagus,  or  stomach  ;  and  general, 
such  as  act  through  the  medium  of  the  circulation.  The  line 
between  the  two  is  not  distinct,  inasmuch  as  tartar  emetic  will 
produce  vomiting  in  either  way,  and  so  will  sulphate  of  zinc,  or 
sulphate  of  copper.  The  local  action  of  sulphate  of  zinc  and 
sulphate  of  copper,  however,  on  the  stomach  is  so  much  greater 
than  their  general  action  that  they  may  be  classed  among  the 
local  emetics. 

Local  Emetics.  General  Emetics. 

Alum.  Tartar  emetic. 

Ammonium  carbonate.  Ipecacuanha  and  Emetine. 

Copper  sulphate.  Apomorphine. 


Mustard.  Senega. 

Salt.  Squill 

Subsulphate  of  Mercury.  Muscarine, 

Water  (lukewarm  and  in  Urechitine, 

copious  draughts).  Digitalis  and  its 
Zinc  sulphate.  congeners,     , 

.Strong  infusions  of  vege- 
table bitters,  as  camo- 
mile, quassia,  &c. 


not  used 
medicinally 
as  emetics. 


374  PHARMACOLOGY  AND  THERAPEUTICS,      [sect.  r. 

The  action  of  local  emetics  is  confined  to  that  of  producing 
vomiting,  which  is  generally  not  long  continued,  ceasing  after 
the  emetic  has  been  evacuated,  and  is  not  accompanied  by  much 
general  depression. 

The  vomiting  occasioned  by  general  emetics,  on  the  other 
hand,  is  much  longer  continued,  and  is  accompanied  by  great 
general  depression,  nausea,  languor,  muscular  weakness,  en- 
feeblement  of  the  circulation,  and  increase  of  the  secretions, 
especially  those  of  saliva,  sweat,  and  mucus  in  the  oesophagus, 
stomach,  and  bronchial  tubes. 

Uses. — Emetics  may  be  used  for  the  purpose  of  simply 
emptying  the  stomach,  or  the  violent  expulsive  efforts  which 
they  occasion  may  be  utilised  in  order  to  remove  foreign  bodies 
or  secretions  from  the  oesophagus  or  from  the  biliary  or  respira- 
tory passages. 

1.  Emetics  may  be  used  to  cause  the  expulsion  of  foreign 
bodies,  such  as  pieces  of  gristle  or  meat  which  have  become 
impacted  in  the  upper  part  of  the  oesophagus,  and,  by  pressing 
on  the  larynx,  are  giving  rise  to  suffocation.  In  such  cases 
apomorphine  given  subcutaneously,  or  injected  into  a  vein  in 
the  dose  of  ^th  or  -Jg-th  of  a  grain,  will  be  found  of  service. 

2.  They  may  be  used  to  remove  the  contents  of  the 
stomach  when  these,  instead  of  undergoing  digestion  and  ab- 
sorption in  the  normal  manner,  have  undergone  fermentative 
changes  and  become  acid,  acrid,  and  irritating,  giving  rise  to 
pain,  either  in  the  stomach  itself,  or  in  some  other  organ,  as  in 
the  head.  In  gastralgia,  or  in  headache  either  depending  upon 
indigestion,  or  associated,  like  sick-headache,  with  a  tendency  to 
vomiting,  large  draughts  of  warm  water  often  give  relief.  Their 
emetic  action  may  be  aided  if  necessary  by  tickling  the  fauces 
with  the  finger,  or  by  using  strong  camomile  tea,  or  mustard 
and  water  in  place  of  water  alone.  Simple  draughts  of  warm 
water,  however,  may  relieve  the  gastralgia  or  headache  without 
causing  vomiting.  They  appear  to  do  so  by  simply  diluting  the 
acrid  contents  of  the  stomach  so  much  that  they  no  longer  irritate 
the  mucous  membrane. 

3.  Emetics  remove  the  poison  from  the  stomach  in  cases 
where  it  has  been  swallowed.  Here  mustard  and  water  is  very 
useful,  as  it  is  the  emetic  which  is  most  likely  to  be  at  hand ;  but 
sulphate  of  copper  and  sulphate  of  zinc  if  readily  procured  are 
to  be  preferred,  as  they  empty  the  stomach  most  quickly  and 
effectually.  In  cases  of  poisoning  by  laudanum,  the  nerve-centres 
are. so  much  deadened  by  the  narcotic  that  they  may  not  respond 
to  the  stimulus  even  of  large  doses  of  these  emetics,  and  then 
it  may  be  necessary  to  employ  the  stomach-pump  or  gastric 
syphon. 

4.  To  expel  bile  from  the  gall-bladder,  to  drive  small  gall- 
stones through  the  gall-duct.     The  bile  is  secreted  under  a  very 


Chap,  xni.] ,  ACTION  OF  DEUGS  ON  DIGESTIVE  SYSTEM.   875; 

low  pressure,  and  a  very  slight  obstruction  in  front  may  prevent 
its  flow  through  the  gall-duct  and  occasion  its  accumulation  in 
the  gall-bladder  and  biliary  capillaries.  The  compression  of 
the  liver  between  the  diaphragm  and  abdomen  muscles,  even 
in  ordinary  respiration,  tends  greatly  to  dispel  the  bile  from  the 
liver,  and  this  expulsive  action  is  of  course  greatly  increased 
during  the  violent  efforts  of  vomiting.  During  these  efforts  the 
bile  may  be  forced  through  the  gall-duct,  driving  before  it  the 
obstruction  which  has  been  occasioned  by  the  accumulation  of 
mucus  within  it  due  to  catarrh,  or  by  the  impaction  of  a  small 
biliary  calculus.  In  this  manner  emetics  may  remove  "jaundice 
due  to  obstruction. 

5.  To  remove  bile  from  the  body  in  cases  of  biliousness, 
fevers,  and  ague.  In  biliousness  the  emetics  have  got  the 
double  action  of  expelling  the  bile  from  the  liver  in  the  way  just 
mentioned,  and  of  removing  it  from  the  body  through  the  stomach. 
When  bile  passes  along  the  intestines;  not  only  is  it  re-absorbed, 
but  poisonous  matters  from  the  intestine  are  absorbed  with  it. 
When  it  is  ejected  from  the  stomach  by  the  efforts  of  vomiting, 
no  time  is  allowed  for  its  re-absorption,  and  so  both  the  bile 
itself,  and  any  poisonous  matter  which  it  contains,  are  more 
rapidly  and  certainly  removed  from  the  body.  It  is  probable  that 
the  malarious  poison  circulates  in  the  bile,  and.  possibly  also  other 
poisons  which  give  rise  to  fevers.  There  can  be  no  doubt  of  the 
advantages  to  be  derived  from  the  use  of  empties  in  ague  before 
the  administration  of  quinine;  and  indeed  cases. of  ague  may  be 
sometimes'  cured  by  the  use  of  emetics  alone  without  quinine, 
while  quinine  without  emetics  is  not  unfrequently.  of  very  little 
use  in  bad  cases.  Emetics  have  also  been  recommended  in  the 
early  stages  of  continued  fevers,  in  order  to  remove  the  poison  on 
which  they  are  supposed  to  depend.  For  such  purposes  ipecacu- 
anha or  tartar  emetic  is  best. 

6.  To  remove  obstructions  from  the  air-passages,  such 
as  false  membranes  from  the  trachea  and  bronchia  in  croup  or 
diphtheria,  or  the  over-abundant  secretion  which  is  clogging 
the  bronchi  and  interfering  with  respiration  in  bronchitis,  and 
more  rarely  in  phthisis.  Ipecacuanha  is  the  emetic  most  readily 
chosen  in  such  cases,  as  it  tends  to  increase  the  secretion  from 
the  air-passages,  as  well  as  to  produce  vomiting.  When  it  does 
not  act  rapidly,  sulphate  of  zinc  or  sulphate  of  copper  may  be  used, 
and  a  teaspoonful  of  alum  is  a  very  efficient  remedy  in  croup. 
When  there  is  much  depression  of  the  circulation,  carbonate  of 
ammonium  is  to  be  preferred  as  an  emetic,  inasmuch  as  it  stimu- 
lates the  circulation,  as  well  as  causes  vomiting. 

Contra-indications. — Emetics  must  be  avoided  in  persons 
suffering  from  aneurism,  and  used  with  care  in  persons  suffering, 
from  atheroma  or  a  tendency  to  haemorrhage  from  the  lungs 
or  uterus,  lest  the  high  blood-pressure  which  occurs  during  the- 


376  PHAEMACOLOGY  AND  THEEAPEUTICS.      [sect,  ii 

efforts  of  vomiting  should  lead  to  the  rupture  of  a  blood-vessel. 
They  should  be  used  with  caution  also  in  persons  suffering  from 
hernia,  or  who  have  a  tendency  to  it,  or  from  prolapsus  of  the 
uterus.  In  pregnancy  we  often  find  obstinate  vomiting  lasting 
for  a  length  of  time,  and  yet  producing  no  abortion ;  but  where 
a  tendency  to  abortion  exists,  emetics  should  be  avoided  if 
possible. 

Anti-emetics  and  Gastric  Sedatives. 

Gastric  sedatives  are  substances  which  lessen  the  irritability 
of  the  stomach  and  thus  diminish  pain,  nausea,  and  vomiting. 

Their  action  may  be  either  local  on  the  stomach,  or  general 
on  the  nervous  system,  and  especially  on  the  vomiting  centre  in 
the  medulla  oblongata. 

Local  Sedatives.  General  Sedatives. 

Alcohol.  Hydrocyanic  acid. 

Alum.  Morphine. 

Arsenious  acid  in  minute  doses.        Opium. 

Atropine. 

Belladonna.  Anti-emetic  Measures. 

Bismuth  salts.  Eecumbent  posture. 

Carbolic  acid.  Injection  of  large 

Cerium  oxalate.  quantities  of 

Chloroform,  agrated  water  ^ 

Cocaine,  the  rectum. 

Creasote. 

Ether. 

Hydrocyanic  acid. 

Ice. 

Morphine. 

Opium. 

Besorcin. 

Silver  nitrate. 

Sulpho-carbolates. 

The  most  powerful  of  all  local  sedatives  is  ice,  and  when 
vomiting  is  persistent,  everything  should  be  iced,  and  ice  swallowed 
in  small  lumps.  Hydrocyanic  acid  and  morphine  probably  act 
by  lessening  the  irritability  of  both  the  nerves  in  the  stomach 
itself  and  of  the  vomiting  centre  as  well.  The  mode  of  action 
of  creasote  and  carbolic  acid  is  rather  uncertain,  because, 
although  they  have  a  local  anaesthetic  action,  yet  they  are  found 
useful  also  in  cases  of  reflex  vomiting,  such  as  the  vomiting  of 
pregnancy. 

As  adjuvants  to  gastric  sedatives,  we  may  mention  such 
substances  as  diminish  or  remove  the  irritation,  although  not 


CHAP.  xm.].  ACTION  OF  DEUGS  ON  DIGESTIVE  SYSTEM.    377 

lessening  the  sensibility,  of  the  stomach  itself.  Thus,  where  the 
irritant  consists  of  very  acrid  fluid  in  the  stomach,  a  large  draught 
of  water,  by  diluting  it,  may  lessen  pain,  or  nausea,  and  alkalies 
have  a  similar  action.  When  the  irritation  is  due  to  congestion 
of  the  mucous  membrane,  astringents  will  also  have  a  sedative 
action.  Probably  this  is  the  explanation  of  the  use  of  alum  in 
the  vomiting  of  ptuhisis,  and  possibly,  also,  of  the  use  of  nitrate 
of  silver  in  the  vomiting  of  chronic  alcoholism. 

Uses. — Gastric  sedatives  are  employed  (1)  to  relieve  pain  in 
the  stomach,  as  in  gastrodynia.  The  most  useful  are  small  doses 
of  morphine,  hydrocyanic  acid,  belladonna,  arsenic,  and  bismuth ; 
(2)  to  relieve  vomiting.  This  depends  upon  the  cause  of  the 
vomiting.  When  it  is  due  to  acrid  substances  in  the  stomach,  the 
best  sedative  is  often  a  large  draught  of  warm  water,  which  either 
dilutes  or  renders  them  less  irritating,  or  causes  their  removal 
by  vomiting.    • 

Where  it  is  due  to  acute  irritation  of  the  walls  of  the  stomach 
itself,  ice,  hydrocyanic  acid  and  morphine,  and  bismuth  are 
best. 

When  due  to  the  acrid  products  of  fermentation  in  the 
stomach,  sulphurous  acid,  creasote,  resorcin,  and  the  sulpho- 
carbolates  are  very  useful. 

When  due  to  chronic  irritation  and  congestion,  alum,  nitrate 
of  silver,  creasote,  carbolic  acid,  and  the  sulpho-carbolates  are 
serviceable. 

When  the  vomiting  is  due  to  strangulated  hernia,  the  hernia 
must  be  reduced,  and  in  cases  of  intussusception  or  obstruction 
these  conditions  must  be  removed.  In  the  vomiting  of  pregnancy, 
the  irritability  of  the  vomiting  centre  must  be  reduced  by  bromide 
of  potassium  or  morphine.  It  is  only  in  extreme  cases  that  the 
source  of  irritation,  viz.  the  pregnant  condition,  is  to  be  removed, 
but  certain  local  means  are  sometimes  useful ;  such  are  separation 
of  the  membranes  around  the  neck  of  the  uterus,  which  may  pos- 
sibly act  by  lessening  the  irritation  in  the  organ,  and  painting  the 
os  uteri  with  stimulating  applications  which  probably  rather  act 
by  a  kind  of  counter-irritation  or  inhibition. 

The  vomiting  of  pregnancy  has  sometimes  been  arrested  by 
the  injection  of  effervescing  water,  and  especially  of  natural 
effervescing  chalybeate  water  like  that  of  Pyrmont,  into  the  rectum 
in  quantities  of  two  litres  at  a  time.  It  is  difficult  to  say  whether 
this  is  due  to  a  local  or  general  sedative  action  of  the  carbonic 
acid  or  to  reflex  inhibition  of  vomiting  (cf.  inhibition  of  sneez- 
ing, p.  246).1 

>  Sohucking,  Deutsch.  Med.  Ztg.,  ii.  1885, 


878  PHAKMACOLOGY  AND  THEEAPEUTICS.      [sect.  I* 


Carminatives. 

Carminatives  are  substances  which  aid  the  expulsion  of  gas 
from  the  stomach  and  intestines.  They  appear  to  do  this  by  in- 
creasing the  peristaltic  movements  of  these  organs,  and  in  the 
case  of  the  stomach  by  causing  the  lower  end  of  the  oesophagus 
or  cardiac  sphincter,  and  perhaps  sometimes  the  pyloric  sphincter, 
to  dilate  so  as  to  allow  of  the  exit  of  gas.  The  stomach  naturally 
contains  a  certain  amount  of  gas,  chiefly  nitrogen  and  carbonic 
acid.  The  nitrogen  is  derived  from  air  which  has  been  swallowed, 
the  oxygen  with  which  it  was  mixed  being  absorbed  by  the  walls 
of  the  stomach. 

For  respiration  goes  on  in  the  stomach,  as  well  as  in  the  lungs, 
though  only  to  a  slight  extent  in  mammals,  and  oxygen  is  absorbed 
and  carbonic  acid  excreted.  The  stomach,  therefore,  generally 
contains  carbonic  acid  in  addition  to  nitrogen ;  some  of  the 
carbonic  acid  also  is  derived  from  the  food.  In  addition  to  these 
gases  there  is  frequently  hydrogen  present :  hydrogen  and  a 
quantity  of  carbonic  acid  being  formed  by  processes  of  fermenta- 
tion going  on  in  the  food.  Sometimes  instead  of  pure  hydrogen 
marsh-gas  is  formed,  which  takes  fire  when  expelled  from  the 
stomach,  and  not  unfrequently  the  hydrogen  unites  with  sulphur, 
forming  sulphuretted  hydrogen,  causing  to  the  patient  an  un- 
pleasant taste  of  rotten  eggs  in  the  mouth,  or  giving  their  smell 
to  the  breath.  It  is  probable  that  this  last  occurrence  is  due  in 
many  cases  to  the  presence  and  decomposition  in  the  stomach 
of  bile,  which  contains  sulphur  as  one  of  its  constituents. 

When  digestion  is  rapid  and  complete,  little  or  no  fermenta- 
tion occurs,  very  much  less  gas  is  formed,  and  therefore  there  is 
no  uncomfortable  distension. 

There  are  several  drugs  which  tend  to  prevent  fermentation, 
while  they  hardly  interfere  at  all  with  the  action  of  the  gastric 
juice.  Among  these  may  be  mentioned  creasote,  sulphurous  acid, 
and  bitters,  though  the  anti-fermentative  action  of  the  last  has 
been  denied.  These  substances  may  all  be  regarded  as  adjuvants 
to  carminatives,  and  so  indeed  may  pepsin,  dilute  alkalies,  and  all 
other  remedies  which  stimulate  the  secretion  of  gastric  juice  and 
thus  aid  digestion. 

Where  there  is  any  tendency  to  venous  congestion  in  the 
stomach,  there  will  be  interference  with  the  respiration  in  the 
stomach,  and  thus  a  greater  tendency  to  the  accumulation  of  gas. 
Any  conditions  interfering  with  the  circulation,  such  as  mitral 
disease  or  hepatic  congestion,  will  thus  tend  to  cause  flatulence, 
and  in  such  cases  digitalis  and  cholagogues  will  prove  useful 
adjuvants  to  carminatives. 

It  is  possible  that  much  mucus  covering  the  surface  of  the 
stomach  may  interfere  both  with  absorption  and  with  gastric 
respiration.   Charcoal  has  been  given  to  remove  flatulence,  on  the 


chap,  xin.]  ACTION  OF  DEUGS  ON  DIGESTIVE  SYSTEM.    879 

supposition  that  it  absorbs  the  gases  in  the  stomach.  But  it 
only  absorbs  gas  when  it  is  dry,  and  the  beneficial  action  which 
it  certainly  possesses  is  probably  a  mechanical  one  in  removing 
mucus  and  stimulating  circulation.  Possibly  bismuth,  nitrate  and 
carbonate,  and  magnesium,  oxide  and  carbonate,  act  similarly, 
though  less  powerfully. 

The  chief  Carminatives  belong  to  the  classes  of  aromatic 
oils,  alcohols,  or  ethers.     They  are : — 
Allspice  and  oil.  Cinnamon  and  oil.        Mace. 

Anise  and  oil.  Cloves  and  oil.  Mustard. 

Asafcetida.  Coriander  and  oil.         Nutmeg  and  oil. 

Cajeput  oil.  Dill  and  oil.  Pepper. 

Capsicum.  Ether  and  acetic  Peppermint  and  oil. 

Caraway  and  oil.  ether.  Spearmint  and  oil. 

Cardamoms.  Fennel.  Spirits. 

Chilies."  Ginger.  Valerian  and  oil. 

Chloroform.  Horseradish. 

Uses. — Carminatives  are  employed  (1)  to  remove  pain  and 
distension  of  stomach  and  intestines  caused  by  flatulence ;  (2)  to 
render  peristaltic  action  regular,  and  diminish  local  spasm  and 
pain  depending  upon  it.  They  are  useful  both  in  cases  where 
the  spasm  is  due  to  irritation  of  the  stomach  and  intestines  by 
irritant  articles  of  food,  irritant  secretions,  or  irritant  medicines. 
They  are  therefore  commonly  used  not  only  in  griping-  and  colic 
pains  due  to  indigestion,  worms,  or  exposure  to  cold,  but  as 
adjuvants  to  purgatives  in  order  to  lessen  the  griping  pain,  which 
they  often  cause  when  given  alone.  In  addition  to  this,  by  ren- 
dering the  peristaltic  action  of  the  bowel  more  regular,  they 
assist  the  action  of  the  purgatives. 

ACTION  OF  DRUGS    ON  THE  INTESTINES. 

Intestinal  Movements  and  Secretion.  —  The  peristaltic 
movements  of  the  intestine  occur  even  when  it  is  separated 
entirely  from  the  body.  Their  rhythmical  occurrence  appears  to 
be  due  to  the  action  of  the  ganglia  contained  in  Auerbach's  plexus, 
which  lies  between  the  outer  longitudinal  and  internal  circular 
layer  of  the  muscular  coat.  The  secretion  is  probably  influenced 
by  Meissner's  plexus,  which  lies  in. the  sub-mucous  coat. 

Both  the  movements  and  the  secretion  of  the  intestine  require 
to  be  regulated  in  accordance  with  the  wants  of  the  body,  and  this 
is  done  by  the  nerves  which  connect  these  plexuses  with  the 
cerebro-spinal  centres.  The  chief  of  these  nerves  are  the  splanch- 
hics  and  the  vagi.  Irritation  of  the  vagi  frequently  causes  move- 
ments of  the  intestine ;  irritation  of  the  splanchnics,  on  the  other 
hand,  arrests  them,  so  that  the  splanchnics  have  been  regarded 
as  the  inhibitory  nerves  of  the  intestine,  just  as  the  vagi  are  the 
inhibitory  nerves  of  the  heart.    But  this  arrest  is  by  no  means 


380  PHAKMACOLOGY  AND  THEEAPEUTICS.      [sect.  I, 

constant ;  sometimes  the  movements  instead  "of  being  arrested 
are  distinctly  increased ;  so  that  it  is  evident  that  the  splanchnics 
contain  a  mixture  of  stimulating  and  inhibitory  fibres,  or  else 
that  the  same  fibres  are  capable  of  exercising  either  function 
Tinder  different  conditions. 

Paralytic  Secretion. — When  all  nervous  connection  between 
the  intestine  and  the  higher  nerve-centres  is  cut  off  by  com- 
pletely dividing  the  intestinal  nerves,  a  copious  secretion,  exactly 
resembling  the  rice-water  stools  of  cholera,  occurs  in  the  intestine. 
This  is  best  shown  by  isolating  three  loops  of  intestine,  by  means 
of  ligatures,  after  they  have  been  previously  carefully  emptied, 
as  shown  in  Fig.  131.  The  nerve-fibres  going  to  the  middle  loop 
are  then  divided,  and  the  intestine  is  returned  to  the  abdominal 
cavity.  After  four  or  five  hours  the  animal  is  killed,  and  the 
intestine  examined ;  it  is  then  found  that  the  loop,  the  nerves  of 
which  have  been  divided,  is  filled  with  fluid,  while  the  other  loops 
which  have  been  under  precisely  the  same  circumstances,  but  the 
nerves  of  which  have  not  been  cut,  remain  empty. 

It  is  evident,  then,  that  certain  nerve-centres  possess  the 
power  of  restraining  the  secretion  from  the  intestine.  These 
nerve-centres  have  been  shown  by  Pye- Smith  and  myself  to  be 
the  smaller  or  inferior  ganglia  of  the  solar  plexus,  with  the 
superior  mesenteric  off-set  from  them.  When  these  ganglia  are 
destroyed,  the  same  abundant  secretion  occurs  in  the  intestine 

/ve/fves 


Pig.  131.— Diagram  slowing  the  effect  of  section  of  nerves  on  secretion  from  the  intestine.    The 
nerves  going  to  the  middle  loop  have  been  divided,  and  it  is  distended  with  the  fluid  secreted. 

as  when  all  the  nerves  are  cut,  but  if  these  ganglia  be  left  intact 
the  spinal  cord  may  be  removed,  the  vagi  and  splanchnics  cut, 
and  the  semilunar  ganglia  excised  without  any  excessive  secretion 
occurring  in  the  intestine. 

The  vascular  supply  of  the  intestines  is  regulated  to  a  con- 
siderable extent  by  the  splanchnics,  irritation  of  which  causes 
contraction  of  the  vessels.  There  appears  also,  however,  to  be  an 
important  relation  between  the  intestinal  vessels  and  the  lumbar 
portion  of  the  spinal  cord,  because  when  this  part  of  the  cord  is 


Ghaj?.  xni.]  ACTION  OF  DEUGS  ON  DIGESTIVE  SYSTEM.   381 

destroyed  with  extirpation  of  the  solar  plexus,  haemorrhage  or 
hypersemia  of  the  intestinal  mucous  membrane  occurs,  so  that 
the  internal  surface  of  the  intestine  has  a  somewhat  dysenteric 
appearance.  This  does  not  occur  when  the  solar  plexus  and 
semilunar  ganglia  are  destroyed,,  the  splanchnics  divided,  or  the 
mesenteric  nerves  cut.1 

The  nervous  arrangements  for  regulating  intestinal  move- 
ment and  secretion  are  evidently  exceedingly  complex,  and  until 
our  knowledge  of  their  physiological  relations  is  more  perfect,  we 
cannot  expect  to  understand  completely  the  effect  which  drugs 
produce  upon  them.  These  are  occasionally  very  complicated, 
and  vary  considerably  according  to  the  quantity  of  the  drug 
used.  Drugs  may  affect  the  intestine  by  their  local  action  on 
the  intestine  itself,  by  their  direct  action  on  the  central  nervous 
system,  or  by  their  indirect  action  through  the  alterations  in  the 
quality  or  supply  of  the  blood.  The  quality  of  the  blood  which 
circulates  in  the  intestine  alters  its  movements  very  considerably. 

When  the  aorta  is  clamped,  so  that  the  blood  which  circu- 
lates in  the  intestine  and  in  the  lower  part  of  the  spinal  cord 
becomes  venous,  the  peristaltic  movements  are  usually  much  in- 
creased ;  when  the  compression  is  removed  and  arterial  blood  is 
allowed  to  circulate  again,  the  peristalsis,  instead  of  diminishing, 
as  one  might  expect,  becomes  still  more  intense.  Compression 
of  the  vena  cava  inferior,  or  of  the  portal  vein,  sometimes  causes 
a  slight  increase  in  the  peristaltic  movements,  but  it  is  incon- 
siderable as  compared  with  those  produced  by  clamping  the 
aorta.  During  suffocation,  when  the  blood  becomes  venous 
throughout  the  whole  body  and  exercises  an  irritating  action,  not 
only  on  the  nerve-centres  present  in  the  intestine  and  in  the 
lumbar  portion  of  the  spinal  cord,  but  also  on  the  brain  and 
upper  part  of  the  cord,  the  effect  on  the  movements  of  the  in- 
testine is  variable.  They  are  sometimes  increased,  but  some- 
times an  inhibitory  effect  appears  to  be  produced  through  the 
higher  centres  and  their  movements  are  arrested. 

It  is  evident  therefore  that  when  an  animal  has  been  poisoned^ 
by  any  drug,  and  the  intestines  are  examined  after  death,  two 
different  conditions  may  be  found,  which  do  not  depend  upon 
any  peculiar  action  of  the  drug  on  the  intestine,  but  only  upon 
its  effects  on  the  higher  nerve-centres ;  thus,  if  the  higher  centres 
have  been  in  such  a  condition  as  to  cause  inhibition,  the  intes- 
tines may  be  found  in  a  state  of  perfect  rest,  whereas,  if  they 
happen  not  to  be  in  this  condition,  brisk  peristalsis  may  be  ob- 
served. It  very  often  occurs  that  when  the  intestines  are  first 
exposed  after  an  animal's  death,  they  are  found  to  be  at  rest,  but 
as  the  higher  centres  die  from  a  stoppage  of  the  circulation,  the 
peristaltic  movements  become  much  accelerated. 

'  T:  Lauder  Brunton  and  Pye-Smith  on  'Intestinal  Secretion  and  Movement,' 
British  Association  Reports,  1874,  1875,  1876. 


882  PHAEMACOLOGY  AND  THERAPEUTICS,      [sect,  h 

In  order  to  simplify  the  problem  presented  by  the  complin 
cated  nervous  arrangement  in  the  intestine,  Ludwig  and  Salvioh 
have  used  the  plan  of  keeping  up  the  circulation  artificially  in 
a  small  piece  of  intestine,  and  then  investigating  its.  movements 
under  various  conditions.      The  intestine  was  laid  on  a  piece  of 


Fig.  132.— Diagrammatic  representation  of  apparatus  for  testing  the  action  of  drugs  on  the  intestine 
by  artificial  circulation  through  it.  For  the  sake  of  simplicity  the  means  employed  to  keep  up 
the  temperature  of  the  intestine  and  apparatus  have  been  omitted,  a,  a  board  on  which  the 
intestine,  b,  is  laid,  c,  a  cannula  tied  into  a  branch  of  the  mesenteric  artery,  d.  d,  two  stop- 
cocks, by  means  of  which  pure  blood  or  poisoned  blood  may  be  passed  at  will  through  the  can- 
nula, k  and  p,  two  flasks  containing  pure  and  poisoned  b'ood.  g,  a  block  on  which  they  stand, 
and  by  which  they  can  be  raised  to  a  greater  or  less  height,  so  as  to  alcer  the  pressure  under 
which  the  blood  flows.  When  the  apparatus  is  kept  warm  the  pressure  is  more  easily  regulated 
by  passing  air  into  the  flasks  from  a  pressure  bottle.  H,  the  lever  for  registering  the  movements 
of  the  intestine.  One  end  is  weighted  and  rests  on  the  intestine.  I  is  the  .axis  on  which  the 
lever  works,    k.  is  a  revolving  cylinder  on  which  the  movements  are  recorded. 


Fig.  133. — Shows  the  effect  of  anaemia.  The 
upper  tracing  shows  the  movements  of  the 
intestine  supplied  with  normal  blood  ;  the 
lower  shows  the  movements  of  an  intestine 
rendered  more  vigorous  by  anaemia. 


Fig.!  134. — Shows  the  effect  of  peptones.  The 
first  half  of  the  tracing  shows  the  move- 
ments of  an  intestine  supplied  with  blood 
thoroughly  oxygenated ;  the  second  half 
shows  the  effect  of  blood  containing  pep- 
tones. 


Fig.  135.— Shows  the  effect  of  nicotine.   The  part  Fig.  136.— Shows  the  effect  of  opium.    In  the 

of  the  tracing  marked  A.  B  shows  the  intes-  first  part  of  the  tracing  the  intestine  was 

tinal  movements  during  che.  circulation  of  supplied  with  apneeic  blood ;  in  the  latter 

blood  saturated  with  oxygen  (apneeic  blood);  with  blood  containing  opium, 
the  part  NB  of  blood  containing  nicotine. 

cork,  in  a  warm  chamber.  It  was  supplied  with  blood  by  means  of 
a  cannula  placed  in  the  artery,  and  allowed  to  flow  out  through 
a  cannula  in  the  veins  (Fig.  132).  Its  movements  were  registered 
by  a  small  lever  placed  upon  it.  When  blood  fully  oxygenated 
passed  through  it,  the  lever  traced  only  a  straight  line  or  gently 
oscillating  curve  (Fig.  134),  but  when  the  flow  of  blood  was 
stopped,  so  that  the  blood  stagnated  and  became  venous,  contrac- 
tions began  which  were  indicated  as  a  series  of  curves.  A  trace 
of  peptone  caused  first  strong  contraction  and  then  a  number  of 
irregular  contractions,  at  the  same  time  that  the  vessels  became 


chap,  xiii.]-  ACTION  OF  DKUGS  ON  DIGESTIVE  SYSTEM.    383 

fuller  of  blood  (Pig;  184).  Nicotine  causes  brisker  movements  of 
theintestine,  and  lessens  the  rapidity  of  the  flow  of  blood  (Fig.  135) . 
In  large  doses  it  causes  tetanic  contraction  of  the  circular  fibres. 

Atropine  causes  irritation  of  the  vessels,  while  the  muscular 
fibres  remain  at  rest.  The  action  of  opium  is  very  remarkable ; 
When  the  tincture  is  added  in  the  proportion  of  -04  to  -01  per  cent, 
to  the  blood  which  is  circulating  through  the  intestine,  the  cir- 
culation becomes  at  once  lessened,  but  almost  immediately  after- 
wards the  diminution  passes  abruptly  into  great  increase,  so  that 
five  or  seven  times  as  much  blood  flows  through  in  a  given  time 
as  formerly ;  at  the  same  time  all  the  movements  of  the  intestine 
are  abolished,  but  the  intestinal  wall  instead  of  being  relaxed,  as 
one  would  expect,  is  in  a  condition  of  considerable  contraction 
(Fig.  136).  When  the  opium  is  washed  out  of  the  vessels  by 
pure  blood,  the  after-effects  vary  according  to  the  quantity  which 
is  used.  If  it  is  small,  the  movements  and  circulation  in  the 
intestine  soon  become  normal,  but  if  a  large  dose  has  been  used, 
the  circulation  returns  to  the  normal  condition,  but  the  move- 
ments remain  abolished  for  a  length  of  time.  The  peristaltic 
action  induced  by  nicotine  is  arrested  by  opium.  The  local 
action  of  this  drug  therefore  seems  to  be  that  it  converts  the 
peristaltic  movement  into  a  steady  contraction. 

A  remarkable  difference  between  the  action  of  salts  of  sodium 
and  potassium  on  the  intestine  has  been  detected  by  Nothnagel,1 
and  his  results  have  been  confirmed  by  Floel.  When  the  intes- 
tine is  exposed,  and  a  potassium  salt  is  applied  to  its  external 
Or  peritoneal  surface,  it  produces  a  contraction  of  the  muscular 


Fig.  137. — Represents  a  piece  o£  duodenum,  a,  after  irritation  by  potassium  chloride ;  &,  after  irrita- 
tion by  sodium  chloride,  o  indicates  the  point  of  irritation,  and  the  arrows  the  direction  in 
which  the  intestinal  contents. normally  more  from  the  pylorus,  towards  the  anus.  (After  Floel. ) 

walls,  which  remains  localised  to  the  point  of  contact,  or  simply 
causes  a  ring  of  contraction  opposite  the  point  (Fig.  137a).  When 
a  sodium  salt  is  used  instead,  it  produces  a  contraction  which  is 
not  limited  to  the  point  of  contact,  but  always  spreads  some  little 
distance  from  it,  and  sometimes  does  so  in  the  direction  towards 
the  pylorus,  and  not  towards  the  anus  (Fig.  137b),  but  at  other 
times  spreads  equally  in  an  upward  and  downward  direction* 
(Fig.  138  a).  This  peculiar  action  appears  to  be  due  to  the 
potassium  salts  acting  as  "stronger  muscular  irritants  than  the 
sodium  salts,  while  the  progressive  contraction  caused  by  the 
sodium  is  due  to  the  intestinal  nerves  in  their  case  being  to  a 
greater  extent  involved. 

1  Nothnagel,  Virchow's  Archiv,  Bd.  88,  p.  1. 
'  3  Floel,'  PflUger's  Archiv,  vol.  xxxv.  p.  160. 


384  PHARMACOLOGY  AND  THEEAPEUTICS.      [sect.  i. 

The  effect  of  morphine  is  very  remarkable.  When  the  animal, 
in  addition  to  being  ansesthetised  by  ether  only,  as  in  the  previous 
experiment,  has  a  small  dose  of  morphine  injected  also  into  the 
veins,  it  has  a  sedative  effect,  so  that  sodium  salts  applied  to 
the  intestine  produce  only  a  local  contraction  like  potassium 
salts.  But  this  is  only  when  a  certain  dose  of  morphine  is  em- 
ployed, about  0-01  to  0-03  gramme  of  morphine  for  a  rabbit  of 
average  size.     When  the  dose  was  increased  from  0-05  to  0-l 


Fig.  138. — Represents  apieoe  of  intestine,  a,  at  the  commencement  of  contraction,  after  irritation  by 
sodium  chloride  ;  b  at  the  end  of  contraction,    o  indicates  the  point  of  irritation.  (After  Plbel.) 

gramme  of  morphine,  an  exactly  contrary  effect  was  produced, 
and  the  application  of  sodium  salts,  instead  of  being  followed 
only  by  local  contraction,  caused  a  peristaltic  contraction,  which 
was  usually  very  much  more  energetic  than  in  the  normal  con- 
dition, and  not  only  spread  upwards  from  the  point  of  contact, 
but  downwards  towards  the  la.rge  intestine,  which  it  never  did 
under  other  circumstances.1  The  quieting  or  inhibitory  effect  of 
moderate  doses  of  morphine  upon  the  intestine,  irritated  by 
sodium  salts,  appears  to  be  exercised  through  the  splanchnic 
nerves,  inasmuch  as  when  the  mesentery,  going  to  one  part  of 
the  intestine,  is  divided  in  an  animal  that  has  received  a  mode- 
rate dose  of  morphine,  the  application  of  sodium  salts  to  this 
part  is  followed  by  a  peristaltic  wave  ;  while,  in  the  other  parts 
of  the  intestine  where  the  nerves  are  uninjured,  the  sodium 
salt  still  produces  only  local  contractions. 

From  these  experiments  it  is  evident  that  moderate  doses  of 
morphine  produce  a  very  different  effect  upon  the  intestine  from 
large  ones  :  and  this  effect  has  indeed  been  long  recognised  in 
practice. 

Moderate  doses  of  opium  have  a  constipating  action  and  are 
constantly  used  to  check  diarrhoea,  but  large  doses,  such  as  those 
taken  by  opium-eaters,  really  have  no  constipating  effect.  In- 
deed, large  doses  of  opium  injected  directly  into  the  jugular  vein 
of  a  dog  act  as  most  energetic  purgatives,  being  much  more 
prompt  in  their  action  than  almost  any  other  drug  that  we 
know.  Immediately  after  their  injection  the  whole  intestinal 
tract  is  thrown  into  violent  action  and  its  contents  expelled,  after 
which  it  again  becomes  quiet. 

Very  minute  doses  also  seem  to  have  a  purgative  action,  as 
well  as  very  large  ones,  and  I  have  used  them  with  considerable 
success  in  many  cases  of  constipation. 

Constipation  may  be  due  to  diminished  peristaltic  action,  or 

1  Kothnagel,  Vircliow's  Archiv,  Bd.  89,  p.  1. 


chap,  xiii.]  ACTION  OF  DEUGS  ON  DIGESTIVE  SYSTEM.    385 

diminished  secretion,  or  to  both,  and  in  some  cases  is  associated 
with  accelerated  absorption.  In  all  probability  it  is  generally 
due  to  a  diminution  in  the  peristaltic  action.  In  the  normal 
condition  this  ought  to  go  on  regularly,  so  that  the  bowels 
should  be  evacuated,  on  an  average,  once  a  day,  though  in  some 
persons  evacuations  normally  occur  two  or  three  times  a  day, 
and  in  others  only  once  in  three  or  four  days.  In  some  appa- 
rently healthy  persons  I  have  observed  an  interval  of  as  much 
as  two  or  three  weeks.  In  some  persons  the  normal  stimulus  of 
ordinary  easily  digestible  food  does  not  seem  to  be  sufficient  to 
keep  the  bowels  acting,  but  food  which  leaves  much  indigestible 
residue,  such  as  brown  or  bran  bread,  salad,  figs,  prunes,  or 
tamarinds,  will  do  so.  These  latter  fruits  owe  their  laxative 
properties  partly  to  the  insoluble  residue  they  leave  and  which 
acts  as  a  mechanieal  irritant  to  the  intestine,  and  partly  to  the 
salts  and  sugar  and  mild  laxative  principles  they  contain. 
Treacle  and  gingerbread  also  have  a  useful  aperient  action,  and 
their  pleasant  taste  makes  them  specially  suitable  for  children. 
The  effect  of  a  somewhat  stimulant  article  of  food  is  greater 
when  taken  on  an  empty  stomach,  and  thus  a  fig  before  break- 
fast will  have  a  much  greater  laxative  effect  than  one  taken  after 
dinner.  A  glass  of  cold  water  also,  by  stimulating  peristalsis, 
will  have  a  laxative  action'  when  taken  on  an  empty  stomach  at 
bed-time  or  on  rising  in  the  morning.  When  these  means  are 
insufficient  a  slightly  irritating  substance,  such  as  an  aloetic  pill 
taken  on  an  empty  stomach  just  before  dinner,  will  aid  the 
stimulating  effect  of  the  food  which  is  taken  afterwards,  and  will 
be  sufficient  to  ensure  perfectly  regular  and  normal  evacuations 
which  do  not  in  any  way  incommode  the  person.  In  consequence 
of  this  many  people  continue  to  take  such  dinner  pills  regularly 
for  many  years  together.  Others,  again,  suffer  from  constipa- 
tion, but  with  them  small  doses  of  purgative  medicine,  if  they 
act  at  all,  act  violently,  and  leave  the  person  weak  and  un^ 
comfortable,  while  the  bowels  again  become  constipated.  This 
condition  is  found  not  unfrequently  among  women,  and  is  ac- 
companied, sometimes  at  least,  with  pain  or  tenderness  in  one 
or  both  ovaries.  In  such  persons,  also,  contrary  to  the  general 
rule,  walking  exercise  increases  instead  of  diminishing  con- 
stipation. 

My  friend  Dr.  Litteljohn  noticed  that  in  a  case  of  ovarian 
tenderness,  half  a  grain  of  opium  given  to  relieve  the  pain  acted 
as  a  purgative.  On  thinking  over  this,  it  occurred  to  me  that 
the  constipation  in  such  cases  might  be  due  to  reflex  irritation 
of  the  inhibitory  intestinal  nerves  by  the  tender  ovary.  It 
seemed  therefore  probable  that  by  using  graduated  doses  of 
opium,  one  might  be  able  to  lessen  the  action  of  the  inhibitory 
nerves,  or  even  to  divert  the  stimulus  from  them  on  to  the  stimu- 
lating fibres,  and  thus  produce   purgation   instead   of  consti- 

c  c 


386  PHAEMACOLOGY  AND   THERAPEUTICS,      [sect.  i. 

pation.  Not  knowing  what  dose  would  be  sufficient  to  produce 
this  effect,  I  began  with  one  drop  of  tincture  of  opium  given  in 
a  teaspoonful  of  water  every  night.     To  my  astonishment  this 

~)liERVE  CENTRE 
SPLANCHNIC. 


OVARIAN  NERVES 

)OVARY 

Fig.  139. — Diagram  to  show  the  way  in  which  ovarian  irritation  probably  causes  constipation. 

dose  was  not  only  in  most  cases  sufficient,  but  in  one  case  it 
proved  excessive,  doing  no  good,  while  half  a  drop  acted  as  a 
brisk  purgative.  It  is  evident  that  opium  used  in  this  way  will 
not  act  as  a  purgative  in  cases  of  constipation  depending  upon 
general  insensibility  of  the  intestinal  nerves.  >  The  cases  in 
which  it  is  most  useful  are  those  of  delicate  women  of  a  nervous 
temperament,  suffering  from  ovarian,  pain,  and  in  whom,  ordi- 
narily, purgatives  produce  excessive  action  followed  by  consti- 
pation. Small  doses  of  belladonna  have  also  been  recommended 
in  constipation,  and  it  is  probable  that  they  act  in  a  similar 
manner  when  given  alone,  and  that  belladonna,  hyoscyamus,  and 
essential  oils  assist  the  action  of  purgatives  by  tending  to  divert 
the  stimulus,  which  the  irritating  constituent  of  a  purgative  pro- 
duces, from  the  inhibitory  to  the  accelerating  intestinal  nerves. 
We  know  at  present  but  little  regarding  diminished  secretion  as 
a  cause  of  constipation. 

Action  of  Drugs  on  Absorption  from  the  Intestines. — 
Ether  introduced  into  the  intestine  greatly  increases  its  vascu- 
larity. It  also  quickens  absorption  very  much,  as  is  shown  by 
the  fact  that  poison  acts  more  quickly,  and  such  substances 
as  ferro- cyanide  of  potassium  appear  sooner  in  the  urine,  when 
they  are  administered  along  with  ether  than  when  given  alone. 
Carbonic  acid  has  a  somewhat  similar  though  weaker  action. 

Coto  bark  has  been  used  in  diarrhoea,  and  as  it  has  no  proper 
astringent  action,  its  utility  has  been  ascribed  to  an  antiseptic 
action  by  which  it  diminished  the  formation  of  irritant  products 
in  the  intestines.  Albertoni  has  investigated  the  action  of  the 
coto  alkaloids,  and  finds  that  although  cotoine  somewhat  lessens 
putrefaction  and  the  development  of  bacteria,  it  does  not  stop 
them  either  in  the  organism  or  outside  it.  It  has,  however,  a 
very  peculiar  action  on  the  vessels  of  the  intestine.  By  keeping 
up  artificial  circulation  in  a  loop  of  intestine  (vide  p.  382),  he 


chap,  xiii.]  ACTION  OF  DRUGS  ON  DIGESTIVE  SYSTEM.    387 

finds  that  cotoine  dilates  the  arteries,  causes  the  blood  to  flow 
more  readily  into  the  veins,  and  preserves  the  vitality  of  the  in- 
testine. It  also  dilates  the  vessels  of  the  kidney,  and  causes  the 
blood  to  flow  more  rapidly  through  them,  but  does  not  alter  the 
circulation  in  the  submaxillary  gland. 

Albertoni  thinks  that  the  benefit  which  cotoine  produces  in 
diarrhoea  is  due  to  dilatation  of  the  intestinal  vessels,  and  the 
increased  power  of  absorption  which  it  causes.  He  considers 
that  in  many  cases  of  diarrhoea  diminished  absorption  is  a  most 
important  factor.1 

Paracotoine  acts  like  cotoine,  but  less  strongly. 

Opium  and  chloral  also  dilate  the  vessels  of  the  intestine,  but 
their  action  is  a  paralysing  one,  while  that  of  cotoine  is  not. 

It  is  possible  that  the  beneficial  action  of  bael  fruit  in  dysen- 
tery may  depend  on  some  similar  property,  as  this  substance  has 
the  peculiarity  of  acting  as  a  laxative  in  health,  while  it  lessens 
the  evacuations  in  dysentery. 

Cholagogues  probably  influence  absorption  from  the  intes- 
tine powerfully  (p.  406). 

Intestinal  Astringents. — Diarrhoea  may  depend  (1)  upon  ex- 
cessive peristaltic  action,  whereby  the  contents  of  the  intestine 
are  hurried  along  before  time  has  been  allowed  for  their  absorp- 
tion, (2)  upon  diminished  absorption,  (3)  upon  excessive  secre- 
tion. In  one  form  of  diarrhoea,  where  the  introduction  of  food 
into  the  stomach  seems  to  excite  peristaltic  action  throughout 
the  intestine  so  that  the  person  is  frequently  forced  to  rise  from 
the  table  in  order  to  evacuate  the  bowels,  small  doses  of  one 
half  to  two  minims  of  liquor  arsenicalis  given  immediately  before 
meals,  as  recommended  by  Einger,  frequently  act  like  a  charm. 
In  ordinary  cases  of  diarrhoea,  opium,  by  lessening  the  irrita- 
bility of  the  intestine,  is  most  serviceable.  Some  medicines 
lessen  peristaltic  action,  not  by  affecting  the  bowel,  but  simply 
by  removing  the  stimuli  which  were  exciting  it.  Thus  small 
doses  of  soda  are  useful  in  the  diarrhoea  of  children  by  neutral- 
*1*  ising  the  acid  which  was  acting  as  an  irritant.  Creasote  has 
a  similar  action  by  lessening  putrefaction  or  fermentation,  and 
thus  preventing  the  formation  of  irritant  products.  It  is  pro- 
bable that  lime  acts  also  to  a  certain  extent  by  its  antacid 
properties,  but  there  is  little  doubt  that  there  are  other  factors 
in  its  astringent  action  which  we  do  not  yet  understand.  The 
effect  of  cotoine  on  intestinal  absorption  has  just  been  men- 
tioned. With  the  view  of  ascertaining  whether  we  could  find 
any  drug  which  would  arrest  the  copious  secretion  from  the  in- 
testine which  takes  place  in  cholera,  Pye- Smith  and  I  made  a 
large  number  of  experiments.  For  this  purpose  we  isolated  loops 
of  intestine,  and  into  one  injected  sulphate  of  magnesium  mixed 

1  ArchivfUr  exper.  Path,  und  Pharm.,  vol.  xvii.  p.  291. 

c  o  2 


888  PHABMACOLOGY  AND  THEEAPEUTICS.      [sect.  i. 

with  the  drug  to  be  tested.  In  some  experiments  we  injected  the 
sulphate  of  magnesium  into  the  intestine,  and  the  drug  which  we 
wished  to  test  into  the  veins. 

Sulphate  of  atropine,  iodide  of  methyl-atropine,  chloral- 
hydrate,  emetine,  morphine,  sulphate  of  quinine,  tannin,  and  sul- 
phate of  zinc,  were  all  tried  locally  with  negative  results.  Chloral 
and  morphine  injected  subcutaneously  also  gave  negative  results.' 


Pig.  140. — Diagram  illustrating  diarrhoea  depending  on  the  presence  of  scybala  in  the  intestine, 
a  is  a  scybalous  mass ;  b  is  the  fluid  which  it  causes  the  intestine  to  secrete. 

In  many  cases  the  best  way  of  checking  diarrhoea  at  its  com- 
mencement is  to  give  a  purgative  such  as  castor-oil,  either  alone 
or  with  a  few  drops  of  tincture  of  opium  in  it.  The  irritant  sub- 
stances which  cause  the  diarrhoea  are  swept  out  of  the  intestine 
by  the  action  of  the  purgative,  and  any  irritation  which  remains 
is  soothed  by  the  opium.  Chronic  watery  diarrhoea,  alternating 
with  constipation,  is  often  best  treated  in  the  same  way.  We 
may  suppose  that  here  the  presence  of  scybalous  masses  in  the 
intestine  gives  rise  to  a  watery  discharge,  which  does  not,  how- 
ever, wash  away  the  scybala  themselves  (Fig.  140).  When  a 
purgative  is  given  which  causes  secretion  from  the  intestine  above 
the  scybala,  the  fluid  in  its  downward  flow,  assisted  also  by  the 
increased  peristalsis,  washes  away  the  scybala,  and  thus  removes 
the  source  of  irritation. 

Purgatives. 

Purgatives  are  substances  which  cause  intestinal  evacua- 
tions. They  are  divided  according  to  their  nature  into  laxatives, 
simple,  drastic,  and  saline  purgatives,  hydragogues,  and 
cholagogues. 

Laxatives  are  those  which  increase  only  slightly  the  action 
of  the  bowels  and  render  the  motions  slightly  more  frequent  and 
softer,  without  causing  any  irritation.  Most  articles  of  food 
which  leave  a  large  indigestible  residue  in  the  stomach  act  as 

1  Report  to  Brit.  Assoc,  1874. 


chap,  xm.]  ACTION  OF  DEUGS  ON  DIGESTIVE  SYSTEM.    889 

laxatives :  such  are  oatmeal,  brown  bread,  and  bran  biscuits. 
Articles  of  food  which  contain  salts  of  vegetable  acids  and  sugar 
in  considerable  quantity  also  act  as  laxatives.  The  chief  laxa- 
tives are : — 


Honey. 

Tamarinds. 

Sulphur. 

Treacle. 

Figs. 

Magnesia. 

Gingerbread. 

Prunes. 

Castor-oil  (in  small 

Manna. 

Stewed  apples. 

doses). 

Cassia. 

Figs,  raspberries,  and  strawberries,  in  addition  to  containing 
sugar  and  vegetable  acids,  have  a  number  of  small  seeds  which 
are  absolutely  indigestible,  and  these  have  probably  a  mechanical 
action  in  stimulating  the  bowel. 

Simple  purgatives  also,  when  given  in  small  doses,  act  as 
laxatives :  such  are  carbonate  of  magnesium,  magnesia,  olive-oil, 
and  sulphur. 

Simple  purgatives  are  more  active  than  laxatives,  and  their 
administration  is  usually  followed  by  one  or  more  copious  and 
somewhat  liquid  stools.  Their  action  is  sometimes  accompanied 
by  some  irritation  and  griping.    These  are : — 

Aloes.  Senna. 

Ehubarb.  Castor-oil. 

Ehamnus  (various  species), 

e.g.  Frangula  and  Cascara 

Sagrada. 

Drastic  purgatives  are  those  which  cause  violent  action  of 
the  bowels,  usually  accompanied  by  evidences  of  greatly  increased 
peristaltic  action,  such  as  borborygmi.  They  cause  irritation  of 
the  intestine,  and  when  taken  in  large  doses  produce  inflamma- 
tion and  symptoms  of  poisoning.     These  are : — 

Elaterium.  Gamboge. 

Colocynth.  Podophyllin. 

Jalap.  Croton-oil. 
Scammony. 

Saline  purgatives  consist  of  neutral  salts  of  metals  of  the 
alkalies  or  alkaline  earths.  The  more  commonly  employed 
are : — 

Sulphate  of  potassium.  Bi-tartrate  of  potassium. 

„  sodium.  Tartrate  of  potassium  and  sodium. 

„  magnesium.  Citrate  of  magnesium. 

Phosphate  of  sodium.  Sulpho-vinate  of  sodium. 
Tartrate  of  potassium. 

Hydragogues  are  purgatives  which  excite  a  copious  secretion 
from  the  intestinal  mucous  membrane  and  thus  remove  much 


390  PHARMACOLOGY  AND  THEEAPEUTICB.      [sect,  i." 

water  from  the  body ;  some  of  them  belong  also  to  the  drastic 
group  and  others  to  the  saline. 

Bi-tartrate  of  potassium. 
1  Elaterium. 
Gamboge. 

Cholagogue  purgatives  are  those  which  remove  bile  from 
the  body.  Some  drugs  aid  the  removal  of  bile  by  stimulating 
the  secretion  of  the  liver,  but  these,  when  they  have  no  purgative 
action,  are  classed  as  hepatic  stimulants.  Cholagogue  purgatives 
probably  act  by  quickening  peristaltic  action  of  the  duodenum, 
and  small  intestine,  thus  preventing  the  absorption  of  the  se- 
creted bile. 

Aloes.  Euonymin. 

Ehubarb.  Iridin. 

Mercurial  preparations  (blue  Podophyllin. 
pill,  calomel,  grey-powder). 

Action  of  Purgatives. — Purgatives  may  act  in  three  ways : 
1st,  by  quickening-the  peristaltic  action  of  the  bowels ;  2nd,  by 
increasing  secretion  of  the  intestinal  membrane,  and  thus  to  some 
extent  washing  out  its  interior;  3rd,  by  hindering  absorption  of 
the  fluids  of  the  intestines. 

Simple  purgatives  act  chiefly  by  stimulating  peristaltic 
movements,  and  have  little  effect  on  the  secretion. 

Hydragogue  and  cholagogue  purgatives  increase  the  secre- 
tion more  than  the  peristaltic  action,  and  drastics  increase  both. 
It  has  been  held  by  several  eminent  German  pharmacologists 
that  the  more  watery  stools  produced  by  many  purgatives  are  due 
only  to  more  rapid  peristaltic  action,  which  hurries  along  the  in- 
testinal contents  before  there  has  been  time  for  the  absorption 
of  their  fluid  constituents. 

This  opinion  is  chiefly  based  on  the  observations  of  Thiry  and 
Eadziejewski. 

Thiry  isolated  a  small  piece  of  intestine,  one  end  of  which  he 
attached  to  the  abdomen  and  the  other  he  sewed  up.  The  part 
of  the  intestine  from  which  this  piece  had  been  removed  was 
again  united  by  sutures,  so  that,  the  intestine  was  perfect  as 
before,  though  rather  shorter.  The  small  bag  of  intestine  re- 
tained its  vascular  and  nerve  supply  uninjured  and  secreted 
readily  when  tickled  with  a  feather ;  but  purgative  medicines, 
such  as  croton-oil,  senna,  sulphate  of  magnesium,  aloes,  jalap, 
and  sulphate  of  sodium,  when  applied  to  it,  produced  no  in- 
creased secretion.  These  experiments  led  pharmacologists  to 
believe  that  the  ordinary  idea  that  purgatives  produced  in- 
creased secretion  from  the  intestine  was  erroneous ;  and  the 
necessity  for  any  such  supposition  seemed  to  be  removed  by  an 


chap,  xrn.]  ACTION  OP  DRUGS  ON  DIGESTIVE  SYSTEM.    391 

experiment  of  Eadziejewski,  who  made  an  intestinal  fistula  in 
the  ascending  colon  of  a  dog,  and  found  that  the  intestinal  con- 
tents as  poured  into  the  large  from  the  small  intestine  exactly 
resembled  the  stools  which  ordinarily  follow  the  administration 
of  a  purgative. 

The  ordinary  phenomena  produced  by  purgative  medicine^, 
would  therefore  seem  to  be  readily  explained  by  increased 
peristalsis  alone,  but  some  other  experiments  by  Colin  and  by 
Moreau  have  shown  that  the  method  employed  by  Thiry  did  not 
afford  trustworthy  results  as  to  the  action  of  purgatives  on  the 
intestines.  Moreau  isolated  three  loops  of  intestine  by  means  of 
ligatures,  carefully  emptying  the  loops  beforehand.  He  then 
injected  a  purgative  medicine  into  the  middle  loop  and  returned 
the  intestine  to  the  abdomen.  On  examination  some  hours  after- 
wards, it  was  found  that,  although  all  three  loops  had  been  under 
similar  conditions,  the  one  into  which  the  purgative  had  been 
injected  was  distended  with  fluid  while  the  others  remained 
perfectly  empty.  These  experiments  were  repeated  by  Vulpian, 
and  afterwards  by  myself,  with  similar  results.  There  can  be 
no  doubt  whatever,  then,  that  purgatives  act  both  by  increasing 
peristaltic  action  and  intestinal  secretion.  Some  purgatives  act 
chiefly  by  the  one,  and  some  chiefly  by  the  other. 

In  the  case  of  some  of  the  salines,  the  secretion  is  greatly 
increased,  while  the  peristaltic  movement  is  so  little  affected 
that  the  secretion  may  lie  so  long  in  the  intestine  as  to  be  re- 
absorbed, and  the  drug  therefore  fails  to  produce  purgation  at 
all.  For  this  reason  it  is  usual  to  combine  such  salines  with 
simple  purgatives,  which  will  accelerate  the  peristalsis. 

Laxatives  have  little  action  on  the  system  beyond  that  which 
is  due  to  the  removal  of  waste  and  irritating  substances  from 
the  bowels ;  but  simple  purgatives,  and  still  more  drastic  pur- 
gatives, in  addition  to  the  direct  action  upon  the  bowels,  exert 
an  indirect  effect  upon  the  blood,  removing  from  it  a  not  incon- 
siderable portion  of  its  fluid,  and  therefore  causing  a  form  of 
partial  depletion. 

The  action  of  cholagogues  will  be  more  particularly  considered 
in  another  paragraph  (p.  404). 

The  action  of  purgatives  generally,  and  especially  of  saline 
cathartics,  has  been  a  subject  of  very  great  dispute,  and  it  is  a 
matter  of  extreme  difficulty  to  determine  exactly.  The  question 
seems  to  be,  however,  settled  by  the  masterly  researches  of  Dr. 
Matthew  Hay,  and  I  cannot,  I  think,  do  better  than  give  his  con- 
clusions in  his  own  words. 

1.  A  saline  purgative  always  excites  more,  or  less  secretion 
from  the  alimentary  canal,  depending  on  the  amount  of  the  salt 
and  the  strength  of  its  solution,  and  varying  with  the  nature  of 
the  salt. 

2.  The  excito-secretory  action  of  the  salt  is  probably  due  to 


892  PHAEMAOOLOGY  AND  THEEAPEUTICS.      [sect.  i. 

the  bitterness  as  well  as  to  the  irritant  and  specific  properties  of 
the  salt,  and  not  to  osmosis. 

3.  The  low  diffusibility  of  the  salt  impedes  the  absorption  of 
the  secreted  fluid. 

4.  Between  stimulated  secretion  on  the  one  hand,  and  im- 
peded absorption  on  the  other,  there  is  an  accumulation  of  fluid 
in  the  canal. 

5.  The  accumulated  fluid,  partly  from  ordinary  dynamical 
laws,  partly  from  a  gentle  stimulation  of  the  peristaltic  move- 
ments excited  by  distension,  reaches  the  rectum  and  produces 
purgation. 

6.  Purgation  will  not  ensue  if  water  be  withheld  from  the 
diet  for  one  or  two  days  previous  to  the  administration  of  the 
salt  in  a  concentrated  form. 

7.  The  absence  of  purgation  is  not  due  to  the  want  of  water 
in  the  alimentary  canal,  but  to  its  deficiency  in  the  blood. 

8.  Under  ordinary  conditions,  with  an  unrestricted  supply  of 
water,  the  maximal  amount  of  fluid  accumulated  within  the  canal 
corresponds  very  nearly  to  the  quantity  of  water  required  to  form  a 
5  or  6  per  cent,  solution  of  the  amount  of  salt  administered. 

9.  If,  therefore,  a  solution  of  this  strength  be  given,  it  does 
not  increase  in  bulk. 

10.  If  a  solution  of  greater  strength  be  administered,  it 
rapidly  increases  in  volume  until  the  maximum  is  attained. 
This  it  accomplishes  in  the  case  of  a  20  per  cent,  solution  in 
from  one  hour  to  one  hour  and  a  half. 

11.  After  the  maximum  has  been  reached,  the  fluid  begins 
gradually  and  slowly  to  diminish  in  quantity. 

12.  C ceteris  paribus,  the  weaker,  or  in  other  words,  the  more 
voluminous  the  solution  of  the  salt  administered  is,  the  more 
quickly  is  the  maximum  within  the  canal  reached ;  and  accord- 
ingly purgation  follows  with  greater  rapidity. 

13.  Unless  the  solution  of  the  salt  is  more  concentrated  than 
10  per  cent,  it  excites  little  or  no  secretion  in  the  stomach. 

14.  The  salt  is  absorbed  with  extreme  slowness  by  the 
stomach  of  the  cat. 

15.  The  salt  excites  an  active  secretion  in  the  intestines,  and 
probably  for  the  most  part  in  the  small  intestine,  all  portions  of 
this  viscus  being  capable  of  yielding  the  secretion  in  almost  equal 
quantities. 

16.  The  bile  and  pancreatic  juice  participate  but  very  little 
in  the  secretion. 

17.  The  secretion  is  probably  a  true  succus  entericus,  re-, 
sembling  the  secretion  obtained  by  Moreau  after  division  of  the 
mesenteric  nerves. 

18.  The  secretion  is  promoted  by  local  irritation  of  the  in-. 
testine,  as  by  ligatures,  but  only  in  the  immediate  vicinity  of  the, 
irritation. 


chap,  xiii.]   ACTION  OF  DEUGS  ON  DIGESTIVE  SYSTEM.    393 

19.  Absorption  by  tbe  intestine  generally  is  reflexly  stimu- 
lated by  such  irritation  (the  effect  of  numerous  ligatures  applied 
at  points  remote  from  the  seat  of  the  injected  salt  being  to  dimin- 
ish the  amount  of  purgative  fluid  by  accelerated  absorption). 

20.  If  the  salt  solution  be  injected  directly  into  the  small 
intestine,  the  stronger  within  certain  limits  the  solution  is,  the 
greater  will  be  the  accumulation  of  fluid  within  the  intestine. 

21.  This  difference  is  not  observed  when  the  salt  is  adminis- 
tered per  os,  as  the  strong  solution  becomes  diluted  in  the  stomach 
and  duodenum  before  passing  into  the  intestine  generally. 

22.  The  difference  is  due  to  the  local  action  of  the  salt  on  the 
mucous  membrane,  and  probably  more  to  an  impeded  absorption 
than  to  a  stimulated  secretion. 

23.  When  the  salt  is  administered  in  the  usual  manner,  it 
appears,  in  the  case  of  the  sulphate  of  magnesium  and  sulphate 
of  sodium,  to  become  split  up  in  the  small  intestine,  the  acid 
being  more  rapidly  absorbed  than  the  base. 

24.  A  portion  of  the  absorbed  acid  shortly  afterwards  returns 
to  the  intestines. 

25.  After  the  maximum  of  excretion  of  the  acid  has  been 
reached,  the  salt  begins  very  slowly  and  gradually  to  disappear 
by  absorption,  which  is  checked  only  by  the  occurrence  of 
purgation. 

26.  During  the  alternations  of  absorption  and  secretion  of 
the  acid,  it  is  the  salt  left  within  the  intestine  which  excites 
secretion,  the  absorbed  and  excreted  acid  exerting  no  such  action 
whilst  in  the  blood,  or  during  the  process  of  its  excretion,  as 
Headland  believed. 

27.  The  salt  does  not  purge  when  injected  into  the  blood, 
and  excites  no  intestinal  secretion. 

28.  Nor  does  it  purge  when  injected  subcutaneously,  unless 
in  virtue  of  its  causing  local  irritation  of  the  abdominal  subcuta- 
neous tissue,  which  acts  reflexly  on  the  intestines,  dilating  their 
blood-vessels,  and  perhaps  stimulating  their  muscular  movements. 

29.  The  sulphate  of  sodium  exhibits  no  poisonous  action 
when  injected  into  the  circulation. 

30.  The  sulphate  of  magnesium  is,  on  the  other  hand,  power- 
fully toxic  when  so  injected,  paralysing  first  the  respiration  and 
afterwards  the  heart,  and  abolishing  sensation  or  paralysing  the 
sensory-motor  reflex  centres. 

31.  Both  salts,  when  administered  in  tbe  usual  manner, 
produce  a  gradual  but  well-marked  increase  in  the  tension  of 
the  pulse. 

32.  According  as  the  salt-solution  within  the  intestine  in- 
creases in  amount  there  occurs  a  corresponding  diminution  of 
the  fluids  of  the  blood. 

33.  The  blood  recoups  itself  in  a  short  time  by  absorbing 
from  the  tissues  a  nearly  equal  quantity  of  their  fluids. 


394  PHABMACOLOGY  AND   THEEAPEUTICS.      [sect,  v 

34.  The  salt,  after  some  hours,  causes  diuresis,  and  with  it 
a  second  concentration  of  the  blood,  which  continues  so  long  as 
the!  diuresis  is  active. 

35.  As  the  intestinal  secretion  excited  by  the  salt  contains  a 
very  small  proportion  of  organic  matter  as  compared  with  the 
inorganic  matter,  the  purgative  removes  more  of  the  latter  than 
the  former  from  the  blood.  In  certain  cases  a  large  quantity  of 
the  salts  of  the  blood  is  thus  evacuated. 

36.  The  amount  of  the  normal  constituents  of  the  urine  is 
not  affected  by  the  salt. 

37.  After  the  administration  of  sulphate  of  magnesium  much 
more  of  the  acid  than  of  the  base  is  excreted  in  the  urine. 

38.  The  salt  has  no  specific  action  in  lowering  the  internal 
temperature  of  the  body,  or  has  it  only  to  a  very  small  extent. 

39.  It  reduces,  however,  the  absolute  amount  of  heat  in  the 
body. 

Uses. — Purgatives  are  used,  firstly,  to  remove  from  the 
intestinal  tube  faecal  matters.  They  thus  not  only  prevent  the 
accumulation  of  such  matters,  but  remove  the  irritation  which, 
their  presence  produces,  and  which  may  evidence  itself  in  dis- 
turbances of  other  organs,  producing,  for  example,  headache  and 
malaise.  These  disagreeable  symptoms  produced  by  constipation 
are  perhaps  partly  due  to  the  irritation  of  the  intestinal  nerves 
producing  reflex  disturbance  of  the  circulation,  but  it  is  probable 
also  that  they  may  be  due  in  part  to  the  toxic  action  of  poisonous 
gases,  liquids,  or  solids,  generated  in  the  intestine  by  imperfect 
digestion  or  decomposition  of  the  food.  For  such  purposes  as 
this  we  may  employ,  as  we  find  them  necessary,  laxatives  or 
simple  purgatives. 

The  second  use  of  purgatives  is  to  remove  liquid  from  the 
body  in  cases  of  dropsy,  due  either  to  heart  or  kidney  disease. 
For  such  purposes  we  use  saline  hydragogue  cathartics. 

From  his  researches  on  the  action  of  saline  cathartics  Dr. 
Hay  had  found  that  if  a  salt  be  given  in  a  concentrated  solution 
when  the  alimentary  canal  contains  little  or  no  fluid,  it  produces 
an  almost  immediate  and  very  decided  concentration  of  the  blood 
by  the  removal  of  a  large  quantity  of  its  water  in  the  form  of  in- 
testinal secretion.  But  if  the  salt  be  given  in  sufficient  water, 
or  if  the  alimentary  canal  contain  sufficient  fluid  at  the  time  of 
administration,  no  such  concentration  occurs.  The  concentra- 
tion reaches  its  maximum  in  half  an  hour,  but  does  not  last 
more  than  half  an  hour  or  an  hour,  when  it  begins  to  decline, 
and  continues  to  do  so  until  it  reaches  the  normal  at  the  end  of 
about  four  hours.  This  return  of  the  blood  to  its  normal  con- 
centration is  not  due  to  re-absorption  from  the  intestine,  but  to 
the  absorption  of  lymph  and  fluids  from  the  tissues.  Some 
hours  after  the  administration,  either  of  a  concentrated  or  dilute 
saline  solution,  the  blood  undergoes  another  concentration,  less. 


chap,  xni.]  ACTION  OF  DRUGS  ON  DIGESTIVE  SYSTEM.    895 

than  the  first  but  continuing  longer.  Saline  cathartics,  as  often 
used  in  dilute  saline  solution,  owe  their  use  in  dropsy,  to  a  great 
extent,  to  their  diuretic  action.  When  given  in  concentrated 
solution  under  proper  conditions,  the  benefit  they  produce  by 
purgation  is  exceedingly  great.  These  conditions  are  that  the 
alimentary  canal  should  be.  freed  from  food  and  especially  from 
liquids  by  previous  abstinence  for  some  hours,  and  that  the  salt 
should  be  given  along  with  the  smallest  possible  quantity  of 
water.  Sulphate  of  magnesium  being  soluble  in  less  than  its 
Own  weight  of  water  is  most  suitable.  Alkaline  tartrates,  and 
Eochelle  salt  may  also  be  useful;  sulphate  of  sodium  is  more 
insoluble,  and  therefore  less  suitable ;  phosphate  of  sodium  and 
sulphate  of  potassium  are  too  insoluble  to  be  of  any  service.1 

The  third  use  is  to  lower  the  temperature  in  fever,  and  for 
this  we  chiefly  use  salines.  The  modus  operandi  here  is  not  yet 
well  understood,  as  they  have  no  such  action  in  health  (p.  394). 

The  fourth  use  is  to  lower  the  blood-pressure,  and  thus  to 
prevent  the  rupture  of  a  blood-vessel,  and  consequent  apoplexy, 
or  to  prevent  further  extravasation  in  a  case  where  the  vessel 
has  already  burst. 

The  regular  use  of  aperients  is  especially  necessary  in  gouty 
persons  with  contracted  kidney  and  high  blood-pressure.  How 
far  their  utility  is  to  be  ascribed  to  their  direct  effect  in  lowering 
the  blood-pressure,  and  how  far  to  the  removal  01  waste  products 
which  might  raise  the  pressure  it  is  impossible  at  present  to  say. 
The  utility  of  purgatives  after  apoplexy  has  occurred  may  be 
doubtful,  and  though  usually  administered,  they  probably  do  no 
good.  But,  even  if  they  do  no  good,  they  do  no  harm.  A  drop  of 
croton-oil  or  a  few  grains  of  calomel  on  the  tongue  is  the  usual 
form  of  administration. 

A  fifth  use  is  to  prevent  straining  at  stool  where  violent 
efforts  are  dangerous,  as  in  aneurism,,  hernia,  &c. 

Action  of  Irritant  Poisons. 

A  great  number  of  drugs  which  are  employed  in  medicine, 
and  are  most  useful  when  given  in  small  doses,  act  as  irritant 
poisons  in  large  ones.  Their  action  is  then  not  restricted  to  the 
stomach,  nor  even  to  the  whole  of  the  intestinal  canal,  but  they 
exercise,  in  addition,  a  marked  effect  upon  other  functions  of  the 
body,  such  as  respiration  and  circulation. 

In  considering  the  physiological  action  of  many  drugs  it  is 
necessary  to  describe  the  effect  they  will  produce  when  given  in 
large  quantities,  as,  for  example,  in  an  overdose,  as  well  as  in 
moderate  or  small  ones. 

It  will  save  both  time  and  space  to  consider  here  the  action 


1  Lancet,  April  21, 1883. 


396 


PHAKMACOLOGY  AND  THERAPEUTICS,      [sect.  i. 


of  irritant  poisons  generally,  and  to  refer  to  this  description 
when  discussing  the  effect  of  individual  drugs. 

The  symptoms  of  irritant  poisoning  are  to  a  great  extent  the 
same,  whatever  be  the  irritants  swallowed ;  it  is  therefore  con- 
venient to  give  an  account  of  these  symptoms,  and  then  to  men- 
tion the  special  peculiarities  which  occur  in  the  case  of  different 
poisons. 

A  poison  is  most  usually  swallowed,  and  it  then  comes  suc- 
cessively in  contact  with  the  lips,  mouth  and  tongue,  gullet  and 
stomach.  It  may  sometimes  reach  no  farther,  being  either 
evacuated  by  vomiting  or  absorbed.  It  frequently,  however,  also 
passes  into  the  intestine.  On  all  those  parts  which  it  reaches 
it  exerts  a  local  action;  besides  this,  however,  it  exerts  a  reflex 
action  on  the  respiration  a,nd  circulation.  Corrosive  poisons 
produce  a  feeling  of  burning  in  the  lips,  mouth,  gullet,  and 
stomach  ;  the  pain  in  the  stomach,  extending  more  or  less  over 
the  abdomen,  is  accompanied  by  tenderness,  and  is  increased  by 
pressure.  It  is  thus  distinguished  from  the  pain  of  colic,  which 
is  usually  relieved  by  pressure. 

The  irritation  of  the  stomach  gives  rise  to  vomiting ;  the 
vomited  matters  usually  consisting,  first  of  the  contents  of  the 
stomach,  next  of  bile  or  mucus,  and  lastly  of  mucus  stained- 


{(brain  \\    - 


'/'-MEDULLA 
/    OBLONGATA 


-\  -AFFERENT 
NERVES 


■  a- -stomach 
'  /  ^so-inhibitory 

/      /V£fll/ES 

/  INTESTINAL 
'    VESSELS 


Pio.  141.— Diagram  to  show  the  nervous  mechanism  by  which  the  action  of  the  heart  may  be 
depressed  by  irritation  of  the  stomach.  The  reflex  irritation  of  the  vagus  may  render  the 
heart's  action  simply  weak,  or  slow  and  weak  (vide  p.  310). 

with  blood.  These  matters  may  sometimes  be  more  or  less  acted 
upon  by  the  poison,  where  this  is  a  strong  acid  or  alkali.  The 
intense  irritation  in  the  stomach  produces  effects  on  the  respira- 
tion and  circulation  very  much  like  those  caused  by  a  severe 
blow  in  the  epigastrium.  The  heart's  action  is  greatly  weakened 
at  first,  and  it  may  be  rendered  slow  from  reflex  irritation  of  the 
vagus,  but  in  the  later  stages  it  is  generally  rapid,  very  small, 
weak,  or  almost  imperceptible ;  sometimes  it  may  be  intermit- 


chap,  xiii.]  ACTION  OF  DEUGS  ON  DIGESTIVE  SYSTEM.    397 

tent  (see  Fig.  141).  On  account  of  the  weakness  of  the  circula- 
tion the  face  and  the  general  surface  of  the  body  are  pale,  the 
cheeks  sunken,  and  the  extremities  cold.  The  frequency,  of  the 
respiration  may  vary,  may  be  either  slower  or  quicker  than 
normal,  but  it  is  almost  always  laboured  and  shallow,  as  the 
intense  irritation  in  the  stomach  renders  the  descent  of  the 
diaphragm  in  deep  inspiration  painful,  and  the  sufferer  there- 
fore tries  to  avoid  it. 

Although  the  pulse  at  the  beginning  of  the  poisoning  may  be 
slow,  when  advanced  it  is  usually,  as  already  mentioned,  very 
rapid.  Exceptions  to  this  rule  may  occur,  chiefly  in  the  case  of 
poisons  which,  after  their  absorption,  have  an  action  on  the 
heart  itself;  these  are  potassium  nitrate  and  salts  of  barium. 
In  consequence  of  the  weakness  of  the  circulation  the  face  is 
usually  very  pale,  but  an  exception  to  this  may  occur  in  poison- 
ing by  corrosive  sublimate,  where  the  face  may  be  flushed.  In 
arsenical  poisoning  the  face  is  not  only  pale,  but  assumes  a 
bluish  hue,  and  the  pinching  may  be  extreme,  so  that  the 
condition  resembles  that  of  a  person  suffering  from  Asiatic 
cholera. 

Where  the  poison  is  exceedingly  corrosive,  as  in  the  case  of 
acids  and  caustic  alkalies,  its  local  action  on  the  stomach  in  causing 
swelling  of  the  mucous  membrane  may  tend  partially  to  occlude 
the  pylorus,  and  the  greater  part  of  the  poison  may  either 
remain  in  the  stomach  itself  or  be  ejected  by  vomiting  without 
passing  into  the  intestine.  In  such  cases  vomiting  will  occur 
alone  without  being  accompanied  by  purging,  and  the  pain  in 
the  abdomen  may  be  less  diffused.  Most  irritant  poisons,  how- 
ever, pass  from  the  stomach  into  the  intestines,  and  thus  violent 
purging  is  induced  in  addition  to  the  vomiting.  The  inflamma- 
tion of  the  intestines  also  causes  the  pain  to  be  diffused  over  the 
whole  abdomen. 

Peculiarities  in  the  Action  of  different  Irritant  Poisons. 
— Acids  throw  down  albumen  as  a  white  precipitate,  and  in  con- 
sequence, "when  brought  in  contact  with  the  lips  or  tongue  in  a 
concentrated  condition,  they  cause  white  stains.  The  white  stain 
is  most  marked  in  the  case  of  carbolic  acid  ;  it  occurs  also  from 
hydrochloric  acid;  it  may  occur  from  sulphuric,  but  as  the 
further  action  of  the  sulphuric  is  to  char  albumen  or  other 
organic  substances,  the  stain  may  acquire  a  brown  or  black 
colour.  Nitric  acid  produces  a  yellow  stain,  rendered  brighter 
by  the  application  of  ammonia.  Perchloride  of  iron  produces  a 
yellowish-brown  stain  ;  the  caustic  alkalies  remove  the  epidermis 
and  give  a  soapy  feeling  to  the  surface,  but  do  not  leave  any  stain. 
After  a  short  time  the  mucous  membrane  becomes  injected  and 
swollen  from  the  irritation. 

In  the  mouth  the  taste  peculiar  to  the  poison  often  leads  to 
its  detection,  so  that  very  little  of  it  may  be  swallowed  in  cases 


S98  PHAEMACOLOGY  AND  THEEAPEUTICS.      [sect.  i. 

where  a  person  was  about  to  take  it  unwittingly.  Arsenic, 
although  a  powerful  irritant  in  the  stomach,  is  almost  tasteless. 

As  the  poison  passes  down  the  gullet,  it  may  have  an  import- 
ant influence  on  the  respiratory  tract ;  this  is  especially  the 
case  where  it  gives  off  fumes  like  nitric  acid,  hydrochloric  acid, 
and  ammonia ;  the  fumes,  passing  into  the  larynx  and  trachea, 
excite  irritation,  spasm,  and  inflammation,  and  may  cause  death 
by  suffocation.  Death  by  suffocation  may,  however,  sometimes 
occur  from  the  action  of  poisons  which  do  not  fume,  e.g.  sulphuric 
acid ;  the  local  irritation  producing  such  great  oedema  and  reflex 
spasm  about  the  epiglottis  as  to  cause  obstruction  to  the  respira- 
tory passages.  Sometimes,  also,  such  poisons  as  sulphuric  acid 
may  pass  directly  into  the  trachea  instead  of  the  oesophagus,  and 
thus  cause  very  rapid  death  from  suffocation. 

Purging  is  usually  absent  and  the  bowels  constipated  in 
poisoning  by  strong  alkalies  or  acids,  and  by  salts  of  lead ;  the 
former  probably  act  by  corroding  the  stomach,  and  partially 
occluding  the  pylorus ;  the  latter  by  lessening  the  peristaltic 
movements  of  the  intestine.  In  the  case  of  lead  salts  the 
abdominal  pain  differs  from  that  of  ordinary  irritant  poisons, 
being  of  a  colicky  nature,  and  to  a  certain  extent  relieved  by 
pressure. 

Secondary  Effects  of  Irritant  Poisoning. —  After  the 
immediate  condition  of  collapse  caused  by  the  powerful  action  of 
the  irritant  has  passed  off,  the  local  inflammation  which  it  has 
produced  may  give  rise  to  a  general  febrile  condition,  with  hot 
skin,  flushed  face,  and  quick  bounding  pulse.  This  condition 
may  be  accompanied  by  other  symptoms  due  to  the  physiological 
action  of  the  poison  after  its  absorption  ;  thus  in  the  case  of  cor- 
rosive sublimate,  there  may  be  the  metallic  taste,  sore  gums,  and 
profuse  salivation  characteristic  of  mercurial  poisoning. 

One  of  the  most  important  instances  of  the  secondary  effects 
of  irritant  poisons  is  phosphorus ;  after  the  primary  symptoms 
of  gastric  irritation  have  passed  off  the  patient  may  appear  per- 
fectly well,  and  then  vomiting  and  purging  may  set  in  a  second 
time.  These  are  due,  not  to  the  local  action  of  the  phosphorus 
which  has  been  swallowed  on  the  stomach  and  intestines,  but  to 
the  changes  in  the  liver,  blood,  and  other  organs,  which  the  phos- 
phorus has  produced  after  its  absorption.  A  similar  condition 
has  been  observed  in  poisoning  by  arsenic,  but  usually  the  symp- 
toms of  arsenical  poisoning  are  continuous,  and  do  not  exhibit 
a  distinct  intermission  of  this  kind. 

Death  may  occur  from  the  secondary  action  of  some  poisons 
a  good  while  after  Ihe  primary  symptoms  have  disappeared ; 
thus  strong  acids  and  alkalies  may  produce  death,  weeks  or 
even  months  after  they  have  been  swallowed,  from  the  effects  of 
their  local  action  on  the  oesophagus  or  the  stomach.  During 
the  passage  down  the  oesophagus  they  may  destroy  the  mucous 


chap,  xin.]  ACTION  OF  DRUGS  ON  DIGESTIVE  SYSTEM.    399 

membrane  to  such  an  extent  that  when  it  heals  and  the  cicatrix 
begins  to  contract,  the  lumen  of  the  tube  may  be  completely 
obstructed,  so  that  no  food  can  reach  the  stomach,  and  the 
patient  dies  of  starvation ;  or  the  mucous  membrane  of  the 
stomach  may  be  destroyed  to  such  an  extent  that  what  remains 
is  insufficient  to  digest  the  food,  and  the  patient  dies  from  non- 
assimilation. 

ACTION  OF  DRUGS  ON  THE  LIVER. 

The  liver  is  by  far  the  largest  organ  in  the  body,  and  it  is 
placed  in  a  very  peculiar  situation.  It  acts  as  a  porter  or  door- 
keeper to  the  circulation,  all  the  substances  which  are  absorbed 
from  the  intestinal  canal  having  to  pass  through  the  portal  vein 
and  the  capillaries  of  the  liver  before  they  can  enter  the  general 
circulation. 

Since  the  discovery  by  Ludwig  and  Schmidt-Mulheim  that 
peptones  are  poisonous  when  injected  directly  into  the  circulation, 
the  liver  has  acquired  a  new  importance.  Schiff  and  Lautenbach 
indeed  had  previously  made  some  experiments  which  they  thought 
showed  that  a  subtle  poison  existed  in  the  blood  even  of  healthy 
animals,  but  was  destroyed  by  the  liver.  They  based  this  idea  on 
the  observation  that  ligature-  of  the  portal  vein  causes  death  in 
animals  with  very  much  the  same  symptoms  as  when  they  are 
bled  to  death.  Ludwig  had  formerly  explained  this  phenomenon 
by  supposing  that  the  ligature  caused  the  blood  to  accumulate 
in  the  large  and  dilatable  portal  radicles  and  prevented  it  from 
getting  into  the  general  circulation  again.  The  animal  was  thus, 
as  Ludwig  expressed  it,  bled  to  death  into  its  own  veins.  Schiff 
and  Lautenbach,  however,  thought  the  symptoms  *were  due 
rather  to  poison  than  to  this  mechanical  alteration  in  the  circu- 
lation, because  they  found  that  when  the  blood  of  an  animal 
whose  portal  vein  had  been  ligatured  was  injected  into  a  frog, 
it  produced  death  within  three  hours,  whereas  blood  from  a 
similar  animal  whose  portal  vein  had  not  been  ligatured  produced 
no  effect. 

The  liver  therefore  seems  to.  have  a  most  important  function 
in  destroying  the  poisonous  properties  of  peptones,  and  per- 
haps other  substances  produced  during  digestion,  and  possibly 
also  of  poisonous  products  of  tissue-waste.  The  peptones  are 
converted  by  it  into  sugar  and  glycogenic  substance.1 

Drugs  which  act  on  the  liver  are  usually  divided  into  hepatic 
stimulants  and  cholagogues,  and  into  hepatic  depressants. 

It  has  been  for  a  very  long  time  a  matter  of  clinical  experience 
that  the  administration  of  mercurial  purgatives  was  frequently 
followed  by  the  discharge  of  greenish  bilious-looking  evacuations 

1  Seegen,  Pfltiger's  Archiv,  xxviii.  p.  990. 


400  PHAEMACOLOGY  AND  THEEAPEUTICS.      [sect.  i. 

and  a  great  improvement  in  the  general  condition  of  the  patient. 
These  two  results  were  classed  together  as  cause  and  effect,  and 
the  improvement  was  considered  to  be  due  to  the  removal  of  bile. 
It  was  then  supposed  that  the  bile  was  formed  in  the  blood  and 


Bottle  containing  blood  >- 


■  Liver. 

.  Cannula  for  outflow  of 
blood. 


Fig.  142. Diagram  to  show  the  effect  of  artificial  circulation  of  blood  through  the  liver,  under 

different  pressures.  The  continuous  lines  indicate  the  size  of  the  liver,  and  the  arrangement  of 
the  apparatus  during  circulation,  under  a  low  pressure.  The  dotted  lines  indicate  the  increased 
size  of  the  liver,  and  the  arrangement  of  the  apparatus,  nnder  a  high  pressure. 

simply  excreted  by  the  liver,  and,  therefore,  the  bilious-looking 
stools  were  ascribed  to  stimulation  of  the  secreting  function  of  the 
liver  by  the  mercurials.  Hepatic  stimulants  and  cholagogues  were 
therefore  considered  to  be  identical:  We  now  know  that  the  bile 
is  formed  in  the  liver  and  not  simply  excreted  by  it  from  the 
blood,  and  that  bile  formed  in  the  liver  may  again  be  absorbed 
into  the  blood.  Increased  functional  activity  of  the  liver  might 
thus  lead  to  the  presence  of  a  greater  instead  of  a  less  quantity 
of  bile  in  the  blood.  Eecent  experiments  have  also  shown  that 
one  of  the  most  marked  cholagogues  which  we  know,  viz.  calomel, 
appears  rather  to  diminish  than  to  increase  the  actual  secretion 
of  bile,  so  that  we  are  now  obliged  to  distinguish  between  hepatic 
stimulants  and  cholagogues.  Hepatic  stimulants  are  drugs 
which  increase  the  functional  activity  of  the  liver,  and  the  amount 
of  bile  which  it  forms.  Cholagogues  are  substances  which 
remove  bile  from  the  body,  possibly  by  acting  rather  on  the  in- 
testines ;  they  do  not  necessarily  increase  the  secretion  of  bile, 
they  may  only  prevent  its  re-absorption  and  thus  diminish  the 
quantity  in  the  circulation.  Hepatic  depressants  are  drugs 
which  lessen  the  quantity  of  bile  secreted  by  the  liver. 

In  relation  to  tissue-waste  it  is  not  to  be  forgotten  that  the 
products  of  the  functional  activity  of  one  organ  are  not  only 
poisonous  to  itself,  but  may  be  poisonous  to  other  organs.  Thus 
the  waste  products  of  muscular  activity  gradually  poison  the 
muscle  and  prevent  its  contraction,  although  as  soon  as  they 
are  washed  out  with  salt  solution  the  muscle  recovers  its 
power. 

Lactic  acid  also,  which  is  a  product  of  muscular  waste,  is 
poisonous  not  only  to  muscle  but  to  some  extent  to  nerves,  and 


chap,  xiii.]   ACTION  OF  DEUGS  ON  DIGESTIVE  SYSTEM.  101 

lessens  the  functional  activity  of  the  brain  and  produces  sleep. 
At  the  same  time  it  is  possible  that  these  waste  products,  poisonous 
in  themselves,  may  through  slight  changes  be  rendered  available 
for  nutrition,  just  as  peptones  which  are  themselves  poisonous 
are  most  important  foods. 

Besides  acting  on  peptones,  the  liver  seems  to  have  the  power 
of  destroying  the  poisonous  properties  of  some  vegetable 
alkaloids.  For  example,  J^th  of  a  drop  of  nicotine  given  to  a 
frog  does  not  produce  death,  but  Jg-th  is  sufficient,  when  the 
.  liver  has  been  previously  removed.  Coniine,  cobra  poison  and 
hyoscyamine,  all  exert  much  less  poisonous  action  after  they 
pass  through  the  liver,  before  they  reach  the  general  circulation, 
than  they  do  when  injected  directly  into  the  blood.  Curare, 
prussic  acid,  and  atropine,  on  the  other  hand,  do  not  have  their 
action  modified.1 

The  result  of  these  experiments  may  be  partly  explained  on 
the  supposition  that  a  good  deal  of  the  poison  has  been  ex- 
creted along  with  the  bile,  and  has  thus  been  prevented  from 
reaching  the  general  circulation.  But  it  is  probable  that  in 
addition  to  the  function  of  excreting  poisons,  the  liver  has  also 
got  the  power  of  destroying  poisons,  and,  it  may  he,  the  power 
of  removing  poisons  from  the  circulation  by  merely  storing  them 
for  a  time. 

In  relation  to  this  subject  it  is  interesting  to  bear  in  mind 
that  alkaloids  to  which  the  name  of  ptomaines  has  been  given 
(p.  99),  are  formed  in  dead  bodies  during  the  process  of  decom- 
position, and  that  when  a  solution  of  peptone  is  treated  with 
potash  and  ether  it  yields  a  body  which  appears  to  be  a  volatile 
alkaloid.  If  putrid  peptone  is  treated  in  the  same  way,  a  solid 
non-volatile  alkaloid  is  obtained.2 

Ptomaines  are  hot  only  formed  in  dead  bodies,  they  are  also 
formed  in  the  intestine  by  the  decomposition  of  parts  of  its  con- 
tents. They  have  been  found  in  large  quantities  by  Bouchard 
both  in  the  stools  of  persons  suffering  from  diarrhoea  or  typhoid 
fever,  and  in  normal  fasces.  They  appear  to  be  absorbed  from 
the  intestine  into  the  blood  and  excreted  by  the  urine.  They 
have  been  found  by  Bouchard  in  the  urine  both  in  health  and 
disease,  and  Bocci  has  shown  that  the  human  urine  has  a  para- 
lysing action  on  frogs  like  that  of  curare,  or  of  the  ptomaines 
which  Mosso  and  Guareschi  have  obtained  from  putrefied  fibrin 
or  brain. 

Some  time  ago  I  pointed  out 3  the  resemblance  between  the 
languor  and  weakness  which  occur  in  many  cases  of  indigestion 
and  the  symptoms  of  poisoning  by  curare,  and  drew  attention  to 

1  Lautenbach,  Philadelphia  Medical  Times,  May  26,  1877. 

2  Tanret,  Comptes  Bendus,  xcii.  1163. 

3  Lauder  Brunton, '  Indigestion  as  a  Cause  of  Nervous  Depression,'  Practitioner, 
vol.  xxv.  October  and  November  188Q. 

D  D 


402  PHAEMACOLOGY  AND  THEEAPEUTICS.      [sect.  r. 

the  probability  that  the  languor  was  due  to  the  effect  of  poisonous 
substances  absorbed  from  the  intestine.  These  I  considered  to 
be  probably  peptones,  but  it  is  possible  that  they  may  be  pto- 
maines. But  whether  the  poisonous  substances  be  peptones  or 
ptomaines,  the  function  of  the  liver  is  equally  important  in  pre- 
venting them  from  reachiDg  the  general  circulation. 

Bearing  in  mind,  then,  the  office  of  the  liver  as  a  porter  to 
prevent  the  passage  of  injurious  substances  from  the  intestinal 
canal  into  the  blood,  and  the  great  effect  that  any  alteration  in 
the  circulation  through  it  may  produce  upon  the  circulation,  and 
consequently  on  the  functions  of  all  the  intestinal  organs,  we  shall 
much  more  readily  understand  the  importance  of  this  gland,  the 
largest  in  the  body,  than  if  we  look  upon  it  simply  as  an  instru- 
ment for  secreting  the  bile  which  plays  a  useful,  but  still  sub- 
ordinate part  in  the  process  of  digestion. 

We  are  still  but  imperfectly  acquainted  with  its  functions,  but 
we  may  say  that  they  are  at  least  five : — 

1st,  to  form  and  store  up  glycogen,  a  material  which  will 
afterwards  be  used  in  evolving  heat  and  muscular  energy ;  it  will 
thus,  as  it  were,  perform  the  office  of  a  kind  of  coal-bunker  to 
the  body  ; 

2ndly,  to  secrete  bile  for  use  in  digestion ; 

3rdly,  to  excrete  bile  ; 

4thly,  to  destroy  peptones  which  are  poisonous  when  they 
are  directly  introduced  into  the  general  circulation,  and  to  con- 
vert them  into  glycogen,  &c.  ; 

5thly,  to  destroy  or  store  up  and  excrete  other  organic 
poisons  which  may  have  been  formed  in  the  alimentary  canal 
during  the  process  of  digestion,  or  may  have  been  introduced 
into  it  from  without. 

The  glycogenic  function  of  the  liver  is  influenced  by  a 
number  of  drugs,  especially  phosphorus,  and  substances  belong- 
ing to  the  same  chemical  group.  Phosphorus,  arsenic,  and 
antimony,  all  destroy  the  glycogenic  function,  and  at  the  same 
time  tend  to  cause  fatty  degeneration  of  the  organ.  It  is  pos- 
sible that  these  effects  of  the  poisons  are  closely  connected,  but 
the  exact  connection  between  them  ha3  not  yet  been  ascer- 
tained. 

In  consequence  of  the  disappearance  of  glycogen  from  the 
liver  which  is  caused  by  these  drugs,  puncture  of  the  fourth 
ventricle  will  no  longer  cause  glycosuria  in  animals  which  have 
been  poisoned  by  them.  Attempts  have  been  made  to  utilise 
this  fact  in  the  treatment  of  diabetes,  but  as  yet  the  results  have 
not  been  very  satisfactory. 

Hepatic  Stimulants. —The  action  of  drugs  on  the  secretion 
of  the  liver  has  been  very  carefully  studied  by  some  observers, 
especially  by  Bohrig,  Butherford,  and  Vignal.  The  mode  of 
experimenting  was  to  curarise  a  dog,  ligature  the  common  bile' 


chap,  xiii.]   ACTION  OF  DEUGS  ON  DIGESTIVE  SYSTEM.    403 

duct  and  insert  a  cannula  into  it.  The  bile  was  thus  entirely 
prevented  from  reaching  the  intestine,  and  the  whole  of  it  flowed 
through  the  cannula  into  a  vessel  in  which  it  was  collected,  so 
that  the  amount  secreted  in  a  given  time  was  readily  estimated. 
The  drug  was  then  administered,  usually  by  injection  into  the 
duodenum,  and  the  increase  or  diminution  which  this  caused  hi 
the  bile  was  noticed. 

The  ingestion  of  food  greatly  increases  the  secretion  of  bile, 
and  in  order  to  get  rid  of  this  disturbing  factor,  the  experiments 
were  all  made  on  fasting  animals. 

A  great  number  of  drugs  were  experimented  upon,  some  of 
which  were  found  to  stimulate  the  liver,  and  increase  the  quan- 
tity of  bile  without  altering  its  quality,  so  that  their  action  upon 
the  liver  would  be  nearly  analogous  to  that  of  laxatives  upon  the 
intestine ;  others  increased  the  quantity  of  bile,  and  rendered  it 
more  watery ;  others  again  had  little  effect  upon  the  liver,  but 
stimulated  the  intestinal  secretion  and  movements. 

The  following  are  hepatic  stimulants  :— 

Acid,    dilute    nitro-  Ammonium  benzo-    Podophyllin.1 

hydro-chloric.1  ate.2  Sanguinarin.1 

Aloes.1  Baptisin.2  Colchicin.1 

Eochelle  salt.3  Euonymin.1  Colocynth.1 

Sodium  sulphate.2  Hydrastin.2  Jalap.2 

Sodium  phosphate.1  Juglandin.2  Ehubarb.2 

Potassium  sulphate.2  Iridin.1  Ipecacuanha.1 

Mercuric  chloride.1  Leptandrin.2  Physostigma 3 

Sodium  salicylate.1  Phytolaccin.1                (extract). 
Sodium  benzoate.1 

Those  drugs  which  stimulate  the  intestine  much,  as  a  rule 
increase  only  slightly  the  secretion  of  bile  by  the  liver,  and 
podophyllin,  which  in  certain  doses  acts  as  a  powerful  hepatic 
stimulant,  ceases  to  have  this  effect  when  it  produces  marked 
purgation.  These  effects  occur  independently  of  the  action  of 
the  drugs  on  the  re-absorption  and  re-secretion  of  bile,  inasmuch 
as  in  the  experiments  quoted  the  whole  of  the  bile  was  collected 
directly  from  the  liver  and  not  allowed  to  pass  at  all  into  the  in- 
testine. A  large  number  of  substances  belonging  to  the  aromatic 
series  act  powerfully  on  the  liver.  Some  of  them,  like  salicylate 
of  sodium,  greatly  increase  the  watery  constituents  of  the  bile,  so 
that  it  is  not  only  more  abundant,  but  much  more  dilute  than 
normal.  Others  of  them,  e.g.  toluylendiamine,  increase  the  solids 
to  such  an  extent  that  the  bile  becomes  so  viscid  that  it  cannot 
flow  through  the  bile-ducts,  and  being  absorbed  gives  rise  to  jaun- 
dice.  A  number  of  bitters  belong  to  the  aromatic  series  (p.  364). 

'  The  most  powerful  stimulants  in  the  preceding  list  are  indicated  by  ('),  the 
less  powerful  by  (2)  and  (*). 


404  PHAEMACOLOGY  AND   THEEAPEUTICS.      [sect,  t 

It  seems  not  improbable  that  by  further  observations^  many 
aromatic  compounds  may  be  arranged  in  a  regular  series,  ac- 
cording to  their  action  on  the  solid  and  liquid  constituents  of 
the  bile. 

Cholagogues. — In  making  experiments,  similar  to  those  of 
Eutherford  and  Yignal,  Schiff  observed  that  the  secretion  of 
bile  was  very  much  greater  for  a  short  time  immediately  after 
the  bile-duct  was  tied,  than  it  was  later  on;  and  on  further 
investigation  he  found  that  this  was  due  to  the  fact  that  the  liver 


Liver  -with  bile-duct  lead- ) 
ing  into  the  duodenum . .  [ 

Portal  rein  with  entero- ' 
hepaticcirculation,  show- 
ing absorption  and  re- 
excretion  of  bile 


Mesenteric  veins 


Stomach. 


Jra.  143.— Entero-hepatic  Circulation. 

has  a  double  function  ;  it  not  only  forms  new  bile,  but  re- 
excretes  the  old  bile  which  has  been  re-absorbed  from  the  in- 
testine. A  certain  quantity  of  bile  is  lost  in  the  fsBces,  but  a 
considerable  portion  of  it  seems  to  be  utilised  again  and  again ; 
being  formed  by  the  liver,  poured  out  into  the  intestine,  re- 
absorbed and  again  excreted.  This  circulation  of  bile  between, 
the  intestine  and  the  liver  has  been  called  by  Lussana  the 
entero-hepatic  circulation  (Fig.  143).  It  has  been  shown  that 
the  bile  which  is  absorbed  from  the  duodenum  does  not  merely 
act  as  a  stimulus  to  the  liver  to  cause  a  greater  formation  of  new 
bile,  but  is  actually  re-excreted,  by  injecting  ox-bile,  which  gives 
Pettenkofer's  reaction,  into  the  duodenum  of  a  guinea-pig,  and 
finding  that  shortly  afterwards  the  bile  which  issued  from  the 
gall-duct  gave  this  reaction  while  the  bile  normally  secreted  by 
the  guinea-pig  does  not. 

Not  only  is  bile  re-excreted  in  this  manner  by  the  liver,  but 
other  substances  also,  such  as  medicines  and  poisons,  are  like- 
wise excreted.  The  absorption  and  re-excretion  take  place  with 
great  rapidity,  for  Laffter,  in  some  experiments  made  under 
Heidenhain's  direction,  found  that  rhubarb  injected  into  the 
duodenum  appeared  in  the  bile  in  less  than  five  minutes.     Sub- 


chap,  xiii.]  ACTION  OF  DEUGS' ON  DIGESTIVE  SYSTEM.    405 

stances  injected  into  the  blood  were  also  excreted  by  the  bile 
•with  great  rapidity,  so  that  sulphindigotate  of  sodium,  introduced 
directly  into  the  circulation  in  some  experiments,  began  to  colour 
the  bile  blue  one  minute  after  its  injection.  Other  substances 
are  also  absorbed  from  the  intestine  and  excreted  by  the  liver 
and  passed  round  in  the  entero-hepatic  circulation,  just  like  the 
bile.  Curare  is  one  of  these,  and  to  this  probably  is  due  in  a 
great  measure  the  absence  of  fatal  effect  from  its  introduction 
into  the  Btomach.  Iron  also  circulates  with  the  bile,  and  it  is 
probable  that  the  beneficial  effect  of  large  doses  may  be  due  in 
part  to  the  action  of  the  iron  upon  the  liver.  The  objection  has 
been  raised  to  the  employment  of  large  doses  that  they  are  useless, 
inasmuch  as  the  whole  of  the  iron  which  is  taken  into  the  mouth 
is  again  expelled  in  the  faeces,  but  there  can  be  no  doubt  that 
clinically  large  doses  of  iron  are  sometimes  beneficial.  Copper 
and  manganese  also  appear  in  the  bile,  and  it  is  probable  that 
lead  and  all  the  heavy  metals  pass  chiefly  out  of  the  body 
by  this  channel.  For  the  action  of  the  liver  on  alkaloids  see 
p.  401. 

It  has  been  suggested  by  Lussana  that  the  malarial  poison 
also  circulates  in  the  entero-hepatic  circulation. 

From  the  fact  that  bile  is  re-absorbed  from  the  intestine,  it 
is  obvious  that  an  hepatic  stimulant  which  simply  increases 
the  secretion  of  the  bile  by  the  liver,  will  not  of  itself  act  as 
a  cholagogue  and  remove  the  bile  from  the  body.  In  order  to 
do  this,  this  action  must  be  combined  with  increased  peristaltic 
action  of  the  bowels,  which  will  hurry  the  bile  out  and  prevent 
its  re-absorption.  If,  in  addition  to  increased  peristalsis,  we 
have  increased  secretion  from  the  intestinal  mucous  membrane, 
so  as  to  wash  out  the  intestine,  we  shall  get  the  bile  still  more 
effectually  removed  from  the  body.  The  necessity  for  such  a 
combination  has  indeed  been  long  ago  shown  by  clinical  ex- 
perience, and  the  advantages  of  following  a  mercurial  pill  by  a 
saline  purgative  in  order  to  clear  it  away  have  long  been  recog- 
nised. Some  hepatic  stimulants  increase  also  the  peristaltic 
movements  and  secretions  from  the  intestine— for  example,  those 
substances  which  have  been  already  enumerated  as  cholagogue 
purgatives. 

Aloes.  Colocynth.  Sulphate  of  potassium. 

Baptism.  Jalap.  Sulphate  of  sodium. 

Colchicum  in  large  Podophyllin.  Phosphate  of  sodium, 

doses.  Ehubarb.  Mercury  salts. 

In  most  cases,  however,  it  is  advisable  to  combine  hepatic 
and  intestinal  stimulants  in  order  to  ensure  a  more  complete 
cholagogue  effect.  Thus  calomel  as  employed  in  Eutherford's 
experiments  has  no  stimulant  action  on  the  liver,  but  stimulates 
the  intestinal  glands;   corrosive   sublimate,  on  the   contrary, 


406  PHAKMACOLOGY  AND   THEEAPEUTICS.      [sect.  r> 

stimulates  the  liver  powerfully  but  has  a  very  feeble  stimulant 
action  on  the  intestine;  a  combination  of  the  two  stimulates 
both  the  liver  and  the  intestinal  glands.  When  used  in  medicine, 
calomel  is  recognised  to  be  a  powerful  cholagogue,  one  of  the 
most  powerful  indeed  that  we  possess,  and  it  is  by  no  means 
impossible  that  a  small  portion  of  it  may  be  converted  into 
corrosive  sublimate  in  the  intestine,  so  that  we  thus  get  fr6m 
the  calomel,  when  given  alone,  the  combined  effects  of  both 
the  mercurial  preparations  just  mentioned.  It  is  more  prob- 
able, however,  that  the  cholagogue  action  of  calomel  is  due  to 
its  having  a  peculiar  stimulant  action  on  the  duodenum  and 
ileum,  so  as  to  hurry  the  bile  along  the  intestine  and  prevent 
its  re-absorption.  The  reason  for  supposing  that  this  is  the  case 
rather  than  that  part  of  it  is  converted  into  corrosive  sublimate 
and  stimulates  the  liver,  is  that  when  given  to  dogs  with  a  per- 
manent fistula  it  does  not  increase  the  flow  of  bile,  which  it  would 
probably  do  if  any  corrosive  sublimate  were  formed.  Another  is 
that  after  the  administration  of  calomel,  leucin  and  tyrosin, 
which  are  products  of  pancreatic  digestion,  are  found  in  the 
stools,  and  it  seems  not  improbable  that  their  appearance  under 
such  circumstances  is  due  to  their  having  been  hurried  along  the 
intestine  from  the  duodenum  to  the  anus,  and  evacuated  without 
time  being  allowed  for  their  absorption  or  decomposition  in  the 
intestine. 

Adjuncts  to  Cholagogues. — The  pressure  under  which  bile 
is  secreted  is  very  low,  so  that  a  very  slight  obstruction  to  its 
flow  through  the  common  bile-duct  is  sufficient  to  cause  its 
accumulation  in  the  gall-bladder  and  gall-ducts,  and  thus  to  lead ' 
to  its  re-absorption.  This  is  readily  observed  in  cases  of  catarrh, 
either  of  the  duodenum  or  of  the  gall-ducts.  In  such  cases  the  use 
of  ipecacuanha  is  indicated.  This  drug  has  been  found  clinically 
to  be  of  great  service,  and  it  probably  acts  by  lessening  the  tenacity 
of  the  mucus  in  the  gall-duct,  and  thus  tends  to  remove  the 
obstruction  in  front,  while  at  the  same  time  it  increases  the 
pressure  behind,  by  stimulating  the  hepatic  secretion.  The 
movements  of  the  diaphragm  have  a  powerful  action  in  aiding 
the  expulsion  of  bile  from  the  liver ;  they  do  this  to  a  certain 
extent  in  ordinary  respiration,  but  their  effect  is  much  greater 
in  forced  inspiration.  Exercise  therefore  tends  to  expel  bile  from 
the  liver,  and  prevent  its  accumulation  in  the  biliary  capillaries, 
but  a  little  brisk  exercise  as  in  riding,  rowing,  climbing,  tennis, 
&c,  will  have  in  a  few  minutes  a  more  beneficial  action  than  a 
lazy  constitutional  walk  of  a  couple  of  hours. 

The  secretion  of  bile  is  not  only  increased,  but  the  pressure 
under  which  it  is  secreted  is  raised  by  sipping  fluids.  This  is, 
in  all  probability,  due  to  nervous  influence,  for  it  has  been  shown 
by  Kronecker  that  taking  a  liquid  in  numerous  small  sips  will 
for  the  time  completely  abolish  the  inhibitory  action  of  the  vagus 


chap,  xiii.]  ACTION  OF  DEUGS  ON  DIGESTIVE  SYSTEM.    407 

on  the  heart.  It  is  prohably  in  consequence  of  this  fact,  that 
Carlsbad  water,  when  taken  in  numerous  sips  for  an  hour  or 
more,  as  at  Carlsbad  itself,  is  so  exceedingly  efficacious  in  hepatic 
diseases,  while  sodium  sulphate,  which  is  the  main  constituent  of 
the  water,  was  found  by  Eutherford  to  have  only  a  very  slight 
action  as  a  stimulant  to  the  liver. 

Uses  of  Hepatic  Stimulants  and  Cholagogues.  —  The 
pressure  under  which  the  bile  is  secreted  is  very  small,  but  the 
blood-pressure  also  in  the  portal  vein  is  very  low.  In  consequence 
of  this  a  very  slight  increase  in  the  tension  of  the  bile  within  the 
gall-ducts,  or  diminution  of  the  pressure  of  blood  in  the  vein, 
causes  the  bile  to  be  absorbed.  It  is  then  carried  by  the  circu- 
lation to  various  parts  of  the  body  and  disturbs  their  functions. 
It  lessens  the  power  of  the  heart  and  appears  to  diminish  the 
activity  of  the  brain,  so  that  persons  suffering  from  biliousness 
and  presenting  a  slight  icteric  tinge  of  the  conjunctiva,  are  apt  to 
feel  irritable,  stupid,  and  out  of  sorts  generally.  Cholagogues 
are  useful  by  removing  bile  from  the  body,  and  thus  relieving 
the  symptoms  above  mentioned.  It  is  probable,  however,  that 
they  also  in  some  way  improve  the  portal  circulation,  and  thus 
lessen  congestion  of  the  stomach  and  intestines,  as  in  Beaumont's 
experiments  on  Alexis  St.  Martin  (p.  369). 


Hepatic  Depressants. 

Purgatives  will  act  as  hepatic  depressants  and  lessen  the 
secretion  of  the  liver  by  removing  from  the  intestine  the  bile 
which  would  otherwise  be  re-absorbed,  and  by  hurrying  out  also 
the  food  which  might  yield  materials  for  the  secretion  of  new 
bile ;  but  some  substances,  such  as  calomel,  castor-oil,  gamboge, 
and  magnesium  sulphate,  were  found  by  Eutherford  to  depress 
the  secretion  in  cases  where  the  bile-duct  was  ligatured  and  the 
animals  fasting,  so  that  in  all  probability  the  effect  of  the  drugs 
in  diminishing  the  secretion  was  due  to  their  lowering  the  blood- 
pressure  in  the  liver. 

Action  of  Drugs  on  the  Pancreas. 

The  pancreatic  juice  is  important  in  the  process  of  digestion, 
as  it  has  the  threefold  power  of  converting  starch  into  sugar,  of 
digesting  proteids  with  the  formation  of  peptones,  and  of  splitting 
up  and  emulsifying  fats. 

The  process  of  secretion  in  the  pancreas  is  associated  with  in- 
creased blood-supply  as  in  other  glands.  Its  nerves  arise  from 
the  hepatic,  splenic,  and  superior  mesentery  plexuses,  with 
branches  from  the  vagi  and  splanchnics.  Electrical  stimulation 
of  the  gland  itself  will  cause  secretion,  and  so  will  stimulation  of 


408  PHAEMACOLOGY  AND   THEEAPEUTICS.      [sect.  i. 

the  medulla  oblongata.  It  is  arrested  by  powerful  irritation  of 
sensory  nerves,  such  as  the  central  end  of  the  vagus,  the  crural, 
or  sciatic,  and  by  the  production  of  nausea  or  vomiting. 

The  secretion  is  stimulated  by  the  injection  of  ether  into  the 
stomach,  and  appears  to  be  paralysed  by  atropine  in  the  same 
way  as  the  secretion  of  the  salivary  gland. 

When  fibrin  is  digested  with  pancreatic  juice  the  solution 
soon  begins  to  swarm  with  bacteria,  and  products  of  decomposi- 
tion occur,  among  which  is  indol  with  a  peculiarly  disagreeable 
odour. 

When  calomel  is  added  to  pancreatic  juice,  it  does  not  impair 
its  digestive  action  upon  starch,  proteids,  or  fats,  but  it  arrests 
decomposition,  and  thus  prevents  the  formation  of  indol  and 
scatol,  although  leucin  and  tyrosin,  which  are  normal  products 
of  pancreatic  digestion,  are  still  formed.  Salicylic  acid  has  a 
similar  action.1 

After  the  administration  of  calomel  the  stools  are  often  of  a 
green  colour,  and  this  is  due  to  unaltered  bile.  From  the  ex- 
periments on  biliary  fistulse  already  mentioned  it  is  probable  that 
this  bile  in  the  motions  is  not  due  to  increased  secretion  by  the 
liver,  but  to  the  occurrence  of  diminished  absorption,  caused  by 
its  more  rapid  passage  through  the  intestine,  and  possibly  also  to 
lessened  transformation  from  the  effect  of  the  calomel  in  pre- 
venting its  decomposition. 


Anthelmintics. 

These  are  remedies  which  kill  or  expel  intestinal  worms. 

They  have  been  divided  into  vermicides,  which  kill  the 
worm,  and  vermifuges,  which  expel  the  worm  without  neces- 
sarily killing  it,  e.g.  purgatives. 

The  chief  worms  which  infest  the  intestine  are  tape-worms, 
round-worms,  and  thread-worms. 

The  chief  Vermicides  are  : — 

For  Thread-Worms. — Local  injections  of  alum,  iron,  lime- 
water,  quassia,  eucalyptol,  sodium  chloride,  and  tannin  or  sub- 
stances containing  it,  as  catechu,  hsematoxylon,  kino,  rhatany. 

For  Eound-Worms. — Santonin,  santonica. 

For  Tape-Worms. — Areca  nut,  filix  mas,  kamala,  kousso, 
pomegranate,  pelletierine,  turpentine,  chloroform. 

As  Vermifuges. — Castor-oil,  scammony,  rhubarb. 

Adjuncts.— Ammonium  chloride,  common  salt  and  iron,  and 
bitter  tonics,  are  useful  internally  in  preventing  excessive  secre- 
tion of  intestinal  mucus,  which  affords  a  nidus  for  intestinal 
worms. 


Zeitschr.  f.  physiol.  Chem.,  vi.  2. 


chap,  xiii.]   ACTION  OP  DRUGS  ON  DIGESTIVE  SYSTEM.    409 

Uses. — They  are  used  to  destroy  and  remove  -worms  present 
in  the  intestine.  In  order  that  the  remedies  should  come  into  more 
intimate  contact  with  the  worms,  and  thus  destroy  them  more 
easily,  it  is  usual  to  clear  out  the  intestine  by  a  purgative  some 
hours  before  the  administration  of  the  remedy,  which  is  usually 
given  on  an  empty  stomach,  or  with  a  small  quantity  of  milk. 
After  some  hours  another  purgative  is  given,  in  order  to  bring 
the  worms  away.  As  much  mucus  in  the  intestine  forms  a  nidus 
for  the  worms,  remedies  which  diminish  it  tend  to  prevent  their 
occurrence.  For  this  purpose  preparations  of  iron  and  bitter 
tonics  are  useful. 


410  PHARMACOLOGY  AND  THERAPEUTICS,     [sect.  x. 


OHAPTEE  XIV. 
DRUGS  ACTING  ON  TISSUE-CHANGE. 

Tonics. 

These  are  remedies  which  impart  permanent  strength  to  the 
body,  or  its  parts.  "When  an  individual  is  loose  and  limp,  and 
feels  unfit  for  work,  like  a  relaxed  bowstring,  tonics  restore  his 
energy  and  strength,  and  again  fit  him  for  work.  As  their  action 
in  this  respect  resembles  the  effect  of  tightening  a  bowstring, 
they  have  received  the  name  of  tonics,  which  is  derived  from 
tovos,  tension.  The  feeling  of  debility  may  depend  on  many 
different;  causes.  It  may  be  due  to  weakness  of  the  muscles,  or 
weakness  of  the  nervous  system.  Again,  the  nerves  and  muscles 
may  suffer  because  the  circulation  is  languid  and  feeble,  or 
because  the  blood  which  supplies  them  is  deficient  in  oxygen,  or 
in  nutritive  matter.  These  deficiencies  again  may  depend  on 
deficient  nutrition,  due  to  want  of  appetite,  so  that  too  little  food 
is  consumed,  or  to  an  improper  or  insufficient  diet,  or  to  imperfect 
digestion,  so  that  the  food  is  not  assimilated.  But  weakness  may 
be  also  induced  by  the  accumulation  of  waste-products  in  the 
body,  which  interfere  with  the  functional  activity  of  the  muscu- 
lar and  nervous  systems ;  and  these  products  may  accumulate, 
because  they  are  formed  in  excess  in  the  tissues  themselves  by 
overwork,  or  in  the  intestinal  canal  from  imperfect  digestion  ; 
or  because  they  may  be  allowed  to  pass  too  readily  from  the 
intestinal  canal  into  the  blood  by  deficient  action  of  the  liver. 

Or  their  excretion  may  be  defective  from  the  kidneys  being 
insufficiently  active,  or  the  bowels  constipated. 

The  mode  of  action  of  tonics  is  so  manifold  that  they  have 
been  divided  into  blood  tonics  or  hsematinics,  vascular  tonics, 
gastric  tonics,  intestinal  tonics,  and  nervine  tonics. 

Uses.  —In  order  to  ascertain  what  form  of  tonic  is  required, 
it  is  necessary  to  determine  carefully  what  part  of  the  organism 
is  in  fault.  In  very  many  cases  the  imperfect  functional  ac- 
tivity in  the  body  generally,  which  exhibits  itself  in  languor  and 
weakness,  is  due  to  accumulation  of  waste-products,  and  not 
to  deficient  nutriment.  In  such  cases  the  plan  of  loading  the 
stomach  with  food,  and  giving  iron,  wine,  and  beef-tea,  simply 


chap,  xiv.]    DEUGS  ACTING  ON  TISSUE -CHANGE.  411 

increases  the  mischief.  If  it  is  found,  on  examination  of  the 
urine,  that  the  kidneys  are  not  excreting  a  sufficient  quantity 
of  solids,  and  especially  of  urea,  it  is  necessary  to  diminish  the 
quantity  of  food,  and  especially  of  animal  food,  as  all,  or  nearly 
all,  the  nitrogen  taken  into  the  body  must  be  excreted  by  the 
kidneys. 

In  order  that  no  unnecessary  work  be  thrown  on  the  kidneys, 
we  must,  as  far  as  possible,  prevent  products  of  imperfect  diges- 
tion from  being  absorbed  from  the  intestinal  canal,  and  therefore 
the  state  of  the  liver  must  be  carefully  attended  to,  and  the 
bowels  themselves  carefully  regulated. 

In  cases  where  the  debility  does  not  depend  upon  excessive 
waste-products  in  the  blood  and  tissues,  but  upon  defective  oxida- 
tion due  to  deficiency  of  haemoglobin,  the  patient  must  be  treated 
by  haematinics  such  as  iron,  cod-liver  oil,  and  phosphate  of  lime. 
When  the  digestion  is  imperfect,  gastric  or  intestinal  tonics 
must  be  used  as  the  case  requires. 

Where  enfeeblement  of  the  stomach  appears  to  be  present,  as 
shown  by  loss  of  appetite,  and  such  signs  of  imperfect  digestion  as 
flatulence  or  weight  and  pain  after  eating,  gastric  tonics  are  used. 
Should  the  muscular  coat  of  the  stomach  be  feeble  or  inactive,  as 
shown  by  tendency  to  dilatation  and  splashing  of  the  contents  on 
movement,  strychnine  is  especially  indicated,  and  galvanism  or 
systematic  kneading  may  be  also  employed.  Where  the  stomach 
is  too  debilitated  to  respond  sufficiently  to  this  form  of  treatment, 
as  after  long-continued  gastric  catarrh,  or  in  old  age,  its  work 
must  be  partly  done  for  it,  and  then  such  digestives  as  hydro- 
chloric acid  and  pepsin  are  useful.  When  the  muscular  move- 
ments of  the' intestine  are  sluggish,  as  indicated  by  constipa- 
tion and  by  a  tendency  to  distension  of  the  bowel  with  gas,  nux 
vomica  and  belladonna  may  be  given;  and  when  its  mucous 
membrane  appears  to  be  relaxed  and  flabby,  and  secreting  too 
profusely,  the  mineral  acids,  astringents,  and  metallic  saltg  may 
be  of  much  service.  When  the  pulse  is  soft  and  feeble,  and  there 
is  a  tendency  to  vascular  dilatation,  either  general  or  local,  as 
shown  by  local  congestion  and  oedema  of  the  dependent  parts, 
or  by  drowsiness  in  the  upright  position  and  sleeplessness  in  the 
recumbent  posture,  vascular  tonics  are  serviceable.  Nerve 
tonics  are  used  wbere  the  nervous  functions  are  imperfectly  per- 
formed, as  shown  by  dulness,  loss  of  memory,  incapacity  for 
work,  languor,  paralysis,  or  tendency  to  spasm,  as  in  chorea. 
As  the  functions  of  the  nervous  system  depend  very  greatly  upon 
the  quality  of  the  blood  with  which  it  is  supplied,  and  on  the' 
rapidity  of  the  circulation,  the  other  tonics  frequently  require  to 
be  given  in  addition  to  nervine  tonics. 


412  PHAEMACOLOGY  AND  THERAPEUTICS,    [sect,  i.. 


Haematinics. 

Blood-tonics,     blood-restoratives,     analeptic    tonics.— 

These  are  generally  remedies  which  improve  the  quality  of  the 
blood;  but  the  name  blood-tonics  or  haematinics  is  generally 
applied  specially  to  such  remedies  as  increase  the  quantity  of 
red  blood-corpuscles  and  haemoglobin  in  the  blood.  The  quality 
of  the  blood  depends  upon  a  number  of  conditions :  upon  the 
amount  and  nature  of  the  food  ingested,  on  the  digestion,  on  the 
formation  and  excretion  of  the  various  products  of  tissue-change, 
and  more  especially  on  the  formation  and  destruction  of  the  red, 
blood-corpuscles  themselves. 

The  red  blood-corpuscles  are  probably  formed  in  the  spleen, 
the  medulla  of  bones,  the  liver,  and  possibly  other  parts  of  the 
body,  from  leucocytes  which  lose  their  nucleus,  take  up  haema- 
globin,  and  alter  their  form  to  that  of  the  red  corpuscles. 

The  red  corpuscles  are  probably  destroyed,  at  least  to  a 
great  extent,  in  the  liver,  and  probably  also  in  the  spleen.  The 
colouring  matter  of  bile  contains  a  quantity  of  iron,  and  appears 
to  be  formed  from  haemoglobin. 

An  abnormal  condition  of  the  liver,  by  leading  to  excessive 
destruction  of  blood-corpuscles,  may  therefore  be  an  important 
cause  of  ansemia.  The  corpuscles  contain  albuminous  matters 
as  well  as  haemoglobin,  and  deficiency  of  albumen  in  the  blood  will 
lead  to  ansemia.  Thus,  in  cases  of  Bright's  disease,  the  loss  of 
albumen  through  the  kidneys  tends  to  produce  anaemia,  and  this 
must  be  combated  by  lessening  the  loss,  if  possible,  as  well  as  by 
supplying  albumen. 

The  blood-corpuscles  also  contain  fat,  and  deficiency  of  fatty 
food  will  tend  to  produce  anaemia.  Cod-liver  oil,  on  the  other 
hand,  which  is  an  easily  assimilated  form  of  fat,  is  a  powerful 
haematinic.  In  ansemia  there  is  a  deficiency  of  iron  in  the  blood, 
and  chalybeate  preparations  are  among  the  most  powerful  of  all 
haematinics. 

One  well-marked  disease  due  to  imperfect  nutrition  is  scurvy. 
In  it  there  is  not  only  a  deficiency  of  red  blood-corpuscles,  but  a 
tendency  to  extravasation.  Its  pathology  is  not  definitely  made 
out,  and  it  has  been  supposed  to  be  due  to  a  deficiency  of  salts  of 
potassium  in  the  blood,  but  it  is  much  more  likely  that  it  is  due 
to  increase  in  the  chlorides,  and  especially  chloride  of  sodium, 
either  absolutely  or  relatively  to  the  carbonates. 

Excess  of  chloride  of  sodium  causes  the  blood-corpuscles  to 
pass  out  of  the  vessels  (p.  63),  and  potassium  salts  alone,  or  beef- 
tea,  which  contains  them,  do  not  cure  scurvy ;  but  it  is  removed ' 
by  fresh  vegetables  or  by  lime-juice. 


qHAV.  xiv.]     DEUGS  ACTING  ON  TISSUE-CHANGE.  413 

Alteratives. 

These  are  remedies  which  improve  the  nutrition  of  the  body 
without  exerting  any  very  perceptible  action  on  individual 
organs.     The  chief  alteratives  are : — 

Arsenic.  Colchicurn. 

Mercury.  Guaiacum. 

Iodine.    Iodides.  Stillingia. 

Cod-liver  oil.  Sanguinaria. 

Sarsaparilla.  Xanthoxylum. 

Sulphur.  Mezereum. 

Gold. 

Action. — Healthy  nutrition  depends  (1)  upon  a  proper  supply 
of  oxygen  and  nutriment  to  each  tissue  and  organ  in  the  body, 
(2)  on  the  proper  amount  and  kind  of  tissue-change  in  the  vari: 
ous  cells ;  (3)  on  the  proper  removal  of  waste. 

The  proper  supply  of  oxygen  and  of  nutriment  to  the  body 
generally  will  depend  upon  the  state  of  the  respiratory  and 
digestive  organs ;  their  proper  supply  to  the  tissues,  as  well  as 
the  removal  of  waste  from  them,  will  depend  upon  the  circuT 
lation ;  and  the  removal  of  waste  from  the  body  generally  will 
depend  upon  the  bowels,  skin,  and  kidneys. 

The  drugs  which  act  upon  the  different  organs  just  men- 
tioned are  considered  under  other  headings,  but  the  changes 
which  take  place  in  the  tissues  themselves  appear  to  be  effected 
by  drugs  which  produce  no  marked  corresponding  changes  in 
assimilation,  circulation,  or  excretion.  It  is  uncertain  how  they 
act :  it  is  possible  that  they  may  alter  in  some  way  the  action  of 
enzymes  in  the  body,  but  it  is  also  possible  that  they  act  by  rer 
placing  the  normal  constituents  of  the  tissues  and  forming 
compounds  which  tend  to  break  up  in  a  different  way  from  those 
which  are  ordinarily  present. 

Thus  chloride  of  sodium  and  nitrogenous  bodies  such  as  albu- 
men  are  amongst  the  most  important  constituents  of  the  body ; 
and  we  find  that  among  the  chief  alteratives  are  substances 
which  will  replace  chlorine,  sodium,  or  nitrogen  in  many  com- 
pounds. Thus  we  have  iodine  and  iodides,  and  nitric  or  nitro^ 
hydrochloric  acids,  which  will  displace  or  replace  chlorine.  We 
have  chlorine  itself,  and  chlorides  which  may  alter  the  proportion 
of  chlorides  to  other  salts  in  the  blood  and  tissues,  and  thus 
modify  the  solubility  of  various  constituents  of  the  tissues.  We 
have  salts  of  potassium  and  calcium,  which  may  replace  those  of 
sodium ;  sulphur,  and  sulphides  which  may  replace  oxygen ;  phos- 
phorus, hypophosphites,  antimony  and  arsenic,  which  may  replace 
nitrogen  ;  mercury  and  its  salts,  which  may  replace  calcium. 

Besides  these  we  have  organic  alteratives,  regarding  the 
action  of  which  we  can  at  present  form  no  hypothesis  unless 


414  PHABMACOLOGY  AND  THEBAPEUTICS.      [sect.  t. 

they  influence  the  processes  of  digestion.  Nitro-hydrochloric 
acids,  taraxacum,  and  small  doses  of  mercurials,  probably  act 
either  by  modifying  the  digestion  of  food  in  the  duodenum  and 
jejunum,  or  by  modifying  the  changes  which  it  undergoes  in  the 
liver  after  absorption. 

The  action  of  drugs  upon  tissue-change  has  usually  been  investigated  by 
ascertaining  the  amount  of  urea  excreted  before,  during,  and  after  the  ad- 
ministration of  a  drug.  Most  of  the  older  experiments  on  this  subject  are  of 
little  or  no  value,  as  sufficient  care  was  not  taken  to  ensure  that  the  amount 
of  nitrogenous  food  consumed  each  day  during  the  experiment  was  exactly 
the  same.  As  all  the  nitrogen  taken  in  the  food  reappears  in  the  urine,  any 
irregularity  in  the  quantity  introduced  into  the  body  will  cause  a  correspond- 
ing irregularity  in  the  quantity  excreted.  After  this  fact  was  ascertained, 
the  plan  adopted  by  some  experimenters  was  to  deprive  an  animal  of  food  for 
several  days,  until  the  excretion  of  urea  due  to  the  gradual  destruction  of  its 
nitrogenous  tissues  became  nearly  constant.  The  plan  now  adopted  is  to 
give  to  a  dog  or  a  man  a  quantity  of  food  of  a  uniform  quality  and  the 
amount  of  nitrogen  in  which  is  exactly  known.  The  quantity  given  each  day 
is  exactly  weighed.  The  same  amount  of  nitrogen  is  thus  introduced  into 
the  organism  every  day,  and  therefore  any  variations  in  the  amount  of  nitrogen 
excreted  must  be  due  to  changes  in  the  organism  itself. 

Observations  on  the  excretion  of  urea  only  give  us  a  very  partial  and 
imperfect  knowledge  of  the  process  of  tissue-change,  and  they  ought  to  be 
combined,  as  in  the  experiments  of  Pettenkofer  and  Voit,  with  observations  on 
the  amount  of  oxygen  absorbed  and  of  carbonic  acid  given  off.  Such  experir 
ments  as  these,  although  very  valuable,  are  very  laborious,  and  comparatively 
few  have  hitherto  been  made.1 

From  experiments  made  with  those  necessary  precautions 
just  described  it  has  been  found  that  free  consumption  of  water 
increases  tissue-change  very  considerably,  as  is  shown  by  the 
increased  excretion  of  urea. 

Common  salt,  sulphate  of  sodium,  phosphate  of  sodium, 
acetate  of  sodium,  borax,  nitrate  of  potassium,  chloride  of 
ammonium,  carbonate  of  ammonium,  and  probably  all  salts 
which  pass  out  in  the  urine  carrying  water  with  them,  somewhat 
increase,  tissue-change  and  the  amount  of  urea  excreted.  Fats 
and  fatty  acids  apparently  lessen  the  decomposition  of  albuminous 
tissues  and  the  excretion  of  urea,  but  glycerine  has  no  action  of 
this  sort.  Alcohol  in  small  or  moderate  doses  lessens,  in  large 
doses  increases,  tissue-change.  Benzoic  acid,  salicylic  acid,  and 
benzamide,  all  increase  tissue-change.  Contrary  to  what  perhaps 
might  have  been  expected,  tea,  coffee,  and  cocoa  have  no  action 
whatever  on  the  excretion  of  urea.2  The  experiments  which  seemed 
to  show  that  they  diminished  it,  appear  to  have  been  made  without 
the  necessary  precautions.  Morphine  slightly  diminishes  the  ex- 
cretion of  urea,  but  its  action  is  much  more  marked  on  the  con- 
sumption of  oxygen  and  exeretion  of  carbonic  acid.     These  are 


1  A  complete  account  of  the  whole  subject  is  given  by  Voit  in  Hermann's 
Handb.  d.physiol,  Band  VI,  Theil  i.  This  contains  also  complete  references  to 
the  literature. 

2  Voit,  op.  ciU 


chap,  xiv.]     DEUGS  ACTING  ON  TISSUE -CHANGE.  415 

greatly  increased  in  the  stage  of  excitement,  and  greatly  diminished 
in  the  stage  of  quiescence.  It  would  appear  that  these  changes 
are  not  due  to  the  direct  action  of  the  morphine,  but  only  to  the 
alterations  of  muscular  activity  which  follow  its  administration. 

Quinine  lessens  tissue-change,  iron  appears  to  increase  it, 
mercury  also  slightly  increases  it,1  while  iodine  appears  to  have 
little  influence  upon  the  quantity  of  urea  excreted.  This  fact  is 
of  itself,  I  think,  sufficient  to  show  that  the  mere  estimation  of  the 
quantity  of  urea  excreted  before  and  after  the  administration  of 
a  drug  is  quite  insufficient  to  give  us  any  precise  information 
regarding  its  action  on  tissue-metamorphosis. 

Antimony,  arsenic,  and  phosphorus  have  a  special  action  on 
tissue-change,  and  powerfully  affect  the  glandular,  nervous,  respi- 
ratory, and  cutaneous  systems.  In  large  quantities  they  affect 
the  liver  very  markedly,  producing  fatty  degeneration ;  and  this 
also  occurs  in  other  tissues. 

This  fatty  degeneration  is  due  to  a  twofold  action : — 1st, 
increased  tissue-metamorphosis ;  and  2nd,  diminished  oxidation. 
In  the  normal  condition  albuminous  tissues  split  up  as  indicated 
below : — 


Albuminous 

tissues 


Non-nitrogenous 
substances .    •  e.g.  Fat,  &c. 

Nitrogenous         e.g.  Leuoin, 
substances         Tyrosin,  &o. 


■gll     by  lungs. 

|l|  Urea,  excreted  by 
S%  \     kidneys. 


.  excreted 


In  poisoning  by  antimony,  arsenic,  and  phosphorus,  the  nitro- 
genous products  of  tissue-waste  appear  in  much  larger  quantity 
in  the  urine  than  normally,  owing  to  the  increased  decomposition 
which  is  going  on.  They  may  appear  in  the  urine  in  the  form  of 
an  excessive  quantity  of  urea,  as  in  cases  of  phosphorus-poisoning 
in  the  dog,  but  in  man  they  may  appear  in  the  form  of  leucin 
and  tyrosin.  Owing  to  the  diminished  oxidation  the  non-nitro- 
genous substances  remain  in  the  body  as  fat,  instead  of  being 
oxidised  and  passing  out  of  the  body  as  carbonic  acid. 

The  exact  nature  of  their  effect  on  the  nervous  system  has 
not  been  made  out.  Their  action  on  the  skin  and  epithelial  cells 
of  the  lungs  seems  to  be  that  of  causing  fatty  degeneration. 

Fatty  degeneration  of  the  liver  occurs  also  in  poisoning  by 
salts  of  silver. 

Mercury  has  a  peculiar  power  of  breaking  up  newly  deposited 
fibrin  and  of  causing  disorganisation  of  syphilitic  deposits.  Iodine, 
iodides,  and  probably  also  chlorides,  appear  to  act  on  the  lymph- 
atic system  and  promote  absorption :  their  action  is  specially 
well-marked  in  cases  of  glandular  enlargement. 

Uses. — In  general  malnutrition  without  definite  symptoms., 
mercurials,  taraxacum,  and  nitro-hydrochloric  acid  are  used  and 

1  Roeck,  quoted  by  Voit,  op.  cit. 


416  PHARMACOLOGY  ANDf  THERAPEUTICS,      [sect.  i. 

are  especially  indicated  where  the  liver  is  suspec'ted  to  be  in  fault, 
as  where  there  are  symptoms  of  biliousness,  and  also  where  oxalates 
and  urates  are  found  abundantly  in  the  urine. 

In  gout,  salts  of  potassium  and  colchicum  are  used.  Phos- 
phorus and  arsenic  are  employed  in  nervous  debility  :  and  they, 
as  well  as  antimony,  are  serviceable  in  neuralgia,  chorea,  and 
other  nervous  diseases. 

In  diseases  of  the  skin,  arsenic  iB  chiefly  employed. 

In  diseases  of  the  respiratory  organs,  antimony  is  very  ser- 
viceable when  the  attack  is  acute  ;  and  arsenic  is  most  valuable 
in  some  chronic  conditions,  especially  in  chronic  consolidation, 
where  it  probably  acts  by  producing  fatty  degeneration  and  soften- 
ing of  the  effusion,  so  that  it  is  either  absorbed  or  expectorated. 

Mercury  is  employed  specially  to  break  up  deposits  of  lymph 
jand  to  prevent  adhesions,  as  in  iritis  and  pericarditis ;  and  is  also 
used  and  is  most  serviceable  in  the  treatment  of  syphilis.  It  is 
most  generally  employed  in  the  secondary  stage  of  this  disease  : 
in  the  third  stage  it  is  either  given  along  with,  or  entirely  replaced 
by  the  use  of,  iodides. 


Antipyretics,  Febrifuges. 

These  are  remedies  which  reduce  the  temperature  of  the 
body  in  fever.  They  act  much  more  powerfully  when  the  tem- 
perature is  abnormally  high  than  when  it  is  normal. 

The  constant  temperature  of  warm-blooded  animals  depends 
upon  the  maintenance  of  a  proper  balance  between  the  amount 
of  heat  generated  in  the  body,  chiefly  by  oxidation,  and  the 
amount  given  off  to  the  surrounding  medium — air  or  water.  The 
heat  is  chiefly  generated  in  the  muscles  and  glands.  It  is  chiefly 
given  off  by  the  skin,  although  some  is  also  lost  by  the  lungs,  etc. 

A  little  heat,  but  not  much,  may  be  given  off  by  radiation 
alone.  The  power  of  dry  air  to  take  up  heat  is  very  slight,  and 
so  the  skin  is  not  much  cooled,  and  very  little  sensation  of  cold 
is  felt  at  temperatures  much  below  0°  if  the  air  is  both  still  and 
dry.  If  the  air  be  moist  its  capacity  for  heat  is  much  greater, 
and  the  loss  of  heat  from  the  skin  being  much  more  rapid,  a  per- 
son may  actually  feel  the  weather  colder  at  4°  F.  than  at  — 40°  F., 
the  air  being  still  in  both  cases.  If  air,  either  dry  or  moist,  is  in 
motion,  so  that  fresh  portions  of  it  come  successively  into  contact 
with  the  skin,  the  loss  of  heat  is  much  more  rapid,  and  a  little 
wind  will  render  even  dry  air  unbearably  cold  at  a  temperature 
which  would  be  quite  supportable  if  the  air  were  still. 

Loss  of  heat  occurs  more  readily  in  small  animals  than  in 
large.     This  is  represented  diagrammatically  in  Fig.  144. 

It  is  to  be  observed  that  during  sleep  the  action  of  the  vaso- 
motor centre  is  less,  the  vessels  of  the  surface  dilate,  and  loss  of 


chap,  xiv.]    DEUGS  ACTING  ON  TISSUE-CHANGE. 


417 


heat,  with  danger  of  consequent  chill,  takes  place  more  rapidly. 
For  the  effects  of  local  chill  to  the  surface,  the  results  of  Ross- 
bach's  experiments  may  be  consulted  (p.  251). 


Fig.  144.— Diagram  to  show  that  loss  of  heat  occurs  more  readily  in  small  animals  than  in  large 
The  unshaded  part  in  a  and  6  represents  the  surface  through  which  heat  is  lost ;  the  black  part 
shows  the  heat-producing  part  of  the  body.  These  are  shown  separately  in'  a'  and  &',  from 
which  it  is  evident  that  in  the  small  animal  the  heat-producing  area  is  about  the  same  size  as 
while  in  the  large  animal  it  is  double  the  size,  of  the  heat-dispersing  area. 

But  heat  may  be  generated  in  muscles  and  glands  apart  from 
the  circulation  in  them,  and  Sachs  and  Aronsohn  have  shown 
that  a  centre  regulating  the  production  of  heat  is  situated  in  the 


Cardiac  muscle 

Vessels  of  surface 

Liver 

Muscles  of  abdominal  wall 

Intestine 


Aorta. 


Vessels  of  surface* 


Muscles  of  back. 


.  Muscles  of  limbs. 


Pio.  1 48.— Diagram  to  illustrate  the  action  of  alterations  in  the  circulation  of  the  surface  of  the 
body  and  the  internal  organs  and  muscles  upon  temperature.  In  this  figure  the  superficial 
vessels  are  represented  as  contracted,  and  there  is  therefore  not  only  less  loss  of  heat,  but  the 
blood  being  driven  to  the  internal  organs  and  muscles,  the  circulation  in  them  is  increased  and 
the  production  of  heat  augmented.  The  parts  where  heat  is  produced  are  the  dark,  the  dark- 
ness being  in  proportion  to  the  greater  production.  The  parts  where  heat  is  retained  without 
much  being  formed,  e.g.  the  blood,  are  moderately  shaded.  Those  where  heat  is  lost  are  left 
white.  In  the  intestine  heat  is  both  formed  and  lost  (p.  418),  and  so  the  intestines  are  partly 
dark  and  partly  light. 

neighbourhood  of  the  corpora  striata.1     It  is  probable  that  the 
temperature  may  be  affected  by  drugs  acting  on  the  nervous 


Deutsche  med.  Wochenschr.,  December  1884. 


E  E 


418 


PHAEMACOLOGY  AND  THEKAPEUTICS.      [sect.  I. 


system  apart  from  the  circulation  and  also  by  drugs  which  affect 
the  tissues  themselves  (p.  58  et  seq.).1 

The  circulation  exercises  a  very  important  influence  upon  (1) 
the  amount  of  heat  lost  from  the  surface  and  (2)  the  amount  of 
heat  produced  in  the  internal  organs  and  muscles.  This  is 
represented  diagrammatically  in  Figs.  145  and  146. 


Cardiac  muscle  — 

Vessels  of  surface  — 
Liver  — 

Muscles  of  abdominal  wall  - 

Intestine r$fl-] 


Vessels  of  surface. 


""  Muscles  of  back. 


Muscles  of  limbs. 


Fig.  14R. — Diagram  to  illustrate  tbc  action  of  alterations  in  the  circulation  of  the  surface  of  the 
body  and  the  internal  organs  and  muscles  upon  the  temperature.  In  the  diagram  the  cutaneous 
vessels  are  represented  as  dilated,  and  thus  not  only  is  more  heat  lost  from  the  surface,  but, 
blood  being  withdrawn  from  the  internal  organs  and  muscles,  the  circulation  in  them  is  lessened 
and  less  heat  produced. 

The  vessels  of  the  skin  form  a  cooling  apparatus  (p.  440), 
while  heat  is  generated  in  the  muscles,  voluntary  and  involuntary, 
and  in  glands,  e.g.  the  intestine  and  liver.  The  intestine  is, 
however,  only  protected  by  the  thin  abdominal  walls  from  the 
cooling  action  of  the  external  air,  and  so  it  may  act  either  in 
cooling  or  warming  the  body,  according  to  circumstances. 

When  the  vessels  of  the  surface  are  dilated,  the  blood  not 
only  courses  freely  through  them  and  becomes  cooled,  but,  being 
withdrawn  from  the  muscles  and  glands,  there  is  less  heat  pro- 
duced. The  reverse  is  the  case  when  the  cutaneous  vessels  are 
contracted.  The  condition  of  the  vessels  depends  on  the  action 
of  the  vaso-motor  centre,  and  drugs  acting  upon  it  may  greatly 
modify  the  temperature. 

Antipyretics  may  be  divided  into  two  great  classes :  those 
which  lessen  the  production  of  heat,  and  those  which  increase 
the  loss  of  heat ;  and  these  again  may  be  subdivided  as  shown 
in  the  following  table : — 

1  Umbach,  Archivf.  exp.  Path.  u.  Pharm.  1886,  xxi. 


chap,  xiv.]    DEUGS^  ACTING  ON  TISSUE-CHANGE. 


419 


"Lessen    production   of 
heat 


Anti- 
pyretics 


Acting  on  tissue-change  . 


Acting  on  the  circula- 
tion...  


'Generally 


Locally 


'Quinine. 
Cinchonine. 

Quinidine. 
Cinch  on  idine, 
Berberin. 
Benzoic  acid. 
Carbolic  acid. 
Picric  acid. 
Salicylic  acid. 
Salicylate  of  sodium. 

„         quinine. 

„         methyl, 
(oil  of  winter-green). 
Salic  in. 
Kairin. 
Camphor. 
Eucalyptol. 
Thymol. 

Other  essential  oils. 
„  Alcohol. 

'  Antimony  salts. 

Aconite. 

Digitals. 

Veratrine* 

Coichicum. 
VThallin. 

/Wet  cupping. 

Leeches. 
■j  Dry  cupping. 

Blisters. 
I  Poultices. 


'By  dilating  the  cutaneous  vessels,  f^?oho1,  ^ 
yandincrLing  radiation .1    ™^« 


Increase  loss  of  heat . . . 


By  increasing  the  loss] 
of  heat  due  to  evapo-  Y  Sudoriflcs 
ration  of  perspiration ) 


By  abstracting  heat  from  the  body  _ 


Mode  of  action  uncer-  ( Purgatives, 
tain 1  Venesection. 


'  [  Antipyrin,1  thallln. 

Antimonial  prepara- 
tions. 
Opium  and  ipecacuanha 
Nitrous  ether. 

/Cold  bath. 

Cold  affusion1. 

Cold  sponging. 

Wet  pack. 

Ice  to  the  surface. 

Ice-bags  to  the  neck. 

Cold  drinks. 
VCold  enemata. 


The  mode  of  action  of  those  which  affect  the  blood  and 
tissues  themselves  has  already  been  considered  tolerably  fully 
under  the  head  of  'Oxidation  of  Protoplasm'  (p.  67).  They 
appear  simply  to  diminish  the  temperature  by  lessening  oxi- 
dation. The  mode  of  action  of  antipyretics  which  produce 
their  effect  through  the  circulation,  has  not  been  investigated 
in  detail  with  satisfactory  exactitude,  but  it  is  supposed  that  by 
lessening  the  rapidity  of  the  circulation  through  those  parts  of 
the  body  in  which  the  increased  tissue-change  is  taking  place, 
the  temperature  is  reduced. 

Blisters  will  have  this  effect  locally  by  causing  contraction  of 
the  vessels  in  the  inflamed  part,  as  already  described  under  the 
head  of  Counter-irritants  (p.  343). 

Antipyretics,  which  increase  the  loss  of  heat,  may  do  so  (1) 
by  causing  greater  dilatation  of  the  vessels  of  the  skin,  and  thus 


Bettelheim,  '  Ueber  das  Antipyrin,'  Wien*  med.  JahrbUcher,  1885. 

£  E  2 


420  PHAEMACOLOGY  AND  THEEAPEUTICS.      [sect.  i. 

allowing  a  quicker  radiation  of  heat  from  the  body ;  (2)  by  aug- 
menting the  secretion  of  sweat :  and  thus  carrying  off  heat  by 
means  of  evaporation  (see  Diaphoretics,  p.  440) ;  or  (3)  they  may 
actually  remove  warmth  from  the  body,  as  cold  baths,  cold 
affusion,  cold  sponging,  wet  packing,  cold  enemata,  or  ice  to  the 
surface. 

Uses.— Antipyretics  are  used  to  lower  the  temperature  when 
it  has  risen  above  the  normal,  whatever  be  the  cause.  A  high 
temperature  may  be  produced  simply  by  prolonged  exposure  to 
heat.  This  exposure  and  the  rise  in  temperature  it  occasions, 
seems  to  induce  increased  tissue-change,  and  this  increase  of  the 
tissue-change  will  keep  up  a  febrile  temperature,  even  after  the 
external  temperature  has  fallen.  Such  thermal  fever  is  found  in 
warm  climates,  and  in  it  quinine  injected  subcutaneously  seems 
to  be  very  efficient. 

A  high  temperature  may  also  occur  from  specific  fevers,  as 
typhus,  typhoid,  scarlet  fever,  measles,  and  acute  rheumatism. 
The  most  rapid  and  powerful  antipyretic  in  such  cases  is  the 
application  of  cold  by  bathing,  or  sponging ;  and  probably  next 
in  efficiency  come  large  doses  of  quinine  or  salicylate  of  sodium. 
In  typhoid  fever,  salicylate  of  sodium  does  not  seem  to  act  so 
rapidly  as  it  does  in  acute  rheumatism. 

Venesection,  though  formerly  the  antipyretic  which  was 
•chiefly  relied  upon,  has  now  fallen  to  a  great  extent  out  of  use- 
probably  from  its  having  been  very  much  abused. 

In  persons  suffering  from  acute  inflammation  of  the  lungs  or 
bronchi,  where  the  amount  of  lung-tissue  which  remains  sound 
is  insufficient  to  aerate  the  whole  mass  of  blood,  and  the  patient 
is  becoming  livid,  small  bleedings  are  serviceable ;  they  not  only 
relieve  the  breathing,  but  lessen  delirium  which  may  be  present. 

Venesection  lowers  the  temperature  for  a  short  time,  but  it 
soon  rises  again  in  many  cases,  so  that  bleeding  alone  is  by  no 
means  a  powerful  antipyretic,1  unless  the  quantity  of  blood  ab- 
stracted be  so  great  as  probably  to  injure  the  patient  seriously ; 
yet  in  combination  with  other  antipyretics  it  may  sometimes  be 
of  very  great  service. 

Local  bleeding  by  leeches  or  by  wet  cupping  sometimes 
gives  very  great  relief,  lessening  both  local  inflammation  and  the 
general  symptomatic  fever  consequent  upon  it,  in  pneumonia, 
pleurisy,  pericarditis,  peritonitis,  &c.  In  such  cases  blisters 
may  be  used  to  diminish  the  local  inflammation,  and  thus  aid 
the  action  of  other  antipyretics. 

Vascular  antipyretics,  such  as  aconite  and  digitalis,  also 
seem  to  be  of  more  service  in  symptomatic  fever  than  they  are 
in  specific  fevers. 

1  Wunderlich's  Medical  Thermometry,  pp.  118,  134,  378,  New  Sydenham 
Society's  edition. 


chap,  xiv.]    DEUGS  ACTING  ON  TISSUE -CHANGE.  421 

Purgatives  take  an  intermediate  place  between  antipyretics 
■which  lessen  the  production  of  heat  by  acting  on  the  tissues,  and 
those  which  act  on  the  circulation.  They  diminish  the  force  of 
the  circulation,  and  may  in  this  way  lessen  the  production  of 
heat.  But  it  is  not  impossible  also,  although  this  is  a  point 
on  which  we  have  not  sufficient  information,  that  they  may  do 
so  by  removing  from  the  body  substances  whose  effect  when 
present  in  the  circulation  or  tissues  would  be  to  maintain  the 
high  temperature. 

Amongst  antipyretics  which  increase  the  loss  of  heat  we  have : 
first,  alcohol,  which  is  included  also  in  the  former  list  of  those 
which  lessen  the  production  of  heat,  for  it  appears  to  act  in  both 
ways,  both  diminishing  oxidation  and  also  increasing  the  loss  of 
heat.  It  does  this  by  dilating  the  vessels  of  the  skin  and  allow- 
ing free  radiation  from  the  surface,  and  also  by  the  cooling  effect 
of  evaporation  of  the  sweat,  although  its  action  as  a  sudorific  is 
not  very  marked.     Antipyrin  seems  to  act  in  a  similar  manner. 

We  have  also  the  whole  class  of  sudorifics  (p.  440).  One  of 
the  most  useful  of  these  in  checking  a  febrile  condition  just  at 
its  outset  is  a  dose  of  compound  ipecacuanha  powder,  or  Dover's 
powder,  which  has  now,  to  a  great  extent,  taken  the  place  of  the 
older  remedy  having  a  somewhat  similar  action,  viz.  antimonial 
powder,  or  James's  powder. 

Another  mixture  in  great  favour  is  acetate  of  ammonium  and 
spirit  of  nitrous  ether.  The  most  powerful,  however,  of  all 
remedies  which  increase  the  loss  of  heat  is  the  application  of 
cold  water  or  ice.  The  mode  of  applying  these  is  discussed  at 
page  464. 


422  PHAEMACOLOGY  AND  THERAPEUTICS,      [sect.  i« 


CHAPTEE  XV. 
ACTION  OP  DRUGS  ON  EXCRETION. 

ACTION  OP  DRUGS  ON  THE  KIDNEYS. 

The  kidney  has  a  twofold  office.  It  has  (1)  to  regulate  the 
amount  of  water  in  the  body  under  various  conditions ;  (2)  to 
remove  the  products  of  tissue-waste.  These  products  must  be 
removed  in  a  state  of  solution  from  the  part  of  the  kidney  where 
they  are  excreted,  and  yet  sometimes  provision  must  be  made 
for  the  water,  by  which  they  are  washed  out,  being  retained  in 
the  body.  The  urine  in  mammals  and  amphibia  is  liquid ;  in 
birds  and  reptiles  it  is  semi-fluid  or  solid,  yet  the  solid  con- 
stituents are  removed  in  solution  from  the  urinary  tubules,  and 
the  water  in  which  they  are  dissolved  is  afterwards  absorbed. 
We  may  say  then  that  the  kidney .  has  not  only  a  twofold,  but 
a  threefold  action : — 1st,  the  excretion  of  waste-products ; 
2ndly,  a  provision  for  the  removal  of  excessive  water ;  and 
3rdly,  an  arrangement  for  the  retention  of  water  in  the  body, 
Dy  its  re-absorption  after  it  has  washed  out  the  waste-products. 
On  looking  at  the  kidney  we  find  three  structures  which  seem  to 
be  connected  with  these  three  functions,  viz. :  (1)  convoluted 
tubules  with  epithelial  cells,  which  in  all  probability  are  the 
chief  structures  for  excreting  waste-products ;  (2)  the  Malpighian 
corpuscles  for  excreting  water  along  with  some  solids,  and  (3) 
usually  one  or  more  constrictions  in  the  tubule  which  may  serve 
the  purpose  of  preventing  too  rapid  exit  of  the  water,  and  thus 
allow  time  for  its  re-absorption  in  cases  where  its  retention  is 
desirable,  as  for  example  on  a  hot  day  and  when  the  supply  of 
drinking-water  is  very  limited. 

The  process  of  secretion  in  the  kidney  was  regarded  by 
Bowman  as  consisting  of  the  filtration  of  water  from  the  vessels 
of  the  glomeruli  into  the  tubules,  and  the  excretion  of  waste- 
products  by  the  epithelium  lining  the  tubules.  Ludwig,  however, 
came  to  look  upon  it  rather  as  a  process  of  filtration  and  re- 
absorption  ;  a  dilute  solution  of  urea  and  salt  being,  according  to 
him,  poured  out  from  the  Malpighian  corpuscles  and  gradually 
concentrated  by  the  absorption  of  water  in  its  passage  along  the 
tubules.    This  theory  had  so  many  facts  in  its  favour  that  it  was 


chap,  xv.]      ACTION  OF  DEUGS  ON  EXCRETION.  423 

for  a  good  while  exclusively  adopted,  but  latterly  Heidenhain,  in 
an  admirable  series  of  experiments,  has  shown  that  such  sub- 
stances as  indigo  are  certainly  excreted  by  the  epithelium  of 
the  tubules.  At  the  same  time  Hufner  has  shown,  by  a  com- 
parison of  the  structure  of  the  kidney  in  fishes,  frogs,  tortoises, 
birds,  and  mammals,  that  the  form  of  the  tubules  closely 
agrees  with  that  required  for  the  re-absorption  of  water  in  each 
case.  Fishes  have  a  low  blood-pressure,  and  so  the  resistance 
in  the  kidney  requires  to  be  small  in  order  to  allow  of  the  secre- 
tion of  urine.  Living  as  they  do  in  water,  they  do  not  require 
any  apparatus  for  its  retention  in  the  body.     In  them  therefore 


Fig.  147. — Diagram  showing  the  form  of  the  urinary  tubules  In  different'  classes  of  animals,  after 
Hufner.  1.  Fish.  2.  Frog.  3.  Tortoise.  4.  Bird.  5.  Mammal.  The  letters  have  the  same 
signification  in  each,  a.  Capsule  of  the  glomerulus,  b.  Convoluted  tubule,  c.  Loop.  d.  Col- 
lecting tubule,    u  in  2  indicates  the  transverse  section  of  the  ureter. 

ihe  tubule  is  short  and  wide,  and  destitute  of  any  constriction 
which  would  retard  the  outflow  of  the  fluid.  In  frogs  there  must 
be  ample  provision  for  the  retention  of  water  in  the  body,  as 
evaporation  takes  place  freely  from  their  skin.  In  them  we  find, 
as  we  might  expect,  that  the  tubule,  and  especially  the  contracted 
part  of  it,  is  very  Jong.  In  tortoises  no  evaporation  from  the 
skin  can  take  place,  and  in  th^m  the  contracted  part  of  the 
tubule  is  short.  This  renders  it  probable  that,  while  the  ideas 
advanced  by  Bowman  and  supported  by  Heidenhain  are  in  the 
main  true,  the  re-absoiption  of  water  on  which  Ludwig  lays  so 
much  stress  is  also  an  important  factor  in  the  secretion  of  urine 
under  different  circumstances. 

But  it  is  not  only  rendered  probable  by  the  facts  of  compara- 


424  PHAEMACOLOGY  AND   THEEAPEUTICS.      [sect.  i. 

tive  anatomy ;  it  appears  to  be  proved  by  direct  experiment. 
Eibbert1  has  extirpated  the  medullary  subslance  of  the  kidney 
in  the  rabbit  while  leaving  the  cortical  substance.  He  has  thus 
succeeded  in  collecting  the  urine  as  it  is  excreted  by  the  Mal- 
pighian  corpuscles  before  it  has  passed  through  Henle's  loops, 
and  has  found  that  the  urine  secreted  by  the  cortical  substance 
alone  is  much  more  watery  than  that  which  is  secreted  by  the 
entire  kidney — a  fact  which  appears  conclusively  to  prove  that 
water  is  actually  re-absorbed,  and  the  urine  rendered  more  con- 
centrated, during  its  passage  through  the  tubules  of  the  medul- 
lary substance. 

In  the  frog  and  triton  the  arrangement  of  the  kidney  is  such 
as  to  allow  of  a  much  more  complete  investigation  of  the  different 
factors  in  secretion,  than  in  mammals,  because  in  amphibia,  the 
glomeruli  which  separate  the  water  and  the  tubules  which  ex- 
crete the  solids,  receive  their  blood-supply  to  a  great  extent  in- 
dependently. The  glomeruli  are  supplied  by  branches  of  the 
renal  artery.  The  tubules  are  supplied  by  a  vein  which  proceeds 
from  the  posterior  extremities  and,  entering  the  kidney,  breaks 
up  into  a  capillary  plexus  bearing  a  somewhat  similar  relation  to 
the  renal  tubules  as  that  which  the  portal  vein  does  to  the  lobules 
of  the  liver.     It  is  therefore  called  the  portal  vein  of  the  kidney. 

The  arterial  circulation  in  the  glomeruli  and  the  venous 
portal  circulation  round  the  tubules  are  not  entirely  distinct,  for 
the  efferent  arteries  of  the  glomeruli  unite  with  the  portal  capil- 
laries, and,  moreover,  arterial  twigs  also  pass  directly  from  the 
renal  artery  into  the  capillary  venous  plexus  {vide  Fig.  148). 
The  two  systems  are  so  far  distinct  that  Nussbaum  has  been 
able  to  ascertain  with  considerable  exactitude  the  part  played  by 
each  in  secretion,  although  Adami 2  has  shown  that  the  com- 
munication is  freer  than  Nussbaum  supposed.  By  ligaturing 
the  renal  artery.  Nussbaum  destroyed  the  functional  activity  of 
the  glomeruli,  and  by  ligaturing  the  portal  vein  of  the  kidney 
he  destroyed  that  of  the  tubules.  By  injecting  a  substance  into 
the  circulation  after  ligature  either  of  the  artery  or  the  vein,  and 
observing  whether  it  is  excreted  or  not,  he  determines  whether  it 
is  excreted  by  the  glomeruli  or  by  the  tubules.  In  this  way  he 
finds  that  sugar,  peptones,  and  albumen  pass  out  through  the 
glomeruli  exclusively,  for  they  are  not  excreted  when  the  renal 
arteries  are  tied.  Albumen,  however,  only  passes  out  through 
the  glomeruli  when  an  abnormal  change  has  already  occurred  in 
the  vascular  wall ;  as,  for  example,  after  the  circulation  has  been 
arrested  for  a  while  by  ligature  of  the  renal  artery.  Indigo- 
carmine,  when  injected'  after  ligature  of  the  renal  arteries,  passes 
into  the  epithelium  of  the  tubules,  but  it  does  not  give  rise  to 
any  secretion   of  water,  so  that  the  bladder  is  found  empty. 

1  Eibbert,  Vvrchow's  Archiv,  July  1883,  p.  189. 
»  Adami,  Journ.  of  Phys.,  vol.  vi.  1885. 


chap,  xv.]      ACTION  OP  DRUGS  ON  EXCRETION.  425 

Urea,  on  the  contrary,  is  not  only  excreted  by  the  tubules  after 
ligature  of  the  renal  artery,  but  carries  with  it,  in  the  process  of 
secretion,  from  the  venous  plexus,  a  considerable  quantity  of 
water,  so  that  the  bladder  becomes  partially  filled. 

Branch  of  renal  artery   

Afferent  artery  to  the  glomerulus 

Connecting  branch > 

Artery  passing  directly  to  thel 

plexus  (corresponding  to  one  I 

of  the  arterige  rectse) J 

Glomerulus  with  efferent  artery  . . 


Union  of   arterial    and   venous  1 
branches  to  form  the  plexus     J 

Portal  vein  of  the  kidney  

Urinary  tubule 


Abdominal  vein. 

Small  branch  connecting  the 
efferent  artery  from  the  glome- 
rulus directly  with  the  abdo- 
minal vein. 


Pie.  148.— Diagram  of  the  circulation  in  the  kidney  of  the  newt.    Modified  from  Nussbaum. 

Tbe  excretion  of  water,  therefore,  takes  place  in  a  double 
manner :  it  passes  out  through  the  glomeruli  when  the  renal 
arteries  are  free,  and  it  passes  out  from  the  venous  plexus  along 
with  urea,  even  although  the  renal  arteries  are  tied. 


Pig.  149. — Diagrammatic  sketch  of  the  blood-vessels  in  a  mammalian  kidney.  0  is  an  artery 
aBCending  into  the  cortical  substance  of  the  kidney ;  p  is  a  branch  from  it  which  divides  into 
two  branches,  q  and  P.  q  breaks  up  at  once  into  a  number  of  twigs.  P  is  the  afferent  artery 
to  a  glomerulus,  S,  of  the  lowest  row.  (  is  the  efferent  vessel  of  the  glomerulus.  It  divides 
into  two  branches,  one  of  which,  «,  ascends  towards  the  cortex,  whilst  the  other,  v,  descends 
towards  the  medulla.    (Prom  Schweigger-SeideL  Die  Hieren,  Halle,  1865.) 

In  the  kidneys  of  the  higher  animals  (Pig.  149)  and  of  man  the 
glomeruli  and  the  tubules  do  not  receive  blood  from  two  entirely 
different  sources ;  but  there  is  an  arrangement  somewhat  similar, 
for  the  plexus  surrounding  the  tubules  does  not  receive  blood 
only  from  the  efferent  vessels  of  the  Malpighian  corpuscles,  but 
gets  it  also  directly  from  the  renal  arteries.  There  are  three 
channels  by  which  the  blood  may  pass  from  the  renal  arteries 
into  the  venous  plexus  without  going  through  the  glomeruli. 
The  first  is  the  inosculation  which  takes  place  between  the 
terminal  twigs  of  the  renal  artery  and  the  venous  plexus  on  the 


426 


PHAKMACOLOGY  AND  THEEAPEUTICS.      [sect.  r. 


surface  of  the  kidney  directly  under  the  capsule.1  The  second 
channel  is  formed  by  small  branches  given  off  directly  by  the 
interlobular  arteries  or  by  the  afferent  arteries  before  they  reach 
the  glomeruli.     The  former  of  these  may  be  regarded  as  corre- 


Fiq.  150.— Diagram  of  the  tnbules  and  vascular  supply  of  the  kidney.    On  the  left  is  a  tnbule  alone ; 
in  the  middle  is  a  tubule  along  with  the  blood-vessels ;  on  the  light  are  blood-vessels  only. 

sponding  to  the  artery  which  passes  directly  to  the  plexus  in  the 
newt,  and  the  latter  to  the  branch  connecting  it  with  the  afferent 
artery  (Fig.  148).  These  arterial  twigs  are  found  not  only  near 
the  surface  of  the  kidney,  but  also  in  the  deeper  layers  of  the 
cortical  substance.2  The  third  and  most  important  channel  is 
afforded  by  the  arterise  rectae,  which  spring  from  the  branches 
of  the  renal  artery  at  the  boundary  between  the  cortical  and 
medullary  substance  and  pass  into  the  medulla,  where  they 
form  a  plexus  with  elongated  meshes  surrounding  Henle's  loops 

Near  their  origin  the  arterise  rectae 


and  the  collecting  tubules. 


1  Ludwig,  HandwDrterbuch  d.  Physiol.,  v.  B.  Wagner,  Bd.  2. 

2  Sehweigger-Seidel,  Die  Nieren,  p.  67  ;  Heidenhain,  Hermann's  Sandbuch  d. 
Physiologie,  vol.  v.,  Th.  1,  p.  293. 


chap,  xv.]      ACTION  OF  DRUGS  ON  EXCEETION.  427 

inosculate  with  the  venous  plexus  surrounding  the  convoluted 
tubules  (Fig.  150). 

Through  these  three  channels  it  is  possible  for  blood  to  reach 
the  secreting  structures  of  the  kidney  and  there  get  rid  of  urea, 
salts,  &c,  without  losing  water  by  its  passage  through  the 
glomeruli.  On  the  other  hand,  if  these  vessels  contract,  while 
the  size  of  the  renal  artery  and  the  pressure  of  the  blood  within 
it  remain  unaltered,  more  blood  will  be  forced  into  the  Mal- 
pighian  corpuscles,  and  thus  the  quantity  of  water  excreted  will  be 
increased.  At  the  same  time  the  contraction  of  the  arterise  rectse 
will  probably  diminish  absorption  from  the  tubules,  and  thus  the 
quantity  of  water  excreted  will  be  increased  in  a  twofold  manner. 

Circumstances  Modifying  the  Secretion  of  Urine. — The 
experiments  of  Ludwig  and  his  pupils  have  shown  that  the 
amount  of  urine  secreted  depends  very  closely  upon  the  pressure 
of  blood  in  the  Malpighian  corpuscles,  or,  to  put  it  more  exactly, 
on  the  difference  of  pressure  between  the  blood  in  these  cor- 
puscles and  the  pressure  within  the  tubules.  For  if  the  ureter 
be  tied  so  that  the  pressure  of  urine  in  the  tubules  is  increased, 
the  secretion  is  greatly  diminished,  and  even  arrested,  even 
though  the  pressure  of  blood  in  the  renal  artery  be  high. 

A  somewhat  similar  effect  to  that  of  ligature  of  the  ureter  is 
produced  by  ligature  of  the  renal  vein,  for  the  blood  accumulating 
in  the  venous  plexus  surrounding  the  tubules  compresses  them 
so  as  to  prevent  the  flow  of  urine  through  them.  A  similar  con- 
dition may  occur  from  cardiac  or  pulmonary  disease  obstructing 
the  venous  circulation. 

But  unless  under  exceptional  circumstances  which  alter  the 
pressure  within  the  tubules,  such  as  compression  of  the  tubules 
by  congestion  of  the  venous  plexus,  as  in  cardiac  disease,  im- 
paction of  a  calculus  in  the  ureter,  or  pressure  on  the  ureters  by 
dropsical  accumulations  or  tumours,  the  rapidity  of  the  secretion 
of  urine  depends  on  two  factors :  (1)  arterial  pressure  in  the 
glomeruli;  and  (2)  the  composition  of  the  blood. 

The  pressure  of  blood  in  the  glomeruli  may  be  raised : 

(1)  By  increase  of  the  arterial  tension  generally. 

(2)  By  increased  tension  locally. 

Such  a  general  increase  may  be  brought  about  by  greater 
action  of  the  heart,  or  by  contraction  of  the  blood-vessels  in 
other  vascular  areas,  such  as  the  intestines,  muscles  or  skin,  by 
nervous  stimulation,  exposure  to  cold,  or  the  action  of  drugs. 

The  pressure  may  be  increased  locally  by  dilatation  of  the 
renal  arteries,  e.g.  from  section  of  the  vaso-motor  nerves,  or 
possibly  stimulation  of  vaso-dilating  nerves. 

In  addition  to  such  increase  of  pressure  in  the  glomeruli  by 
increase  of  blood-supply  to  them,  we  must  not,  however,  forget 
the  possibility  of  increased  pressure  in  them  by  contraction  of 
the  efferent  vessels   leading   from  them,  as  well   as   of  those 


428  PHAEMACOLOGY  AND  THERAPEUTICS,      [sect.  I. 

arterial  twigs  (arterise  recta)  which  pass  directly  to  the  venous 
plexus  surrounding  the  tubules,  and  which  form  no  inconsider- 
able part  of  the  vascular  supply  of  the  kidney. 

Alterations  in  the  size  of  the  renal  vessels  were  formerly 
ascertained  simply  by  exposing  the  kidney  and  observing  its 
colour,  contraction  of  the  arteries  being  associated  with  paleness, 
and  dilatation  with  redness  of  the  organ.  A  much  more  exact 
method  has  been  introduced  by  Roy,  who  encloses  the  kidney  in 
a  capsule  filled  with  oil  and  connected  with  a  registering  appa- 
ratus. When  the  vessels  dilate,  the  kidney  increases  in  size, 
and  diminishes  when  they  contract,  so  that  the  alterations  can 
be  readily  recorded  on  the  same  revolving  cylinder  on  which  the 
general  blood-pressure  is  registered  by  the  manometer. 

The  pressure  of  blood  in  the  glomeruli  may  be  diminished 
generally : 

(1)  By  failure  of  the  heart's  action ;  or 

(2)  By  dilatation   of  the   vessels   of  large   areas,  as  the 

intestines,  muscles,  or  skin. 

The  pressure  of  blood  in  the  glomeruli  may  be  diminished 
locally  by  contraction  of  the  renal  arteries,  or  of  the  afferent 
branches  to  the  glomeruli. 

The  heart's  action  may  fail  from  many  causes,  which  have 
already  been  discussed  more  particularly. 

Dilatation  of  the  vessels  in  the  skin,  intestines,  &c,  may  be 
caused  by  exposure  to  warmth,  by  the  action  of  drugs,  or  by 
paralysis  due  to  nervous  injury. 

Section  of  the  splanchnics  or  of  the  spinal  cord  causes  para- 
lysis of  the  renal  arteries,  and  ought,  therefore,  to  increase  the 
secretion  of  urine.  This  does  occur,  though  not  invariably,  when 
the  splanchnics  are  divided ;  but  section  of  the  spinal  cord,  by 
paralysing  the  intestinal  and  other  vessels,  lowers  the  blood' 
pressure  so  much  that  the  supply  of  blood  to  the  kidney  is  not 
only  much  below  the  normal,  but  is  so  small  that  the  secretion 
of  urine  is  generally  almost  completely  arrested. 

The  nerves  of,  the  kidney  consist  of  a  number  of  small 
branches  running  along  the  renal  artery  and  containing  a 
number  of  ganglia.  When  these  nerves  are  cut  the  vessels  of 
the  kidney  dilate;  when  they  are  stimulated  the  vessels  con- 
tract. A  number  of  those  fibres  pass  to  the  kidney  from  the 
spinal  cord  through  the  splanchnics,  so  that  when  the  splanch- 
nics are  cut  the  vessels  of  the  kidney  usually  dilate,  and  when 
they  are  irritated  they  contract. 

The  whole  of  the  nerves,  however,  do  not  pass  through  the 
splanchnics,  for  stimulation  of  a  sensory  nerve,  of  the  medulla 
oblongata,  or  of  the  spinal  cord  in  the  neck,  will  cause  contrac- 
tion of  the  renal  vessels  after  both  splanchnics  have  been  cut, 
and  section  of  the  splanchnics  does  not  always  cause  the  renal 
vessels  to  dilate. 


chap,  xv.]      ACTION  OP  DRUGS  ON  EXCEETION.  429 

The  nervous  centre  for  the  renal  arteries  is  probably,  like 
the  chief  vaso-motor  centre  for  the  body  generally,  in  the  medulla 
oblongata  ;  but  in  all  probability  there  are  also  subsidiary  centres 
in  the  spinal  cord  and  in  the  solar  and  mesenteric  plexuses. 

The  reason  for  supposing  these  latter  centres  to  exist  is,  that 
stimulation  of  the  peripheral  end  of  the  splanchnic,  divided  at 
its  passage  through  the  diaphragm,  causes  contraction  of  both 
kidneys,  and  the  vessels  of  the  kidney  of  the  side  opposite  to  the 
stimulated  nerve  commence  to  contract  later  than  those  on  the 
same  side.  A  delay  like  this  in  the  action  of  the  stimulus  indicates 
that  it  has  not  acted  directly,  but  through  the  medium  of  ganglia. 

When  the  splanchnics  are  divided  the  vessels  of  the  kidney 
sometimes  dilate  and  the  kidney  increases  in  size;  a  profuse 
secretion  of  urine  may  take  place,  which  quickly  increases  to  a 
maximum  and  remains  for  a  considerable  time.  This,  however, 
is  not  a  constant  effect,  and  not  unfrequently  the  vessels  do  not 
dilate,  and  the  kidney,  instead  of  increasing,  diminishes  in  size. 
This  is  what  to  a  certain  extent  might  be  expected,  inasmuch  as 
a  section  of  the  splanchnics  causes  dilatation  of  the  intestinal 
vessels  and  lowers  the  blood-pressure,  and  thus  diminishes  the 
supply  of  blood  to  the  kidney. 

When  a  puncture  is  made  in  the  medulla  oblongata  in  the 
floor  of  the  fourth  ventricle,  profuse  secretion  also  occurs,  but 
this  differs  from  that  caused  by  section  of  the  splanchnics,  in 
being  preceded  by  a  slight  diminution,  by  rising  rapidly  to  a  maxi- 
mum and  then  rapidly  falling.  These  characters  seem  to  show 
that  it  is  due  to  irritation  of  some  vaso-dilating  mechanism,1 
rather  than  to  any  paralysis. 

Stimulation  of  the  vaso-motor  centre  in  the  medulla  oblon- 
gata by  venous  blood,  or  by  drugs  such  as  strychnine  or  digitalis, 
has  a  twofold  action  on  the  kidney,  for  it  tends  to  cause  con- 
traction not  only  in  the  vessels  of  the  kidney,  but  in  those  of 
other  parts  of  the  body.  The  effect  upon  the  kidney  is  thus  a 
complicated  one,  for  the  contraction  of  the  intestinal  and  other 
vessels  by  raising  the  blood-pressure  tends  to  drive  blood  into  the 
kidneys,  at  the  same  time  that  the  contraction  of  the  renal 
arteries  tends  to  keep  it  out..  When  the  renal  nerves  are  cut,  the 
renal  vessels  no  longer  oppose  the  entrance  of  blood,  and  there- 
fore the  renal  vessels  dilate  very  greatly  when  the  vaso-motor 
centre  is  stimulated ;  but  when  the  renal  nerves  are  intact  the 
result  is  a  varying  one,  for  sometimes  contraction  of  the  renal 
vessels  may  be  so  great  as  to  prevent  the  entrance  of  blood  into 
the  kidney,  however  high  the  general  blood-pressure  may  rise ; 
at  other  times  the  general  high  blood-pressure  may  be  able  to 
dilate  the  renal  arteries  in  spite  of  any  resistance  they  may  offer. 
These  different  conditions  may  occur  subsequently  to  one  another ; 
and  this  stimulation  of  the  vaso-motor  centre  may  cause  contrac- 

1  Heidenhain,  Hermann's  Handbuch  der  Physiologie,  vol.  v.  Th.  1,  p.  366. 


480 


PHARMACOLOGY  AND  THERAPEUTICS,      [sect.  i. 


tion  of  the  renal  vessels,  succeeded  by  dilatation,  or  vice  versa. 
Thus  Mr.  Power  and  I  found  that  on  injecting  digitalis  into  the 
circulation  of  a  dog,  the  blood-pressure  rose,  but  the  secretion  of 
urine  was  either  greatly  diminished  or  ceased  altogether.  Here 
it  is  evident  that  the  renal  vessels  had  contracted  so  much  as  to 
prevent  the  circulation  through  the  kidney,  notwithstanding  the 


Eg 


£3 

e  a 


m  s 


Fig.  151.— Curves  showing  the  effect  of  erythrophltBum  upon  the  blood-pressure  and  secretion  of 
urine.    From  Phil.  Trans^  vol.  clxvii. 

rise  which  had  taken  place  in  the  blood-pressure.  After  a  while 
the  blood-pressure  began  to  fall,  and  then  the  secretion  of  urine 
rose  much  above  its  normal,  showing  that  the  general  blood- 
pressure  was  then  able  again  to  drive  the  blood  into  the  kidneys.1 

Similar  observations  were  made  by  Mr.  Pye  and  myself  with 
regard  to  erythrophloeum ;  and  the  accompanying  curves  (Fig.  151) 
show  well  the  result  upon  the  urine  of  the  mutual  action  of  the  rise 
in  blood-pressure  and  the  contraction  of  the  renal  arteries  upon 
the  secretion  of  urine.  It  will  be  noticed  that  at  first  the  blood- 
pressure  rises  more  quickly  than  the  secretion  of  urine,  the  cir- 
culation through  the  kidney  appearing  to  be  opposed  by  the  renal 
arteries.  This  opposition  is  then  overcome,  and  the  secretion  of 
the  urine  rises  more  quickly  than  the  general  blood- pressure. 
The  renal  vessels  again  appear  to  contract,  so  that  the  urine 
diminishes  while  the  blood-pressure  rises  still  further.  We  have 
then  oscillations  due  first  to  one  factor  and  then  to  the  other 
being  predominant ;  and  then,  when  the  blood-pressure  rises  to 
its  maximum,  we  find  that  the  urine  is  at  its  minimum,  the 
secretion  of  urine  again  rising  as  the  blood-pressure  falls. 

A  good  deal  of  discussion  has  arisen  regarding  the  mode  of 
action  of  digitalis,  and  it  has  been  stated  by  many  to  act  as  a 
diuretic  only  in  cases  of  heart  disease,  and  to  have  no  diuretic 

1  Royal  Society's  Proceedings,  No.  153,  1874. 


chap,  xv.]      ACTION  OF  DEUGS  ON  EXCEETION.  481 

action  in  health.  In  my  own  experiments,  however,  I  found 
that  it  acted  as  a  very  marked  diureticeven  in  health,  and  the 
explanation  of  this  discrepancy  may  possibly  be  that  in  my  own 
case  the  blood-pressure  was  low,  whereas  in  the  others  it  was 
probably  much  higher ;  but  I  am  uncertain  regarding  the  true 
explanation,  though  I  am  certain  of  the  fact. 

By  causing  increased  secretion  of  water  through  the  kidneys 
diuretics  may  increase  the  concentration  of  the  blood  and  thus 
produce  thirst,  or  cause  absorption  of  water  from  the  intercellular 
tissue  or  serous  cavities  in  dropsies.  In  my  own  experiments  on 
digitalis  I  weighed  all  my  food  and  measured  all  my  drink  for 
nearly  six  months,  taking  exactly  the  same  quantity  every  day. 
After  producing  profuse  diuresis  by  a  large  dose  of  digitaline 
(sixty  milligrammes  in  two  days),  such  thirst  ensued  that  I  was 
forced  to  take  a  quantity  of  water  to  allay  it.1 

Mode  of  Action  of  Diuretics. — From  what  has  already  been 
said,  it  is  evident  that  diuretics  may  act  in  several  ways.  They 
may  act :     ' 

A,  on  the  circulation  in  the  kidney,  raising  the  pressure 


r 


Afferent  vessels.    (?)  Dilated  by  nitrous 
ether,  potassium  nitrite  


Efferent  vessels.    (?)  Contracted  by  digi-  f  "" 
ta-is,  strychnine,  erythrophloeum,  squill  1  ___ 


Tubules.    (?)  Stimulated  by  urea  and  po- )    * 
tassium  nitrite,  acetate,  &c,  and  other  [  — 

saline   diuretics,3  caffeine,  turpentine,  I  

cantharidin  (?)  Paralysed  by  curare  (?)  ) 


Fia.  162.— Diagram  to  show  the  parts  of  the  secreting  apparatus  of  the  kidney  which  are  probably 
affected  by  different  diuretics. 

in  the  glomeruli — (1)  locally,  (a)  by  contracting  the  efferent 
vessels,  or  the  arterial  twigs  which  pass  directly  to  the  capillary 
plexus  ;  (b)  by  causing  dilatation  of  the  renal  arteries,  and  thus 
increasing  the  supply  of  blood  to  the  kidney.  This  they  may  do 
also  in  more  ways  than  one,  for  they  may  either  paralyse  the 
vaso-motor  nerves  of  the  kidney,  or  act  on  vaso-dilating  mechan- 
isms. (2)  they  may  raise  the  blood-pressure  generally  by  causing 
the  contraction  of  vessels  in  other  parts  of  the  body. 

B.  Other  diuretics  may  act  on  the  secreting  cells  of  the 
tubules,  and  may  increase  both  the  amount  of  water  and  the 
amount  of  solids  excreted  by  them. 

1  The  experiments  were  made  in  1855,  and  published  in  part  in  my  thesis  on 
Digitalis,  with  some  Observations  on  Urine.    London  :  Churchill  &  Co.,  1868. 

2  Munk,  Central,  f.  d.  med.  Wiss.,  No.  27,- 1886. 


432  PHAEMACOLOGY  AND   THEEAPEUTICS.      [sect.  I. 

Calomel  in  continued  doses  acts  as  a  powerful  diuretic,1  pos- 
sibly by  increasing  the  amount  of  urea  in  the  blood,  and  thus 
increasing  the  amount  of  urine.2 

Diuretics  have  already  been  classified  as  stimulating  and 
sedative ;  and  the  sedative  class  agrees  very  closely  with  the  one 
which  we  have  just  indicated  as  acting  on  the  kidney  through 
the  circulation. 

From  what  has  been  said  of  the  action  of  diuretics  it  is 
evident  that  we  may  hope  to  do  much  more  by  combining  them 
than  by  using  them  singly.  Thus  we  see  that  digitalis  instead 
of  acting  as  a  diuretic  may  completely  arrest  the  renal  circula- 
tion and  stop  the  secretion  altogether.  If,  however,  we  can 
combine  it  with  something  which  will  produce  dilatation  of  the 
renal  vessels,  while  the  general  blood-pressure  remains  high,  we 
shall  greatly  increase  the  circulation  through  the  kidney,  and 
obtain  the  desired  result.  Experiments  in  regard  to  this  were 
made  by  Griitzner  with  nitrite  of  sodium.  He  found  that  this 
substance  increased  the  secretion  of  urine  when  the  blood-pres- 
sure was  reduced  to  a  minimum  by  curare  ;  and  he  found  that 
it  also  had  this  effect  when  the  blood-pressure  was  raised  by 
imperfect  respiration.  When  the  vaso-motor  centre  was  greatly 
stimulated,  however,  by  allowing  the  blood  to  become  very  venous, 
the  nitrite  of  sodium  no  longer  produced  any  increase  of  secretion. 

Caffeine,  again,  has  an  action  on  the  kidney  similar  to  that 
of  physostigmine  on  the  salivary  glands  (p.  358).  Thus,  by 
affecting  the  vaso-motor  centre,  it  not  only  produces  contraction 
of  the  vessels  generally,  including  those  of  the  kidney,3  but  sti- 
mulates the  secreting  cells.4  The  contraction  of  the  vessels  may 
counteract  this  stimulating  action,  so  that  no  urine  is  secreted  as 
in  the  case  of  digitalis  (p.  430),  but  when  the  renal  nerves  are 
divided  a  copious  secretion  of  urine  takes  place. 

Diuretics. 

Refrigerant  Diuretics. 

Water  in  large  quantities.  Potassium  salts,  especially  the 

Carbonic  acid  (aerated  waters) .  Acetate.  Citrate. 

Sodium     salts,     e.g.     common         Bitartrate.  Nitrate, 

salt.  •  Chlorate. 

Hydragogue  Diuretics. 

Adonis  Vernalis.  Erythrophlceum. 

Broom.  Nitrous  ether. 

Caffeine.  Squill. 

Colchicum.  Strophanthus. 
Digitalis. 


1  Jendrassik,  Deutsch  Archiv  f.  klin.  Med.,  xxxviii.  p.  499. 

2  Locke,  Practitioner,  xxxvii.  p.  170. 

8  Eiegel,  Verliandl.  d.  III.  Congress  f.  inner.  Med.,  1884. 

*  Yon  Sehroeder,  Central./,  d.  med.  Wiss.,  1886,  p.  465 ;  Langgard, ibid.  p.  B13. 


chap,  xv.]      ACTION  OF  DEUGS  ON  EXCEBTION. 


433 


Alcohol. 

Gin. 

Hock. 
Cantharides. 
Blatta  Orientalis. 
Oleo-resins,  resins  and 
volatile  oils — 

Turpentine. 

Juniper. 

Savin. 

Copaiba. 

Cubebs. 

Black  pepper. 

Matico. 

Kawa. 

Guaiac. 


Stimulant  Diuretics. 

Umbelliferous  plants  chiefly 
containing  volatile  oils- 
Parsley. 

Carrot. 

Dill. 

Fennel. 
Cruciferous  plants — > 

Mustard. 

Horseradish. 

Asparagus. 
Uva  ursi. 
Sarsaparilla. 
Buchu. 
Pareira. 
Chimaphila. 
Taraxacum. 
Ononis  spinosum. 
Santonica. 


The  following  tabular  view  of  the  probable  mode  of  action  of 
the  various  diuretics  may  help  to  show  it  more  distinctly : 


f  Increased  action  of  the  heart  I  ^e1*81'3- 
Generally  i  '  alcohol. 

'  1  Contraction  of  vessels  in  intestine  and  through- 

v    out  the  body. 


I- 


Raise   arterial 
pressure.... 


Locally  in 

*    kidney . 


/Contract  efferent  ves- 
sels or  arterise  rectaa 
bo  as  to  raise  pressure 
in  glomerulus  and 
lessen  absorption  in 
tubules,  or  both. 


Dilate  afferent  vessels.  • 


Act  on  the  se- 
creting nerves, 
or  secreting 
cells  of  the 
.kidney  itself .   , 


("Crea. 
Caffeine. 
Calomel. 

Increase  solids  excreted.  (S'S 


'By  action  on  vaso- 
motor centres. 

By  local  action  on 
vessels  or  nervous 
structures  in  the 
kidney  itself. 

Paralyse  vaso-motor 
nerves  or  involun- 
tary muscular  fibre, 
or  stimulate  vaso- 
dilating nerves. 


"Digitalis. 

Erythrophloeum. 

Strophantus. 

Squill. 

Convallaria. 

Strychnine. 

Caffeine  (p.  432). 
.Cold  to  surface. 

?  The  same  as  in 
preceding  list. 

'  ?  Broom. 

?  Turpentine. 
?  Juniper. 
?  Copaiba. 
?  Cantharides. 

Nitrites. 
-  Alcohol. 
?  Urea/ 


acetate,  <fcc,  and  other  saline  diuretics. 


Uses. — Diuretics  may  be  employed  for  the  purpose  of  re- 
moving either  water  or  solids  from  the  body.     They  are  used  : — 

1st,  to  remove  the  excess  of  fluid  met  with  in  the  tissues  and 
serous  cavities  in  cases  of  dropsy. 

2nd,  to  hasten  the  removal  of  injurious  waste-products  and 
poisonous  substances  from  the  blood. 

3rd,  to  dilute  the  urine. 

1  When  a  current  of  blood  is  passed  artificially  through  an  excised  kidney,  the 
stream  is  much  accelerated  by  the  addition  of  urea.  Abeles,  Sitz.-Ber.  d.  k.  k. 
Wiener  Akad.,  Bd.  87,  Abt.  3,  April  1883. 

F  F 


434  PHAEMACOLOGY  AND  THERAPEUTICS,      [sect.  i. 

In  cases  where  the  accumulation  of  fluid  depends  on  venous 
congestion,  as  for  example  in  cardiac  dropsy,  those  diuretics 
which  act  on  the  general  vascular  system,  like  digitalis,  stroph- 
antus, squill,  or  erythrophlceum,  are  most  efficient  hecause 
they  tend  to  remove  the  cause  of  the  dropsy  (p.  333),  as  well  as 
to  assist  the  absorption  and  excretion  of  the  fluid  already  effused. 

When  the  dropsy  depends  on  the  disease  of  the  kidneys  or 
liver,  other  diuretics  should  either  be  given  instead  of,  or  along 
with,  digitalis  or  squill.  Even  in  cases  of  cardiac  disease  where 
digitalis  or  squill  are  not  proving  efficacious,  the  addition  of  a 
little  blue  pill  greatly  assists  their  action,  though  it  would  be 
hard  to  say  in  what  way  it  does  so. 

In  dropsy  depending  on  kidney  disease,  decoction  of  broom, 
oil  of  juniper,  and  nitrous  ether  are  amongst  the  most  reliable 
diuretics,  and  in  hepatic  dropsy,  copaiba. 

Diuretics  are  used  to  increase  the  secretion  of  solids  in 
febrile  conditions,  and  in  cases  of  kidney  disease  where  the 
excretion  of  waste-products  is  deficient,  and  their  retention 
threatens  to  prove  injurious.  In  such  cases  nitrate  and  bi- 
tartrate  of  potassium,  turpentine,  juniper,  and  caffeine  are 
useful. 

Diuretics  are  also  used  to  increase  the  proportion  of  water 
in  the  urine,  and  thus  to  prevent  the  solids  being  deposited  from 
it  and  forming  calculi  in  the  kidney  or  bladder,  or  even  to  dis- 
solve again  such  concretions  as  have  been  already  formed. 

Adjuvants  to  Diuretics. — As  the  amount  of  urine  secreted 
depends  upon  the  difference  in  pressure  between  the  blood  in  the 
glomeruli  and  the  urine  in  the  tubules,  it  is  evident  that  any 
pressure  on  the  tubules,  whether  caused  by  obstruction  of  the 
ureter  by  a  calculus,  by  the  mechanical  pressure  of  dropsical 
accumulations  in  the  abdomen,  or  by  distension  of  the  venous 
plexus  in  the  kidney  itself,  will  tend  to  lessen  the  secretion  of 
urine.  Consequently  we  sometimes  find  that  in  such  cases 
diuretics  fail  to  act  until  the  pressure  has  been  relieved  by  para- 
centesis in  cases  of  dropsy,  or  the  venous  congestion  lessened 
by  the  use  of  a  brisk  purgative,  or  by  cupping  over  the  loins. 

If  the  venous  congestion  is  very  great,  as  in  cases  of  mitral 
disease  or  of  chronic  bronchitis  with  emphysema  and  dilated 
heart,  bleeding  from  the  arm  may  be  advantageous  or  even 
imperatively  necessary.  In  dilated  heart  and  in  mitral  incom- 
petence, the  action  of  digitalis  on  the  heart  itself,  strengthening 
its  action  and  enabling  it  more  effectually  to  pump  the  blood 
out  of  the  venous  into  the  arterial  system  and  thus  reduce 
venous  congestion,  will  aid  its  action  upon  the  kidneys. 

Action  of  Drugs  on  Albuminuria. — In  the  normal  kidney 
no  albumen  passes  from  the  vessels  or  lymphatics  into  the  uri- 
nary tubules,  but  under  abnormal  conditions  it  may  do  so  and 
the  urine  become  albuminous. 


Chap,  xv.]      ACTION  OF  DEUGS  ON  EXCEETION.  485 

Albuminuria  may  be  produced  by  ligature  or  compression  of 
the  renal  artery  ;  by  ligature  of  the  renal  vein ;  and,  though  to 
a  less  extent,  by  ligature  of  the  ureter.  A  similar  effect  to  that 
of  ligature  of  the  renal  artery  may  be  produced  by  causing  it 
to  contract  temporarily  by  means  of  drugs  such  as  digitalis.  In 
the  experiments  made  by  Mr.  Power  and  myself  we  noticed  that 
the  urine  which  was  secreted  after  the  secretion  had  been  com- 
pletely stopped  by  digitalis  was  albuminous. 

Albuminuria  is  also  noticed  after  poisoning  by  strychnine, 
which,  as  Griitzner  has  shown,  has  a  similar  action  to  digitalis, 
and  in  cases  of  suffocation  or  of  epilepsy,  where  the  vaso-motor 
centre  is  stimulated  by  venous  blood. 

Other  drugs  appear  to  cause  albuminuria  by  a  direct  action 
on  the  kidney  itself.  A  marked  example  of  this  is  cantharides, 
which  produces  both  albuminuria  and  hematuria.  Shortly  after 
its  injection,  the  kidney  appears  congested  and  swollen,  and  on 
microscopic  examination  it  is  found  that  the  alterations  begin 
first  in  the  glomeruli  and  convoluted  tubules,  and  gradually  ex- 
tend to  the  straight  tubules.  These  changes  consist  in  intense 
congestion,  especially  in  the  glomeruli,  with  increased  tension  of 
blood  in  the  vessels.  Then  the  liquid  constituents  of  the  blood 
pass  through  the  vascular  walls,  carrying  along  with  them 
granules,  red  corpuscles,  and  white  corpuscles.  This  exudation 
then  passes  from  the  glomerulus  along  the  whole  length  of  the 
tubules,  the  epithelium  of  which  next  becomes  changed,  the  cells 
which  line  them  swelling  up,  multiplying,  and  becoming  modified 
in  form,  migration  of  leucocytes  also  occurring.  In  short,  we 
have  the  signs  of  inflammation  beginning  in  the  glomeruli  and 
•passing  along  the  tubules. 

Lead  produces  also  disease  of  the  kidney,  but  of  a  different 
kind.  The  kidney  in  animals  poisoned  by  it  is  pale  and  granular 
with  an  adherent  capsule  and  with  atrophy  of  the  cortical  sub- 
stance, in  which  crystals  are  often  present.  These  appearances 
are  due  to  chronic  interstitial  nephritis  caused  by  calcareous 
deposits  in  Henle's  loops.  These  block  up  the  tubuli,  produce 
subacute  inflammation  of  the  glomeruli  and  tubules,  with  atrophy 
and  cirrhosis.  A  similar  result  is  produced  also  by  mercury. 
Chlorate  of  potassium  has  a  very  peculiar  action  on  the  kidney. 
In  large  doses  it  produces  a  peculiar  kind  of  hematuria,  the 
urine  being  dark  brown  and  containing  large  quantities  of 
broken-up  blood-corpuscles.  The  drug  arrests  the  secretion  of 
the  urine  by  blocking  up  the  tubules  with  plugs  of  broken-up 
blood-corpuscles. 

Tannin  and  tannate  of  sodium  appear  to  have  a  certain 
power  to  lessen  the  exudation  of  albumen  through  the  Mal- 
pighian  tufts,  as  Eibbert  found  that  when  albuminuria  was 
produced  artificially  in  rabbits  by  temporary  ligature  of  the  renal 
artery,  both  tannin  and  tannate  of  sodium  either  lessened  or 

us 


436  PHAEMACOLOGY  AND  THEEAPEUTICS.      [sect.  i. 

prevented  the  exudation  of  albumen.  Arbutin,  the  active  prin- 
ciple of  uva  ursi,  appe'ars  to  be  still  more  efficacious,  but  requires  to 
be  given  in  somewhat  large  doses.     Fuchsin  has  a  similar  actions 

Lithontriptics. 

These  are  remedies  employed  for  the  purpose  of  preventing 
the  solids  of  the  urine  from  being,  deposited,  or  of  causing  re- 
solution. 

One  of  the  most  important  is  the  abundant  use  of  water,  and 
sometimes  it  is  advisable  to  use  distilled  water  in  place  of  or- 
dinary water,  as  distilled  water  is  free  from  salts  of  any  kind. 
Distilled  water  has  a  disagreeable,  flat  taste,  but  it  may  be  made 
quite  agreeable  by  charging  it  with  carbonic  acid  in  a  gasogen. 

The  substances  which  most  generally  are  deposited  from  the 
urine  are  uric  acid,  acid  urates,  oxalate  of  calcium,  and  phos- 
phates ;  the  two  former  are  liable  to  be  deposited  when  the  urine 
is  too  acid,  and  the  two  latter  when  it  is  alkaline  or  neutral. 
Oxalate  of  lime  also  may  be  deposited  from  faintly  acid  urine. 
These  substances  may  be  deposited  either  in  the  kidney  or 
bladder,  and  thus  give  rise  to  renal  or  vesical  calculi. 

The  lithontriptics  generally  employed  when  uric  acid,  or  acid 
urates  are  present,  are  salts  of  lithium  and  potassium,  as  the 
urate  of  potassium  is  more  soluble  than  the  urate  of  sodium, 
and  the  urate  of  lithium  more  soluble  than  even  that  of  potas- 
isum.  On  account  of  the  low  atomic  weight  of  lithium  its 
salts  have  the  further  advantage  of  combining  with  a  much 
larger  relative  proportion  of  uric  acid  than  the  salts  of  potassium 
or  sodium.  When  phosphates  are  present,  mineral  acids,  such  as 
phosphoric,  are  sometimes  employed,  but  it  is  difficult  to  render 
the  urine  acid  by  the  internal  administration  of  mineral  acids, 
although  it  is  easy  to  render  it  alkaline  by  the  administration  of 
alkalies.  Benzoic  and  cinnamic  acids,  however,  in  passing  through 
the  body,  are  converted  into  hippuric  acid,  and  they  render  the 
urine  acid.  They  may  either  be  given  alone,  or  in  combination 
with  ammonia,  as  benzoate  of  ammonium,  because,  although 
ammonium  is  alkaline,  yet  it  appears  to  undergo  conversion 
into  urea  in  the  body,  and  does  not  render  the  urine  alkaline. 

The  deposition  of  oxalate  of  calcium  is  usually  connected 
with  disturbances  in  the  digestive  system,  and  I  have  observed, 
in  a  hospital  ward,  that  a  deposit  of  it  is  very  commonly  found 
in  the  urine  after  the  patients  have  had  cabbage  for  dinner. 
The  administration  of  nitro-hydrochloric  acid  frequently  tends  to 
prevent  the  deposition  of  oxalates,  and  this  is,  perhaps,  on  the 
whole,  the  best  remedy  for  the  form  of  dyspepsia  to  which  the 
name  of  oxalic  diathesis  is  sometimes  given.  Sometimes^  how- 
ever, carbonate  of  sodium,  by  aiding  the  digestion,  seems  to  be 
more  beneficial. 


chap,  xv.]      ACTION  OF  DRUGS  ON  EXCRETION.  437 

ACTION  OF   DRUGS  ON   THE  SKIN. 
Diaphoretics  and  Sudorifics. 

The  difference  between  these  classes  of  remedies  is  simply 
one  of  degree.  When  a  drug  increases  the  secretion  of  sweat 
only  slightly,  so  that  it  can  still  evaporate  from  the  skin  -without 
running  down  in  drops,  it  is  called  a  diaphoretic;  but  when 
it  increases  it  so  greatly  chat  it  can  no  longer  evaporate,  and 
,  streams  down  the  skin,  it  is  called  a  sudorific. 

The  secretion  of  sweat,  like  that  of  saliva,  consists  in  the 
formation  of  the  secretion  by  the  cells  of  the  gland  from  the 
material  which  is  yielded  by  the  fluid  in  the  lymph-spaces  around 
I  the  gland. 

New  material  is  constantly  supplied  to  this  fluid  by  the  blood 
which  circulates  in  the  vessels.  We  therefore  find  that  increased 
circulation  of  blood  through  the  cutaneous  vessels  and  increased 
.  secretion  of  sweat  usually  accompany  one  another,  but  this  is 
not  always  the  case.  In  the  sweat-glands,  as  in  the  salivary 
glands,  the  secreting  nerves  which  regulate  the  activity  of  the 
cells  are  independent  of  the  vascular  nerves  which  regulate  the 
capacity  of  the  vessels.  In  fever  or  in  poisoning  by  atropine 
the  vessels  may  be  widely  dilated  and  the  current  of  blood 
through  them  rapid,  while  the  secretion  of  sweat  is  arrested. 
On  the  other  hand,  in  dying  persons  we  see  a  copious  secretion 
of  sweat  occur,  while  the  circulation  through  the  skin  has  become 
very  feeble  or  almost  stagnant.  A  certain  amount  of  sweat, 
indeed,  may  even  be  secreted  by  amputated  limbs,  the  material 
for  it  being  afforded  by  the  lymph  around  the  glands.  But 
profuse  secretion  of  sweat  cannot  go  on  long  unless  the  gland 
is  freely  supplied  with  blood,  for  otherwise  the  Bupply  of  new 
material  would  cease.  Dilatation  of  the  vessels  therefore  aids 
the  secretion  of  sweat.  Dilatation  may  be  induced  by  section  of 
vaso- motor  nerves  or  stimulation  of  vaso-dilating  nerves.  Thus, 
when  the  sympathetic  is  cut  in  the  neck  of  a  horse,  dilatation 
of  the  vessels  is  produced  by  the  section,  and  sweating  occurs  on 
that  side. 

The  vaso-dilating  and  secreting  nerves  of  the  sweat-glands 
usually  run  together,  and  by  irritation  of  a  nerve-trunk,  such  as 
that  of  the  sciatic,  the  vessels  of  the  foot  may  be  dilated,  and 
sweating  excited. 

Warmth  usually  increases  both  the  circulation  of  blood  in 
the  skin  and  the  secretion  of  sweat ;  while  cold  has  the  contrary 
effect. 

The  nerve-centres  which  excite  the  secretion  of  sweat  appear 
to  be  situated  in  the  spinal  cord ;  the  centre  for  the  posterior 


488  PHAKMACOLOGY  AND  THEKAPEUTICS.      [sect.  I. 

extremities  being  situated  in  the  upper  lumbar  and  lower  thoracic 
part  of  the  cord  in  the  cat ;  while  that  for  the  upper  extremities 
in  the  same  animal  is  situated  in  the  lower  part  ,of  the  cervical 
region  of  the  cord. 

The  sweat-glands  may  be  excited  to  secrete : 

(1)  By  the  action  of  drugs  upon  the  terminations  of  nerves 

in  the  glands. 

(2)  By  the  action  of  drugs  on  the  sweat-centres  themselves. 

(3)  Beflexly  by  stimulation  of  sensory  nerves. 

(4)  By  mental  stimuli. 

An  example  of  the  stimulation  of  sweating  by  the  action  of 
drugs  on  the  nervous  terminations  in  the  glands  themselves 
is  afforded  by  pilocarpine,  which  will  cause  secretion  even  when 
the  nerves  which  connect  the  centres  with  the  glands  have 
been  cut. 

Secretion  may  be  also  arrested  by  the  paralysing  action  of 
drugs  upon  the  terminal  fibres ;  thus,  atropine,  locally  injected, 
prevents  the  secretion  of  sweat,  however  much  the  nerve  going 
to  the  gland  or  the  nerve-centres  be  stimulated ;  and  atropine 
also  antagonises  the  effect  of  pilocarpine  on  the  nervous  termina- 
tions, and  arrests  the  secretion  which  the  latter  causes. 

The  nerve-centres  may  be  stimulated  directly  by  the  con- 
dition of  the  blood  which  is  passing  through  them,  or  reflexly  by 
irritation  of  sensory  nerves.  Stimulants  of  these  nerve-centres 
are :  (1)  a  venous  condition  of  the  blood ;  (2)  high  temperature 
of  the  blood ;  and  (3)  poisons,  especially  nicotine. 

A  venous  condition  of  the  blood  is  one  of  the  most  powerful 
stimulants,  and  it  is  to  this  that  the  sweats  which  precede  death 
are  in  all  probability  due ;  for  while  watching  a  patient  dying, 
I  have  observed  that  drops  of  sweat  appeared  on  the  brow  just  at 
the  time  that  the  blood  became  venous,  as  was  evidenced  by  the 
commencing  lividity  of  the  finger-nails  and  lobes  of  the  ears. 
Under  such  conditions,  while  the  secreting  cells  are  strongly 
stimulated,  the  circulation  is  very  feeble.  - 

A  high  temperature  is  also  a  powerful  stimulant.  In  con- 
sidering its  action  we  must  take  into  account  the  effect  of  the 
warm  blood  upon  the  sweat-centres  in  the  cord,  as  it  circulates 
through  them,  and  its  local  action  also  on  the  sweat-glands 
themselves.  Up  to  a  certain  point  it  appears  to  have  the  effect 
of  dilating  vessels  and  of  increasing  the  activity  of  the  glands 
by  acting  both  on  the  sweat-centres  and  on  the  periphery. 

Local  warmth  to  one  foot  increases  the  secretion  of  sweat, 
and  local  cold  diminishes  it  in  that  foot,  when  the  glands  in  all 
four  feet  of  an  animal  are  stimulated  equally  either  by  excite- 
ment of  the  sweat-centres  or  by  the  action  of  pilocarpine  on  the 
peripheral  ends  of  the  sweat-nerves.1 

1  Luclisinger,  Pflilger's  Archiv,  1876,  vol.  xviii.p.  480. 


chap,  xv.]      ACTION  OF  DEUGS  ON  EXCEETION.  439 

The  sweat-centres  appear  to  be  directly  stimulated  by  nico- 
tine, but  the  action  of  this  drug  may  be  partly  due  also  to  a 
reflex  effect  on  those  centres  through  the  nerves  of  the  stomach. 

The  sweat-centres  appear  to  be  reflexly  excited  by  severe 
irritation  of  any  sensory  nerve  passing  from  the  surface  of  the 
body,  and  the  point  at  which  the  irritation  is  applied  does  not 
seem  to  be  of  much  importance.  They  are  probably  stimulated 
reflexly  from  the  stomach,  as  in  the  sweating  which  accompanies 
nausea. 

The  power  of  the  brain  to  stimulate  the  sweat-centres  is 
shown  in  the  effect  of  mental  emotion,  and  direct  irritation  of 
the  medulla  oblongata  will  cause  sweating  in  cats  even  some 
time  after  death. 

Excretion  by  the  Sweat-glands. — A  number  of  substances 
taken  into  the  body  pass  out  in  small  quantities  through  the 
skin.  Aromatic  and  volatile  substances  appear  to  pass  readily, 
so  also  benzoic  acid,  hippuric  and  cinnamic  acid,  tartaric  acid, 
succinic  acid,  iodide  of  potassium,  quinine,  corrosive  sublimate, 
arseniates  of  sodium  and  potassium.  When  arseniate  of  iron 
has  been  taken,  curiously  enough,  arsenious  acid  has  been  found 
in  the  sweat,  and  iron  in  the  urine.  Some  colouring  matters 
are  excreted  especially  by  the  skin  of  the  armpits,  and  the  under- 
clothing may  sometimes  be  found  stained  of  a  brick-red  colour 
at  these  parts.  I  have  observed  this  in  some  cases  after  drinking 
claret  or  port,  but  it  only  occurs  exceptionally  after  the  employ- 
ment of  these  wines,  and  it  is  possible  that  it  is  due  to  adultera- 
tion with  foreign  colouring  matters,  for  I  have  also  noticed  it 
in  cases  where  no  wine  has  been  drunk,  but  where  pickled  red 
cabbage  or  beetroot  has  been  eaten. 

Relations  between  Sweat-glands  and  Kidneys.  —  The 
sweat-glands  and  the  kidneys  both  remove  water  and  small 
quantities  of  salts  from  the  blood,  and  thus  tend  to  keep  it  at 
its  normal  concentration.  Their  functions  are  complementary,  so 
that  when  much  water  is  excreted  by  the  skin,  less  is  excreted  by 
the  kidneys,  and  vice  versa. 

This  complementary  action  is  to  a  great  extent  due  to  the 
different  distribution  of  blood  under  varying  conditions,  because 
when  both  organs  are  stimulated — as,  for  example,  by  salts  of 
ammonium — diuresis  will  occur,  if  the  blood  be  driven  towards 
the  kidneys  by  external  cold  ;  and  diaphoresis  if  it  be  attracted 
to  the  skin  by  external  warmth. 

The  quantity  of  solids  contained  in  the  sweat  is  very  small — 
only  a  little  over  one  per  cent. — three-fourths  of  these  being 
organic,  and  one-fourth  inorganic.  The  organic  solids  are  chiefly 
fats,  fatty  acids,  and  small  quantities  of  urea — about  one-tenth 
per  cent.  When  the  kidneys  are  insufficient,  however,  to  excrete 
urea,  the  quantity  in  the  sweat  becomes  greatly  increased,  and 
it  has  even  been  found. crystallised  upon  the  skin. 


440 


PHAEMACOLOGY  AND  THEEAPEUTICS.  [sect.j. 


Action  of  the  Skin  in  Regulating  Temperature.— As  I 

have  already  mentioned,  the  skin  has  an  excreting  function  com- 
plementary to  that  of  the  kidneys,  and  it  may  to  some  extent 
relieve  them  when  they  are  doing  their  -work  imperfectly.  But 
its  chief  function  is  that  of  regulating  the  bodily  temperature. 
The  quantity  of  heat  which  is  changed  into  potential  energy,  in 
converting  liquid  water  into  gaseous  steam,  is  very  great.  Five 
and  a  half  times  as  much  heat  is  required  to  convert  boiling 
water  into  steam  as  to  raise  the  same  amount  of  water  from  the 
freezing  to  the  boiling  point.  The  immense  loss  of  heat  thus 
occasioned  converts  the  healthy  skin  under  the  influence  of  great 
heat  into  an  actual  cooling  apparatus.  In  negroes  on  the  West 
Coast  of  Africa  it  has  been  noticed  that  while  the  skin  is  perspir- 
ing profusely,  it  is  as  cold  as  marble,  and  Sir  Charles  Blagdon 
observed  that  in  a  room  with  a  temperature  of  198°  Fahr.  his 
side  felt  quite  cold  to  the  touch. 


The  chief  diaphoretics  are : — 


■s 

'-3-JS 
3  § 


CO 


f  Ammonium  acetate. 
„  citrate. 

Dover's  Powder. 

Ipecacuanha. 
j  Opium. 

Camphor. 


Nicotine. 
Antimony. 


Also  reflexly 
through  sto- 
mach (?)  (p. 
439). 


60 

■s-Ji  s 
.a  g  I 

m 


Doubtful 
action 


Pilocarpine. 
Warmth  to  surface,  as 

in  baths. 
Warm  drinks. 
Alcohol. 
/Serpentaria. 
Sassafras. 
Guaiac. 
Mezereum. 
Senega. 


Uses. — Diaphoretics  are  used  in  cases  of  threatened  catarrh 
or  inflammation  of  mucous  or  serous  surfaces,  or  internal  organs 
after  exposure  to  cold.  Their  beneficial  action  in  such  cases  may 
be  partly  due  to  the  withdrawal  of  blood  from  internal  organs 
to  the  surface  of  the  body,  but  it  is  not  improbable  that  in  addi- 
tion to  this  the  condition  of  the  skin  which  they  induce  exercises 
a  favourable  action  reflexly  on  internal  parts.  There  seems  to 
be  a  sort  of  complementary  action  between  the  skin  and  the 
internal  mucous  membranes,  as  well  as  between  the  skin  and 
kidneys.  This  is  sometimes  well  marked  in  gouty  patients, 
where  the  disappearance  of  an  eruption  from  the  skin  is  followed 
by  asthma,  and  vice  versa.  It  is  also  shown  by  the  experiments 
of  Kossbach  (p.  252) ;  and  the  effect  of  irritation  of  the  stomach 
and  nausea  on  the  secretion  of  the  skin  has  already  been  noticed 
(p.  489). 

One  of  the  best  diaphoretics  to  cut  short  commencing  catarrh 
is  compound  ipecacuanha  powder.  In  fevers,  with  the  exception 
of  rheumatic  fever,  the  skin  is  generally  dry  although  the  tern- 


chap,  xv.]      ACTION  OF  DEUGS  ON  EXCRETION.  441 

perature  is  high,  and  diaphoretics  are  employed  to  increase  the 
cutaneous  secretion,  and  thus  to  lower  the  temperature. 

In  exanthemata,  after  the  eruption  disappears  from  the  skin, 
there  is  a  tendency  to  inflammation  of  internal  organs,  and  in 
order  to  prevent  this,  diaphoretics  are  used,  those  which  act 
markedly  on  the  vessels,  or  stimulating  diaphoretics,  heing 
especially  indicated. 

The  advantage  of  a  free  supply  of  blood  in  chronic  morbid 
conditions,  such  as  chronic  ulcers,  has  already  been  mentioned 
when  speaking  of  irritants  (p.  343) ;  and  in  chronic  morbid 
conditions  of  the  skin  diaphoretics  are  sometimes  employed  to 
promote  the  cutaneous  circulation.  In  diseases  of  the  kidneys, 
when  it  is  advantageous  to  lessen  their  functional  activity,  dia- 
phoretics are  employed  in  order  to  make  the  skin  act  vigorously ; 
and  they  are  used  also  to  assist  the  kidneys  in  removing  the 
fluid  which  has  already  accumulated  in  the  body  in  cases  of 
dropsy.  When  the  kidneys,  though  not  diseased,  are  called  upon 
to  do  excessive  work — as  in  diabetes  mellitus,  and  polyuria — 
diaphoretics  are  employed  to  aid  them.  Where  an  unnatural 
secretion  of  fluid  is  taking  place  from  the  intestine,  as  in  cases  of 
chronic  diarrhoea,  diaphoretics  are  also  employed  to  divert  secre- 
tion from  the  intestine  to  the  skin,  and  thus  lessen  the  diarrhoea. 

Antihidrotics  or  Anhidrotics. 
These  are  substances  which  lessen  the  secretion  of  sweat : — 

Acids.  Nux  vomica  and  Strychnine. 

Belladonna  and  Atropine.  Quinine. 

Hyoscyamus.  Picrotoxine. 

Amanita  muscaria  and  Ipecacuanha  (compound 

muscarine.  powder). 

Agaricus  albus.  Zinc  salts. 
Jaborandi  and  Pilocarpine. 

These  remedies  may  act  (1)  on  the  sweat-glands  themselves 
by  lessening  the  excitability  either  of  the  secreting  cells  or  of  the 
secreting  nerves ;  (2)  on  the  sweat-centres,  by  lessening  their 
excitability  or  removing  the  excitant ;  and  (3)  on  the  circulation. 
Belladonna  in  large  doses  paralyses  the  ends  of  the  secreting 
nerves,  just  as  it  does  in  the  salivary  glands,  so  that  the  sweat- 
glands  will  not  secrete  even  when  a  strong  stimulation  is  applied 
to  their  nerves.  As  belladonna  acts  thus  when  locally  applied, 
it  may  be  used  for  local  sweating  in  the  form  of  extract  or  of 
solution  of  atropine  painted  on,  or  rubbed  over,  the  surface.  It 
is  thus  useful  in  cases  of  local  sweating  of  the  palms  of  the  hands 
and  soles  of  the  feet.  It  may  also  be  given  internally  to  paralyse 
the  ends  of  the  secreting  nerves,  and  thus  to  arrest  the  night- 
sweats  in  phthisis.    But  in  all  probability  its  beneficial  effect  in 


442 


PHAEMACOLOGY  AND  THEEAPEUTICS.      [sect.  i. 


the  night-sweats  of  phthisis  is  not  dependent  on  its  paralysing 
action  on  the  secreting  nerves,  for  it  is  useful  in  doses  which  appear 
too  small  to  produce  this  effect,  and  which  also  do  not  act  imme- 
diately, but  rather  after  some  time.  Its  utility  in  such  cases, 
therefore,  is  probably  due  to  an  effect  on  the  nerve-centres,  and 
especially  to  a  stimulating  action  on  the  respiratory  centre. 

The  night-sweats  of  phthisis  are  usually  followed  by  great 
weakness  and  prostration,  which  has  sometimes  been  attributed 
to  the  loss  of  salts  and  organic  matter  contained  in  the  sweat. 
But  the  quantity  of  these  is  very  small,  and  the  same  depression 
is  not  noticed  when  there  is  an  increase  of  two  or  three  ounces 


Motor  nerves  of  thorax 

Motor  nerves  of  diaphragm.. 


Diaphragm 


Nerves  to  sweat-glands. 


Respiratory  centre  —  more 
readily  stimulated  by 
venous  blood  than  the 
sweat-centres  in  the  spinal 
cord. 

Carotid  artery  and  vertebral 
arteries  supplying  the  re- 
spiratory centre  with  blood. 


Sweat-centres  in  spinal  cord 
with  arteries  carryingblood 
'to  them,  and  with  nerves 
passing  to  sweat-glands. 


Fig.  163.— Diagram  to  illustrate  the  action  of  antibidrotics.  The  secretory  nerves  passing  to  the 
sweat-glands  from  the  sweat-centres  in  the  spinal  cord  have  been  represented  as  a  single  nerve 
for  the  sake  of  simplicity. 

in  the  daily  secretion  of  urine,  although  it  will  carry  off  quite  aa 
large  a  quantity  of  both  salts  and  organic  matter.  Nor  is  the 
same  depression  produced  by  the  profuse  sweating  due  to  active 
exertion,  nor  even  by  the  sweating  in  ague.  The  depression  is 
not  the  consequence  of  the  profuse  sweat ;  both  are  probably  the 
consequence  of  one  common  cause.  This  cause  I  believe  to  be 
partial  failure  of  the  respiration  and  consequent  accumulation 
of  carbonic  acid  in  the  system,  which  leads  at  the  same  time  to 
stimulation  of  the  sweat-centres  and  impairment  of  tissue-change 
throughout  the  body  generally. 

In  healthy  persons  the  respiratory  centre  is  more  sensitive 
to  the  stimulus  of  carbonic  acid  than  other  parts  of  the  nervous 
system.  Thus  any  increase  in  the  venosity  of  the  blood  at  once 
stimulates  this  centre,  and  through  it  the  diaphragm  and  respi- 
ratory muscles  of  the  thoracic  wall,  rendering  the  respiration 


chap,  xv.]     ACTION  OP  DKUGS  ON  EXCEETION.  443 

more  active,  and  increasing  arterialisation.  Consequently,  the 
blood  does  not  become  venous  enough  to  stimulate  the  sweat- 
centres.  But  when  the  respiratory  centre  is  depressed  by  exces- 
sive reflex  stimulation  during  the  day  in  the  process  of  coughing, 
and  by  the  natural  depression  which  occurs  during  sleep,  it  may 
respond  less  readily  to  the  stimulus  of  venous  blood.  The  amount 
of  carbonic  acid  in  the  blood  may  thus  accumulate  to  such  an 
extent  that  the  sweat-centres  are  stimulated  before  the  respira- 
tory centre  responds,  and  thus  the  profuse  sweats  which  are  so 
depressing  to  the  patient  may  occur. 

It  is  probable  that  this  is  only  part  of  the  truth,  and  that 
there  are  other  factors  in  the  production  of  abnormally  profuse 
sweats ;  for  in  children  suffering  from  rickets,  the  head  per- 
spires profusely  during  sleep,  yet  the  mucous  membranes  are  of 
a  bright  rosy  colour.  Nevertheless,  acting  on  this  idea,  I  have 
given  at  night  such  substances  as  are  powerful  stimulants  to  the 
respiratory  centre,  like  nux  vomica  and  strychnine,  and  I  have 
found  that  the  sweating  is  usually  arrested  by  them.  A  small 
dose  is  sometimes  sufficient,  but  occasionally  it  must  be  steadily 
increased  until  as  much  as  half  a  drachm  of  the  tincture  of  nux 
vomica  is  given  at  once.  The  only  disadvantage  that  I  have 
noticed  from  this  treatment  is  that  the  excitability  of  the  respi- 
ratory centre  sometimes  persists  during  the  day,  and  renders  the 
cough  more  troublesome.  I  have  tried  to  remedy  this  by 
combining  strychnine  with  opium,  and  partially  succeeded.  If  We 
■  now  review  the  remedies  used  in  the  night-sweating  of  phthisis, 
we  shall  see  that  almost  every  one  -of  them  has  a  stimulant 
action  on  the  respiratory  centre.  This  is  possessed  in  a  marked 
degree  by  atropine  and  hyoscyamus.  Ipecacuanha  has  this 
action  also,  and  its  combination  with  opium,  in  the  form  of 
Dover's  powder,  although  it  causes  sweating  in  healthy  persons, 
tends  to  restrain  it  in  phthisical  patients.  Picrotoxine,  salts  of 
zinc,  and  pilocarpine,  all  stimulate  the  respiratory  centre  also, 
and  we  find  that  the  last  is  useful  in  the  night-sweats  of  phthisis, 
although  we  should  expect  from  its  physiological  action  that  it 
would  be  injurious,  stimulating,  as  it  does,  the  terminations  of 
the  secreting  nerves  in  the  sweat-glands  themselves.  It  is  pos- 
sible, however,  that  in  addition  to  the  stimulation  of  the  sweat- 
centres  by  venous  blood,  the  night-sweats  of  phthisis  may  be 
sometimes  increased  by  the  high  temperature  of  the  patient, 
and  in  such  cases  quinine,  as  Murrell  has  pointed  out,  is  likely 
to  be  most  serviceable. 

ACTION  OF  DRUGS   ON  THE   BLADDER 

The  walls  of  the  bladder  consist  of  involuntary  muscular 
fibre  which  expels  the  urine  by  its  contraction.  Around  the 
neck  of  the  bladder  is  a  band  of  involuntary  muscular  fibre,  the 


444  EHAKMACOLOGY  AND  THEEAPEUTICS.     [sect.  J. 

sphincter  vesicae,  which  by  its  contraction  closes  the  orifice  and 
prevents  the  escape  of  urine.  The  sphincter  vesicas  receives  its 
motor  supply  through  the  third,  fourth,  and  fifth  sacral  nerves. 

The  nerve-centre  for  the  movements  of  the  bladder  is 
situated  in  the  spinal  cord  opposite  the  fifth  lumbar  vertebra  in 
dogs,  and  the  seventh  in  rabbits.  This  centre  is  able  to  regulate 
the  retention  and  discharge  of  the  urine  by  the  bladder  even 
when  the  spinal  cord  is  divided  between  it  and  the  brain,  but  the 
activity  of  the  centre  under  normal  conditions  is  modified  by  the 
brain,  so  that  we  may  consider  that  there  is  a  cerebral  as  well 
as  a  spinal  centre  for  the  bladder.  The  spinal  centre  may  bo 
set  in  action  either  reflexly,  or  by  stimuli  passing  down  from  it 
to  the  brain.  The  cerebral  centre  may  be  set  in  action  either 
reflexly  or  voluntarily. 

Usually  when  the  pressure  of  the  urine  within  the  bladder  is 
increased  beyond  a  certain  limit  depending  not  only  on  the 
quantity  of  the  water,  but  on  the  state  of  the  contraction  of  the 
bladder  itself,  the  neck  of  the  bladder  becomes  slightly  dilated, 
and  a  drop  of  urine  exuding  acts  as  a  stimulus  to  the  sensory 
nerves  of  the  urethra,  and  thus  calls  reflexly  into  action  the 
centre  in  the  spinal  cord  by  which  at  the  same  time  the 
sphincter  vesicas  is  inhibited,  and  the  detrusor  urinae  stimulated. 
Eeflex  action  may  also  be  induced  by  stimulation  of  other 
nerves,  as  for  example  by  the  application  of  a  wet  sponge  to  the 
,anus  or  perinseum.  The  cerebral  centre  is  usually  called  into 
action  by  the  sensation  of  the  bladder  being  full.  It  may  be 
called  into  action  voluntarily,  although  there  is  little  urine  in 
the  bladder  ;  and  also  may  be  excited  by  emotion,  such  as  fear. 

It  may  be  also  excited  reflexly  through  the  sense  of  hearing. 
Boerhaave  was  accustomed,  when  patients  found  difficulty  in 
passing  water,  to  make  an  attendant  pour  water  from  a  height 
into  a  basin  in  the  patient's  hearing.  The  splashing  thus  occa- 
sioned induced  the  patient  to  pass  water,  and  a  similar  effect, 
as  is  well  known,  is  produced  on  horses  by  whistling.  Nervous 
agitation  has  often  the  contrary  effect  of  producing  retention  of 
water.  When  it  is  desirable  for  a  person  to  pass  water — e.g. 
when  a  specimen  of  urine  is  wanted  for  examination — it  is 
advisable  to  put  him  in  a  room  by  himself  and  turn  on  a  tap 
within  his  hearing.  The  removal  of  the  restraint  exercised  by 
the  presence  of  another  person,  along  with  the  stimulant  action 
of  the  sound  of  falling  water,  rarely  fails  to  produce  the  desired 
effect.  Even  the  recollection  of  the  sound  of  falling  water  will 
tend  to  cause  evacuation  of  the  bladder,  and  when  there  is  diffi- 
culty in  passing  water  the  patient  may  sometimes  obtain  relief 
by  thinking  of  a  waterfall.  Washing  the  hands  in  cold  water 
also  tends  reflexly  to  cause  evacuation  of  urine,  and  the  effect  of 
a  wet  sponge  to  the  perinaeum  has  already  been  mentioned. 
Vesical  sedatives  are  substances  which  lessen  the  irritability 


chap,  xv.]     ACTION  OF  DKCJGS  ON  EXCEETION.  445 

of  the  bladder,  and  thus  remove  pain,  and  lessen  the  desire  to 
urinate.  This  desire  may  be  excited  not  only  by  the  presence 
of  urine  in  the  bladder,  but  by  the  irritation  of  calculi,  or  in- 
flammation of  the  mucous  membrane  of  the  bladder  itself. 
When  calculi  are  a  source  of  irritation,  carbonate  of  calcium  taken 
internally  seems  to  lessen  the  irritability.  In  cystitis  the  irrita- 
tion is  diminished  by  the  use  of  very  hot  water  externally,  in  a 
bidet  or  hip-bath.  The  irritability  of  the  nerves  may  be  dimin- 
ished by  opium,  belladonna,  and  hyoscyamus,  and  by  drinking 
freely  of  warm  water,  either  alone  or  in  the  form  of  an  infusion 
or  decoction  of  some  mucilaginous  substance,  e.g.  linseed-tea  or 
barley-water. 

In  chronic  inflammation  the  irritation  may  be  diminished  by 
astringents  such  as  buchu,  uva  ursi,  pareira  brava,  and  alche- 
milla.  Vesical  tonics  are  substances  which  increase  the  con- 
tractile power  of  the  muscular  fibres  in  the  bladder.  They  are 
therefore  useful  in  two  different  conditions,  for  by  strengthen- 
ing the  detrusor  urinse  they  prevent  retention,  and  by  strength- 
ening the  sphincter  vesicae  they  prevent  incontinence. 

Some  of  these  remedies  appear  to  act  by  increasing  the 
stimulating  power  of  the  urine,  so  that  the  sphincter  vesicae  is 
consequently  more  firmly  contracted ;  of  this  class  is  cantharides. 
Others  appear  to  alter  the  direction  of  reflex  action ;  such  are 
"the  passing  of  a  bougie  through  the  urethra  once  or  twice  a  day, 
or  the  application  of  an  injection  of  nitrate  of  silver,  ten  to 
thirty  grains  to  the  ounce,  to  the  neck  of  the  bladder.  Others 
act  on  the  nerve-centres  and  apparently  are  useful  sometimes 
by  lessening  the  reflex  susceptibility  from  the  bladder,  so  that 
the  detrusor  urinae  is  less  called  into  action ;  at  other  times  by 
increasing  the  susceptibility  of  the  nerve-centre,  so  that  the 
sphincter  vesicae  is  more  firmly  contracted — of  the  latter  class  is 
strychnine  ;  to  the  former  belongs  bromide  of  potassium,  which 
must  be  given  at  night.  Belladonna,  which  is  one  of  the  most 
useful  remedies  in  incontinence  of  urine,  aots  upon  the  nerve- 
centres,  but  whether  it  acts  in  the  same  way  as  strychnine  or  as 
bromide  of  potassium,  it  is  difficult  to  say.  It  is  quite  possible 
that  it  lessens  the  sensibility  of  the  bladder  to  changes  of  pressure 
within  it  in  somewhat  the  same  way  as  it  lessens  the  sensibility 
of  the  heart  to  changes  in  blood-pressure  (p.  298). 


Urinary  Sedatives  and  Astringents. 

When  the  urinary  passages  are  healthy,  the  secretion  of 
mucus  from  them  is  very  slight,  and  the  presence  of  urine  in 
the  bladder  or  its  passage  along  the  urethra  usually  gives  rise  to 
no  pain.  Pain  and  scalding  are  sometimes  caused  by  an  ab- 
normally acid  urine,  or  by  the  presence  of  crystals  of  uric  acid 


446  PHAEMACOLOGY  AND  THEEAPEUTICS.     [sect.  i. 

in  it,  even  though  the  mucous  membrane  itself  be  healthy.  In 
such  cases  the  use  of  potash  or  lithia  is  indicated  to  restore  the 
healthy  character  of  the  urine. 

When  the  bladder  itself  is  irritable  or  inflamed,  the  secretion 
of  mucus  is  increased  and  there  is  constant  desire  to  micturate. 
There  are  here  two  indications  to  be  fulfilled :  one  is  to  lessen 
the  irritability,  and  the  other  is  to  remove  the  inflammation. 
In  lessening  the  irritability,  belladonna  seems  to  be  especially 
useful,  and  to  diminish  the  inflammation,  astringents  are  em- 
ployed. 

In  inflammation  of  the  urethra  the  same  indications  exist, 
and  here  also  cubebs,  copaiba,  and  sandal- wood  oil  are  employed. 
It  is,  however,  easier  to  apply  astringents  locally  to  the  urethra 
than  to  the  bladder,  and  consequently  astringent  injections  are 
more  frequently  used :  these  are  usually  solutions  of  alum,  sul? 
phate  or  acetate  of  zinc,  and  acetate  of  lead. 

Finely-divided  powders  act  also  beneficially  by  keeping  the 
inflamed  walls  of  the  urethra  apart,  and  on  this  account  a  mix- 
ture of  sulphate  of  zinc  and  acetate  of  lead,  which  gives  a  fine, 
white,  insoluble  precipitate  of  sulphate  of  lead,  is  more  efficacious 
than  either  of  the  solutions  employed  alone.  Kaolin  or  china 
clay,  which  is  a  completely  inert  powder,  as  well  as  bismuth  and 
calomel,  have  also  been  used  for  a  similar  purpose.  As  it  is 
found  that  the  secretion  in  gonorrhoea  frequently,  if  not  always, 
contains  microscopic  organisms,  the  injection  of  antiseptics  has 
been  used :  among  these  may  be  mentioned  permanganate  of 
potassium  and  zinc,  boric  acid,  carbolic  acid,  sulpho-carbolates, 
sulphurous  acid,  as  well  as  drugs  having  both  an  astringent  and 
antiseptic  action,  like  chloralum,  perchloride  and  pernitrate  of 
mercury,  and  chloride  of  zinc. 

The  beneficial  effects  of  copaiba  in  inflammation  of  the 
bladder  and  urethra  are  probably  due  to  its  antiseptic  action. 
It  is  excreted  in  considerable  quantities  by  the  kidneys  and 
renders  the  urine  antiseptic,  so  that  its  decomposition  and  the 
appearance  of  bacteria  in  it  are  greatly  retarded  or  completely 
prevented.  The  whole  urinary  passages  from  the  glomeruli  of 
the  kidney  to  the  orifice  of  the  urethra  are  thus  washed  out  by 
antiseptic  urine,  which  does  not  decompose,  and  which  tends 
to  destroy  or  remove  any  germs  that  may  be  present.  Cubebs, 
terpenes,1  and  naphthalin2  have  probably  a  similar  action. 

1  Sohmiedeberg,  Arzneimittellehre,  p.  121. 

*  Bossbaoh,  Berlin,  klin.  Wochenschr.,  1884,  No.  46,  p.  279. 


447 


CHAPTER  XVI. 
ACTION  OF  DEUGS  ON  THE  GENEEATIVE   SYSTEM. 

Aphrodisiacs  and  Anaphrodisiacs. 

The  sexual  function  is  regulated  by  two  nerve-centres,  one  of 
which  is  cerebral  and  the  other  spinal.     The  cerebral  centre  is  . 
the  seat  of  the  feelings  and  appetite  which  prompt  the  individual 
to  seek  sexual  congress. 

The  spinal  centre  regulates  the  condition  of  erection  in  the 
sexual  organs  which  is  necessary  for  coitus.  These  two  centres 
may  act  independently  of  each  other,  e.g.  when  the  spinal  cord 
is  cut,  but  in  the  normal  condition  they  naturally  influence  each 
other,  excitement  of  the  spinal  centre  re-acting  on  the  cerebral 
centre  so  as  to  awaken  sexual  feelings,  and  excitement  of  the 
cerebral  centre  re-acting  on  the  spinal  so  as  to  produce  erection 
of  the  genital  organs. 

Erection  is  due  partly  to  dilatation  of  the  arteries  in  the 
erectile  tissues  of  the  genital  organs,  and  partly  to  compression 
of  the  efferent  veins.  The  blood  being  thus  allowed  to  flow 
freely  into  the  organs,  and  prevented  from  flowing  out,  distends 
them  so  as  to  render  them  turgid  and  more  or  less  rigid. 
During  the  orgasm  the  turgidity  is  increased  by  partial  stoppage 
of  respiration,  which,  by  rendering  the  blood  venous  and  thus 
stimulating  the  vaso-motor  centre,  tends  to  raise  the  blood- 
pressure  in  the  body  generally,  and  in  the  erectile  tissues 
particularly. 

Dilatation  of  the  arteries  in  the  genital  organs  and  conse- 
quent erection  occurs  on  stimulation,  either  of  the  genital  centre 
in  the  lumbar  spinal  cord  or  of  the  vaso-dilating  nerves  (nervi 
erigentes)  which  pass  from  it  to  the  genital  organs  and  end  in  a 
ganglionic  plexus  surrounding  the  arteries. 

The  lumbar  genital  centre  may  be  excited  either  reflexly  by 
stimulation  of  the  sensory  nerves  of  the  genital  organs  and  ad- 
joining parts,  or  by  psychical  stimuli  transmitted  to  it  from  the 
brain. 

The  exact  seat  of  the  cerebral  genital  centre  has  not  been 
determined,  but  Eckhard  has  found  that  irritation  of  the  crura 


448  PHAEMACOLOGY  AND  THEEAPEUTICS.     [sect.  i. 

cerebri  can  produce  similar  effects  to  stimulation  of  the  nervi 

erigentes. 

The  cerebral  genital  centre  may  be  stimulated  and  sexual 
feelings  aroused  by  impressions  made  on  the  nerves  of  special 


Optic  nerves 

Auditory  nerves 

Olfactory  nerves ) 

Nerves  of  mammae  and  general  surface  .... 


Nervi  erigentes  passing  to  the  genital  arteries 
Sensory  nerves  of  the  genital  organs 


prostate  and  bladder 
perineum  and  rectum. . ... 


'"Sensory  nerves  of  nates 
and  rectum. 


FIG.  154.— Diagram  to  illustrate  the  action  of  aphrodisiacs  and  anaphrodisiacs.  The  darkly-shaded 
spot  indicates  the  genital  centre  in  the  brain,  and  the  lighter  spot  the  spinal  centre  in  the 
lumbar  portion  of  the  cord.  The  direction  in  'which  impulses  are  conveyed  along  the  nerves 
are  indicated  by  the  arrows.  The  nerves  from  the  general  surface  have  been  represented  as 
going  to  the  cerebral  centre,  and  acting  through  it  on  the  spinal  centre.  It  is  probable,  how- 
ever, that  several  of  them  pass  directly  to  the  spinal  centre,  as  represented  in  the  case  of  the 
nerves  of  the  nates. 

or  general  sense,  e.g.  on  the  eye,  ear,  nose,  on  the  mammae,  and 
general  surface  of  the  body,  the  genital  organs  and  parts  adjoin- 
ing, as  the  bladder,  prostate,  and  nates.  Thus,  sexual  excitement 
may  occur  in  consequence  of  the  sight  of  persons  or  pictures, 
the  reading  or  hearing  of  licentious  stories,  or  of  irritation  of  the 
surface  of  the  body  either  by  gentle  friction  or  by  pruriginous 
irritation  due  to  irritating  articles  of  clothing,  parasites,  or  skin 
diseases^  Distension  of  the  bladder  has  a  somewhat  similar 
effect,  and  the  irritation  consequent  on  an  enlarged  prostate  is 
probably,  in  part  at  least,  the  cause  of  the  great  sexual  excite- 
ment which  sometimes  occurs  in  elderly  men.  A  very  acid  con- 
dition of  the  urine,  such  as  is  found  in  some  gouty  patients,  may 
possibly  have  a  similar  action.  Chlorate  and  nitrate  of  potassium 
administered  internally  are  said  by  Jacobi '  to  render  the  urine 
so  irritating  and  to  produce  such  sexual  excitement  as  to  lead  to 
onanism.  Ascarides  in  the  rectum  may  cause  excitement  of  the 
cerebral  genital  centre  and  give  rise  to  nocturnal  emissions  as 
well  as  possibly  to  diurnal  excitement,  and  in  females  they  may 
cause  even  greater  irritation  by  passing  into  the  vagina.  Irrita- 
tion of  the  rectum  from  the  presence  of  piles  or  fissure  may  also 
give  rise  to  such  great  sexual  excitement  as  to  induce  onanism 
or  nymphomania.     Faeces  in  the  rectum,  and  perhaps  in  the 

1  Medical  Times  and  Gazette,  1876,  vol.  i.  p.  177. 


ch.  xvi.]  ACTION  OF  DEUGS  ON  GENEEATIVE  SYSTEM.    449 

colon,  may  also  cause  sexual  excitement  in  some  persons  or 
increase  it  when  present. 

Such  sources  of  local  irritation  may  sometimes  be  insufficient 
to  affect  the  cerebral  centre  during  waking  hours,  when  the 
attention  is  otherwise  engaged,  but  may  do  so  powerfully  during 
sleep,  or  when  the  cerebral  functions  are  disturbed  by  cannabis 
indica,  and  they  may  then  produce  erotic  dreams  or  seminal 
emissions. 

The  lumbar  centre  is  most  readily  excited  by  mechanical 
stimulation  of  the  genital  organs,  but  it  may  be  also  powerfully 
stimulated  from  the  mucous  membranes  of  the  urinary  passages, 
as  is  seen  in  the  painful  priapism  which  occurs  in  poisoning  by 
cantharides. 


Optic  nerves.... 
Auditory  nerves 
Olfactory  nerves 


Nerves  of  mammae  and  general  surface 

Stomach 

Intestine  


Nervi  erigentes 

Sensory  nerves  of  genital  organs  . 


prostate  and  bladder  .  I 
perineum  and  rectum ,  I 


Sensory  nerves  of 
rectum  and  nat  es. 


Fig.  155.— Diagram  to  illustrate  the  effects  on  the  genital  centres  of  irritation  of  the  stomach  or 
intestine  by  flatulence,  acrid  matters,  or  fascal  accumulations. 

Stimulation  of  the  lumbar  centre  without  stimulation  of  the 
cerebral  centre  may  occur  from  the  presence  of  fasces  in  the 
rectum  and  perhaps  in  the  colon,  so  as  to  give  rise  to  seminal 
emissions  during  sleep  unaccompanied  by  any  dreams  of  a  sexual 
character.  Distension  of  the  stomach  or  intestines  by  flatus 
may  have  a  similar  effect  (Fig.  155). 


Aphrodisiacs. 

These  are  medicines  which  increase  the  sexual  appetite. 

Irritation  of  the  nates,  either  mechanically  alone,  by  flogging, 
or  mechanically  and  chemically  combined,  by  urtication  or 
flogging  with  nettles,  has  been  used  as  an  aphrodisiac.1 


1  Trousseau  et  Picloux,  TraiU  de  Thirapeutique. 


a  a 


450  PHARMACOLOGY  AND   THERAPEUTICS.      [sect   i. 

The  sexual  function  requires,  however,  for  its  proper  per- 
formance a  healthy  state  of  the  body,  and  good,  or  at  least  fair, 
nutrition ;  without  these  mere  re"nex  excitement  of  the  genital 
centres  is  likely  to  prove  inefficient  for  the  propagation  of  the 
race.  Tonics  generally,  such  as  iron,  are  therefore  to  be  regarded 
as  indirect  aphrodisiacs. 

Strychnine  has  probably  a  double  action,  both  increasing  the 
general  nutrition  and  rendering  the  genital  nervous  centres,  both 
lumbar  and  cerebral,  more  susceptible  to  the  action  of  stimuli. 
Its  aphrodisiac  action  is  sometimes  an  objection  to  its  use  as  a 
tonic,  for  both  it  and  nux  vomica  may  cause  seminal  emissions 
■which  more  than  counterbalance  its  tonic  action  and  weaken 
the  patient. 

Cannabis  indica  has  been  regarded  as  an  aphrodisiac,  but 
the  trials  of  it  made  in  this  country  seem  to  show  that  it  does 
not  itself  at  least  have  any  such  action,  and  merely  induces  a 
condition  of  partial  delirium  in  which  Easterns  may  possibly 
have  visions  of  a  sexual  nature,  and  indeed,  they  try  to  give  a 
sexual  direction  to  the  mental  disturbance  which  the  cannabis 
produces,  by  mixing  with  it  musk,  ambergris,  or  cantharides. 

Catharides  act  as  an  aphrodisiac,  but  their  action  is  probably 
due  to  an  irritating  effect  on  the  mucous  membrane  of  the 
urethra,  and  their  use  in  such  doses  as  to  have  any  aphrodisiac 
action  is  attended  with  danger.  Blatta  orientalis  when  used  as 
a  diuretic  may  have  an  aphrodisiac  action  like  cantharides.1 

Alcohol  appears  to  excite  the  cerebral  centre  and  increase  the 
sexual  appetite,  while  it  interferes  with  the  proper  performance 
of  the  generative  act.2  This  interference  may  be  due  to  partial 
paralysis  of  the  lumbar  centre  or  the  nervi  erigentes ;  but  para- 
lysis of  the  vaso-motor  centre  is  probably  a  potent  factor,  or  may 
indeed  be  the  only  cause  of  the  impotency  produced  by  alcohol ; 
for  alcohol  paralyses  the  vaso-motor  centre  to  such  an  extent 
that  it  will  not  react  to  the  stimulus  of  venous  blood,  and  even 
suffocation  will  not  raise  the  blood-pressure.3  Consequently,  the 
rise  in  blood-pressure  which  holding  the  breath  will  normally 
produce  during  coition  (p.  447)  will  not  occur  when  much  alcohol 
has  been  taken,  and  the  penis,  although  it  may  be  turgid  from 
dilatation  of  the  vessels,  will  not  acquire  the  rigidity  necessary 
for  the  generative  act. 

1  Buttenwieser,  Der  practische  Arzt,  Feb.  1882. 
1  Shakespeare,  Macbeth,  act  ii.  scene  3. 
*  Dogiel,  jPflilger's  Archiv.  vol.  viii. 


ch.  xvi.]  ACTION  OF  DRUGS  ON  GENERATIVE  SYSTEM.    451 

Anaphrodisiacs. 

These  are  medicines  which  diminish  the  sexual  passion. 
The  agents  employed  as  anaphrodisiacs  are  : — 

Ice.  Conium. 

Cold  baths,  local  and  Camphor. 

general.  Digitalis. 

Bromides  of  potassium  Purgatives. 

and  ammonium.  Nauseants. 

Iodide  of  potassium.  Bleeding. 

Anaphrodisiacs  may  act  locally  on  the  genital  organs,  or  may 
act  upon  the  genital  nerve-centres. 

The  effect  on  the  nervous  system  may  be  directly  exerted  on 
the  nervous  structures  themselves,  on  the  circulation,  nutrition, 
and  general  surroundings.  Amongst  the  most  powerful  local 
anaphrodisiacs  is  the  continuous  application  of  cold  by  means  of 
ice.  Bromide  of  potassium  possibly  has  also  a  local  as  well  as 
a  general  action. 

"When  the  lumbar  portion  of  the  cord  is  abnormally  stimu- 
lated reflexly,  the  stimulus  ought  to  be  removed :  thus,  in  warm 
countries,  where  smegma  may  accumulate  around  and  irritate 
the  glans  penis,  very  careful  washing  is  requisite  and  circum- 
cision is  an  advantage.  Both  in  warm  and  cold  countries  cir- 
cumcision, either  general  or  partial,  is  useful  if  the  prepuce  be 
very  long  and  its  orifice  much  contracted. 

When  the  irritation  appears  to  arise  from  the  presence  of 
very  acid  urine,  or  of  crystals  of  uric  acid,  irritating  the  bladder 
or  urethra,  as  in  gouty  persons,  potash  or  lithia  should  be  em- 
ployed to  lessen  the  acidity  of  the  urine,  or  to  render  it  neutral. 
Where  abnormal  irritation  of  the  genitals  is  present  the  urine 
should  be  examined  for  sugar  as  well  as  for  uric  acid,  as  the 
sugar  may  cause  local  irritation  of  the  prepuce  or  vulva. 

Distension  of  the  bladder  ought  also  to  be  avoided,  and  in 
persons  who  suffer  from  seminal  emissions,  occurring  in  the 
morning,  it  is  occasionally  advisable  that  they  should  be 
awakened  and  empty  the  bladder  an  hour  or  more  before  their 
usual  time  of  rising. 

If  stone  in  the  bladder  is  acting  as  an  irritant,  surgical  treat- 
ment Bhould  be  employed,  but  in  cases  where  this  is  inadvisable, 
or  where  the  irritation  is  dependent  on  enlarged  prostate,  general 
anaphrodisiacs  must  be  used,  such  as  bromide  of  potassium 
in  large  doses,  care  also  being  taken  that  the  condition  of  the 
urine  is  not  abnormally  acid  or  alkaline.  Ascarides  in  the 
rectum  must  be  treated  with  anthelmintics.  "When  irritation 
arises  from  piles  the  use  of  sulphur  internally  is  often  beneficial, 
though  surgical  interference  may  be  necessary  both  for  them  and 
for  fissure. 

o  a  2 


452  PHAEMACOLOGY   AND   THEEAPEUTICS.      [sect.  i. 

When  irritation  arises  from  fascal  accumulations  in  the 
rectum  or  colon,  they  should  be  removed  and  their  return  pre- 
vented by  the  careful  use  of  aperients. 

Flatulent  distension  of  the  stomach  or  intestines  may  be  re- 
moved by  alkalis  and  cholagogues,  bitters  (p.  378),  and  especially 
by  strychnine,  which  gives  tone  to  the  intestine.  It  thus  happens 
that,  notwithstanding  the  tendency  of  strychnine  to  cause  sexual 
excitement  and  produce  emissions  by  its  action  on  the  nerve- 
centres,  it  may  sometimes  effectually  relieve  these  conditions  by 
its  action  on  the  intestine. 

As  anything  which  tends  to  increase  the  flow  of  blood  to  the 
genital  organs  or  the  lumbar  portion  of  the  spinal  cord  heightens 
their  excitability,  care  should  be  taken  not  only  to  avoid  this,  but 
also  to  direct  as  much  as  possible  the  current  of  blood  to  other 
parts  of  the  body.  Thus,  warm  and  heavy  clothing  or  pads 
about  the  hips  or  loins  should  be  avoided,  and  a  hard  mattress 
should  be  used  in  the  place  of  a  feather  bed.  Sometimes  patients 
suffer  from  emissions  in  consequence  of  lying  on  their  back. 
This  is  probably  due  to  the  effect  of  warmth  on  the  spinal  cord, 
and  in  order  to  avoid  it,  a  towel  or  girdle  should  be  put  around 
the  loins  with  a  knot  tied  in  it,  or  some  hard  substance  fastened 
on  it  opposite  the  spine,  so  that  the  person  would,  even  during 
sleep,  be  prevented  from  lying  on  his  back.  Walking  exercise  is 
not  so  useful  as  exercise  of  the  arms,  as  in  rowing,  gymnastics, 
or  mechanical  occupations,  such  as  those  of  a  carpenter  or  black- 
smith, because,  in  walking,  the  current  of  blood  passes  towards 
the  lower  extremities  and  part  of  it  may  become  directed  to  the 
pelvis.  In  the  other  occupations  just  mentioned,  the  current 
of  blood  is,  on  the  contrary,  directed  to  the  upper  extremities. 
Working  a  treadle,  as  in  turning  a  lathe  or  sewing-machine,  is 
objectionable,  both  because  the  blood  is  directed  towards  the 
lower  extremities  generally  and  because  it  may  become  specially 
directed  to  the  genitals  by  occasional  friction  of  the  clothes. 

Hard  mental  work  has  also  a  similar  effect  to  that  of  bodily 
exercise.  In  addition  to  these  measures,  a  meagre  diet,  and 
especially  a  vegetable  diet,  with  the  avoidance  of  stimulants,  is 
of  considerable  service. 


Emmenagogues  and  Ecbolics. 

Emmenagogues  are  remedies  which  restore  and  regulate 
the  normal  menstrual  flow  when  it  is  absent  or  deficient  or 
irregular. 

Ecbolics  are  remedies  which  cause  the  expulsion  of  the 
contents  of  the  uterus. 

In  menstruation  both  ovaries  and  uterus  become  congested. 
An  ovum  is  discharged,  and  a  flow  of  blood  occurs  from  the 


ch.  xvi.]  ACTION  OF  DKUGS  ON  GENEEATIVE  SYSTEM.    453 


uterus.  Diminution  or  absence  of  the  menstrual  flow  may  be 
occasioned  either  by  general  or  local  conditions :  thus  great 
debility  or  anaemia  may  cause  it,  and  it  is  very  frequent  indeed 
in  the  anaemia  and  debility  which  are  consequent  on  the  occur- 
rence of  slight  consolidation  in  the  lungs. 

A  local  cause  may  be  deficient  determination  of  blood  to  the 
ovaries  and  uterus,  although  no  general  anaemia  exists. 

The  remedies  employed  for  these  two  conditions  are  termed 
indirect  emmenagogues.  To  correct  anaemia,  iron,  manganese, 
and  cod-liver  oil  may  be  employed. 

In  order  to  determine  more  blood  to  the  uterus,  warm  foot- 
baths, warm  hip-baths,  mustard  hip-baths,  mustard  stupes  or 
poultices  to  the  thighs  and  lower  part  of  the  abdomen,  and 
leeches  to  the  inside  of  the  thighs  or  to  the  genitals,  and  aloetic 
purgatives,  may  be  employed. 

It  might  at  first  seem  from  theoretical  considerations  that 
foot-baths  could  hardly  have  any  action  on  the  uterus,  but  warm 
foot-baths  cause  great  dilatation  of  the  arteries  in  the  legs,  and 
it  is  probable  that  this  dilatation  extends  up  the  iliacs,  so  that 
more  blood  may  be  sent  to  the  genitals  as  well.  But  in  addition 
to  this,  it  is  not  at  all  improbable  that  a  close  nervous  connection 
exists  between  the  vascular  supply  of  the  uterus  and  of  the  feet, 
for  not  only  does  the  warm  foot-bath  tend  greatly  to  restore,  but 
cold  and  wet  feet  are  amongst  the  most  powerful  agents  in 
checking,  menstruation. 

Other  substances,  which  seem  to  have  a  direct  stimulating 
action  upon  the  womb  itself,  are  called  direct  emmenagogues. 
It  is  not  easy  to  see  at  present  how  they  act ;  we  know,  however, 
that  when  given  in  large  doses  they  cause  contraction  of  the 
womb,  and  thus   act  as   ecbolics.      The  chief  emmenagogues 


are: 


Indirect  Emmenagogues. 

"Hotfoot. 
Hot  hip. 
Mustard. 
'  To  genitals. 
.  To  thighs. 
Baths. 
Poultices. 
w  Stupes. 
Purgatives,  as  aloes. 
Iron. 

Manganese. 
Cod-liver  oil. 
Strychnine. 


Baths 


Leeches 


Mustard 


Direct  Emmenagogues. 

Ergot. 

Digitalis. 

Savin. 

Quinine. 

Asafcetida. 

Myrrh. 

Guaiacum. 

Cantharides. 

Borax. 

Bue. 

Hydrastis.1 


1  Fellner,  '  Die  physiolog.  Wirkung  einiger  Praparate  des  Hydrastis  Canadensis. 
Wien.  med.  Jahrbiicher,  1885. 


454  PHAEMACOLOGY  AND  THEEAPEUTICS.      [sect.  i. 


Ecbolics. 

The  involuntary  muscular  fibres  of  the  uterus  appear,  like 
those  of  the  ureter  or  of  the  frog's  heart,  to  possess  the  power  of 
rhythmical  contraction,  and  may  contract  when  entirely  separated 
from  the  general  nervous  system.  They  are,  however,  controlled 
by  the  higher  nerve-centres.  There  appears  to  be  one  centre, 
situated  in  the  lumbar  portion  of  the  spinal  cord,  which  is  of 
itself  sufficient  to  regulate  all  the  movements,  for  they  go  on 
normally,  even  when  the  spinal  cord  has  been  completely  divided 
above  it.  This  centre  may  be  reflexly  stimulated  and  contrac- 
tions of  the  uterus  induced  by  irritation  of  the  ovarian,  crural, 
or  sciatic  nerves.  It  may  be  also  stimulated  by  the  action  upon 
it  of  drugs  circulating  in  the  blood,  as  ergotin,,picrotoxine,  or 
strychnine,  or  by  great  venosity  of  the  blood,  due  to  asphyxia. 

There  appears,  however ,  also  to  be  a  second  centre  for  the 
uterus,  as  for  the  male  genital  organs,  in  the  brain  (vide  p.  448), 
by  which  the  lumbar  centre  may  be  excited,  and  in  consequence 
of  this,  stimulation  of  the  cerebellum,  crura  cerebri,  corpora 
striata,  and  optic  thalami,  also  gives  rise  to  uterine  contractions. 

Von  Basch  and  Hofmann  consider  that  the  impulses  pass  to 
the  uterus  from  the  central  nervous  system,  along  two  sets  of 
nerves.  One  is  composed  of  nerves  passing  from  the  inferior 
mesenteric  ganglion  to  the  hypogastric  plexus.  Stimulation  of 
these  causes  circular  contraction  of  the  uterus,  descent  of  the 
cervix  and  dilatation  of  the  os.  The  other  consists  of  branches 
passing  from  the  sacral  nerves  across  the  pelvis  to  the  hypogastric 
plexus,  and  representing  the  nervi  erigentes.  On  stimulation  of 
these  the  uterus  contracts  longitudinally ;  the  cervix  ascends  and 
the  os  closes. 

The  mode  of  action  of  ecbolics  has  not  been  satisfactorily 
ascertained.  Ammonia  injected  into  the  circulation  appears  to 
cause  contraction  of  the  muscular  fibres,  for  it  causes  contraction 
of  the  uterus  even  when  all  nervouB  connections  have  been 
divided.  Ergot  possibly  acts  in  the  same  way,  but  it  is  possible 
also  that  it  acts  on  the  spinal  centre. 

The  chief  ecbolics  are : — 

Ergot. 

Hydrastis. 

Quinine. 

Savin. 

Thuja. 

Uses. — Ecbolics  are  used  to  accelerate  the  expulsion  of  the 
child  when  the  passages  are  free  but  expulsive  power  is  deficient, 
and  to  cause  firm  contraction  of  the  uterus  and  so  prevent 
haemorrhage  after  delivery. 


ch.  xvi.]  ACTION  OF  DEUGS  ON  GENEEATIVE  SYSTEM.    455 

Adjuncts.— Compression  of  the  uterus  by  kneading,  pressure 
over  it  by  a  pad,  the  hand  dipped  in  cold  water  laid  over  the 
uterus,  or  a  cold  pad.  Sternutatories  have  been  used  to  supple- 
ment the  expulsive  power  of  the  uterus,  and  when  necessary, 
operative  interference  must  be  had  recourse  to. 

The  injection  of  hot  water  into  the  vagina,  as  hot  as  can  be 
borne,  is  a  great  aid  in  causing  firm  contraction  of  the  uterus, 
and  thus  stopping  post  partem  haemorrhage.  Some  of  the  liquid 
probably  enters  the  cervix  through  the  flaccid  os  (vide  p.  351). 


Action  of  Drugs  upon  the  Mammary  Glands. 

The  milk-glands  somewhat  resemble  the  salivary  glands  in 
the  way  in  which  they  are  affected  by  the  central  nervous  system, 
and  by  the  action  of  drugs  upon  them.  The  action  of  the  central 
nervous  system  on  the  milk-glands,  however,  has  not  been  made 
out  with  anything  like  the  same  clearness  as  in  the  case  of  the 
salivary  glands,  experiments  on  animals  not  having  given  very 
definite  results.  It  is  chiefly  inferred  from  the  effect  of  mental 
emotions  in  checking  or  altering  the  secretion  of  the  milk ;  and 
from  the  effect  of  belladonna  locally  applied  in  checking  the 
secretion.  The  amount  of  secretion  appears  to  depend  on  the 
amount  of  blood-pressure  in  the  gland,  and  gentle  stimulation  of 
the  nipple  increases  both  the  flow  of  blood  to  the  gland  and  the 
-secretion  of  milk.  It  is  uncertain  whether  there  are  definite 
secreting  nerves  affecting  the  gland-cells  apart  from  the  vaso- 
motor nerves. 

The  character  of  the  milk  depends  to  a  great  extent  upon  the 
feeding  and  exercise  of  the  mother,  and  diet  is  the  most  important 
agent  in  regulating  both  the  quality  and  the  quantity  of  the  milk. 
As  Dolan  points  out,  it  not  unfrequently  happens  that  a  wet 
nurse,  when  first  she  arrives,  yields  such  milk  that  the  child  she 
is  nursing  thrives  well,  but  the  quality  soon  falls  off.  In  place 
of  much  outdoor  exercise  and  plain,  nutritious  diet;  she  is  fed 
luxuriously  and  gets  little  exercise.  In  order  to  restore  the 
quality  of  the  milk  in  such  a  case,  the  woman  must  be  restored 
as  far  as  possible  to  her  previous  conditions  of  diet  and  exercise. 

Many  substances  are  excreted  in  the  milk,  such  as  ammonia 
and  the  aromatic  oils  to  which  vegetable  substances  belonging 
to  Umbelliferae  and  Cruciferse  owe  their  "flavour,  probably  also 
all  volatile  oils  are  thus  excreted.  Amongst  those  which  have 
actually  been  found  to  pass  into  the  milk  are  the  oils  of  anise, 
cumin,  dill,  wormwood,  and  garlic,  as  well  as  turpentine  and 
copaiba.  The  purgative  principles  of  rhubarb,  senna,  scammony, 
and  castor-oil,  pass  into  the  milk.  Opium,  iodine,  and  indigo  do 
so  also,  and  metals,  such  as  antimony,  arsenic,  bismuth,  iron, 
lead,  mercury,  and  zinc.    Volatile  oils,  having  an  agreeable  taste, 


456  PHAEMACOLOGY  AND  THEEAPEUTICS.      [sbot.i. 

do  not  appear  to  affect  the  secretion  of  milk  directly,  but  appear 
to  render  it  pleasant  to  children,  so  that  they  take  the  breast 
eagerly.  When  lactation  is  defective  they  may  increase  the 
reflex  stimulus  to  the  nipple  by  making  the  child  suck  more 
vigorously  and  thus  increase  the  quantity  of  milk.  For  this 
reason  such  volatile  oils  as  anise  and  dill  may  be  useful  as  galac- 
tagogues.  Garlic,  on  the  contrary,  renders  the  milk  disagreeable 
to  children,  so  that  they  will  not  take  it.  Copaiba  also  renders 
the  milk  disagreeable.  The  nearest  approach  to  a  true  galacta- 
gogue  is  jaborandi,  but  it  affects  the  gland  only  temporarily. 
Beer  and  porter  stimulate  the  secretion  for  a  short  time,  but 
they  produce  no  proportionate  benefit  in  the  child,  and  nursing 
mothers  are,  as  a  rule,  much  better  without  alcohol,  and  should 
rather  take  milk  instead.  When  the  milk  of  the  mother  is  defi- 
cient in  saline  constituents  they  may  be  supplied  by  giving  the 
appropriate  salts  to  the  mother. 

Various  physiological  actions  may  be  produced  in  the  child 
by  administering  drugs  to  the  mother.  The  administration  of  acids 
to  nursing  mothers  is  generally  to  be  avoided,  as  they  are  apt  to 
cause  griping  in  the  child.  Neutral  salts  as  a  rule  pass  into  the 
milk  and  cause  looseness  of  the  bowels  in  the  child.  Senna, 
castor-oil,  rhubarb,  scammony,  sulphur,  and  probably  jalap,  act 
as  purgatives  to  the  child.  Salts  of  potassium  administered  to 
the  mother  will  act  as  diuretics  to  the  child.  Turpentine  ad- 
ministered to  the  mother  also  can  be  detected  in  the  urine  of  the 
child ;  and  this  is  also  the  case  with  copaiba  and  iodide  of  potas- 
sium. Opium  administered  to  the  mother  may  act  as  a  narcotic 
to  the  child,  and  mercury,  arsenic,  and  iodide  of  potassium  may 
all  be  given  to  nursing  children  by  administration  to  the  mother. 


457 


CHAPTEE  XVII. 

METHODS  OF  ADMINISTERING  DEUGS. 

Drugs  may  be  used  either  for  their  local  or  general  action,  and 
sometimes  for  a  combination  of  the  two.  Thus  a  solution  of 
opium  may  be  applied  to  the  eye  for  its  local  effect  in  relieving 
irritation  of  the  conjunctiva.  It  may  be  given  by  the  mouth  or 
injected  under  the  skin  to  relieve  pain  and  induce  sleep,  though 
the  seat  of  the  pain  may  be  far  removed,  both  from  the  point  of 
injection  and  from  the  alimentary  canal ;  or  the  opium  may  be 
applied  in  the  form  of  a  pessary  in  uterine  disease  to  relieve  pain, 
both  by  its  local  action  on  the  part,  and  its  general  action  on  the 
system  after  absorption. 

In  order  to  produce  their  general  action  drugs  may  be  intro- 
duced into  the  system  through  the  skin,  subcutaneous  cellular 
tissue,  lungs,  mucous  membranes,  especially  that  of  the  aliment- 
ary canal,  serous  membranes  and  veins.  The  same  drug  applied 
in  the  same  quantity  through  different  channels  may  have  different 
effects ;  for  not  only  may  slower  absorption  give  rise  to  difference  in 
the  amount  present  at  any  time  in  the  blood,  as  already  explained 
(p.  38),  but  a  reflex  effect  upon  the  organism  may  be  produced 
by  the  local  action  of  the  drug  at  the  place  of  introduction. 

Application  of  Drugs  by  the  Skin. 

There  are  three  different  methods  of  applying  drugs  by  the 
skin  which  are  well  recognised,  these  are  : — 

1.  Epidermic,  to  the  skin  covered  by  epidermis. 

2.  Endermic,  to  the  skin  denuded  of  epidermis. 

3.  Hypodermic,  to  the  subcutaneous  cellular  tissue. 

Epidermic  Application. — Eemedies  are  applied  to  the  un- 
broken skin  chiefly  for  their  local  action  on  the  part  to  which 
they  are  applied,  or  their  reflex  action  through  the  nervous  system 
on  more  distant  parts.  The  epidermic  applications  are  compara- 
tively rarely  used  as  a  means  of  introducing  drugs  into  the  system, 
for  the  epidermis  opposes  such  an  obstacle  to  absorption,  that  it 
takes  place  slowly  and  with  great  difficulty. 

In  some  of  the  lower  animals,  such  as  frogs,  respiration  takeB 
place  to  such  an  extent  through  the  skin,  that  the  animal  will 
live  for  a  long  time  after  respiratory  movements  have  ceased. 
Eespiration  also  takes  place  through  the  skin  in  man,  but  to  a 


458  PHARMACOLOGY  AND  THEEAPEUTICS.      [sect.  i. 

very  slight  extent,  the  absorption  of  oxygen  and  the  excretion  of 
carbonic  acid  being  only  about  ^-fr^th  part  of  that  in  the  lungs. 

The  skin  is  able  to  absorb  other  gases  as  well  as  oxygen,  such 
as  sulphuretted  hydrogen,  carbonic  acid,  carbonic  oxide,  and  the 
vapours  of  hydrocyanic  acid,  ether,  and  chloroform. 

From  the  relief  which  persons  who  have  been  shipwrecked  and 
have  suffered  from  extreme  thirst  have  received  by  bathing  in 
sea- water,  or  putting  on  shirts  wet  with  sea-water,  it  seems  prob- 
able that  the  skin  is  able  to  absorb  water,  but  this  fact  also  shows 
that  solids  dissolved  in  the  water  are  not  absorbed  by  the  skin. 
A  good  deal  of  discussion  has  taken  place  regarding  the  absorp- 
tion by  the  skin  of  substances  applied  to  it  in  a  state  of  solution. 
Experiments  on  this  point  have  usually  been  made  with  iodide 
of  potassium,  on  account  of  the  ease  with  which  this  salt  can  be 
detected  in  the  urine.  The  results  have  generally  been  negative, 
but  sometimes  they  have  been  positive.  The  general  result  is 
that  the  salt  is  never  absorbed  by  the  skin  from  the  solution,  and 
that  in  the  cases  where  absorption  has  taken  place,  it  has  been 
due  to  the  skin  not  having  been  washed  after  the  bath,  so  that 
the  iodide  has  crystallised  on  the  surface,  and  has  afterwards  by 
friction  of  the  clothes  been  rubbed  into  the  sebaceous  glands. 
It  would  appear  that  the  fat  in  the  skin  as  well  as  the  epidermis 
presents  an  obstacle  to  the  absorption  of  substances  in  solution, 
but  when  they  are  applied  in  such  a  form  that  they  can  readily 
mix  with  the  sebaceous  matter  of  the  skin,  they  are  tolerably 
readily  absorbed,  as  for  example  when  they  are  used  in  the  form 
of  ointment  and  well  rubbed  into  the  skin,  so  as  to  penetrate  into 
the  sebaceous  follicles  and  also  the  sweat-glands.  They  are  also 
absorbed  when  dissolved  in  ether,  and  especially  in  chloroform, 
even  when  simply  painted  over  the  surface.  Alcoholic  solutions 
are  not  absorbed  when  painted  on  in  this  way,  although  they 
may  be  absorbed  if  rubbed  well  in.  It  has  been  supposed  that 
the  absorption  of  chloroform  solution  is  due  to  the  chloroform 
mixing  with  the  sebaceous  matter.  But,  if  true  at  all,  this  is 
certainly  not  the  complete  explanation  of  the  fact,  for  as  has  just 
been  mentioned,  alcoholic  solutions  are  not  absorbed,  although 
alcohol  as  well  as  chloroform  will  dissolve  sebaceous  matter. 
Waller  has  also  shown  that  chloroform  passes  rapidly  through 
the  dead  skin,  carrying  with  it  alkaloids  dissolved  in  it.  Its 
action  is  therefore  to  a  great  extent  due  to  its  peculiar  endos- 
motic  power. 

The  vascularity  of  the  skin  greatly  alters  its  absorptive  power. 
In  the  frog,  absorption  usually  occurs  rapidly  through  the  skin, 
so  that  if  the  hind  legs  be  immersed  for  a  few  minutes  in  a  solu- 
tion of  cyanide  of  potassium,  tho  salt  is  rapidly  absorbed  and 
can  be  detected  in  the  mouth  of  the  animal  in  a  few  minutes. 
But  if  the  circulation  be  depressed  by  the  previous  administration 
of  ether,  curare,  or  any  cardiac  depressant,  this  absorption  into 


chap,  xvii.]  METHODS  OF  ADMINISTEEING  DEUGS.         459 

the  system  does  not  take  place;  for  although  the  cyanide  of 
potassium  passes  through  the  skin,  yet,  the  subcutaneous  circu- 
lation being  feeble,  it  is  not  conveyed  away  from  the  point  of 
local  application  into  the  system  generally. 

The  absorption  of  drugs  may  therefore  be  diminished  by  de- 
pression of  the  circulation  either  locally  at  the  point  of  application 
or  in  the  system  generally.  It  may  be  rendered  more  rapid  by 
increased  circulation  at  the  point  of  application.  A  general  in- 
crease in  the  circulation  usually  accelerates  the  circulation  in  the 
different  parts  of  the  body,  but  does  not  necessarily  do  so,  for  the 
vessels  of  a  part  may  remain  contracted  while  the  general  circu- 
lation is  more  rapid  than  usual. 

A  local  increase  in  the  circulation  occurs  from  inflammation 
of  a  part,  or  from  temporary  irritation  such  as  that  produced  by 
rubbing,  or  by  the  application  of  irritant  substances.  The  use  of 
friction,  therefore,  increases  absorption  not  only  by  pressing  the 
substances  employed  into  the  sweat-glands  and  hair-follicles  but 
also  by  increasing  the  circulation,  and  this  effect  will  take  place 
to  a  still  greater  extent  if  the  substances  used  have  a  tendency  to 
cause  dilatation  of  the  vessels. 

The  most  common  methods  of  applying  drugs  epidermically 
are  baths,  poultices,  inunction,  and  friction. 


Baths. 

These  may  be  either  local  or  general.  In  general  baths, 
the  whole  of  the  body  excepting  the  head  is  exposed  to  the  action 
of  various  agents.  According  to  the  nature  of  the  agent,  baths 
may  be  divided  as  follows : — 


( 


I.  Watbb. 


A.  Simple. 


B.  Medicated. 


W 


(2) 
(3) 
f* 

s 
kl 

(Q)  Tepid  bath. 

(2)  Warm  bath. 

(3)  Hot  bath. 
(4}  Hot  foot-bath. 

J  Hot  sitz-bath. 


Ordinary  full  bath. 

Affusions. 

Spray. 

Sitz-bath. 

Foot-bath. 

Cold  pack. 

Compresses. 

Douches. 


us; 
fa 


ill 


3) 

4' 

!5 
'6 

i 


Sea-bathing. 

Common  saline  bath.  Artificial  sea- 
water  made  by  dissolving  bay-salt 
in  water  (1  lb.  of  salt  in  30  gals,  of 
water). 

Carbonic  acid  and  saline. 

Acid  bath. 

Alkaline  bath. 

Sulphurated  bath. 

Mustard  bath. 

Fine  bath  (Fichtennadelbad). 


460  PHABMACOLOGY  AND   THEEAPBUTICS.      [sect.  I. 


II.  Vapoub. 


A.  Aqueous.  (1)  Simple.  {  SimplTvapour. 

(2)  Medicated.         Vinegar. 


B.  Volatilised  drugs,  e.g.  Calomel. 
III.  Am.    .        .    Turkish  bath. 

Cold  Bath. — The  effect  of  a  bath  depends  very  much  upon 
its  temperature. 

In  a  cold  bath,  the  temperature  of  the  water  is  at  or  below 
70°  F. 

The  first  effect  of  immersion  in  a  cold  bath  is  contraction  of 
the  vessels  of  the  skin,  accompanied  by  a  feeling  of  chilliness  and 
perhaps  even  of  shivering.  When  the  water  reaches  the  level  of 
the  chest,  the  respiratory  centre  becomes  reflexly  affected,  and  the 
respiration  becomes  gasping. 

After  a  few  minutes  the  cutaneous  vessels  begin  to  relax, 
and  the  blood  returning  to  the  surface  warms  it.  If  the  person 
now  comes  out  of  the  bath,  dries  quickly  and  rubs  vigorously, 
the  brisk  circulation  in  the  skin  gives  rise  to  a  pleasant  feeling  of 
warmth. 

The  feeling  of  warmth,  or  at  least  of  lessened  coldness,  will 
occur  even  if  the  bath  be  continued,  but  the  increased  circula- 
tion in  the  skin  allows  the  blood  to  be  much  more  rapidly  cooled, 
and  thus  the  temperature  of  the  body  is  much  more  quickly 
reduced.  When  the  blood  which  has  been  thus  cooled  in  the  skin 
returns  to  the  nerve-centres,  it  appears  to  stimulate  the  vaso- 
motor centre  and  produce  a  second  contraction  of  the  cutaneous 
vessels,  accompanied  by  a  greater  and  more  persistent  chilliness 
than  before. 

The  object  of  cold  baths  is  usually : — 1st,  either  to  have  a 
tonic  and  bracing  influence  on  the  body ;  or  2ndly,  to  abstract 
heat  from  the  body  in  cases  of  fever. 

As  a  tonic  the  cold  bath  is  often  very  efficacious,  and  not  only 
gives  a  feeling  of  strength  and  comfort,  but  tends  to  prevent  those 
who  take  it  from  catching  cold  so  readily  as  they  might  otherwise 
do.  The  vessels  of  the  skin  are,  as  has  already  been  mentioned, 
the  regulators  of  temperature,  and  contract  when  they  are  exposed 
to  cold :  thus  protecting  the  internal  organs  from  its  chilling 
influence.  But  Eosenthal  has  found  that  when  animals  are  kept 
for  a  long  time  in  a  warm  chamber,  their  vessels  lose  to  a  great 
extent  their  contractile  power,  and  thus  the  animal  becomes  much 
more  readily  chilled  when  exposed  to  cold.  Cold  baths,  by  train- 
ing, as  it  were,  the  cutaneous  vessels  to  contract,  tend  to  protect 
the  organism  from  the  injurious  effects  of  accidental  exposure. 
Besides  this,  however,  the  stimulation  to  the  circulation  which 
comes  as  an  after-effect,  tends  to  increase  both  the  tissue- 
change  in  the  body,  and  the  excretion  of  waste-substances  from  it. 
In  consequence  of  this,  cold  bathing  is  usually  followed  by  an 


ch&p.  xvii.]  METHODS  OF  ADMINISTEEING  DEUGS.         461 

increased  appetite,  so  that  the  most  favourable  conditions  for  the 
nutrition  of  the  body  are  supplied  by  cold  baths,  viz.  increased 
supply  of  food,  increased  tissue-change,  increased  excretion  of 
waste. 

Cold  baths  may  therefore  be  looked  upon  as  a  most  powerful 
tonic. 

But  -while  cold  baths  are  of  great  use  to  those  with  whom 
they  agree,  they  may  be  productive  of  great  harm  when 
they  are  indiscreetly  used.  As  a  general  rule  it  may  be  said 
that  when  they  cause  much  discomfort  during  the  bath,  and 
especially  if  they  cause  chilliness  afterwards,  not  removed  by 
brisk  friction,  they  do  harm  rather  than  good.  This  is  more 
especially  the  case  with  children  and  with  persons  of  feeble 
circulation. 

Eosenthal's  experiments,  already  quoted,  show  us  that  there 
is  a  scientific  basis  for  the  popular  notion  of  '  hardening '  by 
exposure.  But  this  process  may  be  carried  much  too  far,  and 
instead  of  getting  excitement  of  the  circulation  with  all  its  atten- 
dant advantages,  the  effect  of  the  bath  may  be  to  lower  the 
temperature,  depress  the  circulation,  and  greatly  injure  the 
nutrition.  The  risk  of  such  injury  may  be  much  diminished 
by  proper  attention  to  the  mode  of  giving  the  bath.  In  children 
or  delicate  persons  it  is  better,  as  a  rule,  to  avoid  immersing 
the  whole  body,  and  especially  to  avoid  putting  the  feet  in  cold 
water  at  the  same  time  as  the  body.  The  best  way  is  to  let  the 
person  sit  down  in  a  sitz-bath  with  the  feet  out  and  quickly  to 
dash  the  water  over  the  face,  chest,  back,  and  arms.  Then  a 
large  bath  sheet  is  to  be  thrown  around  the  body  so  as  completely 
to  envelope  it,  and  to  prevent  its  being  chilled  durirjg  the  process 
of  drying.  For  during  the  exposure  of  the  body  while  the  sur- 
face is  still  wet,  the  chilling  process  is  going  on  by  evaporation 
during  summer,  and  by  conduction  by  the  cold  air  in  winter. 
This  may  be  seen  markedly  in  persons  of  a  feeble  circulation 
who  rise  from  the  bath  with  a  feeling  of  slight  glow,  but  lose 
it  completely  and  begin  to  feel  chilly,  if  the  process  of  drying 
is  delayed.  Instead  of  a  bath  sheet,  a  dressing-gown  made  of 
towelling  may  be  used.  For  very  delicate  persons  the  water  of 
the  bath  should  be  rendered  tepid  by  the  addition  of  a  little  hot 
water,  and  the  face  may  not  be  sponged  until  after  the  rest  of 
the  body  has  been  dried  and  the  clothes  put  on.  In  winter  the 
temperature  of  the  room  must  not  be  too  low ;  it  is  best,  there- 
fore, for  delicate  persons  to  take  a  slightly  tepid  bath  before  a 
fire.  Tolerance  to  cold  is  moreover  often  established  by  gradu- 
ally reducing  the  temperature  of  the  water  in  successive  baths, 
care  being  taken  that  no  feeling  of  chilliness  supervenes. 

Sometimes  the  vigorous  use  of  a  flesh-brush  over  the  chest 
tends  to  assist  the  reaction,  and,  if  practicable,  a  short  though 
brisk  walk  is  advisable  just  after  the  bath.     It  must  not,  however, 


462  PHAEMACOLOGY  AND  THERAPEUTICS,     [sect.  I. 

be  long,  as  otherwise  exhaustion  might  set  in,  and  the  appetite 
instead  of  being  increased  would  be  diminished. 

Besides  the  tonic  action  which  cold  baths  exert  on  the  circu- 
lation and  on  the  body  generally,  they  appear  to  have  a  beneficial 
action  in  certain  disturbances  of  the  respiration. 

The  respiratory  centre  (p.  241)  may  be  strongly  affected  re- 
flexly  by  cold  applied  to  the  surface  of  the  chest,  as  is  shown  by 
the  gasping  breathing,  or  inspiratory  tetanus,  observed  when 
the  cold  water  reaches  the  chest  on  walking  slowly  into  it.  In 
children  suffering  from  broncho-pneumonia  the  severe  attacks 
of  dyspnoea  which  sometimes  occur  are  relieved  by  a  momentary 
immersion  in  water  at  a  temperature  of  60°  F. 

Cold  sponging,  as  recommended  by  Einger  in  his  excellent 
work  on  Therapeutics,  is  exceedingly  useful  in  laryngismus 
stridulus.  It  should  be  used  two  or  three  times  a  day  whatever 
be  the  weather.  If  the  child  be  hoarse,  it  should  not  be  allowed 
to  go  out,  but  if  there  is  no  hoarseness,  the  fresh  air,  even  if 
cold,  will  be  advantageous.  To  arrest  a  paroxysm  cold  water 
should  be  dashed  over  the  child. 

Einger  also  recommends  it  for  a  catch  in  the  breath  occur- 
ring in  young  children  during  the  night,  awaking  them  from 
Bleep. 

By  abstracting  heat,  cold  baths  are  useful  in  fever  in  several 
ways.  By  reducing  the  temperature  they  tend  to  lessen  the 
amount  of  tissue-change  which  is  already  excessive,  and  they 
thus  tend  to  husband  the  patient's  strength,  as  well  as  to  reduce 
the  alterations  of  the  tissues,  such  as  fatty  degeneration  of  the 
heart,  which  occur  in  consequence  of  a  high  temperature.  By 
lessening  the  temperalurj  also,  they  diminish  the  rapidity  of 
the  pulse,  and  by  thus  prolonging  the  cardiac  diastole  give  more 
opportunity  for  the  nutrition  of  the  muscular  walls  of  the  heart. 

A  high  temperature,  if  it  is  remittent,  is  better  supported 
than  a  lower  temperature  which  is  continuous,  and  therefore 
Liebermeister,  to  whom  we  in  a  great  measure  owe  the  recent 
introduction  of  cold  baths  as  a  therapeutic  measure,  uses  them 
with  the  object  of  increasing  and  prolonging  the  remissions 
in  temperature  which  usually  occur  spontaneously  in  febrile 
diseases — producing  a  condition  of  '  relative  apyrexia.' 

There  are  several  ways  of  employing  cold  baths  to  reduce 
temperature.  One  is  that  of  cold  affusion,  in  which  the  patient 
is  put  into  a  tub  and  four  or  five  gallons  of  cold  water  thrown 
over  him.  Another  is  to  place  the  patient  in  a  bath  at  about 
90°  F.  and  gradually  reduce  the  temperature,  by  the  addition 
of  cold  water,  to  80°,  70°,  or  even  60°  F.  The  patient  is  kept  in 
this  from  ten  to  twenty  minutes,  according  to  his  strength  and 
the  height  of  the  temperature.  As  the  temperature  continues  to 
fall  for  some  time  after  the  removal  of  the  patient  from  the 
water,  the  bath  should  not  be  continued  so  long  as  to  lower  it  to 


chap,  xvii.]   METHODS  OF  ADMINISTEEING  DEUGS.         4G3 

the  full  extent   required  while  he  is  in  the  bath,  lest  collapse 
occur  afterwards. 

Instead  of  the  bath  being  gradually  cooled  down,  it  may  be 
used  at  once  at  a  temperature  between  60°  and  90°  according 
to  the  condition  of  the  patient,  and  if  the  temperature  be  very 
high,  the  water  must  be  cooled  still  more  by  means  of  ice,  and 
its  action  aided  by  ice  given  by  the  mouth  and  rubbed  or  laid 
upon  the  surface  of  the  body.  This  treatment  may  be  adopted 
even  although  pneumonia  be  present,  if  the  patient's  life  is 
threatened  by  an  excessive  rise  in  temperature.  When  the  tem- 
perature rises  again  the  bath  should  be  repeated. 

Cold  Pack. — The  pack  is  a  less  efficient  means  of  abstract- 
ing heat  from  the  body,  but  it  is  useful  in  causing  a  different 
distribution  of  blood  in  the  body.  It  is  therefore  sometimes 
very  useful  in  lessening  delirium  and  producing  quietness  and 
sleep.  In  employing  it,  a  wet  sheet  is  wrung  well  out  of  cold 
water  and  wrapped  tightly  around  the  patient ;  over  this  are 
wrapped  one  to  three  blankets.  A  little  heat  is  abstracted  at 
first  by  the  cold  of  the  sheet,  but  this  is  very  little,  and  indeed 
it  is  asserted  by  some  that  cold  packs,  instead  of  abstracting  heat, 
prevent  its  escape.  The  skin  soon  becomes  warm,  and  frequently 
profuse  perspiration  is  produced.  A  certain  amount  of  heat  is 
lost,  though  perhaps  not  very  much,  by  the  evaporation  through 
the  blankets.  It  is  probable,  however,  that  the  production  of 
heat  is  to  a  certain  extent  lessened,  at  least  in  restless  patients, 
by  their  movements  being  mechanically  restrained  by  the  sheet, 
and  also  by  the  blood  being  withdrawn  from  the  internal  organs 
and  muscles  to  the  skin.  As  the  pack  restrains  the  movements 
in  a  most  complete  way  and  with  a  force  against  which  it  is  in 
vain  to  struggle,  while  at  the  same  time  it  is  comfortable  and 
soothing,  it  frequently  induces  sleep  when  narcotics  have  been 
useless. 

Cold  sponging  is  sometimes  a  very  useful  means  of  abstract- 
ing heat  in  cases  of  fever,  where  the  patient  is  weak  and  the 
''  temperature,  though  perhaps  not  going  above  104°  or  105°  F., 
tends  rapidly  to  regain  its  former  height  after  cooling,  and  where 
it  seems  inadvisable  to  subject  the  patient  to  the  frequent  move- 
ment in  and  out  of  bed  required  in  cold  baths.  The  loss  of 
heat  consequent  on  cold  sponging  is  due  partly  to  the  applica- 
tion of  the  cold  water,  but  it  is  due  chiefly  to  the  evaporation 
which  takes  place  from  the  surface  of  the  body.  Consequently 
sponging  with  tepid  or  even  with  hot  water  will  also  reduce 
temperature. 

Cold   Douches.' — In  this  form  of  bath  a  stream  of  water 
having  considerable  force  is  directed  against  a  part  of  the  body. 

1  For  a  short  and  concise  account  of  the  various  appliances  used  in  hydro- 
therapeutics,  vide  Paper  on  '  Eational  Hydro-therapeutics,'  by  G.  h.  Pardington, 
M.D.,  Practitioner,  Jan.  1884. 


464  PHABMACOLOGY   AND   THEEAPEUTICS.      [sect.  I. 

The  stream  may  either  be  unbroken,  and  to  this  the  name  douche 
is  usually  restricted,  or  it  may  be  broken  up  by  delivery  through 
a  rose  into  a  number  of  minute  streams,  so  as  to  form  a  shower 
or  rain  bath.  If  the  douche  is  large  (one  or  two  inches  in  dia- 
meter) it  causes  a  great  amount  of  shock  and  sometimes  does 
much  harm.  Usually  a  stream  of  a  quarter  of  an  inch  in 
diameter  is  quite  sufficient  for  all  purposes.  Douches  are  chiefly 
applied  to  the  spine,  spleen,  liver,  joints,  anus,  and  vagina. 
The  spinal  douche  usually  consists  of  a  single  stream,  and  may 
either  be  allowed  to  fall  vertically  upon  the  spine,  the  body  being 
more  or  less  inclined,  or  it  may  be  delivered  from  a  horizontal 
pipe  with  the  body  in  an  upright  position.  It  is  useful  as  a 
stimulant  in  melancholia,  cerebral  ansBmia,  and  general  debility. 
To  avoid  too  great  depression  it  is  better  to  apply  hot  and  cold 
water  alternately,  unless  it  is  used  immediately  after  a  hot 
application  such  as  a  spinal  pack.  Douches  to  the  head  are 
useful  in  alcoholic  coma.  Douches  to  the  liver  and  spleen  have 
been  found  useful  in  chronic  congestion  and  enlargement  of  these 
organs.  The  douche  applied  to  stiffened  joints  appears  sometimes 
to  be  of  considerable  service. 

The  ascending  douche  is  usually  delivered  through  a  rose, 
so  as  to  form  a  shower,  and  it  is  directed  against  the  perinseum 
while  the  patient  is  in  a  sitting  position.  It  is  useful  in  haemor- 
rhoids and  pruritus  ani,  and  when  used  at  a  regular  hour  daily, 
first  tepid  and  then  cold,  it  is  useful  in  constipation. 

The  vaginal  douche  is  used"  by  the  patient  lying  on  her  back 
with  her  knees  drawn  up  and  with  the  pipe  in  the  vagina.  It  is 
useful  in  vaginal  leucorrhcea  and  cervical  catarrh,  and  in  chronic 
subinvolution  and  hyperplasia  the  hot  douche  at  105°,  F.  to  11 0°  F. 
twice  a  day  for  several  minutes  is  of  much  service. 

Local  Application  of  Cold. 

Sitz-bath. — When  a  person  sits  down  in  a  cold  sitz-bath,  or 
when  he  sits  down  in  an  empty  bath  and  cold  water  is  poured 
into  it,  until  it  covers  the  hips,  the  vessels  of  the  parts  exposed 
to  the  cold  contract,  and  the  blood  is  consequently  driven  into 
other  parts  of  the  body.  It  would  appear,  however,  that  not  only 
do  the  vessels  of  the  skin  contract,  but  also  that  contraction  of 
the  intestinal  vessels  occurs  reflexly  through  the  splanchnic 
nerves :  so  that  in  consequence  there  is  a  feeling  of  warmth  and 
fulness  in  the  head,  an  increase  in  the  volume  of  the  arm,  as 
measured  by  the  plethysmograph,  and  a  rise  of  temperature  in 
the  axilla. 

A  cold  sitz-bath,  when  applied  only  from  one  to  five 
minutes  and  followed  by  a  brisk  rubbing,  tends  to  increase  the 
amount  of  blood  in  the  abdominal  organs,  to  quicken  the  circu- 

1  Pardington,  op.  cit. 


,«hap.  xvii.]   METHODS  OP  ADMINISTERING  DRUGS.       '  465 

lation  in  the  liver  and  spleen,  and  to  augment  the  activity  of  the 
movements  of  the  intestine  and  bladder.  It  may  therefore  be 
used  with  advantage  in  constipation  and  in  disorders  of  the 
bladder  depending  on  weakness,  such  as  either  difficulty  in  expel- 
ling the  urine  or  difficulty  in  retaining  it. 

In  pregnancy,  cold  sitz-baths  are  sometimes  useful,  giving  a 
feeling  of  comfort  and  strength,  and  lessening  the  sensations  of 
dragging  in  the  abdomen. 

Where  any  tendency  to  premature  expulsion  of  the  foetus 
exists  they'  should  be  avoided,  as  the  increased  circulation  which 
.  they  cause  in  the  pelvic  organs  might  lead  to  abortion. 

When  cold  sitz-baths  are  continued  for  a  long  time,  as  from 
ten  to  thirty  minutes,  at  a  temperature  from  8°  to  15°  C,  the 
•  contraction  of  the  abdominal  vessels  appears  to  be  more  perma- 
nent, and  thus  they  may  be  employed  for  the  purpose  of  lessen- 
.  ing  congestion  in  the  intestine,  and  may  be  used  with  advantage 
in  cases  of  obstinate  diarrhoea  and  congestive  enlargement  of  the 
liver  and  spleen. 

The  effect  of  a  prolonged  sitz-bath  in  lessening  congestion  of 
the  abdominal  organs  is  greatly  increased  if  it  be  preceded  by  a 
wash-down,  with  brisk  friction,  so  that  the  blood  maybe  attracted 
to  the  other  parts  of  the  surface  as  well  as  driven  out  of  the 
abdomen  by  contraction  of  the  intestinal' vessels. 

Cold  Foot-bath. — Coldness  of  the  feet  not  only  causes  dis- 
comfort to  the  person,  but  if  it  occurs  at  night,  it  may  prevent 
sleep.  Putting  them  in  hot  water  may  warm  them  temporarily, 
but  will  not  do  so  permanently,  and  a  much  better  way  is  to  put 
them  in  cold  water,  rub  them  briskly  while  in  it,  and  then  dry 
them  thoroughly  with  a  soft  towel,  giving  them  a  rub  afterwards 
with  a  rough  bath-towel. 

Cold  foot-baths  are  to  be  avoided  during  the  menstrual  period, 
as  they  have  a  very  great  power  indeed  to  check  menstruation 
and  frequently  bring  on  amenorrhcea.  Their  power  to  check 
the  menstrual  flow  is  popularly  known,  and  sometimes  great 
harm  is  occasioned  by  yQung  women  using  them  to  check  men- 
struation, in  order  that  'they  may  be  able  to  attend  some  party 
of  pleasure;  .' 

Cold  Compresses.  ^-By  the  application  of  cold  over  the 
course  of  an  artery,  it  can  be  made  to  contract,  and  the  amount 
pf  blood  to  the  district  which  it  supplies  may  consequently  be 
diminished.  This  is  shown  by  the  accompanying  curve  taken  by 
Winternitz  from  the  radial  artery  (Fig.  156).  ' 

The  first  half  of  the  curve  (^4)  was  taken  before  anything- 
had  been  applied  to  the  arm.  The  instrument  being  allowed  to 
remain,  ice  was  next  applied  to  the  arm,  and  the  second  half 
of  the  curve  (B).  shows  the  contraction  which  it  had  produced 
in  the  artery. 

When  the  cold  application  fs-  allowed  to  remain  for  a  while, 

H  H 


466  PHAKMACOLOGY  AND  THEKAPEUTICS.      [sect,  i, 

it  gradually  acquires  the  temperature  of  the  hody,  and  if  evapo- 
ration be  prevented,  it  comes  to  have  the  same  effect  as  warmth, 


Fio.156. — Tracings  from  the  radial  artery  at  the  wrist :  A  before  and  B  after  the  application  of  a 
cloth  dipped  in  cola  water  round  the  arm.    (After  Winternitz.) 

but  if  constantly  renewed,  the  contraction  of  the  artery  may  be 
kept  up.  A  similar  contraction  to  that  just  noticed  in  the  ves- 
sels of  the  arm  may  be  produced  in  the  vessels  of  the  head  by 
cold  applications  around  the  neck.  This  is  shown  by  thf  fall  of 
temperature  in  the  auditory  meatus.  Cold  may  be  applied  to 
the  neck  either  by  a  bag  containing  ice,  or  by  an  india-rubber 
bag,  or  coils  of  tubing,  through  which  cold  water  may  be  kept 
constantly  flowing. 

As  a  very  large  proportion  of  the  whole  blood  in  the  body 
flows  through  the  carotids,  the  application  of  cold  to  the  neck 
may  act  as  a  general  antipyretic.  The  accurate  application  of 
ice-bags  to  the  neck  so  as  to  cover  the  supra-clavicular  regions 
also,  and  thus  to  cool  the  blood  in  the  subclavians,  has  been 
recommended  in  fever,  to  reduce  the  temperature  generally.  In 
tonsillitis  cold  to  the  neck  is  useful,  for  its  local  action.1 

Cold  to  the  head  is  frequently  applied  in  delirium,  menin- 
gitis, and  severe  cephalalgia.  It  may  be  applied  either  by  a  bag 
containing  cold  water  or  ice,  or  still  more  conveniently  by  a  cap 
consisting  of  india-rubber  tubing  through  which  water  constantly 
flows. 

A  continuous  stream  of  water  through  an  ordinary  water-bed 
reduces  the  temperature  slightly  and  thus  relieves  the  symptoms 
in  prolonged  fever. 

Warm  Baths. 

Tepid  Baths.— These  baths  range  from  85°  P.  to  65°  F.  or 
29"49  C.  to  18'3°  C.  They  are  chiefly  used  for  cleansing  pur- 
poses, and  at  the  lower  margin  of  about  65°  P.  they  may  be  used 
for  a  somewhat  tonic  action  in  persons  of  feeble  circulation 
(p.  461). 

Warm  Baths. ^These  range  from  97°  F.  to  85°  F.,  or 
36"1°  C.  to  29"4°  C.  When  the  water  is  above  these  tempera- 
tures it  forms  a  hot  bath.  The  warm  water  softens  the  epi- 
dermis, and  is  thus  of  much  use  in  chronic  skin-diseases.  It 
dilates  the  vessels  of  the  surface  of  the  body,  and  thus  tends  to 

1  Stephan,  Allg.  med.  Central-Ztg.,  No.  87, 1884. 


chap.  xvii.].  METHODS  OP  ADMINISTEE1NG  DEUGS.         4G7 

lessen  any  internal  congestion.  At  the  same  time  it  tends  to 
induce  perspiration.  On  this  account  the  warm  bath  is  useful 
in  lessening  pain  depending  on  congestion  of  internal  organs 
and  in  preventing  congestion  from  going  on  to  inflammation. 
It  is  therefore  very  serviceable  when  there  is  a  threatening  of 
bronchitis,  or  gastro-intestinal  catarrh,  colic,  &c.  It  tends  to 
reduce  the  temperature  both  by  dilating  the  peripheral  vessels 
and  inducing  perspiration,  and  is  therefore  useful  in  febrile 
conditions.  By  withdrawing  blood  from  the  brain  it  tends  to 
induce  sleep. 

Hot  Baths.— These  range  from  97°  F.,  or  36-1°  C,  upwards. 
A  much  higher  temperature  than  can  be  endured  at  first  can  be 
borne  if  the  temperature  be  gradually  raised  by  the  gradual 
addition  of  hot  water  to  the  bath  while  the  body  is  immersed, 
and  the  bath  may  thus  be  raised  as  high  as  110°  P.  Hot  baths 
not  only  prevent  loss  of  heat  from  the  surface,  but  if  above  the 
temperature  of  the  blood,  actually  impart  heat  to  the  body. 
The  consequence  of  this  is  that  the.  temperature  of  the  body  rises, 
very  rapidly,  and  therefore  the  respiration  and  pulse  both  become1 
very  quick.  The  peripheral  vessels  become  still  more  dilated 
than  in  the  warm  bath,  and  the  blood  pours  so  rapidly  through 
them  that,  in  spite  of  the  quick  and  powerful  action  of  the  heart, 
there  may  be  a  tendency  to  syncope  when  the  head  is  raised. 
After  remaining  in  such  a  bath  from  ten  to  twenty  minutes,  the 
patient  must  be  carefully  lifted  out  so  as  to  avoid)  any  risk  of 
syncope,  and  should  be  wrapped  in  warm,  dry  blankets.  The 
hot  bath  is  a  still  more  powerful  agent  than  the  warm,  bath  in 
producing  sweating,  and  is  employed  in  cases  of  dropsy. 

Hot  Foot-bath. — A  hot  foot-bath  has  a  general  effect  that 
can  hardly  be  explained  by  the  simple  dilatation  of  the  vessels  in 
the  feet  and  consequent  derivation  of  blood  to  them.  It  seems, 
indeed,  to  exert  some  reflex  action  on  other  parts  of  the  body 
and  causes  a  general  feeling  of  warmth.  It  is  very  useful  as  an 
adjunct  to  vascular  stimulants  in  relieving  congestion  and  pre- 
venting inflammation,  as  in  threatened  catarrh,  bronchitis,  &c. 
When  the  feet  are  put  into  a  hot.  bath,  we  find  that  the  femoral 
arteries  become  much  dilated  and,  pulsate  much  more  vigor- 
ously than  they  did  before.  It  is  not  improbable  that  this 
dilatation  extends  beyond  the  femoral  to  the  iliac  arteries,  and 
that  the  supply  of  blood  is  increased  in  the  pelvic  organs  as  well 
as  in  the  feet.-  In  cases  of  amenorrhcea,  especially  where  it  has 
been  brought  on  by  exposure  to  cold,  hot  foot-baths  tend  to 
restore  the  menstrual  flow.  They  should  be  begun  four  or  five 
nights  before  the  period  is  expected,  and  continued  during  the 
time  it  ought  to  last.  Their  efficacy  may  be  increased  by  the 
addition  of  a  little  mustard. 

Hot  Sitz-baths,— These  have  a  still  greater  tendency  than' 
hot  foot-baths  to  increase  the  circulation  in  the  pelvic  organs,- 

H  H  2 


468  PHARMACOLOGY  AND  THEEAPEUTICS.     [sect.  i. 

and  they  may  be  used   either   alone  or  with  mustard  in  the 
manner  just  described  in  cases  of  amenorrhcea. 

Poultices. — Poultices  are  simply  a  means  of  applying  heat 
and  moisture  to  a  limited  portion  of  the  surface  of  the  body. 
Thek  mode  of  action  has  already  been  discussed  (p.  342).  They 
consist  essentially  of  some  farinaceous  substance  made  into  a 
paste  with  hot  water,  and  the  most  common  substances  used  as 
bases  are  linseed  meal,  bread,  bran,  oatmeal  or  starch.  In  all 
cases,  not  only  should  the  water  with  which  the  poultice  is  made 
be  perfectly  boiling,  but  the  bowl  in  which  it  is  to  be  mixed,  the 
spoon  with  which  it  is  to  be  stirred,  and  the  tow  or  flannel  in 
which  it  is  to  be  laid,  should  all  be  as  hot  as  possible.  By  adding 
the  linseed  meal  to  the  water  and  constantly  stirring,  there  is 
less  chance  of  the  poultice  being  knotty  than  if  the  water  were 
added  to  the  meal.  If  the  poultice  is  intended  to  be  applied  to 
a  wound,  sore,  boil,  or  carbuncle,  it  should  be  spread  upon  a 
piece  of  flannel  or  tow  and  applied  directly  to  the  skin,  because 
the  softening  action  of  the  water  and  oil  it  contains  on  the 
dermal  tissues  is  required  as  well  as  the  warmth.     But  where 


Fig.  157.— The  upper  figure  represents  the  bag  empty ;  the  lower  one  the  bag  filled  and  sewn  up. 

the  poultice  is  used  to  relieve  pain,  congestion,  or  inflammation* 
of  the  internal  organs,  as  in  pleurisy,  pneumonia,  or  colic— intes- 
tinal, biliary,  or  renal,  it  ought  not  to  be  applied  directly  to  the- 
skin,  but  should  be  separated  from  it  by  something  which  con- 
ducts heat  badly,  such  as  flannel.  The  reason  for  this  is  that 
it  is  impossible  to  apply  a  yery  hot  poultice  directly  to  the  skin 
on  account  of  the  pain  it  causes,  whereas. if  a  substance  which, 
conducts  heat  badly  be  interposed,  the  poultice  can  be  applied, 
boiling  hot,  the  heat  gradually  passes  through  without  becoming, 
inconveniently  great,  .and  is  retained  for  a  much  longer  time,      f 


chap,  xvu.]  METHODS  OF  ADMINISTERING  DEUGS.         469 

In  order  to  accomplish  this,  a  flannel  bag  should  be  prepared, 
a  convenient  size  being  twelve  inches  by  eight  -t  this  should  be 
closed  at  three  edges  and  open  at  the  fourth;  one  side  of  it 
should  be  about  one  inch  or  one  inch  and  a  half  longer  than  the 
other,  as  represented  in  the  diagram  (Fig.  157>,  and  it  is  con- 
venient also  to  have  four  tapes  attached  at  the  points  which  form 
the  corners  when  the  bag  is  closed,  in-  order  to  keep  the  poultice 
in  position.  Besides  this,  another  strip  of  flannel  should  be 
prepared  of  the  same  breadth  as  the  length  of  the  bag,  and  long 
enough  to  wrap  round  it  once  or  oftener.  Crushed  linseed, 
bowl,  and  spoon  should  then  be  got  together,  and  the  spoon  and 
bowl  thoroughly  heated  by  means  of  boiling  water ;  the  poultice 
should  then  be  made  with  perfectly  boiling  water,  and  rather 
soft.  As  soon  as  it  is  ready  it  should  be  poured  into  the  bag, 
previously  warmed  by  holding  it  before  the  fire ;  the  flap  which 
is  formed  by  the  longest  side  of  the  bag  should  now  be  turned 
down  and  fastened  in  its  place  by  a- few  long  stitches  with  a 
needle  and  thread ;  it  should  then  be  quickly  wrapped  in  the 
strip  of  flannel  (also  previously  warmed),  and  fastened  in  situ,  if 
necessary,  by  means  of  the  tapea.  It  may  be  covered  outside 
with  a  sheet  of  cotton  wool. 


Medicated  Baths. 

The  addition  of  stimulating  substances,  such  as  salt,  to  the 
water,  increases  the  stimulation  to  the  skin,  and  the  amount  of 
after-reaction. 

In  sea-bathing  the  stimulating  effect  of  the  salt  is  further 
increased  by  the  mechanical  shock  of  the  waves,  and  sometimes 
also  by  the  friction  of  the  fine  sand  of  the  beach.  Sea-bathing 
alfio  differs  from  baths  in  the  fact  that  muscular  exertion  is 
combined  with  it,  either  in  simply  moving  about  and  retaining 
one's  footing,  or  still  more  in  swimming. 

Carbonic  Acid  Bath. — This  is  a  saline  bath',  containing  two 
to  three  per  cent,  of  chloride  of  sodium,  and  not  more  than  one 
per  cent,  of  chloride  of  calcium,  with  varying  proportions  of 
free  .carbonic  acid  up  to  3  grammes  in  the  litre.  It  has  been 
recommended,  for  chronic  heart-disease,  both  functional,  and 
organic,  and  is  said  to  act  as  a  cardiac  tonic.1 

Acid  Bath. — This  bath  is  made  by  mixing  eight,  ounces  of 
nitro-hydrochloric  acid  with  a  gallon  of  water  at  blood  heat 
(98°  F.)  This  is  sometimes  used  as  a  foot-bath,  but  it  is  better 
applied  as  a  compress.  A  flannel  roller  about  a  foot  wide,  and 
long  enough  to  go  twice  round  the  body,  should  be  soaked  in  the 
acidulated  water,  wrung  thoroughly  out,  and  rolled  round  the 
region  of  the  liver ;  a  piece  of  oil-silk,  large  enough  to  cover  it 

1  Aug.  Schott,  Berl.  kUn.  Wochensch.,  No.  33, 1885. 


470        .    PHAEMACOLOGY  AND  THEEAPEUT1CS.     [sect.  i. 

completely  and  leave  a  little  margin  over,  should  then  be  put 
over  it.  It  may  be  worn  for  several  days,  being  renewed  every 
night,  and  it  is  chiefly  useful  in  chronic  disease  of  the  liver.1 

Alkaline  Bath. — This  is  made  by  adding  crystallised  car- 
bonate of  sodium  to  water  in  the  proportion  of  about  one  drachm 
to  each  gallon.     It  is  chiefly  used  in  chronic  skin-diseases. 

Sulphurated  Bath. — This  may  be  made  by  dissolving  sul- 
phurated potash  in  water,  about  half  a  drachm  to  the  gallon,  or, 
in  imitation  of  Barege  waters,  may  be  made  by  mixing  sodium 
sulphide,  sodium  carbonate,  and  sodium  chloride  in  the  propor- 
tion of  twenty  grains  of  each  to  the  gallon.  These  are  chiefly 
useful  in  chronic  scaly  skin-diseases,  and  in  rheumatism.  Much 
more  benefit  is  usually  obtained  by  a  visit  to  sulphur  springs, 
such  as  those  of  Aix-les-Bains,  Aix-la-Chapelle,  Barege,  Har- 
rogate, or  Strathpeffer,  than  from  the  use  of  sulphur  baths  at 
home. 

Mustard  Bath. — This  is  made  by  adding  mustard  to  water 
in  the  proportion  of  about  half  a  drachm  to  a  drachm  and  a 
quarter  per  gallon.  It  is  a  powerful  stimulant,  but  must  not  be 
applied  too  long.  It  must  be  remembered  that,  while  slight 
stimuli  to  the  skin  increase  the  frequency  and  energy  of  the 
cardiac  contractions  and  the  rapidity  of  the  circulation,  and 
raise  the  temperature,  severe  irritation  of  the  skin  lessens  the 
frequency  of  the  pulse  and  the  rapidity  of  the  circulation,  dilates 
the  vessels  and  lowers  the  temperature.2  The  patient  should 
never  be  allowed  to  remain  more  than  ten  minutes  in  the  bath, 
and  should  be  at  once  removed  as  soon  as  he  feels  either 
burning  of  the  skin  or  icy  coldness.  Mustard  baths  are  generally 
used  in  order  to  quicken  the  appearance  of  the  eruption  in  the 
exanthemata. 

Pine  Bath. — This  is  made  by  adding  a  decoction  of  the  shoots 
of  pines  to  water,  but  it  is  more  convenient  to  use  the  oleum 
pini  sylvestris  in  the  proportion  of  one  minim  to  the  gallon. 
These  baths  are  used  in  rheumatism,  gout,  paralysis,  scrofula, 
and  skin-diseases. 

Vapour  Baths. 

In  these  the  body  is  exposed  to  steam  instead  of  being  im- 
mersed in  hot  water.  The  effect  is  much  the  same  as  that  of 
the  hot  bath.  The  so-called  Bussian  bath  consists  of  a  room 
filled  with  steam  and  provided  with  benches  at  various  levels. 
The  higher  the  level  the  greater  is  the  heat,  and  usually,  except- 
ing on  the  lower  benches,  it  is  only  possible  to  breathe  with  any 

1  Squire's  Companion  to  the  British  Pharmacopoeia,  13th  ed. 

2  Naumann,  Prager  med.  Jahrschr.,  1863,  i.  p.  1,  and  1867,  i.  p.  133 ;  Heiden- 
hain,  Pfluger's  Archiv,  Bd.  iii.  p.  604,  and  Bd.  v.  p.  77;  Biegel,  Pflilger's  Archiv, 
Bd.  iv.  p.  350. 


chap,  xvii.]   METHODS  OF  ADMINISTEKING  DEUGB.         471 

comfort  by  holding  a  sponge  dipped  in  cold  water  before  the  nose. 
From  this  room  the  bather  goes  to  another  where  he  is  drenched 
with  cold  water  by  a  douche,  and  is  then  quickly  dried,  and 
allowed  to  rest  for  some  time  before  dressing.  These  baths  are 
chiefly  used  in  chronic  rheumatism.  They  are  liable  to  the  same 
objections  as  the  hot  bath,  and  to  a  still  greater  extent,  for  the 
inhalation  of  the  hot  steam  produces  greater  difficulty  of  breath- 
ing, greater  acceleration  of  the  pulse,  and  greater  tendency  to 
syncope.  Vapour  baths,  in  which  the  body  only  is  exposed  to 
the  action  of  the  steam,  and  the  head  is  left  out  are  much  better. 
They  are  usually  applied  either  by  means  of  a  kind  of  box  in 
which  the  body  of  the  bather  is  enclosed  while  the  head  remains 
outside,  or  else  by  introducing  steam  under  the  bedclothes,  which 
are  supported  by  a  kind  of  cradle,  while  the  bedclothes  are  tucked 
tightly  round  the  patient's  neck  to  prevent  the  escape  of  the 
.  vapour.  The  latter  plan  is  very  useful  in  cases  of  dropsy  and 
uraemia,  as  it  induces  a  copious  perspiration  and  does  not  ex- 
haust the  patient  nearly  so  much  as  a  hot  bath.  In  cases  of 
acute  rheumatism  a  vapour  bath  of  vinegar  has  been  recom- 
mended. 

Calomel  Fumigation. — This  is  used  as  a  means  of  inducing 
the  general  action  of  mercury.  The  patient  is  seated. naked  on 
a  wickerwork  chair,  underneath  which  is  put  a  stand  holding  a 
shallow  cup  containing  20  to  30  grains  of  calomel.  The  calomel 
is  volatilised  by  means  of  a  spirit  lamp,  and  a  blanket  or  water- 
proof sheet  being  thrown  round  the  patient  so  as  completely  to 
envelope  himself,  his  chair,  and  the  fumigating  apparatus,  the 
calomel  fumes  become  condensed  upon  his  skin  in  a  fine  state  of 
division.  It  is  absorbed  with  considerable  rapidity,  probably  from 
becoming  mixed  with  the  sebaceous  secretion  from  the  skin,  and 
the  general  action  of  mercury  is  quickly  induced. 


Air  Baths. 

Turkish  Bath. — The  Turkish  bath  usually  consists  of  three 
rooms,  although  frequently  there  are  more.  The  temperature  of 
the  first,  or  dressing-room,  is  moderate,  that  of  the  second  is 
higher,  and  that  of  the,  third  is  higher  still.  In  the  first  room, 
the  bather,  after  undressing,  winds  one  towel  round  his  loins, 
and  a  second  round  his  head  in  the  form  of  a  turban.  If  he  has 
any  tendency  to  cerebral  congestion,  the  second  one  may  be  wet- 
He  then  passes  into  the  second  room,  where  he  usually  waits  a 
Bhort  time  before  passing  into  the  third  room.  Some  people, 
however,  go  directly  into  the  third  room.  In  both  the  second 
and  third  rooms  the  bathers  partake  freely  of  cold  water.  A  few 
minutes'  stay  in  the  warmest  room  is  usually  sufficient  to  make 
the  bather  perspire  freely,  and  he  then  returns  to  the  second  or 


■172  PHAEMACOLOGY   AND  THERAPEUTICS,     [sect.ij 

cooler  room,  where  he  may  remain  half  an  hour  or  more,  accord- 
ing to  circumstances.  He  may  then  be  shampooed,  the  surface 
of  the  body  being  rubbed,  the  muscles  kneaded,  and  the  smaller 
joints  extended.  He  is  next  washed  with  a  lather  of  soap,  and 
sluiced  with  basins  of  tepid  or  warm  water.  For  some  people  it 
is  most  agreeable  after  this  to  be  simply  wrapped  in  warm  towels 
and  allowed  to  repose  in  the  dressing-room.  Others  prefer  to 
finish  up  with  a  cold  douche  before  proceeding  to  the  dressing- 
room.  Here  they  remain  resting  for  a  considerable  time  before  they 
again  dress.  Turkish  baths  are  exceedingly  useful  in  chronic 
rheumatism  and  gout,  and  in  persons  suffering  from  the  effects 
of  malaria.  The  chief  objection  to  the  Turkish  bath  is  the 
length  of  time  that  it  takes.  In  some  persons  it  has  a  weakening 
effect,  but  in  many  others  it  has  none.  The  chief  precautions 
are  not  to  stay  too  long  in  the  hot  room,  and  to  leave  it  at  once 
if  giddiness  or  a  feeling  of  tightness  in  the  head  comes  on.  If 
the  skin  perspires  with  difficulty,  the  necessity  for  caution  in 
entering  the  hot  room  becomes  still  greater,  and  it  is  advisable 
rather  to  spend  a  longer  time  in  the  second  room,  and  drink 
freely  of  water  before  entering  the  hotter  room,  if,  indeed,  this 
be  entered  at  all  on  the  first  few  times  of  taking  the  bath.  Per- 
sons who  suffer  from  a  feeling  of  exhaustion  after  a  Turkish  bath 
should  not  take  a  cold  douche  nor  a  plunge  into  water  after  per- 
spiring, but  should  simply  allow  themselves  to  cool  very  gradually, 
and  should  take  some  stimulant,  such  as  coffee  or  beef-tea,  while 
doing  so.  Persons  who  suffer  from  malaria  also  should  spend  a 
good  while  in  the  second  room  before  attempting  to  enter  the 
third,  as  the  sudden  application  of  heat  to  the  skin  and  lungs 
seems  to  irritate  the  vaso-motor  centres  and  cause  chilliness,  or 
even  shivering^ 

Friction  and  Inunction. 

Friction  of  the  skin  causes  first  a  temporary  contraction  ot 
the  vessels,  followed  by  a  more  or  less  permanent  dilatation,  so 
that  the  skin  continues  red  for  a  length  of  time  after  the  irrita- 
tion has  ceased.  This  redness  is  accompanied  by  a  warm  glow 
from  the  increased  circulation  in  the  skin,  and  friction  is  there- 
fore useful  as  an  adjunct  to  cold  baths.  Besides  this,  friction 
along  the  extremities  in  an  upward  direction  tends  to  aid  the 
flow  of  lymph,  and  thus  to  remove  the  products  of  waste  from 
the  muscles. 

The  fascia  covering  a  muscle  forms  a  pumping  apparatus  for 
removing  waste-products  from  the  muscles  (Fig.  158) .  It  consists 
of  two  layers,  a  b  and  ef,  and  between  these  are  lymph  spaces,  some 
of  which,  x,  are  seen  in  transverse,  and  others,  which  appear  black 
from  the  injection  with  which  they  are  filled,  are  seen  in  lon- 
gitudinal section.     Each  time  the  muscle  contracts,  it  becomes- 


chap,  xvii.]  METHODS  OF  ADMINISTEEING  DKUGS.         473 

thicker,  presses  the  two  layers  of  fascia  together,  and  drives  the 
lymph  from  the  spaces  onwards  into  the  lymphatics.  Each  time 
the  muscle  relaxes,  the  layers  of  fascia  tend  to  separate,  and 


Pig.  158. — Injected  lymph-spaces  from  the  fascia  lata  of  a  dog.    The  injected  lymph-spaces  are 
black  in  the  figure.    (After  Ludwig  and  Schweigger-Seidel.) 

lymph  from  the  muscle,  carrying  with  it  the  waste-products, 
fills  the  spaces  between  the  layers.  The  action  of  the  muscle 
itself  thus  tends  to  remove  the  waste-products  which  give  rise  to 
fatigue  (vide  Massage,  p.  131),  but  after  over-exertion  their 
removal  may  be  greatly  aided  by  gentle  but  firm  upward  friction, 
which  will  have  a  similar  action  on  the  fascia  to  the  alternate 
compression  and  separation  of  its  two  layers,  caused  by  the  action 
of  the  muscle  itself. 

Gentle  firm  friction  thus  lessens  or  may  even  remove  en- 
tirely the  feeling  of  fatigue  and  weight  in  the  extremities  after 
exertion.  When  applied  to  the  nape  of  the  neck,  or  along  the 
spine,  it  is  sometimes  useful  in  headache,  in  nervous  irritability, 
and  in  sleeplessness. 

When  applied  between  the  shoulders  in  persons  suffering 
from  flatulence,  it  appears  to  aid  the  expulsion  of  gas  from  the 
stomach. 

The  effect  of  friction  as  a  counter-irritant  is  greatly  in- 
creased by  the  use  of  stimulating  liniments.  These  are  applied 
by  pouring  a  little  into  the  hollow  of  the  hand  and  then  rubbing 
it  over  the  surface  of  the  body,  or  else  by  soaking  a  piece  of 
flannel  in  the  liniment  and  rubbing  the  skin  with  it.  Linimen- 
tum  ammonias  applied  thus  to  the  chest  is  useful  in  the  bron- 
chitis of  children ;  arid  linimentum  camphors  compositum,  B.P., 
or  linimentum  terebinthinse  may  be  used  in  a  similar  way  for 
adults.  .  .. 

In  chronic  inflammation  of  joints,  liniments  may  be  applied 
in  a  similar  way.  Sometimes  it  may  be  advisable  also  in  such 
cases  to  swathe  the  joint  in  a  piece  of  flannel  or  lint,  soaked  in 
the  liniment  so  as  to  procure  more  continuous  application. 

Inunction. — Metallic  salts  are  very  slightly,  if  at  all,  ab- 
sorbed from  -the  skin  when  applied  to  it  in  watery  solution,  and 
wiped  off  without  being  allowed  to  dry.     But  when  applied  in 


'474  PHARMACOLOGY  AND  THERAPEUTICS,     [sect.  i. 

the  form  of  ointments  a  considerable  absorption  takes  place, 
especially  if  lanolin  be  used  as  a  basis.  Advantage  is  taken  of 
this,  in  order  to  obtain  the  general  action  .of  mercury  without  its 
local  effect  on  the  intestinal  canal.  For  this  purpose  mercurial 
ointment  is  rubbed  on  the  skin,  and  especially  on  those  parts 
where  the  epidermis  is  thin,  as  under  the  axillae  and  on  the 
inside  of  the  thighs. 

Absorption  also  takes  place,  however,  through  the  skin  of  the 
hands,  and  if  the  ointment  is  not  rubbed  on  by  the  patient  him- 
self, but  by  another  person,  in  whom  the  action  of  mercury  is 
undesirable,  it  has  been  recommended  that  the  latter  should 
cover  his  hands  with  a  piece  of  bladder  thoroughly  well  oiled  in 
order  to  prevent  absorption. 

In  children,  instead  of  applying  the  mercurial  ointment  by 
inunction,  it  is  customary  to  smear  the  ointment  on  a  piece  of 
flannel,  and  to  keep  it  applied  to  the  abdomen  of  the  child  by 
means  of  a  bandage. 

Endermic  Application  of  Drugs. 

This  method  consists  in  applying  the  drug  to  the  skin  pre- 
viously denuded  of  its  epidermis  or  epithelial  layer  by  blistering. 
The  drug  may  be  applied  in  the  form  of  powder,  solution,  oint- 
ment, liniment,  or  plaster,  but  most -frequently  in  the  form  of 
powder.  The  drug  is  more  readily  absorbed  when  applied  in 
this  manner  than  when  applied  over  the  epidermis.  Cantharides 
may  be  used  for  the  purpose  of  raising  a  blister,  but  a  more 
convenient  method  is  to  fill  a  thimble  with  cotton-wool  or  lint 
soaked  in  the  strongest  liquor  ammonias,  apply  it  to  the  spot 
and  keep  it  on  for  five  minutes.  If  the  cuticle  has  not  then 
risen  in  a  blister  apply  a  poultice  until  it  rises.  Cut  off  the 
cuticle,  place-  the  powder  on  the  denuded  .surface,  and  cover  it 
with  a  piece  of  oil-silk  fixed  in  position  by  two  pieces  of  strapping 
crossed  over  it.  This  method  was  chiefly  employed  for  the  local 
application  of  morphine.  It  has  now  been  almost  entirely  super- 
seded by  the  hypodermic  method,  but  may  still  be  occasionally 
employed  in  cases  where  it  is  advisable  to  combine  the  counter- 
irritant  action  of  the  blister  with  the  local  sedative  effect  of  the 
morphine. 

Hypodermic  Administration  of  Drugs. 

This  method,  the  introduction  of  which  we  owe  to  Dr.  Alex- 
ander Wood  of  Edinburgh,  possesses  great  advantages. 

It  consists  in  the  injection  of  a  solution  of  a  remedy  under 
the  skin.  Absorption  takes  place  from  the  subcutaneous  cellular 
tissue  rapidly,  and  it  is  much  less  likely  to  be  modified  by  altered 
conditions  of  the  organism  than  absorption  from  the  stomach 


Ohap.  xvn.]   METHODS  OF  ADMINISTERING  DRUGS.         475 

and  intestine.  For  in  the  intestinal  canal  there  is  not  only  the 
condition  of  the  circulation  to  he  taken  into  consideration,  but 
the  fulness  or  emptiness  of  the  stomach  and  intestine,  the  con- 
dition of  their  epithelial  covering  and  of  their  nervous  supply, 
and  the  state  of  the  liver.  These  conditions  may  not  only  delay 
but  entirely  prevent  absorption. 

The  advantages  of  the  hypodermic  method,  therefore,  are  1st, 
certainty  of  effect,  and  2nd,  rapidity  of  action. 

As  absorption  of  a  drug  takes  place  so  much  more  rapidly 
from  the  subcutaneous  cellular  tissue  than  from  the  stomach,  a 
less  quantity  is  excreted  during  the  process  of  absorption,  and  con- 
sequently a  smaller  quantity  of  the  drug  is  required  (p.  38  et  seq.). 

But  absorption  does  not  take  place  with  equal  rapidity  from 
all  parts  of  the  intercellular  tissue.  The  vascularity  of  this 
-tissue,  and  the  rate  of  absorption  from  it,  are  greater  on  the 
temples  and  breast  than  on  the  back,  and  greater  on  the  inner 
than  on  the  outer  surface  of  the  arms  and  legs. 

As  the  liquids  used  for  hypodermic  injection  are  usually 
concentrated  solutions  of  powerful  poisons,  it  is  important  that 
'neither  more  nor  less  than  the  quantity  previously  determined 
upon  should  be  administered.     The  syringe  consists  of  two  parts 


a  15  14  la  la  u 


Pie.  159.— Syringe  for  hypodermic  injection. 

■(Fig.  159),  a  glass  barrel  in  which  a  piston  plays  airtight,  and  a 
hollow  needle  which  fits  tightly  on  to  the  end  of  the  syringe  either 
with  or  without  a  screw.  The  bore  of  the  needle  being  very  fine 
it  is  apt  to  get  choked  by  rust,  or  by  crystals  of  the  substance  last 
employed  for  injection  forming  within  it,  and  rendering  it  im- 
permeable and  useless.  In  order  to  avoid  this  it  should  be  care- 
fully washed  with  water  each  time  it  is  used,  and  a  small  piece 
of  thin  wire  kept  constantly  in  it  during  the  intervals  of  use,  or, 
better  still,  a  little  oil  drawn  into  the  bore  of  the  needle.  When 
the  syringe  has  not  been  used  for  some  time,  the  packing  of  the 
piston  is  apt  to  shrink,  so  that  it  will  no  longer  either  suck  in 
fluid  or  drive  it  out  of  the  barrel  efficiently.  This  may  often  be 
remedied  to  a  great  extent  by  soaking  the  syringe  for  a  short 
time  in  warm  water  and  driving  the  piston  up  and  down  in  it. 
If  this  is  insufficient  the  piston  may  be  taken  out,  and  sufficient 
■  thread  wound  round  it  to  make  it  work.  Care  must  be  taken 
also  that  the  needle  fits  tightly  on  the  syringe,  and  that  no 
leakage  takes  place  at  the  junction.  The  liquid  to  be  injected 
should  contain  no  solid  particles  which  may  obstruct  the  needle; 
and  if  any  such  should  be  present,  the  fluid  may  be  filtered 
through  clean  blotting-paper. 


476  PHAEMACOLOGY  AND  THEEAPEUTICS.     [sect.  i. 

The  exact  quantity  required,  and  no  more,  should  then  be 
drawn  up  into  the  syringe  and  injected.  Some  syringes  have  a 
small  screw  upon  the  piston,  so  as  to  stop  its  movement  at  any 
required  point.  With  such  a  syringe  the  barrel  may  be  filled 
quite  full  of  the  solution,  and  the  required  quantity  injected  by 
forcing  the  piston  down  until  it  is  stopped  by  the  screw.  The 
advantage  of  this  arrangement  is  that  if  any  leakage  should 
occur,  the  screw  may  be  moved  further  up,  and  an  additional 
quantity  of  solution  injected  without  the  necessity  of  withdraw- 
ing and  reintroducing  the  needle  under  the  skin.  If  all  proper 
precaution's  be  taken,  however,  the  necessity  for  such  a  proce- 
dure will  rarely  arise. 

Convenient  places  for  injection  are  the.  outside  of  the  arm 
near  the  deltoid,  the  fore-arms,  or  the  thighs.  In  order  to  avoid 
the  risk  of  introducing  the  needle  into  a  vein,  the  injection 
should  not  be  made  over  a  vein  visible  through  the  skin.  The 
skin  should  be  pinched  up  between  the  finger  and  thumb,  the 
needle  pushed  directly  through  it,  and  then  passed  onwards  a 
little  way  obliquely  in  the  subcutaneous  cellular  tissue. 

Objections  to  Hypodermic  Injections. — The  chief  objec- 
tions are,  (1)  the  pain  caused  at  the  time  by  the  introduction  of 
the  needle,  or  by  the  drug  itself  after  its  injection,  (2)  the  in- 
flammation which  either  the  needle  or  the  drug  may  give  rise  to 
subsequently,  (3)  the  scars  which  may  be  left  by  the  frequent 
repetition  of  the  injection,  (4)  the  danger  of  communicating  a 
specific  or  contagious  disease,  (5)  the  danger  of  injecting  the 
drug  directly  into  a  vein,  and  thus  producing  a  dangerous  or 
fatal  effect  from  the  too  rapid  entrance  of  the  drug  into  the 
circulation.  With  a  little  care  these  untoward  results  may  be 
almost  entirely  avoided.  If  the  needle  is  well  sharpened  the 
pain  of  introducing  it  is  very  slight,  and  may  be  still  further 
lessened  by  making  the  patient  take  several  deep  breaths  in 
rapid  succession  before  the  injection  is  made.  If  the  patient  is 
excessively  sensitive,  partial  or  complete  anaesthesia  of  the  part 
may  be  produced  by  cold  or  by  carbolic  acid  (p.  204). 

The  solutions  should  always  be  perfectly  free  from  solid  par- 
ticles and  should  be  as  neutral  and  bland  as  possible.  Metallic 
salts  have  their  irritating  properties  diminished  or  removed  when 
combined  with  albumen  or  with  an  alkaline  citrate  or  tartrate  so 
as  to  form  double  salts. 

By  washing  the  syringe  and  needle  thoroughly  out  with 
carbolic  acid,  the  danger  of  conveying  any  specific  or  contagious 
disease  is  rendered  very  slight,  and  it  may  be  completely  avoided 
by  heating  all  parts  of  the  syringe  in  a  spirit-lamp  before  using 
them.  The  syringe  employed  by  Koch  in  his  experiments  on 
the  effects  of  micro-organisms  in  producing  disease  (Fig.  159)  is 
admirably  adapted  for  this  purpose,  as  all  parts  of  it  can  be 
readily  heated,  and  the  padding  upon  the  piston,  which  is  more 


chap.  xyii.].  METHODS  OF  ADMINISTERING  DEUG.S.         477 

likely  to  retain  infective  matter  than  any  other  part  of  the 
syringe,  can  be  renewed  each  time  that  the  instrument  is  em- 
ployed. In  order  to  prevent  pain  or  inflammation  being  caused 
by  the  solution  injected,  care  should  be  taken  that  its  reaction  is 
as  nearly  as  possible  neutral,  and  that  the  quantity  should  not 
be  great.  The  smart  which  follows  the  injection  is  lessened  by 
rubbing  the  finger  gently  over  the  part  so  as  to  distribute  the 
fluid  in  the  subcutaneous  tissue.  If  it  is  necessary  to  employ 
such  large  quantities  as  half  a  drachm  or  a  drachm,  as  may  be 
the  case  with  ergot,  it  is  better  not  to  inject  the  solution  under 
the  skin  but  into  the  substance  of  a  muscle,  such  as  the  gluteus 
maximus. 

Cicatrices  are  not  apt  to  follow  injection  if  the  precautions 
already  mentioned  have  been  taken,  and  if  the  injections  are  not 
made  too  frequently  at  the  same  point. 

Application  of  Drugs  to  the  Eye 

For  inflammation  of  the  lids,  ointment  is  smeared  between 
the  edges. 

Cold  water  is  applied  to  the  conjunctiva  for  its  tonic  action, 
by  keeping  the  eyes  open  and  then  dipping  the  face  into  a  basin 
of  water. 

Strong  solutions  like  that  of  atropine  are  applied  to  the  con- 
junctiva by  dropping  them  into  the  outer  canthus  of  the  eye  and 
allowing  them  to  flow  over  the  surface.  If  such  a  solution  is  to 
be  applied  frequently,  it  may  be  dropped  into  the  inner  canthus, 
and  the  head  held  so  as  to  allow  it  to  drop  out  of  the  outer 
canthus ;  for  when  the  reverse  procedure  is  employed  the  atro- 
pine may  pass  down  the  lacrimal  ductj  and  being  absorbed  may 
produce  its  general  effect  upon  the  system  and  cause  symptoms 
of  poisoning. 

Application  of  Drugs  to  the  Ear. 

Astringent  solutions  are  usually  applied  to  the  auditory 
meatus,  by  injecting  them  in  a  gentle  stream  by  means  of  a 
small  syringe  (Fig.  160).    , 


Fig.  160. — Vulcanite  syringe  for,  injecting  solutions  into  the  ear. 

For  the  mode  of  injecting  into  the    middle   ear,   special 
treatises  on  aural  surgery  must  be  consulted. 


473 


PHARMACOLOGY  AND  THERAPEUTICS,     [sect,  i. 


Application  of  Drugs  to  the  Nose. 

Drugs  are  applied  to  the  nose  in  the  form  of  powder,  which 
may  be  taken  in  the  same  way  as  snuff  by  putting  a  little  on  the 
top  of  the  thumb,  holding  it  in  front  of  the  nose  and  strongly 
inspiring  ;  or  the  powder  may  be  put  on  a  small  piece  of  card-- 
board  in  which  a  pinhole  has  been  made  just  under  the'  powder, 
or  with  a  small  perforated  spoon  like  that  used  in  Scotland  for 
snuff.  Sternutatories  may  be  used  in  this  way,  and  so  may 
Ferrier's  powder  for  soothing  the  mucous  membrane  in  cases  of 
commencing  catarrh. 

Fluids  may  be  applied  by  insufflation,  the  nose  being  simply 
immersed  in  them  and  strong  inspiration  being  made. 

They  may  also  be  applied  by  the  nasal  douche.  This  con- 
sists simply  of  a  long  india-rubber  tube  to  act  as  a  Byphon  (Fig. 
161).     The  upper  end  of  it  is  placed  in  a  vessel  filled  with  the 


-Weight. 


Clip  to  stop  the  flew  —  ■§; 


Conical  nozzle' 


FiU.  161. — Nasal  douche. 


solution  to  be  applied,  and  it  is  prevented  from  falling  out  by  a 
hollow  lead  weight  attached"  to  its  upper  end.  At  the  lower  end 
is  a  conical  nozzle,  which  completely  plugs  the  nostril.  The 
tube  being  filled  with  the  fluid  by  suction  so  that  it  commences 
to  act  as  a  syphon*  the  nozzle  is  placed  in  one  nostril,  and  the, 
head  is  held  with  the  mouth  open  over  a  basin;  In  this  position' 
the  posterior  nares  are  cut  off  by  the  soft  palate  from  the  pha- 
rynx, and  the  solution  passes  up  one  nostril  and  not  through 
the  other,  so  that  the  nasal  cavity  is  washed  out  and  its  mucous 


chip,  xvn.]  METHODS  OF  ADMINISTEEING  DEUGS.         479 

membrane  acted  upon  by  the  solution  which  is  employed.  By 
altering  the  position  of  the  head,  both  in  insufflation  and  in 
washing  with  the  douche,  the  part  of  the  nose  reached  by  the 
fluid  will  be  changed.  Thus  when  the  head  is  held  much  for- 
ward, the  anterior  and  upper  part  of  the  nose  will  be  chiefly 
cleansed,  when  the  head  is  held  upright,  the  posterior  and  lower, 
and  when  the  position  is  intermediate,  the  middle  part  of  the 
nose  will  be  most  affected. 

The  nose  may  also  be  washed  out  by  using  a  large  syringe 
(ear)  with  a  piece  of  india-rubber  tubing  fitted  on  to  the  nozzle. 
If  at  the  moment  of  injection  the  patient  be  directed  to  say 
'  anemone '  (or  some  such  word)  and  expectorate,  the  injection 
will  come  out  of  the  mouth. 

Pure  water  is  irritating  to  sensitive  mucous  membranes  like 
that  of  the  nose,  and  so  instead  of  employing  pure  water  it  is 
much  better  to  use  a  *5  to  1  per  cent,  solution  of  common  salt, 
which  is  a  bland,  non-irritating  fluid.  Such  a  solution  may  be 
made  by  adding  a  drachm  of  common  salt  to  a  pint  of  water. 

Fluids  may  also  be  applied  to  the  nose  in  the  form  of  spray, 
either  direeted  simply  into  the-nostrils,  or  by  means  of  a  catheter 
perforated  with  a  number  of  minute  holes,  and  introduced  along 
the  floor  of  the  nasal  fossa.  The  former  may  be  used  for  apply- 
ing astringent  and  deodorising  solutions,  and  the  latter  for  the 
purpose  of  washing  out  the  nose  and  removing  hardened  secre- 
tion's. 

Application  of  Drugs  to  the  Larynx. 

Solid  powders  may  be  applied  to  the  larynx  by  insufflation. 
The  insufflator  (Fig.  162)  used  for  this  purpose  consists  of  a  tube 
curved  at  one  end,  and  having  at  the  other  a  piece  of  india-rubber 
tubing  or  an  india-rubber  ball,  by  which  a  powder  may  be  blown 
through  the  tube  near  this  end  of  the  tube.  There  is  a  small 
opening  in  its  side  through  which  the  powder  may  be  introduced* 
and  this  is  afterwards  covered  by  a  sliding  ring  or  a  piece  of 
india-rubber  tubing  so  as  to  prevent  the  powder  from  escaping* 
The  bent  part  of  the  tube  is  carefully  introduced  into  the  mouth 
so  as  not  to  cause  retching  by  touching  the  tongue  or  soft  palate, 
and,  when  the  end  of  it  points  down  over  the  larynx,  the  patient 
is  told  to  take  a  deep  breath.  At  the  moment  of  inspiration  the 
operator  forces  the  powder  out  of  the  tube  into  the  larynx,  either 
by  blowing  through  the  india-rubber  mouthpiece,  or  by  com- 
pressing the  india-rubber  ball.  Morphine  applied  by  this  method 
gives  more  relief  than  almost  anything  else  in  laryngeal  phthisis. 
About  one-sixth  of  a  grain  is  sufficient,  and  in  order  to  give  it 
sufficient  bulk  it  may  be  mixed  with  either  starch  or  bismuth. 

Solutions  may  be  simply  applied  by  means  of  a  sponge  firmly 
tied  to  a  piece  of  whalebone  having  the  proper  curve ;  as  the 


480  PHAEMACOLOGY  AND  THERAPEUTICS,     [sect,  i. 

patient  inspires  this  is  pushed  down  the  larynx.  Doubts  have 
been  expressed  as  to  whether  the  sponge  does  get  through  the 
larynx,  but  I  have  seen  the  erico-thyroid  membrane  projected 
forwards  by  the  sponge  applied  in  this  manner. 


Pig.  162. — Insufflator  for  applying  powders  to  the  larynx.  A,  piece  of  india-rubber  covering  the 
opening  in  the  insufflator,  by  which  the  powder  is  placed  in  it.  B,  india-rubber  tube  by  which 
the  powder  is  blown  out  of  the  insufflator  into  the  larynx,  c,  curved  end  of  insufflator  for 
introduction  into  the  pharynx. 

Nitrate  of  silver  applied  in  this  way  gives  relief  in  cases  of 
phthisis,  but  it  is  a  very  rough  method,  and  the  application  of 
the  solution  by  means  of  a  brush,  with  the  aid  of  the  laryngoscope, 
is  much  to  be  preferred.  When  the  sponge  has  not  been  firmly 
fixed  it  has  been  known  to  come  off  and  fall  into  the  trachea. 

Fluids  may  be  applied  by  a  brush  to  the  larynx,  the  operator 
using  the  brush  with  one  hand  and  holding  the  laryngoscopic 
mirror  with  the  other,  while  the  patient  holds  his  tongue  out 
himself.  If  the  patient  is  made  to  take  several  deep  breaths 
in  succession,  a  slight  anaesthetic  condition  is  produced,  which 
renders  the  operation  much  more  easy. 

Caustics  are  best  applied  to  the  larynx  by  means  of  a  caustic- 
holder  in  which  the  caustic  is  concealed  until  it  reaches  the  point 
of  application,  when  it  can  be  projected  by  a  touch  of  the  finger, 
and  again  withdrawn  at  the  wish  of  the  operator. 

Solid  nitrate  of  silver  may  also  be  applied  by  heating  the  end 
of  a  partially  curved  metal  rod,  then  touching  the  stick  of  caustic. 
In  this  way  a  uniformly-diffused  and  minute  quantity  of  the 
caustic  is  melted  oh  to  the  end  of  the  instrument,  which  is  then 
applied  by  aid  of  the  mirror. 

Liquid  may  be  applied  to  the  larynx  in  the  form  of  spray, 
produced  either  by  means  of  Eichardson's  apparatus  or  by  a 
current  of  steam.  The  nozzle  of  the  spray-producer  may  be 
simply  directed  towards  the  pharynx,  or  the  tongue  and  the 
cheeks  may  be  protected  from  the  spray  by  a  cylindrical  glass 
speculum. 


•chap,  xvii.]  METHODS  OF  ADMINISTERING  DRUGS.        481 

Application  of  Drugs  to  the  Lungs. 

Inhalations. — Vapours  employed  as  inhalations  act  not 
only  on  the  bronchial  tubes  but  upon  the  larynx,  pharynx,  and 
nostrils.  One  of  the  commonest  is  that  of  simple  hot  water.  A 
jug  is  filled  about  half-full  of  boiling  water  and  the  head  held 
over  it,  the  steam  being  kept  in  by  means  of  a  napkin  or  towel 
thrown  over  the  head  and  around  the  mouth  of  the  jug.  This 
application  often  gives  great,  though  temporary,  relief  in  nasal, 
laryngeal,  and  bronchial  catarrh. 

Vapour  may  be  medicated  by  the  addition  of  various  sub- 
stances to  it,  such  as  carbolic  acid,  tincture  of  benzoin,  creasote, 
or  pine  oil.  But  in  order  to  gain  the  full  advantage  of  the 
admixture  of  these  substances  it  is  better  that  the  inspired  air 
should  not  merely  play  over  the  surface  of  the  hot  water,  but  be 
drawn  through  it,  and  for  this  purpose  inhalers  are  employed. 
In  these  the  air  is  inspired  by  means  of  a  mouthpiece  fitted 
with  a  valve.  This  valve  prevents  the  air  from  passing  into 
the  mouthpiece,  so  that  during  inhalation  it  is  sucked  through 
a  tube  which  dips  under  the  water  and  passes  into  the  mouth 
laden  with  the  vapour.  During  expiration  it  passes  readily 
through  the  valve  just  mentioned. 

In  cases  of  bronchitis  the  patient  breathes  much  more  easily 
when  the  air  of  the  room  is  kept  warm  and  moist,  and  this  is 
effected  by  means  of  a  bronchitis  kettle.  This  is  simply  a  tin 
kettle  with  a  spout  about  three  feet  long  which  projects  into  the 
room,  so  that  when  the  kettle  is  kept  boiling  briskly  a  constant 
current  of  steam  is  driven  well  out  into  the  room.  When  this 
cannot  be  obtained  a  substitute  may  be  extemporised  by  rolling  a 
piece  of  brown  paper  into  a  tube,  tying  a  piece  of  string  around 
it  at  intervals  so  as  to  keep  it  in  shape,  and  putting  it  over  the 
spout  of  an  ordinary  kettle.  In  cases  of  tracheotomy  it  is  usual 
to  keep  the  air  still  warmer  and  moister  by  hanging  sheets 
around  the  bed  so  as  to  convert  it  into  a  kind  of  tent,  and  then 
conveying  the  steam  from'  a  bronchitis  kettle  into  it  by  means 
of  an  india-rubber  tube,  or  keeping  up  a  constant  spray  by  one  of 
Lister's  steam  spray  producers. 

The  vapour  of  the  drug  itself,  without  admixture  with  steam, 
may  in  some  cases  be  inhaled  (see  Vapores,  p.  533).  Oil  of 
eucalyptus  or  a  solution  of  thymol  in  alcohol  is  thus  useful  as  an 
antiseptic  inhalation  in  gangrene  of  the  lung  and  bronchiectasis. 
Terebene  is  also  used  in  this  way  in  cases  of  emphysema  and 
chronic  bronchitis.  The  vapour  of  pyridine  in  a  room  is  used  in 
asthma. 

Smoke. — The  attacks  of  difficulty  of  breathing  which  come  on' 
m  cases  of  pure  spasmodic  asthma,  in  advanced  kidney  disease, 
or  in  emphysema,  are  frequently  much  relieved  by  inhaling  the 
smoke  which  issues  from  burning  touch-paper  or  from  powdered 

1 1 


482  PHAKMACOLOGY  AND  THEEAPEUTICS.      [sect,  u 

stramonium  {vide  also  p.  260).  The  touch-paper  or  stramonium 
may  be  simply  laid  on  a  plate,  or  may  be  placed  at  the  bottom  of 
a  cup  or  jug,  and  the  fumes  inhaled.  Datura  is  often  used  in  the 
form  of  cigarettes  made  either  from  the  leaves  of  the  datura 
stramonium  or  datura  tatula. 

Application  of  Drugs  to  the  Digestive  Tract. 

Mouth  and  Pharynx. — "Weak  solutions  are  applied  to  the 
mouth  in  the  form  of  washes  with  which  the  mouth  is  rinsed 
out.  Stronger  ones  may  be  painted  with  a  camel's-hair  brush 
inside  the  cheek,  lips,  gums,  tongue  or  pharynx.  Solutions  may 
be  applied  to  the  pharynx  by  painting  with  a  brush ;  solid  sub- 
stances, as  caustics,  by  rubbing.  In  using  caustic,  care  must  be 
taken  that  it  is  firmly  attached  to  the  caustic-holder,  and,  in 
the  case  of  nitrate  of  silver,  that  only  a  short  point  is  used,  as 
otherwise  the  caustic  may  fall  off,  or  the  stick  of  nitrate  of  silver 
may  break  and  be  swallowed.  This  is  especially  necessary  in 
touching  the  throat  in  children.  In  cases  of  post-nasal  or 
pharyngeal  catarrh,  solutions  such  as  glycerin  of  tannin,  &c, 
may  be  applied  to  the  back  of  the  soft  palate  and  the  posterior 
part  of  the  nares  by  means  of  a  camel's-hair  brush  fixed  on  a 
wire  which  may  be  bent  to  any  desired  angle. 

Masticatories. — We  sometimes  give  the  patients  solid  pieces 
of  a  drug  to  chew.  These  are  called  masticatories.  We  use 
them  for  their  action  upon  the  mouth  itself,  e.g.  pellitory,  where 
we  wish  to  increase  the  secretion  of  saliva ;  or  where  we  not  only 
wish  to  produce  the  effect  upon  the  mouth,  but  the  effect  of  the 
drug  mixed  with  the  saliva  upon  the  stomach  and  intestines,  as. 
in  the  case  of  rhubarb. 

Gargles. — In  gargling,  a  full  breath  is  taken,  the  mouth  is 
filled  with  the  liquid  which  is  to  be  applied  to  the  pharynx,  and 
the  head  being  then  thrown  back  the  fluid  runs  against  the 
pharynx  and  is  partly  thrown  up  against  the  soft  palate  by  the 
air  which  gradually  escapes  from  the  lungs.  In  cases  where  it  is 
advisable  for  the  fluid  to  reach  the  posterior  nares,  the  patient 
should  lie  down  flat,  take  a  mouthful  of  the  liquid,  draw  out  the 
tongue  as  far  as  possible  with  a  handkerchief,  and  gargle  while 
in  that  position.  By  throwing  the  head  suddenly  forward  the 
liquid  may  be  brought  through  the  nose.  This  is  useful  both  as 
a  method  of  applying  the  liquid  more  thoroughly  to  the  pharynx 
and  as  a  training  preparatory  to  rhinoscopic  examination.1 

Stomach. — Drugs  are  applied  to  the  stomach  in  the  form  of 
solutions  or  draughts,  pills,  powders,  or  boluses,  &c,  which  are 
swallowed. 

Powders  may  be  very  conveniently  given  in  wafers.  A  thin 
wafer  is  moistened  with  water,  and  the  powder  being  introduced* 

1  Bumbold,  Chicago  Med.  Journ.,  August  1877,  p.  113, 


phap.  xvii.]  METHODS  OF.  ADMINISTERING  DEUGS.         483 

is  folded  up  in"  it  and  swallowed.  Another  most  convenient 
vehicle  is  oatmeal  porridge,  a  little  of  which  is  put  upon  a  spoon, 
and,  a  depression  being  made  in  it  with  the  finger,  the  powder  is 
put  into  it  and  covered  over  with  porridge.  The  porridge  should 
fill  the  front  half  of  the  spoon,  and  the  back  part  should  be  filled 
with  milk,  which  helps  the  child  to  swallow  more  easily. 
Powders  are  sometimes  given  to  children  in  jelly,  but  this  is  too 
soft,  and  so  also  is  the  paste  made  of  bread  and  milk,  although 
this  may  be  used  when  porridge  cannot  be  readily  obtained. 
Pills  may  be  simply  swallowed  with  water,  or  taken  in  jelly,  but 
some  people  are  unable  to  take  them  without  choking,  and 
children  especially  have  much  difficulty  in  swallowing  them. 
This  difficulty  is  readily  got  over  by  dividing  the  pill  into  four 
or  more  parts,  and  taking  each  part  in  a  little  oatmeal  porridge. 
Custard  puddings,  or  puddings  made  of  corn-flour  or  arrowroot, 
may  be  used  instead  of  porridge,  but  are  hardly  so  good. 

Stomach-pump. — In  cases  where  the  patient  is  unable  to 
swallow  from  paralysis  of  the  pharynx,  constriction  of  the 
OBSophagus,  or  narcotic  poisoning,  the  stomach-pump  may  be 
used.  This  consists  of  a  large,  double-acting  syringe  with  a 
flexible  tube  attached.  In  using  it  care  must  be  taken  •  (1)  to 
have  the  tube  well  softened  in  hot  water ;  (2)  to  keep  its  end 
directed  towards  the  pharynx,  and  not  bent  too  much  forward, 
lest  it  enter  the  larynx ;  (3)  not  to  use  violence  in  introducing 
the  tube,  lest  it  should  be  driven  into  the  mediastinum,  or  even 
through  the  walls  of  the  stomach  itself,  into  the  peritoneal 
cavity ;  (4)  not  to  use  violence  in  working  the  syringe,  lest  the 
mucous  membrane  of  the  stomach  should  be  drawn  into  the  lower 
orifice  of  the  tube  and  injured. 

In  place  of  the  stomach-pump  the  gastric  syphon  may 
sometimes  be  advantageously  employed,  especially  for  feeding. 
It  consists  of  a  piece  of  thick-walled,  soft,  and  flexible  india- 
rubber  tubing.  It  is  so  soft  and  flexible  that  it  can  hardly  by 
any  possibility  injure  the  oesophagus  or  stomach,  and  yet  it  is 
sufficiently  firm  to  pass  down  without  much  difficulty.  After  it 
is  in,  an  ordinary  funnel  is  attached  to  the  projecting  end,  and 
water,  beef-tea,  or  whatever  substance  one  wishes  to  introduce 
into  the  stomach,  is  simply  poured  in,  the  funnel  being  kept  at, 
or  above,  the  level  of  the  patient's  mouth.  When  it  is  desired  to 
empty  the  stomach  water  is  poured  in,  in  the  manner  just 
described,  the  tube  being  pinched,  and  then  the  outer  end  of  the 
funnel  is  held  down  as  low  as  possible — the  syphon  action  is  thus 
reversed,  and  the  fluid  which  has  just  been  poured  into  the 
stomach  again  flows  out  of  it. 

1  In  cases  of  poisoning  it  may  be  absolutely  necessary  to  use  the  stomach-pump, 
but  in  ordinary  cases  a  tube  should  never  be  passed- down  the  oesophagus  until  the- 
absence  of  aortic  aneurism  has  been  ascertained  by  a  careful  examination  of  the, 
patient's  chest. 

i  i  2 


484  PHAEMACOLOGY  AND  THERAPEUTICS,      [sect.  r. 

Intestine. — Drugs  are  applied  to  the  intestine  by  means  of 
enemata  or  suppositories.  Enemata  are  liquid  injections  into 
the  rectum  for  the  purpose  of  emptying  the  lower  parts  of  the 
bowels  when  we  do  not  wish  to  excite  the  whole  bowel,  or  when 
we  wish  to  cause  as  little  movement  as  possible  to  the  patient. 
They  are  also  used  for  the  purpose  of  administering  nutriment 
when  the  patient  is  unable  to  swallow  or  to  retain  food  given  by 
the  mouth.  In  using  enemata  for  the  purpose  of  inducing  action 
of  the  bowels  the  quantity  should  be  considerable — sixteen  fluid 
ounces,  or  even  more.  When  they  are  intended  to  be  retained, 
the  quantity  is  usually  small — not  more  than  two  to  four  fluid 
ounces  at  most.  In  using  the  enema  syringe  care  should  be 
taken  that  it  is  first  emptied  of  air  and  that  it  is  not  pushed 
forcibly  into  the  bowel.  The  nozzle  should  not  be  directed  too 
much  backward,  as,  if  this  be  done,  and  especially  if  force  be 
employed,  ulceration  of  the  posterior  wall  of  the  rectum  may  be 
induced.  Where  enemata  are  given  for  the  purpose  of  nutrition, 
a  much  larger  quantity  than  four  ounces  may  be  retained  by 
using  the  proper  method.  A  flexible,  soft  rubber  tube  should  be 
passed  for  eight  or  ten  inches  up  the  intestine  and  the  nutrient 
enema  may  then  be  slowly  and  gently  introduced  either  by  using 
a  syringe  or  by  simply  pouring  it  into  the  tube  by  a  funnel.  By 
this  method  the  fluid  is  introduced  into  the  sigmoid  flexure  or 
descending  colon,  and  if  the  patient  can  be  propped  somewhat  so 
as  to  lie  on  his  left  side,  none  of  it  may  descend  into  the  rectum. 
In  this  case  there  will  be  little  or  no  tendency  to  evacuate  it  and 
the  whole  may  be  readily  absorbed. 

The  retention  of  a  nutritive  enema  may  be  aided  by  folding  a 
soft  napkin  so  as  to  form  a  pad,  and  pressing  it  firmly  against 
the  anus  for  a  few  minutes  after  the  enema  has  been  given,  and 
'  until  the  desire  to  evacuate  the  bowel  has  passed  away. 

Suppositories  are  drugs  made  up  into  a  conical  shape  by 
means  of  cacao-butter.  When  introduced  into  the  rectum  the 
cacao-butter  melts,  the  drugs  become  spread  over  the  surface  of 
the  mucous  membrane  of  the  rectum  and  gradually  absorbed. 
They  are  employed  when  we  wish  to  get  the  local  action  of  a 
drug  upon  the  rectum,  or  the  parts  surrounding  it,  or  when  we 
wish  to  get  the  general  action  of  a  drug  after  its  absorption 
without  producing  any  local  effect  upon  the  stomach. 

Application  of  Drugs  to  the  Urethra.— They  are  usually 
employed  as  lotions.     The  syringe  used  to  -inject  them  should 


Fig.  163.— Vulcanite  syringe  for  injecting  solutions  into  the  urethra. 

not  have  a  small  thin  nozzle,  but  should  have  a  conical  point, 
such  as  that  shown  in  Pig.  168,  which  fills  up  the  opening  of  the 


chap,  xvn.]   METHODS  OF  ADMINISTEEING  DEUGS.         485 

urethra  and  allows  the  injection  to  be  forced  up  to  the  neck  of 
the  bladder  without  any  escaping. 

Application  of  Drugs  to  the  Vagina  and  Uterus. — Lotions 
are  usually  either  injected  into  the  vagina  with  a  syringe,  or 
allowed  to  flow  into  it  from  a  reservoir  at  some  height  above  the 
patient.  In  either  case,  if  it  is  desirable  that  the  lotion  should 
remain  in  contact  with  the  vaginal  walls  or  cervix  uteri,  the 
patient  should  lie  on  her  back  with  the  hips  raised  by  a  pillow. 
The  syringe  employed  for  the  vagina  is  usually  furnished  with  a 
shield  to  prevent  it  from  being  introduced  too  far,  and  it  ought 
to  have  no  central  opening,  but  only  openings  at  the  side,  as 
occasionally,  when  astringent  ,and  irritating  fluids  have  been  used 
with  syringes  having  a  central  aperture,  they  have  been  forced 
into  the  cavity  of  the  uterus,  and  have  there  produced  uterine 
contraction  and  consequent  pain.  Sedative  and  astringent  sub- 
stances are  often  introduced  in  the  form  of  pessaries  or  vaginal 
suppositories,  in  which  the  active  substance  is  mixed  with  either 
cacao-butter  or  with  gelatine  and  glycerin.  Solids  such  as 
caustics  are. applied  either  to  the  vaginal  walls  or  cervix  directly 
through  a  speculum,  and  powders  are  applied  on  pledgets  of 
cotton-wool.  Tents,  consisting  of  thin  sticks  of  a  porous  sub- 
stance, are  introduced  into  the  cervix  itself  for  the  purpose  of 
dilating  it,  and  solutions  may  be  injected  into  the  uterine  cavity 
itself  by  means  of  a  syringe  provided  with  a  long  nozzle. 


486  PHARMACOLOGY  AND  THERAPEUTICS,      [sect.  i. 


CHAPTER  XVm. 
ANTIDOTES. 

Antidotes  are  remedies  which  counteract  the  effect  of  poisons. 

Action. — Antidotes  may  act  in  two  ways  ;  they  may  either 
prevent  the  action  of  the  poison  on  the  body,  or  they  may 
counteract  its  effects.  Many  of  them,  especially  those  which 
are  employed  in  the  case  of  mineral  poisons,  form  chemical 
compounds  with  the  poisons  which  are  almost  insoluble  and 
therefore  inert. 

Some  of  these  compounds  though  nearly  insoluble  will  never- 
theless be  gradually  dissolved  and  absorbed  if  left  too  long  in 
the  stomach,  and  therefore  it  is  advisable  to  remove  them  by 
means  of  emetics  or  by  the  stomach-pump  or  stomach-syphon 
as  soon  as  possible.  Indeed,  it  is  advisable  in  all  cases  of 
poisoning,  when  the  substance  has  been  taken  into  the  stomach, 
to  empty  the  stomach  at  once  before  proceeding  to  administer 
the  antidote.  The  only  possible  exception  is  when  a  highly 
corrosive  substance  has  been  taken  which  may  have  partially 
dissolved  the  wall  of  the  stomach  and  rendered  it  extremely 
liable  to  rupture  during  emesis,  or  on  the  introduction  of  a 
stomach-tube.  If  the  poison  has  been  absorbed,  we  must  try  to 
counteract  its  poisonous  action  on  the  respiration,  circulation,  or 
temperature,  by  giving  substances  which  will  tend  to  produce  an 
opposite  effect. 

The  more  common  poisons  with  their  antidotes  are  given  in 
the  following  table : — 

Poisonous  Gases. 

Sulphuretted  hydrogen.     Chlorine  cautiously  inhaled. 

Chlorine  .....  "J 

Bromide [  Steam  inhalations. 

Iodine  vapour    ,     .    .  J 

Vapour  of  ammonia    .     Vapour  of  vinegar. 

Carbon  monoxide  .     .   (S^^^d  artifickl  "*&*&*• 


CHAP.  XVIII.] 


ANTIDOTES. 


487 


Poisonous  Gases — continued. 

Artificial  respiration,  with  the  tongue 
Nitrous  oxide     .     .     .         drawn  forward,  and  with  intermittent 

pressure  over  the  cardiae  region  if  the 
heart  is  failing. 

CharcS  fumes'     '     '] Artifcjial  respiration. 

Carbonic   acid  '(choke  P^^J^r*  ^  ^^  ^^ 

MdrahP)a'  •■'■    '         '   f™0^11 

FkeSdamr»         *  Mustard  plasters  over  surface. 


Acids — 

Sulphuric .     . 
?   Hydrochloric . 

Nitric   .    . 

Phosphoric    , 


Oxalic  acid  .... 
Bin-oxalate  of  potas- 
1  sium  (salts  of  lemon 
or  salts  of  sorrel)  . 
Tartaric  acid  .  .  . 
Acetic  acid   .... 


Hydrocyanic  acid 


Acids. 

/Alkalies- 
Bicarbonate  of  sodium  or  potassium. 
Magnesia. 
Chalk  or  whiting. 
Plaster  from  the  wall. 
Soap. 
Milk. 

Eggs  beaten  up.  .,     , 
Olive  or  almond  oil. 


Chalk  or  whiting,  or  plaster  from  the 
wall,  with  water. 


/Alternate  cold  and  warm  affusions. 

Artificial  respiration. 

Injection  of  atropine  (2  to  4  minims  of 
liquor  atropinse)  repeated,  every  half- 
hour. 
\  Per-  and  proto-  salts  of  iron,  with  mag- 
nesia, are  recommended  to  render  the 
acid  insoluble,  but  it  acts  so  quickly 
that  there  is  usually  no  time  for  their 

•    application. 


Caustic  potash  or  soda 
Caustic  lime .... 
Caustic  ammonia  .  . 
Carbonate  of  sodium  or 
potassium .... 


Alkalies. 

Vinegar. 
Lemon  juice. 
Other  dilute  acids. 
Milk. 
Oil. 


488 


PHAEMACOLOGY  AND  THEE  APE  UTICS.     [sect,  j) 


Aconite 


Alcohol 


Anaesthetics  .     .     .     . 
Chloroform,  ether,  &c. 


Alkaloids,  &c. 

^Spirits. 
Ammonia. 
Warmth. 
Digitalis. 
Atropine.  ,     , 

(Coffee. 

ICold  louche  to  head. 

[Artificial  respiration,  inversion,  &c. 


Antimony 


Arsenic 


(If  vomiting  does  not  occur  wash  out  the 
stomach  with  water  firBt ;  then  with 
tannic  or  gallic  acid ;  then  give  milk 
and  white  of  egg  as  demulcent  to 
stomach. 

/Wash  out  the  stomach  with  large 
draughts  of  warm- water,  either  by  the 
stomach-pump,  or  if  the  arsenic  itself 
does  not  cause  vomiting,  -  by  using 
sulphate  of  zinc.  ■ 

(Give  magnesia,  or  still  better,  freshly 
precipitated  oxide  of  iron  made  by 
precipitating  a, solutipn  pf  perchloride 
of  iron  with  carbonate  of  sodium  or 
with  ammonia.  Dialysed  iron  is  also 
very  useful. 

(Give  stimulants  and  ceffee ;  inject  caf- 
feine subcutaneously ;  arouse  from 
stupor,  as  in  opium-poisoning,  and, 
if  necessary,  artificial  respiration. 
Give  cautiously  physostigma. 

j  Give  Epsom  or  Glauber's  salts  or  dilute 
I     sulphuric  acid. 

Belladonna.    Vide  Atropine. 

Burttfitt's  Disinfecting  Fluid.     Vide  Metallic  Salts. 

(Stimulants. 
Calabar  bean     .     .     .  ■  Atropine. 

Artificial  respiration  if  necessary. 

Cannabis  Indica.     Vide  Morphine. 

/Large  quantity  of  demulcent  drinks. 

Barley  water. 

Gruel. 

Linseed  tea.  > 

v Avoid  oils  and  fats. .     ,     , 


Atropine- 


Barium  salts 


Cantharides 


CHAP.  XVIII.] 


ANTIDOTES. 


489 


Carbolic  acid 


Alkaloids,  &c. 

f  Saccharated  lime, 
t  Stimulants. 

Cherry  laurel  water.     Vide  Hydrocyanic  Acid... 

/Keep  patient  warm. 

Arouse  him. 

•oi,i~.„i  Give  him  coffee  per  rectum. 

Chloral     ..,..-{ T .  ,      v.  •         a      •  •  t 

Liquor  strychnmae,  ■  4  -  minims,  subcu- 

taneously,    repeated  every  10  to  20 

V    minutes,  if  necessary. 

Bichromate  of  potassium.    Same  as  Acids. 

[Tannic  or  - 

.     .  J  Gallic  acid, 
I  Stimulants. 

[Tannic  acid. 
.     .  \  Stimulants. 
iCoffeo. 

(Tannic  or 
Gallic  acid. 
Strong  tea  or  coffee. 
Stimulants  warmed. 
,  Artificial  respiration. 
Copper.     Vide  Metallic  Salts. 
Corrosive  sublimate.     Vide  Metallic  Salts,     ,    ,     ,. 
Creasote.     Vide  Carbolic  Acid. 


Colchicum 


Conium 


Quinine 


Croton  oil 


Curare 


)( Demulcents. 
I  Stimulants. 

/Artificial  respiration. 

If  there  is  a  wound,  ligature  above  it  if 
possible,  and  incise  and  suck  strongly. 
The  ligature  should  be  loosened  from 
time  to  time,  and  again  tightened,  so 
as  not  to  let  too  much  poison  into  the 
blood  at  once. 


Cyanide  of  potassium.     Vide  Hydrocyanic  Acid. 
/Strong  tea. 


Digitalis  . 


Ergot 


Tannin. 
^  Stimulants. 
":  (Aconite,  5  minims"  of  the  tincture  fiiib> 
cutaneously.  • 

Keep  perfectly  quiet,  lying  in  bed. 

,    (Tannin,  .     .     „     , 

■  iStimulaata,- 


490 


PHAEMACOLOGY  AND  THEEAPEUTICS.     [sect.  I. 


Gelsemium   . 

Hyoscyanms. 
Insect  powder. 

Laburnum    . 


Lobelia 


Metallic  salts 


Alkaloids,  &c. 

Atropine. 
.     .     ,  ■  Stimulants. 

Artificial  respiration. 

Vide  Atropine. 

Vide  Arsenic. 

Stimulants. 
.     .     .  •  Coffee. 

Alternate  hot  and  cold  douches  to  chest. 

Lead.     Vide  Metallic  Salts. 

Tannin. 

Stimulants. 

Strychnine  hypqdermically  (5  minims 

.     of  liq.  strychnin®). 

White  of  egg  freely  to  form  insoluble 
compound :  then  wash  out  stomach 
to  remove  it :  afterwards  demulcents. 

Poultices  to  surface,  and  morphine  if 
^    necessary. 

/Warm  coffee  after  the  stomach  is 
emptied. 

Ammonia. 

Arouse  by  flicking  with  a  towel,  or  by 
J  galvanic  battery,  and  keep  awake  by 
\  walking  about  and  renewal  of  stimula- 
tion if  necessary. 

2  to  4  minims  of  liq.  atrophias  subcuta- 
neously. 

Artificial  respiration,  if  necessary. 

'2  to  4  minims  liq.  atropines,  subcuta- 

neously :  repeat  if  necessary. 
Castor  oil. 
.Stimulants. 

[Stimulants. 

\  Alternate  hot  and  cold  douche. 

(Artificial  respiration. 

Cold  to  head. 
•  Ergotin. 

Atropine,  subcutaneously. 

Vide  Hydrocyanic  acid. 


Morphine . 


Mushrooms 


Nitro-benzol .     . 
Nitrite  of  Amyl . 

Nitro-glycerin    . 


Oil  of  Bitter  Almonds. 
Opium.     Vide  Morphine. 


Phosphorus 


Sulphate  of  copper. 

Oil  of  turpentine,  old  and  oxidised. 

Avoid  oils  and  fats. 


-onAP.  xviii.] 


Physostigma 


ANTIDOTES. 

Alkaloids,  &c. 

/Stimulants. 

Atropine. 

Chloral. 

Strychnine. 

Artificial  respiration. 
rChloral. 
{Bromide  of  potassium. 

Atropine. 


491 


Picrotoxine  ,     .     . 

Pilocarpine   .     .     . 
-Bat-paste.    Vide  Phosphorus. 

*****  t  Demulcents 


Snake-bite 


/Ligature  limb,  cut  out  part  with  pen- 
knife and  sear  with  hot  iron. 

■  Alcoholic  stimulants. 
Ammonia. 

^Artificial  respiration. 

Stramonium.     Vide  Atropine, 

Chloroform. 
Tannin. 
'  Bromide  of  potassium. 
;Chloral. 

Tannin.  ' 

■  Stimulants,  warm. 
Strychnine. 

(Demulcents. 

1  Sulphate  of  magnesium. 

,  Stimulants.:        ■     J,    ;  ;    ,i 

.  Coffee,  warm. 
Becumbent  posture* 
Vermin-killer.     Vide  Strychnine. 


Strychnine    .     .    . 

Tobacco   .    .    .    . 

•Turpentine  (oil  of) . 
Veratrine.     .     .     . 


J92  PHAEMACOLOGY  AND  THEEAPEUTICS.      [sect.  i. 


CHAPTER  XIX, 
ANTAGONISTIC  ACTION  OF  DEUGS. 

The  idea  that  one  drug  might  be  made  to  counteract  the  deadly 
effects  of  another  is  a  very  old  one,  and  in  the  middle  .ages 
alexipharmics  and  mithridates  were  used*  as  "antidotes.  Of  late 
years,  however,  the  subject  has  been  investigated  experimentally, 
and  a  more  accurate  knowledge  of  it  obtained.  Amongst  the  first 
of  these'  experimental  researches  were  those  of  Preyer,  on  the 
antagonism  of  atropine  and  hydrocyanic  acid ;  of  Schmiedeberg 
and  Koppe  on  the  antagonism  of  muscarine  and  atropine  ;  and 
of  Fraser  on  the  antagonism  between  physostigma  and,  atropine. 

Although  the  fact  is  undisputed  that  we  are  occasionally  able 
by  the  administration  of  one  drug,  to  prevent  the  appearance  of 
certain  symptoms  which  would  otherwise  have  certainly  been 
produced  by  another  previously  administered,  it  is'  by  no  means 
certain  that  the  one  simply  counteracts  the  effect  of  the  other. 

Some  regard  the  effect  of  one- drug  in  counteracting  another 
as  a  case  of  chemical  combination  or  substitution,  the  second 
drug  either  becoming  added  on  to  a  compound  of  the  first  with 
some  of  the  tissues,  or  else  displacing  it  from  such  a  compound 
with  the  tissues.  _  Others,  again,  think  that  no  chemical  aetiori 
of  this  sort  takes  place,  but  that  each  drug  acts  upon  the  tissue 
or  tissues  by  itself— one,  for  example,  exciting,  and  the  other 
paralysing. 

In  favour  of  the  first  view  may  be  mentioned  the  analogy 
between  the  action  of  poisons  and  ;the  formation  of  acid-albumin 
and  alkali-albumin,  either  of  which  can  be  changed  into  the 
other  by  excess  of  alkali  or  of  acid  respectively. 

The  objection  is  a  very  natural  one  that  the  doses  of  alkaloids 
required  to  produce  marked  physiological  action  are  so  extremely 
small  that  one  can  hardly  fancy  any  chemical  action  being  the 
cause  of  their  physiological  action.  I  have,  however,  on  one 
occasion,  by  the  addition  of  a  single  drop  of  liquor  potassae,  con- 
verted a  milky-looking  fluid,  consisting  of  the  nuclei  of  fowl's 
blood-corpuscles  suspended  in  water  and  measuring  90  cc,  into 
a  solid  jelly-like  mass — a  result  more  striking  than  if  a  similar 
quantity  injected  into  a  frog  had  induced  rigor  in  every  muscle. 
Even  such  a  result  is  infinitely  less  delicate  than  the  colour  re- 
actions by  which  alkaloids  are  detected. 


chap.  xix.].     ANTAGONISTIC  ACTION  OP  DEUGS.  493 

Some  of  the  best-marked  examples  of  antagonism  in  regard 
to  involuntary  muscular  fibre  are  those  observed  by  Einger  in 
the  frog's  heart,  and  they  strongly  support  the  view  which  he 
•  advocates  of  chemical  substitution.  As  already  mentioned,  cal- 
cium salts  and  veratrine  greatly  prolong  the  cardiac  systole  ;  but 
this  prolongation  is  at  once  removed,  and  the  systole  rendered 
normal  by  a  small  quantity  of  a  potassium  salt.  The  salts  of 
potassium  alone  render  the  systole  short  and  weaker,  and  then 
normal,  but  this  action  again  is  neutralised  by  calcium. 

A  similar  condition  has  been  observed  by  Cash  and  myself  in 
the  voluntary  muscles  of  the  frog.  The  contraction  of  the  gas- 
trocnemius is  prolonged  to  a  slight  extent  by  calcium,  and  to  a 
great  extent  by  veratrine,  and  also  by  barium  salts.  This  con- 
traction is  quickly  reduced  to  the  normal  by  the  addition  of  a 
small  quantity  of  potash. 

There  is  no  very  well-marked  case  of  antagonism,  in  which 
one  drug  is  able  to  restore  power  to  motor  nerves  which  have 
been  paralysed  by  another  drug ;  such  antagonism,  however,  has 
been  observed  in  regard  to  the  vagus.  By  small  doses  of  atro- 
pine this  may  be  paralysed  ;  by  a  dose  of  physostigma  adminis- 
tered afterwards  the  inhibitory  power  may  again  be  restored ; 
and  by  a  further  dose  of  atropine  it  may  be  again  paralysed; 
This  action  has  been  denied  by  Eossbach,  but  in  experiments  on 
the  subject  by  myself,  I  have  obtained  this  effect  in  such  a 
marked  degree  that  I  have  no  doubt  regarding  it.  It  is  possible 
that  the  different  results  obtained  may  be  due  partly  to  the 
animal  employed,  partly  to  the  dose,  partly  to  the  preparations 
of  the  drug,  and  partly  to  the  temperature  at  -which  the  experi- 
ments are  made.1  In  my  experiments  the  vagus  was  irritated, 
and  I  ascertained  that  the  stimulation  was  strong  enough  to  stop 
the  heart.  A  very  small  quantity  of  atropine  was  then  injected, 
and  the  same  stimulus  was  repeated.  After  enough  atropine 
had  been  gradually  injected  to  abolish  the  inhibitory  action  of 
the  vagus  completely,  some  physostigma  was  injected  into  the 
jugular  vein,  and  the  irritation  again  repeated  with  the  effect  of 
stopping  the  heart  as  at  first. 

The  antagonism  of  certain  drugs  upon  the  frog's  heart  has 
received  much  attention.  In  considering  this  subject  care  must 
be  taken  to  distinguish  between  experiments  made  with  the 
ventricle  alone,  containing  involuntary  muscular  fibres  but  no 
ganglia,  and  the  whole  heart,  in  which  both  muscle  and  ganglia 
are  contained.  The  experiments  on  veratrine,  calcium,  and 
potassium,  already  alluded  to,  were  made  with  the  ventricle 
alone ;  those  which  are  now  to  be  considered  have  reference  to 

1  My  experiments  were  made  on  rabbits  during  the  summer.  The  preparation 
of  physostigma  employed  was  a  glycerin  extract  of  the  bean,  and  the  preparation 
of  atropine  used  was  the  Liquor  Atropine,  B.F,  (1875). 


494  PHAKMACOLOGY  AND  THEEAPEUTICS.      [sect.  i. 

the  whole  heart.  Atropine  appears  to  have  the  power  not  only 
of  destroying  the  inhibitory  action  of  the  vagus  upon  the  heart, 
but  of  antagonising  those  drugs  which  inhibit  the  heart  and 
render  its  beats  slower,  or  stop  them  altogether,  such  as  mus-  • 
carine,  physostigma,  pilocarpine,  and  phytolacca.  Digitalin  and 
saponin  have  a  mutually  antagonistic  power,  so  that  when  the 
frog's  heart  has  been  stopped  by  either  of  them,  the  other  will 
restore  its  pulsations.  A  limited  antagonism  also  exists  between 
muscarine,  aconitine,  and  digitalin ;  when  the  heart  has  been 
stopped  by  digitalis,  muscarine  and  aconite  will  restore  its  move- 
ments. Digitalin  will  also  restore  the  pulsations  in  a  heart 
which  has  been  arrested  by  aconite.  Physostigmine,  camphor, 
and  other  drugs  which  stimulate  the  muscular  fibre  of  the  heart 
will  remove  the  still-stand  caused  by  muscarine. 

Another  very  important  antagonism  is  that  between  drugs 
acting  on  the  respiratory  centre  and  spinal  cord.  The  mode  of 
action  of  these  drugs  is  difficult  to  explain  on  account  of  our 
imperfect  knowledge  of  the  physiology  of  the  structures  on  which 
they  act.  Chloral  lessens  the  excitability  of  these  structures, 
strychnine  increases  it.  These  drugs  have  to  a  certain  extent 
an  antagonistic  action,  so  that  a  fatal  dose  of  strychnine  may  be 
so  antagonised  by  chloral  as  to  prevent  death;  and  a  small 
quantity  of  strychnine  may  prevent  death  from  chloral.  Atro- 
pine has  an  exciting  action  on  the  respiratory  centre,  somewhat 
like  strychnine  though  very  much  less  marked ;  and  atropine 
also  will  antagonise  chloral.  It  has  also  an  antagonistic  action 
to  aconite,  which  has  a  peculiar  depressing  influence  on  the 
respiratory  centre. 

The  sedative  action  of  chloral  enables  it  to  antagonise  picro- 
toxine  which  has  a  stimulant  action  on  the  brain  causing  con- 
vulsions. Opium  and  belladonna  have  to  a  certain  extent  an 
antagonistic  action  to  one  another.  The  first  point  which 
appeared  to  indicate  an  antagonistic  action  was  their  different 
effect  on  the  pupil ;  but  probably  the  point  on  which  they  chiefly 
antagonise  one  another  is  their  action  on  respiration,  atropine 
acting  as  a  stimulant  and  morphine  as  a  depressant  to  the 
respiratory  centre. 

The  alkaloids  of  tea,  coffee,  and  allied  substances,  viz.  theine 
or  caffeine,  cocaine  and  guaranine,  are  antagonistic  to  morphine* 
These  alkaloids  in  small  and  moderate  doses  increase  the  irrita- 
bility of  the  brain,  spinal  cord,  heart,  and  vaso-motor  system,, 
and  in  large  doses  paralyse  them.  Morphine  and  these  alkaloids 
to  a  certain  extent  counteract  one  another,  so  that  a  lethal  dose 
of  one  may  be  prevented  from  causing  death  by  administering 
the  other. 

The  antagonism  of  drugs  is  also  marked  in  regard  to  their 
action  on  the  glandular  system  ;  thus  the  excessive  salivation 
produced  by  physostigma, .  pilocarpine,   and  bromal  .  may    be- 


chap,  xix-1     ANTAGONISTIC  ACTION  OF  DKUGS, 


495 


arrested  by  atropine,  which  also  arrests  the  excessive  secretion 
from  the  skin  caused  by  pilocarpine,  and  the  secretion  from  the 
mucous  membrane1  of  the  lungs  produced  by  bromal. 

The  following  table  shows  the  most  important  examples  of 
antagonism.  The  lethal  and  antagonistic  doses  have  only  been 
ascertained  for  a  few.  When  the  remark  '  not  antagonistic ' 
occurs  in  the  table,  it  means  that  the  second  drug  mentioned 
will  not  prevent  death  from  a  lethal.'  dose  of  the  first,  although 
the  first  will  prevent  death  from  a  lethal  dose  of  the  second. 


TABLE  SHOWING  THE  ANTAGONISM  OF  DKUGS. 


Lethal 

Lethal 

Antidotal 

dose.— I. 

dose.— II. 

doses 

Aconitine . 

Atropine. 

1   th 

aoo 

7 

1    'h             t 

?50 

»»        •        ■ 

Digit  alin. 

I    rh 
900 

1 

1    th 
[iOO 

H  •        *        * 

Strychnine 

1    th 
900 

.  1   tb 
288 

1   <h 
750 

Alcohol     . 

Strychnine      .        . 



,  1    lb 
S88 

Ammonium      t 
chloride          J 

Chloral   .... 

— 

Atropine   . 

Aconitine        .        . 

7 

1    th   i 
900        \ 

not 
antagonistic 

»        *        • 

Bromal-hydrate 

7  ' 

**{ 

not 
antagonistic 

»»        •        • 

Chloral-hydrate 

7 

7 

»»        •        • 

Hydrocyanic  acid    . 

7 

»»        •        • 

Jaborandi        .        . 

7 

»»        •        • 

Muscarine       .        . 

7 

»»        •        • 

Morphine        .        . 

7 

■'     i 

not 
antagonistic 

>»        •        • 

Physostigmine 

7 

1  th 
25 

»        *        * 

Phytolacca 

7 

Pilocarpine 

Quinine  .... 

7 
7 

Barium     . 

Sodium  sulphate    . 

»j          *        * 

Potassium  salts 

Bromal-hydrate 

Atropine. 

1* 

7 

Brucine     . 

Choral    .... 

Calabarine 

,,.... 

Carbolic  acid    . 

)»•""• 

Chloral     . 

Ammonium  chloride 
Atropine.        .        . 

. 

Brucine  .... 
Calabarine 

>  •        • 

*          ■        • 

>  •        • 

Carbolic  acid  . 
Codeine  .... 
Physostigma   .        . 
Picrotoxine     .        . 
Strychnine      .        . 
Thebaine         .        . 

Chloroform 

Amyl  nitrite    .        . 

Cocaine    . 

Morphine 

Codeine     , 

Chloral    .... 

Digitalin  . 

Aconitine        .        . 

M                   •               • 

Muscarine 

»»                   •                • 

Saponin  .... 

Gelscmiuni        . 

Opium     .... 

ii      •        • 

Atropine .... 

496 


PHARMACOLOGY  AtiD  THERAPEUTICS,     [sect.  i. 


TABLE   SHOWING  THE  ANTAGONISM  OF 

DEUGS- 

-contmued* 

1 

Lethal 

Lethal 

Antidotal 

< 

dose. — I. 

dose.— II. 

doses 

Morphine . 

Atropine .... 

•        • 

Caffeine  .        . 

,f 

Chloroform 

Cocaine  . 

i)        *        • 

Baturine 

»»        •        • 

Hyoscyamine  . 

Nicotine 
Physostigma  . 

Muscarine 

Atropine . 

Opium 

Gelsemium 

»          •        • 

Veratrum  viride 

Physostigma     . 

Atropine . 
Chloral    . 
Morphine 

Saponin    . 

Digitalin . 

Strychnine 

Alcohol   . 

»        ■        • 

Chloral    . 
Hydrocyanic  acid 

it        •        • 

Nicotine  . 
Nitrite  of  amy! 

Thebaine  . 

Chloral   . 

497 


CHAPTER  XX. 
DOSAGE. 

The  circumstances  which  affect  dosage  have  already  been  dis- 
cussed (p.  37).  In  practice  we  reckon  the  dose  according  to  age, 
making  allowances,  however,  for  the  size  and  sex  of  the  patient. 
Various  tables  have  been  drawn  up  for  this  purpose.  One  in 
common  use  is  Dr.  Young's.  It  is  to  convert  the  age  into  a 
fraction  by  adding  twelve  to  it  and  using  the  number  thus 
obtained  as  the  denominator,  the  age  itself  being  the  enumerator. 
Thus,  if  a  child's  age  be  three  years,  the  denominator  will  be 
3  +  12  =  15,  and  the  enumerator  will  be  3.  The  dose  for  the 
child  will  therefore  be  3^  =  ^  =  J-  of  that  for  an  adult.  For  a 
child  five  years  old  it  will  be  5^  =  -fa,  which  is  between  one- 
third  and  one-fourth  of  that  for  an  adult.  If  the  child  is  large 
for  its  years,  we  would  give  one-third ;  if  small,  we  would  rather 
give  one-fourth. 

Another  rule,  proposed  by  Dr.  Cowling,  is  to  divide  the 
number  of  the  patient's  next  birthday  by  twenty-four.  Thus, 
for  a  child  three  years  old,  the  fraction  representing  the  dose 
would  be  7*4=£ ;  for  a  child  five  years  old,  -£i=\. 

The  rule  which  I  should  propose  as  being  more  convenient 
for  the  metric  system  is  a  modification  of  Dr.  Cowling's.  If  we 
assume  that  the  body  has  attained  its  full  growth  at  twenty-five 
years  of  age  instead  of  twenty-four,  we  get  the  proportion  by 
dividing  the  number  of  the  next  birthday  by  twenty -five.  Thus, 
for  a  child  three  years  of  age,  the  proportion  would  be  -jV  = 
nearly  -i- ;  for  a  child  five  years  of  age,  fs—  between  J-  and  -J-, 
This  number  does  not  lend  itself  readily  to  fractions  such  as  the 
preceding,  but  it  is  very  easy  to  divide  by  twenty-five  by  simply 
multiplying  by  four  and  dividing  by  100.  When  the  metrical 
system  is  used,  all  that  is  necessary  is  to  multiply  the  full  dose 
by  the  number  of  the  child's  next  birthday,  then  by  four,  and 
remove  the  decimal  point  two  places  to  the  left.  Thus,  if  the  full 
dose  for  an  adult  be  1  gramme,  the  dose  for  a  child  of  three  will 
be  '  "^J*  -  =-160  gramme  or  16  centigrammes.  If  the  full  dose 
for  an  adult  be  -3  gramme,  the  dose  for  a  child  of  three  will  be 
'3x1040x4 — -048,  or  48  milligrammes.    If  the  full  dose  be  1  gram  me, 

KK 


498  PHAEMACOLOGY  AND  THEEAPEUTICS.     [sect.  i. 

the  dose  for  a  child  of  five  will  be  1  xlu60x  4  =-240  gramme  or  24 
centigrammes.  If  the  full  dose  be  -3  gramme,  the  dose  for  a 
child  of  five  will  be  '3  x1060x  4  —  -072  gramme  or  72  milligrammes. 
To  put  this  rule  shortly,  the  number  of  grammes  in  the  full 
dose  multiplied  by  the  child's  next  birthday  and  by  four,  gives 
the  result  in  centigrammes.  The  number  of  decigrammes  mul- 
tiplied in  the  same  way  gives  the  result  in  milligrammes. 


SECTION  II. 

GENERAL  PHARMACY. 


X  K 


601 


CHAPTEE  XXI 

PHAEMACEUTICAL  PEEPAEATIONS. 

Phakmacy  includes  both  the  general  preparation  of  drugs  from 
crude  natural  products  and  their  combinations  with  other  sub- 
stances, so  as  to  render  them  either  more  effectual  or  more  easily 
administered. 

The  great  rule  for  the  administration  of  medicines  is  (1)  curare 
(2)  cito,  (3)  tute,  et  (4)  jucunde—  that  they  shall  not  only  (1)  cure, 
but  that  they  shall  do  so  (2)  quickly,  (3)  safely,  and  (4)  pleasantly. 
According  to  this  rule  many  prescriptions  contain  four  ingredients, 
viz. :  (1)  the  substance  which  is  to  cure,  or  the  basis ;  (2)  the 
adjuvant  to  help  it ;  (3)  the  corrective  to  prevent  any  bad  effects ; 
and  (4)  the  vehicle  to  make  it  pleasant  to  take.  This  rule,  how- 
ever, is  carried  out  not  only  in  written  prescriptions,  but  in  those 
also  which  have  been  adopted  by  the  profession  at  large,  as  a 
means  of  saving  labour  and  time  in  the  routine  of  practice,  and 
embodied  in  the  Pharmacopoeia  as  useful  preparations. 

Formerly  we  were  dependent  for  our  medicines  chiefly  on  the 
crude  products  of  the  animal,  vegetable,  and  mineral  kingdoms. 
As  chemistry  advanced  various  inorganic  compounds  were  dis- 
covered and  added  to  the  Materia  Medica,  and  as  our  knowledge 
of  this  science  becomes  greater  and  our  power  of  preparing  various 
organic  bodies  increases,  we  find  that  such  bodies  are  becoming 
more  and  more  introduced  into  medicine.  As  examples  of  these, 
we  may  take  carbolic  acid,  chloral,  chloroform,  ether,  hydrocyanic 
acid,  iodoform,  nitrite  of  amyl,  salicylic  acid,  and  kairin. 

We  seem  now  on  the  verge  of  discovering  the  mode  of  pre- 
paration of  many  organic  alkaloids,  and  when  this  has  been  done, 
the  vegetable  Materia  Medica  will  be  less  important  than  it  is 
now,  inasmuch  as  it  is  probable  that,  by  using  artificial  alkaloids, 
prepared  always  under  similar  conditions,  we  may  obtain  purer 
products  and  greater  constancy  of  action  than  we  can  at  present 
from  the  natural  active  principles. 

Eecent  discoveries  have  shown  that  plants  generally  contain 
active  principles  so  closely  associated,  that  the  mixture  was  re- 
garded as  a  pure  alkaloid,  and  yet  these  drugs  have  very  different 


502  GENEEAL  PHAEMACY.  [sect.  ii. 

and  sometimes  opposite  physiological  actions.  Thus  ordinary 
conhne  usually  contains  pure  conh'ne  and  methyl-coniine,  the 
former  of  which  paralyses  the  motor  nerves,  while  the  latter 
paralyses  the  spinal  cord.  Extract  of  physostigma,  and  supposed 
pure  physostigmine,  or  eserine,  have  been  found  to  contain  two 
active  principles,  viz.  physostigmine  having  a  paralysing  action, 
and  calabarine  having  a  tetanising  action  on  the  spinal  cord. 

The  power  which  chemistry  now  gives  us  also  of  modifying 
the  chemical  constitution  of  organic  bodies  and  therewith  their 
physiological  action,  will  almost  certainly  enable  us  to  treat  disease 
much  more  perfectly  than  we  can  at  present.  For  such  modified 
drugs,  however,  we  must  be  indebted  to  the  chemist.  He  will 
prefer  to  operate  on  substances  which  have  been  already  prepared 
by  himself  rather  than  on  crude  drugs  obtained  from  plants.  But 
at  present  we  are  still  dependent  on  the  vegetable  kingdom  for 
a  large  number  of  our  most  useful  remedies.  In  plants  they  are 
associated,  as  a  rule,  with  quantities  of  woody  tissue  which  is  quite 
inrrt  and  indigestible,  and  which  would  interfere  very  much  both 
with  their  easy  administration  and  with  their  action. 

Sometimes  the  crude  drug  is  given  in  the  form  of  a  simple 
powder,  without  any  admixture,  as  in  the  case  of  guaiac '  given 
in  tonsillitis,  where  it  is  advisable  to  have  the  local  action  of  the 
drug  on  the  throat,  as  well  as  its  general  action  on  the  system. 
Sometimes  the  powder  may  be  readily  given  by  enveloping  it  in 
a  wafer,  and  swallowing  it  with  a  little  water,  and  at  other  times 
it  is  made  up  with  saccharine,  and  more  or  less  adhesive  sub- 
stances, into  the  form  of  a  confection  or  bolus  ;  or  suspended  in 
water  by  means  of  mucilage  in  the  form  of  a  mixture.  Usually 
however  the  active  parts  of  the  drug  are  extracted  by  means  of 
solvents,  and  either  given  in  solution,  or  in  the  solid  form,  after 
the  solvents  have  been  evaporated.  There  are  a  number  of  pre- 
parations according  to  the  solvents  used,  and  the  mode  in  which 
they  are  applied.  Probably  the  most  convenient  arrangement 
is  not  to  take  the  groups  of  preparations  according  to  the  sol- 
vents or  mode  of  preparation,  but  alphabetically  for  the  sake  of 
reference. 

Groups  of  Officinal  Preparations. 

The  letters  B.P.  stand  for  the  British  Pharmacopoeia  of  1885, 
and  U.S.P.  for  the  United  States  Pharmacopoeia  of  1883.  When 
the  letters  B.P.  or  U.S.P.  precede  the  name  of  a  class  or  of  a 
substance,  they  indicate  that  it  is  contained  in  the  corresponding 
pharmacopoeia  only,  and  not  in  the  other.  They  succeed  the 
name  or  are  omitted  when  the  class  or  substance  occurs  in  both 
pharmacopoeias.  When  there  are  differences  between  things 
bearing  the  same  name  in  the  British  and  United  States  Phar- 
macopoeias, the  letters  B.P.  are  placed  after  the  descriptions  of 


chap,  xxi.]     PHAEMACEUTICAL  PEEPAEATIONS.  503 

that  contained  in  the  British,  and  U.S.P.  after  that  of  the  United 
States  Pharmacopoeia. 

U.S.P.  Abstracta.  Abstracts. — These  are  very  dry,  powdered 
extracts.  They  are  twice  the  strength  of  the  crude  drug,  and 
about  twice  the  strength  of  the  corresponding  fluid  extracts.  They 
are  prepared  by  extracting  the  active  principles  from  200  parts  of 
the  crude  drug  by  percolation  with  the  strong  or  diluted  alcohol, 
mixing  the  percolate  with  some  sugar  of  milk,  letting  it  dry,  and 
then  adding  sufficient  sugar  of  milk  to  make  up  the  product  to 
100  parts.     They  are  eleven  in  number. 

DOSE.  DOSE. 

Abstraotum  Aconiti  \-l  gr.        Abstraotum  Ignatiaa j-1^  gr. 


Belladonna    £-1  gr. 

Conii  1-3  gr. 

Digitalis  £-1  gr. 

Hyoscy ami 2  -3  gr. 


Jalapas 5-15  gr. 

Nuois  Vomica? .  J-2    gr. 

Podophylli 5-10  gr. 

Senegas  1-3    gr. 

Valerians 10-20  gr. 

Aceta.  Vinegars. — These  are  solutions  of  medicines  in  vine- 
gar or  acetic  acid.  In  the  B.P.  there  are  three,  in  the  U.S.P.  there 
are  four. 

B.P.  DOSE.  U.S.P.  DOSE. 

Acetum.  Aoetum  LobelisB 30-60  min. 

„      Cantharidis  „      Opii 10-15  min. 

„      Scillse 15-60  min.  „      Sanguinarise 3-4fluiddr. 

„      Scillse 15-60  min. 

Alkaloidea.  Alkaloids. — These  are  organic  bases  which 
may  be  regarded  as  compound  ammonias. 

Like  ammonia  they  all  contain  nitrogen,  and  form  salts  with 
acids.  Most  of  them  contain  oxygen  in  addition  to  nitrogen, 
carbon,  and  hydrogen,  and  occur  as  crystalline  solids.  Some,  e.g. 
coniine,  nicotine,  sparteine,piperidin,  contain  no  oxygen,  and  occur 
as  oily  liquids.  They  generally  have  a  powerful  physiological  action. 
They  occur  in  many  exogenous  plants,  but  only  veratrine  and 
substances  nearly  allied  to  it  have  been  obtained  from  the  class 
of  endogens  and  muscarine  from  thallogens.  They  occur  in  the 
plants  in  combination  with  acids.  The  alkaloids  themselves  are 
generally  soluble  in  alcohol,  but  sparingly  soluble  in  water.  Their 
salts  are  more  soluble  in  water.  The  general  plan  of  obtaining 
them  is  to  prepare  an  aqueous  solution  either  of  the  salt  origin- 
ally present  in  the  plant,  or  of  one  formed  by  treatment  with  an 
acid,  and  to  precipitate  them  by  an  alkali,  generally  ammonia, 
from  it.  As  the  alkaloids  are  soluble  in  alcohol  they  would  be 
very  imperfectly  precipitated,  or  not  at  all,  if  the  ammonia  were 
added  to  an  alcoholic  solution  of  their  salts. 

In  the  B.P.  of  1867  the  names  of  alkaloids  all  terminated  in 
'  ia,'  like  ammonia,  e.g.  quinia,  strychnia.  Chemists  have  now 
generally  returned  to  the  older  nomenclature,  and  assign  the 
termination  'ine'  to  alkaloids,  e.g.  strychnine,  quinine.  To 
neutral  principles  they  give  the  termination  '  in,'  e.g.  santonin. 


504 


GENEEAL  tHAEMACY. 


[SECT.  IK 


saliciii.     This  terminology  has  been  followed  in  the  B.P.  of  1885 
and  the  U.S.P.  of  1883. 

General  Properties  and  Reactions  of  Alkaloids.  -  Alka- 
loids are  basic  in  nature,  like  ammonia,  forming  salts  with 
acid  radicals,  easily  decomposed  by  the  action  of  alkalies  and 
alkaline  carbonates. 

Alkaloids  are,  for  the  most  part,  insoluble  in  water,  with  the 
exception  of  brucine  and  codeine,  which  are  readily  soluble ; 
they  are  all  soluble  in  alcohol,  benzene,  and  chloroform.  Their ' 
salts  are  soluble  in  water,  and  have  the  property  of  turning  the 
plane  of  polarised  light  to  the  left :  cinchonine,  conchinine, 
coniihe,  laudanosine, however,  turn  the  plane  to  the  right.  Some 
alkaloids  have  no  effect  on  polarised  light,  e.g.  berberine,  crypto- 
pine,  emetine,  hydrocotarnine,  narceiine,  veratrine,  caffeine,  and 
piperine. 

In  solution,  alkaloids  are  precipitated  by  a  solution  of  iodine 
in  iodide  of  potassium,  by  potassio-mercuric  iodide,  and  a  similar 
double  iodide  of  cadmium  and  bismuth,  also  by  picric  acid  and 
by  phospho-molybdic  and  phospho-tungstic  acids. 


Accmitina  (Aconitine). 
Apomorphinsa     Hydroehloras     (Hydro- 
chlorate  of  Apomorpliine). 
Atropina  (Atropine). 
Atropines  Sulphas. 
Beberinaa   Sulphas  (Sulphate  of  Bebe- 

rine). 
Caffeina  (Caffeine). 
Caffe'nce  Citras  (Citrate  of  Caffeine). 
Cinchonidinse    Sulphas     (Sulphate    of 

Cinchonidine). 
Cinchoninffi  Sulphas  (Sulphate  of  Cin- 
chonine). 
CocainsB  Hydroehloras  (Hydroohlorate 

of  Cocaine). 
Codeina  (Codeine). 

Morphinse  Acetas  (Acetate of  Morphine). 
„        Bimeconatis  Liquor  (Solution 
of     Bimeconate    of     Mor- 
phine). 
„        Hydroehloras  (Hydroohlorate 

of  Morphine). 
„         Sulphas   (Sulphate    of    Mor- 
phine). 
Physostigmina  (Physostigmine). 
Pilocarpines  Nitras  (Nitrate  of  Pilocar- 
pine). 
Quininse  Hydroehloras  (Hydroohlorate 

of  Quinine). 
Quininaa  Sulphas  (Sulphate  of  Quinine). 
Strychnina  (Strychnine). 
Strychninse      Hydroehloras      (Hydro- 
chlorate  of  Strychnine). 
Veratrina  (Veratrine). 


U.S.P. 

Apomorphina  (Apomorphine). 
Atropina  (Atropine). 
Atropinae  Sulphas   (Sulphate  of  Atro- 
pine). 
Caffeina  (Caffeine). 

CinchonidinsB  Sulphas  (Sulphate  of  Cin- 
chonidine). 
Cinchonina  (Cinchonine). 
Cinchoninas  Sulphas  (Sulphate  of  Cin- 
chonine). 
Codeina  (Codeine). 
Hyoscyaminaa  Sulphas  (Sulphas  of  Hy- 

oscy  amine). 
Morphina  (Morphine). 
Morphinse  .  Acetas    (Acetate    of    Mor- 
phine). 
Morphina?  Hydroehloras  (Hydrochlorate 
of  Morphine). 
„        Sulphas    (Sulphate  of   Mor- 
phine). 
Physostigminffl  Salicylas  (Salicylate  of 

Physostigmine). 
Pilocarpines      Hydroehloras      (Hydro- 
chlorate  of  Pilocarpine). 
Piperina  (Piperine). 
Quinidinse  Sulphas  (Sulphate  of  Quini- 

dine). 
Quinina  (Quinine). 
Quininse      Bisulphas     (Bisulphate    of 

Quinine). 
QuininsB  Hydrobromas   (Hydrobromate 
of  Quinine).  '  - 

„        Hydroehloras  (Hydroohlorate 

of  Quinine). 
„        Sulphas   (Sulphate    of    Qui- 
nine). 


chap,  xli.]     PHABMACEUTICAL  PEEPAEATIONS.  505 

U.S.E. 

Quinine    Valerianas    (Valerianate     of 

Quinine). 
Strychnina  (Strychnine). 
Strychninae      Sulphas      (Sulphate    of 

Strychnine). 
Veratrina  (Veratrine). 
Chinoidinum  (Chinoidin  or  Quinoidin),  U.S.P.,  is  a  mixture  of  bases. 

Along  with  the  alkaloids  may  be  mentioned  several  neutral 
principles  which  resemble  alkaloids  in  having  a  powerful  physio- 
logical action. 

B.P.  TT.S.P. 

Aloin.  Chrysardbinum  (Chrysarobin). 

Chrysarobinum  (Chrysarobin).  Picrotoxinum  (Picrotoxin). 

Elaterinum  (Elaterin).  Salicinum  (Salicin). 

Ergotinum  (Ergotin).  Santoninum  (Santonin). 
Salicinum  (Salicin). 
Santoninum  (Santonin). 

The  substances  whose  names  are  printed  in  italics  in  the 
above  list  are  not  pure  principles.  The  chrysarobinum  of  the 
pharmacopoeias  is  a  mixture  of  substances  containing  chrysarobin 
and  chrysophanic  acid,  and  ergotin  is'  only  a  purified  extract  of 
ergot.  Lupulinum  (B.P.)  is  only  a  glandular  powder  derived 
from  hops,  although  from  the  sound  of  its  name  it  might  be 
supposed  to  be  an  active  principle. 

Aquae.  Waters.  (16  in  B.P. ;  15  U.S.P.) — One  is  simply 
water,  another  distilled  water.  The  others  in  the  B.P.  are  water 
containing  small  quantities  of  volatile  oils  in  solution,  with  the 
exception  of  two,  aqua  chloroformi  and  aqua  laurocerasi,  which 
contain  chloroform  and  hydrocyanic  acid  respectively  instead  of 
a  volatile  oil.  Two  waters  are  prepared  by  simply  dissolving  the 
substances  in  them  in  the  cold ;  these  are  aqua  camphorse  and 
aqua  chloroformi.  All  the  rest  are.  prepared  by  distillation.  Two 
are  prepared  by  distilling  the  volatile  oils  with  water ;  these  are 
peppermint  and  spearmint  waters.  All  the  rest  are  prepared  by 
distilling  the  plant  in  a  retort  with  water  and  continuing  the 
process  until  a  certain  quantity  is  distilled  over. 

In  the  U.S.P.  aqua  ammonise,  aqua  ammonise  fortior,  and 
aqua  chlori  consist  of  solutions  of  ammoniacal  and  chlorine 
gases  in  water.  One,  the  aqua  creasoti,  consists  of  a  solution  of 
one  part  of  creasote  in  100  of  water. 

The  others  consist  of  volatile  oils  in  water.  Only  two,  aqua 
aurantii  norum  and  aqua  rosae,  are  prepared  by  distilling  the 
flowers  with  water.  The,  others  -are  prepared  by  thoroughly 
distributing  the  requisite  quantity  of  volatile  oil  through  a  quan- 
tity of  cotton,,  and  dissolving  it  in  water,  by  allowing  the  latter 
to  percolate  through.  Camphor  is  dissolved  in  alcohol  before 
.adding  it  to  the  cotton. 

Waters  are  chiefly  used  as  vehicles. 


506 


GENEEAL  PHAEMACY. 


[SECT.  II. 


The  dose  of  all  those  in  the  B.P.  with  one  exception  is  from 
half  an  ounce  to  two  ounces.  This  exception  is  aqua  laurocerasi, 
which  is  not  used  as  a  vehicle,  but  is,  on  the  contrary,  a  powerful 
drug  containing  hydrocyanic  acid,  and  the  dose  of  it  is  very 
small,  5-30  minims. 

Aqua  anethi  is  a  favourite  remedy  for  flatulence  in  children, 
and  in  them  it  is  given  in  a  dose  of  a  teaspoonful  or  more. 


Aqua 


■  (16). 


Aqua 


Destillata. 

i 
■        a" 

-2  oz. 

5-3C 

i- 

mimms 

Mentha  Piperita.. 

2  oz. 

Menthse  Viridis ... 

U.S.P.  (15)\  DOSE. 

Destillata. 

Ammonias 10-30  minims 

Ammonias  Fortior.. 

Amygdalse  AmarsB .    2  drachms. 

Anisi £-2  oz. 

Aurantii  Florum...  „ 

Camphorte „ 

Chlori „ 

Cinnamonii £-2  fluid  oz. 

Creasoti 1-4  drachms. 

Foeniculi 1-2  fluid  oz. 

Menthre  Piperitse. . .  „ 

Mentha?  Viridis  ....  „ 

Bosas.. „ 


Sambuci 


B.P.  Cataplasmata.  Cataplasms  oe  Poultices.  (6.) — 
These  are  used  as  a  means  of  applying  externally  moisture  and 
warmth,  and  in  certain  cases  medicaments,  to  parts  of  the  body. 
They  consist  of  linseed  meal  or  of  bread  crumb,  made  into  a  paste 
with  hot  water.  In  one,  cataplasma  conii,  hemlock  leaf  is  added 
to  relieve  pain ;  in  another,  cataplasma  sinapis,  mustard  is  used 
to  stimulate  the  skin ;  and  in  the  cataplasma  carbonis,  cataplasma 
fermenti,  and  cataplasma  sodas  chlorinatae,  wood  charcoal,  yeast, 
and  chlorinated  soda  respectively,  are  added  for  the  purpose  of 
removing  fcetor  or  acting  as  disinfectants. 


Cataplasma  Carbonis. 
„  Conii. 

,,  Fermenti. 


b.p.  (6). 


Cataplasma  Lini. 
„  Sinapis. 

„  Sodae  Chlorinatse. 


U.S.  P.  Cerata.  Cerates. — These  are  ointments  containing 
wax.  The  admixture  of  wax  with  oil  or  lard  in  cerates  renders 
them  harder  than  ointments,  though  they  are  softer  than 
plasters.  They  can  be  spread  on  linen  or  leather,  at  ordinary 
temperatures,  without  requiring  heat  like  plasters,  and  they 
can  be  applied  to  the  skin  without  melting  and  running  like 
ointments. 


Ceratum. 


TJ.S.P.  (8). 


Camphors. 

Cantharidis. 

Cetacei. 


Ceratum  Extracti  Cantharidis. 
„      Plumbi  Subacetatis. 
„      Besinee. 
„      Sabinaa. 


Chartae.      Papees. — Charta  epispastica  or  cantharidis,  and 
charta  sinapis,  consist  of  irritating  substances  spread  upon  paper, 


B.P. 

(3). 

Collodium 

Flexile. 

»» 

Yesicang. 

chap,  xxi.]     PHARMACEUTICAL  PREPARATIONS.  507 

and  used  for  the  purpose  of  producing  rubefaction  or  vesication. 
Charta  potassii  nitratis  consists  of  bibulous  paper  soaked  in  a 
solution  of  nitrate  of  potassium  and  dried,  and  is  used  for  burning 
to  give  relief  in  asthma  by  inhalation  of  the  fumes. 

b.p.  (2).  u.s.p.  (3). 

Charta  Epispastioa.  Charta  Cantharidis. 

„      Sinapis.  „      Potassii  Nitratis. 

„      Sinapis. 

Collodia.  Collodions. — In  these  collodion  is  used  as  a  solvent 
and  means  of  application. 

u.s.p.  (3). 
Collodium. 

„  cum  Cantharide. 

„  Flexile. 

„  Styptieum. 

Confectiones.  Confections,  Electuaries  or  Conserves. — 
These  are  soft  pastes  which  contain  the  drug  mixed  with  sugar 
or  honey,  and  are  convenient  forms  of  administering  drugs, 
which  would  be  unpleasant  to  take  alone,  and  would  be  too 
bulky  for  pills.  In  two  of  them,  the  confection  of  dog  roses,  and 
of  red  roses,  the  drug  is  of  itself  inert,  and  the  confection  is 
used  only  as  a  vehicle ;  in  the  others,  the  drug  is  active,  and  the 
confection  is  used  as  a  mode  of  administering  it.  The  dose  of 
all  is  1  to  2  drachms,  with  the  exception  of  the  confection  of 
opium  (B.P.)  and  of  scammony  (B.P.). 

B.P.  (8).  DOSE.  U.S.P.  (2).  DOSE. 

Confectio  Opii 5-20  grs.      Confeotio  Eoseb 

Piperis ,  „        Sennse 1-2  dr. 

Eosse  Caninse ^ 

Boss  GalliosB 

Scammonii 10-30  grs. 

SennsB 

Sulphuris  . 


Terebinthinse 


Decocta.  Decoctions. — These  are  made  by  boiling  the  drug 
with  water,  and  then  straining  while  hot.  Usually  the  boiling 
is  continued  from  ten  to  twenty  minutes,  in  order  to  dissolve  out 
the  active  part  of  the  drug ;  prolonged  boiling  frequently  alters 
it,  and  may  render  it  inert. 

B.P.  (13).  DOSE.  U.SiP.  (2).  ,DOSE. 

Decoctum  Aloes  Compositum  J-l  fl.  oz.      Decoctum  Cetrarite ad  lib. 

„        Cetrarise ad  lib.  „        Sarsaparilla  Com- 

„        Cinchonas  [Eubrae]  1-2  fl.  oz.  positum 4-6  fl.  oz. 

„        Granati  Eadicis  ...        „ 

„        Hsematoxyli „ 

„        Hordei ad  lib. 

(for  ex- 
ternal 
use. 

„        Pareme 1-2  fl.  oz 

„        Quercus 


505  GENEEAL  PHAEMAOY.  [sect.  II. 

B.P.  DOSE. 

Decootum  Sarsse 2-10  fl.  oz. 

„         Sarsse  Compositum        „ 

„        Scoparii 2-4  fl.  oz. 

„        Taraxaci 

U.S.  P.  Elixiria.  Elixirs.  —  These  are  diluted  tinctures 
rendered  agreeable  by  aromatics  and  sugar.  The  only  one  in 
the  U.S.P.  is  used  as  a  vehicle. 

U.S.P.  (1). 
Elixir  Aurantii  (Simple  Elixir). 

Emplastra.  Plasters. — These  consist  of  adhesive  substances 
spread  upon  leather  or  cloth,  so  as  to  stick  to  the  part  of  the 
body  to  which  they  are  applied. 

Lead  plaster  is  one  of  the  most  important,  as  it  forms  a  basis 
for  other  plasters.  It  is  also  used  for  covering  slight  wounds 
and  excoriations.  Eesin  plaster  is  more  adhesive,  and  is  used  to 
hold  the  edges  of  wounds  together  and  to  apply  pressure.  Two 
others,  emplastrum  belladonnae  and  emplastrum  opii,  contain 
narcotic  substances  with  the  intention  of  lessening  pain  locally. 
The  others  are  used  for  the  purpose  of  affording  mechanical 
support  or  gentle  stimulation,  and  emplastrum  cantharidis  (B.P.) 
is  used  as.  a  vesicant. 

b.p.  (14).  U.S.P.  (17). 
Emplastrum  Ammoniaoi  cum  Hydrar-      Emplastrum  Ammoniaoi  (Ammoniac), 

gyro.                                              „  „           c.  Hydrargyro 

Belladonnas.  (ammoniac  with  mercury). 

Calefaciens  (warming).                     „  ArnicsB  (Arnica). 

Cantharidis.                                      „  .    AsafceticUe  (Asafoetida).   ■ 

Ferri.                                                 „  Belladonna  (Belladonna). 

Galbani.                                             „  Capsici  (Capsicum). 

Hydrargyri.                                          „  Ferri  (Iron). 

Opii.                                                  „  Galbani  (Galbanum). 

Picis.                                                     „  Hydrargyri  (Mercurial). 

Plumbi.                                              „  Icthyocollaa  (Court). 

„      Iodidi.                                  „  Opii  (Opium). 

Kesinse.                                             „  Picis   Burgundicas    (Bur- 

„            Saponis.  gundy  pitch). 

„                 „       Euscum.                              „  Picis    Canadensis    (Hem- 
lock pitch). 

„  Picis     cum     Cantharide 

(warming). 

„  Plumbi  (Diachylon). 

„  Resinse  (adhesive). 

„  Saponis  (Soap). 

B.P.  Enemata.  Injections,  Enemas,  or  Clysters. — These 
are  preparations  for  injection  into  the  rectum.  When  the  quan- 
tity injected  is  large,  and  especially  if  cold,  it  is  usually  returned 
almost  immediately ;  therefore,  when  we  wish  to  get  it  retained, 
a  small  quantity  only,  and  warm,  must  be  employed.  The 
vehicle  in  most  injections  is  starch  mucilage.  In  the  enema  of 
aloes  10  ounces,  and  in  those  of  Epsom  salts  and  of  turpentine, 
15  ounces  of  the  vehicle  are  used,  and  these  enemata  are  em- 


chap,  xxi.]     PHAEMACEUTICAL  PEEPAKATIONS.  509 

ployed  for  the  purpose  of  evacuating  the  bowel.  In  the  case  of 
the  enema  opii  which  we  wish  to  be  retained  the  quantity  is  only 
2  ounces.  This  is  used  both  as  a  local  and  general  sedative,  in 
order  to  relieve  pain  in  or  about  the  pelvis,  or  to  produce  the 
general  action  of  opium  after  its  absorption,  in  cases  where 
medicines  cannot  be  retained  by  the  stomach,  or  when  it  is  un- 
advisable  to  administer  them  by  the  mouth.  The  enema  asafoe- 
tidae  is  perhaps  the  most  powerful  remedy  we  possess  in  cases 
of  tympanitic  distension  of  the  bowels.  As  it  is  used  for  the 
purpose  of  exciting  the  contraction  of  the  bowels  and  the  expul- 
sion of  flatulence,  but  not  of  simply  evacuating  the  rectum,  an 
intermediate  quantity  is  used,  viz.  4  ounces.  Asafcetida  con- 
tains a  gum  as  well  as  a  resin,  and  therefore  no  mucilage  is  re- 
quired to  suspend  it,  and  water  only  is  required  in  preparing  it. 
The  enema  of  tobacco  is  now  so  rarely  used,  on  account  of 
the  danger  from  collapse,  that  it  has  been  omitted  from  the  B.P. 
of  1885  ;  but  formerly,  before  the  introduction  of  chloroform,  it 
was  frequently  employed  in  order  to  cause  muscular  relaxation 
of  voluntary  and  involuntary  muscles  in  hernia,  tetanus,-  ob- 
struction of  the  bowels,  &c. 

B.P.  (5).  NONE   IN  tT.S.P. 

Enema  Aloes  (aloes  40  grains,  potassium  carbonate  15  grains). 
„     Asafcetidse  (asafcetida  30  gr.,  water  4  fl.  oz.). 

„      Magnesii  Sulphatis  (sulphate  of  magnesium  1  oz.,  olive  oil  1  fl.  oz.).' 
„      Opii  (tincture  of  opium  \  fl.  dr.). 
„      Terebinthinae  (oil  of  turpentine  1  fl.  oz.). 

B.P.  Essentiae.  Essences.— These  are  strong  solutions 
of  1  part  volatile  oil  in  4  of  rectified  spirit.  They  are  used  as 
carminatives,  and  are  usually  given  in  the  form  of  a  few  drops 
on  a  piece  of  lump  sugar,  or  with  a  little  hot  sugar  and  water, 
in  order  to  remove  flatulence. 

B.P.  (2).  DOSE. 

Essentia  Anisi 10-20  m. 

„        Menthae  Piperita 10-20  m. 

Extracta.  Extracts. — Extracts  consist  of  the  soluble  parts 
of  plants  .reduced  to  the  consistence  of  a  thick  paste  by  extrac- 
tion and  evaporation.  The  plan  of  treatment  adopted  in  order 
to  extract  the  soluble  parts,  and  leave  behind  the  woody  fibre 
and  other  inert  constituents  varies,  according  as  the  plant  is 
fresh  or  dry. 

From  fresh  plants,  green  extracts  (B.P.)  are  obtained  by 
evaporation  of  the  fresh  juice  after  removal  of  the  coagulable 
albumin.  From  dried  plants  the  active  principles  are  removed 
by  treatment  with  cold  or  boiling  water,  with  spirit,  ether,  or 
acetic  acid,  and  the  solutions  thus  obtained  are  evaporated  to  a 
consistence  suitable  for  making  pills,  or  else  to  dryness. 

Where  the  active  principles  are  of  a  resinous  or  alkaloidal 
nature,  and   are  more  soluble,  fn  .^purg  than  in  dilute  ^spirit, 


510 


GENEEAL  PHAEMACY. 


[sect.  II. 


alcohol  or  rectified  spirit  is  used ;  in  other  cases  dilute  alcohol 
or  proof  spirit  is  employed.  Where  the  drug  contains  more 
than  one  active  substance  and  one  is  more  soluble  in  spirit,  and 
the  other  in  water,  both  spirit  and  water  are  used.  In  order  to 
prevent  extracts  which,  when  freshly  prepared,  are  of  a  proper 
consistence  for  making  pills,  from  becoming  too  dry  and  hard  by 
keeping,  the  U.S.P.  in  several  instances  directs  them  to  be  mixed 
with  5  per  cent,  of  glycerine. 


b.p.  (34). 

Extractum  Aconiti 

Aloes  Barbadensis 
„     Socotrina... 

Authemidis 

Belladonnas 

„    Alcoholieum 

Calumba 

Cannabis  Indies... 
Cascarce  Sagrada.. 

Colehici 

„      Aoetioum. 
Colcynthidis       "1 
Compositum  J 

Conii 

Gelssmii  Alooholi- 


Gentiana 

Glycyrrhiza . 
Hamatoxyli.. 
Hyoseyami.. 
Jaborandi 


DOSE.  U.S.P.  (31).  DOSE. 

1-2  gr.      ExtractumAconiti G_i  8r 

2-6  gr.  „  Aloes  Aquosum  ...  2-10  gr. 

„  „          Arnica  Badicis 3-5  gr. 

2-10  gr.  „  Belladonnas    Alco- 

i-1  gr.                              holicum  J  gr. 

Xg-i  gr.  ,  „  Cannabis  Indica...  „ 

2-10  gr.  „          Cinchona 10-30  gr. 

3-1  gr.  „  Colehici  Badicis...  1-2  gr. 

2-8  gr.  „         Colooynthidis £-1  gr. 

i-2  gr.  „  „           Com- 

£-2  gr.                               positum    5-30  gr. 

3-10  or  "  Conii  Alcoholieum  £-1  gr. 

^'  „          Digitalis \  gr. 

2-6  gr.  „         Ergota 5-15  gr. 

„          Euonymi 1-3  gr. 

J-2  gr.  „          GentianSe  10-30  gr. 

2-10  gr.  „          Glycyrrhiza ad  lib. 

10-30  gr.  „  „         Purum  ad  Kb. 

„  „         Hamatoxyli 10-30  gr. 

5-10  gr.  „  Hyoseyami    Alco- 

2-10  gr.                             holieum 1-2  gr. 

5-15  gr.  „          Iridis 1-2  gr. 

Erameria 5-20  gr.  „          Juglandis  5-10  gr. 

Lactuca 5-15  gr.  „         Erameria 10-20  gr. 

Lupuli ,  „          Leptandra  : 20-30  gr. 

MezereiJEthereum  „         Malti 1-4  dr. 

Nucis  Vomica A-2  gr.  „         Mezerei 

Opii |-2  gr.  „         Nucis  Vomica £-2  gr. 

Papaveris 2-5  gr.  „          Opii....: |_1  gr. 

Pareira 10-30  gr.  „          Podophylli 1-3  gr. 

Physostigmatis  ...     jL-j  gr.  „  Physostigmatis  ...  £,-£  gr. 

Quassia 3-5  gr.  „         Quassia 1-2  gr. 

Ehamni  Frangula  15-20  gr.  „         Bhei 5-10  gr. 

Bhei 5-15  gr.  „         Stramonii \-\  gr. 

Stramonii \-\  gr.  „         Taraxaei 20-60  gr. 

Taraxaci 5-30  gr. 

Fluid  U.S.P.  or  Liquid  B.P.  Extracts.— These  are  made 
like  watery  extracts,  excepting  that  instead  of  evaporating  the 
infusion,  decoction,  or  alcoholic  solution  (U.S.P.)  to  a  solid 
paste,  it  is  only  reduced  to  a  small  bulk,  and  in  the  B.P.  some 
spirit  is  added  to  it  in  order  to  prevent  decomposition. 

B.P.  (13).  DOSE. 

Extractum  Bela  Liquidum 1_2  fluid  drachms. 

„  Casearse  Sagrada  Liquidum A_2  fluid  drachms'. 

„         Cimicifuga  Liquidum 3.  30  minims. 

„  Cinchona  „        10-30  minims. 

»         Coo®  »       i-2  fluid  drachms. 

„         Ergotffl  „       iO-30  minims. 


chap,  xxi.]     PHAKMACEUTICAL  PBEPAEATIONS.  Sll 

E.P.  DOSE. 

Extractum  Filicis  Liquidum       15-60  minims. 

„         Glycyrrhizse    „  60-120  minims. 

„         Opii  „  10-40  minims. 

„         Pareirse  „  J- 2  fluid  drachms. 

„         Ehamni  Frangulee  Liquidum 1-4  fluid  drachms. 

„  Sarsse  Liquidum 2-4  fluid  drachms. 

„         Taraxaci  Liquidum £-2  fluid  drachms. 

u.s.p.  (79).  DOSE. 

Extractum  Aconiti  Fluidum J-l  m.  (0-03-0-06  c.c). 

„         Arnicse  Badicis  Fluidum 5-10  m.  (0-3-0-6  e.c). 

„         Aromaticum  , 10-20  m.  (0-6-1-25  c.c). 

„         Aurantii  Amari  15-30  m.  (0-9-1-9  cc). 

„         Belladonnas  1-2  m.  (0-06-0-12  c.c). 

„         Brayera  , i-l  fl.  oz.  (15-30  c.c). 

„         Buchu  „        30-60  m.  (1-9-3-8  c.c). 

„  Calami  , 5-15  m.  (0-3-0-9  c.c). 

Calumba)  15-30  m.  (0-9-1-9  c.c). 

„         Cannabis  Indicas  „        £-1  m.  (0-03-0-06  cc). 

„         Capsici  „        J-l  m.  (0-03-0-06  c.c). 

„         Castanese  1-2  fl.  dr.  (3-75-7-5  c.c.) 

„         Chimaphilas  „        1  fl.  dr.  (3-75  c.c). 

„         Cbiratas  „        J  fl.  dr.  (1-9  c.c). 

„         Cimicifugai  %-l  fl.  dr.  (1-9-3-75  c.c). 

Cinchona  , £-2  fl.  oz.  (7-5-60  c.c). 

„         ColchiciBadicis  „        2-8  m.  (0-12-0-5  c.c). 

„  „       Seminis  „ ....2-8  m.  (0-12-0-5  cc). 

„         Conii  „        5  m.  (0-3  c.c). 

„         Cornus  30  m.  (1-9  c.c). 

Cubeba)  10-40  m.  (0-6-2-5  c.c). 

„         Cypripedii  15  m.  (0-9  c.c). 

„         Digitalis  1-2  m.  (0-06-0-12  c.c). 

„         Dulcamara  , 30-60  m.  (1-9-3-75  c.c). 

„         Ergotas  £-4  fl.  dr.  (1-9-15  c.c). 

„         Erythroxyli  20-60  m.  (1-25-3-75  c.c). 

„         Eucalypti  „        5-10  m.  (0-3-0-6  c.c). 

„         Eupatorii  , 20-60  m.  (1-25-3-75  cc). 

„         Frangula)  „        10-20  m.  (0-6-1-25  c.c). 

„         Gelsemii  „        2-3  m.  (0-12-0-18  cc). 

Gentianaj  „        10-30  m.  (0-6-1-9  c.c). 

Geranii  „        30-60  m.  (1-9-3-75  c.c). 


Glycyrrhizai  „        30-120  m.  (1-9-7-5  cc). 

■    a.  (1-9-3-75  c.c). 
GrindelitB  „        30-60  m.  (1-9-3-75  c.c). 


Gossypii  Badicis  30-60  m.  (1-9-3-: 


GuaransB  „        1-2  fl.  dr.  (3-75-7-5  cc). 

Hamamelidis  , 30  m.  (1-9  c.c). 

Hydrastis  „        1-2  fl.  dr.  (3-75-7-5  c.c). 

Hyoscyami  „        5  m.  (0-3  c.c). 

Ipecacuanha  „ 15-30  m.  (0-9-19  c.c). 

Iridis  5-10  m.  (0-3-0-6  c.c). 

Kramerias  , 10-60  m.  (0-6-3-75  c.c). 

Lactucarii  5-30  m.  (0-3-1-9  c.c). 

Leptandra  20-60  m.  (1-25-3-75  c.c). 

Lobelia;  „        10-20  m.  (0-6-1-25  c.c). 

Lupulini 10-15  m.  (0-6-0-9  c.c). 

Matieas  , 30-60  m.  (1-9-3-75  c.c). 

Mezerei  , for  external  use. 

Nueis  Vomica)  „        3-5  m.  (0-18-0-3  cc). 

Pareirss  , 1-2  fl.  dr.  (3-75-7-5  c.c). 

Pilocarpi  , 15-30  m.  (0-9-1-9  cc). 

Podophylli  , 5-15  m.  (0-3-0-9  c.c.) 

Pruni  Virginians , 30-60  m.  (1-9-3-75  c.c). 


512 


GENEEAL   PHARMACY. 


[sect,  n. 


„          Bhei                    „         

5  30  m.  (0-3  1-9  c.o.). 

1  2  fl.  dr.  (3-75-7-5  c.c). 

£  lfl.  dr.  (1-9  3-75  c.o.). 

lfl.  dr.  (3-75  cc). 

3  8  m.  (0-18  0-5  cc). 

3  5  m.  (0-18  0-3  cc). 

2  4fl.  dr.  (7-5  15  c.c). 

„          Sarsaparillie 

„          Scillffi                  „ 

30  60  m.  (1-9  3-75  cc). 

1  3  m.  (0-12-0-18  cc). 

..30  60  m.  (1-9  3-75cc.% 

1  5  m.  (0-06  0-3  c.c). 

1  4  fl.  dr.  (3-75  15  c.c). 

20  30  m.  (1-25  1-9  cc). 

..1  2  fl.  dr.  (3-75  7-5  c.c). 

„          Tritici                 „ 

1  2  m.  (0-06  0-12  c.o.) 

1  3fl.  dr.  (3-75  11-25  c^). 

3  6  fl.  dr.  (11-25  22-5  c.c). 

30  60  m.  (1-9  3-75  c.c.'). 

lfl.  dr.  (3-75  c.c). 

'. 1  2  m.  (0-06-0-12  c.c). 

30  60  m.  (1-9  3-75  cc). 

30-60  m.  (1-9  3-75  cc"). 

10  20  m.  (0-6  1-25  c.c). 

B.P.  Fresh  or  Green  Extracts.  —  These  extracts  have 
already  been  enumerated  among  the  others.  In  preparing  "them, 
the  juice  obtained  from  the  fresh  leaves^  flowering  tops  or  fruits, 
of  the  plant,  by  pressure,  is,  heated  to.  130°  F.  to  coagulate  the 
green  colouring  matter.  This  is  then  filtered  off  and  laid  *aside. 
The  filtrate  is  next  heated  to  200°  F.  so  as  to  coagulate  the  albu- 
min ;  this  is  filtered  off  and  thrown  away.  The  filtrate  is  then 
evaporated  at  a  temperature  not  exceeding  140°  to  a  thin  syrup. 
The  colouring  matter  is  then  added  to  it,  and  the  whole 
evaporated  to  a  proper  consistence.  In  the  case  of  extracts  of 
colchicum  and  taraxacum  there  is  no  chlorophyll  to  separate,  as 
the  juices  are  obtained  by  expression  from  the  colchicum  conn 
and  the  taraxacum  root,  and  not  from  flowering  tops.  Conse- 
quently the  juice  is  at  once  heated  to  the  boiling  point  to  coagu- 
late the  albumin,  and  after  this  has  been  filtered  out  the  filtrate 
is  evaporated  at  a  temperature  of  160°  P.  In  the  case  of  green 
extracts,  the  preservation  of  the  green  colour  is  usually  regarded 
as  a  sign  that  they  are  good.  It'  certainly  indicates  that  the 
first  and  the  last  parts  of  the  process  have  been  conducted  with 
care,  as  too  high  a  temperature  destroys  the  green  colour.  It  is 
therefore  probable  that  the  whole  process  may  have  been  care- 
fully done ;  but  this  is  not  certain,  for  the  juice  may  have  been 
exposed  to  a  high  temperature,  and  thus  injured  during  its 
evaporation  after  the  chlorophyll  has  b'een  removed  and  before 
it  has  again  been  added.      ..... 


chap,  xxi.]     PHAKMACEUTICAL  PEEPAEATIONS.  613 

The  green  extracts  of  the  B.P.  are  (8) : — 

Extraotum  Aooniti.  Extraotum  Colchici  Acetioum.        Extraotum  Lactucai. 

„  Belladonna.  „  Conii.  „  Taraxaci. 

„  Colohioi.  „  Hyoscyami. 

Glycerina,  B.P. ;  Glycerita,  U.S. P.  Glycekines. — These 
are  solutions  of  soothing,  astringent,  or  antiseptic  substances  in 
glycerine.  Glycerine  being  thick  and  adhesive,  they  form  most 
useful  local  applications,  either  to  the  skin  or  mucous  mem- 
branes i 

Those  in  the  B.P.  containing  carbolic,  tannic,  and  gallic  acids 
have  one  part  of  the  drug  by  •weight  to  four  of  glycerine  by 
measure ;  starch,  being  very,  light  and  bulky,  is  used  in  only 
half  this  proportion,  i.e.  one  ounce  of  starch  to  eight  ounces  of 
glycerine.  In  the  U.S.P.  the  starch  is  in  the  proportion  of  1  to 
9,  i.e.  10  per  cent.  The  glyceritum  vitelli  contains  45  parts  fresh 
yolk  of  egg  to  55  of  glycerine. 

B.P.   (9).  TJ.S.P.  (3). 

Glyoerinum.  •  Glycerinum. 

Acidi  Carbolioi  (1  to  4).  "Glyeeritum  Amyli  (1  in  10). 

„    Gallici  (1  to  4).  „  Vitelli  (4|  in  10). 

„    Tannioi  (1  to  4). 
Aluminis  (1  to  5). 
Amyli  (1  to  8). 
Boracis  (1  to  6). 
Plumbi  Subacetatis. 
TragacanthsB  (3  to  14). 

Infusa.  Infusions. — These  are  prepared  by  simply  pouring 
boiling  water  on  the  drug,  allowing  it  to  stand  for  some  time, 
and  then  straining. 

There  are  four  exceptions  to  this  rule  of  using  boiling  water, 
viz.  calumba,  quassia,  chiretta,  and  cusparia.  Infusions  of 
calumba  and  quassia  are  prepared  with  cold  water.  The  reason 
for  using  cold  water  in  the  case  of  calumba  is  that  the  root 
contains  a  quantity  of  starch,  which  is  extracted  if  hot  water  be 
used,  and  renders  the  infusion  liable  to  decompose,  especially  in 
hot  weather. 

I  have  been  unable  to  find  any  definite  reason  assigned  for 
using  cold  water  in  the  preparation  of  infusion  of  quassia,  ex- 
cepting that  cold  water  is  sufficient  to  dissolve  the  active 
principle. 

In  the  only  instance  in  which  I  have  seen  an  infusion  made 
with  hot  water  used,  it  caused  vomiting,  so  that  perhaps  an 
infusion  made  with  hot  water  has  a  more  irritating  action  than 
that  made  with  cold. 

Infusions  of  chiretta  and  cusparia  are  made  with  water  at 
120°  F.  instead  of  boiling  water,  as  they  are  more  agreeable  when 
prepared  in  this  way. 

The  infusions  of  substances  not  specified  in  the  U.S.P.  are 
directed  by  it  to  be  prepared  by  taking  ten  parts  of  the  substance 

L  L 


514  GENEEAL  PHAEMACY.  [sect.  n. 

in  coarse  powder  and  100  of  boiling  water.  These  are  to  be  put 
into  a  vessel  with  a  tight  cover,  and  allowed  to  stand  for  two. 
hours.  The  infusion  is  then  strained,  and  enough  water  passed 
through  the  strainer  to  make  the  product  weigh  100  parts. 

All  the  infusions  both  of  the  B.P.  and  U.S.P.  are  strained, 
with  the  exception  of  the  infusion  of  cusso  or  brayera. 

B.P.  (28).  DOSE.  U.S.P.  (5).  DOSE. 

(Of  all  not  specified  1-2  fl.  oz.) 

Infusum  Anthemidis 1-4  fl.  oz.      Infusum  Brayerse  (Cusso) 10  oz. 

„      Aurantii »      Cinchona 2  oz. 

„  „       Compositum  „      Digitalis  '    £  oz. 

„      Buchu l-4.fi.  oz.  „      Pruni  Virginiante 2-3  oz. 

Calumbte »      Senna  Compositum  ...4  fl.  oz. 

„      Caryophylli 

„      CascarilUe 

„      Catechu 

„      ChiratsB 

„       Cinchonas  Acidum... 

,,      Cuspariee 

„      Cusso   (Brayera  an- 

thelmintica)    4-8  fl.  oz. 

„      Digitalis 1-4  fl.  dr. 

„      Ergotse 

„      Gentians    Composi- 
tum  

„      Jaborandi 

„       KrameriiE  

„      Lini 

„      Lupuli 

„      MaticsB 

„      Quassia .: 

„      Bhei 

„      Bosae  Acidum 

„      Senega 

,,       Senna 

„      Serpentaria 

„      Uvsb  Ursi 

„      Valeriana 

B.P.  Injectiones  Hypodermicse.  Hypodermic  Injections. — 
These  are  strong  solutions  for  subcutaneous  injection  (p.  475). 
As  the  solutions  may  become  decomposed  by  keeping,  they  should 
be  fre'sbly  prepared ;  and  even  the  injection  of  morphine  should 
not  be  kept  long.  Any  solid  particles  should  be  removed  by 
filtiation  (p.  476).  The  injections  of  apomorphine  and  of  ergotin 
are  simply  made  by  dissolving  these  substances  in  camphor 
water  and  filtering  if  necessary.  The  injection  of  morphine  is 
prepared  by  dissolving  freshly-precipitated  morphine  in  acetic 
acid  and  water.  It  is  ten  times  as  strong  as  the  liquor  and  is 
rather  stronger  than  the  corresponding  preparation  in  the  B.P. 
of  1867,  containing  1  grain  in  10  minims,  instead  of  1  grain  in 
12  minims. 


1  This  infusion  is  about  twice  the  strength  of  the  B.P.  The  dose  is  usually 
stated  at  £  oz.  twice  a  day,  but  in  many  cases  this  dose  would  probably  prove  too 
large,  and  it  is  safer  to  begin  with  a  smaller  dose,  and  gradually  push  it  as  the 
patient  will  stand  it. 


chap,  xxi.]     PHABMACEUTICAL  PEEPAEATIONS.  515 

B.P.  DOSE. 

Injectio  Apomorphinse  Hypodermioa  (2  in  100) 2-8  min. 

„       Ergotini  „  (1  to  2) 3-10  min. 

„       Morphina  „  (1  in  10)  1-5  min. 

B.P.  Lamellae.  Gelatine  Discs. — These  are  thin  discs  of 
gelatine  with  some  glycerine,  each  weighing  about  ^th  grain 
and  containing  a  small  quantity  of  an  alkaloid.  They  are  chiefly 
used  for  local  application  to  the  eye.  They  may  sometimes  be 
convenient  for  preparing  solutions  for  hypodermic  injection  by 
dissolving  them  in  a  few  drops  of  water. 

Lamellae  Atropines  (g^th  grain  in  each). 
„      Cocaines  (535th  grain  in  each). 
„      Physostigminse  (— jjth  grain  in  each). 

Linimenta.  Liniments  or  Embrocations. — These  are  pre- 
parations for  rubbing  or  painting  on  a  part  of  the  body  in  order 
to  produce  local  stimulation  or  relieve  pain.  The  basis  of  most 
of  those  in  the  British  Pharmacopoeia  is  olive  oil,  and  of  those  in 
the  United  States  Pharmacopoeia  cotton-seed  oil.1  Camphor  is 
added  to  most  of  the  liniments  in  the  B.P.  for  its  local  stimulant 
action,  and  also  that  its  strong  smell  may  lessen  the  risk  of  the 
liniment  being  used  internally.  There  are  four  exceptions  in  the 
B.P. — the  liniments  of  ammonia,  lime,  croton  oil,  and  iodide  of 
potassium  with  soap.  With  the  exception  of  the  liniment  of 
Ume  all  these  contain  very  strong  smelling  substances,  namely, 
ammonia  in  the  corresponding  liniment,  cajuput  oil  in  the  croton 
oil  liniment,  and  oil  of  lemon  in  the  iodide  of  potassium  and 
soap  liniment. 

Camphor  is  not  contained  in  the  liniments  of  the  U.S. P., 
with  the  exception  of  the  liniments  of  belladonna,  camphor, 
chloroform  and  soap. 

Soap  is  used  to  give  a  lubricating  quality  to  four  liniments  in 
the  B.P.,  viz.  opium,  iodide  of  potassium  with  soap,  soap  and 
turpentine ;  and  to  two  in  the  U.S.P.,  viz.  chloroform  and  soap. 
In  the  compound  mustard  liniment,  whose  composition  is  nearly 
the  same  in  the  B.P.  and  the  U.S.P.,  castor  oil  is  used  as  a 
lubricant  along  with  alcohol.  In  one,  the  turpentine  Jiniment 
of  the  U.S. P.,  the  lubricating  substances  are  lard  and  yellow  wax. 

Three  liniments  in  the  B.P.,  aconite,  belladonna,  and  iodine, 
and  one  in  the  U.S.P.,  belladonna,  are  really  exceedingly  strong 
solutions  of  active  principles  in  spirit  with  camphor  added  for 
the  purposes  already  mentioned. 

The  liniments  last  mentioned  contain  no  fatty  substances  as 
lubricants,  nor  does  the  croton  oil  liniment  of  the  B.P.,  com- 
pound camphor  liniment  (B.P.),  nor  the  linimentum  cantharidis 
(U.S.P.).    Croton  oil  liniment  (B.P.)  is  a  solution  of  croton  oil 

'  I  have  been  told  that  a  great  deal  of  what  is  sold  as  olive  oil  in  Great  Britain 
is  really  cotton-seed  oil. 


516 


GENEEAL  PHAEMACY. 


[sect.  II. 


with  cajuput  oil  in  spirit.  The  compound  camphor  liniment  is 
a  mixture  of  strong  solution  of  ammonia  with  rectified  spirit, 
camphor,  and  oil  of  lavender. 

The  linimentum  cantharidis  (U.S.P.)  is  a  solution  of  the 
active  principles  of  cantharides  in  turpentine.  The  difference  in 
composition  between  the  ordinary  camphor  liniment  (B.P.),  which 
is  simply  a  mixture  of  camphor  and  olive  oil,  and  the  compound 
camphor  liniment  should  be  carefully  borne  in  mind.  The  lini- 
mentum terebinthinse  aceticum  (B.P.)  consists  of  oil  of  turpen- 
tine and  acetic  acid  mixed  with  ordinary  camphor  liniment.  But 
if  anyone,  thinking  to  increase  its  efficacy,  should  add  to  it  com- 
pound camphor  liniment,  the  acetic  acid  and  ammonia  would 
neutralise  one  another  more  or  less  completely,  and  the  activity 
of  both  liniments  would  be  to  a  great  extent  destroyed. 


B.P.  (16). 
The  proportion  of  ingredients  is  put  after  each  constituent. 


I  Iiinimentum 


Aconiti  . 

Ammonias 

Belladonna     . 

Calois     . 

Camphors 
Camphoroe 
Compositum 

Chloroformi    . 

Crotonis . 

Hydrarcyri     . 

Iodi        , 


Opii        . 

Potassii  Iodidi 
cum  Sapone 

Saponis  . 


Sinapis    Com- 
positum 


Terebinthinas . 

Terebinthinas 
Aceticum 


Basis 


Aconite  root 
(20) 

Liquor       Am- 
monia? (1) 

Belladonna 
root  (20) 

Liquor    Calcis 

(1) 
Camphor  (1)   . 
Camphor  (1)   . 


Chloroform  (1) 

Croton  oil  (2) . 

Mercury  oint- 
ment (1) 
Iodine  (5) 

Tincture  of 
Opium  (1) 

Iodide  of  Po- 
tassium (12) 

Hard  Soap  (16) 

Oil  of  Mustard 
(1-4) 


Oil  of  turpen- 
tine (16) 

Oil  of  turpen- 
tine (4) 


Solvent 


Bectified  spirit 
(30) 


Bectified  spirit 
(30) 


Bectified  spirit 
(6) 


Bectified  spirit 
(7) 


Iodide  of  Po- 
tassium (2) 


Glycerine  (8) 


Water  (32)      . 
Bectified  spirit 

(128) 
Castor  oil  (7)  . 


Adjuvant 


Camphor  (1) 
Camphor  (1) 


Liquor  am- 
moniac fortior 
(2) 

Cajuput  oil  (7) 

Liquor  am- 
monias (1) 


Curd  Soap  (16) 
Oil  of  Lemon 

V) 

Camphor  (8) 

Oil  of  Bose- 
mary  (3) 

Ethereal  ex- 
tract of  Me- 
zereon  (1) 

Camphor  (3)   . 

Camphor  (1) 

Soft  Soap 

Glacial  Acetic 
Acid  (1) 


Vehicle 


Olive  oil  (3) 

Olive  oil  (1) 
Olive  oil  (4) 


Liniment      of 
Camphor  (1) 


Liniment  of 
Camphor  (1) 

Glycerine  (1) 

Bectified  spirit 
(40) 

Liniment  of 
Soap  (1) 

Water  (80) 


Bectified  spirit 

(44) 
Water  (2) 

Liniment      of 
Camphor  (4) 


chap,  xxi.]     PHAEMACEUTICAL  PEEPAEATIONS. 


517 


u.s.p.  (10). 


Linimentum 


Solvent 


Adjuvant 


Vehicle 


Ammonias 
Beiladoamc     . 

Calcis     . 
Camphors 

Cantharidis     . 

Chloroformi  . 

Plumbi     Sub- 
acetatis 

Saponis 


Sinapis    Com- 

positum 

Terebinthinas . 


Liquor  Am- 
monias (3) 

Fluid  Extract 
of  Bella- 
donna (95) 

Lime  water  (1) 

Camphor  (1)  . 

Cantharides 

(15) 
Chloroform  (4) 

Solution  of 
Subacetate  of 
Lead  (4) 

Soap  (10) 


Volatile  Oil  of 
Mustard  (3) 

Oil  of  Turpen- 
tine (35) 


Oil  of  Turpen- 
tine (85) 


Water  (20) 


Castor  oil  (15) 


Camphor  (5) 


Camphor  (5)  . 

Oil  of  Rose- 
mary 

Extract  of  Me- 
zereon  (2) 

Camphor  (6) 

Besin  Cerate 
(65) 


Cotton-seed  oil 
(7) 


Cotton-seed  oil 

(1) 
Cotton-seed  oil 


Soap  liniment 

(6) 
Cotton-seed  oil 

(6) 
Alcohol  (70) 


Alcohol  (74) 


Liquores.     Solutions. — These  are  solutions  of  active  sub- 
stances in  water,  either  alone  or  with  the  aid  of  other  solvents. 


Liqi 

b.p.  (48). 

DOSE. 

10-30  m. 
3-10  m. 
2-6  fl.  dr. 
25-75  m. 
2-6  fl.  dr. 
i-lifl.dr. 

2-8  m.* 

2-8  m  * 

1-4  m,* 

|-lfl.dr. 

l-4fl.oz. 

15-60  m. 
10-20  m. 

10-30  m. 

U.S.P.  (27) 

SOSE. 

2-8  m. 

„    Arsenici  et  Hydrargyri 

£-l£  oz. 

5-10  m. 

2-4  fl.  oz. 

2  10  m. 

,            „            „    Fortior 

,            „        Citratis 

,            „             „  Fortior 
,     Antimonii  Chloridi  ... 

,     Arsenici     Hydrochlo- 

„        „    et  Quinine    Ci- 

„        „    Subsulphatis  .... 

„    Hydrargyri  Nitratis.... 

„    Magnesii  Citratis 

„    PlumbiSubacetatis... 
„          „      SubacetatisDi- 

10  m. 

10-20  m. 
5-20  m. 

,     Arsenii  et  Hydrargyri 

,     Atropines  Sulphatis... 
,     Bismuthi  et  Ammonii 

3-6  m. 

5  m. 
6-12  fl.  oz. 

i-2  fl.  oz. 
10-60  m. 

5  m. 

»        i,           »       Fortior 
n       „           ,,      Fortior 

i-2fl.oz. 

10-60  m. 

30  60  m. 

3-8  m. 

518  GENEEAL  PHAEMACY.  [sect.  n. 

B.P.  DOSE.  tT.S.P.  DOSE. 

Liquor  Ferri  Pernitratis 10-30m.       Liquor  Sodii  Silicatis 

„     Persulphatis  ...  „     Zinci  Ohloridi 

,,     Gutta  Percha 

„     Hydrargyri      Nitratis 

Acidus 

„      Hydrargyri   Per- 

chloridi £-2fl.dr. 

„      Iodi ** 

„     Lithite  Effervescens...5-10fl. oz. 
„     Magnesii  Carbonatis  .  1-2  fl.  oz. 

„  „       Citratis 5-10fl.oz. 

„      Morphines  Acetatis  ...10-60  m.* 
„  „      Bimeconatis 

„  „        Hydrochlo- 

ratis tt 

„     Plumbi  Subacetatis... 
„  „  „  Dilutus 

„     Potasses „ 

„  „      Effervescens..5-10  fl.  oz. 

„     Potassii     Permanga- 

natis l-4fl.dr.* 

„     Sodas  10-60  m. 

„        „     Effervescens 5-10  fl.  oz. 

„     Chlorataj 10-20  m. 

„     Sodii  Arseniatis 5-10  m.* 

„         „     Ethylatis 

„      Strychnines      Hydro- 

ohloratis  5-10  m.* 

„      Zinci  Chloridi  

The  strength  of  the  liquors  marked  with  an  *  in  the  preceding  list  hag  been 
changed  from  4  grains  to  1  fluid  oz.,  or  1  in  109  (B.P.  1867)  to  4£  grains  in  1  fluid 
oz.,  or  1  in  100  in  the  B.P.  1885.  The  strength  of  the  one  marked  **  has  been 
increased  from  5  in  109  to  5  in  100. 

B.P.  Lotiones.  Lotions. — Mixtures  of  active  substances 
in  water  for  external  application. 

Lotio  Hydrargyri  Flava  (1  part  Ferchloride  of  Mercury  to  243  of  Lime-water). 
„  „  Nigra  (    „       Subchloride  „  146  „  ). 

U.S. P.  Massae.  Masses. — These  simply  consist  of  sub- 
stances mixed  together  to  a  consistence  suitable  for  making 
pills. 

Massa  Copaibas. 

„     Ferri  Carbonatis. 
„      Hydrargyri. 

Mellita.  Honeys. — In  these  preparations  honey  is  used  as 
a  vehicle.  Oxymel  and  oxymel  scillse  of  the  B.P.,  which  contain 
acetic  acid,  may  be  regarded  as  belonging  to  this  class. 

B.P.  (4).  TJ.S.P.  (2). 

Mel  Boracis.  Mel  Despumatum. 

„  Depuratum.  „  Bosas. 

Oxymel. 

„       Scillse. 

Misturae.  Mixtures. — These  usually  consist  of  insoluble 
substances  simply  mixed  with  water  or  suspended  in  it  by  the 
aid  of  gum  or  other  viscid  substances.    .In  almond  (B.P.  and 


chap,  xxi.]     PHAEMACEUTICAL  PKEPAEATIONS.  519 

U.8.P.),  chalk  (B.P.  and  U.S.P.),  guaiac  (B.P.),  and  compound 
glycyrrhiza  (U.S.P.)  mixtures,  gum  is  added.  In  the  atnmonia- 
cum  (B.P.  and  U.S.P.),  asafcetida  (U.S.P.)  and.  compound  iron 
(B.P.  and  U.S.P.)  mixtures,  gum  is  contained,  in  the  ammonia- 
cum,  asafcetida,  and  myrrh  used  in  their  preparation  respec- 
tively. 

In  scammony  mixture  (B.P.)  the  scammony  resin  is  simply 
suspended  in  milk.  In  egg  flip  or  brandy  mixture  (mistura 
spiritus  vini  gallici)  (B.P.)  and  chloroform  mixture  (U.S.P.)  yolk 
of  egg  forms  the  basis  of  the  mixture. 

The  magnesia  and  asafcetida,1  and  rhubarb  and  soda  mix- 
tures of  the  U.S.P.  contain  insoluble  substances  mixed  with 
water  without  the  addition  of  any  viscid  substance;  in  the 
creasote  mixture  (B.P.)  the  syrup  may  be  looked  upon  as  viscid 
and  tending  to  keep  the  ingredients  mixed,  but  the  aromatic 
iron  and  compound  senna  mixtures  of  the  B.P.  and  the  acetate 
of  iron  and  ammonium  (U.S.P.)  mixture  are  simply  solutions  and 
not  mixtures  in  the  usual  sense. 

B.P.  (10).  DOSE.  U.S.P.  (11).  DOSE. 

Mistura  Ammoniaci J_l  fl.  oz.      Mistura  Ammoniaci  J-l  fl.  oz. 

Amygdala  1-2  fl.  oz.  „       Amygdala) 1-2  fl.  oz. 

„        Asafcetidse £-1  fl.  oz. 

„        Chloroformi „ 

„        Cretsa  1-2  fl.  oz. 

„       Ferri  Composita  ...,.        „ 

,,  „    et      Ammonii 

Acetatis £-1  fl.  oz. 

„  ,     Glycyrrhizas      Com- 
posita   J  oz.- 

„        Magnesias  et  Asafce- 
tida!          20  m. 

„       Potassii  Citratis J  fl.  oz. 

„       Bhei  et  Sodas £-1  dr. 

Mucilagines.  Mucilages.  —  These  are  thick  solutions, 
partial  or  complete,  of  gum  or  starch,  which  are  convenient  for 
suspending  heavy  powders  in  mixtures. 


Creasoti 

Cretas 

Ferri  Aromatica 

„    Composita 

Guaiaci 

Soammonii 

Sennse  Composita  ... 
Spiritus  Vini  Gallici 


B.P.  (3). 

D.S.P.  (5). 

Mucilago  Acacias. 
„       Amyli. 
lt      Tragacanthas. 

Mucilago  Acacia:. 
„       Cydonii. 
„       Sassafras  Medulla) 
„       Tragacanthso. 
Ulmi. 

Olea.  Oils. — These  are  divided  into  fixed  and  volatile.  The 
fixed  are  obtained  by  simple  expression  ;  the  volatile  by  distilla- 
tion excepting  in  the  case  of  oil  of  lemon,  which  being  con- 
tained in  distinct  vittae  in  the  rind,  may  be  expressed  instead  of 
being  distilled. 

1  In  this  mixture  there  is  no  gum,  for  although  it  is  contained  in  crude 
asafcetida,  it  is  not  contained  in  the  tincture  of  asafcetida  used  in  this  preparation. 


520 


GENEEAL  PHAEMACY. 


[sect.  H'. 


Fixed  Oils. 


B.P.  (9).  DOSE. 

Oleum  Amygdalee 1-4  fl.  dr. 

„  Crotonis  (oroton  oil)...   ^-1  min. 

„     Lini 

„    Morrhuae 1-8  fl.  dr. 

„  Myristicaa  Expressum.. 

„     Olivae „ 

„    Phosphoratum 5-10  min. 

„    Eicini 1-8  fl.  dr. 

„     Theobromatis 


tj.s.p.  (11).  DOSE. 

Oleum  Adipia 

„    Amygdala  Expressum  1-8  fl.  dr. 

„     Gossypii  Seminia 

„     Lini 

„     Morrhuaa J-4  fl.  oz. 

„     OlivsB , 

„    Phosphoratum 1-5  min. 

„    Eicini 1-8  fl.  dr. 

„     Sesami 

„     Theobromas 

„    Tiglii  (croton  oil) ;-l  min. 


Volatile  Oils. 


(25). 


DOSE   OF  EACH. 

1-4  m.  unless  otherwise  mentioned. 


Oleum  Anethi 

Aniai 

Anthemidia 

Cajuputi 

Carui 

Caryophylli 

Ginnamomi 

Copaiba; 5-20  min. 

Coriandri 

Cubebffi 5-20  min. 

Eucalypti 

Juniperi 1-10  min. 

Lavandulae 

Limonia 

Mentha?  Piperita 

„       Viridia 

Myristicae 

Pimentae 

Pini  Sylvestria for  use  as  vapour. 

Eoamarini 

Rutin 

Sabinaa 

Santali 10-30  min. 

Sinapis For  external  use  only. 

Terebinthinte 10-20  m.  as  diuretic,  2-6  fl.  dr.  as  anthel- 
mintic. 

tr.s.p.  (40).  DOSE. 

Oleum  .SLthereum ,; 

„      Amygdalae  Amaras \-\  min  (0-016-0-06  c.c). 

„     Anisi 5-15  min.  (0-3-0-9  c.c). 

„     Aurantii  Corticis 

,,  „        Plorum 

„     Bergamii 

„     Cajuputi 5-20  min.  (0-3-1-25  c.c). 

„      Cari 1-10  min.  (006-0-6 c.c). 

„      Caryophylli 2-6  min.  (0-12-0-36  c.c). 

„      Chenopodii 4-8  min.  for  a  child  (025-0-5  cc). 

„      Cinnamomi 1-3  min.  (0-06-0-18  cc). 

,,      Copaibas 10-15  min.  (0-6-0-9  c.c). 

„      Coriandri 

„      Cubebai 10-12  min.  at  first  (0-6  or  0-72  cc), 

gradually  increased. 


chap,  xxi.]     PHAEMACEUTICAL  PREPARATIONS, 


521 


Volatile  Oils— continued. 

tJ.S.P.  DOSE. 

Oleum  Erigerontis 10  min.  to  £  fluid  drachm  (0-6-1-9  o.c). 

Eucalypti 10-15  min.  (0-6-0-9  c.c). 

Foeniculi 5-15  min.  (0-3-0-9  c.c). 

Gaultheria 

Hedeomse  (pennyroyal) 2-10  min.  (0-12-0-6  c.c). 

Juniperi 5-15  min.  (0-3-0-9  c.c). 

Lavandula 1-5  min.  (006-0-3  c.c). 

„         -Elorum  ........... 

Limonis 

Menthse  Piperita; 2-6  min.  (0-12-0-36  c.c). 

.  „      Viridis 2-6  min.  (0-06-0-36  c.c,). 

Myrcise 

Myristicas 2-3  min.  (0-12-0-18  o.c). 

Picis  Liquidas   

Pimentaj .; 3-6  min.  (0-18-0-36  c.c). 

Bosaa 

Bosmarini  3-6  min.  (0-18-0-36  c.c). 

Butfe 2-5  min.  (0-12-0-3  c.c). 

Sabinae 2-5  min.  (0-12-0-3  c.c).      . 

Santali 20-30  min.  (1-25-1-9  c.c). 

Sassafras 3-5  min.  (0-18-0-3  c.c). 

Sinapis  Volatile 

Succini 5-15  min.  (0-3-0-9  c.c). 

Terebinthina?     5^30  min.  (0-3-1-9  c.c). 

Thymi../ : 

Valeriana; 4-5  min.  (0-24-0-3  c.c). 

Oleata.     Oleatjes. — Solutions  of  bases  in  oleic  acid.     They 
are  more  readily  absorbed  by  the  skin  than  ointments. 


Oleatum  Hydrargyri. 
„      Zinci. 


Oleatum  Hydrargyri. 
,,      Veratrinte. 


Oleoresinae.  Oleoresins. — These  are,  as  the  name  implies, 
mixtures  of  volatile  oil  and  resin.  They  are  extracted  by 
treating  the  crude  substance  with  stronger '  ether,  and  removing 
the  ether  partly  by  distillation  and  pa^tly.by  evaporation.  Their 
advantage  is  that  they  remain  in  a  liquid  or  semi-liquid  state, 
and  are  stable,  not  requiring  alcohol  to  prevent  decomposition. 

B.P.  DOSE. 

Oleoresina  Cubeba 5-30  min. 


Oleoresina  Aspidji ^-1  fl.  dr.,(V9-3'75  c,c). 

„         Capsici |-1  min.  (0-015-006  c.c). 

Cubebte .....5-30  min.  (0-3-1-9  c.c). 

„       'Lupulini  ..: 2-5  gr.  (0-13-0-33  gm.). 

„         Piperis i-1  min.  (0-015-0-06  c.c). 

„        '  Zingiberis   J , . .  JL- 1  min.  (0-006-0-06  c.c). 

Oxymel.— Vide  Mellita. 

Pilulae.    Pills. — Pills  are  small  round  masses-  which  can 
be  conveniently  swallowed.    They  are  rarely  made  of  a  greater 


$22 


GENERAL  PHAEMACY. 


[SECT.  II. 


so 

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524  GENEEAL  PHARMACY.  [sect.  it. 

weight  than  five  grains,  as  they  then  become  too  bulky  to  be 
swallowed  easily.  Those  of  the  U.S.P.  are  four  grains  each.  In 
their  composition  the  old  rule  of  curare  cito,  tute,  et  jucunde, 
has  been  pretty  strictly  followed,  and  most  of  them  in  addition  to 
the  basis  contain  an  adjuvant,  corrective,  and  vehicle  (see  Table, 
pp.  522,  523).  To  prevent  them  sticking  together  they  are 
generally  shaken  with  some  dry  powder,  such  as  lycopodium, 
carbonate  of  magnesium,  flour,  starch,  or  liquorice  powder. 
Sometimes  they  are  gilt  or  silvered  by  shaking  them  while 
freshly  prepared,  and  without  the  addition  of  any  dusting 
powder,  along  with  gold  or  silver  leaf  in  a  hollow  spherical  wooden 
box.  Sometimes  pills  are  coated  with  sugar.  Becently  a  coating 
of  firm,  gelatine  has  been  used,  and  perhaps  the  best  coating  of 
all  in  certain  cases  is  keratin  (q.  v.). 

Pulveres.  Powdeks. — The  fineness  of  powders  is  ascertained 
by  the  size  of  the  meshes  of  the  sieve  through  which  they  pass, 
and  is  represented  by  numbers  ranging  from  No.  20  to  No.  60, 
these  numbers  indicating  the  numbers  of  parallel  wires  of  ordinary 
thickness  within  a  linear  inch  forming  the  meshes  of  the  sieves 
used.  The  officinal  powderB  contain  two  or  more  substances 
triturated  and  mixed  together. 

B.P.  (15).  DOSE. 

>Pulvis  Amygdalae  Compositus 60-120  grs. 

Antimonialis  3-10  grs. 

Catechu  Oompositus 20-40  grs. 

Cinnamomi  Compositus 3-10  grs. 

Cretffl  Aromaticus 10-60  grs. 

„  „  cum  Opio 10-40'grs. 

Elaterini  Compositus  ^-5  grs. 

Glyeyrrhizaa  Compositus. 30-60  grs. 

Ipecacuanhas  Compositus 5-15  grs. 

Jalapae  Compositus 20-60  grs. 

Kino  Compositus : 5-20  grs. 

Opii  Compositus , 2^5  grs. 

Ehei  Compositus 20-60  grs. 

Seammonii  Compositus 10-20  grs. 

Tragacanthffi  Compositus 26-60  grs. 

U.S.P.  (9).  DOSE. 

Pulvis  Antimonialis .....3-8  grs.  (0-2-0-52  gm.). 

„  Aromaticds 10-30  grs.  (0-65-1-95  grft.). 

„  Gretas  Compositus.; 10-30  grs.  (0-65-1-95  gm.). 

„  Effervescens  Compositus.- One  powder. 

„  Glyeyrrhizffl  Compositus 30-60  grs.  (1-95-3-9  gm.). 

„  Ipecacuanhas  et  Opii..... 5-15  grs.  (0-33.-1  gm.). 

„  JalapsB  Compositus 30-60  grs.  (1-95-3-9  gm.). 

,  „  Mprphinse  Compositus 10  grs.  (0-65  gm.). 

„  Bhei  Compositus 30-60  grs.  (1-95-3-9  gm.). 

Resinae.  Kesins. — These  are  brittle,  amorphous  solids,  con- 
sisting of  an  acid  or  mixtures  of  acids  formed  by  the  oxidation 
of  terpenes  which  are  volatile  hydrocarbons  having  the  formula 
C10H16.  Eesins  are  insoluble  in  water,  but  soluble  in  spirit. 
They  melt  when  heated,  and  solidify  again  on  cooling.     They 


chap,  xxi.]     PHARMACEUTICAL  PREPARATIONS.  §25 

dissolve  in  alkalies,  forming  a  kind  of  soap.  •  They  frequently 
occur  in  plants  along  with  unoxidised  volatile  oils  as  oleo-resins. 
Resins  may  be  obtained  from  oleo-resins,  e.g.  turpentine,  by 
simple  distillation,  when  the  volatile  oil  distils  over  and  the  resin 
remains.  They  may  be  got  by  heating  the  part  of  the  plant  in 
which  they  are  contained,  e.g.  guaiac  resin.  They  may  be  pre- 
pared by  dissolving  them  out  of  the  plants  by  means  of  alcohol 
and  removing  the  alcohol  by  distillation,  or  precipitating  them 
by  throwing  the  strong  tincture  into  water.  Resins  are  of  an 
acid  nature,  and  the  addition  of  a  little  mineral  acid  to  water 
causes  them  to  be  precipitated  more  readily. 

b.p.  (5).  u.s.p.  (5). 

Besina,  Eesina  Copaiba. 
„      Guaiaci.  „      Jalapa. 

„      Jalapse.  „      Podophylli. 

„      Podophylli.  „      Scammonii. 

„      SoammoniiE.  Guaiaei  Besina. 

Spiritus.  Spirits. — With  the  exception  of  rectified  and  proof 
spirit,  these  are  alcoholic  solutions  of  volatile  oils  or  ethers.  The 
dose  is  |  to  1  fluid  drachm,  except  where  otherwise  mentioned, 
and  except  in  the  case  of  brandy,  rum,  and  whisky,  the  doses  of 
which  vary  very  much,  according  to  the  purpose  for  which  they 
are  used. 

B.P.  (18).  DOSE. 

Spiritus  iEtheris 30-90  min. 

„        Compositus  \-%  fluid  drachms. 

„        Nitrosi t, 

Ammonise  Aroma  tic  u  s 

„  Foetidus 

Armoracja  Compositus 1-2  fluid  drachms, 

Cajuputi 

Camphora 1Q-30  min. 

Chloroformi 10-60  min. 

Cinnamomi 

Juniperi §-lJ  fluid  drachms. 

Lavandula. .. , 

Mentha  Piperita  

Myristica  

Bectificatus , 

Bosmarini 10-60  min. 

Tenuior 

Vini  Gallici 

U.S.P.  (22).  DOSE. 

Spiritus  J2theris 1-3  fluid  drachms  (3-75-11-25  c.c). 

„  „       Compositus \-1  fluid  drachms  (1-0-7-5  c.c). 

„       Nitrosi 30-60  min.  (1-9-3-75  c.c). 

„      Ammonia  10-30  min.  (0-6-1-9  c.c). 

Aromaticus  30-60  min.  (1-9-3-75  c.c). 

„      Anisi  1-2  fluid  drachms  (3-75-7-5  c.c.l. 

„      Aurantii 1-2  fluid  drachms  (3-75-7-5  c.c). 

„      Camphor® 5-60  min.  (0-3-3-75  c.c). 

„      Chloroformi 10-60  min.  (0-6-3-75  ccj. 

„      Cinnamomi 10-20  min.  (0-6-1-25  c.c.).  , 

„      Frumenti  (Whisky) 1 


526  GENEEAL  PHAEMACY.  [sect.  n. 

r.s.p.  DOSE. 

Spiritus  Gaultherias 10-20  min.  (0-6-1-25  cc). 

„      Juniperi 30-60  min.  (1-9-3-75  c.c). 

„  „       Compositus 2-4  fluid  drachms  (7-5-15  c.c). 

„      Lavandula? 30-60  min.  (1-9-3-75  c.c). 

„      Limonis 

„      Mentha)  Piperita! 10-20  min.  (0-6-1-25  c.c). 

„  „      Viridis 30-40  min.  (1-9-2-5  c.c). 

„      Myrcias  (Bay  Bum) 

„      MyristicsB 1  fluid  drachm  (3-75  c.c). 

„      Odoratus  (Cologne  Water) 

„      Vim  Gallici 

Suppositoria.  Suppositoeies.  —  These  are  small  conical 
masses  for  introducing  drugs  into  the  rectum  (p.  484).  They  are 
used  either  to  produce  a  local  action  on  the  rectum  itself,  or  on 
the  adjoining  pelvic  organs,  such  as  the  uterus  or  the  bladder ; 
or  to  introduce  certain  drugs  into  the  body  when  we  wish  to 
avoid  any  local  action  on  the  stomach. 

Thus  the  morphine  suppositories  may  be  used  for  their  general 
action  in  inducing  sleep,  or  for  their  local  action  in  soothing  pain 
or  irritation  in  the  rectum  or  pelvic  organs,  or  to  check  diarrhoea. 
The  compound  lead  suppository  may  be  used  in  diarrhoea  for  its 
local  action  on  the  rectum,  and  likewise  for  its  general  action-  in 
checking  bleeding  from  the  lungs,  etc.  The  same  may  be  said 
of  the  mercurial  suppository.  The  others  are  more  intended  for 
local  action. 

The  basis  of  the  suppositories  is  cacao-butter  (oil  of  theo- 
broma),  excepting  in  those  where,  as  their  name  indicates,  curd 
soap  is  used  along  with  glycerine  of  starch. 

B.P.  (8). 

Suppositoria  Acidi  Carbolici  cum  Sapone. 

„  „     Tannici. 

„  „           „       cum  Sapone, 

„  Hydrargyri. 

„  Iodoformi. 

„  Morphines. 

„  „         cum  Sapone. 

„  Plumbi  Composita. 

In  the  U.S.P.  no  special  suppositories  are  named,  but  a 
formula  is  given  for  their  preparation.  The  quantity  of  the 
medicine  required,  brought  to  a  proper  consistency  if  necessary, 
-is  to  be  mixed  with  a  small  quantity  of  oil  of  theobroma  by 
rubbing  together,  and  then  sufficient  oil  of  theobroma  previously 
melted  and  cooled  to  the  temperature  of  35°  C.  (95°  F.)  is  to  be 
mixed  thoroughly  with  it,  ana  immediately  poured  into  suitable 
moulds  cooled  by  ice.  In  the  absence  of  moulds  the  mass  is  to 
be  divided  into  parts  of  a  definite  weight,  which  are  to  be  made 
into  a  convenient  form  for  a  suppository.  Unless  otherwise 
specified,  they  should  weigh  fifteen  grains  or  one  gramme. 

Succi.  Juices. — These  consist  of  the  fresh  juices  of  the 
plant,  which  are  mixed  with  a  sufficient  quantity  of  spirit  to 


chap,  xxi.]     PHAEMACEUTICAL  PEEPARATIONS. 


527 


prevent  them  from  decomposing,  except  in  the  case  of  lemon, 
mulberry,  and  buckthorn  juice,  to  which  no  alcohol  is  added. 


Succus  Belladonna. 
„      Conii. 
„      Hyoscyami. 
„      Scoparii. 


b.p.  (7). 


Succus  Taraxaci. 
„  Limonis. 
„        Mori. 


U.B.P. 
Succus  Limonis. 


Syrupi.  Sirups. — These  are  strong  solutions  of  sugar ;  many 
of  them  contain  flavouring  or  colouring  matters,  and  are  used  to 
make  medicines  more  agreeable  to  the  eye  or  palate. 

In  the  case  of  the  syrups  containing  ferrous  salts  the  sugar 
prevents  oxidation,  and  thus  preserves  the  preparation  from  de- 
composition. 


B.P.  (17). 


Syrupus. 


All  1  fluid  drachm  except  those  specially  marked. 


Aurantii 

„        Floris 

Chloral i-2  fluid  drachms. 

Ferri  Iodidi |-1  fluid  drachm. 

„     Phosphatis 

Hemidesmi 

Limonis  

Mori  

Papaveris 

Ehei 1-4  fluid  drachms. 

Bhoeados 

Bosse  Gallicse    

Scillse |-1  fluid  drachm. 

Senna 1-4  fluid  drachms. 

Tolutanus 

Zingiberis £-1  fluid  drachm. 

u.s.p.  (33).  DOSE. 

Syrupus  Acaciae 

Acidi  Citrici 

„    Hydriodici 1-4  fl.  dr.  (3-75-15  c.c). 

Allii 1  fl.  dr.  (3-75  c.c). 

Altheie 1-4  fl.  dr.  (3-75-15  c.c). 

Amygdalae 

Aurantii 

„        Florum    1  fl.  dr.  (3-75  c.c). 

Calcii  Lactophosphatis 2-4  fl.  dr.  (7-5-15  c.c). 

Calcis 1  fl.  dr.  (3-75  c.c). 

Ferri  Bromidi £-1  fl.  dr.  (1-9-3-15  c.c). 

„      Iodidi 15-30  m.  (0-9-1-9  c.c). 

„      Quininae    et   Strychnin*  1  j  fl  ^  {3.75       , 
Phosphatum.. J 


1-2  fl.  dr.  (3-75-7-5  c.c). 
cumFerro 1-2  fl.  dr.  (3 


Eypophosphatum 

„  cumFerro 1-2  fl.  dr.  (3-75-7-5  c.c). 

T               ,  I  (Emetic)  A-l  oss.  (15-30  c.c). 

Ipecacuanha |  (Expectorant)  30-60  m.  (1-9-3-75  cc.) 

Kramerise 4-  fl.  oz.  (15  c.c). 

Lactucarii 2-3  fl.  dr.  (7-5-11-25  cc). 

Limonis 

Picis  Liquida? 1-2  fl.  dr.  (3-75-7-5  c.c). 

Pruni  Virginians £  fl.  oz.  (15  c.c). 


528  ,  GENERAL  PHAEMACY.  [sect..ii. 


Syrupus  Bhei 1  fl.  dr.  £3-75  e.c). 

„  „      Aromatious 1  fl.  dr.  (375  c.c). 

Bosas 1  fl.  dr.  (3-75  c.c). 

Bubi .....1-2  fl.  dr.  (3-75-7-5  c.c). 

„  „    Ideei 

„       SarsaparillaVCompositus i  fl.  oz.  (15  c.c.). 

„        SciUte 1  fl.  dr.  (3-75  c.c). 


Gompositus (Expectorant)  20-30m.  (1 25-1-9  c.c). 

■  ".dr.  (3-75-7-5  c.c). 
Sennse 1-4  fl.  dr.  (3-75-15  c.c). 


Senegas 1-2  fl.  dr.  (3-75-7'i 


„       Tolutanus... 

Zingiberis 1  fl.  dr.  (3-75  c.c). 

B.P.  Tabellae.  Tablets  of  chocolate  each  weighing  2|  grains, 
containing  an  active  substance.  The  only  officinal  ones  are  tablets 
of  nitroglycerine,  containing  y^-th  grain  of  pure  nitroglycerine 
in  each. 

B.P.  DOSE. 

Tabellas  Nitroglycerin! , ,....1  or°two  tablets. 

Tincturae.  Tinctures. — These  are  solutions  of  active  prin- 
ciples in  spirit.  Eectified  spirit,  or  alcohol,  is  used  whenever 
the  active  principle  is  more  soluble  in  strong  than  in, dilute 
alcohol,  as  in  the  case  of  alkaloids,  such  as  of  veratrum  viride ; 
resins,  such  as  asafcetida,  benzoin,  and  Indian  hemp ;  oils,  such 
as  those  of  cubebs,  lavender,,  tolu,  orange  peel,  larch  bark,  and 
ginger ;  and  other  substances;  such  as  chloroform,  acetate  of  iron, 
perchloride  of  iron,  iodine,  kino. 

Aromatic  spirit  of  ammonia  is  used  in  the  ammoniated  tinc- 
ture of  guaiac,  of  valerian,,  and  of  opium  (B.P.  and  U.S.P.).  In 
the  case  of  guaiac  and  valerian  the  active  principles  have  an  acid 
character,  and  so  ammonia  tends  to  dissolve  them  more  com- 
pletely. In  both  of  them,  however,  as  well  as  in  ammoniated 
tincture  of  opium,  the  ammonia  has  got  a  stimulating  action  of 
its  own,  which  tends  to  aid  the  effect  of  the  other  substances. 

Tinctures  of  fresh  herbs  (Tincture  Herbarum  recentium), 
when  not  otherwise  directed,  are,  according  to  the  U.S.P.,  to  be 
prepared  by  macerating  fifty  parts  of  the  fresh  herb  bruised  or 
crushed  in  a  hundred  parts  of  alcohol  for  fourteen  days,  then 
expressing  the  liquid,  and  filtering. 

B.P.  (72).  BOSE. 

The  usual  dose  is  ^-2  fl.  dr.  unless  otherwise  mentioned. 

Tinctura  Aconiti 1-10  min. 

Aloes 

Arnicse 

Asafoetidas ^-1  fluid  drachm. 

Aiirantii 

„        Kecentis  

Belladonnas 5-20  min. 

Benzoini  Composita. £_1  fluid  drachm. 

Buchu 

Calumbce 

Camphoras  Composita 15  min.-l  fluid  drachm. 

Cannabis  Indicse 5-20  min. 


chap,  xxi.]     PHARMACEUTICAL  PREPARATIONS. 


529 


B.P.  DOSB. 

Tinctura  Cantharidis , 5-20  min. 

Capsici 5_20  min. 

Cardamomi  Composita 

Casoarillse 

Catechu 

Chirats 

Chloroformi  Composita 10-60  min. 

„  et  Morphinae 5-10  min. 

CimioifugsB 15-60  min. 

Cinchonas 

„        Composita 

Cinnamomi 

Coeoi 

Colehioi  Seminum 10-30  min. 

Conii 10-60  min. 

Cropi 

Cubebae 

Digitalis 5-30  min. 

Ergotffl 10-60  min. 

Ferri  Aoetatis 5-30  min. 

„     Perehloridi 5-30  min. 

Galls , 

Gelsemii 5-20  min. 

Gentianae  Composita ■. 

Guaiaci  Ammoniata  ...". £-1  fluid  drachm. 

Hyoscyami  £-1  fluid  drachm. 

Iodi 5-20  min. 

Jaborandi ^-1  fluid  drachm. 


Kino 

Kramerias 

Laricis 15-30  min. 

Lavandulae  Composita 

Limonis 

Lobeliae 10-30  min. 

„      ^therea 10-30  min. 

Lupuli 

Myrrhae 30-60  min. 

Nucis  Vomicae 10-30  min. 

Opii 5-40  min. 

„    Ammoniata 30-60  min. 

Podophylli  15-60  min. 

Pyrethri 

Quassire 

Quininse 

„        Ammoniata 

Ehei (Stomachic)  J-2  fluid  drachma. 

„    (Purgative)  4-8  fluid  drachms. 

Sabinae 10-60  min. 

Scillae 10-30  min. 


Sennss 1  fluid  drachm  to  4  fluid  oz. 

Serpentarise 

Stramonii 10-30  min. 

Sumbul 10-30  min. 

Tolutana 10-30  min.  or  more. 

Valerianae  

„        Ammoniata -j-1  drachm. 

Veratri  Viridis '. 5-20  min. 

Zingiberis 10-60  min. 

„        Fortior 5-20  min. 

Tincture  of  Litmus,  in  Appendix,  used  as  a  test. 


M  M 


530  GENERAL  PHARMACY.  [sect. 

W.B.P.  (73)  dose. 

Tinotura  Aooniti 1-3  m.  (0-06-0-18  c.c ). 

£joes  (As  laxative)  4-1  fl.  dr. 

"  '"    '  (As  purgative)  2-4  fl.  dr. 

"      et  Myrrhse 1-2  fl.  dr.  (3-75-7-5  cc). 

Arnicas  Florum 10-30  m.  (0-6-1-9  c.o.). 

„     Eadiois 20-30  m.  (1-25-1-9  o.c). 

"  Asafoetidse 30-60  m.  (1-9-3-75  o.c). 

„  Aurantii  Amari 1-2  fl.  dr.  (3-75-7-5  o.c). 

„  „        Dulcis 

„  Belladonna! 15-30  m.  (0-9-1-9  o.c). 

„  Benzoini 20-30  m.  (1-25-1-9  o.c). 

Composita J-2  fl.  dr.  (1-9-7-5  o.c). 

„  Bryonia!   1-2  fl.  dr.  (3-75-7-5  c.c). 

„  Galendal» 

„  Calumbte 1-4  fl.  dr.  (3-75-15  cc). 

„  Cannabis  Indies!  ,....30  m.  (1-9  o.c). 

„  Cantharidis 3-10  m.  (0-07-0-30  cc). 

„  Capsici 30-60  m.  (1-9-3-7  cc). 

„  Cardamomi 1  fl.  dr.  (3-75  cc). 

„  „  Composita 1-2  fl.  dr.  (3-75-7-5  cc). 

„  Catechu  Composita 4-3  fl.  dr.  (1-9-11-25  o.c). 

„  Chiratffi 1-2  fl.  dr.  (3-75-7-5  cc). 

„  Cimicifugse 1-4  fl.  dr.  (3-75-15  o.c). 

„  Cinchonas 1-4  fl.  dr.  375-15  c.c). 

Composita 1-4  fl.  dr.  (3-75-15  c.c). 

„  Cinnamomi 1-4  fl.  dr.  (3-75-15  cc). 

„  Colchici 4-2  fl.  dr.  (1-9-7-5  o.c). 

„  Conii 30  m.  (1-9  o.c.)  to  be  increased. 

„  Croci 1-3  fl.  dr.  (3-75-11-25  c.c). 

„  Cubebas   1-2  fl.  dr.  (3-75-7-5  cc). 

„  Digitalis 10-20  m.  (0-6-1-25  c.c). 

„  Ferri  Acetatis 20-60  m.  (1-25-3-75  c.c). 

„     Chloridi 10-30  m.  (0-6-1-9  c.c). 

„  Galls 1-3  fl.  dr.  (3-75-11-25  c.c). 

„  Gelsemii 10-20  m.  (0-6-1-25  c.c). 

„  Gentians  Composita 1-2  fl.  dr.  (3-75-75  c.c). 

„  Guaiaci 1  fl.  dr.  (3-75  c.c). 

„  „      Ammoniata  ...; 1-2  fl.  dr.  (3'75-7-5  o.c). 

„  Herbarum  Beoentium 

„  Humuli 1-3  fl.  dr.  (3-75-11-25  c.c). 

„  Hydrastis 30-60  m.  (1-9-3-75  c.c). 

„  Hyoscyami 60  m.  (3-75  c.c). 

„  Ignatise 15-20  m.  (0-9-1-25  c.c). 

„  Iodi 5-15  m.  (0-3-0-9  o.c). 

„  Ipecacuanhas  et  Opii 10  m.  (0-6  c.c). 

„      Kino 1-2  fl.  dr.  (3-75-7-5  cc). 

,,      Kramerisi 1-2  fl.  dr.  (3-75-7-5  cc). 

„      Lavandula!  Composita  30-60  m.  (1-9-3-75  c.c). 

„  Lobeliai 30-60  m.  (1-9-3-75  c.c). 

„      Maticse 1  fl.  dr.  (3-75  cc). 

„      Moschi 4-2  fl.  dr.  (1-9-7-5  o.c). 

„      Myrrhs 15-30  m.  (0-9-1-9  c.c). 

„      Nucis  Vomicai 20  m.  (1-25  o.c). 

„      Opii 11  m.  (0-65  cc)  or  22  drops. 

„         „    Camphorata  1-4  fl.  dr.  (3-75-15  c.c). 

„         „    Deodorata 11  m.  (0-65  o.c). 

„      Physostigmatis 20-40  m.  (1-25-2-5  c.c). 

„      Pyrethri 

„      Quassia 1  fl.  dr.  (3-75  c.c). 

„      Bhei .1-2  fl.  dr.  (3-75-7-5  cc). 

„         „    Aromatica 4-1  fl.  dr.  (1-9-3-75  cc). 

j,         „    Dulcis 2-3  fl.  dr.  (7-5-11-25  c.c). 

„      Sanguinariai ... 30-60  m.  (1-9-3-75  c.c). 


chap,  xxi.]     PHAEMACEUTICAL  PREPARATIONS.  531 

U.S.P.  DOSE. 

Tinctura  Saponis  Viridis 

„  SoillsB 10-20  m.  (0-6-1-25  c.c). 

„  Serpentarise 1-4  fl.  dr.  (3-75-15  c.c). 

„  Stramonii 20-30  m.  (1-25-1-9  c.c). 

„  Sumbul 20-60  m.  (1-2-3-7  c.c). 

„  Tolutana 1-2  fl.  dr.  (3-75-7-5  c.c). 

„  Valerianae ..1-4  fl.  dr.  (3-75-15  c.c). 

„  „        Ammoniata 30-60  m.  (1-9-3-75  c.c). 

„  Vanilla 

„  Veratri  Viridia 3-8  m.  (0-18-0-5  c.c). 

„  Zingiberis 8-40  m.  (0-5-2-5  c.c). 

U.S.P.  Triturationes.  Triturations. — These  are  intimate 
mixtures  of  substances  with  sugar  of  milk.  Each  contains  10 
per  cent,  of  the  active  substance.  A  general  formula  for  their 
preparation  is  given  in  the  U.S.P.,  although  only  one  is  named. 
According  to  this  formula  10  parts  of  the  substance  and  90 
parts  of  sugar  of  milk  are  to  be  weighed  out  separately.  The 
substance,  reduced  to  a  moderately  fine  powder  if  necessary,  is 
mixed  in  a  mortar  with  about  its  own  bulk  of  sugar  of  milk,  and 
they  are  triturated  together.  Fresh  portions  of  the  sugar  of 
milk  are  added  from  time  to  time  until  the  whole  has  been  added, 
and  the  trituration  is  continued  until  the  substance  is  intimately 
mixed  with  the  sugar  of  milk  and  finely  comminuted. 

u.s.p.    Trituratio  Elaterini. 

Trochisci.  Lozenges. — These  are  small,  flat,  and  hard,  so 
that  they  can  be  readily  carried  about  and  melt  slowly  in  the 
mouth.  They  are  thus  convenient  for  giving  drugs  which  are 
intended  to  act  upon  the  mouth  or  throat  locally,  or  to  be  readily 
carried  about  and  taken  at  times  and  in  places  where  more  bulky 
preparations  would  be  inconvenient.  Thus  we  have  lozenges  of 
chlorate  of  potassium,  which  are  useful  for  soreness  of  the  mouth 
and  tongue ;  tannic  acid  and  catechu,  which  are  useful  in  relaxed 
sore-throat  and  hoarseness;  ipecacuanha  with  morphine,  and 
with  opium,  which  are  useful  in  coughs ;  bicarbonate  of  sodium 
useful  before  meals  in  dyspepsia  or  after  meals  in  acidity ;  bismuth 
for  irritability  of  the  stomach;  and  reduced  iron  for  debility. 
Bismuth,  morphine,  and  opium  are  also  useful  in  diarrhoea.  In 
many  cases  it  happens  that  although  patients  can  take  potions 
before,  after,  or  with  their  morning  and  evening  meals,  they  are 
unable  to  do  so  in  the  middle  of  the  day  when  they  are  absent 
from  home  and  engaged  in  various  avocations.  For  such  cases 
lozenges  form  a  useful  means  of  administering  medicine. 

B.P.  (11).  U.S.P.  (16) 

Trochisci  Acidi  Tannici.  Trochisci  Acidi  Tannici. 

„        Bismuthi.  „        Ammonii  Chloridi. 

„       Catechu..  „       Catechu. 

„       Ferri  Bedacti.  „       Cietffi. . 

„       Ipecacuanha.  „       Cubebse. 

B        MorphinsB.  „        Ferri. 

„       Morphina!  et  Ipecacuanha.  „       GlycyrrhiziE  et  Opii. 

u  m  •> 


532 


GENEBAL  PHAEMACY. 


[SECT.  II. 


B.P.  TT.S.P. 

Trochisci  Opii.  Trochisci  Ipecacuanhas. 

„        Potasaii  Ghloratis.                              „  Kramerise. 

„       Santonini.                                         „  Magnesia;. 

,,       Sodii  Bicarbonatis.                          .„  ,  Menthas  Piperita;. 

„  Morphinas  et  Ipecacuanhas. 

„  Potassii  Chloratis. 

„  Sodii  Bicarbonatis. 

„  „      Santoninatis. 

„  Zingiberis. 

Unguenta.  Ointments. — These  are  soft  admixtures  of  medi- 
cines with  fatty  substances  for  external  application.  The  basis 
of  many  of  them  is  lard,  either  alone  or  mixed  with  benzoin  in 
order  to  preserve  it  from  rancidity,  or  mixed  with  white  wax  in 
the  form  of  ointment  (unguentum  U.S.P.).  In  the  B.P.,  simple 
ointment,  which  consists  of  white  wax  and  almond  oil,  forms  the 
basis  of  several  ointments. 

The  semi-solid  substances,  obtained  from  American  petro- 
leum, form  a  useful  basis  for  ointments,  as  they  do  not  become 
rancid.  They  consist  of  hydrocarbons,  mostly  of  the  marsh-gas 
series.  There  are  two  chief  varieties,  one  softer,  having  a 
melting  point  about  40°  C.  (104°  F.),  the  other  51°  C.  (or  121°  F.). 
They  are  obtained  by  distilling  off  the  lighter  and  more  volatile 
portions  from  American  petroleum.  They  are  known  under 
different  names,  paraffin  (B.P.),  petrolatum  (U.S.P.),  unguentum 
petrolei,  and  vaseline. 


b.p.  (43). 

u.s.p.  (25). 

Unguentum  Acidi  Borici.                                 Unguentum  Acidi  Carbolici. 

i) 

„    Carbolici.                                        , 

,        Aeidi  Gallici. 

„ 

„     Salicylici. 

,             „     Tannici. 

j» 

Aconitinas.                                               , 

,        Aquas  Bosas  (cold  cream) 

>) 

Antimonii  Tartarati. 

,        Belladonnas. 

»» 

Atropinas.                                                    , 

,        Chrysarobini. 

!» 

Belladonnas.                                             , 

,        Diachylon. 

„ 

Calamines. 

,        Gallas. 

J) 

Cantharidis. 

,        Hydrargyri. 

)J 

Cetacei. 

,                „            Ammoniati. 

») 

Chrysarobini. 

i                „            Nitratis. 

J> 

Creasoti. 

>                „             Oxidi  Flavi. 

JI 

Elemi. 

.                „                „    Bubri. 

)> 

Eucalypti. 

,        Iodi. 

)» 

Galls. 

,        Iodoformi. 

tl 

„      cum  Opio. 

,        Mezerei. 

J) 

Glycerini     Plumbi    Subace- 

,        Picis  Liquidas. 

tatis. 

,        Plumbi  Carbonatis. 

J» 

Hydrargyri  (blue  ointment). 

i            „        Iodidi. 

II 

„       Ammoniati. 

,        Potassii  Iodidi. 

)» 

,,       Com  posi  turn. 

,        Stramonii. 

)! 

„      Iodidi  Bubri. 

,        Sulphuris. 

») 

„       Nitratis. 

>               „          Alkalihum. 

t)  • 

„           „      ,,Dilutum. 

,        Veratrinas. 

j, 

„      Oxidi  Bubri. 

,        Zinci  Oxidi.   , 

»i 

„      Subchloridi. 

Iodi.   . 

„ 

Iodoformi. 

»» 

•Piois  Liquidas.      ,, 

GHM-,  xxi.]     PHARMACEUTICAL  PKEPARATIONS.  533 


B.P. 

Unguentum  Plumbi  Acetatis. 

„  „         Carbonatis. 

h  i,        Iodidi. 

„  Potassse  Sulphurata. 

„  Potassii  Iodidi.. 

„  Besinae. 

„  Sabinse. 

j,  Simplex. 


„  Sulphuris. 

„  „      .      Iodidi. 

„  Terebinthinfe. 

„  Veratrhue. 

„  Zinci. 

„  „      Oleati. 

B.P.  Vapores.  Vapoubs,  Inhalations. — These  are  prepara- 
tions for  applying  volatile  drugs  to  the  air-passages  for  the 
purpose  of  deodorising,  disinfecting,  stimulating  or  soothing. 
The  drug  is  mixed  with  water,  and  the  vapour  inhaled.  If  the 
drug  be  not, readily  volatile,  warm-water  is  used,  as  in  the  vapor 
creasoti,  or  the  water  is  warmed  during  inhalation,  as  in  the 
vapor  iodi..  In  the  vapor  olei  pini  sylvestris,  light  carbonate  of 
magnesium  is.  added,  to  aid  the  suspension  of  the  drug-  in  the 
water. 

B.P.  (6). 

Vapor  Acidi  Hydrocyanici 10  to  IS  min.  of  the  dilute  acid  to  one 

drachm  of  cold  water. 

„      Chlori ....2  oz.  in  cold  water.  . 

„      Conines  f  fluid  oz.  of  suecus  to  1  oz.  water 

and  1  dim.  of  li<j.  potasses. 

Creasoti 12  min.  to  8  oz.  of  boiling  water. 

Iodi .". 1  drin.  oi  tincture  to  the  oz.  of  water. 

,,      Olei  Pini  Sylvestris 40  min.  of  fir -wool  oil,  20  grs.  magnes. 

carb. ;   water  to  1  oz  :  1  dr.   in 
warm  water,  1  pint  as  inhalation. 

The  vapours  of  chlorine,  creasote,  and  iodine  may  be  used  for 
deodorising  in  cases  of  ozsena  or  in  cases  of  chronic  bronchitis 
with  offensive  sputa. 

Antiseptic  inhalations,  such  as  those  of  creasote  and  iodine, 
as  well  as  non-officinal  inhalations  of  iodoform  and  oil  of  pine, 
have  been  recently  used  in  the  treatment  of  phthisis,  with  the 
object  of  destroying  the  tubercle  bacillus.  For  this  purpose  a 
special  form  of  inhaler  is  used,  which  fits  over  the  mouth  and 
nose.  It  contains  a  sponge  which  is  soaked  with  the  drug  to  be 
inhaled  either  pure  or  dissolved  in  spirit  or  water. 

They  are  probably  also  useful  even  in  simple  catarrh,  by 
destroying  organisms  which  may  have  found  their  way  into  the 
air-passages  and  occasion  or  keep  up  inflammation.  The 
vapours  of  hydrocyanic  acid  and  conium  are  useful  for  the 
purpose  of  allaying  irritability,  as  in  spasm  of  the  glottis,  violent 
coughing,  or  spasmodic  asthma. 


534  GENEEAL  PHAEMACY.  •  {sect.  ii. 

Vina.  Wines. — These  are  made  in  the  same  way  as  tinc- 
tures, sherry  or  orange  wine  (B.P.)  or  stronger  white  wina 
(U.S.P.)  being  employed  instead  of  spirit. 

B.P.  (11)  DOSE. 

Vinum  Aloes 1-2  fluid  drachma. 

„  Antimoniale 5-30  min.  as  expectorant. 

„  „            J-l  fluid  oz.  as  emetic. 

„  Aurantii 

„  Colchici 10-30  min. 

„  Ferri  1-4  fluid  drachms. 

„  „     Citratis 1-4  fluid  drachms. 

„  Ipecacuanhse 5-40  min.  as  expectorant. 

„  „           1-8  drachms  as  emetic. 

„  Opii 10-40  min. 

„  Quininse ^-1  fluid  oz. 

„  Ehei 1-2  drachms. 

„  Xericum 

tj.s.p.  (14). 

Yinum  Album 

„      Album  Fortius 

,,  J  Stomachic,  1-2  drachma. 

•>      Aloea I  Purgative,  ^-1  fluid  oz. 

„      Antimonii Expectorant,  10-30  min. 

„       Aromaticum 

„      Colchici  Eadicis  10  min.-l  fluid  drachm. 

„  „       Seminis 30  min.-2  fluid  drachms. 

„      Ergotse  1-4  fluid  drachms. 

„      Ferri  Amarum 2-4  fluid  drachms. 

„  „     Citratis 1-4  fluid  drachms. 

-  ipr-to {SSSWtota"" 

„      Opii 15-20  min. 

„      Bhei 1-4  fluid  drachma. 

„      Rubrum 


section  iir. 
INORGANIC  MATERIA  MEDICA. 


637 


CHAPTEE  XXII. 

HYDEOGEN,  OXYGEN,  OZONE,  CAEBON,  SULPHUE, 
AND  THE  HALOGENS. 

Although  the  officinal  substances  included  in  this  chapter  differ 
widely  from  each  other  in  many  respects,  yet  their  relations  to 
oxygen  form  a  connecting  link  between  them.  Sulphur  belongs 
to  the  same  chemical  group  as  oxygen.  The  chief  action  of 
charcoal  is  its  power  of  oxidising  organic  substances  by  means  of 
oxygen  which  it  has  condensed  in  its  pores.  The  halogens  pro- 
bably owe  their  disinfecting  properties  in  great  measure  to  their 
power  of  liberating  oxygen  from  water  in  the  presence  of  organic 
matter  which  they  thus  oxidise  and  destroy. 

HYDROGEN  (H;  1).    Not  officinal. 

Preparation. — By  adding  diluted  hydrochloric  or  sulphuric  acid  to  granu- 
lated zinc — 


,  Uses:— It  is  of  little  or  no  use  as  a  remedy,  and  is  only  used 
as  a  test. 

It  is  very  frequently  employed  in  testing  for  arsenic,  antimony, 
Or  sulphur.  When  in  its  nascent  condition  it  has  active  chemical 
affinities,  and  readily  unites  with  these  substances,  forming  sul- 
phuretted, arseniuretted,  or  antimoniuretted  hydrogen.. 

OXYGEN  (0;  16).     Not  officinal. 

..  Pbopebtibs. — Oxygen  is  a  colourless  gas  without  smell, 
slightly  heavier  than  common  air.  It  forms  rather  more  than  a 
fifth  by  volume  of  the  atmosphere. 

Preparation. — By   heating   chlorate    of  potassium  with   peroxide  of 
manganese— 

2KC103  =  2KCl  +  302. 

Peroxide  of  manganese  merely  aids  the  decomposition  of  the  chlorate  of 
potassium,  and  takes  no  part  in  the  reaction. 

Physiological  Action.— Oxygen  applied  to  the  unbroken  skin 
has  but  little  actiont  but  when  applied  to  a  wound  it  increases 


538  INOKGANIC  MATEEIA  MEDICA.  [sect.  hi, 

the  circulation  in  it,  and  acts  as  a  stimulant.  When  inhaled  by 
healthy  persons  it  causes  a  slight  feeling  of  warmth  in  the  mouth, 
extending  downwards  over  the  front  of  the  body.  In  some  people 
it  appears  to  cause  nervous  symptoms  somewhat  like  those  pro- 
duced by  nitrous  oxide. 

In  animals,  excess  of  oxygen  produces  tetanic  symptoms  almost 
like  those  of  strychnine,  and  death.  This  effect  is  produced  by 
a  pressure  of  three  atmospheres,  and  it  is  evident  that  it  is  due 
to  the  oxygen  and  not  to  the  simple  increase  in  atmospheric 
pressure  only,  because  when  ordinary  air  is  used,  a  pressure  of 
three  atmospheres  has  no  such  action,  and  a  pressure  of  twenty- 
five  atmospheres  is  requisite  to  produce  this  effect  (Bert). 

It  has  been  thought  by  some  that  when  oxygen  has  been  once 
breathed  it  loses  something  which  enables  it  to  support  life. 
The  reason  of  this  belief  is  that  animals  soon  die  which  are  kept 
in  a  confined  space,  from  which  the  carbonic  acid  formed  during 
respiration  is  absorbed  by  lime  or  baryta,  and  its  place  supplied 
by  fresh  oxygen.  Professor  Seegen,  however,  has  found  that  the 
death  in  such  cases  is  not  due  to  the  removal  of  anything  from  the 
oxygen,  but  to  actual  poisoning  by  the  products  of  tissue-waste. 
In  some  experiments  he  noticed  that  the  air  in  which  the  animal 
had  been  confined  for  a  while,  although  its  chemical  composition 
was  correct,  had  a  disagreeable  smell,  and  the  animal  after  its 
removal  soon  died  of  pneumonia.  When  the  air  which  the  animal 
was  breathing  was  extracted  from  one  end  of  the  compartment, 
made  to  pass  through  a  red-hot  tube,  and  introduced  at  the  other 
end  so  that  any  organic  matter  formed  during  respiration  was 
consumed,  the  animal  could  be  kept  for  almost  any  length  of 
time  without  injury  to  its  health. 

Uses. — Oxygen  has  been  applied  to  the  surface  in  atonic, 
scrofulous,  and  syphilitic  ulcers,  and  in  cases  of  senile  or  other 
gangrene.  It  has  more  especially  been  employed  in  cases  of  respi- 
ratory disease,  such  as  emphysema,  bronchial  dilatation,  phthisis, 
and  gangrene  of  the  lung,  in  asphyxia  from  noxious  vapours  .or 
anaesthetics,  and  in  spasmodic  asthma.  It  seems  to  be  chiefly 
of  use  in  the  latter  disease.  It  has  been  employed  also  in  cases 
of  difficulty  of  breathing,  of  cardiac  disease,  and  of  anaemia  from 
loss  of  blood  or  suppuration.  It  has  been  employed  also  in  con- 
ditions where  oxidation  seems  to  be  deficient,  as  in  gout  and  dia- 
betes, where  sometimes  the  sugar  disappears  from  the  urine  during 
its  inhalation.  Oxygen  has  also  been  used  in  the  treatment  of 
epilepsy  and  spasm. 

It  has  been  strongly  recommended  by  Bert  in  paralysis  occurs 
ring  in  divers,  due  to  their  sudden  ascension  from  a  great  depth 
to  the  surface.  When  submerged  at  a  considerable  depth  the 
pressure  of  the  air  causes  both  nitrogen  and  oxygen  to  be  absorbed 
by  the  blood ;  when  they  return  to  the  surface  the  oxygen  enters 
into  combination,  but  the  nitrogen  is  set  free  in  the  blood-vessels*. 


.ch.  xxii,]    HYDROGEN,  OXYGEN,  OZONE,  CAEBON,  ETC.    539 

forming  minute  bubbles,  which  act  as  emboli,  obstructing  the 
circulation  in  the  nerve-centres  and  in  the  lungs,  thus  producing 
■paralysis  and  dyspnoea.  The  nitrogen  diffuses  as  readily  into 
an  atmosphere  of  oxygen  as  into  an  absolute  vacuum ;  and  there- 
fore when  animals,  in  which  such  a  state  has  been  artificially 
induced,  have  been  made  to  breathe  pure  oxygen,  bubbles  of 
nitrogen  disappear  from  the  blood,  the  circulation  is  speedily 
restored  to  its  normal  condition,  and  the  paralysis  and  dyspnoea 
disappear. 

Its  inhalation  has  been  recommended  in  cases  of  cholera. 


OZONE.    Not  officinal. 

When  an  electric  spark  is  passed  through  air  a  peculiar  smell 
is  noticed ;  this  is  due  to  the  formation  of  ozone.  The  electricity 
in  passing  through  the  air  appears  to  break  up  the  molecules  of 
ordinary  oxygen  (Fig.  164),  and  the  atoms  which  are  thus  dis- 


Fig.  1 64. — Diagram  to  illustrate  the  formation  of  ozone  by  electricity,  a  represents  oxygen,  through 
which  a  spark  is  passing ;  6  after  it  has  passed.  The  double  rings  are  intended  to  represent 
molecules  of  oxygen,  each  containing  two  atoms.  As  the  electric  spark  passes  through  the 
oxygen  it  breaks  up  the  first,  molecule,  carrying  one  atom  on  to  join  the  second  molecule  of 
oxygen,  and  form  one  of  ozone.  The  atom  which  is  left  joins  another  molecule  of  oxygen,  and 
also  forms  ozone.    (After  Lockyer.) 

sociated  join  together  so  as  to  form  ozone.  It  is  also  formed  by 
the  slow  oxidation  of  phosphorus,  and  is  formed  also  by  proto- 
plasm (p.  69).  Two  atoms  are  present  in  a  molecule  of  oxygen 
and  three  in  that  of  ozone.  When  electricity  is  passed  through 
a  quantity  of  oxygen,,  contained  in  a  tube  over  mercury,  so  as  to 
convert  a  portion  of  it  into  ozone,  it  becomes  condensed  in  bulk 
and  acquires  much  greater  chemical  activity.  On  warming  it 
again  to  about  300°  C.  the  molecules  of  ozone  become  again  dis- 
sociated, ordinary  oxygen  is  formed,  the  gas  then  returns  to  its 
original  bulk,  and  it  loses  its  active  properties.  Ozone  has  a 
most  powerful  oxidising  property,  attacking  metals  and  forming 
oxides,  and  destroying  organic  substances,  such  as  paper  anc| 
caoutchouc.  It  has  a  curious  action  upon  albumen,  already 
described  (p.  58),  and  decomposes  blood.    As  might  be  expected, 


540  INOEGANIC  MATEEIA  MEDICA.  [sect.  in. 

it  is  exceedingly  poisonous  to  low  organisms,  and  is  fatal  also  to 
the  higher  animals. 

Its  effect  appears  to  be  due  in  a  great  measure  to  its  having 
such  a  powerful  irritant  and  even  destructive  effect  on  the  albu- 
minous tissues  of  the  respiratory  passages,  that  it  causes  reflex 
depression  of  the  heart  and  interferes  with  the  ordinary  respira- 
tion in  the  lungs.  It  thus  diminishes  instead  of  increasing  oxi- 
dation. In  animals  it  causes  sometimes  quickness,  and  some- 
times slowness  of  the  respiration  (vide  p.  241),  and  produces  ex- 
citement followed  by  exhaustion  and  sometimes  convulsions. 

When  it  is  present  only  in  small  quantity  in  air,  it  may  be 
inhaled  without  any  disagreeable  effects,  and  is,  according  to 
Binz,  a  decided  soporific. 

Uses. — It  has  been  recommended  in  cases  similar  to  those 
already  mentioned  under  oxygen  ;  and  also  in  infectious  diseases, 
and  in  diphtheria,  where  it  is  likely  to  be  useful  by  destroying 
low  organisms,  which  produce  the  disease. 

PEROXIDE  OF  HYDROGEN  (H202;  34).     Not  officinal. 

Properties. — "When  the  watery  solution  thus  obtained  is 
evaporated  it  forms  a  transparent  oily  liquid  ;  but  it  is  generally 
employed  in  the  form  of  a  3  per  cent,  solution  (10  to  15  volumes) 
in  water  or  in  ether.  The  ethereal  solution  is  commonly  known 
by  the  name  of  ozonic  ether  ;  it  is  generally  more  stable  than 
the  aqueous  solution,  which,  especially  if  kept  in  a  badly  stop- 
pered bottle,  soon  decomposes  into  water  and  oxygen. 

Preparation. — It  is  generally  prepared  by  treating  barium  di-oxide  with 
dilute  sulphuric  acid  (Ba02  +  H2  SO,  =  H203  +  BaS04)  and  filtering  off  the 
aqueous  solution  from  the  sulphate  of  barium  •which  is  precipitated. 

Action  and  Uses. — Peroxide  of  hydrogen  has  a  powerful 
oxidising  effect  upon  organic  substances,  readily  giving  off  an 
atom  of  oxygen  in  much  the  same  way  as  ozone.  It  has  there- 
fore been  used  for  similar  purposes  to  ozone.  It  destroys  bacteria, 
and  is  a  "powerful  antiseptic.1  "When  mixed  with  the  secretion 
from  a  chancre  it  destroys  its  infective  power  ;  and  it  has  been 
employed  as  a  local  dressing  for  chancres,  and  also  as  an  appli- 
cation for  diphtheritic  sore-throat.  Curiously  enough,  although 
when  mixed  with  blood  or  with  albumen  it  becomes  decomposed 
almost  immediately,  it  appears  to  be  tolerably  stable  in  the  body* 
and  is  said  to  have  been  found  in  the  urine  after  it  has  been  taken 
by  the  mouth.  By  long-continued  action  upon  egg-albumin,  it 
is  said  to  produce  hemi-albumose  and  peptone.2  Its  internal 
administration  has  been  recommended  in  rheumatism,  scrofula, 
diabetes,  and  cardiac  disease. 

1  Professor  Dewar,  Cambridge,  unpublished  experiments. 

2  Chandelon,  Beitrag  zum  Studium  der  Peptonisation,  Ber.  d.  Deutsch.  Chem. 
£es.  XVII.  p.  2H3  (1885). 


CH.  xxn.]    HYDEOGEN,  OXYGEN,  OZONE,  CAEBON,  ETC.    541 


CARBON  (G;  12). 

This  element  is  employed  in  medicine  in  the  form  of  animal 
and  vegetable  charcoal. 

Carbo  Ligni,  B.P.  and  U.S. P.  Wood  Charcoal. — Wood 
charred  by  exposure  to  a  red  heat  without  access  of  air,  B.P. 
Charcoal  prepared  from  soft  wood,  U.S. P. 

Characters. — In  black,  brittle,  porous  masses,  without  taste 
or  smell,  very  light,  and  retaining  the  shape  and  texture  of  the 
wood  from  which  it  was  obtained.  When  pulverised  it  forms  a 
fine  black  powder. 

Preparation. — It  is  prepared  either  by  burning  the  wood  under  turf,  or 
In  retorts,  so  that  the  hydrogen  and  oxygen  are  driven  off  and  charcoal  alone 
remains.  If  too  much  air  be  allowed  to  have  access,  the  charcoal  itself  be- 
comes burnt,  and  too  large  a  proportion  of  ash  comes  to  be  present. 

Impurities. — Too  much  ash. 

Tests. — When  burned  at  a  high  temperature  with  free  access  of  air  it 
leaves  not  more  than  two  per  cent,  of  ash. 

Dose. — 20-60  grains. 

Officinal  Preparation. 
B.P.  u.s.p. 

Cataplasma  Carbonis.  None. 

B.P.  Cataplasma  Carbonis.  Charcoal  Poultice. — Powdered  charcoal  1 ; 
bread  4 ;  linseed-meal  3 ;  boiling  water  20.  Mix  the  water,  bread,  and  linseed- 
meal,  then  add  half  the  charcoal  and  sprinkle  the  remainder  on  the  surface.  By 
simply  sprinkling  a  part  of  the  charcoal  on  the  surface  of  the  poultice  it  is  not 
wetted,  and  its  disinfectant  power  not  destroyed. 

Action. — Charcoal  has  the  power  of  absorbing  gases  and  of 
condensing  them  within  its  pores.  Amongst  others  it  absorb's 
oxygen  readily.  The  oxygen  thus  condensed  has  an  oxidising 
action  akin  to  that  of  ozone,  and  the  charcoal  parts  with  it 
readily  when  brought  into  contact  with  oxidisable  substances, 
whether  these  substances  be  in  solution  or  in  the  form  of  gas, 
but  especially  the  latter.  Thus  it  oxidises  and  decomposes 
sulphuretted  hydrogen  very  readily,  and  also  quickly  oxidises 
and  destroys  decomposing  organic  substances.  It  thus  acts  as 
a  deodoriser  and  disinfectant.  It  only  possesses  this  power,  how- 
ever, when  it  is  dry,  and  loses  it  when  it  is  wet.  For  this  reason 
the  whole  of  it  is  not  mixed  with  the  poultice  in  the  cataplasma 
carbonis,  a  part  of  it  being  merely  sprinkled  on  the  surface.  Its 
oxidising  power  is  destroyed  completely  only  when  the  charcoal 
is  thoroughly  saturated  with  water,  and  this  occurs  with  diffi- 
culty even  when  it  is  thrown  into  water.  Consequently  its 
oxidising  power  may  still  be  exerted  in  fluids  to  which  it.  has  been 
freshly  added.  ; 

Uses. — It  is  employed  as  a  deodoriser  and  disinfectant  in 
.traps  through  which  sewer,  gases  may  pass,  and  in  a  respirator 


542  INOEGANIC  MATERIA  MEDICA.  [sect.  in. 

for  persons  exposed  to  sewer  gas  or  other  noxious  emanations. 
As  a  poultice  it  is  employed  for  foetid  and  phagedenic  ulcers  and 
gangrene.  It  forms  a  useful  tooth-powder,  cleaning  the  teeth 
rapidly,  but  it  is  much  more  apt  to  scratch  the  enamel  than  a 
tooth-powder  of  chalk.  When  taken  into  the  stomach  it  relieves 
flatulent  distension  and  acidity  in  the  stomach  and  intestines. 
It  has  thus  been  used  in  acute  and  chronic  dyspepsia,  gastrodynia, 
and  even  cancer  of  the  stomach ;  in  constipation,  flatulent  dis- 
tension of  the  colon,  diarrhoea,  dysentery,  cancer  of  the  rectum; 
it  is  recommended  in  drachm-doses  by  Sir  William  Jenner  to 
correct  flatulence  and  foetid  stools  in  typhoid  fever.  It  has  been 
supposed  to  relieve  flatulence  by  absorbing  the  gases  in  the 
stomach  and  intestines,  but  as  it  will  become  wet  by  the  juices 
of  the  intestinal  canal  after  it  is  swallowed,  it  is  much  more 
probable  that  it  acts  mechanically,  by  removing  mucus,  or  by 
stimulating  the  circulation  and  peristaltic  movements  in  the- 
walls  of  the  stomach  and  intestine.  This  is  rendered  all  the 
more  probable  by  the  fact  that  in  some  cases  where  it  is  useful 
the  patient  is  likewise  benefited  by  beginning  each  meal  with 
solid  food,  and  abstaining  from  liquids  until  the  meal  is  well 
over,  so  that  the  stomach  may  receive  a  mechanical  stimulus 
from  the  food,  which  would  be  prevented  by  the  ingestion  of  much 
liquid  at  the  beginning  of  the  meal.  In  large  doses  it  acts  as  a 
mild  purgative.  It  has  also  been  used  in  diabetes  and  in  inter- 
mittent fevers. 

Administration. — It  is  either  used  in  the  form  of  powder,  or 
made  up  into  biscuits  or  lozenges. 

Carbo  Animalis,  B.P.  and  U.S.P.  Animal  Charcoal. — 
Bone  black.  Animal  charcoal  prepared  from  bone,  U.S.P.  The 
residue  of  bones  which  have  been  exposed  to  a  red  heat  without 
the  access  of  air.  Consists  principally  of  carbon  and  phosphate 
and  carbonate  of  calcium,  B.P. 

Carbo  Animalis  Purificatus,  B.P.  and  U.S.P.  Purified 
Animal  Charcoal. 

Characters. — It  is  a  black  powder  without  taste  or  smell. 
It  absorbs  colouring  matters,  and  tincture  of  litmus  diluted  with 
20  times  its  bulk  of  water  agitated  with  it  and  thrown  upon  a 
filter  passes  through  colourless.     It  is  insoluble  in  all  reagents. 

Preparation. — By  dissolving  out  the  earthy  matter  by  hydrochloric  acid, 
w  ashing  and  drying. 

Impurities. — Too  much  ash. 

Test. — When  burnt  at  a  high  temperature  with  a  little  red  oxide  of 
mercury  and  free  access  of  air,  it  leaves  only  a  slight  residue. 

Dose. — 20-60  grains. 

Uses.— From  its  power  of  absorbing  colouring  matters, 
animal  charcoal  is  used  in  the  preparation  of  organic  alkaloids, 
for  the  purpose  of  decolorising  them.    It  not  only  carries  down 


ch.  xxii.]    HYDKOGEN,  OXYGEN,  OZONE,  CARBON,  ETC.    543 

colouring  matters  with  it,  but  alkaloids  as  well,  and  therefore  a 
considerable  loss  is  occasioned  in  the  process  of  bleaching.  Ad- 
vantage has  been  taken  of  this  power  to  use  animal  charcoal  as 
an  antidote  in  poisoning  by  opium,  aconite,  nux  vomica,  &c.  The 
alkaloid  is  removed  from  solution  by  the  animal  charcoal  and 
retained  by  it  with  considerable  pertinacity.  It  would,  however, 
be  gradually  dissolved  out  if  allowed  to  remain  too  long  in  the 
stomach,  and  therefore  the  stomach-pump,  or  emetics,  must  be 
used  in  addition.  As  an  antidote  it  is  used  in  doses  of  a  table- 
spoonful  frequently  repeated. 


SULPHUR  (S;  32). 

Sulphur  is  found  native  in  volcanic  districts,  and  occurs  in 
combination  with  metals  as  sulphites  in  various  ores,  especially 
in  iron  and  copper  pyrites. 

Sulphur  Sublimatum,  B.P.  and  U.S.P-  Sublimed  Sulphur, 
Flowers  of  Sulphur. 

Characters. — A  fine,  slightly  gritty,  citron-yellow  or  greenish- 
yellow  powder,  without  taste  or  smell  unless  heated.  It  may 
sometimes  have  a  slight  characteristic  odour,  a  faintly  acid  taste 
and  an  acid  reaction  from  slight  oxidation  occurring  with  the 
formation  of  small  quantities  of  sulphurous  acid. 

Solubility. — It  is  insoluble  in  water  or  alcohol,  slightly  soluble  in  oils 
and  fats,  and  completely  soluble  in  carbon  disulphide. 

Eeaction. — When  ignited  it  burns  with  a  blue  flame,  forming  sulphurous 
acid  gas,  and  leaving  no  residue,  or  only  a  trace. 

Preparation. — By  sublimation  from  crude  or  rough  sulphur.  Native 
sulphur  is  usually  mixed  with  earthy  impurities.  "When  heated  the  sulphur 
volatilises.  If  the  vapour  is  condensed  in  a  large  room  it  falls  in  a  fine 
powder.  If  condensed  in  water  it  forms  masses,  which,  when  melted  and 
run  into  moulds  form  roll  sulphur,  but  this  is  not  officinal.  Ores  containing 
sulphur  are  decomposed  by  heat,  and  part  of  the  sulphur  they  contain  sub- 
limes, and  may  be  condensed  in  the  same  way  as  native  sulphur. 

Impurities. — Ores  are  apt  to  contain  arsenic,  and  when  this  is  the  case 
sulphide  of  arsenic,  being  volatile,  sublimes  along  with  the  sulphur  and 
renders  it  impure.  During  sublimation  the  sulphur  may  undergo  oxidation, 
and  thus  sulphurous  or  sulphuric  acid  may  be  present  in  it  as  impurities. 

Tests. — Vide  Sulphur  Lotum. 

Officinal  Preparations. 
b.p.  dose.  u.s. p. 

Confectio  Sulphuris,  as  laxative 60-120  gr.      Sulphur  Lotum. 

„  „  as  alterative 5-20  gr.  „        Prsocipitatum. 

Emplastrum  Ammoniaci  cum  Hydrarg-yro. 

„  Hydrarg-yri. 

Pulvis  Gly  cy rrhlzae  Compositus  (1  in  12)  30  to  60  gr. 

Unguentum  Sulphuris.  Unguentum  Sulphuris. 

'  Used  in  preparing : 

Antimonium  Sulphuratum. 
Potassa  Sulphurata. 
Sulphuris  Iodidum. 
Sulphur  Proecipitatum-. 


544  INOEGANIC  MATEEIA  MEDICA.  [sect.  in. 

B.P.  Confeotio  Sulphuris.  Confection  of  Sulphur. — Sulphur  4 ;  acid 
tartrate  of  potassium  1 ;  syrup  of  orange-peel  4  ;  tragacanth  in  powder  ^  part. 
The  acid  tartrate  of  potassium  is  added  for  the  purpose  of  increasing  the  secretion 
from  the  intestine,  while  the  sulphur  stimulates  peristaltic  action. 

Unguentum  Sulphuris.  Sulphur  Ointment. — Sulphur  mixed  with  benzoated 
lard,  1  part  to  4,  B.P. ;  30  to  70,  XJ.S.P.  The  U.S.P.  ointment  is  nearly  twice  as 
strong  as  the  B.P. 

Uses. — See  pp.  546,  547. 

In  skin  diseases  sulphur  is  used  both  as  an  antiparasitic, 
and  as  a  stimulant  in  chronic  and  passive  congestion.  It  is  used 
as  an  ointment  in  scabies,  and  in  tinea  tonsurans,  in  severe 
cases  of  which  an  ointment  of  sulphur  and  tar  with  soap  may  be 
used,  four  drachms  of  sulphur  and  oil  of  cade  to  one  ounce  each 
of  green  soap  and  lard.  In  the  true  prurigo  of  Hebra  it  may  be 
employed  in  Vleminckx's  solution,  which  is  made  according  to 
the  following  formula  : — 

9>    Calcis  ^ss. 

Sulphuris  Sublimati 3J. 

Aqua?  Jx. 

Evaporate  to  Jvj.,  then  filter. 

The  solution  must  be  rubbed  into  the  skin  while  the  patient 
is  in  a  bath  at  the  temperature  of  the  body  (98°  P.).  Obstinate 
cases  of  psoriasis  may  be  similarly  treated.  Unguentum  sulphu- 
ris is  useful  in  acne,  sycosis,  seborrhoea,  and  chronic  indurated 
eczema.  In  lupus  erythematosus  and  lupus  attended  with  a 
congested  condition  of  the  scalp,  a  paste  of  alcohol  and  sulphur 
is  recommended. 

U.S.P.     Sulphur  Lotum.     Washed  Sulphur. 
Characters  and  Impurities. — Those  of  sulphur  sublimatum. 

Preparation. — By  digesting  sulphur  with  dilute  ammonia,  thoroughly 
washing,  drying  at  a  gentle  heat,  and  passing  through  a  No.  30  sieve.  In 
this  process  the  ammonia  not  only  neutralises  any  sulphurous  or  sulphurio 
acid,  but  dissolves  out  and  removes  sulphide  of  arsenic  which  may  be  present 
in  the  sulphur,  and  which  is  soluble  in  ammonia. 

Tests. — Water  agitated  with  it  should  not  redden  blue  litmus  paper 
(absence  of  free  acid).  If  washed  sulphur  be  digested  with  two  parts  of  water 
of  ammonia,  and  the  mixture  filtered,  the  filtrate,  on  being  supersaturated 
with  hydrochloric  acid,  should  remain  unaltered  (absence  of  arsenious 
sulphide),  nor  should  a  precipitate  make  its  appearance  on  passing  hydro- 
sulphuric  acid  through  the  nitrate  (absence  of  arsenious  acid). 

Officinal  Preparations. 

U.S.P. 

Pulvis  Glycyrrhizaj  Compositus.     (1  in  12J.) 

Sulphuris  Iodidum. 

Unguentum  Sulphuris  Alkalinum. 

U.S.P.  Unguentum  Sulphuris  Alkalinum.  Alkaline  Sulphub  Ointment. 
Sulphur  20 ;  carbonate  of  potassium  10  ;  water  5  ;  benzoated  lard  65. 

Sulphur  Praecipitatum,  B.P.  and  U.S.P.  Precipitated 
Sulphur,  Lao  Sulphuris,  Milk  op  Sulphur. 


ch.  xxii.]    HYDEOGEN,  OXYGEN,  OZONE,  CAEBON,  ETC.    545 

Chaeactbbs. — Being  in  a  finer  state  of  division  than  sublimed 
sulphur,  it  looks  almost  white,  with  only  a  slight  tinge  of  yellow. 
Otherwise  its  characters  are  the  same. 

Preparation. — By  boiling  sulphur  with  slaked  lime  and  water.  Calcium 
sulphide  and  calcium  hyposulphite  are  thus  formed. 


These  dissolve  in  water,  and  are  separated  from  any  residual  lime  by  filtra- 
tion. To  the  filtrate,  in  an  open  space  or  under  a  chimney,  hydrochloric 
acid  is  then  added,  which  decomposes  these  substances  with  the  evolution  of 
sulphuretted  hydrogen  and  sulphurous  acid  gases,  and  throws  down  sulphur 
in  the  form  of  an  exceedingly  fine  powder,  which  is  washed  until  the  washings 
are  tasteless  (U.S.P.)  and  have  no  acid  reaction  and  cease  to  give  a  preci- 
pitate with  oxalic  acid  (B.P.),  showing  that  both  acid  and  lime  have  been 
removed. 

Impurities. — There  is  a  great  temptation  to  fraudulent  manufacturers  to 
use  sulphuric  acid  instead  of  hydrochloric  acid.  It  is  not  only  cheaper  but  it 
yields  a  large  product,  consisting  to  a  great  extent  of  sulphate  of  calcium, 
which  is  precipitated  along  with  the  sulphur  instead  of  remaining  in  solution 
like  the  calcium  chloride  which  is  formed  when  hydrochloric  acid  is  em; 
ployed. 

With  Hydrochloric    acid,  CaS5  +  2CaS203  +  6HC1  =  3S2  +  2H20  +  H2S  +  2S02 

+  3CaCl2. 
With  Sulphurio    acid,    CaSi  +  2CaS2Os  +  3H2S04  =  3S2  +  2H20-t-H2S  +  2SO.! 

+  3CaSOt. 

Besides  this  there  are  the  other  impurities  which  may  be  present  in  the  sub- 
limed sulphur  employed  in  the  process. 

Tests. — It  should  be  completely  volatilised  by  heat  and  leave  no  residue 
of  sulphate  behind.  Under  the  microscope  it  should  exhibit  only  minute 
globules  of  sulphur  and  no  crystals  of  sulphate.  The  absence  of  the  im- 
purities contained  in  sublimed  sulphur  is  ascertained  by  the  tests  already 
given. 

Dose. — Of  precipitated  sulphur,  as  alterative  10  grs.,  as 
laxative  30-60  grs. 

Sulphuretted  Hydrogen.  Hydrogen  Sulphide.  (H2S ;  34.) 
A  colourless  gas,  with  a  smell  of  rotten  eggs.  Used  only  as  a 
test. 

Properties. — It  precipitates  most  metals  as  sulphides  from 
acid  solutions,  the  precipitate  with  arsenic  being  yellow ;  anti- 
mony, orange ;  cadmium,  yellow ;  copper,  lead,  mercury,  and 
silver,  black ;  bismuth,  brown ;  gold  and  platinum,  brownish 
black. 

Preparation. — By  pouring  diluted  sulphuric  acid  on  sulphide  of  iron. 
By  passing  the  gas  into  cold  water  a  solution  is  obtained. 

General  Action  of  Sulphuretted  Hydrogen. — As  sulphu- 
retted hydrogen  is  formed  in  small  quantities  from  sulphur  when 
the  latter  is  used  in  various  ways,  it  may  be  more  convenient  to 
take  its  action  before  that  of  sulphur.  It  is  very  destructive  to 
plant  life  even  in  very  minute  quantities.     There  is  a  curious 

N  N 


546  INOBGANIC  MATEEIA  MBDICA.  [sect.  in. 

difference  between  the  action  of  sulphuretted  hydrogen  and  that 
of  sulphurous  acid  on  plants.  The  latter  seems  to  act  as  an 
irritant,  causing  the  leaves  to  crumple  up  and  fall  off,  but  even 
when  the  leaves  are  destroyed  by  sulphurous  acid  the  plant  may 
again  recover.  Sulphuretted  hydrogen  causes  the  leaves  simply 
to  become  flaccid  and  droop,  but  when  this  has  once  taken  place 
the  plant  does  not  recover. 

In  animals  it  destroys  the  functions  of  all  tissues,  and  in 
consequence  has  two  actions  which  are  well  marked,  (1)  decom- 
posing the  blood  and  thus  producing  symptoms  of  asphyxia,  and 
(2)  paralysing  the  nervous  system  and  muscles.  It  is  ab- 
sorbed by  the  skin,  by  the  lungs,  mucous  membrane  of  the 
alimentary  canal,  and  subcutaneous  cellular  tissue,  and  may 
produce  symptoms  of  poisoning  through  any  of  these  channels. 
In  frogs,  which  are  less  affected  than  mammals  by  interference 
with  the  respiration,  the  symptoms  produced  by  sulphuretted 
hydrogen  are  those  of  paralysis  of  voluntary  motion  and  reflex 
action,  preceded  by  a  stage  of  restlessness.  In  mammals  the 
symptoms  are  those  of  asphyxia;  muscular  tremors  occur,  and 
are  succeeded  by  asphyxial  convulsions  and  death.  Most  cases 
of  poisoning  by  sulphuretted  hydrogen  in  man  occur  from  in- 
halation of  the  gas  which  is  often  found  in  large  quantities  in 
cesspools. 

One  case  has  been  recorded  where  symptoms  of  poisoning 
occurred  from  the  excessive  formation  of  the  gas  in  the  intes- 
tinal canal,  and  subsequent  absorption  into  the  blood.  Cases  of 
poisoning  are  best  treated  by  artificial  respiration. 

Special  Action. — Even  in  minute  quantities  it  destroys  the 
catalytic  action  of  many  substances  on  peroxide  of  hydrogen. 
In  this  respect,  as  well  as  in  many  of  the  symptoms  it  produces, 
it  resembles  hydrocyanic  acid. 

On  the  blood.  It  first  reduces  and  then  decomposes  haemo- 
globin. Both  the  blood  and  the  muscles  of  frogs  poisoned  by  it 
exhibit  a  greenish  colour.  As  death  occurs  in  mammals  before 
the  blood  has  become  so  extensively  changed,  it  simply  exhibits 
the  characters  of  asphyxial  blood.  It  induces  rigor  mortis  rapidly 
in  the  muscular  substance  both  of  the  voluntary  muscles  and 
of  the  frog's  heart. 

Action  of  Sulphur. — Sulphur,  when  brought  into  contact 
with  living  protoplasm,  enters  into  combination  and  forms 
sulphuretted  hydrogen  or  sulphurous  acid.  When  sulphur  is 
sprinkled  over  actively-growing  fungi,  like  those  which  cause  the 
vine-disease,  these  gases  are  formed  and  the  fungi  destroyed. 

Sulphur  has  little  or  no  action  on  the  skin,  excepting  a 
mechanical  one.  It  is  a  laxative  (p.  394).  When  taken  into  the 
intestinal  canal,  a  considerable  part  of  it  again  passes  ont  un- 
changed ;  a  little  of  it,  however,  appears  to  be  converted  into 
sulphides  and  into  sulphuretted  hydrogen.   The  latter  is  excreted 


ch.  xxii.}   HYDKOGEN,  OXYGEN,  OZONE,  CAEBON,  ETC.    547 

by  the  breath,  and  may  give  to  it  the  peculiar  disagreeable  smell 
of  rotten  eggs.  It  is  also  excreted  by  the  skin,  so  as  to  blacken 
any  silver  articles  which  may  be  worn  about  the  person.  The 
sulphides  give  rise  to  increased  peristaltic  action  of  the  bowels, 
so  that  the  motions  become  more  frequent  and  softer ;  colicky 
pains  are  sometimes  produced.  The  sulphides,  after  absorp- 
tion into  the  blood,  are  excreted  in  the  urine,  chiefly  as  sul- 
phates. 

Uses. — For  its  use  in  skin  disease,  vide  p.  544.  It  has  been 
applied  by  insufflation  to  the  throat  in  diphtheria,  in  order  to 
destroy  the  organisms  present  in  the  pharynx,  in  the  same  way 
as  in  the  vine-disease.  I  have  seen  one  case  do  very  well  under 
this  treatment ;  but  its  general  efficacy  is  by  no  means  certain. 
Internally  it  is  employed  as  a  mild  laxative  in  cases  of  constipa- 
tion where  active  purgatives  are  inadmissible,  as  in  pregnancy, 
in  haemorrhoids,  fissure  of  the  anus,  and  stricture  or  prolapsus 
of  the  rectum.  It  has  been  used  also  in  cases  of  lead-poisoning, 
to  prevent  the  reabsorption  of  the  lead  from  the  intestine. 

It  has  been  found  useful  in  case's  of  sexual  irritation  arising 
from  hemorrhoidal  congestion  (p.  451),  and  also  in  the  nervous 
excitement  and  other  disturbances  accompanying  the  meno- 
pause. 

It  exerts  a  beneficial  action  on  the  tissues  in  chronic  rheu- 
matism and  gout,  and  is  especially  useful  in  the  form  of  sul- 
phurous waters.  During  its  elimination  by  the  lungs  it  is 
supposed  to  have  a  beneficial  action  on  them,  and  it  is  conse- 
quently used  in  chronic  bronchitis. 


HALOGEN   ELEMENTS. 

Fluorine  (Fl;  19  or  19-1).     Chlorine  (CI ;  35-5  or  35-4). 

Bromine  (Br;  80  or  79-75).     Iodine  (I;  127  or  126-58). 

These  substances  form  a  series  in  which  the  atomic  weights 
are  nearly  in  the  relation  of  1,  2, 4,  and  7  {vide  also  p.  16) .  They 
are  distinguished  by  the  activity  of  their  chemical  affinities  and 
the  number  of  compounds  they  form. 

General  Source. — The  name  halogen  (from  aks,  the  sea)  has 
been  given  to  the  group,  because  its  most  important  members, 
chlorine,  bromine,  and  iodine,  are  derived  from  the  sea  ;  chlorine 
being  obtained  from  sea-salt,  bromine  from  sea-water,  iodine 
from  sea-weed. 

General  Characters. — They  are  all  very  volatile.  At 
ordinary  temperatures,  chlorine  is  a  gas,  bromine  a  liquid,  and 
iodine  a  solid,  but  both  bromine  and  iodine  give  off  vapour  freely. 
On  account  of  their  active  chemical  affinities  they  unite  directly 
with  metals,  as  is  seen  in  the  officinal  processes  for  the  prepara- 
tion of  iodide  of  iron  and  green  iodide  of  mercury.    They  have 


548  INOKGANIC  MATEKIA   MEDICA.  [sect,  in 

all  a  great  affinity  for  hydrogen,  and  are  therefore  powerful  de- 
composers of  organic  matter,  destroying  organic  colours  and 
disagreeable  emanations  of  organic  origin,  as  well  as  decompos- 
ing sulphuretted  hydrogen  (H2S  +  C12  =  2HC1+  S?)  and  ammonia 
which  occur  amongst  the  products  of  decomposition  of  organic 
matter.  They  are  therefore  used  as  deodorisers  and  disinfectants. 
Chlorine  is  used  for  bleaching,  but  bromine  and  iodine  form 
coloured  compounds  with  many  organic  substances,  and  so  are 
not  used  for  this  purpose. 

Probably  the  bleaching  power  of  chlorine  is  not  due  to  its 
decomposing  organic  colours  by  removing  hydrogen  from  them, 
but  rather  to  its  decomposing  water  by  removing  the  hydrogen 
from  it,  and  thus  setting  free  nascent  oxygen,  which  is  the  direct 
destroyer  of  organic  matters.  The  reason  for  this  supposition  is 
that  chlorine  does  not  act  upon  colouring  matters  when  they  are 
dry,  but  only  when  moist. 

Mode  of  Pbepaeation. — Chlorine,  bromine,  and  iodine  are 
all  prepared  by  expelling  them  from  their  compounds  with  the 
alkaline  metals  by  means  of  sulphuric  acid  and  manganese 
dioxide. 

Chlorine  is  prepared  by  putting  sodium  chloride,  sulphuric 
acid  and  manganese  dioxide  into  a  retort,  applying  heat  and  col- 
lecting the  chlorine  gas  in  a  receiver,  by  displacement  or  over 
warm  water,  or  passing  it  into  cold  water  which  dissolves  it 
freely,  forming  liquor  chlori  (B.P.)  or  aqua  chlori  (U.S.P.). 

Bromine  is  prepared  in  a  similar  manner  from  the  bromides 
of  sodium  and  magnesium  contained  in  the  bittern  or  mother- 
liquor  left  after  the  salt  has  crystallised  out  of  sea-water  or  out 
of  the  brine  obtained  in  salt  mines.  In  order  to  obtain  the  bro- 
mine pure,  the  bittern  is  often  not  treated  directly  with  sulphuric 
acid  and  manganese  dioxide.  Instead  of  this  the  bromine  is  first 
separated  by  passing  chlorine  through  the  liquid,  which  is  then 
shaken  up  with  ether.  The  chlorine  decomposes  the  magnesium 
bromide  and  the  ether  dissolves  the  bromine  thus  set  free.  The 
bromine  is  then  converted  again  by  potash  into  bromide,  from 
which  bromine  is  obtained  by  means  of  manganese  dioxide  and 
acid. 

Iodine  is  prepared  in  a  similar  manner  to  chlorine  from  the 
iodides  of  sodium  and  magnesium  contained  in  sea-weed.  The 
iodides  are  obtained  from  the  weed  by  calcining  it  in  a  retort,  or 
by  burning  it,  when  the  ashes  in  which  they  are  contained  form 
a  hard  mass  called  kelp.  This  is  treated  with  successive  portions 
of  water  until  the  soluble  salts  are  all  dissolved  out  (lixiviation). 
The  solution  is  filtered,  and  evaporated  to  a  small  bulk,  when 
the  less  soluble  salts,  as  the  sulphates,  &c,  crystallise  out.  The 
mother-liquor  containing  the  iodides  of  sodium  and  magnesium 
is  then  treated  with  manganese  dioxide  and  sulphuric  acid,  and 
the  iodine  distils  over. 


ch.  xxii.]    HYDROGEN,  OXYGEN,  OZONE,  CARBON,  ETC.    549 

The  reactions  which  occur  in  the  preparations  just  described 
are — 

Chlorine    2NaCl  +  2H2SO,  +  Mn02  =  01,  +  Na2S04  +  MnS04  +  2H20. 

Brnmir.fi  /  2NaBr  +  2H^04  +  Mn02  =  Br2  +  Na2S04  +  MnS04  +  2H20. 
Bromine   {    MgB^  +  2H2s0i  +  Mno2  =  Br2  +  MgSOi  +  MnSOi  +  2H  a 

Tn^linp       f2NaI  +  2H2S04  +  MnO,  =  I,  +  Na2S04  +  MnSO.  +  2H,0. 
loaine      ^  Mgj2  +  ^g^  +  Mn02  =  ^  +  MgS0)  +  UnSQt  +  2^Q 

General  Action. — As  chlorine,  bromine,  and  iodine  decom- 
pose organic  compounds  having  a  disagreeable  odour,  they  have 
been  supposed  to  have  a  similar  action  upon  the  germs  of  infec- 
tious diseases.  Chlorine,  and  sometimes  iodine,  are  therefore 
used  as  deodorisers  and  disinfectants  in  sick  rooms.  Bromine 
cannot  well  be  used  on  account  of  its  abominable  smell. 

The  objections  to  chlorine  or  the  vapour  of  iodine  as  disinfec- 
tants are  that  we  do  not  at  all  know  that  they  have  any  disin- 
fecting power  in  the  dilute  state,  in  which  only  they  can  be  used 
in  a  sick  room.  When  applied  to  the  skin  or  mucous  membranes 
they  cause  a  greater  or  less  amount  of  irritation  or  inflamma- 
tion, according  to  the  length  of  time  during  which  they  act,  and 
the  greater  or  less  degree  of  concentration  in  which  they  are 
applied.  They  probably  do  not  enter  the  blood  in  the  free  state, 
but  combine  with  bases  or  with  albuminous  substances  at  the 
place  of  application,  and  are  absorbed  as  chlorides,  bromides,  or 
iodides,  or  else  as  albuminous  compounds.  Accprding  to  Binz, 
free  chlorine,  bromine,  and  iodine,  and  all  their  readily  decom- 
posable compounds,  have  a  narcotic  action,  and  paralyse  nervous 
centres  in  the  brain  by  a  direct  action  on  the  nervous  structures 
themselves.  He  considers  that  they  cause  death  by  paralysis  of 
the  respiratory  centre,  and  not  by  paralysis  of  the  heart. 


CHLORINE.    CI;  355. 

A  greenish-yellow  gas  with  a  suffocating  odour.  Its  prepara- 
tion and  general  action  have  already  been  described  (p.  548). 

Action. — When  applied  for  a  long  time  to  the  skin,  as  in 
persons  who  have  to  work  in  an  atmosphere  containing  it,  it 
causes  itching,  reddening,  and  inflammation.  When  applied  to  the 
more  sensitive  mucous  membranes  of  the  respiratory  passages, 
it  acts  as  a  stimulant  or  irritant.  In  a  concentrated  form  it  may 
cause  death  from  spasm  of  the  glottis,  or  intense  bronchitis.  In 
a  more  dilute  form  it  is  used  as  a  stimulant,  deodoriser,  and 
disinfectant.  The  manner  of  employing  it  is  to  put  a  saucer 
containing  salt,  binoxide  of  manganese,  and  sulphuric  acid  on  a 
shelf  or  high  piece  of  furniture  in  the  sick  room,  and  thus  allow 
the  chlorine  vapour,  which  is  heavier  than  air,  to  diffuse  itself 
through  the  apartment.  When  placed  on  the  floor  it  is  of  little 
use. 


550  INOKGANIC  MATEEIA  MEDICA.  [sect.  in. 

Liquor  Chiori,  B.P. ;  Aqua  Chlori,  U.S.P-  Chlorine 
Water. — An' aqueous  solution  of  chlorine  containing  at  least  0*4 
per  cent,  of  the  gas  U.S.P.,  or  2-66  grains  in  1  fluid  ounce  = 
about  0-6  per  cent.  B.P. 

Characters. — A  greenish-yellow  clear  liquid  with  a  strong 
smell  and  taste  of  chlorine.  It  instantly  decolorises  dilute  solu- 
tions of  litmus  and  indigo. 

Preparation. — By  passing  washed  chlorine  into  water  (p.  548).  The 
chlorine  is  directed  by  the  B.  and  U.S.P.  to  be  prepared  from  hydrochloric 
acid  and  manganese  dioxide,  instead  of  from  sodium  chloride.  4HC1  +  Mn02 
=  CL,  +  MnCl2  +  2H20. 

Impurities. — The  chief  is  too  little  chlorine.  When  exposed  to  light  it  is 
apt  to  be  decomposed,  the  chlorine  combining  with  the  hydrogen  of  the  water 
and  forming  hydrochloric  acid.  The  chlorine  water  thus  loses  strength,  and  it 
also  becomes  weaker  by  the  chlorine  escaping  when  the  bottle  is  imperfectly 
stoppered  or  frequently  opened.  A  solution  of  chlorinated  soda  or  lime  may  be 
sometimes  substituted  for  chlorine  water. 

Tests. — The  amount  of  chlorine  is  not  tested  directly  but  indirectly,  by 
estimating  the  amount  of  iodine  which  a  definite  quantity  of  chlorine  water 
liberates  from  iodide  of  potassium.  In  this  process,  chlorine  water  (439 
grains  or  1  fluid  ounce  B.P.,  or  35'4  gm.  U.S.P.)  is  mixed  with  iodide  of  potas- 
sium (20  grains  B.P.,  0-9  gm.  U.S.P.)  and  water  (1  fluid  ounce  B.P.,  20  gm. 
U.S.P.).  The  amount  of  iodine  which  is  set  free  by  the  chlorine  (2KI  +  Cl2 
=  2KC1  + I2)  gives  a  red  colour  to  the  solution,  and  corresponds  in  quantity  to 
the  chlorine  contained  in  the  water.  The  red  solution  requires  for  its  de- 
colorisation  750  grain-measures  B.P.,  or  40  cc.  U.S.P.  of  the  volumetric  solu- 
tion of  hyposulphite  of  sodium.     The  reaction  which  occurs  is  : — 

Iodine.    Sodium  Hyposulphite.    Sodium  Iodide.    Sodium  Tetrathionate.    Water. 

I2     +     2Na2H2S204     =     2NaI      +       Na2S406     +    2BL.O. 

Uses. — Chlorine  is  used  in  solution  as  a  lotion  to  foul- smelling 
ulcers  or  cancer  ;  as  an  application  to  relieve  itching  in  chronic 
skin  diseases ;  and  as  a  gargle  or  wash  to  the  mouth  in  affections 
of  the  mouth,  throat,  and  tonsils,  especially  where  they  are 
accompanied  by  foetor,  as  in  mercurial  ptyalism  and  ulceration 
of  the  tonsils.  It  is  sometimes  given  internally  in  cases  of  blood- 
poisoning.  As  an  inhalation  it  has  been  used  in  cases  of  phthisis, 
it  is  said  with  good  effect.  It  is  also  employed  as  a  stimulant 
and  deodoriser  in  cases  of  chronic  bronchitis  with  foetid  sputa. 
(Vide  Vapor  Chlori,  p.  533.) 

The  aqueous  solution  is  so  unstable  and  liable  to  lose  its 
strength,  that  compounds  of  chlorine  from  which  it  can  be  easily 
evolved  are  more  convenient  for  general  use.  The  chief  of  these 
are  the  following  compounds  with  lime  and  with  soda. 

Calx  Chlorinata,  B.P. ;  Calx  Chlorata,  U.S.P.  Chlorinated 
Lime. — A  product  obtained  by  exposing  slaked  lime  to  the  action 
of  chlorine  gas  so  long  as  the  latter  is  absorbed.  It  possesses 
bleaching  and  disinfecting  properties.  It  may  be  regarded  as 
consisting,  chiefly,  of  a  compound  of  hypochlorite  and  chloride  of 
calcium  (CaCl202,CaCl2)  or  as  a  direct  compound  of  chlorine  and 


en.  xxii.]    HYDROGEN,  OXYGEN,  OZONE,  CAEBON,  ETC.    551 

lime,  B.P.  A  compound  resulting  from  the  action  of  chlorine 
upon  hydrate  of  calcium,  and  containing  at  least  25  per  cent,  of 
available  chlorine,  U.S.P. 

Characters. — A  greyish-white  powder  having  the  odour  of 
chlorine  and  an  acrid  taste  ;  it  absorbs  carbonic  acid  and  water 
when  exposed  to  the  air,  and  at  the  same  time  gives  off 
chlorine;  it  is  only  partly  soluble  in  water.  The  solution  is 
alkaline,  and  possesses  bleaching  properties  (e.g.  it  bleaches 
sulphate  of  indigo) . 

It  is  readily  decomposed  by  acids,  even  by  carbonic  acid,  and 

thus  when  exposed  to  the  air  chlorine  is  given  off  slowly.     The 

addition  of  a  stronger  acid  causes  it  to  be  evolved  rapidly.    Its 

f  CI 
probable  constitution  is  Ca  |  ^pj     This  is  decomposed  by  water 

into  a  mixture  of  calcium  chloride  and  hypochlorite,  and  as 
it  is  usually  moist  it  may  be  regarded  as  usually  consisting  of 
a  mixture  of  these  substances.  On  the  addition  of  sulphuric 
acid,  hypochlorous  and  hydrochloric  acids  are  set  free,  which 
reacting  on  one  another  yield  free  chlorine.  HCIO  +  HC1  = 
C12  +  H20. 

Eeaction. — The  addition  of  oxalic  acid  causes  the  rapid  and  copious 
evolution  of  chlorine  and  the  deposition  of  oxalate  of  calcium. 

Impurities. — Imperfect  saturation  with  chlorine.  It  is  tested  volumetri- 
cally  in  a  similar  way  to  liquor  chlori,  the  chlorine  being  set  free  from  it  by 
the  addition  of  hydrochloric  acid.  The  chlorine  thus  liberated  should  amount 
to  30  per  cent.  B.P.,  25  per  cent.  U.S.P. 

Officinal  Pkepabations. 
B.P.  u.s.p. 

liquor  Calcls  Chlorinatae.  Liquor  Calcis  Chlorate. 

Vapor  Cblori  (p.  533). 
Chlorinated  lime  is  used  in  the  preparation  of  Chloroform. 

liquor  Calcls  Chlorinatae.  Solution  of  Chlorinated  Lime. — It  is  a  solu- 
tion of  1  lb.  to  the  gallon  of  water,  and  when  tested  volumetrically  it  should  con- 
tain 13  grains  of  available  chlorine  in  1  fluid  oz. 

Liquor  Sodae  Chlorinatae,  B.P. ;  Liquor  Sodae  Chloratae, 
U.S.P.  Solution  of  Chlorinated  Soda. — (Labarraque's  dis- 
infecting fluid.) 

,  •   Characters. — A  colourless  alkaline  liquid,  with  astringent 
taste  and  feeble  odour  of  chlorine. 

Preparation. — By  passing  chlorine  into  a  solution  of  sodium  carbonate 
B.P.,  or  by  decomposing  chlorinated  lime  by  sodium  carbonate  U.S.P. 

Tests. — It  behaves  like  a  solution  of  chlorinated  lime,  but  is  not  pre- 
cipitated by  oxalic  acid  nor  oxalate  of  ammonium.  (Distinction  from  and 
absence  of  solution  of  chlorinated  lime.) 

Dose. — 10  to  20  minims. 

Officinal  Preparation,  B.P. 
Cataplasma  Sodae  Chlorinatae. 
Cataplasm  a  Sodae  Chlorinatse.—  Linseed  meal  2  ;  solution  of  chlorinated 
soda  1 ;  boiling  water  4. 


552  INOEGANIC  MATEEIA  MEDICA.  [sect.  in. 

Uses. — Chlorinated  lime  is  chiefly  employed  as  a  disinfectant 
and  a  deodoriser.  In  sick  rooms  some  of  it  is  put  in  saucers, 
and,  according  to  the  rapidity  with  which  the  evolution  of 
chlorine  is  desired,  either  acid  is  added  to  it,  or  it  is  simply 
moistened  and  exposed  to  the  air,  when  it  is  slowly  decomposed 
by  the  carbonic  acid.  It  is  employed  also  for  disinfecting 
typhoid  stools,  water-closets,  and  sewers.  For  this  purpose  it 
is  used  either  in  powder  or  solution.  A  solution  is  used  to 
disinfect  the  sheets  and  bedding  of  patients  suffering  from 
infectious  diseases. 

Solutions  of  chlorinated  lime  or  of  chlorinated  soda  may  be 
employed  instead  of  chlorine  water  or  permanganate  of  potassium 
for  washing  the  hands  after  dissecting  or  performing  post-mortem 
examinations.  They  are  applied  externally  to  wounds  and  ulcers 
of  all  sorts  which  have  a  foetid  discharge  and  a  tendency  to 
slough.  Not  only  do  they  remove  the  fcetor,  but  they  often  in- 
duce a  healthy  action  in  the  tissues  themselves ;  and  instead  of 
the  ulceration  or  sloughing  extending  farther  and  farther,  the 
slough  is  thrown  off  and  leaves  behind  it  a  healthy,  healing 
surface.  As  the  removal  of  sloughs  is  aided  by  heat,  we  have  in 
the  B.P.  the  poultice  of  chlorinated  soda. 

Like  chlorine  they  are  destructive  to  plant  life,  and  they  are 
therefore  useful  in  skin-diseases  depending  on  the  presence  of 
parasitic  fungi,  such  as  ringworm  of  the  scalp,  and  in  scabies 
which  is  due  to  the  presence  of  a  parasitic  acarus.  As  they  have 
a  stimulant  action  on  the  skin,  they  are  sometimes  useful  in 
eczema  and  prurigo. 

They  are  employed  as  gargles,  or  washes  to  the  mouth  when 
foetid  ulcers  occur  in  these  parts,  as  in  ptyalism  or  in  scarlatina; 
as  an  injection  into  the  nose  they  have  been  used  to  lessen  the 
discharge  and  to  remove  the  fcetor  in  ozasna,  a  disease  in  which 
the  discharge  from  the  nostrils  is  sometimes  so  disgusting  as  to 
be  almost  unendurable  to  the  patient  himself  as  well  as  to  those 
around  him.  They  are  likewise  useful  in  foetid  discharges  from 
the  vagina,  such  as  occur  when  the  uterus  is  the  seat  of  malig- 
nant disease. 

Internally  they  have  been  employed  in  so-called  putrid  fevers, 
when  it  was  imagined  there  was  a  special  tendency  to  decom- 
position in  the  blood,  such  as  typhus  and  malignant  scarlatina. 
They  have  been  given  more  especially  in  these  diseases  when 
there  was  great  prostration  of  strength,  with  foetid  evacuations 
and  a  dry  and  furred  tongue. 

BROMUM.    Br ;  80. 

Bromine,  B.  and  U.S. P.  A  liquid  non-metallic  element 
obtained  from  sea-water  and  from  some  saline  springs. 

Characters. — A  dark  brownish-red,  very  volatile  liquid,  with 


oh.  xxn.]    HYDEOGEN,  OXYGEN,  OZONE,  CARBON,  ETC.    553 

a  strong,  disagreeable  odour.     The  solution  renders  cold  starch- 
water  yellow. 

Preparation. — Vide  p.  548. 

Impurity. — Iodine.  > 

Test. — When  agitated  with  sufficient  soda  to  render  the  fluid  very 
slightly  alkaline,  it  forms  a  colourless  liquid,  which,  if  coloured  by  a  further 
addition  of  a  little  bromine,  does  not  become  blue  on  the  subsequent  addition 
of  a  cold  solution  of  starch.     B.P.  (absence  of  iodine). 

If  an  aqueous  solution  of  bromine  be  poured  upon  reduced  iron  and 
shaken  with  the  latter  until  it  has  become  nearly  colourless,  then  filtered, 
mixed  with  gelatinised  starch,  and  a  few  drops  of  bromine  solution  be  now 
carefully  poured  on.  the  top,  not  more  than  a  very  faint  blue  zone  should 
appear  at  the  line  of  contact  of  the  two  liquids  (limit  of  iodine),  U.S.P. 

Uses. — Bromine,  although  a  powerful  disinfectant,  is  not 
much  used,  on  account  of  its  exceedingly  foetid  and  disagreeable 
smell.  It  is  a  powerful  irritant,  and  when  inhaled  without 
sufficient  dilution  with  air  will  produce  pneumonia.  Taken  in 
small  doses,  for  a  length  of  time,  it  has  produced  mental  de- 
pression, drowsiness,  and  stupidity.  It  is  sometimes  used  as  a 
caustic  to  the  os  uteri,  and  from  its  deodorising  and  antiseptic 
action  it  is  especially  useful  where  there  is  a  foetid  discharge.  It 
is  used  internally  in  the  form  of  its  potassium,  sodium,  ammo- 
nium, calcium,  and  zinc  salts,  and  of  hydrobromic  acid,  which 
do  not  possess  its  powerfully  irritant  local  action. 

Potassii  Bromidum,  B.  and  U.S.P.  Beomidb  of  Potas- 
sium.    (KBr;  118-75.) 

Characters. — In  colourless  cubical  crystals,  with  no  odour, 
but  a  pungent  saline  taste. 

Preparation. — Vide  p.  605. 

Solubility. — It  is  readily  soluble  in  water,  less  soluble  in  spirit. 

Reactions. — Its  aqueous  solution  gives  the  reactions  of  potassium  (p.  603) 
and  a  bromide  (p.  594). 

Impurities. — Iodide  and  bromate. 

Test. — For  the  iodide,  vide  p.  560.  Bromate  is  detected  by  adding  dilute 
sulphuric  acid  to  the  crushed  crystals.  They  should  not  at  once  assume  a 
yellow  colour.  The  acid  liberates  hydrobromic  acid  from  the  bromide,  and 
if  bromate  be  present  the  reaction  between  it  and  the  hydrobromic  acid 
liberates  free  bromine.     5HBr  +  HBrOs  =  3H20  +  3Br2. 

Action. — Bromide  of  potassium  does  not  seem  to  have,  like 
the  iodide,  any  marked  influence  on  the  lymphatic  system,  and 
although  it  has  been  occasionally  used  instead  of  the  iodide  in 
lymphatic  swellings  and  enlargements  of  organs,  this  use  of  it  is 
not  general.  When  swallowed  in  small  doses  it  produces  no 
effect,  but  when  taken  in  large  doses  for  a  considerable  time 
it  causes  an  eruption  like  acne  upon  the  face,  the  complexion  at 
the  same-time  becoming  muddy  or  bronzed.  The  chief  symptoms 
are,  however,  impairment  of  the  functions  of  the  spinal  cord  and 
the  brain.  There  is  a  great  diminution  of  reflex  action,  so  that 
touching  the  pharynx  no  longer  produces  any  tendency  to  vomitj 


554  INOEGANIC   MATEEIA   MEDICA.  [sect.  in. 

even  though  the  touch  itself  be  felt.  There  is  drowsiness  and 
heaviness,  a  great  inclination  to  sleep  and  insensibility  to  out- 
ward impressions,  the  memory  is  impaired,  the  speech  becomes 
hesitating  and  articulation  imperfect,  the  intellect  is  less  clear, 
the  genital  functions  are  much  diminished,  the  gait  becomes 
tottering  and  unsteady,  and  the  muscles  weak.  To  these  symp- 
toms the  name  of  bromism  is  given. 

Uses. — Its  chief  use  is  in  nervous  diseases  for  the  purpose 
of  producing  sleep,  allaying  excitement,  and  diminishing  spasm. 

Bromide  of  potassium  is  most  useful  as  a  hypnotic  in  cases 
of  sleeplessness  due  to  mental  excitement  and  worry.  Some 
persons,  after  hard  study  or  close  attention  to  business,  instead 
of  sleeping  at  night  are  no  sooner  in  bed  than  the  brain  seems 
to  become  doubly  active,  the  carotids  throb  and  they  toss  about 
from  side  to  side  trying  in  vain  to  get  rid  of  the  ideas  which 
come  in  a  constant  train  before  them.  In  such  cases  when 
bromide  of  potassium  is  taken,  the  throbbing  of  the  carotids  and 
temporals  and  the  fulness  in  the  head  disappear  and  sleep  is 
induced.  A  dose  of  10-15  grains  given  before  bed-time  may  be 
sufficient  in  mild  cases,  but  when  the  agitation  is  great  30  or  40 
grains  must  be  given,  and  should  be  assisted  by  cold  ablution  to 
the  head  and  a  prolonged  warm  foot-bath.  The  dose  may  be 
repeated,  if  necessary,  every  hour  or  two  hours,  until  the  desired 
effect  has  been  obtained.  One  great  advantage  that  bromide  of 
potassium  possesses  over  other  hypnotics  is  that  it  can  be  pushed 
without  fear,  and  the  same  is  true  of  other  bromides.  They  are 
riot  dangerous  to  life,  and  even  when  they  are  pushed  so  far  as 
to  cause  bromism,  the  symptoms  usually  pass  off  rapidly  when 
the  drug  is  discontinued. 

It  is  very  useful  in  lessening  the  excitability,  susceptibility 
to  worry,  and  irritability  of  temper  from  which  gouty  persons 
often  suffer.  It  should  be  given  with  a  considerable  proportion 
of  water. 

In  delirium  tremens  where  there  is  sleeplessness  with  fearful 
visions  it  may  be  given  in  doses  from  20-30  grains  or  even 
more  every  two  hours  till  sleep  is  induced.  It  is  of  most  benefit 
in  the  earlier  stages  before  the  delirium  has  become  furious,  and 
is  useful  also  at  the  end  of  the  attack  in  dispelling  delusions 
which  may  still/remain. 

During  the  latter  months  of  pregnancy,  women  are  some- 
times troubled  at  night  with  the  imagination  that  they  have 
committed  or  are  about  to  commit  some  great  crime,  such  as 
murdering  their  husbands  or  children;  and  these  delusions, 
according  to  Einger,  are  removed  by  potassium  bromide. 

It  is  also  useful,  he  says,  in  the  treatment  of  night  scream- 
ing in  children,  apparently  allied  to  nightmare.  They  awake  out 
of  sleep  screaming,  seem  very  much  frightened,  and  do  not 
appear  to  recognise  their  mother  or  other  friends  who  try  in 


ch.  xxii.]    HYDBOGEN,  OXYGEN,  OZONE,  CAEBON,  ETC.    555 

vain  to  soothe  them.  In  the  sleeplessness  of  mania  it  is  fre- 
quently though  not  always  successful.  It  may  be  used  in 
fevers  and  inflammation  when  sleep  is  absent,  and  whenever 
opium  and  belladonna  or  hyoscyamus  fail  to  produce  sleep  or 
cause  sickness. 

In  convulsive  nervous  affections,  such  as  whooping  cough, 
laryngismus  stridulus  and  spasmodic  asthma,  it  is  very  useful, 
and  also  to  some  extent  in  St.  Vitus's  dance  and  hysteria. 

It  is  especially  beneficial  in  epilepsy,  and  by  its  use  the  con- 
vulsions can  almost  always  be  lessened  if  not  entirely  stopped. 
A  similar  result  has  been  obtained  in  experiments  on  animals 
(p.  187).  It  is  not  so  useful  when  the  convulsions  are  violent, 
and  it  is  not  so  beneficial  when  there  is  only  a  transitory  loss  of 
consciousness,  as  in  petit  trial.  It  is,  perhaps,  however,  not  so 
much  a  curative  as  an  alleviative  remedy,  and  the  fits  are  apt  to 
return  when  its  administration  is  discontinued. 

It  is  useful  in  relieving  sickness,  especially  in  pregnancy. 
In  sea-sickness  it  is  perhaps  more  useful  than  any  other  remedy. 
It  should  be  taken  in  thirty-grain  doses  twice  or  thrice  a  day, 
for  a  day  or  two  before  the  voyage  begins,  and  should  be  kept  up 
while  it  continues.  In  severe  cases  it  may  be  necessary  to  push 
the  bromide  so  far  as  to  keep  up  a  state  of  more  or  less  somno- 
lency and  stupidity  during  the  whole  voyage. 

From  its  power  of  lessening  the  sexual  passion  it  is  used  as  an 
anaphrodisiac  in  priapism  and  nymphomania. 

It  is  also  useful  in  menorrhagia,  especially  when  this  occurs 
,in  young  women,  according  to  Binger,  while  Garrod  says  it  is 
more  useful  in  old  women. 

It  is  useful  in  neuralgia  occurring  in  debilitated  subjects,  and 
sometimes  accompanied  by  flushed  face  with  cold  hands  and  feet. 
It  has  been  used  in  diabetes. 

Sodii  Bromidum,  B.  and  U.S.P.  Bromide  of  Sodium. 
(NaBr;  102-8.) 

Chabacteks. — Small,  colourless,  or  white  monoclinic  crystals, 
or  a  crystalline  powder  permanent  in  dry  air,  odourless,  having 
a  saline,  slightly  bitter  taste,  and  a  neutral  or  faintly  alkaline 
reaction. 

Preparation. — Vide  p.  618. 

Solubility. — Soluble  in  1-2  parts  of  water  and  in  13  parts  of  alcohol  at 
15°  C.  (59°  F.) 

Eeactions. — It  gives  the  reactions  of  sodium  (p.  617),  and  if  disulphide  of 
carbon  be  poured  into  a  solution  of  the  salt,  then  chlorine  water  added  drop  by 
drop,  and  the  whole  agitated,  the  disulphide  will  acquire  a  yellow  or  yellowish- 
brown  colour  (bromide)  without  a  violet  tint  (absence  of  iodide). 

Dose. — 10  to  60  grains. 

Action. — Its  actions  are  the  same  as  those  of  bromide  of 
potassium,  but  it  is  said  to  be  less  irritating  to  the  stomach,  and 
less  apt  to  cause  depression  when  used  for  a  length  of  time. 


556  INORGANIC  MATERIA  MEDICA.  [sect.  hi. 

Ammonii  Bromidum,  B.  and  U.S.P-  Bromide  of  Ammo- 
nium.    (NH4Br ;  97-8.) 

Characters. — In  colourless  crystals  -which  become  slightly 
yellow  by  exposure  to  the  air,  and  have  a  pungent  saline  taste. 

Preparation. — Vide  p.  635. 

Reactions. — Its  solution  gives  the  reactions  of  ammonia  (p.  634),  and  a 
bromide  (p.  594). 

Dose. —  2  to  20  grains, 

Uses. — The  bromide  of  ammonium  has  been  employed  for 
the  same  purposes  as  the  bromide  of  potassium.  It  may  be  used 
in  cases  where  the  bromide  of  potassium  appears  to  cause  de- 
pression,  either  instead  of  the  potassium  salt,  or  mixed  with  it, 
and  the  mixture  of  bromide  of  potassium  with  bromide  of  ammo-  • 
nium  has  been  supposed  to  have  a  better  action  than  either  salt 
alone.  The  best  proportion  is  said  to  be  that  of  1  part  of 
bromide  of  potassium,  1  of  bromide  of  sodium,  and  J  of  bromide  of 
ammonium.1 

U.S.P-  Lithii  Bromidum.  Bromide  of  Lithium.  (LiBr; 
86-8.) 

Characters. — A  white  granular  salt,  very  deliquescent,  odour- 
less, having  a  very  sharp,  somewhat  bitter  taste,  and  a  neutral 
reaction. 

Pbepabation. — Vide  p.  631. 

Solubility. — Very  soluble  in  water  and  in  alcohol. 

Reactions.— Those  of  lithium  (p.  630)  and  of  a  bromide  (p.  594). 

Dose. — 15-30  grs. 

Action. — The  same  as  that  of  bromide  of  potassium.  It  is 
said  by  some  to  have  a  stronger  hypnotic  action  than  the  other 
bromides,  but  by  others  to  be  less  effective  than  the  potassium  salt. 

Uses.' — The  same  as  those  of  potassium  bromide.  It  may 
be  preferable  to  the  potassium  salt  in  the  irritability  of  gouty 
subjects. 

U.S.P.  Calcii  Bromidum.  Bromide  of  Calcium.  (CaBr„ ; 
199-6.) 

Characters. — A  white  granular  salt,  very  deliquescent,  odour- 
less, having  a  pungent  saline  and  bitter  taste,  and  a  neutral  re- 
action. 

Preparation. — By  adding  milk  of  lime  to  a  boiling  solution  of  ammonium 
bromide. 

Reactions. — An  aqueous  solution  of  the  salt  yields  the  reactions  of  cal- 
cium (p.  646)  and  a  bromide. 

Uses. — 15  to  80  grains  (1  to  2  gm.). 

Dose. — The  same  as  those  of  potassium  bromide  (p.  553).  It 
is  said  not  to  depress  like  the  potassium  bromide. 

U.S.P.  Zinci  Bromidum.— Vide  p.  672. 


Erlenmeyer,  Centbl.  f.  Nervenhk.  1881.     No.  i. 


oh.  xxii.]    HYDEOGEN,  OXYGEN,  OZONE,  CAEBON,  ETC.    557 


IODUM.     I ;  127  or  1266,  U.S.P. 

Iodine. — A  non-metallic  element  obtained  from  the  ashes  of 
sea- weeds  and  from  mineral  iodides  and  iodates. 

Chakaotbes. — Heavy,  bluish-black,  rhombic  plates  of  a  peculiar 
odour  and  metallic  lustre,  which,  when  heated,  yield  a  beautiful 
violet-coloured  vapour. 

Preparation. — Vide  p.  548. 

Solubility. — It  is  very,  sparingly  soluble  in  water,  but  freely  dissolved 
by  alcohol,  by  ether,  and  by  a  solution  of  iodide  of  potassium. 

Eeaction. — The  aqueous  solution  strikes  a  deep  blue  colour  with  starch. 

Impurities. — Moisture,  metallic  impurities  fraudulently  added,  cyanide 
of  iodine  (the  nitrogen  in  this  is  yielded  by  marine  animals  amongst  the  sea- 
weed), chloride  of  iodine,  chlorine  and  bromine. 

Tests. — It  should  not  adhere  to  the  sides  of  the  bottle,  and  its  solution  in 
chloroform  should  be  clear  and  limpid  (absence  of  moisture).  It  sublimes  as 
a  purple  vapour  without  leaving  any  residue  (absence  of  fixed  impurities) , 
and  the  portion  that  first  comes  over  does  not  include  any  slender  colourless 
prisms  emitting  a  pungent  odour  (absence  of  cyanide  of  iodine) ;  12-7  grains 
dissolved  in  an  ounce  of  water  containing  fifteen  grains  of  iodide  of  potassium 
require  for  complete  discoloration  1,000  grain-measures  of  the  volumetric 
solution  of  hyposulphite  of  sodium. 

Peepabaiions,  b.p. 


Arsenii  Iodidum. 

Emplastrum  Plumbi  Iodidi. 

Hydrargyri  Iodidum  Eubrum. 

Iodoformum. 
*Iiinimentum  lodl  (p.  516). 

Linimentum  Potassii  Iodidi  cum  Sa- 

pone  (p.  516). 
*Iiiquor  lodi,  aqueous  solution  (1  in 
20). 

Pilula  Ferri  Iodidi  (p.  522). 

Plumbi  Iodidum. 

Potassii  Iodidum. 

Sodii  Iodidum. 


Sulphuris  Iodidum. 
Syrupus  Ferri  Iodidi. 
*Tlnctura  lodi,  alcoholic  solution  (1 

in  40). 
TJnguentum  Hydrargyri  Iodidi  Eubri. 
*         „  lodi  (1  in  31). 

„  Plumbi  Iodidi. 

„  Potassii  Iodidi. 

„  Sulphuris  Iodidi. 

*Vapor  lodi  (Tincture  of  Iodine,  1  fl. 
dr.  mixed  with  1  fl.  oz.  of  water, 
gently  warmed,  and  the  vapour  in-., 
haled). 


Ammonii  Iodidum.  Sulphuris  Iodidum. 

Argenti  Iodidum.  Tinctura  lodi  (8  in  100). 

Arsenici  Iodidum.  *Unguentum  lodi  (4  in  100). 
♦Liquor  lodi  Compositus  (5  in  100).  „  Plumbi  Iodidi. 

Plumbi  Iodidum.  „  Potassii  lodi. 

Potassii  Iodidum.  Zinci  Iodidum. 
Sodii  Iodidum. 

The  preparations  marked  with  *  in  the  preceding  list  contain  iodine  in  a  free 
state  dissolved  by  the  aid  of  iodide  of  potassium  (p.  556).  Tinctura  lodi  U.S.P. 
contains  free  iodine  dissolved  in  alcohol.  The  others  contain  it  in  a  state  of  com- 
bination. 

U.S.P.  Liquor  lodi  Compositus.  Iodine  5,  iodide  of  potassium  10,  distilled 
water  85.  This  solution  differs  from  Liquor  lodi  P.B.,  only  in  containing  10  per 
cent,  of  iodide  of  potassium,  while  the  B.P.  preparation  contains  7|  per  cent. 

Sulphuris  Iodidum.    B.P.  and  U.S.P.    Iodide  of  Sulphub. 

Chaeactebs. — Greyish-black,  crystalline  lumps.  It  smells 
like  iodine  and  stains  the  skin.  When  boiled  with  water  it  is 
decomposed,  iodine  passing  off  and  sulphur  remaining. 


558  INOKGANIC  MATEEIA  MEDICA.  [sect.  iii. 

Preparation. — By  fusing  iodine  and  sublimed  sulphur  together. 

Officinal  Preparation,  b.p. 
Unsuentum  Sulpburis  lodidi.  - Ointment  of  iodide  of  sulphur  (30  grains 
to  an  ounce  of  prepared  lard). 

Iodine  is  rendered  much  more  soluble  either  in  water  or  spirit 
by  the  addition  of  iodide  of  potassium,  hence  this  substance  is 
used  in  the  liniment,  liquor,  tincture,  and  ointment  of  the  B.P., 
and  in  the  compound  solution  and  ointment  of  the  U.S.P.  It  is 
not  contained  in  the  tincture  of  the  U.S.P.,  which  is  a  simple 
solution  of  iodine  in  alcohol. 

Dose. — The  only  preparations  of  iodine  used  for  internal  admi- 
nistration are  the  tinctureB.P.  and  U.  S.P.,  the  liquor  B.P.  and  com- 
pound solution  U.S.P.,  of  all  of  which  the  dose  is  5  to  20  minims. 

Physiological  Action. — Like  chlorine  and  bromine,  iodine  is 
a  powerful  antiseptic  and  oxidising  agent.  When  applied  to  the 
unbroken  skin,  iodine  stains  it  of  a  dark  yellowish-brown  colour, 
causes  slight  warmth,  and  afterwards  a  little  itching.  In  stronger 
solutions  it  will  cause  a  painful  burning  sensation,  and  desqua- 
mation of  the  epidermis.  In  still  stronger  solution  it  may  pro- 
duce vesication.  When  taken  internally,  in  small  doses,  it  acts 
as  an  irritant  to  the  intestinal  canal,  causing  catarrh  of  the 
mucous  membrane.  When  absorbed  into  the  blood  it  somewhat 
increases  the  rapidity  of  the  pulse.  It  has  little  action  upon 
blood-pressure.  Its  influence  upon  the  temperature  is  very  slight, 
but  it  seems  rather  to  raise  it.  Iodine  appears  to  have  a  tendency 
to  cause  absorption  of  enlarged  glands  and  thickenings  caused 
by  chronic  inflammation.  It  seems  to  combine  with  such  metals 
as  lead  and  mercury,  which  have  become  deposited  in  the  tissues 
in  cases  of  chronic  poisoning,  forming  with  these  soluble  iodides, 
which  are  eliminated  in  the  same  way  as  iodine  itself.  It  is 
eliminated  by  the  urine,  nasal  mucous  membrane,  saliva,  intes- 
tinal mucus  and  milk,  in  all  of  which  it  may  be  readily  detected. 
It  appears  to  be  eliminated  even  more  readily  by  the  saliva  than 
by  the  urine  (p.  358),  and  on  this  account  it  may  remain  a  con- 
siderable time  in  the  body.  During  the  process  of  elimination 
it  may  irritate  those  parts  where  it  is  set  free  from  its  compounds, 
as  the  nose  or  skin.  Even  in  small  doses  it  may  cause  symp- 
toms of  iodism.  These  consist  in  irritation,  either  of  the  nose 
or  intestinal  tract ;  the  most  prominent  are  great  running  at  the 
nose,  lacrimation,  and  sometimes  frontal  headache.  Similar, 
symptoms  are  produced  by  exposure  to  the  fumes  of  iodine  for  & 
length  of  time.  The  nasal  symptoms  may  be  accompanied  or 
replaced  by  symptoms  of  gastric  irritation,  loss  of  appetite,  slight 
nausea,  and  tendency  to  looseness  of  the  bowels.  The  symptoms 
of  poisoning,  such  as  have  occurred  from  the  injection  of  large 
quantities  of  iodine  solution  into  an  ovarian  cyst,  were,  first, 
collapse,  followed  after  a  little  while  by  an  appearance  of  fever,, 


oh.  xxii.]    HYDROGEN,  OXYGEN,  OZONE,  CAEBON,  ETC.    559 

with  rapid  pulse  and  flushed  face,  but  without  any  rise  of  tem- 
perature. This  condition  passed  off  in  several  days,  but  during 
apparent  convalescence  the  patient  suddenly  died.  Small  doses 
of  iodine,  by  improving  the  health  of  patients,  may  increase  the 
menstrual  flow,  and  may  act  as  aphrodisiacs.  Larger  doses 
generally  have  a  very  marked  anaphrodisiac  action,  and  it  has 
been  stated  that  long-continued  use  has  produced  atrophy  of  the 
mammae,  ovaries,  and  testes.  It  has  been  stated  that  very  large 
doses  affect  the  nervous  system,  causing  delirium,  and  twitch- 
ing or  paralysis  of  the  muscles  (p.  549). 

Uses. — Iodine  applied  to  the  epidermis  acts  as  a  parasiticide, 
and  may  be  used  in  cases  of  tinea  to  destroy  the  fungus,  either 
alone  or  combined  with  tar  in  the  proportion  of  two  drachms  of 
iodine  to  one  ounce  of  light  oil  of  wood  tar.  Its  solution,  painted 
on  the  surface,  is  useful  in  removing  muscular  pains,  and  in 
causing  absorption  of  thickening  around  joints,  or  of  enlarged 
strumous  glands.  When  painted  on  the  surface  it  sometimes 
causes  absorption  of  the  enlarged  thyroid  gland  in  goitre,  and, 
when  outward  application  is  insufficient,  success  is  sometimes 
obtained  by  injecting  from  ten  to  thirty  minims  of  tincture  of 
iodine  into  the  substance  of  the  tumour  by  means  of  a  hypo- 
dermic syringe,  care  being  taken  to  avoid  injection  into  a  vein. 
Its  solution,  painted  on  the  surface,  is  also  useful  in  causing 
absorption  of  fluid  from  serous  cavities,  as  in  pleurisy.  Sometimes, 
after  the  fluid  has  been  evacuated  from  a  serous  sac,  such  as  the 
pleura,  or  the  tunica  vaginalis  in  hydrocele,  or  from  ovarian 
cysts,  a  dilute  tincture  of  iodine  is  injected  into  the  sac  to  pre- 
vent the  fluid  from  again  accumulating. 

In  removing  slight  consolidation  of  the  lung,  remaining  after 
pneumonia  or  pleurisy,  or  in  cases  of  commencing  phthisis,  the 
external  application  of  liniment  of  iodine  is  very  useful.  It 
should  be  painted  on  the  surface,  every  second  or  third  day,  so 
as  always  to  keep  one  part  a  little  tender.  By  mixing  the  lini- 
ment with  the  tincture  in  varying  proportions  any  degree  of 
strength  can  be  obtained.  Cases  of  ozaena  are  sometimes  much 
benefited  by  washing  out  the  nose  with  a  solution  of  common  salt 
to  which  a  few  drops  of  tincture  of  iodine  have  been  added.  The 
vapour  of  iodine  is  employed  in  chronic  bronchitis  and  phthisis. 

On  account  of  its  irritating  action  on  the  intestinal  mucous 
membrane,  iodine  is  rarely  given  internally,  its  place  being  sup- 
plied by  iodide  of  potassium,  but  some  consider  that  iodine  is 
sometimes  more  effectual,  and  it  has  been  given  in  scrofula,  skin 
diseases,  and  glanders. 

The  liquor  iodi  B.P.,  or  compound  solution  of  iodine  U.S.P., 
is  useful  in  arresting  vomiting  when  administered  internally  in 
doses  of  3  to  5  minims. 

Potassi  Iodidum,  B.  and  U.S. P.  Iodide  of  Potassium. 
(Kl;  165-6.) 


560  INOBGANIC  MATEEIA  MEDICA.  [sect.  in.. 

Chakactebs.—  In  colourless,  generally  opaque,  cubic  crystals. 

Pkeparation. — By  mixing  iodine  and  solution  of  potassa,  when  iodide 
and  iodate  of  potassium  are  formed,  6KHO  +  61  =  KI03  +  5KI  +  3H20.  The 
iodate  is  then  reduced  to  iodide  by  roasting  with  charcoal,  5KI  +  KIOs  +  3C 
=  6KI  +  3CO. 

Solubility. — It  is  readily  soluble  in  water,  and  in  a  less  degree  in  spirit. 

Beactions. — It  commonly  has  a  feeble  alkaline  reaction ;  its  solution  gives 
the  reactions  of  potassium  (p.  603)  and  an  iodide  (p.  594). 

Impurities. — Iodate  from  imperfect  reduction,  chlorides,  sulphates,  car- 
bonates. Iodate  is  the  most  important  impurity,  since  the  dilute  acid  of  the 
gastric  juice  will  form  hydriodic  acid  from  the  iodide,  and  this  will  liberate 
free  iodine  from  the  iodate  in  the  stomach,  and  thus  give  rise  to  such  gastric 
irritation  that  the  iodide  cannot  be  borne  in  doses  where  pure  iodide  would  be 
readily  tolerated. 

Tests. — The  addition  of  tartaric  acid,  B.P.,  or  dilute  sulphuric  acid, 
U.S.P.,  and  mucilage  of  starch,  B.P.,  or  gelatinised  starch,  U.S.P.,  to  its 
watery  solution  does  not  develop  a  blue  colour  (absence  of  iodate).  If 
iodate  be  present  the  acid  liberates  hydriodic  acid,  and  this  re-acting  on  the 
iodate  forms  free  iodine,  6HI  +  KIOs  =  3EL,0  +  KI  + 16.  Solution  of  nitrate 
of  silver  added  in  excess  forms  a  yellowish- white  precipitate,  which,  when 
agitated  with  ammonia,  yields  on  standing  a  clear  liquid  in  which  excess  of 
nitric  acid  causes  no  turbidity,  B.P.  (absence  of  chloride).  Iodide  of  silver  is 
insoluble  in  ammonia,  but  chloride  is  readily  soluble,  so  the  chlorides,  if 
present,  would  be  taken  up  by  the  ammonia  and  re-precipitated  on  the  addi- 
tion of  acid.  Its  aqueous  solution  is  only  faintly  precipitated  by  the  addition 
of  saccharated  solution  of  lime. 

Dose. — 2  to  10  grains. 

Pkepabations  containing  Iodide  of  Potassium. 

b.p.  strength. 

Linimentum  Iodi  (p.  516) 22  grs.  in  1  fl.  oz.  nearly. 

„  Potassli  lodldi  cum  Sapone  (p.  516)  54£  grs.  in  1  fl.  oz.  nearly. 

Liquor  Iodi  33  grs.  in  1  fl.  oz. 

Tinctura  Iodi  (Dose,  1-5  min.)  11  grs.  in  1  fl  oz.  nearly. 

Unguentum  Iodi 16  grs.  in  1  oz.  nearly. 

„  Potassii  Iodidi 1  part  in  8J,  nearly. 

U.S.P.  DOSE. 

Unguentum  Potassii  Iodidi    

Liquor  Iodi  Compositus 2-6  min.  (O'KMMO  c.c). 

Unguentum  Potassii  Iodidi,  E.  and  V.S.P.  Ointment  op  Iodide  op 
Potassium. — Iodide  of  potassium  64  grains,  carbonate  of  potassium  4  grains, 
distilled  water  1  fluid  drachm,  prepared  lard  1  ounce.  Dissolve  the  iodide  of 
potassium  and  carbonate  of  potassium  in  the  water,  and  mix  thoroughly  with  the 
lard.    B.P. 

Iodide  of  potassium  12,  hyposulphite  of  sodium  1,  boiling  water  6,  benzoated 
lard,  81.    U.S.P. 

The  ointment  is  apt  to  become  discoloured  by  the  liberation  of  free  iodine 
when  iodide  of  potassium  and  lard  only  are  used.  The  carbonate  of  potassium, 
B.P.,  is  added  in  order  that  it  may  combine  with  any  iodine  set  free,  and  the  hypo- 
sulphite, U.S.P.,  is  also  used  to  prevent  this  discoloration. 

Action. — The  action  of  iodide  of  potassium  appears  to  depend 
partly  on  the  iodine  and  partly  on  the  potassium  it  contains.  It 
differs  from  that  of  free  iodine  (p.  558)  in  being  much  less 
irritant.     On  this  account  it  is  of  little  use  as  a  local  stimulant,. 


ch.  xxii.]    HYDROGEN,  OXYGEN,  OZONE,  CAEBON,  ETC.    561 

but  it  can  be  given  in  much  larger  doses.  It  has  been  supposed 
that  iodine  is  set  free  from  iodides  in  the  stomach ;  but  probably 
this  is  not  the  case,  at  least  to  any  great  extent,  unless  the 
iodides  are  contaminated  with  iodates.  Iodide  of  potassium  and 
other  alkaline  iodides  are  readily  absorbed.  It  is  conveyed  by 
the  blood  to  the  various  tissues  of  the  body.  It  has  been  sup- 
posed by  Binz  to  be  partially  decomposed  by  some  of  them, 
with  the  evolution  of  free  iodine  both  in  the  blood  and  in  the 
tissues,  and  he  attributes  its  most  important  actions  to  this 
decomposition.  The  iodine  set  free  from  the  iodide  is  taken  up 
by  albuminous  substances,  and  the  entrance  of  the  iodine 
molecule  into  their  composition  causes  them  to  undergo  more 
rapid  metamorphosis.  Gummatous  deposits  appear  to  be  espe- 
cially affected  in  this  way. 

Lead  and  mercury  also  appear  to  be  set  free  by  it,  from  their 
combinations  with  the  tissues,  and  entering  once  more  into  the 
circulation  are  eliminated.  Iodides  are  eliminated  very  rapidly 
by  the  kidneys,  salivary  glands,  probably  by  all  mucous  mem- 
branes, and  by  the  skin.  During  the  process  of  elimination 
iodine  is  occasionally  set  free  and  causes  local  irritation.  This 
is  especially  marked  in  the  mucous  membrane  of  the  nose,  and 
in  the  skin,  but  it  may  occur  also  in  the  conjunctivae,  bronchi, 
and  stomach.  The  irritation  of  the  nasal  mucous  membrane 
thus  produced  gives  rise  to  the  symptoms  generally  known  as 
iodism.  They  are  f  xactly  the  same  as  those  produced  by  pro- 
longed exposure  to  the  fumes  of  iodine.  They  consist  of  running 
at  the  nose,  and  frontal  headache,  which  probably  depends  upon 
swelling  of  the  mucous  membrane  lining  the  frontal  sinuses. 
There  is  also  frequently  running  of  the  eyes.  Not  unfrequently 
the  bronchial  mucous  membrane  becoming  congested  there  is 
cough  and  pain  in  the  chest.  These  symptoms  are  most  readily 
produced  by  small  doses  of  2-5  grains,  and  they  may  usually  be 
arrested  either  by  discontinuing  the  medicine  or  increasing  the 
dose.  When  the  dose  is  raised  to  10  grains  the  symptoms 
usually  disappear,  and  I  have  only  seen  one  case  in  which  they 
persisted  after  the  dose  had  been  raised  to  30  grains.  In  some 
persons  the  congestion  is  not  confined  to  the  nose,  but  extends  to 
the  back  of  the  throat  and  to  the  larynx,  so  that  serious  symptoms 
of  suffocation  may  follow  the  laryngeal  congestion  produced  in 
them  by  iodide.  As  the  iodine  is  eliminated  in  the  tears,  severe 
conjunctivitis  may  follow  the  application  of  calomel  to  the  eyes  of 
persons  who  are  taking  iodide  at  the  same  time.  Affections  of 
the  skin  usually  occur  with  large  doses  of  iodide.  The  most 
common  form  of  eruption  is  acne,  but  tubercular  eruptions  are 
also  met  with.  They  appear  to  be  caused  by  decomposition  of 
the  iodide  with  elimination  of  free  iodine  in  the  sweat  and 
sebaceous  matter.  They  are  said  to  be  lessened  by  the  simul- 
taneous use  of  arsenic,  and  to  be  prevented  by  perfect  cleanliness 

o  o 


562  INOEGANIC  MATEEIA  MEDIC  A.  [sect.  in. 

and  daily  baths.  Occasionally  the  iodide  causes  gastric  irrita- 
tion with  diminished  appetite.  It  is  readily  excreted  by  the 
salivary  glands,  and  may  give  rise  to  salivation  (p.  358).  It 
sometimes  gives  rise  not  only  to  congestion  of  the  bronchial 
mucous  membrane  and  cough,  but  to  haemoptysis,  exudation 
into  the  pleural  cavity,  and  even  pneumonic  consolidation. 

In  some  persons  it  greatly  depresses  the  genital  functions. 

During  its  excretion  by  the  kidneys  it  acts  as  a  diuretic, 
though  not  a  very  powerful  one. 

Uses. — Although  iodide  of  potassium  is  probably  absorbed 
in  very  small  quantity  by  the  unbroken  skin,  even  when  mixed 
with  oil  or  fat,  yet  the  iodide  of  potassium  and  soap  liniment, 
especially  when  mixed  with  its  own  bulk  of  opium  liniment, 
sometimes  gives  considerable  relief  when  applied  to  inflamed 
and  rheumatic  joints  by  means  of  flannel  or  lint.  When  used 
with  lanolin,  it  is  said  to  be  more  readily  absorbed  and  to  give 
still  greater  relief  in  chronic  joint  disease.  Iodide  of  potassium 
is  chiefly  used,  however,  internally  in  syphilis,  rheumatism, 
scrofula,  and  chronic  poisoning  by  lead  or  mercury.  In 
the  primary  and  secondary  stages  of  syphilis,  mercury  is 
generally  used  either  alone  or  in  combination  with  iodine.  In 
the  tertiary  stage,  iodide  of  potassium  is  more  generally  given 
alone,  although  it  is  said  by  some  to  have  but  little  effect 
unless  mercury  has  been  administered  at  some  previous  time. 
If  this  opinion  be  correct,  the  beneficial  action  of  iodide  of 
potassium  may  be  due,  in  part  at  least,  to  its  again  liberating 
part  of  the  mercury  which  has  been  in  a  state  of  more  or  less 
dormant  combination  with  some  of  the  tissues.  The  powerful 
action  of  iodide  of  potassium  in  removing  syphilitic  deposits  is 
readily  seen  when  these  deposits  are  superficial,  as  nodes  on  the 
shin  or  on  the  sternum,  or  when  they  can  be  readily  seen,  like 
deposits  in  the  larynx.  Sometimes  such  deposits  are  unaffected 
by  small  doses,  such  as  five  grams  of  iodide,  but  disappear 
rapidly  when  the  dose  is  increased  to  ten  grains  or  more.  From 
its  beneficial  action  on  visible  deposits  we  may  infer  that  it  has 
a  similar  action  on  those  which  are  deeply  situated,  and  indeed 
sometimes  we  may  observe  enlargement  and  induration  of  the 
liver,  probably  dependent  on  a  syphilitic  condition,  rapidly  dis- 
appear under  the  use  of  the  iodide.  In  chronic  rheumatism, 
especially  when  the  pain  is  worse  at  night,  it  is  sometimes 
useful. 

It  apparently  increases  the  activity  of  the  lymphatic  system, 
and  is  used  in  enlargement  of  glands  connected  with  this  system, 
e.g.  enlarged  thyroid,  enlarged  spleen,  and  the  enlarged  lym- 
phatic glands  which  occur  in  scrofula,  as  well  as  in  scrofulous 
conditions  generally. 

It  is  given  wherever  absorption  is  deficient  and  organs  become 
hypertrophied,  e.g.  the  breasts,  testicles,  prostate,  uterus,  ovaries, 


ch.  xxii.]    HYDROGEN,  OXYGEN,  OZONE,  CARBON,  ETC.    563 

&c.  In  cancer  and  tubercle  it  is  of  little  benefit ;  it  is  some- 
times given,  and  possibly  with  benefit,  in  order  to  aid  the 
absorption  of  pneumonic  consolidation. 

In  bronchitis  with  much  congestion  and  deficient  secretion  it 
is  a  useful  expectorant,  rendering  the  mucus  more  abundant  and 
less  tenacious,  so  that  it  is  more  readily  expectorated. 

As  syphilitic  skin-diseases  often  disappear  under  its  use,  it 
has  been  applied  to  other  skin-diseases  not  dependent  on  syphilis, 
such  as  psoriasis,  lepra,  herpes,  impetigo,  lichen,  prurigo,  sycosis, 
acne,  lupus,  &c,  especially  in  scrofulous  patients. 

In  frogs  it  destroys  sensibility  and  voluntary  motion  by  act- 
ing on  the  spinal  cord.     It  is  useful  in  large  doses  to  diminish 
the  pain  in  cases  of  aneurism,  and  is  also  used  in  neuralgia, 
;  paralysis,  convulsions,  &c. 

The  relief  which  it  affords  to  the  pain  of  aneurism  is  very 
marked,  but  it  must  be  given  in  large  doses,  e.g.  thirty  grains. 
The  benefit  which  it  affords  may  be  partly  due  to  weakening  of 
the  circulation,  partly  to  diminished  sensibility  by  the  action  of 
the  drug  on  the  nervous  system,  and  partly  to  beneficial  altera- 
tions in  the  morbid  condition  of  the  walls  of  the  affected  vessels, 
which  are  often  syphilitic  in  character. 

It  is  exceedingly  useful,  as  already  mentioned,  in  chronic 
metallic  poisoning,  e.g.  by  mercury  or  lead. 

It  is  used  in  dropsies  as  a  diuretic,  and  is  also  employed  as 
an  emmenagogue. 

Sodii  Iodidum,  B.  and  U.S.P.  Iodide  of  Sodium.  Nal; 
149-6. 

Characters. — Minute,  colourless,  or  white  monoclinic  crystals, 
or  a  crystalline  powder,  deliquescent  on  exposure  to  air,  odour- 
less, having  a  saline  and  slightly  bitter  taste  and  a  neutral  or 
faintly  alkaline  reaction. 

Solubility. — Soluble  in  0"6  part  of  water  and  in  1*8  parts  of  alcohol  at 
15°  C.  (59°  F.). 

Eeaction. — If  disulphide  of  carbon  be  poured  into  a  solution  of  the  salt, 
then  chlorine  water  added  drop  by  drop,  and  the  whole  agitated,  the  disulphide 
of  carbon  will  acquire  a  violet  colour. 

Dose. — 3  to  30  grains. 

Uses. — It  is  employed  in  place  of  iodide  of  potassium.  Its 
physiological  actions  are  almost  exactly  the  same,  but  it  appears 
to  be  less  depressing  and  to  irritate  the  stomach  less.  It  may 
thus  be  given  in  larger  doses. 

U.S.P.  Ammonii  Iodidum.  Iodide  of  Ammonium.  NH4I ; 
144-6. 

Characters. — A  white  granular  salt,  or  minute  crystalline 
cubes,  very  deliquescent  and  soon  becoming  yellow  or  yellowish- 
brown  on  exposure  to  air ;  odourless  when  white,  but  emitting  a 

oo2 


564  INOEGANIO  MATEEIA  MEDICA.  [sect.  m. 

slight  odour  of  iodine  when  coloured,  having  a  sharp  saline  taste 
and  a  neutral  reaction. 

Uses. — A  solution  of  £-drm.  in  an  ounce  of  glycerine  has  been 
used  as  an  application  to  enlarged  tonsils.  An  ointment  con- 
taining 20  to  60  grs.  of  the  iodide  to  1  oz.  of  lard  has  been  used 
in  cases  of  lepra  and  psoriasis.  It  is  chiefly  used  internally  for, 
syphilis,  scrofula,  and  glandular  enlargements,  either  instead  of 
or  along  with  iodide  of  potassium.  A  mixture  ol  the  two  iodides 
has  been  thought  by  some  to  be  more  efficacious  than  either 
used  singly,  and  the  iodide  of  ammonium  prevents  the  depress- 
ing action  often  exerted  by  the  iodide  of  potassium  alone. 

U.S.  P.  Zinci  Iodidum.— Vide  p.  673. 
U.S.P.  Argenti  Iodidum.— Fide  p.  680. 

Hydrargyri  Iodidum  Rubrum,  B.  and  U.S.P.  —  Vide 
p.  696. 

U.S.P.  Hydrargyri  Iodidum  Viride.— Vide  p.  696. 
Plumbi  Iodidum,  B.  and  U.S.P.— Vide  p.  705. 

The  action  of  the  iodides  of  zinc,  silver,  mercury,  and  lead 
is  modified  to  such  an  extent  by  the  special  action  of  the  metal, 
that  the  compounds  are  better  considered  under  the  headings  of 
their  respective  metals  (q.v.)  than  side  by  side  with  the  compounds 
with  the  alkalis. 


565 


CHAPTEE  XXm. 
ACIDS. 

Genebal  Chabactees. — It  is  somewhat  difficult  to  get  a  correct 
definition  of  an  acid.  Most  of  them  have  a  sour  taste  and 
redden  blue  litmus :  they  combine  with  alkalis  and  destroy  the 
power  which  these  have  of  turning  red  litmus-paper  blue. 

They  may  be  regarded  as  compounds  of  hydrogen  with  certain 
radicals,  hydrogen  being  readily  displaced  by  other  bases.  Some 
acids,  as  boric  and  carbolic,  have  no  sour  taste.  Carbolic  acid 
does  not  redden  litmus-paper,  but  it  is  in  reality  an  alcohol, 
although  in  chemical  combinations  it  behaves  like  an  acid. 

Geneeal  Pbepabation  of  Acids. — Most  acids  are  prepared  by 
liberating  them  from  their  alkaline  salts  by  means  of  sulphuric 
acid.  When  they  are  volatile  they  are  separated  by  distillation, 
and  when  non-volatile  by  crystallisation. 

Sulphuric  acid,  which  is  of  such  importance  in  the  preparation 
of  other  acids,  is  itself  prepared  by  oxidising  the  fumes  of  sulphur 
by  means  of  nitric  acid.  Sulphur  is  burnt,  and  the  sulphurous 
oxide  thus  produced  is  conducted  along  with  the  vapour  of  nitric 
acid  into  a  large  leaden  chamber,  where  it  is  mixed  with  steam. 
Sulphurous  oxide  is  oxidised  by  the  nitric  acid  and  sulphuric 
oxide  is  formed,  which  uniting  with  the  watery  vapour  forms 
sulphuric  acid.  The  nitric  acid  is  deoxidised  in  this  process  into 
nitric  oxide ;  this  unites  with  the  oxygen  of  the  air  to  form  nitric 
peroxide,  and  this  again  supplies  fresh  oxygen  to  the  sulphurous 
acid,  N02  +  S02  +  H20  =?NO  +  H2B04.  In  this  way  a  small  quan- 
tity of  nitric  acid  is  sufficient  to  oxidise  a  large  quantity  of 
sulphuric  acid ;  reduction  and  reoxidation  going  on  alternately 
in  the  nitrous  fumes.  The  sulphuric  acid  formed  in  the  leaden 
chamber  is  drawn  off  and  evaporated  to  the  proper  strength. 


566 


INOEGANIC   MATEEIA   MEDICA. 


[SECT.  III. 


The  acids  which  are  prepared  by  liberation  from  their  Baits 
by  sulphuric  acid  are  given  in  the  following  tables  : — 


Volatile  Acid 

Prepared  from 

By  addition  of  Sulphuric  Acid  and 

Carbonic  Acid  .        . 

Any  carbonate,  gener- 

Conducting into  water  or  alka- 

ally Carbonate  of 

line  solution,  according  to  the 

Calcium 

purpose  required. 

Hydrochloric    Acid, 

Sodium  chloride 

Distilling  into  water,  which  dis- 

B. and  U.S.P. 

solves  the  acid. 

Nitric  Acid,  B.  and 

Sodium    Nitrate,   or 

Distilling. 

U.S.P. 

Potassium  Nitrate 

Acetic  Acid,  B.  and 

Crystallised  Sodium 

Ditto. 

U.S.P. 

Acetate 

Glacial  Acetic  Acid, 

Dried  Sodium  Ace- 

Ditto. 

B.  and  U.S.P. 

tate 

Dilute  Hydrocyanic 

Potassium   Ferroey- 

Distilling  into  water. 

Acid,B.andU.S.P. 

anide 

Sodium  chloride  and  sodium  nitrate  are  found  native :  the 
sodium  acetate  is  prepared  from  gas  liquor  by  saturating  with 
sodium  carbonate. 

In  preparing  hydrocyanic  acid  the  cyanide  is  not  employed, 
but  the  ferrocyanide  which  is  prepared  by  heating  together 
animal  refuse  and  iron  filings  and  potassium  carbonate. 


Non- Volatile  Acid 


Prepared  from 


By  addition  of  Sulphuric  Acid  and 


Chromic  Acid  . 

Tartaric     Acid,     B. 
and  U.S.P. 

Citric  Acid,  B.  and 
U.S.P. 

Lactic  Acid,  B.  and 
U.S.P. 


Boric  Acid,  B.  and 
U.S.P. 


Potassium  Bichro- 
mate 

Tartrate  of  Calcium, 
madefrom  acid  tar- 
trate of  potassium 

Citrate  of  Calcium, 
made  from  lemon- 
juice 

Lactate  of  Calcium, 
obtained  by  pecu- 
liar fermentation 
of  sugar 

Sodium  borate . 


Collection  of  crystals,  draining, 

and  drying. 
Subsequent     decantation    from 

calcium  sulphate,  evaporation 

and  crystallisation. 
Subsequent  decantation,  <fec,  as 

for  tartaric  acid. 

Decantation  and  evaporation. 


Precipitation;  the  boric  acid, 
sparingly  soluble  in  water,  falls 
as  a  precipitate,  and  the  sodium 
sulphate  is  removed  by  decaff- 
tation  or  nitration.  <iSS 


If  sulphuric  acid  were  added  to  citrate  or  tartrate  of  potassium 
or  sodium,  it  would  be  difficult  to  separate  the  acid  from  the 
sulphate.  To  avoid  this,  the  citrates  and  tartrates  of  calcium  are 
first  prepared,  and  to  these  sulphuric  acid  is  added.  There 
results  an  insoluble  calcium  sulphate  which  falls  as  a  precipitate, 
and  the  solution  of  citric  or  tartaric  acid  is  readily  separated  by 
decantation  or  filtration,  and  evaporated  to  crystallisation. 

_  Citrate  of  calcium  is  prepared  by  adding  chalk  to  boiling  lemon- 
juice,  and  washing  the  colouring  matter  from  the  precipitate  by 


CHAP.  XXIII.] 


ACIDS. 


567 


hot  water.  Hot  i3  employed  in  preference  to  cold  water  because 
citrate  of  calcium  is  less  soluble  in  it.  Tartrate  of  calcium  is  pre- 
pared from  the  crude  acid  tartrate  of  potassium  or  argol,  which 
is  deposited  from  wine  during  the  process  of.  fermentation. 
Chalk  is  first  added  to  a  solution  of  it,  whereby  a  neutral  tartrate 
is  formed,  2(KHC4H406)  +  CaC03 = CaC4H406  +  K2C4H406  +  C02  + 
H20.  This  is  then  decomposed  by  the  addition  of  calcium* 
chloride  or  sulphate,  K2C4H406  +  CaCL  =  CaC4H406  +  2KC1. 

Exceptions  to  the  rule  that  acids  are  prepared  from  salts 
by  the  addition  of  sulphuric  acid  : — 


Acid 

Prepared  by 

Sulphuric  Acid  . 

Phosphoric  Acid 

Oxalic  Acid 
Sulphurous  Acid 

Hydrobromic  Acid     . 

Arsenious  Acid  . 

Benzoic  Acid     . 
Carbolic  Acid     . 

Oleic  Acid          . 

Salicylic  Acid    . 

Tannic  Acid      . 
Gallic  Acid        . 

Combustion  of  sulphur  and  the  oxidation  and  hydration 

of  the  resulting   sulphurous  acid  gas  by  means  of 

nitrous  and  aqueous  vapours. 
Oxidising  phosphorus  by  heating  it  with  diluted  nitric 

acid   until   nitrous  fumes  have  ceased  to  form,  and 

then  diluting  it  to  the  proper  strength. 
Oxidising  sugar  by  heating  with  nitric  acid. 
Deoxodising  sulphuric  acid  by  means  of  charcoal  and 

passing  the  fumes  into  water. 
By  passing  sulphuretted  hydrogen  into  bromine  and. 

water  2Br2  +  2H2S  =  4HBr  +  S2. 
Boasting  arsenical  ores,  collecting  the  acid  which  sub- 
limes, and  purifying  it  by  resublimation. 
Heating  gum  benzoin  when  the  acid  sublimes. 
Fractional   distillation  of  coal-tar  oil  and  subsequent 

purification. 
Decomposing  lead  oleate  by  hydrochloric  acid  or  by 

decomposing  fats  by  superheated  steam  and  separation 

from  solid  fats  by  pressure. 
By  passing  carbonic  acid  gas  over  sodium  carbolate 

which  is  made  by  evaporating  a  mixture  of  caustic 

soda  and  carbolic  acid  to  dryness. 
Dissolving  out  from  the  fresh  nut-galls  in  which  it  is 

contained  by  ether  and  water. 
Dissolving  it  out  from  fermented  nut-galls  by  hot  water. 

Hydrobromic  acid,  although  volatile,  is  not  unfrequently 
prepared  without  distillation.  McLean  Hamilton  and  Milner 
Fothergill's  plan  is  to  dissolve  84|  grs.  of  potassium  bromide  in 
a  fluid  ounce  of  water,  and  add  99  grs.  of  tartaric  acid  to  it. 
After  standing  at  a  low  temperature  for  twelve  hours,  acid 
tartrate  of  potassium  crystallises  out,  and  leaves  a  solution  con- 
taining about  10  per  cent,  of  real  hydrobromic  acid. 

General  Action  of  Acids.- — They  have  an  affinity  for  electro- 
positive or  basic  substances,  and  combine  with  them  when  they 
come  in  contact.  Stronger  acids  drive  out  weaker  ones  from 
their  combination  with  bases,  setting  them  free ;  but  are  them- 
selves sometimes  driven  out  by  weaker  ones  if  these  form  an 
insoluble  combination. 

When  they  come  in  contact  with  the  tissues  they  produce 
changes  in  a  twofold  manner ;  (1)  by  forming  new  compounds 


568  INOEGANIC  MATEEIA  MEDICA.  [sect.  in. 

(2)  by  destroying  others  previously  existing.  The  different  acids 
possess  different  affinities,  and  the  actions  they  exert  vary  with 
the  acid  and  with  the  degree  of  its  concentration,  weak  acids 
having  their  affinities  easily  satisfied.  All  the  tissues  of  the 
body  are  alkaline,  and  the  first  effect  of  acids  will  be  to  neutralise 
the  alkali,  and  if  albumin  be  dissolved  in  it  to  precipitate  it.  If 
sufficient  acid  be  present,  they  all,  with  the  exception  of  nitric 
acid,  again  redissolve  it.  Acids  unite  with  albumin  in  different 
proportions,  forming  acid-albumin.  When  mixed  with  blood 
they  not  only  precipitate  albuminous  substances,  but  decompose 
haemoglobin,  forming  a  substance  which  holds  oxygen  with  more 
tenacity  than  haemoglobin.  They  coagulate  myosin  and  produce 
instantaneous  rigidity  in  muscles.  Sulphuric  and  phosphoric 
acids  have,  besides  their  chemical  affinities,  a  strong  attraction 
for  water,  and  completely  decompose  the  tissues  to  which  they 
are  applied,  so  that  they  are  most  powerful  escharotics.  Nitric 
acid  does  not  readily  redissolve  the  albumin  precipitated  by  it, 
and  thus  forms  a  barrier  to  its  own  action,  so  that  it  does  not 
penetrate  so  deeply  as  sulphuric  acid. 

Bound  the  tissue  killed  by  acids  inflammation  ensues,  and 
an  eschar  is  separated.  When  their  action  is  less  intense 
they  cause  inflammation  of  the  surface  of  the  dermis,  and  pro- 
duce vesication.  Still  less  concentrated,  they  precipitate 
albumin  from  its  solutions  in  the  tissues,  act  as  irritants,  and 
cause  contraction  of  the  blood-vessels.  This  effect  is  removed 
by  the  alkalinity  of  the  blood,  and  the  irritation  may  be  only 
sufficient  to  cause  a  temporary  congestion  subsequent  to  the 
contraction.  Then  the  acids  act  only  as  rubefacients.  As  such 
they  are  used  in  the  form  of  baths. 

In  the  mouth  they  cause  a  peculiar  taste,  and  a  feeling  of 
roughness  in  the  teeth.  They  cause  an  increased  flow  of  saliva 
from  the  parotid,  and  of  the  thin  saliva  which  the  submaxillary 
secretes  when  the  chorda  tympani  is  irritated,  but  have  no  effect 
on  the  sympathetic  saliva.  They  are  therefore  "given  to  allay 
thirst  in  fever,  the  increased  secretion  of  saliva  which  they  pro- 
voke keeping  the  fauces  moist  (p.  357). 

Acids  stimulate  the  secretion  of  the  alkaline  saliva  and  intes- 
tinal juice,  and  excite  the  expulsion  of  bile  from  the  gall-bladder. 
They  are  supposed  generally  to  stimulate  those  glands  whose 
secretions  are  alkaline.  On  the  other  hand  alkalis  stimulate 
the  secretion  of  gastric  juice,  which  is  acid ;  and  they  are  sup- 
posed to  stimulate  in  general  those  glands  whose  secretion  is 
acid.  Professor  Einger  supposes  that  the  converse  is  also  the 
case,  and  that  acids  and  alkalis  severally  hinder  the  secretions 
of  a  like  character.  This  supposition  may  be  correct,  and  no 
doubt  when  an  acid  is  present — e.g.  in  the  stomach — it  will 
neutralise  any  alkali  which  may  be  taken,  and  either  retard  its 
stimulant  action  on  the  gland  or  prevent  it  altogether,  according 


chap,  xxm.]  ACIDS.  569 

to  the  relative  quantities  of  acid  present  and  of  alkali  employed. 
The  presence  of  much  alkali  will  also  hinder  the  action  of  an 
acid  stimulus  in  the  same  manner,  but  whether  acids  and  alkalis 
have  any  further  effect  in  hindering  secretion  than  that  just 
mentioned  is  uncertain. 

Acids  are  partly  neutralised  by  the  saliva,  and  partly  act  as 
astringents  on  the  mouth  and  fauces.  They  are  thus  used  in 
congestion  of  the  throat.  As  they  corrode  the  teeth,  they  are 
generally  given  through  a  glass  tube  or  quill,  and  the  teeth 
should  be  rubbed  with  chalk  afterwards. 

Digestion  in  the  stomach  is  accomplished  by  the  action  of 
pepsin  along  with  dilute  hydrochloric  acid  (-2  per  cent,  in  man). 
This  ferment  only  acts  in  presence  of  free  acid ;  but  the  amount 
of  acid  necessary  is  different  in  different  animals,  being  greatest 
in  the  carnivora  (-3  per  cent.  HC1  in  the  dog)  and  least  in  the 
herbivora.  Pepsin  seems  able  to  go  on  dissolving  fibrin  almost 
without  a  limit,  but  fresh  acid  must  always  be  added.  If  the 
secretion  is  deficient,  digestion  goes  on  slowly  and  fermentation 
of  the  food  takes  place,  causing  the  formation  of  other  acids  and 
liberation  of  gases. 

The  secretion  of  gastric  juice  may  be  stimulated  by  alkalis 
given  just  before  meals ;  but  if  the  stomach  is  so  much  out  of 
order  as  not  to  respond  to  the  stimulus,  hydrochloric  or  phos- 
phoric acid  may  be  given  after  meals,  alone,  or  with  pepsin.  In 
,  febrile  conditions  there  is  a  deficiency  of  free  acid  in  the  stomach, 
although  pepsin  is  present  in  plenty.  In  chronic  gastric  catarrh, 
especially  when  accompanied  by  dilatation,  the  free  acid  is  greatly 
diminished,  and  in  carcinoma  of  the  stomach  it  would  seem  to 
be  wanting  in  the  great  majority  of  cases.  In  such  conditions, 
therefore,  the  administration  of  diluted  hydrochloric  acid  is. 
indicated* 

For  acid  eructations  and  heartburn  depending  on  excessive 
acidity  of  the  gastric  juice,  acids  should  be  given  before  meals 
(Einger). 

Some  persons  are  troubled  by  eructations  of  sulphuretted 
hydrogen  with  a  taste  of  rotten  eggs.  These  persons  have  gene- 
rally oxalic  acid  in  the  urine,  and  frequently  suffer  from  depres- 
sion of  spirits.  Such  patients  are  benefited  by  acids,  especially 
nitro-hydrochloric  acid.  Persons  who  suffer  from  dyspepsia  and 
depression  of  spirits  with  oxaluria  are  also  benefited  by  mineral 
acids,  even  when  no  sulphuretted  hydrogen  is  present  in  the 
intestines. 

When  the  use  of  acids  is  long  continued  they  lessen  the 
secretion  of  gastric  juice,  and  produce  a  catarrhal  condition  of 
the  mucous  membrane  of  the  stomach.  They  should  therefore 
not  be  given  for  more  than  a  week  or  two  at  a  time.  They 
should  then  be  left  off  for  a  short  time,  or  alternated  with  alkalis. 
Constant  use  of  acid  wines  has  a  similar  tendency  to  produce. 


570  INOEGANIC  MATEEIA  MEDICA.  [sect.  in. 

catarrh.  Vinegar  is  sometimes  drunk  in  order  to .  lessen  obesity 
or  even  plumpness.  It  has  this  effect  by  inducing  gastro-intes- 
tinal  catarrh,  but  sometimes  the  derangement  of  the  digestion 
occasioned  by  it  has  been  so  great  as  to  cause  death. 

Acids  stimulate  the  expulsion  of  bile  from  the  gall-bladder, 
and  the  secretion  of  intestinal  juice.  As  they  will  be  rapidly 
neutralised  by  the  bile  and  pancreatic  juice,  and  absorbed  in  the 
duodenum,  they  can  hardly  reach  the  lower  and  middle  parts  of 
the  alimentary  canal  as  acids.  Their  action  in  relieving  diarrhoea 
is  difficult  to  explain. 

When  absorbed  from  the  intestine  they  must  pass  through 
the  liver  before  they  can  reach  the  general  circulation  (p.  399  et 
seq.).  It  is  probable  that  during  their  passage  through  the  portal 
system  they  alter  the  processes  of  tissue-change  which  go  on  in 
the  liver,  and  check  the  formation  of  urea.  The  reason  for  this 
supposition  is  that  acids  are  excreted  in  the  urine  chiefly  in  the 
form  of  ammoniacal  salts.  In  the  normal  condition  ammonia  is 
readily  converted  into  urea  in  the  organism,  and  when  given 
internally  it  appears  in  the  urine  in  the  form  of  urea,  and  not  of 
ammoniacal  salts.  The  appearance  of  these  salts  in  the  urine 
after  the  administration  of  acids  shows  that  the  normal  process 
of  conversion  into  urea  has  been  dhrinishtd.  Possibly  it  is  to 
such  alterations  in  the  tissue-change  in  the  liver  that  the  so- 
called  tonic  action  of  acids  is  due  (p.  410),  as  well  as  the  marked 
benefit  obtained  in  hepatic  disorders  from  the  administration  of 
nitric  and  nitro-hydrochloric  acids.  Although  acids  appear 
in  the  urine  in  combination  with  ammonia  and  other  bases, 
yet  their  free  administration  increases  the  acidity  of  the  urine. 
They  are  therefore  used  to  prevent  the  deposits  of  phosphatic 
calculi  which  are  apt  to  occur  in  alkaline  urine. 

Poisoning  by  Acids. — The  symptoms  of  poisoning  by  acids, 
and  the  antidotes  to  be  employed,  have  already  been  described 
(pp.  395,  397,  and  486).  In  cases  of  acute  poisoning  where 
death  has  not  occurred  too  quickly,  much  albumen,  haamatin, 
and  indican  have  appeared  in  the  urine,  and  fatty  degenera- 
tion of  the  liver,  muscles,  and  kidneys  has  been  found.  In  the 
kidneys  the  cloudy  swelling  and  fatty  degeneration  of  the  cells 
were  accompanied  by  evidences  of  inflammation  in  the  connective 
tissue  also,  as  it  exhibited  proliferation  of  nuclei,  especially  along 
the  course  of  the  vessels. 

Acidum  Sulphuricum,  B.  and  U.S.  P.  Sulphuric  Acid. — 
It  contains  96-8  per  cent,  of  H?S04  (98)  and  corresponds  to  79 
per  cent,  of  anhydrous  sulphuric  acid,  S03  (80). 

Properties. — A  colourless,  oily-looking,  heavy  liquid.  Sp.  gr. 
1-843 ;  no  smell,  but  intensely  acid  taste.  It  blackens  and  cor- 
rodes most  organic  substances.  It' has  a  great  affinity  for  water, 
and  when  mixed  with  it  evolves  much  heat.    When  diluted  it 


chap,  xxiii.]  ACIDS.  571 

gives  a  copious  white  precipitate  of  barium  sulphate  (BaS04) 
with  chloride  of  barium,  insoluble  in  nitric  or  in  hydrochloric 
acid. 

Preparation. — Vide  p.  565. 

iMPUMTps.— Lead  derived  from  the  leaden  chambers  in  which  it  is  pre- 
pared ;  nitric  acid  from  the  nitrous  fumes;  arsenic  from  impure  sulphur 
being  used  and  the  arsenious  fumes  passing  over  with  the  sulphurous  acid ; 
and  water  from  imperfect  concentration  or  fraudulent  addition. 

Tests. — Not  unfrequently  it  contains  so  much  lead  in  the  form  of  sulphate 
that  when  diluted  with  water  it  deposits  a  white  precipitate,  the  sulphate 
being  soluble  in  the  strong  but  not  in  the  weak  acid.  It  should  not  do  this, 
and  when  evaporated  in  a  platinum  dish  it  should  leave  little  or  no  residue; 
(no  lead,  arsenic,  or  saline  impurities).  When  a  solution  of  sulphate  of  iron 
is  carefully  poured  over  its  surface  there  is  no  purple  colour  developed  where 
the  two  liquids  unite  (no  nitric  acid).  Diluted  with  six  times  its  volume  of 
distilled  water  it  gives  no  precipitate  with  sulphuretted  hydrogen  (no  arsenic 
or  lead).  The  absence  of  water  is  ascertained  by  the  sp.  gr.  not  being  be- 
low 1*840,  and  by  the  volumetric  estimation  of  its  neutralising  power  with 
solution  of  soda. 

Officinal  Pbepaeations. 
B.P.  u.s.p. 

Acidum  Sulphuricum  Aromaticum.        Acidum  Sulphuricum  Aromaticum. 

n  „  Sllutum.  „  „  Dilutum. 

Infusum  Rosa-  Acidum, 

Acidum  Sulphuricum  Aromaticum,  B.  and  U.S.P.  Aromatic  Sulphuric 
Acid.  Is  sulphuric  acid  diluted  with  alcohol  and  flavoured  with  cinnamon  and 
ginger.    About  1  in  13  B.P.,  and  1  in  10  U.S.P.  by  measure. 

Infusum  Cinchona  Acidum  contains  aromatic  sulphuric  acid  1  part  in  80. 

Acidum  Sulphuricum  Silutum,  B.  and  V.S.P.  Dilute  Sulphuric  Acid. 
Is  the  strong  acid  diluted  with  11  parts  B.P.,  16£  parts  U.S.P.,  of  water  by  measure ; 
1  in  10  by  weight  U.S.P. 

Doses. — Of  either  aromatic  or  dilute  sulphuric  acid  5-30  min. 
freely  diluted. 

Incompatibles. — Preparations  of  lead. 

Action. — It  is  a  most  powerful  caustic,  and  quickly  chars 
and  destroys  the  parts  it  touches.  When  mixed  with  charcoal 
paste  it  is  used  as  a  caustic  in  cancer,  and  with  lard  in  obstinate 
skin-diseases.  When  swallowed,  as  it  not  unfrequently  is  in 
manufacturing  districts,  it  produces  symptoms  of  irritant  poison- 
ing (p.  395).  The  antidotes  are  alkalis,  soap,  oil,  whiting,  milk, 
plaster  from  the  wall,  or  magnesia. 

Uses. — Internally  it  is  used,  after  free  dilution,  to  quench 
thirst  in  fever,  to  prevent  absorption  of  lead  from  the  stomach 
in  painters  and  colour-grinders,  to  check  diarrhoea,  especially  in 
phthisis,  to  arrest  haemoptysis  and  other  haemorrhages,  and  to 
lessen  night-sweats  and  mucous  discharges. 

Acidum  Sulphurosum,  B.  and  U.S.P.  Sulphurous  Acid. — 
Sulphurous  acid  gas  (S02 ;  64)  dissolved  in  water  and  consti- 
tuting 9*2  per  cent,  of  the  solution. 

Properties. —A  colourless  liquid  with  a  strong  sulphurous 
odour. 

•Preparation.— Vide  p.  567,  2H3S04  +  0  =  C02  +  2S08  +  2HjO, 


572  INOEGANIC   MATBEIA   MEDICA.  [sect,  in, 

Bbactions. — Unlike  sulphuric  acid,  it  gives  no  precipitate  with  chloride 
of  barium,  but  if  chlorine  be  added  to  it,  it  becomes  converted  into  sulphuric 
acid,  and  then  gives  a  precipitate,  S02  +  2H20  +  Cl2  =  H2S04  +  2H01. 

Impurities.— Sulphuric  acid,  solid  impurities,  too  little  sulphurous  acid. 

Test. — It  should  give  no  precipitate,  or  only  a  slight  one,  with  chloride  of 
barium  (little  or  no  sulphuric  acid) ;  but  very  few  specimens  answer  either 
to  this  test  or  to  the  officinal  volumetric  test,  on  account  of  the  liability  of  the 
acid  to  decompose.  It  should  leave  no  residue  on  evaporation.  Its  strength 
is  determined  by  its  sp.  gr.  1-04,  and  the  volumetric  test. 

Dose. — ^-1  fluid  drachm  diluted  with  water. 

Action. — It  is  a  powerful  deoxidising  agent.  It  is  extremely 
destructive  to  plant  life,  and  so  may  destroy  disease-germs. 

Uses.- Gaseous  sulphurous  acid  is  used  to  disinfect  rooms. 
The  room  should  be  closely  shut  up,  and  a  brazier  with  charcoal 
placed  in  it.  On  this  sulphur  is  thrown,  and  the  fumes  are 
allowed  to  permeate  the  room  for  several  hours.  Care  must  be 
taken  that  the  brazier  is  so  placed  that  there  is  no  danger  of 
anything  in  the  room  catching  fire.  A  solution  mixed  with 
glycerine  may  be  applied  in  skin-diseases  depending  on  parasitic 
fungi.  It  is  very  useful  in  cases  of  vomiting,  especially  when 
the  vomited  matters  have  a  frothy  or  yeasty  appearance  due  to 
the  presence  of  sarcinse  and  to  the  occurrence  of  fermentation 
in  the  stomach.  Applied  as  spray  it  sometimes  gives  relief  in 
laryngeal  phthisis. 

Acidum  Hydrochloricum,  B.  and  U.S.  P.  Hydeochlobio 
or  Muriatic  Acid. — Hydrochloric  acid  gas  (HC1 ;  36-4)  dissolved 
in  water,  and  forming  31-8  B.P.,  31-9  U.S.P.,  per  cent,  by  weight 
of  the  solution. 

Properties.— A  nearly  colourless  liquid,  sp.  gr.  1*16.  It 
emits  white  vapours  having  a  pungent  odour,  and  has  a  strongly 
acid  taste. 

Preparation. — By  warming  chloride  of  sodium  with  sulphuric  acid, 
washing  the  evolved  HC1,  and  conducting  it  into  cold  water  by  which  it 
is  absorbed.  Excess  of  sulphuric  acid  is  employed  if  glass  vessels  are  used 
in  the  preparation  either  of  this  or  of  nitric  acid,  as  the  bisulphate  of  potas- 
sium left  behind  is  more  soluble  than  the  neutral  sulphate,  and  thus  the 
vessels  are  more  easily  cleaned.     NaCl  +  H2S04  =  NaHS04  +  HC1. 

Reaction. — It  gives  with  nitrate  of  silver  a  curdy  white  precipitate  soluble 
in  excess  of  ammonia,  insoluble  in  nitric  acid. 

Impurities. — Salts  ;  sulphuric  acid,  with  its  impurities  lead  and  arsenic; 
chloride  of  sodium  or  chlorine  ;  sulphurous  acid  formed  from  sulphuric  by 
organic  substances ;  iron  from  the  apparatus  in  which  it  is  made  commer- 
cially. 

Arsenic  is  of  importance  as  an  impurity  because  hydrochloric  acid  is 
sometimes  used  in  testing  for  arsenic  by  the  formation  of  arseniuretted 
hydrogen.  When  testing  for  arsenic  in  cases  of  suspected  poisoning  both  the 
acid  and  the  zinc  must  be  tested  first,  in  order  to  ascertain  their  purity  before 
the  suspected  substance  is  added. 

Tests. — When  diluted  with  four  times  its  volume  of  distilled  water  it 
gives  no  precipitate  with  solution  of  chloride  of  barium  (absence-  of  sulphuric 
acid),  or  with  sulphuretted  hydrogen  (absence  of  lead  or  arsenic),  and  does 
not  tarnish  or  alter  the  colour  of  bright  copper  foil  when  boiled  with  it 


chap,  xxiii.]  ACIDS.  573 

(absence  of  arsenic).  When  diluted  with  five  volumes  of  water  it  should  not 
liberate  iodine  from  iodide  of  potassium  (absence  of  chlorine) ;  and  when 
1  c.c.  is  diluted  to  10  c.c.  with  water  and  supersaturated  with  ammonia,  the 
addition  of  two  drops  of  ammonium  sulphide  causes  no  black  colour  (absence 
of  iron).  If  a  fluid  drachm  of  it  mixed  with  half  an  ounce  of  distilled  water 
be  put  into  a  small  flask  with  a  few  pieces  of  granulated  zinc,  and  while  the 
effervescence  continues  a  slip  of  bibulous  paper  wetted  with  solution  of  sub- 
acetate  of  lead,  B.P.,  or  nitrate  of  silver,  TJ.S.P.,  be  suspended  in  the  upper 
part  of  the  flask  above  the  liquid  for  about  five  minutes,  the  paper  will  not 
become  discoloured  (absence  of  sulphurous  or  arsenious  acid,  S02  +  6H  = 
HjS  +  2H20).  When  evaporated  it  leaves  no  residue  (no  sodium  chloride  or 
other  fixed  impurity). 

Preparations  containino  Free  Hydrochloric  Acid. 

B.P.  dose. 

Acidum  Hydrochloricum  Dilutum  (acid  8,  diluted 

with  water  up  to  26£  by  measure)  10-30  m. 

Acidum  Nitro-hydrochloricum  Dilutum 10-30  m. 

Liquor  Antimonii  Chloridi 

„      Arsenici  Hydrochloricus  

„      Morphins  Hydrochloratis   

U.S.P. 

Acidum  Hydrochloricum  Dilutum  (acid  6,  water  13  by 

weight;  5J  and  14  by  measure)  10-30  m. 

Acidum  Nitro-hydrochloricum 

„  „  „  Dilutum 10-30  m. 

Action  and  Uses. — It  produces  symptoms  of  poisoning  like 
those  of  sulphuric  acid.  The  stains  which  it  leaves  upon  the 
mucous  membrane  are  white.  It  is  rarely  used  externally.  It 
may  be  employed  to  quench  thirst  in  fevers,  and  to  lessen  phos- 
phatic  deposits  in  the  urine ;  it  is  sometimes  useful  in  cases  of 
sore-throat.  As  it  is  the  acid  of  the  gastric  juice,  it  may  be 
given  after  meals  in  cases  of  indigestion,  where  we  suspect 
deficiency  of  acid  (p.  568),  and  to  aid  the  digestion  of  food,  as  well 
as  to  relieve  thirst  in  febrile  conditions  (pp.  360  and  569) . 

Acidum  Hydrobromicum  Dilutum,  B.  and  U.S.P.  Diluted 
Hydeobeomic  Acid. — A  liquid  composed  of  10  per  cent,  of  real 
or  gaseous  hydrobromic  acid  (HBr  ;  80-8)  and  90  of  water. 

Chaeactees.  —  A  clear,  colourless  liquid,  odourless,  having  a 
strongly  acid  taste  and  an  acid  reaction.  Sp.  gr.  1-077.  By 
heat  it  is  completely  volatilised. 

Eeactions. — On  adding  chlorine  or  nitric  acid  to  diluted  hydrobromic  acid, 
bromine  is  liberated,  which  is  soluble  in  chloroform  or  in  disulphide  of  carbon, 
imparting  to  these  liquids  a  yellow  colour.  Test  solution  of  nitrate  of  silver 
causes  a  white  precipitate,  insoluble  in  nitric  acid  and  in  water  of  ammonia, 
and  sparingly  soluble  in  stronger  water  of  ammonia. 

Tests. — On  being  kept  for  some  time,  the  acid  should  not  become  coloured. 
Test-solution  of  chloride  of  barium  should  not  produce  a  turbidity  or  precipitate 
(sulphuric  acid). 

Dose. — 15  to  50  min.  B.P.  Two  fluid  drachms  contain  12 
grains  of  bromine,  which  are  equal  to  about  18  grains  of  bromide 


574  INOEGANIC  MATEEIA  MEDICA.  [sect.  in. 

of  potassium  (United  States  Dispensatory).  It  may  be  given  in 
syrup. 

Action  and  Uses. — It  appears  to  act  as  a  sedative  to  the 
nervous  system,  diminishing  reflex  action  and  lessening  tendency 
to  spasm,  in  the  same  way  as  bromide  of  potassium,  but  differ- 
ing from  it  in  not  producing  the  feeling  of  depression  frequently 
caused  by  potassium  bromide. 

It  has  been  employed  in  epilepsy,  and  to  relieve  nervousness. 

It  is  useful  in  headache  and  singing  in  the  ears,  either  idio- 
pathic or  due  to  the  administration  of  quinine  or  of  iron.  It  is 
used  also  to  remove- the  bad  effects  of  excess  in  tea  or  alcohol, 
and  to  quiet  palpitation. 

Syrupus  Acidi  Hydriodici,  U.S.  P.  Syrup  of  Hydbiodic 
Acid. — A  liquid  containing  1  per  cent,  of  pure  hydriodic  acid 
(HI;  127-6),  sugar,  and  spirit  of  orange. 

Characters. — A  transparent,  colourless,  or  not  more  than 
straw-coloured,  liquid,  odourless,  and  having  a  sweet  acidulous 
taste.     Sp.  gr.  1-300. 

Tests. — If  bisulphide  of  carbon  be  poured  into  a  small  portion  of  the  syrup 
and  a  little  chlorine  water  added,  the  disulphide  will  separate  with  a  violet 
colour  in  shaking.  Gelatinised  starch  should  not  give  to  the  syrup  more 
than  a  faint  bluish  tinge ;  and  the  precipitate  by  siiver  nitrate  ought  to  be 
insoluble  in  ammonia.  31"9  grammes  of  the  syrup  require,  for  complete  pre- 
cipitation, 25  cubic  centimetres  of  the  standard  solution  of  nitrate  of  silver. 

Dose. — 1  to  4  fluid  drachms. 

Action  and  Uses. — Hydriodic  acid  may  be  given  in  asthma 
and  bronchitis  instead  of  iodide  of  potassium,  to  which  its  action 
is  similar  (p.  560). 

Acidum  Nitricum,  B.  and  U.S.P.  Nitric  Acid.  HN03; 
63. — An  acid  prepared  from  nitrate  of  potassium  or  nitrate  of 
sodium  by  distillation  with  sulphuric  acid  and  water,  and  con- 
taining 70  per  cent.  B.P.,  or  69-4  U.S.P.,  by  weight  of  nitric 
acid,  HN03,  corresponding  to  60  per  cent,  of  anhydrous  nitric 
acid,  Nj,0,. 

Characters. — A  colourless  liquid,  having  a  specific  gravity 
of  1-42.  Boiling-point,  250°  F.  When  exposed  to  the  air  it 
emits  an  acrid,  corrosive  vapour. 

Eeactions. — If  it  be  poured  over  copper-filings,  dense,  red  vapours  are 
immediately  formed ;  but  if  the  acid  be  mixed  with  an  equal  volume  of  water, 
and  then  added  to  the  copper,  it  gives  off  a  colourless  gas,  which  acquires  an 
orange-red  colour  as  it  mixes  with  the  air,  and  which,  if  it  be  introduced  into 
a  solution  of  sulphate  of  iron,  communicates  to  it  a  dark  purple  or  brown 
colour,  due  either  to  solution  of  N,0Q  in  the  sulphate  or  combination  with  it. 
If  submitted  to  distillation  the  product  continues  uniform  throughout  the 
process. 

Impurities. — Weaker  or  stronger  acid,  sulphuric  or  hydrochloric  acids, 
fixed  impurities. 


chap,  xxni.]  ACIDS.  "  575 

Tests. — It  leaves  no  residue  when  evaporated  !to  dryness  (no  fixed  im- 
purities, as  iron,  lead,  &c).  Diluted  with  six  times  its  volume  of  distilled 
water  it  gives  no  precipitate  with  chloride  of  barium  or  nitrate  of  silver  (ab- 
sence of  sulphuric  or  hydrochloric  acids). 

Preparations  containing  Free  Nitric  Acids. 
b.p.  dose.  u.s.p. 

Acldum   Nitricum   Dilutum  Acidum    Nitricum     Dilutum     (acid    1, 

(acid  1,  with  about  4  of  water  water  6  by  weight ;   1£,  and  12£  by 

by  measure) 10-30  m.      measure). 

Acidum     Nitro-hydrochlorieum  Acidum  Nitrohydrochloricum. 

Dilutum.... : „  „  „  Dilutum. 

liquor  Ferri  Pernitratis 

„    Hydrargyri  NiCratis  Acidus 
XJnguentum  Hydrargyri  Nitratis 

Action. — It  is  an  exceedingly  powerful  caustic,  and  destroys 
the  tissues,  but,  unlike  sulphuric  acid,  it  forms,  to  some  extent, 
a  barrier  to  its  own  action  by  coagulating  the  albumin  with 
which  it  meets.  When  swallowed,  it  may  not  only  produce  the 
symptoms  of  irritant  poisoning  already  described  (p.  395),  but 
the  vapour,  getting  into  the  larynx,  may  cause  spasm  of  the  glottis, 
and  death  from  suffocation,  or  may  produce  intense  bronchitis. 

Uses. — Nitric  acid  is  applied  externally  to  destroy  chancres, 
warty  growths,  and  haemorrhoids ;  to  the  surface  of  phagedenic 
ulcers  ;  and  to  bites  of  snakes  or  rabid  dogs,  in  order  to  destroy 
the  virus  and  prevent  its  absorption.  Internally  the  dilute  acid 
is  used  to  quench  thirst  in  febrile  conditions,  like  other  dilute 
acids,  and  it  is  useful  in  cases  of  dyspepsia.  It  is  supposed 
to  have  an  action  upon  the  liver,  and  certainly  appears  to  be  of 
use  in  cases  of  so-called  biliousness.  When  absorbed  it  has  an 
astringent  action,  and  is  exceedingly  serviceable  in  diminishing 
the  secretion  from  the  lungs  in  bronchitis  and  in  the  sub-acute 
exacerbations  of  phthisis.  It  is  also  employed  in  cases  of  syphilis 
occurring  in  debilitated  subjects,  where  mercurials  are  not  well 
borne.  It  diminishes  the  phosphatic  deposits  in  the  urine,  and, 
in  a  dilute  condition,  has  been  injected  into  the  bladder  in  order 
to  dissolve  calculi  already  formed. 

U.S.P.  Acidum  Nitrohydrochloricum.  Niteohydeochloeic 
Acid. 

Chaeactbes. — A  golden  yellow,  fuming,  and  very  corrosive 
liquid,  having  a  strong  odour  of  chlorine  and  a  strongly  acid  re- 
action. By  heat  it  is  wholly  volatilised.  It  readily  dissolves  gold 
leaf,  and  a  drop  added  to  a  test  solution  of  iodide  of  potassium 
liberates  iodine  abundantly. 

Preparation. — By  mixing  nitric  acid  (4)  with  hydrochloric  acid  (15  parts), 
and,  when  effervescence  has  ceased,  preserving  it  in  glass-stoppered  bottles, 
which  should  not  be  more  than  half-filled  and  kept  in  a  cool  place. 

Acidum  Nitrohydrochloricum  Dilutum,  B.   and   U.S.P. 

Dilute    Niteohydeochloeic   Acid. — It    contains   free  chlorine, 


576  INOEGANIO   MATEKIA   MEDICA.  [sect.  hi. 

hydrochloric,  nitric,  and   nitrous  acids  and  other  compounds, 
dissolved  in  water. 

Preparation. — By  mixing  nitric  acid  3,  hydrochloric  4,  water  25,  by 
measure,  and  allowing  it  to  stand  for  14  days  before  it  is  used,  B.P.  By  dilut- 
ing nitrohydrochloric  acid  (1)  with  water  (26  parts  by  weight,  U.S.P.).  The 
proportions  of  the  components  U.S.P.  are,  by  measure,  nitric  acid  3,  hydro- 
chloric acid  13£,  water  80. 

Dose. — 5  to  20  minims. 

Use. — This,  like  nitric  acid,  is  supposed  to  have  a  special 
action  upon  the  liver.  It  is  sometimes  used,  in  the  form  of  baths 
or  compresses,  in  hepatic  disorders,  and  is  frequently  given  in 


Fig.  185. — Showing  the  position  of  the  frontal  headaches  relieved  by  acids  and  alkalis  in  the  absence 
of  constipation.  The  lower  is  relieved  by  acids,  the  upper  by  alkalis  before  meals.  The  lower 
one  also  indicates  the  occasional  position  of  headache  caused  by  straining  the  eyes. 

cases  of  dyspepsia,  biliousness,  and  jaundice.  When  given  before 
meals  it  seems  to  check  acidity  in  the  stomach,  and  it  is  very 
useful  in  removing  headache  situated  in  the  forehead,  just  above 
the  eyebrows,  and  unaccompanied  by  constipation  (Fig.  165).  If 
the  ordinary  diluted  acid  fails,  a  few  drops  of  the  strong  acid 
diluted  with  water  at  the  time  it  is  taken  may  succeed,  and  if 
this  fails  a  mixture  evolving  oxides  of  nitrogen  and  oxides  of 
chlorine  may  prove  successful.1 

Acidum  Aceticum,  B.  and  U.S.P.  Acetic  Acid.  HC2H302; 
60. — An  acid  liquid  prepared  from  wood  by  destructive  distilla- 
tion and  subsequent  purification.  100  parts-  by  weight  contain 
33  B.P.,  36  U.S.P.,  parts  of  acetic  acid  110,11302 ;  60  corre- 
sponding to  28  parts  of  anhydrous  acetic  acid,  C„H603. 

Chabacteks. — A  colourless  liquid  having  a  strong  acid  reaction 

1  Such  a  mixture  is  : 

fy  Solutionis  Sodii  Nitritis  (1  in  4). 

Sol.  Potassii  Chloratis  (1  in  4),  aa  Jij. 
Misce. 
$,  Acidi  Hydrochlorici  Diluti. 
Aquae,  aa  Jij. 
One  teaspoonful  of  each  mixture  to  be  added  to  a  wineglassful  of  water  and  taken 
after  meals.-  Cook,  Practitioner,  vol.  xxvii.  p.  328. 


chap,  xxni.]  ..         ACIDS.  677 

and  a  pungent  odour.    Specific  gravity  1-044  B.P.,  1-048  U.S.P., 
atl5°0. 

Impurities. — Lime,  lead,  copper,  tin,  sulphuric  and  hydrochloric  acids, 
and  sulphurous  acid  due  to  the  action  of  organic  matter  on  the  sulphuric 
acid. 

Tests. — It  leaves  no  residue  when  evaporated  (no  lime,  &c),  and  gives 
no  precipitate  with  sulphuretted  hydrogen  (no  metals),  chloride  of  harium 
(absence  of  sulphuric  acid),  or  nitrate  of  silver  (absence  of  hydrochloric 
acid).  If  a  fluid  drachm  of  it  mixed  with  half  an  ounce  of  distilled  water 
and  half  a  drachm  of  pure  hydrochloric  acid  be  put  into  a  small  flask  with  a 
few  pieces  of  granulated  zinc,  and  while  the  effervescence  continues  a  slip  of 
bibulous  paper  wetted  with  solution  of  subacetate  of  lead  be  suspended  in  the 
upper  part  of  the  flask  above  the  liquid  for  about  five  minutes,  the  paper  will 
not  become  discoloured  (absence  of  sulphuric  acid,  S02  +  6H  =  H2S  +  2H20). 

Preparations  containing  Free  Acetic  Acid. 

b.p.  strength.  dose. 

Acetum 4-6  per  cent,  anhydrous  aeetic  acid...l  fl.  dr.  to  1  fl.  oz. 

„       Cantharidis 

„       Scillse 15  to  40  min. 

Acidum  Aceticum  Glaciale 84  per  cent,  anhydrous  acid. 

„        Aceticum   28      „     „  „  „ 

n  ii         Dilutum 3-6  „    „  „  „     1  fl.  dr.  to  1  fl.  oz. 

Extracium  Colchici  Acetum 

Linimentum     Terebinthinte    Aceti- 
cum (p.  516)    1  volume  acetic  acid  in  3. 

Liquor  Epispasiicus 1  volume  acetic  acid  in  5» 

Mistura  Creasoti  

Oxymel 1  to  2  fl.  dr. 

„      ScfllsB Jtolfl.  dr. 

Syrupus     ^tolfl.dr. 

Tinctura  Ferri  Aeetatis 5  to  30  min. 

U.S.P.  DOSE. 

Acetum  Lobelia 30  min.  to  1  fl.  dr.  (2  to  I  gin.) 

„        Opii 4  to  15  min.  (025  to  1  c.c.) 

„       Sanguinariaa    15  to  30  min.  (1  to  2  gm.) 

as  emetic,  3  to  4  fl.  dr.  (12  to  16  gm.) 

„        Scillffl    15  min.  to  1  fl.  dr.  (1  to  4  gm.) 

Acidum  Aceticum 

„  „  dilutum 

„  „  glaciale  

Extractum  Colchici  Eadicis    J  to  2  gr.  (0-03  to  0-12  gm.) 

Syrupus  Scillffi 15  min.  to  1  dr.  (1  to  4  c.c.) 

Tincture  Ferri  Aeetatis   15  min.  to  1  dr.  (1  to  4  c.c.) 

Acidum  Aceticum  Dilutum,  B.  and  T7.S.P.  Diluted  Acetic  Acid. — 
Acetic  acid,  1  part  diluted  with  water  7  parts,  B.P.,  or  acid  17,  water  83,  U.S.P. 

Properties,  Impurities. — The  same  as  of  acetic  acid,  except  so  far  as  they  are 
affected  by  its  dilution. 

Dose. — 1  to  2  fluid  drachms. 

Preparations  in  which  Diluted  Acetic  Acid  is  used. 

E.P. 

Acetum  Scillffi.  Liquor  Morphinse  Aeetatis. 

Acidum  Aceticum  Glaciale,  B.  and  U.S.P. — Glacial  Acetic 
Acid,  HCaH302 ;  60.  Concentrated  acetic  acid,  corresponding  to 
at  least  84  per  cent,  of  anhydrous  acid,  GJIfi^,  B.P.  Nearly  or 
quite  absolute  acetic  acid,  U.S.P. 

Charactbbs  ajid  Eeactions. — It  crystallises  when  cooled  to 

P  p 


578  INOEGANIC  MATEBIA  MEDICA.  [sect.  in. 

34°  F.,  and  remains  crystalline  until  the  temperature  riBes  to 
above  48°  F.  Specific  gravity  1-065  to  1-066,  and  this  is  increased 
by  adding  ten  per  cent,  of  water.  At  the  mean  temperature  of  the 
air  it  is  a  colourless  liquid,  with  a  pungent  acetous  odour,  B.P. 

At  or  below  15°  C.  (59°  F.)  a  crystalline  solid ;  at  a  higher 
temperature,  a  colourless  liquid.  When  liquefied  and  as  near  as 
possible  to  15°  C.  (59°  F.)  it  has  the  sp.  gr.  1-056-1-058.  Its 
properties  are  similar  to  those  of  acetic  acid,  and  it  is  similarly 
affected  by  reagents.     U.S.P. 

Preparations  in  which  Glacial  Acetic  Acid  is  used. 

B.P. 

Acetum  Cantharidis.  Mistura  Creasoti. 

Linimentum  Terebinthina3  Aceticum  (p.  516). 

B.P.  Acetum.  Vinegar. — An  acid  liquid,  prepared  from 
malt  and  unmalted  grain  by  the  acetous  fermentation. 

Chaeactebs. — A  liquid  of  a  brown  colour  and  peculiar  odour. 

Impurities. — A  little  sulphuric  acid  added  to  it  is  said  to  make  it  keep 
tetter.  Too  much  may  be  fraudulently  added  in  order  to  increase  its  acidity. 
Lead  from  the  vessels  in  which  it  is  kept. 

Tests. — If  ten  minims  of  solution  of  chloride  of  barium  be  added  to  a 
fluid  ounce  of  the  vinegar,  and  the  precipitate,  if  any,  be  separated  by  filtra- 
tion, a  further  addition  of  the  test  will  give  no  precipitate  (limit  of  sulphuric 
acid).     Sulphuretted  hydrogen  causes  no  change  of  colour  (absence  of  lead). 

Dose. — 1  to  2  fluid  drachms. 

Preparation  in  which  Vineqar  is  used. 
Emplastrum  Saponis  Fuscum. 

Action  and  Uses. — When  applied  externally  to  the  skirt, 
glacial  acetic  acid  causes  the  formation  of  a  large  bleb.  It  is  used 
to  destroy  warts  and  corns,  and  is  sometimes  employed  as  a 
vesicant  in  cases  of  kidney-disease,  where  danger  is  apprehended 
from  the  use  of  cantharides.  When  the  vapour  of  it  is  sniffed 
up  the  nose,  it  causes  reflex  contraction  of  the  blood-vessels,  and 
raises  the  blood-pressure.  It  is  therefore  useful  in  lessening 
drowsiness  and  preventing  syncope,  or  arousing  patients  from  it 
(pp.  194  and  265).  _ 

Dilute  acetic  acid  is  applied  to  the  skin  in  cases  of  headache, 
and  is  used  to  sponge  the  surface  and  check  perspiration  when 
too  profuse.  It  checks  bleeding,  and  may  be  used  to  stop  oozing 
from  leech-bites,  or  to  wash  out  the  mouth  after  the  extraction 
of  a  tooth,  and,  when  sniffed  up  the  nose,  sometimes  arrests 
epistaxis.  It  is  occasionally  employed  in  the  form  of  an  enema 
to  destroy  ascarides. 

When  applied  either  alone  or  mixed  with  proof  spirit  on  a 
napkin  to  the  vulva  it  is  sometimes  very  useful  in  checking 
menorrhagia  (vide  p.  351). 

Acidum    Phosphoricum   Concentratum,    B.P.,    Acidum 


ciiap.  xxin.]  ACIDS.  579 

Phosphoricum,  U.S.P.  Phosphokic  Acid.— Phosphoric  acid, 
H3P04,  with  33-7  per  cent,  of  water,  B.P.  A  liquid  composed  of 
50  per  cent,  of  ortho-phosphoric  acid  (H3P04 ;  98)  and  50  per 
cent,  of  water,  U.S.P. 

Characters.— A.  colourless  syrupy  liquid,  without  odour,  and 
of  a  strongly  acid  taste  and  reaction,  sp.  gr.  1-347.  When  heated 
it  loses  water,  and  when  a  temperature  of  about  200°  C.  (392°  F.) 
has  been  reached,  the  acid  is  gradually  converted  into  pyro- 
phosphoric  and  metaphosphoric  acids,  which  may  be  volatilised 
at  a  red  heat. 

Preparation. — Oxidising  phosphorus  by  nitric  acid.     Vide  p.  567. 
,    Keactions. — When  diluted,  and  supersaturated  with  ammonia,  the  test- 
solution  of  magnesium  gives  a  white  precipitate.  Vide  also  the  reactions  and 
tests  of  acidum  phosphoricum  dilutum. 

Pbepabations  coNTAiNraa  Fbee  Phosphoric  Acid. 

B.P.  U.S.P. 

Acidum  Phosphoricum  Dilutum.      Acidum  Phosphoricum  Dilutum. 
Syrupus  Ferri  Phosphatis. 

Acidum  Phosphoricum  Dilutum,  B.  and  U.S.P.  Diluted 
Phosphoric  Acid. — Concentrated  phosphoric  acid,  3  parts  mixed 
with  water  up  to  20  parts  ;  forming  a  solution  corresponding  to 
10  per  cent,  by  weight  of  phosphoric  anhydride,  P205,  B.P. 

Phosphoric  acid  20  parts  with  80  of  water,  U.S.P. 

Characters. — A  colourless  liquid,  with  a  sour  taste  and 
strongly  acid  reaction.     Specific  gravity,  l-08. 

Eeactions. — With  ammonio -nitrate  of  silver  it  gives  a  canary-yellow 
precipitate,  soluble  in  ammonia  and  in  diluted  nitric  acid.  Evaporated,  it 
leaves  a  residue  which  melts  at  a  low  red  heat,  and  upon  cooling  exhibits  a 
glassy  appearance. 

Impurities. — Phosphorous  acid,  meta-  and  pyro-phosphorio  acids,  nitric, 
sulphuric,  and  hydrochloric  acids,  arsenic. 

Tests. — It  is  not  precipitated  by  sulphuretted  hydrogen  (no  metals), 
chloride  of  barium  (no  sulphuric  acid),  nitrate  of  silver  acidulated  with  nitric 
acid  (no  hydrochloric  acid),  nor  by  the  solution  of  albumin  (absence  of  meta- 
phosphoric acid  which  coagulates  albumin).  When  mixed  with  an  equal 
volume  of  pure  sulphuric  acid,  and  then  introduced  into  solution  of  sulphate 
of  iron,  it  does  not  communicate  to  it  a  dart,  colour  (absenoe  of  nitric  acid). 
Mixed  with  an  equal  volume  of  solution  of  perchloride  of  mercury  and  heated, 
no  precipitate  is  formed  (no  pyro-phosphates).  Its  strength  is  estimated 
gravimetrically  by  ascertaining  the  increase  in  weight  which  occurs  in  oxide 
of  lead  when  phosphoric  acid  is  poured  on  it,  evaporated  and  ignited. 

Dose. — 10-30  minims. 

Uses. — Phosphoric  acid  may  be  used  to  allay  thirst,  like 
other  dilute  acids,  in  febrile  states,  and  in  diabetes.  It  may  be 
given  in  larger  doses  than  other  mineral  acids  without  deranging 
digestion,  and  is  therefore  to  be  preferred  to  them  in  cases  where 
it  requires  to  be  given  for  a  length  of  time,  as  in  diabetes  and 
alkalinity  of  the  urine.  It  is  said  to  be  useful  in  scrofula,  and 
to  diminish  the  growth  of  bony  tumours. 

p  p  2 


580  INOBGANIC  MATEEIA  MEDICA.  [sect.  in. 

Acidum  Tartaricum,  B.  and  U.S.P-  Taetabic  Acid. 
H2C4H406;  150.— A  crystalline  acid  prepared  from  the  acid 
tartrate  of  potassium. 

Chaeactbes. — In  colourless  crystals,  the  primary  form  of 
which  is  the  oblique  rhombic  prism.  It  has  a  strongly  acid  taste, 
and  is  readily  soluble  in  water  and  in  rectified  spirit.  When  to 
either  solution,  not  too  much  diluted,  a  little  acetate  of  potassium 
is  added,  a  white  crystalline  precipitate  is  formed. 

[27  grains  bicarbonate  of  potassium. 

20  grains  neutralise  1 22      „  „  sodium. 

( 15^    „     carbonate  of  ammonium. 

Peepaeation. — Vide  p.  566. 

Impueities. — Lead,  copper,  and  iron  from  the  vessels  in  which  it  is  pre- 
pared ;  calcium,  or  acid  tartrate  of  potassium,  from  the  substances  used  in  its 
preparation  ;  racemic  and  oxalic  acids. 

Tests. — An  aqueous  solution  of  the  acid  is  not  affected  by  sulphuretted 
hydrogen  (absence  of  metals),  and  gives  no  precipitate  with  the  solution  of 
sulphate  of  calcium  (no  racemic  er  oxalic  acids),  or  of  oxalate  of  ammonium 
(no  calcium).  It  leaves  no  residue,  or  only  a  mere  trace,  when  burned  with 
free  access  of  air  (no  acid  tartrate  of  potassium) . 

Dose. — 10  to  30  grains. 

Action  and  Uses. — Used  for  cooling  drinks. 

Acidum  Citricum,  B.  and  U.S.P-  Citeic  Acid. 
H3C6H5OrH20 ;  210.— A  crystalline  acid  prepared  from  lemon- 
juice,  or  from  the  juice  of  the  fruit  of  the  lime,  Citrus  Bergamia. 

Chaeactees. — In  colourless  crystals,  of  which  the  right  rhom- 
bic prism  is  the  primary  form ;  very  soluble  in  water,  less  soluble 
in  rectified  spirit,  and  insoluble  in  pure  ether.  The  crystals 
dissolve  in  three-fourths  of  their  weight  of  cold,  and  in  half  their 
weight  of  boiling  water.  The  diluted  aqueous  solution  has  an 
agreeable  acid  taste.  When  the  solution  is  made  by  dissolving 
thirty- four  grains  of  the  acid  in  one  ounce  of  water,  it  resembles 
lemon-juice  in  strength  and  in  the  nature  of  its  acid  properties, 
and,  like  lemon-juice,  it  undergoes  decomposition  and  becomes 
mouldy  by  keeping. 

The  quantity  contained  in  ^  fl.  oz.  of  this  solution,  viz. : — 

(25  grains  bicarbonate  of  potassium. 

17  grains  neutralises  j  20      „  „  sodium. 

1 15      „      carbonate  of  ammonium. 

Peepaeation. — Vide  p.  566. 

Impurities. — Lead  and  copper  from  the  vessels  in  which  it  is  prepared, 
calcium  used  in  its  preparation,  tartaric  acid,  which  is  cheaper,  and  is  apt  to 
be  mixed  with  or  substituted  for  it,  sulphuric  acid  or  sulphates,  oxalic  acid. 

Tests. — The  aqueous  solution  is  not  darkened  by,  sulphuretted  hydrogen 
(absence  of  metals),  gives  no  precipitate  when  added  in  excess  to  solution  of 
acetate  of  potassium  (no  tartaric  acid),  or  of  chloride  of  barium  (no  sulphates), 
and  if  sparingly  added  to  cold  lime-water  it  does  not  render  it  turbid  (no 
oxalic  acid).  The  crystals  leave  no  ash  when  burned  with  free  access  of 
air  (no  calcium). 

Dose. — 10  to  30  grains. 


chap,  xxin.]  ACIDS.  681 

Preparations  containing  Free  Citric  Acid. 
B.P.  u.s.p. 

Succus  limonis.  Syrupus  Acidi  Citrici. 

Syrupus  Iilmonis.  „       Limonis. 

Vinum  Quininse. 

TX.S.P.  Syrupus  Acidi  Citrici.      SYRUP   OE    ClTRIC   AeiD. — Citric 

acid  8,  water  8,  spirit  of  lemon  4,  syrup  980. 

Action  and  Uses. — Citric  acid,  from  the  agreeable  taste  of  its 
solution  in  water,  is  used  for  drinking  in  fever  to  allay  thirst, 
either  alone  or  with  alkaline  bicarbonates  as  effervescing  drinks. 
It  is  also  used  in  scurvy,  as  it  is  supposed  by  some  to  be  the  in- 
gredient to  which  lemon-juice  owes  its  curative  properties  in  that 
disease. 

B.P.     Oxalic  Acid,  Purified.     H2CaO,.  2H20 ;  126. 

Dissolve  1  pound  of  commercial  oxalic  acid  in  30  fluid  ounces 
of  boiling  distilled  water,  filter  the  solution,  and  set  it  aside  to 
crystallise.  Pour  off  the  liquor,  and  dry  the  crystals  by  exposure 
to  the  air  on  filtering  paper  placed  on  porous  bricks. 

Test. — It  is  entirely  dissipated  by  a  heat  below  350°  F. 

Uses. — As  a  test. 

Standard  Solution  of  Oxalic  Acid,  B.P.  and  V.S.P 63  grammes 

dissolved  in  water  to  1000  c.c. 

Acidum  Boricum,  B.  and  U.S.P.  Boric  or  Boracic  Acid; 
H3B03 ;  62. 

Characters.  —  Transparent,  colourless,  six-sided  plates, 
slightly  unctuous  to  the  touch,  permanent  in  the  air,  odourless, 
having  a  cooling,  bitterish  taste  and  a  feebly  acid  reaction ;  in 
solution  turning  blue  litmus-paper  red  and  turmeric  paper 
brown,  the  tint  in  the  latter  case  remaining  unaltered  in  presence 
of  free  hydrochloric  acid.  The  alcoholic  solution  burns  with  a 
flame  tinged  with  green. 

Preparation. — Vide  p.  566. 

Impurities. — Sulphates,  chlorides,  lead,  copper,  iron,  &c,  calcium  and 
sodium  salts. 

Tests. — An  aqueous  solution  of  boric  acid  should  not  be  precipitated  by 
test  solutions  of  chloride  of  barium,  nitrate  of  silver  with  nitric  acid,  sulphide- 
of  ammonium,  or  oxalate  of  ammonium.  A  fragment  heated  on  a  clean 
platinum  wire  in  a  non-luminous  flame  should  not  impart  to  the  latter  a 
persistent  yellow  colour. 

Dose. — 5-30  grains. 

Officinal  Preparation. 

B.P. 

Unguentum  Acidl  Borlcl. — Boric  acid  1,.  soft  paraffin  4,  hard  paraffin  2: 

Action  and  Uses. — From  its  power  of  turning  turmeric 
brown  it  is  used  as  a  test  for  this  substance  in  rhubarb.  It  has 
the  power  of  destroying  low  organisms,  and  has  therefore  been 
used  as  an  antiseptic  application  to  wounds  either  in  the  form, 
of  a  solution  (1  part  in  20  of  hot  water)  or  of  an  ointment.  The 
antiseptic  ointment  originally  recommended  by  Lister  consisted 


582  INORGANIC  MATERIA  MEDICA.  [sect.  nr. 

of  a  mixture  of  the  acid  (1)  with  white  wax  (1),  paraffin  (2), 
almond  oil  (2).  This  is  rather  hard,  and  a  better  ointment 
consists  of  the  powdered  acid  (3),  paraffin  (5)  and  vaseline  (10). 
The  relative  proportions  of  these  may  be  varied  according  to  the 
temperature,  more  or  less  paraffin  being  added  according  as  the 
temperature  is  high  or  low.  Boric  acid  lint  is  a  useful  antiseptic 
dressing  for  small  wounds  and  ulcers ;  and  as  an  antiseptic  hot 
fomentation  in  small  abscesses,  whitlows,  &c.  The  powdered  acid, 
mixed  with  starch,  forms  a  useful  dusting  powder  for  infants,  and 
lessens  the  fcetor  of  perspiration.  When  given  internally  it  is  said 
to  be  occasionally  useful  in  cases  of  vomiting  in  somewhat  the  same 
way  as  sulphurous  acid,  and  it  has  also  been  given  along  with 
ether  in  septic  diseases.  Boro-glyceride,  discovered  and  patented 
by  Barff,  is  made  by  heating  92  parts  of  glycerine  with  62  of 
boric  acid.  A  solution  of  1  in  40  of  water  is  recommended  as  a 
powerful  antiseptic.  It  is  used  to  preserve  food,  and  as  a  lotion 
for  the  treatment  of  wounds  and  in  purulent  ophthalmia.1 

Acidum  Chromicum,  B.  and  U.S.P.  Cheomic  Acid,  Cr03; 
100-4.     It  is  an  anhydride  (not  a  true  acid). 

Chaeactees. — Small,  crimson,  needle-shaped  or  columnar 
crystals,  deliquescent,  odourless,  having  a  caustic  effect  upon  the 
skin  and  other  animal  tissues,  and  an  acid  reaction.  Very  soluble 
in  water,  forming  an  orange-red  solution.  Brought  in  contact 
with  alcohol,  mutual  decomposition  takes  place.  When  heated 
to  about  190°  C.  (374°  F.)  chromic  acid  melts  and  at  250°  C. 
(482°  F.)  it  is  mostly  decomposed,  with  the  formation  of  dark 
green  chromic  oxide  and  the  evolution  of  oxygen.  On  contact, 
trituration,  or  warming  with  strong  alcohol,  glycerine,  spirit  of 
nitrous  ether,  or  other  easily  oxidisable  substances,  it  is  liable  tc 
cause  sudden  combustion  or  explosion. 

Tests. — If  1  grain  of  chromic  acid  be  dissolved  in  100  c.c.  of  cold  water 
and  mixed  with  10  c.c.  of  hydrochloric  acid,  the  further  addition  of  1  c.c.  of 
test  solution  of  chloride  of  barium  should  cause  not  more  than  a  white 
turbidity  (limit  of  sulphuric  acid). 

Oiticinal  Preparation. 

B.P. 

liquor  Acidi  Cbromlci  (acid  1,  water  3  parts). 

Action. — It  has  a  great  power  of  coagulating  albumin,  and 
destroying  low  organisms,  and  as  it  parts  very  readily  with  oxygen 
it  oxidises  organic  matter  and  decomposes  ammonia  and  sulphu- 
retted hydrogen.  It  is  thus  a  powerful  deodoriser  and  disin- 
fectant. It  is  chiefly  used  as  a  caustic  to  destroy  condylomata, 
and  morbid  growths  in  the  mouth,  larynx,  or  uterus,  and  to 
phagedenic  ulcers,  poisoned  wounds,  &c.  As  a  solution  of  1  in 
40,  it  has  been  especially  recommended  in  syphilitic  affections  of 


Extra  Pharmacopoeia,  Martindale  and  Westcott. 


chap,  xxiii.]  ACIDS.  583 

the  tongue,  mouth,  and  throat.  As  a  lotion,  it  has  been  employed 
to  lessen  fcetid  discharges,  and  as  an  injection  in  ozaena,  leucor- 
rhcea  and  gonorrhoea.  Care  must  be  taken  not  to  prescribe  it 
with  any  substance  to  which  it  readily  yields  oxygen,  such  as 
alcohol,  glycerine,  &c,  as  the  mixture  may  explode  spontaneously. 

Acidum  Carbonicum.  Carbonic  Acid,  C02 ;  44.  Not  offi- 
cinal. It  is  very  extensively  used  dissolved  in  water,  as  aerated 
water,  effervescing  soda,  potash,  or  lithia  waters,  or  in  wine,  as 
champagne. 

Properties. — Colourless  gas,  heavier  than  air,  causing  a  pun- 
gent feeling  in  the  nostrils.  Soluble  in  its  own  volume  of  water. 
Its  solubility  is  increased  by  the  presence  of  carbonates,  or  by 
pressure,  and  when  this  is  removed  the  gas  escapes  and  causes 
the  fluid  to  effervesce.  The  solution  has  an  acid  reaction.  Car- 
bonates of  magnesium,  calcium,  iron,  &c,  which  are  only  spar- 
ingly soluble  in  water,  are  dissolved  with  comparative  ease  by 
water  holding  the  gas  in  solution. 

Action  and  Uses. — Like  other  acids,  when  applied  to  the  skin 
it  acts  as  an  irritant,  but  only  slightly.  After  a  prolonged  ap- 
plication it  causes  a  slight  reddening  of  the  skin  and  a  feeling  of 
warmth,  which  changes  on  the  continuance  of  the  application 
into  burning  or  prickling,  felt  most  where  the  skin  is  thin  and 
richly  supplied  with  nerves,  as  the  external  genitals,  and  this  ii 
not  unfrequently  accompanied  by  sweating.  Carbonic  acid  baths 
(p.  469)  are  therefore  sometimes  used  in  catarrh  and  rheumatism 
as  a  slight  rubefacient  to  the  whole  skin,  and  to  cause  sweating, 
especially  where  they  can  be  obtained  with  ease,  as  in  places  where 
there  are  springs  containing  much  carbonic  acid.  These  baths 
— e.g.  the  ferruginous  carbonic  acid  baths  of  various  continental 
spas — have  an  aphrodisiac  action  and  may  be  useful  in  sterility. 

Carbonic  acid  has  been  used  as  a  stimulant  to  ulcers,  either 
by  directing  a  stream  of  gas  directly  upon  them  or  by  applying, 
a  poultice  of  yeast  (Cataplasma  Fermenti,  B.P.),  which  in  the 
process  of  fermentation  causes  a  constant  production  of  this  gas. 

Streams  of  carbonic  acid  have  been  applied  to  the  eyes,  ears, 
nose,  vagina,  and  rectum  in  catarrhal  inflammation  or  ulceration 
of  these  parts,  in  order  to  cause  a  slight  hyperemia  of  the  parts 
and  healing  of  the  inflammation  and  to  dimmish  pain,  as  it  is 
supposed  to  act  locally  by  diminishing  the  sensibility  of  the  nerves 
of  the  part. 

In  the  mouth  carbonic  acid,  like  other  acids,  acts  as  a  sti- 
mulant to  the  secretion  of  saliva,  and  so  water  containing  it 
quenches  thirst  better  than  pure  water,  and  it  is  therefore  often 
used  in  feverish  states  (p.  360). 

In  the  stomach  it  causes  that  slight  pain  which  we  confound 
with  hunger,  and  a  pleasant  feeling  of  warmth  just  as  ont  the 
skin.    Here  too  it  most  probably  causes  a  slight  hyperemia,  and 


584  INOEGANIC  MATEEIA  MEDICA.  [sect.  m.. 

increased  secretion.  The  greatest  part  leaves  the  stomach  as 
gaseous  eructations,  but  a  portion  is  absorbed  and  enters  the 
blood.  Its  action  is  thus  transient,  and  it  produces  no  material 
change  in  the  chemical  composition  either  of  the  contents  or  walls 
of  the  stomach.  It  increases  the  raj  idity  of  the  absorption  of 
water  in  the  intestinal  canal,  as  is  shown  by  the  fact  that  water 
containing  carbonic  acid  is  excreted  by  the  kidneys  much  sooner 
after  it  has  been  drunk,  than  water  without  it.  It  relieves  irri- 
tation in  the  stomach,  and  allays  or  stops  vomiting  or  nausea 
and  slight  derangements  of  digestion.  Carbonic  acid  is  naturally 
present  in  the  intestines,  in  greater  quantities  in  the  large  than 
the  small.  The  carbonic  acid  i»  partly  that  which  passes  from 
the  blood  into  the  intestine  in  interchange  for  the  oxygen  con- 
tained in  the  air  we  swallow,  and  is  partly  formed  by  processes 
of  fermentation  which  take  place  in  the  chyme. 

That  part  of  the  carbonic  acid  which,  after  introduction  into 
the  stomach,  passes  into  the  blood  is  excreted  by  the  lungs. 
Injected  into  the  blood  through  a  vein,  it  is  likewise  excreted  in 
the  same  way  without  causing  an  injury,  unless  it  is  injected  in 
such  a  quantity  that  some  remains  as  gas  undissolved  in  the 
blood,  and  then  it  causes  death  mechanically,  just  like  ah-,  by 
hindering  the  passage  of  blood  through  the  lungs. 

Poisoning  by  Cabbonic  Acid. — When  it  is  inhaled,  the  ordi- 
nary interchange  between  the  carbonic  acid  in  the  blood  and  the 
oxygen  of  the  air  is  prevented,  the  gas  in  the  blood  accumulates, 
and  the  processes  of  oxidation  in  tissues  being  interfered  with, 
their  functions  are  lessened  or  destroyed  (p.  262). 

The  nervous  system  is  first  affected,  and  there  is  headache, 
beating  or  singing  in  the  ears,  giddiness,  flushing  of  the  face. 
Then  there  is  a  feeling  of  want  of  breath,  tightness  of  the  breast, 
palpitation  of  the  heart  and  great  anxiety.  If  the  C02  be  still 
inhaled,  the  pulse  becomes  slower,  consciousness  is  lost,  delirium 
or  coma  ensues,  and  death  occurs  with  convulsions. 

In  poisoning  by  carbonic  acid  three  stages  may  be  distin- 
guished, (1)  dyspnoea ;  (2)  convulsions ;  (3)  paralysis. 

During  the  first  stage  the  carbonic  acid  appears  to  act  as  a 
stimulus  to  the  nerve-centres  in  the  medulla,  and  especially  to 
the  respiratory  and  vaso-motor  centres.  In  the  second  stage  it' 
stimulates  other  motor  centres  (p.  237) .  In  the  third  it  paralyses 
them.  In  the  first  stage,  that  of  dyspnoea,  the  respirations  are 
both  rapid  and  deep,  the  inspiratory  as  well  as  the  expiratory' 
movements  being  increased.  Both  the  inhibitory  and  the  acce- 
lerating centres  for  the  heart  are  stimulated,  but  the  irritation 
of  the  vagus-roots  preponderates,  and  the  heart  is  generally  slow. 
The  vaso-motor  centre  in  the  medulla  is  also  stimulated,  and  theJ 
blood-pressure  rises.  Besides  this  the  carbonic  acid  also  stimulates 
either  subsidiary  centres  in  the  spinal  cord  (pp.  285  and  286),  or 
acts  directly  on  the  walls  of  the  vessels  themselves,  causing  them 


chap,  xxiii.]  ACIDS.  585 

to  contract  (p.  282),  for  the  blood-pressure  rises  during  inhalation 
of  carbonic  acid  even  when  the  spinal  cord  has  been  divided  below 
the  medulla.  The  vessels  of  the  surface  become  dilated.  This  is 
ascribed  by  Frankel  to  stimulation  of  a  dilating  centre.  During 
the  second  stage,  that  of  convulsions,  the  respiration  becomes 
more  and  more  laboured,  and  the  expiratory  movements  greater, 
until  general  convulsions  occur.  The  blood-pressure  rises  still 
more,  the  heart  becomes  still  slower,  and  the  right  ventricle  more 
distended.  In  the  third  stage,  that  of  paralysis,  the  inspiratory 
movements  become  more  and  more  feeble,  the  intervals  between 
them  longer  and  longer,  and  finally  they  cease.  The  vaso-motor 
centre  becoming  exhausted  the  blood-pressure  falls,  and  this  fall 
is  probably  aided  by  the  action  of  the  carbonic  acid  on  the  mus- 
cular walls  of  the  blood-vessels  themselves  (p.  282),  as  well  as  by 
weakness  of  the  heart.  The  heart  generally  continues  to  beat 
.for  some  minutes  after  respiration  has  completely  ceased,  and  if 
artificial  respiration  be  commenced  before  pulsation  is  entirely 
arrested,  life  may  generally  be  saved.  Indeed,  this  is  the  case 
even  when  the  cardiac  pulsations  are  quite  imperceptible,  and 
therefore  in  eases  of  death  from  asphyxia  it  is  well  to  keep  up 
artificial  respiration  if  possible  for  an  hour  or  even  longer,  not- 
withstanding the  apparent  hopelessness  of  the  case.  It  should 
only  be  discontinued  when  a  ligature  tied  moderately  tightly 
causes  no  trace  of  congestion  in  the  finger-tip  after  being  on  for 
ten  minutes,  and  it  ought  to  be  supplemented  by  intermittent 
pressure  on  the  cardiac  region  in  order  to  stimulate  the  heart. 
These  observations  apply  not  only  to  poisoning  by  carbonic  acid, 
but  to  poisoning  by  all  drugs  which  produce  death  by  asphyxia, 
and  to  death  by  drowning. 

Post-mortem  examination  shows  great  venous  congestion 
everywhere,  the  right  side  of  the  heart  being  distended  with 
blood,  the  brain  much  congested,  with  exudation  and  even  ex- 
travasation, and  the  blood  extraordinarily  dark. 

Tbbatment. — In  cases  of  poisoning  by  carbonic  acid,  as  in 
miners  or  men  who  have  been  suffocated  in  wells  or  brewers' 
vats,  the  great  object  is  to  get  the  blood  oxygenated  as  quickly  as 
possible.  Get  the  person  into  the  fresh  air,  and  if  the  respiratory 
movements  have  ceased,  dash  cold  water  on  the  face  and  chest 
to  awaken  them  reflexly.  If  this  does  not  do,  have  recourse  to 
artificial  respiration.  The  next  thing  is  to  see  that  the  heart  is 
beating.  When  the  right  ventricle  is  distended  with  blood  it 
becomes  paralysed,  and  if  it  does  not  begin  to  beat  shortly  after 
artificial  respiration  has  been  begun  the  jugular  vein  should  be 
opened  in  order  to  relieve  the  dilatation.  There  are  no  valves 
between  the  heart  and  the  jugular  vein  (at  least  of  any  import- 
ance), so  the  blood  flows  directly  out  and  the  distended  ventricle 
is  relieved.  One  must,  of  course,  be  careful  to  prevent  the  access 
of  air  into  the  vein. 


586  INOKGANIC  MATEEIA  MEDICA.  [sect,  im 

Acidum  Hydrocyanicum  Dilutum,  B.  and  U.S.P.  Di- 
luted Hydrocyanic  Acid.  Prussic  Acid. — Hydrocyanic  acid, 
HCN,  dissolved  in  water,  and  constituting  2  per  cent,  by  weight  of 
the  solution,  B.P.  A  liquid  consisting  of  2  per  cent,  of  absolute 
hydrocyanic  acid  (HCN  ;  27)  and  98  per  cent,  of  water,  U.S.P. 

Characters. — A  colourless  liquid  with  a  peculiar  odour. 
Specific  gravity,  0-997.  It  only  slightly  and  transiently  reddens 
litmus-paper. 

Ebaction. — Treated  with  a  minute  quantity  of  a  mixed  solution  of  sul- 
phate and  persulphate  of  iron,  afterwards  with  potash,  and  finally  acidulated 
with  hydrochloric  acid,  it  forms  Prussian  blue. 

Preparation. — By  distilling  yellow  prussiate  of  potash  with  H2S04. 

Potassium  Everett's 

Ferrocyanide  Yellow  Salt 

2KfieGjs  +  6H2SO,  =  6HCy  +  K2Fe,Cya  +  6KHS04. 

Half  the  cyanogen  of  the  ferrocyanide  passes  over  as  hydrocyanic  acid, 
while  a  ferrocyanide  of  potassium  and  iron,  often  called  Everett's  yellow  salt, 
remains  behind  along  with  potassium  sulphate. 

Impurities. — The  most  important  is  want  of  strength,  so  that  when  pre- 
scribed it  has  not  the  desired  effect.  It  loses  strength  when  kept,  and  there- 
fore the  volumetric  test  is  more  important  than  in  the  case  of  other  acids. 

Tests. — A  fluid  drachm  of  it  evaporated  in  a  platinum  dish  leaves  no 
fixed  residue  (no  fixed  impurities) .  It  gives  no  precipitate  with  chloride  of 
barium  (no  sulphuric  acid),  but  with  nitrate  of  silver  it  gives  a  white  pre- 
cipitate entirely  soluble  in  boiling  concentrated  nitric  acid  (no  hydrochloric 
acid).  270  grains  of  it  rendered  alkaline  by  the  addition  of  solution  of 
soda,  require  1,000  grain-measures  of  the  volumetric  solution  of  nitrate 
of  silver  to  be  added  before  a  permanent  precipitate  begins  to  form, 
which  corresponds  to  2  per  cent,  of  the  real  acid.  Silver  nitrate  forms  a 
soluble  double  cyanide  of  silver  and  sodium,  and  till  all  the  hydrocyanic  acid 
is  used  up  no  silver  oxide  is  precipitated.  AgNOs  +  2NaCy  =  NaN03  + 
NaAgCy2.  The  silver  oxide  reacts  on  the  soluble  compound,  and  decomposes 
it,  so  that  a  permanent  precipitate  of  silver  cyanide  is  formed.  2NaAgCya  + 
Ag20  +  H20  =  2NaHO  +  4AgCy. 

Standard  silver  test  solution  contains  ^  of  an  equivalent  of  AgNOs,  and 
1,000  grains  therefore  combine  with  ^  of  2NaCy. 

Dose. — 2  to  8  minims.  As  a  lotion,  5-10  min.  to  1  fl.  oz.  of 
water,  rose  water,  elderflower  water,  or  almond  mixture.  The 
addition  of  1  fl.  dr.  of  glycerine  tends  to  prevent  evaporation. 

Preparations.    B.P. 
Vapor  Acidi  Hydrocyanic!. 
Tinctura  Chloroform!  et  Morpnlnee  (contains  1  vol.  in  16). 
B.P.   Vapor  Acidi  Kydrocyanlcl.    Vapour  of  Hydrocyanic  Acid. — Mix 
10  to  15  minims  of  diluted  hydrocyanic  acid  with  1  fluid  drachm  of  cold  water  in  a 
suitable  apparatus,  and  let  the  vapour  that  arises  be  inhaled. 

Action. — Hydrocyanic  acid  differs  from  all  the  other  acids 
in  having  upon  the  organism  an  action  peculiarly  its  own.  It  is 
one  of  the  most  powerful  and  most  rapid  poisons  known.  It 
destroys  protoplasmic  movement,  kills  infusoria,  checks  oxida- 
tion, and  arrests  fermentation.  When  applied  to  the  skin  it 
passes  through  the  epidermis  and  paralyses  the  ends  of  the 
Bensory  nerves  below,  so  that  the  part  becomes  numb,  and  tactile 


chap,  xxrii.]  ACIDS.  587 

sensation  is  diminished  or  destroyed.  It  is  rapidly  absorbed 
from  the  mucous  membranes,  and  its  action  is  the  same  when 
applied  to  any  of  them.  A  single  drop  of  pure  hydrocyanic  acid 
injected  into  the  eye,  nose,  or  mouth  of  a  small  animal  causes  it 
to  fall  down  dead  as  if  struck  by  lightning,  and  the  same  dose  is 
•  sufficient  to  cause  the  death  even  of  a  large  animal.  In  these 
cases  the  pupils  are  usually  widely  dilated,  and  the  animal 
generally  utters  a  characteristic  cry.  When  a  smaller,  but  still 
fatal  dose  is  given,  the  poisoning  may  be  divided  into  three 
stages.  In  the  first  stage  the  brain  is  chiefly  affected.  There 
is  giddiness,  uncertain  gait,  a  few  slow  breaths,  and  then  rapid 
respiration  and  irregular  action  of  the  heart.  These  are  suc- 
ceeded in  the  second  stage  by  violent  convulsions,  tonic  and 
clonic.  The  head  is  bent  backwards,  the  limbs  are  stiffly  ex- 
tended, and  sensibility  is  generally  lost,  although  reflex  action 
may  still  persist.  In  the  third  stage  there  is  coma,  complete 
loss  of  sensibility,  paralysis  of  the  voluntary  muscles,  almost 
imperceptible  pulse,  slow  and  weak  respiration — the  expiratory 
movements  predominating,  and  death. 

It  is  evident  that  these  are  the  symptoms  of  rapid  asphyxia 
They  are  very  like  those  produced  by  carbonic  acid,  but  much 
more  rapid,  and  resemble  those  of  poisoning  by  sulphuretted 
hydrogen.  The  convulsions  occur  only  in  warm-blooded  animals, 
and  not  in  frogs.  In  this  point  they  resemble  those  of  simple 
asphyxia  (p.  237).  They  differ  from  those  of  ordinary  asphyxia, 
however,  in  the  fact  that  whereas  the  blood  is  venous  when 
asphyxial  convulsions  occur,  the  blood  is  arterial  in  colour  when 
the  hydrocyanic  acid  convulsions  occur.  They  differ  also  in  not 
being  arrested  by  artificial  respiration. 

Death,  in  animals  poisoned  by  hydrocyanic  acid,  is  due 
to  sudden  arrest  of  the  heart  in  the  more  rapid  cases,  and  to 
paralysis  of  the  respiration  in  those  which  occur  more  slowly, 
In  consequence  of  this,  the  blood  in  the  left  side  of  the  heart  is 
found  to  be  arterial  in  cases  of  instantaneous  death,  but  venous 
in  those  instances  where  some  minutes  have  been  required.  It 
is  stated  that  in  the  first  stage  of  poisoning  the  blood  is  more 
arterial  than  usual,  though  it  afterwards  becomes  more  venous. 
This  has  been  said  to  depend  upon  diminution  of  the  oxidising 
power  of  the  blood  by  the  action  of  the  acid.  Hydrocyanic  acid 
is  said  to  form  a  compound  with  haemoglobin  (cyan-hamioglobin) 
which  does  not  readily  give  up  its  oxygen  (p.  70).  But  this  com- 
pound is  often  not  to  be  found  in  the  blood  of  animals  poisoned 
by  the  acid,  and  the  arterial  appearance  is  more  probably  due  to 
dilatation  of  the  peripheral  vessels  allowing  the  blood  to  pass 
through  them  rapidly,  without  undergoing  the  usual  changes, 
just  as  it  does  in  the  sub-maxillary  gland  on  irritation  of  the 
chorda  tympani  nerve.  This  is  rendered  all  the  more  probable 
by  the  fact,  that  at  the  exact  moment  in  which  the  blood  becomes 


588  INOEGANIC  MATERIA  MBDICA.  [sect,  nil 

.  of  an  arterial  colour  in  the  veins,  the  blood-pressure  suddenly 
falls  in  the  arteries  (Eossbach). 

The  respiratory  changes,  however,  do  seem  to  be  also  inter- 
fered with,  for  in  the  first  stage  of  poisoning  the  exhalation  of 
carbonic  acid  is  diminished.  As  the  diminution  in  the  power  of 
the  blood  to  give  oxygen  off  is  hardly  sufficient  to  explain  this, 
and  as  the  convulsions,  apparently  asphyxial  in  character,  come 
on  while  the  blood  is  still  arterial,  we  may,  with  some  probability, 
suppose  that  the  respiratory  changes  are  due  to  the  effect  of  the 
hydrocyanic  acid  in  lessening  internal  respiration  in  the  nervous 
tissues  themselves  (pi  239). 

The  stoppage  of  the  heart  in  mammals  is  partly  due  to  irrita- 
tion of  the  vagus-roots  in  the  medulla,  and  partly  to  paralysis  of 
the  motor  ganglia  in  the  heart. 

When  placed  upon  the  heart  of  a  frog  it  arrests  its  beats,  but 
the  heart,  at  first,  still  contracts  when  irritated,  though  after  a 
short  time  its  muscular  irritability  is  also  lost. 

That  its  action  in  stopping  the  mammalian  heart  is  partly 
due  to  irritation  of  the  vagus-roots  is  shown  by  the  fact  that,  in 
some  animals,  section  of  the  vagi  prevents  the  stoppage.  .The 
effect  of  hydrocyanic  acid  is,  first  to  raise,  and  afterwards  greatly 
to  depress  the  arterial  pressure,  and  at  the  same  time  to  slow 
the  pulse.  The  slowing  and  paralysis  of  respiratory  movements 
which  this  acid  produces  are  chiefly  due  to  its  action  on  the 
respiratory  centre  in  the  medulla  oblongata.  When  directly 
applied  to  the  medulla  in  the  alligator  it  causes  continuous 
powerful  expiration  and  death,  whereas  when  given  in  other  ways 
considerable  time  is  required  for  its  action  to  be  produced.  It 
appears  to  paralyse  the  brain,  peripheral  afferent  nerves,  then 
spinal  cord,  motor  nerves,  and  muscles.  That  the  afferent 
nerves  are  paralysed  before  the  cord  is  proved  by  the  fact  that 
when  frogs  are  poisoned  with  prussie  acid,  and  afterwards  with 
strychnine,  slight  irritation  of  the  sensory  nerve-roots  will  cause 
tetanus,  after  irritation  of  the  periphery  has  ceased  to  produce 
any  effect. 

This  fact  was  observed  by  Von  Kiedrowski,  working  under 
Eeichert's  direction.  The  same  author  observed  the  effect  of  the 
local  application  of  hydrocyanic  acid  in  paralysing  muscle  and 
nerve,  by  removing  the  soft  parts  and  bones  from  the  lower  part 
of  the  thigh  of  a  frog,  leaving  the  leg  attached  to  the  body  only  by 
nerves  (Fig.  166).  The  grastrocnemius  and  crural  muscles  were 
then  separated,  and  the  gastrocnemius  with  its  nerve  was  immersed 
in  aqueous  humour  diluted  with  water,  and  the  crural  muscles 
with  their  nerves  in  a  similar  liquid  to  which  hydrocyanic  acid 
had  been  added.  A  fter  four  hours  the  crural  muscles  did  not  con- 
tract on  direct  irrit  ation,  but  the  gastrocnemius  did  so  readily. 
This  showed  that  the  acid  had  paralysed  the  muscles.  Irritation 
of  the  gastrocnemius ,  of  its  nerve  /  g,  or  of  the  sciatic  nerve  a, 


chap,  xxm.]  ACIDS.  589 

caused  reflex  movements  in  the  body  of  the  frog,  but  irritation 
of  the  crural  muscles  caused  no  such  reflex  movements,  showing 
that  the  ends  of  the  sensory  nerves  within  them  had  been  para- 
lysed. When  the  sciatic  a  was  irritated  the  crural  muscles  did 
not  contract,  but  the  gastrocnemius  did.  The  poison  probably 
paralyses  motor  nerves  as  well  as  muscles,  for  it  is  found  that 
the  muscles  contract,  though  feebly,  on  direct  irritation,  after 
they  have  ceased  to  respond  to  the  strongest  irritation  of  the 
motor  nerves. 

5 


Fig.  166.— After  Kiedrowsfcl.  Diagram  to  show  the  effect  of  hydrocyanic  acid  when  applied  locally, 
a,  the  sciatic  nerve ;  b,  thigh  of  a  frog  ;  d  and  e,  branches  of  sciatic  going  to  the  crural  muscles ; 
fg,  branch  going  to  the  gastrocnemius. 

Uses. — Hydrocyanic  aeid  is  used  externally  in  order  to  lessen 
itching  in  skin-diseases,  and  is  best  applied  in  combination  with 
glycerine.  It  is  chiefly  employed  internally  to  diminish  irrita- 
bility of  the  stomach,  and  to  relieve  vomiting,  also  pain  in  the 
stomach  or  intestines,  and  functional  palpitation  of  the  heart 
dependent  on  dyspepsia.  It  is  also  used  to  relieve  cough  in  cases 
of  bronchitis,  phthisis,  asthma,  and  whooping  cough.  It  has 
sometimes  been  employed,  though  with  doubtful  effect,  in  chorea, 
epilepsy,  and  hysteria.  Its  vapour  is  sometimes  used  to  lessen 
irritability  of  the  respiratory  passages  and  cough. 

Acidum  Lacticum,  B.  and  U.S.P.  Lactic  Acid.  HC3H503; 
90. — A  liquor  composed  of  75  per  cent,  of  absolute  lactic  acid 
and  25  per  cent,  of  water. 

Characters. — A  nearly  colourless  syrupy  liquid,  odourless, 
having  a  very  acid  taste,  and  an  acid  reaction.  Sp.  gr.,  1-212. 
It  is  freely  miscible  with  water,  alcohol  and  ether,  but  nearly 
insoluble  in  chloroform.  It  is  not  vaporised  by  a  heat  below 
160°  C.  (320°  F.) ;  at  higher  temperatures  it  emits  inflammable 
.vapours,  then  chars,  and  is  finally  entirely  volatilised,  or  leaves 
but  a  trace  of  residue. 

Preparation. — By  adding  chalk  to  sour  milk  and  decomposing  the  lactate 
of  calcium  with  sulphuric  acid  {vide  p.  566). 


590  INOKGANIC  MATEEIA  MEDICA.  [sect,  in. 

Impurities. — Hydrochloric  acid,  sulphuric  acid,  sarcolactic  acid,  lead, 
iron,  sugars,  glycerin,  organic  impurities. 

Tests. — When  diluted  with  water,  lactic  acid  should  afford  no  precipitate 
with  test  solutions  of  nitrate  of  silver,  chloride  of  barium,  sulphate  of  copper, 
nor  with  sulphide  of  ammonium  after  the  addition  of  excess  of  water  of  am- 
monia. It  should  not  reduce  warm  test-solution  of  potassio-cupric  tartrate. 
When  mixed  and  heated  with  excess  of  hydrated  zinc  oxide  and  extracted  with 
absolute  alcohol,  the  latter  should  not  leave  a  sweet  residue  on  evaporation. 
Cold  concentrated  sulphuric  acid  shaken  with  an  equal  volume  of  lactic  acid 
should  assume  at  most  only  a  pale  yellow  colour. 

Dose. — 1  to  3  fl.  dr.  per  diem,  diluted  or  sweetened,  like 
lemonade. 

When  used  as  a  caustic  it  may  either  be  applied  on  lint 
covered  with  gutta  percha  or  as  a  paste  of  silica  saturated  with 
the  acid.  After  being  left  on  for  12  hours  it  should  be  washed 
off,  and  the  application  renewed  as  necessary. 

Pkepabation. 

B.P.  DOSE. 

Addum  Xiacticum  Xtllutum  (acid  3,  water  up  to  20) J-2  fl.  dr. 

Action. — It  has  been  employed  in  a  solution  of  1  part  to  5,  to 
dissolve  the  false  membrane  in  croup  and  diphtheria.  In  cases 
of  dyspepsia  it  is  used  to  aid  digestion  in  somewhat  the  same 
way  as  hydrochloric  acid,  and  it  has  been  given  also  to  lessen 
the  alkalinity  of  the  urine  and  prevent  phosphatic  deposits.  In 
diabetes  it  has  been  employed  with  considerable  success  along 
with  an  exclusively  meat  diet  in  doses  of  \  oz.  in  1  pint  of  water 
daily,  though  it  is  said  to  have  given  rise  to  rheumatism  in  a 
diabetic  patient.  Buttermilk  has  been  recommended  in  place  of 
it,  but  the  difficulty  of  obtaining  this  in  towns  is  very  great. 

Acidum  Oleicum,  B.  and  U.S.P.     Oleic  Acid. — HC18H3302; 

282. 

Chakacters. — A  yellowish,  oily  liquid,  gradually  becoming 
brown,  rancid  and  acid,  when  exposed  to  the  air ;  odourless,  or 
nearly  so,  tasteless,  and,  when  pure,  of  a  neutral  reaction. 
Sp.  gr.,  0-800  to  0-810. 

Preparation. — It  is  obtained  by  adding  lead  oxide  to  almand  oil,  which 
forms  an  oleate  of  lead  or  lead  soap,  and  decomposing  this  by  hydrochloric 
acid.  Or  by  decomposing  palm  oil  by  superheated  steam,  and  separating 
from  any  solid  fats  by  pressure  (vide  p.  566). 

Solubility. — Oleic  acid  is  insoluble  in  water,  but  completely  soluble  in 
alcohol,  chloroform,  benzin,  benzene,  oil  of  turpentine,  and  the  fixed  oils. 

At  14°  O.  (57-2°  F.)  it  becomes  semi-solid,  and  remains  so  until  cooled  to 
4°  C.  (39-2°  F.),  at  which  temperature  it  becomes  a  whitish  mass  of  crystals. 

Tests. — At  a  gentle  heat  the  acid  is  completely  saponified  by  carbonate 
of  potassium.  If  the  resulting  soap  be  dissolved  m  water  and  exactly 
neutralised  with  acetic  acid,  the  liquid  will  form  a  white  precipitate  with  test- 
solution  of  acetate  of  lead.  This  precipitate,  after  being  twice  washed  with 
boiling  water,  should  be  almost  entirely  soluble  in  ether  (absence  of  more 
than  traces  of  palmitic  and  stearic  acids).  Equal  volumes  of  the  acid  and  ot 
alcohol,  heated  to  25°  C.  (77°  F.)  should  give  a  clear  solution,  without  sepa- 
rating oily  drops  upon  the  surface  (fixed  oils). 


.chap,  xxiii.]  ACIDS.  591 

Uses. —  Oleic  acid  is  employed  only  for  the  preparation  of 
oleates,  which  are  not  only  elegant  preparations,  but  appear  to 
be  more  readily  absorbed  than  other  ointments. 

Preparations. 
B.P. 
Oleatum  Hydrargryri  (yellow  oxide  of  mercury  1,  oleic  acid  9).     This  oleate 
may  be  prepared  with  half  the  above  proportion  of  oleic  acid,  the  remainder  being 
added  just  before,  or  not  long  before,  the  oleate  is  dispensed. 
Oleatum  Zinci  (oxide  of  zinc  1,  oleic  acid  9). 
XTnguentum  Zinci  Oleati  (oleate  of  zinc  1,  soft  paraffin  1). 

U.S.P.  AMOUNT  USED. 

Oleum  Hydrargyri.    Oleate  oe  Mercury  (Hydrargyri 

Oxidum  Flavum,  1  part ;  Acidum  Oleicum,  9  parts) 10  min.,  externally. 

Oleatum  Veratrinse.      (Veratrinum,   2   parts ;  Acidum 

Oleicum,  98  parts)...: 6-25  gr.,  externally. 

Acidum  Arseniosum.— Vide  p.  719. 
Acidum  Benzoicum. — Vide  p.  964. 
Acidum  Carbolicum. — Vide  p.  813. 
Acidum  Chrysophanicum. — Vide  p.  909. 
Acidum  Gallicum. — Vide  p.  1033. 
Acidum  Meconicum. — Vide  p.  846. 
Acidum  Pyrogallicum. — Vide  p.  819. 
Acidum  Salicylicum. — Vide  p.  819. 
Acidum  Tannicum. — Vide  p.  1031. 


592  INOKGANIC  MATEKIA  MBDICA.  [sect.  in. 


CHAPTER  XXIV. 

METALS. 

GENERAL  CLASSIFICATION  OF  THE  METALS. 

It  has  already  been  mentioned  (p.  20)  that  Mendelejeff's  classifi- 
cation of  the  elements,  although  it  gives  us  the  outlines  of  a  true 
natural  classification,  is  not  at  present  perfect,  inasmuch  as  it 
separates  members  of  natural  groups,  such  as  those  of  the  earthy 
metals.  In  regard  to  this  classification  it  must  be  borne  in  mind 
that  by  it  the  elements  are  arranged  in  groups  according  to  their 
atomicity,  and  this  is  not  in  all  cases  determined.  A  glance  at 
the  table  (p.  19)  'will  show  this,  for  copper,  silver,  and  gold  are 
there  included  both  in  Group  I.,  containing  monad  metals,  and 
in  Group  VIII.  But  the  commonest  and  most  stable  compounds 
of  copper,  such  as  cupric  oxide  or  cupric  sulphide,  appear  to  show 
that  it  is  a  dyad  rather  than  a  monad.  Silver,  also,  though  it 
appears  like  copper  in  Groups  I.  and  VIII.,  may  also  be  a  dyad,1 
while  gold  forms  two  series  of  compounds,  in  one  of  which  it  is 
monad,  and  in  the  other  triad.  In  the  classification  which  I 
have  adopted,  I  have  followed  Mendelejeff's  tables  as  modified 
by  Watts,  but  I  have  modified  them  somewhat,  in  order  not  to 
separate  metals  having  a  similar  physiological  action. 

Class  I.— MONAD  METALS.2 

Group  I. — Alkalis — Potassium,  Sodium,   Lithium,    Casium, 
Rubidium. 
II. — Ammonium. 

'  The  formula  of  argentous  oxide  is  Ag^O,  and  if  this  formula  be  correct,  and 
silver  be  a  monad,  oxygen  must  be  a  tetrad ;  but  if  silver  be  a  dyad,  argentous 

oxide  may  be  represented  as  j^sIq_\„  (Fownes'  Chemistry,  by  Watts,  12th 
ed.  vol.  i.  p.  369.) 

2  The  metals  whose  names  are  printed  in  italics  are  not  officinal. 


chap,  xxiv.]  METALS.  593 


Class  II.— DYAD  METALS. 

Group  I. — Metals  of  the  alkaline  earths— Calcium,  Strontium, 
Barium. 
(Appendix.)     Metals   of  the  earths— Aluminium, 
Cerium,  Beryllium,  Zirconium,  Thorium,  Lan- 
thanum, Didymium,  Yttrium,  Erbium. 
II. — Magnesium. 

Ill, — Copper,  Zinc,  Silver,  Cadmium. 
IV. — Mercury. 

Class  III.— TEIAD  METALS. 
Thallium,  Iridium,  Gallium. 

Class  IV.— TETEAD   METALS. 
Tin,  Lead,  Titanium. 

Class  V.— PENTAD  ELEMENTS. 

Nitrogen,  Phosphorus,  Arsenic,  Antimony,  Bismuth,  Vana- 
dium, Tantalum,  Niobium  or  Columbium. 

Class  VI.— HEXAD   METALS. 
Chromium,  Uranium,  Tungsten,  Molybdenum. 

Class  VII.— HEPTAD   METALS. 
Manganese. —  Vide  next  group. 

Class  VIII. 

Group  I. — Iron  metals.     Iron,  Nickel,  Cobalt,  Manganese. 
II.—  Platinum,  Gold. 

General  Tests  eor  the  Acid  Eadicals  in  Metallic  Salts. — 
As  the  same  acids  occur  in  the  salts  of  different  metals,  the 
tests  for  their  presence  are  described  again  and  again  in  the 
Pharmacopoeias.  In  order  to  save  repetition,  it  may  be  advisable 
to  give  here  in  a  tabular  form  the  tests  for  the  different  acids. 
It  is  to  be  remembered  that  the  same  tests  apply  to  the  simple 
recognition  of  a  metallic  salt,  and  to  its  detection  as  an  impurity 
in  other  substances.  The  tests  are  generally  applied  to  solutions 
of  the  salt  in  water. 

Q  Q 


594 


INORGANIC   MATERIA   MEDIO  A. 


[SECT.  Ill, 


Salt 


Acetate*  . 

Borate 

Benzoate  * 
Bromide  . 


Carbonate 
Bicarbonate 


Citrate* 

Chloride    . 
Hypophosphite . 


Hyposulphite 


Iodide 


Nitrate 


Eeagent 


Sulphuric  acid . 

Ferric  chloride 
Sulphuric  acid . 


Dilute  solution  of 
ferric  sulphate 

Disulphide  of  carbon 
and  chlorine  water 


Acid 


Calcium  chloride 


Sulphuric  acid  and 

heat 
Nitrate  of  silver 


Heat 


Nitrate  of  silver 

Hydrochloric  acid 
and  mercuric 

chloride 

Sulphuric  acid 


Disulphide  of  carbon 
and  chlorine  water 


Starch  water,  starch 
paste,  or  gelatin- 
ised starch,  with 
chlorine  water 

Sulphuric  acid  and 
copper 

Sulphuric  acid  and 
solution  of  ferrous 
sulphate 


Reaction 


Vapour  of  acetic  acid  given  off  and 
recognised  by  its  smell. 

Deep  red  colour. 

The  saturated  solution  causes  deposit 
of  shining  scales,  which  give  a 
green  colour  to  the  flame  of  alcohol. 

Flesh-coloured  precipitate. 

H  disulphide  of  carbon  be  poured  into 
a  solution  of  the  salt,  the  chlorine 
water  added  drop  by  drop,  and  the 
whole  agitated,  the  disulphide  will 
acquire  a  yellow  or  yellowish-brown 
colour.  (If  iodine  be  present  there 
will  be  a  violet  tint.) 

Causes  effervescence. 

Causes  effervescence  more  abundant 
than  in  the  case  of  the  carbonate. 
With  solution  of  mercuric  chloride 
bicarbonates  give  a  white,  and  car- 
bonates a  yellow  precipitate. 

The  solution  remains  clear,  but  de- 
posits white  precipitate  on  boiling 
(calcium  citrate  being  less  soluble 
in  hot  than  in  cold  water). 

Is  charred  and  evolves  the  odour  of 
acetic  acid. 

White  precipitate,  soluble  in  ammo- 
nia, insoluble  in  hydrochloric  or 
nitric  acids. 

Heated  in  a  dry  test-tube  it  evolves 
phosphoretted  hydrogen,  which 
takes  fire  spontaneously,  and  burns 
with  a  bright  flame. 

White  precipitate,  which  rapidly  turns 
brown  and  black. 

White  precipitate  of  calomel,  and  on 
further  addition  separation  of  me- 
tallic mercury. 

Gives  rise  to  the  smell  of  burning  sul- 
phur, and  causes  white  precipitate 
of  sulphur  (bisulphite  and  sulphite 
give  no  precipitate). 

If  disulphide  of  carbon  be  poured  into 
a  solution  of  the  salt,  then  chlorine 
water  added  drop  by  drop,  and  the 
whole  agitated,  the  disulphide  of 
carbon  will  acquire  a  violet  oolour. 

Blue  colour  in  the  cold,  discharged  by 
boiling. 


Nitrous  fumes. 

When  sulphuric  acid  is  added  to  a 
solution  containing  a  nitrate,  and  a 
solution  of  ferrous  sulphate  is  care- 
fully poured  over  it,  a  dark  colour 
appears  at  the  junction  of  the  two 
liquids. 


CHAP.  XXIV.] 


METALS. 


595 


Salt 

Reagent 

Beaction 

Oxalate*  .       . 

Calcium  chloride 

White  precipitate.    In  applying  the 
test  to  cerium  and  iron,  their  salts 
must  be  decomposed  by  boiling  with 
potash  or  soda.  The  oxide  of  cerium 
or  iron  is  removed  by  filtration,  and 
the  reagent  applied  to  the  filtrate, 
which  contains  oxalate  of  potassium 
or  sodium. 

Phosphate 

Chloride  of  ammon- 
ium,      ammonia, 
and    sulphate    of 
magnesium 

White  precipitate. 

Phosphide 

Sulphuric  or  hydro- 
chloric acid 

Evolves  phosphoretted  hydrogen. 

Salicylate  * 

Ferric  salts      .        . 

Intense  violet  colour. 

Sulpho-carbolate 

Ferric  chloride 

Violet  colour.    This  salt  can  be  dis- 
tinguished from  the  salicylate  by 
heat,  when  it  gives  off  inflammable 
vapours  having  the  odour  of  car- 
bolic acid. 

Sulphate  . 

Barium  chloride      . 

White  precipitate,  almost  insoluble  in 
nitric  acid. 

Sulphide  . 

Mineral    acids,    e.g. 
sulphuric   or    hy- 
drochloric 

Gives  off  sulphuretted  hydrogen. 

Sulphite    . 

Ditto 

Gives  off  sulphurous  acid  (has  neutral 
or  feebly  alkaline  reaction). 

Bisulphite 

Ditto 

Ditto  (has  acid  reaction). 

Tartrate* . 

Acetic  acid  in  pre- 

White crystalline  precipitate  of   bi- 

sence of  potash 

tartrate. 

ii         •        • 

Sulphuric  acid  and 

Is  charred  and  evolves  the  odour  of 

heat 

burnt  sugar. 

J!                   •               • 

Nitrate  of  silver 

White  precipitate,  becoming  blaek  on 

boiling. 
Solution  rendered  neutral  by  potash 

Bitartrate  * 

Nitrate  of  silver 

gives  with  the  reagent  a  white  pre- 

cipitate becoming  black  on  boiling 

(very  sparingly  soluble  in  water  :  is 

thus    distinguished    from    neutral 

tartrate,  which  is  readily  soluble). 

»         •        - 

Sulphuric  acid  and 
heat 

Same  reaction  as  tartrate. 

*  In  the  preceding  table  the  salts  of  organic  acids  marked  *  when  ignited  in 
a  crucible  or  on  a  piece  of  platinum  foil,  become  charred  and  oxidised,  leaving  a 
residue  which  consists  of  carbonate.  This  is  black  from  the  presence  of  carbon, 
if  ignition  has  not  been  carried  sufficiently  far  to  convert  all  the  carbon  into  car- 
bonic acid.  This  residue  gives  the  reaction  .of  a  carbonate,  effervescing  with  acids, 
and  it  is  frequently  convenient  to  convert  the  carbonate  into  chloride,  before 
applying  tests  for  the  base. 


QQ  2 


596  LNOEGANIC  MATEEIA  MEDICA.  [sect.  hi. 

Class  I.— MONAD  METALS. 

Group  I.— METALS   OF   THE   ALKALIS. 
Lithium,  Sodium,  Potassium,  Rubidium,  Ccesium. 

Group  II.— AMMONIUM. 

I  have  omitted  silver  and  gold  from  this  class,  because  both 
their  physiological  actions  and  physical  properties  appear  to 
show  that  they  do  not  belong  to  it.  I  have  put  ammonium  into 
a  group  by  itself  and  separated  it  from  the  other  members  of  this 
class,  because  it  differs  from  them  in  being  a  compound  and  not 
an  element ;  in  being  volatile ;  and  in  having  an  entirely  different 
physiological  action. 

General  Characters. — They  are  all  powerful  bases  and  have 
a  great  affinity  for  oxygen.  The  oxides  of  the  first  group  are 
non-volatile,  and  are  sometimes  termed  fixed  alkalis,  while 
ammonia  is  volatile.  They  all  have  a  strong  alkaline  reaction, 
neutralising  acids  readily,  turning  red  litmus-paper  blue,  and 
turmeric  paper  brown. 

General  Eeactions. — They  are  not  precipitated  from  solu- 
tions by  the  successive  addition  of  (1)  hydrochloric  acid,  (2) 
hydrogen  sulphide,  (3)  ammonium  sulphide,  (4)  ammonium 
carbonate,  and  (5)  sodium  phosphate. 

General  Physiological  Action. — The  alkalis  are  of  great 
physiological  importance,  and  salts  of  potassium  and  sodium  form 
a  large  proportion  of  the  saline  constituents  of  the  body.  These 
two  elements  are  differently  distributed,  potassium  being  chiefly 
found  in  solid  tissues,  while  sodium  is  more  abundant  in  the  fluids. 
They  are  found  as  carbonates,  biearbonates,  chlorides,  phosphates, 
and  sulphates.  The  proportion  of  these  salts  in  the  body  is,  how- 
ever, very  different,  as  are  also  their  uses  in  the  economy.  The 
chlorides  are  by  far  the  most  abundant,  and  sodium  chloride 
may  be  looked  upon  as  the  most  important  constituent  of  the 
nutritive  fluids  in  which  all  the  tissues  of  the  body  are  bathed. 
But  while  sodium  chloride  forms  the  saline  basis  of  these  fluids, 
the  other  constituents  are  indispensable  for  the  continued  life  of 
the  tissues.  All  the  fluids  of  the  body  are  alkaline,  and  death 
occurs  whenever  the  alkalinity  is  diminished  below  a  certain 
point,  even  though  the  fluids  and  tissues  are  far  from  having  an 
acid  reaction.  Such  a  reaction  is  only  observed  in  the  tissues 
after  death.  The  importance  of  the  different  saline  constituents 
in  nutrition  has  been  most  fully  worked  out  in  the  case  of  the 
frog's  heart  (p.  305  et  seq.). 

In  the  case  of  the  heavy  metals,  which  are  not  normal  con- 
stituents of  the  body,  the  action  of  their  salts  depends  almost 


chap,  xxiv.]  METALS.  597 

entirely  on  the  base  and  only  slightly  on  the  acid  with  which  it 
is  combined.  In  the  case  of  the  alkalis,  however,  this  is  not  so, 
the  action  of  their  salts  depending  much  on  the  acid. 

In  consequence  of  this  it  is  necessary  in  considering  the 
physiological  action  of  salts  of  the  alkaline  metals  to  divide  them 
into  at  least  three  groups : — 

1.  Alkaline  salts,  hydrates,  carbonates,  and  bicarbonates. 

(Sub-groups— Salts  of  organic  acids,  acetates,  citrates, 
tartrates). 

2.  Chlorides. 

3.  Sulphates  and  other  salts  which  are  slowly  absorbed. 

General  Action  of  the  Alkaline  Group. — Alkaline  salts 
have  their  activity  diminished  by  combination  with  carbonic  or 
organic  acids.  The  hydrates  have  an  intense  local  action  on  the 
tissues ;  and  the  carbonates  have  an  action,  the  same  in  kind, 
but  much  less  in  degree.  In  the  case  of  the  bicarbonates  it 
is  still  further  diminished,  and  in  the  acetates,  citrates,  and 
tartrates  it  is  absent.  The  hydrates  of  potassium  and  sodium 
dissolve  horny  tissues  such  as  the  epidermis.  They  combine 
with  albumen  and  form  a  soluble  alkali-albuminate. 

When  applied  to  the  slcin  the  hydrated  alkalis,  which  have  a 
great  affinity  for  water,  withdraw  it  from  the  tissues  and  form  a 
solution  which  softens  and  partly  dissolves  the  epidermis  and 
then  acts  on  the  softer  textures  below,  combining  with  and  dis- 
solving them.  Bound  the  part  thus  killed  inflammation  sets  in, 
and  a  slough  separates.  The  rapidity  with  which  they  absorb 
water  and  form  a  solution  which  flows  readily  over  adjacent 
parts,  where  its  action  is  injurious,  is  an  objection  to  their  appli- 
cation, and  the  part  actually  cauterised  by  them  should  always 
be  less  than  the  part  we  wish  to  destroy.  From  this  very 
property  of  widely  destroying  the  tissues  over  which  they  flow, 
or  through  which  they  soak,  they  are  admirably  adapted  for 
application  in  cases  where  we  desire  this  effect,  as  in  cauterising 
poisoned  wounds. 

When  applied  as  caustics  to  unhealthy  sores,  cancer,  &c, 
their  action  is  sometimes  limited  by  adding  lime  and  forming  the 
so-called  Vienna  paste  (p.  346).  The  water  which  they  withdraw 
from  the  tissues  is  sucked  up  by  the  lime,  forming  a  solid 
hydrate  and  preventing  the  caustic  from  becoming  too  fluid  and 
running  over  other  parts.  When  less  concentrated  they  may 
only  irritate  the  surface  sufficiently  to  produce  exudation,  but 
they  generally  soften  or  dissolve  the  epidermis  so  much  that 
vesicles  do  not  form  well.  When  still  more  diluted  they  may 
cause  only  congestion  or  redness  of  the  skin.  They  are  then 
said  to  act  as  rubefacients.  This  rubefacient  action  may  be 
used  for  the  purpose  of  relieving  troublesome  itching  in  skin- 
diseases,  or  to  produce  derivation  from  other  parts. 


598  INOEGANIC  MATEEIA  MEDICA.  [sect.  in. 

Ammonia  does  not  dissolve  the  epidermis,  and  so,  unlike 
potash  or  soda,  it  does  not  act  as  an  immediate  caustic,  but 
only  passes  through  the  epidermis  and  irritates  the  skin  below, 
causing  lymph  to  be  effused  between  it  and  the  epidermis,  and 
thus  acting  as  a  vesicant.  It  may,  however,  act  as  a  caustic  if 
its  evaporation  is  prevented  and  it  is  applied  too  long,  the  irrita-- 
tion  then  becoming  so  great  as  to  lead  to  suppuration,  or  even  to 
sloughing  of  the  part. 

From  their  great  solvent  power,  and  especially  their  power  of 
dissolving  greasy  substances,  alkalis  are  used  for  cleansing  the 
skin,  but  when  used  alone  they  very  frequently  produce  irritation, 
and  we  therefore  generally  employ  them  in  the  form  of  soap,  or 
in  the  form  of  those  salts  which  have  only  a  very  slight  alkaline 
character,  such  as  borax. 

In  the  mouth  they  neutralise  any  acid  present.  They  may 
thus  relieve  toothache  due  to  irritation  of  the  exposed  nerve  in 
a  carious  tooth  or  of  the  roots  of  the  teeth  close  to  the  gums  by 
acid  secretions.  A  dilute  solution  of  sodium  bi-carbonate  as  a 
wash  to  the  mouth  frequently  relieves  soreness  of  the  teeth,  or 
headache  depending  on  dental  irritation,  and  prevents  injury 
from  acid  tonics.  Alkalis  are  used  inj;he  shape  of  borax  to  heal 
aphthae  in  the  mouth  and  as  soap  for  cleaning  the  teeth. 

In  the  stomach  they  increase  the  amount  of  gastric  juice 
secreted ;  and  where  this  is  deficient  and  the  food  lies  heavy  and 
is  digested  slowly  and  with  difficulty,  they  should  be  given  before 
a  meal  or  just  at  its  commencement,  either  in  the  form  of  a 
medicinal  mixture  or  as  aerated  potash  or  soda  water.  The 
amount  of  acid  secreted  by  the  stomach  after  their  introduction 
is  sufficient  to  neutralise  them  pretty  rapidly,  and  probably  only 
the  caustic  alkalies  which  act  very  rapidly  have  time  to  produce 
any  local  action  before  they  are  neutralised,  unless  large  quantities 
have  been  ingested.  Where  there  is  a  large  amount  of  mucus 
on  the  surface  of  the  stomach  it  will  both  hinder  the  exit  of  the 
gastric  juice  from  the  follicles  and  the  entrance  of  the  peptones 
from  the  stomach  into  the  blood.  Caustic  alkalies  have  a  great 
power  of  dissolving  mucus.  They  probably  do  this  to  some  extent 
before  they  are  neutralised,  and  this  may  be  the  reason  why  we 
occasionally  find  that  they  are  of  great  service  when  a  correspond- 
ing amount  of  their  carbonates  does  little  or  no  good.  From 
the  effect  they  produce  on  the  secretion  of  gastric  juice,  alkalis  in 
small  doses  are  said  to  act  as  gastric  stimulants  (p.  863). 

When  the  amount  of  acid  in  the  stomach  is  too  great,  either 
because  too  great  a  proportion  of  it  has  been  present  in  the  gastric 
juice,  or  because  it  has  been  generated  by  the  decomposition  of 
food,  digestion  goes  on  slowly,  and  burning  acid  eructations  take 
place  after  meals.  In  such  cases  we  give  alkalis  to  neutralise 
the  excess  and  to  restore  the  proportion  of  acid  in  the  stomach 
to  its  normal.     They  are  then  said  to  act  as  antacids  (p.  869). 


chap,  xxiv.]  METALS.  599 

Alkalis  are  serviceable  as  antidotes  in  poisoning  by  acids, 
metals,  and  alkaloids.  They  neutralise  the  acids,  they  precipi- 
tate the  metals  as  insoluble  oxides,  and  they  render  alkaloids  less 
soluble  by  taking  away  the  acid  with  which  they  are  generally 
combined.  They  thus  retard  their  absorption  and  afford  time 
for  the  use  of  other  means. 

The  chyme  from  the  stomach  is  normally  acid,  and  will  there- 
fore act  as  a  stimulus  to  the  expulsion  of  bile  from  the  gall-bladder. 
It  is  partly  neutralised  by  the  bile  and  pancreatic  juice,  but 
generally  remains  acid  throughout  the  small  intestines  and 
will  act  as  a  stimulus  to  the  secretion  of  intestinal  juice.  If  it 
be  neutralised  by  alkalis  in  the  stomach,  this  stimulus  will  be 
removed  and  digestion  consequently  impaired.  Many  substances 
will  thus  pass  through  the  intestinal  canal  undigested,  which 
amounts  to  the  same  thing  as  if  less  food  had  been  taken. 

Through  this  derangement  of  the  digestion  the  blood  will  be- 
come poorer  in  solids,  the  person  will  become  emaciated,  the  fat 
will  naturally  be  first  absorbed,  and,  along  with  this,  perhaps 
pathological  formations  may  also  disappear. 

The  excessive  use  of  alkalis  or  their  carbonates  is  thus  inju- 
rious, and  their  employment  to  reduce  obesity  may,  unless  care- 
fully watched,  be  followed  by  serious  consequences,  like  the  use  of 
acids  for  a  similar  purpose  (p.  569). 

Caustic  alkalis  injected  directly  into  the  blood  cause  death  in 
a  few  minutes,  probably  from  formation  of  alkali- albuminate 
in  the  blood  and  its  consequent  coagulation.  Shortly  after  death 
the  blood  is  found  coagulated.  Smaller  amounts  taken  in  from 
the  stomach  will  to  some  extent  increase  the  alkalinity  of  the 
blood,  but  are  rapidly  separated  by  the  kidneys.  They  cause 
thirst,  and  probably  the  larger  amount  of  water  drunk  in  conse- 
quence is  one  cause  of  the  diuresis  they  produce.  From  their 
power  of  dissolving  fibrin  outside  the  body,  they  have  been  given 
in  acute  rheumatism  to  prevent  fibrinous  deposits  on  the  heart. 
It  is  not  certain  that  the  amount  we  can  introduce  into  the  blood 
without  injury  to  the  patient  has  this  effect. 

After  small  doses  of  liquor  potassse  the  urea  and  sulphuric 
acid  in  the  urine  are  increased,  and  Parkes  therefore  thinks  that 
the  tissue-change  of  the  albuminous  substances  is  increased. 
Alkalis  are  therefore  classed  as  alteratives  (p.  414). 

They  are  used  both  to  increase  the  amount  of  water  passed 
and  to  diminish  its  acidity  if  this  be  excessive.  They  are  there- 
fore classed  amongst  diuretics  (p.  432),  and  remote  antacids 
(p.  370). 

General  Action  of  the  Group  of  Chlorides. — Chloride  of 
sodium  is  not  only  one  of  the  most  abundant  saline  constituents 
of  the  animal  body,  but  it  is  one  of  the  most  important  solvents 
of  albuminous  substances.  "Water  will  dissolve  albumins  proper, 
but  globulins  are  insoluble  in  it,  and  are  precipitated  by  it  from 


600  INOKGANIC  MATEEIA  MEDICA.  [sect.  hi. 

solutions.  Dilute  solutions  of  chloride  of  sodium  on  the  contrary 
dissolve  both  albumins  and  globulins.  From  this  action  of  water 
on  albuminous  substances  it  is  very  irritating  when  applied  to 
a  cut  surface,  or  to  the  delicate  mucous  membrane  of  the  nose, 
while  muscles  dipped  in  it  swell  up,  and  pass  into  a  state  of  rigor. 
Weak  solutions  of  chloride  of  sodium,  on  the  other  hand,  have  no 
irritating  action,  and  may  be  applied  to  cut  surfaces  or  mucous 
membranes  without  causing  pain,  and  to  muscle  and  nerve  without 
producing  any  injurious  effect.  A  solution  of  the  strength  of  0-65 
per  cent,  is  the  one  usually  employed  in  physiological  experiments 
as  a  basis  for  the  nutritive  fluid  in  artificial  circulation  through 
the  frog's  heart  or  vessels,  and  as  a  solvent  for  alkaloids  which 
are  to  be  injected  into  the  lymph-sac  of  the  frog,  in  order  to  avoid 
the  local  irritation  which  the  injection  of  a  watery  solution  would 
produce.  A  solution  of  this  strength  is  often  called  '  normal  salt 
solution '  in  physiological  treatises. 

While  dilute  solutions  of  chloride  of  sodium  are  ready  solvents 
of  albuminous  substances  and  are  non-irritating,  sodium  chloride, 
in  substance  or  in  concentrated  solutions,  precipitates  globulins, 
withdraws  water  from  the  tissues,  and  acts  as  an  exceedingly 
powerful  irritant  to  cut  surfaces,  mucous  membranes,  muscle, 
and  nerve.  Common  salt  taken  in  a  large  quantity  at  once  will 
irritate  the  stomach  and  cause  vomiting.  It  is  absorbed  with 
great  rapidity,  but  it  is  also  excreted  so  rapidly  that  it  produces 
no  definite  symptoms  of  irritation  in  any  part  of  the  body, 
excepting  that  part  of  the  nervous  system  by  which  the  sensa- 
tion of  thirst  is  perceived.  This  sensation  becomes  so  urgent 
when  much  salt  has  been  taken  that  any  risk  will  be  encountered 
in  order  to  gratify  it.  Should  it  be  impossible  to  obtain  fresh 
water,  other  parts  of  the  nervous  system  become  involved,  and 
travellers  whose  supply  of  water  has  failed  in  the  desert,  or 
shipwrecked  sailors  who  have  drunk  sea-water,  have  become 
delirious.  It  is  difficult  to  say,  however,  how  far  the  delirium  is 
due  to  the  direct  irritant  action  of  sodium  chloride  on  the  brain, 
as  many  other  factors  may  concur -in  its  production.  Under 
ordinary  circumstances,  the  thirst  occasioned  by  sodium  chloride 
after  its  absorption,  causes  as  much  water  to  be  drunk  as  will 
allow  the  salt  to  be  excreted  by  the  kidneys,  leaving  the  propor- 
tion both  of  salt  and  water  in  the  body  nearly  the  same  as  before. 
During  its  stay  in  the  body  the  salt  does  not  appear  to  alter  the 
composition  of  the  tissues,  and  the  chief  alterations  produced 
by  it  are  probably  due  to  its  action  on  the  solubility  of  albu- 
minous substances  and  on  the  processes  of  osmosis  between  the 
intercellular  fluid  and  blood,  and  the  circulation  of  lymph  in  the 
tissues.  In  consequence  of  this,  sodium  chloride  increases  tissue- 
change,  as  is  shown  by  an  increase  in  the  amount  of  urea 
excreted.  A  similar  increase,  however,  occurs  when  the  quantity 
usually  taken  is  diminished,  the  amount  of  water  daily  consumed 


chap,  xxiv.]  METALS.  601 

remaining  the  same.  The  alteration  here  is  probably  also  due  to 
increased  rapidity  of  the  circulation  of  fluid  through  the  tissues 
(Voit),  but  it  may  also  be  due  in  part  to  the  different  solubilities 
of  albuminous  substances  in  solutions  of  sodium  chloride  of  dif- 
ferent strengths.  Certain  albuminous  tissues  may  thus  be 
affected  by  one  proportion  of  salt  in  the  blood,  others  by  another, 
so  that  increase  and  diminution  of  the  normal  proportion  of 
sodium  chloride  may  increase  tissue-change  in  the  body  as  a 
whole,  though  not  in  the  same  tissues.  The  proportion  of 
chloride  of  sodium  in  the  body  is  not  always  the  same.  It 
depends  on  the  quantity  taken  daily,  and  may  be  increased  or 
diminished  within  certain  limits.  If  a  definite  quantity  be  taken 
daily  for  some  time,  the  same  quantity  will  be  found  in  the  urine, 
so  that  the  amount  present  in  the  body  is  constant.  If  the 
quantity  consumed  be  now  increased,  no  increase  takes  place  in 
the  excretion  for  about  three  days,  a  storage  of  salt  taking  place 
in  the  body.  After  about  three  days  the  quantity  excreted  daily 
in  the  urine  will  again  be  found  equal  to  the  quantity  daily  taken, 
the  amount  present  in  the  body  remaining  constantly  at  the 
higher  level.  If  the  quantity  daily  taken  be  now  diminished, 
no  diminution  takes  place  in  the  quantity  excreted  for  about 
three  days,  and  then  the  quantities  daily  taken  and  excreted 
again  correspond.  The  amount  stored  up  at  first  is  now  gone, 
and  the  proportion  of  salt  in  the  body  is  now  again  reduced  to 
its  lower  level.1 

Increased  consumption  of  sodium  chloride  not  only  increases 
the  quantity  of  it  and  of  urea  in  the  urine  but  increases  also  the 
excretion  of  potassium  salts. 

On  the  other  hand,  potassium  salts  also  increase  the  excre- 
tion of  sodium.  Between  salts  containing  no  chlorine,  such  as 
carbonate  or  phosphate,  and  the  sodium  chloride  in  the  blood,  a 
double  decomposition  takes  place,  potassium  chloride,  and  sodium 
carbonate  or  phosphate,  being  formed.  These  newly-formed 
salts  are  unnecessary  for  the  organism,  and  are  excreted  in  the 
urine  along  with  the  unaltered  remainder  of  the  phosphate  or 
carbonate  administered.  Considerable  quantities  both  of  chlorine 
and  sodium  may  thus  be  removed  from  the  organism.  In  con- 
sequence of  this,  herbivorous  animals  and  people  living  chiefly 
on  a  vegetable  diet,  and  who  thus  consume  considerable  quanti- 
ties of  potassium  salts,  feel  the  need  of  sodium  chloride  greatly, 
and  on  the  American  prairies  the  herds  of  buffaloes  travel 
hundreds  of  miles  to  visit  the  salt  licks.  Beyond  a  certain  point, 
however,  the  excretion  of  sodium  chloride  is  not  increased  by 
potassium  salts,  and  when  the  quantity  of  sodium  salts  in  the  body 
is  low,  excretion  is  not  increased  at  all. 

When  an  abnormal  quantity  of  fluid  is  present  in  the  tissues, 

1  Ludwig,  Manuscript  Notes  of  Lectures,  1869-1870. 


602  INOEGANIC  MATEEIA  MEDICA.  [sect.  hi. 

as  in  dropsies,  an  increase  in  the  saline  constituents  of  the  blood 
may  cause  its  absorption,  especially  if  the  quantity  of  water 
drunk  by  the  patient  be  limited.  It  is  probable  that  in  addition 
to  their  diuretic  action  the  alkaline  salts  affect  the  nutrition  of 
the  tissues  themselves,  and  that  salts  of  potassium  are  better 
than  those  of  sodium  in  cases  of  dropsy,  because  of  their  action 
on  the  tissues. 

General  Action  of  the  Sub-Group  of  Sulphates,  &c. — 
This  group  contains  salts  which  are  sparingly  absorbed,  such  as 
sulphates,  phosphates,  and  bitartrates.  That  they  are  sparingly 
absorbed  is  shown  by  the  fact  that  when  administered  internally 
they  only  appear  to  a  small  extent  in  the  urine.  They  usually 
act  as  purgatives,  but  if  from  any  cause  their  purgative  action 
should  be  prevented,  and  they  remain  long  in  the  intestine, 
absorption  will  occur,  though  slowly.  In  herbivorous  animals, 
which  have  a  much  longer  intestinal  canal  than  carnivora,  larger 
doses  of  these  salts  are  required  to  produce  a  purgative  action. 
The  mode  of  action  has  already  been  discussed  (p.  390  et  seq.). 

Comparative  Action  of  the  Alkaline  Metals. — As  the  action 
of  the  base  appears  to  be  less  modified  by  the  acid  radical  in  the 
case  of  the  chlorides  than  of  other  salts  of  the  alkaline  metals, 
they  are  better  adapted  for  experiments  on  the  comparative 
action  of  the  members  of  this  class. 

Group  I. — The  chlorides  of  lithium,  sodium,  potassium, 
rubidium,  and  caesium  produce  in  frogs  gradually  increasing 
torpor,  paralysis,  and  death.  The  chief  action  appears  to  be  on 
the  spinal  cord,  which  is  paralysed,  a  slight  primary  excitement 
occurring  in  the  case  of  potassium  and  rubidium.  Lithium  and 
potassium  paralyse  also  the  ends  of  the  motor  nerves.  Sodium 
does  so  also,  though  to  a  much  less  extent.  Caesium  and  rubidium 
do  not  do  so,  excepting  when  given  in  very  large  doses. 

The  contractile  power  of  muscle  is  almost  always  diminished 
by  lithium,  unaffected  by  sodium,  and  increased  by  the  other 
members  of  this  group  in  small  or  moderate  doses.  Large 
quantities  of  potassium  diminish  both  the  irritability  and  con- 
tractile power  of  muscle  voluntary  and  involuntary. 

In  frogs  the  heart  becomes  weaker  and  finally  stops  in 
diastole. 

Group  II. — Ammonium  differs  entirely  from  the  members  of 
the  first  group  in  the  symptoms  it  produces.  While  they  para- 
lyse the  spinal  cord  with  little  or  no  previous  excitement,  causing 
torpor  and  death,  ammonia  at  first  stimulates  the  cord,  pro- 
ducing tetanic  convulsions.  The  action  of  ammonium  is  consi- 
derably modified  by  the  acid  radical  with  which  it  is  combined. 
All  the  ammonium  salts  have  an  action  on  the  spinal  cord, 
motor  nerves,  and  muscles,  and,  in  advanced  poisoning,  para- 
lyse these  structures. 

They  do  not,  however,  affect  all  these  structures  with  equal 


chap,  xxiv.]  METALS.  603 

readiness.  The  organ  first  affected,  and  consequently  (p.  26) 
the  symptoms  of  poisoning,  vary  with  the  salt  employed.  Some 
salts  affect  the  spinal  cord  first,  others  the  motor  nerves.  Am- 
monia and  ammonium  chloride  produce  tetanus.  The  bromide 
producer  hyperesthesia  with  some  clonic  spasm,  passing  into 
tetanus,  which,  however,  comes  on  very  late. 

The  sulphate  also  produces  hyperesthesia  and  clonic  Bpasms, 
but  rarely  tetanus.  The  phosphate  produces  paralysis  without 
convulsions,  either  clonic  or  tonic,  the  only  indication  of  any  con- 
vulsant  action  being  slight  twitches  accompanying  movements 
in  the  hind  limbs  before  reflex  action  has  ceased.  The  iodide 
produces  progressive  paralysis  and  no  tetanus.  The  brain  ap- 
pears to  be  affected  before  the  spinal  cord.  This  is  shown  by 
tho  frog  croaking  when  stroked,  as  it  does  after  removal  of  the 
cerebral  hemispheres,  and  by  the  reflex  from  the  conjunctiva 
failing  before  that  from  the  limbs. 

Ammonium  salts  appear  to  form  a  series,  at  one  end  of 
which  the  members  stimulate  the  spinal  cord  and  have  no 
marked  paralysing  action  on  the  motor  nerves,  while  those  at 
the  other  end  have  no  marked  stimulating  action  on  the  cord, 
but,  on  the  contrary,  have  a  marked  paralysing  action  both  on 
the  cord  and  on  motor  nerves.  At  the  stimulating  end  of  this 
series  are  ammonia  and  ammonium  chloride,  and  at  the  para- 
lysing end  ammonium  iodide ;  whilst  the  bromide,  phosphate, 
and  sulphate  lie  between. 


Group  I.— METALS  OP  THE  ALKALIS. 
POTASSIUM.     K;  39. 

General  Sources  of  Potassium  Salts. — The  chief  source 
of  potassium  salts  is  the  ash  left  by  the  combustion  of  plants  or 
trees  ;  but  there  are  two  subsidiary  sources,  viz.  nitrate  of  potas- 
sium, which  is  found  native,  and  bitartrate  of  potassium,  which 
is  deposited  from  wine  in  the  process  of  fermentation. 

General  Eeactions  op  Potassium  Salts. — In  analysis, 
potassium  is  distinguished  from  all  other  bases,  excepting  mag- 
nesium, sodium,  and  ammonium,  by  not  being  precipitated  by 
ammonium  sulphide  nor  carbonate  of  ammonium.  The  positive 
reactions  by  which  its  presence  is  ascertained  are — (1)  its  preci- 
pitation when  converted  into  an  acid  tartrate  ;  (2)  its  precipita- 
tion by  perchloride  of  platinum ;  (3)  the  violet  colour  it  imparts 
to  flame. 

The  sparing  solubility  of  the  acid  tartrate  is  the  test  which 
is  used  in  the  U.S.P.  to  distinguish  all  salts  of  potassium.  The 
reagent  employed  is  tartaric  acid  in  the  case  of  potassium 
hydrate,  carbonate,  and  bicarbonate ;  in  the  case  of  the  tartrate 
of  potassium  and  sodium,  acetic  acid  is  used.     In  the  case  of 


604 


INORGANIC  MATERIA  MEDICA. 


[sect.  nr. 


most  other  salts  a  saturated  solution  of  bitartrate  of  sodium  is 
added  to  their  aqueous  solution.  Potassium  chlorate  is  calcined 
and  the  reagent  added  to  a  solution  of  the  residue.  Potassa 
sulphurata  is  decomposed  by  boiling  with  hydrochloric  acid,  the 
sulphur  removed  by  nitration,  and  the  nitrate  neutralised  by 
soda  before  the  reagent  is  applied.  No  test  for  potassium  is 
given  in  the  case  of  potassium  bitartrate  or  permanganate. 

This  test  is  only  employed  in  the  British  Pharmacopoeia  in 
four  instances— viz.  neutral  tartrate,  acetate,  bromide,  and 
iodide.  In  the  case  of  the  neutral  tartrate  the  test  is  applied  by 
adding  a  small  quantity  of  acetic  acid,  and  thus  producing  acid' 
tartrate.  In  the  case  of  the  acetate,  bromide,  and  iodide,  it  is 
applied  by  adding  tartaric  acid.  On  the  addition  of  perchloride 
of  platinum  to  chloride  of  potassium  a  double  chloride  of  potas- 
sium and  platinum  is  formed,  and  falls  as  a  sparingly  soluble 
pale-yellow  precipitate.  If  the  potassium  salt  be  other  than  a 
chloride,  part  of  the  chlorine  in  the  platinum  salt  is  used  up  to 
convert  the  potassium  into  a  chloride,  and  thus  loss  of  the 
expensive  reagent  takes  place.  To  avoid  this  loss  hydrochloric 
acid  is  always  to  be  added  before  the  addition  of  the  platinum 
salt.  This  reaction  is  not  used  for  the  bromides  and  iodides, 
because  bromide  and  iodide  of  platinum  would  be  formed  and  a 
loss  of  the  reagent  would  occur.  In  testing  some  potassium 
salts,  modifications  are  observed  in  the  mode  of  applying  the 
test.  Before  applying  it  to  the  chlorate  the  salt  is  calcined,, 
oxygen  is  thus  driven  off,  and  the  residue,  consisting  of  chloride 
of  potassium,  doe^  not  require  the  addition  of  hydrochloric  acid. 
The  permanganate  is  also  calcined,  but  the  potash  contained  in 
the  residue,  after  being  dissolved  out  by  water  from  its  admixture 
with  manganese  dioxide  requires  to  be  treated  with  acid  as  usual. 
In  the  case  of  the  sulphide  the  hydrochloric  acid  causes  the 
evolution  of  hydrogen  sulphide,  which  must  be  removed  by  boil- 
ing, and  causes  also  the  precipitation  of  sulphur,  which  must  be 
removed  by  filtration  before  the  addition  of  platinum  chloride. 

Preparation  of  Potassium  Salts. 


Prepared  from 

By 

Potassium  carbonate, 

Wood  ashes 

Lixiviating,     evaporating,    and 

B.  and  U.S.P. 

crystallising. 

Liquor  potassie,  B.P. 

Potassium  carbonate 

Treating    solution  with    slaked 

„    potassii,  U.S.P. 

lime  and  partially  evaporating. 

Caustic    potash,    B. 

Do. 

Ditto,  and   evaporating  to  dry- 

and U.S.P. 

ness. 

Potassium  bicarbon- 

Do. 

Passing  carbonic  acid  gas  into 

ate,  B.  and  U.S.P. 

solution. 

Potassium   sulphite, 

Do. 

Passing  sulphurous  acid  gas  into 

U.S.P. 

strong  solution  until  acid,  add- 
ing equal  weight  of  potassium 
carbonate  and  crystallising. 

3HAP.  XXIV.] 

METALS. 

605 

Pbeparation  of  Potassium  Salts — (continued). 

Prepared  from 

By 

Potassium     acetate, 

Potassium  carbonate 

Dissolving  in  acetic  acid. 

B.  and  U.S.P. 

Potassium  citrate,  B. 

Do. 

Neutralising  with  citric  acid. 

and  U.S.P. 

Potassium  hypophos- 

Do. 

Decomposing  by  hypophosphite 

phite,  U.S.P. 

of  calcium. 

Potassium  chlorate, 

Do. 

Treating  with  lime  and  chlorine. 

B.  and  U.S.P. 

Fotassa     sulphurata, 

Potassium  carbonate 

Heating  together. 

B.  and  U.S.P. 

and  sulphur 

Potassium  ferrocyan- 

Potassium  carbonate 

Fusing  with  animal  matter  and 

ide,  B.  and  U.S.P. 

iron;  lixiviating  and  crystal- 
lising. 

Potassium    cyanide, 

Potassium     ferrocy- 

Igniting  either  alone,  or  with  car- 

B. and  U.S.P. 

anide 

bonate  of  potassium.  The  for- 
mer process  is  official  B.P.  and 
gives  a  purer,  the  latter  a 
more  abundant  product. 

Potassium  acid  tar- 

Crude tartar  or  argol 

Treating  with  charcoal  or  clay. 

trate,  B.  and  U.S.P. 

Potassium    tartrate, 

Acid      tartrate      of 

Neutralising  with  potassium  car- 

B. and  U.S.P. 

potassium 

bonate. 

Potassium     nitrate, 

Native 

— 

B.  and  U.S.P. 

Potassium  sulphate, 

Acid    sulphate    left 

Neutralising  with  carbonate  of 

B.  and  U.S.P. 

from  admixture  of 
sulphuric  acid  and 
potassium  nitrate 
in  the  preparation 
of  nitric  acid 

potassium  or  calcium. 

Potassium    perman- 

Chlorate   of    potas- 

Ignition   together,   boiling   and 

ganate,     B.      and 

sium,  caustic  pot- 

neutralising. 

U.S.P. 

ash,  and  oxide  of 
manganese 

Potassium  bichrom- 

Chromate of  potas- 

Treating with  sulphuric  acid. 

ate,  B.  and  U.S.P. 

sium 

Potassium       iodide, 

Potash  and  iodine    . 

Mixing  and  heating  with  char- 

B. and  U.S.P. 

coal. 

Potassium  bromide, 

Potash  and  bromine . 

As  in  the  iodide. 

B.  and  U.S.P. 

Genbeal  Action  of  Potassium  Salts. — According  to  Einger, 
potassium  is  a  protoplasmic  poison  destroying  muscle,  nerves, 
and  nerve-centres  when  applied  to  them  sufficiently  long  and  in  a 
sufficiently  concentrated  form.  But  this  action  is  not  peculiar  to 
potassium,  for  sodium,  ammonium,  hydrocyanic  acid,  and  pro- 
bably many  other  substances  possess  it.  Potassium  salts  differ 
from  sodium  salts  in  diffusing  more  readily  through  membranes. 
They  are  more  easily  absorbed  and  more  easily  excreted  than 
sodium  salts.  In  the  living  organism  they  occur  chiefly  in  the 
solid  structures,  such  as  blood-corpuscles  and  muscles,  while 
sodium  salts  occur  chiefly  in  the  fluids  of  the  body. 

When  applied  to  muscle,  potassium  salts  in  minute  doses  may 
increase  its  contractile  power  (p.  135) ;  but  in  larger  doses,  or  when 


60C  INORGANIC  MATERIA   MEDICA.  [sect.  hi. 

continued  for  a  longer  time,  they  diminish  its  power  and  finally 
paralyse  it  altogether.  They  remove  the  excessive  prolongation 
of  muscular  contraction  produced  by  veratrine,  barium,  calcium, 
strontium,  and  by  large  doses  of  sodium  or  lithium  (p .  135) , 

They  have  a  somewhat  paralysing  action  on  motor  nerves. 
They  paralyse  also  the  nerve-centres,  generally  after  a  primary, 
transitory,  excitement. 

A  peculiar  difference  in  the  action  of  sodium  and  potassium 
salts  locally  applied  to  the  intestine  has  been  already  noticed 
(p.  383).  Large  doses  paralyse  the  muscular  fibre  of  the  intep  ■ 
tines,  and  it  is  possible  that  this  paralysing  action  is  the  cause  of 
the  digestive  disturbances  which  the  prolonged  use  of  potassium 
salts  causes  (Rossbach). 

When  administered  by  the  mouth  they  may  produce,  like  other 
salts  in  large  doses,  irritation  of  the  gastro-intestinal  canal. 
They  are,  however,  so  quickly  excreted  that  they  can  hardly 
produce  poisoning  by  their  action  on  the  heart  while  circulating 
in  the  blood ;  they  probably  modify  the  nutrition  of  the  tissues 
and  act  as  alteratives.  It  is  probable  that  potassium  salts  may 
accumulate  to  a  certain  extent  in  the  body  in  the  same  way  as 
sodium  chloride  (p.  601).  By  feeding  animals  with  potassium 
salts  the  poisonous  action  of  barium  may  be  lessened.  Cash  and 
I  have  now  found  that  when  injected  simultaneously  with  salts 
of  barium  (cf.  p.  137),  they  will  antagonise  the  action  of  the 
latter,  and  prevent  death  from  an  otherwise  lethal  dose  of  barium. 
Similar  experiments  with  potassium  and  veratrine  have  given 
negative  results.  The  prolonged  use  of  potassium  salts  is  apt 
to  cause  some  depression,  and  larger  doses  continued  for  some 
time  may  diminish  the  force  of  the  circulation.  They  do  not 
paralyse  the  heart  when  given  by  the  mouth,  but  when  injected 
directly  into  the  veins  they  produce  transitory  excitement,  clonic 
spasms,  paralysis,  and  death. 

Death  is  preceded  by  convulsions,  and  is  caused  by  stoppage 
of  the  heart  while  respiration  still  continues.  Even  after  both 
heart  and  respiration  have  ceased  and  the  animal  is  apparently 
dead,  life  may  be  restored  by  the  patient  use  of  artificial  respira- 
tion, and  mechanical  irritation  of  the  heart  by  compressing  the 
cardiac  region.  After  the  heart  has  thus  been  induced  to  beat 
spontaneously,  respiration  still  remains  in  abeyance  for  some  time. 
The  nerve-centres  are  also  paralysed,  and  neither  voluntary 
movement  nor  reflex  action  occur  for  some  time.  When  reflex 
excitability  returns  it  is  often  much  exaggerated,  so  that  a  slight 
shake  or  gentle  touch  on  the  surface  may  cause  spasms.  In  this 
respect  potassium  somewhat  resembles  atropine,  and  the  possible 
explanation  of  this  action  has  already  been  discussed  (p.  171  etseq.). 

The  effect  of  potassium  salts  on  the  circulation  somewhat 
resembles  that  of  digitalis.  In  large  doses  they  cause  a  rapid 
fall  of  the  blood-pressure  and  pulse-rate.    Smaller  doses  cause  a 


chap,  xxiv.]  METALS.        '  607 

slight  fall  of  both  pulse-rate  and  pressure,  followed  by  a  rise  of 
both.  During  the  rise  of  pressure,  however,  the  pulse  becomes 
again  slow,  and  continues  so  even  when  the  pressure  again  begins 
to  fall  to  the  normal.  The  rise  of  pressure  occurs  even  when 
the  spinal  cord  is  divided,  and  probably  depends  on  contraction 
of  the  arterioles  (p.  281). 

Potassii  Carbonas,  B.  and  U.S.P.  Carbonate  of  Potassium, 
K2C03,  with  about  16  per  cent,  of  water  of  crystallisation,  B.P. 
(K2C03)  3H20  ;  330,  U.S.P. 

Characters. — A  white  crystalline  powder,  alkaline,  and 
caustic  to  the  taste,  very  deliquescent. 

Solttbility. — It  is  readily  soluble  in  water,  but  insoluble  in  spirit. 
Eeaction. — It  gives  the  reactions  of  a  carbonate  (p.  894)  and  of  potas- 
sium (p.  603). 

20  grains  Carbonate  }  ,    ,.        [17  grains  Citric  Acid,  or 

of  Potassium  J  t  18  grains  Tartaric  Acid. 

Dose. — 10  to  30  grains. 

Action. — When  taken  internally  it  acts  as  an  irritant  poison. 
It  is  rarely  used  internally,  but  may  be  given  instead  of  liquor 
potassse,  or  of  bicarbonate,  or  in  an  effervescent  form  with  citric  or 
tartaric  acid.  It  is  chiefly  employed  in  the  preparation  of  other 
potassium  salts.  A  dilute  solution  of  it  may  be  used  as  an 
application  to  the  skin  to  relieve  itching,  and  for  this  purpose 
may  be  alternated  with  dilute  acid.  Carbonate  of  potassium  is 
also  used  as  an  ingredient  in  sulphur  ointments  (Ung.  Sulph. 
Alk.  U.S.P.  p.  544)  in  cases  of  indurated  acne :  the  strength 
may  be  half  a  drachm  to  a  drachm  in  the  ounce  of  ointment. 

Liquor  Potassae,  B.  and  U.S.P.  Solution  of  Potash,  B.P.; 
of  Potassa,  U.S.P. — An  aqueous  solution  of  hydrate  of  potassium 
(KHO  ;  56)  containing  5-84  per  cent,  of  the  hydrate,  B.P. ;  about 
5  per  cent.,  U.S.P. 

Dose. — 15  to  60  minims. 

Uses. — Dilute  liquor  potassae  is  used  externally  as  a  lotion 
in  freckles,  and  when  diluted  with  water  in  the  proportion  of  1 
to  6,  is  employed  in  order  to  soften  ingrowing  toe-nails.  Inter- 
nally it  acts  both  as  a  direct  and  remote  antacid  and  as  an 
alterative.  It  is  given  in  scaly  skin-diseases,  in  eczema  and 
acne,  especially  when  these  occur  in  gouty  subjects,  or  are  ac- 
companied by  acidity  of  the  stomach.  In  cases  of  dyspepsia, 
with  irritability,  it  is  said  to  have  a  sedative  action  upon  the 
stomach,  and  thus  to  be  preferable  to  the  bicarbonate.  It  is 
believed  to  be  useful  in  jaundice,  and  in  enlargement  or  cancer 
of  the  liver.  For  its  action  upon  the  system  it  has  been  adminis- 
tered in  rheumatism,  both  acute  and  chronic.  It  is  given  to 
cause  the  absorption  of  fat  in  obese  persons,  but  may  destroy 
the  general  health  (cf.  p.  599).    It  has  been  used  to  cause  the 


608  INOEGANIC  MATEEIA  MEDICA.         [sect.  in. 

absorption  of  scrofulous  glands  and  of  bronchoeele.  It  increases 
the  bronchial  secretion,  and  renders  it  more  liquid  and  easier  to 
cough  up.  It  is  therefore  useful  in  bronchitis  where  the  secretion 
is  scanty  and  difficult  to  expectorate,  and  is  equally  serviceable 
in  the  intercurrent  bronchitic  attacks  to  which  phthisical  patients 
are  liable  (p.  252). 

Potassa  Caustica,   B.P- ;   Potassa,   U.S.P.    KHO;    56. 

Catjstic  Potash. — Hydrate  of  potassium,  KHO,  containing  some 
impurities. 

Charactees. — In  hard  white  pencils,  very  deliquescent,  power- 
fully alkaline  and  corrosive. 

Reactions  and  Tests. — A  watery  solution  gives  the  reactions  of  potassium 
(p.  603)  and  those  showing  the  absence  of  impurities. 

Preparation  containing  Caustic  Potash. 
liquor  Potassse 27  grains  in  1  fluid  ounce. 

Preparation  in  which  Caustic  Potash  is  used. 
Potassii  Permanganas. 

Uses. — It  is  used  as  a  caustic  where  we  wish  to  burn  deeply 
and  widely,  as  in  snake-bites,  the  bites  of  rabid  animals,  or  in 
poisoned  wounds.  It  is  occasionally  employed  to  open  abscesses, 
more  especially  abscess  of  the  liver,  in  which  it  is  sometimes  pre- 
ferred to  the  knife,  as  by  its  use  we  secure  adhesion  of  the  liver  to 
the  abdominal  wall  before  the  abscess  is  opened,  and  thus  prevent 
any  pus  from  finding  its  way  into  the  peritoneal  cavity.  Einger 
says  that  the  best  way  to  apply  it  is  to  cut  a  hole  in  a  thick 
piece  of  plaster,  smaller  than  the  size  of  the  slough  which  we 
wish  to  make,  and  rub  on  the  caustic  potash,  slightly  wetted 
until  the  tissues  assume  a  greyish  colour,  then  to  wash  the  part 
with  vinegar,  and  apply  a  poultice.  Solutions  of  caustic  potash 
of  the  strength  of  10  to  30  grains  to  the  ounce  of  distilled  water 
are  useful  in  dissolving  the  thickened  patches  of  old  eczema : 
acetic  acid  must  be  applied  to  neutralise  the  potash,  and  the 
treatment  renewed  once  or  twice  a  week. 

U.S.P.  Potassa  cum  Calce.  Potassa  with  Lime  ;  Vienna 
Paste. 

Chaeactees. — It  is  a  greyish-white,  deliquescent  powder  with 
a  strongly  alkaline  reaction. 

Reaction. — It  gives  the  tests  of  potassium  (p.  603)  and  calcium  (p.  646).. 
Preparation. — Equal  parts  of  caustic  potash  and  lime  made  into  a  paste 
with  alcohol. 

Uses. — It  is  used  for  the  same  purposes  and  in  the  same 
manner  as  caustic  potash,  but  being  less  deliquescent  its  action 
is  slower  and  more  limited ;  it  is  thus  more  easily  restricted  to 
the  part  which  it  is  wished  to  destroy,  and  is  less  liable  to  spread. 

Potassii  Bicarbonas,  B.  and  U.S.P.  Bicarbonate  of 
Potassium.    KHC03 ;  100. 


chap;  xxiv.]  METALS.  609 

Characters. — Colourless  right  rhombic  prisms,  not  deliques- 
cent, of  a  saline  feebly  alkaline  taste,  not  corrosive. 

Reactions  and  Tests. — It  gives  the  reactions  of  a  bicarbonate  (p.  594 
and  of  potassium  (p.  603)  and  those  showing  the  absence  of  impurities. 

20  grains  Bicarbonate  1        ,,.     j  14  grains  Citric  Acid,  or 
of  Potassium  f  neuxrause  j  15  graing  Tartaric  Acid_ 

Dose. — 10  to  40  grains. 

Preparation. 

B.P. 

liquor  Potassae  Effervescens  (Potash  water) 30  grs.  in  1  pint. 

Uses. — Solutions  of  bicarbonate  of  potassium  may  be  used 
externally  to  relieve  itching.  Internally  it  is  given  in  dyspepsia, 
rheumatism,  gout,  and  scalding  depending  upon  excessive  acidity 
of  the  urine  with  presence  of  uric  acid,  or  in  cases  of  deposit  of 
this  acid  in  the  urinary  passages. 

Potassii  Acetas,  B.  and  U.S.P.  Acetate  of  Potassium 
CH2K(CO0H);  98. 

Chaeactees. — White  foliaceous  satiny  .masses,  very  deliques- 
cent. 

Eeactions. — With  a  watery  solution,  tartaric  acid  causes  a  crystalline 
precipitate  (potassium),  sulphuric  acid  the  disengagement  of  acetic  acid,  and 
a  dilute  solution  of  perchloride  of  iron  strikes  a  deep  red  colour  (acetate). 

Impurities. — Acid,  carbonate,  lead. 

Tests. — Neutral  to  test  paper  (no  acid) ;  almost  entirely  soluble  in  rectified  • 
spirit  (no  carbonate).    Its  solution  is  unaffected  by  sulphide  of  ammonium 
(no  metals). 

Dose. — 10  to  60  grains. 

Preparation  in  which  Acetate  oe  Potassium  is  used. 
Tinctura  Perri  Acetatis. 

Uses. — From  its  slight  local  action  and  its  great  solubility 
it  produces  little  effect  directly  on  the  stomach  and  is  easily 
absorbed  into  the  blood.  Here  it  is  converted  into  carbonate 
and  renders  the  blood  and  the  secretions  which  come  from  it 
more  alkaline.  This  salt  of  potassium  is  one  which  is  very 
frequently  used  for  the  purpose  of  rendering  the  urine  alkaline. 
It  is  one  of  the  most  powerful  saline  diuretics  we  possess,  and 
is  much  used  in  dropsies,  alone  or  combined  with  other  diuretics, 
or  with  tonics  and  stimulants,  e.g.  acetate  of  iron  and  acetic 
ether. 

When  given  in  large  doses  (120  grains  and  upwards)  and  in 
a  concentrated  form  it  acts  as  a  purgative. 

It  is  employed,  like  other  potassium  salts,  as  an  alterative  in 
acute  rheumatism,  skin  diseases,  and  enlarged  glands. 

Potassii  Citras,  B.  and  U.S.P.  Citeate  of  Potassium. 
K3C6K507.  B.P.  K3C6H50,.H20;  324.  U.S.P.  Liquor  Potassii 
Citeatis,  U.S.P. 

B  B 


610  INORGANIC  MATERIA  MEDICA.  [sect.  in. 

Charactbes. — A  -white  powder,  of  saline  feebly  acid  taste, 
deliquescent,  and  very  soluble  in  water. 

Eeactions  and  Tests. — Heated  with  sulphuric  acid  it  forms  a  brown  fluid, 
gives  off  an  inflammable  gas  and  evolves  the  odour  of  acetic  acid  (citrate). 
Its  solution  gives  the  reactions  of  potassium  (p.  603)  and,  mixed  with  a 
solution  of  chloride  of  calcium,  remains  clear  till  it  is  boiled,  when  a  white 
precipitate  separates  which  is  readily  soluble  in  acetic  acid.  This  precipitate 
is  citrate  of  calcium,  which  is  less  soluble  in  hot  than  in  cold  water. 

Dose. — 20  to  60  grains. 

Uses. — Is  very  pleasant  to  the  taste,  produces  no  local  action 
and  is  very  soluble.  It  is  thus  easily  absorbed  into  the  blood, 
and  there  becomes  carbonate.  It  is  less  liable  to  purge  than 
other  potassium  salts,  and  can  thus  be  given  in  larger  doses. 
After  absorption  it  acts  like  the  carbonate,  causes  diuresis  and 
lessened  acidity  or  even  alkalinity  of  the  urine,  and  probably 
influences  tissue-change  as  well.     It  is  antiscorbutic. 

Potassii  Tartras  Acida,  B.P. ;   Potassii  Bitartras,  U.S.P- 

Acid  Taeteatb  of  Potassium,  B.P. ;  Bitaeteate  op  Potassium, 
U.S.P.     Ceeam  of  Taetae.     KHC4H406;  188. 

An  acid  salt  obtained  from  the  crude  tartar  which  is  de- 
posited during  the  fermentation  of  grape-juice,  B.P. 

Chaeaotees. — A  gritty  white  powder,  or  fragments  of  cakes 
crystallised  on  one  surface ;  of  a  pleasant  acid  taste. 

Solubility. — Sparingly  soluble  in  water,  insoluble  in  spirit. 

Reactions  and  Tests. — Heated  in  a  crucible  it  evolves  inflammable 
gas  and  the  odour  of  burnt  sugar,  and  leaves  a  black  residue  (tartrate).  The 
calcined  residue  consists  of  potassium  carbonate  and  gives  its  reactions. 

Dose. — 20  to  60  grains  as  a  diuretic ;  £-£  oz.  as  purgative. 

Pkepabations  in  which  Acid  Tartrate  op  Potassium  is  used. 

B.P.  U.S.P. 

Acidum  Tartaricum.  Pulvis  Jalapse  Compositus. 

Antimonium  Tartaratum. 
Confectio  Sulphuris. 
Perrum  Tartaratum. 
Potassii  Tartras. 
Pulvis  Jalap«-  Compositus. 
Soda  Tartarata. 

Uses.— Prom  there  being  two  equivalents  of  tartaric  acid  to 
one  of  potassium  it  has  a  somewhat  acid  taste,  and  is  used 
instead  of  tartaric  or  other  acids  for  making  cooling  drinks 
in  fevers,  &c.  A  refreshing  drink  called  Potus  Imperialis,  or 
Imperial,  is  made  by  dissolving  1  to  1£  drachm  of  acid  tartrate 
and  a  little  sugar  in  a  pint  of  boiling  water  and  infusing  with 
half  the  fresh  peel  of  a  lemon. 

In  small  doses  it  is  absorbed,  oxidised  in  the  blood  to  car- 
bonate, and  acts  like  the  acetate  as  a  diuretic. 

In  larger  doses  it  retains  water  with  great  avidity,  and  pre- 


chap,  xxiv.]  METALS.  611 

vents  its  absorption  into  the  blood  for  a  long  time.  It  therefore 
causes  the  stools  to  be  very  watery,  by  detaining  water  in  the 
intestine,  but  it  has  no  irritating  action  on  the  intestine,  and 
produces  no  increased  peristalsis.  If  no  other  medicine  be  given 
to  cause  peristalsis,  the  salt  and  the  water  it  has  been  retaining 
will  be  absorbed.  Its  action  is  thus  very  much  like  that  of  a 
simple  enema  of  water  going  along  the  whole  intestine,  and  like 
a  simple  enema  it  produces  no  depressing  effect. 

It  is  much  used  in  dropsies  as  a  purgative,  generally  in  com- 
bination with  jalap  or  scammony  to  produce  peristalsis,  whether 
the  dropsy  be  due  to  affections  of  the  heart  or  kidneys,  and  also 
in  Bright's  disease,  even  when  unaccompanied  by  dropsy.  It 
has  also  been  employed  as  a  laxative  in  dysentery,  piles,  and 
prolapsus  ani. 

Potassii  Tartras,  B.  and  U.S. P.  Tartbate  of  Potassium, 
K2C4H406.H20  (B.P.),  or  (K2C4H406)2H20 ;  470  (U.S.P.). 

Characters. — In  small,  colourless,  four  or  six-sided  prisms. 

Eeactions. — It  gives  the  reactions  showing  the  presence  of  tartaric  acid 
and  potassium  like  the  bitartrate,  but  it  is  readily  distinguishable  by  its 
greater  solubility  in  water. 

Impurity. — Bitartrate. 

Test. — Entirely  dissolved  by  its  own  weight  of  water. 

Dose.— As  a  diuretic,  20-60  grains.  As  a  purgative,  J-^ 
ounce. 

Uses. — In  small  doses  it  is  absorbed,  converted  into  carbon- 
ate in  the  blood  and  acls  as  a  diuretic,  antilithic,  &c,  like  the 
acetate  and  citrate.  In  larger  doses  it  acts  as  a  purgative,  like 
other  saline  cathartics. 

Potassii  Sulphas,  B.  and  U.S. P.  Sulphate  of  Potassium. 
K2S04;  174. 

Chaeactebs. — Colourless  hard  six-sided  prisms  terminated 
by  six-sided  pyramids. 

Solubility. — Sparingly  soluble  in  water,  insoluble  in  alcohol. 

Reactions. — It  decrepitates  strongly  when  heated.  Its  solution  in  water 
gives  the  reactions  showing  the  presence  of  potassium  and  a  sulphate  (v.  p. 
595). 

Impueitibs. — Calcium,  chlorides,  iron  and  lead. 

Test. — The  solution  should  give  no  precipitate  with  oxalate  of  ammo- 
nium (no  calcium),  nitrate  of  silver  (no  chloride),  nor  ammonium  sulphide  (no 
metals). 

Dbss. — 15  to  60  grains. 

Preparations. 
B.P. 

Pllula  Coloeynthidis  Composita  (p.  522)     1  part  in  24. 

„  „  et  Hyoscyami  (p.  522)  1         „     36. 

„      Xpecacuanbae  cum  Scilla  (p.  522) 1        „      3. 

Pulvis  Ipecacuanhas  Composltus 4        „      5. 

b  a  2 


C12  INOEGANIC  MATEEIA  MEDICA.  [sect,  n: 

Uses. — Sulphate  of  potassium  is  employed  as  a  saline  purga 
tive  in  eases  of  dyspepsia,  biliousness,  and  albuminuria.  It  i 
generally  combined  with  some  other  aperient,  such  as  rhubart 
From  its  hardness  it  is  used  to  aid  in  pulverising  tough  vegetabl 
substances,  like  ipecacuanha  in  the  preparation  of  Pulv.  Ipeca 
cuanhse  Co.,  B.P.  It  was  once  supposed  to  have  the  power  o 
arresting  the  secretion  of  milk,  and  was  therefore  given  to  womei 
who  wished  to  stop  suckling. 

Potassii  Nitras,  B.  and  U.S. P.  Nitrate  of  Potassium 
KN03;  101. 

Nitrate  of  potassium  of  commerce,  purified,  if  necessary,  bj 
crystallisation  from  solution  in  distilled  water. 

Characters. — In  white  crystalline  masses  or  fragments  o: 
striated  six-sided  prisms,  colourless,  of  a  peculiar  cool  salint 
taste. 

Eeactions. — Thrown  on  the  fire  it  deflagrates;  warmed  in  a  test-tube 
with  sulphuric  acid  and  copper  wire  it  evolves  ruddy  fames  (nitrate).  Its 
solution  gives  the  reactions  of  potassium  (p.  603). 

Impurities. — Sulphates  and  chlorides,  which  are  detected  by  the  usual 
tests  (v.  p.  594). 

Dose. — 10  to  30  grains. 

Pkepaeations. 
B.P.    Arg-entl  et  Potassii  Nitras.  TJ.S.P.    Argeuti  Nitras  Dilutns. 

U.S.P.  Charta  Potassii  Nitratis.  Nitrate  of  Potassium  Paper.  Unsized  paper 
dipped  in  a  20  per  cent,  solution  of  nitrate  of  potassium  and  dried. 

Action. — In  large  doses,  nitrate  of  potassium  will  produce 
death  by  gastro-enteritis,  with  vomiting,  weakness,  and  arrest 
of  the  circulation,  due  partly  to  the  reflex  action  of  the  drug,  and 
partly  to  its  direct  action  on  the  heart  after  absorption.  When 
injected  into  the  blood,  it  slows  the  pulse  by  lessening  the  irri- 
tability of  the  cardiac  ganglia,  lowers  the  temperature,  anct= 
causes  dyspnoea  and  death  with  convulsions.  The  convulsions 
are  due  to  arrest  of  the  heart,  and  consequent  irritation  of  the 
brain  by  venous  blood. 

Uses.- -Nitrate  of  potassium  gives  up  its  oxygen  readily,  and 
paper  dipped  in  a  strong  solution  of  it  (Charta  potassii  nitratis, 
U.S. P.)  and  then  dried,  may  be  burnt  in  a  plate,  and  the  fumes 
inhaled,  in  asthma.  It  has  been  suggested  that  among  the  pro- 
ducts of  combustion  the  nitrite  of  potassium  is  the  most  effi- 
cacious. A  ball  of  nitre,  kept  in  the  mouth  and  allowed  to  melt 
slowly  away,  gives  relief  in  cases  of  relaxed  sore-throat.  It 
has  been  used  internally  in  acute  bronchitis,  spasmodic  asthma 
(either  internally  or  by  inhaling  its  fumes),  and  in  dyspepsia  with 
congestion  of  the  mucous  membranes.  Generally  it  is  avoided 
in  inflammation  of  the  stomach,  intestine,  kidneys,  and  bladder, 
on  account  of  its  local  irritant  action.  On  account  of  its  action 
on  the  heart  it  has  been  given  in  haemoptysis  and  other  hsemor- 


chap,  xxiv.]  METALS.  613 

rhages.  On  account  of  its  supposed  action  on  the  blood  it  was, 
and  is,  used  in  inflammation,  fevers,  and  exanthemata.  As  an 
alterative  it  is  used  in  scurvy,  purpura,  rheumatism,  and  gout. 
Twenty  grains  of  nitre  with  thirty  of  potassium  bicarbonate 
taken  in  the  morning  in  a  large  soda-water  tumbler  full  of  water 
will  sometimes  prevent  the  onset  of  a  gouty  paroxysm,  and  will 
also  remove  the  headache  consequent  upon  a  debauch.  Nitrate 
of  potassium  is  also  used  as  a  diuretic  in  cases  of  dropsy  and 
gonorrhoea,  and  as  a  stimulant  to  the  bladder  in  cases  of  in- 
continence of  urine. 

Potassii  Chloras,  B.  and  U.S. P.  Chlorate  of  Potassium, 
EC103;  122-4. 

Characters. — In  colourless  rhomboidal  crystalline  plates,  with 
a  cool  saline  taste. 

Preparation. — By  passing  chlorine  through  a  mixture  of  potassium  car- 
bonate and  slaked  lime.  If  potassium  carbonate  alone  were  used  part  of  it 
would  be  converted  into  KOI  and  lost.  SK^COj  +  3C1,  =  5K01  +  KC103  +  3C02. 
To  save  this,  lime  is  used,  which  is  much  cheaper.  After  the  mixture  has 
been  saturated  with  chlorine  it  is  boiled,  filtered,  evaporated,  and  the 
chlorate  crystallised  out.  KjCOj  +  6CaH202  +  601,  =  2KC103  +  5CaCl,  +  CaCOs 
+  6H,0. 

Solubility  and  Ebactions. — Sparingly  soluble  in  cold  water.  It  ex- 
plodes when  triturated  with  sulphur.  When  heated  it  fuses,  gives  off 
oxygen  gas,  and  leaves  a  white  residue,  which  dissolves  in  water  and  gives 
the  reactions  of  potassium  and  of  a  chloride. 

Impurities. — Chloride  and  calcium. 

Test. — Its  solution  is  not  affected  by  nitrate  of  silver  (no  chloride)  nor 
oxalate  of  ammonium  (no  calcium). 

Dose. — 10  to  30  grains. 

Officinal  Preparations. 
B.P.  and  u.s.p.  Dose. 

Trochisci  Potassii  Chloratis 5  grains  in  each  lozenge. — 1  to  6. 

Used  also  in  preparing  Potassii  Permanganas. 

Action. — Chlorate  of  potassium,  when  injected  into  the  cir- 
culation, has  not  the  same  action  as  other  salts  of  potassium. 
Small  doses  generally  at  first  depress,  and  afterwards  raise  the 
blood-pressure  and  accelerate  the  pulse.  Large  doses  cause 
sudden  stoppage  of  respiration,  and  sinking  of  the  blood-pressure 
down  to  zero,  while  the  exposed  heart  continues  to  beat  at  nearly 
its  normal  rate,  or  a  little  over  it,  for  half  or  three-quarters  of 
an  hour. 

Large  doses  administered  medicinally  have  caused  poisoning, 
especially  in  children.  The  symptoms  are  due  to  the  haemoglobin 
of  the  blood  being  converted  into  methaemoglobin  by  the  action 
of  the  chlorate.  They  consist  in  hematuria  with  blood-casts  and 
diminished  secretion  of  urine,  many  of  the  renal  tubules  being 
filled  with  plugs  of  blood.  The  skin  becomes  discoloured  or 
jaundiced,  and  death  occurs  with  coma  or  convulsions. 

Uses. — Chlorate  of  potassium  is  chiefly  used  as  a  local  appli- 


Gii  INOEGANIC   MATEBIA   MEDICA.  [sect.  in. 

cation  to  the  mouth,  to  bring  about  a  more  healthy  condition  of 
the  mucous  membrane,  and  to  cause  ulceration  present  there  to 
heal  up.  It  is  used  in  stomatitis  occurring  during  nursing,  what- 
ever it  may  depend  upon ;  in  aphthae,  in  cancrum  oris.  As  a 
gargle  it  is  used  in  follicular  pharyngitis ;  and  has  been  employed 
internally  and  as  a  local  application  in  cases  of  croup,  diphtheria, 
and  spasm  of  the  larynx.  It  may  be  used  internally  as  a  lotion 
to  relieve  the  dryness  of  the  throat  after  diphtheria  and  scarla- 
tina. "When  taken  early,  it  is  said  to  lessen  or  arrest  catarrhal 
conditions  of  the  nose,  throat,  and  larynx.  It  has  been  recom- 
mended in  chronic  mucous  diarrhoea  with  whitish  or  mucilagin- 
ous-looking stools.  It  has  also  been  used  as  an  enema  in  cases 
of  dysentery.  After  absorption  into  the  blood  it  has  been  sup- 
posed to  give  off  its  oxygen,  and  thus  to  have  a  disinfectant 
action  in  cases  of  blood-poisoning  and  malignant  fevers.  A  great 
part  of  it  is  excreted  unchanged  by  the  kidneys,  but  in  large 
doses  it  decomposes  the  blood  and  converts  it  into  methsemo- 
globin.  It  has  been  employed  in  acute  and  chronic  bronchitis, 
in  order  to  thin  the  secretion  and  promote  expectoration,  and  as 
a  diuretic  in  cases  of  dropsy.  It  was  recommended  by  the  late 
Sir  James  Simpson  in  20-grain  doses  three  times  a  day,  to 
pregnant  women  where  abortion  was  liable  to  occur  from  fatty 
degeneration  of  the  placenta. 

Potassii  Permanganas,  B.  and  U.S. P.     Permanganate  of 

Potassium.     KMn04,  B.P.     K2Mn208 ;  314,  U.S.P. 

Characters. — Dark  purple,  slender,  prismatic  crystals,  in- 
odorous, with  a  sweet  astringent  taste. 

Preparation.  —  By  heating  caustic  potash  and  manganese  dioxide 
together  in  a  crucible  with  chlorate  of  potassium  which  yields  up  its  oxygen 
to  the  manganese  and  forms  manganate  of  potassium,  3Mn02  +  6K.HO  + 
KCIO3  =t  3K2Mn04  +  KOI  +  3H20.  On  boiling  this  with  water  it  is  decom- 
posed, permanganate  being  formed,  and  manganese  dioxide  being  deposited. 
8KsMn04  +  2H20  =  K2Mn?08  +  Mn02  +  4KHO.  On  decanting  from  the  man- 
ganese dioxide,  neutralising  with  sulphuric  acid,  evaporating,  filtering 
through  asbestos,  and  evaporating  further,  the  salt  crystallises  out. 

Solubility. — It  is  entirely  soluble  in  cold  water.  A  single  small  crystal 
•suffices  to  form  with  an  ounce  of  water  a  rich  purple  solution. 

Beactions. — It  gives  off  oxygen  readily  to  organic  substances  and  is  de- 
composed, manganese  dioxide  being  precipitated,  so  that  the  solution  when 
mixed  with  a  little  rectified  spirit  and  heated,  becomes  yellowish-brown. 
The  crystals  heated  to  redness  decrepitate,  evolve  oxygen  gas,  and  leave 
a  black  residue  from  which  water  extracts  potash,  recognised  by  its  alkaline 
reaction  and  by  the  appropriate  tests. 

Pbepakatiok. 
B.P.     liquor    Fotassll    Fermangranatis    (Permanganate    of    Potassium 
4-4  grs.  in  1  fl.  oz.  of  water  or  1  per  cent,  solution). 
Condy's  fluid  is  a  solution  of  2  grains  to  the  ounce. 

Administration. — The  solution  has  a  disagreeable  taste,  and 
the  solid  permanganate  of  potassium  gives  off  oxygen  so  readily 
that,  if  mixed  with  easily  oxidisable  substances,  such  as  sugar, 


chap,  xxiv.]  METALS.  615 

syrup,  or  glycerine,  the  mixture  may  explode  or  take  fire  spon- 
taneously. Martindale  recommends  that  the  necessary  quantity 
of  permanganate  should  be  made  into  a  pill  with  kaolin  ointment 
consisting  of  equal  parts  of  vaseline,  paraffin,  and  kaolin. 

Action. — Permanganate  of  potassium  very  readily  parts. with 
its  oxygen,  and  thus  destroys  organic  matter;  when  mixed 
with  cobra  poison  it  completely  destroys  the  deadly  power  of 
the  latter,  and  the  mixture  may  be  injected  subcutaneously  with- 
out any  bad  effects.  When  injected  after  the  poison,  however, 
it  does  not  appear  to  come  into  such  immediate  contact  with  it 
in  the  tissues  as  to  destroy  it,  and  it  therefore  does  not  act  as 
an  antidote. 

Uses. — It  is  used  to  disinfect  the  stools  in  typhoid  fever,  and 
to  disinfect  the  hands  after  making  post-mortem  examination,  or 
after  coming  in  contact  with  matters  likely  to  convey  contagion 
or  infection  (p.  105).  It  is  applied  as  a  lotion  to  wounds  and 
sores,  especially  those  having  a  foul-smelling  discharge,  and  may 
be  injected  into  the  cavity  of  abscesses  after  evacuation  of  pus, 
or  used  to  wash  out  the  cavity  of  the  pleura  after  the  fluid  has 
been  removed  in  cases  of  pleurisy.  In  cases  of  ozsena  it  is  em- 
ployed to  wash  the  nose,  and  as  a  lotion  or  gargle  to  tbe  mouth 
in  ulceration  with  fcetor,  such  as  mercurial  stomatitis,  and  also 
in  diphtheria.  It  has  been  recommended  internally  in  cases  of 
diabetes.  It  is  said  by  Einger  and  Murrell  to  be  of  very  great 
use  in  amenorrhcea,  two  or  three  grains  being  given  in  pill  three 
or  four  times  a  day  for  some  days  before  the  period. 

Potassa  Sulphurata,  B.  and  U.S. P.  Sulphueated  Potash, 
B.P. ;  Sulphurated  Potassa,  U.S.P. 

Chaeactees. — Solid,  greenish  fragments,  liver-brown  when 
recently  broken,  alkaline,  and  acrid  to  the  taste. 

Solubility  and  Beactions. — It  readily  forms  with  water  a  yellow  solu- 
tion, which  has  the  odour  of  sulphuretted  hydrogen,  and  evolves  it  freely 
when  excess  of  hydrochloric  acid  is  dropped  into  it,  sulphur  being  at  the 
same  time  deposited.  The  acid  fluid  when  boiled  and  filtered  is  precipitated 
yellow  by  perchloride  of  platinum,  and  white  by  chloride  of  barium. 

Impurity. — Carbonate  left  in  the  preparation,  or  sulphate  formed  by 
decomposition. 

Test. — About  three-fourths  of  its  weight  are  dissolved  by  rectified  spirit, 
in  which  both  carbonate  and  sulphate  are  insoluble. 

Dose. — 2  to  10  grains. 

Pbepaeation. 

B.P. 

TTngnentum  Potassae  Sulpburatse  (5  parts,  hard  paraffin  18,  soft  paraffin  55). 

Action. — When  applied  to  the  skin,  the  ointment  may  be 
used  instead  of  simple  sulphur  ointment.  In  the  intestine  sul- 
phurated potash  seems  to  stimulate  peristaltic  action,  and  to  act 
as  a  laxative.    Apparently  also,  like  sulphur,  it  has  a  somewhat 


610  INOEGANIC  MATEEIA  MEDICA.  [sect.  hi. 

stimulating  action  upon  the  respiratory  mucous  membrane,  and 
upon  the  sweat-glands. 

Uses. — The  ointment  is  used  externally  in  cases  of  scabies 
and  acne.  Sulphurated  potash  is  used  as  a  bath  in  chronic 
rheumatism  (p.  470),  rheumatoid  arthritis,  and  chronic  organic 
nerve-disease,  and  as  a  diaphoretic  in  albuminuria.  It  has  been 
given  internally  in  chronic  bronchitis,  croup,  and  whooping-' 
cough,  and  used  as  an  injection  into  the  rectum  to  destroy 
ascarides,  in  solutions  of  half  a  grain  to  a  grain  in  the  ounce  of 
water. 

Potassii  Bichromas,  B.  and  U.S.  P.  Bicheomate  op 
Potassium,  K2Cr04.Cr03,  B.P.  :  K2Cr207 ;  294-8,  U.S.P. 

Characters. — In  large  red,  transparent,  four-sided  tables; 
anhydrous. 

Eeactions  and  Solubility. — It  fuses  below  redness ;  at  a  higher  tern* 
perature  is  decomposed,  yielding  green  oxide  of  chromium  and  yellow  chro- 
mate  of  potassium,  which  may  be  separated  by  dissolving  the  latter  in  water. 
The  bichromate  dissolved  in  water  gives  a  yellowish-white  precipitate  with 
chloride  of  barium,  and  a  purplish  red  precipitate  with  nitrate  of  silver,  and 
both  these  precipitates  are  soluble  in  diluted  nitric  acid.  The  solution  also 
when  digested  with  sulphuric  acid  and  rectified  spirit  acquires  an  emerald 
green  colour. 

Preparations  in  which  Bichromate  ov  Potassium  is  used. 

Acidum  Chromicum.  Sodse  Valerianas. 

Test  solution  of  Bichromate  of  Potassium,  U.S.P.    1  in  10  of  water. 

Action.— In  frogs  it  causes  general  feebleness  of  motion, 
respiration,  and  circulation,  and  sometimes  convulsions.  The 
nerve-centres  are  first  excited  and  then  depressed.  The  nerve- 
centres  are  affected  before  the  nerves  or  muscles.  The  heart 
stops  in  diastole.  In  mammals  it  causes  vomiting,  diarrhoea, 
and  bloody  stools,  great  feebleness,  and  general  clonic  movements. 
In  rabbits  and  guinea-pigs  convulsions  and  paralysis  occur, 
chiefly  affecting  the  posterior  limbs.  Post  mortem  a  red  colora- 
tion of  the  muscles  is  observed,  and  the  gastric  and  intestinal 
mucous  membranes  are  congested. 

Uses.  —It  has  been  used  by  Vulpian  alternately  with  iodide 
of  potassium  and  nitrate  of  silver  in  tabes  dorsalis  ;  and  in  doses 
of  \-l^  grain  it  is  said  to  be  useful  in  cases  of  dyspepsia  simulat- 
ing cancer  of  the  stomach. 

Potassii  Ferrocyanidum,  B.  and  U.S.P.  Feeeocyanide 
of  Potassium.     K4Fe(CN)6.8HgO ;  421-9. 

Ghaeactees. — In  large  yellow  four-sided  tablets  or  prisms, 
permanent  in  the  air. 

Solubility. — Soluble  in  water,  insoluble  in  alcohol. 

Eeactions. — The  aqueous  solution  precipitates  deep  blue  with  persulphate 
of  iron,  brick-red  with  sulphate  of  copper,  and  white  with  acetate  of  lead. 
Heated  with  diluted  sulphuric  acid,  hydrocyanic  acid  vapours  are  evolved.    . 


chap,  xxiv.]  METALS.  617 

Preparations  for  which  Ferrocyanide  of  Potassium  is  used. 
Acidum  Hydrocyauioum  Dilutum,  Potassii  Cyanidum. 

Test  solution  of  Ferrocyanide  of  Potassium.  Dissolve  J  ounce  of  ferrocyanide 
of  potassium  (yellow  prussiate  of  potash)  in  crystals  in  5  fluid  ounces  of  distilled 
water  and  filter,  B.P. ;  1  in  10  of  water,  U.S.P. 

Test  solution  of  Ferricyanide  of  Potassium.  Dissolve  £  ounce  of  ferricyanide 
of  potassium  (red  prussiate  of  potash)  in  crystals  in  5  fluid  ounces  of  distilled 
water  and  filter,  B.P. ;  1  in  10  of  water,  U.S.P. 

Potassium  Cyanidum,  B.  and  U.S.P.  Cyanide  of  Potas- 
sium.   KCN;  65. 

Characters. — White,  opaque,  deliquescent,  crystalline  masses 
having  the  odour  of  hydrocyanic  acid,  like  which  it  is  intensely 
poisonous  (p.  586). 

B.P.    Preparation  for  which  it  is  used. 
Bismuthum  Purificatum. 

Potassii  Bromidum,  B.  and  U.S.P. — Vide  p.  553. 
Potassii  Iodidum,  B.  and  U.S.P. — Vide  p.  559. 


SODIUM.     Na;  23. 

Sources  op  Sodium  Salts. — The  chief  source  of  sodium  is 
common  salt  obtained  by  the  evaporation  of  sea-water,  or  from 
salt  mines.  Two  subsidiary  sources  are  the  nitrate  of  sodium 
and  borax,  both  of  which  are  found  native. 

General  Eeactions  of  Sodium  Salts. — They  are  not  preci- 
pitated by  any  of  the  ordinary  reagents.  The  special  test  for 
them  is  the  yellow  colour  which  they  give  to  flame.  The  mere 
appearance  of  the  yellow  colour  is  the  test  adopted  by  the  British 
Pharmacopoeia,  but  it  is  improved  upon  in  the  American  Pharma- 
copoeia, which  directs  that  the  flame  should  not  appear  more 
than  transiently  red  when  observed  through  a  blue  glass.  In 
this  way  sodium  salts  are  both  more  readily  distinguished  from 
those  of  potassium,  and  the  presence  of  the  slightest  impurity  is 
easily  observed;  for  sodium  salts  are  so  widely  distributed  in 
nature,  and  the  yellow  colour  which  they  give  to  the  flame  is  so 
bright,  that  minute  quantities  of  sodium  mixed  with  potassium 
may  disguise  the  violet  colour  which  the  potassium  gives,  although 
it  should  be  present  in  much  greater  quantity  than  the  sodium. 
To  distinguish  between  potassium  salts  and  sodium  salts,  it  is 
therefore  necessary  to  look  at  the  flame  through  a  blue  glass, 
which  cuts  off  the  yellow  rays  emitted  by  the  sodium  of  the  flame, 
and  thus  allows  the  violet  ones  of  the  potassium  to  be  seen. 


618 


INOEGANIC  MATEEIA  MEDICA. 


[sect.  in. 


Preparation  of  Sodium  Salts. 


Prepared  from 

By 

Sodium  chloride 

Sea-water . 

Evaporation.    Or  found  native. 

Sodium  sulphate 

Sodium  chloride 

Heating  with  sulphuric  acid  in  the 
preparation  of  hydrochloric  acid. 

Sodium  carbonate     . 

Sodium  sulphate 

Boasting  with  calcium  carbonate 
and  coal. 

Sodium     . 

Sodium  carbonate     . 

Igniting  with  charcoal. 

Sodium  ethylate 
(Liquor) 

Dried  sodium  carbon- 
ate 

Sodium  bicarbonate  . 

Sodium     . 

Dissolving  in  ethylic  alcohol. 

Sodium  carbonate     , 

Heating. 

Ditto 

Mixing  with  dry  carbonate  and 

saturating  with  carbonic  acid. 

Caustic  soda 

Ditto 

Decomposing  by  lime. 

Sodium  acetate 

Ditto 

Neutralising  with  acetic  acid. 

Effervescent       citro- 

Ditto 

Heating  dry  carbonate  with  tar- 

tartrate 

taric  and  citric  acids. 

Tartrate  of  soda  and 

Ditto 

Neutralising  solution  with    acid 

potash    (soda    tar- 

■  tartrate  of  potassium,  evaporat- 

tarata) 

ing  and  crystallising. 

Sodium        benzoate, 

Ditto 

Neutralising  a  hot-  solution  with 

U.S.P. 

benzoic  acid  and  crystallising. 

Sodium  phosphate    . 

Ditto 

Decomposing  bone-ash  with  sul- 
phuric acid,  and  saturating  the' 
acid  phosphate  of  calcium  thus 
obtained  with  sodium  carbonate. 

Sodium      hypophos- 

Ditto 

Decomposing    hypophosphite    of 

phite 

lime  with  sodium  carbonate. 

Liquor   sodte  chlori- 

Ditto 

Passing  chlorine  through  its  solu- 

nate 

tion. 

Sodium  valerianate  . 

Ditto 

Neutralising  by  valerianic  acid. 

Sodium       salicylate, 

Ditto 

Neutralising  solution  by  salicylic 

B.  and  U.S.P. 

acid  with  slight  excess  of  acid 
and  evaporating. 

Sodium  sulphocarbo- 

Ditto 

Decomposing  by  barium  sulpho- 

late,  B.  and  U.S.P. 

carbolate.  The  barium  sulpho- 
carbolate  is  prepared  by  mixing 
equal  parts  of  carbolic  and  strong 
sulphuric  acid,  allowing  them 
to  stand  for  some  days,  diluting 
and  neutralising  with  barium 
carbonate. 

Sodium      bisulphite, 

Sodium  carbonate     . 

Saturating  its  solution  with  sul- 

-  U.S.P. 

phurous  acid. 

Sulphite,      B.      and 

Sodium  bisulphite     . 

Adding  an  equal  weight  of  sodium 

U.S.P. 

carbonate  to  the  bisulphite  pre- 
pared as  above. 

Hyposulphite,  U.S.P. 

Sulphite    .        . 

Heating  with  sulphur. 

and  B.P.,  App. 

Borax 

-— 

Found  native. 

Nitrate 

— 

Found  native. 

Arseniate  . 

Carbonate  and  nitrate 

Fusing  with  arsenious  acid. 

General  Impurities  of  Sodium  Salts. — As  sodium  carbonate 
is  prepared  from  sodium  sulphate,  and  the  latter  from  sodium 
chloride,  sulphates  and  chlorides  may  be  present  as  impurities  J 
in  it.     As  the  other  sodium  salts  are  chiefly  obtained  from  the 
carbonate,  chlorides  and  sulphates  also  come  to  be  present  as 


chap,  xxiv.]  METALS.  619 

impurities  in  them.  They  also  occur  even  in  the  nitrate  of 
sodium  found  native. 

General  Tests  for  Impurities  in  Sodium  Salts.— In  order 
to  distinguish  between  salts  of  potassium  and  sodium,  as  well  as 
to  prove  the  absence  of  potassium  as  an  impurity,  the  B.P. 
directs  that  the  solutions  of  sodium  salts,  when  acidulated, 
should  not  give  a  precipitate  with  perchloride  of  platinum.  The 
U.S.P.  directs  that  the  yellow  colour  which  sodium  salts  give  to 
the  flame  should  not  appear  more  than  transiently  red  when  seen 
through  a  blue  glass.  The  absence  of  chlorides  and  sulphates  is 
ascertained  by  the  usual  tests  (pp.  594,  595),  and  the  absence  of 
metals  by  the  want  of  any  colour  or  precipitate  on  the  addition 
of  hydrosulphuric  acid  or  ammonium  sulphide. 

General  Action  of  Sodium  Salts.  — Salts  of  sodium  diffuse 
more  slowly  than  those  of  potassium.  They  are  neither  absorbed 
nor  excreted  so  readily,  and  have  not  a  marked  diuretic  action. 
When  locally  applied  to  muscle  and  nerve  in  large  doses  they 
paralyse  both,  but  not  so  powerfully  as  salts  of  potassium,  nor 
have  they  such  a  paralysing  action  upon  the  involuntary  muscle, 
either  of  the  heart  or  the  intestine.  In  large  doses  they  lengthen 
the  muscular  curve,  and  increase  the  length  of  the  curves  pro- 
duced by  calcium  and  strontium  instead  of  shortening  them,  like 
potassium  (p.  142). 

Urate  of  sodium  is  less  soluble  than  urate  of  potassium  or 
lithium.  It  is  therefore  less  readily  excreted,  and  forms  the 
nodules  known  by  the  name  of  chalk-stones  in  gouty  patients. 

B.P.  Sodium.  Sodium.  Na;  23.  The  metallic  element 
sodium  as  met  with  in  commerce.  It  should  be  preserved  in 
well- stoppered  bottles  under  mineral  naphtha. 

Characters. — A  soft  metal,  rapidly  oxidising  in  the  air,  but 
showing  a  bright  metallic  surface  when  freshly  cut. 

Eeactions. — It  attacks  water  or  alcohol,  with  evolution  of  hydrogen  gas, 
little  or  no  insoluble  matter  remaining.  Twenty-three  grains,  cautiously 
dissolved  in  water,  require  for  neutralisation  at  least  975  grain-measures  of 
the  volumetric  solution  of  oxalic  acid. 

Preparation. 
Liquor  Sodii  Ethylatis. 

B.P.  Liquor  Sodii  Ethylatis.  Solution  of  Ethtlate  of 
Sodium. — It  contains  19  per  cent,  of  the  solid  salt,  NaC2H50. 

Characters. — A  colourless  liquid  of  syrupy  consistence,  be- 
coming brown  by  keeping.     Specific  gravity  0-867. 

Preparation.— By  dissolving  metallic  sodium  (1)  in  ethylic  alcohol  (20)  con- 
tained in  a  flask  which  is  kept  cool  in  a  stream  of  cold  water.  The  solution, 
should  be  recently  prepared. 

Eeactions. — When  heated  it  boils  and  gives  off  alcoholic  vapours,  leaving 
ft  white  salt  which,  on  being  strongly  heated,  chars.     If  the  white  salt  be 


620  INORGANIC  MATERIA  MEDICA.  [sect.  nr. 

mixed  with  water  and  heated,  it  yields  alcohol,  and  the  solution,  on  evapora- 
tion, leaves  a  white  residue  consisting  almost  wholly  of  caustic  soda. 

Action. — It  is  a  powerful  caustic. 

Use. — To  destroy  naevi.  It  should  be  applied  by  means  of 
a  glass  rod  to  the  naevus  for  two  or  three  days  successively,  and 
then  discontinued  until  the  scab  which  forms  has  become  de- 
tached, after  which  the  treatment  should  be  resumed. 

Sodii  Chloridum,  B.  and  U.S.P.  Chloride  op  Sodium. 
Common  Salt.     NaCl;  58-4. 

Characters. — In  small  white  crystalline  grains,  or  trans- 
parent cubic  crystals,  free  from  moisture.  It  has  a  purely  saline 
taste,  and  imparts  a  yellow  colour  to  flame. 

Solubility  and  Beactions. — Is  soluble  in  water.  The  solution  gives 
the  reaction  of  a  chloride  (p.  594),  and  does  not  give  that  of  potassium  but  of 
sodium  (p.  617). 

Pbepakations  in  which  Chlobide  of  Sodium  is  used. 

Acidum  Hydrochloricum.  Hydrargyri  Perchloridum. 

Hydrargyri  Subchloridum. 

Actions. — Although  chloride  of  sodium  is  not  much  used  as 
a  remedy,  it  is  most  important  as  a  food.  It  forms  a  large  pro- 
portion of  the  salts  of  the  body,  and  no  doubt  plays  a  very 
important  part  in  tissue-change.  When  persons  are  deprived  of 
it  for  a  length  of  time  the  longing  for  it  becomes  intense,  and 
animals  will  go  very  great  distances  to  obtain  it.  When  mixed 
witih  water,  in  the  proportion  of  0-65  to  ioo,  the  solution  does 
not  destroy  animal  tissues  like  water  alone,  and  may  \>e  mixed 
with  blood  without  destroying  the  corpuscles  (vide  p.  600) .  Strong 
solutions,  however,  are  intensely  irritating.  When  injected  into 
the  lymph-sac  of  a  frog  it  causes  increased  diapedesis  of  the  red 
corpuscles,  which  then  pass  out  through  the  vessels  in  consider- 
able numbers.  It  is  possible  that  an  increase  in  the  proportion 
of  sodium  chloride  may  have  something  to  do  with  the  produc- 
tion of  scurvy,  as  this  disease  appears  to  be  relieved  by  salts 
containing  another  base  than  sodium  and  another  acid  radical 
than  chlorine. 

Uses. — Externally  it  is  used  as  a  stimulant  to  the  skin  in 
the  form  of  baths  (pp.  459  and  469).  A  solution  of  salt  of  ^  to 
1  per  cent,  has  been  recommended  by  Kiihne  to  wash  wounds 
and  raw  surfaces  in  place  of  water,  as  it  does  not  destroy  the 
vitality  of  the  tissues,  and  a  similar  solution  may  be  used  instead 
of  water  to  wash  out  the  nasal  cavities,  either  alone  or  mixed 
with  other  medicaments.  When  taken  in  considerable  quan- 
tities it  produces  vomiting,  and  may  be  used  as  an  emetic, 
either  alone  or  to  aid  the  action  of  other  emetics.  Half  a  tea- 
spoonful  of  dry  salt,  repeated  until  nausea  is  produced,  is  said 
sometimes  to  arrest  haemoptysis.  It  appears  to  diminish  the 
secretion  of  mucus,  and  may  be  given  to  children  suffering  from 


chap,  xxiv.]  METALS.  621 

worms,  where  the  intestinal  mucus  is  excessive  and  affords  a 
nidus  for  the  parasites. 

A  solution  (3ss  in  ^j.  water)  flavoured  with  liquorice,  in  table- 
spoonful  doses  every  two  hours,  sometimes  proves  very  useful  in 
causing  absorption  of  pleuritic  serous  exudation.  It  is  contra- 
indicated  when  the  exudation  is  purulent. 

After  haemorrhage  there  is  generally  excessive  thirst,  and  the 
addition  of  chloride  of  sodium  to  the  water  drunk  by  the  patient 
has  been  recommended  in  order  to  prevent  destruction  of  the 
blood-corpuscles  which  might  arise  from  the  absorption  of  small 
amounts  of  pure  water.  During  convalescence  patients  some- 
times exhibit  a  desire  for  salt  and  indigestible  food,  which,  if 
given,  would  probably  derange  the  digestion,  but  the  craving 
may  be  allayed  by  giving  salt  alone.  It  has  been  used  in  bilious 
diarrhoea,  in  doses  of  10  to  60  grains,  three  or  four  times  a  day. 

As  an  enema  to  destroy  ascarides  it  is  frequently  used.  The 
proportion  generally  is  1  or  2  tablespoonfuls  to  the  pint  of  water. 

Sodii  Carbonas,  B.  and  U.S.  P.  Carbonate  of  Sodium. 
Na2CO3.10H2O ;  286. 

Obtained  from  the  ashes  of  marine  plants,  or  produced  by 
chemical  decomposition  with  chloride  of  sodium. 

Characters. — In  transparent,  colourless,  laminar  crystals,  of 
a  rhombic  shape,  efflorescent,  with  a  harsh  alkaline  taste  and 
strong  alkaline  reaction. 

Ebactions. — By  heat  it  undergoes  aqueous  fusion,  and  then  dries  up, 
losing  63  per  cent,  of  its  weight. 

20  grains  1        ,     ,.     f  9*7  grains  Citric  Acid. 

Carbonate  of  Sodium!  llOJ grains  Tartaric  Acid. 

Dose. — 5  to  30  giains. 

Pkepabations. 

B.P.  DOSS. 

Sodii  Carbonas  Exsiccata.     Dried  carbonate  of  sodium  (used  for 

pills)  3-10  grs. 

Uses. — It  is  not  much  used  as  a  remedy.  Its  chief  use  is 
in  the  preparation  of  other  sodium  salts.  A  dilute  solution  of  it 
may  be  used  as  a  wash  to  the.  skin  to  remove  itching.  In  cases 
of  anaemia  it  may  be  combined  with  ferri  sulphas  exsiccata, 
4  grains  of  each,  in  pill. 

Soda  Caustica,  B.P.  ;  Soda,  U.S.P.  Caustic  Soda,  B.P. ; 
Soda,  U.S.P. — Hydrate  of  sodium,  NaHO,  40,  with  some  im- 
purities. 

Characters. — Hard,  greyish-white  pencils  or  fibrous  pieces, 
deliquescent  in  moist  air,  dry  and  efflorescent  in  dry  air,  very 
alkaline  and  corrosive. 

Eeactions  and  Tests. — It  gives  the  tests  of  sodium  (p.  617),  and  not  of 
potassium.    Its  solution  in  water,  acidulated  by  nitric  acid,  effervesces  only 


622  INOEGANIC  MATEEIA  MEDICA.  [sect.  in. 

slightly  (limit  of  carbonate)  and  gives  only  scanty  white  precipitates  with 
nitrate  of  silver  and  chloride  of  barium  (limit  of  chlorides  and  sulphates). 
Impurities. — Carbonate,  chlorides,  sulphates. 

Preparation  containing  Caustic  Soda. 
liquor  Sodse 188  grains  in  1  fluid  ounce. 

Use. — It  is  used  as  caustic  like  potash,  but  has  less  affinity 
for  water,  and  so  does  not  take  it  from  the  tissues  and  destroy 
them  so  powerfully.  At  the  same  time  it  has  less  tendency  to 
run  over  adjacent  parts. 

Liquor  Sodje,  B.  and  U.S.P.  Solution  op  Soda.— An 
aqueous  solution  of  hydrate  of  sodium  (NaHO ;  40)  containing 
about  3  per  cent,  of  the  hydrate,  U.S.P.  (4-1  per  cent.  B.P.). 

Characters. — Like  those  of  liquor  potassse  (p.  607),  but  it  is 
not  precipitated  by  tartaric  acid  nor  by  perchloride  of  platinum. 

Uses. — Is  used  in  preparing  ferric  oxide  and  in  other  phar- 
maceutical processes,  as  it  is  cheaper  than  solution  of  potash. 
Internally  it  may  act  on  the  blood,  rendering  it  and  the  secretions 
more  alkaline,  but  it  will  not  alter  nutrition  in  the  way  that 
potassium  salts  do. 

Sodii  Bicarbonas,  B.  and  U.S.P-  Bicarbonate  op  Sodium, 
NaHCC-3 ;  84. 

Characters. — In  powder,  or  small  opaque  irregular  scales, 
white,  of  a  saline  and  not  unpleasant  taste. 

Eeactions. — It  gives  the  reactions  showing  the  presence  of  sodium,  and 
of  carbonic  acid.  It  is  distinguished  from  carbonate  by  its  solution  in  cold 
water  giving  a  white  and  not  a  coloured  precipitate  with  solution  of  per- 
chloride of  mercury. 

20  grains  of  Bi-     I        ,     ,.     [16-7  grains  of  Citric  Acid,  or 
carbonate  of  Sodium)  ll7"8  grains  of  Tartaric  Acid. 

Dose. — 10  to  60  grains. 

Preparations  containing  Bicarbonate  or  Sodium. 

8.P.  DOSE. 

liquor  Soda?  Effervescens  (soda-water)... 30  grains  in  1  pint £-1  pint. 

Sodii  Cltro-tartras  Effervescens 17  parts  in  31 6  grs.  to  j-oz. 

Trocnisci  Sodii  Biearbonatis 5  grs. in  each  lozenge...  1  to  6. 

U.S.P. 

Sodii  Bicarbonas  Venalis  (for  external  use). 

Mistura  Bhei  et  Sodse     2  dr.  to  3  oz. 

Pulvis  Effervescens  Compositus   one  or  two  powders. 

U.S.P.  Sodii  Bicarbonas  Venalis.  Commercial  Bicarbonate  op  Sodium.—  Should 
contain  95  per  cent,  of  pure  bicarbonate,  which  it  resembles  in  appearance  and  tests. 

U.S.P.  Mistura  Bhei  et  Soda.  Mixture  op  Bhubarb  and  Soda. — Bicarbonate  of 
sodium  3,  fluid  extract  of  rhubarb  3,  spirit  of  peppermint  3,  water  q.s.  to  make  100. 

U.S.P.  Pulvis  Effervescens  Compositus.  Compound  Effervescing  Powder.— 
Bicarbonate  of  sodium  8,  tartrate  of  potassium  and  sodium  24,  mixed  to  make  a 
powder  of  160  grains ;  tartaric  acid,  in  separate  powder,  35  grains. 

Uses. — Bicarbonate  of  sodium  has   a   slight  local  irritant 


chap,  xxiv.]  METALS.  623 

action.  It  may  be  used  as  a  wash  in  cases  of  itching  skin- 
diseases,  e.g.  prurigo,  and  as  a  lotion  to  eczema.  The  strength 
is  2  grains  to  the  ounce,  and  it  is  applied  like  water-dressing. 

A  solution  of  this  strength  when  used  to  rinse  the  mouth 
sometimes  relieves  the  pain  of  toothache,  and  also  relieves 
headache,  either  temporal  or  occipital,  depending  on  decayed 
teeth,  even  though  no  pain  should  be  felt  in  the  tooth  itself. 

It  may  also  be  used  to  prevent  injury  to  the  teeth  from  acid 
tonics. 

Mixed  with  tincture  of  opium,  and  introduced  into  the  cavity 
of  a  decayed  tooth  by  means  of  a  pledget  of  cotton- wool,  it  will 
often  arrest  the  pain  of  toothache.  When  swallowed  it  stimu- 
lates the  secretion  of  gastric  juice,  and  is  a  most  efficient  remedy 
when  given  from  ten  minutes  to  half  an  hour  before  meals,  in 
cases  of  atonic  dyspepsia,  where  the  patient  complains  of  weight 
or  pain  at  the  pit  of  the  stomach,  pain  between  the  scapulae,  and 
much  flatulence  unaccompanied  by  constipation.  In  such  cases 
it  is  often  advantageous  to  combine  it  with  a  bitter  tonic  and 
some  carminative.  As  dyspepsia  often  occurs  in  persons  engaged 
in  business  who  cannot  carry  mixtures  about  with  them,  the 
lozenges  (B.P.)  are  very  useful,  for  they  can  be  easily  carried 
about  and  taken  when  necessary. 

It  also  relieves  frontal  headache,  unaccompanied  by  constipa- 
tion, where  the  headache  is  situated  just  at  the  junction  of  the 
forehead  with  the  hairy  scalp.  Frontal  headache,  lower  down, 
just  above  the  eyebrows,  is  better  treated  by  nitro-hydrochloric 
acid  (p.  576) .  In  persons  who  suffer  from  great  acidity  after  meals, 
it  may  be  used  as  an  antacid.  A  solution  of  ^  or  1  grain  to  the 
ounce  of  water  or  milk  is  exceedingly  useful  in  the  diarrhoea  and 
marasmus  of  infants. 

It  is  also  serviceable  in  cases  of  diabetes,  to  lessen  the  amount 
of  sugar.  It  renders  the  bronchial  secretion  less  tenacious,  but 
is  not  so  useful  as  bicarbonate  of  potassium.  The  lozenges  are 
very  convenient  in  such  cases. 

It  seems  to  have  less  tendency  than  potash  to  produce 
catarrh  of  the  stomach,  and  may  be  used  for  a  longer  time 
(p.  606). 

As  sodium  naturally  exists  in  large  quantity  in  the  blood,  the 
amount  we  can  add  is  but  a  small  fraction  of  that  quantity,  and 
its  alterative  action  is  very  slight.  It  will  increase  the  alkalinity 
of  the  blood,  and  has  been  given  instead  of  bicarbonate  of  potas- 
sium in  acute  rheumatism,  but.  it  is  perhaps  not  so  good.  The 
urate  of  sodium  is  not  so  soluble  as  that  of  potassium,  so  sodium 
is  not  so  good  in  the  uric  acid  diathesis  (Garrod),  and  its  diuretic 
power  is  also  less. 

B.P.    Sodii   Citro-Tartras    Effervescens.      Effervescent 

ClTRO-TAKTKATE    OF    SODIUM. 


624  INOEGANIO  MATERIA  MEDICA.  [sect.  in. 

Characters.— A  granular  powder  which  effervesces  on  the 
addition  of  water. 

Dose. — 60  grains  to  J-ounce. 

Use. — If  absorbed  there  may  be  some  slight  difference  be- 
tween the  effect  of  this  salt  and  of  tartarated  soda,  which  contains 
some  potash,  but  this  is  very  slight,  and  of  no  importance.  It 
is  used  only  for  its  laxative  effect.  It  is  both  pleasanter  to  take 
than  tartarated  soda,  and  it  is  less  likely  to  cause  unpleasant 
feelings  in  the  stomach. 

Soda  Tartarata,  B.P.  ;  Potassii  et  Sodii  Tartras,  U.S.P. 

Tartarated  Soda,  B.P. ;    Tartrate  of  Potassium  and  Sodium, 
U.S.P.     Eochelle  Salt.     NaKC4H406.4H20 ;  282. 

Characters. — In  colourless,  transparent  prisms  or  halves  of 
prisms,  of  the  right  rhombic  order,  generally  eight-sided ;  tasting 
like  common  salt. 

Impurity. — Bitartrate  of  potassium. 

Test. — Entirely  soluble  in  cold  water. 

Eeaotions. — Heated  with  sulphuric  acid  it  blackens,  evolving  inflammable 
gases  and  the  odour  of  burnt  sugar  (tartrate).  It  imparts  a  yellow  colour  to 
flame  (sodium).  A  strong  solution  givas  a  crystalline  precipitate  with  a  small 
quantity  of  acetic  acid  (potassium). 

Dose.— As  a  purgative,  i  to  ^  ounce ;  as  a  diuretic,  30  to  60 
grains. 

Uses. — In  large  doses  it  retains  water,  quickens  peristalsis, 
acts  as  a  purgative,  and  is  chiefly  used  as  such.  In  small  doses 
it  is  absorbed  from  the  intestines,  is  converted  in  the  blood  into 
carbonate  of  potassium  and  sodium,  causes  diuresis  and  renderE 
the  urine  alkaline.     It  may  be  used  as  a  remote  antacid. 

Sodii  Acetas,  B.P.  Appendix,  and  U.S.P.  Acetate  of 
Sodium,  U.S.P.     NaC2H30?.3H20 ;  136. 

Uses. — In  testing  and  in  preparing  acetic  ether. 

Borax,  B.P. ;  Sodii  Boras,  U.S.P.  Borax,  B.P. ;  Borate 
of  Sodium,  U.S.P.     Biborate  op  Sodium.     NaaB4O7.10H2O ;  382. 

A  native  salt.  It  is  also  made  artificially  by  boiling  together, 
in  proper  proportions,  boric  acid  and  carbonate  of  sodium. 

Characters.— In  transparent,  colourless  crystals,  sometimes 
slightly  effloresced,  with  a  weak  alkaline  reaction. 

Solubility. — Insoluble  in  rectified  spirit,  soluble  in  water. 

Reactions. — A  hot  saturated  solution,  when  acidulated  with  any  of  the 
mineral  acids,  lets  fall,  as  it  cools,  a  scaly  crystalline  deposit  (boric  acid),  the 
solution  of  which  in  spirit  burns  with  a  green  flame. 

Dose. — 5  to  40  grains. 

Preparations. 
B.P. 

tMycerlnum  Boracis 1  part  in  6  by  weight  (  =  1  oz.  in  i  fluid  oz.  glycerine). 

Mel  Boracis 56  grains  in  1  oz. 

Used  also  to  prepare  boric  acid. 


chap.  xxiv.J  METALS.  625 

Uses. — Borax  destroys  low  vegetable  organisms  and  prevents 
their  germination.  It  thus  acts  as  a  disinfectant.  Applied  to  the 
skin  it  removes  the  epidermis,  and  may  be  used  for  this  purpose 
instead  of  soap.  It  is  used  as  a  lotion  in  acne.  It  forms  a  useful 
wash  to  remove  scurf  from  the  head,  cbloasma  or  liver  spots, 
and  to  allay  itching  in  urticaria,  psoriasis,  impetigo,  and  pruritus 
pudendi,  scroti,  and  ani ;  it  is  also  used  in  acute  eczema  in  a 
solution  of  1  per  cent,  with  1  per  cent,  of  acetate  of  alum.  In 
intertrigo  it  may  be  dusted  on  in  a  mixture  with  5  per  cent,  of 
oxide  of  bismuth  and  starch.  It  is  much  employed  in  aphthous 
conditions  of  the  mouth  and  throat,  either  alone  or  combined 
with  chlorate  of  potassium.  It  may  be  given  simply  in  solution, 
or  in  the  form  of  the  honey  or  glycerine.  As  an  injection  it  is 
useful  in  leucorrhcea  and  gonorrhoea. 

It  has  been  supposed  to  have  a  special  action  upon  the  uterus, 
and  has  been  employed  in  amenorrhcea,  dysmenorrhcea,  and  puer- 
peral fever  and  convulsions.  On  account  of  its  asserted  power 
to  increase  the  uterine  contraction,  it  ought  either  to  be  avoided 
or  employed  with  care  during  pregnancy.  Borax  is  useful  in  some 
cases  of  epilepsy  in  doses  of  10  to  15  grains  three  times  a  day. 
It  acts  as  a  solvent  to  benzoic  acid. 

Sodii  Sulphas,  B.  and  U.S.  P.  Sulphate  op  Sodium, 
Glaubeb's  Salt.    Na2SO4.10H2O ;  322. 

Chaeactees. — In  transparent,  oblique  prisms.  It  has  a  salt 
and  bitter  taste  and  effloresces  on  exposure  to  the  air. 

Solubility. — It  is  soluble  in  water,  insoluble  in  spirit. 

Ebactions. — It  gives  the  reactions  of  sodium  (p.  617)  and  of  a  sulphate 
(p.  595). 

Peepakation,  B.P. — May  be  obtained  from  the  residue  left  in  the  manu- 
facture of  hydrochloric  acid,  by  neutralising  it  with  carbonate  of  sodium,  and 
crystallising  from  solution  in  water. 

Dose. — \  to  1  ounce. 

Uses. — Sulphate  of  sodium,  when  introduced  into  the 
stomach,  is  supposed  to  excite  peristaltic  movements  in  it,  and 
to  have  a  similar  action  upon  the  intestine.  It  produces  in  the 
intestine  a  secretion  of  watery  fluid,  and  acts  as  a  purgative.  It 
is  used  either  alone,  or  mixed  with  bicarbonate  of  sodium,  in 
ulcer  of  the  stomach,  chronic  gastritis,  and  dilatation  of  the 
stomach.  A  mixture  of  sulphate  and  bicarbonate  of  sodium  has 
been  used  in  imitation  of  the  Carlsbad  salts  obtained  by  evapora- 
tion of  the  natural  mineral  water  of  Carlsbad.  The  mixture,  or 
the  natural  salts,  ought  to  be  taken  dissolved  in  warm  water 
immediately  after  rising,  and  it  is  better  to  sip  the  solution  at 
intervals,  while  dressing,  than  to  drink  the  whole  off  at  a  draught 
(p.  406).  One-third  of  a  teaspoonful  of  the  crystallised  salts  in 
a  large  tumblerful  of  warm  water,  taken  immediately  on  rising, 
is  frequently  sufficient  to  produce  one  free  action  of  the  bowels 
after  breakfast,  and  no  more.     This  quantity  of  salts,  with  a 

s  s 


626  INOEGANIC  MATEEIA  MEDIC  A.  [sect.  in. 

smaller  quantity  of  water,  may  have  no  action  ;  and  if  a  smaller 
quantity  of  water  be  used  along  with  a  larger  quantity  of  salts 
it  not  unfrequently  happens  that  several  scanty  motions  occur 
during  the  day,  with  considerable  discomfort  in  the  abdomen. 

Carlsbad  water,  natural  or  artificial,  is  also  useful  in  bilious 
disorders,  and  in  persons  of  a  gouty  diathesis.  A  gentle  course 
will  often  remove  the  dulness,  irritability,  and  other  symptoms 
which  accompany  biliary  derangements  or  precede  a  gouty  attack. 
It  may  be  used,  also,  with  advantage  in  chronic  constipation  and 
tendency  to  congestion  of  the  brain  or  of  the  abdominal  and  pelvic 
organs.  A  continued  course  of  the  water  is  exceedingly  bene- 
ficial in  cases  of  excessive  obesity,  and  also  in  diabetes  mellitus. 

The  Carlsbad  waters  contain  a  number  of  other  salts  which 
are  not  crystallised  out,  and  they  often  prove  much  more  efficient 
when  drunk  at  the  springs  than  when  the  solution  of  the  salts  is 
taken  by  patients  at  their  own  homes.  The  great  benefit  which 
is  often  obtained  from  a  course  of  the  waters  at  Carlsbad  is  no 
doubt  due  in  great  measure  to  the  diet  and  regimen  which 
patients  will  "follow  there  in  company  with  others,  but  which 
•nothing  would  induce  them  to  conform  to  while  at  home. 

Sodii  Sulpho-carbolas,  B.  and  U.S.P.  Sulpho-Carbolate 
of  Sodium.     NaC6H6S04.2H20. 

•Characters. — Colourless,  transparent,  rhombic  prisms,  in- 
odorous, or  nearly  so,,  with  a  cooling,  saline,  and  somewhat  bitter 
'taste. 

Solubility. — Eeadily  soluble  in  water,  less  so  in  spirit. 

Eeactions. — On  ignition  it  gives  off  vapours  of  carbolic  acid,  and  the  resi- 
due dissolved  in  water  gives  a  precipitate  with  chloride  of  barium  (sulphate). 
It  gives  a  yellow  colour  to  flame.  The  watery  solution  is  neutral  to  test- 
paper,  and  gives  a  violet  colour  with  perehloride  of  iron.  It  is  not  at  once 
rendered  turbid  by  chloride  of  barium. 

Dose. — 10-15  grains. 

Action. — Antiseptic  and  mildly  astringent. 

■■Uses. — It  arrests  fermentation  in  the  stomach,  and  when 
given  before  meals  is  useful  in  flatulence  and  acidity  occurring  in 
phthisical  patients.  It  may  be  combined  with  bitters.  It  is  used 
in  septic  conditions. 

Sodii  Phosphas,  B.  and  U.S.P.  Phosphate  of  Sodium. 
Na2HP04.12H20 ;  358. 

Characters. — In  transparent,  colourless,  rhombic  prisms, 
terminated  by  four  converging  planes,  efflorescent,  tasting  like 
common  salt.     It  imparts  a  yellow  colour  to  flame. 

Eeactions. — Its  solution  has  a  faintly  alkaline  reaction ;  it  gives  a  yellow 
precipitate  with  nitrate  of  silver,  the  resulting  fluid  acquiring  an  acid  reaction  ": 
(phosphate). 

Dose.— As  a  purgative,  £  to  1  ounce.  As  an  alterative,  20  to 
40  grains. 


chap,  xxiv.]  METALS.  627 

Uses. — It  is  used  as  a  purgative  in  children  and  in  delicate 
persons,  both  because  it  acts  gently  and  has  little  or  no  taste.  It 
may  be  easily  given  to  children  in  a  little  soup  without  their 
knowing  it. 

It  has  been  used  in  fevers  as  a  purgative,  and  in  rickets  in 
order  to  supply  phosphoric  acid  to  the  bones.  It  has  been  found 
especially  useful  in  children  with  hepatic  derangement,  as  shown 
either  by  white  or  green  stools,  or  by  jaundice.  The  dose  for 
them  is  3  to  10  grains  given  in  food  or  milk. 

U.S.P.  Sodii  Chloras.  Chlorate  of  Sodium.  NaC103;  106-4. 

Characters. — Colourless,  transparent  tetrahedrons  of  the 
regular  system;  permanent  in  dry  air,  odourless,  having  a 
cooling  saline  taste  and  a  neutral  reaction. 

Solubility. — Soluble  in  l'l  parts  of  water,  and  in  40  parts  alcohol  at 
15°  C.  (59°  F.) ;  in  0-5  parts  of  boiling  water,  and  in  43  parts  of  boiling 
alcohol. 

Eeactions. — When  heated  the  salt  melts,  and  afterwards  gives  off  a  por- 
tion of  its  oxygen,  finally  leaving  a  residue  of  sodium  chloride  which  gives 
the  reactions  peculiar  to  it  (p.  620). 

Uses. — Similar  to  those  of  chlorate  of  potassium  (vide  p.  613). 
As  it  is  more  soluble,  stronger  solutions  can  be  employed. 

Sodii  Hypophosphis,  B.  and  U.S.P.  Hypophosphite  of 
Sodium.     NaH2P02.H20 ;  106. 

Charactees. — Small,  colourless  or  white  rectangular  plates, 
or  a  white  granular  powder,  deliquescent  on  exposure  to  air, 
odourless,  having  a  sweetish  saline  taste  and  a  neutral  reaction. 

Solubility. — Soluble  in  1  part  of  water  and  in  30  parts  of  alcohol  at  15°  C. 
(59°  F.) ;  in  0-12  parts  of  boiling  water,  and  in  1  part  of  boiling  alcohol. 

Eeactions. — When  heated  in  a  dry  test-tube  the  salt  loses  water,  and  then 
evolves  a  spontaneously  inflammable  gas  (phosphoretted  hydrogen),  burning 
with  a  bright  yellow  flame.  A  fragment«of  the  salt  imparts  to  a  non-luminous 
flame  an  intense  yellow  colour,  not  appearing  more  than  transiently  red  when 
observed  through  a  blue  glass.  On  triturating  or  heating  the  salt  with  an 
oxidising  agent  the  mixture  will  explode. 

Dose.— 1  to  10  grains  (5  to  10  grs.  B.P.). 

Pbepabation. 

U.S.P. 

Syrupus  Hypophosphitum. 

Uses. — It  is  said  to  have  a  stimulating  action  upon  the 
nervous  system,  and  to  increase  digestion  and  nutrition.  It  is 
chiefly  given  in  the  earlier  stages  of  phthisis  (vide  p.  717),  and 
in  anaemia  and  nervous  debility. 

U.S.P.  Liquor  Sodii  Silicatis. 

Characters. — An  almost  colourless,  slightly  yellow,  viscid 
liquid,  with  a  sharp  saline  taste  and  an  alkaline  reaction. 

s  s  2 


628  INOEGANIC  MATEEIA  MEDICA.  [sect.  nr. 

Reactions. — It  imparts  an  intense  yellow  colour  to  a  non-luminous  flame. 
A  small  quantity  should  not  produce  any  caustic  effect  on  the  skin  (showing 
the  absence  of  excess  of  alkali). 

Use. — It  is  used  for  making  bandages,  which  are  thus  ren- 
dered lighter  than  plaster-of-paris,  and  stronger  than  starch, 
bandages. 

U.S.P.  Sodii  Benzoas.  Benzoate  of  Sodium.  NaC7H50„. 
H20;  162. 

Characters. — A  white,  semi- crystalline,  or  amorphous  powder, 
efflorescent  on  exposure  to  air,  odourless,  or  having  a  faint  odour 
of  benzoin,  of  a  sweetly  astringent  taste,  free  from  bitterness, 
and  having  a  neutral  reaction. 

Tests. — When  heated  the  salt  melts,  emits  vapours  having  the  odour  of 
benzoic  acid,  then  chars,  and  finally  leaves  a  blackened  residue  of  an  alkaline 
reaction  and  exhibiting  the  reactions  of  sodium  (p.  617).  On  mixing  an 
aqueous  solution  of  the  salt  with  a  dilute  solution  of  ferric  sulphate  a  flesh- 
coloured  precipitate  is  produced. 

Dose. — 10  to  20  grains. 

Uses. — It  has  been  strongly  recommended  as  a  remedy  in 
phthisis,  and  has  also  been  used  in  puerperal  fever  and  to  elimi- 
nate uric  acid  in  gout. 

Sodii  Iodidum. — Vide  p.  563. 
Sodii  Bromidum. — Vide  p.  555. 

U.S.P.  Sodii  Pyrophosphas.  Pyrophosphate  op  Sodium. 
Na,P2O7.10H2O ;  446. 

Characters.—  Colourless,  translucent,  monoclinic  prisms,  per- 
manent in  the  air,  odourless,  having  a  cooling,  saline,  and  feebly 
alkaline  taste,  and  a  slightly  alkaline  reaction. 

Solubility. — Soluble  in  12  parts  of  water  at  15°  C.  (59°  F.)  and  in  1*1 
parts  boiling  water ;  insoluble  in  alcehol. 

Eeactions. — Its  aqueous  solution  with  excess  of  test-solution  of  nitrate  of 
silver  gives  a  white  precipitate  and  a  neutral  filtrate. 

Action. — Its  actions  in  medicinal  doses  appear  to  be  nearly 
the  same  as  those  of  the  phosphate,  but  probably  it  would  have 
a  greater  influence  on  the  nervous  system. 

Uses. — To  prepare  the  pyrophosphate  of  iron. 

Sodii  Salicylas,  B.  and  U.S.P.  Salicylate  op  Sodium. 
2NaC7H503.H20 ;  338. 

Characters. — Small,  white,  crystalline  plates,  or  a  crystal- 
line powder,  permanent  in  the  air,  odourless,  having  a  sweetish 
saline  and  mildly  alkaline  taste  and  a  feebly  acid  reaction. 

Solubility.— Soluble  in  1-5  parts  of  water  and  in  6  parts  of  alcohol  at 
15°  C.  (59°  F.)  ;*  very  soluble  in  boiling  water  and  in  boiling  alcohol. 

Reactions. — When  heated  the  salt  gives  off  inflammable  vapour  and 
leaves  an  alkaline  residue  amounting  to  between  30  and  31  per  cent,  of  the 
original  weight,  and  which  gives  the  reactions  of  sodium  carbonate. 


chap,  xxiv.]  METALS.  629 

Dose. — In  rheumatism  with  high  temperature  10  to  20  grains 
every  two  to  four  hours.  The  addition  of  some  aromatic  spirit 
of  ammonia,  or  alcohol  in  some  form,  tends  to  lessen  the  cardiac 
depression  which  the  salicylate  alone  may  cause. 

Action  and  Uses. — It  agrees  in  its  action  with  salicylic  acid, 
excepting  that  it  has  no  power  to  destroy  low  organisms.  In 
febrile  conditions,  and  especially  in  acute  rheumatism,  it  greatly 
lowers  the  temperature  and  lessens  the  pain.  Its  use  should  be 
continued  for  some  time  after  apparent  convalescence,  as  the 
temperature  is  apt  to  rise  again  when  the  administration  of  the 
remedy  ceases.  It  often  gives  relief  in  tonsillitis.  In  small  doses 
it  is  useful  in  chronic  rheumatism.  In  doses  of  ^  to  2^-  grains 
every  quarter  or  half  hour  it  will  often  cut  short  headaches.  The 
symptoms  of  its  physiological  action  are  the  same  as  those  of 
salicylic  acid  (see  p.  819) — ringing  in  the  ears,  &c.  (pp.  228  and 
229).  These  symptoms  may  be  lessened,  by  ergot,  hydrobromic 
acid,  or  bromides.  It  renders  the  bile  more  watery,  and  so  may 
be  used  to  prevent  gall-stones;  it  is  sometimes  very  useful  in 
diabetes. 

U.S.  P.  Sodii  Santoninas.  Santoninate  of  Sodium.  2NaCl5 
H1904.7H2O;  698. 

Preparation.  dose. 

TrocMsci  Sodii  Santoninatis 1  grain  in  each,  1-5  lozenges 

Characters. — Colourless,  transparent,  tabular,  rhombic  crys- 
tals, slowly  coloured  yellow  by  exposure  to  light,  slightly  efflo- 
rescent in  dry  air,  odourless,  having  a  mildly  saline  and  Bomewhat 
bitter  taste,  and  a  slightly  alkaline  reaction. 

Reactions. — The  aqueous  solution,  on  the  addition  of  hydrochloric  acid, 
deposits  a  crystalline  precipitate,  which  is  soluble  in  chloroform,  and  which 
yields,  with  alcoholic  solution  of  potassa,  a  scarlet-red  liquid  gradually 
becoming  colourless. 

Dose. — 8  to  10  grains. 

Uses. — This  substance  has  been  introduced  into  the  U.S.P. 
as  an  anthelmintic. 

Sodii  Sulphis,  B.  and  U.S.P.  Sulphite  of  Sodium. 
Na2S03.7H20;  252. 

Characters. — Colourless,  transparent,  monoclinic  prisms, 
efflorescent  in  dry  air,  odourless,  having  a  cooling  saline  and 
sulphurous  taste. 

Reactions  oe  Sodium  Sulphite,  Bisulphite,  and  Hyposulphite. — They 
all  evolve  sulphurous  acid  vapours,  recognised  by  their  giving  the  smell  of 
burning  sulphur  on  the  addition  of  hydrochloric  acid  to  an  aqueous  solution. 
The  hyposulphite  is  distinguished  from  the  sulphites  by  the  acid  causing 
sulphur  to  be  deposited  from  the  solution,  and  thus  rendering  it  turbid,  whilst 
solutions  of  the  sulphites  remain  clear.  The  sulphites  are  distinguished 
from  each  other  by  the  bisulphite  having  an  acid  and  the  sulphite  a  neutral 
or  feebly  alkaline  reaction. 

Dose. — 5  to  20  grains,  or  even  up  to  1  drachm  (3-9  gm.). 


630  INOBGANIC  MATEEIA  MEDICA.  .  [sect,  in; 

Uses. — A  solution  of  1  part  in  8  of  water  is  used  in  cases  of 
aphthae  in  the  mouth ;  it  has  been  given  also  to  destroy  sarcinaa 
and  torulae  in  cases  of  yeasty  vomiting  (vide  Sulphurous  Acid; 
p.  572).  In  some  cases  of  boils  the  sulphite  and  hyposulphite  in 
15  to  20  grain  doses  every  2  or  3  hours  are  said  to  have  effected 
a  cure. 

U.S.P- Sodii  Bisulphis.  Bisulphite  of  Sodium.  NaHS03; 
104. 

Characters. — Opaque,  prismatic  crystals,  or  a  crystalline  or 
granular  powder,  slowly  oxidised,  and  losing  sulphurous  acid  on 
exposure  to  air,  having  a  faint  sulphurous  odour,  and  a  disagree- 
able sulphurous  taste. 

Dose. — 15  to  60  grains. 

Uses. — The  same  as  those  of  the  sulphite. 

U.S.P.  and  Appendix  B. P.  Sodii  Hyposulphis.  Hyposul- 
phite of  Sodium.     Na2S203.5H20 ;  248. 

Characters. — Large,  colourless  transparent  prisms  or  plates ; 
no  smell ;  cooling,  rather  bitter  taste. 

Use. — It  is  an  antiseptic  and  deodoriser  like  the  sulphites. 
Chiefly  used  as  a  reagent  to  estimate  iodine  (vide  p.  556). 

B.P.  Sodii  Valerianas.   Valerianate  of  Sodium.   NaC6H902. 

Characters. — In  dry  white  masses,  without  alkaline  reaction, 
entirely  soluble  in  rectified  spirit,  and  giving  out  a  powerful 
odour  of  valerian  on  the  addition  of  dilute  sulphuric  acid. 

Preparation. — By  distilling  amylio  alcohol  with  a  mixture  of  dilute 
sulphuric  acid  and  an  aqueous  solution  of  bichromate  of  potassium: 
2K2Cr207  +  8H,S04  =  2(Cr2(S04)3)  +  2K2S04  +  8H50  +  30a ;  and  C^HO  +  Oa 
=  HC5H902  +  H20.  The  valerianic  acid  thus  obtained  is  saturated  with  a 
solution  of  soda  and  dried :  HC6H902  +  NaHO  =  NaC5H902  +  H30. 

Dose. — |  to  5  grains. 

Preparation  in  which  Valerianate  op  Sodium  is  used. 
Zinci  Valerianas. 

Use.— As  an  antispasmodic  in  hysteria.  It  is  chiefly  used 
for  making  the  zinc  salt. 


LITHIUM.     Li;  7. 

Sources  of  Lithium.— Native  silicates  and  phosphates  of 
lithium  and  other  metals. 

Eeaction. — It  is  recognised  by  the  red  colour  which  it  gives  to 
flame.  This  appears  to  be  more  brilliant  when  the  salt  is  first 
converted  into  chloride  by  addition  of  hydrochloric  acid. 

General  Impurities  of  Lithium.— Alkalis,  alkaline  salts,  and 
metals. 


CHAP.  XXIV.] 


METALS. 


631 


Preparation  of  Lithium  Salts. 


Lithium  Salt 

Is  prepared  from 

By 

Carbonate,     B.     and 

TJ.S.P. 
Citrate,  B.  and  TJ.S.P. 
Benzoate,  TJ.S.P. 

Salicylate,  TJ.S.P.      . 

Bromide,  TJ.S.P. 

Lithium  chloride  ob- 
tained from  minerals 
Lithium  carbonate    . 
Ditto 

Ditto 

Ditto 

Precipitating  with  carbonate  of 
ammonium. 

Dissolving  in  citric  acid. 

Neutralising  in  hot  solution  with 
benzoic  acid,  filtering,  and  evapo- 
ratingto dryness,  or  crystallising. 

Neutralising  hot  solution  with 
salicylic  acid,  filtering,  and  eva- 
porating. 

Neutralising  with  sulphuric  acid, 
and  decomposing  the  sulphate 
thus  obtained  by  bromide  of 
potassium. 

Tests. — The  alkalis  are  detected  by  igniting  the  lithium  salt  and  convert- 
ing the  carbonates  -which  remain  (when  the  acid  has  been  an  organic  one,  as 
citric  or  salicylic)  into  chloride  by  the  addition  of  hydrochloric  acid.  On 
evaporating  the  filtered  solution  to  dryness,  1  part  of  the  residue  should  be 
completely  soluble  in  3  parts  of  alcohol,  and  should  give  no  precipitate  on  the 
addition  of  an  equal  volume  of  stronger  ether,  TJ.S.P.  (Alkaline  salts,  if 
present,  would  give  a  precipitate.)  A  solution  in  water  of  another  portion  of 
the  residue  should  give  no  precipitate  with  a  solution  of  oxalate  of  ammonium 
(absence  of  alkaline  earths),  and  no  precipitate  or  colour  with  hydrosulphurie 
acid  or  ammonium  sulphide  (absence  of  metals,  TJ.S.P.). 

General  Action  .of  Lithium  Salts. — The  action  of  lithium 
upon  muscle,  nerves,  and  nerve-centres  is  very  much  like  that  of 
potassium  (vide  p.  605),  but  is  more  powerful. 

Lithii  Carbonas,  B.  and  U.S. P.  Carbonate  of  Lithium. 
Li2C03 ;  74. 

Characters. — In  white  powder  or  in  minute  crystalline  grains, 
alkaline  in  reaction. 

■  Solubility. — It  is  soluble  in  100  parts  of  cold  water,  insoluble  in  alcohol. 

Reactions. — It  dissolves  with  effervescence  in  hydrochloric  acid ;  and  the 

solution  evaporated  to  dryness  leaves  a  residue  of  chloride  of  lithium,  which 

communicates  a  red  colour  to  the  flame  of  a  spirit-lamp,  and  redissolved  in 

water  yields  a  precipitate  with  phosphate  of  sodium. 

Dose. — 3  to  6  grains. 


Preparation. 

B.P. 

liquor  Iilthiae  Effervescens.    Lithia  Water  (10  grains  in  1  pint  of  water 
saturated  with  carbonic  acid),  given  in  quantities  of  5  to  10  fluid  ounces. 

Uses. — The  urates  of  lithium  being  much  more  soluble  than 
those  of  either  potassium  or  sodium,  lithia  is  often  employed  in 


632  INORGANIC   MATERIA   MEDICA.  [sect.  nr. 

preference  to  these  other  alkalis  in  gout.  It  is  given  internally 
in  order  to  aid  in  the  elimination  of  uric  acid  by  the  kidneys,  to 
prevent  the  gouty  paroxysm,  and  to  lessen  the  acidity  of  the 
urine,  to  prevent  the  deposit  of  uric  acid  gravel  or  calculi  in  the 
kidneys  or  bladder,  and  also  to  aid  in  their  solution  when  already 
formed.  It  is  applied  locally  to  parts  affected  with  gouty  inflam- 
mation, in  order  to  aid  in  the  solution  and  absorption  of  the 
urate  of  sodium  in  the  tissues.  For  this  purpose  it  may  be  applied 
to  stiff  joints  and  chalk-stones,  whether  covered  by  the  skin  or 
already  laid  bare  by  ulceration.  A  solution  of  lithia,  five  grains 
to  the  ounce,  is  kept  constantly  applied  to  the  part  for  several 
weeks  together. 

Lithii  Citras,  B.  and  U.S. P.  Citbatb  of  Lithium 
Li3CcH507 ;  210. 

Chaeactees  and  Tests. — A  white  amorphous  powder,  deli- 
quescent, and  soluble  in  water  without  leaving  any  residue. 

Eeactions. — Heated  to  redness  it  blackens,  evolving  inflammable  gases ; 
and  leaving  a  residue  of  lithium  carbonate  which  gives  the  usual  reactions. 

Dose.— 5-10  grains. 

Use. — It  has  a  similar  action  to  the  carbonate,  and  may  be 
used  in  its  stead  where  we  wish  to  avoid  any  local  action  upon 
the  stomach  itself. 

U.S. P.  Lithii  Benzoas.    Benzoate  of  Lithium.  LiC7H502; 

128. 

Chaeactees. — A  white  powder,  or  small  shining  scales  per- 
manent in  the  air,  odourless  or  having  a  faint  benzoin-like 
odour  ;  of  a  cooling  sweetish  taste,  and  a  faintly  acid  reaction. 

Reactions. — When  heated,  the  salt  fuses ;  at  a  higher  temperature  it 
chars,  emits  inflammable  vapours  having  a  benzoin-like  odour,  and  finally 
leaves  a  black  residue  of  an  alkaline  reaction,  and  imparting  a  crimson 
colour  to  a  non-luminous  flame.  On  mixing  the  aqueous  solution  with  a 
dilute  solution  of  ferric  sulphate,  a  flesh-coloured  precipitate  is  produced. 

Dose.— 8-30  grains  (0-5-2  gm.). 

Uses. — It  has  been  used  as  a  remedy  for  gout  and  uric  acid. 

U.S.P.  Lithii  Bromidum.— Vide  p.  556. 

U.S.  P.  Lithii  Salicylas.  Salicylate  of  Lithium. 
2LiC,H603-H20 ;  306. 

Chaeactees. — A  white  powder,  deliquescent  on  exposure  to 
air,  odourless,  or  nearly  so,  having  a  sweetish  taste  and  a  faintly 
acid  reaction. 

Solubility. — Very  soluble  in  water  and  in  alcohol. 

Reactions.— When  strongly  heated  the  salt  chars,  emits  inflammable 
vapours,  and  finally  leaves  a  black  residue  having  an  alkaline  reaction  and 
imparting  a  crimson  colour  to  a  non-luminous  flame.  On  supersaturating 
the  dilute  aqueous  solution  with  hydrochloric  acid  a  bulky  white  precipitate 


cnAP.  xxiv.] 


METALS. 


633 


is  obtained,  which  is  soluble  in  boiling  water,  from  which  it  crystallises  on 
cooling ;  also  soluble  in  ether ;  and  producing  an  intense  violet  colour  with 
ferric  salts. 

Uses. — It  is  used  as  a  remedy  in  gout  and  rheumatism,  and 
is  intended  to  unite  the  properties  of  salicylic  acid  and  lithium. 
It  is  less  irritant  to  the  stomach  than  salicylic  acid. 

Dose.— 20-40  grs.  (1-3-2-6  gm.). 


Monad  Metals. — Gboup  II. 

AMMONIUM   SALTS.     Ammonia.     NH3;  17. 

Ammonium  salts  are  well-defined,  like  those  of  potassium  and 
sodium,  but  the  base,  instead  of  being  a  so-called  element,  is 
known  to  be  a  compound  of  nitrogen  and  hydrogen.  They  are 
formed  by  the  direct  union  of  ammonia,  NH3,  with  acids.  Thus 
ammonia  and  hydrochloric  acid  unite  directly  to  form  ammonium 
chloride,  NH3  +  HC1=NH4C1.  In  the  case  of  other  members  of 
the  metallic  group  this  direct  union  with  the  components  of  the 
acid  does  not  occur,  the  metal  replacing  hydrogen,  e.g.  Zn  +  2HC1 
=  ZnCl2  +  H2.  This  exception  to  the  general  rule  may  be  avoided 
by  regarding  the  compounds  of  ammonia  with  acids  as  not  being 
formed  by  the  direct  union  of  ammonia  with  the  acids,  but  by 
the  replacement  of  hydrogen  in  a  basylous  radical  ammonium, 
NH4. 

In  gaseous  ammonia  the  nitrogen  may  be]  /H 

supposed  to  be   triad  with   its  three  affinities  Y  thns,     N — H 
saturated  by  hydrogen,  J  \H 


In  the  radical  ammonium  the  nitrogen  is 
supposed  to  be  pentad,  four  of  its  affinities  being 
saturated  by  hydrogen,  the  other  being  free  to 
unite  with  an  atom  of  some  other  element, 


H       H 

\    / 
•  thus,     N 

H       H 


In  ammonium 
chloride  this  free 
affinity  is  saturated 
by  chlorine 


H       H 
H  CI  H 


In  liquor  ammo- 
niae  this  free  affinity 
is  saturated  by 
hydroxy!, 


H       H 

\    / 

N 

/l\ 

H  0  H 


The  atoms  of  hydrogen  in  ammonia  or  in  ammonium  can  be 
replaced  by  organic  radicals,  and  compound  ammonias  are 
formed.  "When  the  organic  radical  which  replaces  the  hydrogen 
is  of  a  positive  nature,  the  compounds  are  termed  amines,  but 
if  it  is  of  a  negative  nature  they  are  termed  amides. 


634  INOEGANIC  MATEKIA  MBDICA.  [sect,  hi; 

Ammonium,   NH4,  does   not   exist   in   the   free   state,   and 

NH4 
whether  the  double  molecule,  N3H8  or  ,  exists  separately 

NH4 
is  uncertain. 

It  has  been  supposed  to  form  an  amalgam  with  mercury. 
When  mercury,  potassium,  and  sal-ammoniac  are  mixed,  the 
mercury  swells  up  enormously  and  forms  a  pasty  amalgam. 
This  may  consist  of  ammonium  and  mercury,  but  it  soon  decom- 
poses into  mercury,  ammonia,  and  hydrogen,  so  that  some  have 
supposed  it  to  be  nothing  more  than  mercury  which  has  absorbed 
a  certain  quantity  of  gas,  as  the  mercury  in  this  condition  yields 
to  pressure  in  the  same  way  as  froth  does  in  other  liquids.  At 
all  events  the  salts  of  ammonium  correspond  very  closely  with 
those  of  potassium  and  sodium.  In  their  general  reactions  tbey 
differ,  however,  in  the  fact  that  ammonia  is  volatile,  whereas 
potassium  and  sodium  are  not. 

Sources  op  Ammonium  Salts. — Ammonia  is  formed  chiefly 
by  the  union  of  the  nitrogen  and  hydrogen  contained  in  animal 
or  vegetable  tissues  during  the  processes  of  decomposition  or 
destructive  distillation.  The  principal  commercial  source  of 
ammonium  salts  is  the  ammoniacal  liquor  from  gas-works,  though 
some  of  it  is  also  obtained  by  the  dry  distillation  of  bones  in 
making  animal  charcoal. 

General  Eeactions  op  Ammonium  Salts.  — Like  potash  and 
soda,  ammonia  is  not  precipitated  by  most  reagents.  It  is  re- 
cognised by  its  volatile  alkaline  character.  It  is  given  off  from 
any  of  its  salts  on  the  addition  of  caustic  potash  or  soda  to  them, 
and  is  then  distinguished  by  its  peculiar  smell,  and  by  its  vola- 
tile alkaline  character — tnrning  a  piece  of  red  litmus-paper  blue 
and  turmeric  paper  brown,  when  they  are  held  above  the  test- 
glass  in  which  the  ammonium  salt  has  been  mixed  with  potash 
or  soda.  It  also  forms  white  fumes  of  ammonium  chloride  when 
brought  near  to  strong  hydrochloric  acid. 

General  Impurities  of  Ammonium  Salts. — As  all  the  salts 
are  obtained  from  the  chloride  or  sulphate,  chlorides  or  sulphates 
may  be  present.  Iron  maybe  present,  as  the  chloride  is  usually 
sublimed  in  an  iron  pot,  and,  if  the  heat  employed  be  too  great, 
some  ferric  chloride  sublimes  along  with  the  ammonium  chloride 
and  gives  it  a  reddish  colour.  Some  lead  may  also  be  present 
from  the  leaden  domes  into  which  the  ammonium  chloride  is 
sublimed. 

General  Tests.— Lead  and  iron  are  detected  by  hydrosul- 
phuric  acid,  or  ammonium  sulphide,  and  iron  also  by  ferrocyanide 
of  potassium.  As  the  gas  liquor  contains  many  empyreumatic 
substances,  these  may  sublime,  and  they  are  tested  for  in  car- 
bonate of  ammonium  (U.S.P.)  by  solution  of  permanganate  of 
potassium.  The  colour  of  this  ought  not  to  alter  after  standing 
for  five  minutes. 


CHAP.  XXIV.] 


METALS. 


635 


Pbepaeation  of  Ammonium  Salts. 


Is  prepared 

From 

By 

Ammonium  Chloride, 

Gas  liquor         . 

Adding  hydrochloric  acid  and  sub- 

B. and  U.S.P. 

liming  in  iron  pots  covered  with 
leaden  domes  ;  or  by  adding  sul- 
phuric acid,  and  subliming  the 
ammonium  sulphate  with  so- 
dium chloride  in  the  same  way. 

Ammonium  Sulphate, 

Ditto              a 

Adding  sulphuric  acid  and  sub- 

U.S.P. 

liming. 

Liquor        Ammonite 

Ammonium  chloride, 

Heating  with  lime,  and  saturating 

fortior,  B.P. ;   Aqua 

or  sulphate 

a   quantity   of    water   with  the 

Ammonite     fortior, 

gaseous  ammonia  (NHS)  given 

U.S.P. 

off  :— 
2NIL.C1  +  Ca(OH)2  =  CaCl2  +  2NH3 
+  2H20. 

Liquor       Ammonias, 

Ditto              .        . 

Is  simply  liquor  ammonia?  fortior 

B.P. ;     Aqua    Am- 

diluted  with  2  parts  of  water. 

.   monise,  U.S.P. 

Ammonium    Carbon- 

Ditto             . 

Sublimingwith  calcium  carbpnate. 

ate,  B.  and  U.S.P. 

Ammonium  Valerian- 

Ditto 

Mixing  with  lime  and  neutralising 

ate,  U.S.P. 

valerianic  acid  with  the  am- 
monia given  off. 

Ammonium     Iodide, 

Ammonium  sulphate 

Decomposing  by  potassium  iodide, 

U.S.P. 

precipitating  potassium  sulphate 
by  alcohol,  filtering,  and  evapo: 
rating. 

Ammonium  Bromide, 

Ditto 

Same  process  as  for  iodide,  sub- 

B. and  U.S.P. 

stituting  bromide  for  iodide  of 
potassium.  Or  by  neutralising 
hydrobromic  acid  with  ammonia. 

Liquor  Ammonii  Ace- 

Ammonium    carbon- 

Neutralising with  acetic  acid. 

tatis,  B.  and  U.S.P.1 

ate 

Spiritus      Ammonia? 

Ammonium    carbon- 

Distilling with  volatile  oil  of  nut- 

Aromaticus, B.  and 

ate  and  liquor  am- 

meg, oil  of  lemon,  rectified  spirit, 

'     U.S.P. 

monia 

and  water,  B.P.  Oil  of  lemon,  of 
lavender  flowers,  and  of  pimenta 
are  the  flavouring  agents,  U.S.P. 

Liquor  Ammonii  Ci- 

Liquor  ammonia?  for- 

Neutralising with  citric  acid.    It 

tratis  Fortior,  B.P. 

tior 

would  be  better  prepared  by  neu- 
tralising ammonium  carbonate 
with  citric  acid. 

Liquor  Ammonia;  Ci- 

Liquor  ammonii    ci- 

By  diluting  with  water  five  times. 

tratis,  B.P. 

tratis 

Ammonium       Phos- 

Liquor ammonise 

Neutralising  with  phosphoric  acid. 

phate,  B.  and  U.S.P. 

Ammonium  Sulphide 

Ditto 

Saturating  with  hydrogen  sulphide. 

Ammonium    Nitrate, 

Liquor  ammonia?  or 

Neutralising    with    dilute    nitric 

B.  and  U.S.P. 

carbonate 

acid,  evaporating  and  fusing. 

General  Action  op  Ammonium  Salts.  —  This  has  already 
been  described,  as  well  as  the  modifications  induced  in  it  by 
different  acid  radicals  (p.  602).  The  tetanus  produced  by  am- 
monia and  ammonium  chloride  is  due  to  their  action  on  the 


•      '  Liquor  ammonii  acetatis  fortior,  B.P.,  is  made  from  tho  carbonate,  and  liquor 
ammonii  acetatis  is  prepared  by  diluting  the  strong  solution  with  water. 


636 


INOEGANIC  MATEEIA  MEDICA.  [sect.  m. 


spinal  cord,  and  not  on  cerebral  centres,  for  it  persists,  like  that 
of  strychnine,  after  section  of  the  cord.  The  paralysing  action 
of  ammonium  chloride  on  the  muscles  modifies  the  tetanus,  in 
so  far  that  after  the  first  spasm,  irritation  applied  to  the  skin 
does  not  cause  tetanic  convulsions,  but  only  a  single  reflex 
twitch.  This  effect  is  usually  ascribed  to  the  paralysing  action 
on  the  motor  nerves,  but  it  seems  really  to  be  due  to  an  affection 
of  the  muscles  (Pig.  167) ,  as  well  as  to  a  disturbance  of  the  relation 
between  the  muscle  and  motor  nerve.  Amylamine,  which  is  a 
compound  ammonia,  has  a  paralysing  action  on  muscle  similar 
to  ammonia,  as  shown  in  Fig.  168.  When  a  muscle  has  been 
poisoned  by  some  ammonium  salt,  a  single  stimulation  applied  to 


Muscle  poisoned  by  1 
ammonium  sulphate  J 


Normal  muscle 


F[G.  167. — Tetanus-tracing  to  show  the  paralysing  action  of  ammonium  sulphate  on  muscle.  The 
first  contraction  of  the  poisoned  muscle  is  nearl.v  as  great  as  that  of  the  unpoisoned  one,  but  it 
soon  becomes  exhausted,  and  the  curve  rapidly  falls  during  the  continuance  of  the  stimulation, 
while  that  of  the  normal  muscle  rather  rises. 

the  nerve  causes  a  strong  contraction  like  that  of  an  unpoisoned 
muscle ;  but  a  second  stimulus  has  sometimes  little  or  no  ac- 
tion, and  when  the  muscle  is  stimulated  directly  it  soon  becomes 
exhausted.  Ammonia  is  a  powerful  muscular  irritant,  causing 
contraction  and  subsequent  rigor  mortis  when  applied  directly  to 
voluntary  muscle. 


Fig.  168.— Tetanus-traoing  to  show  the  paralysing  action  of  amylamine  on  muscle.    Cf.  Fig.  167. 

Ammonium  salts  are  said  to  increase  the  secretion  of  the 
mucous  glands  of  the  bronchi  and  of  the  intestine,  as  well' as 
that  of  the  sweat-glands  and  of  the  kidneys.  Ammonia  appears 
to  be  converted  almost  entirely  into  urea  in  the  blood  of  mam- 
mals, but  in  birds  it  is  converted  into  uric  acid.1 


Schroder,  quoted  by  Kruerin,  Ztschr.f.  Biol.,  xxi.  p.  76. 


chap,  xxiv.]  METALS.  637 

It  increases  the  formation  of  glycogen  in  the  liver.1 
Neither  ammonia,  nor  its  carbonate,  nor  its  salts  with  organic 
acids  diminish,  but  rather  increase  the  acidity  of  the  urine,  and 
in  this  ammonia  differs  from  potash,  soda,  and  lithia. 

Ammonii  Chloridum,  B.  and  U.S.P.  Chlokide  of  Am- 
monium.    NH4C1;  53-4. 

Characters.— In  colourless,  inodorous,  translucent,  fibrous 
masses,  tough,  and  difficult  to  powder. 

Solubility. — It  is  soluble  in  water  and  in  rectified  spirit. 

Reactions. — When  heated  it  volatilises  without  decomposition,  and 
lea\es  no  residue.  Its  solution  in  water  gives  the  reactions  of  ammonia 
(p.  634)  and  a  chloride  (p.  594). 

Pkepaeation.    U.S.P. 

DOSE. 

Trochisci  Ammonii  Chloridi.    2  grains  in  each 1  every  hour  or  two. 

Dose. — 5  to  20  grains. 

Action  and  Uses. — Cold  is  produced  during  the  process  of 
solution  in  water  of  ammonium  chloride,  and  so  its  solution  has 
been  used  locally  in  headache,  inflammation  of  the  brain,  mania, 
and  apoplexy.  It  has  been  employed  as  a  lotion  to  remove  ecchy- 
moses,  to  prevent  discoloration  in  bruises  and  sprains,  and  to  allay 
itching  in  prurigo.  It  has  been  applied  locally  as  a  dressing  in. 
abscess  of  the  mamma,  and  to  remove  glandular  enlargements.  As 
a  gargle,  it  has  been  used  to  cause  contraction  of  the  enlarged 
flabby  uvula,  and  to  relieve  the  cough  which  the  tickling  of  the 
pbarynx  by  the  uvula  often  causes. 

A  small  dose  of  5  to  7  grs.  of  ammonium  chloride  has 
no  effect,  but  if  taken  frequently  it  causes  discomfort  and  heat 
in  the  stomach,  slight  headache,  diuresis,  and  an  increased  secre- 
tion of  mucus  from  the  intestine,  although  the  stools  are  not  more 
numerous. 

Large  doses  given  to  animals  often  cause  pain  and  excite- 
ment, then  collapse  (no  diarrhoea) ,  convulsions,  and  death.  The 
stomach  is  congested,  the  mucous  membrane  swollen,  and  the 
epithelial  cells  easily  separated. 

The  same  symptoms  are  produced  when  ammonium  chloride 
is  applied  to  a  wound,  and  the  same  post-mortem  appearances  are 
seen  in  the  stomach. 

It  thus  seems  to  have  a  special  action  on  the  gastric  mucous 
membrane.  It  is  used  in  Germany  in  cases  which  are  usually 
supposed  to  be  due  to  a  catarrhal  state  of  the  stomach — viz. 
when  there  is  loss  of  appetite,  sickness,  bad  taste  in  the  mouth, 
fulness  in  the  stomach,  and  flatulence,  with  a  coated  tongue,  and 
along  with  these  bronchial  catarrh  without  fever.     Ammonium 

1  Eohmann,  Ccntralblatt  f.  Mill.  Med.,  No.  36,  1884. 


638  INORGANIC  MATEEIA  MEDICA.  [sect.  nr. 

carbonate  is  preferred  when  there  is  much  cough  or  the  person 
is  weak. 

It  is  also  used  alone  in  bronchial  catarrh,  when  this  has 
either  come  on  without  fever,  or  the  feverish  symptoms  have 
passed  off.  It  is  supposed  to  have  the  power  of  increasing  the 
secretion  of  mucus  in  the  bronchi  as  well  as  in  the  intestine;  and 
it  is  therefore  not  given  when  the  expectoration  is  profuse,  but 
only  when  it  is  scanty  and  difficult  to  bring  up. 

It  has  been  given  to  relieve  the  vomiting  and  heartburn 
occurring  in  cancer  of  the  stomach.  It  -is  said  to  have  a 
powerful  action  on  the  liver  (p.  636),  and  has  been  strongly 
recommended  in  chronic  congestion  and  hepatic  abscess,  as  well 
as  in  dropsy  depending  upon  hepatic  disease.  For  its  alterative 
action  it  has  been  given  in  muscular  rheumatism,  rheumatic 
pains,  and  neuralgia.  In  neuralgia  it  should  be  given  in  half- 
drachm  doses  several  times  a  day ;  but  if  the  pain  is  not  relieved 
after  four  or  five  doses  have  been  given,  it  may  be  discontinued. 
It  is  also  useful  in  neuralgic  headaches. 

Liquor  Ammonias  Fortior,  B.P. ;  Aqua  Ammonia;  For- 
tior,  U.S. P.  Strong  Solution  of  Ammonia,  B.P. ;  Stronger 
Water  op  Ammonia,  U.S. P. 

Characters. — A  colourless  liquid,  with  a  characteristic  and 
very  pungent  odour,  and  strong  alkaline  reaction.  Specific 
gravity  0-891. 

Peeparations  in  which  Steong  Solution  of  Ammonia  is  used. 
B.P.  u.s.p. 

Ammonii  Phosphas.  Spiritus  Ammonia, 

linimentum  Campnorse  Compositum  (p.  516). 
liquor  Ammoniac. 

„      Ammonii  Citratis  Fortior. 
Spiritus  Ammoniae  Aromaticus. 

„  „  Fostidus. 

Tinotura  Opii  Ammoniata. 

Action  and  Uses. — When  applied  to  the  nose,  the  vapour  of 
strong  ammonia  acts  as  a  powerful  irritant.  It  stimulates  tbe 
nasal  branches  of  the  fifth  nerve,  and  thus  reflexly  excites  the 
vaso-motor  centre  and  raises  the  blood-pressure.  It  thus  tends 
to  prevent  or  to  remove  conditions  of  shock  and  syncope.  When 
applied  for  too  long  a  time,  or  in  too  concentrated  a  form,  it 
may  produce  inflammation  of  the  mucous  membrane  and  respi- 
ratory passages.  Applied  to  the  skin  it  quickly  evaporates,  and 
has  but  a  slight  rubefacient  effect,  but  when  its  evaporation  is 
prevented  it  passes  through  the  epidermis  and  acts  as  a  powerful 
vesicant.  When  swallowed  in  large  quantities,  and  undiluted, 
it  may  produce  gastro-enteritis,  but  on  account  of  the  vapour 
gaining  access  to  the  air-passages  and  causing  immediate  suffo- 
cation, it  may  cause  death  in  a  few  minutes.  Along  with  the 
eastro-enteritis  there  may  be  comatose  symptoms  due  to  the 


chap,  xxiv.]  METALS.  639 

action  of  the  drug  itself  on  the  brain  after  absorption,  and 
in  this  it  differs  from  poisoning  by  caustic  potash  or  soda.  It 
stimulates  the  circulation  reflexly  through  the  nerves  of  the 
stomach,  and  after  its  absorption  stimulates  both  the  respiration 
and  circulation  by  its  direct  action  upon  the  circulatory  and 
respiratory  nerve-centres. 

Uses. —  Inhalation  of  its  fumes  is  used  to  prevent  drowsiness 
or  fainting,  or  to  recover  persons  from  a  faint,  or  from  shock,  or 
from  the  narcosis  produced  by  opium,  syncope,  or  the  depression 
caused  by  vascular  sedatives.  It  should  not  be  applied  for  too 
long  a  time,  lest  bronchitis  be  induced.  It  is  sometimes  employed 
in  a  milder  form  to  cut  short  nasal  catarrh,  to  lessen  pain  in  the 
nose  and  forehead,  and  diminish  the  expectoration  in  chronic 
bronchitis.  It  is  used  as  a  counter-irritant  to  the  skin  in 
rheumatic  pains,  stiffened  rheumatic  joints,  and  bronchitis.  As 
a  vesicant  it  may  be  employed  where  the  use  of  cantharides  is 
objectionable.  A  pledget  of  lint,  somewhat  larger  than  the  blister 
desired,  is  moistened  with  ammonia,  covered  with  a  watch-glass, 
and  applied  to  the  skin  until  a  red  ring  forms  round  the  glass. 
The  pledget  is  then  removed  and  a  poultice  applied.  The  poison 
of  nettles  and  insects  is  frequently  of  an  acid  character,  and 
ammonia  rubbed  over  the  part  stung  will  lessen  the  pain  and 
swelling.  The  injection  of  ten  drops  of  strong  liquor  ammonise, 
diluted  with  three  parts  of  water,  into  the  veins,  has  been  recom- 
mended in  cases  of  snake-bite.  It  may  be  useful  possibly  in 
bites  of  less  poisonous  snakes,  but  is  of  no  utility  in  bites  by 
the  cobra  or  daboia.  It  may  be  given  internally,  diluted,  as  a 
Btimulant  in  cases  of  syncope,  and  in  the  depression,  weakness, 
and  faintness  to  which  some  women  are  subject.  In  these  cases 
the  liquor  ammonise  may  be  employed  as  a  substitute  for 
alcohol,  and  thus  the  tendency  to  contract  habits  of  drinking 
may  be  counteracted.  It  may  be  used,  like  other  alkalis,  to 
stimulate  the  secretion  of  gastric  juice,  and  especially  where  we 
do  not  wish  to  diminish  the  acidity  of  the  urine  or  render  it 
alkaline,  and  also  where  we  wish  to  stimulate  the  nervous 
system,  as  in  cases  of  anaemia  and  debility,  and  more  especially 
where  the  stomach  is  relaxed  and  distended  with  gas.  It  also 
stimulates  the  intestines,  and  aids  the  expulsion  of  gas  from 
them.  It  is  therefore  very  useful  in  the  flatulence  and  colic  of 
children.  It  may  be  employed  to  lessen  the  watery  discharge 
from  the  bowels  where  this  persists  after  the  removal  of  the  irri- 
tant which  has  caused  it. 

U.S.  P.  Spiritus  Ammonise.  Spikit  op  Ammonia. — An  alco- 
holic solution  of  ammonia  containing  10  per  cent,  by  weight  of 
the  gas. 

Preparation. — By  warming  strong  water  of  ammonia  so  as  to  expel  the 
ammoniacal  gas,  passing  this  into  cold  alcohol,  and  diluting  with  alcohol  to 
the  necessary  strength. 


640  INOEGANIC  MATEEIA  MEDICA.  [sect.  in.  ■ 

Liquor  Ammoniae,  B.P. ;  Aqua  Ammoniae,  U.S.P-  Solu- 
tion of  Ammonia,  B.P. ;  Water  of  Ammonia,  U.S.P. — Ammoniacal 
Gas,  NH3 ;  17 ;  dissolved  in  water. 

Preparation. — By  mixing  1  part  of  strong  solution  of  ammonia  with  2  of 
water. 

Preparations. 

B.P.  U.S.P. 

linimentuni  Ammoniae  (p.  516).  Spiritus  Ammonias  Aromaticus. 

Linimentum  Ammonia;  (p.  517). 

Dose. — 10  to  30  minims  well  diluted. 

Uses. — This  may  be  used  as  a  local  application  in  a  similar 
manner  to  the  liquor  ammonias  fortior,  except  that  it  has  not  the 
same  powerful  vesicant  action.  It  may  be  given  internally  for 
similar  purposes.  When  mixed  in  the  proportion  of  two  ounces 
of  liquor  ammonias  with  two  ounces  of  common  salt  and  three 
drachms  of  camphorated  spirit  of  wine  to  thirty- two  ounces  of 
water,  it  forms  Easpail's  sedative  solution,  for  the  treatment  of 
headaches  occurring  at  the  menopause,  or  due  to  uterine  de- 
rangement. 

Ammonii  Carbonas,  B.  and  U.S.P.  Carbonate  of  Ammo- 
nium, N3HnC205,  B.P.     NH4HC03NH4NH2C02 ;  157,  U.S.P. 

A  volatile  and  pungent  ammoniacal  salt,  produced  by  sub- 
mitting a  mixture  of  sulphate  or  chloride  of  ammonium  and 
carbonate  of  calcium  to  sublimation.  It  consists  of  a  mixture  of 
acid  carbonate  of  ammonium  (NH4HC03),  and  carbamate  of 
ammonium  (NH4NH2C0.J. 

Characters. — In  translucent  crystalline  masses,  with  a 
strong  ammoniacal  odour,  and  alkaline  reaction. 

Solubility.— Soluble  in  cold  water,  more  sparingly  in  spirit. 
Beactions. — It  volatilises  entirely  when  heated,  and  is  readily  dissolved 
by  acids  with  effervescence. 

Citric  Acid. 
Tartaric  Acid. 

Dose. — 3  to  10  grains  as  stimulant  and  expectorant,  30  grains 
as  emetic. 

Pbeparations  in  which  Carbonate  of  Ammonium  is  used. 
B-P.  U.S.P. 

Liquor  Ammonii  Acetatis.  Spiritus  Ammonia;  Aromaticus. 

Spiritus  Ammonite  Aromaticus. 

Uses. — Carbonate,  of  ammonium  may  be  used  as  an  inhala- 
tion, and  may  be  given  internally,  for  similar  purposes  to  liquor 
ammonias. 

It  is  an  emetic,  and  may  be  employed  in  cases  of  bronchitis, 
where  the  bronchial  tubes  are"  choked  with  mucus,  and  the 
patient's  circulation  is  weak.  In  smaller  doses  it  stimulates  the 
secretion  of  gastric  juice,  and  may  be  used  in  atonic  dyspepsia, 


20  grains  of  Carbonate!  neutralise  j  23|  grains 
of  Ammonium  J  1 25A  grams 


chap,  xxiv.]  METALS.  641 

flatulence,  and  colic  to  relieve  sinking  and  depression,  and  as 
a  substitute  for  alcoholic  stimulants.  When  employed  for  this 
latter  purpose,  five  to  ten  grains  may  be  given  along  with  ten 
minims  of  tincture  of  capsicum  in  an  ounce  of  bitter  infusion,  to 
be  taken  whenever  the  feeling  of  sinking  comes  on,  or  the  craving 
for  alcoholic  stimulants  is  experienced. 

From  its  power  of  stimulating  the  respiratory  centre,  it  is 
employed  as  a  stimulating  expectorant  in  chronic  bronchitis,  in 
the  broncho-pneumonia  of  children,  and  in  asthma  depending  on 
cardiac  disease.  It  is  also  given  in  measles,  and  has  been  re- 
commended as  almost  a  specific  in  scarlet  fever,  in  doses  of  three 
to  five  grains,  every  one,  two,  or  three  hours,  according  to  the 
severity  of  the  case,  no  acid  drinks  or  fruits  being  allowed  to  the 
patient  at  the  time. 

Carbonate  of  ammonium  has  been  supposed  to  have  the 
power  of  preventing  iodism,  when  given  along  with  iodide  of 
potassium. 

Spiritus  Ammoniae  Aromaticus,  B.  and  U.S. P.  Aromatic 
Spieit  of  Ammonia  (Sal  Volatile). — It  consists  of  carbonate  of 
ammonium,  and  strong  solution  of  ammonia  diluted  with  alcohol 
and  water.  It  is  flavoured  with  volatile  oil  of  nutmeg  and  oil  of 
lemon  in  the  B.P.,  and  with  oil  of  lemon,  oil  of  lavender  flowers, 
and  oil  of  pimenta,  in  the  U.S. P. 

Dose. — 20  to  60  minims  in  water. 

Pbbpaeahons. 

Tinctura  Guaiaci  Ammoniata.     IS.  and  U.S.P. 
„         Valerianae  Ammonlata.     „         „ 

Uses. — It  is  very  commonly  taken  to  relieve  feelings  of  faint- 
ness  and  depression,  and  is  much  safer  than  alcohol,  which  might 
otherwise  be  employed.  It  may  be  used  also  for  other  purposes 
instead  of  carbonate  of  ammonium,  to  which  it  has  a  similar 
action. 

B.P.  Liquor  Ammonii  Acetatis  Fortior.     Steong  Solution 
op  Acetate  op  Ammonium.     Sp.  gr.  L073. 
Dose. — 25  to  75  minims. 

Liquor  Ammonii  Acetatis,  B.  and  U.S.P-  Solution  op 
Acetate  op  Ammonium. — Acetate  of  Ammonium,  NH4C2H302, 
dissolved  in  water. 

Dose. — 2  to  6  fluid  drachms. 

Uses. — It  is  used  as  an  eyewash,  and  as  a  lotion  to  inflamed 
parts.  When  given  internally  it  acts  as  a  diaphoretic,  if  the 
body  be  kept  warm,  or  as  a  diuretic  if  it  be  cool.  As  a  dia- 
phoretic it  is  given  when  the  skin  is  hot  and  dry,  and  is  very 
frequently  used,  especially  combined  with  spirit  of  nitrous  ether, 
whenever  a  feverish  condition  is  present,  whether  its  cause  be 

T    T 


642  INOKGANIC  MATEEIA  MEDICA.  [sect,  in* 

known  or  not.     It  is  especially  used  in  the  exanthemata,  in 
influenza  and  catarrh. 

B.P.  Liquor  Ammonii  Citratis  Fortior.     Strong  Solution 
op  Citrate  of  Ammonium.     Neutral.     Sp.  gr.  1/209. 
Dose.— £  to  1£  fl.  dr. 

B.P.  Liquor  Ammonii  Citratis.  Solution  of  Citrate  of 
Ammonium. — Citrate  of  Ammonium,  or  (NH4)3.C6HsOj,  dissolved 
in  water. 

Dose. — 2  to  6  fluid  drachms. 

Uses. — Like  the  solution  of  the  acetate,  but  more  agreeable. 

B.P.,  Appendix,  Oxalate  of  Ammonium  (NH4)2C204.H20. 
Properties. — Colourless  prismatic  crystals,  no  smell. 
Uses. — Used  to  test  for  calcium,  and  to  separate  it  from 
magnesium. 

Ammonii  Phosphas,  B.  and  U.S.P-  Phosphate  of  Am- 
monium.    (NH4)2HP04;  132. 

Characters. — In  transparent  colourless  prisms. 

Solubility.— Soluble  in  water,  insoluble  in  rectified  spirit. 

Eeactions. — The  aqueous  solution  gives  the  reactions  of  ammonia,  and 
of  a  phosphate  (p.  595). 

Dose. — 5  to  20  grs.  freely  diluted. 

Uses. — It  has  been  used  as  a  remedy  in  cases  of  gout,  in 
order  to  eliminate  urate  of  sodium  from  the  system,  the  theory 
of  its  action  being  that  it  decomposes  the  insoluble  urate  of 
sodium,  converting  it  into  soluble  urate  of  ammonium  and 
phosphate  of  sodium. 

Ammonii  Bromidum. — Vide  p.  556. 

Ammonii  Iodidum. — Vide  p.  664. 

Ammonii  Nitras,  B.  and  U.S.P.  Nitrate  of  Ammonium. 
NH4N03;  80. 

Characters. — Colourless  crystals,  generally  in  the  form  of 
long  thin  rhombic  prisms,  or  in  fused  masses  somewhat  deli- 
quescent, odourless,  having  a  sharp  bitter  taste  and  a  neutral 
reaction. 

Eeactions.— When  gradually  heated,  the  salt  melts  at  165°  to  168°  C. 
(329°  to  331°  P.),  and  at  about  185*  C.  (365°  P.)  it  is  decomposed  into  nitrous 
oxide  gas  and  water,  leaving  ho  residue.  The  aqueous  solution  of  the  salt, 
when  heated  with  potassa,  evolves  vapour  of  ammonia.  On  heating  the  salt 
with  sulphuric  acid,  it  emits  nitrous  vapours. 

Use. — It  is  only  used  for  the  preparation  of  nitrous  oxide. 

U.S.P.  Ammonii  Sulphas.  Sulphate  of  Ammonium. 
(NH4)2S04;  132. 

Characters. — Colourless  transparent  rhombic  prisms,  perma-  \ 
nent  in  the  air,  odourless,  having  a  sharp  saline  taste,  and  a  ! 
neutral  reaction. 


chap,  xxiv.]  METALS.  643 

Uses. — It  is  not  used  internally,  but  is  only  employed  for  the 
preparation  of  other  salts  of  ammonium,  of  ammonium  alum 
(B.P.)  and  sulphate  of  iron  and  ammonium  (U.S.P.). 

U.S.  P.  Ammonii  Valerianas.  Valeeianate  of  Ammonium. 
NH4C5H902;  119. 

Characters. — Colourless  or  white  quadrangular  plates,  deli- 
quescent in  moist  air,  having  the  odour  of  valerianic  acid,  a 
sharp  and  sweetish  taste,  and  a  neutral  reaction. 

Solubility.— Very  soluble  in  water  and  in  alcohol. 

Reactions.— "When  heated  the  salt  fuses,  gives  off  vapour  of  ammonia,, 
and  of  valerianic  acid,  and  is  finally  dissipated  without  leaving  a  residue. 

Dose.— 2  to  8  grs.  (0-13  to  0-52  gm.). 

Use. — It  is  chiefly  used,  like  valerian,  in  cases  of  hysteria. 

Ammonii  Benzoas,  B.  and  U.S. P.  Benzoate  oy  Ammo- 
nium, NH4C7H502 ;  139. 

Charactees. — Thin  white  four-sided  laminar  crystals,  per- 
manent in  the  air,  having  a  slight  odour  of  benzoic  acid,  a 
saline,  bitter,  afterwards  slightly  acrid  taste,  and  a  neutral 
reaction. 

Reactions. — When  strongly  heated  the  salt  melts,  emits  vapours  having 
the  odour  of  ammonia  and  of  benzoic  acid,  and  is  finally  wholly  dissipated. 

Uses. — It  is  used  as  a  diuretic,  and  to  render  the  urine  acid 
where  there  is  a  tendency  to  phosphatic  deposits. 

B.P.  Sulphide  of  Ammonium. — (NH4)2S.     Test  Solution. 

Peopeeties. — Greenish-yellow  transparent  liquid,  with  a 
•disagreeable  pungent  odour.     S.G.  0-999. 

Preparation. — Saturate  a  solution  of  ammonia  by  sulphuretted  hydrogen. 

Dose. — 3  minims,  cautiously  increased. 

Actions. — In  small  doses  it  increases  secretion,  especially  of 

-  bronchi  and  skin,  and  is  thus  used  as  a  sudorific  and  expectorant 

in  chronic  skin-diseases,  rheumatism,  and  bronchitis ;  in  large 

doses  it  causes  giddiness,   drowsiness,  faintness,   and  nausea. 

Little  given. 

It  is  chiefly  used  as  a  test. 


T  T  2 


644  INORGANIC  MATERIA  MEDICA.  [sect.  ni. 


CHAPTEE  XXV. 

METALS— (continued). 

Class  II.— DYAD  METALS. 

Geoup  I.— METALS  OP  THE  ALKALINE  EARTHS. 
Calcium,  Strontium,  Barium. 

Appendix.— METALS  OP  THE  EARTHS. 

Aluminium,  (?  triad)  Beryllium  (dyad),  Zirconium  (tetrad),  Nio- 
bium (tetrad),  Cerium,  Lanthanum,  Didymium,  Yttrium, 
Erbium  (triads). 

Geoup  II.— MAGNESIUM. 

Geoup  III.— COPPER,  ZINC,  SILVER,  Cadmium. 

Geoup  IV.— MERCURY. 


This  large  class  contains  a  number  of  metals  which  have 
widely  different  characters  and  reactions.  Yet  it  will  be  seen 
from  the  following  table  that  the  successive  addition  of  four 
reagents  divides  the  metals  tolerably  nearly  into  those  groups 
which  agree  in  their  physiological  action.  In  some  respects 
Groups  I.  and  II.  of  Class  2  are  perhaps  more  closely  connected 
with  the  alkaline  metals  than  with  the  heavy  metals. 


i 


J.  XXV.] 


METALS. 


645 


ENACTIONS  OS  THE    METALS  IN   CLASS  II. 


Hydrochloric 
Acid 

Sulphuretted 
Hydrogen 

■  Ammonium 
Sulphide 

Ammonium 
Carbonate 

Ammonia 

and 

Sodium 

Phosphate 

TP  I. 

ontium .... 

GNDIX.) 

ninium .... 
tther  earthy  l 

No  precipitate. 
Do. 
Do. 

Do. 
Do. 

No  precipitate. 
Do. 
Do. 

Do. 

Do. 

No  precipitate. 
Do. 
Do. 

White  (Hydrate) 
Do. 

White  precipitate. 
Do. 
Do. 

crp  II. 
gnesium. .« 

Do. 

Do. 

No  precipitate. 

No- precipitate. 

White  ppt. 
(phosphate). 

dt?  in. 

Do. 
Do. 
Do. 

"White  curdy  ppt. 
soluble  in  am- 
monia. 

Do. 

Black  ppt. 
Yellow  ppt. 
Black  ppt. 

White  (sulphide) 

pper    

dmium   .... 

C7P  IV. 
rcuryassub-i 

alt / 

,  as  persalt . . 

White  ppt. 
No  precipitate 

Black  ppt. 
Do. 

It  must  be  borne  in  mind  that  the  above  reagents  are  used 
ceessively,  and  each  remains  in  the  solution.  Thus  when 
imonium  sulphide  is  added,  part  of  it  is  decomposed  by  the 
drochloric  acid  and  ammonium  chloride  is  formed.  It  is  on 
count  of  the  presence  of  the  ammonium  chloride  in  the  liquid 
at  magnesium  is  not  precipitated  by  the  ammonium  sulphide, 
die  aluminium  is. 

Class  II.     Geoup  I. 

General  Action. — In  regard  to  the  action  on  the  nervous 
stem  of  the  chlorides  of  calcium,  strontium,  barium,  beryllium, 
lymium,  erbium,  and  lanthanum,  these  substances  fall  into 
-o  groups — 

(a)  Containing  beryllium,  calcium,  strontium,  and  barium  ; 

(6)  Containing  yttrium,  didymium,  erbium,  and  lanthanum. 

Group  (a)  has  a  tendency  to  increase  reflex  action,  as  evi- 
nced by  spasm  or  tremor  in  the  frog. 

With  group  (b)  reflex  action  in  the  cord  appears  to  be  little 
fected,  but  its  members  appear  to  have  a  tendency  to  paralyse 
otor  centres  of  the  brain  in  the  frog. 

Group  (a)  all  paralyse  motor  nerves  to  some  extent.  Lan- 
anum  has  also  a  slight  paralysing  action,  but  the  other  mem- 
>rs  of  the  group  (b)  have  not,  agreeing  in  this  respect  with 
dium  and  rubidium,  and  differing  from  all  the  others. 


046  TNOBGANIC   MATEEIA  MEDICA.  [sect.  in. 

In  regard  to  their  action  on  muscle  these  substances  cannot 
be  divided  into  sub-groups.  Their  action  on  muscle  has  been 
already  described  (p.  135). 

The  lethal  activity,  on  frogs,  of.  the  chlorides  of  the  alkalies 
and  earths  is  not  in  proportion  to  their  atomic  weight.  It  is  as 
follows,  potassium  being  most  powerful,  and  calcium  least  power- 
ful:— potassium,  beryllium,  rubidium,  barium,  ammonium, 
cesium,  lithium,  lanthanum,  didymium,  erbium,  strontium, 
yttrium,  sodium,  calcium  (vide  p.  29). 

Barium  causes  contraction  of  the  ventricle  of  the  frog's  heart 
in  much  the  same  way  as  veratrine,  and  by  its  local  action  on 
the  walls  of  the  vessels  causes  them  to  contract.  When  injected 
into  the  circulation  it  causes  enormous  rise  of  blood-pressure  at 
first,  followed  by  stoppage  of  the  heart  and  consequent  fall  of 
pressure.  It  causes  contraction  also  of  the  involuntary  fibres  of 
the  bladder  and  intestine,  so  that  the  lumen  of  the  latter  may 
be  almost  completely  obliterated.  The  symptoms  of  poisoning 
in  mammals  are  probably  due  to  its  action  on  the  involuntary 
muscles  of  the  intestines,  heart,  and  vessels,  on  the  voluntary 
muscles,  and  on  the  nervous  system.  They  are  vomiting,  colic, 
diarrhoea,  muscular  weakness  and  cramp,  ringing  in  the  ears, 
tightness  over  the  heart,  and  general  convulsions.  Injection  of 
sulphate  of  sodium  into  the  veins  appears  to  counteract  the 
effect  of  barium,1  and  the  simultaneous  injection  of  potassium 
salts  will  prevent  death  from  an  otherwise  lethal  dose  of  barium.2 
The  action  of  barium  on  muscles  and  on  the  heart  is  abolished 
by  heat  in  the  same  way  as  that  of  veratrine  (p.  128),  and  the 
inhabitants  of  southern  climates  tolerate  much  larger  doses  of 
barium  than  those  of  northern.3 

Metals  of  the  Alkaline  Earths. 
Calcium,  Strontium,  Barium. 

The  only  one  of  these  whose  preparations  are  used  internally 
is  calcium.  At  present  barium  is  only  used  as  a  test,  though 
possibly  it  may  yet  prove  useful  in  muscular  tremor  (p.  134). 

CALCIUM.     Ca;  40,  or  39-9. 

Sources  op  Calcium-salts. — The  chief  source  is  the  carbonate 
found  native  as  chalk  or  limestone. 

General  Test  op  Calcium-salts. — The  addition  of  ammonium 
oxalate  to  calcium  salts  causes  a  white  precipitate  of  calcium  oxa- 
late, which  is  very  sparingly  soluble  in  water.  It  is  soluble  in 
hydrochloric,  but  insoluble  in  acetic  acid. 

1  Hermann,  Lehrbuch  d.  experimented  Toxicologie,  p.  191. 

8  Brunton  and  Cash,  Centralblatt  fil/r  d.  med.  Wissenschafien,  1884,  p.  645. 

•  Lisfranc,  quoted  by  Lewin,  Nebenwirkungen  d.  Armeimittel,  p.  74.  : 


AP.  XXV.] 


METALS. 


647 


General  Preparation  or 

Sams  op  Calcium. 

Is  prepared 

Prom 

By 

Jreta  prasparata,  B. 

Chalk       .        .        . 

The  process  of  elutriation,  which 

and  U.S.P. 

consists  in  stirring  with  water, 
pouring  off  the  liquid  contain- 
ing fine  particles  in  suspension, 
and  allowing  them  to  subside. 

3alx  (quicklime),  B. 

Chalk  or  limestone  . 

Calcining ;  CaC03  =  CaO  +  C02. 

and  U.S.P. 

)alcii  hydras  (slaked 

Quicklime 

Slaking  with  water. 

lime),  B.P. 

3aloii  chloridum,  B. 

Limestone  or  chalk 

Neutralising    with    hydrochloric 

and  U.S.P. 

(Carbonate)  . 

acid  ;  CaCOs  +  2HC1  =  CaCl2 
+  H20  +  C02. 

3alcii  carbonas  pras- 

Calcium  chloride     . 

Precipitating  with  excess  of  car- 

cipitata,   B.    and 

bonate    of    sodium ;    CaCl2  + 

U.S.P. 

Na2C03  =  CaC03  +  2NaCl. 

Dalx  chlorata  (chlo- 
rinated lime),   B. 

Slaked  lime     .       . 

Exposing  lime  to  chlorine  gas 

until  saturated :  thus  is  formed 

and  U.S.P. 

chlorinated  lime,  consisting  of 
a  mixture  of  calcium  chloride 
and  calcium  hypochlorite. 

□aloii  hypophosphis, 

Lime  and  phosphorus 

Heating    together    with    water ; 

B.  and  ILS  J?. 

removing  excess  of  lime  by 
C02,  and  evaporating. 

Calcii  phosphas,  B. 

Bone  ash         .       . 

Dissolving     in    diluted    hydro- 

and U.S.P. 

chloric  acid,  precipitating  with 
ammonia,  and  drying. 

General  Impurities. — The  chief  impurities  are  aluminium  and  magne- 
um. 

Tests.— These  are  usually  detected  by  converting  the  calcium-salt  into 
iloride  by  hydrochloric  acid,  and  evaporating  to  dryness  so  as  to  drive  off 
1  excess  of  acid.  The  residue  is  re-dissolved  in  water  and  the  tests  applied 
i  the  solution.  On  the  addition  of  saccharated  solution  of  lime,  aluminium 
id  magnesium  will  be  precipitated.  The  B.P.  states  that  only  a  very  scanty 
:ecipitate  should  occur,  showing  that  only  traces  of  magnesium  and  alumi- 
ium  are  present.  The  test  used  in  the  U.S.P.  to  detect  aluminium  is  water 
:  ammonia ;  and  to  detect  magnesium,  water  of  ammonia  and  phosphate  of 
)dium.  These  reagents  should  not  give  more  than  a  faint  turbidity  with 
ilute  solutions  of  calcium  salts. 

B.P.  Marmor  Album.    White  Marble.     CaC03. 
Hard  white  crystalline  native  carbonate  of  calcium,  in  masses. 
Ised  in  producing  earbonic  acid  gas. 

B.P.  Creta,  Chalk.  CaC03.  Native  friable  carbonate  of 
:alcium.    Used  in  producing  carbonic  acid  gas. 

Preparation. 
Creta  Prseparata- 

Calx,  B.  and  U.S.P.     Lime.     CaO ;  56. 

An  alkaline  earth,  oxide  of  calcium,  CaO,  with  some  impuri- 
es,  obtained  by  caleiuing  chalk  or  limestone  so  as  to  expel 
arbonic  acid. 


648  INOKGANIC  MATEEIA  MEDICA.  [sect,  m; 

Chaeactees. — In  compact  masses  of  a  whitish  colour,  -which 
readily  absorb  water,  and  which,  when  rather  less  than  then- 
weight  of  water  is  added,  crack  and  fall  into  powder  with  the 
development  of  much  heat. 

Tests. — The  powder  obtained  by  the  process  of  slaking,  when  agitated 
with  distilled  water,  gives,  after  filtration,  a  clear  solution  which  has  an 
alkaline  reaction,  and  is  shown  by  the  appropriate  tests  to  contain  calcium 
and  only  traces  of  aluminium  and  magnesium. 

Preparations. 
B.P.  U.S.?. 

Calcii  hydras.  Liquor  Calcis. 

Potassa  cum  Calce  (p.  608). 
Syrupus  Calcis. 

B.P.  Calcii  Hydras.     Slaked  Lime. 

Hydrate  of  lime,  Ca(HO)2;  74;  with  some  impurities,  recently 
prepared  by  pouring  1  pint  of  water  over  2  lbs.  of  lime  in  a 
metal  pot. 

Solubility. — It  dissolves  in  water,  but  only  sparingly,  11  grs.  being 
dissolved  by  a  pint  of  water  at  60°  F. ;  and,  contrary  to  the  usual  rule,  its 
solubility  is  increased  by  cooling  the  water,  and  diminished  by  heating  it. 

Its  solubility  is  greatly  increased  by  the  addition  of  sugar,  as  in  the 
Liquor  Calcis  Saccharatus,  B.P.,  or  Syrupus  Calcis,  U.S.P. 

Preparations. 

dose. 
liquor  Calcis.  1-4  fl.  oz. 

Liquor  Calcis  Saccharatus.  15-60  min. 

liquor  Calcis  Saccharatus,  B.P. ;  Syrupus  Calcis,  TJ.S.P.  Saccharated 
Solution  of  Lime,  B.P. ;    Syrup  of  Lime,  U.S.P. 

Preparation. — B.P.  Like  lime-water,  mixing  1  ounce  of  lime  with  2  of  sugar 
and  using  them  instead  of  2  of  lime.  This  mixture  contains  7'11  grains  of  lime 
in  1  fluid  ounce.  U.S.P.  Mixing  lime  (5)  and  sugar  (30)  with  boiling  water 
(50) ;  diluting  with  an  equal  volume  of  water,  filtering,  and  evaporating  to  100 
parts. 

Dose. — 15  to  60  minims. 

liquor  Calcis,  B.  and  U.S.P.     Solution  or  Lime.    Lime  Water. 

Preparation. — B.P.  By  shaking  2  ounces  of  slaked  lime  with  1  gallon  of  dis- 
tilled water  in  a  stoppered  bottle  well  for  two  or  three  minutes.  After  twelve 
hours  the  excess  of  lime  will  have  subsided,  and  the  clear  solution  may  be  drawn 
off  with  a  syphon  as  it  is  required  for  use,  or  transferred  to  a  green  glass  bottle 
furnished  with  a  well-ground  stopper.  In  the  U.S.P.  the  lime  is  first  washed  with 
ordinary  water  and  afterwards  stirred  well  with  distilled  water. 

It  is  a  saturated  solution,  and  ccntiins  a  little  over  half  a  grain  to  an  ounce. 

Dose. — 1-4  fl.  oz. 

Preparations. 

B.P.  U.S.P. 

Iiinimentum  Calcis  (p.  516).  Linimentum  Calcis  (p.  517). 

Argenti  Oxidum. 
Lotio  Hydrargyri  Flava. 
Nigra. 

Uses. — When  applied  to  the  surface  either  of  the  skin  or  of 
a  mucous  membrane  from  which  a  watery  discharge  is  issuing, 
lime  seems  to  act  as  a  slight  astringent,  possibly  because  it 
combines  with  the  albumen. 


chap,  xxv.]  METALS.  649 

Lime-water  is  therefore  sometimes  used  as  a  lotion  for  cracked 
nipples  and  as  a  dressing  to  eczematous  surfaces,  where  it  eases 
the  smarting  and  tingling.  It  is  often  mixed  with  oil,  as  in  lini- 
mentum  calcis,  or  glycerine  for  this  purpose.  The  efficacy  of 
the  liniment  is  much  increased  by  the  addition  of  minute  quan- 
tities of  carbolic  acid. 

Linimentum  Calcis — better  known,  perhaps,  under  the  name 
of  Carron  oil — is  used  as  an  application  to  burns  and  scalds.  It 
derives  its  name  of  Carron  oil  from  its  being  so  extensively  used 
by  the  workmen  in  the  foundries  at  Carron. 

It  was  formerly  made  with  linseed  oil,  and  this  preparation  is 
less  fluid,  and  is  often  preferable  to  that  made  with  olive  or  cotton- 
seed oil.  It  is  useful  not  only  in  burns  and  scalds,  but  as  a 
dressing  to  the  face  in  small-pox,  and  in  some  cases  of  eczema 
affecting  a  large  extent  of  skin. 

Lime-water  is  also  used  as  an  injection  to  lessen  discharges 
from  the  ears,  urethra,  vagina  or  vulva,  in  otorrhcea,  gleet,  and 
leucorrhcea,  while  .active  inflammation  is  still  present,  and  as 
an  enema  to  destroy  ascarides  in  the  rectum.  It  may  also  be 
used  as  a  wash  to  the  mouth  in  ulceration.  In  croup  it  has 
been  recommended  as  a  solvent  for  the  false  membrane.  -It 
is  either  applied  as  spray  or  by  a  camel's-hair  pencil.  When 
taken  into  the  stomach  it  will  act  as  an  antacid.  It  is  especially 
useful  in  preventing  vomiting,  and  a  mixture  of  milk  and  lime- 
water  will  often  be  retained  by  the  stomach  and  digested  when 
no  other  food  can  be  borne.  In  children  suffering  from  chronic 
vomiting  and  diarrhoea,  where  the  milk  is  vomited  in  hard 
lumps  instead  of  small  flakes,  lime-water  proves  very  useful. 

In  typhoid  fever  it  tends  to  prevent  milk  from  forming  hard 
undigested  lumps  which  may  irritate  the  intestine,  while  it  has 
,  at  the  same  time  an  astringent  action. 

It  is  very  useful  as  an  astringent  in  diarrhoea,  more  especially 
in  slight  cases  of  diarrhoea  in  children.  When  the  child  is  at 
the  breast  about  one  teaspoonful  of  lime-water  mixed  with  an 
equal  quantity  of  milk  should  be  given  to  it  every  three  hours, 
and  when  it  is  brought  up  by  hand  the  lime-water  is  just  mixed 
with  the  milk  which  the  child  ordinarily  takes.  It  has  been  used 
in  diarrhoea  in  adults  depending  on  ulceration  of  the  intestine, 
with  the  view  of  healing  the  ulcers  by  combining  with  the 
albumen  on  their  surface  and  thus  forming  a  coating  over  them, 
but  it  is  not  so  efficient  as  other  remedies  for  this  purpose. 

Only  a  small  quantity  is  absorbed  by  the  intestine  and  passes 
into  the  blood ;  yet,  after  it  has  been  used  for  a  little  while, 
the  urine  becomes  alkaline  from  the  lime  being  excreted  by  the 
kidneys.  Lime-water  has  been  used  in  cases  of  stone,  and  with 
considerable  benefit.  It  has  been  supposed  to  dissolve  stones  in 
the  bladder ;  but  the  good  effects  which  result  from  its  use  are 
probably  not  due  to  this  cause,  which  is  still  problematical. 


650  INOEGANIC  MATEEIA  MEDICA.  [sect.  hi. 

They  are  most  probably  produced  by  the  lime  lessening  the 
irritating  qualities  of  the  urine,  and  at  the  same  time  acting  as 
an  astringent  on  the  walls  of  the  bladder  and  rendering  it  less 
irritable. 

Liquor  Caleis  Saccharatus,  B.P.,  or  Syrupus  Calcis,  U.S.P., 
may  be  given  in  milk  instead  of  liquor  calcis,  when  it  is  desired 
simply  to  get  the  effect  of  the  lime  and  it  is  unadvisable  to  dilute 
the  milk,  as  admixture  with  liquor  calcis  would  necessarily  do. 
It  has  been  used  also  in  acute  rheumatism. 

Creta  Praeparata,  B.  and  U.S. P.     Prepared  Chalk. 
Properties. — It  is  a  white  powder,  or  in  small  lumps  which 
break  into  powder  readily  on  pressure.    It  has  no  taste  or  smell. 

Preparation. — Prepared  chalk  is  simply  chalk  freed  from  sand  and  other 
impurities  hy  elutriation  (p.  647). 

Solubility. — It  is  insoluble  in  water,  but  it  dissolves  in  acids  such  as 
acetic  acid. 

Eeactions. — While  doing  so  it  effervesces  strongly,  showing  that  it  is  a 
carbonate,  and  the  solution  gives  the  reactions  of  calcium  (p.  646). 

Impurities. — Silica,  barium,  strontium,  magnesium,  iron. 

Test. — It  should  dissolve  without  leaving  any  residue  in  hydrochloric 
acid  (absence  of  silica),  B.P.  The  solution  in  acetic  acid  should  give  no  pre- 
cipitate with  test  solution  of  sulphate  of  calcium  (absence  of  strontium  and 
barium),  and  the  tests  for  magnesium  and  iron  should  not  indicate  more  than 
traces  of  these  substances,  U.S.P. 

Dose.— 10  to  60  gr. 

Officinal  Preparations. 
B.P.  DOSE. 

Mistura  Cretae.     Chalk  mixture.  T 

Chalk  (1)  suspended  in  cinnamon  water  (30)  by  means  of  >  1-2  fl.  oz. 

gum  (1)  and  sweetened  with  syrup  (2)  j 

Pulvis  Cretse  Aromaticus.     Aromatic  powder  of  chalk.        ~) 

Cinnamon  (8),  cardamoms  (2),  cloves  (3),  nutmeg  (6),  saf-  I  10-60  gr. 

fron  (6),  sugar  (50),  chalk  (22)    J 

Pulvis  Cretse  Aromaticus  cum   Opio.     Aromatic   powder  | 

of  chalk  thoroughly  mixed  with  powdered  opium.  >  10-40  gr. 

1  part  of  opium  in  40  J 

U.S.P. 

Mistura  Cretae.     Chalk  mixture.  >  ,  -  „ 

Compound  chalk  powder  (20),  cinnamon  water  (40),  water  (40)  I  *  oz' 

Pulvis  Creta?  Compositus.    Compound  chalk  powder.  I  n  en      n  a      ^ 

Prepared  chalk  (30),  powdered  acacia  (20),  sugar  (50) J  B-buer-  (^4gm.j. 

Trochisci  Cretas.    Chalk  lozenges. 

4  grains  in  each Ad  Kb. 

Chalk  is  also  contained  in  Hydrargyrum  cum  Creta,  B.  and  U.S.P. 

Action. — Carbonate  of  calcium  or  chalk  possesses  the  astrin- 
gent and  antacid  powers  of  lime  itself,  and  is  without  its  irritat- 
ing qualities.  It  can  therefore  be  given  in  much  larger  doses, 
and  so  chalk  is  used,  instead  of  liquor  calcis,  in  the  diarrhoea  of 
adults  accompanied  by  acidity. 

Uses. — Chalk  maybe  used  as  a  dusting  powder  to  the  skin  in 
excoriations,  burns,  and  ulcers.  It  forms  a  useful  tooth-powder. 
Internally  it  serves  to  arrest  diarrhoea,  and  is  often  given,  whatever 
be  the  cause  of  the  diarrhoea ;  but  when  the  disease  depends  upon 


chap,  xxv.]  METALS.  651 

some  irritating  substance  in  the  intestine,  the  irritant  should  be 
removed  by  a  dose  of  castor  oil  previous  to  the  administration  of 
the  chalk.  In  the  form  of  whiting,  chalk  forms  a  useful  antidote 
in  cases  of  poisoning  by  acids,  and  especially  by  oxalic  acid. 

Calcii  Chloridum,  B.  and  U.S.P.  Chloeidb  op  Calcium. 
CaCl2;  110-8. 

Chaeactbes. — Colourless,  slightly  translucent,  hard  and  fri- 
able masses,  very  deliquescent,  odourless,  having  a  hot,  sharp, 
saline  taste,  and  a  neutral  or  faintly  alkaline  reaction. 

Solubility. — Soluble  in  1*5  parts  of  water,  and  in  8  parts  of  alcohol  at 
15°  C.  (59°  F.). 

Eeactions. — The  aqueous  solution  yields  the  reactions  of  calcium  (p.  646) 
and  of  a  chloride  (p.  594). 

Dose. — 1  to  3  grains  for  children,  and  10  to  20  for  adults  in 
syrup.    May  be  given  in  milk  after  meals. 

Officinal  Preparation. 
B.P. 
liquor    Calcii    Ctaloridi.      Solution  of  Chloride  of  Calcium.     Calcium 
chloride  1,  water  5  parts.    Dose. — 15-50  minim  B.   It  is  used  as  a  test  for  tartrates, 
Citrates,  and  oxalates. 

Uses. — Chloride  of  calcium  was  in  much  greater  use  formerly 
than  at  present.  It  was  strongly  recommended  by  Dr.  Warbur- 
ton  Begbie  for  cases  of  strumous  enlargement  of  the  cervical 
glands,  for  strumous  children  with  hectic,  diarrhoea,  and  loss  of 
appetite,  and  for  the  chronic  diarrhoea  of  children.  It  reduced 
the  glandular  swelling  and  improved  the  general  health,  increas- 
ing the  appetite  :  to  do  good,  however,  the  drug  must  be  taken 
for  months  and  even  as  long  as  two  years.1  It  has,  however, 
fallen  almost  into  disuse,  and  is  now  practically  replaced  by  cod- 
liver  oil  and  other  tonics. 

It  has  a  great  affinity  for  water,  and  is  used  to  remove  water 
from  other  substances  in  pharmacy,  e.g.  in  the  preparation  of 
absolute  alcohol  or  ether. 

Calcii  Carbonas  Praecipitata,  B.P. ;  Calcii  Carbonas 
Praecipitatus,  U.S.P.  Precipitated  Caebonate  of  Calcium. 
CaC03;  100. 

Characters. — A  very  fine  white  impalpable  powder,  perma- 
nent in  the  air,  odourless  and  tasteless. 

Solubility. — It  is  insoluble  in  water  or  alcohol. 

Reactions. — Wholly  soluble  in  hydrochloric,  nitric,  or  acetic  acid,  with 
copious  effervescence.  A  neutral  solution  of  the  salt  in  acetic  acid  yields  the 
"reactions  of  calcium. 

Use. — It  may  be  used  as  an  astringent  in  the  same  way  as 
chalk. 

Calcii  Bromidum,  U.S.P. — Vide  p.  556. 

1  Warburton  Begbie's  Works ;  New  Syden.  Soe. 


652  INORGANIC  MATEEIA  MEDICA.  [sect.  in. 

Calcii  Phosphas,  B.P- ;  Calcii  Phosphas  Prsecipitatus, 
U.S. P.  Phosphate  of  Calcium,  B.P. ;  Precipitated  Phosphate 
of  Calcium,  U.S.P.  Ca3(P04)2;  310  {Synonym,  Phosphate  of 
Lime)  . 

Characters. — A  light,  white,  amorphous  powder,  permanent 
in  the  air,  odourless,  tasteless. 

Solubility. — It  is  insoluble  in  water  or  alcohol. 

Impurities  and  Tests. — Wholly  soluble  in  nitric  or  hydrochloric  acid 
without  effervescence  (absence  of  carbonate).  A  solution  of  the  salt  in  diluted 
nitric  acid,  after  being  mixed  with  an  excess  of  acetate  of  sodium,  yields  a 
white  precipitate  with  test  solution  of  oxalate  of  ammonium  (calcium),  and 
a  lemon-yellow  precipitate  with  test  solution  of  ammonio-nitrate  of  silver 
(phosphate). 

Dose. — 1-20  grains.  A  simple  way  of  giving  it  is  to  mix 
it  with  the  salt  used  at  meals. 

OlTICINAIi  PREPARATIONS. 
B.P.  U.S.P.  DOSE. 

It  is  contained  in  Fulvis    Syrupus  Calcii  Laetopbcs-    1-4  fl.  dr.  (7-5-15  cc). 
Antimonlalis.  phatis. 

U.S.P.  Syrupus  Calcii  Lactophosphatis.  Syeup  or  LActophosphate  or  Lime. 
Made  by  dissolving  freshly-precipitated  phosphate  in  laotic  acid,  and  mixing  with 
orange-flower  water  and  sugar  (22  parts  phosphate  in  1,000). 

Action. — Phosphate  of  calcium  is  an  important  constituent 
of  the  body,  and  occurs  in  considerable  quantity  wherever  active 
cell-growth,  either  normal  or  pathological,  is  going  on.  It  forms 
a  large  proportion  of  bones,  and  Chossat  found  that  when  animals 
were  fed  on  food  containing  no  lime-salts,  the  bones  were  soft. 
During  pregnancy,  fractures  unite  slowly,  and  Milne-Edwards 
found  that  when  animals  were  supplied  with  abundance  of  phos- 
phate of  calcium  fractures  united  more  quickly. 

It  has  been  supposed  that  the  constant  use  of  fine  flour  tends 
to  cause  premature  decay  of  the  teeth,  owing  to  the  want  of  suffi- 
cient proportion  of  lime-salts.  The  decay  of  the  teeth  amongst 
Americans  has  been  attributed  to  the  perfection  of  their  machinery, 
which  completely  separates  the  external  parts  of  the  grain  and 
makes  the  flour  exceedingly  fine  and  white. 

Uses. — It  frequently  lessens  or  removes  toothache,  especially 
that  occurring  in  pregnancy  or  lactation  (p.  353).  It  is  useful 
in  cases  of  chronic  diarrhoea  in  children.  It  has  been  recom- 
mended in  cases  of  rapid  growth  or  deficient  repair,  as  in  grow- 
ing children,  anaemia,  and  debility  from  over-work,  child-bearing, 
suckling,  or  diseases  such  as  chronic  abscess,  diarrhoea,  leucor- 
rhcea,  bronchitis,  and  phthisis.  It  is  frequently  given  in  rickets 
with  considerable  benefit,  although  it  is  well  to  combine  it  with 
cod-liver  oil.  It  is  often  advantageously  given,  along  with  iron, 
in  the  form  of  Parrish's  Chemical  Food,  containing  two  and 
a  half  grains  of  phosphate  of  calcium  and  one  grain  of  phosphate 
of  iron  in  every  drachm. 


chap,  xxv.]  METALS.  653 

Calcii  Hypophosphis,  B.P.  and  U.S. P.  Hypophosphite  of 
Calcium,  Ca(PH202)2,  B.P.     CaH4(P02)2 ;  170,  U.S.P. 

Characters.— Colourless  or  white  six-sided  prisms,  or  thin 
flexible  scales,  of  a  pearly  lustre ;  permanent  in  dry  air,  odourless, 
having  a  nauseous,  bitter  taste  and  a  neutral  reaction. 

Ebactions. — The  aqueous  solution  yields  the  reactions  of  calcium  (p.  646). 

Dose, — 1-10  grains. 

Officinal  Preparation. 

b.p.  U.S.P.  DOSE. 

None  Syrupus  Hypophosphitum 1-2  fl.  dr.  (3-75  to  7-5  cc). 

U.S. P.  Syrupus  Hypophosphitum.  Syrup  of  Hypophosphttes.  Consists 
of  the  hypophosphites  of  calcium  (35),  of  sodium  (12),  and  of  potassium  (12) ;  citric 
acid  (1),  spirit  of  lemon  (2),  sugar  (500),  water  q.s.  to  make  1,000. 

Uses. — Hypophosphite  of  lime  is  useful  in  the  early  stages  of 
phthisis  (p.  717),  and  in  nervous  debility  consequent  upon  over- 
work or  worry.  It  may  be  given  between  two  thin  slices  of  bread 
and  butter,  if  no  irritability  of  the  stomach  be  present.  It  is  well 
to  begin  with  a  dose  of  two  grains  and  gradually  increase  it,  as 
otherwise  it  is  apt  to  cause  derangement  of  the  digestion. 

Calx  Chlorinata,  B.P. ;  Calx  Chlorata,  U.S.P-  Chlori- 
nated Lime. — Vide  Chlorine  (p.  549). 

Calx  Sulphurata,  B.  and  U.S.P.  Sulphurated  Limb.— A 
mixture  (commonly  misnamed  sulphide  of  calcium)  consisting 
chiefly  of  sulphide  of  calcium  [CaS  ;  72]  and  sulphate  of  calcium 
[CaS04 ;  136],  in  varying  proportions,  but  containing  not  less 
than  50  per  cent,  of  absolute  sulphide  of  calcium,  B.P.  (36  per 
cent.  U.S.P.). 

Characters. — A  nearly  white  powder  with  a  smell  somewhat 
resembling  that  of  sulphuretted  hydrogen. 

Preparation. — B.P.  By  calcining  sulphate  of  calcium  (7)  with  wood 
charcoal  (1)  when  part  of  the  sulphate  is  reduced  to  sulphide. 

U.S.P.  By  calcining  finely-powdered  lime  (100)  with  precipitated  sulphur 
(90). 

Dose. — -f5-l  gr. 

Action. — In  large  doses  it  is  an  irritant  to  the  stomach,  but 
medicinal  doses  usually  cause  no  trouble,  or  at  most  slight  dis- 
comfort, sometimes  giving  rise  to  eructations  of  sulphuretted 
hydrogen,  and  perhaps  to  some  looseness  of  the  bowels. 

Uses. — It  is  used  chiefly  for  its  effect  on  the  process  of  suppura- 
tion, hastening  the  discharge  of  pus  if  already  formed,  and  check- 
ing its  formation  if  the  inflammation  be  still  in  its  early  stage. 

Sulphite  of  calcium  in  doses  of  ^^-1  gr.  four  or  five  times 
daily  is  said  to  do  good  in  acne. 


654  INOEGANIC  MATEKIA  MEDICA.  [sect.  in. 

Class  II. 

Gboup  I. — Appendix. 

Aluminium.      Ceeium. 

ALUMINIUM.    Al ;  27-5. 

Geneeal  Soueces  of  Alum  Salts. — Aluminium  is  very 
widely  distributed  in  nature,  clays  being  silicates  of  alumina. 
Two  kinds  of  clay,  kaolin  and  fuller's  earth,  being  inert 
powders,  are  used  as  demulcents  (pp.  347  and  446),  and  kaolin 
also  as  a  pill-basis. 

General  Preparation. — It  is  prepared  on  a  large  scale  from  a  kind  of 
clay-slate  called  alum-schist.  This  contains  a  quantity  of  ferric  sulphide. 
It  is  first  roasted  and  moistened  and  exposed  to  air.  The  sulphur  is  thus 
converted  into  sulphuric  acid,  and  ferrous  sulphate  and  aluminium  sulphate 
are  formed.  These  are  separated  hy  lixiviation  with  water,  and  ammonium 
chloride  is  added.  This  forms  ammonium  sulphate,  which  combines  with 
aluminium  sulphate  to  form  alum,  ferrous  chloride  remaining  in  solution. 

General  Eeactions  of  Alum  Salts. — Salts  of  aluminium  give  a  white 
gelatinous  precipitate  of  hydrate  with  caustic  potash  or  soda,  soluble  in 
excess ;  with  ammonia  a  similar  precipitate,  insoluble  in  excess.  The  in- 
solubility of  the  precipitate  with  ammonia  in  excess  of  the  reagent  readily 
distinguishes  aluminium  from  zinc,  which  also  gives  a  white  precipitate  with 
ammonium  sulphide.  Carbonates  of  potassium,  sodium,  and  ammonium 
also  precipitate  the  hydrate,  which  is  insoluble  in  excess  ;  ammonium  sul- 
phide also  gives  a  white  precipitate  of  hydrate. 

General  Impurities  of  Aluminium  Salts. — The  chief  is  sulphate  of 
iron  coming  from  the  schist. 

General  Tests. — Alum  should  give  no  blue  with  either  ferro-  or  ferri- 
cyanide  of  potassium. 

Alumen,  B.  and  U.S.P.  Alum. — A  sulphate  of  aluminium 
and  potassium  (potassium  alum  or  potash  alum),  or  of  alu- 
minium and  ammonium  (ammonium  alum  or  ammonia  alum), 
crystallised  from  solution  in  water,  B.P. ;  a  sulphate  of  alu- 
minium and  potassium,  U.S.P.    K2A12(S04)4.24H20 ;  948. 

Chaeactees. — B.P.  In  colourless  transparent  crystalline 
masses,  exhibiting  the  faces  of  the  regular  octahedron,  and 
having  an  acid  sweetish  astringent  taste. 

Eeactions. — Its  aqueous  solution  gives  with  caustic  potash  or  soda  a 
white  precipitate  soluble  in  an  excess  of  the  reagent  (aluminium) ;  and  an 
immediate  precipitate  with  chloride  of  barium  (sulphate). 

U.S.P.  Large  colourless  octahedral  crystals,  acquiring  a 
whitish  coating  on  exposure  to  air ;  no  smell,  sweet  astringent 
taste,  and  acid  reaction. 

Impurity. — Iron. 

Test. — The  solution  in  water  does  not  acquire  a  Hue  colour  from  the 
addition  of  yellow  or  red  prussiate  of  potash. 

Dose. — 10  to  20  grains. 


chap,  xxv.]  METALS.  6i>5 

Pkbeaeatiohs. 

B.P.  U.S.P. 

Alumen  exsiccatum.  Alumen  exsiccatum. 

Glycerinum  Aluminis  (1  in  5). 

Alumen  Exsiccatum,  B.  and  U.S.  P.  Dried  Alum. 
K2S04A12(S04)3;  516. 

Properties. — Dry  white  powder  with  the  taste  and  other 
properties  of  alum. 

Preparation. — By  heating  potassium  alum  until  the  water  of  crystallisa- 
tion is  driven  off. 

Dose.— As  an  astringent,  10  to  40  grs. ;  as  an  emetic,  30  to 
60  grs.  For  a  lotion  or  gargle,  4  to  20  grs.  to  an  ounce  of  water, 
or  in  the  glycerinum  aluminis,  B.P. 

Action. — Alum  precipitates  albumen  and  gelatin.  It  has 
no  action  on  the  unbroken  skin,  but  when  applied  to  parts 
from  which  the  epidermis  has  been  removed,  it  causes  a  film  of 
coagulated  albumen  to  form  on  the  surface,  and  produces  con- 
traction of  the  tissues  and  vessels  below.  It  thus  lessens  the 
supply  of  blood  to  the  part,  relieves  congestion,  diminishes 
the  swelling,  lessens  the  discharge  from  inflamed  surfaces,  and 
therefore  acts  as  an  astringent.  By  causing  contraction  of 
vessels  and  aiding  the  formation  of  coagula,  it  arrests  haemor- 
rhage, and  is  therefore  used  either  as  a  strong  solution,  or,  if 
this  prove  insufficient,  in  the  form  of  powder  mixed  with  starch 
as  a  styptic.  Dried  alum  abstracts  water  from  the  tissues  and 
acts  as  a  slight  caustic.  "When  swallowed  in  large  quantities 
alum  produces  gastro-enteritis.  In  smaller  doses  it  acts  as  an 
emetic.  It  is  not  so  powerful  as  a  caustic,  astringent,  styptic, 
or  emetic  as  the  salts  of  zinc  or  copper. 

Uses. — Dried  alum  is  sometimes  used  to  check  exuberant 
granulation  in  ulcers.  Bleeding  from  the  nose  may  be  stopped 
by  sniffing  up  or  injecting  a  solution  of  alum  into  the  nostrils, 
and  if  the  solution  be  ineffectual,  powdered  alum  may  be  blown 
up  by  means  of  a  paper  funnel ;  it  is  also  employed  locally  in 
bleeding  from  the  mouth,  throat,  gums,  haemorrhoids,  and  the 
uterus.  As  an  astringent,  alum  is  used  in  both  purulent  and 
simple  ophthalmia,  but  on  account  of  its  solvent  action  on 
the  cornea  it  may  lead  to  perforation,  and  should  therefore 
be  avoided  (p.  216).  A  1  per  cent,  solution,  with  1  per  cent. 
borax,  is  useful  in  acute  eczema.  It  is  used  as  a  lotion  in 
otorrhcea ;  as  a  wash  to  the  mouth  in  ptyalism,  aphthae,  and 
ulceration  of  the  mouth  and  gums ;  as  a  gargle  for  sore-throat, 
congestion  of  the  pharynx,  and  elongation  of  the  uvula,  as  well 
as  for  the  tickling,  violent  coughs  which  depend  upon  them,  and 
are  often  accompanied  by  retching  (p.  248).  Dried  alum  has 
been  applied  in  powder  to  remo.ve  the  false  membrane  from  the 
throat  in  croup  and  diphtheria. 


b55  INOEGANIC  MATEEIA  MEDICA.  [sect,  hi,. 

Alum  may  be  employed  as  a  spray  to  the  larynx  in  coughs 
and  hoarseness  depending  upon  chronic  laryngeal  catarrh.  As 
a  -wash  it  may  be  used  in  inflammation  of  the  vulva  in  children, 
to  relieve  itching  in  pruritis  vulvae,  and  to  prevent  the  recur- 
rence of  prolapsus  ani.  It  is  useful  as  an  injection  in  gonorrhoea 
and  leucorrhoea. 

When  swallowed  it  will  act  on  the  stomach  as  an  astringent, 
and  is  useful  in  preventing  the  vomiting  of  phthisis.  It  is  not 
improbable  that  the  vomiting  which  occurs  usually  after  paroxysms 
of  coughing  is  due  to  the  congestion  produced  in  the  stomach  by 
the  cough,  and  that  the  alum  prevents  the  vomiting  by  lessening 
this  congestion  (p.  377).  When  given  in  larger  quantities  alum 
is  an  emetic,  acting  promptly,  and  producing  little  depression. 
A  teaspoonful  of  powdered  alum  proves  a  very  useful  emetic  in 
cases  of  croup,  and  may  be  given  to  children  mixed  with  honey. 
In  the  intestines  alum  acts  as  an  astringent  also,  and  is  useful 
in  diarrhoea ;  but,  curiously  enough,  in  lead  colic  it  will  act  as  a 
purgative,  relieving  the  pain  and  opening  the  bowels.  Its  utility 
in  lead-poisoning  probably  depends,  to  a  considerable  extent,  on 
its  being  a  sulphate,  and  thus  precipitating  any  lead  salts  it  may 
meet  in  the  intestine  in  the  form  of  insoluble  lead  sulphate,  and 
preventing  absorption  from  the  intestinal  canal.  In  typhoid 
fever,  and  in  chronic  dysentery  and  diarrhoea,  it  is  said  to  be 
useful  in  checking  the  discharges  from  the  bowels. 

After  its  absorption  into  the  blood  it  is  supposed  to  exercise 
an  -astringent  action,  and  is  given  to  check  sweating. 

Internally,  as  a  styptic,  it  is  employed  to  check  bleeding 
from  the  stomach,  intestines,  lungs,  uterus,  or  kidneys. 

Antidote. —  Give  tepid  water  with  small  doses  of  carbonate 
of  sodium  to  decompose  the  alum,  and  empty  the  stomach  by 
the  stomach-pump  or  emetics. 

U.S.P.  Aluminii  Hydras.  Hydeatb  of  Aluminium. 
Al2(HO)6;  156. 

Chabactees. — A  white,  light,  amorphous  powder,  permanent 
in  dry  air,  odourless,  and  tasteless. 

Solubility. — It  is  insoluble  in  water  or  alcohol. 

Eeactions. — Soluble  without  residue  in  hydrochloric  or  in  sulphuric  acid, 
also  in  solution  of  potassa  or  of  soda. 

Uses. — It  is  feebly  astringent  and  desiccant.  Is  used  ex- 
ternally as  a  powder  in  inflammatory  diseases  of  the  skin. 

U.S.P.  Aluminii  Sulphas.  Sulphate  op  Aluminium. 
Ala(S04)3.18H20 ;  666. 

Chaeactees. — A  white,  crystalline  powder,  permanent  in  the 
air,  odourless,  has  a  sweet,  and  afterwards  an  astringent  taste, 
and  an  acid  reaction. 


.chap,  xxv.]  METALS.  C57 

Solubility. — Soluble,  without  leaving  more  than  a  trifling  residue,  in  1-2 
parts  of  water  at  15°  C.  (59°  F.),  and  very  soluble  in  boiling  water ;  almost 
insoluble  in  alcohol. 

Beactions. — The  aqueous  solution  of  the  salt  yields  the  reactions  of 
aluminium  (p.  654)  and  of  a  sulphate  (p.  595). 

Uses. — It  is  a  powerful  antiseptic.  A  saturated  solution 
has  been  used  as  a  mild  caustic  in  enlarged  tonsils,  nasal  polypi, 
nsevi,  scrofulous  and  cancerous  ulcers,  diseases  of  the  os  uteri, 
and  various  chronic  enlargements.  Weaker  solutions  are  used 
as  lotions  to  ulcers,  and  as  injections  in  gonorrhoea,  leucorrhcea, 
and  foetid  discharges  from  the  vagina. 

A  solution  of  the  sulphate  dissolves  recently  precipitated 
gelatinous  alumina,  and  thus  a  benzoated  solution  of  alumina 
can  be  prepared  by  saturating  with  gelatinous  alumina  8  oz.  of 
the  sulphate  in  1  pint  of  water,  adding  6  drms.  of  powdered 
benzoin,  keeping  it  at  a  temperature  of  150°  F.  for  six  hours, 
tod  putting  in  a  cool  place  for  several  days  to  allow  the  deposi- 
tion of  crystals.  This  solution  is  remarkable  for  its  sweet  odour 
and  astringent  balsamic  taste.' 

CERIUM.    Ce ;  92. 

It  iB  a  rare  metal. 

Its  salts  are  supposed  to  resemble  those  of  bismuth  and  silver 
in  their  action. 

Cerii  Oxalas.  Oxalate  of  Cerium,  B.  and  U.S. P. 
CeC204.3H20,  B.P. ;  Ce(C204)3.9H20,  U.S.P. 

Chaeactebs.  —  It  is  a  white  granular  powder,  insoluble  in 
water.  .       

Preparation. — Is  prepared  by  precipitating  a  soluble  salt  of  cerium  with 
oxalate  of  ammonium. 

Reactions. — At  a  red  heat  it  is  decomposed  into  a  reddish-brown  powder, 
■which  dissolves  completely  in  boiling  hydrochloric  acid  without  effervescence 
(oxide).  The  resulting  solution  gives  a  white  crystalline  precipitate  of  double 
sulphate  of  potassium  and  cerium  when  a  saturated  solution  of  sulphate  of 
potassium  is  added  to  it. 

Impurities. — Aluminium,  carbonates,  and  metals.  . 

Test. — When  the  salt  is  boiled  with  caustic  potash  and  filtered,  the  filtrate 
is  not  affected  by  chloride  of  ammonium,  showing  that  no  aluminium  is 
present:  but  when  supersaturated  with  acetic  acid  it  gives  with  calcium 
chloride  a  white  precipitate  of  oxalate  of  calcium.  The  absence  of  car- 
bonates and  metals  is  ascertained  by  the  usual  tests. 

Dose. — 1  to  10  grains.  Large  doses  may  succeed  when 
Bmall  ones  fail. 

Uses. — It  was  introduced  by  the  late  Sir  James  Simpson  as 
a  remedy  to  check  the  vomiting  of  pregnancy,  and  for  this  pur- 
pose is  sometimes  useful.  It  has  also  been  employed  in  cases 
of  chronic  bronchitis  and  dyspnoea,  and  has  been  used  also  in 
nervous  cough  and  nervous  palpitation.  It  has  been  given,  but 
with  doubtful  utility,  in  chorea  and  epilepsy. 

1  United  States  Dispensatory,  15th  ed.  p.  167. 

U  U 


658 


INORGANIC.  MATERIA  MEDICA. 


[sect.  in. 


Class  II. 

Group  II.— Magnesium. 
MAGNESIUM.     Mg;  24. 

Soueoes. — The  chief  source  is  dolomite,  or  mountain  lime- 
stone, which  consists  of  carbonates  of  magnesium  and  calcium. 
Magnesium  is  also  found  native  as  carbonate  and  silicate. 

General  Reactions  of  Magnesium  Salts. — They  give  a 
gelatinous  white  precipitate  with  potash,  soda,  or  ammonia, 
insoluble  in  excess,  but  soluble  in  a  solution  of  ammonium 
chloride.  They  likewise  give  a  white  precipitate  with  potassium 
and  sodium  carbonates,  but  none  with  ammonium  carbonate. 

The  characteristic  test  of  magnesium  is  the  formation  of  a 
precipitate  of  triple  phosphate  on  the  addition  of  ammonia  and 
a  soluble  phosphate  to  a  solution  of  a  magnesium  salt.  Caustic 
ammonia  itself  throws  down  a  precipitate  of  magnesium  hydrate 
insoluble  in  excess,  but  soluble  in  ammonium  chloride.  As  it  is 
easier  to  prevent  the  precipitation  of  hydrate  than  to  re-dissolve 
it  when  down,  it  •  ia  usual  to  add  ammonium  chloride  first,  then 
the  ammonia,  and  lastly  the  phosphate  of  sodium. 

General  Preparation  of  Salts  of  Magnesium. 


Is  prepared , ' 

From 

By 

Magnesium  sulphate, 

Dolomite           .        <  - 

Dissolving    in    sulphuric    acid ; 

B.  and  U.S.P. 

when  soluble  magnesium  sul- 
phate and  insoluble  calcium 
sulphate  are  formed. 

Magnesium   carbon- 

Magnesium sulphate 

Precipitating  with  sodium  car- 

ate (heavy),  B.P. 

bonate,  using  hot  concentrated 
solutions. 

Ditto    (light),    B. 

Ditto    . 

Ditto,  using  dilute  solutions  in 

and  U.S.P. 

the  cold. 

Magnesia  (heavy) ,  B. 

Magnesium   carbon- 

Calcining until  all  the  carbonic 

and  U.S.P. 

ate  (heavy)  . 

acid  is  driven  off,  as  shown  by 
some  taken  from  the  centre  of 
the  crucible  no  longer  effer- 
vescing on  the  addition  of  acid. 

Ditto    (light),    B. 

Ditto  (light). 

Calcining,  like  the   heavy  mag- 

and U.S.P. 

nesia. 

Granulated  citrate  of 

Ditto    .        . 

Mixing  with  citric  acid  and  water, 

magnesium,  U.S.P. 

drying  and  powdering.  The 
powder  is  mixed  with  sugar, 
sodium  bicarbonate,  and  citric 
acid,  damped  with  alcohol, 
passed  through  a  sieve,  so  as 
to  form  a  coarse  powder,  and 
dried. 

Magnesium  sulphite, 

Magnesia.        * 

Suspending  in  water  and  adding 

U.S.P. 

excess  of  sulphurous  acid. 

chap,  xxv.]  METALS.  659 

General  Impurities. — The  chief  impurities  in  the  sulphate  are  the  cal- 
cium and  iron  from  dolomite.  Other  alkaline  earths  and  alkalis  may  also  be 
present.  The  sulphuric  acid  employed  may  be  impure,  or  the  sulphate  may 
have  been  prepared  by  a  process  in  which  hydrochloric  acid  is  used,  and  thug 
chlorides  may  occur.  In  the  carbonate  prepared  from  the  sulphate  the  same 
impurities  may  occur,  as  well  as  unchanged  sulphate.  In  magnesia  these 
may  all  occur,  and  carbonate  as  well. 

Tests. — The  absence  of  iron  and  other  metals  is  ascertained  by  the 
aqueous  solution  giving  no  colour  or  precipitate  with  ferrocyanide  of  potas- 
sium, hydrogen  sulphide,  or  ammonium  sulphide.  Chloride  of  ammonium 
prevents  the  precipitation  of  magnesium  by  ammonia  and  ammonium  carbon- 
ate, but  it  does  not  prevent  the  precipitation  of  other  alkaline  earths,  and 
their  absence  is  ascertained  by  the  solution  remaining  clear  after  the  addition 
of  these  three  reagents. 

General  Action  op  Magnesium. — When  administered  by  the 
mouth  the  difference  between  absorption  and  excretion  (p.  39)  is 
not  great  enough  to  allow  magnesium  salts  to  accumulate  in  the 
blood  sufficiently  to  produce  any  toxic  effects.  When  injected 
into  the  blood,  sulphate  of  magnesium,  in  doses  of  about  5  grs. 
per  pound  of  body  weight,  abolishes  reflex  action,  and  paralyses 
the  respiration  and  heart  in  cats  (Hay),  and  has  a  similar  effect 
in  other  animals  also, 

Magnesii  Sulphas,  B.  and  U.S.P.  Sulphate  of  Magne- 
sium.   Epsom  Salts.     MgS04.7H20 ;  246. 

Properties. — In  minute,  colourless,  transparent,  acicular 
crystals,  whose  form  is  a  rhombic  prism.  They  look  exactly  like 
sulphate  of  zinc.  Its  taste  is  bitter,  and  it  is  called  in  Germany 
Bittersalz.  This  distinguishes  it  from  zinc  sulphate,  which  has  a 
strong  metallic  taste. 

Solubility. — It  readily  dissolves  in  water. 

Reactions. — The  solution  gives  the  reactions  of  magnesium  (p.  658)  and 
a  sulphate  (p.  595). 

Impurities. — Calcium  and  iron. 

Tests. — Its  aqueous  solution  is  not  precipitated  at  ordinary  temperatures 
by  oxalate  of  ammonium  (no  calcium),  nor  does  it  give  a  brown  precipitate 
with  chlorinated  lime  or  soda  (no  iron). 

Dose. — As  a  purgative,  half  an  ounce  to  an  ounce  and  a  half 
for  a  single  dose.  In  repeated  doses,  especially  if  taken  fasting, 
60  to  120  grains.     As  a  diuretic,  20  to  60  grs. 

Officinal  Pkeparations. 
B.P.  u.s.p. 

Enema  Magnesii  Sulphatia.  Infusum  Sennas  Compositum. 

Mistura  Sennse  Composita. 

B.P.     Enema   Magnesii   Sulpnatis.     Enema  of  Sulphate  of  Magnesium 

(Enema  Catharticum).— Sulphate  of  magnesium  1,  olive  oil  1,  starch  mucilage  15. 

Action. — Sulphate  of  magnesium  to  saturation  precipitates 
globulins. 

In  moderate  doses  it  causes  a  copious  secretion  from  the 
intestinal  mucous  membrane,  and  acts  as  a  purgative.  It  does 
not  stimulate  the  muscular  coat  of  the  bowels  much ;  it  thus 

v  v  2 


660  INOBGANIC  MATEEIA   MEDICA.  [sect.  in. 

causes  little  griping.  As  it  does  not  accelerate  peristaltic  action, 
a  part  of  the  fluid  poured  out  into  the  intestine  may  be  reabsorbed 
as  it  passes  slowly  along.  It  is  therefore  usual  when  we  wish  to 
produce  free  purgation  to  combine  the  salt  with  some  purgative 
which  will  stimulate  the  muscular  coat  of  the  bowel,  such  as 
senna  or  cascara  sagrada.  When  given  alone  it  is  apt  to  produce 
much  flatulent  distension  of  the  abdomen  and  rumbling,  and  a 
carminative  is  therefore  often  given  along  with  it.  Its  objection- 
able bitter  taste  may  be  covered  by  dissolving  it  in  acid  infusion 
of  roses  and  adding  spirit  of  chloroform.  It  may  be  employed 
as  a  purgative  enema.  When  absorbed  into  the  blood  it  acts  as 
a  diuretic  if  the  skin  be  kept  cool,  and  as  a  diaphoretic  if  the 
skin  be  kept  warm  or  moderate  exercise  be  taken.  It  is  absorbed 
more  readily  when  given  in  small  quantities,  but  a  little  is  also- 
taken  up  when  purgative  doses  are  employed,  and  it  is  therefore 
a  useful  purgative  in  febrile  states. 

Uses. — Sulphate  of  magnesium  is  one  of  the  most  common 
■and  useful  saline  purgatives.  For  its  mode  of  action  and  uses, 
vide  pp.  391-394.  On  account  of  its  great  solubility  it  may  be 
»used  in  very  concentrated  solution  to  remove  dropsy  (p.  394) 
when  less  soluble  salts  cannot.  Eepeated  small  doses  are  very 
serviceable  in  biliousness. 

U.S. P.  Magnesii  Carbonas.  Carbonate  of  Magnesium. 
(MgC03)4Mg(HO)2.4H20 ;  484.  This  corresponds  to  the  two 
kinds  mentioned  in  the  B.P. 

B.P.  Magnesii  Carbonas.  Carbonate  of  Magnesium. 
(MgC03)3Mg(HO)2.4H20. 

B.P.  Magnesii  Carbonas  Levis.  Light  Carbonate  of 
Magnesium.     (MgC03)3Mg(HO)2.4H20. 

Both  the  light  and  heavy  carbonates  of  magnesium  have  the 
same  chemical  composition,  and  differ  only  in  their  weight. 

Properties.  —A  white  granular  powder  almost  tasteless. 

Preparation. — Both  are  prepared  by  precipitating  a  solution  of  sulphate 
of  magnesium  by  a  solution  of  carbonate  of  sodium ;  removing  the  resulting 
sulphate  of  sodium,  washing  the  carbonate,  and  drying  it  at  a  temperature 
not  exceeding  that  of  boiling  water  so  as  not  to  decompose  it. 

In  preparing  the  heavy  carbonate,  concentrated  boiling  solutions  are  used, 
the  mixture  evaporated  to  dryness,  and  the  sulphate  of  sodium  removed  by 
subsequent  digestion  with  water.  In  preparing  the  light  carbonate,  dilute 
solutions  are  employed :  they  are  mixed  cold ;  boiled  for  fifteen  minutes  J 
and  the  sulphate  of  sodium  separated  by  filtration. 

Reactions. — It  is  recognised  as  a  carbonate  by  dissolving  with  efferves- 
cence in  hydrochloric  acid,  and  the  magnesium  is  detected  by  the  appro- 
priate tests  in  the  resulting  solution  (p.  658).  The  two  carbonates  are  distin- 
guished by  their  weight. 

Action. — When  swallowed,  carbonate  of  magnesium  will  have 
a  less  stimulating  effect  upon  the  mucous  membrane  than  potash 
or  soda,  as  it  is  nearly  insoluble ;  but  on  this  very  account  it  is 


ohap.  xiv.]  METALS.  601 

to  be  preferred  to  them  for  neutralising  acid  in  the  stomach  after 
meals,  inasmuch  as  it  will  only  neutralise  the  excess  of  acid  with- 
out rendering  the  fluids  alkaline.  In  the  intestine  it  acts  as  a 
laxative,  and  is  partly  excreted  in  the  faeces  and  partly  converted 
into  magnesium  salts  which  are  absorbed  and  pass  out  in  the 
urine. 

'  Uses. — As  an  antacid  and  laxative,  especially  in  children ; 
in  heartburn,  in  dyspepsia,  and  vomiting  during  pregnancy ;  and 
in  cases  where  it  is  desirable  to  render  the  urine  alkaline,  as  in 
gouty  persons,  where  potash  and  soda  disagree. 

Dose. — As  an  antacid,  5  to  20  grains ;  as  a  laxative,  10  to  60 
grains.     It  may  be  conveniently  given  in  milk. 

Officinal  Preparations. 
B.P.  DOSE. 

liquor  IVIagnesii  Carbonatis,  as  antacid,  1-4  fl.  dr. ;  as  laxative,  1-2  fl.  oz. 
»  h         Citratis,  as  laxative 5-10  fl.  oz. 

U.S.P. 

Mistura  Magnesii  et  Asafcetids |  fl.  oz. 

B.P.  Xiiquor  Bffag-nesii  Carbonatis.  Solution  of  Carbonate  of  Mag- 
nesium.— It  is  a  solution  of  carbonate  of  magnesium  in  water  containing  carbonic 
acid.  It  contains  about  13J  grains  in  the  fluid  ounce.  It  is  a  pleasant  laxative 
for  children;  and  laxative  and  antacid  for  women,  especially  useful  during 
pregnancy. 

B.P.  and  U.S. P.  Iiiquor  Magnesii  Citratis.  Solution  of  Citrate  of 
Maonesium. — Dissolve  citric  acid,  200  grains,  in  2  ounces  of  water,  add  carbonate 
of  magnesium  100  grains,  and  stir  until  it  is  dissolved.  Filter  the  solution  into  a 
strong  half-pint  bottle,  add  syrup  of  lemons  5  fl.  oz.  and  enough  water  nearly  to 
fill  the  bottle ;  then  introduce  bicarbonate  of  potassium  in  crystals  40  grains, 
and  immediately  close  the  bottle  with  a  cork,  which  should  be  secured  with  string 
or  wire.  Afterwards  shake  the  bottle  until  the  bicarbonate  of  potassium  has 
dissolved. 

U.S.P.  Mistura  Magnesii  et  Asafoetidse  (Dewees'  Carminative). — Carbonate 
of  magnesium  5,  tincture  of  asafoetida  7,  tincture  of  opium  1,  sugar  10,  distilled 
water  up  to  100.    Dose. — |  fl.  oz.  in  hysterical  flatulence. 

Magnesia   Levis,  B.P. ;   Magnesia,   U.S.P.      Magnesia. 

Light  Magnesia,  MgO  ;  40. 

Preparation. 

U.S.P. 

Trochisci  Magnesia  (3  grs.  in  each). 

Magnesia  Ponderosa,  B.  and  U.S.P.     Heavy  Magnesia. 
Characters. — Both  are  white  powders  differing  from  each 
other  only  in  their  weight,  which  is  3|  to  1. 

Solubility. — They  are  insoluble  in  water,  but  dissolve  in  acids  without 
effervescence. 

Reactions. — The  solution  in  acids  exhibits  the  reactions  of  magnesium. 

Dose. — 10  to  60  grains  of  either  heavy  or  light. 
Action  and  Uses. — Like  those  of  the  carbonate. 

Officinal  Preparation. 
Pulvis  Ehei  Compositus,  2  parts  of  heavy  magnesia  in  3. 


6C2  INOBGANIC  MATEEIA  MEDICA.  [sect,  in, 


CHAPTEE   XXVI. 

ME  T  AL  S— (continued). 

Class  II.— DYAD  METALS— (continued). 

General  Actions  op  Heavy  Metals. — The  heavy  metals  form 
compounds  with  albumen,  known  as  albuminates.  These  are 
sparingly  soluble,  and  in  consequence  of  this,  white  of  egg  is  a 
useful  antidote  in  poisoning  with  heavy  metals.  Albuminates  of 
copper  have  been  obtained  by  Harnack  in  which  the  proportion  of 
copper  is  definite,  and  is  either  1-35  or  2-64  per  cent.  On  account 
of  their  affinity  for  albumen  the  heavy  metals  combine  with  the 
albuminous  constituents  of  the  tissues,  and  act  as  powerful 
astringents  (p.  349),  irritants  (pp.  341  and  395),  or  caustics 
(pp.  344  and  346),  according  to  the  strength  of  the  application. 
Their  action  is  comparatively  slight  when  they  are  applied  to  the 
unbroken  skin,  as  the  epidermis  forms  an  obstacle  to  their  action,' 
but  it  is  strongly  marked  where  the  epidermis  is  absent,  as  in 
wounds  cor  ulcers,  and  on  mucous  surfaces  where  the  epithelium 
is  soft.  In  addition  to  their  astringent  action  on  the  fluids  and 
tissues,  two  metals — lead  and  silver — cause  contraction  of  the 
blood-vessels  (p.  349).  In  considering  the  action  of  the  heavy 
metals  belonging  to  this  group  and  those  belonging  to  Classes" 
iri.-VIII.,  on  the  organism,  it  is  necessary  to  distinguish  care- 
fully between — 

(1)  The  local  action  upon  the  surface  of  the  body  or  upon 
the  alimentary  canal,  with  the  reflex  effects  upon  the  nervous, 
respiratory  and  circulatory  systems  consequent  on  this  local 
action,  and — 

(2)  The  effects  produced  on  the  various  organs  of  the  body  by 
the  metal  after  its  absorption.  Thus,  a  large  dose  of  corrosive 
sublimate  when  swallowed  may  produce  the  ordinary  symptoms 
of  irritant  poisoning,  causing  vomiting  and  purging  by  its  local 
action  on  the  stomach  and  intestine,  and  producing  reflexly  general,, 
collapse  with  feeble  circulation  and  respiration.  Yet  if  the  treat- 
ment be  prompt,  none  of  the  metal  may  be  absorbed,  and  thus  the 
symptoms  which  would  be  produced  by  its  action  on  the  various 
organs  when  carried  to  them  by  the  circulation  may  be  absent. 

In  considering  the  effects  produced  by  a  metal  after  its  absorp- 
tion, we  must  remember  that  the  nature  of  its  action  differs 


chap,  xxvi.]  METALS.  663 

according  to  the  quantity  present  in  the  blood  at  any  one  time, 
and  that  this  quantity  depends  on  the  relation  between  the  rapidity 
of  absorption  and  excretion  (p.  39) . 

The  proportion  between  absorption  and  excretion  depends 
greatly  on  the  channel  of  introduction,  and  therefore  the  same 
drug  may  produce  quite  different  effects  according  to  the  mode 
of  its  administration.  Thus  solution  of  perchloride  of  iron,  when 
injected  directly  into  the  veins,  will  cause  almost  immediate 
death  from  coagulation  of  the  blood.  Other  salts  of  iron  which 
have  no  coagulatirjg  action,  if  injected  into  the  circulation,  pro- 
duce paralysis  of  the  central  nervous  system  and  of  the  vaso- 
motor nerves,  causing  loss  of  voluntary  motion,  an  enormous  fall 
of  the  blood-pressure,  and  death.  When  injected  subcutaneously 
iron  is  absorbed,  but  it  enters  the  blood  less  rapidly  than  when 
injected  into  the  veins,  the  quantity  present  in  the  blood  at  any 
one  time  is  less,  and  these  symptoms  are  not  produced.  Never- 
theless absorption  takes  place  from  the  subcutaneous  tissue  so. 
rapidly  that  enough  iron  enters  the  blood  to  produce  a, toxic  action. 
But  this  action,  instead  of  affecting  the  nerves,  is  chiefly  exerted 
on  the  excreting  system,  and  inflammation  of  the  kidneys  occurs. 
When  taken  into  the  intestinal  canal  iron  is  absorbed  very 
slowly,  and  only  a  very  small  quantity  appears  in  the  urine.  It 
is  hard  to  say  whether  the  slight  headache  which  is  apt  to  come- 
on  from  the  administration  of  iron  is  due  to  the  direct  action  of 
the  metal  on  the  nerve-centres  after  its  absorption,  or  is  merely 
reflex  and  due  to  the  action  of  the  metal  on  the  intestine.  No 
injury  is  done  to  the  kidneys  of  healthy  persons,  though  the  effect 
of  the  iron  upon  these  organs  may  be  manifested  by  the  diminu- 
tion of  albumen  in  cases  of  renal  disease. 

The  form  in  which  metals  are  absorbed  from  the  intestinal 
canal  is  probably  that  of  albuminates,  or,  perhaps,  more  properly, 
of  peptonates. 

The  only  heavy  metals  which  are  rapidly  absorbed  from  the 
healthy  intestinal  canal  are  lead,  mercury,  and  arsenic.  Copper, 
zinc,  silver,  tin,  iron,  manganese,  nickel,  and  cobalt  are  absorbed: 
very  slowly  indeed.  This  is  shown  by  the  fact  that  when  given 
*  Internally  only  mere  traces  of  them  appear  in  the  urine.  That 
their  absence  from  this  secretion  is  due  to  non-absorption,  and 
not  to  their  retention  in  the  blood  or  tissues,  is  proved  by  the 
fact  that  when  they  are  injected  subcutaneously  they  pass  readily 
through  the  kidneys. 

Contrary  to  one's  expectation,  it  has  been  found  that  metals' 
are  much  more  readily  absorbed  by  the  gastro-intestinal  mucous 
membrane  when  it  is  in  a  catarrhal  condition  than  when  it  is  in 
a  healthy  state.  When  large  doses  of  metallic  salts  are  given  at 
once  they  are  very  apt  to  produce  acute  catarrh  of  the  intestinal 
canal,  and  they  are  then  readily  absorbed,  and  appear  in  large 
quantity  in  the  urine.     If  small  doses  are  given  at  first,  instead. 


664  INORGANIC  MATERIA  MEDICA.  [sect.  in. 

of  large  ones,  they  may  be  gradually  increased  without  producing 
any  catarrh,  and  then  absorption  into  the  blood  and  excretion  by 
the  urine  does  not  occur,  or  only  to  a  slight  extent,  although  the 
dose  finally  reached  may  be  large. 

The  therapeutic  bearing  of  this  fact  is  that  if  we  wish  to  affect 
the  kidneys  by  metallic  remedies,  e.g.  by  iron  in  cases  of  albu- 
minuria,  the  best  method  of  administering  the  remedy  is  to  begin 
with  large  doses  at  once. 

After  absorption  into  the  blood  the  metals  probably  remain, 
to  a  great  extent,  if  not  entirely,  in  the  plasma,  and  do  not 
become  combined  with  the  corpuscles,  or  only  to  a  very  slight 
extent.1 

They  are  carried  to  all  parts  of  the  body,  and  probably  unite 
with  certain  tissues.  They  remain  in  combination  with  the 
tissues  for  a  greater  or  less  length  of  time,  modifying  their  nutri- 
tion and  functional  activity,  and  then,  being  again  set  free,  they 
become  excreted. 

The  heavy  metals  have  all  a  powerful  poisonous  action  on 
muscles,  nerves,  nerve-centres,  and  glands.  The  Brightness, 
of  the  action  which  they  exert  on  these  structures  when  admin- 
istered by  the  alimentary  canal  is  due  to  their  slow  and  sparing 
absorption  by  it.  But  their  poisonous  power  at  once  becomes: 
evident,  as  in  the  case  of  iron,  when  they  are  injected  either  sub- 
cutaneously  or  directly  into  the  circulation  in  the  form  of  double 
salts  or  organic  compounds,  which  produce  no  local  irritation  at 
the  point  of  injection,  nor  coagulation  of  the  blood  when  they 
are  introduced  directly  into  the  vessels.  The  alterations  in  the 
spinal  cord  in  acute  poisoning  by  some  of  them — e.g.  lead  and 
mercury,  and  also  by  arsenic— have  the  characters  of  acute  central 
myelitis,  the  grey  substance  being  chiefly  affected.  In  more 
chronic  poisoning  the  white  substance  is  affected  as  well,  so  that 
the  alterations  resemble  those  of  diffuse  myelitis.  The  nervous 
symptoms  produced  by  heavy  metals  are  probably  due  to  such 
alterations  in  the  nerve-centres,  and  sometimes  to  peripheral 
alterations  in  the  nerves  also. 

Metals  are  excreted  chiefly  by  the  bile  (p.  405),  by  the  kidneys, 
by  the  mucous  membranes  of  the  stomach  and  intestine ;  and 
probably  to  a  slight  extent  by  the  skin.  Elimination  by  these 
channels  may  commence  very  soon  after  the  metal  has  entered 
the  blood. 

During  the  process  of  elimination  the  metals  may  irritate  the 
eliminating  organs  (Fig.  5,  p.  39),  and  may  cause  vomiting  by  their 
action  on  the  stomach  (p.  372),  diarrhoea  by  their  action  on  the; 
intestine,  and  albuminuria  by  their  action  on  the  kidneys,  although 


1  This  is  beet  shown  by  separating  the  corpuscles  and  plasma  in  »  centrifugal 
machine  and  analysing  them  separately,  so  as  to  ascertain  the  amount  of  metal 
in  each. 


chap,  xxvi.]  METALS.  665 

they  have  heen  injected  into  the  veins,  or  subcutaneously,  and 
only  reach  these  organs  through  the  blood. 

On  account  of  the  quantity  of  metal  which  is  eliminated  by 
the  bile  and  intestinal  mucous  membrane,  purgatives  are  useful 
agents  in  the  treatment  of  chronic  metallic  poisoning  (cf.  pp. 
384  and  561). 

When  metals  have  entered  the  blood  in  considerable  quantities, 
the  kidneys  become  inflamed  during  the  process  of  their  excre- 
tion, and  undergo  changes  which  affect  both  the  tubules  and  the 
glomeruli.  The  tubules  are  affected  first,  and  the  epithelial  cells, 
both  of  the  convoluted  and  straight  tubules,  take  up  the  metal 
and  become  gradually  disintegrated.  They  are  partly  thrown 
out  as  casts,  and  partly  block  up  the  tubules,  causing  secondary 
degeneration  of  the  glomeruli.  Both  tubules  and  glomeruli  be- 
come atrophied.  These  effects  appear  to  be  produced  by  all  the 
heavy  metals. 

Tbe  possible  effect  of  mercury  on  the  kidneys  should  be 
borne  in  mind  when  prescribing  a  very  prolonged  mercurial 
course,  and  it  would  be  interesting  to  inquire  how  far  albumi- 
nuria in  apparently  healthy  persons  is  caused  by  mercurials  (cf. 
p.  20). 

Group  III. — Zinc,  Coppee,  Cadmium,  and  Silver. 

General  Actions. — They  combine  with  albumen  and  form 
insoluble  albuminates,  and  have  thus  an  astringent  action. 

With  the  exception  of  salts  of  silver,  which  form  a  compound 
with  the  epidermis,  they  have  no  action  on  the  epidermis,  but 
they  may  pass  through  the  pores,  especially  chloride  of  zinc. 
This  salt  produces  inflammation,  or  even  mortification,  acting 
by  its  affinity  both  for  water  and  for  albumen.  It  is  used  as  a 
caustic  for  destroying  the  surface  of  unhealthy  sores  and  produc- 
ing a  more  healthy  action.  The  other  preparations  of  the  metals 
in  this  group  act  in  the  same  way,  but  are  less  powerful,  and  are 
applied  to  ulcers  and  to  chronic  skin- diseases. 

They  are  applied  for  their  astringent  action  to  the  eye  in 
gonorrhceal  ophthalmia,  ulcerations  or  opacity  of  the  cornea,  and 
to  the  mucous  membranes  of  the  urethra  and  vagina  in  gonor- 
rhoea and  leucorrhoea. 

Insoluble  preparations  such  as  oxide  of  zinc  have  little  action 
on  the  skin,  but  are  applied  as  powder  or  ointment  to  raw  and 
excoriated  surfaces,  where  protection  from  external  influences 
with  very  slight  stimulation  is  wished,  as  in  intertrigo. 

In  the  mouth  they  combine  with  the  albumen  of  the  tongue 
and  cheeks,  and  produce  a  very  disagreeable  metallic  taste. 
Notwithstanding  this  they  are  employed,  especially  sulphate  of 
copper,  for  ulcers  of  the  mouth  or  fauces. 
.     Zinc  chloride  has  been  recommended  for  carious  teeth. 


666  INOEGANIC .  MATEEIA  MEDICA.  [sect,  m: 

In  the  stomach  they  unite  with  the  albumen  in  its  walls, 
producing  irritation  and  consequent  nausea,  accompanied  by. 
muscular  relaxation.  They  have  been  used  as  nauseants  in 
spasmodic  affections,  as  epilepsy,  chorea,  hysteria,  &c. 

In  a  somewhat  larger  dose  they  produce  vomiting,  which  is 
speedy  and  complete,  especially  in  the  case  of  zinc  and  copper, 
which  are  consequently  much  used  in  cases  of  poisoning  where 
we  wish  the  stomach  emptied  with  all  possible  speed.  They  are 
preferred  in  such  cases  to  tartar  emetic,  as  they  do  not  produce 
so  much  depression,  nor  are  they  so  liable  to  cause  diarrhoea ;  and 
to  ipecacuanha,  because  their  action  is  more  rapid  and  certain. 

The  compounds  of  zinc  or  copper  with  albumen  or  peptones 
will  produce  vomiting,  either  when  given  by  the  mouth  or  when 
injected  into  the  veins,  but  they  are  classed  as  local  emetics 
(p.  373). 

Their  emetic  action  when  injected  into  the  veins  may  be  due 
to  a  direct  action  on  the  vomiting  centre  in  the  medulla  (p.  371); 
but  it  may  also  be  that  they  are  carried  to  the  stomach  by  the 
blood  and  act  reflexly  from  it  (vide  Fig.  5,  p.  39,  and  cf.  p.  373). 

The  albuminates  of  copper  and  zinc,  and  probably  those  of 
the  other  metals,  undergo  changes  both  in  the  stomach  and  in- 
testine before  absorption  which  we  do  not  perfectly  understand. 
Albumen  is  not  simply -dissolved  and  absorbed  in  the  intestinal 
canal,  but  is  converted  into  peptone.  Albuminate  of  copper  has 
been  introduced  into  a  gastric  fistula  in  a  dog,  and  the  blue 
colour  was  seen  to  disappear  at  the  edges,  and  finally  all  copper 
was  removed  from  it  before  the  albumen  was  itself  completely 
digested.  Whether  or  not  the  copper  was  removed  in  combina- 
tion as  a  peptone  or  not  we  cannot  as  yet  say.  Copper  salts 
unite  with  peptone,  forming  an  easily  soluble  compound. 

In  the  intestine  small  doses  lessen  the  frequency  of  the 
stools,  and  have  been  thus  used  in  chronic  diarrhoea  and  dysen- 
tery, but  larger  doses  have  an  irritant  effect  and  cause  diarrhoea. 
The  insoluble  salts,  as  oxide  and  carbonate  of  zinc,  have  a 
much  weaker  action  than  the  soluble  ones,  and  thus  a  large 
quantity  of  them  has  the  same  action  as  a  small  one  of  the 
soluble  salts. 

Chronic  poisoning  by  copper  is  said  to  have  occurred  in 
consequence  of  the  use  of  copper  salts  to  give  a  bright  green 
colour  to  tinned  peas  or  other  vegetables,  as  well  as  from  the  em- 
ployment of  imperfectly  cleansed  copper  pans.  Some  doubt  has 
been  thrown  on  the  possibility  of  producing  chronic  poisoning  by 
the  internal  administration  of  copper  in  small  doses,  as  in  some 
experiments  it  was  given  to  animals  for  a  length  of  time  without 
injury.  More  recent  experiments  show,  however,  that  at  least 
in  ruminants  chronic  poisoning  may  be  produced.  The  symp- 
toms are  loss  of  appetite,  imperfect  rumination,  periodical 
constipation,  imperfect  nutrition,  muscular  weakness,  languor, 


CHAP.  XXVI.] 


METALS. 


667 


jaundice,_  albuminuria,  and  towards  the  end  hemoglobinuria  or 
hematuria.  On  post-mortem  examination  granular  degeneration 
of  the  muscles  and  heart,  enlarged  spleen,  fatty  degeneration 
of  the  liver,  dark  brown  colour  of  the  blood,,  and  granular 
deposits  of  methemoglobin  ■  in  the  renal  tubules,  along  with 
hemorrhagic  parenchymatous  nephritis,  are  found. 

Chronic  poisoning  by  copper  may  occur  among  coppersmiths, 
or  in  families  where  copper  pans  have  been  used.  The  symp- 
toms are  a  metallic  taste,  a  feverish  state,  with  symptoms  of 
subacute  gastro-enteritis,  not  unfrequently  jaundice,  trembling  of 
limbs,  and  cramps.    A  purple  line  is  said  to  form  on  the  gums. 


ZINC.     Zn ;  649. 

Soueces  of  Zinc. — The  chief  are  native  carbonate  or  cala- 
mine (ZnC03)  and  zinc  blende  (ZnS). 

Genbeal  Eeactions  of  Zinc  Salts. — The  most  character- 
istic test  is  that  it  forms  a  white  sulphide,  which  is  precipitated 
on  the  addition  of  ammonium  sulphide  to  a  solution,  and  which 
is  insoluble  in  caustic  alkalies.  Caustic  potash,  soda,  or  ammo- 
nia give  a  white  precipitate  of  hydrate,  soluble  in  excess  ;  am- 
monium carbonate  gives  a  similar  precipitate,  soluble  in  excess  ; 
but  sodium  and  potassium  carbonate  give  a  white  precipitate, 
insoluble  in  excess. 

Genekal  Pkeparation  of  Zinc  Salts. 


Prepared 

From 

By 

Zinc,  B.  and  TJ.S.P.  . 

Zinc  blende  or  cala- 

Boasting, to  drive  off  sulphur  or 

mine 

carbonic  acid,  and  then  distilling 
the  oxide  ■with  charcoal. 

Granulated  zinc,B.P. 

Zinc .        .        .        . 

Melting  and  throwing  into  water. 

Zinc  chloride,  B.  and 

Zinc  .... 

Dissolving  in  hydrochloric   acid 

U.S.P. 

(Zn2  +  4HC1  =  2ZnCl2  +  2H2)  : 
it  is  then  purified  from  lead  or 
iron  by  passing' chlorine  through 
it,  and  adding  carbonate  of  zinc, 
2FeCl2      +      Cl2      =      Fe2Cl6. 
Ferrous             Chlorine            Ferric, 
chloride                                  chloride. 
Fe2Cl„  +    3ZnC03  +  3H20  = 
Ferric           Carhonate 
chloride           of  zinc 
Fe2(HO)a  +    3ZnCl2    +    3C02. 
Ferric              Chloride  of      Carbonic 
hydrate                   zinc             acid  gas. 
PbCl2    +    Cl2    +     2ZnCOs    = 
Chloride     Chlorine       Carbonate 
of  lead                                of  zinc. 
Pb02    +    2ZnCl2    +    2C02. 
Peroxide       Chloride           Carbonio 
of  lead           of  zinc              acid  gas. 

Zino  sulphate,  B.  and 

Zinc          .        • 

Dissolving  in  sulphuric  acid,  and 

U.S.P. 

purifying  in  the  same  way  as 
chloride. 

Zinc    carbonate,    B. 

Zinc  sulphate  -  -       . 

Precipitating  with   carbonate  of 

and  TJ.S.P. 

sodium. 

66S 


INOKGANIC   MATEEIA   MEDICA. 


[sect,  in; 


Geneeal  Peepabation  of  Zinc  Salts  —continued. 


Prepared 

From 

By 

Zinc  acetate,  B.  and 

Zinc  carbonate . 

Dissolving  in  acetic  acid. 

U.S.P. 

Zinc    oxide,    B.  and 

Ditto 

Calcining. 

U.S.P. 

Zinc  oleate,  B.P. 

Zinc  oxide         . 

By  dissolving  in  oleic  acid. 

Zinc   valerianate,  B. 

Zinc  sulphate   . 

Mixing  with  sodium  valerianate. 

and  U.S.P. 

Zinc  bromide,  U.S.P. 

Ditto              f 

Mixing  •with  hot  solution  of  potas- 
sium bromide,  precipitating 
potassium  sulphate  by  alcohol, 
filtering  and  evaporating.  Or  by 
acting  on  zinc  with  bromine. 

Zinc  iodide,  U.S.P.    . 

Zinc  .... 

Digesting  with  iodine  in  water 
and  evaporating: 

Zinc           phosphide. 

— 

Passing  phosphorus  vapour  in  dry 

U.S.P. 

hydrogen  over  melted  zinc. 

Zinc  sulphocarbolate, 

Zinc  oxide 

Heating  a  mixture  of  carbolic  acid 

B.P. 

and  sulphuric  acid,  saturating- 
the  product  with  zinc  oxide, 
evaporating  and  crystallising. 

General  Impurities  of  Zinc  Salts. — Iron,  lead,  copper,  and  arsenic. 

General  Tests. — A  solution  of  zinc  salt  acidulated  with  hydrochloric 
acid  gives  no  precipitate  with  sulphuretted  hydrogen  (absence  of  lead,  copper, 
or  arsenic).  The  absence  of  copper  is  further  ascertained  by  ammonia  giving 
with  a  solution  of  zinc  salts  a  white  precipitate,  soluble  in  excess  without 
colour.  If  copper  be  present  the  solution  would  be  blue.  Solutions  should 
give  no  blue  with  ferro-  or  ferri-cyanide  of  potassium,  nor  any  black  colour 
with  tincture  of  galls  (absence  of  iron). 

General  Action  of  Salts  of  Zinc. — They  combine  with 
albumen  and  coagulate  it.  The  chloride  of  zinc  thus  acts  as  an 
escharotic  after  the  epidermis  has  been  previously  removed  by 
caustic  potash.  Neither  it,  nor  the  sulphate,  nor  acetate  of  zinc 
has  any  action  on  the  unbroken  skin,  but  when  applied  to 
mucous  membranes,  they  will  act  as  irritants  in  large,  and  as 
astringents  in  small  doses. 

Sulphate  and  acetate  of  zinc  are  prompt  emetics,  causing 
rapid  evacuation  of  the  contents  of  the  stomach  with  little  nausea 
or  depression. 

The  mode  of  action  of  zinc  salts  as  emetics  has  not  been 
perfectly  determined.  It  is  probably  partly  due  to  the  local 
effect  upon  the  stomach,  and  partly  to  the  stimulant  action  upon 
the  vomiting  centre  in  the  medulla  oblongata  after  absorption 
into  the  circulation. 

Vomiting  is  produced  by  the  injection  of  zinc  salts  into  the 
circulation,  but  this  may  be  partly  due  to  irritation  of  the  stomach 
by  the  zinc  salts  during  the  process  of  excretion  by  its  mucous 
membrane,  as  well  as  to  the  action  upon  the  medulla. 

In  small  doses  zinc  salts  act  also  as  nervine  tonics,  and 
lessen  sweating. 


Oarbonas  Praecipitatus. 

Chloridum. 

Iodidum. 

Oxidum. 

Phosphidum. 

Sulphas. 

Valerianas. 


Chap,  xxvi.]  METALS.  669 

Zincum.  B.  and  U.S. P.  Zinc.  64-9.  Zinc  of  commerce, 
B.P.  Metallic  zinc  in  the  form  of  thin  sheets  or  irregular  granu- 
lated pieces,  U.S.P. 

Characters. — A  bluish-white  metal  having  the  sp.  gr.  6*9. 
Eeactions. — "When  treated  with  warm  diluted  sulphuric  acid  it  is  almost 
completely  dissolved,  forming  a  colourless  liquid  which  yields  a  white  pre- 
cipitate with  test  solution  of  ferro-cyanide  of  potassium,  or  of  sulphide  of 
ammonium.    U.S.P. 

Preparations  containing  Zinc. 
b.p.  U.S.P. 

Liquor  Zinci  Chloridi.  Liquor  Zinci  Chloridi. 

Oleatum  Zinci.  Unguentum  Zinci  Oxidi. 

Unguentum  Zinci.  Zinci  Acetas. 

„  „      Oleati.  „    Bromidum. 

Zinci  Acetas. 
„    Carbonas. 
„    Chloridum. 
„    Oxidum. 
„     Sulphas. 
„     Sulphocarbolas. 
„    Valerianas. 
Zincum  Granulatum. 
S.P.     Zincum   Granulatum.     Granulated  Zinc — (Zinc  fused  and  poured 
into  water). 

Impurities. — Very  frequently  it  contains  sulphur  or  arsenic. 
Tests. — Zinc  is  chiefly  used  for  preparing  hydrogen,  and  these  impurities 
are  tested  by  adding  pure  dilute  hydrochloric  or  sulphuric  acid  to  it  and  hold- 
ing over  it  a  piece  of  paper  dipped  in  acetate  of  lead.  If  sulphur  be  present 
the  paper  is  blackened.  If  the  piece  of  paper  be  wetted  with  solution  of 
nitrate  of  silver,  a  hrown  or  black  stain  is  produced  if  arsenic  is  present.  On 
lighting  the  hydrogen  and  depressing  a  piece  of  porcelain  on  it,  a  black  stain 
is  produced  if  arsenic  is  present. 

Zinci  Oxidum,  B.  and  U.S.P.  Oxide  of  Zinc.  ZnO. 
80-9. 

Characters. — A  soft,  nearly  white,  tasteless  and  inodorous 
powder,  becoming  pale-yellow  when  heated. 

Impurities. — Undecomposed  carbonate,  chloride,  sulphates,  iron  and 
copper. 

Tests. — Dissolves  without  effervescence  in  diluted  nitric  acid,  forming  a 
solution,  which  is  not  affected  by  chloride  of  barium  or  nitrate  of  silver,  and 
gives  with  carbonate  of  ammonium  a  white  precipitate  which  dissolves  entirely 
•(no  iron)  without  colour  (no  copper)  in  an  excess  of  the  reagent,  forming  a 
solution  which  is  precipitated  white  by  sulphide  of  ammonium. 

Dose. — 2  to  10  grains. 

Officinal  Preparations. 

B.P.  U.S.P. 

Unguentum  Zinci.  Unguentum  Oxidi  Zinci. 

B.P.  Unguentum  Zinci.  Zinc  Ointment. — Oxide  of  zinc  80  grs.,  benzoated 
lard  1  oz.,  or  1  in  6J  nearly. 

U.S.P.  Unguentum  Oxidi  Zinci.  Ointment  of  Oxide  of  Zinc. — Oxide  of  zino 
20,  benzoated  lard  80,  or  1  in  5. 

Uses. — Oxide  of  zinc  is  sparingly  soluble  in  the  stomach.  It 
dissolves  to  a  slight  extent,  too  little  to  act  as  an  emetic,  but 
sufficient  to  produce  the  action  of  small  doses  of  soluble  zinc  salts 
as  a  nervine  tonic  and  astringent. 


670  INOKGANIC  MATEEIA  MEDICA.  [sect,  m; 

It  may  be  used  as  a  dusting  powder  in  intertrigo,  and  the 
zinc  ointment  is  one  of  the  most  efficacious  remedies  we  possess 
for  application  to  excoriated  surfaces.  In  acute  eczema,  zinc 
ointment  can  sometimes  be  borne,  when  other  forms  of  bland 
ointment  only  increase  the  inflammation,  and  in  acute  vesicular 
eczema,  dabbing  the  part  for  about  fifteen  minutes  with  black 
wash  and  then  rubbing  in  zinc  ointment  gently  is  sometimes  a 
very  successful  treatment.  It  has  been  given  in  whooping-cough, 
epilepsy,  hysteria,  nervous  headache,  and  to  check  profuse 
sweating  in  phthisis,  and  profuse  secretion  from  the  bronchi  in 
bronchitis.  In  the  sweating  of  phthisis  it  is  frequently  com- 
bined with  hyoscyamus,.  and  it  is  somewhat  difficult  to  say  how 
much  of  the  beneficial  action  is  due  to  the  hyoscyamus. 

B.P.  Oleatum  Zinci.     Oleatb  of  Zinc  (p.  591). 

B.P.    Officinal  Preparation. 
Unguentum  Zincl  Oleati  (oleate  of  zinc  2,  benzoated  lard  11), 

Uses.— Ointment  of  oleate  of  zinc  alone,  or  along  with  oleate 
of  morphine,  is  an  excellent  preparation  in  many  cases  of  acute 
eczema  and  of  intertrigo. 

B.P.  Calamina  Prjeparata.  Prepared  Calamine. — Native 
carbonate  of  zinc  calcined  in  a  covered  earthen  crucible  at  a 
moderate  temperature,  powdered  and  freed  from  gritty  particles 
by  elutriation. 

Characters. — A  pale  pinkish-brown  powder,  without  gritti- 
ness. 

Solubility. — It  is  almost  entirely  soluble,  with  effervescence,  in  acids. 

Officinal  Preparation. 
Unguentum  Calaminae  (prepared  calamine  1,  benzoated  lard  5). 

Uses. — Used- sometimes  instead  of  oxide.  In  skin  diseases 
preferred  to  the  oxide  by  some,  especially  in  weeping  eczema ;  it 
is  still  better  applied  in  the  form  of  a  lotion,  e.g.  calamine  40 
grs.,  oxide  of  zinc  20  grs.,  glycerine  20  min.,  water  to  1  oz.,  or 
prepared  calamine  12  grs.,  prepared  chalk  24  grs.,  lime  water  1  oz. 

Zinci  Carbonas,  B.P. ;  Zinci  Carbonas  Praecipitatus, 
U.S. P.  Carbonate  of  Zinc.  B.P.  Precipitate?  Carbonate  of 
Zinc  ZnC03(ZnO)2.3H20.  B.P. ;  (ZnC03)„.3Zn(H0)2 ;  546-5, 
U.S.P. 

Characters. — "White,  tasteless,  inodorous. 

Solubility. — It  is  insoluble  in  water ;   soluble,  with,  effervescence  and 
without  residue,  in  dilute  nitric  acid. 

Beactions. — The  solution  in  nitric  acid  gives  the  reactions  of  zino  (p.  667). 

Dose. — 1  to  10  grains. 

Uses. — Like  those  of  calamine, 


xjhap.  xxVi.]      , "  METALS.  671 

Zinci  Chloridum,  B.  and  U.S. P.  Chloride  of  Zinc, 
ZnCl2;  135-7. 

Characters. — Colourless  opaque  rods  or  tablets,  very  deli- 
quescent and  caustic. 

Solubility. — It  is  soluble  almost  entirely  in  water,  alcohol,  and  ether. 
Ebactions. — The  watery  solution  gives  the  reactions  of  zinc  and  of  a 
chloride  (p.  594). 

Preparation  containing  Chloride  op  Zinc. 

Eilquor  Zinci  Cbloridi 366  grains  in  one  fluid  ounce. 

liquor   Zinci  Chloridi,  B.  and  TT.S.P.     Solution  op  Chloride  of  Zinc, 
ZnClz ;  135-7,  U.S.P.    Prepared  like  the  solid,  but  not  so  much  evaporated. 

Uses. — It  is  a  powerful  caustic  distinguished  by  its  property 
of  burning  deeply  and  not  spreading  sidewise  like  many  others. 
It  is  applied,  in  substance,  or  made  into  a  paste  with  starch  or 
gypsum,  to  cancers,  sloughing  or  unhealthy  sores,  and  nsevi. 
Diluted  it  is  applied  to  ulcers. 

It  has  been  used  to  destroy  the  exposed  pulp  in  decayed 
teeth,  warty  growths,  condylomata,  syphilitic  sores,  and  lupus. 
In  the  proportion  of  one  to  two  grains  in  a  pint  of  water  it  has 
been  recommended  by  Einger  as  an  injection  in  gonorrhoea. 

Burnett's  (Sir  W.)  disinfectant  and  deodorising  solution  is 
solution  of  chloride  of  zinc  (of  sp.  gr.  2),  and  it  is  by  the  acci- 
dental use  of  this,  that  most  cases  of  zinc-poisoning  occur. 

Zinci  Sulphas,  B.  and  U.S.P.  Sulphate  of  Zinc. 
ZnS04.7H20;  286-9. 

Characters. — In  colourless  transparent  prismatic  crystals 
with  a  strong  metallic  styptic  taste. 

^Reactions. — Its  solution  in  water  gives  the  reactions  of  zinc  and  of  a 
sulphate  (p.  595). 

Dose. — 1  to  3  grains  as  a  tonic;  10  to  30  grains  as  an 
emetic. 

Uses. — Sulphate  of  zinc  is  used  as  an  astringent  to  lessen 
discharges  from  mucous  membranes  ;  it  is  employed  as  a  lotion 
in  gonorrhoea  and  leucorrhcea ;  as  a  wash  to  the  eye  in  ophthal- 
mia ;  and,  mixed  with  honey,  in  gangrene  of  the  mouth  in  chil- 
dren. It  is  used  as  a  gargle  to  the  throat  in  relaxed  sore-throat, 
pendent  Uvula,  and  enlarged  tonsils. 

As  an  emetic  it  is  chiefly  employed  in  narcotic  poisoning, 
where  the  rapidity  of  its  action,  unaccompanied  by  any  depress- 
ing influence  on  the  circulation,  is  very  serviceable.  It  is  some- 
times used,  also,  to  cause  vomiting  in  croup.  It  is  employed  as 
an  astringent  in  chronic  diarrhoea  and  dysentery.  It  has  also 
been  used  as  a  tonic  in  flatulence  and  flatulent  distension  of  the 
colon.  After  absorption  into  the  blood  it  has  a  tonic  action  on 
some  parts  of  the  nervous  system,  and  is  used  in  the  treatment 
of  convulsive  diseases,  such  as  chorea,  epilepsy,  hysteria,  as  well 


672  INOEGANIC  MATEKIA  MEDICA.  [sect.  in. 

as  in  spasmodic  affections  of  involuntary  muscular  fibre,  such  as 
angina  pectoris  and  spasmodic  asthma. 

Zinci  Sulphocarbolas,  B.P.  Sulphocakbolate  of  Zinc. 
Zn(C6H5S04)2.H20. 

Characters. — Colourless,  transparent,  tabular,  efflorescent 
crystals,  with  an  astringent  taste. 

Solubility. — Soluble  in  about  twice  the  weight  of  rectified  spirit  and  of 
water. 

Reactions. — The  watery  solution  is  coloured  violet  by  perchloride  of  iron, 
and  gives  a  white  precipitate  with  sulphydrate  of  ammonium ;  it  is  made 
faintly  turbid  by  chloride  of  barium,  and  it  is  not  precipita'ted  by  oxalate  of 
ammonium. 

Action. — Sulphocarbolate  of  zinc  is  antiseptic  and  astrin- 
gent. 

Uses. —  It  is  used  as  an  injection  in  otorrhcea,  gonorrhoea,  and 
other  cases  of  purulent  discharges,  in  the  strength  of  2  to  4  grains 
to  the  ounce  of  water.     It  is  not  given  internally. 

Zinci  Acetas,  B.  and  U.S.P.  Acetate  of  Zinc.  Zn(C2H0)3 
(CO.OH)2.2H20;  218-9,  B.P. ;  Zn(C2H302)2.3H20 ;  236:9, 
U.S.P. 

Characters. — Thin,  translucent  and  colourless  crystalling 
plates,  of  a  pearly  lustre,  with  a.  sharp  unpleasant  taste. 

Solubility. — Soluble  in  water. 

Reactions. — The  solution  gives  the  reactions  of  zinc,  and  evolves  acetio 
acid  when  decomposed  by  sulphuric  acid. 

Dose. — 1  to  2  grains  as  a  tonic ;  10  to  20  grains  as  an 
emetic. 

Uses. — It  is  used  for  much  the  same  purposes,  and  in.  the 
same  doses,  as  the  sulphate.  An  unchemical  but  useful  injection 
for  gonorrhoea,  gleet,  and  leucorrhoea,  consists  of  six  grains  of 
sulphate  of  zinc,  with  four  ounces  of  the  dilute  solution  of  sub- 
acetate  of  lead.  In  this  mixture  the  sulphate  of  lead  which  is 
precipitated  has  probably  a  beneficial  action  in  keeping  apart 
the  surfaces  of  the  mucous  canal  into  which  it  is  injected 
(p.  446). 

U.S.P-  Zinci  Bromidum.  Bromide  of  Zinc.  ZnBr2; 
224-5. 

Characters. — A  white,  or  nearly  white,  granular  powder, 
very  deliquescent,  odourless,  having  a  sharp  saline  metallic  taste, 
and  a  neutral  reaction. 

Solubility. — Very  soluble  in  water  and  in  alcohol. 

Reactions. — The  aqueous  solution  of  the  salt  yields  the  reactions  of  zinc 
and  of  a  bromide  (p.  594). 

Dose. — 2  to  8  grains  given  in  syrup. 

Uses. — In  large  doses  it  is  irritant  and  emetic  like  other 
salts  of  zinc.  It  has  been  recommended  in  epilepsy  with  the 
idea  of  combining  the  actions  of  bromine  and  zinc. 


chap,  xxvi.]  METALS.  673 

U.S.P.'  Zinci  Iodidum.     Iodide  of  Zinc.     Znl2 ;  318-1. 

Chaeactees. — A  white,  or  nearly  white,  granular  powder, 
very  deliquescent,  odourless,  having  a  sharp  saline  and  metallic 
taste,  and  an  acid  reaction. 

Solubility. — Very  soluble  in  water  and  in  alcohol. 

Beactions. — The  aqueous  solution  yields  a  white  precipitate  with  test 
solution  of  ferrocyanide  of  potassium  or  of  sulphide  of  ammonium,  a  yellow 
precipitate  with  test  solution  of  acetate  of  lead,  and  a  red  one  with  test 
solution  of  mercuric  chloride  (iodide). 

Dose. — ■§•  to  2  grains. 

Uses. — Locally  it  has  been  used  in  solution  as  an  application 
to  enlarged  tonsils.  An  ointment,  1  part  to  8  of  lard,  has  been 
used  in  place  of  the  ointment  of  iodide  of  potassium  or  of  cad- 
mium to  reduce  swellings.  A  solution  of  2  grains  to  1  oz.  has 
been  used  in  gonorrhoea.  Internally  it  has  been  used  in  scrofula, 
chorea,  and  hysteria.     It  is  best  administered  in  the  form  of  syrup. 

Zinci  Valerianas,  B.  and  U.S.  P.  Valeeianate  op  Zinc. 
Zn(C5H902)2.H20;  284-9. 

Chaeactees. — In  brilliant,  white,  pearly,  tabular  crystals, 
with  a  feeble  odour  of  valerianic  acid,  and  a  metallic  taste. 

Solubility. — It  is  scarcely  soluble  in  cold  water  or  in  ether,  but  is  soluble- 
in  hot  water  and  alcohol. 

Beactions. — Heated  to  redness  in  an  open  crucible,  it  leaves  a  residue 
which,  when  dissolved  in  diluted  sulphuric  acid,  yields  with  ammonia  a  pre- 
cipitate which  entirely  dissolves  in  an  excess  of  the  reagent,  and  the  result- 
ing solution  gives  a  white  precipitate  with  sulphide  of  ammonium  (zinc). 

Preparation. — Mixing  hot  aqueous  solutions  of  sulphate  of  zinc  and 
valerianate  of  sodium,  evaporating  at  a  gentle  heat  and  crystallising.  The 
crystals  are  washed  with  water  until  free  from  sulphate. 

Impurities. — Sulphate  and  butyrate  of  zinc  from  imperfect  preparation. 

Tests. — Its  solution  in  hot  water  is  not  precipitated  by  chloride  of 
barium  (no  sulphate).  It  gives  when  heated  with  diluted  sulphuric  acid  a 
distillate,  which  when  mixed  with  the  solution  of  acetate  of  copper,  does  not 
immediately  affect  the  transparency  of  the  fluid,  but  forms  after  a  little  tivne 
oily  drops,  which  gradually  pass  into  a  bluish- white  crystalline  deposit  (no 
butyrate). 

Dose. — £  to  4  gr.  ;  the  dose  may  be  increased  until  some 
nausea  is  produced. 

Uses. — Valerianate  of  zinc  has  been  supposed  to  combine  the 
nervine  tonic  action  of  zinc  with  the  antispasmodic  effect  of 
valerian ;  but  it  is  much  better  to  use  valerian  itself  or  its  oil 
along  with  a  salt  of  zinc,  as  the  acid  has  no  important  physio- 
logical action.  It  is  used  in  chorea,  especially  when  occurring 
in  hysterical  persons,  and  should  not  be  discontinued  until 
symptoms  of  nausea  begin  to  make  their  appearance.  It  is  also 
employed  in  epilepsy  and  neuralgia. 

U.S.P.  Zinci  Phosphidum.  Phosphide  of  Zinc  Zn3P2 ; 
256-7. 

Chaeactees. — Minutely  crystalline  friable  fragments,  having 
a  metallic  lustre  on  the  fractured  surfaces,  or  a  greyish  black 

x  x 


674 


INOEGANIC  MATEEIA  MEDICA. 


[SECT.  III. 


powder  permanent  in  the  air  having  a  faint  odour  and  taste  of 
phosphorus. 

Solubility  and  Reactions. — Insoluble  in  water  or  alcohol,  but  com- 
pletely soluble  in  hydrochloric  or  sulphuric  acids  with  evolution  of  phospho- 
retted  hydrogen. 

Dose. — Not  more  than  -fa  grain  at  first. 

Uses. — Its  action  is  similar  to  that  of  phosphorus,  and  it 
is  used  in  place  of  it.  Each  grain  contains  nearly  £  grain  of 
phosphorus. 

COPPER.     Cu;  634. 

Sources. — Its  chief  source  is  copper  pyrites,  which  is  a  double 
sulphide  of  copper  and  iron. 

General  Eeactions. — Ammonia  throws  down  a  pale  blue 
precipitate  of  hydrate,  which  is  soluble  in  excess,  forming  a  deep 
blue  solution.  Potassium  ferrocyanide  gives  a  maroon  red 
precipitate. 


Prepared  from 

By 

Copper,  B.P.    . 

Copper  pyrites 

Boasting  with  sand  and  coal. 

Copper  sulphate,  B. 
and  U.S.P. 

Copper     .        . 

Heating  copper  or  its  oxide  with 
sulphuric   acid,   dissolving  in 
water  and  crystallising. 

Copper  nitrate,  B.P. 

Ditto     ... 

Dissolving  in  nitric  acid,  evapo- 
rating and  crystallising. 

Copper    acetate,   B. 
and  U.S.P. 

Copper  sulphate 

Precipitating  with  acetate  of  lead. 

General  Impurity. — Iron. 

General  Test. — If  an  aqueous  solution  of  a  copper  salt  be  mixed  with 
twice  its  volume  of  chlorine  water,  any  iron  present  is  converted  into  a  ferric 
salt.  If  solution  of  ammonia  be  now  added,  cupric  hydrate  will  fall  as  a 
precipitate  of  a  pale  blue  colour,  but  is  redissolved  by  excess,  forming  a  deep 
blue  solution.  If  iron  be  present,  it  will  be  precipitated  by  the  ammonia  and 
not  redissolved. 

Cuprum,  Cu  =  63-4.  B.P.  Copper. — Fine  copper  wire,  about 
No.  25  wire  gauge,  or  0-02  inch. 

Use.' — To  detect  the  presence  of  metals,  as  silver,  mercury, 
and  arsenic,  by  their  being  precipitated  on  its  surface  and  form- 
ing a  stain.  It  is  employed  in  the  preparation  of  sulphate  and 
nitrate  of  copper  and  of  spirit  of  nitrous  ether. 

B.P.  Cupri  Nitras.  Nitrate  of  Copper,  Cu(NO3)2.6H20. 
Characters. — Deep  blue  prismatic  crystals,  very  deliquescent, 
highly  corrosive.  With  one-third  of  its  weight  of  water  it  forma 
at  a  temperature  below  70°  P.  (21-1°  C),  tabular  crystals; 
Cu(N03)2.6H20.  With  a  very  little  more  water,  added  directly  or 
absorbed  from  the  air,  it  yields  a  styptic,  caustic,  corrosive  fluid. 
Eeactions. — The  diluted  aqueous  solution  is  only  faintly  acid  to  litmus; 
it  gives  the  reactions  of  copper  and  a  nitrate  (p.  594). 


chap,  xxvi.]  METALS.  675 

Cupri  Sulphas,1  B.  and  U.S.  P.  Sulphate  of  Coppeb. 
CuS04.5H20;  249-2. 

Chakacters.— A  blue  crystalline  salt,  in  oblique  prisms. 

Preparation. — Vide  p.  674. 

Solubility. — It  is  soluble  in  water,  forming  a  pale  blue  solution  which 
strongly  reddens  litmtis. 

Eeactions. — The  aqueous  solution  gives  the  reactions  of  copper  and  a 
sulphate. 

Dose. — As  an  astringent,  £  to  2  grains ;  as  an  emetic,  5  to 
10  grains. 

B.P.  Sulphate  of  Capper,  Anhydrous.  CuS04.  Sulphate  of  copper 
deprived  of  its  water  by  a  heat  of  400°  F. 

Chakaciees. — A  yellowish-white  powder,  which  becomes  blue  when  moistened 
with  water. 

Action. — Sulphate  of  copper  has  little  or  no  action  on  the 
skin  covered  by  epidermis,  but  when  applied  to  the  denuded 
skin  it  combines  with  the  albuminous-  constituents  of  the  tissues, 
forming  an  albuminate  of  copper.  It  thus  acts  as  a  mild  caustic, 
and  is  an  astringent.  It  has  a  similar  astringent  action  on 
mucous  membranes,  and  when  swallowed  in  large  doses  it  acts 
as  a  powerful  emetic,  like  the  sulphate  of  zinc,  and  in  smaller 
doses  as  an  astringent.  Like  sulphate  of  zinc,  it  probably  exerts 
its  action  partly  on  the  stomach  itself  and  partly  on  the  vomit- 
ing centre.  Small  doses  absorbed  into  the  blood  appear  to  have 
a  tonic  action  on  some  parts  of  the  nervous  system,  and  to  exert 
an  astringent  action  on  mucous  membranes.  The  copper  is 
excreted  by  the  mucous  membrane  of  the  intestine,  by  the  bile, 
sweat,  and  kidneys.  It  is  probable  that  its  effect  as  an  emetic 
when  injected  into  the  blood  is  partially  due  to  the  action  it 
produces  upon  the  stomach  or  intestines  in  the  process  of  elimi- 
nation (p.  39).  Its  action  as  an  astringent  upon  other  mucous 
membranes  is  probably  due  to  a  similar  cause. 

Uses. —  Sulphate  of  copper  in  substance  is  used  as  a  mild 
caustic  to  the  edges  of  sores,  to  repress  exuberant  granulations, 
both  of  ulcers  and  of  trachoma,  and  as  a  styptic  to  arrest  the 
blood  from  leech-bites.  When  mixed  with  honey  it  may  be  ap- 
plied to  the  mouth  in  cancrum  oris.  In  solution  it  may  be  ap- 
plied to  indolent  ulcers,  and  to  remove  warts  and  parasitic  skin- 
diseases,  and  as  an  injection  into  the  nose  to  stop  epistaxis.  It 
is  used  as  a  wash  to  the  eyes  in  ophthalmia,  as  an  injection  in 
gonorrhoea  and  leucorrhcea,  and  as  a  gargle  in  sore-throat.  It  is 
an  efficient  and  rapid  emetic  in  cases  of  narcotic  poisoning,  in 
phosphorus-poisoning,  and  in  croup.    It  is  a  powerful  astringent 

1  Oleate  of  copper  is  a  useful  application  in  cases  of  ringworm,  applied  night 
and  morning.  It  is  first  prepared  by  drying  a  mixture  of  sulphate  of  copper  (3  in 
8  of  water)  and  a  solution  of  Castile  soap  (8  in  32),  and  may  be  applied  in  the 
form  of  ointment,  1  in  4  of  petroleum  cerate.  It  has  also  been  used  for  indolent 
ulcers,  warts,  and  corns. 

x  x  2 


676  INORGANIC  MATERIA  MEDICA.  [sect.  m. 

in  chronic  diarrhoea,  dysentery,  and  colliquative  diarrhoea  of 
phthisical  patients.  It  is  employed,  like  zinc,  in  chorea,  epilepsy, 
and  hysteria,  but  seems  less  useful  than  zinc.  The  nitrate  has 
a  similar  action  to  the  sulphate,  but  is  more  powerful  as  a 
caustic  and  styptic.  It  is  a  useful  application  to  syphilitic  sores 
on  the  tongue. 

B.P.     Test  Solution  of  Ammonio-Sulphate  of  Copper. 

A  test  for  arsenious  acid,  forming  with  it  Scheele's  green. 

B.P.      Subacetate   of  Copper  of  Commerce.      Cu.CuO 

(C2H302)2.     Verdigris,  Aerugo. — Used  in  solution  as  a  test. 

B.P.     Test  Solution  of  Acetate  of  Copper. 

Use. — In  testing  for  butyric  acid  in  valerianates. 

U.S. P.  Cupri  Acetas.  Acetate  of  Copper.  Cu(CH2)2 
(CO-OH)2.H20 ;  199-2. 

Characters. — Deep  green,  prismatic  crystals,  yielding  a 
bright  green  powder,  efflorescent  on  exposure  to  air,  odourless, 
having  a  nauseating  metallic  taste  and  an  acid  reaction. 

Tests. — If  the  aqueous  solution  of  the  salt  be  treated  with  hydrosulphuric 
acid  until  all  the  copper  is  precipitated,  the  filtrate  should  leave  no  residue 
on  evaporation  (alkalis,  alkaline  earths,  or  iron).  If  the  aqueous  solution 
be  heated  to  boiling  with  solution  of  soda  in  excess,  it  will  yield  a  filtrate 
which  should  not  be  clouded  by  hydrosulphuric  acid  (absence  of  lead  and 
zinc). 

Uses. — Like  sulphate  of  copper.     Not  used  internally. 

ARGENTUM.     Ag ;  108  B.P.    (1077  U.S.P.)    Silver. 

Argentum  Purificatum.     B.P-     Eefined  Silver. 

Pure  metallic  silver. 
Impurities. — Gold,  copper,  and  lead. 

Test. — If  ammonia  be  added  in  excess  to  a  solution  of  the  metal  in  nitric 
acid,  the  resulting  fluid  exhibits  neither  colour  nor  turbidity. 

Prepabation. 
Argenti  Nitras. 

Argenti  Nitras,  B.  and  U.S.P.  Nitrate  op  Silver.  Lunar 
Caustic— AgN03 ;  169-7. 

Characters. — In  colourless  tabular  crystals,  the  primary 
form  of  which  is  the  right  rhombic  prism ;  or  in  white  cylindrical 
rods. 

Solubility. — It  is  soluble  in  distilled  water,  and  in  rectified  spirit. 

Reactions. — The  solution  gives  with  hydrochloric  acid  a  curdy  white 
precipitate,  which  darkens  by  exposure  to  light,  and  is  soluble  in  solution  of 
ammonia.  A  small  fragment  heated  on  charcoal  with  the  blowpipe,  first 
melts,  and  then  deflagrates,  leaving  behind  a  dull  white  metallic  coating. 

Preparation. — By  dissolving  silver  in  nitric  acid,  evaporating  and  cry- 
stallising. 

It  is  obtained  in  rods  by  fusing  the  crystals  in  a  capsule  of  platinum  or 


ghap.  xxvi.]  METALS.  677 

thin  porcelain,  and  pouring  the  melted  salt  into  proper  moulds.     Nitrate  of 
silver  must  be  preserved  in  bottles  carefully  stoppered. 

Toughened  nitrate  of  silver  or  '  toughened  caustic  '  is  formed  by  adding 
5  parts  of  nitrate  of  potassium  to  95  parts  of  the  nitrate  of  silver  before 
fusion. 

PREPARATIONS  FOB  WHICH  NllBATB    OF    SlLVER  IS  USED. 

Argenti  et  Potassil  Ultras. 

Argenti  Oxidum. 

Impurities. — Nitrate  of  potassium,  metallic  impurities. 

Tests. — Ten  grains  dissolved  in  two  fluid  drachms  of  distilled  water  give 
with  hydrochloric  acid  a  precipitate,  which,  when  washed  and  thoroughly 
dried,  weighs  8-44  grains.  The  nitrate,  when  evaporated  by  a  water-bath, 
leaves  no  residue. 

Dose. — £  to  |  grain. 

Administration. — As  an  application  to  the  eyes  or  injection 
it  is  used  in  solutions  of  various  strengths,  but  an  ordinary  safe 
one  is  2  grains  to  the  ounce.  When  made  into  pill  it  must  not 
be  mixed  with  tannin,  which  reduces  the  silver  to  the  metallic 
condition  and  becomes  converted  into  gallic  acid  with  evolution 
of  carbonic  acid  gas.  It  is  best  made  up  into  pill  with  kaolin 
and  a  very  little  tragacanth.  As  a  draught  it  may  be  made  up 
with  dilute  nitric  acid,  syrup,  and  mucilage. 

U.S.P.  Argenti  Nitras  Fusus.  Moulded  Niteate  of 
Silver. 

Characters. — A  white,  hard  solid,  generally  in  form  of  pen- 
cils or  cones  of  a  fibrous  fracture,  becoming  grey  or  greyish- 
black  on  exposure  to  light  in  presence  of  organic  matter. 

Preparation. — Prepared  by  fusing  together  nitrate  of  silver  100  parts, 
hydrochloric  acid  4  parts,  and  pouring  into  suitable  moulds. 

Argenti  et  Potassii  Nitras,  B.P. ;  Argenti  Nitras  Dilutus, 
U.S.P.  Nitrate  oe  Silver  and  Potassium,  B.P. ;  Diluted 
Nitrate  of  Silver,  U.S.P.    Mitigated  Caustic. 

Characters. — White  or  greyish-white  cylindrical  rods  or 
cones. 

Preparation. — Prepared  by  fusing  together  nitrate  of  silver  1  part,  with 
nitrate  of  potassium  2  parts,  B.P. ;  1  part,  U.S.P. 

Solubility. — It  is  freely  soluble  in  distilled  water,  but  only  sparingly  in 
rectified  spirit. 

Reactions. — The  aqueous  solution  gives  with  hydrochloric  acid  a  curdy 
white  precipitate  which  darkens  by  exposure  to  light  (silver) ;  the  filtrate 
from  this  mixture  giving  a  yellow  precipitate  with  perchloride  of  platinum 
(potassium),  and  evolving  ruddy  fumes  when  warmed  with  sulphuric  acid  and 
copper  (nitrate). 

General  Action  op  Silver  Salts. —  Soluble  silver  salts, 
such  as  the  nitrate  of  silver,  have  a  strong  affinity  for  the  cement 
by  which  epithelial  or  endothelial  cells  are  united,  and  are, 
therefore,  much  used  in  staining  microscopic  preparations. 
They  also  unite  with  albumen,'  forming  albuminates  of  silver. 
When  applied  to  the  skin,  nitrate  of  silver  produces  a  white 


678  INOEGANIC   MATEEIA   MEDICA.  [sect.  hi. 

mark  which  rapidly  becomes  blackened  by  exposure  to  light,  and 
the  epidermis,  either  alone  or  with  a  slough  varying  in  depth 
according  to  the  strength  of  the  application,  is  thrown  off. 
Locally,  it  causes  greater  contraction  of  the  vessels  than  other 
metals.  In  the  mouth  it  has  an  unpleasant  astringent  taste, 
corrugates  the  mucous  membrane,  and  acts  as  an  irritant  or 
caustic.  In  the  stomach,  in  small  doses,  it  acts  as  an  astrin- 
gent, and  occasionally  lessens  vomiting,  but  in  larger  doses  it 
acts  as  an  irritant,  and  causes  vomiting  and  symptoms  of  irritant 
poisoning  (p.  396).  In  the  intestine  small  doses  are  astringent, 
and,  when  absorbed  from  the  blood,  appear,  like  zinc  or  copper, 
to  have  a  tonic  action  on  some  parts  of  the  nervous  system. 
When  taken  for  a  length  of  time  it  is  apt  to  cause  a  livid  discolo- 
ration of  the  skin.  This  discoloration  appears  to  depend  upon 
the  amount  of  silver  taken  independently  of  the  time  during 
which  its  administration  has  been  continued,  so  that  it  is  ad- 
visable, when  administering  nitrate  of  silver  to  a  patient,  to 
inquire  whether  he  has  previously  taken  it  or  not,  as  the  silver 
remaining  in  the  system,  together  with  that  administered  in  the 
second  instance,  might  cause  a  darkening  of  the  skin  which  the 
quantity  employed  in  the  second  course  alone  would  not  have 
produced.  When  taken  for  a  long  time,  silver  salts  appear  to 
produce  fatty  degeneration  of  the  tissues.  They  are  probably 
very  slowly  eliminated  by  means  of  albuminous  secretions  such 
as  bile. 

Uses. — Nitrate  of  silver  may  be  applied  to  destroy  parasitic 
fungi  and  remove  tinea  ;  to  destroy  the  epidermis  itself  or  epi- 
dermic structures  such  as  warts,  and  to  check  the  bleeding  from 
leech-bites.  In  solution  it  relieves  the  itching  of  pruritus  and  of 
lichen.  When  sponged  over  the  skin  it  hardens  the  epidermis 
and  may  prevent  the  formation  of  bed-sores.  It  is  said  to  arrest 
vesication  in  herpes  if  painted  over  the  surface  as  soon  as  the 
vesicles  begin  to  form.  It  is  also  said  that  the  pitting  of  small- 
pox is  prevented  by  opening  the  vesicle  and  touching  the  surface 
beneath  with  a  solution  of  the  salt,  or  even  by  painting  the  solu- 
tion over  the  skin.  It  has  been  recommended  as  a  remedy  in 
erysipelas,  and  is  applied  either  by  painting  the  strong  solution 
over  and  beyond  the  inflamed  surface,  or  by  drawing  a  line  with 
solid  nitrate  of  silver  upon  the  skin  a  little  way  beyond  the 
margin  of  the  inflammation.  The  alteration  produced  in  the 
tissues  underneath  this  line  is  said  to  prevent  the  extension  of 
the  inflammation  beyond  the  limit  thus  formed.  It  is  of  little 
use  in  poisoned  wounds,  such  as  the  bite  of  a  mad  dog  (p.  347). 
Dilute  solutions  may  be  applied  to  the  eye  in  tinea  tarsi  and 
conjunctivitis.  In  the  mouth  it  may  be  used  as  an  application 
to  ulceration  of  the  tongue,  soft  palate,  or  tonsils,  and  is  often 
employed  for  this  purpose  on  account  of  the  readiness  with  which 
it  can  be  applied ;  it  is  especially  useful  in  follicular  tonsillitis 


chap,  xxvi.]  METALS.  679 

and  pharyngitis.  In  thus  applying  it  care  should  be  taken  that 
it  is  well  fixed  in  the  holder,  as  otherwise  a  quick  motion  of  the 
patient  may  break  off  the  portable  stick  of  nitrate  of  silver,  which 
will  probably  fall  into  the  pharynx,  be  swallowed,  and  may 
produce  symptoms  of  irritant  poisoning.  The  treatment  of 
poisoning  is  to  give  common  salt  in  order  to  form  insoluble,  and 
therefore  inert,  chloride  of  silver.  Where  the  stick  of  nitrate  of 
silver  has  been  swallowed  in  substance  this  treatment  has  not 
always  proved  efficacious,  and  salt  should  therefore  then  be  ad- 
ministered in  combination  with  mucilaginous  substances  such 
as  porridge  and  gruel,  along  with  an  emetic,  so  that  the  stick  of 
silver  may  be  at  once  evacuated  from  the  stomach,  while  the 
mucilaginous  envelope  prevents  it  from  doing  any  harm  to  the 
.oesophagus  on  its  way.  It  has  been  used  to  destroy  the  false 
membrane  in  croup,  and  as  a  useful  application  to  the  larynx  in 
laryngeal  phthisis.  It  may  be  applied  either  in  solution  of  the 
strength  of  30  grains  to  the  ounce  in  laryngeal  phthisis,  by 
means  of  a  brush,  or  in  the  form  of  lycopodium,  which,  after 
being  dipped  in  the  solution  and  then  dried,  may  be  blown  by  a 
curved  tube  into  the  larynx  (cf.  p.  480).  It  is  sometimes  used  as 
an  injection  in  gonorrhoea.  Internally,  it  may  be  employed  in 
irritable  stomach,  and  also  as  an  astringent  in  chronic  diarrhoea 
and  dysentery,  and  as  a  nervine  tonic  in  chorea  and  epilepsy. 

Argenti  Oxidum,  B.  and  U.S.P-  Oxide  op  Silver. 
Ag20;  231-4. 

Characters. — An  olive-brown  powder,  which  at  a  low  red 
heat  gives  off  oxygen  and  is  reduced  to  the  metallic  state. 

Solubility  and  Ebactions. — It  dissolves  completely  in  nitric  acid  -with- 
6ut  the  evolution  of  any  gas,  forming  a  solution  which  has  the  characters  of 
nitrate  of  silver.  29  grains  heated  to  redness  leave  27  grains  of  metallic 
silver. 

Dose. — £  to  2  grains. 

Uses. — It  has  been  used  internally  in  neuralgic  pain  in  the 
stomach,  irritable  dyspepsia,  and  pyrosis.  Another  drug  not 
unfrequently  given  in  similar  affections  is  creasote ;  but  creasote 
and  oxide  of  silver  are  incompatible,  as  the  former  becomes 
oxidised  at  the  expense  of  the  silver  oxide,  and  the  mixture  may 
undergo  spontaneous  combustion.  It  has  been  used  in  haemor- 
rhage from  the  stomach  and  lungs,  and  has  been  highly  recom- 
mended in  menorrhagia. 

U.S.P.  Argenti  Cyanidum.  Cyanide  op  Silver.  AgCN; 
133-7. 

Characters. — A  white  powder  permanent  in  dry  air,  but 
gradually  turning  brown  on  exposure  to  light,  odourless  and 
tasteless. 


680  INOKGANIC  MATE.EIA  MEDICA.  [sect.  m. 

Solubility. — It  is  insoluble  in  water  or  alcohol ;  insoluble  in  cold,  but 
soluble  in  boiling  nitric  acid,  with  evolution  of  hydrocyanic  acid ;  also  soluble 
in  water  of  ammonia  and  in  solution  of  hyposulphite  of  sodium. 

Reactions. — When  heated  the  salt  fuses,  gives  off  cyanogen  gas,  and  on 
ignition  metallic  silver  is  left. 

Oeticinal  Preparation. 

C.S.P. 

Acidum  Hydrocyanicum  Dilutum. 

U.S.P.  Argenti  Iodidum.     Iodide  of  Silver.    Agl;  234-3.. 

Characters. — A  heavy,  amorphous,  light-yellowish  powder, 
unaltered  by  light  if  pure,  but  generally  becoming  somewhat 
greenish-yellow,  without  odour  and  taste. 

Solubility. — It  is  insoluble  in  water,  alcohol,  diluted  acids  or  in  solution 
of  carbonate  of  ammonium.  Soluble  in  about  2,500  parts  of  stronger  water 
of  ammonia. 

Reactions. — It  is  dissolved  by  an  aqueous  solution  of  cyanide  of  potas- 
sium and  the  resulting  solution  yields  a  black  precipitate  with  hydrosulphuric 
acid  or  sulphide  of  ammonium  (silver).  If  a  small  quantity  of  chlorine 
water  be  agitated  with  an  excess  of  the  salt,  the  filtrate  acquires  a  dark  blue 
colour  on  the  addition  of  gelatinised  starch  (iodide). 

Dose. — 1  to  2  grains. 

Use. — It  has  been  used  instead  of  nitrate  of  silver  in  irrita- 
bility of  the  stomach,  dysmenorrhcea,  and  epilepsy. 


Class  II.     Group  IV. 

MERCURY.     Hg;  200. 

Mercury  is  a  liquid  metal.  It  forms  two  series  of  compounds, 
viz.  mercurous,  in  which  it  is  univalent,  e.g.  Hg2Cl2 ;  and  mer- 
curic, in  which  it  is  bivalent,  e.g.  HgCl2.  In  constitution  these 
salts  are  analogous  to  the  cuprous  and  cupric  salts. 

General  Sources. — The  chief  source  is  native  sulphide  or 
cinnabar. 

Metallic  mercury  is  prepared  from  this  by  roasting  it  either 
alone  or  with  lime  or  iron. 

General  Beactions  of  Salts  of  Mercury. — They  are  all, 
either  volatile,  or  decomposed  by  heat  with  the  liberation  of  free 
mercury.  The  soluble  salts  are  decomposed  by  stannous  chloride; 
the  mercuric  salts  giving  first  a  white  precipitate  changing  into 
black,  and  the  mercurous  salts  a  black  one  of  finely  divided  mer- 
cury at  once.  Mercurous  salts  are  most  readily  distinguished 
from  mercuric  salts  by  their  reactions  with  alkaline  carbonates, 
with  ammonia,  or  with  potassium  iodide.  The  differences  will 
be  readily  seen  from  the, following  table.  The  difference  between 
the  reactions  of  potash  and  ammonia  with  mercuric  salts  is  note- 
worthy. 


CHAP.  XXVI.] 


METALS. 


681 


Geneeal  Beactions  of  Salts  or  Meeouey. 


Reagent 

Mercurous  Salts 

Mercuric  Salts 

Stannous  chloride    . 

Black    ppt.     (finely 
divided  mercury) 

White  ppt.,  turning  black  (calo- 
mel changing  into  mercury). 

Caustic  soda  01  pot- 
ash 

Black  ppt. 

Yellow  ppt.  (oxide). 

Carbonates  of  sodium 
or  potassium 

White  ppt.  turning 
black 

Bed-brown  ppt. 

Ammonia 

Black  ppt.        . 

White  ppt.  (double  salt  of  mer- 
cury and  amnion  a). 

Ammonium  carbon- 
ate 

White  ppt.  turning 
black 

White  ppt. 

Potassium  iodide     . 

Greenish-yellow  ppt. 

Bright  scarlet  ppt.,  soluble  in  ex- 
cess either  of  mercuric  chloride 
or  of  potassium  iodide. 

General  Impurities. — Other  metals,  especially  lead,  arsenic,  and  anti- 
mony, may  be  present.  But  there  is  such  an  enormous  difference  between 
the  activity  of  the  mercurous  and  the  mercuric  salts,  that  the  latter  form  the 
most  important  impurities  of  the  former.  Corrosive  sublimate,  for  example, 
is  so  active  that  a  slight  trace  of  it  as  an  impurity  in  calomel  might  cause  a 
medicinal  dose  of  the  latter  to  produce  poisonous  effects. 

General  Test. — Mercuric  salts  are  readily  soluble  in  alcohol,  and  espe- 
cially in  ether,  and  also  in  a  solution  of  sodium  chloride,  while  mercurous 
salts  are  not.  The  presence  of  mercuric  compounds  as  an  impurity  in  mer- 
curous preparations  can  be  ascertained  by  shaking  them  with  ether  (B.P.), 
or  with  a  solution  of  common  salt  (U.S.P.),  filtering,  and  testing  the  nitrate 
for  mercury.  If  no  mercuric  salt  has  been  present,  neither  the  ether  nor 
salt  solution  will  dissolve  anything,  and  so  the  test  will  show  the  absence 
of  mercury.  When  ether  or  alcohol  is  used,  the  absence  of  mercury  may  be 
ascertained  by  evaporating  it  and  finding  that  no  residue  remains. 

General  Action. — Metallic  mercury,  mercurous  salts,  and 
mercuric  salts  all  have  actions  differing  from  each  other  as  far 
as  their  local  effect  is  concerned,  but  agreeing  together  in  their 
general  result  after  absorption  into  the  system.  When  applied 
locally  to  the  skin,  mercury,  either  in  a  state  of  vapour  or  when 
finely  subdivided  in  the  form  of  ointment,  -will  pass  through  the 
epidermis  without  exciting  any  local  irritation,  and  be  absorbed 
into  the  circulation,  where  it  will  produce  the  general  effects  of 
the  drug.  Taken  in  the  form  of  vapour  into  the  lungs,  it  will 
have  a  similar  action.  The  mercurous  salts  are  also  absorbed 
in  the  sam'e  way  as  metallic  mercury.  They  have  a  slightly 
more  stimulating  effect  than  it,  but  do  not  produce  the  same 
intense  irritation  that  the  mercuric  saltB  cause.  The  mercuric 
salts  unite  with  albumen,  forming  albuminates.  They  have 
little  action  on  the  epidermis,  but  when  applied  to  the  denuded 
skin,  or  to  a  mucous  membrane,  they  precipitate  the  albumen, 
and,  when  used  in  a  concentrated  form,  produce  a  slough.  When 
swallowed,  they  cause  the  symptoms  of  gastro-enteritis  produced 
by  other  irritant  poisons,  but  these  may  be  quickly  succeeded  by 


682  INOEGANIC   MATEEIA   MBDICA.  [sect.  in. 

the  symptoms  of  special  mercuric  poisoning  from  the  absorption 
of  the  substance  into  the  circulation  (cf.  p.  398). 

The  general  effects  on  the  body  which  are  produced  alike  by 
mercury  and  its  salts  are  termed  mercurialism. 

The  first  symptoms  produced  by  mercury,  however  it  is  ap- 
plied, are  almost  always  connected  with  the  alimentary  canal," 
and  more  especially  the  mouth.  A  metallic  unpleasant  taste  is 
observed  in  the  mouth,  along  with  a  feeling  of  heat ;  the  saliva  is 
somewhat  increased  and  the  breath  has  a  most  unpleasant  smell. 
The  teeth  feel  sticky,  as  if  their  edges  were  glued  together  with 
some  adhesive  substance,  when  the  patient  tries  to  separate 
them  ;  they  feel  as  if  they  were  longer  than  usual.  The  gums 
are  red  and  swollen  and  tender,  and  chewing  is  painful.  The 
tongue  is  covered  with  a  thick  coating,  and  the  appetite  is  small. 
The  medicinal  administration  of  mercury  is  generally  stopped 
when  the  gums  become  sore  and  salivation  begins.  Id.  children 
salivation  occurs  with  difficulty,  and  mercury  may  be  discon- 
tinued when  the  breath  becomes  fcetid  or  the  previously  healthy 
stools  become  green  and  offensive.  When  the  administration  of 
mercury  is  continued  the  symptoms  increase ;  the  gums  become 
still  more  inflamed,  their  edges  are  covered  with  a  white  sticky  sub- 
stance, and  they  bleed  on  the  slightest  touch ;  the  teeth  become 
loosened  in  their  sockets,  and  the  salivation  becomes  still  greater. 

In  still  worse  cases  ulcers  form  on  the  gums  and  inside  the 
cheeks,  the  tongue  itself  becomes  swollen  so  that  articulation  be- 
comes difficult,  mastication  is  so  painful  as  to  be  nearly  im- 
possible, the  foetor  of  the  breath  is  insupportable,  and  the  saliva 
pours  from  the  mouth  in  great  quantities. 

Along  with  these  symptoms  there  is  a  certain  amount  of 
fever,  which,  indeed,  sometimes  is  present  before  any  local 
symptoms  have  appeared.  There  is  general  depression,  chilliness, 
and  even  rigors,  followed  by  a  rise  of  temperature,  a  feeling  of 
heat,  thirst,  loss  of  appetite,  quick  pulse,  weight  or  pain  in  the 
epigastrium,  nausea,  belching,  vomiting,  and  purging,  sometimes 
bloody  motions,  or  more  rarely  constipation.  These  symptoms 
last  several  days  and  then  decrease,  sweating  occurring  at  the 
same  time,  or  salivation  if  the  fever  has  preceded  it.  Mercurial 
fever  occurs  most  readily  after  a  lengthened  application  of  blue 
ointment. 

"When  the  administration  of  mercury  is  stopped  tfie  symptoms 
decrease,  though  in  the  case  of  broken-down  individuals  necrosis 
of  the  jaw,  and  even  death,  has  occurred. 

Occasionally  it  has  happened  that  even  healthy  individuals, 
instead  of  recovering  after  profuse  salivation,  have  become  per- 
manently dyspeptic. 

These  symptoms  appear  in  adults,  generally  with  great  regu- 
larity, when  a  similar  quantity  of  mercury  has  been  taken  in  a 
similar  time,  though  the  effect  is  modified  by  variouB  conditions, 
as  a,ge,  sex,  the  presence  of  disease,  &c. 


chap,  xxvi.]  '  METALS.  683 

When  persons  are  exposed  for  a  long  time  to  the  fumes  of 
mercury,  and  the  metal  is  thus  taken  in  in  very  small  quantities 
for  a  lengthened  period,  a  different  effect  is  sometimes  produced. 
This  is  called  mercurial  cachexia.  In  this  condition  the  appe- 
tite is  lost,  the  gums  become  livid  and  bleed  easily,  the  breath  is 
foetid,  the  tonsils  and  fauces  become  congested  or  even  ulcerated, 
and  a  tendency  to  diarrhoea  is  often  present.  In  bad  cases  vomit- 
ing and  purging  generally  occur. 

The  lips  become  pale,  the  complexion  earthy,  the  person 
becomes  emaciated,  the  hair  sometimes  falls  out,  the  muscles 
become  weak  and  small.  The  person  is  easily  affected  by  changes 
of  weather;  there  is  a  tendency  to  fainting,  uneasiness,  and 
anxiety ;  the  pulse  and  respiration  become  quick ;  the  pulse  is 
also  small  and  intermittent;  and  palpitation  becomes  very 
troublesome.  The  intellect  is  dull,  and  rheumatic  pains  are  felt  in 
the  muscles  of  the  extremities,  more  rarely  in  those  of  the  trunk. 

These  symptoms  go  on  increasing,  and  new  ones  also  appear. 
Mercurial  tremors  occur  in  the  muscles,  beginning  generally 
in  the  upper  extremities,  and  gradually  extending  till  the  patient 
cannot  execute  any  movement,  and  the  speech  itself  becomes 
stammering. 

Mercurial  paralysis  of  muscles  or  groups  of  muscles  occa- 
sionally occurs.  Generally  this  is  confined  to  the  muscles  of  the 
upper  extremities,  but  sometimes  affects  other  muscles,  such  as 
those  of  the  larynx,  causing  mercurial  aphonia.  These  paralyses 
generally  occur  in  the  later  stages  of  mercurial  erethism,  and 
rarely  occur  before  the  other  symptoms. 

The  mental  qualities  become  also  affected.  Hl-humour, 
irritability,  melancholy,  and  fear  of  death  occur  in  some  persons, 
and  in  others,  though  very  rarely,  idiocy,  and  still  more  rarely, 
furious  mania.     In  some  instances  epilepsy  has  been  observed. 

Mercury  in  the  form  of  organic  compounds  appears  to  have 
a  special  action  on  the  brain.  The  symptoms  are  those  of  im- 
pairment of  the  special  senses,  sight,  taste,  hearing,  of  motor 
power,  and  of  the  cerebral  functions.  Two  chemists  who  were 
engaged  in  the  preparation  of  mercuric  methide  during  three 
months,  suffered  from  weakness  and  dimness  of  vision,  and  one  of 
them  from  some  soreness  of  the  gums,  nausea,  and  vomiting.  At 
the  end  of  this  time  the  symptoms  became  much  worse,  deafness 
and  numbness  came  on,  and  were  succeeded  by  a  semi-comatose 
condition  with  great  restlessness.  In  the  one  who  had  not  pre- 
viously suffered  from  soreness  of  the  gums,  this  now  appeared, 
along  with  fcetor  of  the  breath;  the  urine  was  albuminous, 
Cheyne-Stokes'  breathing  was  observed,  the  evacuations  were 
passed  involuntarily,  and  he  died  comatose  a  fortnight  after  the 
symptoms  became  severe.  Sensibility  was  retained  nearly  to 
the  last.  In  the  other  patient,  impaired  sensation,  loss  of  power 
to  direct  movement,  and  muscular  feebleness  were  succeeded  by 


684  INOKGANIC  MATEEIA   MEDICA.  [sect 

involuntary  passage  of  evacuations,  an  idiotic  condition  of  i 
lessness,  and  violent  muscular  movements,  especially  wher 
was  touched.  After  remaining  in  an  idiotic  state  for  a  yea 
died  of  pneumonia. 

The  action  of  mercury  may  be  modified  by  sex,  age,  or  i 
syncrasy.  Women,  as  a  rule,  are  more  easily  affected  than  r 
whilst  children  may  take  mercury  in  considerable  quant 
without  showing  any  symptom  of  salivation.  In  certain  peri 
large  quantities  of  mercury  may  be  administered  for  a  lengt 
time  without  producing  much  more  effect  than  in  children, 
in  others  exceedingly  injurious  results  may  follow  very  mil 
doses.  A  case  of  salivation  from  as  little  as  a  grain  and  a 
of  calomel  has  been  recorded,  and  from  one-eightieth  of  a  g: 
of  corrosive  sublimate.  In  typhus  it  is  very  hard  to  proc 
salivation,  but  in  persons  suffering  from  Bright's  disease,  altho 
mercury  may  be  useful  as  a  purgative,  it  requires  to  be  gi 
with  caution,  on  account  of  the  violent  effects  which  may  fo' 
even  small  doses. 

Mercury  combines  with  albumen,  and  forms  albuminati 
mercury,  which  is  insoluble  in  water,  but  is  easily  soluble  in 
cess  of  albumen  or  in  chloride  of  sodium.  This  compound  i 
be  formed  in  the  stomach  or  intestines,  and  a  compound  of  e 
curie  oxide  with  albumen  is  probably  the  form  under  wl 
mercury,  however  administered,  circulates  in  the  blood.  W 
taken  into  the  stomach,  mercuric  salts  are  powerful  irrita: 
and,  when  given  in  large  quantities,  cause  gastro-enter: 
vomiting,  and  purging,  with  bloody  stools.  Finely  divi 
metallic  mercury  and  mercurous  salts  are  less  irritating,  and 
simply  as  purgatives. 

A  good  deal  of  discussion  has  arisen  regarding  the  actio] 
mercury  on  the  liver.  It  has  long  been  ranked  as  a  cholagoj 
and  there  can  be  no  question  whatever  that  mercury  and 
compounds  are  very  beneficial  in  cases  of  so-called  bilious 
order  characterised  by  feelings  of  laziness  and  apathy,  inabi 
to  think,  dislike  of  exertion,  not  unfrequently  combined  y 
irritability  of  temper,  deranged  digestion,  and  slight  yello? 
tinge  of  the  eyes.  "When  bile  was  supposed  to  be  formed  in 
blood,  and  to  be  only  excreted  by  the  liver,  the  beneficial  ef 
of  mercury  was  attributed  to  a  stimulating  action  on  the  li 
whereby  it  increased  the  rapidity  of  the  secretion,  and  thus 
moved  the  bile  more  quickly  from  the  blood.  But  it  was  foi 
on  experiment  by  Dr.  Scott  that  mercury  does  not  increase 
rapidity  of  the  biliary  secretion,  and  this  result  was  confirmee 
a  committee  of  the  British  Medical  Association,  the  cbief  mi 
bers  of  which  were  Hughes  Bennett,  Butherford,  and  Gam| 
and  also  by  later  experiments  made  by  Butherford,  Vignal,  i 
Dodds.  As  we  now  know  that  bile  is  formed  by  the  liver,  i 
not  merely  separated  from  it  by  the  blood,  we  can  understi 


chap,  xxvi.]  METALS.  685 

that  the  real  action  of  mercury  as  a  cholagogue  consists,  not  in 
its  stimulating  the  liver  to  form  more  bile,  but  in  removing  more 
readily  from  the  body  the  bile  which  is  already  present  in  excess. 
It  appears  to  perform  this  function  by  stimulating  the  upper  part 
of  the  small  intestine,  and  thus  causing  the  evacuation  of  the 
bile  before  time  has  been  allowed  for  its  reabsorption.  For  the 
liver  does  not  merely  form  bile,  it  also  excretes  bile  which  has 
been  previously  formed  and  reabsorbed  from  the  intestine.  The 
bile  may  thus  serve  several  times  over.  It  is  formed,  passes 
from  the  liver  into  the  duodenum,  is  reabsorbed,  and  carried  by 
the  portal  blood  to  the  liver,  where  it  is  again  excreted  and  poured 
out  through  the  bile-duct  a  second  time  (p.  404).  Part  of 
it,  however,  is   carried   down  the  intestine,  decomposed,   and 

,  evacuated,  and  to  supply  the  place  of  this  a  certain  amount  of 
new  bile  is  constantly  being  formed,  which  is  poured  into  the 
intestine  along  with  the  old.  It  is  evident  that  any  drug  which 
acts  upon  the  lower  part  of  the  intestine  will  have  little  power  to 
remove  the  bile,  as  this  will  have  undergone  absorption  already 
in  the  upper  part  of  the  digestive  tract.  But  any  drug  acting 
upon  the  duodenum  will  cause  the  bile  to  be  rapidly  moved  on 
and  its  absorption  to  be  prevented.  More  especially  will  this  be 
the  case  if  the  cholagogue  be  combined  with  a  saline  purgative, 
which,  by  causing  a  profuse  secretion  of  watery  fluid,  will  wash 
the  bile  out.  This  action  on  the  upper  part  of  the  small  intestine 
is  probably  possessed  by  mercury,    and  the  reasons   for  this 

I  supposition  are  :  (1)  that  it  is  so  beneficial  in  bilious  disorders  ; 

I  (2)  that  it  does  cause  the  appearance  of  bile  in  the  stools,  for 
Buchheim  has  found  by  analysis  that  the  green  stools  which 
occur  after  purgation  by  calomel  actually  owe  their  colour  to 
bile ;  and  (3)  that  in  the  stools  passed  after  mercurial  purgatives, 
leucin  and  tyrosin,  the  products  of  pancreatic  digestion,  have 
been  found,  showing  the  rapid  peristalsis  produced.  Mercury 
acts  as  a  disinfectant  of  the  intestinal  contents. 

After  the  absorption  of  mercury  into  the  blood,  it  is  said,  in 
small  doses,  to  increase  the  number  of  blood-corpuscles  ;  in  larger 
doses,  however,  it  produces  ansemia,  but  how  far  these  results 
are  dependent  upon   the   improvement  or   disturbance   of  the 

I  digestion,  and  how  far  upon  the  action  of  the  mercury  itself 
upon  the  blood,  has  not  been  ascertained.  Albuminate  of  mer- 
cury, when  added  to  blood  out  of  the  body,  gradually  destroys 
the  corpuscles. 

Mercury  appears  to  have  the  power  of  causing  absorption  of 
fibrinous  exudations,  for  the  fibrinous  adhesions  observed  in 
syphilitic  iritis  have  been  seen  to  disappear  as  the  patient  was 
brought  under  the  influence  of  mercury.  When  mercury  is  used 
for  a  long  time,  it  appears  to  lessen  greatly  the  force  of  the  pulse, 
and  large  doses  of  mercuric  preparations,  when  brought  into 
contact  with  a  frog's  heart,  will  arrest  its  pulsations  immediately. 


686  INOKGANIC  MATEEIA  MED1CA.  [sect.  m. 

The  respiration  is  affected  in  persons  who  have  been  taking  too 
much  mercury,  and  becomes  laboured  and  accompanied  by  a 
feeling  of  constriction.  The  temperature  is  rarely  affected, 
excepting  secondarily,  in  consequence  of  local  inflammations 
which  the  mercury  may  excite,  although  sometimes  mercurial 
fever  (p.  682)  precedes  any  marked  local  change. 

Mercury  is  excreted  by  the  saliva,  bile,  urine,  sweat,  and 
milk.  The  salivation  which  it  produces  is  probably  due  in  part 
to  reflex  excitement  of  the  salivary  glands  by  the  irritation  of 
the  tongue,  but  it  is  no  doubt  also  in  part  due  to  irritation  of 
the  nerves  of  the  gland,  or  of  the  gland-structure  itself,  by  the 
mercury.  The  urine  is  said  to  be  somewhat  increased,  and  it  is 
stated  that  the  addition  of  a  little  mercury  to  digitalis  and  squill 
greatly  increases  the  diuretic  action  of  these  drugs.  Calomel  has 
an  undoubted  diuretic  action,  and  it  has  been  suggested  that  it 
owes  this  action  to  the  increase  of  urea  in  the  blood,  produced 
by  part  of  the  salt  being  changed  into  mercuric  chloride,  which 
acts  as  an  hepatic  stimulant  (cf.  p.  432). 

Hydrargyrum.  B.  and  U.S.P.  Mercury.  Hg ;  200  B.P. 
199-7  U.S.P. 

Characters. — A    metal,    fluid    at    common    temperatures, 
brilliantly  lustrous,  and  easily  divisible  into  spherical  globules. 
Eeaction. — Volatilises  at  a  heat  below  that  of  visible  redness,  leaving  no 

residue.  _  ,, 

Frepabations  containing  Meecury.1 

I.  In  the  metallic  state. 

B.P.  (9)  tj.s.p.  (7) 

Hydrargyrum.  Hydrargyrum. 

Emplastrum  Ammoniac!  cum   By-         Emplastrum   Ammoniaci    cum  Hy- 

drargyro  (1  in  5).  drargyro. 

Emplastrum  Hydrargyri  (1  in  3).  Emplastrum  Hydrargyri. 

Hydrargyrum  cum  Creta  (1  in  3).  Hydrargyrum  cum  Creta. 

Xiinimentum  Hydrargyri  (v.  p.  516)  (1  in  6). 

Pilula  Hydrargyri  (v.  p.  522)  (1  in  3).  Massa  Hydrargyri. 

Suppositoria  Hydrargyri  (1  in  6). 

Unguentum  „  (1  in  2).  Unguentum  Hydrargyri. 

„  n    Compositum  (1  in  i\),        „  „         Compositum. 

(5)  II.  Oxidised.  (4) 

Hydrargyri  Oxidum  Flavum.  Hydrargyri  Oxidum  Flavum. 

„  „  Rubrum.  „  „  Bubrum. 

totio  Hydrargyri  Flava. 
„  „  Nigra. 

Unguentum  Hydrargyri  Oxidi  Plavi 
Unguentum  Hydrargyri  Oxidi  Rubrl.  „  „  „     Eubri 

III.  Sulphuretted.  (1) 

None.  Hydrargyri  Sulphidum  Bubrum. 

IV.  As  IWercurous  Chloride. 
(3)  (3) 

Hydrargyri  Subchloridum.  Hydrargyrum  Chloridum  Mite. 

Pilula  Hydrargyri  Subchloridi  Com-        PUulse  Antimonii   Composite  (vids 
poslta  (vide  p.  522).  p.  523). 

Pilulse  Cathartics  Composits  [vidi 
Unguentum  Hydrargyri  Subchloridi.  p.  523). 

1  Altered  from  the  United  States  Dispensatory,  p.  773. 


chap,  xxvi.]  METALS.  687 

Pbeparations  containing  Mekcury — continued. 

Y.  As  mercuric  Chloride. 

B.P.  (4)  u.s.p.  (3) 

Hydrargyri  Percblorldum.  Hydrargyri  Chloridum  Corrosivum. 

Hydrargyrum  Ammoniatum.  Hydrargyrum  Ammoniatum. 

Liquor  Hydrargyrl  Percbloridi. 
Unguentum  Hydrargyrl  Ammoniatum.  Unguentum  Hydrargyri  Ammoniati. 

VI.  Combined  witb  Iodine. 
(3)  (3) 

Hydrargyri  Xodldum  Rubrum.  Hydrargyri  Iodidum  Rubrum. 

„  „  Viride. 

liquor  Arsenii  et  Hydrargyri  lodidi.     Liquor  Arsenii  et  Hydrargyri  Iodidi. 
Unguentum  Hydrargyrl  Iodidi  Rubrl. 

VII.  Combined  witb  Cyanogen. 

(1) 
None.  Hydrargyri  Cyanidum. 

VIII.  Oxidised  and  combined  witb  Acids. 

(5)  (4) 

Hydrargyri  Persulpbas. 

Hydrargyri  Sulphas  Flava. 
liquor  Hydrargyri  Nitratis  Acidus.       Liquor  Hydrargyri  Nitratis. 
Oleatum  Hydrargyri.  Oleatum  Hydrargyri. 

Unguentum  Hydrargyri  Nitratis.  Unguentum  Hydrargyri  Nitratis. 

n  n  ii      DilUtum. 

Impurities. — Other  metals. 

Tests. — The  presence  of  other  metals  is  ascertained  by  their  being  left 
behind  as  a  residue  when  the  mercury  is  volatilised.  It  is  indicated  by  the 
formation  of  a  grey  scum  or  dust  on  the  surface  of  the  metal  after  exposure 
to  air,  and  by  the  mercury  forming  globules  which  are  not  spherical  but 
elongate  to  a  tail  when  allowed  to  run  over  a  piece  of  paper.  They  are  also 
recognised  by  shaking  the  mercury  in  a  perfectly  dry  bottle,  when  a  grey 
powder  will  be  formed  if  they  are  present. 

On  boiling  5  grms.  of  distilled  water  with  5  grms.  of  mercury  and  4-5 
grms.  of  hyposulphite  of  sodium  in  a  test-tube  for  a  minute,  the  mercury 
should  not  lose  its  lustre  nor  acquire  more  than  a  slightly  yellowish  shade 
(absence  of  more  than  a  trace  of  other  metals,  U.S.P.). 

Purification. — Other  metals  may  be  separated  by  distillation,  or  by 
mixing  the  mercury  with  strong  sulphuric  acid  and  letting  it  stand  in  the 
cold  for  twenty-four  hours.  The  other  metals  will  be  converted  into  sulphates, 
but  mercury  is  only  attacked  by  sulphuric  acid  when  it  is  aided  by  heat. 
The  mercury  is  then  washed  with  water  to  remove  the  sulphates,  and  dried 
with  blotting-paper.  Mercury  is  freed  from  dust  and  mechanical  im- 
purities by  pressing  it  through  chamois  leather  or  filtering  it  through  a 
paper  filter  in  the  apex  of  which  several  small  holes  have  been  made  with 
a  needle  or  pin. 

Uses. — Metallic  mercury  in  mass  has  no  action  whatever  on 
the  body.  As  much  as  a  pound  has  been  taken  -without  pro- 
ducing any  physiological  effect.  Such  a  dose  as  this  is  some- 
times given  in  cases  of  intestinal  obstruction  in  the  hope  that 
the  weight  of  the  mercury  may  carry  the  obstruction  before  it. 
The  theory  of  its  action  formerly  held  was  purely  mechanical : 
that  the  mercury  passed  from  the  stomach  to  the  intestines  and 
meeting  with  the  obstruction  drove  it  on ;  but  latterly  Traube 


688  INOKGANIC  MATEEIA  MEDICA.  [sect,  m. 

has  supposed  that  the  mercury  remains  chiefly  in  the  stomach, 
and  by  pulling  on  it  excites  the  intestines  renexly  to  peristaltic 
action.  Whatever  the  correct  theory  may  be,  however,  it  is 
certain  that  the  mercury  does  not  always  stay  in  the  stomach, 
but  does  get  down  into  the  intestine,  and  consequently  some 
precautions  must  be  observed  in  its  administration,  and  it  is 
never  given  except  when  all  other  measures  fail.  The  pre- 
cautions are  not  to  give  it  in  cases  of  intussusception,  as  it  may 
very  probably  render  this  worse;  nor  in  cases  where  the  intestine 
is  considerably  inflamed,  as  the  tissues  being  weak  are  then  easily 
torn;  nor  in  hernia,  as  better  means,  viz.  external  means,  can 
be  employed. 

Hydrargyrum  cum  Creta,  B.  and  U.S. P.     Mercury  with  Chalk. 

Preparations. — By  rubbing  up  chalk  (2)  and  mercury  (1)  together,  B.P.  By 
rubbing  up  mercury  (38),  chalk  (50),  and  sugar  of  milk  (12)  together,  moistening 
them  with  a  mixture  of  equal  parts  of  ether  and  alcohol,  U.S.P. 

Characters. — A  powder  of  light-grey  colour ;  free  from  grittiness ;  insoluble 
in  water ;  partly  dissolved  by  diluted  hydrochloric  acid,  leaving  the  mercury  in  a 
finely-divided  state. 

Impurity. — Mercuric  oxide. 

Test. — The  solution  formed  with  hydrochloric  acid  is  not  precipitated  by  the, 
addition  of  chloride  of  tin. 

Dose. — 3  to  8  grains. 

Uses. — It  has  been  much  recommended  by  Einger  as  a 
remedy  in  many  diseases  both  of  adults  and  of  children.  In 
simple  tonsillitis,  or  the  inflamed  throat  of  scarlatina,  or  in 
mumps,  he  recommends  a  third  of  a  grain  every  hour,  and  the 
same  dose  three  or  four  times  a  day  will,  he  says,  clean  the 
tongue,  remove  the  disagreeable  taste  from  the  mouth,  and 
improve  appetite  and  digestion  in  the  dyspepsia  occurring 
in  chronic  disease  or  commencing  convalescence.  A  similar 
dose  will  cut  short  an  attack  of  jaundice,  with  vomiting  and 
pale  stools,  occurring  in  nervous  persons  after  exposure  to  cold, 
fatigue,  or  excitement ;  and  half  a  grain  thrice  a  day  will  restore 
the  colour  to  the  stools  and  remove  the  dyspepsia  in  patients 
suffering  from  acidity,  flatulence,  and  vomiting  in  the  morning. 
Diarrhoea  in  children,  accompanied  by  pale,  offensive  motions, 
or  by  muddy,  or  green  -  coloured,  or  curdy  stools,  whether 
accompanied  by  sickness  or  not,  is  successfully  treated  by 
similar  doses  of  this  remedy.  It  may  also  be  used  to  produce 
the  general  action  of  mercury  combined  with  opium  or  Dover's 
powder. 

B.P.  Pilula  Hydrargyri.  Mercurial  Pill  ;  Blue  Pill  (p.  522).  3  grs. 
contain  1  of  mercury. 

Dose. — 3  to  8  grains. 

U.S.P.  Massa  Hydrargyri.  Blue  Mass;  Blue  Pill. — Mercury  (33),  powdered 
liquorice  (5),  althaea  (25),  glycerin  (3),  honey  of  rose  (34).  3  grs.  contain  1  of  mercury. 

Uses.— Blue  pill  may  be  given  either  for  its  local  action  upon 
the  intestines  or  to  produce  the  action  of  mercury  upon  the  system. 
This  pill  is  one  of  the  most  effectual  remedies  for  the  condition 
usually  termed  biliousness.     The  patient  complains  of  feeling 


chap,  xxvi.]  METALS.  689 

dull,  heavy,  and  often  sleepy,  suffers  from  occasional  headache, 
has  little  appetite,  and  occasionally  feels  sick.  The  complexion  is 
often  of  a  dirty-yellow,  muddy  colour,  and  the  white  of  the  eyes 
likewise.  The  use  of  blue  pill  in  such  conditions  was  recom- 
mended by  Mr.  Abernethy.  Five  grains  of  blue  pill  are  given 
overnight  and  a  draught  of  salts  and  senna  in  the  morning.  This 
is  very  effective,  but  the  disadvantage  of  it  is  said  to  be  that  the 
bilious  state  is  more  apt  to  return,  and  that  when  a  patient  has 
once  become  habituated  to  the  use  of  mercurials  no  other  medicine 
will  do  instead. 

It  is  one  of  the  best  preparations  for  producing  mercurialism  : 
5  grains  with  ^  grain  of  opium  are  given  in  the  morning,  and 
5  or  10  also  with  £  grain  of  opium  in  the  evening. 

The  addition  of  a  small  quantity  of  blue  pill  to  digitalis  and 
squill  sometimes  increases  their  efficacy  in  cases  of  cardiac  disease. 

Unguentum  Hydrargyri,  B.  and  TT.S.P.  Ointment  of  Mercury,  B.P. ; 
Mercurial  Ointment,  U.S.P. — Contains  1  lb.  each  of  mercury  and  prepared  lard. 
As  this  would  be  too  soft,  1  oz.  of  prepared  suet  is  added. 

Preparations. 
Linimentum  Hydrargyri  (p.  516). 
Suppositoria  Hydrargyri. 
Unguentum  Hydrargyri  Compositum. 

Uses. —  It  may  be  used  either  for  its  general  or  its  local 
action.  When  employed  to  produce  the  general  action  of  mer- 
cury in  the  system,  it  is  rubbed  into  some  part  of  the  body  where 
the  skin  is  thin,  as  the  armpits  or  the  sides  of  the  thighs.  If  it 
is  rubbed  in  by  another  person,  and  not  by  the  patient  himself, 
it  is  advisable  to  protect  the  operator's  hand  by  a  piece  of  bladder 
soaked  in  oil,  in  order  to  prevent  absorption  through  the  palm. 
In  cases  of  congenital  syphilis,  a  piece  of  mercurial  ointment,  the 
size  of  the  thumb-nail  (half  a  drachm  to  one  drachm),  may  be 
put  upon  a  flannel  roller,  and  bound  round  the  child's  belly. 

It  has  been  applied  locally  in  inflammation  of  the  skin,  as 
erysipelas ;  of  the  veins  in  phlegmasia  dolens ;  or  of  the  genital 
organs,  as  in  ovaritis,  orchitis,  and  indurated  testicles. 

B.P,  Suppositoria  Hydrargyri.  Mercurial  Suppositories. — Each  con- 
tains 60  grs.  of  ointment  of  mercury,  benzoated  lard  and  white  wax  each  20  grs., 
oil  of  theobroma  80  grs. 

Uses. — They  are  employed  where  we  wish  to  produce  mercurial 
action  without  the  risk  of  interfering  with  the  digestion. 

B.P.  Unguentum  Hydrargyri  Compositum.  Compound  Ointment  of 
Mercury. — Contains  mercurial  ointment  (6),  yellow  wax  (3),  olive  oil  (31,  and 
camphor  (1J). 

The  compound  ointment  is  used  to  cause  absorption  of  effusion 
or  thickening  around  joints  in  cases  of  disease  or  injury  after  the 
inflammation  has  subsided.  It  ought  to  be  combined  with  pres- 
sure and  rest. 

B.P.  Linimentum  Hydrargyri.    Liniment  of  Mercury. —  Vide  p.  516. 

Y   Y 


690  INOBGANIO   MATERIA   MBDICA.  [sect.  in. 

Used  for  similar  purposes  as  the  plaster  or  ointment.  It  is 
more  irritating  than  either,  on  account  of  the  ammonia  it  contains. 

It  is  said  to  cause  salivation  more  readily  than  _  mercurial 
ointment,  as  the  camphor  and  ammonia  with  which  it  is  mixed 
assist  its  absorption. 

Emplastrum  Hydrargyri,  B.  and  U.S.P.     Mercubial  Plastee. 

Peepaeation.— Rub  mercury  with  olive-oil,  and  sulphur  B.P.  or  resin  U.S.P., 
and  add  lead  plaster  to  give  it  consistency.  Sulphur  and  resin  are  used  to  ex- 
tinguish the  globules  of  mercury,  i.e.  make  them  so  small  as  to  be  invisible. 

Emplastrum  Ammoniac!  cum  Hydrargyro,  B.  and  U.S. P.  Ammonia- 
cum and  Meecuey  Plastee,  B.P. ;  Ammoniac  Plastee  with  Meecuet,  U.S.P. 

Peepaeation. — B.P.  By  rubbing  mercury  3  oz.  with  warm  olive-oil  1  fl.  dr.,  and 
sulphur  8  grs.  until  the  globules  of  mercury  are  no  longer  visible,  then  adding 
melted  ammoniacum  12  oz.  and  mixing.  U.S.P.  Mercury  180  is  extinguished  with 
sulphur  1  and  olive  oil  8  as  in  the  B.P.  process.  Ammoniacum  720  is  digested  with 
diluted  acetic  acid  1,000,  strained,  evaporated  until  it  hardens  on  cooling.  It  is 
then  added  while  hot  to  the  mercury,  and  mixed.  Then  enough  lead  plaster  pre- 
viously melted  is  added  to  make  up  to  1,000  parts. 

Both  plasters  are  used  to  promote  the  absorption  of  glandular 
enlargements,  buboes,  nodes,  and  are  applied  over  the  liver  in 
chronic  enlargement  and  induration.  Emplastrum  hydrargyri 
is  useful  also  in  sycosis,  lupus,  and  other  deep-seated  infiltrations 
of  the  skin. 

B.P.  Hydrargyri  Persulphas.  Peesulphate  of  Meecuet. 
HgS04. 

Chaeactees. — A  white  crystalline  heavy  powder. 

Pbeparation. — Heat  mercury  20  oz.  with  sulphuric  acid  12  fl.  oz.  in  a 
porcelain  vessel,  stirring  constantly  until  the  metal  disappears,  then  continue 
the  heat  until  a  dry  white  salt  remains. 

Eeactions. — It  is  rendered  yellow  by  affusion  with  water,  the  subsulphate 
being  formed.     Entirely  volatilised  by  heat. 

Peepakations  in  which  Sulphate  op  Meecuet  is  used. 
Hydrargyri  Perchloridum.  Hydrargyri  Subchloridum. 

U.S.P.  Hydrargyri  Subsulphas  Flavus.  Yellow  Subsul- 
phate of  Meecuey.     Hg(HgO)2S04;  727-1. 

Chaeactees. — A  heavy  lemon-yellow  powder,  permanent  in 
the  air,  odourless  and  almost  tasteless\ 

Solubility. — It  is  insoluble  in  water  or  in  alcohol,  but  soluble  in  nitric  or 
hydrochloric  acid. 

Eeactions. — When  heated  the  salt  turns  red,  becoming  yellow  again  on 
cooling.  At  a  red  heat  it  is  volatilised  without  residue,  evolving  vapours  of 
mercury  and  of  sulphurous  acid. 

Tests. — As  it  is  a  mercuric  oxysulphate,  it  should  be  soluble  in  20  parts 
of  hydrochloric  acid  without  residue  (no  mercurous  salt). 

Uses. — The  yellow  oxysulphate  has  been  used  under  the  name 
of  Turpeth  mineral  as  an  errhine  in  chronic  ophthalmia.  It  is 
a  prompt  emetic,  and  is  sometimes  preferred  to  other  emetics  in 
croup,  as  it  is  quick  and  certain,  and  does  not  produce  depression 
nor  purging.  The  dose  for  a  child  two  years  old  is  2-5  grains 
(O'IS-O'SS  gm.),  repeated  in  fifteen  minutes  if  necessary.  It 
may  also  be  used  as  an  alterative. 


chap,  xxvi.]  METALS.  691 

Hydrargyri  Subchloridum,  B.P. ;  Hydrargyri  Chloridum 
Mite,  U.S.P.  Subchlobidb  of  Mercury,  HgCl,  B.P. ;  Mild 
Chloride  op  Mercury,  Hg3Cla ;  470-2,  U.S.P.     Calomel. 

Characters  . — A  dull-white,  heavy  and  nearly  tasteless  powder, 
rendered  yellowish  by  trituration  in  a  mortar. 

Solubility. — It  is  insoluble  in  water,  spirit,  or  ether. 

Beactions. — It  is  very  heavy,  and  can  be  distinguished  by  its  weight  from 
almost  every  other  white  powder.  Its  weight  is  noticed  more  distinctly  by 
giving  the  bottle  an  up-and-down  shake.  Digested  with  solution  of  potash  it 
becomes  black  (mercurous  oxide) ;  and  the  clear  solution,  acidulated  with 
nitric  acid,  gives  a  copious  white  precipitate  with  nitrate  of  silver  (chloride). 
Contact  with  hydrocyanic  acid  also  darkens  its  colour. 

Preparation. — Calomel  is  prepared  by  rubbing  up  mercury  with  sulphate 
of  mercury  moistened  with  water  till  globules  are  no  longer  visible,  adding 
sodium  chloride,  mixing  the  whole  by  trituration,  and  subliming  the  mixture 
into  a  large  chamber. 

The  mercury  and  mercuric  sulphate  form  mercurous  sulphate,  and  this, 
with  sodium  chloride,  forms  calomel  and  sulphate  of  sodium,  HgS04  +  Hg  + 
2NaCl  =  Hg2Cl2  +  Na2S04. 

When  the  calomel  is  sublimed  into  a  small  receiver  it  forms  a  thin  crystal- 
line crust  which  adheres  to  the  sides,  but  when  sublimed  into  a  large  cham- 
ber, as  directed  in  the  B.P.,  it  falls  as  a  powder  on  the  floor.  As  some  corro- 
sive sublimate  is  often  formed,  the  powdered  calomel  is  washed  with  water 
-  till  all  the  sublimate  is  removed,  as  shown  by  the  water  no  longer  giving  a 
precipitate  with  ammonium  sulphide. 

It  is  then  dried  under  212°  F.,  and  kept  in  a  well-stoppered  and  dark  bottle. 

Adulterations. — Chalk,  sulphate  of  calcium,  sulphate  of  barium,  car- 
bonate of  lead,  corrosive  sublimate. 

Tests. — It  is  entirely  volatilised  by  a  sufficient  heat  (no  earthy  impurities). 
Warm  ether  which  has  been  shaken  with  it  in  a  bottle  leaves,  on  evaporation, 
no  residue  (no  corrosive  sublimate). 

Dose. — |  grain  to  5  grains. 

Preparations  in  which  Subchlobide  of  Mercury  is  used. 

B.P.  DOSE. 

Xiotio  Hydrargyri  Nigra  (3  grains  to  1  fluid  ounce) 

Pilula  Hydrargyri  Subchloridi  Composita  (1  part  in  5,  v.  p.  S22).  5-10  grs. 
TTnguentum  Hydrargyri  Subcnloridi,  "1  ,.         ,  .     „,    npa„lvl 

Calomel  Ointment  (with  prepared  lard)/  ^  part  m  &*'  nearW 

1    U.S.P. 
PilulsB  Antimonii  Composita  (p.  523). 
Pilulas  Cathartic®  Compositse  (p.  523). 

Pilula  Hydrargyri  Subchloridi  Composita,  B.P.  Pilul.e  Antimonii 
Composite,  U.S.P. ;  Compound  Pill  of  Subchloride  or  Mercury,  B.P. ;  Compound 
Pills  op  Antimony,  U.S.P.    Compound  Calomel  Pill.    Plummer's  Pill  (p.  522). 

B.P.  Xiotio  Hydrargyri  Nigra.  Black  Mercurial  Lotion.  Black  Wash. 
Consists  of  half  a  drachm  of  calomel  mixed  with  half  a  pint  of  lime-water.  It 
contains  suboxide  of  mercury. 

Uses. — Calomel  may  be  employed  as  a  dusting  powder  to  re- 
move condylomata  from  the  skin,  and  condylomatous  patches 
from  the  tongue,  throat,  and  larynx ;  it  is  also  recommended  in 
the  following  powder— calomel,  six  parts,  boric  acid,  three  parts, 
salicylic  acid  one  part.1    As  an  ointment  it  may  be  applied  to 

1  Philadelphia  Medical  Reporter,  June  14,  1884. 

ir2 


692  INOEGANIC   MATERIA   MEDICA.  [sect.  hi. 

relieve  the  itching  in  pruritus  ani  and  pruritus  scroti,  and  pity- 
riasis of  the  scalp,  and  to  heal  strumous  sores  and  lupus  in 
children.  In  pruritus  pudendi  it  is  also  of  service,  though  not 
quite  so  much  as  in  the  other  cases  (Einger);  It  should  not  be 
applied  in  large  quantities,  lest  so  much  of  it  be  absorbed  as  to 
cause  its  physiological  action.  Calomel  ointment  (|  to  1  drachm 
to  the  ounce)  is  useful  in  the  treatment  of  small  patches  of  vesi- 
cular eczema;  and  in  psoriasis  Eochard's  ointment,  which  con- 
tains one  part  of  iodine  and  one  and  a  half  part  of  calomel  to 
seventy  parts  of  simple  ointment,  is  beneficial  in  some  cases. 
Black  wash  is  a  good  application  to  varicose  ulcers,  and  is  used 
as  an  application  to  syphilitic  ulcerations,  as  a  wash  to  the 
mouth  in  syphilitic  sore-throat  and  in  cancrum  oris. 

Internally  calomel  may  be  given  in  cases  of  biliousness,  and 
followed  by  a  saline  purgative  in  the  same  manner  as  is  recom- 
mended under  '  Blue  Pill.'  In  some  cases  of  diarrhoea  it  is  very 
useful  in  combination  with  opium  (p.  106). 

It  may  also  be  used  to  produce  the  general  action  of  mercury 
in  syphilitic  patients,  and  for  this  purpose  may  either  be  given 
internally,  in  combination  with  opium,  or  applied  to  the  skin  in 
the  form  of  calomel  fumigations  (p.  47 1).1 

The  compound  pill  of  subchloride  of  mercury  may  be  used 
in  cases  of  biliousness,  gout  or  rheumatism. 

Calomel  is  a  useful  diuretic  in  some  cases  of  dropsy  (pp.  432 
and  686),  especially  when  due  to  heart-disease.  It  must  be  given 
in  doses  of  4  or  5  grains,  repeated  when  necessary,  salivation 
being  prevented  by  a  chlorate  of  potassium  gargle,  and  diarrhoea 
by  small  doses  of  opium.2 

Hydrargyri  Perchloridum,  B.P. ;  Hydrargyri  Chloridum 
Corrosivum,  U.S.P-  Perchloride  of  Mercury,  B.P. ;  Corro- 
sive Chloride  of  Mercury,  U.S.P.     HgCl2 ;  270-5. 

Characters. — In  heavy  colourless  masses  of  prismatic  crystals, 
possessing  a  highly  acrid  metallic  taste. 

Prepabation. — By  mixing  mercuric  sulphate  with  sodium  chloride  and 
subliming  into  a  small  chamber.  To  prevent  the  formation  of  any  calomel 
some  peroxide  of  manganese  is  added. 

Solubility. — It  is  more  soluble  in  alcohol,  and  still  more  so  in  ether,  than 
in  water. 

Beactions. — Its  acraeous  solution  gives  the  reactions  of  mercuric  salts 
(p.  681)  and  of  a  chloride  (p.  594). 

Dose. — -^  to  ^  grain.  In  cholera  and  summer  diarrhoea  this 
dcse  may  be  given  every  quarter  of  an  hour,  half-hour,  or  hour. 

A  solution  of  1  in  500  or  1  in  1,000  (about  ^  grain  in  1  oz. 
or  the  liquor  of  the  B.P.)  may  be  used  as  an  antiseptic  lotion  or 
for  a  spray  in  diphtheria. 

1  Mercurous  tannate  has  been  used  in  doses  of  one  grain  and  a  half  twice  or 
thrice  a  day  in  syphilis.  It  is  said  to  be  efficient,  and  yet  neither  to  interfere  with 
the  digestion,  nor  to  cause  any  stomatitis.    Zeitsch.  f.  Therapie,  2,  1884. 

2  Jendrassik,  Deutsch.  Archiv  f.  klin.  Med.,  vol.  xxxviii.  p.  499. 


chap,  xxvi.]  METALS.  693 

Officinal  Preparations. 
b'p-  ,  dose.  u.s.p. 

Liquor  Hydrargyri  Percbloridl J_2  fl.  drm.  None. 

Lotio  Hydrargyri  Flava  (18  grs.  in  10  fl.  oz.). 

Used  in  preparing. — Hydrargyri  Iodidum  Rubrum ;  Hydrargyrum  Ammoniatum. 
B.F.     Liquor    Hydrargyri    Percbloridl.     Solution    of   Peechlomde  of 
Mebcuby.— Contains  £  grain  of  perchloride  of  mercury  in  1  oz.  of  water,  with  \ 
grain  of  ammonium  chloride  to  keep  it  in  solution  and  prevent  precipitation. 

Uses. — When  mixed  with  albumen,  corrosive  sublimate  pre- 
cipitates it,  forming  a  mercuric  albuminate.  It  is  one  of  the 
most  powerful  antiseptics  known  (p.  95).  It  may  be  applied  (in 
the  strength  of  2  grains  to  the  ounce  of  water)  to  the  skin  to 
destroy  vegetable  and  animal  parasites  present  upon  it,  such  as 
the  fungus  in  pityriasis  versicolor,  in  sycosis  and  favus,  the  acarus 
in  scabies  and  the  pediculus  pubis.  It  is  the  most  powerful 
remedy  for  the  removal  of  the  pigment  in  chloasma,  and  may  be 
applied  in  a  lotion  of  bichloride  of  mercury  2  grains,  tincture  of 
benzoin  half  a  drachm,  and  1  ounce  of  almond  emulsion.  For 
the  rapid  removal  of  pigment  Hebra  used  a  solution  of  5  grains 
to  the  ounce  of  alcohol  and  water,  and  applied  it  by  means  of  com- 
presses for  4  hours,  so  as  to  raise  a  blister  ;  the  relief,  however, 
is  not  permanent,  since  pigmentation  returns.  The  danger  of 
absorption  must  be  considered,  so  that  it  is  unwise  to  apply  the 
treatment  to  large  surfaces.  It  is  useful  in  allaying  the  itching 
of  pruritis  scroti  and  pudendi,  prurigo,  and  urticaria.  It  may 
be  employed  as  a  wash  in  ophthalmia  (p.  216),  as  a  gargle  in 
syphilitic  sore-throat,  as  a  spray  in  diphtheria  (p.  692),  and  as  an 
injection  in  gonorrhoea,  gleet,  and  leucorrhcea,  or  for  the  uterus 
and  vagina  in  puerperal  conditions.  When  swallowed  in  strong 
solution  it  sometimes  causes  an  irritant  poisoning  (p.  395  et 
seq.) ;  and  if  this  should  pass  off,  it  may  be  succeeded  by  intense 
salivation  due  to  the  absorption  of  the  drag.  The  treatment  in 
such  cases  is  to  give  albuminous  substances,  such  as  white  of  egg 
or  milk,  in  order  to  form  mercuric  albuminate  in  the  stomach, 
and  thus  prevent  its  irritant  action  on  the  mucous  membrane.  If 
the  irritation  which  the  drug  itself  produces  is  not  sufficient  to 
cause  vomiting,  the  stomach  should  be  emptied  by  an  emetic  or 
the  stomach-pump,  in  order  to  prevent  digestion  and  absorption 
of  the  mercuric  albuminate  and  the  poisoning  which  might  occur 
from  its  absorption.  In  small  and  frequently-repeated  doses  it 
is  useful  in  the  dysenteric  diarrhoea  of  adults  or  children  and  in 
cholera,  its  utility  probably  depending,  to  a  great  extent  at  least, 
on  its  antiseptic  power,  which  is  not  destroyed,  like  that  of  other 
antiseptics,  by  considerable  admixture  with  organic  matter,  such 
as  the  faecal  contents  of  the  intestine  (p.  106) .  After  its  absorp- 
tion it  has  the  same  effect  as  the  other  salts  of  mercury,  and  may 
be  used  for  this  purpose  in  syphilitic  cases. 

B.P.  Lotio  Hydrargyri  Flava.     Yellow  Wash. 

Peepaeation. — By  mixing  18  grs.  of  corrosive  sublimate  with  half  a  pint  of 
lime-water. 


694  INORGANIC   MATERIA   MEDICA.  [sect.  in. 

Uses. — It  is  used  as  a  stimulating  application  to  syphilitic 
sores  in  cases  where  the  black  w^sh  is  not  sufficiently  powerful. 

Hydrargyri  Oxidum  Flavum,  B.  and  U.S.P.  Yellow 
Oxide  of  Meecuey.     HgO ;  215-7. 

Chaeactees. — A  yellow  powder  readily  dissolved  by  hydro- 
chloric acid,  yielding  a  solution  which,  with  solution  of  ammonia, 
gives  a  white  precipitate.  It  is  entirely  volatilised  when  heated 
to  incipient  redness,  being  resolved  into  oxygen  gas   and  the 

vapour  of  mercury. 

Preparations. 

u.s.p. 

Unguentum  Hydrargyri  Oxidi  Flavi  (1  in  10  of  Unguentum). 

B.   AND    U.S.P. 

Oleatum  Hydrargyri  (yellow  oxide  10,  oleic  acid  90,  parts). 

Uses. — The  oleate  of  mercury  a'cts  beneficially  in  ringworm, 
and  may  be  used  for  inunction  in  cases  of  syphilis  in  doses  of  10 
to  30  drops. 

Hydrargyri  Oxidum  Rubrum,  B.  and  U.S.P.  Bed  Oxide 
of  Meecuey.     HgO ;  215-7. 

Chaeactee. — An  orange-red  powder. 

Solubility  and  Eeactions. — It  is  readily  dissolved  by  hydrochlorio  acid, 
yielding  a  solution  which,  with  caustic  potash  added  in  excess,  gives  a  yellow 
precipitate,  and  with  solution  of  ammonia  a  white  precipitate. 

Preparation. — Triturate  nitrate  of  mercury  and  metallic  mercury  together, 
and  heat  until  nitrous  fumes  cease  to  be  given  off.  Hg^O^j  +  Hg  =»  2HgO  + 
N204. 

Impurity. — Undecomposed  nitrate. 

Test.— Entirely  volatilised  by  a  heat  under  redness,  being  at  the  same 
time  decomposed  into  mercury  and  oxygen.  If  this  be  done  in  a  test-tube, 
no  orange  vapours  are  perceived. 

Preparations. 

b.  AND  U.S.P. 

With  soft  and  hard  paraffin,  B.P. ;  with  ointment,  U.S.P. 
Uses. — The  red  oxide  is  rarely  given  internally.  The  oint- 
ment may  be  used  in  ophthalmia  and  conjunctivitis  in  the  same 
way  as  the  nitrate  of  mercury  ointment,  and  as  an  application 
to  the  auditory  meatus  in  otorrhcea  occurring  after  scarlet  fever. 
It  is  also  useful  in  scaly  skin-diseases,  syphilitic  sores  on  the 
skin,  and  in  ulcers  within  the  margin  of  the  anus. 

Hydrargyrum  Ammoniatum,  B.  and  U.S.P.    Ammoniated 
Meecuey.     White  Peeoipitate.     NH2HgCl;  251-1. 
Chaeactee. — An  opaque  white  powder. 
Solubility. — It  is  insoluble  in  cold  water,  alcohol,  and  ether. 
Eeactions. — Digested  with  caustic  potash,  it  evolves  ammonia,  acquiring 
a  pale  yellow  colour,  and  the  fluid,  filtered  and  acidulated  with  nitric  acid, 
gives  a  white  precipitate  with  nitrate  of  silver.     Boiled  with  a  solution  of 
chloride  of  tin  it  becomes  grey,  and  affords  globules  of  metallic  mercury. 


chap,  xxvi.]  METALS.  695 

Preparation. — By  dissolving  corrosive  sublimate  in  water,   and   pre- 
cipitating by  ammonia. 

Impurities. — Chalk,  sulphate  of  calcium,  baryta,  lead,  carbonates,  mer- 
curous  salts. 

■  Tests. — Entirely  volatilised  at  a  heat  under  redness  (no  chalk,  etc.).  It 
should  dissolve  in  hydrochloric  acid  without  residue  (no  mercurous  salt) 
and  without  effervescence  (no  carbonate). 

Preparation. 

b.  and  u.s.p. 

Unguentum  Hydrargyri  Ammonlati.l  part  in  10,  B.  and  U.S.P. 

(It  was  about  15  per  cent.  B.P.  1867.)  With  simple  ointment,  B.P. ;  with  benzoated 

lard,  U.S.P. 

Uses. — Not  used  internally.  The  ointment  is  used  in  order 
to  destroy  parasitic  fungi,  but  more  especially  to  kill  pediculi  in 
the  hair  or  on  the  body.  It  is  also  useful  in  impetigo  contagiosa, 
lichen,  pityriasis,  herpes,  subacute  eczema,  and  other  skin- 
diseases. 

Liquor  Hydrargyri  Nitratis  Acidus,  B.  and  U.S.P.  Acid 
Solution  op  Nitrate  op  Mercury.  Hg(N03)2 ;  323-7. 
1  Characters  and  Eeactions. — A  colourless  and  strongly  acid 
solution,  which  gives  a  yellow  precipitate  with  solution  of  potash 
added  in  excess  (mercuric  oxide).  If  a  crystal  of  sulphate  of  iron 
be  dropped  into  it,  in  a  little  time  the  salt  of  iron,  and  the  liquid 
in  its  vicinity,  acquire  a  dark  colour  (nitrate). 

Uses. — It  is  a  powerful  caustic,  and  is  used  as  such  in  lupus. 

It  is  to  be  applied  with  a  camel's-hair  brush  to  the  extent  of  a 

prown  piece   over   the  ulcers,  tubercles,  and  scars  which  are 

soft  and  ready  to  break.     The  part  is  then  covered  with  lint 

moistened  in  the  solution.     It  soon  becomes  white,  a  kind  of 

[<■"  erysipelatous  inflammation  sets  in  around  it,  and  it  falls  off  as  a 

I',  yellow  scab.     The  solution  is  also  applied  to  the  os  uteri  when 

there  are  large  ulcers  with  flabby  unhealthy  granulations  upon 

it.    It  has  been  used  in  cancer  and  in  chancres,  condylomata, 

syphilitic  and  scrofulous  ulcers,  favus,  and  obstinate  psoriasis. 

If  applied  often  it  may  cause  mercurialism,  and  indeed  salivation 

has  occurred  after  one  application  to  the  os  uteri.     To  prevent 

,  this  it  should  be  washed  off  immediately  after  being  applied. 

Unguentum  Hydrargyri  Nitratis,  B.  and  U.S.P.  Oint- 
ment of  Nitrate  of  Mercury.     Citrine  Ointment. 

Characters. — It  has  a  fine  lemon-yellow  colour  and  a  con- 
sistence like  butter.  It  is  apt  to  become  decolourised  when  mixed 
with  metals  or  deoxidising  powders,  and  hence  an  excess  of  acid 
is  used  in  order  that  it  may  reoxidise  them  as  necessary.  It 
should  be  spread  with  a  wooden  or  ivory  spatula. 

Preparation. — By  mixing  a  hot  solution  of  mercury  in  nitric  acid  with 
lard  and  olive  oil,  B.P. ;  or  with  lard  oil,  U.S.P. 

Uses. — This  ointment  was  made  in  imitation  of  Singleton'^ 


696  INOKGANIC  MATERIA   MEDICA.  [sect.  hi. 

golden  eye-ointment,  and  it  is  of  remarkable  service  in  ophthalmia 
tarsi.  It  should  be  mixed  with  its  own  weight  of  almond  oil 
and  applied  to  the  lids. 

It  is  also  applied  to  phagedenic  ulcers  and  syphilitic  sores, 
and  soon  destroys  the  parasitic  fungi  on  which  ringworm,  &c, 
depend. 

Preparation. 

B.E. 

Unguentum  Hydrargyri  Nitratis  DUutum  (Nitrate  of  Mercury  Ointment 
Soft  Paraffin  2). 

U.S.P.  Hydrargyri  Iodidum  Viride.  Green  Iodide  of 
Mercury.     Hg2I2;  652-6. 

Characters. — A  dull  green  powder,  which  darkens  in  colour 
upon  exposure  to  light. 

Solubility. — It  is  insoluble  in  water.  When  it  is  shaken  in  a  tube  with 
ether  nothing  is  dissolved. 

Ebactions. — Gradually  heated  in  a  test-tube,  it  yields  a  yellow  sublimate, 
which,  upon  friction,  or  after  cooling,  becomes  red,  while  globules  of  metallic) 
mercury  are  left  in  the  bottom  of  the  tube. 

Preparation. — By  rubbing  iodine  and  mercury  together  in  a  porcelain 
mortar,  occasionally  moistening  with  a  few  drops  of  spirit. 

Dose. — 1  to  3  grains. 

Uses.— It  is  employed  for  the  purpose  of  combining  the 
action  of  iodine  with  that  of  mercury,  as  in  cases  of  secondary 
and  tertiary  syphilis  occurring  in  persons  of  a  scrofulous  consti- 
tution, and  especially  in  the  syphilis  of  children. 

Hydrargyri  Iodidum  Rubrum,  B.  and  U.S.P.  Bed  Iodide 
op  Mercury.     Hgl2 ;  452-8. 

Characters. — A  crystalline  powder  of  vermilion  colour,  be- 
coming yellow  from  an  alteration  in  its  crystalline  form  when 
gently  heated  over  a  lamp  on  a  sheet  of  paper,  and  again  be- 
coming red  when  placed  on  a  sheet  of  paper  and  rubbed  with  a 
smooth  substance. 

Solubility. — It  is  almost  insoluble  in  water,  dissolves  sparingly  in 
alcohol,  but  freely  in  ether,  or  in  an  aqueous  solution  of  iodide  of  potassium. 

Eeactions. — When  digested  with  solution  of  soda  it  assumes  a  reddish- 
brown  colour  (mercuric  oxide) ;  and  the  fluid,  cleared  by  filtration  and  mixed 
with  solution  of  starch,  gives  a  blue  precipitate  on  being  acidulated  with 
nitric  acid  (iodide).    Entirely  volatilised  by  a  heat  under  redness. 

Preparation. — By  mixing  solutions  of  corrosive  sublimate  with  potassium- 
iodide  in  the  proper  proportions. 

Dose. — Jg-  to  £  grain. 

Preparations. 

B.P. 

Unguentum  Hydrargyri  lodidl  Rubrl  \    ,         .  .     no 

(Ointment  of  Eed  Iodide  of  Mercury)  ... /  x  Part  m  28, 

With  yellow  wax  and  almond  oil. 

B.  AND   U.S.P.  DOSE. 

liquor  Arsenic!  et  Hydrargyri  Xodidi 10-30  min. 


chap,  xxvi.]  METALS.  697 

Uses. — It  may  be  used  for  the  same  purposes  as  the  green 
iodide,  but,  like  all  the  mercuric  salts,  it  is  much  more  powerful 
than  the  corresponding  mercurons  one. ,  It  is  a  powerful  local 
irritant,  and  is  used  in  the  form  of  ointment  in  cases  of  goitre. 
The  mode  of  employing  it  is  to  rub  the  ointment  upon  the 
tumour,  and  afterwards  to  expose  the  patient  either  to  the  heat 
of  the  sun  or  of  a  fire  as  long  as  he  can  bear  it.  This  treatment 
was  first  used  in  India.  In  this  country,  where  the  sun's  rays' 
are  not  so  powerful,  the  heat  of  a  fire  may  be  employed,  and  I 
have  found  it  efficacious  when  used  in  this  way.  Bed  iodide 
ointment  is  useful  in  obstinate  skin-diseases,  especially  lupus 
erythematosus. 

It  is  frequently  given  in  syphilis,  one  of  the  most  common 
ways  of  prescribing  it  being  to  give  one-half  to  one  drachm  of 
the  solution  of  the  perchloride  with  several  grains  of  potas- 
sium iodide.  The  periodide  is  thus  formed,  and  is  dissolved  in 
excess  of  the  potassium  iodide. 

U.S.P.  Hydrargyri  Cyanidum.  Cyanide  of  Mercury. 
Hg(CN)2;  251-7. 

Characters. — Colourless  or  white  prismatic  crystals,  be- 
coming dark-coloured  on  exposure  to  light ;  odourless,  having  a 
bitter  metallic  taste,  and  a  neutral  reaction. 

Eeactions. — When  slowly  heated  the  salt  decomposes  into  metallic 
mercury  and  cyanogen  gas,  which  is  inflammable,  burning  with  a  purplish 
flame.  On  farther  heating,  the  blackish  residue  containing  globules  of 
metallic  mercury  is  wholly  dissipated.  On  adding  hydrochloric  acid  to  the 
aqueous  solution,  hydrocyanic  acid  vapour  is  evolved. 

Tests. — A  5  per  cent,  aqueous  solution  of  the  salt,  when  mixed  with  a 
dilute  aqueous  solution  of  iodide  of  potassium,  should  not  yield  a  red  or 
reddish  precipitate  soluble  in  excess  of  either  liquid  (absence  of  mercuric 
chloride). 

• .    Dose. — Jg-  to  £  grain. 

Uses. — It  may  be  given  in  syphilis.  A  solution  of  5^10  grains 
in  an  ounce  of  water,  painted  on  with  a  camel's-hair  brush,  is 
a  useful  application  to  syphilitic  sores  of  the  tongue  or  mouth. 

U.S.P.  Hydrargyri  Sulphidum  Rubrum.  Eed  Sulphide 
of  Mercury.    HgS;  231*7. 

Characters. — Brilliant  dark-red  crystalline  masses,  or  a  fine 
bright  scarlet  powder,  permanent  in ,  the  air,  odourless  and 
tasteless. 

Solt/bility. — It  is  insoluble  in  water,  alcohol,  nitric  or  hydrochloric  acid, 
or  in  dilute  solutions  of  alkalis. 

Reactions. — It  is  dissolved  by  nitrohydrochloric  acid,  and  on  adding  an 
excess  of  stannous  chloride,  metallic  mercury  is  precipitated. 

Uses. — It  is  used  for  mercurial  fumigation.  Thirty  grains 
maybe  used  instead  of  calomel,  in  the  way  already  described 
(p.  471). 


698 


INOEGANIC  MATEEIA  MEDICA. 


[SECT.  III. 


Class   IV. 

Tetrad  Metals. 
LEAD.     Titanium.    TIN. 

General  Actions. — Lead  and  tin  resemble  one  another  to  a 
considerable  extent  in  their  physiological  action.  After  absorp- 
tion into  the  circulation  lead  affects  the  muscles,  involuntary 
and  voluntary,  and  the  central  nervous  system.  Its  action  on 
muscle  appears  to  be  first  irritant  then  paralysing.  The  irritant 
action  on  the  muscle  of  the  intestine  leads  to  colic,  and  on  the 
voluntary  muscle  to  cramps  in  man.  In  animals,  when  the 
quantity  administered  in  experiments  at  one  time  is  much  larger, 
paralysing  action  is  more  marked,  and  in  frogs  and  rabbits, 
muscular  weakness  and  rapid  loss  of  irritability  both  in  the 
voluntary  muscles  and  heart  are  marked  symptoms.  In  cats 
the  paralysis  of  voluntary  muscle  is  less  marked,  and  in  dogs 
it  is  absent. 

The  motor  area  of  the  central  nervous  system  appears  to  be 
much  more  affected  by  lead  than  the  sensory ;  and  in  dogs,  cats, 
and  pigeons  choreic  movements  and  even  convulsions  occur 
without  impairment  of  sensation  or  consciousness.  The  irrita- 
tion of  the  motor  centres  is  succeeded  by  paralysis  and  death. 

Tin  has  an  action  resembling  lead  in  increasing  the  contrac- 
tions of  the  intestinal  canal  and  causing  paralysis  of  the  spinal 
cord.  In  rabbits  it  produces  weakness  and  apparent  recovery, 
and  then  paresis  and  death.1 


LEAD.     Pb  ;  207. 

General  Source  op  Lead  Salts. — Lead  is  obtained  entirely 
from  the  native  sulphide  called  galena,  by  roasting. 

General  Eeactions. — The  chief  reactions  of  lead  salts  are 
shown  in  the  following  table  : — 


Reagent 

Reaction 

Hydrogen  sulphide                          ) 
Ammonium  sulphide      .        .        J 
Caustic  potash  or  soda    . 

Carbonates  of  potassium,  sodium, ) 
or  ammonium                               ' 

Sulphuric  acid  or  sulphates    . 

Potassium  iodide    .... 

Black  precipitate. 

White        „          soluble  in  excess. 
„            „          insoluble        „ 

»            »                i»                » 

„            „                „         in  nitric  acid. 
Yellow      „                „ 

1  T.  P.  White,  Archivf.  exp.  Path.  u.  Pharm.  1880,  viii.  p.  33. 


chap,  xxvi.]  METALS.  699 

General  Impurities. — Alkaline  earths,  zinc  or  copper. 

General  Tests.— As  alkaline  earths  and  zinc  are  not  precipitated  by 
sulphuretted  hydrogen,  they  can  be  detected  by  passing'this  gas  through  the 
solution  of  a  lead  salt  until  all  the  lead  has  been  precipitated  as  sulphide. 
On  removing  the  sulphide  by  filtration,  and  evaporating  the  filtrate  to  dry- 
ness, no  residue  should  remain  if  the  lead  be  pure,  U.S.P. 

Copper  may  be  detected  by  precipitating  the  lead  from  a  solution  by 
sulphuric  acid,  filtering,  and  super-saturating  with  ammonia.  If  copper  be 
present,  the  solution  wDl  exhibit  a  blue  colour,  U.S.P.  Insoluble  salts,  as  the 
oxide,  may  be  dissolved  in  dilute  nitric  acid  super-saturated  with  ammonia. 
The  nitrate  should  show  no  blue  colour. 

Action. — Soluble  lead-salts  unite  with  albumen,  and  form 
albuminate  of  lead.  They  have  little  or  no  irritating  action 
when  applied  directly  to  the  denuded  skin  or  to  a  mucous 
membrane.  In  the  mouth  they  have  an  astringent  action,  but 
a  sweet  instead  of  a  corrosive  taste.  In  large  doses  in  the 
stomach  they  may  excite  vomiting,  and  may  produce  symptoms 
of  irritant  poisoning.  In  the  intestine  they  act  as  powerful 
astringents.  After  absorption  into  the  blood  lead  is  carried  by 
the  blood  to  all  parts  of  the  body,  and  there  becomes  deposited. 
It  appears  to  be  eliminated  very  slowly,  so  that  when  even  very 
minute  quantities  are  taken  continuously  chronic  lead-poisoning 
may  be  produced. 

One  of  the  most  important  sources  of  lead-poisoning  of 
this  sort  is  drinking  water.  Soft  water  attacks  the  leaden  pipes 
in  which  it  may  be  conveyed,  or  the  cisterns  in  which  it  may 
be  stored,  and  dissolves  enough  lead  to  cause  lead-poisoning, 
the  small  quantity  of  one  grain  per  gallon  appearing  to  be  suffi- 
cient. 

Hard  waters  are  not  injurious,  as  they  cause  a  coating  of 
phosphate  or  sulphate  of  lead  to  form  on  the  surface  of  the  pipe 
or  cistern,  and  thus  protect  it  from  further  attacks.  Other 
sources  of  lead-poisoning  are  beer  or  cider  which  has  stood  in 
the  pipes  leading  to  the  tap,  and  snuff,  from  the  decomposition 
of  the  lead-foil  which  surrounds  ■  it.  There  are  certain  trades 
the  workers  in  which  are  very  liable  to  lead-poisoning,  such  as 
colour-grinding,  painting,  plumbing,  type-founding  and  printing 
(compositors),  or  persons  making  stereotype  plates.  The  chief 
source  of  poisoning  in  these  trades  is  the  lead  which  adheres  to 
the  hands  and  is  swallowed  along  with  the  food,  and  the  pre- 
cautions to  be  adopted  are  cleanliness,  washing  the  hands  care- 
fully before  taking  meals,  taking  the  food  in  a  different  room 
from  that  in  which  the  work  is  carried  on,  changing  the  clothes 
when  the  work  is  over,  and,  if  necessary,  drinking  water  acidu- 
lated with  sulphuric  acid. 

Treatment  of  chronic  lead-poisoning  consists  in  eliminating 
the  poison,  first  from  the  tissues  and  then  from  the  body. 
Various  means  have  been  employed,  such  as  sulphur  baths,  the 
internal  administration  of  sulphur,  frequent  doses  of  castor  oil. 
As  the  lead  is  eliminated  by  the  skin  and  mucous  membrane,  sul- 


700  INOEGANIC  MATEEIA  MEDICA.  [sect.  in. 

phur,  applied  either  to  the  skin  or  taken  internally,  will  convert 
it  into  an  insoluble  sulphide  and  prevent  its  re- absorption. 
Castor  oil  will  remove  from  the  intestinal  canal  the  lead  excreted 
into  it.  But  the  treatment  which  I  employ,  and  which  I  find 
very  satisfactory,  is  to  combine  the  use  of  iodide  of  potassium 
with  that  of  sulphate  of  magnesium,  giving  from  five  to  ten  grains 
of  the  iodide  three  times  a  day,  and  a  drachm  of  the  sulphate 
also  three  times  a  day,  with  an  interval  of  about  two  hours 
between  the  medicines.  The  object  of  this  treatment  is  (1)  to 
dissolve  the  lead  deposited  in  the  tissues  by  means  of  the  iodide 
(p.  561),  and  to  cause  its  elimination  by  the  mucus  of  the  ali- 
mentary canal,  and  (2)  to  render  the  lead  insoluble  after  it  has 
passed  into  the  intestine  by  means  of  the  sulphate,  and  to  re- 
move it  thence  as  quickly  as  possible. 

The  symptoms  of  chronic  lead-poisoning  are  a  blue  line 
on  the  gums,  lead  colic,  lead  cramps,  and  lead  paralysis.  The 
blue  line  on  the  gums  may  appear  when  neither  the  colic, 
cramps,  nor  paralysis  are  present.  It  appears  to  be  produced 
by  sulphuretted  hydrogen  in  the  mouth  precipitating  the  lead  as 
black  sulphide  in  the  gums  just  at  the  margin  of  the  teeth,  and 
this,  shining  through  the  tissue  above  it,  appears  of  a  bluish 
colour.  It  is  absent  when  the  teeth  have  been  lost,  and  slight  if 
they  are  kept  clean. 

The  lead  colic  may  either  be  preceded  by  symptoms  of 
digestive  derangement,  such  as  loss  of  appetite,  or  may  appear 
at  once.  It  is  characterised  by  a  tearing  pain  referred  chiefly. 
to  the  region  of  the  umbilicus,  and  generally  accompanied  by 
obstinate  constipation.  It  is  usually,  though  not  always, 
relieved  by  pressure,  but  may  sometimes  be  somewhat  increased 
by  it. 

Lead  cramps  are  almost  entirely  confined  to  the  flexor  sur- 
faces, specially  marked  in  the  calves  of  the  legs,  and  are  usually 
worse  at  a  change  of  weather.  They  may  either  accompany  or 
succeed  the  colic. 

Lead  paralyses  are  usually  confined  to  the  extensor  surfaces, 
and  more  particularly  affect  the  extensors  of  the  wrist,  so  that 
this  form  of  paralysis  is  sometimes  known  as  wrist-drop.  The 
affected  muscles  become  atrophied,  and,  as  the  extensor  tendons 
also  act  as  ligaments  of  the  wrist,  the  bones  of  the  carpus  may 
become  displaced.  The  paralysis  probably  depends  on  an 
affection  of  the  spinal  cord  rather  than  of  the  muscles  them- 
selves ;  for  degeneration  of  the  muscles  does  not  occur  until  after 
the  paralysis  has  set  in  for  some  time,  and  the  muscles  are 
affected  in  physiological  groups  which  act  together,  although 
supplied  by  different  nerves.  Thus  the  supinator  longus,  which 
is  rather  a  flexor  than  a  supinator,  escapes  in  lead-poisoning, 
while  the  supinator  brevis  and  extensor  muscles  in  the  forearm- 
are  paralysed.     Tn  peripheral  paralysis  of  the  musculo-spinal 


f.  xxvi.]  METALS.  701 

ve  from  cold  or  pressure  the  supinator  longus  is  paralysed  as 
1  as  the  others.1 

Cerebral  symptoms,  consisting  of  headache,  delirium,  epi- 
tiform  convulsions,  or  stupor  and  coma,  have  been  described  as 
urring  in  lead  poisoning,  and  have  been  termed  encephab- 
hia  saturnina.  These  have  been  ascribed  to  cerebritis  caused 
the  action  of  lead  upon  the  brain,  but  it  seems  not  impossible 
i,t  they  are  really  due  to  uraemia.  If  this  be  so  they  may  be 
;arded  as  the  direct  consequences  of  the  action  of  lead  which, 

causing  the  degeneration  of  the  kidneys  to  be  presently 
scribed,  leads  to  imperfect  elimination  of  tissue-waste. 

Affections  of  the  eye  are  sometimes  associated  with  the 
■ebral  symptoms  just  mentioned,  and  are  noticed  in  cases 
:ere  there  is  no  kidney  disease.  Sudden  onset  of  amblyopia 
ihout  organic  changes  may  occur,  but  is  then  usually  transient, 
e  amblyopia  consists  in  a  general  dimness  of  vision,  or  in  a 
ninution  of  the  field  of  vision  of  one  or  both  eyes.  Optic 
uritis  (papillitis)  also  occurs  in  some  cases,  and  may  proceed 
atrophy. 

Chronic  lead-poisoning  has  a  tendency  to  induce  cirrhotic 
anges  in  the  kidneys  with  albuminuria,  the  tubules  becoming 
>cked  by  plugs  of  lead-carbonate  and  atrophy  ensuing. 

Lead  appears  to  cause  contraction  of  the  muscular  walls  of 
3  arteries,  and  to  raise  the  arterial  tension  and  to  slow  the 
art.  This  action  has  been  supposed  to  depend  on  a  local 
tringent  effect  upon  muscular  fibre  itself,  but  as  in  cases  of 
ronic  poisoning  the  proportion  of  lead  in  the  nervous  system 
much  greater  than  in  muscular  fibre,  it  is  more  probable  that 
ese  effects  are  of  nervous  origin.  The  contraction  of  the 
testine  which  gives  rise  to  the  colic  is  probably  due  rather  to 
b  action  of  the  lead  upon  the  nerves  of  the  intestine  than  upon 

muscular  coats. 

Lead  is  eliminated,  to  a  slight  extent,  in  the  urine,  and 
obably  largely  by  the  mucus  of  the  intestinal  canal.  It  ap- 
ars  to  check  the  elimination  of  uric  acid,  and,  in  London,  gout 
Burs  very  frequently  among  patients  who  work  in  lead. 

Lead-salts  may  be  administered  in  medicinal  doses  for  a  con- 
lerable  time  without  bringing  on  any  sign  of  lead-poisoning  ; 
t  Garrod  has  observed,  and  I  can  confirm  the  statement,  that 
e  administration  of  medicinal  doses  of  lead-salts  will  bring  on 
it  of  gout  in  persons  predisposed  to  it.  Lead-poisoning  appears 
occur  readily  in  gouty  subjects. 

Uses. — Lead  lotions  are  sometimes  applied  externally  to 
rains  and  bruises.  They  are  useful  in  relieving  the  itching 
d  the  discomfort  of  pruritus,  and  in  lessening  the  discharge  of 
sema.    As  injections  they  may  be  applied  in  otorrhcea,  vulvitis 

1  Duchenne's  Works,  selected  by  Poore,  New  Syd.  Sob. 


702  INOEGANIC   MATEEIA  MEDICA.  [sect,  hi, 

in  children,  gonorrhoea,  and  leucorrhcea.  They  are  not  used  in 
ulceration  of  the  cornea,  lest  lead  should  be  deposited  in  the 
ulcer  and  leave  a  permanent  opacity  (p.  216) .  Internally,  lead 
is  used  for  its  local  action  on  the  stomach  in  pyrosis,  and  on 
the  intestine  in  diarrhoea  and  dysentery,  and  for  its  astringent 
action  on  the  vessels  in  hsematemesis,  haemoptysis,  and  bleeding 
from  the  kidneys  and  uterus.  It  has  also  been  employed  in  pal- 
pitation from  hypertrophied  heart,  and  in  aortic  aneurism. 

Plumbi  Oxidum,  B.  and  U.S.P.     Oxide  of  Lead.    PbO; 
223. 

Chaeactee. — In  heavy  scales  of  a  pale  brick-red  colour. 

Solubility  and  Reactions. — Completely  soluble  without  effervescence  in 
diluted  nitric  and  acetic  acids,  either  solution,  when  neutral,  giving  the  re- 
actions of  lead  (p.  698).     It  should  contain  no  copper. 

Preparation. — By  roasting  lead  in  a  current  of  air. 

Preparations  in  which  Oxide  of  Lead  is  Used. 

Emplastrum  Plumbi.  Liquor  Plumbi  Subacetatis. 

„  Saponis  Fuscum.  Plumbi  Acetas. 

Emplastrum  Plumbi,  B.  and  U.S.P.     Lead  Plaster. 
Preparation. — By  heating  oxide  of  lead  with  olive  oil  and  water.    The 
oleic  acid  of  the  oil  combines  with  the  lead,  forming  oleate  of  lead,  and  leaving 
glycerine.    This  plaster  is  a  lead  soap. 


Preparations. 

B.P. 

U.S.P. 

Emplastrum  Perri. 

„         Galbani. 

Emplastrum  Ammoniaci  cum  Hydrargyro. 
,,            Asafcetidse. 

„          Hydrargyri. 
„         Resinse. 

„             Ferri. 
,,             Galbani. 

„         Saponis. 

„            Hydrargyri. 
„            Opii. 
„            Besinffi. 

„            Saponis. 
Unguentum  Diachylon  (1  in  4,  nearly). 
And  several  other  plasters  into  -which  it 
enters,  as  resin  plaster. 

Uses. — Lead  plaster  is  used  to  hold  together  the  edges  of 
wounds,  to  protect  irritable  surfaces,  either  alone  or  by  keeping 
other  dressings  in  contact  with  them  by  means  of  its  adhesive 
power.     It  is  also  used  as  a  means  of  applying  pressure. 

Unguentum  Diachylon  (U.S.P.)  is  very  useful  in  chronic 
eczema,  and  in  the  acute  form  after  severe  inflammatory  sym- 
ptoms have  subsided.  It  must  be  applied  thickly  spread  on  a 
cloth,  which  is  kept  in  place  by  a  bandage.  It  is  also  useful  in 
hyperidrosis,  especially  of  the  feet,  the  treatment  being  con- 
tinued, without  washing,  and  with  a  daily  change  of  dressing,  for 
ten  to  fourteen  days.  In  sycosis,  after  shaving,  the  application 
of  soft  soap  twice  a  day,  and  diachylon  ointment  in  the  intervals, 
has  a  very  beneficial  effect. 


chap.  xxVi.]  METALS.  703 

Plumbi  Carbonas,  B.  and  U.S.P.  Carbonate  of  Lead. 
(PbC03)2Pb(HO)2;  773-5. 

Characters. — A  soft,  heavy,  white  powder,  blackened  by 
sulphuretted  hydrogen. 

Solubility  and  BEACTIONS.^-Insoluble  in  water,  soluble  with  efferves- 
cence in  diluted  acetic  acid  without  leaving  any  residue,  and  forming  a  solu-, 
tion  which  gives  the  reactions  of  lead. 

Preparation. — By  exposing  lead  to  the  fumes  of  vinegar  and  to  C02. 

Impurity. — Calcium. 

Test. — The  acetic  solution  when  treated  with  excess  of  sulphuretted 
hydrogen,  boiled  and  filtered,  gives  no  precipitate  with  oxalate  of  ammonium. 

Preparation. 

B.  AND  U.S.P. 

Vnguentum  Plumbi  Carbonatls 1  part  in  8,  B.F. ;  1  in  10,  U.S.P. 

With  simple  ointment,  B.P. ;  with  benzoated  lard,  U.S.P. 

Uses. — Carbonate  of  lead  is  used  as  an  application  to  ex- 
coriated surfaces,  piles,  boils,  and  ulcers. 
The  ointment  is  used  in  the  same  way. 

Plumbi  Acetas,  B.  and  U.S.P.  Acetate  of  Lead. 
Pb(CH2)2(CO.OH)2.     3H20;  378-5.     Sugar  of  Lead. 

Characters. — In  white  crystalline  masses,  slightly  efflores- 
cent, having  an  acetous  odour,  and  a  sweet,  astringent  taste. 

Solubility  and  Eeactions. — Its  solution  in  water  slightly  reddens 
litmus,  and  gives  the  reactions  of  lead  (p.  698)  and  of  an  acetate  (p.  594). 

Preparation. — By  dissolving  oxide  of  lead  in  acetic  acid. 

Impurity. — Slight  amount  of  carbonate. 

Test. — Its  solution  in  distilled  water  is  clear,  or  has  only  a  slight  milki- 
ness,  which  disappears  on  the  addition  of  acetic  acid. 

Dose. — 1  to  4  grains. 

Preparations  in  which  Acetate  op  Lead  is  Used. 

b.p.  '  U.S.P. 

Glycerinum  Plumbi  Subacetatis. 

Liquor               „              „            5,  ounces  to  1  pint.    Liquor  Plumbi  Subace- 
tatis. 
Pilula  Plumbi  cum  Opio  (v.  p.  522),  3  parts  in  4. 
Suppositoria  Plumbi  Composita...!  part  in  5. 
Vnguentum  Plumbi  Acetatls 1  part  in  38. 

Uses. — The  acetate  is  the  preparation  of  lead  most  frequently 
used  as  a  local  application  in  inflammations,  ulcers,  ophthalmia, 
and  gonorrhoea,  or  for  its  general  actions  on  the  system. 

B.P.  Pllula  Plumbi  cum  Opio.    Pill  of  Lead  and  Opium. 
Dose. — 3  to  5  grains. 

Uses.— It  is  a  powerful  astringent,  used  either  for  the  purpose 
of  obtaining  the  local  astringent  action  of  lead  upon  the  bowels 
in  diarrhoea,  or  for  its  general  effect  upon  the  system,  after  ab- 
sorption, as  in  haemoptysis. 

B.P.  Suppositoria  Plumbi  Composita.  Compound  Lead  Suppositories. 
Each  suppository  contains  1  grain  of  opium  and  3  grains  of  acetate  of  lead. 


704  INOEGANIC  MATEEIA  MEDICA.  [sect.  hi. 

Uses.— Used  in  piles  and  dysentery  accompanied  by  much 
tenesmus,  or  in  phthisis,  where  we  wish  to  stop  haemoptysis 
without  putting  lead  or  opium  into  the  stomach  and  thus 
running  the  risk  of  interfering  with  digestion. 

B.P.  TJnguentum  Plumbl  Acetatls.  Ointment  of  Acetate  or  Lead. — 
Acetate  of  lead  (12  grains),  benzoated  lard  (1  ounce). 

Uses. — It  is  used  as  a  sedative  and  astringent  application 
to  ulcers,  excoriations,  painful  piles,  irritable  and  itching  skin- 
diseases,  erysipelas,  burns,  bruises,  &c. 

Liquor  Plumbi  Subacetatis,  B.  and  U.S.P.     Solution  of 

SUBACETATE    OF   LEAD. 

Subacetate  of  lead,  Pb(C2H302)2.PbO,  dissolved  in  water, 
B.P.  An  aqueous  liquid  containing  in  solution  about  24  per 
cent.  B.P.,  25  per  cent.  U.S.P.,  of  subacetate  of  lead. 

Characters. — A  dense  clear  colourless  liquid,  with  alkaline 
reaction  and  sweet  astringent  taste,  becoming  turbid  by  exposure 
to  the  air  and  forming  with  mucilage  of  gum-arabic  an  opaque 
white  jelly. 

Eeactions. — It  gives  the  reactions  of  lead  and  of  an  acetate. 
Preparation. — By  boiling  acetate  of  lead,  oxide  of  lead  in  powder,  and 
distilled  water  together. 

Preparations. 

B.P.  U.S.P. 

Glycerinum  Plumbi  Subacetatis.  Ceratum  Plumbi  Subacetatis. 

liquor  „  „     Dilutus.       Linimentum  „  ,,      (v.  p.  517). 

Liquor  „  „  Dilutus. 

Uses. — It  is  recommended  by  Kinger  as  an  application  to 
pityriasis  and  eczema,  and  in  combination  with  one  or  two  parts 
of  glycerine  to  the  milder  forms  of  lupus  after  the  crusts  have 
been  removed.  Diluted,  and  mixed  with  liquor  morphinse  acetatis, 
it  is  a  useful  application  to  hEemorrhoids. 

B.P.  Glycerinum  Plumbi  Subacetatis.  Glycerine  of  Subacetate  of 
Lead.  . 

Preparation. — By  boiling  acetate  of  lead,  oxide  of  lead,  glycerine  and  water 
together  and  evaporating  off  the  water. 

PREPARATION. 

B.P.  Vnguentum  Glycerinl  Plumbi  Subacetatis.  Glycerine  of  Sub- 
acetate of  lead  1,  soft  paraffin  4,  hard  paraffin  1£  parts. 

Liquor  Plumbi  Subacetatis  Dilutus,  B.  and  U.S.P.  Diluted  Solution 
of  Subacetate  of  Lead. — Consists  of  2  fl.  dr.  of  solution  of  lead  and  2  fl.  dr.  of 
rectified  spirit  diluted  with  water  up  to  a  pint,  B.P.  Solution  of  acetate  of  lead  3,; 
distilled  water  97  parts,  U.S.P. 

Uses. — Used  as  a  mild  astringent  and  sedative  to  irritable 
and  itching  skin-diseases  and  superficial  inflammation ;  as  an 
eye-wash  unless  ulceration  of  the  cornea  be  present ;  as  an  injec- 
tion in  leucorrhcea  and  pruritus  pudendi. 

U.S.P.  Ceratum  Plumbi  Subacetatis.  Cerate  of  Subacetate  of  Lead.— Solu- 
tion of  subacetate  of  lead  (20  parts),  camphor  cerate  (SO  parts),  U.S.P. 

Uses. — Chiefly  as  an  application  to  chapped  hands  and  ulcers; 


.chap,  xxvi.]      ,    ,  METALS.  705 

U.S.P.  Linimentum  Plumbi  Subacetatia.  Liniment  of  Subacetate  of  Lead. — 
Vide  p.  517. 

Uses. — To  allay  itching  in  chilblains  and  skin-diseases. 

Plumbi  Nitras,  B.  and  U.S.P.  Nitrate  of  Lead.  Pb(NO,),  ; 
330-5. 

Characters. — In  colourless  octahedral  crystals  which  are 
nearly  opaque,  permanent  in  the  air,  of  a  sweetish  astringent 
taste. 

Solubility. — Soluble  id  water  and  alcohoL 

Eeactions. — The  aqueous  solution  gives  the  reactions  of  lead  (p.  698). 
Added  to  sulphate  of  indigo  it  discharges  the  colour. 

Preparation. — By  dissolving  lead  in  nitric  acid  with  the  aid  of  heat  and 
crystallising. 

Preparation  in  which  Nitrate  of  Lead  is  used. 
Plumbi  Iodidum. 

Uses. — It  is  sometimes  applied  as  ,a  disinfectant,  and  occa- 
sionally to  cracked  hands  or  lips  and  fissured  nipples,  and  in 
onychia  maligna.  It  has  been  given  in  order  to  check  haemor- 
rhage from  the  lungs. 

Plumbi  Iodidum,  B.  and  U.S.P.  Iodide  of  Lead,  J?bl 
0rPbI2;  459-7. 

Characters. — A  heavy,  bright,  citron-yellow  powder,  neutral, 
with  no  taste  or  smell. 

Solubility. — Sparingly  soluble  in  water,  readily  soluble  in  chloride  of 
ammonium. 

Eeaction. — When  strongly  heated  it  first  fuses  and  then  is  decomposed, 
emitting  violet  vapours  of  iodine,  and  leaving  a  citron-yellow  residue. 

Preparation. — By  mixing  solutions  of  nitrate  of  lead  and  potassium 
iodide. 

Impurities. — Chromate,  zinc,  alkalis,  and  alkaline  earths. 

Tests. — On  triturating  1  part  of  the  salt  with  2  parts  of  chloride  of 
ammonium  in  a  porcelain  mortar,  and  adding  2  parts  of  water,  a  colour- 
less liquid  should  result  (absence  of,  and  difference  from,  chromate).  This 
liquid,  diluted  with  water,  affords  a  white  precipitate  with  diluted  sulphuric 
acid,  and  a  black  one  with  bydrosulphuric  acid.  If  all  the  lead  has  been 
precipitated  from  a  portion  of  the  solution  by  the  last-named  reagent,  the 
filtrate  should  leave  no  residue  on  evaporation  and  gentle  ignition  (absence 
of  zinc,  alkalis,  or  alkaline  earths). 

Preparations. 

Tt  P.  Emplastrum  Plumbi  lodidi.  Iodide  of  Lead  Plaster,  1  part  in  9 
(with  soap  and  resin  plaster), 

Dnguentum  Plumbi  lodidi,  B.  and  U.S.P.  Ointment  of  Iodide  of  Lead; 
with  simple  ointment,  1  part  in  8,  B.P. ;  with  benzoated  lard,  1  part  in  10,  U.S.P. 

Uses. — It  has  been  used  externally  as  an  application  to  ring- 
worm, and  as  a  counter-irritant  in  scrofulous  enlargement  of  the 
glands.  It  has  been  given  internally  in  enlarged  glands,  and  in 
chronic  enlargement  of  the  spleen.  In  the  latter  case  the  iodine 
may  be  supposed  to  have  a  beneficial  effect  upon  the  corpuscles 
of  the  spleen,  and  the  lead  to  cause  contraction  by  acting  upon 
the  involuntary  muscular  fibre  of  the  organ. 

The  ointment  is  used  for  enlarged  glands. 

z  z 


706  INOBGANIC.  MATEEIA  MEDICA.  [sect.  in. 


TIN.    Sn;  118. 

B.P.  Tin,  granulated. 

Grain  tin,  reduced  to  small  fragments  by  fusing  and  pouring 
into  cold  water. 

Use. — Used  formerly  in  powder  as  an  anthelmintic  in  |  ounce 
doses. 

Solution  of  Chloride  of  Tin.     SnCl2. 

Peepaeation. — By  dissolving  granulated  tin  in  dilute  hydrochloric  acid. 

Uses. — It  has  a  powerful  affinity  for  oxygen  and  for  chlorine. 
When  added  to  trichloride  of  gold  it  gives  a  precipitate  called 
purple  of  Ca'ssius  whose  composition  is  not  known.  It  is  used 
as  a  test  for  mercury.  When  added  to  calomel  it  abstracts 
chlorine  and  precipitates  metallic  mercury.  When  added  to 
corrosive  sublimate  it  precipitates  calomel,  which  it  afterwards 
reduces  to  mercury. 

Salts  of  tin  are  not  commonly  used  in  practice,  but  have  been 
given  in  nervous  diseases  in  somewhat  the  same  way  as  zinc. 

Chloride  of  tin  is  a  caustic  of  considerable  power.  In 
poisoning  by  it  the  treatment  would  be  to  give  milk  and  alkaline 
carbonates. 


PHAP.  xxvii.]  METALS.  707 


CHAP  TEE  XXVII. 

ME  T  AL  S— (continued) . 

Class  V.— PENTAD   ELEMENTS. 

Nitrogen,  Phosphorus,  Vanadium,  Arsenic,  Niobium, 
Antimony,  Tantalum,  Bismuth. 

In  the  heading  to  this  class  I  have  substituted  the  word 
elements  for  metals,  for  nitrogen  and  phosphorus  belong  to  it, 
although  they  are  non-metallic  elements. 

They  form  analogous  compounds  -with  oxygen  and  hydrogen. 

12  3  4  5 

'      Nitrogen N  ...  N20  ...  N202  ...  N203  ...  N204  ...  N205     ...  NH3 

Phosphorus    ...  P  ...  P203  P203     ...  PH3 

Vanadium V  ...  V20  ...  V202  ...  V203  ...  V.,04  ...  V2Os     ... 

'      Arsenic  As  ...  As.,03  ...  As2Os  ...  AsH, 

Antimony  Sb  ...  Sb"203  ...  Sb203  ■••  SbH3 

Bismuth Bi  '    ...  Bi203  ...  Bi205 

Nitrogen.     N ;  14.    Non-officinal. 

Nitrogen  when  free  is  chemically  inactive,  and  does  not 
readily  unite  with  other  elements.  It  is  also  physiologically  in- 
active, but  has  been  used  as  an  anaesthetic.  The  anaesthesia  is 
due  to  asphyxia,  from  absence  of  oxygen  ;  but  as  the  carbonic 
acid  is  constantly  removed  by  the  inhalation  of  nitrogen,  the 
symptoms  of  irritation  produced  by  it  in  ordinary  asphyxia  are 
absent. 

Combined  with  hydrogen,  as  in  ammonia  and  salts  of 
ammonium,  nitrogen  stimulates  and  then  paralyses  nerve-centres, 
motor  nerves  and  muscles  (p.  144) ;  and  the  action  varies  in  the 
salts,  for  while  the  chloride  affects  the  spinal  cord,  the  iodide  pa- 
ralyses motor  nerves  and  muscles.  When  nitrogen  is  combined 
,  with  carbon,  the  activity  of  the  substance_  depends  on  whether 
the  nitrogen  is  pentad  or  triad,  as  in  — N§=C,  and  -CHEN,  in  the 
first  of  which,  with  one  free  affinity  belonging  to  the  nitrogen, 
the  compounds '  are  very  poisonous,  while  in  the  second,  where 
the  free  affinity  belongs  to  the  carbon,  the  compounds  are  com- 
paratively harmless. 

The  1st,  3rd,  and  5th  of  its  oxygen  compounds  in  the  above 
table  can  take  up  the  elements  of  water  and  of  metallic  oxides  to 
form  salts. 

z  z  2 


703  INOEGANIC  MATEEIA  MEDICA.  [ssct.  in. 

Hydrooen  Salt.  Metallic  Salt,  e.g.  of  Potassium. 

Ityponitrous  acid  H2ON20  or  HNO.  Potassium  hyponitrite  K,ON.,0  or  KNO. 
"Nitrous  acid          H2ON2Os  or  HN02.  „         nitrite  K2ON203  or  KN02. 

-Nitric  acid  HzON205  or  HN03.  „         nitrate         K2ON205  or  KN03. 

The  acid  compounds  of  nitrogen  with  oxygen  resemble  those 
of  phosphorus  and  arsenic  in  this,  that  the  nitrites  are  con- 
siderably more  active  than  the  nitrates,  just  as  the  phosphites 
and  arsenites  are  more  active  than  the  phosphates  and  arseniates. 
The  action  of  nitrites  on  the  organism  was  first  investigated  in 
the  case  of  nitrite  of  amyl,  but  by  some  unpublished  experiments 
made  in  Professor  Ludwig's  laboratory  in  1869-70,  I  satisfied 
myself  of  the  correctness  of  Dr.  B.  W.  Bichardson's  observation,1 
that  other  nitrites,  such  as  those  of  ethyl  and  sodium,  had  an 
action  on  the  blood-pressure  similar  in  kind  though  less  in 
degree.  In  other  experiments  Dr.  Gresswell  and  I  found  that 
the  nitrites  of  propyl  and  butyl  had  also  this  action,  and  that 
all  nitrites  were  muscular  poisons.2  Mr.  Tait  and  I  found  that 
nitroglycerine  ,  had  an  action  resembling  the  nitrites  both  in 
its  effect  on  blood-pressure  and  the  change  it  caused  in  the 
colour  of  the  blood,  but  the  headache  it  produced  deterred  us 
.from  employing  it  in  the  treatment  of  patients.3 

Nitrous  Oxide.  Nitkogen  Monoxide.  Laughing  gan.  N20. 
Not  officinal. 

Preparation. — By  heating  nitrate  of  ammonium. 

Action. — "When  a  mixture  of  nitrous  oxide  and  air  is  inhaled 
it  causes  excitement,  generally  characterised  by  fits  of  involuntary 
laughter,  dancing,  singing,  and  shouting,  although  it  sometimes 
appears  to  arouse  pugnacity.  "When  inhaled  pure,  it  produces, 
first  of  all,  a  feeling  of  increased  circulation  through  the  body 
generally,  accompanied  by  warmth  and  a  little  singing  in  the 
ears.  If  the  inhalation  be  now  stopped,  the  effect  may  pass  off, 
but  occasionally,  after  a  few  breaths  of  pure  ah-  have  been 
taken,  the  same  excitement  may  ensue  which  is  usually  produced 
by  the  inhalation  of  mixed  air  and  gas.  On  one  occasion,  having 
inhaled  pure  gas  for  a  short  time,  I  felt  a  little  warmth  of  the 
skin  and  a  humming  in  the  head,  and,  thinking  it  was  time  to 
desist,  laid  down  the  mask  of  the  inhaler.  After  a  few  breaths 
of  fresh  air,  I  noticed  that  on  attempting  to  speak,  the  speech 
was  slow  and  hesitating.  An  electric  shock  then  seemed  to 
shoot  through  the  spine,  and  I  was  seized  with  an  uncontrollable 
desire  to  laugh,  jump,  and  throw  the  arms  about,  while  the  per- 
ceptive faculties  appeared  quite  unaffected.  Although  unable  to 
control  my  movements,  I  was  perfectly  conscious  of  their  ludi' 
crous  nature,  and  was  astonished  that  two  men  who  were  sitting 
by,  and  who  afterwards  informed  me  that  they  thought  the  whole 

1  B.  W.  Bichardson,  Brit,  and  For.  Med.  Ghir.  Rev.,  July,  1867. 

a  St.  Bartholomew's  Hospital  Reports,  1876,  p.  143.  3  Ibid.  p.  140. 


chap,  xxvn.]  METALS.  709 

thing  a  bad  joke,  -were  able  to  preserve  their  gravity.  After 
lasting  for  one  or  two  minutes,  the  effect  of  the  gas  suddenly 
and  completely  passed  off. 

When  inhalation  is  continued  for  a  longer  time,  the  feelings 
of  warmth  and  buzzing  in  the  ears  are  succeeded  by  gradually 
increasing  dimness  of  perception  ;  sight,  sounds,  and  tactile  im- 
pressions become  much  dimmer  than  usual :  and  then  the  per- 
son becomes  unconscious.  At  this  time  the  face  usually  assumes 
a  livid  aspect,  and  during  the  period  of  insensibility  small  opera- 
tions may  be  performed  without  the  patient  being  the  least  aware 
of  them.  When  the  administration  of  the  gas  is  stopped,  re- 
covery quickly  and  completely  occurs,  often  passing  off  without 
leaving  any  after-effects,  though  occasionally  more  or  less  head- 
ache is  experienced  for  some  hours.  No  stage  of  exhilaration 
such  as  that  which  has  already  been  described  as  occurring  after 
the  administration  of  a  small  quantity  of  nitrous  oxide  is  noticed 
during  recovery  from  complete  narcosis. 

Nitrous  oxide  appears  to  act  as  an  anaesthetic  chiefly  by  de- 
priving the  nerve-centres  of  oxygen.  As  the  inhalation  of  pure 
nitrogen  has  a  similar  anaesthetic  power,  the  exhilarating  effect 
of  small  doses  of  nitrous  oxide  seems  to  show  besides  that  it  has 
a  special  relation  to  the  nerve-centres. 

Uses. — It  is  useful  as  an  anesthetic  for  extraction,  of  teeth, 
evulsion  of  the  toe-nail,  and  other  minor  operations..  The  in- 
tense venosity  of  the  blood  which  occurs  during  its  use  renders 
it  unsuitable  for  continued  administration,  and  therefore  in- 
admissible in  the  case  of  lengthy  operations.  It  is  sometimes, 
used  to  commence  anaesthesia,  ether  being  given  after  the  patient, 
is  unconscious. 

Mode  of  Administkation. — The  most  convenient  mode  of 
administering  it  is  to  have  it  condensed  in  a  large  iron  bottle, 
from  which  the  gas  may  be  readily  conveyed  to  the  patient  by 
means  of  a  flexible  tube  attached  to  a  mask.  The  mask  ought 
to  be  provided  with  a  margin  of  inflated  india-rubber,.,  so  that  it 
will  fit  perfectly  tight  to  the  face,  and  thus  prevent  the  escape 
of  gas.  After  the  operation  it  is  well  to  make  the  patient 
perform  some  act,,  such  as  taking  hold  of  the  glass  of  water  after 
a  tooth  has  been  extracted,  in  order  to  hasten  the .  return  of 
consciousness. 

PHOSPHORUS.     P;  31.     B.  and  U.S.P. 

A  non-metallic  element  obtained  from  bones. 

Chabactees. — A  semi-transparent,  yellowish,  waxy-looking 
solid.  When  exposed  to  air  it  emits  white  fumes  which  are 
luminous  in  the  dark  and  have  a  garlicky  odour. 

Preparation. — By  treating  bones  with  sulphuric  acid,  when.sulph.ate  of 
calcium  is  precipitated  and  acid  phosphate  of  calcium  remains, in  solution. 


710  INOEGANIC  MATEEIA  MEDICA.  [sect,  ni 

This  is  evaporated  and  distilled  with  charcoal,  which  removes  the  oxygen, 
The  phosphorus  distils  over  and  is  condensed  under  water. 

Ojticinaii  Preparations. 
B.P.  DOSE. 

Pllula  Pbospliori  (i  gr.  in  3  grs.)  (p.  522) 2-4  grs. 

Oleum  Fhosphoratum  (phosphorus  in  almond  oil,  about  1  per  cent.)  ...1-10  m. 

TT.S.P. 

Pilulffi  Phosphori  (^  gr.  in  each)  (p.  523)    „ 1-5  pills. 

Oleum  Phosphoratum  (with  stronger  ether  and  almond  oil  1  per  cent.)  ...     1-5  m. 

Action  of  Phosphorus. — Living  protoplasm  has  the  power  of 
oxidising  all  the  members  of  this  group,  and  also  of  reducing  the 
products  of  their  oxidation  (Binz).  It  is  probable  that  this  action 
goes  on  more  easily  with  phosphorus  than  with  nitrogen.  Hence 
if  phosphorus  replaces  nitrogen  in  a  living  cell  it  will  quicken 
metabolism.  It  is  absorbed  unchanged  into  the  blood,  and  is 
excreted  by  the  kidneys  either  as  phosphorus  or  phosphoric  acid. 
In  small  doses  it  appears  to  cause  development  of  the  fibrous 
tissue  in  the  liver,  and  in  doses  too  small  to  affect  the  liver  or 
stomach  it  acts  upon  the  osseous  tissues.  Its  action  upon  the 
bones  is  somewhat  peculiar,  and  has  been  fully  investigated  by 
Wegner.  When  phosphorus  is  given  to  growing  animals  the 
bone  as  it  develops  is  denser  than  usual,  the  cancellous  tissue 
being  like  the  denser  tissue  in  the  long  bones.  Cancellous  tissue 
formed  before  the  administration  of  phosphorus  remains  un- 
changed. If  the  administration  be  still  continued,  the  cancellous 
tissue  formed  previously  to  the  use  of  the  drug  is  absorbed,  and 
serves  to  form  the  cavity  of  the  bone,  and  after  a  while  the 
normal  cancellated  tissue  at  the  end  of  the  epiphysis  is  also 
replaced  by  solid  bone.  Afterwards  even  the  dense  bone  thus 
formed  becomes  absorbed,  and  forms  the  cavity  of  the  long  bone. ; 
In  adult  animals  phosphorus  also  causes  the  bones  to  become^ 
denser,  and  this  is  especially  noticeable  in  chickens,  in  which  the 
cavity  of  the  bone  may  be  completely  filled  up,  so  that  long  bones 
form  a  solid  rod  instead  of  a  tube.  The  influence  of  phosphorus 
upon  osseous  tissues  is  not  due  to  excess  of  phosphates  produced 
by  it  in  the  blood,  but  to  stimulation  of  tissue-growth  itself  by 
the  phosphorus,  for  Wegner  found  that  in  animals  fed  with 
phosphorus  but  almost  entirely  deprived  of  phosphates,  the  same 
dense,  bony  substance  was  formed,  except  that  instead  of  the 
bone  being  hard,  it  was  like  that  which  occurs  in  rickets.  In 
men  and  women  exposed  to  the  fumes  of  phosphorus,  e.g.  those 
employed  in  the  manufacture  of  lucifer-matches,  caries  of  the 
lower  jaw  is  a  frequent  occurrence.  This  is  not  due  to  the 
action  of  the  phosphorus  after  absorption  into  the  circulation,, 
but  to  the  direct  effect  of  the  fumes  upon  the  bone  itself.  For 
it  has  been  found  that  when  a  bone  of  an  animal  fed  by  phos- 
phorus was  exposed,  no  carious  change  took  place ;  but  if  one 
were  exposed  to  the  fumes,  caries  was  produced,  and  amongst' 


chap,  xxvii.]  METALS.  7H 

lucifer-match  makers  it  has  been  noticed  that  only  those  who 
have  carious  teeth  suffer  from  necrosis  of  the  jaw.  When  doses 
larger  than  those  which  induce  induration  of  the  bones  are  given, 
the  phosphorus  appears  to  act  upon  the  connective  tissue  of  the 
stomach  and  liver,  causing  chronic  inflammation  of  these  organs, 
and  atrophy  of  the  secreting  cells,  so  that  cirrhosis  of  the  liver 
appears.  In  poisonous  doses  phosphorus  first  produces  the 
symptoms  of  gastro-enteritis,  with  a  garlicky  taste  in  the  mouth, 
the  vomited  matters  having  a  similar  odour,  containing  bile,  and* 
but  rarely,  blood.  They  sometimes  shine  in  the  dark.  At  the  end 
of  twenty-four  to  thirty-six  hours,  the  symptoms  of  gastro- 
intestinal irritation  cease,  and  the  patient  is  apparently  well 
with  the  exception  of  vague  pains  in  the  limbs  and  loins.  During 
this  period,  however,  fatty  degeneration  of  the  liver,  stomach, 
and  kidneys  is  going  on,  and  the  effect  of  the  changes  in  these 
organs  soon  manifests  itself.  Sometimes,  after  two  or  three 
days,  the  patient  may  die  suddenly,  without  exhibiting  any  fresh 
symptoms,  but  usually,  on  the  second  or  third  day,  jaundice 
appears,  while  the  urine  contains  bile,  and  often  albumen,  leucin, 
and  tyrosin.  There  is  occasionally  vomiting  and  purging,  head- 
ache, sleeplessness,  delirium,  and  coma,  and  death  with  or  with- 
out convulsions.  In  some  cases,  when  the  poisoning  runs  a  less 
acute  course,  the  effect  of  fatty  degeneration  of  the  vessels  is 
most  prominent,  discharges  of  blood  occurring  from  the  stomach, 
intestines,  nose,  lungs,  bladder,  uterus,  and  ears,  and  ecchymoses 
appearing  on  the  surface.  Increasing  anasmia  and  debility  finally 
kill  the  patient. 

The  treatment  in  cases  of  poisoning  by  phosphorus  is  to  wash 
out  the  stomach  freely  by  means  of  the  stomach-pump,  or  to 
employ  it  by  an  emetic  of  sulphate  of  copper,  and  to  give  oxidised 
oil  of  turpentine  in  40-minim  doses  in  mucilage  every  fifteen 
minutes  for  an  hour.  Fats  and  oils  should  be  withheld,  as  they 
dissolve  any  phosphorus  which  may  be  present  in  the  stomach, 
and  assist  its  absorption. 

The  fatty  degeneration  produced  by  phosphorus  appears  to 
depend  on  a  more  rapid  splitting  up  of  albuminous  tissues,  along 
with  deficient  oxidation.  This  was  shown  by  Voit  and  Bauer, 
who  produced  fatty  degeneration  of  the  organs  by  the  administra- 
tion of  phosphorus  in  dogs  absolutely  deprived  of  food,  where  the 
fat  found  after  death  could  neither  have  come  from  food  nor  from 
fat  deposited  in  other  parts  of  the  body,  as  this  had  all  been 
absorbed  before  the  administration  of  the  drug  had  been  com- 
menced. It  must  therefore  have  been  formed  in  situ  from  the 
decomposition  of  albuminous  substances,  and  these  were  shown 
to  have  split  up  more  quickly  than  usual  by  the  amount  of  urea 
in  the  urine  being  increased  by  the  phosphorus,  while  oxidation 
in  the  body  was  shown  to  have  diminished  by  the  amount  of 
oxygen  absorbed  and  .carbonic  acid  given  off  .being  lessened.    In 


712  INORGANIC- MATEEIA  MEDICA.  [sect.  hi. 

man,  the  products  of  albuminous  waste  are  often  not  converted 
into  urea,  but  appear  in  the  urine  as  leucin  and  tyrosin. 

The  action  of  compounds  containing  phosphorus  appears  to 
depend  considerably  on  the  more  or  less  complete  saturation  of 
its  affinities,  and  the  readiness  with  which  the  phosphorus 
may  attach  itself  to  the  organic  constituents  of  the  tissues.  Thus, 
phosphoric  acid,  in  which  the  affinities  of  the  phosphorus  are 
fully  saturated  by  oxygen,  appears  simply  to  act  as  an  acid  with- 
out exerting  any  specific  action,  and  when  combined  with  sodium, 
its  effects  are  simply  those  of  a  neutral  alkaline  salt. 

Metaphosphoric  and  pyrophosphoric  acids  appear  to  have  a 
specific  poisonous  action  more  nearly  resembling  that  of  phos- 
phorus. Pyrophosphate  of  sodium  paralyses  the  nerve-centres 
in  the  spinal  cord  and  medulla  oblongata,  producing  drowsiness, 
loss  of  reflex  action,  paralysis,  and  death,  which  is  sometimes 
preceded  by  convulsions.  It  lowers  the  blood-pressure  in 
mammals,  slows  the  beats  of  the  frog's  heart,  renders  them 
powerful  and  finally  arrests  them  in  systole.  When  death  does 
not  occur  rapidly,  marked  fatty  degeneration  of  the  heart  and 
kidneys  is  found,  and  a  similar  change  takes  place,  though  to 
a  less  extent,  in  the  liver.  Although  it  acts  as  a  poison  when 
injected  subcutaneously  or  into  the  circulation,  pyrophosphate 
of  sodium  has  no  poisonous  action  when  taken  into  the  intestinal 
canal. 

Metaphosphate  of  sodium  has  a  similar  but  less  powerful 
action. 

Uses.-— Phosphorus  forms  an  important  constituent  of  ner- 
vous tissue,  and  has  been  employed  in  cases  of  nervous  debility, 
neuralgia,  wakefulness,  paralysis,  locomotor  ataxia,  and  impo- 
tence._  In  some  cases  of  leucocythsemia  it  is  useful.  It  has  been 
used  in  osteomalacia,  and  instead  of  arsenic  in  skin-diseases 
(vide  also  p.  719).  Even  in  small  doses  it  may  cause  nausea, 
with  unpleasant  eructations.  It  is  well,  therefore,  to  commence 
with  a  very  small  dose,  such  as  -j-fo  of  a  grain. 

ARSENIUM  (ARSENIC).    As;  75. 

Metallic  arsenic  is  not  used  in  medicine.  It  is  steel-coloured, 
crystalline,  and  brittle,  and  when  heated  gives  off  garlicky  fumes. 
Very  light  (sp.  gr.  5-8),  very  volatile.  It  forms  two  classes  of 
salts.  In  one — the  arsenious  salts — it  is  tri-,  in  the  other — ar- 
senic salts— pent-atomic.  Arsenious  oxide,  As203,  usually  called 
arsenious  acid,  forms  arsenites.  Arsenic  oxide,  As205,  or  arsenic 
acid,  forms  arsenates,  or,  as  they  are  termed  in  the  B.  and  U.S.P., 
arseniates. 

General  Swctkces  of  Arsenic— It  occurs  in  jnany  ores  combined  with 
metals,  oxygen,  and  sulphur.    Its  presence  as  a  frequent  impurity  in  sulphui; 


CHAP.  XXVII.] 


METALS. 


713 


has  already  been  mentioned  (p.  S43).  It  is  chiefly  obtained  by  roasting  the 
arsenides  of  iron,  nickel,  and  cobalt,  and  condensing  tjie  arsenious  oxide  in  a 
long,  nearly  horizontal,  chimney. 

General  Tests  for  Arsenious  Acid.— With  hydrosulphuric  acid  it  gives 
a  yellow  precipitate,  which  is  brightest  in  acid  solutions.  Silver  nitrate  gives 
a  canary-yellow  and  copper  sulphate  a  brilliant  green  precipitate  (Scheele's 
green).  These  are  very  soluble  in  acid,  and  neither  of  them  is  thrown  down 
from  simple  aqueous  solutions  of  arsenious  acid  (a  little  acid  being  freed  in 
the  reaction) ;  a  little  alkali  must  be  present.  Both  are  very  soluble  in  excess 
of  ammonia,  so  that  to  avoid  adding  excess  ammonio-nitrate  of  silver  and 
ammonio-sulphate  of  copper  are  used  as  reagents,  in  preference  to  adding 
ammonia,  along  with  simple  solutions  of  nitrate  of  silver  or  of  sulphate  of 
copper.  Arseniates  throw  down  a  brick-red  precipitate  with  ammonio-nitrate 
of  silver,  and  are  thus  distinguished  from  arsenites. 


General  Reactions  of  Arsenic,  Antimony,  and 

Bismuth, 

l              Arsenic 

Antimony 

Bismuth 

Hydrosulphuric  acid 
Water       •       •       » 

Yellow      precipitate 
(soluble  in  ammo- 
nium su!phide  and 
re-precipitated   by 
acids). 

*-      t       • 

Orange  or  brick-red.  pre- 
cipitate   (solub'e    in 
ammouium    sulphide, 
and   precipitated    by 

acids). 

Strong  solution  thrown 
into  much  water  gives 
a   white    precipitate, 
which   becomes    or- 
ange   on   the   addi- 
tion of  hydrosulphuric 
acid. 

Black  precipitate  (in- 
soluble in  ammonium 
sulphide). 

Strong  solution  thrown 
into   water   gives  a 
white       precipitate, 
which    becomes 
black  on  the  addi* 
tion  of  hydrogen  sul- 
phide. 

General  Action  of  Aesenic. — Although  arsenic,  like  anti- 
mony, has  no  great  affinity  for  albumen,  and  does  not  produce 
with  it  a  coagulum,  yet  when  applied  to  the  skin  denuded  of  its 
epidermis,  it  acts  as.  a  caustic  and  produces  a  slough.  If  used 
in  a  dilute  form,  and  over  a  large  surface,  it  maybe  absorbed, 
and  may  produce  the  general  effects  of  the  drug  upon  the  system. 
When  applied  in  a  concentrated  form  it  appears  to  produce  a 
slough  more  rapidly,  and  the  dead  tissue  forms  a  barrier  to  its 
further  absorption.  In  the  mouth  it  has  a  somewhat  sweetish 
taste,'  and  in  small  doses  excites  in  the  stomach  a  feeling  of 
appetite.  In  larger  doses  it  produces  irritation,  colicky  pains, 
diarrhoea,  and  mucous  evacuations,  sometimes  tinged  with  blood. 
In  still  larger  doses  it  causes  symptoms  of  gastro-enteritis,  vomit- 
ing, and  purging,  the  stools  being  finally  of  a  rice- watery  appear- 
ance, closely  resembling  those  of  Asiatic  cholera.  These  are  also 
occasionally  accompanied  by  collapse,  with  pale,  pinched,  and 
somewhat  livid  surface,  and  violent  cramps  of  the  extremities, 
so  that  cases  of  arsenical  poisoning  may  be  readily  mistaken  for 
cholera,  and  vice  versa.  There  is  sometimes 'strangury,  priapism, 
suppression  of  urine  or  bloody  urine;  the  consciousness  is 
retained  to  the  last.  In  some  cases  there  are  no  symptoms  at 
all  of  gastro-intestinal  irritation,  the  nervous  system  being 


714  INOEGANIC  MATEEIA  MEDICA  [sect,  na 

affected,  and  the  patient  presents  the  symptoms  of  coma,  very 
much  resembling  those  of  opium-poisoning. 

The  treatment  in  cases  of  arsenical  poisoning  is  to  wash  out 
the  stomach  freely  by  means  of  the  stomach-pump,  and  the 
copious  administration  of  diluents,  taking  care  to  ensure  their 
evacuation  by  the  subsequent  speedy  administration  of  such 
emetics  as  mustard  or  sulphate  of  zinc  if  they  are  not  at  once 
rejected  by  the  vomiting  caused  by  the  arsenic  itself.  Freshly- 
prepared  peroxide  of  iron  may  be  administered  in  doses  of  a 
tablespoonful  every  ten  minutes,  and  alcohol  has  been  given 
when  the  moist  peroxide  could  not  be  obtained.  Demulcents 
should  afterwards  be  given  to  allay  the  irritation. 

Chronic  poisoning  by  arsenic  may  occur  from  the  inhalation 
of  arsenical  vapour  or  dust,  arising  from  wall-papers,  dresses,  or 
other  substances  containing  arsenic.  The  proportion  of  arsenic 
necessary  to  produce  poisoning  when  taken  into  the  lungs  in 
this  way  appears  to  be  very  small.  The  symptoms  are  at  first 
increased  appetite,  then  colicky  pains  and  mucous  or  dysenteric 
stools,  with  great  prostration,  irritation  of  the  eyes,  running  at 
the  nose,  a  short  cough,  which  is  dry  .or.  accompanied  by  slight 
expectoration,  and  a  white  silvery  appearance  of  the  tongue. 
These  symptoms  may  sometimes  continue  for  months,  or  even 
years,  without  the  cause  being  suspected,  until  the  recovery  which 
ensues  upon  the  removal  of  the  offending  wall-paper  gives  thq 
clue  to  their  cause. 

When  taken  internally  for  a  length  of  time  a  condition  of 
tolerance  may  be  induced  in  the  case  of  arsenic,  as  well  as  in  that 
of  antimony.  This  is  seen  in  the  arsenic-eaters  of  Styria,  who, 
beginning  with  small  quantities,  are  gradually  capable  of  taking 
larger  and  larger  doses,  until  they  can  swallow  at  once,  with  safety, 
as  much  as  five  grains.  In  taking  such  doses  as  these  they  are 
careful  not  to  take  water  with  the  arsenic,  so  that  it  is  probably 
slowly  absorbed  from  the  stomach,  and  is,  very  possibly,  rapidly 
evacuated.  Dr.  Craig  Maclagan  watched  a  noted  arsenic-eater 
swallow  his  dose,  and  obtained  from  the  urine  which  he  after- 
wards passed  a  considerable  quantity  of  the  poison.  By  using 
the  arsenic  in  this  way,  these  people  are  said  to  undergo  much" 
greater  exertion  than  usual  without  exhaustion,  and  to  be  able  to 
ascend  the  steep  Styrian  hills  without  being  affected  with  breath- 
lessness.  Some,  no  doubt,  die  in  the  attempt  to  acquire  the  habit, 
but  those  who  have  once  become  accustomed  to  the  drug 
appear  to  continue  its  use  without  deriving  any  harm  from 
it,  and,  moreover,  seem  sturdy  and  vigorous,  and  live  to  an  old 
age. 

After  absorption  into  the  blood,  arsenic  appears  to  some  extent 
to  modify  tissue-change.  When  a  solution  of  arsenious  acid  is 
added  to  blood  outside  the  body,  it  retards  coagulation,  prevents 
putrefaction,-  and  conserves  the  form  of  the  red  blood-corpuscles* 


CHAP.  XXVII.J 


METALS. 


715 


A  very  dilute  arsenical  solution  also  conserves  the  irritability  of 
the  excised  nerve  and  muscle  of  the  frog. 

Considerable  doses  of  arsenic  given  for  a  length  of  time  pro- 
duce fatty  degeneration  of  the  liver  and  other  organs,  and  cause 
the  glycogen  to  disappear  from  the  liver,  so  that  puncture  of  the 
fourth  ventricle  no  longer  produces  glycosuria. 

Minute  doses  of  arsenic  appear  to  increase  the  rapidity  of  the 
pulse.  Larger  doses  diminish  the  pulse  and  blood-pressure.  In 
frogs  the  heart  is  slowed,  and  finally  stands  still  in  diastole.  This 
stoppage  of  the  heart  appears  to  be  due  to  paralysis  of  the  motor 
ganglia,  as  the  muscular  substance  will  still  continue  to  contract 
upon  direct  irritation.  In  warm-blooded  animals  it  appears  to 
prolong  the  irritability  of  the  heart,  so  that  it  will  still  continue 
to  beat  for  many  hours  after  the  death  of  the  animal.  According 
to  Kiintzer,  this  is  due  to  retardation  of  the  vital  processes  in  the 
mammalian  heart,  so  that  it  comes  to  resemble  that  of  a  cold-, 
blooded  animal.  In  animals,  arsenic  has  been  found  to  diminish 
the  blood-pressure  from  the  beginning.  This  appears  to  be  due 
partly  to  diminished  activity  of  the  heart,  but  chiefly  to  para- 
lysis of  the  splanchnics  allowing  the  abdominal  vessels  to  dilate 
(p.  284) .    In  frogs  it  produces  apparent  paralysis,  but  this  appears 


4  '"^$#u 


Fig.  169.— Vertical  section  of  the  healthy  epi- 
,  dermis  of  a  frog,    a.  Columnar  layer  of  cells. 
6,  Halpighian  layer,    c,  Intermediate    layer. 
-  e,.Corneous  layer.  /,  Sheet  of  connective  tissue 
forming  boundary  between  dermis  and  epi- 
dermis.   (After  Kunn.) 


Fig.  170.— Vertical  section  of  epidermis  from  a 
frog  poisoned  by  arsenic.  6,  vacuole  in  the 
softened  protoplasm  of  the  columnar  layer 
of  celts.  At  a  the  protoplasm  is  more 
softened  and  the  vacuoles  enlarged  so  that 
the  cells  are  attached  to  the  dermis  only  by 
threads  of  protoplasm.    (After  Nunn.) 


rather  due  to  diminished  sensibility  of  the  grey  matter  in  the  pos- 
terior cornua  of  the  spinal  cord  than  to  real  paralysis ;  for  the 
nerves  and  muscles  in  this  state  are  found  to  be  still  quite  irrit- 
able, and  although  the  animal  is  insensible  to  pinching  it  can  and 
does  move  when  laid  on  its  back.  As,  according  to  Schiff,  the 
muscular  sensations  are  conveyed  in  the  white  substance  of  the 
posterior  columns,  this  would  appear  to  be  unaffected,  while  the 
grey  substance  which  conveys  sensations  of  pain  is  completely 
paralysed  (p.  160). 

In  some  cases  of  poisoning  by  arsenic,  paralysis  of  one  or 
more  limbs  occurs  after  the  acute  symptoms  have  passed  off.  It 
usually  affects  the  extensors  more  than  the  flexors,  and  is  gene- 
rally temporary,  though  it  may  be  permanent. 


710  INOKGANIC  MATEEIA  MEDICA.  [sect.  m> 

The  action  of  arsenic  on  the  skin  is  peculiar.  Einger  and 
Murrell  noticed  that  in  frogs  poisoned  by  it  the  cuticle  could  be 
stripped  off  the  whole  body  with  the  greatest  readiness  within  a 
few  hours  after  its  administration.  This  condition  was  found  by 
Nunn  to  depend  upon  softening  of  the  protoplasm  of  the  colum- 
nar layer  of  cells  in  the  epidermis,  so  that  the  cuticle  remained 
attached  to  the  dermis  only  by  a  few  protoplasmic  threads  (Figs. 
169  and  170). 

Other  epithelial  structures  are  also  affected,  and  Cornil  has 
found  fatty  degeneration  of  the  epithelium  lining  the  alveoli  of 
the  lungs  in  animals  poisoned  by  arsenic  (Fig.  171). 

Arsenic  is  eliminated  chiefly  by  the  urine,  and  to  a  less  ex- 
tent by  the  bile,  and  slightly  by  the  skin.  Its  elimination  by  the 
urine  is  very  rapid. 

Uses.— Arsenic  has  been  used  externally  as  a  caustic  appli- 
cation to  cancers,  and  forms  the  basis  of  most  of  the  secret '  cures ' 


Fig.  171. — Section  of  lung,  hardened  in  osmfc  acid,  from  guinea-pig  poisoned  by  arsenious  acid. 
The  capillaries,  v,  project  iato  the  cavities  .of  the  alveoli,-  and  are  full  of  red  b'.ood-corpnscles. 
The  protoplasm,  a,  of  the  cells  is  filled  with  fatty  granules.  The  nuclei  are  well  preserved. 
(After  Cornil.) 

for  this  disease.  The  old  recipe  for  this  purpose  consists  of  the 
following  ingredients :  Arsenious  acid,  2  drachms ;  cinnabar, 
2  drachms ;  ashes  of  old  leather,  8  grains ;  dragon's  blood, 
12  grains,  made  into  a  paste  with  water  or  saliva. 

In  applying  a  paste  of  this  sort  it  is  advisable  that  it  should 
consist  of  at  least  one-fifth  of  arsenic,  and' that  it  should  not  be 
applied  to  too  large  an  extent  of  surface  at  a  time.  The  arsenical 
paste  used  by  Hebra  consisted  of  arsenious  acid  1  gramme,  cin- 
nabar 3  grains,  and  emollient  ointment  24  grains. 

Internally,  arsenic  is  used  for  its  local  action  on  the  intestinal 
canal  as  a  tonic  and  astringent,  for  its  action  on  tissue-change,- 
and  as  a  tonic  and  anti-spasmodic  in  cases  of  nervous  disease. 
In  the  stomach,  small  doses  stimulate  the  appetite,  and  are  useful 
in  allaying  pain  and  checking  vomiting.  It.  may  be  given  in 
irritative  dyspepsia,  in  gastralgia,  heartburn,  in  the  vomiting  of 
drunkards,  and  in  gastric  ulcer  or  cancer.  It  is  also  recommended 
by  Einger  in  cases  of  regurgitation  of  food  unaccompanied  by 
nausea.    It  is  very  useful  in  cases  of  diarrhoea  where  the  ten- 


chap,  xxvn.]      ■  METALS.  717 

dency  comes  on  during  or  immediately  after  the  ingestion  of  food, 
whether  in  adults  or  children ;  it  is  then  best  given  in  small  doses 
before  meals  (p.  387) . 

Arsenic  is  a  powerful  antiperiodic,  nearly  rivalling  quinine ;  it 
seems  less  serviceable  than  quinine  in  well-marked  cases  of  ague, 
but  is  sometimes  as  good,  or  even  better,  than  it  in  the  irregular 
malarious  manifestations  such  as  headache,  neuralgia,  &c,  which 
are  known  under  the  head  of  masked  malaria.  It  is  sometimes 
useful  in  chronic  rheumatism  and  rheumatic  gout,  and  in  neuralgia 
of  various  sorts  its  effects  are  occasionally  almost  magical. 

It  has  been  used,  not  only  in  tic  and  hemicrania,  but  in 
spasmodic  nervous  diseases  such  as  angina  pectoris,  chorea,  and 
epilepsy,  whooping-cough  and  asthma.  It  is  often  very  service- 
able in  hay  fever,  and  in  cases  of  spasmodic  sneezing  coming  on 
after  exposure  to  dust  or  even  without  any  apparent  cause.  It 
has  been  employed  in  chronic  bronchitis  with  copious  expectora- 
tion, and  in  ordinary  catarrh  without  febrile  disturbance.  It  ap- 
pears to  be  very  useful  in  the  commencement  of  phthisis.  Under 
its  influence  the  author  has  seen  consolidation  of  the  lung,  con- 
sequent on  catarrhal  pneumonia,  clear  up  completely,  even  in  a 
subject  having  a  very  bad  family  history. 

Probable  mode  of  action  of  Arsenic  in  Phthisis. 

The  treatment  of  phthisis  is  so  important  that  it  may  be  ad- 
visable to  discuss  in  a  few  words  the  probable  mode  of  action  of 
arsenic  and  hypophosphites  in  its  early  stages.  It  is  now  probable 
that  this  disease  depends  on  the  presence  of  a  bacillus  (B.  tuber- 
culosis, p.  83).  In  order  that  it  should  grow  within  the  body, 
however,  it  is  necessary  that  a  suitable  nidus  should  be  present, 
and  the  different  susceptibility  to  the  disease  of  different  indir 
viduals,  or  of  the  same  individual  at  different  times,  probably 
depends  on  their  liability  to  present  a  suitable  nidus.  The 
Bacillvs  tuberculosis  differs  from  such  bacilli  as  the  B.  anthracis 
in  being  of  a  very  slow  growth,  so  that  when  it  is  cultivated 
artificially  on  a  solid  medium  it  takes  about  ten  days  before  it 
succeeds  in  establishing  itself  and  begins  to  grow.  Consequently, 
when  applied  to  an  open  wound,  or  when  inhaled  into  the  lungs 
of  a  healthy  person,  it  does  not,  like  the  Bacillus  anthracis,  at 
once  begin  to  multiply  and  produce  disease  in  the  organism,  but 
it  is  usually  removed  by  washing  in  the  case  of  a  wound,  or  by 
expectoration  in  healthy  persons.  But  if  its  removal  be  inter- 
fered with  it  will  produce  disease.  Thus,  if  instead  of  being 
applied  to  an  open  wound  it  be  injected  under  the  skin  so  that 
it  cannot  be  removed  by  washing,  it  will  after  a  time  begin  to 
grow,  and  produce  tuberculosis,  first  local  and  then  general.  It 
■  is  probable  that  the  case  is  similar  in  the  lungs.  In  the  healthy 
•  lung  it  finds  no  nidus,  and  is  removed  by  expectoration,  but  if  a 


718  INOEGANIC  MATEEIA  MEDICA.  [sect,  m, 

portion  of  the  lung  be  consolidated  by  catarrhal  pneumonia,  the 
consolidated  part  probably  affords  a  nidus  to  the  bacillus,  and 
the  longer  the  consolidation  lasts  the  greater  the  risk  of  bacilli 
finding  entrance.  In  croupous  pneumonia  the  exudation  into 
the  alveoli,  consisting  chiefly  of  fibrin  with  a  few  leucocytes, 
quickly  breaks  up  and  is  absorbed,  so  that  it  is  comparatively 
rarely  followed  by  phthisis.  But  the  proliferated  epithelial  cells 
which  fill  the  alveoli  of  the  lung  in  catarrhal  pneumonia  are 
much  more  resistant ;  they  break  down  and  are  absorbed  much 
more  slowly,  and  hence  a  much  longer  time  is  given  during 
which  bacilli  may  find  a  nidus.  The  marked  hereditary  nature 
of  phthisis  is  a  curious  point  in  a  disease  which  we  suppose  to 
depend  on  the  presence  of  a  bacillus,  and  is  a  character  in  which 
it  differs  from  such  diseases  as  anthrax,  ague,  or  relapsing  fever, 
which  are  also  due  to  foreign  organisms.  But  the  difference 
probably  depends  on  the  slow  growth  of  the  tubercle  bacillus, 
which  renders  a  prolonged  undisturbed  rest  at  the  point  where 
it  enters  the  body  necessary  for  its  further  growth.  The 
disease  is  not  hereditary,  but  the  predisposition  to  such  morbid 
changes  in  the  lungs  as  affords  a  nidus  to  the  bacilli  is  here- 
ditary. 

The  more  rapidly  the  effused  products  in  pneumonia  can  be 
removed  from  the  lung,  the  less  chance  have  the  bacilli  of  finding 
a  nidus.  It  is  probable  that  arsenic,  which  causes  fatty  degene- 
ration of  the  normal  epithelial  cells  lining  the  alveoli,  also  causes 
a  similar  degeneration  of  such  cells  when  filling  the  alveolar 
cavities.  By  thus  breaking  them  up  and  quickening  their  ab- 
sorption, arsenic  will  lessen  the  risk  of  bacilli  finding  a  nidus 
in  them  and  converting  catarrhal  consolidation  into  phthisis. 
Probably  the  hypophosphites  act  in  a  similar  way.  If  the 
patient  should  be  in  places  where  there  are  no  tubercle  bacilli, 
the  consolidation  may  persist  for  a  long  time  without  phthisis 
occurring,  and  hence  one  advantage  of  sea- voyages  in  cases  of 
recent  consolidation. 

Mode  op  Administration. — In  those  cases  where  the  local 
action  of  arsenic  on  the  stomach  and  intestine  is  desired,  it  is 
best  to  give  it  in  small  doses  before  meals,  but  where  the  action 
of  the  drug  on  other  organs  of  the  body  is  desired,  it  should  be 
administered  immediately  after  meals. 

The  symptoms  which  show  that  arsenic  is  beginning  to  pro- 
duce its  physiological  effect,  and  that  it  is  time  to  diminish  the 
dose  or  cease  its  administration,  are  irritation  of  the  eyes,  with 
a  pricking  sensation  in  them,  the  conjunctivae  being  somewhat 
injected,  and  the  patient  showing  a  tendency  to  rub  the  eyes ; 
or  the  digestive  canal  may  be  the  first  to  show  the  effect  of  the 
drug,  the  tongue  being  covered  with  a  thin  white  silvery  fur,  or 
red,  with  enlarged  fungiform  papillse  ;  the  appetite  may  fail,  and 
colicky  pains  with  a  tendency  to  diarrhoea  may  appear  before  the 


.obap.  xxvn.]    .  METALS.  719 

eyes  are  affected.    Either  of  these  symptoms  indicates  that  the 
drug  should  be  discontinued,  or  the  dose  diminished. 

In  skin  diseases  arsenic  is  used  more  frequently  than  any 
other  internal  remedy.  As  it  increases  metabolism  in  the  cells 
,of  the  epidermis  (p.  716)  it  is  contraindicated  in  acute  cases,  or 
when  there  is  any  active  cutaneous  inflammation  in  a  chronic 
case.  It  is  sometimes  useful  in  chronic  eczema  when  associated 
■with  chlorosis,  and  in  lupus,  chronic  urticaria,  and  the  neuralgia 
following  herpes  zoster.  According  to  Mr.  Hutchinson  it  cures 
pemphigus.  The  skin-diseases,  however,  in  which  arsenic  is  most 
useful  are  psoriasis  and  lichen  ruber ;  beginning  with  two  minims 
of  Fowler's  solution  three  times  daily,  the  dose  should  be 
gradually  increased  to  12  minims  or  even  30  minims  daily,  and 
it  should  be  given  until  either  the  amendment  begins,  or  the 
signs  of  conjunctivitis  or  gastric  irritation  appear.  When  these 
are  noticed,  the  dose  should  be  diminished  until  they  become 
just  perceptible,  and  the  administration  of  the  drug  should  be 
continued  for  some  time  after  the  eruption  has  disappeared,  in 
order  to  prevent  its  recurrence. 

Acidum  Arseniosum,  B.  and  U.S. P.  Aesenious  Acid. 
As203;  197-8. 

An  anhydride  (not  a  true  acid),  obtained  by  roasting  arsenical 
ores,  and  purified  by  sublimation. 

Chaeactees. — Occurs  in  sublimed  masses  which  usually 
present  a  stratified  appearance  caused  by  the  existence  of  sepa- 
rate layers  differing  from  each  other  in  degrees  of  opacity,  or  as 
a  heavy  white  powder.  When  slowly  sublimed  in  a  glass  tube  it 
forms  minute  brilliant  and  transparent  octahedral  crystals. 

Solubility. — It  is  sparingly  soluble  in  water. 

Eeactions. — Its  solution  gives  with  ammonio -nitrate  of  silver  a  canary- 
yellow  precipitate  insoluble  in  water,  but  readily  dissolved  by  ammonia  and 
,by  nitric  acid.     Sprinkled  on  a  red-hot  coal  it  emits  a  garlicky  odour. 

Impurities. — Gypsum  and  chalk. 

Test. — It  is  entirely  volatilised  at  a  temperature  not  exceeding  400°  F. 
Four  grains  of  it  dissolved  in  boiling  water  with  eight  grains  of  bicarbonate 
of  sodium  discharge  the  colour  of  808  grain-measures  of  the  volumetric 
(Solution  of  iodine.    As203  +  2H20  +  41  =  As205  +  4HI. 

Dose. — ^  to  -fe  of  a  grain,  in  solution.  It  may  also  be 
given  in  the  so-called  '  Asiatic  pills,'  which  are  used  in  some 
parts  of  the  Continent.  These  consist  of  arsenious  acid,  075  grm., 
powdered  black  pepper,  6  grm.,  gum  arabic,  l-5grm.,  powdered 
marsh-mallow  root,  2  grammes,  to  make  100  pills,  of  which  three 
are  to  be  taken  daily. 

Preparations   of  Arsenious  Acid. 
B.P.  DOSE. 

Xiquor  Arsenicalis 2-8  min. 

„        Apsenici  Hydrocbloricus 2-8  min. 

n.s.p. 

Liquor  Potassii  Arsenitis  2-8  min. 

Liquor  Acidi  Arseniosi 5  min. 


720  INOEGANIC  MATERIA  MEDICA.  [sect.  in. 

Pbeparations  op  Arsenic  Acn>. 

E.   AND   U.S.P. 

Ferri  Arsenias.  Sodii  Arsenias.  Liquor  Sodii  Arseniatis. 

liquor  Arsenicalis,  B.P.;  Liquor  Potassii  Arsenitis,  U.S.P.  Arsenical 
Solution,  B.P. ;  Solution  of  Aesenite  of  Potassium,  U.S.P.  Fowlee's  Solu- 
tion.—Is  a  mixed  solution  of  arsenite  and  carbonate  of  potassium  flavoured  with 
compound  tincture  of  lavender.  Contains  1  part  arsenious  acid  in  100  of  water, 
or  about  4J  grains  in  1  fi.  oz.,  B.  and  U.S.P.  In  the  B.P.  1867,  it  contained  4  grs. 
in  1  fl.  oz.,  or  1  in  109. 

Chaeactebs. — A  reddish  liquid,  alkaline  to  test-paper,  and  having  the  odour 
of  lavender. 

'  Reaction. — After  being  acidulated  with  hydrochloric  acid,  it  gives,  with  sulphu- 
retted  hydrogen,  a  yellow  precipitate,  which  is  brightest  when  the  arsenical  solu- 
tion has  been  previously  diluted. 

Dose.— 2  to  8  minims. 

Use. — This  is  the  preparation  of  arsenic  most  commonly 
employed.     It  may  be  given  along  with  alkalis. 

liquor  Arsecici    Hydrochloricus,   B.P. ;    liquor   Acidi    Arsenlosi, 

f.s.P.  Hydkochloeic  Solution  of  Aesenio,  B.P. ;  Solution  of  Aesenious  Acid, 
U.S.P. — A  solution  of  arsenious  acid,  87  grs.  with  2  fl.  dr.  of  hydrochloric  acid  in 
20  fl.  oz.  of  water,  B.P. ;  1  part  arsenious  acid  and  2  of  hydrochloric  in  100  of 
water,  U.S.P.    It  is  a  1  per  cent,  solution  in  both  Pharmacopoeias. 

Chaeactees  and  Reaction. — A  colourless  liquid,  having  an  acid  reaction.  Sul- 
phuretted hydrogen  gives  at  once  a  bright  yellow  precipitate. 

Dose. — 2  to  8  minims. 

Use. — Some  think  it  milder  than  the  ordinary  liquor.  Garrod 
thinks  not.  It  can  be  given  along  -with  per  chloride  of  iron  in 
solution,  or  with  acids. 

Sodii  Arsenias,  B.  and  U.S.P.  Arseniate  of  Sodium, 
Na2HAs04.7H20 ;  311-9. 

Characters. — In  colourless  transparent  prisms. 

Preparation. — By  fusing  arsenious  acid  with  nitrate  and  carbonate  of 
sodium.  The  As203  is  oxidised  by  the  nitrate  to  As205,  which  combines 
with  the  sodium  to  form  arseniate. 

Solubility. — It  is  soluble  in  water. 

Eeactions. — The  solution  in  water  is  alkaline,  giving  white  precipitates 
with  chloride  of  barium,  chloride  of  calcium,  and  sulphate  of  zinc,  and  a 
brick -red  precipitate  with  nitrate  of  silver  (arseniate),  all  of  which  are  soluble 
in  nitric  acid. 

Dose. — f^  to  £  gr. ;  of  the  dried  salt,  ^  to  r\  gr. 

Preparations. 

b.  and  u.s.p. 

Xiqoor  Sodii  Arseniatis.  4|  grains  dried  in  1  fl.  oz.  of  water,  or  1  in  100, 
B.  and  U.S.P. 

Dose. — 5  to  10  minims. 

Action. — It  acts  like  other  preparations  of  arsenic,  but  does 
not  irritate  the  stomach  so  much,  and  may  be  given  in  larger 
doses.     In  frogs  it  produces,  like  arsenious  acid,  paralysis  of  the 


chap,  xxvir.]  METALS.  721 

brain  and  spinal  cord,  but  is  much  less  powerful  (Ein'ger  and 
Murrell). 

_  Uses.— It  may  be  used  in  the  same  diseases  as  arsenious 
acid.  It  is  perhaps  one  of  the  best  remedies  for  neuralgia 
which  we  have. 

Arsenii- Iodidum,  B.  and  U.S.P.  Iodide  of  Absenium,  B.P. ; 
of  Aesenic,  U.S.P.     Asl3;  454-7. 

Chaeactees. — Small  orange-coloured  crystals. 

Solubility. — Beadily  and  almost  entirely  soluble  in  water  and  in  rectified 
spirit. 

Reactions. — Its  aqueous  solution  has  a  neutral  reaction,  and  gives  a 
yellow  precipitate  with  sulphuretted  hydrogen.  Heated  in  a  test-tube  it 
almost  entirely  volatilises,  violet  vapours  of  iodine  being  set  free. 

Preparation. — By  the  direct  combination  of  iodine  and  metallic  arsenic, 
or  by  evaporating  to  dryness  an  aqueous  mixture  of  arsenious  and  hydriodic 
acids. 

Dose.— ^  gr. 

Use. — In  skin  diseases. 

Liquor  Arsenii   et   Hydrargyri   Iodidi,    B.   and   U.S.P. 

Solution  of  Iodide  of  Aesenic  and  Meecuey.  Donovan's 
Solution.1  Iodide  of  arsenium,  Asl3,  and  red  iodide  of  mercury, 
Hgl2,  of  each  45  grains  (1  per  cent,  of  each  by  weight),  water  up 
to  10  fl.  oz.,  B.P.  Iodide  of  arsenic,  1;  red  iodide  of  mercury,  1 ; 
water  up  to  100,  U.S.P. 

Chaeactees. — A  pale  yellow  liquid,  with  a  metallic  taste. 

Incompatibles. — Solutions  of  opium  or  morphine. 

Dose. — 5  to  30  minims  (0-3-1-8  c.c). 

Uses. — In  skin  diseases,  syphilis,  rheumatism,  and  nocturnal 
pains. 

ANTIMONY.     Sb;  122. 

Antimony  forms  two  classes  of  salts,  antimonious  and  anti- 
monic.     In  the  former  it  is  tri-  and  in  the  latter  pent-atomic. 

Geneeal  Soueces. — It  is  chiefly  found  native  in  the  form  of 
the  black  antimonious  sulphide,  Sb2S3. 

Geneeal  Beactions. — It  is  recognised  by  the  orange-coloured 
precipitate  which  it  gives  with  sulphuretted  hydrogen  in  acid 
solutions.  A  characteristic  reaction  is  the  white  precipitate 
which  falls  on  throwing  a  strong  solution  of  a  salt  of  antimony, 
such  as  the  chloride,  into  water,  and  the  change  of  the  white 
into  an  orange  colour  on  the  addition  of  sulphuretted  hydrogen. 
A  similar  reaction  occurs  with  salts  of  bismuth,  but  the  white 
precipitate  becomes  black  on  the  addition  of  sulphuretted 
hydrogen  (p.  713). 

A  solution  of  chloride  of  antimony  gives  with  potash  or  soda 

1  It  contained  1  in  109  in  B.P.  1867.  The  original  Donovan's  Solution  con- 
tained nearly  42  grains  of  each  iodide  in  10  fluid  ounces. 

3   A 


722  INOKGANIC  MATEEIA  MEDICA.  [sect.  in. 

a  white  precipitate  -which  only  dissolves  in  large  excess,  and 
with  ammonia  a  white  precipitate  insoluble  in  excess.  But  ii 
tartaric  acid  be  present  the  precipitate  dissolves  in  a  slight  ex- 
cess of  potash  or  soda,  and  with  ammonia  only  a  slight  precipitate 
is  formed. 

General  Actions  of  Antimony. — Salts  of  antimony  probably 
combine  with  albumen,  but  in  alkaline  solutions  they  form  no 
precipitate.  They  only  form  precipitates  in  acid  solutions,  and 
they  consequently  appear  to  exert  an  irritant  action  only  on 
those  parts  of  the  animal  body  where  they  meet  with  an  acid  secre- 
tion, such  as  the  orifices  of  the  sweat-glands  and  of  the  stomach. 
When  applied  to  the  skin  the  chloride  of  antimony  destroys 
the  cuticle,  and  acts  as  a  powerful  escharotic,  producing  a  deep 
slough  and  a  slowly  healing  sore. 

The  other  preparations,  however,  instead  of  affecting  the 
whole  surface  to  which  they  are  applied,  produce  inflammation 
in  isolated  spots,  which,  beginning  with  papules,  proceeds  to 
pustules  resembling  those  of  small-pox.  A  similar  pustular  irri- 
tation is  sometimes  noticed  upon  the  fauces  of  persons  who  have 
been  taking  antimony  for  some  time,  or  have  been  poisoned  by 
it.  When  taken  internally,  small  doses  produce  little  more 
than  a  feeling  of  warmth  in  the  stomach  and  slightly  increased 
diaphoresis,  but  larger  doses  cause  loss  of  appetite,  nausea 
accompanied  by  enfeeblement  of  the  circulation,  and  a  feeling 
of  great  depression  and  weakness.  Not  only  the  secretion  of 
sweat,  but  those  of  the  mucous  membranes,  stomach,  intestine, 
and  respiratory  passages,  seem  at  the  same  time  to  be  consider- 
ably increased.  In  still  larger  doses  antimony  produces  vomit- 
ing, with  great  depression  of  the  circulation,  and  relaxation  both 
of  the  voluntary  a.nd  involuntary  muscles.  In  large  and  poison- 
ous doses  it  causes  gastro-enteritis,  with  profuse  diarrhoea  and 
extreme  collapse.  The  pulse  is  small  and  quick,  the  surface 
cold,  and  covered  with  clammy  perspiration.  There  is  great 
weakness  and  severe  cramps  of  the  extremities,  and  the  symp- 
toms somewhat  resemble  those  of  Asiatic  cholera.  Death  may 
occur  in  this  condition.  It  is  sometimes  preceded  by  delirium 
and  convulsions,  and  tonic  or  clonic  convulsive  spasms. 

The  treatment  of  antimonial  poisoning  consists  in  the  ad- 
ministration of  tannin,  and  in  some  readily  accessible  form.  The 
most  easily  obtained  is  a  strong  infusion  of  tea,  and  the  tannin 
is  more  readily  extracted  from  this  by  the  addition  of  a  small 
quantity  of  bicarbonate  of  sodium.  Infusions  of  oak  bark  or  of 
cinchona  may  also  be  used  if  obtainable.  Milk  and  mucilaginous 
drinks  may  also  be  used.  A  diffusible  stimulant  should  be  given 
to  counteract  the  collapse. 

The  mode  in  which  tartar  emetic  causes  vomiting  has  given 
rise  to  considerable  dispute.  It  acts  as  an  emetic  even  when  in- 
jected into  the  veins,  as  well  as  when  given  by  the  stomach,  and 


chap,  xxvii.]  METALS.  723 

it  was  found  by  Magendie  that  when  the  stomach  of  an  animal 
was  excised,  and  a  pig's  bladder  filled  with  liquid  attached  to  the 
lower  end  of  the  oesophagus,  the  injection  of  tartar  emetic  into 
the  circulation  caused  movements  of  vomiting,  and  the  contents 
of  the  bladder  were  expelled  just  as  if  the  stomach  had  been  in 
situ.  This  experiment  seemed  to  prove  not  only  that  the  act  of 
vomiting  was  independent  of  the  movements  of  the  stomachy 
itself,  but  also  that  tartar  emetic  caused  vomiting  by  acting  upor 
the  vomiting  centre,  and  not  upon  the  stomach.  The  objection, 
however,  has  been  raised  that  the  action  of  the  drug  upon  the 
vomiting  centre  is  not  direct,  but  reflex ;  and  it  has  been  urged 
that,  although  the  stomach  was  removed,  the  antimony  might 
still  be  carried  by  the  circulation  to  the  oesophagus  and  intes- 
tines, and  by  there  causing  irritation  might  produce  reflex 
vomiting.  This  seems  improbable,  especially  as  the  antimonial 
salts  have  a  comparatively  slight  action  on  organs  having,  like 
the  oesophagus  and  intestines,  an  alkaline  reaction,  instead  of  an 
acid  one,  as  the  stomach  has. 

It  is  probable,  then,  that  tartar  emetic  does  produce  vomit- 
ing by  its  direct  action  on  the  vomiting  centre  in  the  medulla 
oblongata,  but  this  direct  action  is  not  the  only  way  in  which  it 
stimulates  the  vomiting  centre — it  also  produces  a  reflex  action 
upon  it  through  the  stomach.  For  it  has  been  found  that  even 
when  tartar  emetic  is  injected  into  the  veins,  it  is  eliminated  by 
the  mucous  membrane  of  the  stomach  (p.  38  et  seq.),  and  may  thus 
act  upon  that  organ  in  the  same  way  as  when  introduced  directly 
into  it.  If  its  emetic  action  be  due  in  any  great  measure  to  irri- 
tation of  the  stomach,  one  would  expect  that  a  smaller  dose 
would  be  found  sufficient  to  produce  vomiting,  when  introduced 
directly  into  the  stomach,  than  when  injected  into  the  veins,  for 
in  the  former  case  the  whole  of  it  will  come  in  contact  with  the 
stomach  and  will  do  so  at  once ;  in  the  latter  case  only  a  fraction 
of  the  quantity  injected  into  the  veins  will  reach  the  stomach, 
and  some  time  will  be  required  before  it  accumulates  in  the 
gastric  mucous  membrane  sufficiently  to  cause  irritation.  This 
is  exactly  what  is  found  by  experiment,  and  vomiting  is  produced 
more  quickly,  and  by  a  smaller  dose,  when  the  drug  is  introduced 
into  the  stomach,  than  when  injected  into  the  veins,  just  as  we 
should  expect  to  be  the  case  if  its  emetic  action  were  due  in  con- 
siderable measure  to  its  action  upon  the  stomach  itself.  This 
view  is  also  supported  by  another  experiment,  for  after  the 
nervous  channel  by  which  impressions  are  conducted  from  the 
stomach  to  the  vomiting  centre  is  destroyed  by  section  of  the 
vagi,  double  the  dose  of  the  drug  is  required  in  order  to  produce 
vomiting.  It  may  then  be  concluded  that  antimony  acts  chiefly 
a3  an  emetic  by  irritating  the  stomach,  and  thus  exciting  the 
vomiting  centre  reflexly,  but  that  it  also  acts  directly  on  this 
centre  when  conveyed  to  it  by  the  blood  (p.  873). 

3  a  2 


724  INOEGANIC  MATERIA  MEDICA.  [sect.  in. 

When  applied  directly  to  the  heart  of  a  frog,  it  first  increases, 
then  slows,  and  finally  arrests  its  pulsations  in  diastole.  This 
action  appears  to  be  chiefly  due  to  paralysis  of  the  cardiac 
muscle  itself,  and  possibly  also  to  the  effect  upon  motor  ganglia. 

The  effect  of  antimony  upon  the  circulation  appears  to  de- 
pend partly  upon  the  direct  action  of  the  drug  upon  the  heart 
and  vessels,  and  partly  on  its  reflex  action  upon  them  through 
the  nerves  of  the  stomach.  In  warm-blooded  animals  the  pulse 
becomes  quicker  as  the  feeling  of  nausea  increases,  and,  after  the 
vomiting,  again  falls  nearly  to  the  normal.  Its  volume  is  at  the 
same  time  diminished.  After  the  nausea  has  ceased,  the  pulse 
again  becomes  quicker,  and  after  this  secondary  acceleration  has 
reached  a  greater  or  less  height,  according  to  the  dose,  it  again 
sinks  to  the  normal. 

As  the  primary  acceleration  during  the  stage  of  nausea 
ceases  with  vomiting,  it  is  probably  to  be  attributed  to  reflex 
irritation  of  the  accelerating  centres,  or  reflex  depression  of  the 
vagus  through  the  gastric  nerves,  whereas  the  cause  of  the 
secondary  acceleration  is  more  probably  to  be  sought  in  dimin- 
ished power  of  the  vagus  nerve  itself.  The  blood-pressure 
sinks  constantly  from  the  very  beginning,  and  this  sinking  is 
probably  due  to  diminished  power  of  the  cardiac  pulsations.  The 
temperature  in  the  extremities  appears  to  be  diminished  during 
the  stage  of  nausea,  owing  to  the  smaller  amount  of  blood  going 
to  them.  As  less  blood  reaches  the  surface  in  this  condition, 
there  is  less  opportunity  afforded  for  its  being  cooled  by  contact 
with  the  atmosphere,  and  the  temperature  in  the  body  gradually 
rises,  even  above  the  normal.  When  the  spasm  of  the  vessels  in 
the  extremities  relaxes,  they  also  become  warmer  than  normal. 
As  the  effects  pass  off,  the  temperature  sinks  to  the  normal  or 
below  it. 

The  respiration  is  first  increased,  and  then  diminished. 

Large  doses  of  antimony  affect  the  spinal  cord  both  in  cold- 
and  warm-blooded  animals.  It  appears  to  paralyse,  after, 
perhaps,  slightly  exciting,  both  the  sensory  and  motor  tracts  of 
the  spinal  cord,  and  as  this  paralysis  appears  in  frogs  while  the 
heart  still  continues  to  beat,  it  must  be  due  to  the  direct  action 
of  the  drug  upon  the  nervous  system  itself,  and  not  to  its  in- 
direct action  through  the  circulation.  The  motor  and  sensory 
nerves  appear  also  to  be  paralysed.  The  muscles  are  weakened 
(p.  127). 

When  given  for  a  length  of  time,  antimony  seems  to  produce 
fatty  degeneration  of  various  organs. 

The  action  of  antimony  upon  the  skin  in  frogs  is  even  more 
rapid  than  that  of  arsenic  (p.  716),  and  differs  from  it  in  this  re- 
spect, that  the  softening  does  not  affect  the  cells  of  the  columnar 
layer  only,  but  extends  to  those  of  the  intermediate  layer  (Pig. 
172).   In  consequence  of  this,  the  cuticle-  does  not  merely  become 


chap,  xxvn.]  METALS.  725 

detached  from  the  dermis  and  peel  off  in  strips  as  in  poisoning 
by  arsenic,  but  the  cells  of  the  epidermis  becoming  detached 


Fig.  172. — Vertical  section  of  epidermis  from  a  frog  poisoned  by  antimony,  a.  Columnar  layer  in 
which  large  cavities  are  formed.  6,  Columnar  cells  in  which  the  reduced  protoplasm  is  drawn 
into  processes,  c,  Spaces  in  the  intermediate  layer,  d,  Light  lines  between  cells  indicating  a 
softening  and  separation  of  cells.    (After  Nuim.) 

from  each  other,  the  cuticle  becomes  converted  into  a  soft  jelly- 
like mass  which  can  be  scraped  or  brushed  off. 

Tartar  emetic  appears  to  be  eliminated  by  the  mucus  of  the 
stomach  and  alimentary  canal,  by  the  bile,  and  by  the  kidneys. 
Its  action  upon  the  renal  secretion  is  somewhat  uncertain.  It 
appears  to  increase  urea,  uric  acid,  and  pigment,  and  to  diminish 
the  water  and  the  chloride  of  sodium,  probably  by  increasing  the 
perspiration. 

Uses. — The  local  uses  of  antimony  will  be  considered  under 
the  special  preparations. 

When  antimony  is  given  internally  for  its  action  on  the  sys- 
tem generally,  tartar  emetic  is  the  preparation  usually  employed, 
but  the  other  preparations  of  antimony  have  a  similar  action 
when  given  in  appropriate  doses.  It  can  be  used  for  its  emetic 
action,  nauseant  and  depressant  action,  or  diaphoretic  action. 
As  an  emetic  it  has  been  employed  in  cases  of  croup,  in  order 
to  cause  expulsion  of  the  false  membrane ;  but  for  this  purpose 
other  emetics,  such  as  ipecacuanha,  alum,  or  sulphate  of  zinc, 
are  now  more  generally  employed,  as  they  do  not  cause  so  much 
depression.  It  has  also  been  used  with  considerable  success  to 
cut  short  an  attack  of  intermittent  fever,  either  alone  or  com- 
bined with  a  purgative.  Indeed,  in  cases  where  malarial  poison- 
ing has  been  •intense,  quinine  sometimes  proves  ineffectual  unless 
preceded  by  the  administration  of  an  emetic  and  purgative.  It 
has  sometimes  been  injected  into  the  veins  to  produce  vomiting, 
in  cases  of  obstruction  of  the  oesophagus,  as,  for  example,  by  a 
piece  of  meat  firmly  lodged  in  it,  and  to  cause  expulsion  of  a 
biliary  calculus  lodged  in  the  gall-duct,  by  the  pressure  from 
behind  which  the  movements  of  vomiting  produce,  along  with 
the  relaxation  of  the  muscular  fibres  of  the  gall-duct  itself. 

When  large  doses  are  administered  several  times,  what  is 
termed  tolerance  of  the  drug  sets  in,  and  it  no  longer  produces 
vomiting.  It  has  been  used  in  this  way  in  pneumonia,  but  the 
plan  is  now  rarely  followed.     How  this  tolerance  is  produced  is 


726  INOEGANIC   MATEEIA   MEDICA.  [sect.  in. 

not  at  present  understood.  It  is  not  improbable  that  it  may  be 
caused  by  the  irritant  action  of  the  first  few  doses  upon  the 
stomach  arresting  the  secretion  of  the  acid  juice,  and  producing 
a  condition  similar  to  that  which  occurs  in  fever.  In  this  con- 
dition subsequent  doses  of  the  tartar  emetic,  meeting  with  no 
acid,  will  have  but  a  feeble  action  upon  the  stomach. 

In  cases  of  obstinate  constipation  it  has  been  used  along 
with  sulphate  of  magnesium.  As  a  nauseant  it  has  been  given 
to  relax  the  cervix  uteri  in  labour ;  in  acute  inflammations,  e.g. 
in  acute  orchitis,  where  the  emetic  is  first  given,  and  nausea 
is  kept  up  by  a  continued  administration  of  smaller  doses ;  and 
also  in  pericarditis,  pneumonia,  pleurisy,  peritonitis,  meningitis, 
bronchitis,  and  hepatitis,  as  well  as  in  acute  rheumatism.  As 
an  expectorant  it  is  used  in  bronchitis.  The  cases  in  which  it 
is  especially  serviceable  are  those  in  which  there  is  great  conges- 
tion and  much  dyspnoea,  with  little  or  no  secretion,  as  shown  by 
loud,  sibilant  rales  over  the  chest,  the  pulse  being  full,  and  the 
face  flushed,  with  a  tendency  to  lividity.  It  has  also  been  given 
to  check  haemoptysis  when  there  is  much  excitement  of  the 
circulation.  As  a  sedative  it  is  of  use  in  nervous  diseases, 
attended  with  much  excitement,  such  as  certain  cases  of  insanity, 
delirium  tremens,  and  puerperal  convulsions.  In  the  delirium 
of  fever,  it  has  been  highly  recommended  by  Dr.  Graves,  in 
combination  with  opium,  as  a  means  of  producing  sleep.  Where 
the  delirium  is  furious  the  tartar  emetic  must  be  given  in  full, 
and  the  opium  in  small  doses ;  while  if  the  delirium  is  milder 
and  the  sleeplessness  great,  the  opium  dose  must  be  increased 
and  that  of  the  tartar  emetic  diminished.  The  same  treatment 
may  be  adopted  in  the  delirium  and  sleeplessness  of  delirium 
tremens. 

For  its  diaphoretic  action,  antimony  has  been  used  to  arrest 
commencing  inflammations,  such  as  catarrh,  and  to  check  febrile 
conditions.  For  this  purpose  it  is  not  unfrequently  given  as 
tartar  emetic  in  doses  of  ^  grain  frequently  repeated,  or  as 
James's  powder.  In  acute  dropsy  it  appears  to  be  occasionally 
useful,  especially  as  a  diaphoretic,  in  combination  with  bitartrate 
of  potassium  and  squills. 

Pbeparations  containing  Antimony. 

B.p.  u.s.p. 

Antimonii  Oxidum.  Antimonii  et  Potassii  Tartras. 
Antimonium  Nigrum  Purificatum.  ,,  Oxidum. 

„  Suiphuratum.  Antimonii  Sulphidum. 

„  Tartaratum.  „  „  Purificatum. 

I>iquor  Antimonii  Chloridi.  „  Suiphuratum. 

Pilula  Hydrargyri  Subcbloridi  Com-  Pilulse  Antimonii  Composite  (p.  523). 

poslta  (v.  p.  522). 

Pulvis  Antimonialls.  Pulvis  Antimonialis. 

Unguentum  Antimonii  Tartarati.  Syrupus  Soillse  Compositus. 

Viaum  Antimoniale.  Vinum  Antimonii. 


chap,  xxvii.]  METALS.  727 

U.S.P.  Antimonii  Sulphidum.  Sulphide  of  Antimony. — 
Native  sulphide  of  antimony,  Sb2S3 ;  340 ;  purified  from  sili- 
ceous matter  by  fusion,  and  as  nearly  free  from  arsenic  as 
possible. 

Characters. — Steel-grey  masses  of  a  metallic  lustre,-  and  a 
striated  crystalline  fracture  without  taste  or  smell. 

TJ.S.P.  Preparation. 
Antimonium  Sulphidum  Purifioatum. 

This  is  the  ore  from  which  the  other  compounds  are  pre- 
pared. 

It  seems  to  be  inert,  and  is  not  used  internally. 

Antimonium  Nigrum  Purificatum,  B.P. ;  Antimonii  Sul- 
phidum Purificatum,  U.S.P.  Black  Antimony,  B.P. ;  Purified 
Sulphide  of  Antimony,  U.S.P.     Sb2S3;  340. 

Characters. — A  greyish-black  crystalline  powder,  without 
smell  or  taste. 

Solubility. — It  is  insoluble  in  water  or  alcohol. 

Eeactions. — It  dissolves  almost  entirely  in  boiling  hydrochloric  acid, 
evolving  sulphuretted  hydrogen,  and  the  solution  affords  a  white  precipitate 
when  poured  into  water. 

Preparation. — The  crude  sulphide,  purified  by  fusion,  is  obtained  in  very 
.fine  powder  by  elutriation,  then  digested  with  ammonia  to  remove  arsenic, 
washed  and  dried. 

Impurities. — Other  sulphides  and  arsenic. 

Tests. — If  one  grain  be  dissolved  in  hydrochloric  acid,  and  the  solution, 
slightly  diluted,  be  gently  warmed  with  a  piece  of  bright  copper  foil,  the 
copper  being  washed,  dried,  and  heated  in  a  dry  narrow  test-tube,  no  crystal- 
line sublimate  (of  arsenious  anhydride)  should  form  on  the  upper  cool  part 
of  the  tube. 

Pbepabatiohs. 
B.P.  u.s.p. 

Antimonium  Sulphuratum.  Antimonium  Sulphuratum. 

Liquor  Antimonii  Chloridi. 

Antimonium  Sulphuratum,  B.  and  U.S.P.  Sulphurated 
Antimony. 

B.P.  Sulphide  of  antimony,  Sb2S3 ;  336 ;  with  a  small  and 
variable  amount  of  oxide  of  antimony,  Sb203. 

U.S.P.  Chiefly  antimonious  sulphide,  Sb2S3;  340;  with  a 
very  small  amount  of  antimonious  oxide. 

Characters. — B.P.  An  orange-red  powder.  U.S.P.  A  reddish- 
brown,  amorphous  powder,  odourless  and  tasteless. 

Solubility. — It  is  insoluble  in  water  and  in  alcohol. 

Eeactions. — B.P.  It  is  readily  dissolved  by  caustic  soda,  also  by  hydro- 
chloric acid  with  the  evolution  of  sulphuretted  hydrogen  and  the  separation 
of  sulphur.  Sixty  grains,  moistened  and  warmed  with  successive  portions  of 
nitric  acid  until  red  fumes  cease  to  be  evolved,  and  then  dried  and  heated  to 
redness,  give  a  white  residue  weighing  about  40  grains. 

U.S.P.  When  heated  with  twelve  parts  of  hydrochloric  acid,  it  is  nearly  all 
dissolved,  with  evolution  of  sulphuric  acid.  The  residue,  after  having  been 
washed  and  dried,  burns,  on  the  application  of  a  flame,  with  the  characteristie 


728 


INOKGANIC  MATEEIA  MEDICA. 


[sect.  iit. 


odour  of  sulphur,  and  should  leave  not  more  than  a  scanty  ash.  On  dropping 
a  solution  of  sulphurated  antimony  in  hydrochloric  acid  into  water,  a  white 
precipitate  is  produced,  which,  after  washing  and  drying,  should  weigh  not 
less  than  85  per  cent,  of  the  sulphide.  The  liquid  filtered  from  this  preci- 
pitate yields  an  orange-red  precipitate  with  hydrosulphuric  acid. 

Distilled  water  toiled  with  sulphurated  antimony,  filtered  and  acidulated 
with  hydrochloric  acid,  should  be  rendered  not  more  than  slightly  opalescent 
by  test  solution  of  chloride  of  barium  (limit  of  sulphate). 

Pbepaeation. — By  boiling  black  antimony  with  caustic  soda  and  sulphur, 
the  sulphide  is  partly  converted  into  oxide  and  partly  unites  with  sodium, 
forming  sulphantimonite  and  antimonite  of  sodium. 


Sulphide  of 
Antimony 

2SKS.  -) 


Soda 
6NaHO  = 


Sulphantimonite   Antimonious 
of  Sodium  Oxide 


Antimonious 
Oxide 

Sb203     + 


Soda 
6NaHO 


2Na3SbS3    +     Sb203   +   3H20, 
and 

Antimonite 
of  Sodium 
=    2Na3Sb03   +   3H20. 


Owing  to  the  presence  of  free  sulphur,  sulphantimoniate,  and  antimoniate 
of  sodium  are  also  formed. 


Sulphide  of 
Antimony  Soda 

2Sb2S3  +  S2  +  6NaHO 


Sulphantimoniate 
of  Sodium 


Antimonic 
Oxide 


2Na3SbS4 
and 


+     Sb205   +   3H20, 


Antimonic 
Oxide 

Sb20,     H 


Soda 
6NaHO     = 


Antimoniate 
of  Sodium 


2Na3Sb04  +   3H20. 

The  sulphides  and  oxides  of  antimony  are  soluble  in  the  solutions  of  the 
salts  of  antimony  just  mentioned.  The  addition  of  sulphuric  acid  decomposes 
the  salts,  with  the  formation  and  precipitation  of  the  oxides  and  sulphides. 
In  order  to  ensure  uniformity  of  the  product  the  acid  is  added  while  the 
solution  is  hot. 

These  antimony  compounds  are  soluble  in  caustic  soda,  but  when  this  is 
neutralised  they  are  precipitated,  the  greater  part  of  them  being  decomposed 
and  the  Sb„0,  reconverted  into  Sb„S,. 


Sulphantimonite 
of  Sodium 


Sulphurio 
Acid 


2NasSbSs    +    3H2S04 


Sodium      Antimonious    Sulphuretted 
Sulphate        Sulphide  Hydrogen 

3Na2S04    +    Sb2S3    +     3H2S. 


Antimonite  Antimonious 

of  Sodium  Oxide  Water 

2Na3Sb03   +   3H2S04    =    3Na2S04    +    Sb2Os    +    3H20. 


Sulphantimoniate 
of  Sodium 


2Na3SbS,    +    3H2S04    =    3Na2S04 


Antimoniate 
of  Sodium 


Antimonic 
Sulphide 

+     Sb2S5     + 

Antimonic 
Oxide 


3H.,S. 


2Na3Sb04    +    3H2S04    =    3Na2S04  +    Sb205    +    3H20. 


Dose. — 1  to  5  grains. 


Preparations. 

B.F. 


Pilula  Hydrargyri   Eubehloridl  Composlta  (Hummer's  pill)") 
(p.  522) 1  part  in  5 / 


5-10  gr. 


PilulaB  Antimonii  Composites  (Hummer's  pill)  (p.  523).. ..1  part  in  4 1  or  2  pills. 

The  oxide  it  contains  is  probably  the  active  part,  and  as  this 
is  variable  the  action  is  rather  uncertain. 


chap,  xxvn.]  METALS.  729 

Liquor  Antimonii  Chloridi,  B.P.  Solution  of  Chloride 
of  Antimony. 

Characters.— A  heavy  liquid,  usually  of  a  yellowish-red 
colour. 

Eeactions. — A  little  of  it  dropped  into  water  gives  a  white  precipitate, 
and  the  filtered  solution  lets  fall  a  copious  deposit  on  the  addition  of  nitrate 
of  silver.  If  the  white  precipitate  formed  by  water  be  treated  with  sulphur- 
etted hydrogen  it  becomes  orange-coloured.  The  specific  gravity  of  the 
solution  is  1'47.  One  fluid  drachm  of  it  mixed  with  a  solution  of  a  quarter 
of  an  ounce  of  tartaric  acid  in  four  fluid  ounces  of  water,  forms  a  clear  solu- 
tion, which,  if  treated  with  sulphuretted  hydrogen,  gives  an  orange  precipi- 
tate, weighing,  when  washed  and  dried  at  212°  F.,  at  least  22  grains. 

Preparation. — By  boiling  black  antimony  with  hydrochloric  acid,  SbsS3 
+  6HCl  =  2SbCl3  +  3HaS. 

Preparation  in  which  Solution  of  Chloride  op  Antimony  is  used. 
Antimonii  Oxidum. 

Uses. — Is  a  powerful  caustic — sometimes  applied  to  cancers 
and  to  poisoned  wounds. 

Antimonii  Oxidum,  B.  and  U.S. P.  Oxide  of  Antimony. 
Sb203;  288. 

Characters. — A  greyish-white  powder,  fusible  at  a  low  red- 
heat. 

Solubility. — It  is  insoluble  in  water,  but  readily  dissolved  by  hydrochloric 
acid. 

Eeactions. — The  solution,  dropped  into  distilled  water,  gives  a  white 
deposit,  at  once  changed  to  orange  by  sulphuretted  hydrogen.  It  dissolves 
entirely  when  boiled  with  an  excess  of  the  acid  tartrate  of  potassium. 

Preparation. — By  pouring  solution  of  chloride  of  antimony  into  water 
and  treating  the  precipitate  of  oxychloride  with  sodium  carbonate. 

Chloride  of  Oxychloride  of         Hydrochlorio 

Antimony  Antimony  Acid 

12SbCla    +    15H20    =    2SbCl3,  5Sb803  +  30HC1. 

Oxychloride  of  Carbonate  Oxide  of  Sodium 

Antimony  of  Sodium  Antimony        Chloride 

2SbCls,5Sb203    +    3Na2COs    =    6Sb.,03    +    6NaCl    +    3C02. 

Dose. — 1  to  4  grains. 

Preparations, 
b.  and  u.s.p.  dose. 

Pulvis  Antlmonialis.    Antimonial  powder  or  James's  powder  (one 

part  of  oxide  of  antimony  with  two  of  phosphate  of  calcium) 3-10  grs. 

Uses  — Oxide  of  antimony  may  be  used  for  the  same  purposes 
as  tartar  emetic,  but  it  is  not  soluble  in  water,  and  it  depends 
very  much  on  the  state  of  the  stomach  how  much  of  it  will  be 
dissolved.  It  is  therefore  less  certain  in  its  action  than  tartar 
emetic  and  the  latter  is  consequently  to  be  preferred.  In  conse- 
quence of  its  insolubility  it  is  said  to  be  slower  and  milder  than 
tartar  emetic,  but  this  advantage  is  more  than  counterbalanced 
by  its  uncertainty. 

James's  powder  is  given  as  an  antipyretic  in  fever  and  rheu- 
matism. It  is  also  given  in  chronic  skin-diseases  along  with 
mercury. 


730  INOEGANIC  MATERIA  MEDICA.  [sect.  hi. 

Antimonium  Tartaratum,  B.P. ;  Antimonii  et  Potassii 
Tartras,  U.S.P.  Taetaeatbd  Antimony,  Tartar  Emetic,  B.P. ; 
Tartrate  of  Antimony  and  Potassium,  U.S.P. 

KSbC4H407.H20,  B.P.;  2KSbOC4H406.H20 ;  664,  U.S.P.- 
A  tartrate  of  potassium  and  antimony. 

Characters. — In  colourless  transparent  crystals  exhibiting 
triangular  facets. 

Solubility. — It  is  soluble  in  water,  and  less  so  in  proof  spirit. 

Eeactions. — It  decrepitates  and  blackens  upon  trie  application  of  heat 
(tartrate).  Its  solution  in  water  gives  with  hydrochloric  acid  a  white  pre- 
cipitate, soluble  in  excess,  and  which  is  not  formed  if  tartaric  acid  be  pre- 
viously added. 

Preparation. — By  boiling  acid  tartrate  of  potassium  and  oxide  of  anti- 
mony together,  2KH04H406  +  Sb3Os  =  2K(SbO)C4H406  +  B^O. 

Dose. — As  a  diaphoretic  -^  to  |th  of  a  grain;  as  an  emetic, 
1  to  2  grains.  Of  the  wine  as  a  diaphoretic,  10  to  40  min. ;  as 
an  emetic  for  children,  \  to  1  fl.  dr.  repeated  frequently. 

Pbeparations. 
b.p.                                                    strength.  dose. 

Vnfpientum  Antimonii  Tartarati...l  part  in  5 

(with  simple  ointment.) 

VinUmWin1etim0nlale'    Antim0nia1}  2  gr.  in  1  fl.  oz.  of  sherry...5  min -1  fl.  dr. 

U.S.P.  STRENGTH.  'DOSE. 

Syrupus  Scillffi  Compositus  5  min.-l  fl.  dr. 

4  parts  in  60  of  water  and 


Vinua  Antimonii.    Wine  of  Antimony 


stronger  white  wine  up  to 
1,000. 


Use. — This  preparation  of  antimony  is  readily  soluble,  and 
as  the  proportion  of  the  dose  administered  which  actually  takes 
effect  is  more  constant  than  that  of  the  other  preparations  of 
antimony,  it  has  gradually  displaced  them.  For  its  uses  vide 
p.  725. 

Tartar  emetic  ointment  has  been  used  as  a  counter-irritant 
in  cases  of  neuralgia,  paralysis  of  children,  enlarged  joints,  acute 
meningitis,  laryngitis,  acute  bronchitis,  whooping-cough,  phthisis, 
asthma,  angina  pectoris,  and  subacute  ovaritis.  For  many  of 
these  purposes  the  application  of  iodine  preparations  is  now 
preferred. 

BISMUTH.     Bi;2io. 

Bismuth  forms  three  classes  of  compounds  in  which  it  is  bi-, 
tri-,  and  quinqui-valent  respectively. 

General  Sources. — It  is  found  native  in  the  metallic  state. 

General  Beactions. — It  is  distinguished  by  the  white  pre- 
cipitate which  falls  on  throwing  a  solution  of  the  nitrate  or 
chloride  into  water,  and  the  blackening  of  this  by  sulphuretted 
hydrogen  (vide  p.  713). 


CHAP.  XXVII.] 

METALS 

731 

General  Pkepabation  of  Salts  of  Bismuth. 

Salt 

Prepared  from 

By 

Subnitrate,  B.    and 

Bismuth  .        .        . 

Dissolving  in  nitric  acid,  throwing 

U.S.P. 

the  solution  into  a  large  quantity 
of  water,  collecting  and  drying 
the  precipitate. 

Carbonate,        B.P. ; 

Ditto    .        . 

Dissolving  in  nitrio  acid,  evapo- 

Subcarbonate, 

rating  to  a  small  bulk  and  adding 

U.S.P. 

to  solution  of  ammonium  car- 
bonate. 

Oxide,  B.P.      . 

Subnitrate       . 

Boiling  with  solution  of  soda. 

Citrate,B.andtJ.S.P. 

Ditto 

B.P.  Dissolving  in  nitric  acid,  and 
adding  freshly-made  citrate  of 
sodium.  U.S.P.  Boiling  with 
citric  acid  and  washing  with  a 
large  quantity  of  water,  when 
insoluble  citrate  is  formed. 

Citrate  of    bismuth 

Citrate  of  bismuth  . 

Mixing  the  citrate  to  a  smooth 

and  ammonium,  B. 

paste  with  water  and  adding  am- 

and U.S.P. 

monia  until  it  is  dissolved  and 
the  liquid  is  neutral  or  faintly 
alkaline ;  filtering,  evaporating, 
and  drying. 
Do.,  and  diluting  instead  of  eva- 

Solution of  citrate  of 

Ditto 

bismuth    and   am- 

porating. 

monium,  B.P. 

Gbnbeal  Action. — The  soluble  salts  of  bismuth,  such  as  the 
titrate  of  bismuth  and  ammonium,  when  given  in  large  doses 
have  an  action  like  that  of  antimony  or  arsenic  and  cause  gas- 
troenteritis with  fatty  degeneration  of  the  liver.  Small  doses  of 
soluble  preparations,  or  larger  doses  of  sparingly  soluble  prepara- 
tions, have  a  sedative  effect  on  the  stomach  like  that  of  minute 
doses  of  arsenic.  The  subnitrate  is  so  sparingly  soluble  that  its 
utility  in  gastric  catarrh  is  probably  due  to  its  mechanical  action, 
like  charcoal  (p.  542)  or  binoxide  of  manganese. 

Uses. — Subnitrate  of  bismuth  is  used  under  the  name  of 
Spanish  or  pearl  white  to  whiten  the  complexion,  and  as  a  dust- 
ing powder,  lotion,  or  ointment  to  chapped  nipples  and  hands, 
abraded  surfaces  and  chronic  oozing  from  the  skin,  as  eczema, 
in  order  to  take  up  moisture  and  allay  smarting  and  itching. 

It  has  also  been  employed  externally  as  an  application  in 
scaly  diseases,  and  in  intertrigo  in  combination  with  starch  and 
boric  or  salicylic  acid.  Prom  its  power  of  diminishing  the 
irritability  of  mucous  membranes  it  was  applied  by  Ferrier, 
along  with  morphine  in  the  form  of  a  snuff,1  to  arrest  nasal 
catarrh,  and  has  been  used  as  an  injection  in  ozasna,  leucorrhcea, 
and  gonorrhoea,  to  diminish  the  irritability.  In  powder  with  mor- 
phine and  starch  it  is  a  useful  insufflation  in  laryngeal  phthisis 
and  other  painful  laryngeal  affections.     It  is  applied  as  a  local 

1  Bismuth  subnitrate  6  drachms ;  hydrochlorate  of  morphine  2  grains ;  powdered 
acacia  2  drachms. 


732  INOKGANIC  MATEEIA  MEDICA.  [sect.  m. 

sedative  to  diminish  the  pain,  nausea,  or  vomiting  in  irritable 
dyspepsia,  and  to  lessen  the  irritability  of  the  intestine  in  diar- 
rhoea and  dysentery.  It  is  very  serviceable,  either  alone  or  com- 
bined with  lime  or  alkalis  in  the  gastro-intestinal  catarrh  caused 
by  cold,  which  is  commonly  known  as  cold  in  the  stomach,  as 
well  as  in  the  same  affection  occurring  in  children  at  the  period 
of  dentition. 

It  is  useful  in  pyrosis,  gastralgia,  and  vomiting,  whether  the 
vomiting  be  from  ulcer  of  the  stomach  or  other  causes.  It  acts 
remarkably  well  in  the  indigestion  and  pain  in  the  stomach 
caused  by  the  use  of  alcohol.  In  such  cases  it  is  best  given 
with  a  little  magnesia,  about  ten  grains  of  the  subnitrate  with 
an  equal  quantity  of  magnesia  or  its  carbonate. 

The  carbonate  of  bismuth  is  more  soluble  in  the  gastric  juice 
than  the  subnitrate,  and  is  supposed  to  be  more  powerful,  and  the 
same  advantage,  if  advantage  it  be,  is  possessed  by  the  citrate  of 
bismuth  and  ammonium.  My  own  experience  leads  me  to  prefer 
the  less  soluble  subnitrate  to  either  of  the  other  preparations. 

B.P.  Bismuthum.  Bismuth. — A  crystalline  metal.  In  its 
crude  state  it  is  impure. 

PREPARATION. 

Blsmutbum  Purificatura. 

B.P.  Bismuthum  Purificatum.     Purified  Bismuth. 
Chaeactees. — A  crystalline  metal  of  a  greyish- white, colour, 
with  a  distinct  roseate  tinge.     Specific  gravity  9-83. 

Solubility  and  Beactions. — Dissolved  in  a  mixture  of  equal  volumes 
of  nitric  acid  and  distilled  water,  it  forms  a  solution  which,  by  evaporation 
yields  colourless  crystals,  that  are  decomposed  on  the  addition  of  water, 
giving  a  white  precipitate. 

Preparation. — By  fusing  with  cyanide  and  carbonate  of  potassium,  car- 
bonate of  sodium  and  sulphur. 

Impurities. — Arsenic,  iron,  copper,  cadmium,  lead,  antimony. 

Test. — If  the  mother  liquor  from  which  the  crystals  have  been  separated 
be  evaporated  with  hydrochloric  acid  until  all  the  nitric  acid  is  dissipated,  a 
little  of  the  product  yields  no  evidence  of  arsenium  on  being  examined  by 
the  hydrogen  test  commonly  known  as  Marsh's  Test ;  no  blue  coloration  on 
adding  water  and  excess  of  ammonia  (no  copper),  and  no  precipitate  on  fil- 
tering and  saturating  the  ammoniacal  filtrate  with  nitric  acid  (no  tin  or 
cadmium) ;  no  white  precipitate  with  diluted  sulphuric  acid  (no  lead) ;  no  red 
or  black  precipitate  with  sulphite  of  sodium  (no  selenium  nor  tellurium) ;  no 
blue  precipitate  with  ferrocyanide  of  potassium  (no  iron). 

Preparations  containing  Bismuth. 
B.P.  U.S.P. 

Bismuthl  Carbonas.  Bismuthi  Carbonas. 

„  Subnitras.  „        Citras. 

liquor  Bismuthi  et  Ammonli  Ci-  „        Subnitras. 

tratis. 
Trochisci  Bismuthl. 

Bismuthi  Subnitras,  B.  and  U.S.P.  Subnitrate  of  Bis- 
muth.   BiON03.H20;  306,  U.S.P. 


chap,  xxvii.]  METALS.  733 

Characters. — A  heavy  white  powder  in  minute  crystalline 
scales,  blackened  by  sulphuretted  hydrogen. 

Solubility. — Insoluble  in  water,  but  soluble  in  nitric  acid  mixed  with 
half  its  volume  of  distilled  water. 

Reactions. — The  solution  in  nitric  acid  when  poured  into  water  gives  a , 
white  precipitate.    It  forms  with  sulphuric  acid  diluted  with  an  equal  bulk 
of  water  a  solution  which  is  blackened  by  sulphate  of  iron  (nitrate).     The 
nitric  acid  solution  gives  no  precipitate  with  diluted  sulphuric  acid  (no  lead) 
nor  with  solution  of  nitrate  of  silver  (no  chloride). 

Impurities. — Lead,  nitrates,  chlorides. 

Dose. — 5  to  20  grains. 

Peepabation. 

B.P.  DOSE. 

Trochisci  Bismuth!,  2  grs.  in  each  lozenge 1  to  6  lozenges. 

Bismuthi  Carbonas,  B.P. ;  Bismuthi  Subcarbonas,  U.S.P. 

Carbonate  of  Bismuth,  B.P. ;  Subcarbonate  of  Bismuth,  U.S.P. 
2(Bi2C03).H20,  B.P. ;  (BiO)2C03.HaO ;  530,  U.S.P. 

Characters. — A  white  powder,  blackened  by  sulphuretted 
hydrogen. 

Solubility. — It  is  insoluble  in  water,  but  soluble  with  effervescence  in 
.  nitric  acid. 

Reactions. — The  solution  gives  the  reactions  of  bismuth  (pp.  713,  731). 
Impurities. — Nitrate. 

Test. — When  added  to  sulphuric  acid  coloured  with  sulphate  of  indigo 
the  colour  of  the  latter  is  not  discharged. 

Dose. — 5  to  20  grains. 

Bismuthi  Citras,  B.  and  U.S.P-  Citrate  of  Bismuth. 
BiC6H507 ;  399. 

Characters. — A  white  amorphous  powder,  permanent  in  the 
air,  odourless  and  tasteless. 

Solubility. — It  is  insoluble  in  water  or  alcohol,  but  soluble  in  water  of 
ammonia. 

Dose. — 2  to  5  grains. 

Uses. — Used  to  prepare  the  solution  of  bismuth  and  ammo- 
nium. 

Peepaeations. 

B.P.  U.S.P. 

liquor  Bismuthi  et  Ammonii  Bismuthi  et  Ammonii  Citras. 

Citratis.  Liquor  „  CitratiSi 

B.P.  Liquor  Bismuthi  et  Ammonii  Citratis.  Solution  of 
Citrate  of  Bismuth  and  Ammonium. 

Characters.— A  colourless  solution  with  a  saline  and  slightly 
metallic  taste.  Neutral  or  slightly  alkaline  to  test-paper ;  mixing 
with  water  without  change.  One  fluid  drachm  contains  3  grains 
of  oxide  of  bismuth. 

Reactions. — It  gives  the  reactions  of  ammonia  and  bismuth. 

Dose. — £  to  1  fluid  drachm. 


734  INOEGANIC  MATEEIA  MEDICA.  [sect.  in. 

B.  and  U.S.P.  Bismuthi  et  Ammonii  Citras.  Citrate  of 
Bismuth  and  Ammonium. 

Characters. — Small,  shining,  pearly  or  translucent  scales, 
becoming  opaque  on  exposure  to  air,  odourless,  having  a  slightly 
acidulous  and  metallic  taste,  and  a  neutral  or  faintly  alkaline 
reaction. 

Reactions. — The  aqueous  solution  of  the  salt  gives  the  reaction  of  bis- 
muth, of  ammonia  (p.  634)  and  of  a  citrate  (p.  594). 

Dose. — 2  to  4  grains. 

Uses. — The  solution  of  bismuth  and  ammonium,  B.P.,  and  the 
soluble  salt,  U.S.P. ,  are  more  astringent  and  irritant  in  their 
action  than  the  insoluble  subnitrate,  oxide,  or  carbonate.  They 
may  be  used  as  astringents,  but  are  inferior  to  the  insoluble 
preparations  as  a  means  of  allaying  irritation. 


chap,  xxvin.]  METALS.  733 


CHAPTEE    XXVIII. 

METALS— (continued). 

Class  VIII 

Group  I. 

Iron — Nickel — Cobalt — Manganese. 

FERRUM  ;  IRON.    Fe  ;  55-9. 

Metallic  iron  in  the  form  of  fine,  bright,  and  non-elastic 
wire. 

Iron  forms  ferrous  salts  in  which  it  is  bivalent,  e.g.  FeCl2  or 
FeS04,  and  ferric,  in  which  it  is  either  trivalent  or  quadrivalent. 
Ferric  chloride  may  be  regarded  as  FeCl3  or  as  Fe2Cl6,  in  which 
each  of  two  atoms  of  quadrivalent  iron  have  one  affinity  satu- 
rated by  union  with  each  other,  and  the  other  three  by  chlorine, 
Cl3=Fe— Fe=Cl3. 

General  Sources. — It  is  found  native  in  the  metallic  state, 
and  also  as  oxide,  sulphide,  chloride,  carbonate,  phosphate,  sul- 
phate, and  arseniate.  It  is  obtained  from  its  ores  by  smelting 
with  coke  and  clay  or  limestone. 

General  Eeactions. — These  are  shown  in  the  accompanying 
table.  The  reactions  most  generally  mentioned  in  the  pharma- 
copoeias are  those  with  ferrocyanide  and  ferricyanide  of  potassium. 
It  is  to  be  remembered  that  a  preparation  of  iron  containing  it 
in  both  the  ferrous  and  ferric  condition,  or  which,  by  its  decom- 
position, yields  iron  in  these  two  states,  gives  a  precipitate  with 
both  of  these  reagents.  The  arseniate  of  iron,  B.P.,  phosphate 
of  iron,  and  the  citrate  of  iron  and  quinine  are  examples  of 
this. 


?36 


INOEGANIC   MATEEIA  MEDICA. 


[SECT.  III. 


General  Beactions  op  Ikon  Salts. 


Hydrogen  sulphide  . 

Ammonium  sulphide 
Caustic  alkalis  and 
ammonia 


Carbonates  of  ditto  , 


Potassium    ferro- 
eyanide 

Potassium     ferri- 
cyanide 
Tincture  of  galls 


Ferrous  Salts 


No  precipitate 

Black  precipitate 

Nearly  white  precipi- 
tates of  ferrous  hy- 
drate rapidly  be- 
coming green  and 
then  brown 

Whitish  precipitate 
of  ferrous  carbonate 
which  changes  like 
the  hydrate 

Nearly  white  precipi- 
tate becoming  blue 
on  exposure 

Deep  blue  precipitate 


Ferric  Salts 


White  precipitate  of  sulphur  (the 
ferric  are  reduced  to  ferrous). 

Black  precipitate. 

Foxy-red  precipitates  of  ferric 
hydrate. 


Foxy-red  precipitates.     Carbonic 
acid  escapes. 


Deep  blue  precipitate  (Prussian 
blue).1 

No  precipitate.    Dark  coloration. 

Intense  black. 


General  Impurities. — Zinc,  copper,  and  fixed  alkalis  may  be  present  in 
its  salts.     Ferrous  salts  may  be  present  as  impurities  in  ferric  and  vice  versa. 

Tests. — The  test  used  for  the  chloride  in  the  U.S.P.  is  as  follows  : — If  the 
iron  he  completely  precipitated  from  a  solution  of  the  salt  by  an  excess  of 
water  of  ammonia  the  filtrate  should  not  yield  either  a,  white  precipitate 
(absence  of  zinc)  or  a  dark-coloured  precipitate  with  hydrosulphuric  acid 
(absence  of  copper),  nor  should  it  leave  a  fixed  residue  on  evaporation  and 
gentle  ignition. 

The  absence  of  ferrous  salts  as  impurities  in  ferric  is  ascertained  by  the' 
solution  giving  no  precipitate  with  /erricyanide  of  potassium. 

The  absence  of  ferric  salts  as  an  impurity  in  ferrous  is  ascertained  by  the 
precipitate  with  /errocyanide  of  potassium  not  being  blue  at  first,  but  nearly 
white,  and  only  becoming  blue  on  exposure. 


General  Preparation  of 

Salts  of  Ikon. 

Prenared  from 

By 

Ferrous       Sulphate 

(p.  741) 
Dried    Sulphate   (p. 

741) 
Granulated  Sulphate, 

B.P.,   Precipitated, 

U.S.P.  (p.  741) 
Carbonate    (Saccha- 

rated)  (p.  742) 

Do.    (Mistura    Ferri 
Composita)  (p.  742) 

Iron 

Ferrous  sulphate 
Ditto     . 

Ditto    .        . 
Ditto    .        .        . 

Dissolving  in  sulphuric  acid. 

Heating    to  drive  off    water  of 

crystallisation. 
Pouring  an  aqueous  solution  into 

spirit. 

Decomposing  (by  ammonium  car- 
bonate, B.P.),  (by  sodium  bi-car- 
bonate,  U.S.P.),  and  mixing  with 
sugar. 

Decomposing  by  potassium  carbo- 
nate and  mixing  with  myrrh,  &c. 

1  With  the  tartrate  of  iron  and  ammonium  (U.S.P.)  no  colour  or  precipitate  is 
produced  unless  the  solution  is  acidulated  with  hydrochloric  acid. 


CHAP.  XXVIII.] 


METALS. 


737 


Genebal  Preparation  of  Salts  of  Ibon — i 


fm 
^0 


wf 


Ferric  Sulphate,  B.P. 

(p.  742) 
Feme   Tersulphate, 

U.S.P.  (p.  742) 
Ferric   Subsulphate, 

U.S.P.  (p.  743) 
Ferric  Oxide  (p.  743) 


Ferri  r;  Oxide  (Hy- 
drated,  TJ.S.P.)  (p. 
743) 

Ferric  Oxide  (Hy- 
drated,B.P.)(p.744) 

Eeduced  Iron  (p.  744) 

Ferric  Chloride  (p. 
745) 


Ferric  Nitrata(p.  747) 


Ferric  Oxychloride 
(DialyaedIron)B.P. 
(p.  746) 

Ferric  Acetate  (Solu- 
tion of),  B.  and 
TJ.S.P.  (p.  744) 

Ferric  Citrate.TJ.S.P. 
(p.  748) 


Tartrate  of  iron  and 

potassium,  TJ.S.P. 
(FerrumTartaratum, 

B.P.)  (p.  747) 
Tartrate  of  iron  and 

ammonium,  TJ.S.P. 

(p.  747) 
Citrate  of  iron  and 

ammonium,  B.  and 

TJ.S.P.  (p.  748) 
Citrate  of  iron  and 

quinine,     B.     and 

U.S.P.  (p.  749) 
Citrate  of  iron  and 

strychnine,    TJ.S.P. 

(p.  749) 
Sulphate  of  iron  and 

ammonium,  TJ.S.Pi. 

(p.  749) 


Prepared  from 


/ 
Ferrous  sulphate     ■ 

Ferric  sulphate        . 

Ditto      .        .        . 

Ditto      .        , 

Ferric  oxide     .        . 
Iron         a        , 

Iron         '.        . 
Ferric  chloride 

Ferric  sulphate 

Ditto  (Tersulphate) 

Persulphate     .        . 


Ditto 


Ditto 


Ditto  and  sulphate 
of  quinine 

Ferric  sulphate  and 
strychnine 

Ferric  sulphate  and 
ammonium  sul- 
phate 


By 


Adding  sulphurio  acid  and  oxidis- 
ing by  heating  with  nitric  acid. 
(6FeS04  +  3H„S04  +  2HNO„  = 
3Fe2(S04)3+"4H20  +  N202.) 

Ditto,  using  too  little  sulphurio 
acid  to  form  tersulphate. 

Mixing  with  magnesia  and  water, 
U.S.P. 

Mixing  with  water  and  solution 
of  soda,  B.P. 

By  precipitating  with  ammonia, 
washing  and  making  into  a  paste 
with  water,  TJ.S.P. 

Pouring  the  diluted  solution  into 
solution  of  soda,  B.P. ;  and  dry- 
ing below  212°. 

Passing  hydrogen  over  it  while 
heated  (Fe203  +  6H  =  Fe2  +  3H20) 

Dissolving  in  hydrochloric  acid 
and  oxidising  by  nitric  acid. 
(3Fe2  +  12HC1  =  6FeCl2  +  12H 
6FeCl2  +  6HCl  +  2HN03  = 
3Fe2Cl6  +  4H,0  +  N202.) 

Dissolving  in  nitric  acid  (Fe2  + 
8HN03  =  Fe2(N03)0  +  4H20  + 
N202). 

Precipitating  ferric  oxide  by  am- 
monia, dissolving  it  in  solution 
of  perchloride,  and  dialysing  the 
solution  until  it  is  tasteless. 

Precipitating  ferric  oxide  by  am- 
monia, washing,  and  dissolving 
in  glacial  acetic  acid,  and  dilut- 
ing to  the  necessary  strength. 

Precipitating  oxide  by  ammonia, 
washing  and  dissolving  in  citric 
acid.  This  forms  the  Liquor 
Ferri  Citratis,  U.S.P.  Ferri  Ci- 
tras  is  prepared  by  evaporation 
of  the  Liquor  under  60°  C. 

Precipitating  ferric  oxide  by  am- 
monia, washing  and  mixing  with 
acid  tartrate  of  potassium. 

Ditto,  using  tartaric  acid  and  tar- 
trate of  ammonium  in  place  of 
acid  tartrate  of  potassium. 

Ditto,  using  citric  acid  and  am- 
monia. 

Precipitating  ferric  oxide  and 
quinine  by  ammonia  and  dis- 
solving it  in  citric  acid. 

Precipitating  ferric  oxide  by  am- 
monia and  dissolving  it  along 
with  strychnine  in  citric  acid. 

Heating  them  together. 


3   B 


738 


ItfOBGANIC  MATERIA  MEDICA. 


[SECT.  III. 


General  Pbepabation  of  Salts  of  Ikon— continued: 


Ferrous  Lactate, 
U.S.P.  (p.  750) 

Ferrous  Oxalate, 
U.S.P.  (p.  750) 

Ferrous  Iodide,  B.P. 
(Syrup  of)  (p.  750) 


Ferrous  Iodide  (Pill 
of),  B.P.  (p.  760) 

Ferrous  Bromide 
(Syrup  of)  U.S.P. 
(p.  751) 

Arseniate  of  Iron, 
B.P.  (p.  751) 


Phosphate  of  Iron, 
B.  and  U.S.P.  (p. 
751) 


Pyrophosphate  of 
Iron,U.S.P.(p.752) 

Hypophosphite  of 
Iron,U.S.P.(p.752) 


Valerianate  of  Iron, 
U.S.P.  (p.  752) 


Prepared  from 


Iron . 

Ferrous  sulphate 

Iron .        4        . 


Ditto 


Ditto 


Ferrous  sulphate,  ar- 
seniate of  sodium, 
and  acetate  of  so- 
dium 


Ferrous  sulphate, 
phosphate    of     so- 
dium, and  acetate 
of  sodium 

Citrate  of  iron . 

Ferrous  sulphate 


Ferric  sulphate 


By 


Dissolving  in  lactid  acid. 

Precipitating  a  solution  with  ox- 
alic acid  (ferrous  oxalate  is  very 
slightly  soluble). 

Heating  with  iodine  and  water 
(the  completion  of  the  process 
is  recognised  by  the  brown  colour 
of  the  iodine  disappearing  and 
the  froth  becoming  white)  and 
then  adding  syrup. 

Same  as  syrup,  but  mixing  with 
sugar  and  powdered  liquorice 
root  instead  of  with  syrup . 

Same  as  syrup  of  iodide,  using 
bromine  instead  of  iodine. 

Mixing  a  solution  of  arseniate  and 
acetate  of  sodium  with  one  of 
ferrous  sulphate.  If  arseniate  of 
sodium  alone  were  used,  free  sul- 
phuric acid  would  be  formed, 
which  would  react  on  the  arsen- 
iate. 3FeS04  +  2Na2HAsO,  = 
Fe3As2Os  +  2Na2S04  +  B^SOj. 
To  avoid  this  acetate  of  sodium  is 
added.  The  sulphuric  acid  com- 
bines with  the  sodium  and  sets  free 
acetic  acid,  which  has  no  action 
on  the  arseniate  of  iron.  3FeS04 
+  2Na2HAs04  +  2NaC2HsO"2  = 
FesAs208  +  3Na2S04  +  2HC.H302. 

The  same  process  as  in  the  pre- 
paration of  arseniate.  The  reac- 
tions are  similar.  3FeS04  + 
2Na2HPO,  +  2NaC2H3C2  =  Fe, 
P208  +  3Na2S04  +  2HC2HS02. 

Decomposing  solution  by  solution 
of  sodium  pyrophosphate. 

Decomposing  by  hypophosphite 
of  calcium  when  ferrous  hypo- 
phosphite is  precipitated,  but 
on  evaporation  becomes  ferric. 

Decomposing  by  valerianate  of 
sodium. 


Genekal  Action  of  Ikon  Salts.— Iron  differs  from  most  of  the 
other  heavy  metals  in  forming  a  normal  constituent  of  the  animal 
body,  so  that  it  may  be  regarded  as  a  food  as  well  as  a  medicine. 
It  forms  an  important  constituent  of  the  haemoglobin  in  the  blood. 
This  acts  as  the  oxygen-carrier  to  the  tissues,  and,  therefore,  the 
tissue-oxidation  and  the  functional  activity  of  the  organs  depend 
more  or  less  upon  the  amount  of  iron  present  in  the  body.  Ac- 
cording to  Preyer,  in  a  healthy  woman  the  minimum  amount  of 


chap,  xxvm.]  METALS.  789 

iron  in  100  grammes  of  blood  is  -048  gramme,  of  haemoglobin 
11-57  grammes ;  the  maximum,  -057  gramme  and  13-69  grammes 
of  iron  and  hemoglobin  respectively.  In  a  healthy  man,  in  100 
grammes  the  proportion  is  -0508  gramme  of  iron  (minimum),  -063 
(maximum),  12-09  grammes  haemoglobin  (minimum),  and  15-07 
grammes  (maximum).1  Both  per-  and  proto-salts  of  iron  form 
compounds  with  albumen,  but  they  differ  in  their  properties.  The 
ferrous  salts  give  a  yellow  colour  with  albuminous  solutions,  but 
do  not  precipitate  them,  the  albuminous  compound  being,  ap- 
parently, usually  soluble.  Diluted  ferric  salts,  on  the  contrary, 
precipitate  albumen  slowly,  and  concentrated  solutions  precipitate 
it  rapidly.  The  precipitate  is  soluble  in  dilute  acids  and  in  gastric 
juice. 

When  applied  to  the  skin  neither  ferrous  nor  ferric  salts  have 
any  action,  as  they  do  not  dissolve  the  epidermis  nor  pass  through 
it  in  any  appreciable  quantity.  When  applied  to  a  denuded 
surface,  or  to  a  mucous  membrane  they  combine  with  albumen. 
The  ferrous  salts  have  but  a  slight  astringent  action,  whereas  the 
ferric  salts  coagulate  the  albumen  on  the  surface  and  also  blood. 
They  are  thus  powerful  astringents  and  styptics.  In  the  mouth 
they  all  have  an  inky  taste,  and  as  they  are  liable  to  form  black 
sulphides  with  sulphuretted  hydrogen,  which  is  not  unfrequently 
present  in  the  breath,  they  are  apt  to  discolour  the  teeth  or  tongue. 
In  the  stomach  they  have  an  astringent  and  irritant  action,  that 
of  the  ferric  being  more  powerful  than  that  of  the  ferrous  salts. 
In  the  intestine  they  have  a  somewhat  similar  action ;  meeting 
here,  as  they  often  do,  with  sulphuretted  hydrogen  they  become 
converted,  in  great  part,  into  sulphides,  and,  passing  out  in  the 
stools,  give  to  them  an  inky  black  colour  which  sometimes  alarms 
patients.  In  small  doses  they  usually  have  an  astringent  action, 
and  tend  to  cause  constipation.  Larger  doses,  on  the  other  hand, 
seem  to  stimulate  peristalsis,  and  increase  the  number  of  stools, 
and  sometimes  even  small  doses  will  cause  diarrhoea  in  some 
individuals.  After  absorption  into  the  blood  they  are  found  to 
increase,  not  only  the  number  of  the  blood-corpuscles,  but  the 
percentage  of  haemoglobin  contained  in  them,  and  may  also  cause 
a  little  free  iron  to  be  present  in  the  serum.  By  thus  increasing 
oxidation  in  the  tissues  they  increase  the  functional  activity  of 
the  various  organs.  The  effect  of  ferrous  and  ferric  salts  added 
to  the  blood  is  very  different,  ferric  salts  producing  a  firm  coagu- 
lum,  whereas  the  ferrous  salts  tend  rather  to  diminish  the  coagu- 
lability of  the  blood. 

Iron  has  an  action  on  the  nervous  system  which  varies  ac- 
cording to  the  dose  and  mode  of  administration.  When  injected 
subcutaneously  in  frogs,  iron  salts  cause  slight  excitement  and 
then  paralysis  of  the  central  nervous  system.  In  the  later  stages 
of  poisoning  the  irritability  of  the  voluntary  muscle3  is  diminished, 

1  Preyer,  Die  Blutcrystalle.    Jena,  1871. 

3  B  2 


740  INOEGANIC  MATEEIA  MEDICA.  [sect  in 

but  the  heart  is  not  affected.  In  mammals  they  cause  conges- 
tion of  the  stomach  and  intestine,  and  diarrhoea.  They  produce 
paralysis  both  of  sensation  and  motion.  The  blood-pressure 
falls.  This  is  due  to  paralysis  of  the  vaso-motor  nerves,  es- 
pecially of  the  intestine,  resembling  that  produced  by  arsenic, 
antimony,  emetin,  and  colehicin. 

Iron  is  eliminated  to  a  considerable  extent  by  the  bile  (p.  405), 
by  the  mucous  membrane  of  the  intestine,  and  by  the  kidneys. 

Uses  of  Ikon. — The  ferrous  salts  are  rarely  employed  for  their 
local  action.  The  ferric  salts  are  used  as  styptics.  The  strong 
solution  of  perchloride  may  be  employed  to  arrest  bleeding  from 
the  cavity  of  a  tooth  after  extraction,  or  to  stop  the  oozing  from  a 
wound  where  it  is  impossible  to  ligature  all  the  bleeding  points. 
When  diluted  it  may  be  used  as  an  injection  to  arrest  haemorrhage 
from  the  nose,  or  may  be  injected  into  the  cavity  of  the  uterus 
to  arrest  bleeding  from  that  organ.  Mixed  with  laudanum  it  has 
been  used,  as  an  injection  in  gonorrhoea  and  gleet.  Both  ferrous 
and  ferric  salts  are  administered  internally  in  order  to  produce 
the  general  action  of  iron  in  increasing  the  blood-corpuscles. 
They  differ  to  some  extent,  however,  the  ferrous  salts  having  a 
less  astringent  action  on  the  intestines  than  the  ferric.  In  cases 
where  the  mucous  membrane  of  the  alimentary  canal  is  irritable 
this  is  advantageous,  as  in  such  instances  the  ferric  salts  might 
cause  digestive  disturbances  and  headache.  In  other  instances, 
however,  especially  those  where  the  tongue  is  pale  and  flabby, 
the  more  astringent  preparations  are  to  be  preferred.  The  chief 
use  of  iron  is  as  a  haematinic,  and  the  condition  in  which  it  is 
most  beneficial  is  where  we  have  anaemia  and  chlorosis,  whether 
these  be  due  to  loss  of  blood,  imperfect  nutrition,  chronic  dis- 
charges, scrofula,  syphilis,  malarial  poisoning,  amenorrhoea  or 
albuminuria,  or  be  consequent  upon  acute  febrile  disease ;  but  it 
is  also  serviceable  in  a  number  of  disturbances  of  the  nutritive  and 
nervous  systems.  It  has  been  recommended  in  large  doses  in  cases 
of  blood-poisoning,  such  as  diphtheria  and  erysipelas,  and  in  ner- 
vous diseases  like  chorea,  epilepsy,  giddiness,  formication,  twitch- 
ing of  the  fingers,  and  subjective  Bensations  of  light  and  heat  or 
cold  to  which  some  patients  are  liable,  especially  about  the  climac- 
teric period.  It  is  also  used  internally  in  order  to  diminish  dis- 
charges from  the  mucous  membranes  of  the  intestines,  as  in 
chronic  diarrhoea  and  dysentery,  and  from  the  vagina  in  leucor- 
rhoea.  It  acts  as  an  astringent  on  the  kidney,  lessening  the 
amount  of  blood  in  hematuria,  and  sometimes  the  amount  of 
albumen  in  albuminuria.  It  is  also  a  useful  adjunct  to  diuretics 
in  cardiac  and  renal  dropsy  (p.  338) . 

B.P.  Vinum  Ferri. — This  is  prepared  by  macerating  iron 
wire  in  sherry  for  a  month.  Some  of  it  is  converted  into  tartrate 
and  dissolved  by  the  bitartrate  of  potassium  in  the  wine. 


chap,  xxviii.]  METALS.  741 

Dose. — 1  to  2  fl.  dr.  or  more. 

Use. — It  is  useful  in  anaemia  both  in  children  and  adults,  and 
may  be  given  with  cod-liver  oil. 

B.P.  Mistura  Ferri  Aromatica.— This  is  a  curious  prepara- 
tion containing  tannate  of  iron  in  very  small  quantities.  It  is 
sometimes  called  Heberden's  ink.  It  is  usually  said  that  iron 
and  tannin  are  incompatible,  and  so  they  are  in  so  far  that  they 
produce  ink,  but  this  preparation  is  said  to  be  a  very  useful  one. 

Iron  cannot  be  taken  up  in  very  large  quantities,  and  its 
absorption  is  often  prevented  by  the  condition  of  the  patient's 
stomach.  This  preparation  has  been  put  together  evidently  with 
the  view  of  combining  all  the  drugs  which  were  likely  to  do  good 
by  themselves,  and  in  total  disregard  of  the  chemical  action  which 
would  take  place  among  themselves. 

Preparation. — By  macerating  pale  cinchona  bark  (1  oz.),  calumba  root 
(J-oz.),  cloves  (£-oz.),  and  fine  iron  wire  (£-oz.),  in  peppermint  water  (12  oz.) 
for  three  days,  agitating  occasionally ;  then  filtering  and  adding  as  much 
peppermint  water  to  the  filtrate  as  will  make  the  product  measure  12^  fl.  oz. ; 
to  this  add  compound  tincture  of  cardamoms  (3  fl.  oz.)  and  tincture  of  orange 
peel  (£  fl.  oz.),  and  preserve  the  mixture  in  a  well-stopped  bottle.  The  pale 
cinchona  bark  contains  tannin,  which  combines  with  the  iron.  Both  it  and 
calumba  are  gastric  tonics,  and  the  carminatives  relieve  flatulence. 

Dose. — 1  to  2  fl.  oz. 

Ferri  Sulphas,  B.  and  U.S.P.  Sulphate  of  Ieon. 
FeS04.7H20;  277-9. 

Characters. — In  oblique  rhombic  prisms,  of  a  pale  greenish 
blue  colour  and  styptic  taste. 

Solubility. — It  is  insoluble  in  rectified  spirit,  soluble  in  water. 

Beactions. — The  aqueous  solution  gives  the  reaction  of  a  sulphate  (p.  594) 
and  of  a  ferrous  salt  (p.  786). 

Dose. — 1  to  5  grains. 

Preparations. 

S.F.  U.S.P. 

Ferri  Sulphas  Exsiccata Ferri  Sulphas  Exsiccata. 

Filula  Aloes  et  Ferri  (vide  p.  522)  1  part  in  7. 

Ferri  Sulphas  Exsiccata,  B.P. ;  Ferri  Sulphas  Exsic- 
catus,  U.S.P.     Dried  Sulphate  of  Iron.    FeS04.H20  ;  169-9. 

Prepared  by  heating  sulphate.  It  is  less  apt  to  oxidise,  and  is  well  fitted 
for  pills. 

Dose. — J  to  3  grains. 

Preparation. 

U.S.P. 

Pilulffl  Aloes  et  Ferri  (vide  p.  523). 

Ferri  Sulphas  Granulata,  B.P. ;  Ferri  Sulphas  Praecipi- 
tatus,  U.S.P-  Granulated  Sulphate  of  Iron,  B.P.  Pre- 
cipitated Sulphate  of  Iron,  U.S.P.    FeS04.7H20 ;  277-9. 

Characters  and  Tests. — In  small  granular  crystals  of  a  pale 


742  INORGANIC  MATERIA  MEDICA.  [sect.  in. 

greenish-blue  colour.  In  other  respects  it  corresponds  to  the 
characters  and  tests  for  sulphate  of  iron. 

Dose. — 1  to  5  grains. 

Uses. — It  is  very  astringent.  It  has  been  used  externally 
as  ointment  or  lotion  to  the  skin  in  erysipelas,  as  a  lotion  in 
ophthalmia,  and  as  a  lotion  or  injection  in  prolapsus  ani,  and 
bleeding  piles.  It  has  also  been  used  as  an  injection  in  gonor- 
rhoea and  leucorrhcea. 

Internally  it  is  used  in  cases  of  anemia,  especially  where  this 
is  accompanied  by  a  tendency  to  profuse  sweating,  passive 
haemorrhages,  or  mucous  discharges,  such  as  chronic  catarrh  or 
leucorrhcea.  Its  astringent  action  on  the  stomach  has  been  said 
to  render  it  serviceable  in  gastrodynia  and  gastric  ulcer. 

Ferri  Carbonas  Saccharata,  B.P. ;  Saccharatus,  U.S.P- 

Sacchaeated  Carbonate  op  Ibon,  B.P. ;  Sacchaeated  Feeeous 
Carbonate,  U.S.P. 

Carbonate  of  iron,  FeO,C02  or  FeC03,  mixed  with  peroxide 
of  iron  and  sugar,  the  carbonate  forming  at  least  37  per  cent,  of 
the  mixture  B.P.,  15  per  cent.  U.S.P. 

Chaeactees. — Small  coherent  lumps,  or  powder,  of  a  grey 
colour,  with  a  sweet,  very  feeble  chalybeate  taste. 

Solubility.— It  dissolves  with  effervescence  (carbonate)  in  warm  hydro- 
chloric acid  diluted  with  half  its  volume  of  water. 

Reactions. — The  solution  gives  only  traces  of  sulphate  (p.  595)  and 
exhibits  the  reactions  of  a  ferrous  salt. 

Dose. — 5  to  20  grains. 

Pkepakations. 

B.P.  DOSE. 

Pilula  Ferri  Carbonatis  (vide  p.  522) 1  part  in  1J 5-20  grs. 

U.S.P. 

Massa  Ferri  Carbonatis  3-5  grs. 

U.S.P.  Massa  Ferri  Carbonatis.  Mass  of  Caebonate  or  Ikon. — Sulphate  of 
iron,  100  parts  ;  carbonate  of  sodium,  110  parts  ;  honey,  38  parts  ;  sugar,  25  parts ; 
syrup  and  water,  q.s. 

Mistura  Ferri  Composita,  B.  and  U.S.P.  Compound 
Mixtube  of  Ieon.     Geiffith's  Mixttjee. 

Composition. — Sulphate  of  iron,  25  grs. ;  carbonate  of  potas- 
sium, 30  grs. ;  myrrh  and  refined  sugar,  of  each  60  grs. ;  spirit 
of  nutmeg,  4  fl.  drs. ;  rose  water,  9£  fl.  oz.,  B.P.  Sulphate  of 
iron,  6;  myrrh,  18;  sugar,  18;  carbonate  of  potassium,  8; 
spirit  of  lavender,  50 ;  rose  water,  900,  U.S.P. 

Dose. — 1  to  2  fluid  ounces. 

Uses. — Carbonate  of  iron  in  its  various  preparations  is  one 
of  the  most  useful  forms  of  iron  for  administration  as  a  hema- 
tinic  and  emmenagogue. 

Liquor  Ferri  Persulphatis,  B.P. ;  Tersulphatis,  U.S.P. 
Solution  of  Peesulphate  of  Ieon,  B.P. ;  of  Tersulphatb, 
U.S.P.    Fe2(S04)3;  399-8. 


chap,  xxviii.]  METALS.  748 

Characters.— A  dense  solution  of  a  dark-red  colour,  inodorous 
and  very  astringent,  miscible  in  all  proportions  with  alcohol  and 
water. 

Reactions.— Diluted  with  ten  volumes  of  water,  it  gives  the  reactions  of 
a  sulphate  and  of  a  ferric  salt  only. 

Pbepaeatioks  in  which  Solution  op  Persulphate  of  Ikon  is  used. 

B-p-  U.S.P. 

Fern  et  Ammonii  Citras.  Ferri  et  Ammonii  Citras. 
Ferri  et  Quininse  Citras.  „     „         „        Tartras. 

Ferri  Peroxidum  Hydratum.  „     „  Potassii         „ 

Ferrum  Tartaratum.  „    Oxidum  Hydratum. 

..         ><  „        oum  Magnesift. 

/  Liquor  Ferri  Nitratis. 

),  „     Citratis. 

Uses. — Not  used  as  a  remedy,  but  to  prepare  peroxide,  &e. 

U.S. P.  Liquor  Ferri  Subsulphatis.  Solution  of  Sub- 
sulphate  of  Iron.  Solution  of  Basic  Ferric  Sulphate, 
(Monsel's  Solution.) 

Characters.  —  Like  the  tersulphate ;  but  on  mixing  two 
volumes  of  the  solution  with  one  of  concentrated  sulphuric  acid 
a  solid  white  mass  separates  on  standing. 

Dose. — 3  to  10  minims  (-18--64  c.c). 

Action. — Astringent,  styptic,  haematinic.  Less  irritating 
than  the  tersulphate. 

Uses. — Like  the  chloride.  It  is  a  useful  astringent  in  relaxed 
sore-throat  and  tonsillitis. 

U.S. P.  Ferri  Oxidum  Hydratum.  Hydrated  Oxide  of 
Iron.    Fe2(HO)6;  213-8. 

Characters. — A  soft,  moist,  pasty  mass,  of  a  reddish-brown 
colour. 

Solubility. — Dissolves  readily  in  diluted  hydrochloric  acid. 
Reactions. — The  solution  gives  the  reaction  of  a  ferric  salt  only. 

Dose. — \  to  \  ounce. 

Use. — As  an  antidote  for  arsenic,  it  should  be  given  in  doses 
of  a  tablespoonful  every  five  or  ten  minutes.  It  may  be  used  in 
anaemia  and  amenorrhcea. 

Preparations. 
U.S.P.    Emplastrum  Ferri   (hydrated  oxide  dried,  with  Canada  turpentine, 
Burgundy  pitoh,  and  lead  plaster). 

TJ.S.P.    Trochisci  Ferri  (troches  of  iron).    Iron  lozenges,  5  grs.  in  each  lozenge. 

U.S.P.  Ferri  Oxidum  Hydratum  cum  Magnesia.  Hy- 
drated Oxide  of  Iron  with  Magnesia. — Antidote  to  arsenious  acid. 

Preparation. — Mix  the  solution  of  tersulphate  of  iron  1,000  grs.  (65-00  gm.) 
with  twice  its  weight  of  water.  Euh  the  magnesia,  150  grains  (10-00  gm.) 
with  water  to  a  smooth  and  thin  mixture  ;  transfer  this  to  a  bottle  capable  of 
holding  32  fl.  oz.,  or  about  1  litre,  and  fill  it  up  with  water.  When  the  pre- 
paration is  wanted  for  use,  mix  the  two  liquids  by  adding  the  magnesia 
mixture  gradually  to  the  iron  solution,  and  shake  them  together  until  a 
homogeneous  mass  results. 

Note. — The  diluted  solution  of  tersulphate  of  iron  and  the  mixture  of 
magnesia  with  water  should  always  be  kept  on  hand,  ready  for  immediate  use. 


744  INOKGANIC   MATERIA   MEDICA.  [sect.  hi. 

Use.— -As  an  antidote  in  poisoning  by  arsenic. 

B.P.  Ferri  Peroxidum  Hydratum.  Htdkated  Peroxide 
of  Iron.    Fe203H20  or  Fea02(HO)2. 

Characters. — A  reddish-brown  powder,  destitute  of  taste  and 
not  magnetic. 

Solubility. — It  dissolves  completely,  though  slowly,  with  the  aid  of  heat, 
in  hydrochloric  acid,  diluted  with  half  its  volume  of  water. 

Beactions. — The  solution  gives  the  reactions  of  a  ferric  salt  only. 

Dose. — 5  to  30  grains. 

B.P.    Preparation. 
Emplastrum   Ferri.      Iron  Plaster. — Efydrated  peroxide   of   iron  in   fine 
powder,  Burgundy  pitch,  and  lead  plaster  (1  part  in  11). 

Uses. — Not  astringent.  Given  in  powder  or  electuary  chiefly 
in  cases  of  tic  and  neuralgia. 

Iron  plaster  is  often  called  «  strengthening  plaster.'  It  forms 
a  mechanical  support  to  weak  parts  and  keeps  them  warm. 
Used  in  pains  or  weakness  across  the  loins  in  females,  in  rheu- 
matic pains,  as  lumbago,  weak  joints,  &c. 

Ferrum  Redactum,  B.  and  U.S. P.  Eedtjced  Iron.— 
Metallic  iron,  with  a  variable  amount  of  magnetic  oxide  of  iron. 

Characters. — A  fine  greyish-black  powder,  strongly  attracted 
by  the  magnet,  and  exhibiting  metallic  streaks  when  rubbed  with 
firm  pressure  in  a  mortar. 

Solubility. — It  dissolves  in  hydrochloric  acid  with  the  evolution  of 
hydrogen.     (Fe  +  2HC1  =  Fe  CI,  +  H2.) 

Beactions. — The  solution  gives  a  light  blue  precipitate  with  the  yellow 
prussiate  of  potash. 

Impurity. — Magnetic  oxide. 

Test. — "When  ten  grains  are  added  to  an  aqueous  solution  of  fifty  grains 
of  iodine  and  fifty  grains  of  iodide  of  potassium  (Fe  + 12  =  Fe  I2  which  dis- 
solves in  KI),  and  digested  in  a  small  flask  at  a  gentle  heat,  the  reduced 
iron  is  converted  into  iodide  and  dissolved,  and  not  more  than  five  grains 
should  be  left  undissolved,  which  should  be  entirely  soluble  in  hydrochlorio 
acid  (oxide). 

Dose. — 1  to  5  grains. 

Xrochiscl  Ferri  Redacti,  B.P.      Beduced    Ieon    Lozenges,  B.P. — Each 
lozenge  contains  one  grain  of  reduced  iron. 
Dose. — 1  to  6  lozenges. 

Uses. — This  preparation  is  generally  well  borne  even  if  the 
stomach  be  somewhat  irritable.  It  has  no  astringent  action. 
When  dissolved  by  the  gastric  juice  it  evolves  hydrogen,  and  if 
sulphur  be  present  as  an  impurity  eructations  of  sulphuretted 
hydrogen  are  produced. 

U.S.P.  Liquor  Ferri  Acetatis.  Solution  op  Acetate 
op  Iron. — An  aqueous  solution  of  ferric  acetate  [Fe^CjHaOJg ; 
465-8] — containing  33  per  cent,  of  the  anhydrous  salt.  Sp.  gr. 
1-160. 

Preparation. 

Tinctura  Ferri  Acetatis  (Solution  of  Acetate  50,  Alcohol  30,  Acetic  Ether  2). 
Dose.— 15  min.  to  1  fl.  dr. 


chap,  xxvm.]  METALS.  745 

B.P.  Liquor  Ferri  Acetatis  Fortior.  Strong  Solution 
of  Acetate  op  Ikon. 

Characters. — A  deep-red  fluid  with  a  sour,  styptic  taste  and 
acetous  odour,  miscible  with  water .  or  rectified  spirit  in  all  pro- 
portions.    Sp.  gr.  1-127. 

Reactions.— Diluted  with  water  it  gives  the  reactions  of  a  ferric  salt. 

Dose. — 1  to  8  minims. 

Pbepabations. 

B.P.  DOSE. 

Liquor  Ferri  Acetatis  (strong  solution  1,  diluted  with  water  to  4)   5  to  30  min. 
Tinctura  Ferri  Acetatis  (  „  „       1,       „  „     spirit  to  4)    5  to  30  min. 

Use. — May  be  given  along  with  acetate  of  potassium  in 
dropsy. 

U.S.P.  Mistura  Ferri  et  Ammonii  Acetatis.  Mixture 
of  Acetate  of  Iron  and  Ammonium  (Basham's  Mixture)  com- 
prises tincture  of  chloride  of  iron  (2  parts),  diluted  acetic  acid  (3), 
solution  of  acetate  of  ammonium  (20),  elixir  of  orange  (10),  syrup 
(15),  water  (50). 

Dose. — £-1  fluid  ounce. 

Use. — As  a  hsematinic  generally,  and  in  cases  of  renal  disease 
especially. 

U.S.P.  Ferri  Chloridum.  Chloride  of  Iron.  Fe2Cls. 
12H20;  540-2. 

Characters.—  Orange-yellow  crystalline  masses,  very  deliques- 
cent, odourless  or  having  a  faint  odour  of  hydrochloric  acid,  a 
styptic  taste,  and  an  acid  reaction. 

Solubility. — Freely  and  wholly  soluble  in  water,  alcohol,  or  ether. 

Keactions. — The  dilute  aqueous  solution  gives  a  brown-red  precipitate 
with  water  of  ammonia,  a  blue  one  with  test  solution  of  ferrocyanide  of 
potassium,  and  a  white  one,  insoluble  in  nitric  acid,  with  test  solution  of 
nitrate  of  silver. 

Uses. — In  the  solid  state  it  keeps  indefinitely,  whereas  in 
solution  it  is  apt  to  deposit  ferric  oxide  leaving  excess  of  acid  in 
the  solution  which  renders  it  irritating.  "When  required  it  may 
be  dissolved  in  water  in  the  proportion  of  1^-6  drachms  toihe 
ounce  of  water.    When  semi-deliquesced  it  is  an  efficient  styptic. 

Liquor  Ferri  Perchloridi  Fortior,  B.P.  Liquor  Ferri 
Chloridi,  U.S.P.  Strong  Solution  of  Perchloride  of  Iron, 
B.P.     Solution  of  Chloride  of  Iron,  U.S.P. 

Characters. — An  orange-brown  solution  with  a  strong  styptic 
taste,  miscible  with  water  and  rectified  spirit  in  all  proportions. 

Reactions. — Diluted  with  water  it  gives  the  reactions  of  a  chloride 
(p.  594)  and  of  a  ferric  salt  only. 

Preparations. 
B.P.  DOSE. 

Liquor  Ferri  PercMoridl  (with  water) 1  volume  in  4. ..10-30  min. 

Tinctura  Ferri  Percbloridi  (with  spirit)...!  volume  in  4. ..10-30  min. 


746  INOEGANIC  MATEEIA  MEDICA.  [sect.  in. 

U.S.P.    Tinetura  Ferri  Chloridi.     Tincture  of  Chlobide  or  Ibos.    Dose,  10 
to  30  minims. 

Pbepaeation. 
Mistura  Ferri  et  Ammonii  Acetatis,  U.S.P. 

Usus. — The  strong  solution  is  one  of  the  most  powerful 
styptics  we  possess.  It  forms,  almost  immediately,  a  hard  black 
coagulum  with  blood,  and  by  blocking  up  the  mouths  of  the 
vessels  arrests  further  hemorrhage.  Cotton  wool  steeped  in  this 
may  be  used  to  arrest  the  hemorrhage  from  the  cavity  of  a 
tooth  after  its  extraction,  and  to  stop  the  bleeding  from  leech- 
bites.  It  has  been  applied  as  a  caustic  in  hospital  gangrene,  in 
bleeding  from  the  uterus,  and,  diluted  with  three  volumes  of 
water,  it  may  be  injected  into  the  uterine  cavity,  but  is  better 
applied  by  swabbing  it  over  the  interior  of  the  uterus  with  a 
sponge.  It  has  been  injected  into  aneurisms,  in  order  to  pro- 
duce coagulation  within  them.  There  is,  however,  great  danger 
that  part  of  the  clot  may  become  detached  and  carried  onwards, 
producing  embolism,  or  that  inflammation  and  ulceration  may 
take  place  within  the  aneurismal  sac  itself. 

It  has  also  been  injected  into  varicose  veins  and  nsevi  for  a 
similar  purpose,  but  in  nsevi  on  the  face  it  may  cause  sloughing, 
and  leave  scars.  It  has  been  used  as  a  spray  for  the  purpose  of 
arresting  haemorrhage  from  the  lungs. 

The  liquor  and  tincture  are  perhaps  more  often  employed 
than  any  other  preparation  of  iron.  They  are  astringent, 
generally  causing  constipation,  but  sometimes  they  irritate  the 
intestine,  increasing  the  number  of  stools.  They  are  amongst 
the  most  efficient  preparations  of  iron  as  haematinics.  They  are 
contraindicated  by  a  red  irritable  tongue,  and  succeed  best 
when  the  tongue  is  pale,  flabby,  and  marked  with  the  teeth  at 
the  edges. 

I  have  found  that  when  patients  bear  iron  badly  and  com- 
plain of  headache  even  after  small  doses,  they  can  take  with 
benefit  a  single  drop  of  the  tincture  or  solution  of  the  perchloride 
in  a  full  tumbler  of  wa.ter.  In  its  great  dilution  the  mixture 
somewhat  resembles  chalybeate  waters,  which  often  succeed 
much  better  than  pharmaceutical  preparations.  The  tincture 
has  been  given  in  erysipelas  in  very  large  doses,  20-30  minims, 
repeated  every  hour  or  two. 

The  tincture  is  useful  in  purpura  with  extensive  extravasations. 
In  skin-diseases  generally,  such  as  eczema,  lupus,  seborrhoea,  and 
psoriasis,  it  is  only  useful  when  they  are  associated  with  anaemia, 

B.P.  Liquor  Ferri  Dialysatus.  Solution  op  Dialysed 
Ieon. — This  solution  of  dialysed  iron,  so-called,  is  a  solution  of 
highly  basic  ferric  oxychloride,  or  chloroxide  of  iron,  from  which 
most  of  the  acidulous  matter  has  been  removed  by  dialysis. 

Characters. — A  clear  dark  reddish-brown  liquid,  free  from 


chap,  xxvm.]  METALS.  747 

any  marked  ferruginous  taste.    Neutral  to  test-papers.    Specific 
gravity  about  1*407. 

Beactions.— The  solution  gives  no  precipitate  with  ferrocyanide  of  potas- 
sium or  with  nitrate  of  silver,  but  after  being  heated  with  hydrochloric  acid 
it  yields  with  ferrocyanide  of  potassium  a  blue  precipitate. 

Dose. — 10  to  30  minims. 

Liquor  Ferri  Pernitratis,  B.P. ;  Liquor  Ferri  Nitratis 
U.S. P.  Solution  of  Pernitrate  op  Ieon,  B.P. ;  Nitrate  op 
Iron.U.S.P.     Fe2(N03)6;  483-8. 

Characters. — A  clear  solution  of  a  reddish-brown  colour, 
slightly  acid  and  astringent  to  the  taste. 

Beactions. — When  to  a  little  of  it  placed  in  a  test-tube  half  its  volume  of 
pure  sulphuric  acid  is  added,  and  then  a  solution  of  sulphate  of  iron  is  poured 
on,  the  whole  assumes  a  dark-brown  colour  (nitrate).  It  gives  the  reactions 
of  a  ferric  salt  only. 

Dose. — 10  to  40  minims. 

Uses. — It  has  been  used  as  an  astringent  in  the  diarrhoea, 
of  children,  and,  also  as  an  astringent,  to  diminish  discharges 
from  mucous  surfaces,  also  to  arrest  haemorrhage  from  internal 
organs.  It  can  be  given  along  with  spirit  of  nitrous  ether  or 
nitrate  of  potassium  in  cases  of  anaemia  with  albuminuria  and 
dropsy. 

Ferrum  Tartaratum,  B.P. ;  Ferri  et  Potassii  Tartras, 
U.S. P.  Tartarated  Iron,  B.P. ;  Tartrate  op  Iron  and  Potas- 
sium, U.S.P. 

Characters. — Thin,  transparent  scales  of  a  deep  garnet  colour, 
slightly  sweetish  and  astringent  in  taste. 

Solubility. — It  is  soluble  in  water  and  sparingly  soluble  in  spirit. 

Eeactions. — The  aqueous  solution,  when  acidulated  with  hydrochloric 
acid,  gives  the  reactions  of  a  ferric  salt  only.  When  the  salt  is  boiled 
with  solution  of  soda,  peroxide  of  iron  separates,  but  no  ammonia  is  evolved 
(not  the  ammonia-citrate),  and  the  filtered  solution  when  slightly  acidulated 
by  acetic  acid  gives,  as  it  cools,  a  crystalline  deposit  (potassium). 

Dose. — 5  to  10  grains. 

The  double  salts  of  iron  with  potassium,  ammonium,  quinine, 
&c,  are  usually  called  the  scale  preparations  of  iron  from  their 
appearance.  These  are  less  astringent  than,  and  do  not  confine 
the  bowels  so  much  as,  either  the  proto-sulphate  or  the  per-salts. 
Another  advantage  is  that  they  may  be  given  along  with  alkaline 
carbonates  without  being  precipitated.  They  are  employed  in 
cases  where  the  other  preparations  cause  headache,  or  derange 
the  digestion,  on  account  of  the  stomach  being  irritable. 

U.S. P.  Ferri  et  Ammonii  Tartras.  Tartrate  op  Iron  and 
Ammonium. 

Characters. —  Transparent  scales,  varying  in  colour  from 
garnet-red  to  yellowish-brown,  only  slightly  deliquescent,  without 


748  INOEGANIC  MATEEIA   MEDIO  A.  [sect.  in. 

odour,  having  a  sweetish  and  slightly  ferruginous  taste  and  a 
neutral  reaction. 

Solubility. — It  is  readily  soluble  in  water. 

Reactions. — It  ie  not  precipitated  by  ammonia,  but  gives  a  brown  pre- 
cipitate of  ferric  oxide  with  potash  and  evolves  the  vapour  of  ammonia.  On 
adding  test  solution  of  ferrocyanide  of  potassium  to  the  salt,  no  blue  colour 
or  precipitate  is  produced  unless  the  solution  is  acidulated  with  hydrochloric 
acid. 

Ferri  et  Ammonii  Citras,  B.  and  U.S.P.  Citeatb  op  Iron 
and  Ammonium. 

Characters.— In  thin,  transparent  scales  of  a  deep  red  colour, 
slightly  sweetish  and  astringent  in  taste.  It  feebly  reddens  litmus 
paper. 

Solubility. — It  is  soluble  in  water,  but  almost  insoluble  in  rectified 
spirit. 

Beactions. — Heated  with  solution  of  potash  it  evolves  ammonia  and 
deposits  peroxide  of  iron.  The  alkaline  solution  from  which  the  iron  has 
separated  does  not,  when  slightly  supersaturated  with  acetic  acid,  give  any 
crystalline  deposit  (distinction  from  and  absence  of  tartrate). 

Dose. — 5  to  10  grains. 

Preparations. 

B.F.  DOSE. 

Vinum  Ferri  citratls.  8  grains  in  1  fl.  oz.  of  orange  wine... 1-4  fl.  drs. 

n.s.p. 

Ferri  et  Strychninse  Citras 

Liquor  Ferri  et  Quinmse  Citratis  

Vinum  Ferri  Citratis  1-2  fl.  drs. 

U.S.P.  Vinum  Ferri  Citratis.  (Citrate  of  iron  and  ammonium,  4  ;  tincture  of 
sweet  orange-peel,  12  ;  syrup,  36 ;  stronger  white  wine,  44.) 

U.S.P.  Liquor  Ferri  Citratis.  An  Aqueous  Solution  of 
Ferric  Citrate,  Fe2(C6Hs07)2 ;  489"8,  containing  about  35  per 
cent,  of  the  anhydrous  salt. 

Characters. — A  dark  brown  liquid,  odourless,  having  a 
slightly  ferruginous  taste  and  acid  reaction. 

Beactions. — It  gives  the  reactions  of  a  citrate  (p.  594)  and  a  bluish  green 
precipitate  with  ferrocyanide  of  potassium,  which  is  increased  and  rendered 
dark  blue  by  the  subsequent  addition  of  hydrochloric  acid. 

Dose. — Ten  minims  (0-6  c.c),  equal  to  5  grains  of  the  salt. 

U.S.P.  Ferri  Citras.  Citrate  of  Iron.  Fe,(C6H,07)2.6H,0; 
597-8.  7 

Characters. — Transparent  garnet-red  scales,  permanent  in 
the  air,  odourless,  having  a  very  faint  ferruginous  taste  and  an 
acid  reaction. 

Solubility. — Slowly  but  completely  soluble  in  cold  water  and  readily  so 
in  boiling  water ;  insoluble  in  alcohol. 
Beactions. — Vide  supra. 

Preparation. 
Ferri  Quininse  Citras. 

Use.— Is  pleasant.    A  solution  of  240  grains  in  1  fl.  oz.  of 


chap,  xxviii.]  METALS.  749 

water  keeps  perfectly,  and  may  be  given  in  doses  of  10  minims, 
equal  to  5  grains,  as  a  tonic. 

Ferri  et  Quininae  Citras,  B.  and  U.S. P.  Citrate  of  Iron 
and  Quinine. 

Characters. — Thin  scales  of  a  greenish  golden-yellow  colour, 
somewhat  deliquescent. 

Solubility. — It  is  entirely  soluble  in  cold  water. 

Reactions. — The  solution  is  very  slightly  acid,  and  is  precipitated 
reddish-brown  (iron)  by  solution  of  soda,  white  (quinine)  by  solution  of 
ammonia,  blue  by  the  yellow  (ferric)  and  red  prussiates  (ferrous)  of  potash, 
and  greyish-black  by  tannic  acid.  The  taste  is  bitter  (quinine)  as  well  as 
chalybeate. 

Dose. — 5  to  10  grains. 

U.S. P.  Liquor  Ferri  et  Quininae  Citratis.  Solution  of 
Citrate  of  Iron  and  Quinine.  (Citrate  of  iron  and  ammonium, 
65 ;  quinine,  12 ;  citric  acid,  28 ;  alcohol,  30  ;  distilled  water 
up  to  200.) 

Dose. — 8  to  15  minims  (J-l  c.c). 

Preparation, 
c.s.p. 

Vinum  Ferri  Am  arum.  Bitter  Wine  op  Iron.  (Solution  of  citrate  of  iron 
Bnd  quinine,  8  ;  tincture  of  sweet  orange  peel,  12  ;  syrup,  36  ;  stronger  white  wine, 
34.)    Dose  1-2  fl.  drs.  (4-16  c.c). 

U.S.P.  Ferri  et  Strychninas  Citras.  Citrate  of  Iron  and 
Strychnine. 

Characters. — Transparent  garnet-red  scales,  deliquescent  on 
exposure  to  air ;  odourless,  having  a  bitter  and  slightly  ferru- 
ginous taste  and  a  slightly  acid  reaction. 

Solubility. — Soluble  in  water. 

Reactions. — If  one  gm.  of  the  salt  be  dissolved  in  4  c.c.  of  water  in  a 
small  test-tube,  then  1  c.c.  of  solution  of  potassa  added  and  the  mixture 
shaken  with  2  c.c.  of  chloroform,  the  residue  left  on  evaporating  the  chloro- 
form will  answer  to  the  reaction  of  strychnine.     (See  '  Strychnina.') 

Dose.— 3  to  5  grains  (0-20-0-33  gm.). 
Uses. — As  tonic   and  chalybeate  to  combine  the   uses   of 
strychnine  and  iron. 

U.S.P  Ferri  et  Ammonii  Sulphas.  Sulphate  of  Iron  and 
Ammonium.  Ammonio-Ferric  Sulphate  or  Ammonio-Ferric  Alum. 
Fe2(NH4)2(S04)4.24H20 ;  963-8. 

This  is  an  ammonia  iron-alum  in  which  the  place  of  the 
aluminium  oxide  is  occupied  by  the  ferric  oxide. 

Characters. — Pale  violet  octahedral  crystals  efflorescent  on 
exposure  to  air,  odourless,  having  an  acid  styptic  taste  and  a 
slightly  acid  reaction. 

Dose. — 5  to  10  grains. 

Uses. — It  is  more  astringent  than  common  alum,  and  has 
not  the  stimulating  properties  of  other  iron  salts.     It  is  useful  in 


750  INOKGANIC  MATEEIA  MEDICA.  [sect,  in, 

leucorrhcea.     Internally  it  is  sometimes  very  useful  in  lessening 
albumen  in  cases  of  intermittent  albuminuria. 

U.S.P.  Ferri  Lactas.  Lactate  of  Iron.  Fe(C3H503)2.3H20; 
287-9. 

Chabactees. —  Pale  greenish-white,  crystalline  crusts  or 
grains,  permanent  in  the  air  ;  odourless,  having  a  mild  sweetish 
ferruginous  taste  and  a  slightly  acid  reaction. 

Solubility. — Soluble  in  water. 

Beactions. — When  heated  on  platinum  foil  the  salt  froths  up,  gives  out 
thick  white  acrid  fumes,  and  chars,  a  brown-red  residue  being  finally  left.  If 
the  salt  be  boiled  for  fifteen  minutes  with  nitric  acid  of  the  sp.  gr.  1-200, 
white  granular  mucic  acid  will  be  deposited  on  cooling  the  liquid. 

Peepabation. 

U.S.P.  Syrupus  Hypophosphitum  cum  Ferro.  (Lactate  of  iron,  1 ;  syrup  of 
hypophosphites,  99.) 

Dose. — 12-20  grains  per  diem ;  of  syrup,  £  to  1  fi.  dr. 
Use. — In  chlorosis  and  anaemia. 

U.S.P-  Ferri  Oxalas.  Oxalate  op  Ieon.  reC204.H20 ; 
161-9. 

Chabacteks. — A  pale  yellow,  or  lemon-yellow  crystalline 
powder,  permanent  in  the  air,  odourless  and  nearly  tasteless. 

Solubility. — It  is  very  slightly  soluble  in  cold  or  hot  water,  but  soluble 
in  cold  concentrated  hydrochloric  acid  and  in  hot  diluted  sulphuric  acid. 

Dose.— 2  to  3  grains  (0-13  to  0-20  gm.). 

B.  and  U.S.P.  Syrupus  Ferri  Iodidi.  Syrup  of  Iodide  of 
Ieon.  Fel2;  309-1. — It  contains  4-3  grains  of  iodide  of  iron  in 
1  fluid  drachm. 

Characters. — Yellowish  or  greenish-yellow  liquid  with  a  sweet 
inky  taste. 

Dose.—  \  to  1  fl.  dr. 

B.  and  U.S.P.  Pilula  Ferri  Iodidi  (vide  pp.  522, 523).  Pill 
of  Iodide  of  Iron.     Pill  with  sweet  inky  taste. 
Dose. — 3  to  8  grains. 

U.S.P.  Ferri  Iodidum  Saccharatum.  Sacchabated  Iodide 
of  Iron. 

Chabactees. — A  yellowish-white  or  greyish  powder  very 
hygroscopic,  odourless,  having  a  sweetish  ferruginous  taste,  and 
a  slightly  acid  reaction. 

Dose.— 2  to  5  grains  (0-13-0-33  gm.). 

Uses. — Iodide  of  iron  is  given  when  a  combination  of  the 
effect  of  iodine  on  the  lymphatic  system  is  desired  along  with  the 
hsematinic  action  of  iron.  It  is  thus  very  useful  in  the  form  of  the 
syrup  in  dispensary  practice  in  large  towns,  where  pale,  ansemic, 
flabby,  and  scrofulous  children  abound,  and  come  in  large 
numbers  to  be  treated.     It  is  generally  advantageous  to  combine 


chap,  xxvm.]  METALS.  751 

it  with  cod-liver  oil,  a  few  drops  of  the  syrup  being  dropped  into 
the  oil  and  taken  along  with  it.  It  has  been  given  in  phthisis  in 
the  same  way,  and  has  been  found  useful  in  rheumatic  arthritis 
and  syphilis. 

U.S. P.  Syrupus  Ferri  Bromidi.  Syrup  of  Bromide  of 
Iron.— A  syrupy  liquid  containing  10  per  cent,  of  ferrous  bro- 
mide.   FeBr2;  215-5. 

Dose. — ^  to  1  fluid  drachm  (1-9  to  3-75  c.c). 

Use. — In  nervous  diseases  accompanied  by  anaemia.  It  is 
doubtful,  however,  whether  it  is  not  better  to  give  the  iron  and 
bromine  separately,  as  sufficient  bromine  cannot  be  given  in  this 
form.  It  may,  however,  be  advantageously  combined  with  other 
bromides. 

B.P.  Ferri  Arsenias.  Arseniate  of  Iron. — Arseniate  of 
iron,  Fe3As208,  partially  oxidised. 

Characters. — A  tasteless  amorphous  powder  of  a  green 
colour. 

Solubility. — It  is  insoluble  in  water,  but  readily  dissolved  by  hydro- 
chloric acid. 

Eeactions. — The  solution  in  hydrochloric  acid  gives  a  copious  light-blue 
precipitate  with  the  yellow  prussiate  of  potash  (ferric),  and  a  still  more 
abundant  one  of  a  deeper  colour  with  the  red  prussiate  of  potash  (ferrous). 
A  small  quantity  boiled  with  an  excess  of  caustic  soda  and  filtered  gives, 
when  exactly  neutralised  by  nitric  acid,  a  brick-red  precipitate  on  the 
addition  of  solution  of  nitrate  of  silver  (arseniate). 

Dose. — -fa  to  ^  grain. 

Uses. — Used  when  we  wish  to  employ  arsenic  and  iron 
together,  as  in  skin-diseases  in  anaemic  subjects. 

Ferri   Phosphas,  B.  and  U.S.P.    Phosphate  of  Iron. — 
Phosphate  of  iron,  Fe„P208,  partially  oxidated. 
Characters. — A  slate-blue  amorphous  powder. 

Solubility. — It  is  insoluble  in  water,  soluble  in  hydrochloric  acid. 

Eeactions. — The  solution  yields  a  precipitate  with  both  the  yellow  (ferric) 
and  red  prussiates  of  potash,  that  afforded  by  the  latter  being  the  more 
abundant  (ferrous) ;  and.  when  treated  with  tartaric  acid  and  an  excess  of 
ammonia,  and  subsequently  with  the  solution  of  ammonio-sulphate  of  mag- 
nesium, lets  fall  a  crystalline  precipitate  (phosphate).  "When  the  salt  is 
digested  in  hydrochloric  acid  with  a  lamina  of  pure  copper,  a  dark  deposit 
does  not  form  on  the  metal  (distinction  from  and  absence  of  arseniate). 

Dose. — 5  to  10  grains. 

Preparations  containing  Phosphate  of  Ibon. 
B.p.  DOSE. 

Syrupus  Ferri  Phosphatis  (freshly-precipitated  phosphate  (p.  738)  is 

dissolved  in  dilute  phosphoric  acid  and  sugar  added)  1  gr.  in  1  fl.  dr.  ...1  fl.  dr. 

U.S.P. 

Syrupus  Ferri,  Quininse,  et  Strychnines  Phosphatum.  (Phosphate  of  iron,  133; 
quinine,  133  ;  strychnine,  4  ;  phosphoric  acid,  800  ;  sugar,  6,000  ;  distilled  water 
up  to  10,000.)     This  preparation  resembles  Easton's  Syrup. 


752  INORGANIC  MATERIA  MEDICA.  [bect.  m. 

Uses. — It  is  used  in  diabetes,  in  rickets,  and  in  nervous  de- 
pression. It  is  frequently  given  along  with  the  phosphates  of 
calcium,  potassium,  and  sodium,  as  the  preparation  usually 
called  Parrish's  Chemical  Pood,  or  with  the  phosphates  of 
quinine  and  strychnine,  as  in  Easton's  Syrup. 

U.S. P.  Ferri  Pyrophosphas.     Pyrophosphate  of  Iron. 

Characters. — Thin,  apple  green,  transparent  scales,  perma- 
nent in  dry  air  when  excluded  from  light,  but  turning  dark  on 
exposure  to  light.  Odourless,  having  an  acidulous,  slightly  saline 
taste,  and  a  slightly  acid  reaction. 

Solubility. — Very  soluble  in  water. 

Reactions. — When  heated  with  solution  of  potassa  in  excess  a  brown-red 
precipitate  is  thrown  down,  and  the  filtrate,  after  being  supersaturated  with 
acetic  acid,  yields  a  white  precipitate  with  test  solution  of  nitrate  of  silver 
(difference  from  phosphates). 

Dose.— 2  to  5  gr.  (0-13  to  0-33  gm.). 

Uses.— Has  no  disagreeable  taste,  and  is  very  soluble,  so  that 
it  can  be  given  in  any  form. 

U.S.P.  Ferri  Hypophosphis.  Hypophosphite  of  Iron. — 
Fe2(H2P02)6;  501-8. 

Characters. — A  white  or  greyish-white  powder,  permanent 
in  the  air,  odourless  and  nearly  tasteless. 

Solubility. — It  is  only  slightly  soluble  in  water,  more  readily  so  in  pre- 
sence of  hypophosphorous  acid,  freely  soluble  in  hydrochloric  acid,  or  in 
solution  of  citrate  of  sodium,  forming  with  the  latter  a  green  solution. 

Reactions.— "When  strongly  heated  in  a  dry  test-tube,  the  salt  evolves  a 
spontaneously  inflammable  gas  (phosphoretted  hydrogen),  and  on  ignition 
leaves  behind  ferric  'pyrophosphate.  The  salt  is  readily  oxidised  by  nitric 
acid  or  other  oxidising  agents.  It  should  be  completely  soluble  in  acetic 
acid  (absence  of  ferric  phosphate).  This  solution,  when  mixed  with  test- 
solution  of  oxalate  of  ammonium,  should  not  afford  a  white  precipitate 
soluble  in  hydrochloric  acid  (absence  of  calcium). 

Dose.  -  5  to  10  grains  in  pill,  more  generally  given  in  syrup. 
Uses.— In  nervous  debility  with  anaemia,  and  also  in  phthisis. 

U.S.P.  Ferri  Valerianas.  Valerianate  of  Iron.— Fe3 
(C6H0O2)  ;  717-8. 

Characters. — A  dark  tile-red  amorphous  powder,  permanent 
in  dry  air,  having  a  faint  odour  of  valerianic  acid,  and  a  mildly 

styptic  taste. 

Solubility.— Insoluble  in  cold  water,  but  readily  soluble  in  alcohol. 

Reactions. — Boiling  water  decomposes  it,  setting  free  the  valerianic  acid 
and  leaving  ferric  hydrate.  When  slowly  heated  the  salt  parts  with  its  acid 
without  fusing,  but  when  rapidly  heated  it  fuses  and  gives  off  inflammable 
vapours  having  the  odour  of  butyric  acid. 

Dose. — 1  grain  or  more. 

Uses. — In  hysteria  with  anaemia. 


chap,  xxviii.]  METALS.  758 


MANGANESE.     Mn  ;  55. 

Manganesii  Oxidum  Nigrum,  B.P. ;  Mangani  Oxidum 
Nigrum,  U.S.  P.  Black  Oxide  of  Manganese. — Native  crude 
peroxide  of  manganese  containing  at  least  66  of  the  pure  oxide. 
Mn02 ;  86,  U.S.P. 

Characters. — A  heavy  black  powder. 

Solubility  and  Eeactions. — Dissolves  almost  entirely  in  hydrochloric 
acid  with  evolution  of  chlorine,  and  gives  off  oxygen  when  heated  to  redness. 

Uses.  — Used  for  producing  chlorine,  and  for  making  oxygen. 
It  has  been  used  instead  of  bismuth  in  pyrosis  and  irritable 
conditions  of  the  stomach,  with  pain  after  eating ;  and  instead 
of  iron  in  debilitating  diseases,  anaemia,  syphilis,  scurvy,  and  in 
skin-diseases. 

U.S. P.  Mangani  Sulphas.  Sulphate  of  Manganese. — 
MnS04.4H20 ;  222. 

Characters. — Colourless  or  pale  rose-coloured,  transparent 
tight  rhombic  prisms,  odourless,  having  a  slightly  bitter  and 
astringent  taste,  and  a  faintly  acid  reaction. 

Solubility. — Soluble  in  water. 

Eeactions. — The  aqueous  solution  of  the  salt  yields,  with  sulphide  of 
ammonium,  a  flesh- coloured  precipitate  completely  soluble  in  moderately 
diluted  acetic  acid  (absence  of  zinc) ;  with  test-solution  of  ferro-cyanide  of 
potassium  it  affords  a  reddish-white  precipitate,  and  a  brown  one  with  test- 
solution  of  ferricyanide  of  potassium. 

Action  of  Manganese  Salts. — -When  injected  into  the  blood, 
or  subcutaneously,  manganese  salts  paralyse  voluntary  move- 
ment and  reflex  action,  and  stop  the  heart  in  diastole.  The 
paralysis  of  reflex  action  is  due  to  destruction  of  the  transverse 
conduction  of  the  spinal  cord  (p.  161),  longitudinal  conduction 
remaining  intact  until  death  (Robert) .  Proto-sulphate  produces 
purging  in  doses  of  1  to  2  drms.,  and,  in  consequence  of  Gmelin's 
experiments,  has  been  thought  to  increase  the  secretion  of  bile. 

Uses. — Has  been  used  in  place  of  iron  in  anaemia,  but  with- 
out good  results.  Possibly  it  may  be  serviceable  in  amenor- 
rhoea. 

Potassii  Permanganas,  B.P.  and  U.S. P.—  Vide  p.  614. 

Class  VIII. 

Group  II. — Gold,  Platinum. 

AURUM  ;  GOLD.     Au  ;  196-2. 

B.P.  Gold,  Fine.     Gold,  free  from  Metallic  Impurities. 
Gold  foil  is  used  for  stopping  teeth  and  to  make  the  test 
solution. 

8  c 


'7S4  INOEGANICT MATERIA  MEDICA.  [sect,  raw 

B.P.  Solution  of  Chloride  of  Gold. 

Preparation. — By  dissolving  gold  foil  in  a  mixture  of  nitric  and  hydro- 
chloric acids  and  diluting. 

U.S.P.  Auri  et  Sodii  Chloridum.  Chlokide  of  Gold  and 
Sodium. 

A  mixture  composed  of  equal  parts  of  dry  chloride  of  gold, 
AuCl3 ;  302-4 ;  and  chloride  of  sodium,  NaCl ;  58*4. 

Chaeactees. — An  orange-yellow  powder,  slightly  deliquescent 
in  damp  air,"  odourless,  having  a  saline  and  metallic  taste  and  a 
slightly  acid  reaction. 

Solubility. — The  compound  is  very  soluble  in  water ;  at  least  one  half 
of  it  should  be  soluble  in  cold  alcohol. 

Eeactions. — When  exposed  to  a  red  heat  it  is  decomposed  and  metallic 
gold  is  separated.  A  fragment  of  the  compound  imparts  an  intense  per- 
sistent colour  to  a  non-luminous  flame. 

Preparation. — By  dissolving  gold  in  nitro  -hydrochloric  acid  and  evaporat- 
ing to  dryness,  chloride  of  gold  is  obtained.  This  is  dissolved  in  water,  and 
mixed  with  its  own  weight  of  pure  decrepitated  common  salt  also  dissolved 
in  water.    The  mixed  solution  is  then  evaporated  to  dryness. 

Dose. — -^  to  £  grain  (-006--012  gm.),  once  or  twice  a  day. 

Action. — Salts  of  gold  cause  rapid  paralysis  of  the  central 
nervous  system  in  frogs,  which  appears  to  affect  first  the  optic 
lobes  and  cerebellum,  then  the  cord,  and  lastly  the  cerebral  lobes 
(ride  p.  183  et  seq.).  In  mammals  small  doses  appear  to  increase 
the  appetite ;  larger  ones  cause  symptoms  of  irritation  in  the 
stomach  and  intestines,  viz.  loss  of  appetite,  diarrhoea,  and 
emaciation,  followed  by  paralysis  of  the  limbs,  a  catarrhal  condi- 
tion of  the  respiratory  passages,  and  death  by  asphyxia.  Large 
doses  injected  into  the  veins  cause  oedema  of  the  lungs,  and 
rapid  death,  with  convulsions,  from  asphyxia.  In  man  they  are 
said  to  increase  the  secretions,  and  to  produce  salivation  like 
mercury,  but  without  stomatitis.  They  are  eliminated  in  the 
urine. 

Uses. — Salts  of  gold  have  been  supposed  to  act  lite  those  of 
mercury  and  silver.  They  have  been  given  like  mercurial  salts 
in  syphilis,  scrofula,  and  cancer ;  and,  like  silver  salts,  have 
been  used  in  myelitis.  Gold  has  been  supposed  to  act  specifically 
on  the  genital  organs,  and  has  been  used  in  chronic  uterine  in- 
flammation and  irritation,  and  inflammation  and  neuralgia  of 
the  ovaries. 

PLATINUM.     Pt;  197. 

B.P.  Platinum  Foil. 

A  heavy  whitish  metal  Sp.  gr.  8-921.  Withstands  considerable 
heat.  The  foil  is  convenient  for  holding  salts  of  organic  acids 
which  it  is  wished  to  char. 

B.P.  Solution  of  Perchloride  of  Platinum.    PtCl4;  339. 

Preparation.^^  dissolving  thin  platinum  foil  in  a  mixture  of  nitric 
acid  and  hydrochloric  acid  and  diluting. 


chap,  xxviii.]  METALS.  755 

Uses. — Used  to  distinguish  potassium  from  sodium  and  to 
precipitate  salts  of  ammonium,  and  of  compound  ammonias, 
e.g.  organic  alkaloids. 

Action.  —  Soluble  salts  of  platinum  are  as  poisonous  as 
arsenic.  In  frogs  they  appear  to  paralyse  the  centres  for  volun- 
tary motion  in  the  cerebral  lobes,  and  irritate  the  motor  centres 
between  them  and  the  cord,  so  that  voluntary  motion  is  dimi- 
nished, but  reflex  convulsions  occur.  The  excitability  of  voluntary 
muscle  is  much  lessened,  that  of  the  heart  is  not  apparently 
altered.  In  mammals  the  most  prominent  symptom  is  paralysis 
of  the  peripheral  ends  of  the  vaso-motor  nerves.  In  conse- 
quence of  this,  diarrhoea,  blood  in  the  motions,  hyperemia  of  the 
abdominal  viscera,  and  ecchymoses  of  the  mucous  membrane  of 
the  stomach  and  intestine  and  bladder  occur. 

B.P-  Platinum  Black. 

Preparation. — Platinum  in  a  state  of  minute  division,  obtained  by  adding 
excess  of  carbonate  of  sodium  and  some  sugar  to  solution  of  perchloride  of 
platinum,  and  boiling  until  a  black  precipitate  is  formed,  which  is  washed 
and  dried. 

Action. — Platinum-black  appears  to  have  a  greater  power 
than  even  charcoal  to  condense  gases,  and  especially  oxygen,  in 
its  pores.  By  giving  the  oxygen  off  again  it  acts  as  an  oxidising 
agent. 

Use. — To  test  amylic  alcohol  by  oxidising  it  into  valerianic 
acid. 


3  u2 


SECTION  IV. 

OEGANIC  MATERIA  MEDICA. 


This  Section  contains  Organic  Compounds  artificially  prepared, 
and  not  merely  extracted  from  Vegetable  Substances  containiiig 
them.  Although  it  is  small,  it  contains  some  of  the  most  important 
remedies  we  possess,  and  in  the  future  will  probably  replace  to  a 
great  extent,  and  perhaps  entirely,  the  Vegetable  Materia  Hedica. 


CHAPTER  XXIX. 
CAEBON  COMPOUNDS— FATTY  SERIES. 
Carbon  is  a  tetrad  element.    It  is  sometimes  represented  graphi- 
cally thus :  — C — .   It  combines  with  four  atoms  of  a  monad,  or 

'  '        <°> 

two  of  a  dyad  element,  e.g.  H — C — H  or   yG?  ,  or  it  combines 

I  \    > 

H  \(K        /\ 

with  one  atom  of  a  triad  and  one  of  a  monad^  H — C N.     It 

V 

also  unites  with  itself,  and  the  complex'  molecules  thus  formed 
combine  with  other  elements  or  radicals.  Thus  the  number  of 
its  compounds  is  almost  endless. 

These  compounds  are  divided  into  two  great  series,  according 
to  the  mode  in  which  the  atoms  are  linked. 

We  have  thus  in  Inorganic  Chemistry  two  great  series,  the 
metalloids  and  metals,  and  in  Organic  Chemistry  two  great  series, 
the  fatty  and  the  aromatic. 

Series  of  Carbon  Compounds. — In  the  first,  or  fatty  series, 
the  carbon  atoms  are  supposed  to  be  linked  so  as  to  form  an 
open  chain,  e.g. : 

III  If       /°~ 

_C-  C— C—  or  —  C— C— C—       &c. 

I     1     I  I     I      \ff= 

In  the  second,  or  aromatic  series,  the  carbon  atoms  are  sup- 
posed to  be  linked  so  as  to  form  a  closed  chain. 

i 

/s 

— c     c— 

II     I 

— C      c— 


760  OEGANIC  MATERIA  1IEDICA.  [sect,  iv, 

Some  of  the  simpler  compounds  of  carbon  have  already  been 
considered — carbonic  acid,  C02  (p.  583),  hydrocyanic  acid,  HCN 
(p.  585),  acetic  acid,  C2H402  (p.  577). 

General  Action. —  It  will  be  noticed  that  compounds  of 
carbon  with  hydrogen  alone,  as  in  the  hydrocarbons  of  the 
marsh-gas  series ;  with  oxygen  alone,  as  in  carbonic  acid,  C02 ; 
with  sulphur  alone,  as  in  bisulphide  of  carbon,  CS2;  or  with 
chlorine  alone,  as  in -tetrachloride  of  carbon,  CC14,  all  tend  to 
paralyse  the  nervous  system,  and  to  destroy  the  functional 
activity  of  its  various  parts  in  a  definite  order.  Thought  fails 
first,  next  sensation,  and  next  reflex  action  (p.  206). 

The  -compounds  with  hydrogen  have  a  comparatively  slight 
action  on  muscle,  but  those  containing  chlorine  are  more 
powerful  muscular  poisons,  and  destroy  the  contractility  of  mus- 
cular fibre,  both  voluntary  and  involuntary. 

Many  compounds  containing  oxygen  in  addition  to  carbon 
and  hydrogen  have  an  anaesthetic  action,  e.g.  alcohol  and  ether; 
others,  like  acetic  acid,  have  a  strongly  irritant  action.  Com- 
pounds of  carbon  with  nitrogen,  hydrogen,  and  oxygen  may  have 
a  very  complicated  chemical  -constitution,  and,  as  in  the  organic 
alkaloids,  have  physiological  actions  which  are  too  varied  and 
specialised  to  allow  of  their  being  classed  at  present  under  a 
general  law. 

U.S.P.  Carbonei  Bisulphidum. — Bisulphide  of  Carbon. 
CS2 ;  76. — Bisulphide  of  carbon  should  be  kept  in  well-stopped 
bottles,  in  a  cool  place,  remote  from  lights  or  fire. 

Chabacters. — A  clear,  colourless,  highly  refractive  liquid, 
very  diffusive,  having  a  strong,  characteristic  odour,  a  sharp, 
aromatic  taste,  and  a  neutral  reaction'. 

Solubility. — It  is  insoluble  in,  water ;  soluble  in  alcohol,  ether,  chloro- 
form, and  fixed  or  volatile  oils. 

Beactions—  Specific  gravity  1-272.  It  vaporises  abundantly  at  ordinary 
temperatures,  is  highly  inflammable,  boils  at  46°  C.  (114-8°  F.),  and,  when 
ignited,  burns  with  a  blue  flame,  producing  carbonic  and  sulphurous  acids. 

It  should  not  affect  the  colour  of  blue  litmus-paper  moistened  with  water 
(absence  of  sulphurous-acid).  A  portion,  evaporated'  spontaneously  in  a  glass 
vessel  should  leave  no  residue  (sulphur).  Test-solution  of  acetate  of  lead 
agitated  with  it  should  not  be  blackened  (absentee  of  hydrosulphuric  acid). 

Action. — When  inhaled  it. is  a  rapid,  powerful,  but  transient 
anaesthetic. 

Uses. — It  can  be  used  to  produce  local  anaesthesia  by  atomis 
sation.  It  has  been  employed  as  a  local  irritant  in  enlarged 
lymphatic  glands,  neuralgia,  and  deafness  accompanied  by  in- 
sufficiency of  wax ;  and  has  been  given  as  an  internal  antiseptic 
in  enteric  fever,  in  the  form  of  a  mixture  with  water  and  pepper- 
mint oil.1 


1  Dujardin-Beaumetz,  Bull.  Gin.  de  Thirap.,  Aout,  1885,  p.  97. 


chap,  xxrx.]    CABBON  COMPOUNDS— FATTY  SEBIES.       7^1 


FATTY  SEEIES. 
HYDROCARBONS. 

The  chemical  nature  of  a  carbon  compound  depends  on  the 
arrangement  of  its  constituent  atoms,  but  in  its  .physical  cha- 
racters on  the  number  of  the  atoms. 

The  physical  character  of  a  compound  greatly  influences  its 
physiological  action,  a  gaseous  body  being  mope  easily  absorbed 
and  excreted  than  a  liquid,  and  a  liquid  more  easily  than  a  solid. 
There  will' also  be  differences  amongst  the  gaseous,  liquid,  and 
solid  bodies  themselves,  for  if  a  liquid,  for  example,  has  a  low 
boiling-point  so  as  to  volatilise  readily  at  ordinary  temperatures, 
it  will  more  resemble  a  gas  in  its  action,  while  a  liquid  which  has 
a  high  boiling-point  will  act  more  like  a  solid. 

Thus  in  the  group  of  hydrocarbons  belonging  to  the  paraffin 
series  the  lowest  members  are  gaseous  at  ordinary  temperatures, 
the  highest  members  form  solid  wax-like  bodies,  while  those 
which  are  intermediate  are  liquid.  Obviously  we  cannot  expect 
a  gas  which  can  be  inhaled  in-  large  quantities,  and  which  will 
be  quickly  excreted  when  pure  air  is  inhaled  instead,  to  have 
the  same  action  as  a  solid  wax-like  substance  which  can  only  be 
slowly  absorbed,  and  slowly  excreted  or  broken  up  in  the 
organism. 

The  boiling-point  of  substances  belonging  to  a  series  differs 
somewhat  according  to  the  chemical  nature  of  the  substance,  but 
amongst  the  members  of  the  series  having  the  same  chemical 
nature  it  rises  with  the  number  of  atoms.  It  will  be  seen  from 
the  accompanying  table  that  the  boiling-point  differs  according 
to  the  series,  e.g.  that  of  chlorides  is  lower  than  that  of  bromides; 
this,  again,  is  lower  than  that  of  iodides.  In  each  series  also 
of  chlorides,  bromides,  or  iodides,  the  boiling-point  rises  with 
the  number  of  carbon  atoms  which  the  member  of  the  series 
contains. 

As  the  action  of  substances  depends  so  much  on  their  volar 
tility,  it  may  be  convenient  to  give  here  the  boiling-points  of  the 
various  members  of  the  paraffin  series  (p.  762) . 

Physiological  Action  of  Hydrocarbons  belonging  to  the 
Marsh-Gas  Sbbies. — These  hydrocarbons  may  be  regarded  as 
hydrides  of  the  radicals,  methyl,  &c.  Those  low  in  the  series — 
methane,  ethane,  propane,  and  butane — are  permanent  gases  at 
ordinary  temperatures,  and  when  inhaled  pure  produce  anaes- 
thesia much  like 'that  of  nitrous  oxide.  The  intermediate  fluid 
members  of  the  series,  e.g.  pentane,  and  substances  containing 
them,  as'benzin,  petroleum  oil,  &c,  give  off  vapour  having  an 
anaesthetic  action  somewhat  like  that  of  chloroform. 


762 


OKGANIC  MATERIA  MEDICA. 


[SECT.  IV. 


BahicaIi 

CO 

S    I 

«fW 

■Sri 

--W 
oO 

<D      « 

aw. 

**° 

m0= 

5° 

H 

Methyl,  CH3   . 

40° 

Gas. 

66-0° 

Gas. 

Ethyl,  Oft     . 

12-50 

39" 

72° 

Gas. 

78-4° 

2U-8' 

35° 

Propyl,  C3H7   . 

46-4° 

71° 

102° 

Gas. 

97.40 

48-8° 

85° 

Butyl,  C4H9     . 

77-6° 

100-4' 

129-6° 

1° 

116-9° 

58° 

140° 

Amyl,  CSH„    . 

105-6° 

128-7° 

153-4° 

38° 

138° 

92-5° 

163° 

Hexyl,  CaH!3  .        . 

... 

... 

179-4° 

70° 

158° 

127-9° 

205° 

Heptyl,  C,HU . 

... 

... 

... 

99° 

176° 

150° 

Octyl,CsH17    . 

108° 

199° 

221° 

124° 

192° 

... 

281° 

Dodeoyl,  C12H25 

,.* 

... 

... 

202° 

■  *• 

... 

... 

Hexdecyl,  or  Cetyl,  "1 
C16H33 .        .        / 

•■• 

278° 

300° 

Melting- 

point 

55° 

The  higher  members  of  the  series  are  solid  at  ordinary  tem- 
peratures, and  are  used  as  a  basis  for  ointments  under  the  names 
of  petrolatum,  vaseline,  cosmoline,  &c. 

U.S.P.  Benzinum.  Benzin.  Peteoleum  Benzin.  Petro- 
leum Ether. — A  purified  distillate  from  American  petroleum, 
consisting  of  hydrocarbons,  chiefly  of  the  marsh-gas  series 
[C5H12 ;  CaH14,  and  homologous  compounds],  having  a  specific 
gravity  from  0-670  to  0-675,  and  boiling  at  50°  to  69°  C.  (122°  to 
140°  P.). 

Benzin  should  be  carefully  kept  in  well- stoppered  bottles  or 
cans,  in  a  cool  place,  remote  from  lights  or  fire. 

Characters. — A  transparent,  colourless,  diffusive  liquid,  of  a 
strong,  characteristic  odour,  slightly  resembling  that  of  petro- 
leum, but  much  less  disagreeable;  neutral  in  reaction.  It  is 
highly  inflammable,  and  its  vapour,  when  mixed  with  air  and 
ignited,  explodes  violently. 

Solubility. — It  is  insoluble  in  water,  soluble  in  about  6  parts  of  alcohol, 
and  readily  so  in  ether,  chloroform,  benzene,  and  fixed  and  volatile  oils. 

Bbactions. — Benzin,  when  evaporated  upon  the  hand,  should  leave  no 
odour,  and  when  evaporated  in  a  warmed  dish  should  leave  no  residue  (absence 
pf  heavy  hydrocarbons).  When  boiled  a  few  minutes  with  one-fourth  its 
volume  of  spirit  of  ammonia  and  a  few  drops  of  test-solution  of  nitrate  of 
Bilver,  the  ammoniacal  liquid  should  not  turn  brown  (absence  of  pyrogenous 
products,  and  sulphur  compounds) ;  and  it  should  require  6  parts  of  officinal 
alcohol  to  dissolve  it  (difference  from  benzene).  If  five  drops  are  added  to  a 
mixture  of  40  drops  of  sulphuric  acid  with  10  drops  of  nitric  acid,  in  a  test- 
tube,  the  liquid  warmed  and  set  aside  for  half  an  hour,  and  then  diluted,  in  a 
shallow  dish,  with  twice  its  volume  of  water,  it  should  not  have  the  bitter- 
almond-like  odour  of  nitre-benzene  (absence  of  benzene). 

Dose. — As  a  vermifuge,  30  minims. 

Uses. — It  is  a  good  solvent  for  fats,  resins,  caoutchouc,  and 
some  of  the  alkaloids.    It  has  been  used  externally  as  a  sedative 


chap,  xxix.]    CAKBON  COMPOUNDS— FATTY  SEEIES.       7C3 

in  prurigo  and  other  cutaneous  diseases,  and  to  relieve  the  itch- 
ing in  urticaria,  and  internally  as  a  vermifuge  for  tape-worm. 

U.S.P.  Petrolatum.  Petrolatum.  [Petroleum  Ointment, 
Vaseline.] — A  semi-solid  substance,  consisting  of  hydrocarbons, 
chiefly  of  the  marsh-gas  series,  C16HM,  &c,  obtained  by  distilling 
off  the  lighter  and  more  volatile  portions  from  American  petro- 
leum, and  purifying  the  residue.  Melting-point  about  40°  C.  to 
51°  C.  (104°  F.  to  125°  F.),  the  first  constituting  the  softer,  and 
the  second  the  firmer  variety. 

When  petrolatum  is  prescribed  or  ordered,  without  specifying 
its  melting-point,  the  low-melting  variety,  which  liquefies  at 
about  40°  C.  (104°  F.),  is  to  be  dispensed. 

Characters. — A  yellowish  or  yellow,  fat-like  mass,  trans- 
parent in  thin  layers,  more  or  less  fluorescent,  especially  when 
melted,  completely  amorphous,  tasteless  and  odourless,  or  giving 
off,  at  most,  only  a  faint  petroleum  odour  when  heated,  and 
having  a  neutral  reaction.  When  gently  heated,  until  the  mass 
is  almost  entirely  melted,  the  liquid  portion  has  a  specific 
gravity  varying  from  0*835  to  0-860. 

Solubility. — It  is  insoluble  in  water,  scarcely  soluble  in  alcohol,  or  in 
cold  absolute  alcohol,  but  soluble  in  64  parts  of  boiling  absolute  alcohol,  and 
readily  soluble  in  ether,  chloroform,  bisulphide  of  carbon,  oil  of  turpentine, 
benzin,  benzene,  and  in  fixed  or  volatile  oils. 

Reactions. — When  heated  on  platinum  foil,  it  is  completely  volatilised 
without  emitting  the  acrid  vapours  of  burning  fat  or  resin.  If  5  gm.  of 
petroleum  ointment  be  digested,  for  half  an  hour,  with  5  gm.  of  soda  and  25 
gm.  of  water,  the  aqueous  layer  separated,  and  supersaturated  with  dilute 
sulphuric  acid,  no  oily  substance  should  separate  (absence  of  fixed  oils  or  fats 
of  vegetable  or  animal  origin,  or  of  resin).  Liquefied  petroleum  ointment 
agitated  with  sulphuric  acid  of  specific  gravity  1-540  should  not  acquire  a  dark 
colour  within  two  hours  (absence  of  readily  carbonised  organic  impurities). 

B.P.  Paraffinum  Durum.  Hard  Paraffin.  Synonyms: 
Paraffin  ;  Paraffin  Wax  ;  Solid  Paraffin. 

A  mixture  of  several  of  the  harder  members  of  the  paraffin 
series  of  hydrocarbons;  usually  obtained  by  distillation  from 
shale,  separation  of  the  liquid  oils  by  refrigeration,  and  purifica- 
tion of  the  solid  product. 

Characters.— Colourless,  semi-transparent,  crystalline,  in- 
odorous and  tasteless,  slightly  greasy  to  the  touch.  Specific 
gravity,  0-82  to  0-94. 

Solubility. — Insoluble  in  water,  slightly  soluble  in  absolute  alcohol, 
freely  soluble  in  ether. 

Reactions.— It  melts  at  110°  to  145°  F.  (43-3°  to  62-8°  C),  and  burns 
with  a  bright  flame,  leaving  no  residue. 


Pbepaeations. 


TJnguentum  Acidi  Borici. 
„  „    Carbolic!. 

■i  „     Salicylici. 

„  Eucalypti. 

„  Glyeerim  Flumbi  Subace- 

tatis. 


TJnguentum  Hydrargyri  Oxidi  Itubri. 
„  Potassce  Sulphuratse. 

„  Sulphuris  Iodidi. 

„  Yeratrins. 


764  OEGANIC  MATEEIA  MEDIOA.  [sect,  ivj 

B.P.  Paraffinum  Molle.  Soft  Paraffin.  Synonyms :  Petro- 
latum ;  Petroleine  ;  Unguentum  Paraffinum. 

A  semi-solid  mixture  containing  some  of  the  softer  or  more 
fluid  members  of  the  paraffin  series  of  hydrocarbons ;  usually 
obtained  by  purifying  the  less  volatile  portions  of  petroleum.  It 
is  known  in  commerce  by  various  fanciful  names. 

Characters. — White  or  yellowish,  translucent,  soft,  greasy  ; 
free  from  acidity,  alkalinity,  or  any  unpleasant  odour  or  flavour, 
even  when  warmed  to  120°  F.  (48-9°  C).  Specific  gravity  at  the 
melting-point,  from  about  0-840  to  0-870.  Melts  at  95°  to  1056 
F.  (35°  to  40°-5  C),  or  even  somewhat  higher,  volatilises  without 
giving  acrid  vapours,  and  burns  with  a  bright  flame,  leaving  no 
residue. 

Solubility. — Insoluble  in  water,  slightly  soluble  in  absolute  alcohol, 
freely  soluble  in  ether,  chloroform,  benzene,  &c. 

Eeactions. — It  is  not  saponified  by  solutions  of  alkalis. 

Pkepaeations. 

Unguentum  Hydrargyri  Oxidi  Eubri. 
„  „       Nitratis  Dilutum. 

Potassse  Sulphuratse. 


Unguentum  Aoidi  Borici. 
„  „     Carbolioi. 

„  „     Salicylicl. 

„  Eucalypti. 

„  Glyeerini  Plumbi  Subaoe 

tatis. 


Sulphuris  Iodidi. 
Veratrinse. 
Zinci  Oleati. 


Uses. — These  hydrocarbons,  which  are  not  liable  to  become 
rancid,  have  been  found  very  useful  as  a  bland  protection,  and  as 
a  substitute  for  animal  and  vegetable  fats  in  the  preparation  of 
ointments. 

ALCOHOLS. 

Alcohols  of  the  Sekies  G2H2n+1OH. — These  may  be  re- 
garded as  hydrates  of  the  radicals.  They  differ  from  the  hydrides 
by  the  radical  being  united  in  them  to  hydroxyl,  HO,,  instead  of 
to  hydrogen.     The  most  important  of  them  are : — ■ 

Methyl  alcohol,  CH40.    Wood  spirit. 

Ethyl  alcohol,  C2H60.     Spirit  of  wine. 

Propyl  alcohol.     C3H80. 

Amyl  alcohol,  C6H120.    Fusel  oil  or  potato  spirit. 

General  Action. — These  alcohols  have  all  a  toxic  action 
when  given  in  sufficiently  large  doses.  The  general  effect  they 
produce  on  the  organism  appears  to  be  much  the  same  in  all, 
■viz.  paralysis  affecting  the  nerve-centres  in  the  inverse  order 
of  their  development.  Their  lethal  power  and  the  symptoms 
they  produce  are  modified  by. their  physical  characters,  such 
as  tbeir  solubility  in  water,  and  their  volatility ;  for  if  they  are 
not  readily  soluble  in  water  they  cannot  be  readily,  absorbed, 
and  probably  will  not  be  readily  excreted.,-  Their  toxic  power 
increases  with  their  atomic  weight,  so  that  a  less  quantity  of-  the 
higher  alcohols  will  produce  death.  This  is  shown  in  the'fol- 
lowing  table  by  Dujardin-Beaupetz.    It  will  be  noticed,  how- 


chap,  xxix.]     CARBON  COMPOUNDS— FATTY  SERIES.        765, 


ever,  that  the  lowest  term  and  also  the  higher  terms  of  the  series 
form  exceptions.  This  may  possibly  be  due  to  rapid  absorption 
as  compared  with  excretion  (p.  39)  in  the  case  of  methylic  alco- 
hol, and  to  slow  absorption  in  the  case  of  oenanthic  and  caprylic 
alcohols : — ■ 


Kind  of  Alcohol 


Mean  toxic  dose  in  grammes 

per  kilogramme  weight  of  the 

animal 


Non-fermented 


Fermented       . 


Non-fermented 


Methylic  Alcohol,  CH40 


Ethylic 

Propylic 

(Isopropylic) 

Butylic 

Amylic 

(Enanthic 
Caprylic 


C,H,0 

0,H„0 
(C,HsO) 

0A.0 ' 

C5H120 

C,HlfiO 
CBHlaO 


8-0 
3-9 

20 
1-7 

8-0 

7-  to  7-5 


Diluted 
7-0 

7-75 
3*75 
(3-7  to  3-8) 
1-85 
1-50 


All  the  alcohols  produce  symptoms  which  are  divided  by 
Dujardin-Beaumetz  into  three  stages,  the  first  of  which  corre- 
sponds to  the  firsl  and  second  stages  of  action  I  have  given  at 
p.  206,  and  his  second  and  third  corresponding  to  the  third  and 
fourth  of  mine,  respectively.  These  stages  are  modified  by  (a) 
the  kind  of  alcohol  used,  (b)  its  quantity,  and  (c)  the  resistance 
of  the  subjects. 

Ethylic  alcohol  has  the  most  typical  action,  and  in  poisoning 
by  it  all  the  stages  succeed  one  another  in  regular  order.  In  the 
case  of  the  other  alcohols  obtained  by  fermentation  the  stages 
are  also  regular,  but  the  farther  the  alcohol  is  from  ethylic,  the 
less  regular  do  the  stages  become.  They  succeed  one  another 
more  rapidly,  their  character  is  less  marked,  and  convulsive 
phenomena  appear. 

In  the  case  of  methylic  alcohol,  the  excitement  is  greater,  the 
subsequent  stages  succeed  one  another  more  quickly,  and  reach 
their  acme  sooner  ;  but  if  the  dose  be  insufficient  to  cause  death, 
the  effects  pass  off  more  quickly. 

In  the  case  of  cenanthic  and  caprylic  alcohol,  the  stages  do 
not  present  the  same  regularity,  and  convulsions  occur. 

All  the  alcohols  now  mentioned  lower  the  temperature. 

On  post-mortem  examination  after  acute  poisoning  by  alco- 
hols, the  blood,  stomach,  intestines,  liver,  lungs,  and  kidneys  are 
found  to  be  affected.  It  is  possible,  however,  that  some  of  these 
lesions  are  not  to  be  regarded  as  specific  consequences  of  the 
action  of  alcohol,  but  rather  as  due  to  the  death  by  asphyxia 
which  ensues  from  the  respiratory  paralysis.  The  blood  is  of  a 
dark  colour,  and  forms  clots  in  the  heart.  When  the  alcohol  is 
given  by  the  mouth,  the  stomach  and  intestine  are  much 
congested   and    softened,    the  congestion  being  greater  when 


7G6  OEGANIC  MATEEIA  MEDICA.  [sect.  iv. 

the  alcohol  is  undiluted.  When  the  alcohol  is  injected  sub- 
cutaneously,  the  stomach  is  little  altered,  but  the  intestine 
is  congested,  the  congestion  being  probably  due,  according  to 
Dujardin-Beaumetz,  to  elimination  of  the  alcohol  by  the  intes- 
tinal mucous  membrane.  The  liver  is  the  gland  most  affected. 
It  is  congested,  soft,  and  friable.  The  spleen  is  also  gorged 
with  blood,  and  soft.  The  lungs  are  congested  with  small 
extravasations,  which  are  most  abundant  when  the  alcohol  has 
been  given  by  the  mouth.  Haemorrhages  are  observed  in  the 
kidneys,  especially  in  the  case  of  the  non-fermented  alcohols. 

Methyl  Alcohol.  CH3OH ;  Wood  Spibit.  Synonyms :  Cab- 
binol,  Hydboxymethane,  Methol.     Not  officinal. 

Chaeactees. — A  colourless,  mobile  liquid.  When  pure  it  has 
a  taste  and  smell  somewhat  like  ethyl  alcohol ;  but  ordinary 
wood  spirit  contains  many  impurities  which  give  it  a  disagreeable 
odour  and  burning  taste! 

Preparations. — By  destructive  distillation  of  wood,  and  neutralisation 
and  repeated  distillation  of  the  product. 

Uses. — The  admixture  of  wood  spirit  with  alcohol  renders 
the  latter  so  disagreeable  as  to  unfit  it  for  drinking,  so  that  it 
can  be  sold  under  the  name  of  methylated  spirit  as  a  solvent 
and  for  other  uses  in  the  arts,  without  interfering  with  the  duties 
on  potable  alcoholic  drinks. 

Alcohol  Ethylicum,  B.P.  C2H5.OH.  Ethyl  Alcohol. 
Absolute  Alcohol. 

Chaeactees. — Colourless  and  free  from  empyreumatic  odour. 
Sp.  gr.  0-797  to  0-800.   Containing  1  to  2  per  cent,  of  water,  B.P. 

General  Source  and  Preparation. — Alcohol  is  prepared  from  solutions 
of  maltose  by  adding  to  them  a  ferment,  which  causes  the  sugar  to  split  up 
into  alcohol  and  carbonic  acid. 

The  solutions  of  maltose  which  yield  alcohol  are  generally  prepared  from 
malt.  This  is  made  by  steeping  barley  for  a  while  in  water  till  it  begins  to  ger- 
minate. The  barley  when  fresh  contains  starch  and  a  ferment  termed  diastase, 
which  converts  the  starch  into  maltose  during  the  process  of  germination. 

When  this  has  gone  far  enough,  as  is  ascertained  by  the  radicle  attaining 
a  certain  length,  the  process  is  stopped  by  roasting  the  malt,  as  the  sugar 
would  all  be  used  up  again  by  the  plant  if  it  were  allowed  to  continue  its 
growth.  The  malt  is  then  infused  in  warm  water,  and  the  solution  of  maltose 
which  it  yields  is  fermented  by  yeast,  a  small  fungus  which  causes  the  sugar 
to  split  up  and  yield  alcohol.  The  alcohol  thus  obtained  is  very  much 
diluted  with  water,  and  in  order  to  separate  them  the  liquor  is  distilled,  when 
the  alcohol  passes  over  first,  and  the  greater  part  of  the  water  is  left  behind. 

Reactions. — Entirely  volatilised  by  heat.  Not  rendered  turbid  by  mixing 
with  water,  and  does  not  cause  anhydrous  sulphate  of  copper  to  become 
decidedly  blue  on  shaking. 

General  Impurities. — Water,  fusel  oil,  and  aldehyde.  The  water  may 
have  come  to  be  present  either  as  an  accidental  impurity  or  as  an  intentional 
adulteration.  One  of  the  most  important  impurities  of  alcohol  is  the  presence 
of  organic  alkaloids.  A  good  deal  of  spirit  is  made  from  spoiled  grain, 
maize,  &c,  which  cannot  be  used  for  food.  In  diseased  grain  alkaloids  are 
formed,  and  these  appear  to  pass  over  with  the  alcohol  during  distillation. 


chap,  xxix.]    CAEBON  COMPOUNDS— PATTY  SEEIES.       767 

Tests.— Water  is  detected  by  the  use  of  the  hydrometer,  as  any  admixture 
of  water  with  alcohol  raises  the  specific  gravity  of  the  latter. 

The  presence  of  oily,  fatty,  or  resinous  substances  in  alcohol  is  recognised 
by  diluting  it  with  water,  when  these  substances,  being  insoluble  in  weak 
spirit,  are  precipitated  and  render  the  solution  turbid. 

;  Traces  of  fusel  oil  and  aldehyde  are  almost  always  present,  and  they  are 
reckoned  as  impurities  by  the  B.P.  only  when  they  rise  above  a  certain 
amount.  The  quantity  of  them  present  in  alcohol  is  determined  by  adding 
to  4  oz.  of  it  30  grain-measures  of  standard  solution  of  nitrate  of  silver  and 
exposing  it  to  the  sunlight  for  twenty-four  hours.  The  nitrate  of  silver  m 
deoxidised  by  these  substances  and  a  black  precipitate  consisting  ot  oxide 
or  of  some  organic  compound  is  deposited. 

Genebal  Action  of  Alcohol. — When  alcohol  is  added  in 
sufficient  quantity  to  albuminous  solutions  it  precipitates  them,- 
apparently  simply  by  withdrawing  the  water  from  them,  because 
when  water  is  added  to  the  freshly-precipitated  albumin  it  redis- 
solves  easily.  When,  however,  the  precipitate  is  kept  for  some 
time  in  alcohol  it  loses  its  solubility,  and  is  no  longer  redissolved 
by  water.  Peptones  are,  however,  uncoagulated  by  long  standing 
under  alcohol.  When  applied  to  the  skin,  alcohol  evaporates 
readily,  and  gives  rise  to  a  sensation  of  cold.  It  renders  the  epider- 
mis drier  and  harder,  and  if  kept  in  contact  with  the  skin,  evapora- 
tion being  prevented,  it  passes  through  the  epidermis,  and,  acting 
upon  the  tissue  below,  stimulates  it,  causing  an  increased  supply 
of  blood  to  the  part,  and  producing  a  feeling  of  warmth  or  burn- 
ing. A  similar  action  takes  place  when  it  is  applied  to  a  mucous 
membrane,  e.g.  when  taken  into  the  mouth.  It  here  produces 
a  slight  precipitate  of  albumin  on  the  surface  and  acts  as  an 
astringent,  drawing  the  parts  slightly  together,  and  forming  on 
the  surface  a  whitish  pellicle,  which,  however,  rapidly  disappears. 
It  causes  considerable  reflex  secretion  of  saliva.  When  taken 
into  the  stomach  in  small  quantities,  it  has  a  similar  action  on 
that  organ,  causing  increased-vascularity  and  increased  secretion, 
accompanied  by  a  feeling  of  warmth,  and  it  excites  a  feeling  of 
appetite,  for  which  purpose  it  is  taken  by  some  persons  before 
meals.  It  aids  the  expulsion  of  flatulence  from  the  stomach  and 
intestines.  In  cases  of  diarrhoea  it  has  a  somewhat  astringent 
action  in  the  intestine,  but  in  persons  accustomed  to  take 
alcohol  to  excess  the  bowels  are  always  rather  loose,  constipation 
occurring  very  rarely,  if  at  all. 

After  absorption  into  the  blood,  it  appears  to  form  a  com- 
pound with  haemoglobin,  which  takes  up  and  gives  off  oxygen 
less  readily  than  haemoglobin  itself  (Schmiedeberg).  It  thus 
lessens  the  oxidising  power  of  the  blood,  and  will,  consequently, 
diminish  oxidation  in  the  tissues. 

Considerable  dispute  has  arisen  as  to  whether  alcohol  is  a 
food  or  not.  The  chief  argument  in  favour  of  its  not  being  a 
food  is  that  it  is  eliminated  in  the  urine  unchanged,  but  this 
seems  to  occur  only  when  it  is  given  in  considerable  quantities. 
In  small  doses  it  is  partly  eliminated  by  the  breath,  but  most  of 


7G8  OEGANIC  MATEEXA  MEDICA.  [sect.  iv. 

it  appears  to  undergo  combustion  in  the  body,  and  very  little  of 
it  passes  out  in  the  urine.  In  this  respect  it  agrees  with  other 
foods,  such  as  cane-sugar.  Hammond  found  that  when  on 
insufficient  diet  he  was  losing  weight,  the  addition  of  a  little 
filfohol  not  only  enabled  him  to  reach  his  former  weight,  but  to 
add  to  it. 

The  argument  in  favour  of  alcohol  being  a  food  is  that  it  is 
retained  in  the  body,  and  supplies  the  place  of  other  foods,  so 
that  the  quantity  of  food  which  would  without  it  be  insufficient, 
with  its  aid  becomes  sufficient. 

The  conclusion  to  which  all  the  evidence  points  is  that 
alcohol  is  a  food,  and  in  certain  circumstances,  such  as  febrile 
conditions,  it  may  be  a  very  useful  food ;  but  in  health,  when 
other  kinds  of  food  are  abundant,  it  is  unnecessary,  and,  as  it 
interferes  with  oxidation,  it  is  an  inconvenient  kind  of  food. 

After  its  absorption  into  the  circulation  it  causes  dilatation 
of  the  vessels  on  the  surface  of  the  body,  and  increases  the 
rapidity  of  the  pulse.  From  the  freer  circulation  which  thus 
takes  place  in  the  capillaries  of  the  surface,  the  skin  of  the  face 
and  hands  becomes  more  flushed.  The  blood  flows  so  freely 
from  the  arteries  into  the  veins  that  there  is  no  longer  time  for 
it  to  become  completely  venous  in  its  passage.  In  consequence 
of  the  capillaries  being  dilated,  the  skin  is  no  longer  mottled, 
but  of  a  uniformly  pink  colour.  The  veins  are  distended ;  they 
fill  more  rapidly  when  emptied,  and  are  of  a  lighter  blue  than 
usual,  owing  to  the  blood  they  contain  being  more  arterial. 

The  action  of  alcohol  upon  the  temperature  seems  to  depend 
upon  two  factors.  One  of  these  is  its  power  of  lessening  oxidation, 
but  this  only  comes  into  consideration  with  large  doses,  when 
this  factor  may  aid  considerably  in  reducing  the  temperature. 
The  other  factor  is  the  dilatation  of  the  vessels  on  the  surface 
(p.  419),  which  occurs  even  after  moderate  doses.  This  dilatation 
allows  the  warm  blood  from  the  interior  of  the  body  to  circulate 
more  readily  near  the  surface,  and  thus  subjects  it  to  the  cooling 
influence  of  the  surrounding  air,  and  also  to  the  cooling  effect  of 
evaporation  from  the  skin.  By  increasing  the  sweat  it  may 
lessen  the  temperature  of  the  body,  even  when  that  of  the  sur- 
rounding air  is  as  high  or  higher  than  it,  and  it  will  also  cool 
the  blood  by  freer  radiation  when  the  temperature  of  the  atmo- 
sphere is  below  that  of  the  body.  It  is  evident  that  the  cooling 
effects  of  alcohol  will  thus  depend  to  a  great  extent  on  the 
atmospheric  conditions  of  temperature  and  moisture  to  which 
the  person  taking  it  is  subjected,  as  well  as  on  the  quantity  of 
alcohol.  Normally,  when  a  person  is  subjected  to  cold,  the 
vessels  of  the  skin  contract  and  prevent  the  warm  blood  in  the 
interior  of  the  body  from  approaching  the  surface  and  thus  be- 
coming cooled ;  but  when  large  quantities  of  alcohol  are  taken, 
this  mechanism  becomes  paralysed,  the  blood  from  the  interior. 


chap,  xxrx.]     CAEBON  COMPOUNDS— FATTY  ■  SERIES.        769 

circulates  over  the  surface,  and  is  cooled  down  more  and  more 
until  its  temperature  becomes  so  much  reduced  as  to  be  incom- 
patible with  life,  and  the  patient  is  frozen  to  death.  The  dangerous 
effects  of  alcohol  under  such  circumstances  are  well  known  to  the 
lumberers  in  Canada,  and  to  Arctic  voyagers,  who  dread  alcohol, 
and  generally  avoid  it  altogether.  The  utility  of  this  selfsame 
action  of  alcohol  is  very  evident  when  a  person  comes  from  the 
cold  atmosphere  into  a  warm  room ;  for  here  the  individual  may 
still  remain  cold,  although  in  front  of  a  fire,  as  the  contraction 
of  the  surface  vessels  now  continues,  and  the  blood  is  no  longer 
able  to  convey  warmth  to  the  interior,  just  as  it  was  formerly 
unable  to  convey  the  cold.  If  alcohol  be  now  taken,  and  the 
vessels  dilated,  the  blood  is  allowed  to  circulate  in  the  surface, 
soon  becomes  warm,  and  thus  diffuses  the  warmth  equally 
-through  the  body. 

In  considering  the  action  of  alcohol  upon  the  nervous  sys- 
tem, one  must  distinguish  between  the  effect  it  produces  upon 
the  various  nerve-centres  by  increasing  the  circulation  through 
them,  and  the  effect  of  the  alcohol  on  the  nervous  structures 
themselves.  By  increasing  the  circulation  it  may  stimulate  the 
functions  of  all  the  nerve-centres,  and  render  them,  for  the  time 
being,  capable  of  greater  activity.  It  may  thus  enable  its  con- 
sumer to  think  more  clearly,  to  express  himself  more  fluently,  or 
to  perform  feats  of  greater  bodily  activity  than  usual,  but  its 
action  on  the  nerve-centres  themselves  is  a  paralysing  one. 

The  mode  of  action  of  alcohol  on  the  circulation  has  not  been 
well  ascertained ;  but  it  seems  probable  that  in  considering  it  we 
must  take  into  account  both  its  direct  action  upon  the  circula- 
tory apparatus  itself  and  its  reflex  action  upon  that  through 
other  organs.  Thus  it  is  not  improbable  that  even  from  the 
mouth  it  exercises  an  influence  over  the  cranial  circulation 
(p.  193).  Although  we  have  no  experiments  on  the  effect  of 
irritation  of  the  branches  of  the  fifth  nerve  on  the  cranial  cir- 
culation, yet  individuals  of  all  nations,  when  desiring  to  think, 
more  accurately,  are  accustomed  to  irritate  some  branch  of  this 
nerve,  either  by  scratching  the  head,  rubbing  the  forehead  or 
chin,  striking  the  nose  or  taking  snuff.  Chewing  sweet  or  pun- 
gent substances  has  a  similar  effect  in  enabling  some  persons  to 
think  more  clearly,  while,  under  similar  circumstances,  alcohol 
is  sipped  by  others.  From  the  stomach  it  probably  stimulates 
the  heart  and  vascular  system  reflexly,  and  thus  increases  both 
the  cranial  and  the  general  circulation.  When  given  in  very 
large  doses,  as  when  a  bottle  of  whiskey  has  been  drunk  at  a 
draught,  the  reflex  action  on  the  heart  has  been  so  great  that 
death  has  occurred  immediately  from  shock. 

Its  action  upon  the  nervous  tissues  themselves  seems  to  be 
one  of  progressive  paralysis,  affecting  them  in  the  inverse  order 
of  then-  development,  the  highest  centres  being  affected  first, 

3   D 


770  OKGANIC  MATEEIA  MEDICA.  [sect.  iv. 

and  the  lowest  last.  Thus  the  power  of  judgment  usually  goes 
first,  while  the  imagination  may  be  lively,  and  the  emotions 
even  more  than  usually  active,  so  that,  after  a  man  becomes 
incapable  of  discussion,  he  is  combative,  affectionate,  or  lachry- 
mose. The  motor  centres  may  be  nest  affected,  either  after  or 
before  the  perceptive  centres,  so  that  the  speech  may  be  uncer- 
tain and  thick  while  the  power  of  judgment  is  little  affected,  or 
the  speech  may  remain  tolerably  distinct  after  the  power  of 
clear  conception  is  entirely  gone.  The  cerebellum  appears  to 
be  affected  sometimes  before  and  sometimes  after  the  cerebrum. 
This  depends  partly  upon  the  constitution  of  the  individual,  and 
partly  upon  the  quality  of  the  alcoholic  liquor.  The  affection  of 
the  cerebellum  gives  rise  to  double  vision  and  inability  to  walk, 
from  the  relations  of  surrounding  objects  being  no  longer  cor- 
rectly perceived.  After  both  cerebrum  and  cerebellum  are 
paralysed,  the  cord  may  still  retain  its  functional  activity,  so 
that  the  man  who  cannot  walk  may  be  able  to  ride,  owing  to  the 
reflex  contraction  of  the  adductors  produced  by  the  impression 
of  the  saddle.  The  respiratory  centre  is  next  paralysed,  if  the 
quantity  taken  be  sufficiently  large.  The  heart  continues  to 
beat  although  the  respiration  may  be  paralysed ;  but  if  a  suffi- 
cient dose  of  alcohol  be  administered,  and  respiration  be  kept 
up  artificially  in  an  animal,  so  as  to  allow  the  drug  to  act  upon 
the  heart,  the  cardiac  ganglia  may  also  become  paralysed. 

The  sensibility  of  the  vaso-motor  centre  to  reflex  impres- 
sions appears  to  be  early  destroyed,  and  the  consequence  of  this 
is  that  injuries  which  in  a  sober  man  would  produce  death  by 
shock,  have  comparatively  little  effect  on  a  man  who  is  drunk. 

The  diagnosis  of  drunkenness  from  opium-poisoning  and 
from  apoplexy  is  of  great  practical  importance,  for  it  occasionally 
happens  that  cases  brought  into  hospital  by  the  police  have  been 
dismissed  as  cases  of  drunkenness,  and  have  proved  afterwards 
to  be  cases  of  apoplexy.  The  difficulty  of  diagnosis  is  increased  by 
.  the  fact  that  the  patient  may  have  had  alcoholic  drinks  poured 
down  his  throat  by  sympathetic  bystanders,  so  that  the  first 
indication  of  drunkenness,  viz.  the  smell  of  alcohol  in  the 
breath,  may  occur  equally  in  apoplexy.  The  other  chief  points 
of  diagnosis  are  given  under  '  Opium  '  (p.  848) . 

Effect  of  Impurities  on  the  Action  of  Alcohol. — It  will 
be  seen  by  the  annexed  table  from  Dujardin-Beaumetz  that  the 
toxic  action  of  alcohol  is  greatly  increased  by  impurities,  so  that 
inferior  brandy  from  a  public-house  has  a  lethal  action  nearly 
one-half  greater  (as  5-30  to  7-75)  than  pure  ethylic  alcohol. 

Chronic  Alcoholic  Poisoning. — In  persons  who  are  accus- 
tomed to  take  an  excessive  quantity  of  alcoholic  stimulants  for  a 
length  of  time,  although  perhaps  never  sufficient  to  produce  the 
symptoms  of  acute  intoxication,  alterations  are  produced  in  the 
digestive  and  nervous  systems.    One  of  the  commonest  evidences 


hap.  xxix.]     CARBON   COMPOUNDS— FATTY  SERIES.       771 


Toxic  Action  or  Alcohol. 


Kind  of  Spirit 


Mean   toxic   doses   per  kilo- 
gramme of  body-weight  of  dog,    . 
to  cause  death  in  24-36  hours 

Spirits  and 
Brandies 

Crude 

Rectified 

grammes 
7-75 

grammes 

grammes 

7-50 

7-35 

... 

7-30 

6-96 

7-25 

6-90 

7-15 

7-0 

5-30 

... 

6-85 

7-10 
7-35 

Ethylic  alcohol 

Spirit  of  wine  of  Montpellier 

„  „      from  pears 

,,           „     from  cider  and  from  the  marc  of  grapes 
Spirit  from  grain 

„     from  molasses  and  beetroot  .... 
Brandy  from  a  public-house  (ordinary  quality) 

„            „                „            (inferior  quality) 
Spirit  from  potatoes 

„        „          „        (said  to  have  been  ten  times  "1 
rectified) j* 


)f  this  condition  is  vomiting  of  watery  fluid  in  the  morning 
mmediately  after  rising.  The  bowels  are  rarely,  if  ever,  con- 
stipated, being  generally  open  three  or  four  times  daily.  There 
s  a  tendency  to  fatty  degeneration  of  various  organs,  the  skin 
icquires  a  satiny  feeling,  and  the  capillaries  on  the  surface  of 
;he  face  often  become  prominently  dilated,  giving  a  character- 
istic hue  to  the  complexion,  which  is  often  especially  marked 
ipon  the  nose.  The  liver  is  apt  to  undergo  fatty  degeneration, 
ind,  at  first,  to  be  congested.  Afterwards,  the  connective  tissue 
becomes  increased,  the  organ  contracts,  interfering  with  the 
3irculation  in  the  abdominal  viscera,  and  producing  ascites. 
This  may  be  complicated  by  cirrhosis  of  the  kidney  also.  The 
nervous  system  may  also  be  affected,  the  mental  powers  be- 
soming impaired,  the  temper,  at  the  same  time,  frequently  being 
irritable,  while  a  tremnlousness  appears  in  the  tongue,  lips,  and 
hands. 

When  those  accustomed  to  indulge  freely  in  stimulants  are 
stacked  by  acute  disease,  or  when  they  receive  injuries,  or  when, 
in  consequence  of  a  drinking  bout,  their  stomachs  are  so  deranged 
is  to  bring  on  loss  of  appetite  and  vomiting,  and  to  lower  their 
nutrition,  they  are  liable  to  delirium  tremens.  So  long  as  the 
drunkard  is  able  to  eat  and  digest  his  food,  he  is  little  liable  to 
this  disease.  As  a  rule  delirium  comes  on  in  from  two  to  four 
flays  after  he  has  lost  his  appetite  and  begun  to  vomit.  This 
delirium  is  marked  by  a  peculiar  tremor  of  the  tongue,  as  well 
as  of  the  limbs,  and  by  delusions  which  are  especially  connected 
with  the  sense  of  sight,  the  unfortunate  patient  imagining  that 
be  sees  noxious  animals  crawling  around  him,  or  that  he  is 
plagued  by  demons,  which  are  sometimes  of  a  blue  colour,  from 

3  11  2 


772  OEGANIC   MATERIA   MEDICA.  [sect.  rv. 

which  the  disease  is  popularly  known  as  '  blue  devils.'  The 
tongue  is  moist,  and  covered  with  a  thick  white  fur.  There  is 
loss  of  appetite  and  vomiting,  which  is  often  obstinate.  The 
delirium  is  constant  and  active.  It  may  become  violent,  and 
there  is  great  restlessness  and  sleeplessness.  It  may  gradually 
subside,  and  the  patient  recover  his  health,  or  a  condition  of 
mania  may  ensue.  Patients  sometimes  die  suddenly,  without 
any  warning  symptoms. 

The  treatment  of  delirium  tremens  consists  in  keeping  up 
the  strength  of  the  patient  by  a  nutritive  diet,  and  preserving 
him  from  exhaustion  by  combating  the  sleeplessness  which  would 
cause  it.  The  vomiting,  which  is  the  chief  obstacle  to  nutrition, 
is  often  well  combated  by  a  combination  of  bismuth,  magnesia, 
and  hydrocyanic  acid,  to  which  small  quantities  of  morphine 
may  be  added.  Until  the  patient  is  able  to  retain  food,  he  ought 
to  be  fed  by  nutritive  enemata,  while  chloral  may  be  administered 
for  the  sleeplessness.  A  combination  of  chloral  with  bromide  of 
potassium  is  often  very  useful.  Large  doses  of  digitalis  have 
been  given  in  order  to  quiet  the  delirium,  and  sometimes  with 
benefit ;  but  this  is  a  very  dangerous  treatment,  and  it  seems 
not  improbable  that  the  reason  why  the  enormous  doses  of  such 
a  powerful  drug  have  produced  so  little  effect  has  simply  been 
that  they  have  not  been  absorbed  from  the  stomach,  for  I 
have  seen  a  case  in  which  food  lay  undigested  and  unabsorbed 
in  the  stomach  for  a  period  of  four  days,  after  which  it  was 
vomited. 

Causes  of  Cheonic  Alcoholism.— The  craving  for  stimulants 
which  leads  to  chronic  alcoholic  poisoning  may  be  acquired  by 
the  habit  of  drinking  in  society ;  but  it  is  not  seldom  due  to  the 
practice  of  taking  alcohol  in  order  to  relieve  depression  of  spirits, 
bodily  or  mental  weakness,  or  inability  to  work  as  long  or  as  well 
as  might  be  desired.  In  men,  the  depression  of  spirits  and 
feeling  of  weakness  may  be  due  to  unfavourable  physical  sur- 
roundings, close  atmosphere,  over-work,  exhausting  discharges, 
or  mental  worry.  In  women,  it  may  not  only  be  connected  with 
any  of  these,  but  also  with  uterine  derangement.  The  craving 
appears  to  be  partly  gastric  and  partly  systemic,  and  it  is  to  be 
combated  by  the  substitution  for  alcohol  of  other  stimulants 
which  will  not  have  the  same  deleterious  action.  As  a  stimulant 
to  the  stomach,  producing  a  sensation  of  warmth,  tincture  of 
capsicum  is  very  useful,  and  aromatic  spirit  of  ammonia  stimu- 
lates both  the  stomach  itself  and  the  circulation  and  nervous 
system  generally.  A  useful  formula  consists  of  20  or  30  minims 
of  aromatic  spirit  of  ammonia,  with  5  to  10  minims  of  tincture 
of  capsicum,  in  two  ounces  of  infusion  of  gentian  or  cascarilla.; 
This  draught,  which  amounts  to  an  ordinary  wineglass-full, 
should  be  taken  when  the  craving  is  felt.  In  place  of  this 
draught  a  lemon  may  be  sucked,  or  a  glass  of  iced  or  cold  water, 


chap,  xxix.]     CAEBON  COMPOUNDS— FATTY  SEEIES.       773 

or  effervescing  water,  may  be  slowly  sipped  so  as  to  get  its 
stimulating  action  on  the  cerebral  circulation  (p.  193)  and  heart 
(p.  194).  At  the  same  time  chalybeate  tonics  and  strychnine 
may  be  given  in  order  to  increase  the  nutrition  of  the  tissues 
generally.  The  liquid  extract  of  red  cinchona  bark  has  been 
recommended  in  such  cases,  and  no  doubt  this  medicine,  along 
with  easily  digested  food,  beef-tea,  and  warm  nutritive  drinks, 
such  as  hot  cocoa,  may  prove  a  useful  adjunct  in  the  treatment 
of  chronic  alcoholism. 

In  some  patients  the  tendency  to  drink  appears  to  be  epileptic 
in  character.  The  person  affected  by  it  will  remain  sober  for 
weeks  or  even  months,  and  then  be  suddenly  seized  with  the  fit, 
begin  to  drink,  and  remain  drunk  for  several  days  together,  and, 
after  the  conclusion  of  the  bout,  will  again  remain  sober  for  a 
long  time.  I  have  seen  a  case  in  which  this  species  of  inter- 
mittent drunkenness  was  brought  on  by  a  fall  from  a  horse,  and 
was  associated  with  epilepsy.  The  fit  began  with  an  intense 
craving  for  drink,  and  after  one  or  two  days'  drunkenness  epilepsy 
came  on.  If  the  desire  for  drink  was  not  gratified,  the  fit  came 
on  sooner  after  the  craving  began  than  it  would  otherwise  have 
done,  but  it  was  not  30  violent.  The  treatment  in  these  cases  is 
bromide  of  potassium  combined  with  tonics. 

Uses. — The  cold  produced  by  the  evaporation  of  alcohol  when 
it  is  applied  to  the  skin  and  rapidly  dissipated  by  fanning  or 
blowing  upon  it  is  useful  in  preventing  syncope,  in  relieving 
headache,  or ,  in  rousing  from  fainting  or  coma.  For  these  pur- 
poses one  of  the  most  convenient  forms  of  application  is  eau-de- 
_  cologne,  and  in  cases  of  headache  this  may  be  used,  diluted  with 
equal  parts  of  water,  and  applied  by  means  of  a  thin  handkerchief. 
The  power  of  alcohol  to  harden  the  epidermis  renders  it  a  useful 
application  in  cases  where  we  desire  to  hinder  the  formation  of 
bed-sores  or  prevent  the  nipples  from  cracking.  Brandy  is  the 
form  most  frequently  employed  for  this  purpose,  as  it  stimulates 
the  circulation  when  its  evaporation  is  prevented,  and  especially 
when  aided  by  friction.  Alcohol,  diluted  simply,  or  in  conjunction 
with  one  half  per  cent,  carbolic  or  salicylic  acid,  is  useful  in 
relieving  pruritus  in  erythema  and  other  diseases ;  a  similar , 
lotion  is  also  useful  in  alopecia  furfuracea.  In  urticaria  it  is  best 
combined  with  petroleum  (v.  p.  762).  It  has  been  used  as  a  lini- 
ment in  the  form  of  brandy  or  spirit  to  sprained  joints.  A  little 
brandy  held  in  the  mouth  increases  the  secretion  of  saliva,  and 
often  relieves  toothache.  Alcohol  is  also  a  useful  gargle  in  relaxed 
sore-throat,  port  wine  being  a  form  in  which  it  is  frequently 
applied  for  this  purpose.  It  is  also  a  useful  astringent  wash  to 
the  mouth  in  cases  of  profuse  salivation.  As  in  small  doses  it 
increases  the  secretion  of  gastric  juice,  it  forms  a  useful  addition 
to  the  meals  of  persons  whose  digestive  powers  are  weak  either 
in  consequence  of  temporary  exhaustion  or  from  permanent 


774  OBGANIC  MATEKIA  MEDICA.  [sect.  iv. 

debility,  occurring  in  convalescence  from  acute  disease,  general 
malnutrition,  or  from  old  age.  Some  men,  after  being  busily- 
engaged  all  day,  go  home  exhausted,  and  dine  immediately  on 
their  arrival.  The  consequence  of  this  is  that  their  food  remains 
undigested,  and  they  suffer  from  weight  of  the  stomach  and 
drowsiness.  This  condition  may  generally  be  prevented  in  persons 
below  middle  age,  by  simply  making  them  rest  for  a  while,  so 
that  the  stomach,  as  well  as  the  body  generally,  may  recover  from 
fatigue  before  the  meal  is  taken ;  but  in  elderly  individuals  the 
addition  of  a  little  alcoholic  stimulant  may  be  necessary  to  ensure 
digestion.  This  use  of  alcohol  was  noticed  in  the  Ashantee  cam- 
paign, in  which  the  effect  of  alcohol  as  a  stimulant,  compared 
with  beef-tea,  was  carefully  tested.  It  was  found  that  when  a 
ration  of  rum  was  served  out  the  soldier  at  first  marched  more 
briskly,  but  after  about  three  miles  had  been  traversed  the  effect 
of  it  seemed  to  be  worn  off,  and  he  then  lagged  more  than  before. 
If  a  second  ration  were  then  given  its  effect  was  less  marked,  and 
wore  off  sooner  than  that  of  the  first.  A  ration  of  beef-tea,  how- 
ever, seemed  to  have  as  great  a  stimulating  power  as  one  of  rum, 
and  not  to  be  followed  by  any  secondary  depression.  At  the  end 
of  the  march  a  short  rest  during  the  cooking  of  the  evening  meal 
seemed  sufficient  to  enable  the  younger  men  to  eat  and  digest  it 
without  the  aid  of  rum,  which  they  did  not  desire ;  but  the  men 
who  had  passed  middle  age  not  only  wanted  their  own  share 
of  the  alcohol,  but  were  glad  to  get  that  of  their  younger  comrades' 
also. 

In  the  intestine  alcohol  is  used  as  a  carminative  to  relieve 
flatulent  distension,  as  an  antispasmodic  in  colic,  and  as  an 
astringent  in  diarrhoea. 

Alcohol  as  a  Stimulant. — As  a  stimulant  alcohol  seems 
serviceable  in  acute  diseases  running  a  limited  course,  where  we 
wish  to  sustain  the  patient's  strength  until  the  crisis  is  past,  as 
well  as  to  prevent  it  sinking  from  debility  afterwards.  The 
various  rules  which  have  been  given  for  the  administration  of 
alcohol  (in  fever)  may  be  condensed  into  one.  If  the  alcohol 
tends  to  bring  the  patient  nearer  to  his  normal  condition  it  is 
doing  good ;  if  it  takes  him  further  away  from  a  healthy  condition 
it  is  doing  harm.  The  points  which  are  usually  specially  attended 
to  are  the  condition  of  the  tongue,  pulse,  respiration,  skin,  and 
nervous  system. 

If  it  is  found  that;  the  alcohol  (a)  renders  the  dry  tongue 
moist,  (b)  slows  and  strengthens  the  pulse  when  it  is  too  quick, 
or  quickens  it  when  it  has  been  abnormally  slow,  (c)  slows  the 
hurried  respiration,  (d)  renders  the  skin  cooler  or  moister  when 
too  hot  and  dry,  and  (e)  lessens  delirium  and  brings  on  sleep, — 
then  its  action  is  beneficial.  If  it  have  an  opposite  effect  it  is. 
harmful.  Useful  indications  regarding  the  advantage  of  alcohol,  , 
and  the  amount  to  be  given  in  any  particular  case  may  be. 


chap,  xxix.]     CARBON   COMPOUNDS— FATTY   SERIES.       775 

obtained  by  the  practitioner  remaining  beside  the  patient,  count- 
ing the  pulse,  and  watching  the  tongue,  respiration,  skin,  and 
general  condition  for  a  quarter  of  an  hour  after  the  dose  has 
been  given.  He  -will  thus  be  able  to  give  more  definite  directions 
than  he  otherwise  could  as  to  its  continuance  when  he  is  absent. 
Particular  care  should  be  taken  in  the  administration  of  alcoholic 
stimulants  to  patients  in  the  small  hours  of  the  morning.  It  is 
about  this  time  that  attendants  are  most  apt  to  become  sleepy, 
and  therefore  careless,  and  just  at  this  time,  also,  the  external 
temperature  is  lowest,  the  fire  is  apt  to  get  low,  and  the  vital 
powers  of  the  patient  are  most  likely  to  sink.  In  giving  alcoholic 
stimulants  to  support  the  strength  in  disease,  care  must  be  taken 
that  they  are  not  given  so  frequently  and  in  such  large  quantities 
as  to  disorder  the  stomach  and  produce  subacute  gastritis. 
Sometimes,  when  given  very  freely  to  support  the  failing  circula- 
tion, they  have  this  effect ;  the  result  of  which  is  that  both  food 
and  stimulants  are  vomited,  and  the  patient  may  be  brought  to 
death's  door.  The  treatment  here  consists  in  the  free  adminis- 
tration of  ice,  along  with  two  or  three  minims  of  solution  of 
morphine  and  of  hydrocyanic  acid,  frequently  repeated  until  the 
vomiting  is  arrested. 

During  its  elimination  by  the  urine,  alcohol  may  act  as  an 
irritant  to  the  urinary  passages  when  these  are  already  inflamed. 
It  is,  consequently,  injurious  in  gonorrhoea ;  and  some  sorts  of 
beer,  especially  Bavarian  beer,  will  even  bring  on  gonorrhoea  in 
persons  who  have  previously  had  it,  but  who  have  been  free  from 
it  at  the  time  of  taking  the  beer. 

U.S.P.  Alcohol.  Alcohol. — A  liquid  composed  of  91  per- 
cent, by  weight  (94  per  cent,  by  volume)  of  ethyl  alcohol 
(C2H5HO  ;  46),  and  9  per  cent,  by  weight  (6  per  cent,  by  volume) 
of  water. 

Chabacters. — A  transparent,  colourless,  mobile,  and  volatile 
liquid,  of  a  characteristic,  pungent  and  agreeable  odour,  and  a 
burning  taste.  It  boils  at  78°  C.  (172°-4  F.),  and  is  readily  in- 
flammable, giving  a  blue  flame  without  smoke.  Specific  gravity 
0-820  at  15°-6  C.  (60°  F.),  and  0-812  at  25°  C.  (77°  F.).  It  should 
not  change  the  colour  of  blue  or  red  litmus-paper  previously 
moistened  with  water. 

Impurities. — Fusel  oil,  amyl  alcohol,  methyl  alcohol,  aldehyde,  oak-tannin, 
foreign  organic  matters. 

Tests. — If  a  portion  of  at  least  50  cc.  be  evaporated  to  dryness  in  a  glass 
vessel,  no  residue  or  colour  should  appear.  If  mixed  with  its  own  volume  of 
water  and  one-fifth  its  volume  of  glycerin,  a  piece  of  blotting-paper  on  being 
made  wet  with  the  mixture,  after  the  vapour  of  alcohol  has  wholly  disappeared, 
should  give  no  irritating  or  foreign  odour  (no  fusel  oil).  And  if  a  portion  be 
evaporated  to  one-fifth  its  volume,  the  residue  should  not  turn  reddish  upon 
the  addition  of  an  equal  volume  of  sulphuric  acid  (no  amyl  alcohol).  When 
treated  in  a  test-tube  with  an  equal  volume  of  solution  of  potassa,  there  should 
not  be  an  immediate  darkening  of  the  liquid  (no  methyl  alcohol,,  aldehyde, 


776  OEGANIO   MATEEIA  MEDICA.  [sect.  iv. 

and  oak- tannin).  If  a  portion  of  about  150  cc.  be  digested  .for  an  hour  with 
20  grs.  of  carbonate  of  lead  and  filtered,  the  filtrate  then  distilled  from  a 
water-bath,  and  the  first  20  cc.  of  the  distillate  treated  with  1  cc,  of  test- 
solution  of  permanganate  of  potassium,  the  colour  should  not  disappear 
within  one  or  two  minutes  (absence  of  methyl  alcohol).  If  20  cc.  are  shaken 
in  a  glass-stoppered  vial,  previously  well  rinsed  with  the  same  alcohol,  with 
2  cc.  of  test-solution  of  nitrate  of  silver,  the  mixture  should  not  be  rendered 
more  than  faintly  opalescent  during  one  day's  exposure  to  direct  sunlighr, 
(absence  of  more  than  traces  of  foreign  organic  matters,  fusel  oil,  &c). 

B.P  Spiritus  Rectificatus.  Becthted  Spieit.  Alcohol, 
C2H60,  with  16  per  cent,  of  water ;  obtained  by  the  distillation 
of  fermented  saccharine  fluids. 

Characters.— Colourless,  transparent,  very  mobile  and  in- 
flammable, of  a  peculiar  pleasant  odour,  and  a  strong  spirituous, 
burning  taste.  Burns  with  a  blue  flame  without  smoke.  Specific 
gravity  0-838.  Eemains  clear  when  diluted  with  distilled  water. 
Odour  and  taste  purely  alcoholic. 

Tests. — Four  fluid  ounces  with  thirty  grain-measures  of  the  volumetric 
solution  of  nitrate  of  silver  exposed  for  twenty-four  hours  to  bright  light,  and 
then  decanted  from  the  black  powder  which  has  formed,  undergoes  no  further 
change  when  again  exposed  to  light  with  more  of  the  test  solution  (no  fusel 
oil). 

Impurities. — Water,  fusel  oil. 

Spiritus  Tenuior,  B.P.;  Alcohol  Dilutum,  U.S.P.  Proof 
Spirit,  B.P. ;  Diluted  Alcohol,  U.S.P. 

Bectified  spirit,  5  pints,  mixed  with  distilled  water,  3  pints ; 
specific  gravity  0*920,  B.P.  Alcohol,  45-5  per  cent,  by  weight 
(53  per  cent,  by  volume),  and  distilled  water,  54-5  per  cent, 
by  weight  (47  per  cent,  by  volume) ;  specific  gravity  0-928  at 
15-6°  C.  (60°  F.),  and  0-920  at  25°  C.  (77°  P.),  U.S.P. 

Spiritus  Vini  Gallici,  B.  and  U.S.  P.  Spirit  of  French  Wine. 
Brandy. 

Spirit  distilled  from  French  wine.  It  has  a  peculiar  flavour, 
and  a  light  sherry  colour  derived  from  the  cask  in  which  it  has 
been  kept,  B.P.  An  alcoholic  liquid  obtained  by  the  distillation 
of  fermented  grapes  and  at  least  four  years  old,  U.S.P.  It  should 
contain  from  39  to  47  per  cent,  by  weight  (46  to  55  per  cent, 
by  volume)  of  alcohol. 

PitEPABATION. 

B.P.  Dose. 

IWlstura  Spiritus  Vini  Gallici 1-2  fl.  oz. 

B.P.  Mistura  Spiritus  Vini  Gallici.  Mixtube  op  Spif.it  or  French 
Wine.  Ego  Flip  (vide  also  Eggs).  Beat  up  the  yolks  of  two  eggs,  and  sugar  £  oz., 
then  add  brandy  and  cinnamon-water,  of  eaoh  i  fl.  oz. 

B.P.  Vinum  Xericum.     Sheery.     A  Spanish  wine. 

Characters. — Pale  yellowish-brown,  containing  about  17  per 
cent,  of  alcohol. 

Uses. — As  a  stimulant,  and  in  preparing  all  the  wines  of  the 
B.P.  except  Vinum  Ferri  Citratis,  Vinum  Aurantii,  and  Vinum 
Quininae. 


chap,  xxix.]    CAEBON  COMPOUNDS— FATTY  SEEIES        777 

U.S.P.  Vinum  Album.     White  Wine. 

Chaeactees. — A  pale,  amber-coloured  or  straw-coloured  alco- 
holic liquid,  made  by  fermenting  the  unmodified  juice  of  the 
grape  freed  from  seeds,  stems,  and  skins.  White  wine  should 
have  a  full,  fruity,  agreeable  taste  without  excessive  sweetness  or 
acidity ;  and  it  should  have  a  pleasant  odour  free  from  yeasti- 
ness.  Its  sp.  gr.  at  15-6°  C.  (60°  F.)  should  not  be  less  than  0-990 
nor  more  than  1-010. 

Impukity. — Tannic  acid. 

Tests. — If  10  co.  of  white  wine  be  diluted  with  an  equal  volume  of  dis- 
tilled water,  and  treated  with  5  drops  of  test-solution  of  ferric  chloride,  only 
a  faint  greenish-brown  colour  should  make  its  appearance  (absence  of  tannic 
aeid).  Upon  evaporation  and  twelve  hours  of  drying  on  the  water-bath,  it 
should  leave  a  residue  of  not  less  than  1-5  per  cent,  nor  more  than  3-0  per 
cent.  Using  litmus-paper  as  an  indicator  250  cc.  of  white  wine  should  re- 
quire for  complete  neutralisation  not  less  than  15  nor  more  than  26  cc,  of 
the  volumetric  solution  of  soda. 

U.S.P.  Vinum  Album  Fortius.     Steongee  White  Wine. 

Composition. — White  wine  7  parts,  alcohol  1  part.  When 
tested  for  alcohol  it  should  not  contain  less  than  20  nor  more  than 
25  per  cent,  of  absolute  alcohol  by  weight. 

Use. — In  preparing  all  the  medicated  wines  in  the  U.S.P. 

U.S.P.  Vinum  Rubrum.     Eed  Wine. 

A  deep  red  alcoholic  liquid,  made  by  fermenting  the  juice  of 
coloured  grapes  with  their  skins. 

Chabactebs. — Eed  wine  should  have  a  full,  fruity,  moderately 
astringent,  pleasant  taste  without  decided  sweetness  or  excessive 
acidity.  It  should  have  a  pleasant  odour  free  from  yeastiness. 
Its  sp.  gr.  at  15°-6  C.  (60°  F.)  should  not  be  less  than  0-989  nor 
more  than  1-010. 

Tests. — If  10  cc.  of  red  wine  be  diluted  with  an  equal  volume  of  distilled 
water,  and  treated  with  5  drops  of  test-solution  of  ferric  chloride,  the  liquid 
should  acquire  a  brownish-green  colour  due  to  tannic  acid.  Upon  evapora- 
tion and  twelve  hours  drying  on  the  water -bath,  it  should  leave  a  residue  of 
not  less  than  1-6  per  cent,  nor  more  than  3"5  per  cent. 

Using  litmus-paper  as  an  indicator,  250  cc.  of  red  wine  should  require  for 
complete  neutralisation  not  less  than  15  nor  more  than  26  cc.  of  the  volu- 
metric solution  of  soda.  If  50  cc.  of  red  wine  be  treated  with  a  slight  excess 
of  water  of  ammonia,  the  liquid  should  acquire  a  green  or  brownish-green 
colour ;  if  it  be  then  well  shaken  with  25  cc.  of  ether,  the  greater  portion  of  the 
ethereal  layer  removed,  and  evaporated  in  a  porcelain  capsule  with  excess  of 
acetic  acid  and  a  few  fibres  of  uncoloured  silk,  the  latter  should  not  acquire 
a  crimson  or  violet  colour  (absence  of  anilin  colours).  "With  test-solution  of 
acetate  of  lead,  red  wine  should  form  a  heavy  precipitate,  which  may  vary 
in  colour  from  bluish-green  to  green. 

B.P-  Alcohol  Amylicum.  Amylio  Alcohol.  Synonym : 
Fousel  Oil. 

Amylic  alcohol,  C5HnHO,  with  a  small  proportion  of  other 
spirituous  substances.  An  oily  liquid,  contained  in  the  crude 
spirit  produced  by  the  fermentation  of  saccharine  solutions  with 


778  OEGANIC  MATEEIA  MEDICA.  [sect.  iv. 

yeast,  and  separated  in  the  rectification  or  distillation  of  such 
crude  spirit. 

Chakacteks. — A  colourless  liquid  with  a  penetrating  and 
oppressive  odour,  and  a  burning  taste.  When  pure  its  specific 
gravity  is  0-818,  and  its  boiling-point  270°  F. 

Solubility. — Sparingly  soluble  in  water,  but  soluble  in  all  proportions  in 
alcohol,  ether,  and  essential  oils. 

Eeactions. — Exposed  to  the  air  in  contact  with  platinum-black  it  is 
slowly  oxidised,  yielding  valerianic  acid. 

Peepabations  ik  which  Amylic  Alcohol  is  used. 
Sodii  Valerianas.        Amyl  Nitris. 

Uses. — It  is  oxidised  into  valerianic  acid. 

ALDEHYDES. 

These  substances  in  their  chemical  constitution  lie  between 
alcohols  and  acids.  They  are  obtained  from  alcohols  by  the 
removal  of  two  atoms  of  hydrogen,  hence  the  name  aldehyde 
(aZcohol  dehy  diogen&tum). 

A 

They  contain  the  group — C — '  (p.  22).     They  reduce  silver 

H 

salts  in  darkness.  Living  protoplasm  has  a  similar  power, 
whereas  dead  protoplasm  has  not,  and  from  this  circumstance  it 
has  been  supposed  that  active  albumin  contains  the  aldehydic 
group  in  its  constitution. 

This  supposition  is  supported  by  the  fact  that  substances 
which  act  energetically  upon  aldehydes  are  also  protoplasmic 
poisons.1 

Acetic  Aldehyde. — Synonyms :  Aldehyde,  ethyl  aldehyde,  or 
ethylidene  oxide.     C2H40.     Not  officinal. 

Chaeacteks. — A  colourless,  mobile  liquid,  with  an  ethereal, 
acrid,  and  suffocating  odour.  Specific  gravity  0-79.  Boiling- 
point,  22°  C.  (71°-6  F.). 

Preparation. — It  may  be  prepared  in  several  ways,  as  the  hydrogen  can 
be  removed  from  alcohol  either  by  oxidising  agents  or  chlorine.  C2H60  +  0 
=  C2H40  +  H20,  or  C2H60  +  Cl2  =  C2H40  +  2HC1. 

Action. — It  is  antiseptic.  It  has  a  strong  local  irritant 
action.  When  inhaled  it  causes  excitement  followed  by  anes- 
thesia. It  has  a  powerfully  depressant  action  on  respiration, 
and  rapidly  produces  asphyxia,  so  that  it  is  not  used  as  an 

anaesthetic. 

Paraldehyde.  CsHI203. — It  appears  to  be  a  polymeric  modi- 
fication of  aldehyde.     Not  officinal. 

1  0.  Loew,  Pfluger's  Archw,  xxxv.  p.  516. 


chap,  xxix.]     CAEBON  COMPOUNDS— FATTY  SEEIES.       779 

Characters. — A  colourless  fluid. 

Dose.— 3  to  6  gin.,  or  more ;  £  to  1  fl.  drachm. 

Administration.— It  is  soluble  in  about  8  parts  of  water,  and 
may  be  given  with  glycerin,  syrup  of  tolu,  or  syrup  of  oranges. 

Action  and  Uses.— It  is  a  pure  narcotic,  causing  sleep  like 
chloral.  It  is  about  half  the  strength  of  chloral,  and  is  said  to 
be  without  any  depressing  action  on  the  heart  and  respiration. 
It  may  thus  be  used  instead  of  chloral  in  cases  of  weak  heart. 
Its  local  action  renders  its  use  unadvisable  in  severe  gastric  dis- 
orders and  laryngeal  phthisis. 

Inconvenience. — It  causes  an  unpleasant  smell  in  the  breath, 
which  is  very  disagreeable  to  some  patients. 

KETONES. 

These  are  aldehydes  in  which  the  distinctively  aldehyde 
hydrogen  has  been  replaced  by  a  radical.  They  thus  bear  a  re- 
lation to  aldehydes  similar  to  that  of  ethers  to  alcohols. 

Alcohol,  E— 0— H  Aldehyde,  E— C— H 

II 

0 
Ether,  E— 0— E  Ketone,     E— C— E 

II 
0 

They  may  also  be  regarded  as  compounds  of  carbonyl  with  two 
radicals,  instead  of  with  one  radical  and  H  as  in  aldehydes,  or 
one  radical  and  hydroxyl  (H— 0^)  like  the  acids  of  this  series. 

Hypnone.1 — Phenyl-methyl-acetone,  or  acetophenone,  CrH« 
(CO)(CH3). 

Characters. — Below  60°  or  70°  it  forms  white  needles,  but 
above  these  temperatures  it  occurs  as  a  liquid  with  a  powerful 
6mell  of  bitter  almonds  and  orange. 

Peepaeation. — By  oxiding  ethyl-benzene  by  chromic  acid  in  presence  of 
acetic  acid,  or  by  distilling  a  mixture  of  acetate  and  benzoate  of  calcium. 

Dose.— -05--015  gm. 

Administration. — It  is  mixed  with  gelatine  and  enclosed  in 
gelatine  capsules. 

Action. — It  is  a  powerful  hypnotic,  and  may  be  used  instead 
of  chloral  or  paraldehyde.     It  appears  to  be  free  from  danger. 

Uses.— To  produce  sleep.  It  is  said  to  be  especially  useful 
in  alcoholism. 

Inconvenience. — It  causes  an  unpleasant  smell  of  acetone  in 
the  breath  which  annoys  patients. 

1  This  name  has  been  given  by  its  introducers,  Dujardin-Beauraetz  and  Bardet. 


780  OEGANIC  MATEEIA  MEDICA.  [sect.  iv. 

SIMPLE    ETHERS. 

These  correspond  in  structure  to  oxides  in  which  the  place 
of  a  metal  is  taken  by  an  alcohol  radical,  thus  potash,  -g-JO  or 

K20,  corresponds  to  p2jTS|0  or  (C2H5)20,  ethylic  ether.- 

JEther,  B.  and  U.S.P.     (C2H5)20;  74.    Ethee. 

A  volatile  liquid  prepared  from  alcohol,  and  containing  not 
less  than  92  per  cent,  by  volume  of  pure  ether  (C2H5)20,  B.P.  A 
liquid  composed  of  about  74  per  cent,  of  ethyl  oxide  (C2H6)20 ; 
and  about  26  per  cent,  of  alcohol  containing  a  little  water.  Specific 
gravity  about  0-750  at  15°  0.  (59°  P.),  U.S.P. 

Chabactees. — A  colourless,  very  volatile  and  inflammable 
liquid,  emitting  a  strong  and  characteristic  odour,  and  boiling 
below  105°  P.     Specific  gravity  0-735,  B.P. 

Reactions. — Fifty  measures  agitated  with  an.  equal  volume  of  water  are 
reduced  to  45,  by  an  absorption  of  10  per  cent.  It  evaporates  without 
residue. 

Preparation. — By  distilling  rectified  spirit  with  sulphuric  acid,  and  free- 
ing the  ether  thus  obtained  from  water  by  redistillation  with  calcium  chloride 
and  lime. 

In  this  process  ethylsulphuric  or  sulphovinic  acid  and  water  are  first 
formed,  ethyl  replacing  one  atom  of  hydrogen  in  the  sulphuric  acid. 


Sulphurio  Ethylsulphuric 

Acid.  Alcohol.  Acid.  Water. 

H\0r>  .      Cz  '5"l  n  CjH,  |  an       .      HI 

Hi 


[}so4  +  <v}°  =  °#3}so<  +  g}o. 


By  the  action  of  fresh  alcohol  on  the  ethylsulphuric  acid  it  is  decomposed, 
ether  being  formed  and  sulphuric  acid  being  reproduced. 

Ethylsulphurio  Sulphurio 

Acid.  Alcohol.  Acid.  Ether. 

c*H»lso     +      H  \o    -    Kl<*n     j.    cAln 
H    (bU*     +     G.M,J°    -    HlS0«     +     CA/0' 

Theoretically  this  process  might  go  on  ad  infinitum  if  fresh  alcohol  were 
continually  supplied  ;  but  practically  the  acid  volatilises  partly  in  the  form  of 
oil  of  wine,  so  that  the  process  cannot  go  on  indefinitely. 

Impurities. — Water,  alcohol,  and  fixed  impurities. 

Tests— "Water  is  detected  by  the  greater  sp.  gr.,  and  so  is  alcohol ;  the 
fixed  impurities  by  their  remaining  on  evaporation. 

Dose.— 20  to  60  min. 

Pbepabations. 

B.P. 

JEther  Purus 

Collodium 6  volumes  in  8  nearly.  « 

„        Flexile 6  8      „  '.* 

Spiritus  JEtheris 1  volume  in  3      „ 

m  !i         Conjposltus 1  M  3       (| 

Tinctura  Chloroformi  et  MorphiniE 1  ,         32 

B.P.  yEther  Purus.  Puee  Ethee.— Ether,  C4H100,  free 
from  alcohol  and  water. 


chap,  xxix.]     CAEBON  COMPOUNDS— FATTY  SEEIES.       781 

Preparation. — By  washing  ether  with  distilled  water,  and  then  distilling 
from  calcium  chloride  and  recently  calcined  lime. 
Test. — Specific  gravity  not  exceeding  0*720. 

Uses.— Used  as  an  anaesthetic ;  to  prepare  some  alkaloids, 
as  aconitine ;  to  test  the  amount  of  quinine  in  bark.  Ether  is 
sometimes  used  locally  in  ringworm,  and  to  dissolve  sebaceous 
matter  from  the  surface  of  the  skin.  In  conjunction  with  alcohol 
it  forms  a  cooling  lotion  in  urticaria  and  pruritus. 

U.S.P.  JEther  Fortior.     Steongee  Ethee,  (C2H5)20 ;  74. 

Preparations. 
Spiritus  iEtheris.  Spiritus  iEtheris  Compositus. 

Chaeactees. — A  liquid  composed  of  about  94  per  cent,  of 
ethyl  oxide  and  about  6  per  cent,  of  alcohol,  containing  a  little 
water.  Specific  gravity  not  higher  than  0-725  at  15"  C.  (59°  E.) 
or  0-716  at  25°  C.  (77°  ¥.). 

Ether  is  highly  inflammable,  and  its  vapour  when  mixed  with 
air  and  ignited  explodes  violently. 

Test. — It  should  hoil  actively  in  a  test-tube  half  filled  with  it  and  held  a 
short  time  in  the  hand  on  the  addition  of  small  pieces  of  broken  glass. 

Uses. — Used  for  inhalation  as  an  anaesthetic. 

Spiritus  iEtheris,  B.  and  U.S.P-     Spirit  of  Ethee. — It  is 
a  mixture  of  ether  (1),  rectified  spirit  (2). 
Test. — Specific  gravity,  0-809. 

Dose.— 30  to  90  min. 

Preparation. 

b.p. 

Tinctura  Lobelia  iEtherea. 

Uses.— Spirit  of  ether  is  used  as  a  carminative  and  stimulant. 
It  is  useful  in  lessening  the  pain  in  the  passage  of  biliary  or 
urinary  calculi. 

Action  of  Ethee. — When  applied  to  the  skin  ether  evapo- 
rates very  readily,  and  causes  intense  cold.  The  application  of 
ether  to  the  surface  will  freeze  it  completely,  and  render  it 
perfectly  insensitive  to  pain.  If  the  freezing  be  continued  for 
too  long  a  time,  the  frozen  part  may  be  killed,  and  separate  as  a 
slough.  In  the  mouth,  ether  acts  as  a  powerful  stimulant  to 
the  salivary  secretion.  In  the  stomach  it  increases  the  secretion 
of  gastric  juice,  stimulates  the  movements  of  the  organ,  expels 
flatulence,  and  probably  tends  to  increase  the  co-ordination  of 
the  movements  of  the  stomach  and  intestine,  so  that  it  diminishes 
spasm  and  relieves  pain.  When  absorbed  into  the  circulation 
from  the  intestine,  or,  still  more  markedly,  when  absorbed  from 
the  lungs  after  an  inhalation,  it  first  stimulates  the  circulation, 
and,  after  a  very  brief,  and  perhaps  hardly  perceptible,  period  of 
stimulation  of  the  nerve-centres,  it  depresses  their  powers  in 


782  OEGANIO  MATEEIA  MEDICA.  [sect.  iv. 

succession.  First  of  all,  it  affects  the  cerebral  hemispheres, 
causing  delirium  and  unconsciousness  ;  next,  the  grey  matter  of 
the  spinal  cord ;  next  the  white  matter  of  the  spinal  cord,  and 
lastly,  the  cardiac  and  vaso-motor  centres  in  the  medulla 
oblongata.  It  does  not  appear  to  destroy  the  irritability  of  the 
muscles  in  animals  poisoned  by  it ;  but  muscles  exposed  to  its 
vapour  soon  lose  their  contractility,  and  fall  into  a  condition  of 
rigor  mortis.  Nerves,  also,  which  are  exposed  to  its  vapour, 
lose  their  irritability,  so  that  when  attempted  to  be  irritated  they 
no  longer  respond,  the  irritability  of  the  sensory  fibres  apparently 
disappearing  before  that  of  the  motor  fibres.  When  the  vapour 
is  applied  only  for  a  short  time,  they  may  regain  their  irritability, 
but  if  its  application  be  continued  too  long,  the  irritability  is 
permanently  destroyed.  There  is  no  marked  alteration  in  the 
blood  of  animals  poisoned  by  ether,  but  when  mixed  in  small 
quantity  with  blood  outside  the  body,  it  appears  to  form  a 
compound  with  the  haemoglobin,  and  to  lessen  its  oxidising 
power.  If  mixed  with  the  blood  in  large  quantity,  it  destroys 
the  blood-corpuscles,  probably  by  dissolving  the  protagon  which 
forms  an  essential  constituent  of  them. 

The  heart  is  very  much  less  easily  paralysed  by  ether  than 
by  chloroform.  If  two  rabbits  are  thoroughly  narcotised  by  ether 
and  chloroform  vapour  respectively,  and  the  thorax  opened,  and 
artificial  respiration  kept  up  with  air  containing  these  vapours, 
the  heart  of  one  can  be  readily  stopped  by  increasing  the  pro- 
portion of  chloroform  vapour  in  the  air  blown  in,  whereas  the 
heart  of  the  other  is  only  arrested  when  the  proportion  of  ether 
vapour  becomes  exceedingly  large.  It  is  this  peculiarity  of  ether 
which  gives  it  the  advantage  over  chloroform,  and  renders  death 
from  syncope  during  operations  less  probable  when  ether  is 
employed  as  an  anaesthetic. 

Another  difference  between  ether  and  chloroform,  which 
renders  the  former  much  safer  as  an  anaesthetic,  is  that  the  vaso- 
motor centre  appears,  like  the  heart,  to  be  very  much  less  readily 
affected  by  ether  than  by  chloroform,  so  that  irritation  of  a 
sensory  nerve  continues  for  a  longer  time  to  raise  the  blood- 
pressure  when  ether  is  employed  as  an  anaesthetic.  The  dis- 
advantages of  ether  are  that  it  is  less  agreeable  to  take,  and 
that  its  odour  hangs  unpleasantly  about  the  patient  for  a  much 
longer  time  than  is  the  case  with  chloroform.-  It  causes  greater 
irritation  of  the  air-passages,  and  may  produce  a  catarrhal 
condition.  It  has  to  be  administered  in  a  more  concentrated 
form  than  chloroform,  and  thus  is  not  so  convenient  as  the 
latter  when  operations  on  the  face  and  mouth  are  necessary.  It 
is  frequently  administered  along  with  nitrous  oxide,  the  nitrous 
oxide  being  first  given  alone  until  the  patient  is  sufficiently 
under  its  influence  not  to  notice  the  taste  or  smell  of  the  ether. 
Nitrous  oxide  loaded  with  ether  vapour  is  then  given,  and  as 


f 


<Shap.  xxrx.]    CAKBON  COMPOUNDS— FATTY  SEEIES.       783 

soon  as  complete  insensibility  is  induced  air  is  mixed  with  ether 
.vapour,  the  anaesthesia  being  maintained  by  regulating  the 
proportion  of  vapour  according  to  the  condition  of  the  patient. 
The  administration  of  ether  is  inadmissible  in  operations  on  the 
mouth  and  face  if  the  thermo-cautery  has  to  be  used. 

SALINE   ETHERS. 

These  correspond  to  metallic  salts,  in  which  the  metal  is 
replaced  by  an  organic  radical,  e.g. : 

Potassium  Sulphate.  Ethyl  Sulphate. 

\  \  S04  or  K2S04  g»g»  j  S04  or  (C2H6)2S04. 


U.S.P.  Oleum  iEthereum.  Ethereal  Oil. — A  volatile 
liquid,  consisting  of  equal  volumes  of  heavy  oil  of  wine  and  of 
stronger  ether. 

The  heavy  oil  of  wine  is  either  a  mixture  of  ethyl  sulphate 
(C2H5)2S04,  and  a  polymeric  form  of  ethylene  (C2H4),  or  else  a 
sulphovinate  of  a  hydrocarbon  radical. 

Characters. — A  transparent,  nearly  colourless,  volatile  liquid, 
of  a  peculiar  aromatic  ethereal  odour,  a  pungent,  refreshing, 
bitterish  taste,  and  a  neutral  reaction  to  dry  litmus-paper. 
Specific  gravity,  0-910. 

Preparation. — By  mixing  alcohol  with  sulphuric  acid,  allowing  it  to 
stand  for  some  hours  (24  B.P. ;  12  U.S.P.),  and  then  distilling.  The  dis- 
tillate consists  of  three  layers — ether,  water,  and  yellow  ethereal  oil  of  wine 
(lime  water  is  added  to  it  to  neutralise  any  acid,  B.P.).  The  yellow  oil  of 
wine  is  separated  and  exposed  to  the  air  for  twenty-four  hours  in  a  shallow 
capsule,  so  that  any  ether  evaporates.  It  is  then  used,  B.P.,  but  according 
to  U.S.P.  it  is  then-  put  in  a  wet  filter,  washed  with  distilled  water,  and 
mixed  with  an  equal  volume  of  stronger  ether. 

Pbepabation. 
Spiritus  JStheris  Compositus. 

Spiritus  iEtheris  Compositus,  B.  and  U.S.P.  Compound 
Spirit  of  Ether.     Hoffmann's  Anodyne. 

Composition. — B.P.,  oil  of  wine  3,  ether  64,  rectified  spirit 
128 ;  U.S.P.,  ethereal  oil  3  parts,  stronger  ether  30,  alcohol  67. 
The  strength  of  the  two  preparations  is  nearly  the  same,  as  the 
oil  of  wine  is  diluted  to  make  the  ethereal  oil  of  the  U.S.P. 

Use. — Like  that  of  spirit  of  ether,  but  more  powerful.  It  is 
given  in  similar  doses. 

iEtherAceticus,B.  and  U.S.P.  Acetic  jEther.  C2H5C2H302; 
88.     Acetate  op  Ethyl. 

Characters. — A  transparent  and  colourless  liquid,  of  a  strong 
fragrant  ethereal  and  somewhat  acetous  odour,  a  refreshing  taste 
and  a  neutral  reaction. 


784  OEGANIC    MATERIA  MEDICA.  [sect,  iv 

Preparation. — By  distilling  rectified  spirit  with  acetate  of  sodium  and 
sulphuric  acid,  NaC2Hs02  +  E^SO,,  +  C2H„0  =  C2H5C2Hs02  +  NaHS04  +  H,0. 
The  acetic  ether  and  water  distil  over  together,  and  they  are  separated  by 
means  of  calcium  chloride. 

Dose.— 20  to  60  min. 

Uses.— It  has  an  action  much  like  ether,  but  is  inconvenient 
as  an  anaesthetic.  It  has  a  pleasanter  taste  than  ether,  and  is 
used  as  a  stimulant,  carminative,  and  antispasmodic.  It  may 
be  given  along  with  the  acetates  of  iron  and  potassium  in  albu- 
minuria. 

Peeparation. 

B.P. 

Liquor  Epispasticus. 

Spiritus  Athens  Nitrosi,  B.  and  U.S.  P.  Spirit  of  Niteous 

Ether. 

A  spirituous  solution  containing  nitrous  compounds,  aldehyde 
and  other  substances,  B.P.  An  alcoholic  solution  of  ethyl  nitrite 
(C2H5N02 ;  75),  containing  5  per  cent,  of  the  crude  ether,  U.S.P. 

Characters. — Transparent  and  nearly  colourless,  with  a  very 
slight  tinge  of  yellow,  mobile,  inflammable,  of  a  peculiar  pene- 
trating apple-like  odour,  and  sweetish  cooling  sharp  taste. 
Specific  gravity,  0-845. 

Reactions. — It  effervesces  feebly  or  not  at  all  when  shaken  with  a  little 
bicarbonate  of  sodium  (no  acid).  When  agitated  with  solution  of  sulphate  of 
iron  and  a  few  drops  of  sulphuric  acid  it  becomes  deep  olive-brown  or  black. 
When  freshly  prepared  it  should  yield  7  times  its  volume  of  nitric  acid  gas, 
or  5  times  even  after  it  has  been  kept. 

Preparation. — By  distilling  rectified  spirit  with  nitric  and  sulphuric 
acids  and  copper  wire,  and  diluting  the  distillate  with  spirit.  In  this  process 
the  copper  reduces  the  nitric  to  the  nitrous  radical. 

CaH5HO  +  HN03  +  H2S04  +  Ou  =  C2H5N02  +  2HaO  +  CuS04. 
Impurities.— Water,  free  acid. 

Dose. — \  to  2  fluid  drachms. 

Use. — Is  used  as  a  diaphoretic  and  diuretic. 

Preparation. 

u.s.p. 

Mistura  Glycyrrhizae  Composita. 

Amyl  Nitris,  B.  and  U.S.P.  Nitrite  of  Amyl,  C6HnN0  ; 
117. 

Characters. — A  yellowish  liquid  with  a  strong  ethereal, 
fruity  smell.  When  freely  exposed  to  air  it  decomposes,  leaving 
a  large  residue  of  amyl  alcohol. 

Solubility. — Insoluble  in  water,  but  soluble  in  all  proportions  in  alcohol, 
ether,  and  chloroform. 

Preparation. — By  distilling  dilute  amyl  alcohol  with  nitric  acid,  sul- 
phuric acid  and  copper  wire.  The  distillate  is  washed  with  caustic  soda  to 
remove  hydrocyanic  and  other  acids ;  the  moisture  removed  by  potassium 
carbonate,  and  the  nitrite  purified  by  fractional  distillation  between  202°  and 
270°  F.  (128°— 132°  C). 


chap,  xxix.]    CARBON  COMPOUNDS— FATTY  SERIES.       785 

Impurities. — It  is  apt  to  contain  free  acid,  nitrate  of  amyl,  nitro-pentane. 

Tests. — The  physiological  test  is  the  most  certain.  One  or  two  sniffs 
from  a  bottle  containing  the  nitrite  are  usually  sufficient  to  produce  flushing 
■of  the  face  and  fulness  in  the  head.  If  the  preparation  is  impure  or  has 
lost  its  strength,  this  effect  does  not  occur.  Some  specimens  are  entirely 
inert. 

Physiological  Action. — When  mixed  with  blood  it  forms 
methsemoglobin,  which  is  not  so  readily  de-oxidised  as  hemo- 
globin itself.  The  blood,  under  the  influence  of  the  nitrite, 
becomes  of  a  dark  chocolate  colour,  both  in  the  arteries  and 
veins,  and  oxidation  in  the  body  is  interfered  with ;  so  much  so 
that  in  rabbits  convulsions  almost  exactly  resembling  those  of 
ordinary  asphyxia  are  very  rapidly  produced  by  the  inhalation 
of  the  drug.  The  methsemoglobin  may  be  broken  up  by  reducing 
agents,  and  the  blood  will  then  take  up  oxygen  again.  It  is 
therefore  probable  that,  when  the  venosity  of  the  blood  becomes 
great,  the  unoxidised  products  of  tissue-waste  will  act  as  re- 
ducing agents,  and  again  restore  the  internal  respiration.  When 
inhaled,  nitrite  of  amyl  causes  at  first  a  short  dry  tickling  cough, 
followed  in  about  half  a  minute  by  flushing  of  the  face,  throbbing 
of  the  carotids  and  their  branches,  a  quicker  and  fuller  pulse,  a 
feeling  of  tension  in  the  head,  sometimes  lacrimation,  quickened 
respiration,  and  giddiness.  The  giddiness  is  more  especially  felt 
if  the  patient  is  sitting  up.  If  the  dose  of  nitrite  be  large  the 
respiration  becomes  very  quick,  laboured,  and  dyspnoeie.  The 
blood-pressure  is  very  greatly  lessened  by  nitrite  of  amyl,  the 
diminution  being  chiefly  due  to  dilatation  of  the  arterioles.  The 
pulse  in  man  and  in  dogs  is  very  much  quickened  by  it.  In 
rabbits  the  acceleration  is  not  so  great.  This  appears  to  show 
that  the  quickening  is  in  a  great  measure  due  to  diminution  in 
the  tone  of  the  vagus-roots  in  the  medulla  caused  by  the  fall  of 
blood-pressure.  The  dilatation  of  the  arterioles  appears  to  be 
due  to  weakening  or  paralysis,  either  of  the  muscular  walls  of 
the  arterioles  themselves,  or  of  the  vaso-motor  ganglia  in  or 
near  them.  This  is  shown  by  the  fact  that  the  nitrite  of  amyl 
lowers  the  blood-pressure  in  animals,  even  after  the  cord  has 
been  divided  just  below  the  medulla.  It  has  been  objected  to 
this  that  |5ernheim  has  found  that  when  the  capillaries  are 
dilated  by  nitrite  of  amyl  they  may  still  be  made  to  contract  by 
irritation  of  the  vaso-motor  nerves  ;  and  he  concludes  from  this 
that  the  dilatation  is  due  rather  to  paralysis  of  vaso-motor 
centrea  than  to  vaso-motor  nerves,  or  to  the  arterioles.  It  is 
possible  that  the  dilatation  may  be  partly  due  to  weakening 
of  the  vaso-motor  centres  also;  but  Berriheim's  objection  is 
altogether  without  force,  because  in  animals  killed  by  curare, 
the  muscles  will  still  contract  on  the  application  of  an  electric 
current  to  the  motor  nerves.  In  this  case  the  nerves  are  so  far 
paralysed  that  they  will  no  longer  respond  to  the  stimuli  sent 
down  from  the  nerve-centres,  although  they  .will  do  so  to  strong 

3  E 


786  OEGANIC  MATEEIA  MEDICA.  [sect.  rv. 

currents,  and  probably  the  same  thing  occurs  with  the  muscular 
walls  of  the  arterioles  when  paralysed  by  nitrite  of  amyl. 

Action  on  Muscles. — The  voluntary  muscles  are  not  para- 
lysed in  animals  poisoned  by  nitrite  of  amyl,  but  when  the 
muscles  of  a  frog  are  exposed  to  the  vapour  they  soon  lose  their 
contractility.  It  was  stated  by  Dr.  Eichardson  that  nitrite  of 
amyl,  like  curare,  paralysed  the  ends  of  the  motor  nerves,  and 
that  it  acted  in  consequence  as  an  antidote  to  strychnine..  On 
repeating  his  experiments  other  observers  have  failed  to  detect 
any  paralysis  of  motor  nerves.  I  have  found  that  nitrite  of  amyl 
alone  does  not  paralyse  them,  nor  does  strychnine  alone ;  but  if 
a  frog  be  poisoned  with  strychnine  after  one  leg  has  been  protected 
•by  a  ligature  from  the  influence  of  the  poison,  and  is  then  exposed 
to  the  vapour  of  nitrite  of  amyl,  the  joint  action  of  the  strych- 
nine and  nitrite  paralyses  the  ends  of  the  motor  nerves,  while 
the  nerves  of  the  limb  protected  from  the  strychnine  retain 
their  irritability,  although  both  were  equally  exposed  to  the 
nitrite  of  amyl.a 

Action  on  the  Nervous  System. — It  lessens  reflex  action, 
apparently  by  its  action  on  the  spinal  cord. 

On  the  Urine. — When  nitrite  of  amyl  is  given  to  animals 
either  by  inhalation  or  hypodermically,  sugar  appears  in  the 
•urine. 

Uses. — The  action  of  nitrite  of  amyl  in  causing  flushing  was 
-first  observed  by  Guthrie,  and  Dr.  B.  W.  Eichardson  recom- 
mended it  as  a  remedy  in  spasmodic  conditions,  from  the  power 
he  thought  it  to  possess  of  paralysing  motor  nerves.  In  the 
■spring  of  1867  I  had  opportunities  of  constantly  observing  a 
patient  who  suffered  from  angina  pectoris,  and  of  obtaining  from 
him  numerous  sphygmographic  tracings,  both  during  the  attack 
and  during  the  interval.  These  showed  that  during  the  attack 
the  pulse  became  quick,  the  blood-pressure  rose,  and  the  arte- 


1*10. 173.— Normal  pulse-tracing  of  a  patient  suffering  from  aortic  regurgitation  and  angina  pectoris. 

rioles  contracted ;  for  the  form  of  the  pulse-curve  was  such  as 
could  only  be  caused  by  contraction  of  the  arterioles  (Fig.  173). 
The  pain,  which  came  on  every  night,  lasted  for  one  and  a  half 
or  two  hours.    All  other  remedies  were  nearly  useless,  though 

1  These  experiments  were  made  with  Sana  temporwia. 


chap.  xxix.J    CAEBON  COMPOUNDS— FATTY  SEEIES.       787 

bleeding  always  removed  the  pain  for  one  night.  It  seemed 
probable  that  the  great  rise  in  tension  was  the  cause  of  the  pain, 
and  it  occurred  to  me  that  if  it  was  possible  to  diminish  the 
tension  by  drugs,  instead  of  by  bleeding,  the  pain  would  be 
removed. 

I  knew  from  unpublished  experiments  by  Dr.  A.  Gamgee, 
that  nitrite  of  amyl  had  this  power,  and  therefore  tried  it  on 
the  patient.  My  expectations  were  perfectly  answered.  The  pain 
usually  disappeared  in  three  quarters  of  a  minute  after  the  in- 
halation began,  and  at  the  same  time  the  pulse  became  slower 
and  much  fuller,  and  the  tension  diminished.  Occasionally  the 
pain  would  disappear,  though  the  pulse  regained  its  normal 
fulness,  and  on  these  occasions  the  pain  always  reappeared  after 
the  lapse  of  a  few  minutes  (Fig.  174).    Whenever  the  pulse 


$10. 174.— Tracing  of  the  same  pulse  daring  severe  anginal  pain. 

again  regained  its  normal  character  completely  (Fig.175),  I  knew 
that  the  pain  would  not  again  return. 


Pio.  175.— Tracing  of  the  same  pulse  during  temporary  relief  of  pain  by  nitrite  of  amyl.    The  pain 
returned  after  a  few  minutes. 

In  some  cases  of  angina  pectoris  nitrite  of  amyl  has  failed. 
One  reason  of  this  may  be  either  that  the  drug  has  not  been 
pure,  or  that  it  has  undergone  changes  from  age.  In  one  case 
mentioned  to  me  by  Dr.  Balfour,  the  patient  was  only  relieved 
by  nitrite  of  amyl  newly  made,  the  drug  appearing  to  lose  its 
power  in  a  few  days.  As  migraine  is  generally  connected  with 
vascular  spasm,  I  employed  the  nitrite  of  amyl  in  headache,  and 
found  that  frequently,  though  not  invariably,  it  relieved  the  pain. 
It  was  also  useful  in  neuralgia  of  the  scalp.  As  epilepsy  has  been 
supposed  to  depend  upon  spasmodic  contraction  of  the  cerebral 
vessels,  I  employed  it  in  this  disease,  during  the  fit,  without  suc- 
cess, but  Sir  Crichton  Browne  found  that  when  administered 
immediately  after  the  appearance  of  the  aura  it  prevented  the  fit 
which  would  otherwise  have  come  on.  On  the  commencement  of 
the  cold  stage  in  ague  nitrite  of  amyl  cuts  short  the  attack; 
In  sea-sickness,  a  disease  probably  of  cerebral,  rather  than 
gastric,  origin,  it  appears  to  give  relief.     It  has  been  employed 

3  k  2 


788  OKGANIC  MATEEIA  ftfEDICA.  [sect,  iy, 

to  aid  circulation  in  cases  of  syncope,  and  in  chloroform  poi- 
soning, its  administration  in  the  latter  case  being  combined  with 
the  depression  of  the  patient's  head  below  the  level  of  his  body, 
and  the  use  of  artificial  respiration.  In  spasmodic  asthma  it 
sometimes  affords  some  relief,  but  this  is  not  very  marked.  It  is 
useful  in  the  case  of  persons  who  are  subject  to  sudden  flushes  of 
heat  and  profuse  perspiration. 

The  administration  of  nitrite  of  amyl  is  not  attended  with 
much  danger.  I  have  pushed  it  in  many  cases,  and  have  seen 
no  bad  effects  from  its  use.  In  cases  of  chronic  bronchitis  and 
emphysema,  however,  it  is  advisable  not  to  give  it  even  for  the 
relief  of  asthmatic  attacks  which  come  on  in  this  disease,  as  the 
difficulty  of  breathing  already  present  may.  be  seriously  increased 
by  the  action  of  the  drug  upon  the  blood.  It  has  been  thought 
that  its  administration  would  be  especially  dangerous  in  aortic 
disease ;  and  no  doubt  it  is  well  both  in  this  disease  and  in  other 
cases  to  give  the  drug  in  the  recumbent  posture  and  thus  avoid 
the  faintness  which  might  otherwise  occur.  Although  it  causes 
a  feeling  of  fulness  in  the  head,  little  danger  of  apoplexy  is  to  be 
apprehended  from  it,  because  the  blood-pressure,  instead  of  being 
higher,  is  much  lower  than  usual,  and  therefore  the  tendency  of 
•the  vessel  to  burst  must  be  reduced  to  its  minimum. 

Nitro-glycerinum.  Niteo-olyceeine,  Glonoine.  C3H5(N03)3. 
Not  officinal. 

Pbopeeties.  —  A  colourless  transparent  liquid ;  aromatic 
taste. 

Solubili-bt. — It  is  slightly  soluble  in  water,  readily  soluble  in  absolute 
alcohol  and  ether,  soluble  also  in  oils  and  fats. 

Preparation. — By  dropping  pure  glycerine  into  a  mixture  of  sulphuric 
and  nitric  acid  kept  cool  by  ice ;  pouring  the  mixture  into  water ;  washing  it 
well ;  and  carefully  drying  in  a  warm  room. 

Dose. — -^  to  j^  gr.  increased  to  ^  grain  ;  of  Liquor  Nitro- 
glycerin! (non-officinal) '  (1  gr.  in  100  min.  rectified  spirit),  £-10 
minims. 

B.P.  Tabellse  Nitro-glycerini.  Tablets  of  Niteo-glyceeine. 
Tablets  of  chocolate,  each  weighing  2£  grains,  and  containing 
■j-J-oth  of  a  grain  of  pure  nitro-glycerine. 

Dose. — 1  or  two  tablets. 

Liquor  Nitro-glycerini  (non-officinal)  ■  (1  gr.  in  IOC  rectified  spirit),  J-10  min. 

Action. — Its  action  is  much  like  that  of  nitrite  of  amyl  and 
other  nitrites,2  but  is  more  persistent.  In  frogs  it  causes  at 
first  great  restlessness,  then  lethargy,  to  which  convulsions  and 
paralysis  succeed.  In  mammals  it  causes  depression,  with  very 
rapid  pulse  and  respiration,  paralysis  of  reflex  action  and  volun- 
tary motion,  loss  of  sensation,  and  death  by  stoppage  of  the 

1  Martindale  and  Westcott,  The  Extra  Pharmacopoeia. 

8  Lauder  Brunton  and  Tait,  St.  BartJwlomew's  Hospital  Reports,  1876,  p.  140. 


chap,  xxix.]    CAEBON  COMPOUNDS— FATTY  SEEIES.        789 

respiration.  It  agrees  with  nitrites  in  acting  as  a  poison  to 
muscle.  The  spinal  cord  appears  to  be  paralysed  before  the 
cerebral  ganglia,  and  the  convulsions  in  frogs  are  of  cerebral 
rather  than  spinal  origin.  It  paralyses  the  heart  of  the  frog 
when  directly  applied.  It  diminishes  the  oxidising  power  of  the 
blood  and  communicates  to  it  a  chocolate  colour,  like  nitrites, 
and  like  them  also  it  lessens  the  blood-pressure.  In  some 
persons  it  produces  intense  headache,  even  in  exceedingly  minute 
doses.  It  is  curious  that  its  action  upon  the  blood  and  organs 
should  so  exactly  resemble  that  of  nitrites,  because  nitro-glycerine 
is  a  nitrate  and  not  a  nitrite  of  glyceryl.  Hay  has  shown,  how- 
ever, that  nitro-glycerine  is  decomposed  by  alkalis,  two-thirds 
of  its  nitric  acid  being  reduced  to  nitrous  acid  and  uniting  with 
the  alkali  to  form  a  nitrite,  whilst  the  remaining  third  is  set  free 
without  reduction  and  forms  a  nitrate. 

The  reasons  why  nitro-glycerine  acts  more  powerfully  than 
nitrites  probably  are  that  the  whole  of  it  is  absorbed  without 
decomposition,  and  that  nitrous  acid  being  set  free  in  the  blood 
in  a  nascent  condition  is  more  active  than  it  would  otherwise  be. 

Uses. — Like  nitrite  of  amyl,  it  is  useful  in  angina  pectoris, 
headache,  neuralgia,  epileptic  vertigo,  and  epilepsy.  Its  action 
being  more  persistent  than  that  of  nitrite  of  amyl,  it  is  some- 
times more  efficacious.  It  is  sometimes  of  service  in  spasmodic 
asthma,  uraemic  asthma,  and  in  puerperal  convulsions.  It  fre- 
quently relieves  sea-sickness,  and  may  lessen  pain  in  gastralgia 
and  hepatic  'colic.  By  dilating  the  vessels  it  may  cut  short  or 
prevent  the  cold  stage  of  ague.  By  lessening  the  arterial  ten- 
sion and  diminishing  the  resistance  the  heart  has  to  overcome, 
it  is  useful  when  the  heart  is  weak  in  old  persons,  or  from  fatty 
degeneration,  or  where  the  tension  is  abnormally  high,  as  in 
Bright's  disease.  In  conjunction  with  elaterium  it  is  said  to 
have  proved  useful  in  myxcedema. 

B.P.  Liquor  Sodii  Ethylatis.— Vide  p.  619. 


HALOID  COMPOUNDS. 

.  These  correspond  to  haloid  salts  of  metals,  e.g. : 

Potassium  Bromide.  Ethyl  Bromide. 

KBr.  (C2Hs)Br. 

JEthyl  Bromidum.  Bromide  of  Ethyl.  C2H6Br.  Hydro- 
bromic  Ether.     Not  officinal. 

Characters. — A  colourless  volatile  liquid ;  of  peculiar  odour 
and  sweetish  taste.     Specific  gravity,  1-419. 

Peepaeation. — By  distilling  alcohol  with  bromide  and  phosphorus. 

Action  and  Uses. — When  applied  as  spray  it  produces  local 
anaesthesia,  which  seems  to  depend  on  the  action  of  the  drug  on 


790  OKGANIC  MATEEIA  MED1CA.  [sect.  iv. 

the  nerves  as  well  as  on  the  cold  produced.  It  is  used  as  a  local 
anaesthetic  in  neuralgia.  When  inhaled  it  produces  anaesthesia, 
and  has  been  recommended  as  an  anaesthetic  either  alone  or  as 
a  mixture  of  one  part  of  it  with  3  of  chloroform  and  4  of  alcohol. 
Its  advantages  are  that  it  is  not  inflammable  like  ether,  that  it 
does  not  irritate  the  respiratory  passages,  and  that  it  causes  less 
excitement  and  struggling  than  ether  or  chloroform,  and  is  less 
depressing  than  chloroform.  Its  disadvantages  are  that  it  is 
not  absolutely  safe,  as  one  death  at  least  has  occurred  from  its 
use.  Its  odour  remains  longer  in  the  breath  than  either  chloro- 
form or  ether,  and  some  patients  dislike  its  smell  extremely. 

JEthyl  Iodidum.  Iodide  op  Ethyl.  C2H5I.  (Hydriodic 
Ether.)     Not  officinal. 

Characters. — A  colourless  liquid,  with  a  penetrating  odour. 
It  is  apt  to  become  decomposed  by  keeping,  and  acquire  a  brown 
colour  from  free  iodine. 

Preparation. — Like  bromide  of  ethyl,  using  iodine  instead  of  bromine. 

Action  and  Uses. — It  has  an  anaesthetic  action  when  in- 
haled, which  is  more  slowly  produced  but  is  more  persistent  than 
that  of  ethyl  bromide.  It  is  decomposed  in  the  body,  and'  the 
iodine  is  excreted  in  the  urine  as  iodide  of  potassium.  It  has 
been  given  internally  as  an  alterative  in  doses  of  0*2  to  0"5  gm. 
in  scrofula  and  rheumatism,  and  as  a  diuretic  in  cases  of  cardiac 
dropsy.  Its  chief  use,  however,  is  as  an  antispasmodic  in 
asthmatic  paroxysms,  either  of  the  purely  spasmodic  kind,  or 
occurring  in  chronic  bronchitis  and  emphysema,  or  in  cardiac 
or  laryngeal  disease.  In  some  of  these  cases  it  gives  very  great 
relief,  and  not  only  cuts  short  the  paroxysm,  but  benefits  the 
bronchitic  condition  where  this  is  present  (cf.  p.  562). 

Administration. — It  is  best  given  in  small  glass  capsules 
containing  5  minims,  and  encased  in  cotton-wool  and  silk. 
These  can  be  readily  carried  about,  and  when  the  paroxysm 
comes  on  one  is  crushed  between  the  finger  and  thumb,  and  the 
vapour  inhaled  from  the  cotton-wool,  which  becomes  soaked  by 
the  iodide. 

Chloral  Hydras,  B.P.;  Chloral,  U.S.P.  C2HCl3O.H20; 
165-2.  Hydrate  oe  Chloral  (Hydrous  Chloral),  B.P.  Chloral, 
U.S.P. 

Characters. — Whitish  crystals  with  a  peculiar  very  pungent 
odour,  a  bitterish  caustic  taste,  and  a  neutral  reaction.  It  melts 
when  heated,  forming  a  colourless  liquid,  and  volatilises  if  the 
temperature  be  further  raised. 

Preparation. — By  saturating  absolute  alcohol  with  dry  chlorine  gas 
much  hydrochloric  acid  gas  is  formed,  and  the  alcohol  is  first  reduced  to 
aldehyd,  -which  is  then  attacked  by  the  chlorine,  forming  txichloral&ehyi, 
a  word  which  has  been  shortened  to  chloral.  Chloral  is  an  oily  liquid,  which 
is  purified  with  sulphuric  acid,  and  then  with  lime,  and  finally  converted 
into  hydrouB  chloral  by  the  addition  of  water. 


chap,  xxix.] .  CAEBON  COMPOUNDS— PATTY  SEEIES.       791 

Solubility—  It  is  soluble  in  less  than  its  own  weight  of  water,  alcohol, 
or  ether,  and  in  four  parts  of  chloroform. 

^  Reactions.— When  mixed  with  carbolic  acid  or  camphor  it  liquefies. 
When  mixed  with  alkalis  it  is  decomposed  into  chloroform  and  a  formiate  of 
the  base. 

Impurities. — Hydrochloric  acid  and  oily  impurities. 

Test.— The  aqueous  solution  should  be  neutral  or  only  slightly  acid.  A 
solution  in  chloroform  when  shaken  with  sulphuric  acid  should  not  impart 
colour  to  the  acid  (absence  of  oily  impurities). 

Preparation. 

B.P.  DOSE. 

Syrupus  Chloral.     Syrup  pF  Chloral.    Chloral  in  syrup 

and  water,  10  grs.  in  each  fl.  dr 1  fl.  dr. 

Action  of  Anhydrous  Chlobal. — Anhydrous  chloral  applied 
to  the  skin  is  absorbed  and  converted  in  the  organism  into 
chloral  hydrate.  When  thus  applied  it  sometimes  occasions 
hemoglobinuria  and  nephritis.  Anhydrous  chloral  being  little 
used,  the  name  '  chloral '  is  applied  in  ordinary  conversation 
to  chloral  hydrate,  and  in  the  following  account  of  the  action  of 
chloral  hydrate  the  name  chloral  is  intended  to  apply  to  the 
hydrate. 

Action  of  Chlobal  Hydeate. — It  destroys  low  organisms, 
and  prevents  the  decomposition  which  they  occasion.  It  is  there- 
fore sometimes  used  as  an  antiseptic.  In  the  mouth  chloral 
has  a  hot,  burning  taste,  and  when  applied  to  a  raw  surface,  or 
to  the  mucous  membrane  of  the  eye,  it  is  a  powerful  irritant. 
When  injected  under  the  skin  in  a  strong  solution  it  is  apt  to 
cause  inflammation  and  suppuration.  It  was  introduced  into 
medicine  by  Oscar  Liebreich  with  the  object  of  attaining  by  it 
the  same  effects  as  those  of  chloroform  slowly  administered  for  a 
length  of  time.  When  chloral  is  mixed  with  an  alkali  it  is  split 
up,  yielding  formic  acid  which  combines  with  the  alkali  and 
chloroform.  Liebreich  thought  that  if  chloral  were  administered 
internally  the  alkalis  of  the  blood  would  slowly  split  it  up,  and 
that  chloroform  would  thus  be  slowly  generated  from  it  in  the 
circulating  blood  for  a  considerable  length  of  time.  His  expec- 
tations regarding  the  utility  of  chloral  as  a  means  of  producing 
sleep  and  relieving  pain  have  been  fully  answered  ;  but  the  theory 
which  led  him  to  employ  chloral  appears  to  be  erroneous,  and  it 
probably  acts  as  a  hypnotic  and  analgesic  without  undergoing 
any  decomposition  in  the  body.  The  experiments  which  have 
led  to  the  conclusion  that  chloral  is  not  decomposed  in  the  body 
are  chiefly  those  of  Hammersten,  who  found  that  when  a  stream 
of  carbonic  acid  was  passed  through  the  blood  taken  from 
chloralised  animals,  and  then  passed  through  a  red-hot  tube  into 
a  mixture  of  starch  paste  and  iodine  or  a  solution-  of  nitrate  of 
silver,  no  reaction  occurred,  and  that  the  slightest  addition  of 
chloroform  to  the  blood  or  the  administration  of  chloroform 
to  the  animal  beforehand  always  causes  a  reaction  to  take 
place.     The  expired  air  of  chloralised  animals  is  also  free  from 


792  OEGANIC  MATEEIA  MEDICA.  [sect.  iv. 

chloroform.  The  chloral  is  excreted  in  the  urine  as  such  so  long 
as  the  urine  is  acid,  and  it  is  only  when  the  urine  is  alkaline  that 
chloroform  is  found  in  it,  this  being  formed  by  the  decomposition 
of  the  chloral  by  the  alkali  in  the  urine  itself.  In  frogs,  small 
doses  slow  the  respiration,  and  abolish  reflex  action,  but  the 
animal  recovers  perfectly  after  several  hours.  When  the  dose  is 
increased,  the  stoppage  of  the  heart  follows  the  cessation  of  reflex 
movements  and  the  animal  dies._  In  mammals,  the  respiration 
also  becomes  slow,  the  pupil  contracted,  and  sleep  occurs.  From 
this  the  animal  may  first  be  awakened^ith  ease,  but  it  gradually 
becomes  deeper,  and  the  reflex  movements  disappear.  Insensi- 
bility occurs  first  to  painful  impressions,  so  that  the  animal  may 
be  cut  or  burned  without  showing  the  slightest  symptoms  of 
sensation,  whereas  it  will  still  withdraw  its  limb  quickly  when  a 
slight  pressure  is  made  upon  the  toes.  "When  larger  doses  are 
given,  the  temperature  gradually  falls  until  it  can  no  longer  be 
measured  by  an  ordinary  clinical  thermometer.  The  respiration 
gets  slower  and  weaker,  and  finally  ceases  altogether.  When 
chloral  is  added  to  the  blood,  it  causes  the  red  corpuscles  to 
swell  up  and  become  paler,  but  does  not  dissolve  them. 

Action  on  the  Circulation. — It  diminishes  the  blood-pressure 
in  two  ways — first  by  weakening  and  finally  paralysing  the  vaso- 
motor centre,  and  thus  dilating  the  vessels ;  and  secondly  by 
weakening  the  heart.  The  pulse  may  at  first  be  quickened, 
possibly,  in  consequence  of  the  lessened  blood-pressure,  but  it 
afterwards  becomes  slow.  The  slowing  of  the  pulse  is  not  due  to  - 
any  action  of  the  drug  upon  the  vagus,  for  it  occurs  after  section 
of  the  vagi,  or  after  the  previous  administration  of  nicotine, 
atropine,  or  curare.  The  weakening  and  final  stoppage  of  the 
heart  appears  to  be  due  to  paralysis  of  the  cardiac  ganglia,  as 
the  heart  still  continues  to  contract  when  its  muscular  substance 
is  irritated  directly. 

Action  on  Muscles  and  Motor  Nerves. — The  muscles  and 
motor  nerves  are  not  paralysed  by  chloral.  The  paralysis  and 
loss  of  sensibility  are  of  spinal  origin. 

Action  on  the  Spinal  Cord. — Chloral  first  increases  and 
then  diminishes  the  excitability  of  the  spinal  cord,  and  finally 
abolishes  it  altogether.  It  probably  acts  first  upon  the  grey 
matter,  as  impressions  which  are  usually  painful  are  not  felt  at 
a  time  when  tactile  impressions  still  produce  reflex. 

Action  on  the  Brain. — At  first  it  may  cause  a  little  excite- 
ment of  the  brain,  followed  by  sleep,  and  then  by  coma.  These 
actions  are  probably  due  partly  to  the  influence  of  the  drug  on 
the  circulation,  and  partly  to  its  direct  action  on  the  cerebral 
tissue  itself.  In  the  first  stage  of  excitement  the  circulation 
in  the  brain  is  somewhat  increased,  but  as  sleep  comes  on  the 
vessels  contract  and  the  brain  becomes  anaemic. 

The  pupil  is  almost  invariably  contracted ;  the  temperature, 


chap,  xxix.]     CAEBON  COMPOUNDS— FATTY  SEEIES.       793 

fts_  has  already  been  mentioned,  falls  steadily  and  rapidly,  and 
this  fall  appears  to  be  due  partly,  though  not  entirely,  to  lessened 
production  of  heat,  for  it  still  occurs,  though  to  a  less  extent, 
when  the  animal  is  wrapped  up  in  cotton-wool,  or  is  put  in  a 
warm  place. 

The  Treatment  op  Chloral-Poisoning. —  In  conjunction 
with  Professor  Strieker,  I  found  that  animals  which  had  received 
a  dose  of  chloral  which  would  certainly  kill  them  if  they  were 
left  exposed,  would  recover  from  the  effects  of  such  a  dose  if  they 
were  wrapped  up  in  cotton-wool.  If  the  dose  be  still  further 
increased,  so  as  to  kill  the  animal  even  when  carefully  so  wrapped 
up,  it  may  still  be  kept  alive  by  being  put  in  a  warm  place,  so 
that  its  temperature  is  kept  up  artificially.  If,  however,  the  dose 
be  still  further  increased,  the  animal  will  die,  notwithstanding 
these  precautions.  The  treatment  of  cases  of  poisoning  in  man 
is  the  same  as  in  animals,  viz.  to  keep  up  the  temperature  of 
the  patient  by  putting  him  in  a  warm  room,  covering  him  with 
blankets,  applying  hot  bottles,  and  giving  stimulants,  coffee,  &c. 

Chronic  Chloralism. — Despite  its  nauseous  taste,  chloral 
sometimes  excites  a  craving,  just  like  morphine,  in  those  who 
have  begun  its  use  to  allay  nervous  excitement,  or  to  procure 
sleep.  Taken  habitually  in  this  manner,  it  is  apt  to  excite  gastro- 
intestinal disturbance,  and  to  produce  skin-eruptions  (chiefly 
erythematous),  which  sometimes  occur  only  on  taking  alcohol 
also,  to  lower  the  nutrition,  and  to  cause  pains,  nervous  irritability 
and  depression,  which  may  lead  to  disturbance  of  the  mental  equi- 
librium. After  a  time,  the  dose  has  to  be  increased  to  produce 
the  desired  effect,  but  tolerance  is  not  so  readily  established  as  in 
the  taking  of  opium  or  morphine,  so  that  patients  have  died  from 
a  slight  increase  of  the  dose  they  have  been  accustomed  to  take- 

Uses. — If  equal  parts  of  chloral  and  powdered  camphor  are 
rubbed  together,  they  dissolve,  and  form  a  syrup.  This  is  use- 
ful in  neuralgia,  when  painted  over  or  gently  rubbed  into  the 
painful  part.  In  the  proportion  of  chloral  1  part,  camphor  1 
part,  and  simple  ointment  8,  it  is  a  useful  remedy  in  the  itching 
of  Bkin-diseases. 

The  chief  use  of  chloral  is  to  produce  sleep.  It  is  useful  as  a 
hypnotic  in  the  sleeplessness  due  to  overwork  or  worry,  and  the 
wakefulness  depending  on  constitutional  peculiarity,  old  age,  or 
disease,  such  as  fever,  delirium  tremens,  insanity,  and  puerperal 
mania.  In  the  latter  stage  of  Bright's  disease,  where  there  is 
great  sleeplessness  accompanied  by  high  blood-tension,  chloral  is 
very  useful.  The  sleep  which  it  causes  is  generally  quiet  and 
refreshing,  and  as  a  rule  it  is  not  followed  next  day  by  sickness, 
headache,  and  depression,  like  the  sleep  caused  by  opium. 
Usually,  also,  the  sleep  is  not  too  deep  to  prevent  the  patient 
being  readily  awakened  for  the  purpose  of  taking  food. 

Chloral  may  be  used  to  lessen  reflex  excitability  and  diminish 


794  OEGANIC  MATEEIA  MEDICA.  [sect.  iv. 

convulsions,  as  well  as  to  produce  sleep.  For  this  purpose  it  is 
given  in  puerperal  convulsions,  in  the  convulsions  of  children, 
and  in  chorea  and  tetanus.  In  these  two  latter  diseases  it  must 
be  given  in  large  doses.  It  alleviates  the  dyspnoea  in  spasmodic 
asthma,  and  the  asthmatic  attacks  which  occur  in  persons 
labouring  under  chronic  bronchitis  with  emphysema.  In  cases 
of  this  sort,  however,  it  is  well  to  give  it  with  care,  for  Einger 
states  that  in  them  it  often  produces  increased  lividity  and  mut- 
tering delirium,  lasting  for  several  days. 

The  action  of  chloral  as  an  anaesthetic  or  analgesic  is  much 
slighter  than  that  of  chloroform,  but  nevertheless  it  sometimes 
relieves  pain,  and  for  this  purpose  it  has  been  used  in  gastralgia, 
intestinal  and  renal  colic,  neuralgia,  and  chronic  rheumatism. 
It  has  been  recommended  by  Dr.  Playfair  in  doses  of  15  grains, 
repeated  if  necessary  in  twenty  minutes,  before  the  os  uteri 
has  become  completely  dilated,  to  lessen  pain  in  labour. 

Chloral  is  an  antidote  to  strychnine,  physostigma,  and  picro- 
toxine.  Liebreich  states  that  strychnine  is  an  antidote  to 
chloral ;  and  while  some  observers  have  confirmed  his  statement, 
others  have  denied  it,  so  that  strychnine  has  certainly  not  the 
same  power  of  antagonising  the  action  of  chloral  as  chloral  has 
of  antagonising  strychnine. 

Chloral  is  a  useful  remedy  in  sea-sickness,  and  in  the  incon- 
tinence of  urine  in  children. 

B.P.  Butyl-Chloral  Hydras.  Hydrate  of  Butyl- 
Chloral.  C4H5C130 JI20.—  {Synonym :  Croton-chloral  hydrate, 
wrongly  so  called.) 

Characters.— It  forms  white  pearly  crystalline  scales,  with  a 
pungent  smell,  and  acrid,  disagreeable  taste. 

Solubility. — It  is  sparingly  soluble  in  water  (1  in  100),  but  is  readily 
soluble  in  glycerine  (1  in  4). 

Preparation. — By  acting  on  cold  dry  aldehyd  at  14°  F.,  with,  chlorine, 
separating  the  butyl-chloral  by  fractional  distillation,  and  converting  it  into 
solid  hydrous  butyl-chloral  by  the  addition  of  water. 

Dose. — To  lessen  pain,  l|-5  gr.  (0-1-0-3  gm.) ;  as  hypnotic, 
5-15  gr.  (0-3-1-0  gm.). 

Action. — It  acts  much  like  chloral,  though  less  powerfully, 
and  has  a  less  depressing  effect  on  the  heart,  and  is  much  less 
poisonous  than  chloral.  It  is  said  by  Liebreich  to  affect  the  fifth 
nerve  especially,  and  cause  anaesthesia  in  the  parts  supplied  by 
it  before  general  anaesthesia  is  produced. 

Uses. — It  has  been  used  especially  in  facial  neuralgia  and 
migraine  and  paroxysmal  toothache.  It  has  been  used  also  as 
a  hypnotic  instead  of  chloral,  in  cases  of  weak  heart. 

Administration. — The  disagreeable  taste  is  best  covered  by 
syrup  of  tolu,  and  it  may  be  suspended  in  almond  mixture  or 
mucilage. 

Bromal  Hydrate.    C2Br3OH.    Not  officinal. 


chap,  xxix.]     CAEBON  COMPOUNDS— FATTY  SEEIES.       795 

Characters. — An  oily  colourless  substance,  with  a  strong 
smell  and  burning  taste. 

Preparation. — It  is  prepared  in  the  same  way  as  chloral  hydrate,  bromine 
vapour  being  employed  in  place  of  chlorine. 

Action. — It  irritates  the  eyes  and  produces  running  at  the 
nose.  It  has  a  narcotic  action  like  chloral,  but  causes  more 
excitement  and  less  profound  sleep.  It  has  a  more  powerful  para- 
lysing action  on  the  heart,  and  is  poisonous  in  smaller  doses 
than  chloral.  It  generally  causes  salivation,  and  profuse  secre- 
tion from  the  bronchial  mucous  membrane  accompanied  by 
congestion.  In  toxic  doses  it  produces  cyanosis,  dyspnoea,  and 
death  with  convulsions,  which  are  probably  due,  in  great  measure 
at  least,  to  clogging  of  the  respiratory  passages. 

Use. — It  is  said  to  have  been  of  use  in  epilepsy. 

Bichloride  of  Methylene.    CH2C12.     Not  officinal. 

Characters. — A  colourless  volatile  liquid,  with  a  smell  like 
chloroform.     Sp.  gr.  1-344.     Boiling  point,  40°  C.  (104°  P.). 

Preparation.  —  By  acting  on  chloroform  with  nascent  hydrogen, 
CHC13  +  H2  =  CHjO,  +  HC1. 

Action. — Like  that  of  chloroform  but  more  rapid,  though  a 
larger  quantity  is  required.  It  is  said  to  depress  the  action  of 
the  heart  more  than  chloroform,  but  it  has  been  found  a  very 
satisfactory  anaesthetic  in  ovariotomy. 

It  is  very  doubtful  whether  the  substance  sold  as  bichloride 
of  methylene  is  anything  but  a  mixture  of  chloroform  and  alco- 
hol, as  the  pure  substance  is  expensive. 

Chloroformum,  B.P. ;  Chloroformum  Venale,  U.S.P. 
Chloroform.     CHC13;  119-2. 

Characters. — A  limpid  colourless  liquid,  of  an  agreeable 
ethereal  odour,  and  sweet  taste.     Specific  gravity  1-497. 

Solubility. — Dissolves  in  alcohol  and  ether  in  all  proportions ;  and  in 
water  to  the  extent  of  1  volume  in  200,  communicating  to  it  a  sweetish  taste. 

Reactions. — It  is  not  coloured  by  agitation  with  sulphuric  acid,  leaves  no 
residue  and  no  unpleasant  odour  after  evaporation. 

Preparation. — By  distilling  alcohol  with  chlorinated  lime  and  slaked 
lime,  washing  the  distillate  with  sulphuric  acid,  and  redistilling  from  slaked 
lime  and  calcium  chloride. 

In  this  process  the  alcohol  probably  first  becomes  reduced  to  aldehyd. 
From  the  aldehyd,  chloral  is  formed,  and  this  is  broken  up  by  the  caustio 
lime  into  formate  of  calcium  and  chloroform. 

Aldehyd.;  Chloral. 

C2H40  +  3C12  =  C2HC130  +  3HC1. 

Formate  of  Calcium.     Chloroform, 
2C2HC130     +     Ca(HO)2     =     Ca(CO.OH)2     +     2CHC1„. 

Or,  disregarding  the  intermediate  steps,  the  reaction  may  be  represented 
thus : — 

Caloinm 
Alcohol,   hypochlorite. 
4C2H60  +  8CaCl202  =  2CHC1,  +  3Ca(CO.OH)2  +  5CaCl2  +  8H20. 


796 ,  OEGANIC  MATEEIA  MEDICA.  [sect,  iv* 

Impurities.— Hydrochloric  acid,  chlorine,  hydrocarbons,  alcohol. 
Tests. — The  same  as  those  of  purified  chloroform. 

Dose. —  3  to  i.0  min. 

U.S. P.  Chloroformum  Purificatum.  Purified  Chloeo- 
foem.     CHC13;  119-2. 

Peepakation. — By  mixing  chloroform  (200)  with  sulphuric  acid  (60)  and 
allowing  them  to  stand,  with  occasional  shaking,  for  twenty-four  hours  ;  then 
separating  the  lighter  liquid  and  adding  to  it  carbonate  of  sodium  (10)  pre- 
viously dissolved  in  water  (20).  The  mixture  is  then  agitated  thoroughly  for 
half  an  hour  and  set  aside.  The  chloroform  is  then  separated  from  the 
supernatant  layer,  mixed  with  alcohol  (2),  transferred  to  a  dry  retort,  and 
lime  (1)  is  added,  and  the  liquid  distilled,  taking  care  that  the  temperature 
does  not  rise  above  67-2°  C.  (153°  F.),  into  a  well-cooled  receiver,  until  the 
residue  in  the  retort  is  reduced  to  2  parts. 

Tests. — If  5  c.c.  of  purified  chloroform  be  thoroughly  agitated  with  10  c.c. 
of  distilled  water,  the  latter  when  separated  should  not  affect  blue  litmus- 
paper  (absence  of  acids),  nor  test-solution  of  nitrate  of  silver  (chloride),  nor 
test-solution  of  iodide  of  potassium  (free  chlorine).  If  a  portion  be  digested 
warm  with  a  solution  of  potassa,  the  latter  should  not  become  dark-coloured 
(absence  of  aldehyd).  On  shaking  10  c.c.  of  the  chloroform  with  5  c.c.  of 
sulphuric  acid,  in  a  glass-stoppered  bottle,  and  allowing  them  to  remain  in 
contact  for  twenty -four  hours,  no  colour  should  be  imparted  to  either  liquid. 
If  a  few  c.c.  be  permitted  to  evaporate  from  blotting-paper,  no  foreign  odour 
should  be  perceptible  after  the  odour  of  chloroform  ceases  to  be  recognised. 

Preparations. 

B.P.  DOSE. 

Aqua  Chloroformi 1  volume  in  200. ..1-2  11.  oz. 

Licinjentum  Chloroform!  (vide  p.  510)  ...1  „        2. 

Spiritus  Chloroformi 1  „       20. ..20-60  min. 

Tinctura  Chloroformi  Composita 1  „       10. ..20-60  min. 

„  „  ct  Morpliinse 1  „         8... 5-10  min. 

U.S.P. 

Linimentum  Chloroformi  (vide  p.  517) 40  per  Gent. 

Mistura  Chloroformi 8    „      „ 

Spiritus  Chloroformi 10     „      „ 

U.S.P.  Mistura  Chloroformi.  Chloroform  Mixture.  Purified  chloroform  8, 
oamphor  2,  fresh  yolk  of  egg  10,  water  80. 

Dose. — 1  to  2  tablespoonfuls. 

Spiritus  Chloroformi,  B.  and  U.S.P.    Spirit  of  Chloroform. 

Chloroform  1  fl.  oz.,  rectified  spirit  19  fl*  oz.,  B.P. ;  purified  chloroform  10, 
alcohol  90,  U.S.P. 

Dose.— 20  to  60  min. 

B.P.  Tinctura  Chloroformi  Composita.  Compound  Tincture  of  Chloro- 
form. 

Chloroform  2  fi.  oz.,  rectified  spirit  8  fl.  oz.,  compound  tincture  of  cardamoms 
10  fl.  oz. 

Dose. — 20  to  60  minims. 

Uses. — The  liniment  is  used  as  a  stimulant  and  local  anaes- 
thetic. Spirit  of  chloroform,  chloroform  mixture,  and  compound 
tincture  are  used  as  carminatives  and  sedatives.  Chloroform 
water  as  a  vehicle  and  carminative. 

Action  of  Chloeoform. — When  mixed  with  albumen, 
chloroform  produces  a  precipitate,  but  renders  the  supernatant 
albumen  more  easily  filtered  than  before.  It  is  a  powerful  sol- 
Vent  of  protagon,  which  forms  the  essential  ingredient  both  of 


chap,  xxix.]     CARBON  COMPOUNDS— FATTY  SERIES.       797 

the  nerve-centres,  of  the  nerves  themselves,  and  of  the  red  blood- 
corpuscles,  and  some  authors  have  considered  that  to  this  sol- 
vent property  the  action  of  chloroform  as  an  anaesthetic  was,  in 
some  measure  at  least,  due.  This,  however,  is  at  present  hypo- 
thetical. It  appears  to  lessen  the  oxidising  power  of  the  blood, 
although  not  to  a  very  great  extent,  for  the  diminution  of  this 
power  is  hardly  perceptible  in  the  blood  of  animals  poisoned  by 
chloroform,  although  distinct  in  blood  which  has  been  mixed  with 
it.  When  applied  to  the  skin,  it  evaporates  rapidly,  and  produces 
a  feeling  of  cold.  When  its  evaporation  is  prevented,  it  passes 
through  the  epidermis,  and  acts  as  an  irritant  on  the  skin,  produc- 
ing rubefaction,  and  leaving  behind  a  painful  burning  spot,  or 
even  vesication.  It  greatly  assists  the  absorption  of  organic  alka- 
loids by  the  skin,  so  that  a  number  of  them  will  pass  through  the 
epidermis  and  be  absorbed  with  considerable  ease  when  mixed 
with  chloroform,  although  they  would  not  pass  through  at  all  if 
applied  as  an  alcoholic  solution.  In  the  mouth  it  has  an  exceed- 
ingly sweet  taste,  and  stimulates  the  secretion  of  saliva.  When 
swallowed  in  large  quantities,  it  acts  first  as  an  irritant,  produc- 
ing gastro-enteritis,  and  afterwards,  from  its  absorption,  will 
cause  anaesthesia  and  coma,  so  that  the  vomiting,  pain  at  the 
epigastrium,  and  purging,  which  are  first  observed,  gradually 
pass  off,  and  are  succeeded  by  stupor,  coma,  and  abolition  of 
reflex  sensibility,  which  may  either  end  in  death,  or  may  pass 
off,  while  the  irritation  of  the  intestines  and  stomach  may  con- 
tinue for  some  time  afterwards.  In  small  doses  it  probably 
stimulates  the  secretion  of  gastric  juice  and  the  movements  of 
the  stomach  (cf.  p.  367),  and  both  increases  and  co-ordinates 
more  perfectly  the  movements  of  the  stomach  and  intestines,  so 
that  it  causes  expulsion  of  flatulence  and  relieves  griping. 

After  absorption  into  the  blood,  either  from  the  stomach  or 
from  the  lungs,  it  acts  on  the  nervous  system  in  somewhat  the 
same  way  as  alcohol,  paralysing  the  nerve-centres  in  much  the 
same  order.  Its  action,  however,  is  more  rapid  than  that  of 
alcohol,  and  it  does  not  appear  to  produce  the  stimulation  with- 
out derangement  of  the  mental  faculties  which  marks  the  first 
stage  of  the  action  of  alcohol.  Chloroform  appears  to  derange 
the  mental  faculties  from  the  very  first.  The  effect  of  chloroform 
may  generally  be  divided  into  three  stages :  (1)  of  imperfect 
consciousness,  (2)  of  excitement,  and  (3)  of  anaesthesia ;  or  per- 
haps one  might  divide  it  more  exactly  into  four  stages  (p.  206), 
and  add  a  fourth  stage,  that  of  paralysis.  Its  first  effect  is  to 
produce  a  feeling  of  warmth  over  the  surface,  with  affection  of 
the  optic  and  auditory  nerves,  noises  beiDg  heard  in  the  ears, 
and  a  sensation  of  light  experienced  in  the  eyes.  There  is  also  a 
feeling  of  oppression  at  the  chest,  and  sometimes  a  choking  sen- 
sation, occasionally  accompanied  by  cough.  The  choking  and 
cough  are  more  especially  felt  if  the  vapour  is  administered  in 


798  OEGANIC  MATEEIA  MEDICA.  [sect.  rv. 

too  concentrated  a  form,  and  not  unfrequently  the  patient  will 
put  up  his  hand  to  try  and  take  away  the  cloth  containing  the 
chloroform.  External  impressions  are  now  slightly  felt,  sounds 
are  faintly  heard,  questions  are  slowly  and  imperfectly  answered, 
and  any  sensation  of  pain  which  may  he  present  becomes  greatly 
diminished  or  entirely  disappears.  In  children  and  weak  persons 
this  stage  may  pass  into  that  of  complete  anaesthesia,  but  in 
most  cases  it  is  succeeded  by  the  stage  of  excitement.  The 
patient  is  no  longer  conscious  of  what  is  going  on  around  him, 
but  he  may,  according  to  his  temperament,  sing,  shout,  or 
struggle  violently.  The  violent  struggles  are  more  especially 
noticed  in  men  of  irritable  temperament,  wbo  have  been  accus- 
tomed to  the  use  of  alcoholic  stimulants.  In  them  the  excitement 
is  greater,  and  more  chloroform  is  required  in  order  to  produce  the 
stage  of  complete  anaesthesia.  During  the  violent  struggles,  the 
efforts  of  the  patient  may  induce  him  to  hold  his  breath  until  suffo- 
cation seems  impending ;  the  face  becomes  livid,  the  eyes  promi- 
nent, and  the  jugulars  distended.  The  struggling  is  usually  less 
in  women  than  in  men,  and  is  less  in  patients  exhausted  by  pre- 
vious illness.  In  women,  hysterical  sobbing  or  crying  may  occur ; 
occasionally  indications  of  venereal  excitement  have  been  ob- 
served, and  even  a  complete  venereal  orgasm.  When  the  chloro- 
form is  pushed,  this  stage  soon  subsides,  and  the  patient  passes 
into  the  state  of  complete  anaesthesia.  The  limbs  become 
flaccid ;  when  the  hand  is  taken  up  it  falls  like  that  of  a  corpse  ; 
painful  stimuli  produce  neither  reflex  action  nor  any  indication 
of  sensation.  The  last  reflex  actions  to  disappear  are  those  from 
the  conjunctiva,  the  anus,  and  the  vagina.  When  touching  the 
conjunctiva  no  longer  causes  reflex  contraction  of  the  eyelid, 
anaesthesia  may  be  regarded  as  complete,  and  surgical  operations 
may  be  commenced.  During  the  administration  of  chloroform 
the  respiration  is  generally  first  rendered  somewhat  slow,  then 
quicker,  and  lastly  steady,  unless  the  anaesthetic  be  pushed  too 
far,  when  it  again  becomes  slower  and  weaker,  and  finally  ceases 
altogether.  The  pulse  is  usually  affected  in  a  similar  manner. 
The  reason  of  this  appears  to  be  that  the  chloroform  vapour,  as 
it  descends  the  respiratory  passages,  successively  irritates  those 
parts  with  which  it  comes  immediately  in  contact :  (1)  the  nasal 
mucous  membrane,  (2)  the  larynx,  and  (3)  the  lungs.  It  causes, 
through  the  nerves  of  the  nose  and  larynx  (p.  242),  reflex 
slowing  of  the  respiration  and  reflex  slowing  of  the  pulse.  As 
these  nerves  gradually  become  paralysed  by  the  action  of  the 
drug,  its  stimulating  effect  on  the  branches  of  the  vagus  dis- 
tributed to  the  lung  becomes  manifest  in  accelerated  respiration, 
usually  accompanied  by  a  quickened  pulse.  Next,  as  the  drug 
continues  to  act,  it  paralyses  those  nerves  also,  and  the  respira- 
tory centre,  being  now  no  longer  affected  by  any  reflex  irritation, 
continues  to  keep  up  the  respiratory  movements  with  a  some* 


chap,  xxix.]     CARBON  COMPOUNDS— FATTY  SEEIES.       799 

what  slow  and  steady  rhythm.  If  the  drug  be  now  pushed  still 
further,  the  respiratory  centre  itself  becomes  paralysed,  the 
respirations  become  still  slower  and  feebler,  and  finally  cease 
altogether.  These  alterations  in  the  respiratory  rhythm  during 
the  administration  of  chloroform  may  sometimes  be  more  or  less 
interfered  with  by  the  effect  upon  the  respiratory  centre  of  blood 
which  has  become  venous  in  consequence  of  the  altered  respira- 
tory movements.  The  action  of  the  heart  is  also  modified  by 
chloroform,  the  pulse  usually  becoming  somewhat  slower  just  at 
first ;  then  accelerated  during  the  whole  period  of  excitement  ; 
and  afterwards  steady,  at  or  below  its  normal  rate.  The  blood- 
pressure  is  usually  lowered,  and  if  the  chloroform  vapour  be 
Btrong  the  pressure  may  fall  very  considerably,  and  may  even  be 
reduced  to  zero.  The  fall  of  blood-pressure  is  probably  due 
in  great  measure  to  the  dilatation  of  the  vessels,  but  it  may  also 
be  partly  owing  to  enfeebled  action  of  the  heart,  even  at  the 
beginning  of  the  anaesthesia.  When  the  chloroform  has  been 
pushed  so  far  as  greatly  to  lower  the  blood-pressure,  the  fall  is 
caused,  to  a  great  extent,  by  the  weakening  of  the  heart.  The 
dilatation  of  the  vessels  is  not  due  to  paralysis  of  the  vaso-motor 
nerves,  for  these,  when  irritated  directly,  will  still  cause  the 
artery  to  contract  during  chloroform-narcosis.  It  appears  to  be 
due  to  paralysis  of  the  vaso-motor  centre.  The  reflex  power  of 
this  centre  is  first  diminished,  and  then  abolished,  by  chloroform, 
so  that  irritation  of  a  sensory  nerve  during  imperfect  chloroform- 
narcosis,  causes  only  a  slight  rise  of  blood-pressure,  and  in  per- 
fect narcosis  no  rise  at  all. 

The  tension  of  the  intercellular  fluid  and  the  lymph  in  the 
eye  appear  to  be  diminished,  so  that  the  mammae  become  flaccid, 
the  intra-ocular  tension  is  diminished,  and  irregular  astigmatism 
may  occur. 

The  nervous  system  appears  to  be  paralysed  in  the  following 
order :  first,  the  cerebral  hemispheres ;  next,  the  grey  matter  of 
the  cord  ;  next,  the  white  matter  ;  next,  the  reflex  power  of  the 
medulla  oblongata ;  next,  the  automatic  power  of  the  respiratory 
centre,  and  lastly,  the  cardiac  ganglia. 

The  order  in  which  the  nerve-centres  are  paralysed  may 
sometimes  be  changed,  and  the  heart  may  be  affected  before  the 
respiration. 

Dangers  op  Chloroform:. — Cases  may  arise  where  it  is  im- 
possible to  obtain  assistance,  but  whenever  it  is  possible  to  obtain 
help,  anaesthetics  should  never  be  given  without  the  presence  of 
a  third  person,  both  for  the  sake  of  the  administrator  and  of 
the  patient.  In  consequence  of  neglecting  this  rule,  a  number  of 
medical  men  have  suffered  severely  from  false  charges  of  assault 
and  rape  brought  against  them  by  female  patients.  These 
charges,  though  perfectly  false,  have  frequently  been  brought  by 
patients  in  all  good  faith,  and  under  the  belief  that  they  were 


800  OEGANIC  MATEEIA  MEDIC  A.  [sect.  iv. . 

true.  The  action  of  alcohol  on  the  sexual  centres  in  the  brain' 
(pp.  448  and  450)  is  surpassed  by  that  of  chloroform,  and  sexual 
excitement  caused  by  the  latter  (p.  798)  may  be  accompanied  by 
delusions,  which  are  afterwards  remembered  and  believed  by  the 
patients  to  have  been  real  events.  By  having  an  assistant  in  the 
room  false  charges  arising  from  such  delusions  may  be  disproved. 

For  the  patient's  sake  also  no  one  should  attempt,  if  it  can 
possibly  be  avoided,  both  to  administer  anaesthetics  and  to 
operate,  for  this  is  more  than  a  single  man  can  do,  and  the 
attempt  to  do  both  is  likely  to  lead  to  failure  in  either  one  ox 
both. 

The  dangers  resulting  from  the  employment  of  chloroform 
are :  (1)  death  by  stoppage  of  respiration ;  (2)  death  by 
stoppage  of  the  heart.  Usually  the  respiration  stops  before 
the  heart.  This  order,  however,  may  be  somewhat  varied, 
because  occasionally  the  heart  will  fail  before  the  respiration. 
This  may  sometimes  be  due  to  the  employment  of  too  strong 
chloroform  vapour,  because  this  very  quickly  paralyses  the 
heart ;  but  sometimes  the  stoppage  of  the  heart  before  the  respi- 
ration may  be  due  to  the  shock  of  the  operation,  and  not  to  the 
chloroform. 

The  respiration  may  stop  from  (1)  obstruction  to  the  en- 
trance of  air  into  the  glottis  by  the  tongue,  by  vomited  matters, 
or  by  blood,  (2)  by  mechanical  interference  with  the  respiratory 
movements,  (3)  by  paralysis  of  the  respiratory  centre.  If  the 
heart  is  naturally  feeble  it  is  more  apt  to  become  paralysed. 
Aortic  or  mitral  regurgitation  do  not  by  themselves  contra-indicate 
the  use  of  chloroform ;  but  in  all  cases  the  heart  should  be  pre- 
viously examined,  and  if  it  is  found  to  be  weak  and  dilated,  as  in 
emphysema,  and  especially  if  there  should  be  reason  to  suspect 
fatty  degeneration,  it  is  safer  to  employ  ether.  This  is  especially 
the  case  in  persons  who  have  been  addicted  to  the  use  of  alcohol. 

Precautions. — (1)  If  the  patient  should  partially  wake  from 
chloroform-narcosis  during  an  operation,  sickness  is  very  likely 
to  occur.  In  order  to  prevent  this,  it  is  well  that  the  patient 
should  take  no  solid  food  for  four  or  five  hours  before  the  opera- 
tion ;  but,  at  the  same  time,  his  strength  should  be  kept  from 
sinking  by  the  administration  of  beef-tea,  along  with  some 
alcoholic  stimulant  three  hours  before.  When  vomiting  does 
occur,  the  head  of  the  patient  should  be  turned  on  one  side,  so 
as  to  allow  an  easy  exit  to  the  vomited  matters,  which  should, 
if  necessary,  be  removed  from  the  mouth.  Mr.  Mills  tells  me 
that  the  most  common  causes  of  obstruction  to  the  respiration 
are  either  falling  back  of  the  tongue  or  depression  of  the  chin. 
Both  of  these  may  be  remedied  by  changing  the  position  of  the 
head  by  turning  it  on  one  side,  or  forcibly  drawing  the  chin  away 
from  the  sternum  at  each  inspiration.  Very  seldom  it  may  be 
necessary  to  draw  the  tongus  forwards  with  dressing  forceps. 


chap,  xxix.]     CARBON  COMPOUNDS -FATTY   SEEIES.       801 

(2)  Mechanical  interference  with  the  respiratory  movements  may- 
occur  from  unwary  pressure  upon  the  chest,  interfering  with  the 
thoracic  movements.  The  most  common  cause  of  this  is  the 
weight  of  the  patient's  own  body,  when  any  operation  upon  the 
back  requires  him  to  be  laid  upon  his  face.  In  such  cases, 
special  watch  should  be  kept  upon  the  respiratory  movements. 
Mechanical  interference  with  respiration  may  occur  in  old  people 
who  have  lost  their  teeth.  The  flaccid  lips  and  the  alas  nasi  are 
in  them  drawn  inwards  at  each  inspiration,  and  acting  as  valves 
prevent  the  entrance  of  air  into  the  trachea.  In  such  cases  the 
mouth  should  be  opened  by  the  fingers  (Esmarch). 

Stoppage  of  the  respiration  may  occur  from  the  patient  spas- 
modically holding  his  breath  during  the  stage  of  excitement,  but 
this  usually  soon  passes  off  if  the  anaesthetic  be  pushed.  The 
struggling  is  less  if  the  anaesthetic  be  given  gradually.  (3)  Para- 
lysis of  the  respiratory  centre  takes  place  when  the  drug  is 
pushed  too  far.  It  may  sometimes  occur  suddenly,  after  a  fresh 
quantity  of  chloroform  has  been  poured  upon  the  cloth  used  in 
administration.  If  the  respiration  ceases  the  administration  of 
chloroform  should  be  discontinued,  and  the  patient  roused  by 
nicking  the  cheeks  and  breast  with  a  wet  towel.  The  tongue 
should  be  drawn  forwards  with  forceps  and  artificial  respiration 
begun  if  necessary.  As  a  rule  the  patient  can  be  restored  with 
comparative  ease  by  means  of  artificial  respiration,  provided  the 
heart  continues  to  beat,  but  on  rare  occasions  even  the  prolonged 
use  of  this  means  does  not  induce  any  further  voluntary  respira- 
tory movement.  The  easiest  way  of  performing  artificial  respira- 
tion is  to  press  the  sternum  forcibly  inwards,  and  allow  it  to 
return  to  its  normal  position  by  its  own  elasticity.  The  pressure 
should  be  exercised  synchronously  with  the  operator's  own  re- 
spiration. Each  time  the  sternum  is  depressed  the  ends  of  the 
fingers  may  be  pressed  under  the  cartilages  of  the  ribs  on  the 
left  side,  so  as.to  stimulate  the  heart  mechanically  also. 

Stoppage  of  the  heart  may  occur  suddenly,  and  may  take 
place  while  respiration  is  still  going  on.  It  is  usually  ascribed 
to  the  chloroform,  and  no  doubt  concentrated  chloroform  vapour 
inhaled  into  the  lungs  may  arrest  the  heart.  Very  commonly, 
•  however,  it  is  reflex,  and  when  death  occurs  in  such  a  case  it  is 
to .  be  attributed  to  the  want  of  chloroform  rather  than  to  its 
excess.  It  is  worthy  of  note  that  in  the  greater  number  of  the 
cases  recorded  as  deaths  from  chloroform,  the  statement  is  made 
that  the  quantity  administered  was  very  small,  and  that  anaes- 
thesia was  incomplete.  Before  anaesthetics  were  used  at  all, 
death  from  shock  during  operation  was  by  no  means  uncommon, 
and  no  doubt  it  still  occurs  during  imperfect  anaesthesia,  although 
complete  anaesthesia  tends  to  prevent  it.  The  operations  in  which 
death  during  chloroform  chiefly  occurs  are  short  and  compara- 
tively slight,  though  painful,  such  as  extraction  of  teeth,  and 

3  F 


802  OEGANIC  MATBEIA  MEDICA.  [sect.  IV. 

evulsion  of  the  toe-nail — operations  in  which  the  introduction  of 
deep  chloroform  anaesthesia  might  be  regarded  as  superfluous, 
and  involving  a  waste  of  time.  These  operations  appear  to  be 
dangerous  during  imperfect  narcosis,  and  not  so  when  either  no 
anaesthetic  at  all  has  been  given,  or  complete  anaesthesia  has 
been  produced.  The  reason  of  this  probably  is  that  when  no 
anaesthetic  is  given,  irritation  of  the  sensory  nerves  during  the 
operation  causes  two  effects— slowing  or  stoppage  of  the  heart, 
and  reflex  contraction  of  the  vessels.  This  contraction  neutralises 
the  result  of  cardiac  weakness  or  stoppage,  maintains  the  blood- 
pressure,  and  thus  prevents  syncope.  During  imperfect  anaes- 
thesia, the  reflex  contraction  of  the  vessels  is  destroyed,  whereas 
the  effect  on  the  heart  may  still  persist,  so  that  irritation  of  a 
sensory  nerve  may  produce  syncope  by  stopping  the  supply  of 
arterial  blood  from  the  heart,  while  the  blood  still  flows  rapidly 
from  the  arterial  system  through  the  capillaries  into  the  veins. 
When  the  anaesthesia  is  complete,  both  reflexes  are  paralysed,  and 
the  circulation  remains  unaffected  by  any  impression  made  upon 
the  sensory  nerves.  Even  when  chloroform  anaesthesia  appears 
perfectly  complete,  death  from  shock  may  still  occur,  at  any  rate 
in  the  case  of  animals.  I  have  noticed  this  on  two  occasions 
when  engaged  in  making  a  gastric  fistula  in  a  dog.  The  animal 
was  completely  anaesthetised,  but  in  both  instances,  when  drawing 
upon  the  stomach  in  the  process  of  inserting  a  cannula,  the 
animal  died  suddenly.  On  mentioning"  this  to  Professor  Schiff, 
he  informed  me  that  he  had  had  many  similar  experiences,  so 
that  he  had  entirely  abandoned  the  use  of  chloroform  in  such 
operations,  and  substituted  ether. 

When  the  heart  stops,  the  treatment  to  be  adopted  is  to  lay 
the  patient's  head  lower  than  his  body  (p.  264),  to  keep  up  arti- 
ficial respiration,  and  to  administer  nitrite  of  amyl  by  inhalation. 

Instead  of  the  plan  of  artificial  respiration  already  men- 
tioned, Sylvester's  may  be  used.  Howard's  plan  may  be  used 
for  very  strong  patients,  but  is  not  suitable  for  delicate  ones. 
Respiration  may  be  assisted  by  stimulating  the  diaphragm  by 
the  application  of  a  faradaic  current  to  the  phrenic  nerve.  One 
pole  is  applied  to  the  epigastrium  and  the  other  to  the  side  of 
the  neck,  and  the  current  is  made  and  broken  during  the  time- 
chat  the  inspiratory  movement  is  being  made  artificially. 

Uses. — The  vapour  of  chloroform  may  be  applied  to  the  eye 
in  photophobia,  to  the  os  uteri  in  pruritus  pudendi,  neuralgia, 
ulceration,  or  cancer  of  the  uterus,  in  order  to  relieve  pain.  A  few 
drops  held  in  the  hand  of  the  nurse  and  inhaled  by  a  child  when 
a  paroxysm  of  whooping-cough  comes  on,  will  lessen  its  violence. 

The  power  of  chloroform  to  aid  the  absorption  of  vegetable 
alkaloids  may  be  employed  in  order  to  assist  their  action  when 
applied  externally,  but  care  must  be  taken  not  to  apply  them 
over  too  large  a  surface  when  using  such  drugs  as  aconite  or 


chap,  xxix.]     CARBON   COMPOUNDS— FATTY  SEEIES.       803 

veratrine  in  combination  with  chloroform  or  chloroform  liniment. 
A  pledget  of  cotton-wool  dipped  in  chloroform  is  frequently  em- 
ployed as  a  remedy  in  toothache ;  but  as  the  chloroform  irritates 
the  pulp,  and  may  increase  pain  afterwards,  Binger  recommends 
a  piece  of  linen  moistened  with  chloroform  to  be  folded  over  the 
tooth,  so  that  the  vapour  may  act  upon  the  pulp  without  irritating 
it.  It  relieves  vomiting  from  gastric  catarrh  or  sea-sickness, 
lessens  flatulent  distension  of  the  stomach  and  intestines,  and 
may  be  used  in  dyspepsia  and  diarrhoea  after  the  irritant  has 
been  removed.  In  cases  of  dyspepsia  and  chronic  gastritis  with 
dilatation,  washing  out  the  stomach  with  chloroform  water  has 
proved  useful,  by  lessening  pain  and  irritability  of  the  stomach, 
diminishing  the  dilatation,  by  preventing  decomposition  and  the 
formation  of  gas,  as  well  as  by  exciting  movement  and  secretion 
in  the  stomach. 

Chloroform,  in  combination  with  small  doses  of  morphine, 
and  with  some  adhesive  vehicle  such  as  glycerin,  is  a  useful 
remedy  in  coughs,  more  especially  the  coughs  of  phthisis.  When 
inhaled  to  an  extent  quite  insufficient  to  produce  even  the  earlier 
stages  of  anaesthesia  it  may  relieve  the  paroxysms  of  asthma.  The 
first  stage  of  chloroform  action,  viz.  partial  anaesthesia  and  par- 
tial loss  of  consciousness,  is  useful  in  biliary  and  renal  colic,  and 
in  other  cases  of  very  severe  pain,  such  as  intestinal  colic,  severe 
neuralgia,  aneurism,  and  during  labour.  A  most  ingenious  plan 
of  administering  chloroform  in  such  cases  has  been  devised  by 
Mr.  Image,  of  Bury  St.  Edmunds.  A  piece  of  blotting-paper  or 
lint  is  put  in  the  bottom  of  a  tumbler,  and  moistened  with  chlo- 
roform. The  patient  then  takes  the  tumbler  in  the  hand  and 
inhales  the  vapour.  The  shape  of  the  tumbler  prevents  it  from 
being  brought  too  close  to  the  face,  so  that  the  vapour  is  always 
inhaled  with  a  free  admixture  of  air.  As  soon  as  it  begins  to 
take  effect,  the  patient's  hand  and  the  tumbler  drop,  so  that  the 
inhalation  ceases.  When  the  effect  begins  to  pass  off,  the  patient 
again  raises  the  tumbler  and  inhales  anew,  and  so  the  process 

|i,  •  may  go  on  for  a  long  time,  without  any  further  care  on  the  part 
of  the  attendant  than  to  keep  the  lint  or  blotting-paper  in  the 
tumbler  moist  with  chloroform. 

In  severe  cases  of  chorea  with  cerebral  symptoms,  the  in- 
halation of  chloroform  may  be  necessary;  care  is,  however, 
necessary  if  there  be  any  cardiac  disease.  In  the  administra,- 
tion  of  chloroform  for  surgical  operations,  the  towel  or  napkin 
may  be  folded  so  as  to.  form  an  imperfect  cone,  into  the  con- 
cavity of  which  a  little  chloroform  is  poured.  The  towel  is  then 
held  over  the  patient's  face,  a  few  inches  from  his  nose,  the  apex 
of  the  cone  touching  the  bridge  of  the  nose,  its  base  being 
directed  downwards,  and  its  margin  a  couple  of  inches  from  the 

I  face.  Care  should  be  taken  that  no  part  of  the  towel  which  is 
wet  with  chloroform  touches  the  face,  on  account  of  the  burning 

3  F  2 


804  OBGANIC  MATEEIA  MEDICA.  [sect,  rw 

sensation  which  it  produces,  and  that  a  free  admixture  of  air  be  al- 
lowed and  the  vapour  not  administered  in  too  concentrated  a  state. 

Another  way  of  giving  it  is  to  spread  a  single  fold  of  the 
napkin  over  the  patient's  face,  and  allow  the  chloroform  to  fall, 
a  drop  at  a  time,  upon  the  napkin  a  little  in  front  of  the  nose. 
The  drug  may  be  administered  in  a  similar  way  upon  a  wire 
mask  covered  with  a  single  layer  of  flannel.  In  order  to  avoid 
the  possibility  of  the  patient  inhaling  too  concentrated  a  vapour, 
an  apparatus  has  been  devised  by  Mr.  Clover,  consisting  of  a 
bag  of  10,000  cubic  inches  capacity,  which  is  filled  with  air 
containing  4  per  cent,  of  chloroform  vapour,  and  from  this  the 
patient  is  allowed  to  inhale  by  means  of  a  flexible  tube  and  a 
mask.  The  apparatus  is  filled  by  pumping  successive  quantities 
of  air  from  a  bellows  holding  1,000  cubic  inches  through  a  box 
heated  by  hot  water,  into  which  32J  minims  of  chloroform  have 
been  injected,  a  quantity  just  sufficient  to  charge  the  air  with 
the  proper  amount  of  chloroform. 

A  mixture  of  1  part  of  alcohol  with  2  of  chloroform  and  3  of 
ether,  known  under  the  name  of  the  'A,  C,  E  Mixture,'  is  some- 
times used  instead  of  chloroform.  It  is  supposed  to  have  the 
advantage  of  being  more  stimulant  and  less  depressing  to  the 
heart  than  chloroform.  One  disadvantage  of  it  is  that  the  three 
constituents  evaporate  with  unequal  rapidity,  so  that  at  the  end 
of  an  operation  a  patient  may  get  a  much  larger  proportion  of 
chloroform  than  of  the  other  two. 

Iodoformum,  B.   and   U.S.P-     Iodoform,  CHI3;  392-8. — 
Iodoform  should  be  kept  in  well-stoppered  bottles,  in  a  cool  place. 
Characters. — Shining,  lemon-yellow,  crystalline  scales,  some- 
what greasy  to  the  touch ;  having  a  persistent  and  disagreeable 
odour  and  flavour. 

Solubility. — Very  slightly  soluble  in  cold  water,  more  soluble  in  rectified 
spirit,  soluble  in  chloroform  or  ether,  readily  and  entirely  soluble  in  warm 
ether  ;  the  solutions  being  neutral  to  litmus  paper. 

'.  Beactions. — "When  heated  it  first  melts  to  a  brown  liquid,  then  gives  off 
brown  and  violet  vapours,  leaving  a  black  residue  which  entirely  disappears 
on  continued  ignition.  Warmed  with  an  alcoholic  solution  of  potash  and 
the  resulting  fluid  acidified  by  nitric  acid,  iodine  is  liberated,  the  mixture 
acquiring  a  brown  colour,  or,  when  cold,  a  blue  colour  on  the  addition  of 
mucilage  of  starch. 

Preparation. — By  mixing  alcoholic  solution  of  potash  with  tincture  of 
iodine,  and  evaporating  ;  or  by  the  action  of  iodine  on  a  mixture  of  alcohol 
and  solution  of  carbonate  of  potassium  or  sodium. 

Dose. — ^-3  grains. 

Preparations. 
B.P. 

Suppositoria  Iodoformi 3  grains  in  each  suppository. 

B.  and  U.S.P. 
Unguentum  Iodoformi  (with  benzoated  lard)...l  part  in  10. 

Administration. — It  may  be  given  in  the  form  of  pill,  made 
up  with  sugar  of  milk,  tragacanth  and  glycerin,  or  as  a  supr 
pository  made  up  with  cacao-butter. 


CHAP.xxfx.]    CAEBON  COMPOUNDS— FATTY   SEEIES.       805 

As  an  inhalation  in  phthisis,  a  solution  may  be  used  con- 
taining 20  grains  of  iodoform,  20  minims  of  oil  of  eucalyptus, 
or  10  of  creasote,  ^  fl.  oz.  rectified  spirit,  and  £  A-  oz.  of  ether. 
This  is  used  with  an  inhaler  of  horsehair  matting  lined  with 
cotton-wool,  on  the  interior  of  which  the  solution  is  dropped 
(Dreschfeld). 

The  disagreeable  smell  of  iodoform  may  be  covered  by  Tonquin 
bean  (50  per  cent.),  Coumarin,  or  to  some  extent  by  ground  coffee. 

As  an  external  application  it  may  simply  be  dusted  over  the 
sore  and  covered  with  cotton- wool,  or  cotton-wool  may  be  soaked 
in  an  ethereal  solution  of  it  and  then  dried.  The  quantity  of 
iodoform  in  the  cotton-wool  should  be  at  least  10  per  cent.  It 
may  be  applied  to  the  nose  or  throat  as  snuff,  or  mixed  with  half 
its  weight  of  starch  as  insufflation,  or  an  ethereal  solution  may 
be  applied  as  spray.  The  nozzle  of  the  spray-producer  is  apt 
to  become  choked  and  must  be  washed  out  frequently  with  pure 
ether.  It  may  also  be  applied  to  the  nose  in  the  form  of  a  bougie 
containing  £-£  a  grain  made  up  with  gelatin  and  glycerin.  In 
gonorrhoea,  bougies  composed  of  iodoform  5  grains,  oil  of  euca- 
lyptus 10  minims,  and  cacao-butter  35  grains,  are  useful  in  the 
acute  stage. 

Action. — Iodoform  destroys  bacilli,  and  is  an  antiseptic 
and  deodorizer  of  very  considerable  power.  It  also  destroys 
leucocytes.  When  applied  in  substance  or  strong  solution  it 
produces  no  local  irritation,  but  acts  as  a  local  anaesthetic.  Its 
power  in  this  respect  is  so  great  that  a  suppository  containing  it 
when  introduced  into  the  rectum  may  so  diminish  sensibility 
that  defsscation  may  occur  without  the  knowledge  of  the  person 
or  animal  (Wood). 

Its  absorption  from  the  intestine  is  probably  aided  by  fat. 

It  weakens  the  circulation  when  taken  for  some  time,  and 
when  applied  to  the  frog's  heart  it  has  a  powerful  paralysing 
action  on  the  cardiac  ganglia  in  the  same  way  as  chloral  and 
iodal  (p.  323). 

It  has  a  marked  action  on  the  nervous  system.  In  cats 
and  dogs  it  produces  narcosis,  but  not  in  rabbits.  In  man  it 
may  be  absorbed  from  wounds  and  affect  the  nervous  system,  but 
instead  of  producing  sleep  or  anaesthesia,  as  in  dogs,  it  usually 
causes,  in  slight  cases  of  poisoning,  sleeplessness,  headache,  irrita- 
bility, and  loss  of  memory.  In  severe  cases  it  produces  maniacal 
attacks,  hallucinations,  or  melancholia. 

These  disagreeable  effects  appear  to  be  diminished  by  bicar- 
bonate of  potassium  or  sodium  in  doses  of  10  grains  hourly.1  It 
appears  to  have  an  extraordinary  power  to  prevent  the  develop- 
ment of  giant-cells,  and  may  thus  prevent  morbid  tissue-growth. 

Uses. — Its  local  anaesthetic  and  antiseptic  actions  render 

1  Bearing,  Wien.  med.  BUM.,  1884,  No.  9. 


806  OKGANIC  MATEEIA  MEDICA.  [sect.  rv. 

it  useful  as  a  dressing  after  operations  instead  of  carbolic  acid, 
and  it  is  especially  useful  where  a  regular  antiseptic  dressing 
cannot  be  applied,  as  in  operations  on  the  bladder  or  rectum,  or 
wounds  or  ulcers  of  these  parts.  It  is  a  most  useful  application 
to  poisoned  wounds,  chancres,  phagedenic  or  syphilitic  sores, 
and  to  fungating  growths  generally.  It  induces  healthy  action 
in  indolent  sores.  In  deep-seated  infiltrations  of  lupus  it  is  used 
after  the  epidermis  has  been  macerated  and  removed  by  the 
action  of  a  strong  solution  of  potash.  It  lessens  the  discharge 
and  disagreeable  smell  of  ozsena.  It  has  been  used  as  a  vapour 
in  cases  of  phthisis,  and  also  given  internally,  but  with  doubtful 
result :  an  ointment,  1  in  5,  has  been  found  useful  rubbed  into 
the  scalp  in  tubercular  meningitis. 

Methylal.     Vide  Appendix. 

Urethane.     Vide  Appendix. 

Iodol.     Vide  Appendix. 


chap,  xxx.]   CARBON  COMPOUNDS— AEOMATIC  SERIES.   807 


CHAPTEE  XXX. 
CARBON  COMPOUNDS— AROMATIC  SERIES. 

Carbon  Nucleus. — In  this  series  the  carbon  atoms  are  supposed 
to  be  linked  so  as  to  form  a  closed  chain  or  chains.  The  lowest 
member  of  the  series  contains  six  atoms  of  carbon,  which  are  so 
linked  that  the  group  has  six  free  affinities,  thus : 

Ax 

— c     c— 

II      I  ' 

— c     c— 
W 

I 

For  convenience'  sake,  this  carbon  ring,  or  nucleus,  is  often 
graphically  represented  simply  thus : 


k 


/ 

Eadical. — When  five  of  the  free  affinities  are  saturated  by 
hydrogen,  the  group  forms  an  organic  radical  with  one  free 
affinity,  termed  phenyl : 

H    H 

O 

H    H 

Hydride. — When  this   free  affinity  is  also  saturated  by 
H_H 

hydrogen,  the  group  H<^     \E  forms  phenyl  hydride,  or  ben- 

H~H 

zene,  or  benzol,  which  must  be  carefully  distinguished  from  the 
benzin  already  mentioned  (p.  762). 

Bodies  belonging  to  the  aromatic  group  differ  from  those  of 
the  fatty  series  in  the  fact  that  they  do  not  readily  link  on  other 
substances  to  themselves,  and  so  form  compounds  by  addition. 
They  form  them  rather  by  substitution. 


808  OBGANIC  MATEKIA  MEDICA.  [sect.  IV; 

Alcohol. — When  one  atom  of  hydrogen  in  benzene  is  re- 
placed by  hydroxyl  (OH),  phenyl-alcohol  or  carbolic  acid  is 
formed : 

/    \o— H,  or  C6H5OH. 

The  name  of  phenol  has  been  given  to  this  body  as  it  is 
more  convenient  than  .the  names  phenyl-alcohol  or  carbolic  acid, 
and  its  termination,  "  ol,"  indicates  that  it  resembles  alcohol  in 
its  constitution. 

The  relations  of  some  of  the  other  members  of  the  aromatic 
group  to  each  other  may  be  more  easily  seen  if  they  are  put  in  a 
tabular  form : 

Benzene,  <^      ^R,  or  C6H5.H. 

Phenol,  /    ^OH,  or.  C6H5.OH, 
in  which  1  atom  of  hydroxyl  (OH)  replaces  1  of  H  in  benzene. 
Nitrobenzene,  /    \^  |  or  C6H5.N02, 

\— /  \o, 

in  which  1  atom  of  nitroxyl  (N02)  replaces  1  of  H  in  benzene* 

Amidobenzene,  or  /     \-m/         n  -o-  attt 
Anilin  <^>N<^HOrC6H,NH2, 

in  which  1  atom  of  amidogen  (NH2)  replaces  1  of  H  in  benzene. 

Benzoic  acid,  or    /~\r/  nvn-a  rn  OTT 

Phenylformic  acid,  \_/G\Q_g  °r  C°Hs-C0-0H> 

in  which  1  atom  of  carboxyl  (CO-OH)  replaces  1  of  H  in  benzene. 

Benzoic  acid  may  also  be  regarded  as  formic  acid  in  which 
one  atom  of  hydrogen  is  replaced  by  phenyl,  and  so  it  may  be 
called  phenyl-formic  acid. 

As  the  carbon  atoms  in  the  benzene  ring  or  nucleus  are  sup- 
posed to  be  arranged  symmetrically,  it  does  not  matter  which 
atom  of  hydrogen  is  replaced  by  another  radical  if  the  substitu- 
tion takes  place  only  in  one  atom,  e.g.  in  phenol. 

If  we  number  the  carbon  atoms  so  as  to  distinguish  them 
from  one  another,  thus  : 

1 
6/\2 

I        I 
5\/3 

4 


chap,  xxx.]   CAEBON  COMPOUNDS— AEOMATIC  SEEIES.   809 

it  is  evident  that  phenol  is  always  the  same,  whether  the  hy- 
droxyl  is  attached  to  the  carbon  atom,  1,  2,  or  3,  &c.  &c, : 
HO 

0      (T     ^ 

\/  \/  \/H0 

But  this  is  not  the  case  when  substitution  occurs  at  two  or 
more  points  in  the  benzene  ring. 

Thus  when  substitution  in  the  benzene  ring  occurs  at  two 
points  these  may  take  three  different  positions. 

1  The  substitution-products  1 

1  /\2  1  and  6  are  the  same  6/\ 
and         J        |        as  1  and  2,  and  are  usually 

2  \/         termed  ortho-compounds. 

1  1 

1           /\             1  and  5  are  the  same  S\ 

and         i        |  as  1  and  3,  and  are  usually  |        ] 

3  \/3  termed  meta-compounds.  5\/ 

1 

■j         f  \        1  and  4  are  usually  termed 
.■         \  /  para-compounds. 

4 
Thus  three  isomeric  forms  may  occur. 

When  two  atoms  of  hydrogen  are  replaced  by  two  of  hydroxyl, 
instead  of  by  one,  as  in  phenol,  we  have  three  isomeric  substances, 
differing  from  one  another  only  in  the  relative  position  of  the 
substituted  atoms.  These  three  bodies  are  pyrocatechin,  in  which 
the  position  is  1  and  2,  resorcin,  1  and  3,  and  hydroquinone, 
1  and  4.  The  relative  position  of  the  hydroxyl  groups  in  these 
three  bodies  is  indicated  in  their  formulae  by  the  figures  (1 :  2), 
(1 : 3),  and  (1 : 4),  or  by  the  terms  ortho,  meta,  or  para,  re- 
spectively. 

H  H  H 

i  i 

o  I 

V  ? 


H 


H 


Pyrocatechin.  Besorcin.  Hydroquinone. 

Ortho-di-hydroxy  -benzene.    Meta-di-hydroxy-benzene.     Para-di-hydroxy-benzene. 

OA.(OH),(l :  2)  Oja.-COH)^  ;  3)  0,^(0^(1 :  i) 


810  OEGANIO  MATEEIA  MEDICA.  [sect,  iv.' 

When  three  atoms  of  hydrogen  in  benzene  are  replaced  by  hy- 

droxyl  we  get  tri-hydroxy-benzene — pyrogallol  or  pyrogallic  acid. 

H 

I 
0 

fY"H 

\/0-H 

CeH,.(OH)a. 

Tri-hydroxy-benzene. 

Pyrogallol. 

When  two  atoms  of  hydrogen  in  benzene  are  replaced,  the 
one  by  hydroxyl  (OH)  and  the  other  by  carboxyl  (CO.OH),  we 
get  three  isomers,  salicylic  acid,  oxybenzoic  acid,  and  para- 
oxybenzoic  acid. 

H  H 

I  I 

0  0 


k 


A\ 

0        0 
H 

Salicylic  Acid.  Oxybenzoic  Acid.  Para-oxybenzoic  Acid. 

Pyridine  (C5H5N)  is  probably  formed  by  one  atom  of  tetrad  C 
in  the  benzene  ring  being  replaced  by  triad  N : 

II  I 

h/C\c/C\h 

I 
H 

Naphthaline  (Ci0H8)  is  formed  by  the  union  of  two  benzene 
groups,  thus : 

H         H 


C        0        c 
H/W  \C/\K 

H        H 


.chap,  xxs.]    CARBON  COMPOUNDS— AEOMATIC  SEEIES.  811 

Chinoline  (C9H7N)  is  formed  by  the  union  of  benzene  and 
pyridine  groups : 

H 
I 

H— 0         C         C— H 

I  »  I 

H— C         C         C— H 

A    A 

Chinoline  is  closely  connected  with  quinine,  from  which  it 
may  be  produced,  and  it  is  probable  that  many  of  the  organic 
alkaloids  are  closely  related  to  the  aromatic  series. 

That  morphine,  for  example,  is  related  to  phenol  is  shown 
by  the  fact  that  when  morphine  is  treated  with  nitric  acid  and 
heated  with  water  under  pressure,  it  yields  tri-nitrophenol,  or 
picric  acid.1 

Genebal  Action. — The  distinctive  action  of  the  lower  mem- 
bers of  the  fatty  series  is  their  stimulant  and  anaesthetic  action 
on  the  nerve-centres  (p.  760).  The  most  marked  action  of  the 
lower  members  of  the  aromatic  series  is  their  antiseptic  and 
antipyretic  power.  The  antiseptic  action  appears  to  be  very 
easily  modified  by  slight  changes  in  some  substances  of  this 
group.  Thus  salicylic  acid  is  antiseptic,  but  its  sodium  salt  is 
not ;  and  meta-  and  para-oxybenzoic  acids,  which  are  isomeric 
with  salicylic  acid,  have  no  antiseptic  power.  The  members  of 
the  aromatic  series  also  affect  the  nervous  system,  but  they 
appear  to  affect  the  motor  centres  more  than  the  sensory,  so  that 
instead  of  producing  ansesthesia,  like  the  members  of  the  fatty 
series,  they  tend  rather  to  produce  tremor,  convulsions,  and 
paralysis.  Benzene,  chlorobenzene,  bromobenzene,  and  iodo- 
benzene  are  all 'somewhat  similar  in  their  action  upon  frogs  ;  the 
halogen  radicals  not  modifying  the  action  of  the  benzene  to  such 
an  extent  as  they  do  in  the  case  of  ammonium  salts.  The  volun- 
tary muscles  are  weakened  by  them  and  there  is  a  slight  ten- 
dency to  paralysis  of  the  motor  nerves ;  but  the  action  is  chiefly 
exerted  on  the  brain  and  spinal  cord.  The  brain  is  first  affected, 
as  shown  by  general  lethargy  and  disinclination  to  move.  Next 
the  cord  is  affected  ;  motions  are  imperfectly  performed,  and  there 
is  a  tendency  to  general  tremor  on  movement  resembling  that  ob- 
served in  disseminated  sclerosis  ;  sometimes,  however,  the  tremor 
is  observed  independently  of  movement  (Brunton  and  Cash) . 

The  addition  of  hydroxyl  into  the  benzene  nucleus  intensifies 
the  convulsant  action,  so  that  oxybenzene   (carbolic  acid)  and 

1  Chastaing,  Compt.  Bend.,  xciv.  44. 


812  OEGANIC   MATERIA  MEDICA.  [sect.  iv. 

dioxybenzene  cause  convulsions  in  frogs,  and  trioxybenzene  causes 
jerkings,  though  of  a  slighter  character. 

All  the  members  of  the  pyridine  and  chinoline  series  destroy 
life,  either  by  exhaustive  convulsions  or  by  gradual  paralysis  of 
the  respiratory  centres.1  The  members  of  the  pyridine  series — 
pyridine,  picoline,  lutidine,  etc. — have  an  action  similar  in  kind, 
but  differing  in  degree,  the  lethal  power  increasing  as  one  ascends 
in  the  series.  The  higher  members  of  the  pyridine  series  have 
an  action  like  that  of  the  lower  members  of  the  chinoline  series, 
but  are  more  liable  to  cause  death  by  asphyxia  than  the  chino- 
lines,  and  have  more  than  twice  their  lethal  power. 

In  ascending  the  chinoline  series,  a  change,  occurs  in  the 
physiological  action  of  its  members,  the  lower  ones  acting  chiefly 
on  the  sensory  centres  of  the  brain  and  reflex  centres  of  the 
cord,  destroying  voluntary  and  reflex  movement ;  while  the 
higher  act  chiefly  on  the  motor  centres,  first  as  irritants  causing 
violent  convulsions,  and  afterwards  producing  paralysis. 

'  On  comparing  the  action  of  such  compounds  as  chinoline 
(C9H7N)  with  parvoline,  etc.  (C9Hi3N),  or  eollidine  (C8HUN)  with 
coniine  (C8H,,N),  or  dipyridine  (C10H10N2)  with  nicotine  (C10HHN2), 
it  is  observed  that  the  physiological  activity  of  the  substance 
is,  apart  from  chemical  structure,  greatest  in  those  bases  con- 
taining the  larger  amount  of  hydrogen.  Further,  when  the  bases 
of  the  pyridine  series  are  doubled  by  condensation,  as  in  dipyri- 
dine, parapieoline,  etc.,  they  become  not  only  more  active  physio- 
logically, but  have  a  different  action  from  that  of  the  simple  bases.' 2 

As  alterations  in  the  physiological  action  of  the  carbon  com- 
pounds of  this  group  can  be  effected  by  slightly  changing  their 
chemical  composition,  several  attempts  have  been  recently  made 
to  obtain  artificial  alkaloids  which  should  possess  a  strong  anti- 
pyretic action  without  depressing  the  heart  or  causing  sickness: 
Antipyrin,  one  of  the  most  recent  introductions,  appears  to  be 
the  best  as  yet,  but  further  attempts  in  this  direction  may  be 
still  more  successful. 

U.S.  P.  Acidum  Carbolicum  Crudum.  Crude  Carbolic  Acid. 

Characters. — A  nearly  colourless  or  reddish-brown  liquid 
of  a  strongly  empyreumatic  and  disagreeable  odour,  having  a 
benumbing,  blanching,  and  caustic  effect  on  the  skin  or  mucous 
membrane,  and  a  neutral  reaction. 

Eeactions  and  Tests. — Bromine  water  produces  in  an  aqueous  solution 
of  carbolic  or  cresylic  acid  a  white  flocculent  precipitate.  Crude  carbolic 
acid  should  not  dissolve  in  less  than  15  parts  of  water  at  15°  C.  (59°  F.),  nor 
should  the  solution  have  an  alkaline  reaction  (absence  of  alkalis).  If  50 
volumes  of  crude  carbolic  acid  be  diluted  with  warm  water  to  measure  1,000 
volumes,  the  mixture  well  .shaken,  cooled,  and  allowed  to  separate,  the 
amount  of  undissolved  impurities  should  not  exceed  5  volumes  or  10  per 
cent,  by  volume  of  the  crude  acid. 


1  McKendrick  and  Dewar, '  On  the  Physiological  Action  of  the  Chinoline  and 
Pyridine  Bases,'  Proc.  Boy.  Soe.,  1874,  p.  432.      2  McKendrick  and  Dewar,  op.  cit. 


chap,  xxx.]   CAEBON  COMPOUNDS— AROMATIC  SEEIES.    813 

Acidum  Carbolicum.  B.  and  U.S. P.  Carbolic  Acid. 
Phenol.     Phenyl-Alcohol.     C6HsHO  ;  94. 

A  substance  obtained  from  coal-tar  oil  by  fractional  distillation 
and  subsequent  purification. 

Characters. — In  colourless  acicular  crystals,  which  at  a  tem- 
perature of  95°  F.  become  an  oily  liquid,  having  a  strong  odour 
and  taste  resembling  those  of  creasote,  which  it  also  resembles 
in  many  of  its  characters  and  properties.  Its  specific  gravity  is 
1-065;  boiling-point,  370°  F. 

Solubility. — The  crystals  readily  absorb  moisture  on  exposure  to  the 
air,  and  they  are  thus  liquefied ;  the  acid,  however,  is  soluble  in  water  to  the 
extent  of  only  5  per  cent.,  but  it  is  freely  soluble  in  alcohol,  ether,  and 
glycerin. 

Reactions. — It  does  not  redden  blue  litmus-paper.  A  slip  of  deal  dipped 
into  it,  and  afterwards  into  hydrochloric  acid,  and  then  allowed  to  dry  in  the 
air,  acquires  a  greenish- blue  colour.  It  coagulates  albumen.  It  does  not 
affect  the  plane  of  polarisation  of  a  ray  of  polarised  light. 

Dose. — 1  to  3  grains. 

Peepaeations. 

B.F. 

Acidum  Carbolicum  Iiiquefactum  about  90  per  cent. 

Glycei  inum  Acidi  Carbolici.    Glycerine  of  Carbolic  acid 

(Carbolic  acid  1,  Glycerine  4  by  measure) 1  part  in  6  by  weight. 

Suppositoria  Acidi  Carbolici  cum  Sapone.     Carbolic 

Acid  Suppositories.     Carbolic  acid,  1  gr. ;  curd  soap,  15 

gr. ;  starch,  q.s.  to  give  consistence. 
Ung-uentum   Acidi   Carbolici    (Carbolic   Acid,   1 ;    soft 

paraffin,  12  ;  hard  paraffin,  6). 

us.p. 
Unguentum  Acidi  Carbolici  (with  ointment  1  in  10). 

B.P.  Acidum  Carbolicum  Liquefactum.  Liquefied 
Carbolic  Acid. — Carbolic  acid  liquefied  by  the  addition  of  10 
per  cent,  of  water. 

Characters. — A  colourless  or  very  slightly  reddish  or  brown- 
ish liquid  having  the  taste,  odour,  &c,  of  carbolic  acid. 

Solubility. — It  dissolves  in  18  to  26  per  cent,  of  water  at  60°  ~F.  (15-5°  C), 
yielding  a  clear  or  nearly  clear  solution,  from  which  .any  slight  coloured 
impurity  contained  previously  in  the  acid  separates  as  dark  oily  drops. 

Dose. — 1  to  4  minims. 

Action. — Carbolic  acid  is  a  powerful  deodoriser  and  dis- 
infectant (p.  106).  It  precipitates  albumen,  and  destroys  low 
organisms.  It  prevents  the  decomposition  of  albuminous  fluids 
by  bacteria,  and  the  fermentation  of  sugar  by  yeast.  Quantities 
smaller  than  those  which  are  sufficient  to  kill  these  organisms 
suffice  to  prevent  their  development.  It  does  not  appear  to 
destroy  the  action  of  all  organic  ferments  so  readily,  although 
it  doe's  so  when  applied  for  a  long  time,  or  in  concentrated 
solution;  it  prevents  the  conversion  of  starch  into  sugar,  the 
conversion  of  albumen  into  peptones,  and  the  decomposition  of 
amygdalin  with  formation  of  hydrocyanic  acid.     When  applied 


814  OEGANIC  MATEEIA   MEDICA.  [sect.  iv. 

to  the  skin  it  produces  a  white  stain,  and  greatly  diminishes  the 
sensibility  of  the  part.  The  stain  afterwards  becomes  brownish, 
and  of  a  parchment-lite  consistence,  and  the  epidermis  by-and- 
by  peels  off.  Carbolic  acid  does  not  act  as  a  vesicant,  but  ap- 
pears to  cause  anaesthesia  of  the  part  to  which  it  is  applied, 
extending  to  some  distance  below  the  surface.  If  applied  over  a 
large  surface  of  skin  it  may  be  absorbed  to  such  a  degree  as  to 
cause  poisoning,  and  even  death.  The  symptoms  are  weakness, 
delirium,  and  collapse.  When  applied  to  mucous  membranes 
it  has  a  similar  action.  In  the  mouth  it  causes  a  burning  pain, 
and  when  swallowed  produces  symptoms  of  gastro-enteritis,  pain 
in  the  stomach,  and  sometimes  vomiting  and  purging. '  Along 
with  this  there  is  great  collapse,  delirium,  and  death,  sometimes, 
though  not  always,  preceded  by  convulsions,  the  pupils  being 
contracted.  After  death  the  blood  is  found  to  be  very  dark, 
and  its  coagulability  greatly  diminished.  Carbolic  acid  appears 
to  be  a  powerful  poison  to  all  the  tissues,  paralysing  both  muscle 
and  nerve  when  applied  directly  to  them  without  previously 
stimulating  them.  After  absorption  it  acts  especially  on  the 
medulla  oblongata,  but  acts  also  on  the  spinal  cord,  first 
stimulating  and  then  paralysing  these  centres.  From  its  action 
on  the  cord  it  produces  in  frogs  convulsions  resembling  those 
of  strychnine,  these  being  followed  by  paralysis.  It  first  stimu- 
lates the  respiratory  and  vaso-motor  centres,  and  afterwards 
paralyses  them.  It  thus  produces  at  first  quickened  respiration 
with  rise  of  blood-pressure,  and  it  also  quickens  the  pulse.  As 
the  centres  become  paralysed  the  blood-pressure  falls  greatly 
the  respiration  becomes  slower,  and  the  pulse  also  becomes  slower. 
When  it  is  injected  directly  into  the  blood,  so  that  it  can  act  in 
large  quantity  on  the  nerve-centres,  it  paralyses  the  vaso-motor 
centre  at  once,  and  causes  the  blood-pressure  to  fall  very  greatly 
without  much  alteration  being  observed  in  the  action  of  the  heart 
itself.  That  the  vaso-motor  centre  is  completely  paralysed  by 
carbolic  acid  is  shown  by  the  fact  that  after  its  injection  the 
blood-pressure  is  not  raised  either  by  stimulation  of  sensory 
nerves  or  by  aspnyxia.  Although  carbolic  acid  acts  first  and 
most  markedly  on  the  nerve-centres  in  the  medulla  oblongata  it 
affects  the  cerebral  centres  also.  This  effect  is  evidenced  in 
man  by  headache,  giddiness,  and  lassitude,  followed  by  uncon- 
sciousness. In  animals  it  also  affects  the  cerebrum,  as  shown 
by  alterations  in  sensibility  and  motor  power.  It  stimulates  the 
sweat  centre  and  salivary  centres,  producing  perspiration  and 
salivation.  Medium  doses  appear  to  cause  death  by  paralysis  of 
the  respiration,  so  that  artificial  respiration  may  be  of  some  use 
in  preventing  it ;  but  large  doses  paralyse  the  heart  also,  so  that 
death  occurs  in  spite  of  artificial  respiration.  It  diminishes  the 
temperature  in  cases  of  poisoning,  and  also  when  given  to 
animals  in  a  febrile  condition,  though  when  the  fever  is  very 


chap,  xxx.]    CAEBON  COMPOUNDS— AEOMATIC  SEEIES.   8J5 

high  it  does  not  seem  to  have  much  effect.  It  is  excreted  by 
the  kidneys,  and  can  be  readily  detected  in  the  urine  by  bromine 
water.  It  sometimes  gives  rise  to  a  very  dark  colouration  of  the 
urine,  due  to  some  oxidation-product  of  the  carbolic  acid,  probably 
hydroquinone  (p.  809). 

Part  of  the  carbolic  acid  appears  in  the  urine,  in  combination 
with  sulphuric  acid,  as  sulpho-carbolates,  and  if  the  quantity 
administered  has  been  large  the  ordinary  sulphates  may  com- 
pletely disappear.  The  hydroquinone  occurs  also  to  a  great 
extent  in  the  urine  in  combination  with  sulphuric  acid.  The 
compound  is  colourless,  and  thus  the  urine,  when  freshly  passed, 
has  a  normal  appearance ;  on  standing,  the  hydroquinone  be- 
comes free,  undergoes  further  oxidation,  and  causes  the  urine  to 
assume  a  brown  colour. 

Tkeatmbnt  of  Poisoning. — The  stomach  should  be  emptied 
by  emetics,  or  best  by  the  stomach-pump.  Demulcents,  such  as 
olive  oil,  should  then  be  administered.  For  the  treatment  of  the 
general  symptoms  following  carbolic  acid  poisoning,  and  to  aid 
the  elimination  in  the  urine,  the  administration  of  sulphates 
— e.g.  sodium  sulphate  in  10-grain  doses — is  advisable. 

Uses. — It  has  sometimes  been  applied  externally  to  produce 
local  anaesthesia  for  slight  operations,  such  as  opening  abscesses. 

When  mixed  with  oil,  in  the  proportion  of  ten  minims  to  an 
ounce  of  oil,  it  relieves  the  pain  of  burns.  One  of  the  best  means 
for  removing  the  pain  of  toothache  is  to  dip  a  little  cotton-wool 
into  carbolic  acid  melted  by  the  aid  of  heat,  and  insert  the 
pledget  into  the  cavity  of  the  tooth,  covering  it  over  with  dry 
cotton-wool,  to  prevent  the  tongue  being  burned  by  contact  with 
the  acid.  It  is  used  as  a  stimulant  to  indolent  ulcers  and 
wounds,  and  to  destroy  condylomata,  and  has  been  applied  to 
the  throat  in  cases  of  diphtheria,  ulceration,  and  aphthae.  It  has 
been  employed  as  an  injection  in  deep-seated  inflammations 
such  as  chronic  synovitis,  inflamed  glands,  boils,  hydrocele,  ery- 
sipelas, and  poisoned  wounds.  Carbolic  acid,  2  per  cent,  in 
simple  ointment,  is  useful  in  relieving  itching  in  chronic  eczema 
and  urticaria,  and  in  papular  eczema  it  gives  relief  when  applied 
in  a  lotion  of  one  part  of  the  acid  to  one  part  of  boric  acid  and 
200  paxts  of  alcohol.  It  is  used  locally  as  an  antiparasitic  in  favus, 
tinea  versicolor,  and  ringworm.  Its  chief  application,  however, 
is  to  destroy  the  minute  organisms  which  cause  putrefaction  in 
albuminous  fluids,  and  to  prevent  the  untoward  results  which 
would  arise  from  the  absorption  of  putrid  discharges. 

According  to  Sir  Joseph  Lister,  the  untoward  consequences  of 
operations  are  frequently  due,  not  to  the  operation  itself,  but  to 
the  poisoning  of  the  wound  by  the  products  of  decomposing  dis- 
cbarges, and  poisoning  of  the  system .  generally  by  absorption 
of  these  products.  The  decomposition  is  due  to  low  organ- 
isms, such  as  bacteria,  introduced  from  without,  and  it  may  be 


816  OEGANIC  MATEEIA  MEDICA.  [sect.  iv. 

prevented  by  the  use  of  such  substances  as  will  prevent  their 
development  or  destroy  them  when  present.  In  performing  opera- 
tions, therefore,  he  advises  that  the  skin  should  first  be  washed 
with  a  watery  solution  of  carbolic  acid  (1  in  40),  that  the  instru- 
ments also  should  be  treated  with  a  similar  solution,  and  that  the 
incision  should  be  made  under  a  spray  of  carbolic  acid  (1  in  60). ' 
After  the  operation  is  concluded  under  a  constant  use  of  the 
spray,  the  wound  is  covered  with  a  protective  consisting  of  var- 
nished linen  dipped  in  a  solution  of  carbolic  acid  (1  in  40),  above 
which  are  laid  eight  layers  of  gauze,  steeped  in  a  mixture  of 
carbolic  acid  (1),  resin  (4),  and  paraffin  (4).  Between  the  sixth 
and  seventh  layers  is  put  a  piece  of  waterproof  tissue,  in  order  to 
distribute  the  discharge  and  prevent  it  from  oozing  out  at  one 
spot.  If  the  discharge  be  great  the  dressings  ought  to  be  changed 
once  in  twenty-four  hours,  under  the  spray ;  but  as  the  wound 
heals,  the  intervals  between  the  dressings  may  be  lengthened. 

A  solution  of  carbolic  acid  in  oil  is  frequently  used  to  lubri- 
cate, and  at  the  same  time  disinfect,  catheters  (p.  105) ;  but,  as 
Koch's  experiments  show,  such  a  solution  has  no  antiseptic 
power,  and  they  ought  to  be  first  disinfected  with  an  aqueous 
solution  and  afterwards  oiled. 

Carbolic  acid  is  very  useful  in  what  is  sometimes  known  as 
an  influenza  cold,  beginning  with  coryza,  spreading  down  the 
throat  to  the  air-passages,  leading  to  severe  bronchitis  with  much 
depression,  and  occasionally  also  to  gastro-intestinal  catarrh. 
This  form  of  cold  appears,  like  true  influenza,  to  be  extremely 
infectious,  and  to  be  easily  communicated,  not  only  by  one 
member  of  a  family  to  another,  but  even  by  casual  visitors.  It 
may  sometimes  be  arrested,  and  may  frequently  be  rendered  less 
severe,  by  carbolic  acid  spray  applied  to  the  nostrils  and  by  the 
use  of  a  gargle  containing  carbolic  acid.  Other  forms  of  sore- 
throat  are  also  relieved  by  gargles  containing  about  1  per  cent, 
of  carbolic  acid.  Considerable  care  must  be  taken  in  using  the 
gargle  not  to  swallow  it,  on  account  of  the  poisonous  properties  of 
the  acid.  When  the  cold  begins  in  the  nose  the  solution  of  car- 
bolic acid  for  spray  may  contain  1  per  cent.,  but  perhaps  a  still 
better  method  of  applying  it  is  by  a  small  ear-syringe,  as  a  £  or 
J  per  cent,  solution.  A  mixture  of  1  part  of  carbolic  acid  with 
3  of  creasote  has  been  used  for  continuous  inhalation  in  phthisis 
by  means  of  the  oro-nasal  respirator. 

Carbolic  acid  is  also  used  as  an  injection  to  wash  out  serous 
cavities,  after  the  evacuation  of  fluids ;  for  example,  the  cavity 
of  the  pleura  after  the  evacuation  of  the  fluid  in  pleurisy,  and 
the  cavity  of  an  abscess  after  the  removal  of  the  pus.  Internally, 
the  acid  has  been  given  in  cases  of  flatulent  dyspepsia.     It  is  a 

1  The  strength  of  solution  placed  in  the  bottle  of  the  spray-producer  is  1  in  20, 
but  when  mixed  with  the  steam  it  is  reduced  to  1  in  60. 


chap,  xxx.]    CAEBON  COMPOUNDS— AEOMATIC  SEEIES.   817 

useful  application  to  the  uterus  in  chronic  inflammation,  excoria- 
tion, catarrh,  and  cancer,  and  as  an  injection  in  leucorrhoea. 

Sodii  Sulpho-carbolas,  B.  and  U.S.P.     Vide  p.  626. 
B.P.  Zinci  Sulpho-carbolas.     Vide  p.  671. 

Creasotum,  B.  and  U.S.P.     Ckeasote. 

A  product  of  the  distillation  of  wood-tar. 

Chabactebs. — A  liquid,  colourless  or  with  a  yellowish  tinge, 
and  a  strong  empyreumatic  odour.     Specific  gravity,  1-071. 

Solubility.— It  is  sparingly  dissolved  by  water,  but  freely  by  alcohol 
ether,  and  glacial  acetic  acid. 

Reactions. — It  coagulates  albumin.  A  slip  of  deal  dipped  into  it,  and 
afterwards  into  hydrochloric  acid,  acquires  on  exposure  for  a  short  time  to 
the  air  a  greenish-blue  colour.  Dropped  on  white  filtering  paper  and  exposed 
to  a  heat  of  212°  F.,  it  leaves  no  translucent  stain.  It  turns  the  plane  of 
polarisation  of  a  ray  of  polarised  light  to  the  right.  It  is  not  solidified  by  the 
cold  produced  by  a  mixture  of  hydrochloric  acid  and  sulphate  of  sodium. 

Dose. — 1  to  3  drops. 

Preparations. 
b.p.  dose.  u.s.p.  dose. 

Mlstnra  Creasoti  (1  ruin,  in  1  fl.  Aqua  Creasoti 1-4  fl.  dr. 

oz.  nearly) 1-2  fl.  oz. 

TTnguentum  Creasoti  (-with  simple 

ointment,  1  part  in  9) 

Vapor  Creasoti  

U.S.P.  Aqua  Creasoti.  Creasote  Water.  Creasote,  1 ;  distilled  water,  99 ; 
agitate  and  filter. 

B.P.    Mistura  Creasoti.     Creasote  Mixture. 

Take  of  creasote  1  part,  glacial  acetic  acid  1  part,  spirit  of  juniper  2  parts, 
syrup  32  parts,  distilled  water  480  parts. 

B.P.    Vapor  Creasoti.    Inhalation  op  Creasote. 

Mix  creasote  (12  min.)  and  water  (8  fl.  oz.)  in  an  apparatus  so  arranged  that  air 
may  be  made  to  pass  through  the  solution,  and  may  afterwards  be  inhaled. 

Action. — Creasote  destroys  low  vegetable  organisms,  and  pre- 
vents the  fermentation  which  they  cause.  When  administered 
to  small  animals,  it  causes  great  dyspncea,  weakening  of  the 
heart's  action,  paralysis,  and  often  sudden  death.  Its  action 
differs  from  that  of  carbolic  acid  in  the  absence  of  convul- 
sions and  in  causing  increased  coagulability  of  the  blood. 

Creasote  is  a  powerful  muscular  poison.  It  coagulates  albu- 
min and  blood.  When  applied  to  the  skin  it  destroys  the 
epithelium,  and  has  a  similar  action  upon  mucous  membranes. 
In  the  mouth  it  produces  a  burning  sensation  and  much  sali- 
vation. Large  doses  taken  internally  cause  nausea,  vomiting, 
colicky  pains,  and  diarrhoea.  The  pulse  is  quickened,  there  is 
giddiness  and  .headache,  the  respiration  is  slow  and  laboured, 
and  the  secretion  of  urine  is  increased. 

Uses. — It  is  often  employed  as  a  remedy  in  toothache,  a 
small  pledget  of  cotton  wool  being  dipped  into  it  and  placed  in 
the  cavity  of  the  decayed  tooth.     Care  should  be  taken  to  cover 

3  G 


818  OEGANIC   MATEEIA  MEDICA.  [sbct.  iv. 

this  with  fresh  cotton  wool,  to  prevent  the  tongue  from  being 
burned.  Internally,  it  is  given  in  cases  of  vomiting  depending 
upon  abnormal  processes  of  fermentation  in  the  stomach,  and  it 
is  said  to  relieve  vomiting  due  to  other  causes,  such  as  ulcera- 
tion of  the  stomach,  cancer,  Bright's  disease,  sea-sickness,  and 
pregnancy.  It  is  useful  in  diarrhoea,  especially  that  of  children, 
where  the  diarrhoea  depends  upon  irritation  due  to  abnormal 
fermentation-processes  in  the  intestinal  contents.  The  vapour 
is  used  in  phthisis  and  foetid  bronchitis. 

Resorcin.  C6H4(OH)2(l  :  3).  Meta-di-hydroxy-benzene 
(vide  p.  809).     Not  officinal. 

Characters. — White  crystalline  plates  somewhat  like  benzoic 
acid,  melting  at  99°  C.     It  has  a  sweetish  harsh  taste. 

Solubility. — It  is  soluble  in  less  than  2  parts  of  water  and  20  of  olive  oil. 
Beaction. — The  aqueous  solution  gives  a  dark  violet  colour  with  ferric 
salts. 

Dose. — 5-30  grs.  (0-3-2  gm.).  It  is  best  given  with  syrup 
of  oranges  and  freely  diluted. 

Action.— It  is  a  powerful  antiseptic.  It  coagulates  albu- 
min. A  saturated  solution  has  a  caustic  action  on  the  skin,  but 
a  weak  solution — e.g.  5  per  cent. — is  not  irritating  to  the  skin 
or  mucous  membranes.  In  frogs  it  produces  stupor,  collapse, 
clonic  spasms,  and  dyspnoea  like  carbolic  acid.  In  warm- 
blooded animals  it  also  causes  clonic  convulsions,  dyspnoea, 
dilatation  of  the  vessels  and  increased  secretion  of  saliva  and. 
tears.  Death  occurs  through  paralysis.  Large  doses  in  man — 
30  grs.  or  more — cause  giddiness,  singing  in  the  ears,  symptoms 
of  intoxication,  like  those  of  alcohol,  convulsive  tremors  and 
collapse.     In  febrile  conditions  it  greatly  lowers  the  temperature. 

Uses. — It  is  a  powerful  antiseptic  and  has  been  employed, 
locally  in  diphtheria.  A  5  per  cent,  solution  has  been  used  as 
an  application  to  syphilitic  sores  and  skin  diseases,  and  as  an 
injection  into  the  bladder  in  cystitis.  It  appears  to  shorten  the 
duration  of  facial  erysipelas  when  applied  every  four  hours,  in 
the  form  of  a  25  per  cent,  ointment  made  with  vaseline.  A  1 
per  cent,  solution  has  been  used  as  a  collyrium.  In  infantile 
cholera  it  has  proved  very  useful  in  doses  of  1^-5  grains 
(0-1-0-3  gm.),  given  in  infusion  of  chamomile.  Doses  of  5 
grains  three  times  a  day  before  meals  are  useful  in  preventing 
fermentation  in  the  stomach.  As  an  antipyretic  it  lessens  the 
temperature  in  phthisis  and  in  typhoid,  to  a  less  extent  in  pneu- 
monia and  erysipelas.     It  has  also  been  used  in  ague. 

Its  disadvantages  are  the  profuse  perspiration  which  it  pro- 
duces, the  short  duration  of  its  antipyretic  action,  and  the  rapidity 
with  which  the  temperature  again  rises. 

Hydroquinone.  C6H4(OH)2(l :  4).  Para-di-hydroxy-benzenb 
(p.  809).     Not  officinal. 


chap.  xxx.J   CAEBON  COMPOUNDS— AEOMATIC  SEEIES.    819 

Characters. — In  crystals  or  plates  with  a  slight  sweetish  taste. 
Action.— Like  that  of  resorcin,  but  about  four  times  stronger. 
Uses. — Similar  to  those  of  resorcin. 

Pyrocatechin.  C6H4(OH)2(l  ;  2).  Ortho-di-hydroxy-benzene 
(p.  809).     Not  officinal. 

Characters. — It  forms  crystals  or  plates. 

Solubility. — It  is  readily  soluble  in  water,  alcohol,  and  ether. 
Beaction. — It  reduces  cupric  sulphate. 

Action. — Like  that  of  resorcin,  but  it  is  about  three  times 
stronger. 

Uses. — Like  those  of  resorcin. 

Pyrogallic     Acid.       Pyrogallol,      Tri-hydroxy-benzene, 
C6H3(OH)3.  (vide  p.  810).     Not  officinal. 
Characters. — Light,  glistening  crystals. 

Preparation. — By  heating  gallic  acid. 

Solubility. — Eeadily  soluble  in  water  and  alcohol. 

Eeaotion. — It  rapidly  combines  with  oxygen,  becoming  dark  in  colour. 

Dose. — |  to  1£  gr. 

Action. — It  has  a  doubtful  antiseptic  action.  In  mammal's 
it  decomposes  the  red  blood-corpuscles,  causing  brownish  dis- 
coloration of  the  skin  and  mucous  membranes,  thrombosis  in 
the  veins,  haemorrhagic  infarcts  in  the  kidneys  and  methsemo- 
globin  or  blood  in  the  urine.  In  man  the  symptoms  of  poisoning 
come  on  rapidly,  with  headache,  vomiting,  purging,  and  collapse. 

Uses. — Pyrogallol  is  chiefly  used  externally  in  skin  diseases. 
A  20  per  cent,  ointment  has  been  used  as  a  caustic  in  lupus, 
cancer,  and  chancres.  It  appears  to  destroy  the  diseased  part 
without  affecting  the  surrounding  healthy  tissue.  In  place  of  the 
ointment,  a  20  per  cent,  powder  with  starch  may  be  used.  As 
soon  as  the  wound  granulates  it  is  dressed  with  iodoform  :  the 
pain  is  short  and  moderate,  and  no  danger  is  to  be  apprehended 
from  absorption.1  In  lupus  erythematosus,  a  10  per  cent,  oint- 
ment may  be  applied  twice  daily  for  three  or  four  days,  anti- 
septics being  afterwards  used.  An  ointment  of  similar  strength 
and  similarly  applied  is  of  great  service  in  patches  of  psoriasis, 
especially  of  the  face  and  hands.  It  does  not,  like  chrysarobin, 
stain  linen ;  but  the  risk  of  absorption  must  be  considered,  as 
hemoglobinuria  has  followed  its  application  to  large  surfaces  of 
the  body.  It  is  useful  in  tylosis  of  the  palms  and  soles,  and  a  2 
per  cent,  alcoholic  solution  may  be  painted  with  beneficial  result 
over  large  tubercles  in  acne  rosacea,  after  poulticing. 

Internally  it  has  been  given  in  hemorrhage. 

Acidum  Salicylicum,  B.  and  U.S.P.  Salicylic  Acid. 
HC7H503;  138  (p.  810). 

1  Bull,  de  TMrap.,  Jan.  30,  1883 ;  Centralblt.  f.  d.  med.  WissenscJuift,  No.  42, 
1883. 

3  a  1 


820  OEGANIC   MATERIA  MEDICA.  [sect.  iv. 

A  crystalline  acid  obtained  by  tbe  combination  of  the  elements 
of  carbolic  acid  with  those  of  carbonic  acid  gas  and  subsequent 
purification,  or  from  natural  salicylates  Buch  as  the  oils  of  winter- 
green  (Gaultheria  procumbens,  Linn.)  and  sweet  birch  (Betvla 
lenta,  Linn.). 

Characters. — In  white  acicular  crystals,  inodorous  but  light 
and  easily  diffused  and  then  irritating  to  the  nostrils ;  taste  at 
first  sweetish,  then  acid. 

The  crystals  melt  at  about  311°  F.  (155°  C),  and  below 
392°  F.  (200°  C.)  volatilise  without  decomposition. 

Solubility. — It  is  soluble  in  500  to  700  parts  of  water  at  ordinary  tempe- 
ratures ;  readily  soluble  in  alcohol,  ether,  and  hot  water ;  soluble  also  in 
solutions  of  citrate  or  acetate  of  ammonium,  phosphate  of  sodium,  or  borax. 

Reactions. — The  aqueous  solution  gives  with  solution  of  perchloride  of 
iron  a  reddish-violet  colour.  An  alcoholic  solution  allowed  to  evaporate 
spontaneously  should  leave  a  perfectly  white  residue. 

Dose. — 5  to  30  grains. 

B.P.    Pkepabation. 
Vnguentum  Acidi   Salioylicl   (salicylic  acid,  1;  soft  paraffin,  18;  hard 
paraffin  9). 

Officinal  Salicylatb. 

Sodii  Salicylas. 

Action. — "When  mixed  in  a  proportion  of  1  to  10  per  cent, 
with  fluids  containing  the  germs  of  bacteria  it  will  prevent 
their  development,  and  in  the  proportion  of  1  in  60  will  destroy 
bacteria  when  swarming  in  a  fluid  (p.  91) .  Salicylic  acid  like- 
wise destroys  the  life  of  the  torula,  and  prevents  alcoholic  fer- 
mentation, as  well  as  the  fermentation  caused  by  the  organic 
ferments,  &c.  (p.  78). 

It  has  little  power  to  reduce  the  temperature  in  health,  but 
is  a  most  powerful  agent  in  lowering  the  temperature  of  fever. 
When  injected  into  the  blood,  or  administered  by  the  stomach  in 
large  quantities,  it  lowers  the  pulse-rate,  blood-pressure,  and 
respiration.  When  taken  in  medicinal  doses  for  some  time,  it 
produces  noises  in  the  ears,  deafness,  giddiness,  and  headache, 
in  this  respect  resembling  quinine.  Occasionally  it  has  caused 
sudden  depression  of  the  circulation  and  collapse. 

In  large  doses  salicylic  acid  causes  feeble  circulation,  lowers 
the  blood-pressure,  and  produces  death  through  paralysis  of  the 
respiration.  It  is  excreted  in  the  perspiration,  saliva,  and 
urine.  During  its  excretion  it  frequently  irritates  the  kidneys 
and  produces  albuminuria.  It  appears  in  the  urine  partly  as 
salts  of  salicylic  acid,  and  partly  in  combination  with  glycol  as 
salicyluric  acid.  After  its  use  the  urine  is  not  unfrequently 
brown  by  reflected  and  green  by  transmitted  light,  and  contains 
a  substance  which  reduces  copper  solution. 

Uses. — Externally  it  has  been  employed  as  an  antiseptic 
instead  of  carbolic  acid,  and  has  been  used  by  insufflation  in 


chap,  xxx.]  CARBON  COMPOUNDS— AROMATIC  SERIES.    821 

diphtheria  successfully.  A  mixture  of  2  parts  with  100  of  tallow 
applied  directly  to  the  feet,  not  to  the  stockings,  has  been  found 
most  useful  in  preventing  sweating  and  soreness  of  the  feet  in 
soldiers  after  a  long  march.  In  intertrigo  1  to  2  per  cent,  in 
starch  soothes  the  irritation  and  prevents  decomposition  of  the 
sweat.  A  lotion  (4  per  cent.)  is  useful  in  pruritus  and  chronic 
urticaria,  and  one  of  half  per  cent,  in  alopecia  furfuracea.  It 
has  been  recommended  for  soft  sores,  which  should  be  kept 
covered  with  the  pure  acid  for  two  days,  and  then  treated  with 
emollient  ointment.  Salicylic  acid  dissolved  in  collodion  flexile 
(gr.  xxx.  to  3J.)  is  very  useful  for  corns  and  warts,  and  in  a 
plaster  with  gutta-percha  in  corns,  tylosis,  and  in  the  thickened 
patches  of  chronic  eczema ;  also  to  hasten  the  peeling  of  the 
palms  and  soles  after  scarlet  fever. 

In  doses  of  3  to  5  grains  taken  during  meals  it  is  very  useful 
in  arresting  fermentative  changes  in  the  stomach  and  prevent- 
ing acidity  and  flatulence.  It  is  usually  employed  internally  in 
the  form  of  salicylate  of  sodium  (p.  628).  As  already  mentioned 
it  is  useful  both  in  acute  and  chronic  rheumatism.  It  is  of  much 
less  use  in  typhoid  fever  than  in  rheumatism,  and,  although  it 
has  some  antiperiodic  action,  it  is  not  such  a  powerful  remedy 
in  malarious  affections  as  quinine.  Salicylate  of  sodium  is  useful 
in  phlegmasia  alba.  As  already  mentioned,  it  relieves  headache. 
It  seems  to  have  a  peculiar  power  of  increasing  the  secretion  of 
bile  and  rendering  it  more  watery.  In  this  it  differs  from  most 
other  cholagogues,  which  increase  the  proportion  of  solids  in  the 
biie.  It  is  therefore  indicated  .in  cases  where  there  is  a  tendency 
to  the  formation  of  gall-stones. 

Naphthalin,  C10H8  (vide  p.  810).     Not  officinal. 
Source. — It  is  prepared  from  tar. 

Characters. — Colourless  micaceous  crystals  with  a  peculiar 
,  smell. 

Solubility. — Insoluble  in  water,  dilute  acids  or  alkalis.  Sparingly 
soluble  in  cold  alcohol,  more  readily  in  hot  alcohol. 

Purification. — As  the  commercial  naphthalin  is  often  impure  it  should 
be  purified  by  washing  it  with  alcohol  on  a  filter  until  the  alcohol  is  colour- 
less, then  drying  and  subliming. 

Dose. — For  adults  1^-8  grains  as  a  single  dose.  As  much 
as  80  grains  may  be  given  during  the  day.  For  children,  1^-3 
grains  every  three  hours. 

Administration. — In  the  form  of  powder  mixed  with  sugar 
and  scented  with  oil  of  bergamot,  it  may  be  taken  in  wafers  or 
capsules.  It  may  be  used  as  enema,  but  as  it  is  quite  insoluble 
in  water  it  must  be  suspended  in  a  mucilaginous  vehicle  such  as 
decoction  of  marsh  mallow.  The  beBt  way  of  doing  this  is  by 
mixing  the  quantity  of  naphthalin  required  (15-75  grains)  with 
2  or  3  fluid  ounces  of  boihng  distilled  water,  and  stirring  until 


822  ORGANIC  MATERIA  MEDICA.  [sect.  iv. 

it  is  diffused  in  very  fine  drops  throughout  the  liquid.  It  should 
then  be  poured  into  15  or  30  fluid  ounces  of  boiling  marsh- 
mallow  tea  and  vigorously  stirred.  The  liquid  is  then  allowed  to 
cool,  and  introduced  into  the  rectum  by  a  soft  tube  and  funnel 
(p.  484). 

Action.- — It  destroys  low  organisms  and  prevents  the  ger- 
mination of  their  spores.  It  is  a  powerful  antiseptic,  but  it 
must  be  intimately  mixed  with  the  substances  on  which  it  is  to 
have  this  action.  It  has  little  or  no  poisonous  action  on  the 
higher  animals  when  given  either  by  inhalation  or  internally, 
the  reason  probably  being  that  it  is  so  sparingly  soluble  that  it 
is  not  absorbed  in  sufficient  quantity  from  the  intestinal  canal 
to  be  injurious  to  the  organism.  When  given  internally  it  dis- 
infects the  whole  contents  of  the  intestinal  canal,  so  that  the  faeces 
have  either  no  smell  at  all  or  a  faint  smell  of  naphthalin.  It  is 
so  sparingly  soluble  that  most  of  it  Temains  in  the  intestine  and 
acts  on  the  contents  of  the  intestinal  tube  along  its  whole  length 
from  the  stomach  to  the  rectum.  It  is  excreted  in  the  urine, 
partially  unchanged  and  partially  as  naphthol  and  perhaps  phenol. 

Uses. — It  may  be  used  wherever  it  is  desirable  to  destroy 
germs  and  stop  processes  of  putrefaction  or  fermentation  in  the 
intestine.  It  has  proved  useful  in  typhoid  fever,  diarrhoea, 
acute  and  chronic,  vomiting  and  diarrhoea  in  children,  and  tu- 
bercular diarrhoea.  During  its  excretion  by  the  kidneys  the 
urine  is  rendered  aseptic  by  it  or  by  the  products  of  its  decom- 
position, and  it  is  therefore  useful  in  vesical  catarrh.1  It  is 
possible  that  it  may  be  useful  in  cholera. 

Naphthol.  CI0H7OH. — There  are  several  kinds  of  naphthol. 
The  only  one  hitherto  used  is  the  beta-  or  iso-naphthol.  Not 
officinal. 

Characters. — In  white  crystals  with  a  somewhat  agreeable 
smell. 

Solubility. — Sparingly  soluble  even  in  hot  water.  Soluble  in  alcohol, 
ether,  and  chloroform,  in  olive  oil  and  vaseline. 

Action  and  Uses. — It  has  a  therapeutic  action  on  the  skin 
like  tar,  and  may  be  applied  as  ointment  in  the  strength  of  1  to 
5  per  cent.,  for  children  not  over  2  per  cent.  It  is  useful  in 
hyperidrosis  (Kaposi).  It  is  used  in  scabies,  eczema,  and  local 
sweating.  It  may  be  applied  in  ^  to  5  per  cent,  alcoholic,  solution, 
or  as  an  ointment  (10  per  cent.).  When  absorbed  it  causes 
vomiting,  loss  of  consciousness,  convulsions,  and  haematuria. 

Hydrochlorate  of  Rosaniline.    Synonyms:    Fuchsin,  Ma- 
genta, Eoseine,  Anh-iKe  Bed.     C20H19N3HC1.    Not  officinal. 
Characters. — Elongated  crystals  with  a  brilliant  green  lustre. 

1  Eossbaoh,  Berlin,  him.  Wochmschr.,  1884,  Nob.  24,  42,  46. 


chap,  xxx.]   CAjSBON  COMPOUNDS— AEOMATIC  SEEIES.    823 

Solubility. — It  is  readily  soluble  in  water,  giving  a  bright  red  solution. 

Preparation. — Eosaniline  is  a  colourless  substance,  prepared  by  acting 
on  aniline  with  oxidising  agents,,  such  as  arsenic  acid.  The  compounds  of 
rosaniline  with  monobasic  acids  have  brilliant  colours. 

Dose. — J-4  grs. 
_  Actions. — Eosaniline  hydrochlorate,  when  perfectly  pure,  is 
said  to  have  no  marked  physiological  action.  Fabrics  dyed  with 
it  have  acted  as  local  irritants,  producing  eczema;  but  it  is 
probable  that  this  effect  may  be  due,  at  least  in  great  part,  to 
the  presence  of  arsenic.  When  given  internally  it  has  produced 
salivation,  vomiting,  diarrhoea,  and  when  injected  into  the  veins 
it  has  caused  trembling,  staggering,  albuminuria,  and  fatty 
degeneration  of  the  kidneys.  These  symptoms  may  possibly  be 
due  to  the  presence  of  aniline  or  of  arsenic  as  impurities.  It  is 
excreted  by  the  kidneys,  saliva,  and  bile,  and  probably  also  by 
the  intestinal  mucous  membrane.  It  gives  a  magenta  colour  to 
the  urine. 

Use. — To  lessen  or  remove  albumin  from  the  urine  in  albu- 
minuria. 

Pyridine.     C5H5N  (p.  810).     Not  officinal. 

Characters. — A  colourless  liquid  with  a  powerful  odour.  It 
evaporates  when  exposed  to  the  air,  and  mixes  with  water  in  all 
proportions.     Like  chinoline  it  forms  salts. 

Dose. — 4-5  gm.,  allowed  to  evaporate  in  an  open  dish  in  a 
room  of  25  cubic  metres  capacity.  The  patient  must  be  exposed 
to  the  vapour  for  twenty  to  thirty  minutes  three  times  a  day.1 

Action. — (See  also  p.  811.)  According  to  See  it  has  been 
found  by  experiments  on  animals  to  diminish  the  reflex  activity 
of  the  spinal  cord  and  respiratory  centre. 

Uses. — On  account  of  its  sedative  action  upon  the  respiratory 
centre,  pyridine  has  been  used  in  the  manner  described  with  bene- 
ficial effect  in  cases  of  asthma  ;  the  emphysematous  and  cardiac 
forms  as  well  as  the  purely  nervous  seem  to  be  benefited. 

Chinoline.    C9H7N  (p.  811).    Not  officinal. 

Characters. — A  colourless  liquid  with  an  aromatic  odour.  It 
forms  crystalline  salts. 

Dose. — Of  the  tartrate  7-15  grs.  (0-5-1  gm.). 

Action. — It  is  a  powerful  antiseptic  and  antipyretic.  In 
moderate  doses  it  lowers  the  temperature  and  pulse-rate.  In 
large  doses  it  produces  languor,  diminished  reflex  excitability, 
dyspnoea,  paralysis  and  collapse  (vide  p.  811). 

Uses. — It  has  been  used  in  typhoid  fever,  rheumatism,  and 
erysipelas,  apparently  with  benefit.  It  is  little  used  in  pneu- 
monia ;  and  in  phthisis  it  is  apt  to  irritate  the  stomach  and  pro- 
duce collapse. 

»  Germain  See,  Oomptes  Bend.  Ac.  Scien.,  1886. 


824  OEGANIC  MATEEIA  MEDICA.  [sect  iv, 

Kairin.  Hydrochlorate  of  oxy-ethyl-chinoline  Hydeide. 
Not  officinal. 

Dose. — 3-30  grs.     Best  given  in  wafer-paper  or  a  capsule. 

Action. — It  is  a  powerful  antipyretic. 

Uses. — Used  in  febrile  conditions  to  lower  the  temperature. 
Filehne  recommends  that  doses  of  8  grains  should  be  given  every 
hour  at  first  for  four  times  or  until  the  temperature  has  fallen  to 
100°  P.  If  the  temperature  falls  after  four  doses,  4  grains  should 
be  given  hourly  until  the  temperature  again  begins  to  rise,  when 
the  dose  should  be  increased.  If  the  temperature  has  not  fallen 
to  100°  after  four  doses  of  8  grains,  12  or  16  grains  should  be 
given  hourly,  until  the  temperature  of  100°  F.  is  reached,  when 
the  dose  should  be  lowered  as  before.  Like  resorcin,  it  pro- 
duces profuse  sweating. 

Antipyrin.  Not  officinal.  A  synthetically  prepared  alkaloid. 
There  are  two  substances  bearing  this  name,  viz.  methyl- 
oxy-chinicine  and  dimethyl-oxy-chinicine.  The  latter  is  the 
commercial  drug. 

Cbinicine  or  quinicine  is  a  hypothetical  base.  The  supposed 
constitution  of  chinicine  and  methyl-oxy-chinicine  may  be  thus 
graphically  represented : — 

H  IT 

I  /N— H  |  /N— H 

Mi  a/<i 

H— C         C  C— H         H— -C         C  C— CH. 

I  II  I  I  II  I 

H— C         0         C— H         H— G         C  C— H 

I     l\  I     II  H 

H       H     a  HO 

Chinicine  or  Quinicine.  Methyl-oxy-chinicine. 

Solubility. — It  is  very  readily  soluble  in  water,  with  a  sweetish  bitter 
and  rather  pleasant  taste. 

Ebactions. — Its  solutions  give  with  ferric  chloride  a  deep  red,  and  with 
nitrous  acid  a  greenish  blue  colour. 

Dose. — Thirty  grains  hourly  for  three  hours.  For  children 
a  grain  and  a  half  for  every  year  of  the  child's  age  may  be  given 
hourly  for  three  hours.  If  it  causes  vomiting  it  may  be  dis- 
solved in  half  its  weight  of  hot  water  and  injected  subcuta- 
neously. 

Action. — It  reduces  the  febrile  temperature  for  several  (1-20) 
hours  when  given  as  above  in  two  or  three  doses  (vide  p.  419), 
and  when  its  effect  has  passed  off,  the  rise  of  temperature  which 
then  occurs  is  less  frequently  accompanied  by  rigor  than  is  the 
case  with  kairin.  It  causes  profuse  perspiration.  It  slightly 
increases  the  blood-pressure.     It  has  no  action  on  the  respira- 


chap,  xxx.]   CAEBON  COMPOUNDS— AEOMATIO  SEEIES.    825 

tion.    It  is  excreted  in  the  urine.    It  sometimes,  though  rarely, 
causes  vomiting,  and  very  seldom  causes  collapse. 

Uses. — In  febrile  diseases  generally.  It  seems  specially 
useful  in  typhoid  fever  and  phthisis,  but  is  also  useful  in  ery- 
sipelas, surgical  fever,  pleurisy,  and  pneumonia. 

Thallin.  Not  officinal.  A  synthetically  prepared  alkaloid. 
It  is  chemically  tetrahydro-paramethyl-oxy-chinolin. 

Chabactees. — A  colourless  powder,  with  a  taste  and  smell 
reminding  one  of  meadow-sweet. 

Solubility  and  Ebaction. — It  is  soluble  in  water  and  gives  an  emerald 
green  colour  with  perehloride  of  iron,  whence  its  name. 

Dose. — 5  grains  or  more. 
.     Action. — It  is  a  powerful  antipyretic  (p.  419),  but  does  not 
appear  to  be  quite  so  good  as  antipyrin. 

Antifebrin.  Phenylacetamide.  C6H5.CaH3O.NH.  Not  offi- 
cinal. 

Chabactees. — A  pure  white  crystalline  powder;  odourless, 
and  producing  a  slight  burning  sensation  on  the  tongue ;  neutral 
in  reaction.    It  melts  at  113°  C.  and  distils  at  292°  G. 

Preparation. — By  the  action  of  glacial  acetic  acid  upon  anilin. 
Solubility. — It  is  soluble  in  189  parts  of  water  at  6°  C,  more  soluble  in 
boiling  water,  freely  soluble  in  alcohol,  in  wine,  and  in  ether. 

Dose. — £-1  gm.,  not  exceeding  2  gms.  in  the  twenty- four  hours. 

Action  and  Uses. — Antifebrin  seems  not  to  be  poisonous 
to  dogs  and  guinea-pigs  when  given  in  relatively  large  doses.  It 
has  been  introduced  as  an  antipyretic  in  man,  and  has  been 
given  in  typhoid  fever,  erysipelas,1  rheumatic  fever,  and  other 
febrile  conditions.  It  reduces  the  temperature  rapidly,  the  effect 
lasting  from  three  to  seven  hours,  according  to  the  size  of  the 
dose;  the  pulse  is  slowed,  and  the  patient  often  falls  into  a 
quiet  sleep.2  No  vomiting  or  diarrhoea  has  been  noticed,  but 
there  is  some  tendency  to  collapse.  A  quarter  of  a  gramme  of 
antifebrin  is  said  to  have  the  same  effect  as  one  gramme  of 
antipyrin. 

Saccharine.  Benzotl-sulphonic-imide.  CbH4(CO)  (S02)NH. 
Not  officinal. 

Chabactees. — A  white  amorphous  powder,  crystallisable  from 
hot  aqueous  solutions,  with  a  very  sweet  taste  and  faint  flavour 
of  bitter  almonds.  It  melts  at  200°  C,  with  partial  decom- 
position. 

Solubility. — With  difficulty  soluble  in  cold,  more  soluble  in  hot,  water. 
Beadily  soluble  in  alcohol  and  ether.  As  sugar  is  not  soluble  in  ether,  this 
reagent  may  be  employed  to  separate  a  mixture  of  saccharine  and  sugar. 

1  In  one  case  of  erysipelas  I  found  two  doses  of  7  grains  each  with  an  interval 
of  two  hours  reduce  the  temperature  below  normal  and  cause  some  tendency  to  col- 
lapse ;  in  another  case,  2  grs.  every  2  hours  reduced  the  temperature  slowly  and 
steadily  without  collapse. 

2  Cahn  and  Hepp,  Central,  f.  kUn.  Med.,  Aug.  14,  1886. 


826  OKGANIC  MATEKIA  MEDICA.  [sect.  iv. 

Preparation. — Acting  on  toluene,  C6HSCH3,  by  sulphuric  acid  at  100°  C, 
by  which  toluene  sulphonic  acids  (ortho  and  para)  are  formed ;  the  sodium 
salts  of  these  are  next  prepared  and  converted  into  sulphonic  chlorides.  The 
ortho-chloride  is  changed  into  the  amide  by  ammonium  carbonate  and  the 
amide  oxidised,  and  then  treated  with  a  dilute  mineral  acid ;  saccharine  is 
precipitated.1 

Action  and  Uses. — Saccharine  is  antiseptic.  It  is  said  to 
be  quite  innocuous  to  dogs,  even  in  large  doses,  but  it  is  not 
a  food,  like  sugar.  From  its  sweet  taste,  220  times  stronger 
than  that  of  sugar,  it  may  prove  a  useful  substitute  for  sugar  in 
cases  of  diabetes.  It  has  no  injurious  action  in  man,  nor,  like 
salicylate  of  sodium,  has  it  any  curative  action  in  diabetes. 

1  For  full  details  of  this  process,  see  Boscoe,  'Becent  Progress  in  Coal-tar 
Industry,'  Boy.  Inst.  Proe.,  1886 


SECTION  V. 

Vegetable  materia  medica 


VEGETABLE  KINGDOM. 

INTRODUCTION. 

Although  it  is  provable  that,  at  some  future  time,  we  may  be 
able  to  make  artificially  drugs  which  will  be  able  to  produce  on 
the  organism  any  effect  which  we  desire,  yet  many  years  muBt 
elapse  before  this  can  be  done,  and  in  the  meantime  we  may 
possibly  find  our  purpose  served,  at  least  to  a  certain  extent,  by 
the  use  of  new  remedies  of  vegetable  origin.  In  our  search  for 
such  remedies  we  may  be  aided  by  the  knowledge  that  plants 
which  resemble  each  other  in  some  of  their  botanical  characters, 
while  differing  in  others,  frequently  contain  principles  which 
exert  upon  the  body  actions  similar  in  their  general  features,  but 
differing  in  details. 

Thus,  we  find  that  various  species  of  the  genus  Rhanmus  con- 
tain principles  which  have  a  general  similarity  in  action,  but  at 
the  same  time  present  such  differences  that  the  action  of  one 
species  may  be  uncertain  and  painful,  while  that  of  another  is 
certain  and  free  from  discomfort. 

In  plants  which  are  so  much  less  closely  connected  as  no 
longer  to  belong  to  the  same  genus,  but  yet  belong  to  the  same 
natural  order,  we  find  differences  varying  considerably  in  amount. 
For  example,  we  sometimes  find  the  action  of  different  genera 
in  one  natural  order,  e.g.  Gentianacece,  is  as  much  alike  as  the 
action  of  different  species  in  a  genus  belonging  to  another*  order. 
At  other  times  we  find,  as  in  the  CucurUtacece  and  Atropea, 
that  plants  belonging  to  all  the  genera  in  an  order  have  a  ten- 
dency to  produce  somewhat  similar  actions,  but  these  actions 
vary  very  considerably  in  regard  both  to  their  intensity  and 
quality.  In  other  cases  we  find  plants  which  are  so  closely 
allied  as  to  belong  to  the  same  genus  contain  active  principles 
which  have  apparently  an  entirely  opposite  action.  Thus  one 
species  of  strychnos  will  yield  strychnine,  which  causes  death  by 
convulsions,  while  another  will  yield  curara,  which  kills  by  para- 
lysing the  motor  nerves. 

But  more  than  this,  we  find  that  principles  having  a  very 
different,  or  even  an  antagonistic,  action  are  frequently  contained 
in  the  same  plant ;  thus  from  the  poppy  and  from  Indian  hemp 
we  can  obtain  morphine  and  cannabin,  which  are  almost  pure 
narcotics,  and  thebaine  and  tetanocannabin,  which  are  almost 
pure  convulsants.  From  Calabar  bean  we  obtain  physostig- 
mine,  which  paralyses  the  spinal  cord,  and  calabarine,  which 
stimulates  it  so  as  to  produce  convulsions.   ,  From  jaborandi  we 


830  VEGETABLE  MATEEIA  MEDICA.  [sect.  v. 

get  pilocarpine,  which  stimulates  the  ends  of  secreting  nerves, 
and  jaborine,  which  paralyses  them. 

It  is  thus  evident  that  the  action  of  many  drugs  will  depend 
upon  the  proportion  in  which  their  active  principles  are  present 
in  them,  and  it  is"  possible  that  the  proportions  may  be  such  that 
the  drug  may  entirely  fail  to  produce  its  usual  action,  as  would 
be  the  case,  for  example,  if  the  proportion  of  jaborine  in  jabo- 
randi  leaves  should  be  sufficient  to  neutralise  the  action  of  the 
pilocarpine. 

It  is  just  possible,  also,  that  the  proportion  may  occasionally 
be  such  as  to  reverse  the  usual  action  of  the  drug,  and  the  effect 
of  a  mixture  of  alkaloids  may  sometimes  be  considerably  influ- 
enced by  the  greater  susceptibility  of  the  patient  to  the  action  of 
one  or  other  of  them. 

A  great  deal  of  light  has  been  thrown  on  the  relationship  to 
each  other  of  the  alkaloids  in  individual  plants  or  in  allied 
species  by  Crum-Brown  and  Fraser's  discovery  that  the  addition 
of  alcohol-radicals  to  alkaloids  sometimes  completely  alters  their 
action ;  so  that  methyl-strychnine,  e.g.,  has  an  action  like  curara. 

It  is  probable  that  the  active  principles  in  plants  are  formed 
by  the  decomposition  of  the  albuminous  matter  in  their  tissues 
(p.  99),  and  that  the  quantity,  the  quality,  and  the  proportion  of 
different  principles  present  in  the  plant  may  vary  with  the  period 
of  growth,  and  with  the  conditions  under  which  the  plant  is 
grown.  Thus  hyoscyamus  is  comparatively  inert  in  the  first  year 
of  its  growth,  but  it  becomes  active  in  the  second  year ;  and  the 
common  hemp  has  little  or  no  narcotic  power  when  grown  at 
moderate  temperatures,  but  acquires  it  when  cultivated  in  a 
warm  climate,  as  that  of  India  or  the  Southern  States  of  America. 

It  i$  not  at  all  improbable  that  the  active  principles  of  plants 
may  vary  even  with  the  time  of  day,  for  Sachs  has  found  that  a 
great  variation  certainly  takes  place  in  the  amount  of  starch 
present  in  leaves,  so  much  so,  indeed,  that  leaves  gathered  at 
evening  contain  starch  in  considerable  quantities,  while  it  may 
be  almost  absent  from  others  gathered  before  sunrise.  The 
old  herbalists  were  very  particular  regarding  the  times  at  which 
plants  were  to  be  gathered,  and  it  is  quite  probable  that  by  more 
attention  to  such  minutiae,  we  might  obtain  remedies  more 
certain  in  their  effect. 

At  the  same  time,  by  investigating  the  physiological  action 
of  various  plants,  we  may  possibly  be  able  to  obtain  a  series  in 
which  the  actions  vary  regularly  from  one  another,  so  that  we 
can  select  the  one  which  will  best  suit  our  purpose. 

A  mere  knowledge  of  the  names  of  species,  genera,  or 
natural  orders  is  perfectly  useless,  for  the  names  are  liable  to  be 
changed  at  the  will  of  botanists,  but  a  knowledge  of  the  botanical 
relationships  of  plants  may  be  a  useful  indication  in  our  search 
after  new  remedies. 


831 


CHAPTEE  XXXI. 
PHANEEOGAMiE. 

Division  I.— ANGIOSPERM^l. 
Class  I.— DICOTYLEDONES    POLYPETALiE. 

Sub-Class  I.— THALAMIFLOE^E. 
RANUNCULACEiE. 

B.P.  Aconiti  Folia.  Aconite  Leaves. — The  fresh  leaves 
and  flowering  tops  of  Aconitum  Napellus,  gathered  when  about 
one-third  of  the  flowers  are  expanded,  from  plants  cultivated  in 
Britain. 

Characters. — Leaves  have  deeply-cut,  wedge-shaped  segments,  by  which 
even  a  fragment  of  the  leaf  can  be  recognised ;  exciting  slowly,  when  chewed, 
a  sensation  of  tingling.    Flowers  deep-blue,  helmet-shaped. 

Officinal  Preparation. 
B.P.  DOSE. 

Extractum  Aconiti  (green  extract)  1_2  gr. 

B.P.  Aconiti  Radix.  Aconite  Boot.— The  dried  root  of 
Aconitum  Napellus,  collected  in  winter  or  early  spring  before  the 
leaves  have  appeared.     From  Britain  or  Germany. 

U.S.P.   Aconitum.    The  tuberous  root  of  A conitum  Napellus* 

Characters. — Conical  and  tapering,  usually  from  one  to  three  inches 
long,  not  thicker  than  the  finger  at  the  crown,  blackish-brown,  internally 
whitish.  A  minute  portion,  cautiously  chewed,  causes  prolonged 
tingling  and  numbness. 

Pkoperties    and    Composition. — The   chief   active 
principle  in   both   leaves    and    roots  is   an   alkaloid 
aconitine  or  aconitia,  which  is  combined  with  aconitic 
acid.     It   is   only  present  in   small   quantity  in  the 
leaves.     In  the  root  resinous  and  fatty  matters  and 
several  other  active  principles  are  also  present.     Ne- 
paul  aconite,  or  Bikh,  the  root  of  A.  ferox,  contains 
an  alkaloid,    pseudaconitine,   which    is    much  more 
active  than   aconitine.     Japanese   aconite  is  said  to      vi&.m. 
contain  an   alkaloid  which  is  much  more  powerful    the°£atura* 
even  than  pseudaconitine.     It  is  therefore  very  im-    size- 
portant  that  officinal  preparations  should  be  made  only  from 
the  root  of  A.  Napellus. 


832  VEGETABLE   MATEEIA  MEDICA.  [sect.  v. 

Officinal  Preparations. 

S.P.  DOSE. 

Tlnctura  Aconitl 1-15  minims. 

Llnlmentum  Aconiti  (p.  516)  

u.s.p. 

Abstractum  Aconiti |-1  gr.  (-03-36  gm.) 

Extractum  Aconiti i-i  gr.  (-01--02  gm.) 

Extractum  Aconiti  fluidum   |-2  min.  (-03-"12  c.c.) 

TJ.S.P.  Abstractum  Aconiti. — Exhaust  powdered  aconite,  200  parts,  with  alco- 
hol containing  2  parts  of  tartaric  acid.  Retain  the  first  170  parts  of  the  percolate, 
evaporate  the  remainder  to  30,  at  a  temperature  not  exceeding  50°  C.  (122°  F.),  and 
mix  with  the  reserve  portion.  Place  the  mixture  in  an  evaporating  dish,  and  having 
added  50  parts  of  sugar  of  milk,  cover  it  with  a  piece  of  thin  muslin  gauze  and  set 
aside  in  a  warm  place,  where  the  temperature  will  not  rise  above  50°  C.  (122°  F.), 
until  the  mixture  is  dry.  Lastly,  having  added  enough  sugar  of  milk  to  make  the 
mixture  weigh  100  parts,  reduce  it  to  a  fine  uniform  powder. 

B.P.  Aconitina.  Aconitine. — A  white,  usually  amorphous, 
solid  alkaloid. 

"When  rubbed  on  the  skin  it  causes  a  tingling  sensation, 
followed  by  prolonged  numbness.     It  is  a  very  active  poison. 

Preparation. — The  aconitate  of  aconitine  is  dissolved  out  of  the  pounded 
root  by  macerating  in  spirit.  If  ammonia  were  now  added,  the  aconitine 
would  be  set  free,  but  being  soluble  in  spirit  would  not  be  precipitated.  The 
spirit  is  therefore  recovered  by  distillation,  and  the  residual  extract  dissolved 
in  water,  in  which  the  aconitate  of  aconitine  is  soluble,  although  the  alkaloid 
is  very  sparingly  so.  By  adding  ammonia,  aconitine  is  precipitated  mixed 
with  colouring  matter  and  other  principles.  It  is  then  dissolved  in  ether, 
which  leaves  the  colouring  matter  behind.  The  ether  is  recovered  by  dis- 
tillation, and  the  aconitine  further  purified  by  dissolving  in  water  acidulated 
with  sulphuric  acid  and  reprecipitating  by  ammonia. 

Characters  and  Reactions. — A  white,  usually  amorphous,  solid;  strongly 
alkaline  to  reddened  litmus,  neutralising  acids,  and  precipitated  from  them 
by  the  caustic  alkalis,  but  not  by  carbonate  of  ammonium  or  the  bicarbonates 
of  sodium  or  potassium.  It  melts  with  heat,  and  burns  with  a  smoky  flame, 
leaving  no  residue  when  burned  with  free  access  of  air. 

Solubility.— Soluble  in  150  parts  of  cold  and  50  of  hot  water,  and  much 
more  soluble  in  alcohol,  ether,  and  chloroform. 

Officinal  Preparations. 

B.P.  Unguentum  Aconitinee. — Aconitine,  8  gr.,  dissolved  in  rectified  spirit, 
£  fl.  dr.,  and  mixed  with  prepared  lard,  1  oz.    For  external  application  only. 

Physiological  Action. — General  Action. — The  action  of 
aconite  is  exerted  most  markedly  on  the  peripheral  ends  of  sen- 
sory nerves,  on  the  heart,  and  on  the  respiration. 

In  frogs  it  produces  steady  loss  of  motion,  both  voluntary 
and  reflex,  with  gradually  increasing  weakness  of  respiration, 
and  of  the  heart,  which  finally  stops  in  diastole,  usually  about 
the  same  time  as  the  respiration. 

In  man  one  of  the  most  marked  symptoms  is  the  local 
tingling  and  numbness  produced  in  the  mouth  by  aconite  or 
aconitine  if  they  come  into  actual  contact  with  it.  This  irrita- 
tion is  not  limited  to  the  mouth,  but  occurs  also  in  the  gullet 
and  stomach,  where  it  produces  belching,  nausea,  and  vomiting. 


chap,  xxxi.]  THALAMIFL0KJ3.  883 

If  aconite  preparations,  or  aconitine,  are  taken  in  capsules  so 
that  they  do  not  touch  the  mouth  or  tongue,  this  local  tingling 
and  numbness  are  hardly  felt  at  all. 

After  absorption,  however,  the  poison  is  carried  by  the  cir- 
culation throughout  the  body,  and  then  causes  a  tingling  in  all 
parts  of  the  body  in  the  order  of  their  sensitiveness  as  de- 
termined by  Weber.  The  most  sensitive  parts  are  affected  first, 
viz.  the  tongue  and  lips,  the  finger-tips,  face,  perineum,  breast, 
belly,  and  last  the  back. 

The  heart  is  quickly  affected  even  by  very  small  doses,  and 
a  single  drop  of  the  tincture  (B.P.)  given  in  water  twice  or  thrice 
at  intervals  of  a  quarter  of  an  hour  will  in  many  cases  greatly 
reduce  the  rate  of  the  pulse.  This  slowness  of  the  pulse  is  due 
to  an  action  of  the  aconite  upon  the  vagus-roots,  and  does  not 
occur  after  the  administration  of  atropine.  In  some  cases  of 
disease  also  the  pulse  seems  little  affected  by  aconite.  In  larger 
doses  the  vaso-motor  centre  becomes  gradually  paralysed,  while 
the  heart  remains  slow,  the  blood-pressure  falls  greatly,  and  the 
pulse  is  not  only  slow  but  exceedingly  weak  and  irregular. 

Great  muscular  weakness  and  dyspnoea  occur,  the  respira- 
tions being  slow,  shallow,  and  feeble.  The  dyspnoea,  and  pro- 
bably the  weakness  also,  depend  to  a  considerable  extent  upon 
the  feebleness  of  the  circulation  and  consequent  imperfect 
nutrition  of  the  nerve-centres,  for  the  administration  of  atropine 
lessens  the  dyspnoea. 

In  addition  to  this,  however,  there  must  be  a  direct  paralys- 
ing action  on  the  respiratory  centre,  and  death  usually  occurs 
from  stoppage  of  the  respiration. 

When  the  heart  is  examined  immediately  after  death,  it  is 
generally  found  to  be  Btill  pulsating,  although  sometimes  it  is 
found  to  have  stopped  and  even  lost  its  irritability.  In  the  latter 
stage  of  aconite  poisoning  the  effects  of  imperfect  respiration 
may  become  manifest  in  the  livid  colour  and  anxious  appearance 
of  the  face,  the  cold  sweat  on  the  skin,  and  sometimes  protrusion 
of  the  eyes  with  dilatation  of  the  pupil. 

Death  is  sometimes  preceded  by  convulsions,  which  do  not 
appear  to  be  entirely  due  to  asphyxia. 

Action  on  Individual  Organs. — The  muscles  are  little  if  at 
all  affected  by  aconite.  The  terminations  of  the  motor  nerves 
appear  to  be  first  irritated,  so  that  fibrillary  twitchings  of  the 
muscles  occur  in  a  frog ;  afterwards  they  are  paralysed.  The 
peripheral  ends  of  sensory  nerves  in  the  skin  and  mucous 
membranes  are  first  irritated,  so  that  the  peculiar  tingling  and 
numbness  is  felt,  and  sometimes  also  intense  neuralgia,  affecting 
branches  of  the  fifth  nerve;  afterwards  they  are  paralysed.  The 
motor  centres  of  the  spinal  cord,  and  the  respiratory  and  vaso- 
motor centres  in  the  medulla,  appear  to  be  first  slightly  stimu- 
lated, so  that  clonic  convulsions  may  occur.    The  reflex  power  of 

3   H 


834  VEGETABLE  MATEEIA  MEDICA.  [sect,  vi 

the  cord  is  diminished,  the  sensory  ganglia  being  affected  before 
the  motor  ganglia.  The  paralysis  of  the  cord  is  probably  to  a 
great  extent,  however,  due  to  its  imperfect  nutrition  from  failure 
of  circulation.  The  brain  remains  unaffected,  the  mental  facul- 
ties being  usually  clear  up  till  death.  Sometimes  drowsiness 
occurs,  which  may,  however,  be  due  to  the  circulation ;  and 
headache  is  also  observed,  which  seems  to  involve  the  interior  of 
the  head,  and  is  distinct  from  the  facial  neuralgia  observed  in 
earlier  stages  of  the  poisoning.  Like  the  motor  centres  in  the 
cord,  the  vaso-motor  centre  in  the  medulla  oblongata  appears 
to  be  first  stimulated  and  then  paralysed,  so  that  the  blood- 
pressure  rises  at  first  in  rabbits,  though  it  falls  in  dogs  and  cats, 
apparently  from  the  slowing  of  the  pulse  produced  by  stimula- 
tion of  the  vagus-roots  (p.  288).  Later  on,  the  vaso-motor 
centre  becomes  paralysed  to  a  considerable  extent,  though  not 
entirely,  so  that  the  blood-pressure  falls  greatly.  Although  not 
completely  paralysed,  it  becomes  insensible  to  reflex  stimulation, 
so  that  irritation  of  a  sensory  nerve  will  no  longer  raise  the 
blood-pressure. 

The  heart  in  the  frog  is  first  quickened  and  then  slowed.  In 
man  or  mammals  there  is  first  slowness  of  the  pulse,  but  shortly 
before  death  it  may  become  more  rapid.  This  effect  appears  to 
depend  chiefly  upon  primary  stimulation  succeeded  by  paralysis 
of  the  motor  ganglia  in  the  heart,  the  effect  in  mammals  being 
altered  by  the  simultaneous  action  of  the  drug  upon  the  vagus 
roots  in  the  medulla. 

The  respiration  is  at  first  slow  and  deep  with  marked  ex- 
piratory effort ;  afterwards  slow,  shallow,  and  laboured. 

This  effect  appears  to  be  due  to  the  direct  action  of  the  poison 
on  the  respiratory  centre,  together  with  its  indirect  action  through 
weakening  of  the  circulation  (pp.  238  and  239).  Before  death 
convulsions  occasionally  occur,  and  these  are,  to  a  great  extent, 
due  to  the  indirect  effect  of  the  drug  through  the  circulation,  but 
possibly  also  to  a  direct  irritating  effect  on  a  convulsive  centre 
in  the  medulla. 

The  temperature  falls  constantly  throughout.  The  stomach 
is  irritated  immediately  by  the  poison  taken  directly  into  it,  so 
that  violent  vomiting  may  occur ;  but  it  may  also  be  irritated  by 
the  poison  being  eliminated  by  the  gastric  mucous  membrane 
after  injection  subcutaneously  or  into  the  blood,  so  that  the 
effects  are  similar  to  those  produced  by  the  direct  introduction 
of  the  drug  into  the  stomach  (p.  39).  The  secretion  of  the 
salivary  glands  is  increased,  and  usually  the  sweat  also,  possibly 
other  secretions.  The  intestines  are  irritated  like  the  stomach, 
and  diarrhoea  occurs  in  consequence. 

The  pupil  at  the  commencement  of  poisoning  alternately 
contracts  and  dilates,  the  tendency  to  contraction  being  most 
marked ;  and  a  similar  result  occurs  from  the  local  application 


chap,  xxxi.]  THALAMIFLORyE.  835 

of  aconitine  to  the  eye.  Later  on  there  is  extreme  dilatation. 
This  dilatation  may  be  due  to  reflex  irritation  from  the  gastro- 
intestinal mucous  membrane  (p.  218).  Aconite  quickly  passes 
from  the  blood  into  the  tissues,  for  if  the  greater  part  of  the  blood  of 
a  poisoned  dog  is  transfused  into  the  veins  of  a  healthy  one  within 
a  few  minutes  after  poisoning  has  begun,  it  produces  no  effect. 

Therapeutic  Uses  of  Aconite.— Aconitine  is  applied  locally 
in  the  form  of  ointment  in  cases  of  severe  neuralgia,  a  small 
piece  about  the  size  of  a  pea  being  rubbed  into  the  painful  part. 
If  the  neuralgia  affects  the  temple,  great  care  must  oe  taken  that 
the  ointment  does  not  get  into  the  eye,  as  rapid  absorption 
occurs  from  the  conjunctiva,  and  general  poisoning  may  result. 

Aconite  liniment  is  frequently  employed  in  muscular  rheu- 
matism ;  in  various  forms  of  neuralgia,  such  as  sciatica ;  and 
over  swollen  and  painful  joints.  Admixture  with  chloroform 
facilitates  the  absorption  of  alkaloids  through  the  skin,  so  that 
a  mixture  of  aconite  liniment  with  chloroform  liniment  may  be 
more  efficacious  than  either  the  one  or  the  other  separately ;  but 
the  mixture  should  be  employed  with  care,  and  not  over  too  large 
a  surface,  to  prevent  any  risk  of  too  rapid  absorption. 

As  a  local  sedative  to  the  stomach  it  has  been  employed  in 
full  doses  to  check  the  vomiting  of  pregnancy.  Its  chief  use, 
however,  is  in  the  febrile  condition  depending  upon  local  in- 
flammations, such  as  tonsillitis,  sore-throat,  pleurisy,  pneumonia, 
phthisis,  peritonitis,  pericarditis,  acute  rheumatism,  gout,  ery- 
sipelas, otitis,  gonorrhoea,  and  in  urethral  fever.  In  many  of 
those  conditions  small  doses  of  aconite  slow  the  pulse,  lower  the 
temperature,  and  give  much  relief  to  the  patient.  In  cardiac 
disease  its  action  is  somewhat  uncertain.  In  nervous  palpita- 
tion it  is  sometimes  useful,  andit  may  give  relief  in  palpitation 
depending  upon  hypertrophy,  but  frequently  it  is  of  no  use  in 
this  condition.  In  diseases  of  the  nervous  system  its  internal 
application  alone,  or  combined  with  its  external  use,  sometimes 
gives  relief  in  headache,  toothache,  noises  in  the  ear,  neuralgia^ 
especially  in  the  face,  in  intercostal  neuralgia,  and  neuralgia  ac- 
companying herpes  zoster.  It  has  been  found  useful,  also,  in 
some  cases  of  amenorrhoea  depending  on  a  sudden  check  to  the 
menstrual  flow,  and  also  in  severe  menorrhagia. 

Mode  of  Application. — Externally  it  may  be  applied  in  the 
form  of  ointment  or  liniment,  internally  in  the  form  of  tincture 
or  extract.  The  extract  is  Uncertain  in  its  strength,  and  death  has 
occurred  from  the  two  grains  laid  down  as  a  maximum  dose  by 
the  British  Pharmacopoeia.  The  tincture  should  also  be  adminis- 
tered in  very  small  doses,  as  it  is  difficult  to  counteract  its  effect 
when  too  much  has  been  given.  Instead  of  giving  a  large  dose, 
therefore,  all  at  once,  it  is  much  better  to  give  it  in  divided 
doses,  such  as  one  drop  in  a"  little  water,  every  quarter  or  half 
-an  hour  until  the  pulse  has  begun  to  be  affected,  and  then  every 

3  h  2 


836  VEGETABLE   MATEEIA  MEDICA.  [sect,  v.,, 

hour  or  two  afterwards,  according  to  the  necessities  of  the  case, 
so  as  -to  maintain  the  action  (Ringer). 

Staphisagria;     Semina,     B.P. ;      Staphisagria,     U.S. P. 

Stavesaceb   Seeds,   B.P.      Staphisageia.      Stavesacee,    U.S.P. 
— The  seeds  dried  ripe  of  Delphinium  staphisagria. 

Characters. — Irregularly  triangular  or  obscurely  quadrangular,  arched, 
blackish-brown  when  fresh,  but  becoming  dull  greyish-brown  by  keeping. 
Testa  wrinkled  and  deeply  pitted;  nucleus  soft,  whitish,  oily.  No  marked 
odour ;  taste  nauseously  bitter  and  acrid. 

Composition.. — They  contain  several  alkaloids,  the  most  im- 
portant being  delphinine  and  staphisagrine. 

B.P.    Preparation. 
TTnguentum    staphisagriae.     (Crushed  seeds,  1 ;    macerated   in   benzoated 
:lard,  2,  for  two  hours,  and  strained.) 

Action. — Staphisagrine  paralyses  the  motor  nerves  in 
■frogs,  like  curare,  and  kills  mammals  without  convulsions  by 
paralysing  the  respiration.  Delphinine  resembles  aconitine  in 
many  respects,  and  like  it  causes  slowness  of  the  pulse  and  re- 
spiration, paralysis  of  the  spinal  cord,  and  death  by  asphyxia. 
It  stimulates  the  vagus  centre  in  the  medulla,  and  also  the 
accelerating  centre  for  the  heart  {p.  318).  It  slows  the  respira- 
tion, apparently  by  an  action  on  the  slowing  fibres  of  the  vagus, 
for  when  the  vagi  are  cut,  it  quickens  respiration,  probably  by 
stimulating  the  respiratory  centre  in  the  medulla.  In  advanced 
•stages  of  poisoning  it  paralyses  the  ends  of  the  vagus  in  the 
heart  and  also  the  cardiac  muscle.  It  removes  the  still-stand 
caused  by  muscarine  and  digitalin  (Boehm).  By  depressing  the 
action  of  the  spinal  cord  it  arrests  the  convulsions  caused  by 
.strychnine. 

Uses. — Stavesacre  ointment  is  used  to  destroy  pediculi. 

U.S.P.  Pulsatilla.  Pulsatilla. — The  herb  of  Anemone 
Pulsatilla  and  Anemone  pratensis,  and  of  Anemone  patens,  var. 
Nuttalliana,  collected  soon  after  flowering. 

It  should  be  carefully  preserved  and  not  be  kept  longer  than 
one  year. 

Characters. — Leaves  radical,  petiolate,  silky- villous,  twice  or  thrice 
deeply  three-parted  or  pinnately  cleft,  with  linear,  acute  lobes,  appearing  after 
the  large,  purple  (or,  in  the  last-named  species,  sometimes  whitish)  flowers ; 
inodorous,  very  acrid. 

Dose.— 1^-6  grains. 

Composition. — The  fresh  plant  yields  by  distillation  with 
water,  an  acrid,  oily  principle,  with  a  burning,  peppery  taste. 
A  similar  oil  is  got  from  Ranunculus  bulbosus,  R.  flammula,  and 
R.  sceleratus.  Its  therapeutic  value  is  not  great.  When  kept 
for  some  time,  this  oily  substance  becomes  decomposed  into 
anemonic  acid  and  anemonin. 

Action. — The  oil  acts  as  a  vesicant  when  applied  to  the  skin. 
Anemonic  acid  appears  to  be  inert.      Anemonin   sometimes 


chap,  xxxi.]  THALAMIFLOEiE.  837 

causes  local  inflammation  and  gangrene  when  subcutaneously 
injected;  vomiting  and  purging  when  given  internally.  It  is 
uncertain  whether  these  symptoms  are  due  to  anemonin  itself  or 
to  some  impurity  in  it.  The  chief  action  of  pure  anemonin  is  a 
depressant  one  on  the  circulation,  respiration,  and  spinal  cord, 
to  a  certain  extent  resembling  that  of  aconite.  The  symptoms 
are  slow  and  feeble  pulse,  slow  respiration,  coldness,  paralysis 
affecting  first  the  hind  and  then  the  fore-legs,  dyspncea,  and 
death  without  convulsions.  In  poisoning  by  extract  of  Pulsatilla 
convulsions  are  always  present.  Their  absence  in  poisoning  by 
anemonin  appears  to  be  due  to  its  paralysing  action  on  motor 
centres  in  the  brain  (p.  184) ;  it  does  not  paralyse  the  muscles 
and  motor  nerves  in  frogs.       s 

Uses. — It  is  supposed  to  be  diaphoretic  and  emmenagogue. 
It  has  been  used  in  amenorrhoea,  dysmenorrhcea,  catarrh  of 
various  mucous  membranes,  bronchitis,  and  asthma. 

Adonis  Vernalis.  Not  officinal.— This  plant  is  considered 
by  some  to  be  a  species  of  Anemone. 

Composition. — It  contains  a  glucoside  adonidin. 

Action. — Adonidin  has  an  action  almost  exactly  like  that  of 
digitalin,  but  is  much  stronger,  and  is  said  not  to  be  cumulative. 
It  appears  to  be  about  ten  times  as  powerful  as  digitoxin. 

Use. — It  may  be  used  instead  of  digitalis,  and  sometimes 
succeeds  when  digitalis  fails.  It  is,  however,  less  certainly  bene- 
ficial in  valvular  disease  than  digitalis,  and  should  be  used  only 
when  digitalis  fails  (Nothnagel) .  It  appears  to  produce  vomiting 
and  diarrhoea  more  readily  than  digitalis  (Bubnoff) . 

Administeation. — It  may  be  given  in  the  form  of  infusion 
(£-2  dr.  of  the  root  to  6  fl.  oz.  of  water)  in  doses  of  ^  fl.  oz.  every 
two  to  four  hours. 

Cimicifugse  Rhizoma,  B.P. ;  Cimicifuga,  U.S.P.  Cimi- 
ctftjga.  Black  Snakeeoot. — The  dried  rhizome  and  rootlets  of 
Cimicifuga  racemosa.     Synonym  :  Actcea  racemosa. 

Characters. — The  rhizome  is  hard,  2-6  inches  long,  about  \  to  1  inch 
thick,  somewhat  flattened-cylindrical  in  form,  having  on  its  upper  surface 
the  remains  of  several  aerial  stems,  and  below  numerous  6mall  wiry  brittle- 
branched  rootlets,  which  in  commercial  specimens  are  more  or  less  broken 
off.  Both  rhizome  and  rootlets  are  brownish-black,  almost  odourless,  and  of 
a  bitter,  slightly  acrid,  taste.  Their  fracture  is  close,  that  of  the  rootlets  pre- 
senting a  thick  bark,  and  a  central  axis  with  from  three  to  five,  usually  four, 
converging  woody  wedges,  so  as  to  assume  a  triangular,  cross-like,  or  stellate 
appearance.    An  infusion  is  blackened  by  a  persalt  of  iron. 

Composition. — It  contains,  when  fresh,  a  volatile  oil,  a  resin, 
and  a  bitter  neutral  substance,  but  it  is  not  known  to  which  of 
these  its  activity  is  due. 

B.  and  U.S. P.    Officinal  Pkepakations.  dose. 

Extraetum  Cimicifugse  Xriquidum,  B.P.  (Fluidum,  U.S.P.)  ...     3-30  min, 
Tinctura  Cimicifugrse 15-60  min. 

Action. — In  large  doses  this  drug  produces  nausea,  vomiting- 


838  VEGETABLE   MATEEIA  MEDICA.  [sect.  v. 

depression,  headache,  and  giddiness.     Its  action  on  the  heart  is 
said  to  be  like  that  of  digitalis,  but  is  less  powerful. 

Uses.— It  is  used  as  a  stomachic  and  cardiac  tonic  in 
various  conditions  of  weakened  heart.  It  has  been  used  in  chorea, 
rheumatic  affections,  headache,  and  neuralgia,  and  is  useful  as 
an  expectorant  in  bronchitis  or  acute  catarrh,  and  in  phthisis. 
Under  the  name  of  Actcea  raceinosa  it  obtained  a  great  reputation 
as.  a  cure  for  acute  rheumatism,  but  this  was  not  confirmed  on  a 
more  extensive  trial. 

Podophylli  Rhizoma,  B.P. ;  Podophyllum,  U.S.P.  Podo- 
phyllum Boot. — The  dried  rhizome  and  rootlets  of  Podophyllum 
peltatum,  North  America. 


Pig.  177. — Podophyllum,  half  the  natural  size. 

Characters. — In  pieces  of  variable  length,  about  \  of  an  inch  thick,  dark 
reddish-brown  externally,  whitish  within,  breaking  with  a  short  fracture.  At 
intervals  of  about  two  inches  the  rhizome  is  thickened,  and  from  each 
swollen  part  or  joint  a  number  of  pale  brown  rootlets  spring.  These  are 
brittle,  and  many  of  them  break  short  off  close  to  the  rhizome,  leaving  little 
round  white  spots  which  help  to  distinguish  podophyllum  easily  from  other 
roots.  Powder  yellowish-grey,  sweetish  in  odour,  bitterish,  subacrid  and 
nauseous  in  taste. 

Composition. — Its  most  important  constituents  are  podo- 
phyllin,  which  is  a  resinous  substance,  and  berberine,  which 
is  a  yellow  alkaloid  (p.  839) . 

Officinal  Pbeparations  of  Podophyllum. 
B.P.  DOSE, 

Podophylli  Resina £-1  gr. 

U.S.P.  DOSE. 

Besina  Podophylli £-|  gr.  (0-008-0-03  gm.) 

Abstractum     „       5-10  gr.  (0-33-0-67  gm.) 

Extractum       1-3  gr.  (0-06-0-2  gm.) 

„  „       Fluidum 5-15  min.  (0-3-0-9  cc.) 

Podophylli    Resina,    B.P- ;    Resina    Podophylli,    U.S.P. 

Besin  oe  Podophyllum.     Synonym :  Podophyllin. 

Preparation. — The  resin  is  dissolved  out  of  the  powdered  root  by  ex- 
hausting with  spirit,  the  greater  part  of  which  is  recovered  by  distillation, 
and  the  remainder  holding  the  resin  in  solution  is  poured  into  water  slightly 
acidulated  with  hydrochloric  acid,  when  the  resin  is  precipitated  as  a  fine 
powder,  as  it  is  insoluble  in  water.  The  resin  itself  consists  to  a  great  extent 
of  a  fatty  and  resinous  acid,  and  subsides  more  quickly  in  acidulated  than  in 
pure  water.     It  is  afterwards  washed  and  dried. 

Characters  and  Solubility. — A  pale  greenish-brown  amorphous  powder,." 
soluble  in  rectified  spirit  and  in  ammonia;  precipitated  from  the  former 
solution  by  water,  from  the  latter  by  acids.  Almost  entirely  soluble  in  pure 
ether. 

Composition. — It  consists  chiefly  of  a  fatty  and  resinous  acid 
having  little  physiological  action,   and  two  active  substances, 


chap,  xxxi.]  THALAMIFLOEiE.  839 

podophyllotoxin  and  picropodophyllin,  the  former  being  much 
the  more  powerful. 
Dose. — £  to  ^  grain. 

B.P.    Pkeparation. 

DOSE. 

Tinctura  Podopbylli  (1  gr.  of  resin  in  1  fl.  dr.)  15  min.  to  1  fl.  dr. 

Physiological  Action. — The  resin  is  the  part  chiefly  em- 
ployed. It  acts  as  a  drastic  purgative,  increasing  the  secretions 
of  the  intestinal  mucous  membrane,  and  of  the  liver  (p.  403). 
It  acts  on  the  bowels,  when  injected  subcutaneously  as  well  as 
when  introduced  into  the  intestinal  canal.  Like  many  other 
hepatic  stimulants,  it  does  not  increase  the  secretion  of  bile  so 
much  when  it  acts  as  a  purgative  (p.  403) . 

Uses. — It  is  used  in  cases  of  biliousness  associated  with  dark 
stools  (Einger).  When  the  stools  are  pale,  mercurial  pill  is 
usually  employed.  It  is  often  employed  in  combination  with 
other  purgatives,  such  as  colocynth,  aloes,  or  rhubarb.  It  is 
useful  in  congestion  of  the  liver >  and  of  the  portal  circulation,  in 
ague  with  congested  liver,  and  in  sick  headache  with  biliousness. 
Its  action  is  uncertain  and  it  frequently  causes  griping. 

Externally  it  acts  as  an  irritant ;  if  incautiously  handled,  it 
often  produces  conjunctivitis. 

U.S.P.  Hydrastis.  Hydeastis.  Golden  Seal. — The  rhi- 
zome and  rootlets  of  Hydrastis  canadensis. 

Characters. — Bhizome  about  1|  inch  long  and  5  inch  thick;  oblique, 
with  short  branches,  somewhat  annulate  and  longitudinally  wrinkled ;  ex- 
ternally yellowish-grey ;  fracture  short,  waxy,  bright  reddish-yellow,  with  a 
thickish  bark,  about  ten  narrow  wood-wedges,  broad  medullary  rays  and 
large  pith.  Eootlets  thin,  brittle,  with  a  thick,  yellow  bark,  and  subquadran- 
gular,  woody  centre.     Odour  slight ;  taste  bitter. 

Composition. — It  contains  the  yellow,  bitter  alkaloid  ber- 
berine  (p.  838),  and  the  colourless,  also  bitter,  hydrastia,  or 
hydrastine,  besides  a  third  alkaloid  and  a  volatile  principle  not 
yet  isolated. 

U.S.P.    Peepabations. 

DOSE. 

Extractum  Hydrastis  Fluidum 1-2  fl.  dr. 

Tinctura  Hydrastis 2-5  fl.  dr. 

Uses. — Its  uses  are  similar  to  those  of  the  simple  bitters 
(p.  364).  Professor  Eutherford  found  the  resinous  substance  ob- 
tained from  the  root  to  be  an  hepatic  stimulant  of  moderate  power 
(p.  403).  This  substance,  which  is  also  called  hydrastin,  must 
not  be  confounded  with  the  alkaloid.  It  consists  of  a  mixture 
of  hydrastine,  berberine,  and  resin  in  varying  proportions.  The 
pure  alkaloid  hydrastine  is  said  to  be  antiperiodic,  and  causes 
ringing  in  the  ears  like  quinine.  The  mixture  of  the  alkaloids 
acts  as  an  emmenagogue  {vide  p.  453). 


840  VEGETABLE  MATEEIA  MEDICA.  [sect.  v. 


MAGNOLIACEJE. 

B.P.  Anisi  Stellati  Fructus ;  U.S.P.  Illicium.  Stab-Anise 
Fruit. — The  dried  fruit  of  Illicium  anisatum.     China. 

Chaeacteks.— The  fruit  consists  of  8  brown,  boat-shaped  carpels,  joined 
at  their  inner  ends  so  as  to  form  a  star.  Each  contains  one  seed  with  an 
oily  taste.     The  taste  of  the  fruit  is  sweet  and  aromatic. 

Composition. — It  contains  a  volatile  oil  which  so  closely 
resembles  that  of  true  anise  as  to  be  officinal. 

Oleum  Anisi,  B.P.  and  U.S.P. — A  volatile  oil  distilled  in 
Europe  from  anise  fruit ;  or  in  China  from  star-anise  fruit.  For 
Preparations  and  Action  vide  Anise  (p.  935). 

MENISPERMACEiE. 
U.S.P.  Menispermum.  Menispermum.   Canadian  Moonseed. 
— The  rhizome  and  rootlets  of  Menispermum  canadense. 

Chaeactees. — Khizome  several  feet  long,  about  a  quarter  of  an  inch 
(6  millimetres)  thick,  yellowish-brown  or  brown,  finely  wrinkled  longitudinaDy 
and  beset  with  numerous  thin,  rather  brittle  rootlets ;  fracture  tough,  woody ; 
internally  yellowish,  with  a  thickish  bark,  a  circle  of  porous,  short,  nearly 
square  wood-wedges,  and  a  large  central  pith ;  nearly  inodorous ;  taste  bitter. 

Dose. — 5-20  gr.  in  infusion. 

Composition. — It  contains  a  small  quantity  of  berberine  and 
a  colourless  alkaloid. 

Uses. — It  acts  as  a  bitter  tonic,  and  is  sometimes  used  also 
as  a  substitute  for  sarsaparilla. 

Calumbae  Radix,  B.P. ;  Calumba,  U.S. P.  Caltjmba  Eoot. 
■ — The  root,  cut  transversely  and  dried,  of  Jateorrhiza  Calumba 


Fig.  178. — Calumba,  half  the  natural  size. 

(Coeculus  palmatus,  DC.)    From  the  forests  of  Eastern  Africa, 
between  Ibo  and  Zambezi. 

Chaeactees. — Slices  flat,  circular,  or  oval,  about  2  inches  in  diameter, 
from  £  to  £  of  an  inch  thick,  softer  and  thinner  towards  the  centre,  so  as  to 
present  the  appearance  of  bi-concave  discs,  greyish-yellow,  bitter. 

Composition. — It  contains  a  neutral  principle,  calumbin,  a 
yellow  alkaloid  berberine,  to  which  it  owes  its  colour,  and 
calumbic  acid.  All  these  are  bitter.  It  contains  much  starch, 
which  is  dissolved  by  hot  water,  so  that  a  decoction  is  blackened 


chap,  xxxi.]  THALAMIFLOK^E.  841 

by  iodine.  The  infusion  is  consequently  made  with  cold  water 
to  leave  the  starch  behind,  as  it  renders  the  infusion  liable  to  de- 
compose,_especially  in  hot  weather.  It  contains  no  tannin,  and 
the  infusion  can  therefore  be  prescribed  along  with  salts  of  iron. 

Pbepakations. 

B.P.  DOSE. 

Extractum  Calumbae. 2-10  gr.  or  more. 

Infasum  Calumbae  (1  oz.  to  1  pint) 1-2  fl.  oz. 

Tinctura  Calumbae £-2  fl.  dr. 

Also  contained  in  Mistura  Ferri  Aromatica. 

TJ.S.P. 

Extractum  Calumbse  Fluidum 15-30  min.  (09-1-9  c.c.) 

Tinctura  Calumba 1-4  fl.  dr.  (3-75-15  c.c.) 

Action. — Calumba  is  a  pure  bitter  stomachic  tonic. 

Neither  the  berberine  nor  calumbin  which  it  contains  has  any 
powerful  physiological  action.  Berberine  in  doses  of  1^  grain 
given  subcutaneously  kills  rabbits,  with  symptoms  of  prostration 
and  fall  of  temperature  j  but  a  dose  eight  times  as  great  given 
to  them  by  the  mouth  has  no  action,  and  15  grains  only  produce 
in  man  slight  colicky  pains  and  diarrhoea.  It  is  said  to  cause 
contraction  of  the  intestines  and  of  the  spleen,  and  to  lessen  oxi- 
dation in  the  blood.  Calumbin  seems  to  have  still  less  action. 
In  small  doses  it  seems,  like  other  bitters,  to  raise  the  blood- 
pressure  slightly,  and  in  large  doses  to  lower  it. 

Uses. — Calumba  is  used  as  a  bitter  tonic  in  atonic  dyspepsia 
and  debility  of  the  digestive  organs.  It  is  said  to  have  a  sooth- 
ing effect,  and  is  therefore  given  in  irritable  conditions  of  the 
stomach.  It  is  frequently  employed  in  combination  with  iron, 
chiefly  in  the  form  of  infusion ;  the  advantage  it  possesses  over 
other  bitter  infusions,  except  quassia,  for  this  purpose,  being 
that  it  contains  no  tannin,  and  consequently  does  not  form  an 
inky-looking  mixture.  It  may  be  used  as  a  general  tonic  during 
convalescence  from  various  acute  diseases,  and  may  be  prescribed 
in  combination  with  either  acids  or  alkalis. 

Pareirse  Radix,  B.P. ;  Pareira,  U.S.P.  Pareiea  Eoot. — 
The  dried  root  of  Chondrodendron  tomentasuvi,  Brazil. 

Characters. — Generally  seen  in  more  or  less  cylindrical  pieces,  about 
f  inch  to  2  inches  in  diameter  and  4  inches  or  more  in  length.  The  bark  is 
greyish-brown,  and  the  wood  greyish-yellow.  It  is  recognised  by  the  well- 
marked  rings  and  medullary  rays  on  the  wood.  The  rings  are  irregularly 
concentric. 

Composition. — It  contains  an  alkaloid  pelosine  or  buxine, 
which  appears  to  be  identical  with  beberine. 

Pbepaeations. 
B.P.  dose. 

Secoctum  Parelrae 1J  ounce  to  pint 1J-2  fl.  oz. 

Extractum       „  10-20  gr. 

„  „  Xiiquidum 1  oz.  to  1  fl.  oz £-2  fl.  dr. 

U.S.P. 

Extractum  Pareine  Fluidum 1-2  fl.  dr.  (3-75-7-50  c.c.) 


842  VEGETABLE   MATEEIA   MEDICA.  [sect.  v. 

Physiological  Action  and  Uses. — Pareira  is  a  bitter  tonic, 
but  is  chiefly  employed  as  a  stimulant  to  the  mucous  membrane 
of  the  genito-urinary  tract,  in  chronic  catarrh  of  the  bladder. 
It  is  usually  given  in  the  form  of  decoction  or  liquid  extract, 
frequently  combined  with  an  acid  or  an  alkali,  according  to  the 
condition  of  the  urine. 

U.S.P.  Picrotoxinum.  Piceotoxin.  C9H10O4;  182. — A 
neutral  principle  prepared  from  the  seeds  of  Anamirta  paniculata. 

Characters. — Colourless,  flexible,  shining,  prismatic  crystals,  permanent 
in  the  air,  odourless,  having  a  very  bitter  taste,  and  a  neutral  reaction. 

Solubility. — It  is  soluble  in  50  parts  of  boiling  water,  and  in  150  of 
water  at  14°  C. ;  soluble  in  alkalis  and  in  alcohol. 

Eeactions.— When  heated  to  about  200°  C.  (392°  P.),  the  crystals  melt, 
forming  a  yellow  liquid ;  when  heated  on  platinum  foil,  they  char  and  are 
finally  completely  dissipated.  Concentrated  sulphuric  acid  dissolves  picrotoxin 
with  a  golden-yellow  colour,  which  turns  violet-red  on  the  addition  of  a  trace 
of  bichromate  of  potassium.  When  mixed  with  three  times  its  weight  of 
nitrate  of  potassium,  moistened  with  sulphuric ,  acid,  and  then  treated  with 
strong  solution  of  soda  in  excess,  picrotoxin  assumes  a  brick-red  colour  of 
short  duration.  The  aqueous  solution  should  remain  unaffected  by  solutions 
of  salts  of  mercury  or  platinum,  tannic  acid,  iodide  of  mercury  and  potassium, 
or  other  reagents  for  alkaloids  (absence  of,  and  difference  from,  alkaloids). 

Dose. — •  T^  to  -^  gr.  in  pill,  or  in  the  acetic  solution  de- 
scribed under  Uses. 

Action. — It  stimulates  all  the  motor  and  inhibitory  centres 
in  the  medulla,  especially  the  respiratory  and  vagus  centres.  It 
also  irritates  motor  centres,  either  in  the  cerebrum  or  in  the 
medulla  and  cord,  producing,  in  all  vertebrates  alternating  epi- 
leptiform spasms,  with  periodic  stoppage  of  the  motions  of  the 
diaphragm  and  slowness  of  the  pulse.  The  spasms  often  take 
the  form  of  swimming,  running  backwards  or  round  in  a  circle 
(manege  movements),  or  rolling  of  the  body  on  its  axis  (pp.  188 
and  215).     The  temperature  is  somewhat  raised. 

Uses. — It  is  employed  as  an  ointment  (10  gr.  to  1  oz.  of  lard) 
in  tinea  capitis,  and  to  destroy  pediculi.  It  should  be  used  with 
care,  as  its  application  to  the  head  has  been  followed  by  convul- 
sions and  death.  It  has  been  used,  though  unsuccessfully,  in 
epilepsy  in  doses  of  ^ -grain  hypodermically,  and  has  been  found 
useful  in  the  night  sweats  of  phthisis  (p.  443),  in  doses  of  y^  to 
•^  grain  in  pill,  or  2  to  4  minims  of  a  solution  containing  8  grains 
of  picrotoxin,  4  fluid  drachms  of  glacial  acetic  acid,  and  water  up 
to  4  ounces. 

BERBERIDACE^E. 

U.S.P.  Caulophyllum.  Caulophyllum.  Blue  Cohosh. — 
The  rhizome  and  rootlets  of  Caulophyllum  thalictroides. 

Characters. — Ehizome  about  four  inches  (10  centimetres)  long,  and 
about  one-fourth  to  two-fifths  of  an  inch  (6  to  10  millimetres)  thick,  bent; 
on  the  upper  side,  with  broad,  concave  stem-scars  and  short,  knotty  branches ; 
externally  grey-brown,    internally  whitish,    tough    and   woody.    Eootlets 


chap,  xxxi.]  TIIALAMIFLOEJE.  843 

numerous,  matted,  about  four  inches  (10  centimetres)  long,  and  one  twenty- 
fifth  of  an  inch  (1  millimetre)  thick,  rather  tough ;  nearly  inodorous ;  taste 
sweetish,  slightly  bitter,  and  somewhat  acrid. 

Dose. — 1-5  gr.  in  infusion. 

Composition. — It  contains  the  glucoside  saponin  (p.  918)  and 
resins. 

Uses. — It  has  little  medicinal  virtue,  though  it  has  been  re- 
commended as  a  diuretic,  antispasmodic,  and  emmenagogue. 


PAPAVERACEiE. 

B.P.  Papaveris  Capsulae.  Poppy  Capsules.— The  nearly 
ripe  dried  capsules  of  the  white  poppy,  Papaver  somniferum. 
Cultivated  in  Britain. 


Fin.  179.— Poppy  capsule,  lialf  the  natural  size. 

Characters. — Globular,  two  or  three  inches  in  diameter,  crowned  by  a 
sessile  stellate  stigma,  which  distinguishes  them  from  colocynth  and  bael 
fruits. 

Pbepabations. 

B.P.  DOSE. 

Decoctum  Papaveris  (2  oz.  boiled  for  ten  minutes  i  -,,  _  .  _     .   . .     „ 

•    ii    >  a.   i      4       i'j       j       j        4.    i     •  »,  i-Ior  lomentations. 
in  If  pmt  of  water,  strained,  and  made  up  to  1  pint)  1 

Extractum  Papaveris  2-5  gr. 

Syrupus  Papaveris  1 11.  dr.— j  fl.  oz. 

Composition. — The  capsules  contain  a  small  amount  of  mor- 
phine (more  being  found  when  they  are  unripe  than  when  ripe), 
together  with  meconic  ..acid,  and  very  minute  quantities  of 
papaverine  and  papaverosine.  The  seeds  are  devoid  of  these 
principles,  but  contain  much  bland  oil. 

Action  and  Uses. — Poppy  capsules  act  in  a  similar  manner 
to  opium,  but  are  much  weaker,  and  not  so  certain  in  their  action. 
They  are  employed  in  the  form  of  syrup  of  poppies,  and  given 
chiefly  to  children  as  an  opiate.  Considering  the  uncertainty  of 
its  action,  and  in  view  of  the  fact  that  children  are  very  readily 
affected  by  any  preparation  of  opium,  the  drug  should  be  used 
with  caution.  Externally  the  decoction  is  used  for  sedative 
fomentations  to  allay  pain. 


844  VEGETABLE   MATEEIA  kEDICA.  [sect.  v. 

Opium,  B.  and  U.S.  P.     Opium. — The  inspissated  juice  ob- 
tained from  the  poppy,  Papaver  somniferum.  Grown  in  Asia  Minor. 

Pbepaeation. — The  unripe  capsules  are  incised,  or  rather  deeply  scratched. 
The  milky  juice  which  exudes  becomes  inspissated  by  spontaneous  evapora- 
tion, and  is  scraped  off  and  made  into  lumps.  As  these  ought  to  consist  only 
of  the  tears  of  thickened  juice  from  the  incisions,  the  lumps  should  tear  with 
an  irregular  surface,  and  when  drawn  across  a  piece  of  paper  should  leave  a 
light-brown  interrupted  streak.  Sometimes  vegetable  extracts  are  used  to 
adulterate  opium,  and  then  it  has  a  more  even  fracture,  and  makes  a  more 
or  less  even  streak  on  a  piece  of  paper. 

Charactees.— Irregular  lumps,  weighing  from  four  ounces  to  two  pounds ; 
enveloped  in  the  remains  of  poppy-leaves,  and  generally  covered  with  the 
chaffy  fruits  of  a  species  of  rumex  ;  when  fresh,  plastic,  tearing  with  an  irre- 
gular, slightly  moist,  chestnut-brown  surface,  shining  when  rubbed  smooth 
with  the  finger,  having  a  peculiar  odour  and  bitter  taste. 

Test. — Opium  should  yield,  when  assayed,  about  10  per  cent, 
of  morphine,  B.P.,  9  per  cent,  according  to  the  U.S.P. 

Preparations. 

B.P.  DOSE. 

Codeina   „ $_2  gr. 

Confectio  Opii  (Pulv.  Opii  Co.1  ,         ,  .     .„           ,  r  _„ 

192  gr. ;  Syrup  1  oz.).... )  *  Part  ln  i0>  nearly 5"20  &• 

Emplastrum  Opii  (with  resin"!  ■,        i  •    ,n  i  i 

plaster) _      ) >  1  part  in  10 for  external  use. 

Enema  Opii /  i  fl>  dr:, tincture  to  2  fl- oz- stareh 

'     ""    "         1.     mucilage. 

Extractum  Opii  About  1  part  from  2  J-3  gr.  or  more. 

Extractum  Opii  Eiquidum 22  grs.  extract  in  1  fl.  oz.  nearly..  4-40  m.  „     „ 

Injectio  Morphinas  Hypodermica. . .  1  gr.  acetate  of  morphine  in  10  m. 

Llnimentum  Opii  (vide  p.  516)_1  of  tincture  in  2. 

Morphina  Acetas (  Abou.t   X  Part  from  8  or  10  rf,    , 

r  \     opium £-£  gr. 

Morphhiffl  Acetatis  Liquor 4J  gr.  acetate  in  1  fl.  oz 10-60  m. 

Morphines  Bimeconatis  Liquor 5j  grs.  bimeconate  in  1  fl.  oz 5-40  m. 

Morphina!  Hydrochloras f  Ahou}   1  ^  from  8  or  10  of 

I.     opium  i-igr- 

Morphias  Hydroehloratis  Liquor..4£  gr.  hydrochlorate  in  1  fl.  oz... 10-60  m. 

MorphinsB  Sulphas 1  part  from  7£ £-J  gr. 

Pilula  Ipecacuanhas  cum  Scilla )  .        ,  .    „„  ,  _  , . 

(vide  p.  522) /  X  Part  m  23>  nearly  " 5"10  &• 

Pilula  Plumb  i  cum  Opio  (vide}  *         .  .    „  ,   „ 

p.  522) /  *  Part  m  8  ~ 4~8  8*' 

1  Pilula   Saponis  Composita  1  ,        ,.     .  ,  „   „ 

(vide  p.  523) /  1  Part  ln  6-  nearl? 3"5  Sr- 

Pulvis  Crete  Aromaticus  cum  Opio..  1  part  in  40 10-60  gr. 

Pulvis  Ipecacuanha  Compositus...l  part  in  10 5-15  gr. 

Pulvis  Kino  Compositus 1  part  in  20 5-20  gr. 

Suppositoria  Plumbi  Composita....  1  grain  in  each  suppository. 

Pulvis  Opii  Compositus 1  part  in  10 2-5  gr. 

XI  net  ur  a    Camp  horse    Com-1  _         ,     ,    _  .  „    , 

posita )  2  S1- 1°  !  A.  oz 15  m.-l  fl.  dr. 

Tiuctura  Opii  (Laudanum) 33  grains  to  1  fl.  oz.,  nearly 4-40  m.  or  more. 


1  Pilula  Saponis  Composita  is  purely  a  preparation  of  opium.  It  is  sometimes 
convenient  to  give  opium  to  patients  without  their  knowledge.  If  the  pill  were 
called  Pilula  Opii  the  patients  would  see  from  the  prescription  what  they  were 
taking,  while  they  learn  nothing  about  the  nature  of  the  medicine  from  the  name 
Pil.  Saponis  Co.  The  name  of  this  pill  was  changed  from  Pil.  Saponis  Co.  to  Pilula 
Opii  iii  the  B.P.  of  1864,  but  the  inconveniences  which  arose  from  this  were  so  great 
that  the  name  was  altered  again. 


chap,  xxxi.]  THALAMIFLOEjE.  845 

V 

Preparations — continued.  dose. 

Tinctura  OpH  Ammoniata 5  grains  to  1  fl.  oz 1-1  fl.  dr. 

Trochiscl  Opii ith  grain  of  extract  in  each 1-4. 

Unguentum  GaUse  cum  Opio 32grainsto  1  oz. galls  ointment.ior  external  use. 

Vlnum  Opii 22  gr.  extract  in  1  fl.  oz.,  nearly..4-40  m.  or  more. 

B.P.  Pulvis  Xiao  Compositus.  Compound  Powder  of  Kino.— Kino,  3J ; 
opium,  J ;  cinnamon  bark,  1. 

B.P.  Pulvis  Opii  Compositus.  Compound  Powdek  of  Opium.— Opium,  li ; 
black  pepper,  2  ;  ginger,  5 ;  caraway  fruit,  fi  ;  tragacanth,  §. 

B.P.  Tinctura  Campnoree  Composita.  Compound  Tincture  of  Camphor 
(English  Paregoric).— Opium,  40  gr. ;  benzoic  acid,  40  gr. ;  camphor,  30  gr. ;  oil 
of  anise,  5  fl.  dr. ;  proof  spirit,  1  pint. 

B.P.  Tinctura  Opii  Ammoniata.  Ammoniated  Tincture  of  Opium  (Scotch 
Paregoric).— Opium,  in  coarse  powder,  100  gr. ;  saffron,  180  gr. ;  benzoic  acid, 
180  gr. ;  oil  of  anise,  1  fl.  dr. ;  strong  solution  of  ammonia,  4  fl.  oz. ;  rectified 
spirit,  16  fl.  oz. 

B.P.  Vinum  Opii.  Wine  of  Opium.— Extract  of  opium,  1  oz. ;  cinnamon 
bark,  75  gr. ;  cloves,  75  gr. ;  sherry,  1  pint. 

Preparations. 

u.s.p.  DOSE. 

Extractum  Opii i-1  gr.  (0031-0-065  gm.) 


Emplastrum  Opii  (6  parts  in  100) 

Trochisci   Glycyrrhizae  et  Opii  (^ 

gr.  in  each  lozenge) 


prepared  from 
Extractum  Opii. 


U.S.P.  Opii  Pulvis.  Powdbbed  Opium.— Opium  dried  at  a 
temperature  not  exceeding  85°  C.  (185°  F.),  and  reduced  to  a 
moderately  fine  powder.  It  ought  not  to  contain  less  than  12 
nor  more  than  16  per  cent,  of  morphine. 

Preparations. 

U.S.P.  DOSE. 

Acetum  Opii  (Black  Drop) 10-15  min.  (0-60-1  c.c.) 

Opium  Denarcotisatum \-2  gr.  (0-016-0-13  gm.) 

Pilulai  Opii  (Opium  1  gr. ;  Soap,  }  gr.,  vide  p.  523)  One  pill. 

Pulvis  Ipecacuanhie  et  Opii  (1  in  10) 5-15  gr.  (0-32-1  gm.) 

Tinctura  Ipecacuanha?  et  Opii 4-15  min.  (0-25-1  c.c.) 

Tinctura  Opii 6  min. 

Tinctura  Opii  Camphorata   4-15  min.  (0-25-1  c.c.) 

Tinctura  Opii  Deodorata  6  min. 

-  Vinum  Opii 6  min.  (0-37  c.c.) 

TJ.S.P.  Acetum  Opn.  Vingegar  of  Opium.—  Opium,  10 ;  nutmeg,  3 ;  extracted 
with  diluted  acetic  acid  by  maceration  and  percolation  up  to  80  parts  of  liquid ; 
then  sugar,  20,  is  added. 

U.S.P,  Opium  Denarcotisatum.  Denarcotised  Opium. — Prepared  by  removing 
narcotine  and  odorous  principles  by  extraction  with  stronger  ether,  and  adding 
sufficient  sugar  of  milk  to  make  up  the  weight  to  that  of  opium  containing  14  per 
cent,  of  morphine. 

U.S.P.  Tinctura  Opn  Deodorata.  Deodorised  Tincture  of  Opium. — Macerate 
jopium,  10,  with  water,  40,  evaporate  down  to  10,  shake  with  ether,  20,  pour  off  the 
ether,  and  evaporate  until  the  whole  of  the  ether  is  gone.  Mix  with  water,  50, 
filter,  adding  water  up  to  80,  then  add  alcohol,  20. 

U.S.P.  Tinctura  Ipecacuanha  et  Opii.  Tincture  of  Ipecac  and  Opium.— 
'Deodorised  tincture  of  opium,  100,  evaporated  to  85,  then  fluid  extract  of  ipecac, 
10,  is  added,  the  mixture  filtered,  and  diluted  alcohol  added  up  to  100. 

U.S.P.  Tinctura  Opii  Camphorata.  Camphorated  Tincture  of  Opium. — 
Powdered  opium,  4  ;  benzoic  acid,  4  ;  camphor,  4  ;  oil  of  anise,  4 ;  glycerine,  40 ; 
diluted  alcohol  up  to  1,000. 

U.S.P.  Vinum  Opii.  Wine  of  Opium. — Powdered  opium,  10 ;  cinnamon,  1 ; 
cloves,  1;  stronger  white  wine  up  to  100. 


846  VEGETABLE   MATEEIA  MEDIC  A.  [sect,  v.. 

Composition  of  Opium. — Besides  the  usual  constituents  of 
vegetable  products,  such  as  mucilage,  albumin,  pectinous  sub- 
stances, caoutchouc-like  substances,  fat,  volatile  substances,  some 
sugar,  salts  of  ammonium,  calcium,  and  magnesium,  opium  con- 
tains seventeen  or  eighteen  alkaloids  and  two  neutral  substances,  as 
well  as  a  peculiar  acid — meconic  acid.  The  alkaloids  are  chiefly 
combined  with  meconic  acid  or  sulphuric  acid,  but  may  be  partly 
free.  The  three  most  important  alkaloids  are  morphine,  codeine, 
and  thebaine.  The  others  are  papaverine,  pseudomorphine  or 
oxymorphine,  gnoscopine,  codamine,  laudanine,  laudanosine, 
meconidine,  lanthopine,  protopine,  cryptopine,  narcotine,  oxy- 
narcotine,  hydroctarnine,  narceine,  rhoeadine.  The  neutral 
substances  are  meconin  and  meconiasin.  Some  at  least  of  the 
alkaloids  in  opium  may  be  regarded  as  derivatives  from  mor- 
phine. Thus  codeine  and  pseudomorphine  or  oxymorphine  can 
be  produced  from  morphine  artificially. 

Besides  the  derivatives  of  morphine  found  naturally  in  opium, 
various  series  of  alkaloids  can  be  artificially  prepared  from 
morphine  by  (a)  the  addition  of  alcohol  radicals,  or  by  (6)  oxida- 
tion, or  (c)  by  dehydration.  To  the  series  of  alkaloids  produced 
from  morphine  by  the  addition  of  alcohol  radicals,  tbe  name  of 
codeines  has  been  given.  An  example  of  these  is  codethyline, 
obtained  from  morphine  by  the  introduction  of  ether.  Among 
the  alkaloids  produced  by  oxidation  are  oxymorphine  and  oxydi- 
morphine.     Apomorphine  is  produced  by  dehydration. 

B.P.  Acidum  Meconicum.  Meconic  Acid.  H3C,H07.  An 
acid  obtained  from  opium. 

Chaeactebs. — In  micaceous  crystals,  nearly  colourless,  the 
solution  in  water  having  a  strongly  acid  taste  and  reaction. 
Solubility. — It  is  sparingly  soluble  in  water,  readily  soluble  in  alcohol. 
Reactions. — The  solution  is  coloured  red  by  neutral  solution  of  perchloride 
of  iron,  the  colour  being  discharged  by  strong  but  not  by  diluted  hydrochloric 
acid.  The  aqueous  solution  gives  no  precipitate  with  solution  of  iodine  and 
iodide  of  potassium. 

Official  Meconate. 
B.P.  DOSE. 

liquor  Morphlnsc  Blmeconatis 5-40  min. 

Action. — It  has  very  little  physiological  action.  It  has  been 
stated  to  have  a  narcotic  action,  but  this  is  very  feeble. 

U.S.P.  Morphina.  Moephine.  C17HI9N0yH20 ;  303.— An 
alkaloid  prepared  from  opium. 

Chaeactees. — Colourless  or  white  shining  prismatic  crystals, 
or  a  crystalline  powder.  Permanent  in  air,  having  a  bitter  taste 
and  alkaline  reaction.  Heated  on  platinum  foil,  the  crystals  fuse, 
char,  and  disappear. 

Solubility. — Slight  in  cold  water ;  complete  in  500  parts  boiling  water ; 
in  100  alcohol  at  15°  C.  (59°  P.) ;  in  30  boiling  alcohol ;  in  13  boiling 
absolute  alcohol :  almost  insoluble  in  ether;  slightly  soluble  in  chloroform. , 


chap,  xxxi.]  THALAMIFLOEiB.  847 

Eeactions.— Morphine  is  first  reddened  and  then  rendered  yellow  by 
nitric  acid.  "With  ferric  chloride  it  gives  a  blue  colour,  changed  to  green  by 
excess  of  the  reagent,  and  destroyed  by  free  acids  or  alcohol,  but  not  by. 
alkalis.  A  solution  of  morphine,  acidified  by  acetic  or  sulphuric  acid,  is 
not  precipitated  by  tannic  acid. 

Impurities. — Other  alkaloids. 

Tests.— On  adding  20  parts  of  colourless  solution  of  soda  or  potassa  to 
1  part  of  morphine,  a  clear,  colourless  solution  should  result  without  a  residue 
(absence  of  other  alkaloids).  Morphine  yields  a  colourless  solution  with 
cold  _  concentrated  sulphuric  acid,  which  should  not  acquire  more  than  a 
reddish  tint  by  standing  for  some  time,  and  which  should  not  assume  a 
purple  or  violet,  but  merely  a  greenish  colour,  on  the  addition  of  a  small 
crystal  of  bichromate  of  potassium  (absence  of  and  difference  from  strych- 
nine, brucine,  &c). 

Morphinae  Hydrochloras,  B.  and  U.S. P.  Hydrochlorate 
of  Morphine,  U.S.P.  _  C17H19N03HC1.3H20. 

Characters. — White,  feathery,  acicular  prisms  of  a  silky 
lustre,  permanent  in  air. 

Solubility. — It  is  soluble  in  water  (24  parts  at  15°  C.)  and  spirit. 

Eeactions. — The  aqueous  solution  gives  a  white  curdy  precipitate  with 
nitrate  of  silver  (HC1),  and  a  white  one  with  potash,  soluble  in  excess 
(morphine).  It  exhibits  the  reactions  of  morphine.  Heated  on  platinum 
foil,  it  leaves  no  residue  (no  inorganic  salts). 

Preparation. — Mix  concentrated  infusion  of  opium  with  chloride  of 
calcium,  decolorise  by  animal  charcoal,  precipitate  the  morphine  by  ammonia, 
and  neutralise  with  hydrochloric  acid. 

Preparations. 
u.s.p.  None. 

B.P.  DOSE. 

Liquor  Morphinse  Hydrochloratis..  j45  ^f"0™t  1  fl-  0Z"  0r  H 10-60  min. 

Supposltoria  Morphinae  j  gv.  in  each  suppository... 

„  n         cum  Sapone...  \  gr.        „  

Tinctura  Chloroform!  et  Morphinae  ..  1  gr.  in  1  fl.  oz 5-10  min. 

Trochisci  Morphinae J-  gr.  in  each  lozenge 1-4. 

u  »         et  Ipecacu.snh3e..i  gr.      „  „     1-4. 

liquor  Morphinae  Hydrochloratls.  Solution  op  Hydrochlorate  of 
Morphine.— Add  diluted  hydrochloric  acid  (9  min.),  rectified  spirit  (2  fl.  dr.)  to 
distilled  water  (6  fl.  dr.),  and  dissolve  hydrochlorate  of  morphine  (4|  gr.)  in  the 
mixture. 

Tinctura  Chloroforml  et  Morphinae.  Tincture  op  Chloroform  and 
Moephine. — It  contains  in  a  10-minim  dose  chloroform,  1£  min. ;  ether,  £  min. ; 
rectified  spirit,  1}  min.;  hydrochlorate  of  morphine,  js?r>!  diluted  hydrocyanic 
acid,  $  min.;  oil  of  peppermint,  ^  mm. ;  liquid  extract  of  liquorice,  1£  min. ;  treacle, 
and  syrup.    It  resembles  chlorodyne. 

Morphinae  Acetas,  B.  and  U.S.P.  Acetate  of  Morphine. 
C17H,9N03.C2H40v 

Characters.  —A  white  powder,  with  a  faintly  acetous  odour. 

Solubility. — Soluble  in  water  and  in  spirit. 

Eeactions.— Potash  or  soda  gives  a  precipitate  soluble  in  excess,  and 
exhibiting  the  reactions  of  morphine,  U.S.P.  When  sulphuric  acidis  added 
to  the  salt,  acetous  vapours  are  evolved.  When  freshly  prepared  it  is  soluble 
in  12  parts  of  water  at  15°  C. 

Preparation.— Obtain  morphine  by  precipitating  it  from  the  hydro- 
chlorate by  ammonia,  dissolve  it  in  acetic  acid  and  crystallise,  B.P.  In  the 
U.S.P.  morphine  is  officinal,  and  requires  only  to  be  dissolved  in  acetic  acid. 


848  VEGETABLE   MATEKIA  MEDICA.  [sect,  v, 


Preparations. 

u.s.p.  None. 
B.p.  DOSE. 

liquor  BZorpbinse  Acetatis 4  gr.  in  1  fl.  oz.,  or  1  per  cent.. ..60  min. 

.    -„     ■  I"  1-5  ruin. 

InjectlolWorpliinaBHypodermica,l  gr.  in  10  mm -^   or  more. 

liquor  IWorphinse  Acetatis.  Solution  or  Acetate  of  Morphine. — It  is 
prepared  like  the  solution  of  the  hydroohlorate,  using  the  acetate  of  morphine  and 
acetic  acid. 

Injectio  Morphines  Hypodermica.  Hypodermic  Injection  of  Morphine. 
— A  solution  of  acetate  of  morphine,  containing  1  grain  of  the  acetate  in  10  minims 
of  the  injection.  Acetate  of  morphine  is  freshly  prepared  by  precipitating  morphine 
from  a  solution  of  92  grains  of  hydrochlorate  of  morphine  in  2  ounces  of  warm 
distilled  water,  with  sufficient  ammonia  to  render  the  solution  alkaline.  The 
morphine  is  washed  on  a  filter,  dissolved  in  about  an  ounce  of  distilled  water  with 
the  addition  of  acetic  acid,  and  the  use  of  gentle  heat,  until  the  whole  of  the  mor- 
phine is  dissolved  and  a  slightly  acid  solution  formed.  Enough  distilled  water  is 
now  added  to  make  up  the  solution  to  2  fluid  ounces  exactly.  It  is  then  filtered, 
and  kept  from  the  light  in  a  stoppered  bottle.' 

Morphinae  Sulphas,  B.  and  U.S.P.  Sulphate  of  Mor- 
phine.    (C17H19N03)2.H2S04.5H2O ;  758. 

Characters. — White  feathery  silk  crystals,  permanent  in  air, 
with  no  smell,  but  a  bitter  taste. 

Solubility. — Soluble  in  24  parts  of  water  at  15°  C. 
Reactions. — In  its  reactions  it  corresponds  to  trie  hydrochlorate,  but  is 
known  to  be  a  sulphate  by  giving  with  chloride  of  barium  a  white  precipitate 
insoluble  in  hydrochloric  acid. 

U.S.P.  Preparations.    None  in  B.P. 

dose. 

Pulvis  Morphines  Compositus 10  gr.  (0-65  gm.) 

Trochisci  Morphinse  et  Ipecacuanhas 1  or  2. 

U.S.P.  Pulvis  Morphine  Compositus.  Compound  Powder  of  Morphine 
(Tully's  Powder). — Sulphate  of  morphine,  1 ;  camphor,  20  ;  glycyrrhiza,  20 ;  pre- 
cipitated carbonate  of  calcium,  20 ;  alcohol,  q.s.  to  mix  the  camphor  intimately 
with  the  other  ingredients.    It  is  intended  as  a  substitute  ,for  Dover's  powder. 

Apomorphinae  Hydrochloras,  B.  and  U.S.P.  Hydrochlo- 
rate of  Apomorphine.  C,7H17N02HC1 ;  303'4. — The  hydrochlo- 
rate of  an  artificial  alkaloid  prepared  from  morphine.  It  should 
be  kept  in  small,  well-stoppered  vials,  in  a  dark  place. 

Preparation. — By  heating  morphine  or  codeine  in  sealed  tubes  with 
concentrated  hydrochloric  acid. 

Characters. —  Small,  greyish-white,  shining,  acicular  crystals, 
turning  green  on  exposure  to  light  and  air,  inodorous,  with  a 
very  faint  acid  reaction  on  moistened  litmus-paper. 

Solubility. — Soluble  in  thirty -five  parts  of  alcohol,  the  solutions  being 
decomposed  with  production  of  a  green  colour  when  they  are  boiled. 

Reactions. — From  solutions,  bicarbonate  of  sodium  throws  down  a  pre- 
cipitate which  becomes  green  on  standing  and  then  forms  a  purple  solution 

'  The  possibility  of  morphine  being  transformed  into  apomorphine  by  long 
keeping  in  solution  should  be  remembered.  A  3  per  cent,  solution  of  hydrochlorate 
of  morphine,  which  was  hypnotic  when  freshly  prepared,  became  partly  converted 
into  apomorphine  after  being  kept  for  eleven  months,  and  then  produced  violent 
vomiting.— Brit.  Med.  Joum.,  June  26,  1886,  p.  1222. 


chap,  xxxi.]  THALAMIFLOKjE.  849 

■with  ether,  violet  with  chloroform,  and  bluish-green  with  alcohol.  "With 
dilute  solution  of  perchloride  of  iron  it  gives  a  deep  red  and  with  nitric  acid 
a  blood-red  coloration. 

B.P.  Preparation. 
Injectio  Apomorphinee  Hypodermica. — (2  grains  dissolved  in  100  minims 
of  camphor-water  and  filtered.    It  should  be  made  as  required  for  use.) 

Dose.—  -fr-%  grain  (-006--012  gm.),  or  2-8  minims  of  the 
B.P.  injection,  hypodermically  as  emetic. 

Action. — When  given  internally  or  injected  hypodermically 
apomorphine  acts  as  an  emetic,  producing  nausea  and  vomiting 
in  from  five  to  twenty  minutes.  After  vomiting  has  occurred  the 
nausea  usually  disappears  quickly.  It  usually  produces  less  de- 
pression than  tartar  emetic,  but  collapse  has  occurred  from  its 
use  in  children.  It  probably  causes  vomiting,  partly  reflexly 
and  partly  directly,  in  the  same  way  as  tartar  emetic  (p.  373).  It 
stimulates  the  motor  centres  in  the  brain  and  the  respiratory  and 
vomiting  centres  in  the  medulla,  and  afterwards  paralyses  them. 

In  rabbits,  which  cannot  vomit,  apomorphine  causes  constant 
movement,  rapid  breathing,  convulsions,  paralysis,  and  death. 
In  cats  and  dogs  small  doses  cause  vomiting,  while  large  doses  do 
not,  but  produce  manege  movements  and  paralysis  ;  some  degree  of 
inco-ordination  of  gait  may  be  observed  in  man  after  a  large  dose. 

It- paralyses  muscular  fibre,  voluntary  and  involuntary,  but 
does  not  affect  motor  or  sensory  nerves.  The  pulse  is  at  first 
quickened,  while  the  blood-pressure  is  unaltered  ;  but  large  doses 
paralyse  the  heart.  The  secretion  of  bronchial  mucus  is  in- 
creased (p.  253). 

Uses. — It  is  used  as  an  emetic  for  the  purposes  already  men- 
tioned (p.  374).  Its  special  advantages  are  the  readiness  with 
which  it  can  be  administered  by  hypodermic  injection  without 
causing  any  local  irritation  and  the  short  duration  of  the  nausea 
it  occasions.  It  is  useful  also  as  an  expectorant,  alone  or  along 
with  morphine  (p.  250). 

Codeina,  B.  and  U.S.P.  Codeine.  ClgHflNO,.H,0  ;  317. 
— An  alkaloid  contained  in  opium.  It  is  probably  methyl- 
morphine.  Morphine  =  Ci7H18NO.,(OH)  ;  codeine  =  C17H18N02 
(OCH3). 

Chaeactees. — In  colourless  or  nearly  colourless  octahedral 
crystals.  The  aqueous  solution  has  a  bitter  taste  and  an  alkaline 
reaction. 

Preparation.— It  is  separated  from  the  ammoniacal  liquors  from  which 
morphine  has  been  obtained,  by  evaporating,  treating  the  residue  with  water, 
precipitating  with  caustic  potash,  and  purifying  the  precipitated  alkaloid  by 
recrystallisation  from  ether. 

Solubility.— It  is  soluble  in  eighty  parts  of  water  and  ot  solution  of 
ammonia,  readily  soluble  in  spirit  and  in  diluted  acids. 

Beaotions.— The  alkaloid  dissolves  in  sulphuric  acid,  forming  a  colour 
less  solution,  which,  when  gently  warmed  with  molybdate  of  ammonium  or  a 

3  i 


850  VEGETABLE  MATEEIA  MEDICA.    •      [sect.  v. 

trace  of  perchloride  of  iron,  assumes  a  deep  blue  colour,  Moistened  with 
strong  nitric  acid  it  becomes  yellow  but  not  red  (difference  from  and  absence 
of  morphine).     Ignited  in  air  it  yields  no  ash. 

Dose. — For  diabetes  I  grain  gradually  increased  to  5  grains 
or  more  three  times  a  day,  unless  it  produces  great  drowsiness 
or  the  sugar  disappears.  For  cough  ^  of  a  grain  every  three  or 
four  tumrs. 

Action. — Codeine  has  only  a  slight  hypnotic  action,  and  may 
sometimes  be  given  in  doses  of  15  grains  daily  without  producing 
any  marked  drowsiness  in  diabetic  patients.  Others  again  are 
rendered  drowsy  by  5  or  6  grains  daily.  Its  most  marked  action 
appears  to  be  on  the  nerves  of  the  abdominal  viscera  and  on 
motor  centres  in  the  brain.  When  given  for  several  days  it 
lessens  the  irritability  of  the  digestive  tract  so  that  irritant 
poisons,  like  arsenic,  produce  neither  vomiting  nor  purging. 

It  increases  the  irritability  of  the  spinal  cord,  and  produces 
in  frogs  languor  succeeded  by  convulsions  and  paralysis.  In 
mammals  it  appears  rather  to  stimulate  motor  centres  in  the 
brain  (p.  190).  It  causes  some  drowsiness,  but  the  motor  phe- 
nomena are  most  marked.  These  are  twitchings,  manege  or 
swimming  movements,  paralysis  of  the  hind -legs,  and  weakened 
circulation,  followed  by  a  sudden  shriek  and  convulsions.  Death 
may  occur  at  once  or  recovery  take  place. 

I  have  observed  symptoms  very  like  these  in  poisoning  by 
pure  brucine,  and  in  some  points  they  resemble  those  of  picro- 
toxin  (p.  838). 

Uses. — Although  it  is  not  a  powerful  hypnotic,  like  morphine, 
codeine  has  been  strongly  recommended  in  nervous  insomnia, 
and  also  in  cases  where  sleep  is  prevented  by  the  pain  of  rheu- 
matism or  cancer,  or  by  distressing  cough.  Its  power  to  lessen 
the  irritability  of  the  intestinal  nerves  has  been  already  men- 
tioned, and  possibly  it  exerts  a  similar  action  on  the  nerves  of 
other  viscera,  such  as  those  of  the  respiratory  organs,  &c.  Such 
an  action  would  explain  its  beneficial  effects  in  cough  when 
morphine  cannot  be  borne.  Its  chief  use  is  in  diabetes.1  It 
certainly  lessens,  and  sometimes  entirely  removes,  the  sugar 
from  the  urine.  As  Claude  Bernard  found  that  irritation  of  the 
central  end  of  the  cut  vagus  caused  dilatation  of  the  hepatic 
vessels  and  the  appearance  of  sugar  in  the  urine,  it  seems  not 
improbable  that  the  utility  of  codeine  in  diabetes  is  due  to  its 
power  of  lessening  the  irritability  of  the  afferent  fibres  in  the 
nerves  of  the  abdominal  viscera.  This  is  rendered  all  the  more 
likely  by  the  fact  that  codeine  does  not  prevent  the  occurrence  of 
sugar  in  the  urine  in  carbonic  oxide  poisoning,2  where  alterations 
in  tissue  change,  leading  to  glycosuria,  are  probably  of  a  more 
general  nature,  and  less  dependent  on  local  alterations  in  the 
hepatic  circuiation. 

1  Pavy,  Guy's  Eospital  Reports.  a  The  late  Otto  Schultzen. 


chap,  xxxi.]  THALAMIFLOEiB.  851 


Physiological  Action  of  Opium. 

General  Action.— Opium,  and  all  its  alkaloids  hitherto  ex- 
amined, act  almost  exclusively  on  the  central  nervous  system, 
and  in  mammals  especially  on  the  brain,  the  brain- symptoms 
preponderating  in  proportion  as  the  organ  is  developed  relatively 
to  the  other  nerve-centres.  This  conclusion  holds  good  on]  y  for 
mammals,  and  must  be  qualified  in  regard  to  the  frog,  for  in  it 
narcotine,  codeine,  papaverine,  and  thebaine  have  also  a  para- 
lysing action  on  the  motor  ganglia  of  the  heart.  Opium  and  its 
alkaloids  agree  not  only  in  the  organ  they  affect  but  in  the 
nature  of  their  action.  The  symptoms  may  be  divided  into  two 
stages : — 

(1)  Narcosis,  due  to  a  paralytic  action  on  the  brain,  fol- 
lowed by 

(2)  Tetanus,  due  to  increased  irritability  of  the  spinal  cord. 
Action  on  Frogs. — If  the  drug  be  introduced  by  injection 

under  the  skin  of  a  frog,  the  functions  of  the  nerve-centres 
are  abolished  in  the  order  of  their  development,  the  highest 
centres  being  first  affected  (vide  p.  183) . 

The  first  symptom  to  appear  after  the  injection  of  the  drug 
is  a  diminution  of  the  power  of  voluntary  movement ;  the  frog 
remains  quiet,  making  no  effort  at  voluntary  movement ;  but 
when  irritated  responds  to  the  stimulation  by  springing  in  the 
usual  way.  Next,  the  power  of  co-ordination  is  lost ;  the  frog 
springs  as  before  when  irritated,  but  has  no  control  over  the 
direction  of  its  leaps.  It  then  gradually  loses  the  power  of 
springing  in  response  to  stimulation,  and  finally  reflex  action 
cannot  be  excited.     The  heart  is  unaffected. 

After  a  time  increased  excitability  of  the  spinal  cord  comes 
on,  so  that  the  slightest  irritation  causes  muscular  spasms  like 
those  of  strychnine-poisoning.  During  this  condition  the  spinal 
cord  of  the  frog  does  not  react  to  stimuli  in  the  ordinary  way, 
but  responds  as  it  were  by  one  violent  explosion,  after  which  it 
seems  to  become  exhausted  for  a  time,  but  after  an  interval  an- 
other violent  spasm  can  be  induced,  so  that  there  are  alternating 
periods  of  spasm  and  exhaustion.  If  the  action  of  the  drug 
be  not  pushed  beyond  this  point,  the  phenomena  will  pass  off  in 
the  reverse  order  of  their  appearance.  If  pushed  further,  there 
succeeds  a  deepening  paralysis,  and  respiration  becomes  first 
slower  and  then  stops. 

Action  on  Birds. — Birds  are  peculiarly  insusceptible  to  the 
action  of  opium  or  morphine.  But  morphine  produces  in  them 
a  marked  lowering  of  body  temperature,  sometimes  to  the  extent 
of  5°  or  6°  C.1 


1  Brunton  and  Cash,  Central./,  die  med.  Wissensch.,  1886,  p.  241. 

3  i  2 


852  VEGETABLE  MATEEIA  MEDICA.  [sect.  t. 

Action  on  Mammals. — Opium  causes  partial  abolition  of 
voluntary  movement,  sometimes  preceded  by  a  certain  amount 
of  increased  excitability,  followed  by  sleep.  Sometimes  the 
spinal  cord  shows  signs  of  increased  excitability  with  diminished 
conducting  power,  evidenced  by  convulsions  with  a  tendency  to 
paralysis  of  the  hinder  limbs. 

Action  on  Man. — In  man  the  action  of  opium  is  chiefly 
upon  the  brain,  producing  sleep.  When  taken  in  small  doses 
of  $  gr.  to  1  gr.  there  is,  first,  a  stage  of  excitement  of  the  cir- 
culation, as  evidenced  by  the  pulse  being  fuller  and  quicker,  and 
by  the  surface  of  the  skin  being  warm  and  flushed.  During  this 
stage  the  individual  has  the  power  of  directing  his  energies  to 
any  particular  object,  and  the  action  of  the  drug  causes  him  to 
do  well  whatever  he  wishes  to  do.  Thus,  if  he  wishes  to  sleep, 
and  surrounding  circumstances  be  favourable,  an  agreeable 
languor  followed  by  quiet  sleep  comes  on.  He  can  be  easily 
aroused  from  this  sleep  ;  and  after  a  few  hours  the  effect  passes 
off,  leaving,  however,  slight  headache  and  languor,  with  dryness 
of  mouth  and  slight  nausea.  If,  on  the  other  hand,  he  wishes 
to  work,  he  can  do  this  with  increased  energy ;  or,  if  he  desires 
to  exert  the  mind,  he  will  find  his  imagination  more  vivid,  his- 
thoughts  more  brilliant,  and  his  power  of  expression  greater 
(Christison) .     The  after-effects  are  the  same  as  after  sleep. 

With  moderate  doses  of  1  gr.  to  2  grs.  the  stage  of  excite- 
ment is  short  and  is  followed  by  deep  sleep,  from  which  the 
person  can  still  be  aroused.  The  after-effects  are  severe  head- 
ache, with  nausea,  furred  tongue,  and  loss  of  appetite.  During 
the  stage  of  sleep  the  brain  is  ansemic,  both  the  arteries  and 
veins  being  empty  (vide  p.  197). 

With  large  doses,  of  3  grs.  or  more,  the  first  stage  is  very 
short.  Sleep  rapidly  follows,  becomes  deeper  and  deeper,  and 
passes  into  coma,  from  which  the  patient  can  no  longer  be 
aroused.  The  arms  and  limbs  are  limp  ;  the  face  is  generally 
pale,  with  a  bluish  tinge  at  times;  the  eyes  are  sunken,  the 
pupils  very  much  contracted,  almost  to  the  size  of  a  pin's  point ; 
respiration  slow  and  stertorous.  The  pulse  during  sleep  and 
coma  is  slow  and  full;  as  coma  proceeds  it  becomes  feebler. 
Finally  death  by  asphyxia  occurs,  the  respiration  ceasing  before 
the  heart.  It  may  occasionally  be  preceded  by  convulsions, 
though  this  is  rare. 

Post  mortem  the  ordinary  appearances  of  death  by  asphyxia 
are  found,  viz.  congestion  of  the  brain  and  lungs,  &c. ;  the  ven- 
tricles of  the  brain  contain  serous  fluid,  the  veins  of  the  brain 
and  spinal  cord  are  distended  with  dark  blood,  and  there  may 
be  slight  extravasation  of  blood  in  some  of  the  tissues. 

Diagnosis  between  Opium-poisoning,  Intoxication,  and 
Apoplexy.— One  should  obtain  the  history  of  the  case  where  it 
is  possible,  as  this  may  enable  one  to  diagnose  not  only  between 


chap,  xxxi.]  THALAMIFLOB^E.  853 

opium-poisoning,  intoxication,  and  apoplexy,  but  between  these 
and  other  forms  of  coma,  e.g.  post-epileptic  and  ureemic  coma. 
The  former  is  recognised  by  the  history  of  convulsions,  and  the 
latter  by  the  presence  of  albumen  in  the  urine,  with  sometimes 
cedema  of  the  legs.  "When  the  history  cannot  be  obtained — for 
instance,  in  cases  where  the  patient  is  found  lying  unconscious — 
the  diagnosis  is  sometimes  extremely  difficult. 

Notice  first  the  odour  of  breath ;  the  smell  guides  one  in 
opium-poisoning.  The  smell  of  alcohol  does  not  assist  one  much, 
as  it  may  be  taken  with  opium ;  and  in  apoplexy  brandy  is  fre- 
quently given  by  the  person  who  first  finds  the  unconscious  patient. 

Secondly,  the  pupil,  which  is  very  much  contracted  in 
opium,  but  dilated  in  alcoholic,  poisoning,  and  often  unequally 
contracted  in  apoplexy.  It  must  be  borne  in  mind  that  in  apo- 
plexy of  the  pons  varolii,  the  pupils  may  be  equally  and  ex- 
tremely contracted,  just  as  in  opium-poisoning.  In  apoplexy  the 
arms  on  being  raised  and  then  relaxed  fall  unequally  on  the 
two  sides,  one  being  more  rigid  or  flaccid  than  the  other.  The 
rectal  temperature  is  often  an  important  sign,  as  in  apoplexy 
there  is  an  initial  fall  with  a  subsequent  rise  in  the  majority  of 
cases.  In  no  case  should  the  individual  be  treated  roughly  or 
exposed  to  the  slightest  chance  of  a  chill,  but,  on  the  contrary, 
he  must  be  kept  warm ;  and  if  it  appears  to  be  a  case  of  poison- 
ing by  alcohol  or  opium,  and  not  apoplexy,  the  stomach  should 
be  washed  out  and  strong  coffee  injected. 

Treatment  in  Opium  Poisoning'. — Evacuate  the  stomach 
as  soon  as  possible  by  administering  20  gfs.  of  zinc  sulphate  in 
a  little  water ;  if  this  acts,  then  give  some  strong  coffee.  Some- 
times the  zinc  will  not  produce  vomiting  on  account  of  the  in- 
sensibility of  the  stomach  and  vomiting  centre,  due  to  the  action 
of  the  opium.  If  such  be  the  case,  employ  the  stomach-pump, 
wash  out  the  stomach  with  warm  water,  and  inject  coffee.  Keep 
the  patient  awake  by  walking  him  about  the  room,  tapping  on 
the  forehead  with  the  finger-nails,  or  flicking  him  with  a  wet 
towel.  Apply  mustard-leaves  to  various  parts  of  the  body,  or: 
use  a  galvanic  battery.  Cold  affusion  is  a  good  adjunct ;  but 
the  alternate  use  of  hot  and  cold  water  is  better  both  as  a  stimu- 
lant and  as  preventing  the  risk  of  chilling  the  patient.  Lastly, 
give  a  subcutaneous  injection  of  4  minims  of  liquor  atropinae 
sulphatis,  B.P.  every  ten  minutes,  until  symptoms  of  recovery 
show  themselves  or  the  pulse  is  quickened  or  the  pupil  dilated. 

Precautions. — Do  not  allow  the  patient  to  become  cold 
while  trying  to  rouse  him,  and  take  care  not  to  chill  him  when 
applying  cold  affusions,  as  death  may  result  from  syncope  after 
recovery  from  the  comatose  condition.  The  average  length 
of  insensibility  is  twelve  hours,  and  if  this  period  be  passed, 
recovery  is  nearly  certain,  but  sometimes  the  symptoms  may 
reappear,  and  death  from  asphyxia  or  syncope  occur. 


854  VEGETABLE   MATEEIA  MEDICA.  [sect.  V. 

Treatment  of  the  Symptoms  after  an  Ordinary  Dose. — 

Strong  coffee  with  or  without  brandy,  or  lemon-juice  and  water, 
should  be  administered.     The  patient  should  be  kept  in  bed. 

Action  on  Special  Organs. — Opium  has  little  action  on 
muscular  contractility.  The  action  of  opium  on  the  motor 
nerves  is  doubtful.  According  to  some  observers,  it  first  in- 
creases and  then  diminishes  their  excitability,  the  action  com- 
mencing at  the  centres  and  proceeding  towards  the  periphery. 
Others,  however,  have  found  that  opium  has  little  or  no  action 
on  them,  except  towards  the  end  of  poisoning,  when  all  the 
functions  are  paralysed. 

The  sensory  nerves  are  first  excited  and  then  paralysed. 
Opium  applied  locally  is  said  by  some  observers  to  have  no 
action  on  the  sensory  nerves,  but  it  has  been  found  to  have  a 
paralysing  action  by  Baxt.  The  results  of  his  experiments  are 
confirmed  by  clinical  experience,  for  when  the  drug  is  injected 
subcutaneously  it  lessens  sensibility,  diminishes  the  power  of 
distinguishing  tactile  impressions,  and  relieves  pain  when 
present. 

When  applied  externr^y  to  the  eye,  or  to  the  skin  denuded 
of  its  epidermis,  opium  also  relieves  pain. 

Opium  lessens  first  the  conducting  power  of  the  spinal  cord, 
then  the  reflex  functions,  producing  first  inco-ordination  of  the 
movements  of  the  hind  limbs  and  then  paralysis  of  reflex  action. 

Opium  acts  on  the  centres  of  the  brain  in  the  order  of  their 
importance ;  thus  in  the  frog,  there  is,  first,  loss  of  voluntary 
motion,  such  as  may  be  produced  by  extirpation  of  the  cerebral 
hemispheres ;  next,  loss  of  co-ordination,  such  as  is  prqduced  by 
extirpation  of  the  optic  lobes ;  and  lastly,  effects  like  those  pro- 
duced by  destruction  of  the  medulla  (p.  183). 

The  pupil  is  markedly  contracted  by  opium,  the  action  of  the 
drug  being  probably  central  and  not  peripheral ;  but  the  exact 
mode  of  action  has  not  been  definitely  made  out.  Stimulation 
of  sensory  nerves  causes  reflex  dilatation  of  the  pupil,  and  it  is 
not  improbable  that  the  contraction  which  opium  produces  is 
clue  to  its  paralysing  this  reflex  action  more  or  less  completely 
(p.  219). 

The  pupil  sometimes  dilates  just  before  death.  This  dilata- 
tion is  probably  due  to  the  excessively  venous  condition  of  the 
blood,  as  in  the  later  stages  of  chloroform-poisoning. 

The  first  effect  which  opium  has  on  the  circulation  is  to 
cause  a  dilatation  of  the  vessels  of  the  skin,  sometimes  giving 
rise  to  a  cntaneous  eruption  of  a  roseolous  character  accom- 
panied by  itching,  and  coming  on  either  before  or  after  sleep. 

The  vaso-motor  centre  in  the  medulla  is  slightly,  if  at  all, 
affected  by  small  doses  of  opium.     Large  doses  paralyse  it. 

The  drug  appears  to  have  a  peculiar  action  on  the  peripheral 
vaso-motor  apparatus.     It  is  well  known  that  stimulation  of 


ciiap.  sxxi.]  THALAMIFLOEiE.  855 

the  chorda  tympani  causes  dilatation  of  the  vessels  of  the  sub- 
maxillary gland ;  but  I  found  that  after  the  exhibition  of  opium 
the  vessels  of  the  gland  no  longer  dilated,  but  on  the  contrary 
contracted,  on  stimulation  of  the  chorda  tympani,  so  that  the 
blood  which  issued  from  the  gland  was  not  of  a  bright  arterial 
hue,  but  was  very  dark,  and  flowed  drop  by  drop.  This  observa- 
tion requires  confirmation ;  but  if  it  be  confirmed,  this  result 
might  serve  to  explain  the  effect  of  opium  in  cutting  short 
inflammations,  e.g.  of  the  peritoneum. 

In  peritonitis  as  in  other  inflammations  the  blood-vessels  are 
greatly  dilated.  Opium  by  its  action  on  the  vaso-motor  centre, 
and  (if  these  experiments  be  correct)  by  its  action  also  on  the 
peripheral  terminations  of  vaso-motor  nerves,  will  prevent  or 
diminish  the  reflex  dilatation  of  the  vessels  which  the  local 
irritation  would  otherwise  produce.  Congestion  will  thus  be 
diminished  and  inflammation  be  relieved.  The  action  of  opium 
in  peritonitis  is  therefore  probably  twofold.  First,  it  lessens 
peristaltic  movements  of  the  intestines,  and  thus  diminishes 
local  irritation.  Secondly,  it  lessens  the  reflex  activity  of  the 
centres  through  which  local  irritation  causes  dilatation  of  the 
vessels,  and  thus  diminishes  peritoneal  congestion.  The  late 
Sir  Eobert  Christison  used  to  say  that  not  only  coryza,  but 
probably  all  inflammations,  could  be  nipped  in  the  bud  by 
opium  if  it  were  only  given  sufficiently  early  and  sufficiently 
freely. 

The  blood-pressure  appears  to  be  but  little  affected  by 
opium.  It  varies  after  the  injection  of  the  drug,  but  this  varia- 
tion is  probably  due  to  an  alteration  in  the  general  functions  of 
the  body,  for  example,  great  quiet,  &c. 

Opium  has  little  direct  action  on  the  heart,  which  continues 
to  beat  after  the  nervous  centres  have  been  experimentally 
destroyed  in  animals. 

On  Secretion. — The  secretions  of  the  body,  except  those  of 
urine  and  of  sweat,  are  lessened  by  opium. 

If  the  lingual  nerve  of  an  animal  be  stimulated,  a  reflex  flow 
of  saliva  takes  place ;  but  when  -opium  has  been  given  in  suffi- 
cient quantity  this  reflex  action  is  paralysed,  and  stimulation  of 
the  nerve  no  longer  excites  a  flow.  Very  large  doses,  however, 
may  cause  salivation  (p. '355).  Opium  also  diminishes  the  other 
secretions  of  the  alimentary  canal,  causing  impairment  of  diges- 
tion, and  this  action  serves  partially  to  explain  the  constipation 
produced  by  opium. 

The  quantity  of  sweat  secreted  is  increased  by  opium,  and 
especially  so  when  it  is  combined  with  ipecacuanha.  _  Just  before 
death  by  opium  the  secretion  of  sweat  is  greatly  increased,  so 
that  the  surface  is  bathed  in  it ;  but  this  is  due  to  stimulation  of 
the  sweat-centres  in  the  spinal  cord  by  the  increasing  venosity 
of  the  blood  (p.  438). 


856  VEGETABLE   MATEBIA  MEDICA.  [sect.  v. 

The  quantity  of  urine  is  frequently  lessened.  Sometimes  it 
may  be  really  increased,  but  appear  diminished  in  consequence 
of  paralysis  of  the  bladder  preventing  its  being  evacuated. 
Sometimes  there  is  a  constant  desire  to  pass  water. 

On  the  Intestines.— The  action  of  opium  on  the  intestines 
varies  with  the  dose.  On  isolating  a  piece  of  intestine  and 
supplying  it  artificially  with  blood,  the  action  of  opium  may  be 
observed  by  mixing  it  with  the  blood  (p.  383).  When  used  in 
large  quantity  all  peristaltic  action  ceases,  and  the  intestine 
becomes  tetanically  contracted.  Hence  in  large  doses,  injected 
directly  into  the  jugular  vein,  it  acts  as  a  most  powerful  pur- 
gative, causing  one  very  copious  evacuation.  It  acts  chiefly  on 
the  small  intestines.  In  moderate  doses  it  lessens  peristaltic 
action  and  causes  constipation.  In  very  small  doses  it  generally 
increases  peristalsis  and  acts  as  a  purgative,  but  not  invariably 
so.  This  property  is  made  use  of  in  cases  of  constipation  due 
to  reflex  irritation  starting  from  the  ovary.  The  mode  of  action 
has  already  been  discussed  (p.  385). 

Elimination. — Morphine  is  eliminated  by  the  gastric  mucous 
membrane  (p.  39),  and  may  be  found  in  the  stomach  after  sub- 
cutaneous injection.  It  is  excreted  also  in  the  bile,  but  may 
remain  a  long  time  in  the  liver.  It  is  found  unchanged  in  the 
urine.  In  cases  where  its  use  has  been  continued  for  some  time, 
some  of  it  probably  becomes  changed  in  the  body,  as  a  substance 
with  the  chemical  reactions  of  oxydimorphine  has  been  found  in 
the  liver  and  kidneys  in  such  cases  (p.  35). 

Circumstances  Modifying  the  Action  of  Opium. 

Age. — In  childhood  the  brain  is  proportionately  larger  than 
in  adult  life  and  absorption  much  more  rapid,  hence  the  effect 
of  opium  is  greater  than  in  adults,  and  children  bear  it  very 
badly ;  consequently  smaller  doses  must  be  given  than  are  pro- 
portionate to  their  ages.  Care  is  necessary  from  the  age  of  six 
months  to  one  year,  as  1  minim  has  produced  fatal  results.  In 
old  age  the  dose  must  be  diminished  according  to  the  advance  hi 
years. 

Sex. — Women  are  more  readily  affected  than  men,  and  men 
more  liable  to  nausea  and  headache  after  its  administration. 

Idiosyncrasy. — Small  doses  easily  affect  some  subjects,  and 
on  the  other  hand  large  doses  are  nearly  inert  in  others.  Ex- 
citement and  delirium,  instead  of  quietness  and  sleep,  are  not 
unfrequently  produced.  In  such  cases  it  is  best  to  give  a  few 
whiffs  of  chloroform  to  quiet  the  patient  and  induce  sleep,  if  the 
excitement  has  already  come  on.1  If  it  is  necessary  to  give 
opium  or  morphine  to  a  patient  having  this  idiosyncrasy,  it 
ought  to  be  combined  with  chloral  or  a  bromide,  or  with  both. 

1  Morrant  Baker,  St.  Bartholomew's  Hospital  Reports. 


chap,  xxxi.]  THALAMIFL0E.3E.  857 

In  some  persons  excitement  and  wakefulness  occur  on  the  night 
immediately  succeeding  the  dose,  and  sleep  only  occurs  on  the 
second  night. 

Habit. — The  effect  of  habit  is  perceived  in  two  ways — in 
some  cases  large  quantities  are  required  to  produce  a  result ;  in 
others  a  long  interval  is  necessary  for  the  drug  to  take  effect. 
As  much  as  two  pints  of  the  tincture  have  been  taken  in  the 
course  of  a  day ;  and  as  much  as  12  grains  of  morphine  have 
been  subcutaneously  injected.  Both  slowness  and  weakness  of 
action  may  result  from  its  continued  use,  so  that  it  may  be 
necessary  not  only  to  give  a  larger  dose  but  to  give  it  a  consider- 
able time  beforehand.  In  one  case  with  which  I  am  acquainted, 
after  a  few  months  during  which  the  time  gradually  increased,: 
it  became  necessary  to  give  the  dose  twenty-four  hours  before  its 
effect  was  desired. 

The  explanation  of  this  tardy  action  probably  is  that  the 
absorptive  power  of  the  intestines  is  diminished  by  the  continual 
use  of  the  drug,  for  it  is  well  known  that  opium-eaters  can  take 
large  doses  of  corrosive  sublimate  without  experiencing  any  ill- 
effects,  the  drug  being  but  slowly  absorbed. 

But  it  is  quite  possible,  indeed  probable,  that  there  is,  besides 
delayed  absorption,  another  factor  in  the  tolerance  of  opium 
induced  by  repeated  doses.  It  is  possible  that  part  of  the  mor- 
phine introduced  is  converted  in  the  organism  into  oxydimor- 
phine,  which  appears,  to  a  certain  extent,  to  counteract  the 
soporific  action  of  morphine,1  or  into  other  substances  which 
may  have  this  action  (see  p.  35).  Each  dose  of  morphine  will 
thus  leave  in  the  body  substances  having  an  action  antagonistic 
to  the  next  dose,  unless  a  sufficient  interval  should  elapse  between 
them  to  allow  them  to  be  completely  eliminated. 

Opium-eating — Morphinism. — When  opium  is  first  taken, 
its  action  is  to  stimulate  and  afterwards  depress ;  to  remove  this 
depression  the  individual  takes  another  dose ;  the  habit  of  taking 
the  drug  thus  becomes  established.  The  nervous  system  suffers, 
the  mental  powers  become  enfeebled,  the  moral  faculties  per- 
verted, and  there  is  inability  to  distinguish  between  truth  and 
falsehood.  Then  the  motor  powers  .are  attacked,  the  gait  be- 
comes shuffling  and  uncertain,  and  digestion  is  impaired.  The 
bowels  may  be  constipated,  but  are  generally  loose. 

When  morphine  is  taken  for  some  time  in  medicinal  doses, 
obstinate  vomiting  sometimes  sets  in  and  will  not  yield  to 
ordinary  remedies.  It  is  usually  checked  by  discontinuing  the 
administration  of  the  drug.  This  vomiting  may  possibly  be 
due  to  the  morphine  being  converted  into  oxydimorphine 2  or 
apomorphine  in  the  system.3 

1  Diedrioh,  Ueber  Oxydi?norphin,  Inaug.  Diss.,  Gottingen,  1883. 

2  Diedrioh,  op.  cit. 

8  The  view  expressed  in  the  text  received  a  curious  confirmation  shortly  after 


858  VEGETABLE   MATEEIA  MEDICA.  [sect.  v. 

If  the  patient  has  been  accustomed  to  the  use  of  hypodermic 
injections  of  morphine,  hypodermic  injections  of  water  should 
he  substituted  in  such  cases  and  the  strength  supported  by  care- 
ful frequent  administration  of  nourishment. 

Disease. — When  a  patient  is  suffering  intense  pain,  opium 
is  well  borne,  and  must  be  given  in  large  quantities ;  as,  for 
example,  to  a  person  suffering  from  peritonitis.  In  cases  of 
Bright's  disease  small  doses  may  produce  disproportionately  great 
effects  (p.  41).  Hence  in  these  cases  the  drug  must  not  be  given 
in  large  quantities,  and  the  effect  of  each  dose  must  be  carefully 
watched. 

Combination  with  other  Drugs.  —  Chloroform  sometimes 
modifies  the  action  of  opium,  the  chloroform  narcosis  passing 
into  opium  sleep,  or  the  opium  sleep  may  more  resemble  chloro- 
form anaesthesia ;  hence  the  use  of  the  two  drugs  together  may  be 
of  advantage  in  certain  operations,  such  as  excision  of  the  jaw, 
where  it  is  difficult  to  continue  administering  an  anaesthetic  (p .  208) . 

In  some  cases  opium  will  not  produce  sleep  even  in  large 
doses,  and  it  is  then  advisable  to  combine  it  with  a  small  dose  of 
hydrate  of  chloral.  Sometimes  when  opium  has  been  given  to 
produce  sleep,  and  has  only  caused  excitement,  a  few  whiffs  of 
chloroform  will  quiet  the  excitement,  and  the  patient  sinks  into 
a  quiet  sleep. 

Action  of  the  Alkaloids  of  Opium. — The  action  of  the 
opium  alkaloids  has  not  been  fully  made  out,  and  various  results 
have  been  obtained  by  different  observers.  It  is  certain,  how- 
ever, that  morphine  is  in  mammals  almost  entirely  narcotic, 
whilst  thebaine  is  purely  convulsive.  Between  these  extremes 
the  other  alkaloids  probably  range  themselves  in  such  an  order 
that  they  may  be  divided  into  two  sub-groups,  the  first  of  which 
may  be  called  the  morphine  group,  characterised  by  the  pro- 
minence of  the  narcotic  stage ;  while  in  the  other,  which  may  be 
called  the  codeine  group,  the  tetanic  stage  is  more  prominent, 
and  the  narcotic  less  so.  The  members  of  these  groups  may  be 
arranged  as  follows,  so  that  each  subsequent  member  has  a 
weaker  narcotic,  and  in  the  codeine  group  has  at  the  same  time 
a  stronger  convulsive,  action  : — 

Morphine  Group.  Codeine  Group. 

Morphine.  Papaverine. 

Oxydimorphine.  Codeine. 

Narcotine. 

Thebaine. 

the  appearance  of  the  first  edition  of  this  book  by  the  following  annotation  in  the 
Lancet,  which  seems  to  show  that  emetic  substances  (?  alkaloids)  are  excreted' in 
the  saliva  of  opium-eaters : — An  envelope  received  from  a  person  who  habitually 
took  large  quantities  of  morphine  hypodennically  was  reclosed  by  the  person  who 
opened  it,  by  licking  the  adhesive  surface,  with  the  result  of  making  him  violently 
sick.— Lancet,  May  23,  1885,  p.  959.  ' 


chap,  xxxi.]  THALAMIFL0K2E.  85S 

The  codeine  group  contains  also  hydrocotarnine,  laudanosine, 
and  cryptopine ;  but  at  present  we  know  too  little  about  them  to 
assign  a  place  in  the  group  to  them  with  certainty.  The  same 
may  be  said  of  codethyline.  The  codeine  group  becomes  closely 
allied  by  its  last  members  with  the  strychnine  group. 

By  the  addition  of  alcohol-radicals  to  morphine,  substances 
to  which  the  name  of  codeines  has  been  given  are  produced.  In 
some  of  these,  such  as  codethyline,  C„H18N02(OC2Hr)),  obtained 
from  morphine  by  the  introduction  of  ethyl,  the  narcotic  action  is 
diminished,  whilst,  according  to  Von  Sehroeder,  the  convulsive 
action  is  increased,  in  proportion  to  the  number  of  atoms  of  hy- 
drogen substituted  by  alcohol-radicals.  If  such  be  the  case  it 
is  remarkable  that  by  the  addition  of  alcohol-radicals  to  codeine 
or  thebaine,  their  tetanising  action  should  be  altered  into  a  para- 
lysing action,  methyl-thebaine  producing  paralysis  like  methyl- 
strychnine.1 

In  the  alkaloids  produced  from  morphine  by  oxidation 
(oxydimorphine  and  oxymorphine)  the  narcotic  action  is  dimin- 
ished, without  the  convulsant  action  being  increased.  Narceine 
has  no  apparent  physiological  action.2 

Apomorphine  has  no  narcotic  action,  but  is  an  emetic  acting 
on  the  vomiting  centre  in. the  medulla.  In  large  doses  it  does 
not  produce  vomiting,  but  causes  peculiar  manege  movements. 

Morphine  is  said  to  be  less  constipating,  less  diaphoretic, 
and  less  nauseating  than  opium.  Others  affirm  that  opium  is 
less  nauseating.  It  is  also  said  that  opium  quickens  the  pulse 
and  raises  the  temperature  at  first,  and  then  depresses  both, 
while  morphine  depresses  them  both  from  the  first. 

The  activity  of  morphine  appears  to  depend  on  the  presence 
of  hydroxyl  (HO)  in  it.  When  this  is  replaced  by  S04  its  activity 
is  greatly  diminished.3 

Therapeutics. — General  Uses. — The  general  uses  of  opium 
in  disease  are  (1)  to  lessen  pain ;  (2)  to  produce  sleep  ;  (3)  to 
lessen  irritation  in  various  organs. 

Local  Uses.  —Opium  is  a  local  sedative,  and  is  applied  to 
the  skin  and  irritable  surfaces  to  relieve  pain,  thus  :— 

Fomentations  or  liniments  containing  it  are  used  for  in- 
flamed joints,  myalgia,  lumbago,  pleurisy,  peritonitis,  herpes 
zoster,  etc. 

Morphine  dissolved  in  glycerine  and  spread  on  lint  is  used 
to  allay  pain  in  cancer ;  and,  applied  either  by  the  endermic  or 
hypodermic  method,  is  useful  in  neuralgia.  In  many  cases, 
however,  the  injection  of  pure  water  will  relieve  the  pain,  and 
hence  part  of  the  relief  is  probably  due  to  the  local  irritation 
caused  by  the  injection. 

1  Crum-Brown  and  Frase.r.  Trans.  Boy.  Soc.  of  Edinburgh,  vol.  xxv. 

2  Von  Sehroeder,  Archiv  /.  exper.  Path,  und  Pharm.,  vol.  xvii.  p.  96. 
»  Stolnikow,  Ztschr.  f.  Physiol.  Chemie,  viii.  p.  236. 


8G0  VEGETABLE   MATE  EI  A   MEDICA.  [sect.  v. 

Opium  lessens  pain  in  conjunctivitis,  earache,  and  toothache. 
In  conjunctivitis  it  may  be  used  in  the  form  of  liquid  extract 
dropped  into  the  eye ;  and  in  toothache  applied  to  the  cavity  of 
the  tooth  as  laudanum  on  a  pledget  of  cotton  wool.  In  the  latter 
malady  it  is  well  to  add  a  little  sodium  bicarbonate,  to  neutralise, 
the  acid  secretions  in  the  mouth. 

Opium,  used  in  the  form  of  ointment  of  galls  and  opium,  or 
of  opium  or  morphine  suppositories,  relieves  pain  in  the  rectum 
caused  either  by  ulcers,  fissure,  or  haemorrhoids. 

Morphine  subcutaneously  injected  has  been  used  to  produce 
local  anaesthesia,  as  in  evulsion  of  the  toe-nail. 

Digestive  System. — Opium  often  relieves  salivation  when 
due  to  reflex  irritation  in  the  mouth ;  if  this  fails,  belladonna 
may  succeed  (p.  361). 

It  relieves  the  pain  and  vomiting  due  to  irritability  of  the 
stomach,  as  in  cancer  and  ulcer  of  the  stomach,  but  if  they  are 
due  to  simple  neuralgia  of  the  stomach,  small  doses  of  arsenic 
are  preferable. 

In  biliary  colic  opium  or  morphine  is  given  either  by  the 
stomach  or  hypodermically.  It  may  be  used  either  with,  or 
instead  of,  the  inhalation  of  chloroform  (pp.  208  and  209). 

In  diarrhoea  opium  is  often  useful  when  ordinary  astringents 
fail. 

In  dysentery  it  is  generally  combined  with  ipecacuanha. 

In  cholera  opium  is  frequently  given,  but  during  the  cold 
stage  absorption  is  so  slow  that  it  has  very  little  action.  In 
these  cases  patients  have  been  known  to  die  from  opium-poison- 
ing, as  soon  as  partial  recovery  had  taken  place  and  absorption 
was  re-established. 

In  peritonitis  it  is  used  both  internally  and  externally.  It 
should  be  given  freely  in  doses  of  1-2  gr.  every  four  hours  or 
oftener,  and  fomentations  to  the  abdomen  should  be  used  ex- 
ternally. The  action  of  the  opium  in  this  disease  is  twofold, 
and  possibly  threefold: — (i.)  It  stops  the  peristalsis  of  the  bowel, 
(ii.)  It  relieves  pain,  (iii.)  It  has  possibly  an  action  on  the  blood- 
vessels, lessening  congestion  in  the  manner  already  discussed 
(p.  855). 

Very  small  doses  (1  or  even  ^  drop  of  tinctura  opii  in  syrup 
or  peppermint  water)  relieve  certain  forms  of  constipation,  e.g. 
that  caused  reflexly  by  ovarian  irritation.  The  opium  probably 
acts  on  some  reflex  centre  in  the  lumbar  portion  of  the  cord,  and 
the  minute  dose  probably  just  turns  the  reflex  impulse  from  the 
inhibitory  to  the  motor  fibres  of  the  splanchnic  (p.  385).  If 
these  small  doses  are  insufficient,  the  opium  may  be  gradually 
increased  until  it  is  clear  that  it  is  increasing  instead  of  lessening 
the  constipation. 

Respiratory  Tract.—  Opium  will  cut  short  catarrhal  condi- 
tions of  the  respiratory  tract,  and  10  grains  of  Dover's  powder 


chap,  xxxi.]  THALAMIFLOEJE.  8G1 

at  night  are  very  useful  when  a  '  cold '  is  coming  on.  It  is  also 
used  in  phthisis  to  cut  short  an  acute  exacerbation  due  to  taking 
cold  (p.  331). 

It  relieves  cough,  and  is  best  given  in  the  form  of  linctus,  so  as 
to  act  locally  as  well  as  generally  (p.  249  et  seq.).  Applied  locally 
it  is  used  to  relieve  cough  and  pain  on  swallowing  in  tubercular 
disease  of  larynx,  and  a  very  good  method  is  to  mix  £  to  ^  gr.  of 
morphine  with"  1  gr.  of  starch  or  3  grs.  of  subnitrate  of  bismuth, 
and  blow  the  mixture  well  down  into  the  larynx,  the  patient 
taking  a  deep  inspiration  at  the  same  time  (vide  p.  497).  Opium 
is  used  in  asthma  and  bronchitis,  but  one  should  be  careful  of 
its  use  when  the  secretion  from  the  bronchial  mucous  membrane 
is  profuse ;  for  during  sleep,  when  the  respiratory  and  other 
Centres  are  dulled  by  the  opium,  the  fluid  may  increase  to  such 
an  extent  as  to  suffocate  the  patient,  who  is  unable  to  expectorate 
it  on  awaking. 

Circulatory  System. — It  is  useful  in  cardiac  dyspnoea  with 
sleeplessness,  and  in  angina  pectoris  it  sometimes  gives  relief. 

It  is  useful  in  haemorrhages,  especially  those  from  the  uterus. 
It  may  be  combined  with  digitalis  (tincturae  opii  ii^xxx.,  tincturae 
digitalis,  nixxx.). 

Genito-Urinary  Tract. — Opium  is  used  in  diabetes  to  lessen 
the  amount  of  urine  and  of  sugar,  but  codeine  (^-5  grs.  ter  die) 
is  often  used  instead,  the  advantage  it  possesses  being  that  it 
does  not  render  the  patient  so  drowsy.  Opium  allays  irritability 
and  pain,  as  in  renal  colic  or  irritable  bladder. 

Skin. — If  the  skin  is  too  dry,  Dover's  powder  will  cause 
diaphoresis,  and  yet  it  will  check  the  night-sweats  of  phthisis. 

For  the  probable  cause  of  this  peculiar  action  vide  p.  443. 

The  two  most  important  uses  of  opium  and  morphine  are  to 
relieve  pain  and  produce  sleep.  In  their  power  to  relieve  pain 
opium  and  morphine  stand  unrivalled,  for  they  can  be  more 
generally  applied  than  anaesthetics,  such  as  chloroform.  They 
frequently  relieve  pain  even  in  doses  too  small  to  produce  any 
other  marked  effect.  When  the  pain  is  great  large  doses  may 
be  required,  but  even  then  the  other  effects  they  would  usually 
produce  seem  frequently  to  be  counteracted  by  the  pain,  so  that 
they  relieve  it  without  causing  drowsiness  or  stupor.  Opium 
and  morphine  are  employed  in  neuralgias  of  various  kinds,  such 
as  tic,  sciatica,  or  intercostal  neuralgia,  in  dysmenorrhcea  and 
in  cancer.  They  are  used  to  lessen  both  pain  and  inflammation 
in  rheumatism  and  inflammatory  conditions,  such  as  pleurisy, 
pneumonia,  peritonitis,  cystitis.  They  are  used  to  lessen  pain 
and  spasm  in  ordinary  colic,  lead  colic,  and  in  hepatic  and  renal 
colic. 

Nervous  System. — Opium  or  morphine  is  used  to  relieve 
sleeplessness  due  to  almost  any  cause,  but  in _  cases  of  worry  or 
worn-out  conditions  of  the  nervous  system  it  is  better  to  use 


862  VEGETABLE   MATEEIA  MEDICA.  [sect.  v. 

bromide  of  potassium  or  chloral,  as  opium-taking  becomes  a 
habit.     If  these  will  not  act,  it  may  be  necessary  to  use  opium. 

In  fever  and  delirium  10  min.  of  tincture  of  opium  may  be 
given  with  £  gr.  of  tartar  emetic,  and  the  effect  watched. 

In  mania,  delirium  tremens,  and  chorea,  morphine  may  be 
given  subcutaneously,  but  bromide  of  potassium  and  chloral  are 
often  preferable. 

In  intense  melancholia  subcutaneous  injection  of  morphine 
may  be  used,  but  care  must  be  taken  not  to  establish  the  opium 
habit.  Small  doses  of  tincture  of  opium  (5-10  min.)  by  the 
mouth  are  also  very  useful.  Care  should  be  taken  to  disguise 
the  drug  so  that  the  patient  may  not  know  what  he  is  taking, 
and  thus  to  prevent  the  risk  of  his  taking  opium  afterwards  at 
his  own  pleasure.  Morphine  is  sometimes  employed  to  prolong  the 
anaesthesia  of  chloroform,  as  in  excision  of  the  upper  jaw,  where 
it  is  inconvenient  to  continue  the  administration  of  chloroform. 

In  malarial  poisoning  there  appears  to  be  a  hyper-sensibility 
of  the  vaso-motor  centre,  so  that  a  draught  of  cold  air  blowing 
on  the  surface,  slight  gastric  irritation,  or  even  slight  distension 
of  the  bladder,  will  cause  contraction  of  the  cutaneous  vessels, 
and  shivering,  in  one  suffering  from  such  poisoning.  Opium 
appears  to  be  useful  in  such  conditions,  probably  by  lessening 
the  excitability  of  the  vaso-motor  centre. 

Opium-eaters  are  frequently  found  in  the  fen  districts,  and  in 
some  forms  of  ague  in  the  tropics  opium  has  been  of  service 
when  quinine  has  failed,  and  the  two  drugs  combined  have  been 
still  more  serviceable  than  either  alone. 

Contra-indications : — 

(1)  Childhood,  till  the  age  of  5  years.  Either  abstain  totally, 
or  be  most  cautious  in  the  use  of  opium  and  its  preparations,  as 
small  doses  act  with  disproportionate  power. 

(2)  Blocking  of  the  bronchial  tubes  by  excessive  secretion. 

(3)  Congestion  of  the  brain,  with  suffused  eyes  and  contracted 
pupils. 

B.P.    Rhceados  Petala.      Bed  Poppy  Petals. — The  fresh  . 
petals  of  Papaver  Rhoeas.     From  indigenous  plants. 

Characters. — Of  a  scarlet  colour  and  heavy  poppy  odour.     On  drying, 
they  become  dull  in  colour  and  lose  their  odour. 

Composition. — They  contain  a  red  colouring  matter  soluble 
in  water  and  spirit,  but  none  of  the  alkaloids  of  opium.  An 
alkaloid,  rhceadine,  which  they  do  contain  has  no  poisonous 
action. 

Peepaeation. 

B.P.  DOSE. 

Syrupus  Rboeados J  fl.  dr.  or  more. 

Use. — They  have  little  or  no  physiological  action,  and  arc 
only  used  for  colouring. 


chap,  xxxi.]  THALAMIFLOBJE.  863 

_  U.S.P.  Sanguinaria.  Sanguinaria.  Bloodeoox.  —  The 
rhizome  of  Sanguinaria  canadensis,  collected  in  autumn. 

Characters. — About  two  inches  (5  centimetres)  long,  and  two-fifths  of 
an  inch  (10  millimetres)  thick,  horizontal,  cylindrical,  somewhat  branched, 
faintly  annulate,  wrinkled,  reddish-brown ;  fracture  short,  somewhat  waxy, 
whitish,  with  numerous  small  red  resin-cells,  or  of  a  nearly  uniform 
brownish-red  colour ;  bark  thin ;  odour  slight ;  taste  persistently  bitter  and 
acrid. 

Composition. — It  contains  an  alkaloid — sanguinarine. 

Officinal  Pkepaeations. 

U.S. P.  DOSE. 

Acetum  Sanguinarise 15-30  min. 

Extractum  Sanguinarise  Fluidum 1-5  min. 

Tinctura  Sanguinarise 1-3  fl.  dr. 

Action. — Sanguinarine  appears  to  irritate  the  intestinal 
canal,  producing  vomiting  and  diarrhoea.  Small  doses  after 
absorption  stimulate  the  medullary  centres  for  respiration  and 
circulation,  and  motor  centres  in  the  brain  and  spinal  cord. 
They  thus  cause  increased  respiration,  rapid  pulse,  and  increased 
blood-pressure.  Larger  doses  produce  convulsions  which  are 
clonic  in  mammals  and  tetanic  in  frogs.  In  the  latter  they  still 
persist  after  section  of  the  cord.  Large  doses  paralyse  all  these 
centres,  and  cause  death  by  paralysis  of  respiration. 

Uses. — Except  as  a  stimulant  expectorant  in  chronic  bron- 
chitis it  is  rarely  employed. 

U.S.P.  Chelidonium.  Chelidonium.  Celandine. — Cheli- 
donium  majus. 

Characters. — Boot  several-headed,  branching,  red-brown ;  stem  about 
twenty  inches  (50  centimetres)  long,  light  green,  hairy;  leaves  about  six 
inches  (15  centimetres)  long,  petiolate,  the  upper  ones  smaller  and  sessile, 
light  green,  on  the  lower  side  glaucous,  lyrate-pinnatifid,  the  pinnae  ovate- 
oblong,  obtuse,  coarsely  crenate  or  incised,  and  the  terminal  one  often  three- 
lobed;  flowers  in  small,  long-peduncled  umbels  with  two  sepals  and  four 
yellow  petals ;  capsule  linear,  two-valved  and  many-seeded.  The  fresh  plant 
contains  a  saffron-coloured  milk -juice  and  has  an  unpleasant  odour  and  acrid 
taste. 

Dose.— 10  to  30  gr. 

Composition. — It  contains  two  alkaloids — chelidonine  and 
chelerythrine — the  latter  being  supposed  to  be  identical  with 
sanguinarine. 

Action. — Chelerythrine,  however,  as  obtained  from  cheli- 
donium, has  no  tetanising  action,  but  produces  paralysis  and 
loss  of  reflex  action  (Schroff,  jun.).  Chelidonine  has  a  bitter, 
aprid  taste,  but  appears  to  have  little  physiological  action. 

Uses. — Externally  the  fresh  juice  acts  as  a  local  irritant,  and 
is  used  to  destroy  corns  or  warts,  and  to  lessen  itching  in  skin 
diseases.  When  given  internally  in  large  doses  it  excites  violent 
purging.  It  was  formerly  much  used  in  jaundice.  It  appears 
to  act  as  a  bitter  tonic  and  alterative,  and  is  employed  in 
phthisis  and  scrofula. 


864  VEGETABLE  MATEEIA  MEDICA.  [sect,  v. 


CRUCIFERiE. 

B.P.  Sinapis.  Mustard.— Black  mustard  seeds  and  white 
mustard  seeds  powdered  and  mixed. 

Sinapis  Albae  Semina,  B.P. ;  Sinapis  Alba,  U.S. P.  White 
Mustard  Seeds. — The  dried  ripe  seeds  of  Brassica  alba  {Sinapis 
alba,  U.S.P.)     Britain. 

Sinapis   Nigrae   Semina,    B.P. ;   Sinapis    Nigra,  U.S.P. 

Black  Mustard  Seeds. — The  dried  ripe  seeds  of  Brassica  nigra 
(Sinapis  nigra,  U.S.P.) 

The  seeds  of  black  mustard  are  very  small,  round,  and 
brownish-black  outside ;  those  of  the  white  are  larger  and  yellow. 
Both  are  yellow  inside. 

Characters  of  the  Powder. — Greenish-yellow,  of  an  acrid,  pungent 
taste,  scentless  when  dry,  but  exhaling  when  moist  a  pungent,  penetrating, 
peculiar  odour. 

Adulteration. — Starch. 

Test. — A  decoction  cooled  is  not  made  blue  by  tincture  of  iodine. 

Dose. — As  an  emetic,  from  one  teaspoonful  to  a  tablespoonful 
of  mustard  flour,  mixed  with  a  little  water. 

Composition. — The  pungency  of  the  moist  powder  is  due  to 
oil  of  mustard,  but  this  does  not  exist  in  the  seeds  or  fresh 
powder.  Both  black  and  white  mustard  contain  a  crystallisable 
substance,  called  in  the  black  sinigrin,  and  in  the  white  sinalbin, 
and  an  albuminous  body  myrosine.  When  moistened,  both 
sinigrin  and  sinalbin  are  split  up  by  the  myrosine,  which  acts 
as  a  ferment,  and  yield  a  volatile  oil.  This  is  not  quite  the 
same  in  the  two  mustards,  that  from  the  black  being  more 
pungent;  but  the  oil  from  both  possesses  powerful  vesicating 
properties.  The  action  of  myrosine  as  a  ferment  is  destroyed  by 
a  heat  of  60°  C. ;  so  mustard  poultices  should  not  be  made  with 
boiling  water.  Black  mustard  contains  less  myrosine  than  white 
— too  little,  indeed,  to  decompose  the  sinigrin  completely,  so  that 
its  pungency  may  be  increased  by  admixture  with  white  as 
directed  by  the  B.P.,  and  as  found  in  ordinary  table  mustards,. 
Both  mustards  also  contain  a  fixed  oil. 

Preparations. 
B.P.  (of  Mustard).  u.s.p.  (of  Black  Mustard). 

Cataplasma  Sinapis.  Charta  Sinapis. 

Charta  Sinapis.  Oleum  Sinapis  Volatile. 

Oleum  Sinapis. 

Charta  Sinapis,  B.  and  U.S.P.  Mustard  Paper. — Consists  in  the  BP.  of 
mustard  in  powder,  mixed  with  solution  of  gutta-percha,  so  as  to  make  it  stick  to 
the  paper  upon  which  it  is  spread,  and  then  dried.  In  the  U.S.P.  the  fixed  oil  is 
removed  from  the  mustard  by  percolation  with  benzin  before  it  is  spread  on  the 
paper.  It  is  used  as  a  substitute  for  a  mustard  poultice  by  immersing  it  for  a  few 
seconds  in  tepid  water  and  then  applying  it  to  the  skin.  Bigollot's  mustard-leaves 
are  more  frequently  used  than  those  of  the  Pharmacopoeia.     They  cause,  as  a  rule, 


chap,  xxxi.]  THALAMlFLOEJ!,  8G5 

sharper  pain  than  the  ordinary  mustard  poultice,  and  can  rarely  be  borne  as  long. 
They  are,  however,  more  convenient  and  readily  applied,  and  in  oases  of  narcotio 
poisoning  the  sharp  pain  they  cause  renders  them  preferable  to  the  ordinary 
poultice. 

B.P.  Cataplasma  Sinapis.  Mustard  Poultice. — Mix  mustard  (2  J  ounces) 
■with  2  or  3  ounces  of  lukewarm  water ;  mix  the  linseed  meal  with  6  to  8  ounces  of 
boiling  water ;  add  the  former  to  the  latter  and  stir  them  together. 

Oleum  Sinapis,   B.P. ;  Oleum  Sinapis  Volatile,  U.S. P. 

Oil  of  Mustard,  B.P. — The  oil  distilled  with  water  from  the 
seeds  of  black  mustard,  Brassica  nigra,  after  the  expression  of 
the  fixed  oil,  B.P.  A  volatile  oil  obtained  from  black  mustard 
by  maceration  with  water,  and  subsequent  distillation,  U.S.P. 
It  is  sulphocyanide  of  allyl  (C3HSCNS). 

Characters.—  Colourless  or  pale  yellow.  Has  an  intensely  pungent, 
acrid  odour,  and  burning  taste. 

Solubility. — Soluble  in  alcohol  and  ether,,  slightly  in  water. 

Action. — Applied  to  the  skin,  it  produces  almost  instant  vesi- 
cation. 

Preparations. 
B.P.  U.S.P. 

linimentum  Sinapis  Compositum  Linimentum  Sinapis  Compositum 

(vide  p.  516).  (vide  p.  517).    3  parts  of  the  oil 

by  weight  in  100. 

Action. — Locally  applied  to  the  skin  or  mucous  membranes, 
mustard  acts  as  a  stimulant,  causing  warmth,  redness,  pain 
passing  off  if  the  application  is  short,  but  if  the  action  is  pro- 
longed vesication  is  produced.  Externally  applied  for  a  short 
time  in  the  form  of  flying  sinapisms,  it  is  also  a  general  stimu- 
lant, increasing  the  force  of  the  circulation.  Internally,  it  is  a 
prompt  direct  emetic  (a  tablespoonful  of  mustard  in  a  tumbler  of 
hot  water). 

Uses. — -Externally  it  is  used  as  a  counter-irritant  in  myalgia, 
lumbago,  headache,  in  the  form  of  poultice  or  paper  to  the  back 
of  the  neck ;  in  congestion  of  the  brain,  apoplexy,  and  opium- 
poisoning,  in  the  form  of  poultices  or  leaves  to  the  calves  of 
the  legs  and  other  parts,  of  the  body.  It  is  applied  to  the  chest 
in  catarrh,  bronchitis,  congestion  of  the  lung,  and  catarrhal  pneu- 
monia." In  phthisis,  mustard-leaves  applied  to  the  chest  are  use- 
ful to  check  the  spread  of  consolidation  when  the  patient  has 
taken  cold.  It  is  applied  to  the  spine  for  the  relief  of  pains  in 
the  loins,  and  loss  of  power  in  walking  accompanying  spinal 
irritation.  For  this  purpose  a  very  useful  application  is  the 
linimentum  sinapis  compositum  sprinkled  on  some  spongio- 
piline.  Mustard  baths  to  the  feet  are  used  in  amenorrhea 
(p.  453)  and  sleeplessness  (p.  198). 

When  Bigollot's  leaves  are  used,  the  pain  they  cause  in  per- 
sons with  delicate  skins  renders  them  almost  unbearable,  and 
in  such  cases  two  or  three  layers  of  damped  muslin  should  be 
placed  next  to  the  skin,  to  modify  their  action. 

3  u 


8G6  VEGETABLE   MATEEIA  MED1CA.      "      [sect.  v. 

With  the  leaves  of  the  B.P.  it  is  advisable  to  use  one  layer  of 
muslin  to  prevent  the  mustard  coming  off  the  leaf  and  sticking 
to  the  skin. 

Internally,  mustard  is  used  as  a  condiment,  to  increase  the 
appetite  by  stimulating  the  mucous  membrane.  One  important 
use  is  that  of  an  emetic  in  indigestion  of  narcotic  poisoning 
(p.  864).  In  irritant  poisoning — e.g.  by  croton  oil — it  is  best 
given  in  linseed  tea  or  thin  gruel. 

B.P.  Armoracia;  Radix.  Not  in  U.S.P.  Horse-radish 
root. — The  fresh  root  of  Cochlearia  Armoracia,  cultivated  in 
Britain,  and  most  active  in  the  autumn  or  early  spring  before 
the  leaves  have  appeared.' 


Fig.  180. — Horse-radish  root,  reduced  to  J  the  size. 

Chaeactees. — A  long,  cylindrical  fleshy  root,  internally  white.  It  has  a 
pungent  taste  and  smell.  Aconite  root,  which  has  heen  mistaken  for  it,  is 
short  and  conical,  and  has  a  numbing  instead  of  a  pungent  taste. 

Composition. — A  volatile  oil  identical   with  that   of  black, 
mustard  is  developed  in  it  after  it  has  been  cut. 

Preparation. 

B.P.  DOSE. 

Spiritus  Armoraclse  Compositus 1-2  fl.  dr. 

B.P.  Spiritus  Armoraclae  Compositus.  Compound  Spirit  of  Horse- 
radish.— Sliced  horse-radish,  dried  orange-peel,  and  bruised  nutmeg  are  mixed  with 
diluted  proof-spirit  and  distilled. 

Action  and  Uses. — Horse-radish  is  chiefly  used  as  a  condi- 
ment in  cases  of  deficient  digestion;  also  as  a  masticatory  in 
hoarseness.  It  is  sometimes  used  in  atonic  dyspepsia,  and  as  a 
diuretic  in  dropsies.     The  spirit  is  used  as  a  pleasant  vehicle. 


VIOLARIEiE. 

U.S.P.  Viola  Tricolor.  Viola  Tricolor.  Pansy. — The 
wild-grown,  flowering  herb  of  Viola  tricolor. 

Chaeactees. — Stem  angular  and  nearly  smooth ;  leaves  alternate,  petio- 
late,  ovate  or  oblong,  crenate,  with  leaf-like,  pinnatifid  stipules ;  flowers  with 
an  obtuse  spur,  and  the  variegated  petals  shorter  or  longer  than  the  calyx ; 
inodorous ;  taste  somewhat  bitter  and  acrid. 

Dose. — 15  to  75  gr.  (1-5  gm.)  in  decoction. 

Composition  and  Action. — It  contains  a  little  violine,  a  sub- 
stance similar  to  emetine,  and  having  an  emeto-cathartic  action. 

Uses. — It  is  used  externally  in  the  form  of  an  ointment  or  a 
poultice  in  eczema  and  impetigo.  It  is  sometimes  given  internally 
in  bronchitis. 


chap,  xxxi.j  THALAMIFL0EJ1.  867 


CANELLACE.E. 

B.P.  Canella  Cortex.  Canella  Bakk.— The  bark  of  the 
Canella  alba  deprived  of  its  corky  layer  and  dried.  South  Florida 
and  the  West  Indies. 

Characters. — Large  quills  or  flatfish  pieces  about  1  inch  broad ;  buff- 
coloured  externally ;  whitish  internally.  Taste  bitter,  pungent,  acrid ;  odour 
like  a  mixture  of  cloves  and  cinnamon. 

Composition. — A  volatile  oil  (about  1  per  cent.)  consisting  of 
several  oils,  of  which  one  is  identical  with  eugenic  acid,  from  oil 
of  cloves ;  a  bitter  principle,  canellin,  together  with  resin,  starch, 
and  mannite.     There  is  no  tannin. 

Dose. — Of  the  powdered  bark,  15-30  grs. 

Pkeeakation. 

B.P. 

It  is  used  in  Vinum  Bhei  (60  grs.  to  1  pint). 

Action  and  Use.— It  is  an  aromatic  bitter  and  tonic.  Given 
sometimes  in  atonic  dyspepsia.  It  has  been  employed  in  rheu- 
matism and  gout. 

POLYGALACEiE. 

Senegae  Radix,  B.P. ;  Senega,  U.S. P.  Senega  Boot. — 
The  dried  root  of  .Polygala  Senega.     North  America. 


Fig.  181. — Senega,  half  the  natural  size. 

Characters. — A  knobby  rootstock  with    spreading,    tortuous  rootlets, 
twisted  and  keeled. 

Adulterations. — Ginseng  and  other  roots,  detected  by  absence  of  keel. 

Composition. — The  active  principle  which  is  contained  in  the 
cortex  is  called  senegin  or  polygalic  acid.  It  appears  to  be  iden- 
tical with  saponin  obtained  from  Saponari'a  officinalis  and  Quillaia 
Saponaria  (p.  918),  which  is  a  glucoside  splitting  up  when  boiled 
into  grape-sugar  and  sapogenin.  It  is  a  white  powder,  easily 
soluble  in  hot  water  and  alcohol,  forming  a  soapy  emulsion  when 
mixed  with  boiling  water  even  in  small  quantities. 

Pkepakations. 

B.P.  DOSE. 

Infusum  Senegae  (1  in  20  for  half-an-hour) 1-2  fl.  oz. 

Tlnctura  Senegeo .--2  fl.  dr. 

3x2 


868  VEGETABLE  MATEEIA  MEDICA.  [sect.  v. 


Preparations — continued,. 

U.S.P.  DOSE. 

Abstraotum  Senegse 5-10  gr.  (0-3-0-6  gm.) 

Abstractum  Senega  Fluidum... 10-20  min.  (0-6-1-25  c.o.) 

Syrupus  Seneg£e  1-2  fl.  dr.  (3-75-7-5  c.e.) 

Syrupus  Scillse  Compositus  ....For  children  10  min.  to  1  fl.  dr.  (0-6-3-75  c.e.) 
Expectorant  for  adults  20-30  min.  (1-25-1-9  c.o.) 

Action  and  Use. — It  is  employed  as  a  stimulating  expecto- 
rant, diuretic,  and  diaphoretic.  The  indications  for  its  adminis- 
tration as  an  expectorant  are  when  the  power  to  expectorate  is 
small,  but  the  quantity  of  expectoration  is  abnormally  large,  and 
it  is  more  or  less  purulent  in  character,  as  in  the  second  stage  of 
acute  bronchial  catarrh,  or  pneumonia  in  the  stage  of  resolution. 
When  the  expectoration  is  tough  and  scanty,  senega  is  of  little 
use. 

It  is  also  used  in  chronic  pneumonia,  and  chronic  bronchitis, 
and  in  dropsy  dependent  on  renal  disease.  It  is  usually  combined 
with  other  expectorants  and  diuretics.  Its  taste  is  to  many  very 
disagreeable,  but  spirit  of  chloroform  both  makes  it  more  agree- 
ahle  and  tends  -to  lessen  cough.  It  has  been  recommended  in! 
palpitation  due  to  aortic  disease  (pp.  316  and  317),  and  also  in 
amenorrhoea.     {Vide  also  p.  919.) 

Sub-Order.— KRAMERIA. 

Krameriae  Radix,  B.P.;  Krameria,  U.S.P.  Ehatany  Eoot. 
The  dried  root  of  (1)  Peruvian  Ehatany,  Krameria  triandra,  or 
of  (2)  Savanilla  Ehatany,  Krameria  Ixina  {Krameria  tomentosa). 

Characters. — Peruvian  rhatany  is  about  an  inch  thick,  knotty  above,  un- 
branched  or  branched  below;  the  branches  are  long,  often  broken  or  torn, 
reddish-brown  and  rough  externally,  reddish-yellow  internally,  with  a  readily 
separated  bark. 

The  root  of  Krameria,  tomentosa  (Savanilla  Ehatany)  is  less  knotty  and 
more  slender,  and  has  dark  purplish-brown,  firmly  adherent  bark. 

The  bark  of  both  kinds  -is  strongly  astringent,  and  when  chewed  tinges 
the  saliva  red,  but  has  no  marked  odour. 

Composition. — The  bark  contains  about  20  per  cent,  of  a  kind 
of  tannin  called  ratanhia-tannic  acid,  a  red  matter,  ratanhia- 
red,  and  a  neutral  substance,  ratanhin. 

Preparations. 

B.P.  DOSE. 

Extractum  Krameriae 5-20  gr. 

Xnfusum  „  (1  oz.  to  1  pint) 1-2  fl.  oz. 

Pulvis  Catechu  Compositus 20-40  gr. 

Tinctura  Krameriae j-2  fl.  dr. 

U.S.P. 

Extractum  Kramerise 5-20  grs.  (0-3-1-3  gm.) 

„  „        Fluidum.....' 5  min.-l  fl.  dr.  (0-3-3-75  c.e.) 

Syrupus  1  fl.  oz.  (30  c.e.) 

Tinctura  |-2  fl.  dr.  (1-9-7-5  c.e.) 

Trochisei  ad  lib. 


.  chap,  xxxi.]  THALAMIFLOK^E.  8G9 

Action.— It  is  strongly  astringent. 

Uses. — The  powder  is  used  as  a  dentifrice  when  the  gums 
are  spongy  and  bleed  easily.  The  infusion  or  tincture  is  em- 
ployed in  bleeding  from  the  nose,  mercurial  affections  of  the 
mouth,  relaxed  sore-throat,  leucorrhcea,  prolapsus  ani.  In- 
ternally it  is  given  in  diarrhoea,  and  haemorrhage  from  the 
kidneys  or  genito-urinary  passages. 

GUTTIFER^. 

Cambogia,  B.  and  U.S.P.  Gamboge. — A  gum  resin  obtained 
from  Garcinia  Hanburii  (Garcinia  Morella,  var.  pedicellata).  Im- 
ported from  Siam. 

Characters. — In  cylindrical  pieces,  sometimes  hollow  in  the  centre,  1  or 
2  inches  in  diameter,  breaking  easily  with  a  smooth  conchoidal  glistening 
fracture ;  colour  tawny,  changing  to  yellow  when  it  is  rubbed  with  water ; 
taste  acrid ;  powder,  bright  yellow. 

Pbopekties  and  Composition. — Contains  a  resin,  gambogic 
acid,  and  a  soluble  gum,  so  that  it  forms  an  emulsion  with 
water. 

Adulteration. — Starch  fraudulently  added. 

Test. — An  emulsion  made  with  boiling  water,  and  cooled,  does  not  become 
green  with  the  solution  of  iodine. 

Dose. — 1-4  grs. 

Preparation. 
b.P.  Dogtel 

Pilula  Cambogise  Composita  (vide  p.  522) 5-10  gr. 

U.S.P. 

Pilula  Catharticse  Composite  (vide  p.  523) 1-3  pills. 

Action  and  Use. — It  is  a  drastic  hydragogue  purgative,  and 
in  large  doses  causes  violent  irritation  of  the  alimentary  canal, 
with  vomiting  and  griping.  It  is  used  in  combination  with  other 
purgatives  as  a  derivative  in  cerebral  affections,  also  with  cream 
of  tartar  in  dropsies.    It  has  been  used  as  an  anthelmintic. 

TERNSTROMIACEiE. 

Thea.  Tea.  Not  officinal. — The  dried  leaves  of  Thea  sinensis. 
China,  Assam,  Ceylon,  &c. 

Characters. — Both  green  and  black  tea  are  prepared  from  the  same 
species  of  thea.  Green  teas  are  obtained  by  drying  the  freshly-gathered 
leaves  on  a  hot  iron  plate  until  they  shrivel.  Black  teas  are  obtained  by 
allowing  the  leaves  to  lie  in  heaps  and  undergo  a  kind  of  fermentation  before 
drying  them. 

Composition. — They  contain  theine,  a  volatile  oil,  and 
tannin. 

Action. — The  action  probably  depends  partly  on  the  theine 
and  partly  on  the  volatile  oil  they,  contain.    Both  green  and 


870  VEGETABLE   MATEEIA  MEDICA.  [sect.  v. 

black  teas  are  powerful  cerebral  stimulants.  They  render  the 
mental  faculties  more  active  and  tend  to  prevent  sleep.  Green 
tea  is  much  more  powerful  than  black,  and  its  admixture  with 
black  is  sometimes  the  cause  of  sleeplessness  in  persons  who 
have  thus  taken  it  unconsciously.  In  some  persons  it  produces 
giddiness,  restlessness,  and  such  severe  muscular  trembling  that 
the  hand  shakes  violently.  A  quantity  of  tea  eaten  by  a  horse 
caused  great  excitement,  and  probably  anaesthesia,  as  the  animal 
killed  itself  by  dashing  its  head  against  a  stone.  Both  green  and 
black  teas  are  apt  to  cause  indigestion.  This  is  probably  due, 
in  some  measure  at  least,  to  the  tannin  they  contain.  Tea  mixed 
with  gastric  juice  lessens  its  power  of  digesting  fresh  meat,  but 
not  of  digesting  smoked  meat.  This  is  probably  due  to  the 
tannin  hardening  the  soft  fibre  of  fresh  meat,  but  leaving  the 
comparatively  hard  fibre  of  dried  meat,  ham,  &c.  unchanged. 
To  avoid  getting  much  tannin  it  is  advisable  not  to  let  the  tea 
stand  long  on  the  leaves,  but  pour  it  off  quickly,  so  that  the 
volatile  oil  which  gives  the  aroma  only  is  extracted. 

Use. — As  a  cerebral  stimulaki  to  relieve  drowsiness  and 
headache. 

Caffeina,  B.  and  U.S.P-  Caffeine  (Theine  (?),  Gtjabanine). 
C8H,0N4O2.H2O;  112. 

An  alkaloid  (B.P.),  or  proximate  principle  of  feeble  alkaloidal 
power  (U.S. P.),  generally  prepared  from  the  dried  leaves  of 
Camellia  Thea,  or  from  the  dried  seeds  of  Coffea  arabica  (Nat. 
Ord.,  Rubiacecs) ;  or  from  the  Guar  ana,  and  occurring  also  in 
other  plants. 

Characters. — Colourless,  silky,  inodorous,  acicular  crystals. 

Preparation. — By  evaporating  aqueous  infusions  from  which  astringent 
and  colouring  matters  have  been  removed. 

Solubility. — Soluble  in  80  parts  of  cold  water,  the  solution  having  a 
faintly  bitter  taste  and  being  neutral  to  litmus.  More  soluble  in  boiling 
water  and  in  rectified  spirit,  and  very  soluble  in  chloroform;  sparingly 
soluble  in  ether. 

Reactions. — Above  212°  F.  they  melt  and  volatilise  without  decomposition. 
Treated  with  a  crystal  of  chlorate  of  potassium  and  a  few  drops  of  hydro- 
chloric acid,  and  the  mixture  evaporated  to  dryness  in  a  porcelain  dish,  a 
reddish  residue  results,  which  becomes  purple  when  moistened  with  ammonia. 
In  an  aqueous  solution  of  the  alkaloid,  tannic  acid  gives  a  white  precipitate, 
soluble  in  excess  of  the  reagent. 

Dose. — 1  to  5  grains. 

Pbeparation. 

B.P.  _  DOSE. 

Caffeinse  Cltras ,2-10  grains. 

B.P.  Caffeinae  Citras.  Citrate  of  Caffeine. — C8H10N4O2, 
H3C6H607.    A  weak  compound  of  caffeine  and  citric  acid. 

Characters. — A  white  inodorous  powder  with  an  acid  and  faintly  bitter 
taste  and  an  acid  reaction  on  litmus. 

Preparation. — Dissolve  citric  acid  (1)  in  hot  water  (2),  add  caffeine  (1), 
evaporate  to  dryness,  and  reduce  to  a  fine  powder. 


chap,  xsxi.]  THALAMIFLOft^E.  871 

Solubility. — It  is  soluble  in  a  mixture  of  two  parts  of  chloroform  and 
one  part  of  rectified  spirit. 

Keactions. — With  a  little  water  it  forms  a  clear  syrupy  solution,  which 
on  dilution  yields  a  white  precipitate  of  caffeine  that  redissolves  when  ten 
parts  of  water  have  been  added. 

Dose.— 1  to  5  grains.  Caffeine  is  very  soluble  in  solutions 
of  benzoate,  cinnaniate,  or  salicylate  of  sodium.  By  using  these 
as  solvents  concentrated  solutions  of  caffeine  can  be  made  for 
hypodermic  injection.  Caffeine  20  gr.,  salicylate  of  sodium  17£ 
gr.,  water  1  fl.  dr.  makes  a  non-irritating  •solution  containing 
1  gr.  of  caffeine  in  3  min.,  but  stronger  solutions  may  be  made 
if  required. 

Action. — Caffeine  causes  at  first  stimulation  and  subsequently 
paralysis  of  nerve-centres  in  the  cerebrum,  cord,  and  medulla. 
It  has  also  a  marked  action  on  muscular  fibre,  both  voluntary 
and  involuntary.  In  large  doses  it  acts  as  a  gastro-intestinal 
irritant.  Its  action  on  frogs  varies  according  to  the  species. 
In  rana  temporaria  it  produces  a  rigid  condition  of  the  muscles 
resembling  rigor  mortis,  especially  when  locally  applied  to  them. 
In  rafia  esculenta  this  action  on  the  muscles  is  slight,  and  the 
chief  symptom  is  tetanus,  which,  like  that  of  strychnine,  depends 
on  the  action  of  the  drug  on  the  spinal  cord.  This  is  followed 
by  paralysis  (of  voluntary  movement)  and  then  of  reflex  action. 
The  action  of  theine  is  said  by  Mays  to  differ  from  that  of 
caffeine ;  it  affects  in  the  frog  chiefly  sensation,  which  it  para- 
lyses, and  causes  tetanus,  while  caffeine  does  not.1  In  warm- 
blooded animals  also  caffeine(?  theine)  produces  tetanic  con- 
vulsions, which  may  be  arrested  by  artificial  respiration,  and 
death  frequently  prevented  even  from  a  very  large  dose.  Mor- 
phine lessens  the  convulsions  but  does  not  prevent  death. 

From  its  stimulant  action  on  the  brain,  doses  of  2-8  grains 
sometimes  cause  heaviness  of  the  head,  flashes  of  light  before 
the  eyes,  singing  in  the  ears,  loss  of  sleep,  great  restlessness, 
and  delirium. 

Its  stimulant  action  on  the  medulla  and  cardiac  centres 
increases  the  respiration  and  pulse-rate  and  raises  the  blood- 
pressure  in  moderate  doses.  Large  doses  depress  the  respira- 
tion and  pulse,  and  lower  the  blood-pressure.  In  man  the 
pulse,  after  somewhat  large  doses,  becomes  very  frequent,  ir- 
regular, and  intermittent.  This  effect  occurs  in  some  persons 
even  after  a  single  cup  of  coffee,  but  it  is  prevented  in  such 
cases  by  adding  a  little  brandy  to  the  coffee,  as  is  usually  done 
when  coffee  is  taken  without  milk. 

It  appears  sometimes  to  increase  the  salivary  secretion.  It 
has  little  action  on  the  peristaltic  movements  of  the  intestine, 

1  Mays,  Therapeutic  Gazette,  1886,  p.  587.  Mays  states  that,  commercially, 
theine  and  caffeine  are  considered  identical,  so  that  a  specimen  of  so-called  '  caf- 
feine '  may  really  be  theine,  or  a  mixture  of  the  two  alkaloids  (op.  cit.). 


872  VEGETABLE  MATERIA  MEDICA.  [sect.  v. 

but  it  causes  the  intestinal  veins  to  become  much  dilated,  and 
appears  to  cause  haemorrhoids. 

The  temperature  is  not  altered  by  small  doses  of  caffeine, 
but  is  increased  by  large  doses. 

Caffeine  acts  as  a  diuretic,  though  not  invariably  so.  Its 
diuretic  action  may  partly  depend  upon  its  stimulant  action  on 
the  heart  and  vaso-motor  centre,  and  consequent  rise  of  blood- 
pressure,  but  the  contraction  of  vessels  may  be  so  great  that  no 
diuresis  takes  place  till  the  renal  nerves  are  divided  (p.  432) . 
This  diuretic  action  is  also  due  in  part  to  a  stimulant  action  on 
the  cells  of  the  urinary  tubules,  as  Brackenridge,  Schroder,  and 
others  have  shown  that  it  increases  the  excretion  of  urinary  solids 
as  well  as  the  amount  of  water. 

Uses. — It  is  used  in  headache,  especially  migraine  and  in 
cases  where  the  headache  seems  to  be  inside  the  head  without 
any  external  tenderness.  As  a  diuretic  it  is  especially  useful  in 
cardiac  dropsy,  though  it  may  be  given  also  in  cases  of  hepatic 
dropsy.  It  acts  as  a  diuretic  even  when  the  kidneys  are  diseased, 
and  is  useful  even  in  very  advanced  cardiac  cases.  It  is  best 
given  alternately  with  digitalis  or  along  with  it. 

MALVACE^. 

U.S.  P.  Gossypii  Radicis  Cortex.  Cotton  Eoot  Bake. — 
The  bark  of  the  root  Gossypium  herbaceum  and  of  other  species 
of  gossypium. 

Characters. — Thin  flexible  bands  or  quills,  brownish-yellow  outside, 
whitish  and  silky  inside,  no  smell,  taste  faintly  acrid  and  astringent. 

Composition. — It  contains  a  colourless  acid  resin  becoming 
red  on  exposure. 

Preparation,  dose. 

Extractum  Gossypii  Badicis  Fluidum J-l  fl.  dr.  (1-9-3-75  c.e.) 

Action  and  Uses. — It  is  said  to  cause  contraction  of  the 
uterus,  and  is  used  instead  of  ergot.  It  may  be  given  either  as 
the  officinal  fluid  extract  or  as  a  decoction  made  by  boiling  4  oz. 
of  the  bark  in  a  quart  of  water  down  to  a  pint.  Of  this  a  wine- 
glassful  (60  c.c.)  is  given  every  20  or  30  minutes. 

U.S.  P.  Oleum  Gossypii  Seminis.  Cotton  Seed  Oil. — A 
fixed  oil,  expressed  from  the  seed  of  Gossypium  herbaceum  and  of 
other  species  of  gossypium,  and  subsequently  purified. 

Characters. — A  bright,  pale  yellow,  oily  liquid,  odourless,  having  a  bland 
nut-like  taste  and  a  neutral  reaction.     Sp.  gr.  0-920  to  0-930. 

Solubility. — It  is  only  slightly  soluble  in  alcohol,  but  readily  bo  in 
ether. 

Beactions.— When  cooled  to  near  2°C.  (35-6°  IT .)  it  begins  to  congeal. 
Concentrated  sulphuric  acid  instantly  renders  it  dark  reddish-brown. 

Uses. — It  is  a  bland  oil  very  much  like  olive  oil,  and  answers 
perfectly  well  most  purposes  for  which  olive  oil  is  generally  used 


chap,  xxsi.]  THALAMIFLOEiE.  873 

except  for  making  lead  plaster.  A  great  deal  of  the  oil  exported 
from  France  and  Italy  under  the  name  of  olive  oil  is  really  cotton- 
seed oil,  either  alone  or  mixed  with  a  proportion  of  olive  oil. 
Eighty-eight  per  cent,  of  the  cotton-seed  oil  exported  from  New 
Orleans  in  1880  was  sent  to  the  Mediterranean. 

Officinal  Preparations. 

U.S.P. 

Linimentum  Ammonias  (p.  517). 
„  Calois  (p.  517). 

„  Camphorffi  (p.  517). 

„  Plumbi  Subacetatis  (p.  517). 

Gossypium,  B.  and  U.S.  P.  Cotton.  Cotton-Wool.  (Puri- 
fied Cotton.  Absorbent  Cotton.) — The  hairs  of  the  seed  of  Gos- 
sypium barbadense  (G.  herbaceum,  U.S. P.)  and  other  species, 
freed  from  adhering  impurities  and  deprived  of  fatty  matter. 

Preparation. — It  is  made  by  boiling  the  raw  cotton  in  a  dilute  alkaline 
solution,  such  as  a  5  per  cent,  solution  of  caustic  potash  or  soda.  The  alkali 
unites  with  the  fatty  matter  of  the  cotton  to  form  a  soap,  which  is  removed 
by  repeated  washings,  in  the  course  of  which  chlorinated  lime  and  dilute 
hydrochloric  acid  are  used  as  well  as  water. 

Characters. — In  white  soft  filaments,  each  consisting  of  an  elongated 
tubular  cell,  and  when  examined  under  the  microscope  appearing  as  a 
flattened  twisted  band  with  slightly  thickened  rounded  edges ;  inodorous 
.and  tasteless. 

Test. — When  thrown  upon  water  it  should  immediately  absorb  the  latter 
and  sink,  and  the  water  should  not  acquire  either  an  acid  (no  hydrochloric 
acid)  or  alkaline  reaction. 

Pbeparations. 

B.P.  U.S.P. 

Pyroxylin  (Gun  Cotton).  Pyroxylinum  (Gun  Cotton). 

Uses. — Cotton  wool  is  employed  as  a  local  application  to  the 
skin  in  cases  of  burns  and  erysipelas,  to  exclude  external  irrita- 
tion and  protect  the  part  from  cold.  Cotton  wool  is  also  used 
-to  surround  gouty  or  rheumatic  joints* 

A  pledget  of  cotton  wool  placed  in  the  ears  tends  to  prevent 
sore-throat.  The  explanation  of  this  seems  to  be  that  catarrh 
may  result  reflexly  from  irritation  of  the  auricular  branch  of  the 
vagus.     (Cf.  Eossbach's  experiments,  p.  252.) 

When  subjected  to  heat,  so  as  to  destroy  any  adherent  germs, 
it  is  used  in  cultivation  experiments  on  bacteria  (p.  90)  to  plug 
the  orifice  of  the  test-tubes  and  prevent  the  accidental  entrance 
of  germs.  With  a  somewhat  similar  object  it  has  been  used  as  a 
dressing  to  wounds,  from  which  it  excludes  the  germs  which  might 
cause  pyaemia,  erysipelas,  &c.  It  may  be  impregnated  with 
various  antiseptics  and  deodorising  substances,  such  as  iodine, 
picric  acid,  salicylic  acid,  iodoform,  or  benzoic  acid.  Some  of 
these  form  useful  applications  to  the  os  uteri,  to  destroy  foetor 
and  induce  healthy  action.  The  dressing  of  wounds  after  opera- 
tion by  salicylic  acid  or  iodoform  wool  has  almost  completely 
euperseded  the  Listerian  gauze  dressing  (p.  816).. 


874  VEGETABLE   MATEEIA  MEDICA.  [sect.  v. 

Pyroxylin,  B.P. ;  Pyroxylinum,  U.S.P.  Gun  Cotton.— 
Prepared  by  the  action  of  sulphuric  and  nitric  acids  on  cotton. 

Test. — Readily  soluble  in  a  mixture  of  ether  and  rectified  spirit :  leaves 
no  residue  when  exploded  by  heat. 

Use. — To  prepare  collodium  (collodion),  B.  and  U.S.P. 

Collodium.  B.  and  U.S.P.  Collodion.  A  solution  of 
pyroxylin  in  ether  and  alcohol. 

Characters.  —  A  colourless,  highly  inflammable  liquid  with  ethereal 
odour,  which  dries  rapidly  on  exposure  to  the  air,  and  leaves  a  thin  trans- 
parent film,  insoluble  in  water  or  rectified  spirit.  The  great  inflammability 
of  its  vapour  must  be  carefully  remembered.  After  successfully  completing 
the  operation  of  ovariotomy,  a  surgeon  covered  the  wound  with  a  layer  of 
collodion.  In  order  to  inspect  it  more  closely  he  brought  a  light  near,  when 
the  ethereal  vapour  caught  fire,  and  the  patient  died  from  the  effects  of  the 
burns  which  she  received  (Binz). 

Preparations. 

B.P.  U.S.P. 

Collodium  Flexile  Collodium  cum  Cantharide. 

„  Veslcans.  „        Flexile. 

„         Stypticum. 

B.  and  U.S.P.  Collodium  Flexile.  Flexible  Collodion. 
Collodion  mixed  with  Canada  balsam  and  castor  oil. 

Uses. — Collodion  applied  to  the  skin  acts  both  as  a  protective, 
and  also,  through  its  contraction,  exerts  a  gentle  pressure  on  the 
part,  and  is  hence  applied  to  cut  surfaces,  chapped  nipples,  and 
to  check  haemorrhage  from  leech- bites.  The  flexible  collodion 
does  not  crack,  and  therefore  is  more  useful  as  a  protective,  but 
it  exerts  less  pressure  than  ordinary  collodion. 

B.P.  Collodium  Vesicans.  Canthaeidal  Collodion  (blister- 
ing liquid  20,  pyroxylin  1) . 

U.S.P-  Collodium  cum  Cantharide.  Canthaeidal  Col- 
lodion. 

Preparation. — By  dissolving  a  chloroform  extract  of  cantharides  in 
flexible  collodion. 

Action. — When  painted  on  the  skin  it  acts  as  a  rapid  and 
powerful  vesicant.  If  covered  immediately  with  oiled  silk,  so  as 
to  prevent  the  evaporation  of  the  ether,  it  is  said  to  act  more 
rapidly. 

Uses. — Vide  Cantharides. 

U.S.P.     Collodium  Stypticum.     Styptic  Collodion. 
Preparation. — By  dissolving  tannin  in  a  mixture  of  alcohol,  ether,  and 
collodion  (20  parts  tannin  in  100). 

Uses. — To  stop  bleeding  from  leech-bites,  abrasions,  and 
wounds.  When  painted  over  the  bleeding .  surface  the  tannin 
coagulates  the  blood  and  lymph ;  and  this,  with  the  collodion, 
forms  a  film  over  the  surface  which  prevents  further  bleeding  and 


chap,  xxxi.]  THALAMIFL0EJ1.  875 

protects  the  raw  surface  from  exposure  to  air  or  from  accidental 
irritation. 

U.S. P.  Althaea.  Altsea.  [Mabshmallow.J — The  root  of 
Althaea  officinalis. 

Characters. — In  cylindrical  or  somewhat  conical  pieces,  from  three  to 
six  inches  (7  to  15  centimetres)  long,  about  half  an  inch  (12  millimetres)  in 
diameter,  deeply  wrinkled ;  deprived  of  the  brown,  corky  layer  and  small 
radicles ;  externally  white,  marked  with  a  number  of  circular  spots,  and  of  a 
somewhat  hairy  appearance  from  the  loosened  bast-fibres ;  internally  whitish 
and  fleshy.  It  breaks  with  a  short,  granular  and  mealy  fracture,  has  a  faint 
aromatic  odour,  and  a  sweetish,  mucilaginous  taste. 

Pheparation. 

dose. 
Syrupus  Althaeas   1_4  fl.  dr. 

Composition. — It  contains  some  35  per  cent,  each  of  vege- 
table mucin  and  starch. 

Uses. — It  is  bland  and  unirritating,  and  a  useful  demulcent 
in  sore-throat,  coughs,  or  intestinal  irritation.  An  ointment 
made  by  boiling  the  cut  fresh  leaves  with  lard  for  half  an  hour, 
and  then  straining,  has  proved  successful  in  palmar  psoriasis 
after  other  means  failed.1 

STERCULIACEiE,  or  BYTTNERIACE^. 

Oleum  Theobromatis,  B.P. ;  Oleum  Theobromae,  U.S.  P. 

Oil  op  Thbobroma  ;  Cacao  Butter. — A  concrete  oil  obtained 
by  expression  and  heat  from  the  ground  seeds  of  Theobroma 
Cacao. 

Composition. — Consists  chiefly  of  stearin  and  olein. 

Characters. — Of  the  consistency  of  tallow ;  colour  yellowish- white ; 
odour  like  chocolate ;  taste  bland  and  agreeable ;  reaction  neutral.  Does 
not  become  rancid  from  exposure  to  the  air.  Melts  at  30°-35°  C.  (86°- 
95°  F.). 

Adulterations. — Paraffin,  wax,  tallow,  stearin,  &c. 

Tests. — If  2  parts  of  it  be  dissolved  in  4  parts  of  ether  in  a  test-tube,  by 
immersing  the  tube  in  water  at  17°  C.  (63°  F.),  and  if  this  be  afterwards 
plunged  into  water  at  0°  C.  (32°  F.),  the  mixture  should  not  become  turbid, 
nor  separate  a  granular  deposit  in  less  than  3  minutes ;  and  if  the  mixture, 
after  congealing,  be  exposed  to  a  temperature  of  15°  C.  (59°  F.),  it  should 
gradually  become  entirely  clear.     (Absence  of  impurities  mentioned  above.) 

Preparations. 
b.p,  tr.s.p. 

Suppositoria  Acidi  Tannici.  For  suppositories  of  various  kinds, 

„         Hydrargyri.  each  weighing  15  gr.  or  1  gm. 

„  Iodoform!. 

„         Morphins. 
„         Plumbi  Composita. 

Uses. — As  a  basis  for  suppositories.  Also  as  a  non-irritant 
application  to  the  skin. 

1  Berry,  Practitioner,  vol.  xxxi.,  p.  346. 


876  VEGETABLE   MATEEIA  MEDICA.  [sect.  v. 


OHAPTEE  XXXII. 

PHANEKOGAM  M  -{continued). 

Class  I.— DICOTYLEDONES  POLYPETALjE. 

Sub-Class  II.  —  DISCLFLOBjE. 

LINEiE. 

Lini  Semina,  B.P. ;  Linum,  U.S. P.  Linseed,  B.  and  TJ.S.P. 
Flax  Seed,  U.S. P. — The  dried  ripe  seeds  of  Linum  usitatissimum. 
It  is  grown  in  Britain. 

Characters. — About  one-sixth  of  an  inch  long,  oval,  pointed,  flattened, 
smooth,  shining,  brown  externally,  yellowish- white  within. 

Composition.  —  The  covering  of  the  seeds  contains  much 
mucilage,  and  the  seed  itself  contains  nearly  one-third  of  its 
•weight  of  oil.  The  oil  is  obtained  by  expression,  and  the  re- 
maining cake  when  powdered  forms  linseed-meal. 

Preparations. 
b.p.  dose.  u.s.?. 

Farina  liint  Oleum  Lini. 

Infusum  „      ad  lib. 

Oleum       ,.      

B.P.  Infusum  liini.  Linseed  Tea. — Infuse  150  grains  of  linseed,  with  50 
grains  of  dried  liquorice-root  in  No.  20  powder,  in  10  ounces  of  boiling  water  in  a 
covered  vessel  for  2  hours  and  strain. 

Action  and  Uses. — Linseed  tea  is  a  most  useful  demulcent  in 
coughs  depending  in  whole  or  in  part  on  irritation  of  the  pharynx 
and  upper  part  of  the  respiratory  passages.  It  may  be  kept  warm 
all  night  in  a  baby's  food-warmer,  and  a  sip  taken  whenever  the 
patient  awakes.  This  often  prevents  troublesome  paroxysms  of 
coughing,  and  enables  the  patient  to  obtain  a  fair  night's  rest. 
Internally  it  is  used  as  a  demulcent  drink  in  enteritis,  diarrhoea, 
dysentery,  catarrh,  and  irritation  of  the  urinary  organs,  also  in 
phosphorus-poisoning. 

B.P.  Lini  Farina.  Linseed  Meal. — Linseed  reduced  to 
powder.  It  is  used  not  only  in  the  cataplasma  lini  but  also  in 
the  cataplasma  carbonis,  conii,  sinapis,  and  sodas  chlorinatse. 


chap,  xxxii.]  DISCIFLOEiE.  877 

B.P.  Cataplasma  lini.  Linseed  Poultice. — Mix  a  quarter  of  a  pound 
(about  4  tablespoonfuls)  of  linseed-meal  gradually  with  half  a  pint  of  boiling  water 
With  constant  stirring. 

Uses. — Linseed  meal  forms  an  excellent  vehicle  for  applying 
warmth  and  moisture,  and  is  used  in  the  form  of  poultices  in 
inflammation  of  both  superficial  and  deep-seated  parts  (p.  468). 

Oleum  Lini,  B.  and  U.S.P.  Linseed  Oil.  Oil  of  Flax 
Seed,  U.S.P. — A  fixed  oil  expressed  without  heat  from  linseed. 

Characters. — "Viscid,  yellow,  with  a  faint  odour,  and  oleaginous  taste. 
It  thickens,  and  finally  solidifies  on  exposure  to  air. 

Uses. — It  is  sometimes  applied  as  a  soothing  application  to 
burns,  scalds,  and  eczematous  eruptions,  either  alone  or  with 
lime-water  (p.  649).  It  is  sometimes  added  to  purgative  enemata, 
and  has  been  recommended  as  a  cure  for  piles  in  the  dose  of  two 
ounces  of  the  fresh  oil  morning  and  evening.1 

Sub-Obdee.— ERYTH  ROXYLEiE. 

Coca,  B  P. ;  Erythroxylon,  U.S.P.  Coca  Eeythboxylon. 
[Cuca.] — The  dried  leaves  of  Erythroxylon  Coca. 

Characters. — Shortly  stalked,  oval  or  lanceolate,  of  varying  thickness, 
one  to  two  inches  or  more  in  length,  entire,  usually  blunt  and  emarginate, 
quite  smooth ;  midrib  prominent,  with  numerous  faint  freely  anastomosing 
lateral  veins,  and  on  each  side  of  the  midrib  a  curved  line  extends  from  base 
to  apex ;  green  above,  somewhat  paler  beneath.  In  commercial  specimens 
the  leaves  are  more  or  less  broken,  and  frequently  yellowish-green,  yellowish- 
brown,  or  brown,  and  in  rare  cases  the  curved  lines  are  indistinguishable. 
Odour  faintly  tea-like,  especially  when  bruised ;  taste  somewhat  bitter  and 
aromatic. 

Dose. —  ^  to  2  drachms. 

Preparations. 
B.P.  DOSE. 

Cocainse  Hydroehloras    1-1  gr. 

Extractum  Cocse  Liquidum  (1  in  1) |-2  fl.  dr. 

U.S.P. 

Extractum  Erythroxyli  Fluidum 1-4  fl.  dr. 

Composition. — This  drug  contains  the  alkaloids  cocaine, 
ecgonine,  and  hygrine,  and  a  volatile  constituent  which  gives 
a  pleasant  fragrance  to  the  fresh  leaves.  Different  specimens  of 
the  leaves  vary  greatly  in  their  strength.  Leaves  which  have 
been  long  kept  contain  less  of  the  active  alkaloid  than  the  fresh 
leaves. 

B.P.  Cocains  Hydroehloras.  Hydbochlobate  op  Cocaine. 
C17H21N04.HC1. 

The  hydrochlorate  of  an  alkaloid  obtained  from  the  leaves  of 
'Erythroxylon  Coca. 

1  United  States  Dispensatory,  p.  1017. 


878  VEGETABLE   MATEKIA   MEDIC  A.  [sect.  v.. 

Preparation. — It  may  be  obtained  by  agitating  with  ether  an  aqueous 
solution  of  an  acidulated  alcoholic  extract,  made  alkaline  with  carbonate  of 
sodium ;  separating  and  evaporating  the  ethereal  liquid,  purifying  the  product 
by  repeating  the  treatment  with  acidulated  water,  carbonate  of  sodium,  and 
ether ;  decolourising ;  neutralising  with  hydrochloric  acid,  and  recrystallising. 

Characters. — In  almost  colourless  acicular  crystals  or 
crystalline  powder.  The  solution  in  water  has  a  bitter  taste, 
and  produces  on  the  tongue  a  tingling  sensation  followed  by 
numbness. 

Solubility. — It  is  readily  soluble  in  water,  alcohol,  and  ether. 

Beactions. — Its  solution  gives  a  yellow  precipitate  with  chloride  of  gold ; 
and  a  white  precipitate  with  carbonate  of  ammonium,  soluble  in  excess  of  the 
reagent.  It  dissolves  without  colour  in  cold  concentrated  acids,  but  chars 
with  hot  sulphuric  acid.  The  solution  yields  little  or  no  cloudiness  with 
chloride  of  barium  or  oxalate  of  ammonium.  Ignited  in  the  air  it  burns 
without  residue. 

Dose. — £  to  1  grain. 

Preparation,    b.p. 

lamellae  Coeainae.  Discs  of  cocaine  (each  contains  535th  gram  of  hydro- 
chlorate  of  cocaine,  p.  515). 

Action. — Cocaine  is  a  powerful  local  anaesthetic.  When 
applied  to  the  tongue  it  destroys  both  taste  and  tactile  sensi- 
bility, so  that  salt  and  sugar  cannot  be  distinguished,  nor  the 
prick  of  a  pin  felt.  In  the  eye  it  causes  local  anaesthesia  along 
with  dilatation  of  the  pupil,  paralysis  of  accommodation,  slight 
lacrimation,  and  enlargement  of  the  palpebral  fissure.1  When 
injected  into  the  back  of  the  orbit  it  causes  protrusion  of  the  eye- 
ball. Its  effects  appear  to  be  due  to  stimulation  of  the  peripheral 
ends  of  the  sympathetic  (vide  p.  226) .  Subcutaneous  injection  also 
produces  local  anaesthesia  at  the  point  of  application,  so  that  sub- 
sequent irritation  at  that  spot  produces  no  sensation  in  man  and 
no  reflex  action  in  animals.  When  taken  internally  it  appears  to 
have,  in  small  doses,  a  stimulant,  and,  in  large  doses,  a  paralysing 
action  on  the  nerve-centres  somewhat  like  that  of  caffeine.  It 
affects  first  the  cerebral  hemispheres,  next  the  medulla,  and  after- 
wards the  spinal  cord.  In  small  doses  it  is  said  to  lessen  fatigue, 
and  enable  the  Indians  in  Peru  to  make  long  marches ;  and  a 
similar  result  has  been  obtained  in  trials  upon  soldiers  in 
Germany.  Larger  doses  cause  fulness  in  the  head,  weariness, 
slight  deafness,  loss  of  memory,  and  inability  to  control  ideas. 
It  appears  sometimes  to  cause  restlessness,  singing  in  the  ears, 
giddiness,  headache,  and  delirium. 

In  animals  large  doses  appear  to  affect  specially  the  semi- 
circular canals,  possibly  by  an  anaesthetic  action  upon  the 
nerves  connected  with  them.  This  is  shown  by  constant  move- 
ment of  the  head  in  mammals,  disturbances  of  equilibrium,  loss 


'  Jessop,  Practitioner,  January  1885. 


chap,  xixn.]    . '  DISCIFLOE2E.  .  679 

of  co-ordination,  and  rotatory  convulsions  and  opisthotonos. 
The  convulsions  are  of  cerebral  origin  (p.  188),  and  cease  when 
the  spinal  cord  is  divided.  The  motor  columns  of  the  spinal 
cord  appear  to  be  unaffected,  but  the  sensory  columns  are 
paralysed.  In  its  action  on  respiration  and  circulation  cocaine, 
to  a  certain  extent,  resembles  atropine,  and  it  does  so  also  in  its 
action  on  the  pupils,  intestinal  movements,  and  salivary  and 
sweat  glands.  The  respiration  is  greatly  increased  at  first, 
afterwards  diminished,  and  death  occurs  from  respiratory  para- 
lysis. Small  doses  quicken  the  pulse  and  raise  the  blood- 
pressure.  Large  doses  slow  the  pulse  and  lower  the  blood- 
pressure.  The  quickness  of  the  pulse  appears  to  be  due  to 
paralysis  of  the  vagus,  and  the  action  of  cocaine  on  both  pulse 
and  blood-pressure  is  very  like  that  of  atropine.  Small  doses 
increase,  large  ones  paralyse,  the  intestinal  movements.  The 
secretion  of  saliva  and  sweat  is  diminished.  The  urine  does 
not  appear  to  be  affected.  The  temperature  is  generally  raised. 
Uses, — The  expectations  of  the  practical  utility  of  cocaine, 
founded  on  a  knowledge  of  its  physiological  action,  which  Eossbach ' 
expressed  have  been  completely  fulfilled,  and  it  now  bids  fair  to 
replace  as  a  local  anaesthetic,  the  use  of  chloroform  in  many 
minor  operations.  Its  local  anaesthetic  action  was  first  observed 
by  Niemann.  Its  actual  introduction  into  practice  we  owe  to 
Koller.  A  4  per  cent,  solution  dropped  into  the  eye  is  sufficient 
to  produce  local  anassthesia,  so  that  operations  for  cataract  or 
squint  can  be  readily  performed,  and  foreign  bodies  extracted 
.  from  the  eye  under  its  influence.2  A  20  per  cent,  solution 
applied  once  or  twice  to  the  nasal  mucous  membrane  at  intervals 
of  three  or  four  minutes  causes  such  complete  anaesthesia  that  the 
application  of  the  galvano-cautery  is  not.  felt.  A  similar  effect 
iB  produced  on  the  soft  palate  and  larynx,  arid  the  solution  may 
be  applied  to  facilitate  the  use  of  the  laryngoscope  and  lessen 
pain  and  spasm  in"  operations  on.  the  larynx.  It  has  been  applied 
with  benefit  to  the  interior  of  the  nose  in  acute  coryza,  nasal 
polypus,  and  hay  fever.  It  is  useful  in  producing  local  anaes- 
thesia of  the  uterus  and  rectum  in  operations  on  these  parts  ; 
in  vaginismus  and  in  pruritus  of  the  anus  and  vulva.  Internally 
cocaine  or  coca  is  useful  as  a  tonic,  especially  in  debility  with 
nervousness,  and  in  mental  diseases  accompanied  by  depression. 
It  may  be  given  in  the  form  of  the  fluid  extract  either  alone  or 
with  a  glass  of  wine.  A  non-officinal  wine  made  from  the  leaves 
is  also  a  useful  tonic. 

1  Nothnagel  and  Eossbach,  Arzneimittellehre,  5th  edition. 

2  In  consequence  of  the  readiness  with  which  solutions  of  cocaine  undergo 
decomposition,  it  is  best  to  add  a  trace  of  boric  acid  (3  per  cent.)  to  them. 


880  VEGETABLE   MATEEIA  MEDICA.  [sect.  V- 

ZYGOPHYLLEiE, 

Guaiaci  Lignum,  B.  and  U.S.P.  Guaiacum  Wood.— The 
heart-wood  of  Guaiacum  officinale  and  G.  sanctum.  St.  Domingo 
and  Jamaica.  It  should  be  deprived  of  the  sapwood  and  re- 
duced to  chips,  raspings,  or  shavings. 

Characters. — The  wood  is  known  as  Lignum  mice,  occurs  in  logs,  and  is 
very  hard  and  heavy.  The  alburnum,  or  sapwood,  is  yellow  ia»  colour,  the 
duramen,  or  heart-wood,  is  dark  greenish-brown,  which  should  become  dark 
blue-green  on  the  addition  of  nitric  acid. 

Composition. — Contains  resin,  chiefly  in  the  heart-wood. 

Preparation. 

B.P.  DOSE. 

Decoctum  Sarsas  Compositum  (p.  1052) 2-10  fl.  oz. 

U.S.P. 
Decoctum  Sarsaparillte  Compositum 4-6  fl.  oz.  (200-300  gra.) 

Guaiaci  Resina,  B.  and  U.S.P-  Guaiacum  Besin. — The 
resin  of  Guaiacum  officinale  or  G.  sanctum. 

Preparation. — Obtained  from  the  stem  by  natural  exudation,  by  in. 
cisions,  or  by  heat. 

Characters. — In  masses  of  a  greenish-brown  or  reddish-brown  colour ; 
fractured  surface  resinous,  translucent  at  the  edges,  where  the  greenish  colour 
is  usually  well-marked,  and  serves  to  distinguish  this  from  other  resins.  A 
solution  in  rectified  spirit  strikes  a  clear  blue  colour  when  applied  to  the 
inner  surface  of  a  paring  of  raw  potato  (p.  68),  or  on  the  addition  of  tincture 
of  perchloride  of  iron.    Powder  greyish,  turning  green  on  exposure  to  air. 

Composition. — It  contains  several  resinous  acids,  guaiaconic, 
guaiaretic,  and  guaiacic  acids ;  these  are  soluble  in  alkalis  and 
are  precipitated  on  neutralisation. 

Dose.— 10  to  30  gr. 

Preparations 
B.P.  DOSE, 

Ittistura  Guaiaci 1-1!  fl.  oz, 

Tinctura  Guaiaci  Ammoslata -§-1  fl.  dr. 

Pilula  Hydrargyri  Subchloridi  Composita  (v.  p.  522)  5-10  gr. 

U.S.P. 

Tinctura  Guaiaci 1-3  fl.  dr.  (4-12  c.c.) 

„  „       Ammoniata  1-2  fl.  dr.  (4-8  c.c.) 

PilulsB  Antimonii  Composite  (v.  p.  523) 1-2  pills. 

B.P.  ittistura  Guaiaci.  Guaiacum  Mixture. — Guaiacum,  J  oz. ;  refined 
sugar,  |  oz. ;  gum  acacia,  J  oz. ;  cinnamon  water,  1  pint. 

Tinctura  Guaiaci  Ammoniata,  B.  and  V.S.P.  Ammoniated  Tincture  of 
Guaiacum. — Guaiacum  resin,  4  oz. ;  aromatic  spirit  of  ammonia,  to  1  pint  (B.P.). 
Guaiacum,  20  ;  aromatic  spirit  of  ammonia,  100  (U.S.P.). 

Action. — It  causes  a  burning  sensation  in  the  mouth  and 
throat  when  given  in  small  doses.  Large  doses  cause  vomiting 
and  purging.  When  absorbed  it  acts  as  a  stimulant,  an  altera- 
tive, and  a  diuretic. 

Uses. — It  is  employed  in  the  treatment  of  tonsillitis,  Mistura 


chap,  xxxn.]  DISCIFLOBJJ.  881 

Guaiaci  being  in  my  experience  more  efficacious  than  the  am- 
moniated  tincture.  Others  prefer  the  simple  powder,  as  it 
remains  longer  applied  to  the  tonsils  and  pharynx,  and  it  may 
be  given  in  lozenges  containing  2  grains  each,  and  flavoured 
with  red  currant.  It  is  also  used  in  chronic  rheumatism.  It 
has  been  used  in  the  treatment  of  gout  and  syphilitic  periosteal 
diseases. 

GERANIACEiE. 

U.S.P.  Geranium.  Geeanium  [Cbanesbill].  The  rhizome 
of  Geranium  maculatim. 

Chabaotees. — Horizontal,  cylindrical,  two  to  three  inches  (5  to  7  centi- 
metres) long  ;  half  an  inch  (12  millimetres)  or  less  thick ;  tuberculated, 
longitudinally  wrinkled,  dark  brown ;  fracture  short  pale  red-brown ;  bark 
thin;  wood- wedges  yellowish,  small,  forming  a  circle  near  the  cambium 
line ;  medullary  rays  broad ;  central  pith  large ;  rootlets  thin,  fragile ;  in- 
odorous ;  taste  astringent. 

Officinal  Pbepabaiion. 

COSE. 

Extractum  Geranii  Fluidum J  fl.  dr.  to  1  fl.  dr. 

Composition. — It  contains  a  considerable  amount  of  tannic 
and  gallic  acids. 

Uses. — It  is  a  mild  and  not  disagreeable  astringent,  espe- 
cially useful  for  children.  It  is  used  internally  for  diarrhoea, 
and  is  employed  also  as  an  astringent  gargle  in  sore-throat  and 
as  an  injection  in  gonorrhoea  and  gleet. 

RUTACE^E. 

Sub-Obdeb  I.— RUTE-ffi. 

Oleum  Ruts,  B.  and  U.S.P.  Oil  of  Eue. — A  volatile  oil 
distilled  from  the  fresh  herb  of  Buta  graveolens. 

Chabaotees. — Pale  yellow  when  recent ;  odour  strong  and  disagreeable ; 
taste,  bitter,  acrid. 

Composition. — Consists  of  a  hydrocarbon  and  an  oil  con- 
taining oxygen. 

Dose.— 1  to  4  min.  (0-06-0-3  c.c.) 

Uses. — Externally  it  is  rubefacient,  internally  it  is  stimu- 
lant, antispasmodic,  emmenagogue,  and  carminative ;  used  in 
amenorrhcea,  hysteria,  convulsions,  and  flatulence. 


Pig.  182.— Cusparia,  hall  the  natural  size. 


B.P.  Cuspariae  Cortex.  Cusparia,  oe  Angostuea  Baek. — 
The  dried  bark  of  Galipea  Cusparia,  the  Angostura  bark  tree. 
Tropical  America. 

3  L 


882  VEGETABLE   MATEEIA  MEDICA.  [sect.  v. 

Characters. — Consists  of  flattish  pieces  or  quills,  grey  outside,  light 
brown  inside  ;  several  inches  long,  about  an  inch  in  breadth,  and  one-eigntn 
of  an  inch  thick.  Generally  readily  recognised  by  one  edge  being  9™ 
obliquely  or  feathered,  from  the  oblique  introduction  of  the  knife  by  wmcD 
the  bark  has  been  detached.     Odour,  peculiar ;  taste,  bitter. 

Composition. — A  bitter  substance,  cusparine,  and  some 
volatile  oil. 

Adulteration. — The  bark  of  Strychnoa  nux  vomica.        _  . 

Tests. — Nitric  acid  gives  a  blood-red  colour  when  applied  to  the  inner 
surface  of  the  false  bark  from  the  brucine  present  in  it,  but  gives  a  bluish- 
black  colour  with  the  true  bark. 

B.P.  DOSE. 

Infusum  Cuspariae  (1  in  20  at  120°  F.  for  1  hour) 1-2  fl.  oz. 

Action  and  Use. — Cusparia  is  an  aromatic  bitter  tonic, 
and  is  used  in  cases  of  atonic  dyspepsia  and  in  cases  of  weak 
digestion,  especially  during  convalescence  from  acute  diseases. 

Sub-Obdeb  II—  DIOSME^. 

Buchu  Folia,  B.P.  ;  Buchu,  U.S.P.  Buchu  Leaves, 
B.P. ;  Buchu,  U.S.P. — The  dried  leaves  of  (1)  Barosma  betulina, 
(2)  Barosma  crenulata,  (3)  Barosma  serratifolia.  Cape  of  Good 
Hope. 


Ho.  183. — Barosma  betulina.        Fig.  184. — Barosma  crenulata.        Fig.  18B. — Barosma  serratifolia. 

Characters. — Smooth,  marked  with  pellucid  dots  at  the  indentations 
and  apex ;  having  a  powerful,  somewhat  mint-like  odour,  and  a  warm  cam- 
phoraceous  taste.  B.  betulina. — Obovate,  with  a  recurved,  truncated  apex 
and  sharp  cartilaginous  spreading  teeth.  B.  crenulata. — Oval-lanceolate, 
obtuse,  minutely  crenated.  B.  serratifolia. — Narrow  linear-lanceolate,  taper- 
ing at  each  end,  sharply  and  finely  serrated. 

Composition. — The  leaves  contain  a  volatile  oil  in  the  vittse 
which  appear  as  dots  on  the  leaves,  and  a  bitter  substance. 

Prepaeations. 

S.P.  DOSE. 

Infusum  Buchu  (1  in  20  for  |-hour) 1-4  fl.  oz. 

Tinctura       „      1-2  fl.  dr. 

U.S.P. 

Extractum  Buchu  Fluidum 20-45  min. 

Action  and  Use. — Buchu  is  slightly  tonic.  It  is  also  diuretic 
and  diaphoretic.  Its  chief  use  is  as  a  stimulant  to  the  mucous 
membrane  of  the  bladder  in  cases  of  vesical  catarrh  and  irrita- 
tion.   It  is  also  used  with  other  drugs  as  an  expectorant  in 


chap,  xxxn.]  DISCIFLOEJE.  888 

chronic  bronchitis.  It  is  used  in  South  Africa,  in  doses  of  20 
grains  of  the  powdered  leaves,  in  the  treatment  of  diarrhoea  and 
dysentery. 

Sub-Oeder  III.— XANTHOXYLINjE. 

U.S.P.  Xanthoxylum.  Xanthoxvlum.  Prickly  Ash. — 
The  bark  of  Xanthoxylum  fraxineum,  and  of  Xanthoxylum  caro- 
linianum. 

Characters. — Xcmfhoxyhim  fraxmevm  is  in  curved  or  quilled  frag- 
ments, about  gjth  inch  thick ;  outer  surface  brownish-grey,  with  whitish 
patches  and  minute,  black  dots ;  inner  surface  whitish,  smooth,  inodorous ; 
bitterish,  very  pungent. 

Xcmthoxyhtm  ca/roMmarvwm  resembles  the  preceding,  but  is  about  ^th 
inch  thick,  and  is  marked  by  many  conical,  corky  projections,  and  stout, 
brown  spines. 

Preparation. 

DOSE. 

Extractum  Xanthoxyli  Pluidum 30-60  min. 

Composition. — It  contains  a  volatile  oil,  resins,  and  possibly 
berberine. 

Action  and  Uses. — Its  action  seems  to  be  that  of  an  aromatic 
and  somewhat  irritant  bitter,  somewhat  resembling  mezereum 
and  guaiac.  Like  these  drugs  it  is  used  in  rheumatism.  The 
bark  is  chewed  to  relieve  toothache,  and  to  aid  recovery  in  palsy 
affecting  the  tongue. 

Jaborandi,  B.P. ;  Pilocarpus,  U.S.P-  Pilocarpus.  Jabo- 
eandi.— The  dried  leaflets  of  Pilocarpus  pennatifolius. 

Characters. — About  four  inches  (ten  centimetres)  long,  short-stalked, 
oval  or  ovate-oblong,  entire  and  slightly  revolute  at  the  margin,  obtuse  and 
emarginate,  unequal  at  the  base;  coriaceous  pellucid-punctate,  mostly 
smooth  ;  smell,  when  bruised,  slightly  aromatic  ;  taste,  somewhat  bitter  and 
aromatic  at  first,  but  subsequently  pungent  and  increasing  the  flow  of 
saliva. 

Composition. — The  leaves  contain  a  volatile  oil  and  two 
alkaloids,  pilocarpine  and  jaborine. 

Preparation. 

B.P.  DOSE. 

Extractum  Jaborandi 2-10  gvs. 

Infusum  „  (1  in  20  for  J-hour)   1-2  fl.  oz. 

Pilocarpine  Ultras -}g~l  gr. 

Tlnctura  Jaborandi J-l  fl.  dr. 

U.S.P. 

Extractum  Pilocarpi  Eluidum 5-60  min. 

B.P.  Pilocarpine  Nitras.  Nitrate  of  Pilocarpine. 
CnH^NaOj.HNOa. — The  nitrate  of  an  alkaloid  obtained  from 
extract  of  jaborandi. 

Preparation. — By  shaking  the  extract  with  chloroform  and  a  little  alkali, 
evaporating  the  chloroformic  solution,  neutralising  the  product  with  nitric 
acid  and  purifying  by  recrystallisation. 

3i2 


884  VEGETABLE   MATEEIA  MEDICA.  Tsect.  v. 

Characters.^ — In  white  crystalline  powder,  or  in  aoictilar  crystals. 

Solubility.— Soluble  in  eight  or  nine  parts  of  water  at  common  tempera- 
tures, slightly  soluble  in  cold,  freely  soluble  in  hot  rectified  spirit. 

Reactions.— Strong  sulphuric  acid  forms  with  it  a  yellowish  solution  wnicft, 
on  the  addition  of  bichromate  of  potassium,  gradually  acquires  an  eraeraW- 
green  colour.  It  leaves  no  ash  when  burned  with  free  access  of  arc.  It 
causes  contraction  of  the  pupil  of  the  eye. 

U.S.P.  Pilocarpine  Hydrochloras.  Hydeochloeatb  of 
Pilocarpine. — The  hydrochlorate  of  an  alkaloid  prepared  from 
Pilocarpus.     It  should  be  kept  in  small,  well-stoppered  vials. 

Characters. — Minute,  white  crystals,  deliquescent,  odourless,  having  a 
faintly  bitter  taste,  and  a  neutral  reaction. 

Solubility. — Very  soluble  in  water  and  in  alcohol,  but  almost  insoluble 
in  ether  or  chloroform. 

Dose.—  -fo  to  |  gr."  internally  or  by  subcutaneous  injection". 
Uses. — Its  action  and  uses  are  similar  to  those  of  Pilocarpus. 

Action. — Jaborine  has  an  action  like  that  of  atropine  and 
antagonistic  to  that  of  pilocarpine.  The  amount  of  jaborine  in 
the  leaves  is  insufficient  to  antagonise  the  pilocarpine,  so  that 
the  leaves  have  an  action  like  that  of  pilocarpine.  It  is  probable 
that  some  discrepancies  between  the  statements  of  different 
observers  regarding  the  action  of  pilocarpine  may  be  due  to  the 
presence  of  more  or  less  jaborine  in  the  pilocarpine  which  they 
supposed  to  be  pure. 

Pilocarpine  stimulates  the  peripheral  terminations  of 
efferent  nerves  going  to  glands,  and  first  stimulates  and  then 
paralyses  the  efferent  nerves  going  to  structures  composed  of 
involuntary  muscular  fibre.  In  large  doses  it  lessens  but  does 
not  quite  destroy  the  irritability  of  voluntary  muscle  and  motor 
nerves. 

It  appears  to  have  a  certain  action  on  the  nerve-centres. 
It  produces  in  Rana  esculenta  convulsions  like  those  of  picro- 
toxin.  In  Rana  temporaria  it  only  produces  paralysis.  Frogs 
poisoned  by  it  croak,  when  stroked,  in  the  same  way  as  when 
the  cerebrum  is  removed.  In  mammals  it  causes  dyspnoea, 
convulsive  twitching  and  shivering,  and  movements  of  rotation 
(p.  215;  cf.  also  Apomorphine).  These  may,  however,  be  partly 
due  to  the  action  of  the  drug  upon  the  heart.  It  seems,  how- 
ever, to  stimulate  the  centres  of  the  salivary  and  sweat  glands 
as  well  as  the  peripheral  terminations  of  the  secreting  nerves. 

From  its  stimulating  action  on  secreting  nerves  it  produces 
enormous  secretion  of  saliva  from  the  submaxillary,  sublingual, 
and  parotid  glands,  and  enormous  secretion  of  sweat  from  the 
sweat-glands,  beginning  either  in  the  face  or  at  the  point  of 
subcutaneous  injection,  and  extending  over  the  whole  surface 
of  the  body.  It  produces,  though  to  a  less  extent,  secretion  of 
tears  from  the  lacrimal  gland ;  of  wax  from  the  ears ;  of  mucus 
from  the  nose  and  from  the  bronchial  mucous  membrane ;  of 


chap,  xxxii.]  DISCIFLOBjE.  885 

gastric  juice  from  the  glands  of  the  stomach;  probably  of 
intestinal  juice  from  the  intestinal  glands,  and  of  urine  from 
the  kidney.  The  secretion  of  milk  is  sometimes  but  not 
always  increased.  It  does  not  appear  to  increase  the  secretion 
of  bile. 

Its  stimulating  action  on  nerves  supplying  involuntary 
muscular  fibre  is  observed  in  the  eye,  intestine,  heart. and 
vessels,  bladder,  uterus,  and  spleen.  By  stimulating  the  ter- 
minations of  the  third  nerve  in  the  eye  it  causes  contraction  of 
the  pupil  and  spasm  of  accommodation,  and  indistinct  vision. 
After  this  passes  off  there  may  be  dilatation  of  the  pupil.  By 
stimulating  the  intestinal  ganglia  it  causes  increased  peristalsis. 
By  stimulating  the  vagus  ends  in  the  heart  like  nicotine,  large 
doses  of  it  cause  the  pulse  to  become  slow  in  frogs  and  in 
mammals,  and  the  blood-pressure  to  fall.  In  small  doses  its 
effect  is  more  complicated,  as  will  be  afterwards  noticed.  In 
larger  doses  it  paralyses  the  vagus  ends  (A,  Fig.  106,  p.  313), 
but  not  the  inhibitory  ganglia.  By  acting  on  the  bladder  it 
causes  contraction,  and  may  produce  strangury  and  sometimes  re- 
tention. It  causes  contractions  of  the  uterus,  which,  in  rabbits, 
begin  at  the  openings  of  the  Fallopian  tubes  and  proceed  to  the 
os  uteri.  This  depends  also  on  a  peripheral  action  of  the  drug, 
and  is  not  arrested  by  destruction  of  the  spinal  cord.  It  causes 
contraction  of  the  spleen  in  man  both  in  its  normal  condition 
and  when  abnormally  enlarged. 

As  vomiting  is  a  complex  movement  demanding  the  co- 
operation of  the  abdominal  muscles  and  diaphragm,  it  is  evident 
that  it  would  not  ensue  merely  from  increased  contraction  of 
the  gastric  walls.  Jaborandi  appears,  however,  to  irritate  the 
stomach,  and  often  causes  nausea  and  vomiting ;  and  so  does 
pilocarpine,  though  to  a  less  extent,  even  when  subcutaneonsly 
injected. 

It  is  probable  that  even  when  injected  subcutaneously  it  is 
eliminated  by  the  mucous  membrane  of  the  stomach  in  the  same 
way  as  tartar  emetic,  morphine,  atropine,  quinine,  and  strych- 
nine, and  that  it  thus  acts  as  a  local  irritant  to  the  gastric 
nerves  (Fig.  5,  p.  39). 

Its  action  on  the  circulation  is  a  complicated  one,  as  the 
direct  effect  of  the  drug  on  the  heart  and  vessels  is  probably 
much  modified  by  the  reflex  action  from  the  stomach,  intestines, 
&c,  which  have  been  stimulated  by  it.  The  vessels  usually 
become  much  dilated  at  first,  the  carotids  pulsating  violently, 
the  pulse  becoming  rapid,  and  a  feeling  of  heat  being  perceived 
over  the  body.  When  perspiration  sets  in  there  is  sometimes 
a  feeling  of  cold  and  shivering.  The  blood-pressure  usually  falls 
a  little  at  first,  with  quicker  pulse,  then  rises  with  slower  pulse 
(p.  272),  and  finally  falls  greatly  from  vaso-motor  paralysis. 

Respiration. — There  is  sometimes  a  feeling  of  slight  dyspnoea 


886  VEGETABLE   MATERIA   MEDICA.  [sect.  v. 

just  after  the  dose  has  been  given,  but  this  only  lasts  for  a  few 
moments.  Poisorjous  doses  cause  in  animals  dyspnoea  and  con- 
vulsions, which,  as  already  mentioned,  probably  depend  in  some 
measure  on  cardiac  failure.  In  animals  the  abundant  secretion 
into  the  bronchi  and  pulmonary  oedema  produced  by  Targe  doses 
also  lead  to  dyspnoea. 

The  temperature  rises  when  the  patient  is  shivering  and 
falls  during  sweating  (p.  440).  The  secretion  of  sweat  usually 
lasts  for  two  or  three  hours,  and  is  so  copious  that  the  body 
loses  one  or  two  pounds  and  sometimes  as  much  as  eight  pounds 
from  it  and  the  salivation  together.  Sweating  does  not  occur  in 
every  patient  who  takes  pilocarpine,  and  even  salivation  is  not  a 
constant  symptom. 

After  the  sweating  is  over  there  is  usually  a  feeling  of  debility, 
languor,  and  thirst. 

Pilocarpine  is  excreted  unchanged  by  the  urine.  It  does  not 
appear  in  the  saliva. 

The  injurious  effects  sometimes  produced  by  it  are,  in  addi- 
tion to  the  dimness  of  vision  and  vomiting  already  mentioned, 
sudden  collapse,  swelling  of  the  salivary  glands  and  tonsils, 
hiccough,  diminished  secretion  of  urine,  albuminuria,  strangury, 
bleeding  from  the  vagina,  and  anticipation  of  the  menstrual  flux. 

Atropine  antagonises  pilocarpine  very  completely,  prevent- 
ing its  action  if  administered  before  it,  and  removing  its  effects 
if  given  after  it.  Sudden  collapse  ought  therefore  to  be  treated 
by  the  subcutaneous  injection  of  atropine. 

The  nausea  and  vomiting  generally  yield  easily  to  morphine. 

Uses. — As  its  action  is  a  peripheral  rather  than  a  central 
one, -it  affects  the  eye  more  powerfully  when  applied  locally  than 
when  taken  internally.  It  has  been  employed  in  chronic  catarrh, 
in  iridocyclitis,  intraocular  hemorrhage,  turbidity  of  the  vitreous 
humour,  in  separation  of  the  retina,  in  albuminuric  retinitis,  and 
instead  of  physostigmine  in  glaucoma,  &c.  (vide  Myotics,  p.  225). 
It  has  been  used  with  a  certain  amount  of  success  in  deafness 
depending  on  disease  of  the  labyrinth,  especially  when  it  is 
syphilitic.1  In  some  skin  diseases  it  is  very  useful,  especially  in 
prurigo  and  chronic  urticaria  and  in  baldness ;  also  in  cases  of 
Hebra's  prurigo  and  psoriasis.  In  small  doses  it  relieves  thirst 
in  chronic  renal  disease,  and  has  been  used  for  a  similar  purpose 
in  fever  (vide  Eefrigerants,  p.  360). 

It  has  been  used  in  diseases  of  the  throat,  especially  tonsillitis 
and  diphtheria,  but  its  utility  in  the  latter  disease  is  uncertain. 
In  bronchitis,  asthma,  and  whooping-cough  it  sometimes  gives 
relief,  though  it  is  not  so  useful  as  might  be  expected  (p.  254). 
From  its  action  on  the  uterus  it  has  been  used  as  an  oxytocic 
to  induce  premature  labour.    As  a  diaphoretic  it  may  be  used 


Folitzer,  Med.-Chir.  Rundschau,  viii.  1885. 


chap,  xxxii.]  DISCIFLORiE.  887 

in  small  doses  to  induce  diaphoresis  and  prevent  or  relieve 
coryza,  bronchial  catarrh,  or  rheumatism  consequent  on  a  chill 
(p.  330). 

It  has  been  employed  to  remove  pleural  and  peritoneal 
effusions,  and  has  been  used  in  cardiac  dropsy  when  digitalis 
failed,  but  great  care  is  then  requisite  in  its  use. 

Its  chief  use,  however,  is  in  dropsy,  and  especially  in 
uraemia  depending  on  disease  of  the  kidneys ;  it  may  be  given 
subcutaneously  as  the  nitrate  in  £-£  grain  doses.  In  renal 
dropsy  it  not  only  removes  water  from  the  body  but  it  removes 
urea  and  possibly  other  products  of  tissue-waste.  Some  of  the 
urea  is  excreted  in  the  sweat,  and  a  considerable  amount  appears 
in  the  saliva.  Probably  the  removal  of  these  products  from  the 
body  is  the  reason  why  pilocarpine  cuts  short  uraemic  convul- 
sions. In  puerperal  eclampsia  it  is  not  so  successful  as  in  con- 
vulsions depending  on  kidney  disease.  Pilocarpine  has  also  been 
used  to  eliminate  other  poisons  from  the  body,  and  has  been 
used  in  syphilis  and  chronic  poisoning  by  lead,  mercury,  and 
arsenic. 

Contba-indications. — Fatty  heart,  and  impeded  pulmonary  cir- 
culation from  valvular  disease,  emphysema,  or  pleurisy.  These 
conditions  do  not  absolutely  prohibit  the  use  of  the  remedy,  but 
it  must  then  be  given  with  care  and  the  patient  watched.  It 
may  be  combined  with  alcoholic  stimulants,  and  atropine  should 
be  ready  for  subcutaneous  injection  if  necessary. 

AURANTIiE. 

U.S.P.  Aurantii  Flores.  Oeange  Flowers. — The  partially 
expanded  fresh  flowers  of  Citrus  vulgaris  and  Citrus  Aurantium. 
They  may  be  preserved  by  mixing  them  well  with  half  their 
weight  of  chloride  of  sodium,  pressing  them  into  a  jar,  and 
keeping  in  a  cool  place. 

Characters. — Fragrant  and  somewhat  bitter. 

PREPARATION. 

Aqua  Aurantii  Florum. 

U.S.P.  Oleum  Aurantii  Florum.  Oil  of  Oeange 
Flowees,  Oil  op  Neboli. — A  volatile  oil  distilled  from  fresh 
orange  flowers. 

Characters. — Yellowish  or  brownish;  it  has  a  fragrant  odour  of  orange 
flowers,  and  an  aromatic,  somewhat  bitter  taste. 

Composition. — It  consists  chiefly  of  a  hydrocarbon  and  a 
little  neroli  camphor. 

Preparation. 
Spiritus  Odoratus. 

Use. — As  a  flavouring  matter. 


888  VEGETABLE   MATERIA  MEDICA.  [sect.  v. 


Aqua  Aurantii  Floris,  B.P. ;  Aqua  Aurantii  Florum, 
U.S.P-  Orange  Flower  Water.— The  distilled  water  of  the 
flowers  of  the  bitter  orange  tree,  Citrus  vulgaris  {Citrus  bigaradia), 
and  of  the  sweet  orange  tree,  Citrus  auiantium.  Prepared  mostly 
in  France. 

The  orange  flower  water  of  commerce  is  usually  three  tunes 
the  strength  of  that  employed  in  former  years. 

Characters. — Colourless,  or  with  a  slight  greenish-yellow  tint ;  it  has  the 
ragrant  odour  of  the  flowers. 

Impurity. — Lead  from  the  vessels  in  which  it  has  been  kept. 

Test. — It  should  not  be  coloured  by  sulphuretted  hydrogen. 

Composition.— It  contains  a  volatile  oil  (Oil  of  Neroli). 

Preparation. 

B.P.  DOSE. 

Syrupus  Aurantii  Floris 1-2  fl.  dr. 

U.S.P. 

Syrupus  Aurantii  Florum 1-2  fl.  dr.  (4-8  c.o.) 

B.P.  Aurantii  Fructus.  Bitter  Orange. — The  ripe  fruit 
of  the  Citrus  vulgaris  {Citrus  Bigaradia).  Imported  from  the 
South  of  Europe. 

Characters. — It  is  like  the  sweet  orange,  but  darker  in  colour  and  very 

bitter. 

Aurantii  Cortex,  B.P. ;  Aurantii  Amari  Cortex,  U.S.P. 

Bitter  Orange  Peel.— The  dried  outer  part  of  the  rind  of  the 
ripe  bitter  orange. 

Characters. — Thin  strips  of  dark  orange  colour,  with  a  fragrant  odour 
and  an  aromatic  bitter  taste.  It  should  be  nearly  free  from  the  white  part 
of  the  rind. 

Composition. — The  inner  part  of  the  rind  is  white,  spongy, 
and  useless ;  the  outer  part  is  yellow  when  fresh,  but  brownish 
green  when  dried,  and  contains  a  fragrant  volatile  oil,  a  bitter 
neutral  principle  hesperidin,  and  a  small  quantity  of  some  sort 
of  tannin. 

Preparations. 
B.P.  DOSE. 

Of  the  fresh  peel — 

Tinctura  Aurantii  Recentls 1-2  fl.  dr. 

Vinum  Aurantii 

Of  the  dried  peel — 
Znfusum  Aurantii  (|  oz.  in  i  pint) 1-2  fl.  oz. 

„  „        Composltum 1-2  fl.  oz. 

„        Gentians  Compositum  1-2  fl.  oz. 

Spiritus  Axmoraoiffi  Compositus 

Syrupus  Aurantii  (Tinct.  1,  Syrup  7)  1  fl.  dr. 

Xlnctura  Aurantii 1-2  fl.  dr. 

„        Cinchona  Composita i-2  fl.  dr. 

„        Gentianee         „  1-2  fl.  dr. 

V.B.V. 

Extract um  Aurantii  Amari  Fluidum 2-4  fl.  dr.  (8-15  o.o.) 

Tinctura  „  1-2  fl.  dr.  (4-8  c.o.) 


chap,  xxxii.]  DISCIPL0KJ3.  889 

S.F.    Infusum  Aurantii  Compositum.     Compound  Infusion  of  Oiunoe 

Peel.— Bitter  orange  peel,  J  oz. ;  fresh  lemon  peel,  56  gr. ;  cloves,  bruised,  28  gr. 
boiling  distilled  water,  10  ft.  oz. 

U.S.P.  Aurantii  Dulcis  Cortex.  Sweet  Oeange  Peel. — 
The  rind  of  the  fruit  of  Citrus  Aurantium. 

Chaeaoteks.  —  Closely  resembling  bitter  orange  peel,  but  having  an 
orange  yellow  colour.  It  has  a  sweetish  fragrant  odour  and  an  aromatic 
slightly  bitter  taste. 

Preparations.  dose. 

Syrupus  Aurantii 1-2  fl.  dr. 

Tinctura  Aurantii  Dulcis 20  min.-l  fl.  dr. 

Uses. — The  preparations  of  oranges  are  used  almost  entirely 
as  flavouring  vehicles.  The  rind  is  an  aromatic  stomachic,  and 
is  used  with  other  bitters  in  the  treatment  of  dyspepsia. 

U.S.P-  Oleum  Aurantii  Corticis.  Oil  of  Oeange  Peel. — 
A  volatile  oil  extracted  by  mechanical  means  from  fresh  orange 
peel. 

Preparation.  —  It  is  prepared  from  the  outer  part  of  the  rind  by 
expression ;  by  putting  it  in  hot  water  and  skimming  off  the  oil ;  or  by 
rubbing  it  in  a  kind  of  bowl  lined  with  short  spikes  in  the  same  way  as  oil 
of  lemons. 

Characters. — Pale  yellow,  has  the  smell  of  oranges,  and  an  aromatic 
somewhat  bitter  taste.  By  keeping  it  becomes  thicker,  and  gets  a  turpentine- 
like taste.  This  may  be  prevented  by  mixing  the  fresh  oil  with  5  per  cent, 
of  alcohol  and  decanting  from  the  sediment. 

Composition.  —  Contains  two  camphenes  and  a  glucoside, 
hesperidin. 

Officinal  Preparations.  dose. 

Elixir  Aurantii 2-8  fl.  dr.  (4-30  c.c.) 

Spiritus  Aurantii 2-4  fl.  dr.  (4-15  c.c.) 

Spiritus  Myrcite Used  as  perfume. 

Action  and  Use. — Externally  it  is  rubefacient.  Internally, 
in  large  doses,  it  is  an  irritant  poison.  It  is  used  as  a  flavouring 
matter. 

U.S.P.  Elixir  Aurantii.  Elixir  of  Oeange  (Simple  Elixir).— Oil  of  orange, 
1 ;  cotton,  2 ;  sugar,  in  coarse  powder,  100  ;  alcohol  and  water,  of  each  a  sufficient 
quantity  to  make  300  parts.  Mix  alcohol  and  water  in  the  proportion  of  1  part  of 
alcohol  to  3  parts  of  water.  Add  the  oil  of  orange  to  the  cotton  in  small  portions 
at  a  time,  distributing  it  thoroughly  by  picking  the  cotton  apart  after  each  addition ; 
then  pack  tightly  in  a  conical  percolator  and  gradually  pour  on  the  mixture  of 
alcohol  and  water  until  200  parts  of  filtered  liquid  are  obtained.  In  this  liquid 
dissolve  the  sugar  by  agitation,  without  heat,  and  strain. 

Use. — To  cover  the  taste  of  drugs  and  render  them  agree- 
able to  the  palate.  By  mixing  tinctures  and  liquid  extracts  with 
simple  elixir,  preparations  are  obtained  which  are  both  palatable 
and  efficient. 

U.S.P.  Oleum  Bergamii.  Oil  of  Beegamot. — A  volatile 
oil  extracted  by  mechanical  means  from  the  rind  of  the  fresh 
fruit  of  Citrus  Bergamia,  var.  vulgaris. 


890  VEGETABLE  MATERIA  MEDICA.  [sect.  v. 

Characters. — A  greenish  or  greenish-yellow,  thin  liquid,  of  a  peculiar, 
very  fragrant,  odour,  an  aromatic,  bitter  taste  and  a  slightly  acid  reaction. 
Sp.  gr.  0-860  to  0-890.  It  is  soluble  in  all  proportions  in  alcohol  and  in  glacial 
acetic  acid. 

Use. — In  flavouring. 

Preparation. 
Spiritus  Odoratus.    Perfumed  Spirit  (Cologne  Water).— Oil  of  bergamot,  16 ; 
oil  of  lemon,  8  ;  oil  of  rosemary,  8  ;  oil  of  lavender  flowers,  4 ;  oil  of  orange  flowers, 
4 ;  acetic  ether,  2 ;  water,  158  ;  alcohol,  800. 

Uses. — For  perfuming  lotions.  "When  bathed  on  the  temples 
or  forehead  and  evaporated  quickly  by  fanning  the  face,  it  is 
useful  in  headaches  or  tendency  to  faintness.  Eau  de  Cologne 
is  not  unfrequently  taken  as  a  stimulant  by  ladies,  who  have  no 
idea  that  it  contains  alcohol. 

Limonis  Cortex,  B.  and  U.S.P-  Lemon  Peel. — The 
outer  part  of  the  rind  of  the  fresh  fruit  of  Citrus  Limonum. 
Southern  Europe  and  West  Indies. 

Characters. — Like  those  of  orange  peel,  but  the  colour,  is  a  deep  lemon 
yellow. 

Composition. — Similar  to  orange  peel. 

Preparations. 
8.P.  DOSE. 

Infusum  Aurantii  Compositum 1-2  fl.  oz. 

,,         Gentians        „  1-2  fl.  oz. 

Oleum  Xumonis 1-5  min. 

Syrupus       „        '. 1-2  fl.  dr.  or  more. 

Tinctura      „       1-2  fl.  dr. 

U.S.P. 

Oleum  Limonis 1-5  min. 

Spiritus      „      Por  flavouring. 

Syrupus      „ 1-2  fl.  dr.  or  more. 

Mistura  Potassii  Citratis 4-8  fl.  dr.  (15-30  c.c.) 

Oleum    Limonis,    B.   and    U.S.P.     Oil    [of    Lemons. — A 

volatile  oil  expressed  or  distilled  (B.P.)  or  extracted  by  mechani- 
cal means  (U.S.P.)  from  fresh  lemons. 

Characters. — A  pale  yellow  liquid,  having  the  fragrant  odour  of  lemon ; 
an  aromatic,  somewhat  bitterish  taste,  and  a  neutral  reaction.  By  keeping 
it  becomes  thicker,  and  acquires  a  disagreeable  terebinthinate  taste.  This 
may  be  prevented  by  mixing  it  while  fresh  with  5  per  cent,  of  alcohol,  and 
decanting  the  oil  after  it  has  become  clear  from  the  sediment.  When  wanted 
for  use  a  quantity  of  water  equal  to  the  alcohol  may  be  added,  when  they 
unite  and  subside,  leaving  the  oil  on  the  top. 

Preparation. — It  is  sometimes  obtained  by  rasping  the  outside  of  the 
rind  and  expressing  the  oil  it  contains,  sometimes  by  distillation,  but  the  best 
is  got  by  rubbing  the  lemons  over  the  interior  of  a  sort  of  cup  lined  with 
short  points,  when  the  oil  flows  into  a  reservoir  at  the  bottom  of  the  cup. 

Composition. — It  is  said  to  consist  of  two  isomeric  oils  and  a 
kind  of  camphor  formed  from  them  by  exposure  to  air. 

Action. — Externally  it  is  a  strong  rubefacient ;  internally, 


chap,  xxxii.]  DISCLFL0K.3E.  891 

in  small  doses,  it  is  stimulating  and  carminative.     It  is  chiefly 
used  as  a  flavouring  matter. 

OFFICINAL  PbEPAKATIONS. 
»■*■  U.S.P. 

Linimentum  Potassii  Iodidi  cum  Sapone  (p.  616).  Spiritus  Limonis. 

Spiritus  Ammonias  Aromaticus  (1  in  185).  Spiritus  Odoratus. 

Limonis  Succus,  B.  and  U.S.P.  Lemon  Juice. — The 
freshly  expressed  juice  of  the  ripe  fruit  of  Citrus  Limonum. 

Chaeactebs. — Slightly  turbid,  yellowish  liquor,  with  an  acid  taste,  and 
usually  a  slight  odour  of  lemon  from  a  little  of  the  oil  contained  in  the  rind. 

Preparation. — By  squeezing  the  fresh  fruit. 

Composition. — It  contains  some  acid  salts,  especially  those  of 
potassium,  and  7  per  cent,  of  citric  acid  (U.S.P.) ;  36  to  40 
grains  in  the  fluid  ounce  (B.P.). 

Officinal  Peepaeations. 
b.p.  dose.  u.s.p.  dose. 

Syrnpns  Limonis ^-2fl.  dr.        Mistura  Potassii  Citratis. .  .4  fl.  dr.  (15  c.c.) 

Syrupus  Limonis ad  lib. 

U.S.P.  Mistura  PotasstB  Citratis.  Mixture  of  Citeate  of  Potassium  (Neutral 
Mixture). — Fresh  lemon  juice  strained,  100 ;  bicarbonate  of  potassium  about  10 
parts,  or  enough  to  neutralise. 

Syrupus  limonis.  Sybup  of  Lemons,  B.  and  U.S.P. — Boiling  lemon  juice, 
strained,  1  pint,  with  fresh  lemon  peel,  2  oz. ;  refined  sugar,  2J  pounds  (B.P.). 
Boiling  lemon  juice,  40  ;  fresh  lemon  peel,  2  ;  sugar,  60 ;  water  up  to  100  (U.S.P.). 

Not  officinal.  Decoction  of  Lemon, — Cut  a  fresh  unpeeled  lemon  (best  when 
pulled  immediately  from  the  tree)  into  thin  slices,  put  it  into  three  teacupfuls  of 
water,  and  boil  it  down  to  one  teacupful  in  a  clean  earthenware  jar.  Allow  it  to 
stand  over  night  in  the  open  air,  and  give  it  the  first  thing  in  the  morning.  Free 
it,  by  compression  and  nitration,  from  rind,  pulp,  and  seeds  just  before  it  is  drunk. 

Uses. — It  is  used  locally  as  a  gargle  in  sore-throat;  to 
relieve  itching  in  pruritus  of  the  scrotum,  in  uterine  haemorrhage 
after  delivery,  and  mixed  with  equal  parts  of  glycerine  as  an  ap- 
plication to  the  face  in  sunburn.  Internally  it  is  refrigerant, 
and  forms  a  pleasant  drink,  allaying  the  thirst  in  fevers.  It  is 
used,  in  place  of  citric  acid,  to  make  effervescent  mixtures  and 
drinks.  It  is  antiscorbutic,  and  is .  employed  to  prevent  scurvy 
in  long  voyages. 

The  decoction  of  lemon  is  said  to  be  a  powerful  antiperiodic, 
and  to  be  exceedingly  useful  as  a  substitute  for  large  doses  of 
quinine  in  cases  of  ague,  typho-malarial  fevers,  and  malarious 
conditions  generally.  It  appears  to  be  useful  in  reducing  the 
temperature  in  typhoid  fever  even  when  no  malarial  complica- 
tion exists. 

B.P.  Belae  Fructus.  Babl  Fbuit. — The  dried  half-ripe 
fruit  of  Mgle  Mwmelos,  from  Malabar  and  Coromandel. 

Characters. — Fruit  roundish,  about  the  size  of  a  large  orange,  with  a 
hard  woody  rind.  Usually  seen  in  fragments  consisting  of  portions  of  the 
hard  grey  rind  and  dry  adherent  red  pulp  and  seeds.  The  moistened  pulp  is 
mucilaginous. 


892 


VEGETABLE   MATEEIA  MEDICA. 


[sect.  v. 


Composition. — Not  well  ascertained.    It  contains  no  appreci- 
able amount  of  tannin. 

Preparation.     B.P. 

DOSE. 

Extractum  Belae  liquidum 1  fl.  dr.  to  J  fl.  oz. 

Uses. — Although  it  contains  no  tannin  it  is  used  in  diarrhoea 
and  dysentery.     The  fresh  pulp  is  sometimes  used  as  a  laxative. 


Fig.  186.— Bael,  half  the  natural  size. 


Possibly  bael  fruit  may  owe  its  utility  in  dysentery  to  its  pos- 
sessing some  action  similar  to  that  of  cotoine  (p.  387). 


SIMARUBACEiE. 

Quassise  Lignum,  B.P. ;  Quassia,  U.S. P.  Quassia  Wood, 
B.P. ;  Quassia,  U.S.P. — The  wood  of  Pier  ana  excelsa.    Jamaica. 

Characters. — Billets  varying  in  size,  seldom  thicker  than  the  thigh. 
Wood  dense,  tough,  yellowish-white,  intensely  and  purely  bitter.  Also  chips 
and  raspings  of  the  same. 

Composition. — The  wood  contains  a  small  quantity  of  a  bitter 
neutral  principle,  quassiin.  The  wood  contains  no  tannin,  so 
that  an  infusion  does  not  become  black  on  the  addition  of  a 
persalt  of  iron. 

Preparations. 

B.P.  DOSE 

Extractum  Quassise 2-5  gr. 

Xnfusum              „         (1  in  80,  cold  water,  for  5  hour)  ...1-2  fl.  oz. 
Tinctura  „        l_2  fl.  drm. 

C.S.P. 

Extractum  Quassise 3-5  gr.  (0-18-0-32  gm.) 

„  „        Fluidum |-1  fl.  drm.  (2-4  c.c.) 

Tinctura  „        f_2  fl.  drm.  (2-8  c.c.) 

Action  and  Uses. — Quassia  is  a  pure  bitter  stomachic  tonic, 
having  no  other  action  on  man.  On  insects  it  exerts  a  narcotic 
influence  and,  in  the  form  of  an  infusion  sweetened  with  sugar, 
it  is  often  employed  to  destroy  flies. 

In  small  doses  it  increases  the  appetite.  In  large  doses  it 
acts  as  an  irritant  and  causes  vomiting.  The  infusion  is  made 
with  cold  water.  As  it  contains  no  tannin,  it  does  not  form  an 
inky  mixture  with  iron,  like  most  vegetable  bitters,  and  so  can 


chap,  xxxii.]  DISCIFLOEiE.  893 

be  conveniently  prescribed  with  it.  It  is  used  in  atonic  dys- 
pepsia. 

Its  action  is  not  thoroughly  understood,  but  it  is  not  impro- 
bable that  it  lessens  putrefaction  in  the  stomach  and  prevents  to 
some  extent  the  formation  of  acid  substances  during  digestion.  , 

It  is  often  administered  by  using  a  cup  made  of  the  wood  ; 
this  when  filled  with  water,  imparts  its  active  principle  to  that 
fluid.  An  infusion  is  used  in  the  form  of  enema  to  destroy 
thread-worms. 

BURSERACEyE. 

(AMYRIDACE^). 

Myrrha,  B.  and  U.S.  P.  Myrrh. — A  gum-resinous  exuda- 
tion from  the  stem  of  Balsamodendron  Myrrha.  Arabia  Felix 
and  Abyssinia. 

Characters.— In  irregular-shaped  tears  or  masses  varying  much  in  size, 
somewhat  translucent,  of  a  brownish-yellow  or  reddish-brown  colour,  frac- 
tured surface  irregular  and  somewhat  oily ;  odour  agreeable  and  aromatic, 
taste  acrid  and  bitter. 

Composition.— Gum  (50-60  per  cent.)  soluble  in  water,  and 
of  which  arabin  constitutes  a  portion.    The  remainder,  insoluble 
in  water,  is  made  up  principally  of  a  resinous  acid,  myrrhic 
acid,  and  a  volatile  oil. 
Dose.— 10-30  gr. 

Preparations. 
B.P.  DOSE. 

Decoctum  Aloes  Compositum 1-2  fl.  oz. 

Mistura  Ferri  Composita 1-2  fl.  oz. 

Pllula  Aloes  et  Myrrhse  (vide  p.  522) 5-10  gr. 

„       Asafoetidae  Composita  (vide  p.  522) 5-10  gr. 

„       Ehei  Composita  (vide  p.  523) 5-10  gr. 

Tinctura  Myrrhse i_l  fl.  dr. 

u.s.p. 

Mistura  Ferri  Composita 1-2  fl.  oz.  (30-60  c.c.) 

PilulsB  Aloes  et  Myrrhs  (videp.  523) 1  pill. 

„     Ferri  Composite  (vide  p.  523) 2-6  pills. 

„     Galbaui  Composite  (vide  p.  523)  2-4  pills. 

Tinctura  Aloes  et  Myrrhse  1-2  fl.  dr.  (4-8  c.c.) 

Tinctura  Myrrhse 1-2  fl.  dr.  (4-8  c.c.) 

Action  and  Uses. — Myrrh  is  a  very  useful  astringent  in  the 
form  of  wash  or  gargle  for  spongy  gums,  aphthous  stomatitis, 
and  ulcerated  throats.  Internally  it  is  used  as  an  expectorant 
in  chronic  bronchitis ;  and  combined  with  iron  and  aloes  is  used 
in  the  treatment  of  amenorrhcea.  It  is  also  useful  in  bronchor- 
rhcea  and  leucorrhcea. 

B.P.  Elemi.  Elbmi. — A  concrete  resinous  exudation,  the 
botanical  source  of  which  is  undetermined,  but  is  sometimes 
referred  to  Canarium  commune  (or  to  Icica  Abilo).     Manilla. 

Characters. — A  soft  sticky  mass,  yellowish-white,  with  fennel-like 
odour ;  almost  entirely  soluble  in  rectified  spirit. 


894  VEGETABLE  MATEEIA  MEDICA.  [sect.  v. 

Composition. — Two  resins  and  a  volatile  oil. 

Preparation. 
B.P.    llngruentum  Eleml  (with  simple  ointment) 1  part  in  5. 

Uses. — Not  given  internally ;  is  used  as  a  local  stimulant  in 
ulceration. 

MELIACEiE. 

U.S.P.  Azedarach.  Azedakach. — The  bark  of  the  root  of 
Melia  Azedarach. 

Characters. — In  curved  pieces  or  quills  varying  in  size  and  thickness ; 
outer  surface  red-brown,  with  irregular,  blackish,  longitudinal  ridges ;  inner 
surface  whitish  or  brownish,  longitudinally  striate ;  fracture  more  or  less 
fibrous;  upon  transverse  section  tangentially  striate,  with  yellowish  bast- 
fibres  ;  almost  inodorous,  sweetish,  afterward  bitter  and  nauseous. 

If  collected  from  old  roots,  the  bark  should  be  freed  from  the  thick,  rust- 
brown,  nearly  tasteless,  corky  layer. 

Action. — It  produces  vomiting  and  purging  and  symptoms  of 
narcotic  poisoning. 

Use. — It  is  used  as  an  anthelmintic,  to  destroy  the  ascaris 
lumbricoides,  in  the  form  of  a  decoction  (2  oz.  of  the  herb  to  a 
pint  of  water,  boiled  down  to  ^  a  pint).  This  is  given  in  doses 
of  a  tablespoonful  every  two  or  three  hours  until  the  bowels  are 
freely  opened. 

ILICINE^E. 
(AQUIFOLIACE/E.) 

U.S.P.  Prinos.  Prinos.  Black  Aldee. — The  bark  of 
Prinos  verticillatus,  Linne  (Ilex  verticillata,  Gray). 

Characters. — Thin,  slender  fragments,  about  one -twenty -fifth  of  an  inch 
(1  millimetre)  thick,  fragile ;  outer  surface  brownish  ash-coloured  with  whitish 
patches  and  blackish  dots  and  lines,  the  corky  layer  easily  separating  from 
the  green  tissue ;  inner  surface  pale  greenish  or  yellowish ;  fracture  short, 
tangentially  striate ;  nearly  inodorous,  bitter,  slightly  astringent. 

Dose. — 30  grains. 

Action. — It  is  an  astringent  bitter.  It  is  employed  in  the 
form  of  a  decoction,  prepared  by  boiling  two  ounces  of  the  bark 
in  three  pints  of  water  down  to  two  pints.  This  decoction  is 
given  internally,  in  doses  of  two  or  three  fluid  ounces,  in  diar- 
rhoea and  malarial  disorders,  and  is  used  externally  in  indolent 
sores  and  chronic  skin-diseases. 

CELASTRINiE. 

U.S.P-  Euonymus.  Euonymus.  Wahoo. — The  bark  of 
Euonymus  atropurpureus. 

Characters.— In  quilled  or  curved  pieces,  about  one-twelfth  of  an  inch 
(2  millimetres)  thick ;  outer  surface  ash-grey,  with  blackish  patches,  detached 
in  thin  and  small  scales ;  inner  surface  whitish  or  slightly  tawny,  smooth ; 
fracture  smooth,  whitish,  the  inner  layers  tangentially  striate;  nearly 
inodorous ;  taste  sweetish,  somewhat  bitter  and  acrid. 


chap,  xxxn.]  DISCIPLOE^l.  895 

Preparation. 

dose. 
Extractum  Euonymi ....2-5  gr. 

Composition. — It  contains  a  bitter  principle  called  euonymin, 
■which  is  precipitated,  together  with  a  resin  and  a  fixed  oil,  when 
the  strong  tincture  is  poured  into  water. 

Action. — It  acts  as  an  hepatic  stimulant  (p.  403),  hydra- 
gogue  cathartic,  and  diuretic.  In  large  doses  it  causes  intestinal 
and  hemorrhoidal  irritation. 

Use. — In  constipation  accompanied  by  biliousness,  and  in 
chronic  malarial  conditions, 

RHAMNE^E. 

B. P.  Rhamni  Purshiani  Cortex.  Sacked  Babk.  {Synonym. 
Cascaea  Sageada.) — The  dried  bark  of  Rhcmnus  Purshianust 
North  Pacific  Coast. 

Characters.— In  quills  or  incurved  pieces  of  varying  lengths  and  sizes, 
the  bark  itself  being  from  about  A  to  £  of  an  inch  thick,  smooth  or  nearly  so 
externally,  covered  with  a  greyish-white  layer,  which  is  usually  easily  re- 
moved, and  frequently  marked  with  spots  or  patches  of  adherent  lichens. 
Beneath  the  surface  it  is  violet-brown,  reddish-brown,  or  brownish;  and 
internally  reddish-brown  or  yellowish-brown,  and  nearly  smooth,  although 
somewhat  striated  longitudinally.  Fracture  short,  except  internally,  where 
it  is  slightly  fibrous,  more  especially  in  the  larger  pieces.  No  marked  odour ; 
taste  bitter.  It  is  frequently  imported  in  flattened  packets,  consisting  of 
small  pieces  of  the  bark  compressed  into  a  more  or  less  compact  mass. 

Composition. — Cascara  bark  contains  several  resinoid  bodies, 
which  are  supposed  to  be  derived  from  chrysophanic  acid. 
It  also  contains  much  tannin. 

Preparations. 

B.P.  DOSE. 

Extractum  Cascarae  Sagradae 2-8  gr. 

„  „  „  Xiiqutdum \-2  fl.  dr. 

Action  and  Uses. — All  the  species  of  buckthorn  appear  to 
possess  cathartic  properties.  Cascara  Sagrada  is  usually  given 
in  the  form  of  liquid  extract  in  doses  of  \  to  1  fl.  dr.,  but  £  fl.  dr. 
or  less  given  immediately  after  rising  in  the  morning  or  at  bed- 
time is  often  sufficient.  It  may  also  be  given  with  advantage 
in  chronic  constipation  in  doses  of  10-15  min.  thrice  a  day 
before  meals.  It  acts  as  a  stomachic  tonic  and  bitter  in  these 
small  doses. 

Rhamni  Frangulae  Cortex,  B.P. ;  •  Frangula,  U.S. P. 
Feangula  Baek,  B.P. ;  Buckthoen,  TJ.S.P. — The  dried  bark  of 
Rhamnus  Frangula,  collected  from  the  young  trunk  and  moderate- 
sized  branches  and  kept  at  least  one  year  before  being  used. 
Holland. 


896  VEGETABLE    MATERIA  MEDICA.  [sect.  v. 

Characters.— In  quills  about  5\  of  an  inch  thick ;  greyish  or  blackish- 
brown  outside  with  whitish  corky  warts;  brownish-yellow  internally. 
Nearly  inodorous,  taste  sweetish  and  bitter. 

Composition.— The  most  important  constituent  is  a  cathartic 
substance,  frangulin. 

Preparations. 
B.P. 

Extractum  Rhamni  Frangulso 15-60  gr. 

„  „  „  Iilquidum 1-4  fl.  dr. 

u.s.p.  dose. 

Extractum  Frangulse  Fluidum 1  fl.  dr.  (4  c.c.) 

Action  and  Uses. — When  fresh  it  acts  as  an  irritant  poison 
on  the  gastro-intestinal  canal,  but  when  dried  its  action  becomes 
less  violent,  and  more  like  that  of  rhubarb.  It  is  used  as  a 
purgative  in  constipation,  and  may  be  given  in  the  form  of  the 
fluid  extract  or  of  a  decoction  (£  oz.  to  \  pint)  in  tablespoonful 
doses,  or  as  an  elixir,  1  fl.  dr.  of  the  fluid  extract  to  3  of  elixir  of 
orange. 

AMPELIDiE. 
(VITACE^.) 

B.P.  Uvae.  Eaisins. — The  ripe  fruit  of  the  Vitis  vinifera, 
dried  either  wholly  or  partly  by  the  sun.     Spain. 

Composition. — They  contain  grape-sugar  and  acid  tartrate 
of  potassium. 

Preparations. 
Tinctura  Cardamomi  Composita. 
„        Senna. 

Uses. — They  are  used  to  sweeten  preparations.  They  are  a 
useful  stimulant  in  weariness  from  mental  work  (p.  193) ;  and  in 
active  physical  exertion,  such  as  alpine  climbing,  they  not  only 
tend  to  maintain  the  strength  and  prevent  exhaustion,  but  they 
somewhat  relieve  thirst  when  water  cannot  be  had  (p.  360). 

Vinum  Xericum,  B.P.     Sherry  Wine.      Vinum  Album, 

U.S.P.  White  Wine. — A  pale  amber  or  straw-coloured  alcoholic 
liquid,  made  by  fermenting  the  unmodified  juice  of  the  grape 
freed  from  seeds,  stems,  and  skins.  It  should  contain  not  less 
than  10  per  cent,  nor  more  than  12  per  cent,  by  weight  of 
absolute  alcohol. 

Preparation, 
u.s.p. 

Vinum  Album  Fortius,  prepared  by  mixing  7  parts  white  wine  with  1  of  alcohol. 
This  should  contain  not  less  than  20  per  cent,  nor  more  than  25  per  cent,  by  weight 
of  absolute  alcohol. 

U.S.P.  Vinum  Rubrum.  Bed  Wine. — A  deep  red  alcoholic 
liquid  made  by  fermenting  the  juice  of  coloured  grapes  in  pre- 
sence of  their  skins. 


chap,  xxxii.]  DISCIFLOKiE.  897 

It  should  not  contain  less  than  10  per  cent,  nor  more  than 
12  per  cent,  by  weight  of  absolute  alcohol. 
Action  and  Uses. — Vide  Alcohol  (p.  766). 

SAPINDACEiE. 

U.S. P-  Guarana.  Guabana. — A  dried  paste  prepared  from 
the  crushed  or  ground  seeds  of  Paullinia  sorbilis. 

Characters. — Sub-globular,  or  elliptic  cakes,  or  cylindrical  sticks,  hard, 
dark  reddish-brown ;  fracture  uneven,  somewhat  glossy,  showing  fragments 
of  seeds  invested  with  a  black  testa;  odour  slight,  peculiar,  resembling 
chocolate ;  taste  astringent,  bitter ;  it  is  partly  soluble  in  water,  and  in 
alcohol. 

Pbeparation. 

dose. 
Extractum  Guaranse  Pluidum 15  min.  to  1  fl.  oz. 

Composition. — It  contains  four  or  five  per  cent,  of  caffeine 
(p.  870)  and  a  considerable  amount  of  tannic  acid,  and  it  is 
upon  these  that  its  medicinal  value  depends. 

Uses. — It  is  chiefly  used  to  cut  short  attacks  of  sick  headache. 
It  may  be  given  in  doses  of  one  or  two  drachms  of  the  powder, 
mixed  with  hot  water,  or  as  fluid  extract,  when  the  headache  is 
coming  on. 

ANACARDIACEvE. 

(TEREBINTHACE^.) 

Mastiche,  B.  and  U.S. P. — Mastich. — A  concrete  resinous 
exudation  obtained  by  making  incisions  in  the  bark  of  the  stem 
and  large  branches  of  Pistacia  Lentiscus.     Scio. 

Characters. — Globular  or  elongated  tears  about  the  size  of  a  pea,  pale 
yellow,  glass-like,  brittle,  becoming  soft  and  plastic  when  chewed ;  faint 
agreeable  odour  and  slight  terebinthinate  taste. 

Composition. — Consists  of  about  90  per  cent,  of  an  acid  resin 
(mastichic  acid),  soluble  in  alcohol ;  the  remaining  10  per  cent, 
is  masticin,  a  tenacious  resin  soluble  in  ether,  with  traces  of  an 
ethereal  oil. 

Preparation. 

u.s.p. 

PiluliB  Aloes  et  Mastiches  (vide  p.  523). 

Dose. — 20  to  40  gr.  if  administered  internally. 

Uses. — It  is  sometimes  chewed  in  order  to  give  a  pleasant 
odour  to  the  breath.  It  is  chiefly  employed  for  temporarily 
stopping  decayed  teeth,  and  for  arresting  haemorrhage  from 
leech-bites.  When  used  to  stop  teeth  the  cavity  ought  to  be  well 
cleaned  and  dried,  and  a  piece  of  cotton  saturated  with  a  solution 
of  four  parts  of  mastiche  should  be  gently  pressed  into  it  so  as 
not  to  cause  pain,  but  to  fill  the  cavity  exactly.    Another  method 

3  M 


898  VEGETABLE   MATEEIA  MEDICA.  [sect.  v. 

is  to  dissolve  one  part  of  mastiche  with  two  of  collodion,  and  fill 
the  cavity  with  this.  Either  of  these  methods  may  also  be  em- 
ployed to  stop  bleeding  from  leech-bites.  It  has  been  supposed 
to  have  a  stimulating  action  on  the  bronchial  mucous  mem- 
Drane,  and  has  been  used  in  bronchorrhcea,  and  also  in  infantile 
cholera.  It  is  used  to  cover  mercurial  pills  and  prevent  the 
formation  of  amalgam  when  they  are  silvered.  When  mixed 
with  aloes  it  renders  the  pill  less  readily  soluble,  and  so  to  exert 
an  action  more  on  the  lower  than  upper  part  of  the  intestine. 

U.S.P.  Rhus  Glabra.  Ehus  Glabra.  Sumach. — The 
fruit  of  Rhus  glabra. 

Characters. — Sub-globular,  about  one-eighth  of  an  inch  (3  millimetres) 
in  diameter,  drupaceous,  crimson,  densely  hairy,  containing  a  roundish- 
oblong,  smooth  putamen.    It  is  inodorous,  and  its  taste  acidulous. 

Peepabation. 

dose. 

Extractum  Rhois  Glabrae  Fluidum 1-2  fl.  dr. 

Composition. — It  contains  much  tannin. 

Uses. — It  may  be  used  as  an  astringent  in  the  form  of  de- 
coction, or  of  the  fluid  extract  diluted,  for  an  effective  gargle  in 
inflammation  of  the  throat  or  mouth. 

U.S.P.  Rhus  Toxicodendron.  Ehus  Toxicodendron. 
Poison  Ivy.— The  fresh  leaves  of  Rhus  Toxicodendron,  Michaux  ; 
Rhus  Toxicodendron  and  Rhus  radicans,  Linne. 

Characters. — Long-petiolate,  trifoliate ;  the  lateral  leaflets  sessile,  about 
four  inches  (10  centimetres)  long,  obliquely  ovate,  pointed;  the  terminal 
leaflets  stalked,  ovate  or  oval,  pointed,  with  a  wedge-shaped  base  ;  the  leaflets 
entire  and  glabrous  (in  Rhus  radicans,  Linn^),  or  variously  notched,  coarsely 
toothed  or  lobed,  downy  beneath  (in  Rhus  Toxicodendron,  Linne)  ;  when 
dry,  papery  and  brittle  ;  inodorous ;  somewhat  astringent  and  acrid. 

The  fresh  leaves  abound  with  an  acrid  juice  which  darkens  when  exposed 
to  the  air,  and,  when  applied  to  the  skin,  produces  inflammation  and  swelling. 
The  leaves  should,  therefore,  not  be  touched  with  bare  hands. 

Rhus  Toxicodendron  should  not  be  confounded  with  the  leaves  of  Ptelea 
trifoliata,  Linn£,  which  are  similar  in  appearance,  but  have  all  the  leaflets 
sessile. 

Composition. — It  contains  a  volatile  acid  which  appears  to 
be  the  active  principle. 

Action. — In  many  persons,  contact  with  this  plant  causes  an 
eczematous  eruption  of  a  very  distressing  character,  which  is  best 
treated  by  solutions  of  lead,  permanganate  of  potassium,  and  am- 
monia. Internally  it  causes  gastro-intestinal  irritation,  drowsi- 
ness, stupor,  and  delirium. 

Uses. — It  has  been  recommended  in  incontinence  of  urine, 
paralysis,  and  cutaneous  diseases. 

A  fluid  extract  of  a  non-officinal  plant,  Rhus  aromatica,  has 
been  used  successfully  in  incontinence  of  urine  in  doses  of  5  to 
80  min. 


chap,  xxxm  ]  CALYCIFLOEiE.  899 


CHAPTEE  XXXIII. 
Class  I.--DICOTYLEDONES   POLYPETALiE. 

Sub-Class  III.— CALYCIFLOEJ3. 

LEGUMINOSjE. 

Sub-Order  I.— PAPILIONACEiE. 

Glycyrrhizae  Radix,  B.P. ;  Glycyrrhiza,  U.S.P.  Liquor- 
ice Eoot. — The  root  or  underground  stem,  fresh  and  dried,  of 
Glycyrrhiza  glabra. 

Characters. — In  long  cylindrical  branched  pieces,  tough  and  pliable ; 
yellowish-brown  outside,  yellow  inside  ;  taste  sweet  and  slightly  acrid. 
Digested  with  water  it  yields  a  solution  which  gives  a  precipitate  with 
diluted  sulphuric  acid. 

Composition. — Contains  starch,  sugar,  and  a  sweet  principle 
—glycyrrhizin — which  is  the  substance  precipitated  by  sul- 
phuric acid. 

Preparations. 
b.p.  strength.  dose. 

Confectio  Terebinthinaa    1  in  4 60-120  gr. 

Decoetum  Sarsse  Compositum \  oz.  in  1\  pint 2-10  fl.  oz. 

Extraction  Glycyrrbizse 10-30  gr. 

,,  „  Xiiquidum 1  fl.  dr. 

Infusum  Lini 1  in  87J  fl.  parts 1-2  fl.  oz. 

Pilula  Hydrargyri  (vide  p.  522) 3-8  gr. 

„      Ferri  Iodidi  (vide  p.  522) 3-8  gr. 

Pulvis  Glycyrrhizae  Compositus  (vide -p.  910) 30-60  gr. 

OF   EXTRACT   OF   LIQUORICE — 

Confectio  Sennae 1  part  in  94,  nearly. 

Decoetum  Aloes  Compositum 1  oz.  in  30  fl.  oz. 

Tinctura  Aloes 1|  oz.  to  1  pint. 

Trochisci  Opii 

OF   LIQUID   EXTRACT   OF   LIQUORICE — 

Mistura  Sennse  Composita 1  fl.  oz.  in  1  pint. 

Tinctura  Chloroformi  et  Morphines 


U.S.P.  DOSE. 

Extractum  Glycyrrhizae  Fluidum 1  fl.  dr.  (4  c.c.) 

„  „  Purum 1  fl.  dr.  (4  c.c.) 

Glycyrrhizinum  Ammoniatum  5-15  gr.  (0'32-l  gm.) 

Pulvis  Glycyrrhiza  Compositus  (vide  p.  906) 30-60  gr.  (2-4  gm.) 

U.S.P.  Glycyrrhizinum  Ammoniatum.  Ammoniated  Glycyrrhizin.  —Prepared, 
by  exhausting  powdered  liquorice  with  ammonia,  precipitating  by  sulphuric  acid, 
redissolving  in  ammonia,  and  drying.  It  forms  dark  brown  or  reddish  scales,  very 
sweet.    It  is  used  for  flavouring. 

3  ii  2 


900  VEGETABLE  MATEKIA  MEDICA.  [sect.  v. 

Action  and  Uses.— Taken  into  the  mouth,  liquorice  has  a 
sweet  taste;  it  increases  the  flow  of  saliva,  and  being  muci- 
laginous acts  as  a  demulcent.  It  is  used  to  allay  cough  by 
lessening  the  irritation  of  the  mucous  membrane.  It  is  particu- 
larly useful  when  there  is  violent  cough  due  to  irritation  of  the 
pharynx  and  upper  part  of  the  respiratory  passages  (p.  249) .  It 
is  used  as  a  vehicle  to  cover  the  taste  of  other  medicines,  and 
has  been  used  instead  of  sugar  in  diabetes.  The  Pulv.  Glycyr- 
rhizae  Co.,  which  is  really  a  preparation  of  senna  (q.v.,  p.  909), 
is  a  gentle  laxative. 

Scopari  Cacumina,  B.P. ;  Scoparius,  U.S.P-  Broom- 
tops,  B.P. ;  Broom,  U.S.P. — The  fresh  and  dried  tops  of  Cytisus 
Scoparius  (Sarothamnus  Scoparius).     From  indigenous  plants. 

Characters. — Thin  flexible  tough  twigs,  dark  green,  angular,  of  a  bitter 
nauseous  taste,  and  of  a  peculiar  odour  when  bruised. 

Composition. — It  was  found  by  Stenhouse  to  contain  two 
principles :  a  neutral  body,  scoparin,  and  a  volatile  poisonous 
alkaloid,  sparteine. 

Preparations. 
B.P.  DOSE. 

Becoctum  Scoparii  (1  oz.  in  1  pint  for  10  minutes  and  strain)..l-3  fl.  oz. 

Succus  Scoparii 1-2  fl.  dr.  oi  more. 

None  in  u.s.p. 

Physiological  Action. — Broom-tops  have  a  diuretic  action. 

The  action  of  sparteine  is  identical  with  that  of  coniine.  It 
paralyses  the  endings  of  the  motor  nerves  and  vagi,  diminishes 
reflex  excitability  of  the  cord,  and  causes  death  by  paralysis  of 
the  respiratory  centre  in  the  medulla  oblongata.  According  to 
J.  Pick  it  has  a  diuretic  action. 

Scoparin  has  been  supposed  to  be  the  diuretic  principle.  It 
has  little  physiological  action,  and  in  a  number  of  unpublished 
experiments  which  I  made  in  1865  with  a  specimen  given  to  me 
by  my  friend  Dr.  Stenhouse,  I  found  that  in  the  healthy  subject 
it  does  not  produce  diuresis.  Similar  results  have  been  obtained 
by  Paton.  It  is  quite  possible,  however,  that  it  may  act 'as  a 
diuretic  in  cases  of  dropsy. 

Therapeutical  Uses. — Broom-tops  are  most  useful  in  dropsy 
dependent  on  chronic  renal  disease.  They  are  also  useful  in 
cardiac  dropsy,  but  digitalis  is  generally  more  certain.  In  com- 
parative experiments  I  have  found  the  decoction  of  the  dried 
broom-tops  quite  as  efficacious  as  the  juice  expressed  from  the 
fresh  tops. 

Tragacantha,  B.  and  U.S.P.  Tragacanth. — A  gummy 
exudation  obtained  by  making  incisions  in  the  stems  of  Astra- 
galus gummifer  and  some  other  species  of  Astragalus.  Asia 
Minor.  * 


chap,  xxxiii.]  CALYCIFLOEiE.  901 

Characters. — Shell-like  bands,  slightly  curved,  white  or  yellowish,  tough 
and  elastic  ;  very  sparingly  soluble  in  cold  water,  but  swelling  into  a  gelati- 
nous mass,  which  is  tinged  violet  by  tincture  of  iodine. 


Era.  187.— Tragaoanth,  hall  the  natural  size. 

Composition. — Consists  of  a  mixture  of  arabin,  or  common 
gum-arabic ;  and  bassorin,  a  gum  which  does  not  dissolve  in 
water,  but  swells  up  in  it. 

Pbepabations. 
8. p.  dose.  tj.s.p. 

Confectio  Opii 5-20  gr.  Mucilago  Tragaeanthse 

Sulphuris 60-120  gr. 

Glycerinum  Tragaeanthse 6  grs.  to  1  fl.  oz. 

iKuellago  .-  1  fl  oz.  or  more. 

Pulvia  Opii  Compositus 2-5  gr. 

„     Tragaeanthse  Compositus... 20  gr.  upwards. 

Mucilago  Tragaeanthse.  Mtichaqe  op  Thaqacanth. — Tragaoanth,  60  gr. ; 
water,  10  fl.  oz.  (B.P.).    Tragaoanth,  6 ;  glycerine,  18 ;  water  up  to  100  (U.S.P.). 

B.P.  Fulvls  Tragaeanthse  Compositus.  Compound  Powdee  or  Tbaoa- 
canth. — Tragaoanth,  1  ;  gum  acacia,  1 ;  starch,  1 ;  refined  sugar,  3. 

Uses. — It  is  used  to  suspend  heavy  powders,  such  as  sub- 
nitrate  of  bismuth,  and  is  more  efficacious  than  gum-arabic 
owing  to  the  insoluble  gum  bassorin,  which  swells  up  when  water 
is  added.  Also  used  in  making  lozenges,  and  emulsions  of  cod- 
liver  oil. 

Pterocarpi  Lignum,  B.P.  Ked  Sandal- Wood. — The  sliced 
or  rasped  heart-wood  of  Pterocarpus  santalinus.     Ceylon. 

Santalum  Rubrum,  U.S.P.  Eed  Saundeks. — The  wood  of 
Pterocarpus  santalinus. 

Characters. — The  wood  is  in  billets,  chips,  or  powder.  It  resembles  log- 
wood in  appearance,  but  is  denser,  and  the  cut  surface  is  more  glistening  and 
of  a  deeper  red  colour. 

Composition. — It  contains  a  fine  ruby  colouring  matter  named 
santalin,  which  may  be  dissolved  out  by  spirit,  ether,  acetic 
acid,  &c. ;  it  is  insoluble  in  water. 

Pbepabatkw. 
b.p.  dose.  tj.s.p. 

Tinctura  Lavandula  Composita f-2  fl.  dr.  Not  given 

Use. — It  is  used  to  give  colour  to  the  compound  tincture  of 
lavender,  and  thrqugh  this  to  Liquor  arsenicalis. 


902  VEGETABLE   MATEEIA  MEDICA.  [sect.  v. 

Kino,  B.  and  U.S. P-  Kino.— The  juice  obtained  from  in- 
cisions made  in  the  trunk  of  Pterocarpus  marsupium  inspissated 
without  artificial  heat.     Malabar. 

Characters.— Small  angular,  brittle,  glistening,  reddish-black  fragments, 
translucent  and  ruby-red  on  the  edges,  inodorous,  very  astringent.  When 
chewed  it  tinges  the  saliva  blood-red. 

Composition. — Kino-tannic  acid  and  pyrocatechin,  which 
differs  very  slightly  from  catechin,  obtained  from  catechu. 
Through  the  action  of  kino-tannic  acid,  kino  strikes  a  violet 
colour  with  ferrous  salts,  turning  to  green  by  exposure. 

Dose.—  Of  powdered  kino,  10-30  gr. 
Preparations. 

B.P.  DOSS. 

Pulvis  Catechu  Compositus  (p.  951) 20-40  gr. 

„      Kino  „  (p.  845) 5-20  gr. 

Tinctura  Kino J-2  fl.  dr. 

U.S.P. 

Tinctura  Kino |-2  fl.  dr.  (2-8  c.c.) 

Action  and  Uses. — Kino  has  an  astringent  action  both  ex- 
ternally and  internally.  It  is  useful  in  relaxed  sore-throat  as  a 
gargle.  It  is  given  internally  in  diarrhoea  and  in  pyrosis:  From 
its  insolubility  it  is  most  useful  when  we  desire  an  astringent 
action  on  the  lower  part  of  the  intestinal  canal,  but  when  the 
astringency  is  required  in  the  upper  part  it  is  not  so  useful  as 
the  more  soluble  astringents. 

Balsamum  Peruvianum,  B.  and  U.S.P.  Balsam  of  Peru. 
A  balsam  obtained  from  Myroxylon  Pereirce.  It  exudes  from 
the  trunk  of  the  tree  after  the  bark  has  been  beaten  and  scorched 
and  removed.     Salvador  in  Central  America. 

Characters. — A  treacle-like  liquid,  nearly  black  in  bulk,  reddish-brown 
and  translucent  in  thin  films  ;  of  syrupy  consistence,  balsamic  odour,  and  an 
acrid,  slightly  bitter  taste. 

Composition. — Contains  resin,  volatile  oil,  and  both  benzoic 
and  cinnamic  acids. 

Dose. — 10  min.  to  |  fl.  dr.,  and  upwards,  made  into  an 
emulsion  with  mucilage  or  yolk  of  egg. 

Action  and  Uses. — It  is  employed  locally  as  a  parasiticide 
in  scabies  and  in  cases  of  skin-diseases  depending  on  vegetable 
fungi.  It  destroys  both  the  itch-acarus  and  its  eggs.  It  is  much 
more  agreeable  than  sulphur  ointment.  Before  applying  it,  it  is 
advantageous  to  take  a  warm  bath,  and  wash  the  affected  parts 
thoroughly  with  soft  soap,  and  then  to  rub  it  well  in  all  over  the 
body,  especially  into  the  armpits,  between  the  fingers,  and  on  the 
inside  of  the  thighs.  The  treatment  should  be  repeated  every  two 
or  three  days,  during  which  time  the  same  linen  should  be  worn ; 
this  when  cast  off  should  be  well  disinfected,  or  the  disease  may 
return.  It  may  be  used  either  alone  or  in  combination  with 
petroleum  to  destroy  pediculi ;  a  useful  formula  is — balsam  of 
Peru,  20  parts ;  olive  oil,  50 ;  petroleum,  100  parts.     It  is  also 


chap,  xxxin.]  CALYCIFLOK^E.  903 

useful  in  prurigo,  in  pruritus,  and  in  the  later  stages  of  an  acute 
eczema.  It  is  a  useful  stimulant  to  bed-sores  and  ulcers.  It  is 
given  internally  to  lessen  discharge  from  mucous  membranes,  as 
in  bronchorrhoea,  gleet,  and  leucorrhcea;  also  as  a  stimulating 
expectorant  in  chronic  bronchitis. 

Balsamum  Tolutanum,  B.  and  U.S.P.  Balsam  of  Toltj. 
A  balsam  obtained  from  Myroxylon  toluifera.  It  exudes  from 
the  trunk  of  the  tree  after  incisions  have  been  made  into  the 
bark.     New  Granada. 

Characters. — A  soft  and  tenacious  solid  when  fresh,  but  hard,  brittle, 
and  resinous -looking  when  kept,  with  a  fragrant  balsamic  odour ;  soluble  in 
rectified  spirit.    The  solution  shows  an  acid  reaction  with  test-paper. 

Composition.  —  Contains  a  resin,  volatile  oil,  and  free 
cinnamic  and  benzoic  acids. 

Dose. — 10  to  20  grains. 

Peepaeations. 

B.P.  DOSE. 

Pilula  Phosphori  (4  parts  in  9)    

Syrupus  Tolutanus 1-3  11.  dr. 

Tinctura  Benzoini  Composita J-l  fl.  dr. 

„       Tolutana §-1  11.  dr. 

U.S.P. 

Syrupus  Tolutanus , 1-3  fl.  dr.  (4-12  c.c.) 

Tinctura  Tolutana 1-2  fl.  dr.  (4-8  c.c.) 

Uses. — As  a  stimulating  expectorant  in  chronic  coughs.  It 
should  not  be  used  while  acute  inflammation  is  present.  The 
syrup  covers  well  the  taste  of  chloral  or  butyl-chloral. 

Abrus.  Jequirity  Seeds,  Pbatee  Beads,  Jumble  Beads, 
Gumchi,  Indian  Liquorice. — The  seeds  of  Abrus  precatorius. 
Not  officinal. 

Characters. — Small  hard  seeds  of  a  brilliant  scarlet  colour,  with  a  black 
spot  round  the  hilum. 

Composition. — They  contain  a  ferment  closely  associated  with 
a  proteid  to  which  the  name  of  abrin  has  been  given.  The 
activity  of  the  ferment  is  destroyed  by  a  temperature  over  60°  C.1 
The  infusion  when  left  for  a  short  time  swarms  with  bacteria. 

Action. — When  applied  to  the  eye  the  infusion  causes  in- 
flammation of  the  conjunctiva.  The  seeds  are  sometimes  used 
to  kill  cattle  illegitimately.  The  seeds  are  moistened  with  water 
and  rolled  into  small  cylinders  or  needles  with  which  the  animal 
is  stabbed,  the  point  being  left  in  the  wound.  The  animal  dies 
in  a  few  hours.  The  seeds  contain  no  alkaloid,  and  possibly 
death  may  be  due  to  the  ferment  of  the  seeds  causing  micrococci 
and  bacilli  to  develop  in  the  blood  in  the  same  way  as  papain 
(P-  85).        

1  Warden  and  Waddell,  The  Non-iacillar  Nature  of  Abrus-Poison.  Calcutta, 
1884. 


904  VEGETABLE   MATEEIA  MEDICA.  [sect.  v. 

Use. — An  infusion  is  used  to  produce  purulent  ophthalmia 
in  order  to  cure  granular  lids.  The  infusion  is  made  by  mixing 
the  powdered  seeds  (3)  with  cold  water  (500),  and  adding  hot 
water  (500).  This  is  filtered  when  cold.  It  is  applied  three 
times  the  first  day,  and  repeated  on  the  second  or  third  day  if 
necessary.  An  emulsion  made  by  triturating  the  seeds  with 
water  and  painted  on  with  a  brush  is  useful  in  unhealthy  ulcere 
and  lupus. 

Physostigrnatis    Semen,    B.P. ;    Physostigma,     U.S.P. 

Calabab   Bean. — The   dried   seed   of   Physostigma    venenosum. 
Western  Africa. 


Fio.  188.— Calabar  Bean,  half  the  natural  size. 

Characters. — A  kidney-shaped  bean  about  an  inch  long,  chocolate- 
coloured,  shining,  and  with  a  broad  black  groove  along  the  whole  iength  of  the 
convex  edge.    Internally  the  bean  is  white,  and  tastes  like  an  edible  bean. 

Composition. — Contains  two  alkaloids — physostigmine  or 
eserine,  and  calabarine. 

Dose. — Of  the  powdered  bean  1  gr.  gradually  increased. 

Preparations. 

B.P.  DOSE. 

Extractum  Physostigrnatis J—J  gr. 

U.S.P. 

Extractum  Physostigrnatis i-J  gr.  (0-004-0-01  gm.) 

Tinetura  Physostigrnatis 12  min. 

B.P.  Physostigmina.  Physostigmine. — Synonym :  Eserine, 
Cl5H21N302. — An  alkaloid  obtained  from  the  alcoholic  extract  of 
Calabar  bean,  by  dissolving  the  extract  in  water,  adding  bicar- 
bonate of  sodium,  shaking  the  mixture  with  ether,  and  evapo- 
rating the  ethereal  liquid. 

Characters. — In  colourless  or  pinkish  crystals. 

Solubility. — It  is  slightly  soluble  in  water,  but  readily  soluble  in  alcohol 
and  in  dilute  acids. 

Beactions. — The  aqueous  solution  has  an  alkaline  reaction ;  when  warmed 
with  or  when  shaken  with  dilute  solution  of  potash  it  becomes  red,  and  when 
evaporated  to  dryness  over  a  water-bath  it  leaves  a  bluish  residue,  the  acidified 
solution  of  which  is  beautifully  dichroic,  being  blue  and  red.  Physostigmine 
causes  contraction  of  the  pupil  of  the  eye. 

Preparation. 
b.p,  strength. 

lamellae  Physostisminse iireotQ  Sr- in  each. 

U.S.P.  Physostigminae  Salicylas.  Salicylate  of  Physo< 
btigmine.  C16H21N302C7H603 ;  413.— The  salicylate  of  an  alka- 
loid prepared  from  physostigma. 


chap,  xxxiii.]  CALYCIFLOR^E.  905 

Characters. — Colourless,  shining,  acicular,  or  short,  columnar  crystals, 
gradually  turning  reddish  when  long  exposed  to  air  and  light,  odourless, 
having  a  bitter  taste,  and  a  neutral  reaction. 

Dosa.— -Jy  to^gr. 

Physiological  Action. — Physostigma  stimulates  muscular 
fibre,  both  voluntary  and  involuntary,  throughout  the  body,  and 
paralyses  the  nerve-centres. 

The  alkaloids  of  Calabar  bean  have  different  actions,  and 
different  or  even  contradictory  results  may  be  obtained  according 
to  the  amount  of  each  present  in  the  preparation  of  the  bean 
employed.  Physostigmine  or  eserine  paralyses  the  nervous 
centres  and  stimulates  muscular  fibre,  but  Calabarine  causes 
convulsions  like  strychnine. 

General  Action. — A  small  dose  of  physostigma,  from  its 
action  on  the  muscular  fibres  of  the  intestine,  causes  pain  in  the 
abdomen,  with  nausea  and  vomiting.  Prom  its  action  on  the 
vagus  and  motor  centres  it  causes  a  sense  of  oppression  in  the 
chest,  and  weakness.  With  larger  doses  these  symptoms  become 
worse ;  and,  in  addition,  contraction  of  the  pupil,  salivation, 
slowness  of  the  pulse,  and  spasmodic  respiration  occur.  "  Death 
is  due  to  paralysis  of  respiration. 

The  excitability  of  the  muscles  is  increased,  so  that  they 
contract  on  the  application  of  a  slighter  stimulus  than  usual,  but 
their  actual  working  power  is  not  increased.  In  the  first  stage 
of  poisoning  in  frogs  muscular  tremors  are  often  apparent,  and 
are  also  seen  on  the  local  application  of  the  drug  to  the  muscle 
of  frogs.  They  are  due  to  the  local  action  of  the  drug  on  the  intra- 
muscular end-plates,  for  they  occur  when  the  sciatic  nerve  has  been 
divided  before  poisoning,  but  cease  after  the  injection  of  curare. 

The  spinal  cord  is  paralysed ;  the  posterior  columns  first  and 
then  the  anterior  columns.  This  action  on  the  cord  is  the  cause 
of  the  general  paralysis  induced  by  the  drug.  Convulsions  like 
those  of  strychnine-poisoning  may  occur.  They  are  due  to 
calabarine. 

The  medulla  is  paralysed,  and  respiratory  movements  cease 
before  the  reflex  action  of  the  spinal  cord  is  destroyed. 

The  motor  nerves  in  warm-blooded  animals  are  not  usually 
affected  until  very  late,  but  in  frogs  they  are  paralysed  gradually. 

The  sensory  nerves  are  partially  paralysed  by  the  local 
application  of  physostigma  in  a  concentrated  form,  but  not  when 
it  is  injected  into  the  blood. 

The  brain  in  man  seems  not  to  be  paralysed,  for  in  a  number 
of  cases  of  poisoning  which  occurred  among  children  in  conse- 
quence of  eating  the  beans,  consciousness  was  not  impaired  at 
all,  and  neither  convulsions  nor  anaesthesia  occurred.  Not- 
withstanding the  absence  of  convulsions  in  these  cases,  however, 
physostigma  appears  to  have  an  irritant  action  upon  the  brain, 
for  when  it  is  administered  to  epileptic  patients,  or  to  animals 


906  VEGETABLE  MATEEIA  MEDICA.  [sect.  v.. 

rendered  epileptic  by  section  of  the  sciatic  nerve,  it  increases  the 
number  of  fits  (p.  188).  Cats  and  guinea-pigs  poisoned  by  it 
also  show  symptoms  of  great  cerebral  excitement,  becoming  very 
timid  and  running  wildly  about.  This  may  be  partly  due  to 
interference  with  the  respiration,  but  can  hardly  be  the  only 
cause,  as  this  condition  is  not  observed  in  the  case  of  other  drugs 
which  paralyse  the  respiration.  In  frogs  the  brain  appears  to  be 
paralysed  before  the  spinal  cord,  so  that  voluntary  motion  ceases 
before  reflex  action. 

Action  on  the  Eye.  —  When  locally  applied,  physostigma 
causes  contraction  of  the  pupil,  diminishes  intra-ocular  tension, 
and  causes  spasm  of  accommodation,  preceded  by  increased 
power  of  accommodation  for  near  objects  ;  often  twitching  of  the 
eyelids  and  slight  supra-orbital  pain  are  observed.  These  effects 
are  due  either  to  stimulation  of  the  fibres  of  the  third  nerve  or 
of  the  circular  muscular  fibres  of  the  iris ;  but  are  certainly  not 
clue  to  paralysis  of  the  sympathetic,  since  stimulation  of  the 
sympathetic  will,  during  the  influence  of  the  poison,  cause  dila- 
tation of  the  pupil  (p.  222). 

Respiration  is  first  quickened  and  then  retarded.  The 
acceleration  is  due  to  spasm  of  the  bronchial  tubes  according  to 
some  observers ;  but  others  consider  it  to  be  caused  by  stimula- 
tion of  the  ends  of  the  vagi  in  the  lungs  (p.  245) ;  and  it  is  certain 
that  if  the  vagi  are  first  divided,  physostigma  no  longer  causes 
acceleration  of  respiration,  but  slows  it  from  the  first.  The 
slowing  of  respiration  is  due  to  paralysis  of  the  respiratory 
centre  in  the  medulla.  Death  is  the  result  of  this  failure  of 
respiration. 

Action  on  the  Circulation. — Small  doses  sometimes  cause 
a  slight  fall  in  blood-pressure,  larger  ones  always  cause  a  rise. 
This  rise  is  chiefly  due  to  the  increased  contractile  power  of  the 
heart,  but  it  is  not  improbable  that  it  is  aided  by  a  contraction 
of  the  arterioles,  the  muscular  fibres  of  which,  like  all  other 
involuntary  muscles  in  the  body,  are  stimulated  by  the  action 
of  physostigma  upon  them.  According  to  Von  Bezold  and 
Goetz  the  rise  is  also  partly  due  to  tetanic  contraction  of  the 
intestinal  walls,  which  drives  the  blood  out  of  them.  The  irrita- 
bility of  the  vagus  appears  to  be  increased,  as  a  slighter  stimulus 
applied  to  its  trunk  will  stop  the  heart  after  its  administration. 
We  should  therefore  expect  the  normal  stimuli  passing  to  the 
vagus  centre  along  sensory  nerves  from  various  parts  of  the  body 
to  have  a  greater  effect  upon  the  heart  than  usual,  and  thus 
render  its  beats  slower.  This  seems  to  be  the  case,  for  physo- 
stigma causes  slowness  of  the  pulse,  which  does  not  appear  to 
depend  upon  direct  stimulation  of  the  vagus  roots,  as  it  is  absent 
in  animals  which  have  been  deeply  chloralised  before  the  admin- 
istration of  physostigma.  In  such  animals  physostigma,  on  the 
contrary,  quickens  the  pulse  and  raises  the  blood-pressure. 


chap,  xxxiii.]  CALYCIFLOE^.  907 

Muscle. — "When  applied  to  the  frog's  heart  it  renders  the 
pulsations  slower  and  more  powerful.  Its  stimulant  action  on 
the  cardiac  muscular  fibre  is  so  great  that  neither  irritation 
of  the  vagus  nor  of  the  venous  sinus  can  stop  the  heart.  That 
the  vagus  is  not  paralysed  is  shown  by  the  fact,  that  when  the 
stimulant  action  of  the  physostigma  on  the  muscular  fibre  is 
counteracted  by  a  poison  having  a  paralysing  action  on  the 
muscle,  such  as  a  double  salt  of  copper,  stimulation  of  the  vagus 
will  again  produce  the  stillstand  in  diastole.1  In  larger  doses 
physostigma  produces  the  staircase  phenomenon  (p.  312,  and 
Fig.  30,  p.  110),  and  finally  imperfect  stillstand  in  systole.  The 
contracted  ventricle  still  continues  to  pulsate  slightly,  and  when 
it  is  distended  by  increasing  the  pressure  of  the  fluid  within  it 
the  pulsations  become  vigorous,  and  there  is  no  tendency,  as  in 
the  case  of  digitalis,  to  rapid  paralysis  of  the  cardiac  muscle. 

The  action  of  physostigma  on  the  heart  is  counteracted  by 
atropine,  and,  though  to  a  less  extent,  the  action  of  atropine  is 
counteracted  by  physostigma  (p.  493). 

From  its  action  on  involuntary  muscle  it  causes  contraction 
of  the  stomach,  retching  and  vomiting.  It  causes  also  diarrhoea 
and  increased  peristaltic  movements  of  the  intestines,  which 
finally  end  in  tetanic  contraction,  so  that  the  lumen  of  tbe  in- 
testine is  almost  obliterated,  and  it  appears  like  a  hard  cord.  It 
causes  contraction  of  the  spleen,  bladder,  and  uterus :  these 
contractions  are  not  prevented  by  a  dose  of  atropine  sufficient  to 
paralyse  the  nerves.  The  difference  between  the  action  of  mus- 
carine, which  causes  tetanic  contraction  of  the  intestine  by 
acting  on  the  nerves,  and  of  physostigma,  which  produces  a 
similar  effect  by  acting  on  the  muscular  fibre,  is  seen  when  mus- 
carine, atropine,  and  physostigma  are  administered  successively 
to  an  animal.2  The  muscarine  first  causes  tetanic  contraction. 
Atropine  causes  this  to  disappear,  and  produces  complete  relaxa- 
tion, which  is  succeeded  by  a  second  tetanic  contraction  after  the 
administration  of  physostigma.  In  consequence  of  its  action  on 
the  bladder  it' causes  urination. 

Secretion  is  increased  by  physostigma  not  only  in  the  sali- 
vary, but  in  the  sweat,  lacrimal,  and  mucous  glands.  It  seems 
probable  that  the  secretion  is  not  due,  like  that  produced  by 
muscarine,  nicotine,  or  pilocarpine,  to  an  action  on  the  ends  of 
the  secreting  nerves,  but  rather  to  the  action  of  physostigma  on 
the  secreting  cells  themselves,  because,  unlike  the  secretion 
produced  by  the  three  drugs  already  mentioned,  it  still  persists 
after  the  administration  of  atropine.  Physostigma  restores  Its 
excitability  to  the  chorda  tympani  after  its  secretory  fibres  have 
been  paralysed  by  atropine.  When  the  dose  of  physostigma  is 
large,  the  secretion  of  saliva  which  it  occasions  lasts  only  for  a 

1  Harnaek,  Bzichheim's  Arsneimitlellehre,  3te  Aufl.,  p.  712. 
1  Sohmiedeberg,  ArenevmitteUehre,  p.  70. 


908  "VEGETABLE   MATERIA  MEDICA.  [sect.  v. 

short  time,  because  the  vessels  of  the  gland  become  so  much 
contracted  through  the  action  of  the  drug  that  the  circulation  is 
insufficient  to  maintain  the  secretion  (p.  358). 

Uses. — It  is  used  in  certain  diseases  of  the  eye,  e.g.  wounds 
and  ulcers  of  the  cornea,  and  from  its  lessening  intra-ocular 
tension  it  is  used  in  glaucoma  and  staphyloma  (p.  224).  It  re- 
moves dilatation  of  the  pupil  and  paralysis  of  accommodation 
after  the  use  of  atropine,  and,  used  alternately  with  atropine, 
breaks  down  adhesions  after  iritis  (p.  226). 

It  is  used  in  tetanus,  strychnine-poisoning,  general  paralysis 
of  the  insane,  and  mania,  in  paraplegia  and  in  locomotor  ataxy. 

It  is  also  useful  in  constipation  due  to  atony  of  the  intestinal 
walls. 

It  has  been  recommended  in  bronchitis,  catarrh,  and  dys- 
pnoea when  due  to  weakness  of  the  bronchial  muscles  (Einger). 

It  is  used  as  an  antidote  to  atropine  and  also  to  strychnine. 

Treatment  in  Poisoning  by  Physostigma. — Evacuate  the 
stomach  by  an  emetic,  and  inject  atropine  (4  minims  of  the 
liquor  every  ^  hour)  until  the  pulse  quickens  or  the  symptoms 
pass  off.  If  the  dose  of  atropine  be  too  great,  it  seems  to  in- 
tensify the  lethal  action  of  the  physostigma. 

Hsematoxyli     Lignum,     B.P. ;    Haematoxylon,     U.S.P. 

Logwood. — The  heart-wood  of  Hcsmatoxylum  campeehianum. 
Imported  from  Campeachy,  Honduras,  and  Jamaica. 

Characters. — The  logs  are  heavy,  hard,  purplish-black  externally, 
reddish-brown  internally.  The  chips  (which  are  the  officinal  form)  are 
reddish-brown,  and  have  often  a  greenish  lustre ;  they  have  a  feeble,  agreeable 
odour  and  sweetish  taste ;  a  small  portion  chewed  imparts  to  the  saliva  a 
dark  pink  colour. 

Composition. — The  colouring  principle  of  logwood  is  a  crystal- 
line substance,  hematoxylin.  It  is  soluble  in  hot  water  or  in 
alcohol.  Logwood  also  contains  tannic  acid,  which  imparts  to 
it  its  astringent  properties. 

Preparations. 
B.P,  DOSE. 

Decoctum  Kaematoxyli  (1  in  20) 1-2  fl.  oz. 

Extractum  „  10-30  gr. 

U.S.P. 

Extractum  Hasmatoxyli 10-30  gr.  (0-65-1-95  gm.) 

B.P.  Decoctum  Hasmatoxyli.  Decoction  oe  Logwood. — Logwood,  in  chips, 
1  oz. ;  cinnamon  bark,  bruised,  55  gr. ;  distilled  water,  1  pint. 

Boil  the  logwood  in  the  water  for  ten  minutes  in  a  covered  vessel,  adding  the 
cinnamon  towards  the  end.  Strain  the  decoction,  and  pour  as  much  distilled  water 
over  the  contents  of  the  strainer  as  will  make  the  strained  product  measure  a  pint. 

Uses. — It  is  a  useful  astringent  in  diarrhoea,  especially  in 
children.  Its  great  disadvantage  is  the  stain  which  it  imparts 
to  clothing.  For  the  diarrhoea  of  phthisis,  decoctum  heematoxyli 
with  acidum  sulphuricum  aromaticum  is  a  good  prescription.  It 
is  also  used  in  dysentery  and  in  atonic  dyspepsia. 

Chrysarobinum,  Chrysarobin,  B.  and  U.S.P.— Synonyms : 


chap,  xxxiii.]  CALYCIFLOE^E.  GG9 

Araroba  Powder  ;  Goa  Powder. — The  medullary  matter  of  the 
stem  and  branches  of  Andira  Araroba,  dried  and  powdered. 

Characters. — A  light  brownish-yellow,  minutely  crystalline  powder, 
tasteless  and  inodorous. 

Solubility. — Very  sparingly  soluble  in  water,  but  almost  entirely  soluble 
in  150  parts  of  hot  rectified  spirit. 

Ebactions. — On  heating  it  melts  and  partially  sublimes  in  yellow  vapours, 
leaving  a  charred  residue,  which  entirely  disappears  on  ignition  in  air.  It 
dissolves  in  sulphuric  acid  to  form  a  yellow  to  orange-red  solution,  and  in 
solution  of  caustic  potash  to  form  a  yellow  to  reddish  fluorescent  solution,' 
which  becomes  carmine  by  absorption  of  oxygen  from  the  air. 

Composition. — It  contains  more  or  less  chrysophanic  acid 
according  to  age  and  condition,  and  yielding  much  chrysophanic 
acid  by  oxidation. 

Dose. —  £  to  2  grains. 

Pbepabation,.  B.  and  TJ.S.P. 

Wnguentum  Cbrysaroblni.    Chrysarobin  Ointment  (Chrysarobin  1,  benzoated 

lard  24,  B.P. ;  Chrysarobin  10,  benzoated  lard  90,  TJ.S.P.). 

Uses. — -It  is  used  in  psoriasis  and  parasitic  affections  of  the 
skin.  It  may  be  simply  applied  to  the  skin  moistened  with 
vinegar  or  saliva,  or  used  in  the  form  of  qintment  (of  the 
strength  of  1  in  50  to  1  in  10) .  It  should  never  be  applied  to 
the  head,  as  it  may  cause  extensive  erythema  and  cedema  of 
the  face.  It  colours  both  the  skin  and  clothing,  and  it  is  better 
not  to  use  it  over  too  large  a  surface  at  a. time,  as  it  may  cause 
much  irritation.  In  2  per  cent,  ointment  it  is  useful  in  eczema 
after  exudation  has  ceased,  especially  in  that  of  the  genitals  and 
anus.  It  is  an  excellent  application  in  fissured  nipple,  and  is 
useful  in  tylosis  of  the  palms  and  soles  after  the  epidermis  has 
been  removed  by  salicylic  acid  plaster  (vide  p.  821).  It  may 
also  be  given  internally  in  eczema,  impetigo,  acne,  psoriasis, 
urticaria,  and  other  skin  diseases. 

Sub-Ordeb  II.— C^SALPINIjE. 

Senna,  U.S.P.  Senna. — The  leaflets  of  Cassia  acutifolia 
(Alexandrian  senna),  and  of  Cassia  elongata  (Indian  senna). 

Senna  Alexandrina,  B.P.    Alexandrian  Senna. — The  dried 
leaflets  of  Cassia  acutifolia  (Cassia  lanceolata).     Imported  from 
Alexandria,  and  sometimes   in   a  more   or  less   contaminated 
condition,  in  which  case  the  true  senna  leaflets  should  be  care-  _ 
fully  separated  from  all  extraneous  matters. 

Characters. — Lanceolate  or  oval-lanceolate  leaflets,  about  an  inch  long, 
unequally  oblique  at  the  base,  brittle,  greyish-green,  of  a  faint  peculiar 
odour,  and  mucilaginous  sweetish  taste. 

Senna  Indica,  B.P.  Tinnevelly  Senna. — The  dried  leaflets 
of  Cassia  angustifolia  (Cassia  elongata) .     Southern  India. 

Characters.— About  two  inches  long,  lanceolate,  acute,  unequally  oblique 
at  the  base,  flexible,  entire,  green,  without  any  admixture  ;  odour  and  taste 
those  of  Alexandrian  senna,  in  place  of  which  it  may  be  used. 


910  VEGETABLE  MATEEIA  MEDICA.  [sect.  v. 

Composition. — The  properties  of  senna  are  due  principally  to 
a  glueoside,  cathartic  acid,  which,  when  isolated,  is  powerfully 
purgative. 

Adulteration.— Of  Alexandrian  senna,  Solenostemma  Argel ;  none  of 
Tinnevelly  senna. 


FlO.  189.— Alexandrian  Senna,  hall  natural  size.         FIO.  190.— Indian  Senna,  naif  natural  size. 

Test. — Senna-leaves  have  always  an  unequally  oblique  base,  and  are  free 
from  bitterness.    Other  leaves  are  equally  oblique  at  the  base. 

Preparations. 
B.P.  DOSE. 

Confectio  Sennas  60-120  gr. 

Xntusum        » 1-2  fl.  oz. 

Mistura         ,.        Composita 1-1J  fl.  oz. 

Syrupus        1  A-  dr.  upwards. 

Tinctura        1  A-  dr.  to  \  fl.  oz. 

Pnlvis  Glycyrrnizae  Composltus 30-60  gr. 

U.S.P. 

Confectio  Sennas 60-120  gr. 

Extraotum  Sennas  Fluidum 1  fl.  dr.  (4  c.c.) 

Infusum  Sennas  Compositum  2J-  fl.  oz.  (75  c.c.) 

Pulvis  Glycyrrhizas  Compositus  30-60  gr.  (2-4  gm.) 

Syrupus  Sarsaparillas  Compositus 1-4  fl.  dr.  (4-16  c.c.) 

Syrupus  Sennas 1-4  fl.  dr.  (4-16  c.c.) 

Confectio  Sennas,  Confection  of  Senna. — Senna,  in  fine  powder,  7;  cori- 
ander, 3  ;  figs,  12 ;  tamarind,  9  ;  cassia  pulp,  9 ;  prunes,  6  ;  extract  of  liquorice,  1 ; 
refined  sugar,  30;  distilled  water,  up  to  75  (B.P.)  Senna,  10 ;  coriander,  6  ;  cassia 
fistula,  16  ;  tamarind,  10 ;  prunes,  7 ;  figs,  12  ;  sugar,  50 ;  water,  60  (U.S.P.). 

B.P.  Infusum  Sennae.  Infusion  of  Senna. — Senna,  2  ;  ginger,  sliced,  1 ; 
boiled  distilled  water,  20. 

U.S.P.  Infusum  Sennas  Compositum.  Compound  Infusion  of  Senna.  Black 
Draught. — Senna,  6  ;  manna,  12  ;  sulphate  of  magnesium,  12  ;  fennel,  2  ;  boiling 
water,  100.    Macerate,  strain  and  make  up  to  100  with  water. 

B.P.  Wtistura  Sennae  Composita.  Compound  Mixture  of  Senna. — Sul- 
phate of  magnesium,  4  ;  liquid  extract  of  liquorice,  1 ;  tincture  of  senna,  2| ;  com- 
pound tincture  of  cardamoms,  li ;  infusion  of  senna,  15. 

Pnlvis  Glycyrrnizae  Compositus.  Compound  Liquorice  Powder,  B.  and 
U.S.P. — Senna,  2  ;  liquorice  root,  2  ;  fennel  fruit,  1 ;  sublimed  sulphur,  1 ;  sugar, 
6  (B.P.).  Senna,  18 ;  liquorice,  16 ;  fennel,  8 ;  washed  sulphur,  8 ;  sugar,  50 
(U.S.P.). 

Syrupus  Sennae,  B.  and  V.S.P.  Syrup  of  Senna. — Senna,  16  oz. ;  oil  of 
.  coriander,  3  min. ;  refined  sugar,  24  oz. ;  distilled  water,  5  pints,  or  a  sufficiency  ; 
rectified  spirit,  3  fl.  oz. ;  distilled  water,  up  to  2  lb.  10  oz.  (B.P.).  Senna,  33 ;  sugar, 
60 ;  alcohol,  4 ;  oil  of  coriander,  1 ;  water  up  to  100  (U.S.P.). 

B.P.  Tinctura  Sennae.  Tinctore  of  Senna. — Senna,  2|  oz. ;  raisins,  2  oz. ; 
caraway  fruit,  -j  oz. ;  coriander  fruit,  \  oz. ;  proof  spirit,  1  pint. 

Action  and  Uses. — Senna  acts  as  a  laxative  or  brisk  pur- 
gative, according  to  the  dose.  It  acts  chiefly  on  the  small 
intestines,  and  increases  both  peristalsis  and  the  secretion.  It 
is  frequently  combined  with  other  purgatives.  A  useful  remedy 
in  constipation  is  Mistura  Sennse  Co.,  where  we  have  senna  com- 


chap,  xxxiii.]  CALYCIFLOEiE.  911 

bined  with  sulphate  of  magnesium.  In  habitual  constipation, 
the  most  convenient  preparation,  perhaps,  is  Pulvis  Glycyr- 
rhizse  Co.,  which  contains  sulpbur  and  fennel-seeds  as  well  as 
senna  and  liquorice  root.  One  drachm  taken  every  day  at  bed- 
time will  generally  keep  the  bowels  regularly  open  without 
acting  too  violently.  The  sulphur  in  this  preparation  is  in  such 
small  quantity  that  it  might  seem  useless  ;  but  in  a  number  of 
experiments  which  I  made  on  small  quantities  (about  \  grain)  of 
sulphur  many  years  ago,  I  found  that  they  caused  an  increase  of 
flatus  in  the  intestine  which  appeared  to  facilitate  the  expulsion 
of  its  contents. 

Cassia  Fistula.  Pueging  Cassia,  U.S.P. — The  fruit  of 
Cassia,  fistula. 

Cassiae  Pulpa,  B.P-  Cassia  Pulp. — The  pulp  obtained 
from  the  recently  imported  pods  of  Cassia  fistula  (the  purging 
cassia). 

Chaeactees. — BlacMsh  -brown,  viscid,  sweet  in  taste,  and  somewhat 
sickly  in  odour ;  usually  containing  the  seeds  and  dissepiments,  which  should 
be  removed  before  it  is  used. 

Composition. — Sugar,  with  albuminoid  matter. 
Dose. — 120  gr.  or  more. 

Pbepabations. 

b.p.  dose.  u.s.p.  dose. 

Confectio  Sennse 60-120  gr.  Confectio  Sennfe 1-2  dr.  (4-8  gra.) 

Use. — A  simple  laxative  in  doses  of  120  gr.  upwards.  Seldom 
given  alone. 

Tamarindus,  B.  and  U.S.P.  Tamarind. — The  preserved 
pulp  of  the  fruit  of  Tamarindus  indiea.     West  Indies. 

Chabactees.— A  reddish-brown,  sweetish,  subacid  pulp,  preserved  in 
sugar,  containing  strong  fibres,  and  brown  shining  seeds,  each  enclosed  in  a 
membranous  coat. 

Composition. — The  pulp  contains  citric,  tartaric,  and  acetic 
acids,  chiefly  in  combination  with  potassium.  Grape-sugar  is 
also  present. 

Impoeity. — Traces  of  copper. 

Test.— A  piece  of  bright  iron  left  in  contact  with  the  pulp  for  an  hour 
does  not  exhibit  any  deposit  of  copper. 

Dose. —  £  oz.  and  upwards. 

Pbepabations. 

S.P.  dose.  u.s.p.  cosn. 

Confectio  Semite 60-120  gr.         Confectio  Senna 1-2  dr.  (4-8  gra.) 

Uses. — Tamarind,  in  doses  of  \  oz.  upwards,  is  both  a  laxa- 
tive and  refrigerant.  The  pulp  is  said  to  weaken  the  action  of 
resinous  cathartics  in  general,  but  it  is  frequently  prescribed 
with  them,  and  is  used  in  the  form  of  compressed  tablets,  called 
'Tamar  Indien,'  as  a  vehicle  for  the  administration  of  some 


912  VEGETABLE   MATEEIA  MEDICA.  [sect.  v. 

gurgative,  probably  jalap.  A  cooling  and  agreeable  drink  (tama- 
rind whey)  may  be  made  by  adding  4  parts  of  the  pulp  to  100 
of  boiling  milk,  straining  and  filtering. 

Copaiba,  B.  and  U.S.P-  Copaiva,  oe  Copaiba,  B.P. ;  Balsam 
of  Copaiba,  U.S.P. — The  oleo-resin  obtained  by  cutting  deeply  or 
boring  into  the  trunk  of  Copaifera  Langsdorfii,  and  other  species 
of  Copaifera.     Valley  of  the  Amazon. 

Characters. — A  more  or  less  viscid  liquid,  about  the  consistence  of  olive 
oil,  light  yellow,  transparent,  with  a  peculiar  odour  and  a  persistently  bitter 
and  acrid  taste. 

Composition. — Copaiva  consists  of  a  solution  of  several  resins 
in  a  volatile  oil.  The  resins  consist  chiefly  of  crystallisable 
copaivic  acid. 

Impurities. — Wood  oil,  or  gurjun  balsam,  and  fixed  oils,  especially  castor 
oil,  fraudulently  added. 

Tests. — Perfectly  soluble  in  an  equal  volume  of  benzene.  Does  not  become 
gelatinous  after  having  been  heated  to  270"  F.  Is  not  fluorescent  (wood  oil). 
After  heating  on  paper  it  does  not  leave  a  greasy  ring  round  the  stain  (fixed  oil). 

The  absence  of  turpentine  is  shown  by  the  smell  of  it  not  being  given  off 
on  heating,  and  after  distilling  off  the  volatile  oil  the  residue,  when  cool, 
should  be  hard  and  friable  (absence  of  fixed  oils).  The  essential  oil  distilled 
off  from  the  oleo-resin,  when  rectified,  should  not  begin  to  boil  below  200°  C. 
(392°  F.).  On  adding  1  drop  of  copaiba  to  19  drops  of  disulphide  of  carbon, 
and  shaking  the  mixture  with  1  drop  of  a  cold  mixture  of  equal  parts  of  sul- 
phuric and  nitric  acids,  it  should  not  acquire  a  purplish  red  or  violet  colour 
(absence  of  gurjun  balsam).  , 

Preparations. 
b.p.                              dose.                     u.s.p.  dose. 

Oleum  CopaibES  5-20  min.         Massa  Copaibse 10-30  gr. 

U.S.P.  Massa  Copaibte.  Mass  of  Copaiba. — Copaiba,  94 ;  magnesia  recently 
prepared,  6 ;  mix  and  set  aside  till  it  concretes  into  a  pilular  mass.  If  it  does  not 
concrete  in  eight  or  ten  hours,  there  is  deficiency  of  water  in  the  copaiba.  This 
may  be  remedied  in  subsequent  operations  by  shaking  the  copaiba  with  one- 
twentieth  of  its  weight  of  water  and  decanting  after  the  uncombined  water  has 
subsided.  The  mass  is  divided  while  fresh  into  pills  weighing  5  gr.  (0-33  gm.) 
each. 

Oleum  Copaibze,  B.  and  U.S.P.  On,  of  Copaiva. — A  vola- 
tile oil  distilled  from  copaiva. 

Characters. — Colourless  or  pale  yellow,  with  the  odour  and  taste  of 
copaiva. 

Dose. — Of  copaiva,  15  min.  to  1  fl.  dr. ;  of  oil  of  copaiva, 
5  min.  to  20  min.;  of  the  resin  (as  a  diuretic),  15  to  20  gr.  in 
almond  emulsion. 

Copaiva  may  be  taken  mixed  with  yolk  of  egg  or  floating  upon 
■water  or  some  other  liquid,  or  made  into  pills  with  burnt  mag- 
nesia ;  or  lastly,  dissolved  in  water  by  the  aid  of  liquor  potassse, 
with  which  it  forms  a  soap.  Sometimes,  to  hide  its  disagreeable 
taste,  it  is  put  into  membranous  or  gelatinous  capsules. 

Action. — Copaiva  has  a  stimulating  action  on  mucous  mem- 
branes, especially  those  of  the  lungs  and  genito-urinary  tract.  It 
is  diuretic.     Large  doses  have  an  irritant  action,  causing  vomit- 


chap,  xxxiii.]  CALYCIPLOE^l.  913 

ing  and  purging.  It  is  excreted  by  the  kidneys  and  lungs,  and 
may  be  recognised  by  its  characteristic  odour.  It  is  very  apt  to 
produce  an  eruption  of  the  skin,  generally  in  the  form  of  rose- 
coloured  spots  resembling  a  syphilitic  eruption,  but  distinguished 
from  it  by  its  affecting  chiefly  the  backs  of  the  arms  and  legs,  by 
coming  on  suddenly,  and  by  the  intense  itching  with  which  it  is 
accompanied.  Sometimes  it  resembles  urticaria  more  in  its 
appearance,  but  rarely  it  is  eczematous.  Copaiba  forms  a  con- 
jugate glycuronic  acid  in  the  system,  and  is  eliminated  in  the 
urine,  which,  with  nitric  acid,  gives  a  precipitate  of  copaibic 
acid  easily  mistaken  for  albumen,  but  distinguished  by  disappear- 
ing on  the  application  of  heat.  The  conjugate  acid  renders  the 
urine  antiseptic  as  it  is  secreted  by  the  kidneys,  so  that  it  does 
not  readily  decompose,  and  bacteria  either  do  not  appear  in  it  at 
all  or  only  in  very  small  numbers,  even  after  the  surface  has 
become  covered  with  mould.  It  is  probable  that  the  utility  of 
the  drug  in  diseases  of  the  bladder  and  urethra  is  due  to  the 
washing  out  of  the  urinary  passages  by  the  antiseptic  urine 
(p.  446). 

Uses. — Copaiba  is  employed  in  diseases  of  the  mucous  mem- 
branes, and  especially  of  the  genito-urinary  passages,  the  lungs, 
and,  along  with  digitalis,  in  cardiac  dropsy.  It  is  also  useful  in 
chronic  bronchitis  and  bronchorrhcea.  Its  great  disadvantage  is 
its  nauseous  smell  and  taste.  It  is  chiefly  used  in  gonorrhoea. 
It  is  not  advisable  to  use  it  when  the  inflammation  is  acute  and 
severe,  but  it  is  exceedingly  useful  after  the  acuteness  of -the 
inflammation  has  subsided.  It  is  not  so  useful  in  gleet.  It  ap- 
pears to  be  of  service  in  chronic  cystitis.  The  resin  is  a  good 
diuretic,  especially  in  cases  of  dropsy  depending  on  disease  of 
the  liver,  where  the  kidneys  are  healthy. 

Piscidia  Erythrina.  Jamaica  Dogwood. — The  part  used  is 
the  bark.     Not  officinal. 

JpBEPABATION. 

DOSE. 

Extractum  Piscidias  Erythrinse  Fluidum , 20  min.-2  fl.  dr. 

Action. — It  has  been  employed  for  stupefying  and  catching 
fish.  It  is  a  narcotic  not  only  to  fish  but  to  frogs,  rabbits,  and 
man.  It  lessens  reflex  action  at  first,  by  stimulation  of  Setsche- 
now's  centres  (p.  165),  and  afterwards  produces  tetanus  by 
stimulation  of  the  spinal  cord.  It  stimulates  the  vaso-motor 
centre,  raises  blood-pressure,  and  slows  the  pulse.  It  dilatea 
the  pupil.     It  increases  the  secretion  of  the  skin  and  saliva. 

Use. — It  is  employed  as  a  narcotic  instead  of  opium. 

Sub-Oedeb  III.— MIMOSEiE. 

Acaciae  Gummi,  B.P. ;  Acacia,  U.S.P.  Gum  Acacia,  B.P.  j 
Gum  Aeabic,  U.S.P. — A  gummy  exudation  from  the  stem  and 

3  N 


914  VEGETABLE  MATEEIA  MEDICA.  [sect,  v., 

branches  of  Acacia  Senegal  (Acacia  Verek),  and  from  other  species 
of  Acacia. 

Characters. — In  roundish  tears  usually  from  half  an  inch  to  an  inch  in 
length,  nearly  colourless,  brittle,  and  opaque  from  numerous  minute  cracks, 
or  in  angular  fragments  with  shining  surfaces.  Bland  and  mucilaginous  in 
taste ;  insoluble  in  alcohol,  but  soluble  in  water.  The  aqueous  solution  forms 
with  subacetate  of  lead  an  opaque  white  jelly. 

Composition. — Arabin  or  arabic  acid  (gummic  acid)  combined 
with  calcium,  and,  in  smaller  quantities,  with  potassium  and 
magnesium. 

Impurity. — Starch  fraudulently  added. 

Test. — Should  not  give  a  blue  colour  with  iodine. 

Preparations  containing  Gum  Acacia. 
b.f.  dose.  u.s.p.  dose. 

Mistura  Crete    1-2  fl.  oz.        Mucilago  Acacue ad  lib. 

„       Guaiaci f-2  fl.  oz.        Syrupus  Acaciaa „ 

Mucilago  Acaeise ad  lib. 

Puhds  Amygdalae  Compositus... 60-120  gr. 
„    Tragaeanthas      „         ...20-60  gr. 
Trochisci,  in  all. 

Uses. — It  is  a  useful  demulcent  in  coughs  or  sore-throat,  also 
in  irritation  of  the  stomach  and  intestines  due  to  catarrhal  in- 
flammation. It  is  also  serviceable  in  cases  of  irritant  poisoning, 
and  it  bas  been  employed  as  a  masticatory.  The  mucilage  is 
used  to  suspend  powders. 

U.S.P-  Catechu.  Catechu.— An  extract  prepared  from  the 
wood  of  Acacia  Catechu.     Pegu. 

Characters. — In  dark  orown,  irregular  masses,  containing  fragments  of 
leaves,  brittle,  somewhat  porous  and  glossy  when  freshly  broken ;  soluble 
in  alcohol  and  partly  soluble  in  water.  It  is  nearly  inodorous,  and  has  a 
strongly  astringent  and  sweetish  taste. 

It  was  formerly  officinal  in  the  B.P.  It  is  sometimes  called  black  catechu 
to  distinguish  it  from  the  pale  catechu  got  from  Uncaria  Gambler. 

Composition  and  Eeactions. — It  contains  a  form  of  tannic' 
acid  called  catechu-tannic  acid.  This  differs  from  other  forms 
of  tannic  acid  in  not  being  a  glucoside.  It  gives  a  greenish-black 
colour  with  iron,  and  precipitates  gelatine  but  not  tartar  emetic. 

Pbeparations. 

U.S.P.  DOSE. 

Tinctura  Catechu  Composita 15  min.-2  fl.  dr.  (1-8  c.c.) 

Trochisci  Catechu  (1  grain  in  each) ad  lib. 

Tinctura  Catechu  Composita.  Compound  Tincture  of  Catechu. — Catechu,  12 ; 
cinnamon,  8  ;  diluted  alcohol  to  100. 

Uses. — It  is  a  powerful  astringent.  It  may  be  employed  as 
an  injection  in  gonorrhoea  and  gleet.  The  lozenges  are  useful  in 
sore-throat,  hoarseness,  relaxed  uvula,  and  the  tickling  cough 
consequent  on  it  (p.  248).  Internally  it  is  useful  in  diarrhoea, 
and  in  internal  haemorrhages,  especially  from  the  uterus  (vide 
also  p.  951). 


chap,  xxxiii.]  CALYCIFLOBiE.  915' 

Erythrophlceum.  Casca  Bark,  Sassy  Bark.  NotofficinaL— 
The  bark  of  Erythrophloeum  guinense,  a  large  tree  growing  on 
the  coast  of  Africa. 

Composition. — It  contains  an  alkaloid,  erythrophlceine. 

Peepabation. 

DOSE. 

Tinctura  Erythrophloei  (1  in  10) 5-10  min. 

Action. — The  powder  when  inhaled  causes  violent  sneezing. 
Internally  the  infusion  or  tincture  causes  vomiting  and  purging. 
Erythrophlceum  has  an  action  on  the  circulation  (p.  273)  and 
kidneys  like  that  of  digitalis  (p.  430).  The  alkaloid  appears  to 
combine  the  actions  of  digitalin  and  picrotoxin,  producing  con- 
vulsions like  the  latter.     (Harnack.) 

Uses. — I  have  found  it  useful  in  dilated  heart  without  val- 
vular disease.  It  is  also  useful  in  mitral  disease  and  dropsy.  It 
has  the  disadvantage  of  disturbing  the  digestion  still  more  readily 
than  digitalis. 

Indigo,  B.P.  C8HsNO. — A  "blue  pigment  prepared  from 
various  species  of  Indigofera. 

Composition. — Solution  of  sulphate  of  indigo. 
Use. — As  a  test  for  chlorine. 

ROSACEiE. 

Sub-Obdee  I.- PRUNED. 

Amygdala  Dulcis,  B.  and  U.S.P.  Sweet  Almond. — The 
ripe  seed  of  the  sweet  almond  tree,  Primus  Amygdalus  (Amygdalus 
communis),  var.  dulcis.  Imported  from  Malaga,  and.  known  as 
the  Jordan  almond. 

Characters. — Above  an  inch  in  length,  lanceolate,,  acute,  with  a  clear 
cinnamon-brown  seed-coat,  with  a  bland  sweetish  kernel.  Does  not  evolve 
the  odour  of  bitter  almonds  when  bruised  with  water. 

Composition. — Contains  upwards  of  50  per  cent,  of  a  fixed 
oil  which  consists  principally  of  oleic  acid.  It  contains  also  an 
albuminous  substance — emulsin,  which  is  supposed  to  be  pro- 
duced from  a  vegetable  casein  and  asparagin. 

Peepaeations. 

B.P.  DOSE. 

Oleum  Amygdalae 1  fl.  dr.  to  ^  fl.  oz. 

Puivls   Amygdalae  Compositus  (almonds  8,  sugar  4,  gum 

acacia  1) 60  gr.  to  120  gr. 

TOistura  Amygdalae  (1  of  Pulv.  Amygd.  Co.  to  8  of  water)  ....1-2  fl.  oz. 

U.S.P. 

Mistura  Amygdalae 2  fl.  dr.-l  fl.  oz.  (4-16  c.c.) 

Syrupus        , 2  fl.  dr.-l  fl.  oz.  (4-16  c.c.) 

Amygdala  Amara,  B.  and  U.S.P.  Bitter  Almond. — The 
ripe  seed  of  the  bitter  almond  tree,  Primus  Amygdalus  (Amygdalus 
communis),  var.  amara.     Mogadore. 

3  n  2 


916  VEGETABLE   MATEEIA   MEDICA.  [sect.  v. 

■Characters. — EesemHes  the  sweet  almond  in  appearance,  but  is  rather 
broader  and  shorter  ;  has  a  bitter  taste,  and  when  rubbed  with  a  little  water, 
emits  the  odour  of  hydrocyanic  acid. 

Composition.— Bitter  almonds  contain  all  the  constituents  of 
sweet  almonds,  the  fixed  oil,  however,  being  in  less  proportion, 
and  in  addition  a  glucoside  amygdalin  upon  which  emulsin 
(either  of  sweet  or  bitter  almonds)  acts  as  a  ferment  producing 
hydrocyanic  acid  and  volatile  oil  of  bitter  almonds,  thus  : — 

Amygdalin.  Bitter  almond  oil.     Glucose. 

CMH27NOn  +  2H20  =  HCN  +  C7H60  +  C12H24012 

Ammonia  and  formic  acid  are  also  produced  in  the  decom- 
position. Amygdalin  may  be  extracted  by  alcohol,  and  is  not 
poisonous.  Emulsin  by  boiling  loses  its  property  of  decompos- 
ing amygdalin. 

Preparations. 

B.P.  DOSS. 

Oleum  Amygdalae 1  fl.  dr.-J  fl.  oz. 

U.S.P. 

"Syrupus  Amygdalae 2  fl.  dr.-2  fl.  oz.  (7-60  c.c.) 

Oleum  Amygdalae,  B.P. ;  Oleum  Amygdalae  Expressum, 
U.S.P.  Almond  Oil,  B.P. ;  Expressed  Oil  of  Almond,  U.S.P. 
A  fixed  oil  expressed  from  bitter  and  sweet  almonds. 

Characters. — Pale  yellow,nearly  inodorous  or  having  a  nutty  odour, 
with  a  bland  oleaginous  taste. 

Preparation. 
B.P.  u.s.p. 

Oleum  Phosphoratum.  TJnguentum  Aquae  Kosse, 

Unguentum  Cetacei. 
„  Resinse. 

„  Simplex,  and  the  preparations  containing  it. 

U.S.P.  Oleum  Amygdalae  Amarae.  Oil  of  Bitter  Almond. 
A  volatile  oil  obtained  from  bitter  almonds  by  maceration  with 
water,  and  subsequent  distillation. 

Characters. — A  colourless  or  yellowish  thin  liquid  of  a  peculiar  aromatic 
odour,  a  bitter  and  burning  taste  and  a  neutral  reaction. 

Preparation. 

dose. 
Aqua  Amygdala  Amarae  (oil  of  bitter  almond  1,  water  999) Indefinite. 

Uses. — The  fixed  oil  is  demulcent.  It  is  applied  externally 
to  chapped  hands  and  slight  excoriations,  also  to  the  ear  in  ear- 
ache. Internally,  in  doses  of  1  drachm  to  2  drachms,  it  is  a  mild 
laxative.  The  cake  left  after  the  expression  of  the  bland  oil 
from  sweet  almonds  contains  no  starch,  and  is  therefore  em- 
ployed instead  of  bread  in  diabetes.  The  oil  of  bitter  almonds  is 
used  as  a  flavouring  agent.  The  crude  oil  of  the  U.S.P.  con- 
tains hydrocyanic  acid,  and  may  be  used  instead  of  it  as  a  local 
application  in  pruritus,  and  also  for  internal   administration. 


chap,  xxxiii.]  CALYCIFLOEiE.  917 

It  retains  its  strength  better  than  pure  hydrocyanic  acid,  but 
its  disadvantage  is  that  the  proportion  of  the  acid  is  not  con- 
stant. It  may  be  given  in  doses  of  £  to  1  minim  cautiously 
increased. 

Prunum,  B.  and  U.S.P.     Prune. — The  dried  drupe  of  the 
plum,  Prunus  domestica.     Southern  Europe. 
Characters, — Oblong,  shrivelled,  blackish-blue. 

Composition. — Malic  acid,  with  saccharine  and  albuminoid 
matter. 

Dose. — 2  oz.  or  more. 

Preparations. 
XJ.P.                                  cose.                   u.s.p.  DOSE. 

Confectio  Sennae 1-2  dr.         Confectio  Sennas 1-2  dr. 

Use. — Stewed  prunes  form  a  useful  and  pleasant  laxative  for 
children  or  adults.  If  they  do  not  move  the  bowels  when  simply 
stewed,  they  may  be  stewed  along  with  senna,  which  does  not 
impart  to  the  prunes  any  unpleasant  taste,  and  children  will  still 
take  them  readily. 

U.S.P.  Prunus  Virginiana.  Wild  Cherry. — The  bark  of 
Prunus  serotina  (Cerasus  serotina)  collected  in  autumn. 

Characters. — In  curved  pieces  or  irregular  fragments,  one  twelfth  of  an 
inch  (two  millimetres)  or  more  thick,  outer  surface  greenish-brown,  or  yellowish- 
brown,  smooth  and  somewhat  glossy,  marked  with  transverse  scars.;  if  col- 
lected from  old  wood  and  deprived  of  the  corky  layer,  the  outer  surface  is  nut- 
brown  and  uneven  ;  the  inner  surface  somewhat  striate  or  fissured.  Upon 
maceration  in  water  it  develops  a  distinct  bitter-almond  odour ;.  its  taste  is 
astringent,  aromatic  and  bitter. 

The  bark  of  the  small  branches  is  to  be  rejected. 

Preparations. 

dose. 

Extractum  Pruni  Virginianse  Pluidum 30-60  niin.  (2-4  c.c.)- 

Inmsum        „  „  „ 2-3  fl.  oz.  (60-90  c.c), 

Syrupus         „  „  „.       1-4  fl.  dr.  (4-16  c.c.) 

Uses. — A  nervine  sedative  and  tonic,  used  in'  atonic  dys- 
pepsia and  general  debility,  associated  with  general  or  local 
irritation.  In  large  doses  it  renders  the  action  of  the  heart 
slow.  It  has  been  employed  in  hectic  fever  and  consumption, 
and  in  functional  and  organic  cardiac  disease. 

B.P.  Laurocerasi  Folia.  Cherry-Laurel  Leaves. — The 
fresh  leaves  of  Prunus  Laurocerasus. 

Characters. — Ovate-lanceolate  or  elliptical,  distinctly  toothed,  furnished 
with  glands  at  the  base,  smooth  and  shining,  deep  green,  on  strong  short 
footstalks ;  emitting  a  ratafia  odour  when  bruised. 

Composition. — By  distillation  the.  leaves  yield  bitter-almond 
oil  and  hydrocyanic  acid. 


918'  VEGETABLE  MATEEIA  MEDICA.  [sect.  V. 

Preparation. 

DOSE. 

Aqua  laurocerasi  (prepared  by  mixing  the  leaves,  1  lb.,  with 
water  2i  pints,  distilling  off  one  pint,  and  bringing  the  distillate  to  the 
strength  of  0-1  per  cent,  of  real  hydrocyanic  acid  by  diluting  with  water, 
or  by  adding  hydrocyanic  acid  as  required) J-2  fl.  dr. 

Action. — Cherry-laurel  water  has  an  action  similar  to  hydro- 
cyanic acid,  but  is  only  jVth  of  the  strength  of  the  B.P.  acid. 

Use. — Cherry-laurel  water  is  supposed  to  be  an  elegant  mode 
of  giving  prussic  acid. 

Sub-Order  II.— QUILL AJE^E. 

U.S.P.  Quillaia.  Quillaia.  Soap  Babk. — The  bark  of 
Quillaia  Saponaria.     Chili. 

Characters. — Flat,  large  pieces,  about  one-fifth  of  an  inch  (5  millimetres) 
thick  ;  outer  surface  brownish-white,  often  with  small  patches  of  brown  cork 
attached,  otherwise  smooth ;  inner  surface  whitish,  smooth ;  fracture  splin- 
tery, checkered  with  pale  brownish  bast-fibres  embedded  with  white  tissue ; 
inodorous,  very  acrid  and  sternutatory. 

Composition. — It  contains  a  glucoside,  saponin.  Saponin  is 
also  contained  in  senega  and  sarsaparilla.  It  appears  to  be 
identical  with  cyclamin  from  Cyclamen  europmum  and  with  pri- 
mulin  from  Primula  officinalis.  Digitonin  from  digitalis  appears 
to  be  a  kind  of  saponin  differing  somewhat  from  the  others. 

Action  and  Uses. — The  bark  has  little  or  no  application  in 
medicine.  The  powder  when  snuffed  provokes  sneezing.  Its 
infusion  and  extract  are  used  for  cleaning  cloth  and  taking  out 
stains.  On  account  of  the  saponin  it  contains,  the  infusion 
froths  easily  and  the  froth  remains  long.  A  little  of  it  is  some- 
times added  to  syrups,  lemonade,  or  other  drinks,  to  give  them 
a  head.  It  also  retains  fine  powders  in  suspension  and  forms 
emulsions.     It  is  used  to  form  an  emulsion  with  coal-tar. 

Saponin  when  applied  locally  acts  as  a  powerful  irritant,  local 
anaesthetic,  and  muscular  poison.  On  account  of  its  local  irri- 
tant action,  it  produces  most  intense  pain  when  injected  sub- 
cutaneously ;  sneezing  when  applied  to  the  nose ;  vomiting, 
diarrhoea,  and  gastro-enteritis  when  taken  internally  in  large 
doses.  Locally  applied  it  paralyses  nerves  both  sensory  and 
motor,  and  muscular  fibre  both  voluntary  and  involuntary.  It 
therefore  produces  local  paralysis  and  local  anaesthesia  when 
injected  under  the  skin  in  a  frog's  leg.  The  muscles  and  motor 
nerves  being  paralysed,  no  irritation  to  either  will  cause  con- 
traction; and  the  sensory  nerves  being  also  paralysed,  local 
irritation  does  not  produce  reflex  action.  In  the "  voluntary 
muscles  it  produces  a  condition  of  rigor  mortis,  and  the  muscular 
substance  becomes  brittle  and  structureless,  as  after  myositis. 

_  When  locally  applied  to  the  intestine,  either  by  internal  ad- 
ministration or  injection  into  the  peritoneal  cavity,  it  paralyses 
the  involuntary  muscular  fibre  of  the  intestinal  wall.     When 


•chap,  xxxin.]  CALYCIFLOE^l.  919 

applied  to  the  heart  it  causes  rapid  stoppage  in  diastole.  It 
counteracts  the  effect  of  digitalis  on  the  heart,  and  vice  versa 
digitalis  counteracts  the  effect  of  saponin  on  the  heart,  so  that 
when  the  ventricle  of  the  frog's  heart  has  been  brought  to  a 
standstill  by  one  of  these  drugs,  its  pulsations  may  be  restored 
by  the  other. 

When  absorbed  into  the  circulation,  saponin  paralyses  the 
nerve-centres  in  addition  to  the  nerves  and  muscular  structures. 
The  symptoms  it  produces  depend  on  the  mode  in  which  it  is 
introduced  into  the  body  and  the  structures  which  it  first  reaches 
in  consequence.  If  injected  into  the  jugular  vein  so  as  to  reach 
the  heart  first,  it  usually  kills  by  producing  cardiac  paralysis; 
with  slow  pulse,  and  rapid  fall  of  blood-pressure,  and  convulsions 
which  are  probably  asphyxial  and  due  to  the  failure  of  circulation 
(p.  239),  respiratory  movements  still  continuing.  Saponin  also 
paralyses  the  respiratory  and  vaso-motor  centres,  so  that  the 
blood-pressure  falls  much  and  the  respirations  become  feeble  and 
slow.  In  large  doses  saponin  may  paralyse  the  respiratory 
centre  before  the  heart,  so  that  death  ensues  from  failure  of  the 
respiration  while  the  heart  continues  to  beat. 

It  is  possible  .that  quillaia  might  be  used  instead  of  sarsa- 
parilla,  and  it  might  perhaps  be  useful  in  cases  of  aortic  disease 
with  hypertrophy  (p.  338). 

Sub-Okdee  III.— RUBEJE. 

U.S.P.  Rubus.  Eubus.  Blackbeeby.— The  bark  of  the 
root  of  Rubus  villosus,  Eubus  canadensis,  and  Rubus  trivialis. 

Characters. — In  thin,  tough,  flexible  bands,  outer  surface  blackish  or 
blackish-grey,  inner  surface  pale  brownish,  sometimes  with  strips  of  whitish, 
tasteless  wood  adhering ;  inodorous ;  strongly  astringent,  somewhat  bitter. 

Preparation, 
u.s.p.  DOSE. 

Extractum  Eubi  Fluidnm 30-60  gr.  (2-4  c.c.) 

Uses. — It  is  a  pleasant  astringent,  its  efficacy  being  due  to 
tannin.  It  is  useful  in  the  diarrhoea  of  children,  and  also  in 
adults. 

U.S.P.    Rubus   Idaeus.      Easpbekey. — The  fruit  of  Rubus 


Characters. — Deprived  of  the  conical  receptacle  and  therefore  hollow  at 
the  base ;  hemispherical,  red,  finely  hairy,  composed  of  from  twenty  to  thirty 
coalesced  small  drupes,  each  one  crowned  with  the  withered  style;  juice 
red ;  of  an  agreeable  odour  and  pleasant  acidulous  taste. 

The  closely  allied,  light  red  fruit  of  Rubus  sirigosus,  and  the  purplish- 
black  fruit  of  litibus  occidentatis,  may  be  employed  in  place  of  the  above. 

Preparation. 

DOSE. 

Syrnpus  Bubi  IrUei.... ad  lib. 

Use.    To  give  mixtures  an  agreeable  colour  and  flavour. 


920  VEGETABLE  MATEEIA  MEDICA.  [sect.  v. 


Sub-Oedeb  IV.— ROSE.S. 

Oleum  Rosae,  U.S.P.  Oil  of  Eosb.— A  volatile  oil  distilled 
from  the  fresh  flowers  of  Rosa  damascena. 

Characters.— Pale  yellowish,  with  a  strong  odour  of  rose,  and  a  sweetish 
taste. 

Adulterations. — Sandal-wood  oil,  geranium  oil,  and  other  volatile  oils; 
fixed  oils ;  spermaceti. 

Test.— When  slowly  cooled  to  near  10°  C.  (50°  P.)  the  oil  becomes  a 
transparent  solid,  interspersed  with  numerous  slender  shining  iridescent 
scale-like  crystals.  When  rapidly  cooled  to  12-5°  C.  (54-5°  F.)  it  congeals  to 
a  solid  mass  of  light  feathery  shining  scales  or  plates. 

Ross  Centifoliae  Petala,  B.P. ;  Rosa  Centifolia,  U.S.P. 

Cabbage-Kose   Petals,   B.P. ;    Pale   Eose,   U.S.P. — The   fresh 
petals,  fully  expanded,  of  Rosa  centifolia.     Britain. 

Characters. — Pink,  fragrant  roseate  odour ;  taste  sweetish-bitter,  and 
faintly  astringent ;  both  readily  imparted  to  water. 

Composition. — A  minute  quantity  of  volatile  oil,  a  red  colour- 
ing matter,  a  little  gallo-tannic  acid,  fat,  sugar,  acids,  &c. 

Peepaeation. 

B.P.  DOSE. 

Aqua  Rosae ad  lib. 

U.S.P. 

Aqua  Bosie ad  lib. 

Syrupus  Sarsaparilhe  Compositus 1-4  fl.  dr.  (3-75-15  c.c.} 

U.S.P.  Unguentum  Aquas  Boss.  Ointment  op  Bose  Watee  (Cold  Cue  ah). — ■ 
Expressed  oil  of  almond,  50 ;  spermaceti,  10 ;  white  wax,  10  ;  rose  water,  30. 

Uses.— Eose-water  is  much  used  as  a  vehicle  for  gargles  and 
lotions,  and  sometimes  it  is  used  for  internal  administration. 

Rosae  Gallicae  Petala,  B.P. ;  Rosa  Gallica,  U.S.P.  Eed- 
Eose  Petals,  B.P. ;  Bed  Eose,  U.S.P. — The  fresh  and  dried 
petals  of  Rosa  gallica,  collected  before  expanding.     Britain. 

Characters. — Small  cones  consisting  of  numerous  imbricated  deep 
purple  petals,  with  a  roseate  odour,  and  a  bitterish,  astringent  taste. 

Composition. — Similar  to  cabbage-rose  petals. 

Peepaeations. 
b.p.  dose.  u.s.p.  dose. 

Confectto  Rosae  Gallicee...60  gr.  or  more.      Pilulse  Aloes  et  Masticb.es  (p.  523) 
Xnfusum  Rosae  Acidum  ...1-2  fl.  oz.  1  pill. 

Syrupus  Rosae  Gallicee....  lfl.  dr.  or  more.     Confectio  Eosse  ad  lib. 

Extractum  Bosse  Eluidum ..     „ 

MelBosiB „ 

Syrupus  Eosas „ 

B.P.  Xnfusum  Rosae  Acidum.  Acn>  Infusion  of  Boses. — Dried  red-rose 
■petals,  broken  up,  £  oz. ;  diluted  sulphurio  acid,  1  fl.  dr. ;  boiling  distilled  water, 
10  fl.  oz. 

B.P.  Rosae  Canninae  Fructus.  Fbuit  of  the  Dog-Eose. 
Hips. — The  ripe  fruit  of  the  dog-rose,  Rosa  canina,  and  other 
indigenous  allied  species. 


chap,  xxxni.]  CALYCIFLOE^E.  921 

Characters. — An  inch  or  more  in  length,  ovate,  scarlet,  smooth,  shining ; 
taste  sweet,  subacid. 

Composition.— Crystallisable  sugar,  gum,  citric  and  malic 
acids  free  and  combined. 

Peepabation. 

B.P,  DOSE. 

Confectio  Rosse  Caninse 60  gr.  or  more. 

Uses. — The  preparations  of  roses  are  used  chiefly  as  vehicles. 
The  Confectio  Boss  Gallics  and  Confectio  Eossb  Caninse  are  used 
as  bases  for  pills,  and  also  for  linctus.  The  acid  infusion  of 
roses  is  used  as  a  gargle,  and  is  slightly  astringent.  Aquse  Bosas 
is  used  as  a  vehicle. 

Cusso,  B.P. ;  Brayera,  U.S.P.  Kousso,  B.P.;  Kooso, 
U.S.P. — The  dried  panicles  (chiefly  of  the  female  flowers)  of 
Hagenia  abyssinica  {Brayera  anthelmintica).     Abyssinia. 

Characters. — In  bundles,  rolls,  or  compressed  clusters  consisting  of 
panicles  about  10  inches  (25  centimetres)  long.  Flowers  small,  reddish-brown, 
on  hairy  stalks.    Odour  slight,  tea-like,  taste  bitter  and  nauseous. 

Composition. — Tannic  acid ;  a  bitter  acrid  resin  and  some 
volatile  oil  and  kosin  or  koussein.  Kosin  is  the  active  prin- 
ciple of  the  drug.  It  is  a  crystalline  substance  with  an  acid 
reaction.  Koussein  is  a  resinoid  substance,  and  consists  of  im- 
pure kosin. 

Pbepabations. 

B.P.  DOSE. 

Infusum  Cusso 4-8  fl.  bz. 

U.S.P. 

Infusum  Bray erse.. 8  ft.  oz.  (236  c.c.) 

Extractum     „      Fluidum 20-40  min.  (1-25-2-50  c.c.) 

B.P.  Infusum  Cusso.  Infusion  oe  Kousso. — Kousso,  in  coarse  powder, 
J  oz. ;  boiling  distilled  water,  4  fl.'oz.  Infuse  in  a  covered  vessel  for  fifteen  minutes 
without  straining. 

U.S.P.  Infusum  Brayewe.  Infusion  of  Bbayeea. — Brayera  in  No.  20  powder, 
6. j>  boiling  water,  100.  Pour  the  boiling  water  on  the  brayera  and  let  it  macerate 
in  a  covered  vessel  until  cool.    This  infusion  should  be  dispensed  without  straining. 

Action  and  Use. — Cusso  is  used  as  an  anthelmintic  for 
tapeworm.  Kosin  or  coussine,  which  is  the  active  principle, 
administered  in  20-gr.  doses  acts  quite  as  well  as  the  infusion, 
and  has  not  the  disadvantage  of  producing  nausea  and  vomiting, 
which  are  sometimes  caused  by  the  infusion  of  the  pharmaco- 
poeias. 

Sub-Oedeb  V.— POME^E. 

U.S.P.  Cydonium.  Cydonium.  Quince  Seed. — The  seed 
of  Cydonia  vulgaris. 

Characters. — About  a  quarter  of  an  inch  (6  millimetres)  long,  oval,  or 
oblong,  triangularly  compressed,  brown,  covered  with  a  whitish  mucilaginous 
epithelium,  causing  the  seeds  of  each  cell  to  adhere.  With  water  the  seeds 
swell  up,  and  form  a  mucilaginous  mass.  The  unbroken  seeds  have  an  insipid 
taste. 


922  VEGETABLE  MATEEIA  MEDICA  [sect.v- 

Composition. — It  contains  a  large  amount  of  mucilage. 

Preparation. 

DOSE. 

Mucilago  Cydonii  (oydonium  2,  water  100,  macerate  for  half  an  hour,  and 

strain  through  muslin) ad  lab. 

Use.— It  is  useful  as  a  bland  demulcent  preparation  to 
relieve  irritation  of  mucous  surfaces. 

MYRTACE^E. 

Caryophyllum,  B.P. ;  Caryophyllus,  U.S.P.  Cloves.— 
The  dried  unexpanded  flower-buds  of  Eugenia  cary&phyllata 
(Caryophyllus  aromaticus).     East  Indies. 

Chaeactees. — About  £  an  inch  long,  dark  reddish-brown,  plump  and 
heavy,  consisting  of  a  nearly  cylindrical  body  surmounted  by  four  teeth  and 
a  globular  head,  with  a  strong  fragrant  odour,  and  a  bitter  spicy  pungent 
taste.    It  emits  oil  when  indented  with  the  nail. 

Composition. — Cloves  contain  a  large  quantity  of  volatile  oil, 
resin,  gum,  and  tannin. 

Preparations. 
B.P.  DOSE. 

Infusum  Aurantii  Compositum 1-2  fl.  oz. 

„        Caryophylli 1-2  fl.  oz. 

Mistura  Ferri  Aromatica 1-2  fl.  oz. 

Oleum  Caryopbylli 1-5  min.  or  more. 

Vinum  Opii 10-40  min. 

U.S.P. 

Oleum  Caryophylli 

Tinotura  Lavandula  Compositum J-2  fl.  dr.  (2-8  c.c.) 

„        Ehei  Aromatica 2-4  fl.  dr.  (8-15  c.c.) 

Syrupus     „     Aromaticus 1  fl.  dr.  (4  c.c.) 

Vinum  Opii 6  min.  (0-4  c.c.) 

Action  and  Use. — Stimulant  carminative,  used  in  flatulence, 
nausea,  and  atonic  dyspepsia,  chiefly  given  along  with  other 
medicines  to  afford  an  agreeable  flavour  and  prevent  griping. 

Oleum  Caryophylli,  B.  and  U.S.P.  Oil  of  Cloves. — A 
volatile  oil  distilled  from  cloves. 

Chaeactees. — Colourless  when  recent,  but  gradually  becoming  red-brown, 
having  the  odour  of  cloves  and  a  pungent  spicy  taste. 

Composition. — It  consists  chiefly  of  a  phenol-like  substance, 
eugenol  or  eugenic  acid,  which  forms  permanent  salts  with 
alkalis.  With  its  own  bulk  of  strong  solution  of  potash,  the  oil 
forms  a  semi-solid  mass. 

Dose. — Of  the  oil,  2  to  6  drops. 

Preparations. 
b.p.  dose.  u.s.p. 

Confectio  Soammonii 10-30  gr.  or  more. 

Pilula  Colocynthidis  Composita  (v.  522) jj0t  given. 

»  h  et  Hyoscyami  (v.  p.  522)... 5-10  gr. 


.  chap,  xxxiii.]  CALYCIFLOBiE.  923 

Action  and  Use.— Same  as  those  of  cloves.  It  has  a  local 
analgesic  action,  and  is  frequently  used  to  relieve  toothache  by 
putting  a  drop  on  a  piece  of  cotton-wool,  and  introducing  it  into 
the  cavity  of  the  tooth. 

Pimenta,  B.  and  U.S.P-  Pimenta,  B.P. ;  Pimenta,  U.S.P. 
Allspice. — The  dried  unripe  full-grown  fruit  of  the  allspice  tree, 
Pimenta  officinalis  (Eugenia  Pimenta).    West  Indies. 


Fig.  191.— Pimenta. 

Characters. — Of  the  size  of  a  small  pea,  brown,  rough-looking,  somewhat 
like  black  pepper,  but  distinguished  from  it  by  being  crowned  with  the  teeth 
of  the  calyx.     Odour  and  taste  aromatic,  hot,  and  peculiar. 

Composition. — Prom  3  to  4  per  cent,  of  a  volatile  oil  having 
the  same  composition  as  oil  of  cloves,  also  a  considerable  quantity 
of  tannin  and  some  starch. 

Pkepabations. 
s.p.  dose.  u.s.p.  dose. 

Aqua  Pimentse  1-2  fl.  oz.    Oleum  Pimentffi A  lew  drops. 

Oleum        „  1-5  min. 

Oleum  Pimentae,  B.  and  U.S.P.  Oil  of  Pimenta,  B.P.; 
Oil  op  Pimenta,  Oil  of  Allspice,  U.S.P. — A  volatile  oil  dis- 
tilled from  pimenta. 

Characters. — Colourless  or  slightly  reddish  when  recent,  but  becoming 
brown  by  age,  having  the  odour  and  taste-  of  pimenta. 

Composition. — Nearly  the  same  as  oil  of  cloves. 
Use. — Same  as  cloves.     The  oil  may  be  given  in  a  dose  of  2 
or  3  drops  on  a  piece  of  sugar  in  flatulence. 

Pkepabations. 
e.p.  U.S.P. 

None.  Spiritus  Myrcise. 

Chekan.  Cheken.  Not  officinal.  —The  leaves  and  shoots  of 
Myrtus  Chekan  (Eugenia  Chekan).     Chili. 

Characters. — They  resemble  some  buchu  leaves  (Barosma  betulma,),  but 
have  the  margin  entire  and  a  different  smell. 

Composition. — They  contain  a  volatile  oil  resembling  that 
of  eucalyptus^  a  volatile  alkaloid — chekanine — and  tannin. 

Action  and  Uses. — It  is  antiseptic,  tonic,  expectorant,  and 
diuretic.  The  expressed  juice  diluted  with  water  has  been  used 
as  a  lotion  in  inflammation  of  the  eye,  and  a  decoction  of  the 
bark  as  an  astringent  in  dysentery.  It  is  chiefly  used  in  catarrh 
of  the  mucous  membranes,  especially  those  of  the  bronchi  and 
bladder.  It  appears  to  be  very  useful  in  cases  of  bronchitis  with 
thick  purulent  expectoration,  also  in  cases  of  phthisis.  The  oil 
of  myrtle  appears  to  have  a  similar  action. 


924  VEGETABLE   MATEEIA  MEDICA.  [sect.  v. 

PbEPABATIONS,  NOT  OlTICINAIi. 

DOSE. 

Inf usum  Chekan  (1  part  leaves  to  10  of  boiling  water) 

Extractum     „     Fluidum  (prepared  like  Ext.  Cinchona?  Fluid.,  U.S.P.). ..1-3  A.  dr. 
Syrupus         ,,     (1  part  leaves  to  2  of  syrup) • 

Oleum  Myrti.  Oil  of  Myetle.  Not  officinal.— A  volatile 
oil  obtained  from  the  leaves  of  Myrtus  communis. 

Dose. — 015  gin.  in  capsules. 

Action  and  Uses. — It  has  an  antiseptic  action,  and  may  be 
used  in  cases  of  foul  ulcers  and  foetid  discharges  from  mucous 
passages,  as  in  otorrhoea.  It  is  not  a  sufficiently  powerful  irri- 
tant to  affect  the  unbroken  skin,  but  does  so  when  the  epidermis 
is  removed.  It  has  been  used  externally  as  a  rubefacient  in 
rheumatism.  It  causes  warmth  and  increased  flow  of  saliva  in 
the  mouth ;  and  in  small  doses  (0-06-0-09  gm.)  appears  to  aid 
digestion.  In  larger  doses  it  acts  as  an  irritant,  causing  nausea, 
flatulent  distension,  headache,  and  languor.  It  is  excreted  in 
the  urine,  to  which  it  gives  a  smell  like  violets,  and  like  copaiba 
gives  a  precipitate  when  nitric  acid  is  added  to  the  urine.  Like 
copaiba  it  may  be  used  as  an  expectorant  in  chronic  bronchitis 
with  profuse  expectoration,  in  phthisis,  and  in  chronic  inflammar 
tion  of  the  bladder  or  urethra.     (Cf.  p.  446.) 

Oleum  Cajuputi,  B.  and  U.S.P.  Oil  of  Cajuput. — A 
volatile  oil  distilled  from  the  leaves  of  Melaleuca  minor,  B.P.  (M. 
Cajuputi,  U.S.P. ;  M.  Leucodendron) .    East  Indies. 

Characters. — Pale  bluish-green,  transparent.  Odour  strong  and  agree- 
able; taste,  warm  and  aromatic,  leaving  a  sensation  of  coldness  in  the 
mouth. 

Impurity. — Copper,  added  to  preserve  the  fine  green  colour  which  the  oil 
possesses  when  newly  distilled  or  accidentally  present. 

Test.— See  Copper  (p.  674). 

Dose. — 1  to  5  min.  or  more. 

Pkepakations. 
B.P.  dose. 

Linimentum  Crotonis  (p.  516)  c.s.p. 

Spiritus  Cajuputi i-1  fl.  dr.  None. 

Uses.  —  It  is  a  powerful  stimulant  and  antispasmodic. 
Locally  it  acts  as  a  stimulant  and  rubefacient.  It  is  used  exter- 
nally in  skin  diseases — pityriasis,  psoriasis,  and  acne  rosacea. 
In  this  last  disease  it  is  said  to  be  particularly  useful  and  also  in 
eczema.1  It  has  also  been  used  externally,  alone,  or  with  olive 
oil,  in  cases  of  muscular  and  articular  rheumatism,  and  gout. 
Applied  to  a  carious  tooth,  it  relieves  pain  in  the  same  way  as  oil 
of  cloves.  Internally  it  is  used  to  relieve  flatulence.  A  few 
drops  on  a  piece  of  sugar  are  useful  in  neuralgia  and  hysteria, 
and  its  internal  use  is  said  to  be  also  useful  in  chronic  rheu- 
matism. 


1  Claiborne,  Oaillard's  Med.  Journ.,  Virginia,  U.S.A. 


chap,  xxxiir.]  CALYCIPLOEiE.  925 

U.S.P.  Eucalyptus.    Eucalyptus.— The  leaves  of  Eucalyptus 
globulus,  collected  from  rather  old  trees. 

Characters. — Petiolate,  lanceolately  scythe-shaped,  from  six  to  twelve 
inches  (fifteen  to  thirty  centimetres)  long,  rounded  below,  tapering  above, 
entire,  leathery,  grey  green,  glandular,  feather- veined  between  the  midrib 
and  marginal  veins ;  odour  strongly  camphoraceous,  taste  pungently  aromatic, 
somewhat  bitter  and  astringent. 

Composition. — Eucalyptol,  resin,  tannin,  &c. 

Preparations. 

DOSE. 

Extractum  Eucalypti  Fluidum 5-15  min. 

Oleum  Eucalypti 2-5  drops. 

Oleum  Eucalypti,  B.  and  U.S.P-     Oil  of  Eucalyptus. — A 

volatile  oil  distilled  from  the  fresh  leaves  of  Eucalyptus  globulus, 
or  Eucalyptus  amygdalina,  and  some  other  species  of  Eucalyptus. 

Characters. — A  colourless  or  very  pale  yellowish  liquid,  having  a  charac- 
teristic aromatic  odour,  a  pungent,  spicy,  and  cooling  taste,  and  a  neutral 
reaction.    It  is  soluble  in  an  equal  weight  of  alcohol. 

Dose. — 1  to  4  minims.    B.P. 

B.P.    Pbepakation. 
Unguentum  Eucalypti   (Oil  of    Eucalyptus,  1 ;    hard  paraffin,    2 ;    soft 
paraffin,  2). 

Action. — Eucalyptus  oil,  or  eucalyptol,  as  it  is  often  termed, 
is  a  powerful  antiseptic,  even  more  powerful  than  quinine 
(p.  95).  The  antiseptic  action  of  the  oil  is  greater  when  it  is  old 
and  charged  with  oxygen  than  when  it  is  freshly  distilled.  Like 
quinine  (p.  62)  it  arrests  the  movements  of  white  blood-cor- 
puscles, and  its  vapour  prevents  inflammation  in  the  exposed 
mesentery  of  the  frog.  The  red  corpuscles  of  frog's  blood  have 
their  nucleus  rendered  more  distinct,  and  their  surface  wrinkled  by 
it.  Like  quinine  it  causes  contraction  of  the  spleen.  It  is  a  local 
irritant.  When  applied  to  the  skin  and  its  evaporation  prevented, 
it  acts  as  a  rubefacient,  vesicant,  or  pustulant.  When  applied  to 
a  mucous  membrane  or  injected  hypodermically  it  causes  pain. 
When  swallowed  it  causes  burning  in  the  throat,  stomach,  and 
intestine.  It  may  produce  nausea,. loss  of  appetite  and  slight 
looseness  of  the  bowels,  but  it  is  not  an  active  emetic,  nor  purga- 
tive. In  large  doses  after  absorption  it  appears  to  act  chiefly  on  the 
nerve-centres,  producing  paralysis  and  death.  In  invertebrata 
killed  by  exposure  to  its  vapour  the  paralysis  is  preceded  by  ex- 
citement, but  in  vertebrate  animals  the  paralysis  is  not  preceded 
by  excitement.  Its  depressing  action  on  the  spinal  cord  is  so 
great  as  to  abolish  reflex  action  even  when  it  has  been  previously 
increased  by  brucine;  and  from  depression  of  the  brain,  medulla, 
and  heart,  there  is  drowsiness,  feeble  respiration,  lowered  blood- 
pressure  and  fall  of  temperature.     Death  occurs  from  paralysis 


926  VEGETABLE  MATERIA '■  MEDICA.  [sect,  vw 

of  the  respiration.  It  is  excreted  by  the  lungs  and  kidneys. 
Like  turpentine  it  imparts  a  smell  of  violets  to  the  urme  of 
persons  taking  it.  .... 

Uses. — It  has  been  employed  as  an  antiseptic  in  surgical 
dressing  in  the  form  of  eucalyptus  gauze,  but_  is  apt  to  cause 
local  irritation.  It  has  proved  useful  as  a  lotion  to  wash  out 
suppurating  cavities.  As  an  inhalation  it  has  been  employed  to 
check  secretion,  and  remove  fcetor  in  ozama,  in  bronchitis  with 
profuse  or  foetid  expectoration,  in  phthisis  and  in  diphtheria. 
It  has  been  used  in  the  form  of  injections  or  pessaries  in  uterine 
catarrh,  and  after  parturition.  It  has  been  recommended  as  a 
hypodermic  injection  in  pyaemia. 

In  three  cases  of  septicaemia  I  treated  by  it  recovery  occurred 
during  its  use,  and  in  one  of  these  quinine  had  proved  useless. 
It  has  been  used  as  an  antiperiodic  in  ague  and  an  antipyretic 
in  fever,  but  it  has  not  proved  so  useful  as  one  would  have  ex- 
pected from  the  resemblance  between  its  action  and  that  of 
quinine. 

Eucalyptus  trees  when  freely  planted  in  malarious  districts 
appear  to  render  them  more  healthy. 

Granati  Radicis  Cortex,  B.P. ;  Granatum,  U.S.P.  Pome- 
granate Koot  Bark,  B.P. ;  Pomegranate, 'U.S.P. — The  dried 
bark  of  the  root  of  Punica  Granatum.     South  of  Europe. 


Fig.  192.— Pomegranate,  half  the  natural  size. 

Characters. — In  quills  or  fragments  of  a  greyish-yellow  colour  externally, 
yellow  internally,  havings     short  fracture,  little  odour,  and  an  astringent 

slightly  bitter  taste. 

Composition. — The  most  important  constituents  on  which  its 
anthelmintic  action  depends  are  two  liquid  alkaloids,  pelle- 
tierine  and  iso-pelletierine.  It  contains  two  other  alkaloids 
which  are  inactive,  tannin,  mannite,  &c. 

Pbepabation. 
b.p.  dose.  u.s.p. 

Decoctum  Granati  Radicis... (2  ounces  to  1  pint)...l-3  fl.  oz.  None. 

Uses. — Pomegranate  is  chiefly  used  as  an  anthelmintic  for 
tapeworm.  As  it  is  not  purgative,  but  rather  astringent,  its 
use  must  be  followed  by  that  of  a  cathartic.  Often,  several  doses 
are  required.  The  dose  of  the  tannate  of  pelletierine  is  ^-f  gr. 
(0-03-0-05  gm.),  taken  fasting  and  followed  in  fifteen  minutes  by 
a  brisk  purgative. 


chap,  xxxiii.]  CALYCIFLOEiE.  '  927 

PAPAYACE./E. 

Papayotin.  Not  officinal.  The  dried  juice  of  the  papaw  tree, 
Carica  papaya. — Papain.  A  ferment  obtained  from  the  juice 
of  Carica  papaya.  The  term  papain  is  frequently  applied  to  the 
dried  juice. 

Pbepakation. — When  scratches  are  made  on  the  half-ripe 
fruit  of  the  Carica  papaya  a  milky  juice  exudes  in  abundance. 
When  dried  it  forms  a  powder  somewhat  like  gum-arabic,  and  to 
this  the  name  of  papayotin  is  sometimes  given.  Papain  is  the 
pure  ferment  associated  with  a  proteid  and  obtained  by  precipi- 
tation with  alcohol  and  removal  of  the  chief  albuminous  matters 
by  basic  acetate  of  lead. 

Dose. — 5  to  10  grains. 

Action. — The  fruit  of  the  papaw  tree  has  long  been  used  in 
the  West  Indies  to  render  beef  tender.  The  unripe  fruit  is  split 
open  and  rubbed  over  the  surface  of  the  meat  previous  to  cook- 
ing. Its  action  probably  depends  upon  the  fact  that  papain  has 
a  digestive  action  not  only  upon  muscular  fibre,  but  also  upon 
connective  tissue.  It  digests  fibrin  and  albumin  in  neutral 
and  slightly  alkaline  solutions.  It  also  rapidly  dissolves  the  false 
membrane  of  croup.  When  injected  into  the  circulation  in  large 
doses  it  paralyses  the  heart.  In  smaller  quantities  it  appears 
to  favour  the  multiplication  of  micrococci  in  the  blood  (p.  85). 

Uses. — It  has  been  recommended  to  dissolve  the  fibrinous 
membrane  in  croup  and  diphtheria,  a  solution  being  painted  over 
the  pharynx  every  five  minutes.  It  has  also  been  recommended 
to  destroy  epithelioma  and  warts.  Internally  it  appears  to  be 
useful  in  dyspepsia  and  catarrhal  conditions  of  the  stomach. 

CUCURBITACE^E. 

Colocynthidis  Pulpa,  B.P. ;  Colocynthis,  U.S.P.  Colo- 
cynth  Pulp,  B.P,     Colocynth,  U.S.P. — The  dried  peeled  fruit, 


Flo.  193.— Colocynth  (peeled),  half  the  natural  size 

feeed  from  seeds,  of  Citrullus  Colocynthis.    Imported  chiefly  from 
Smyrna,  Trieste,  France,  and  Spain. 

Characters. — Light,  spongy,  white  or  yellowish-white  balls,  intensely 
hitter  in  taste.  The  pulp  from  which  the  seeds  have  been  removed  only  is 
officinal. 


923  VEGETABLE  MATEEIA  MEDICA.  [sect,  v.' 

Composition. — The  active  principle  is  a  glucoside,  colocynthin, 
which  is  soluble  in  water  and  alcohol,  not  in  ether.  The  remain- 
ing part  of  the  pulp  consists  principally  of  resinous  matter. 

Dose. — Of  the  pulp,  2-8  gr. 

Pbepabations. 

B.P.  DOSE. 

Extractum  Colocynthidis  Compositum 3-10  gr. 

Pilula  Colocynthidis  Composlta  (vide  p.  522) 5-10  gr. 

„  „  et  Hyoscyami  (vide  p.  522) 5-10  gr. 

U.S.P. 

Extractum  Colooynthidis Seldom  used  alone. 

„  „  Compositran 5-20  gr. 

Pilulse  Catharticas  Composite  (vide  p.  523)  1-3  pills. 

Extractum  Colooynthidis  Compositum.  Compound  Extract  of  Colo- 
cynth,  B.P. — Coloeynth  pulp,  6  oz. ;  extract  of  Socotrine  aloes,  12  oz. ;  resin  of 
scammony,  4  oz. ;  curd  soap,  in  powder,  3  oz. ;  cardamom  seeds,  in  finest  powder, 
1  oz.  j  proof  spirit,  1  gallon.  An  extract  of  the  coloeynth  is  first  made,  and  then 
mixed  with  the  other  ingredients. 

In  the  U.S.P.  a  simple  extract  is  already  officinah  and  the  proportions  are — 
extract  of  coloeynth,  16  parts  ;  aloes,  50 ;  cardamom,  6 ;  resin  of  scammony,  14 ; 
soap,  14 ;  alcohol,  10. 

Physiological  Action. — The  active  principle  colocynthin  acts 
as  a  powerful  cathartic  on  the  intestines  whether  swallowed, 
administered  hypodermically,  or  injected  into  the  circulation. 
In  small  doses  it  increases  peristalsis,  and  the  secretions  from 
the  intestines  and  liver.  It  thus  produces  watery  and  mucous 
motions,  frequently  accompanied  by  griping.  In  large  doses  it 
causes  gastro-enteritis  with  mucous  and  bloody  stools.  It  ap- 
pears to  act  also  on  the  urinary  system,  as  Tidy  found  inflamma- 
tion of  the  kidneys  and  bladder,  as  well  as  of  the  rectum,  in  dogs 
poisoned  by  it ;  it  is  said  to  act  as  a  diuretic. 

Uses. — It  is  used  in  obstinate  chronic  constipation,  espe- 
cially if  there  is  a  tendency  to  congestion  of  the  brain,  as  in 
plethoric  people.  It  is  also  used  in  amenorrhcea.  It  is  apt  to 
gripe  if  given  alone ;  hence  it  is  well  to  combine  it  with  other 
purgatives  and  with  sedatives  such  as  hyoscyamus.  It  may 
sometimes  be  advantageously  combined  with  mercurial  pill. 

B.P.  Ecballii  Fructus.  Squirting  Cucumber  Fruit. — The 
fruit,  very  nearly  ripe,  of  the  squirting  cucumber,  Ecballium  Ela- 
terium.    Britain. 

Pkepabation, 

B.P.  DOSE. 

Elaterlum i_J.  ar 

lu  2  &r* 

Characters.— Oval,  about  H  in.  long,  covered  with  soft  prickles  termi- 
nating in  white  points.  "When  ripe  the  fruits  are  suddenly  detached  from 
the  stalk  and  the  juice  and  seeds  expelled. 

Composition. — The  juice  deposits  elaterium. 


chap,  xxxin.]  CALYCIFLORiE.  929 

B.P.  Elaterium.  Elatbeium.  {Synonym  :  Extractum  Ela- 
terii). — A  sediment  from  the  juice  of  the  squirting  cucumber 
fruit. 

Preparation. — Expressing  the  juice,  separating  the  deposit  by  straining, 
and  drying  by  a  gentle  heat  on  porous  tiles. 


Fig.  194.— Elaterium. 

Characters. — In  cakes,  about  ^th  inch  thick,  light,  friable,  slightly  in- 
curved, greenish-grey,  tea-like  smell,  acrid  and  bitter. 

Composition.  —  Elaterium  is  composed  of  elaterin,  with 
starch  and  fibrous  and  colouring  matters. 

Impurities. — Chalk  and  earthy  matter  fraudulently  added. 

Tests. — Does  not  effervesce  with  acids  (absence  of  chalk),  yields  half  its 
•weight  to  boiling  rectified  spirit.  It  should  yield  25  per  cent,  or  not  less  than 
20  per  cent,  of  elaterin. 

Dose. — -^th  to  -|  gr. 

Preparation,  B.  and  U.S.P. 
Elaterinum. 

Elaterinum,  B.  and  U.S.P.  Elatbbin.  C20H28O5. — The 
active  principle  of  elaterium.  It  may  be  obtained  by  exhaust- 
ing elaterium  with  chloroform,  adding  ether  to  the  chloroform 
solution,  collecting  the  precipitate,  washing  the  latter  with  ether, 
and  purifying  by  recrystallisation  from  chloroform. 

Characters. — A  chemically  neutral  substance  with  a  bitter  taste.  In 
small  colourless  crystals. 

Solubility. — It  is  insoluble  in  water,  sparingly  soluble  in  rectified  spirit. 

Eeactions. — When  heated  it  melts  and  burns  without  residue.  With 
melted  carbolic  acid  it  yields  a  solution  which,  on. the  addition  of  sulphuric 
acid,  acquires  a  crimson  colour  rapidly  changing  to  scarlet.  It  is  not  pre- 
cipitated from  solution  by  tannic  acid,  nor  by  the  salts  of  mercury  or  of 
platinum. 

Dose.—  -^  to  ^  gr. 

Preparations. 
B.P.  DOSE. 

Pulvls  Elaterini  Compoaitus  (elaterin,  1 ;  sugar  of  milk,  39) \-5  gr. 

n.s.p. 
Trituratio  Elaterini  (1  gr.  elaterin,  9  gr.  sugar  of  milk) %-%  gr. 

Action  and  Uses. — Elaterin  is  the  most  powerful  hydra- 
gogue  cathartic  we  possess,  increasing  the  peristaltic  action  and 
flow  of  fluid  from  the  intestines.  It  only  acts  as  a  purgative 
when  taken  internally,  and  appears  to  require  bile  in  order  to 
act.  When  injected  subcutaneously  it  acts  on  the  nervous 
system,  causing  salivation,  insensibility,  tetanus,  and  dyspnoea. 
It  is  used  in  dropsies,  especially  those  affecting  the  abdominal 
cavity  and  due  to  cirrhosis  of  the  liver.    It  is  also  used  as  a 

3o 


930  VEGETABLE  MATEEIA  MEDICA.  [sect.  v. 

depletory  in  cerebral  affections.  It  is  usually  combined  with 
henbane  and  volatile  oils,  as  it  is  apt  to  gripe.  In  large  doses  it 
may  cause  gastro-enteritis  and  fatal  collapse,  and  should  be 
given  with  care  to  old  or  feeble  persons. 

U.S.P.  Pepo.     Pumpkin  Seed.— ^-The  seed  of  Cucurbita  Pepo. 
Characters. — About  f  inch  long,  broadly  ovate,  flat,  whitish,  nearly- 
smooth,  with  a  shallow  groove  parallel  to  the  edge ;  inodorous,  bland,  and 
oily. 

Composition. — It  is  probable  that  the  active  principle  is  a 
resin  contained  in  the  endopleuron  or  greenish  envelope  imme- 
diately surrounding  the  embryo.  This  resin  is  dissolved  and 
rendered  more  active  by  castor  oil,  which  should  be  given  before 
and  after  the  anthelmintic.  The  decorticated  seeds,  as  well  as 
the  oil  derived  from  them,  are  bland  and  unirritating. 

Dose. — A.n  ounce  or  an  ounce  and  a  half.  The  seeds  may  be 
crushed,  and  flavoured  with  some  aromatic  oil. 

Uses. — It  is  an  excellent  anthelmintic  for  the  removal  of 
tapeworm.  It  should  be  given  the  first  thing  in  the  morning 
after  a  very  light  supper,  and  should  be  followed  in  two  or  three 
hours  by  an  active  purgative.  No  solid  food  should  be  taken 
until  two  hours  after  the  purgative. 

U.S.P.  Bryonia.  Beyonia.  Bryony. — The  root  of  Bryonia 
alba,  and  of  Bryonia  dioica. 

Characters, — In  transverse  sections  about  two  inches  (5  centimetres) 
in  diameter,  the  bark  grey-brown,  rough,  thin,  the  central  portion  whitish  or 
greyish,  with  numerous  small  wood-bundles  arranged  in  circles  and  project- 
ing, radiating  lines ;  inodorous,  taste  disagreeably  bitter. 

Preparation. 

dose. 
Tinctura  Bryonije 2-10  fl.  dr. 

Composition. — It  contains  a  bitter  principle,  bryonin. 
Use. — Its  chief  use  was  that  of  a  hydragogue  cathartic,  but 
it  is  now  superseded  by  jalap. 

UMBELLIFERjE. 

Sub-Order  I.— CAMPYLQSPERMjE. 
B.P.  Conii  Folia.     Hemlock  Leaves. — The  fresh  leaves  and 
young  branches  of  Couium  maculatum ;  gathered  from  wild  British 
plants  when  the  fruit  begins  to  form. 

Characters.— Fresh  leaves,  smooth,  arising  from  a  smooth  stem  with 
dark  purple  spots;  dried  leaves  of  a  full  green  colour  and  characteristic 
mousy  odour.  The  leaf  rubbed  with  solution  of  potash  gives  out  strongly 
the  odour  of  coniine. 

Composition.— The  fresh  leaves  and  branches  contain  the 
same  alkaloids  as  the  fruits,  coniine  and  methyl-conune  (q.v.), 


chap,  xxxiii.]  CALYCIFLORJ33.  931 

although  in  smaller  proportion,  while  the  coniine  is  sometimes 
accompanied  by  a  third  alkaloid,  conhydrine.  These  princi- 
ples are  lost  when  the  leaves  are  dried  or  heated,  both  being  highly 
volatile. 

Dose. — Of  the  powdered  leaf,  2-8  gr. 

Pkepahations. 
b.p.  dose.  u.s.p. 

Cataplasma  Conii  (from  succus) .....For  external  use.  None. 

Extractum  Conii  (green  extract) 2-6  gr.  or  more. 

Succus  Conii  (juice  of  hemlock) 30  min.  to  2  fl.  dr.  or  more. 

Vapor  Coninee vide  infra. 

Pilula  Conii  Composita  (vide  p.  522). .. .5-10  gr. 

B.P.  Cataplasma  Conii.  Hemlock  Poultice. — Juice  of  hemlock,  1 ; 
linseed  meal,  4 ;  boiling  water,  10. 

B.P.  Vapor  Coninae.  Inhalation  of  Conine. — Juice  of  hemlock,  J  fl.  oz. ; 
solution  of  potash,  1  fl.  dr. ;  distilled  water,  1  fl.  oz.  Put  20  min.  of  the  mixture 
on  a  sponge  in  an  inhaler  containing  hot  water. 

Conii  Fructus,  B.P.  Hemlock  Fruit.  —  The  fruit  of 
Conium  maculatum  (spotted  -hemlock),  gathered  when  fully  de- 
veloped, but  while  still  green,  and  carefully  dried. 


Fig.  105.— Conium, 

Characters.—  About  one-eighth  of  an  inch  long,  broadly  ovate  compressed! 
laterally  ;  half- fruit  with  five  waved  or  crenated  ridges.  ■  Beduced  to  powder 
and  rubbed  with  solution  of  potash,  they  give  out  strongly  the  odour  of 
coniine. 

Conium,  U.S.P.  Hemlock. — The  full-grown  fruit  of  Conium 
maculatum,  gathered  while  yet  green. 

Characters. — Similar  to  those  of  hemlock  fruit,  B.P. 

Composition. — Coniine,  a  poisonous  alkaloid,  occurs  in  hem- 
lock as  a  yellow,  oily  liquid,  and  is  separated  by  distilling  the 
fruit  with  slightly  alkaline  water.  The  fruit  contains  methyl- 
conii'ne  in  varying  proportion,  and  a  small  quantity  of  volatile 
oil,  which  does  not  appear  to  be  poisonous. 

PREPARATIONS. 
B.P.  COSE. 

Tinctura  Conii 20-60  min. 

U.S.P. 

Abstractum  Conii 7-8  gr. 

Extractum  Conii  Alcoholicum  2  gr. 

Extractum  Conii  Fluidum 15  min. 

Tinctura  Conii 60  min. 

Physiological  Action. — The  action  of  conium  depends  on  the 
alkaloids,  coniine  and  methyl-coniine,  which  it  contains ;  and  as 

3  u  2 


932  VEGETABLE   MATEEIA  MEDICA.  [sect.  v. 

-their  action  differs  considerably  and  the  relative  quantity  of  each 
varies,  contradictory  results  have  been  obtained  by  different 
observers.  The  symptoms  of  conium-poisoning  are  weakness  of 
the  legs  and  staggering  gait,  passing  on  to  paralysis,  which 
gradually  progresses  upwards  and  finally  causes  death  by  failure 
of  respiration.  The  mind  remains  clear  to  the  last.  Coniine 
paralyses  the  ends  of  the  motor  nerves  and  of  the  vagus,  like 
curare,  and  afterwards  paralyses  the  motor  centres  in  the  brain 
and  spinal  cord.  It  causes  death  by  paralysing  the  respiratory 
muscles.  Death  is  usually  accompanied  by  convulsions  in 
warm-  but  not  in  cold-blooded  animals.  There  is  dilatation  of 
the  pupil,  and  ptosis  from  paralysis  of  the  endings  of  the  third 
nerve.  Locally  applied,  it  appears  to  paralyse  the  ends  of 
sensory  nerves. 

Methyl-coni'fne  acts  on  the  spinal  cord,  causing  paralysis  of 
reflex  action. 

Dimethyl-coniine  and  conhydrine  have  an  action  similar  to 
that  of  coniine,  but  less  powerful. 

Uses. — It  is  used  locally  as  a  poultice  to  soothe  pain  in 
cancer  and  ulcers,  and  as  a  vapour  to  relieve  cough  in  bron- 
chitis and  pertussis.  It  is  used  to  allay  muscular  spasm  in 
chorea,  mercurial  tremor,  and  paralysis  agitans,  but  is  useless  in 
tetanus  and  strychnine-poisoning.  The  best  preparation  to  use 
is  the  succus  in  doses  of  one  drachm,  gradually  increased  as  the 
patient  becomes  tolerant  of  the  drug. 

Sub-Order  II.— ORTHOSPERM^T. 

Asafcetida,  B.  and  U.S.P.  Asafcetida,  B.P. ;  Asafetida, 
U.S.P- — A  gum-resin  obtained  from  the  root  of  Ferula  Narthex 
(Nafthex  Asafcetida)  and  F.  Scorodosma  and  probably  other 
species.     Afghanistan  and  the  Punjaub. 

Chabaoters. — In  irregular  masses,  composed  of  whitish  tears,  which  are 
embedded  in  a  yellowish-grey  or  brownish-grey  sticky  mass.  The  tears,  when 
hard,  break  with  a  conchoidal  fracture,  showing  a  milk-white  colour  which 
changes  gradually,  on  exposure,  -to  pink,  and  finally  to  brown.  Taste  bitter, 
acrid  ;  odour  foetid,  alliaceous.  The  fresh  fracture  touched  with  nitric  acid 
becomes  green  temporarily. 

Composition. — Volatile  oil,  resin,  and  gum.  The  oil  contains 
a  very  large  proportion  of  sulphur. 

Test. — It  dissolves  almost  entirely  in  rectified  spirit,  B.P. ;  60  per  cent, 
soluble  in  alcohol,  U.S.P. 

Dose. — Of  the  gum-resin,  5-30  gr.  or  more. 

Preparations. 
B.P.  DOSE. 

Enema  Asafoetidae vide  infra. 

Pilula  Aloes  et  Asafoetidee  (vide  p.  522) 4-10  gr. 

Pilula  Asafoetidae  Composlta  (vide  p.  522). ..5-15  gr. 

Spiritus  Ammoniac  Foetidus  i_l  fl.  dr. 

Tinctura  Asafoetidse |-1  fl.  dr.  or  more. 


chap,  xxxiii.]  CALYCIFLOKiE.  938 

U.S.P.  DOSE. 

Emplastrum  Asafoetidse for  external  use. 

Mistura  Asafoetidse  4-8  fl.  dr. 

„       Magnesise  et  Asafoetidse 4  fl.  dr. 

Pilulse  Asafcetidae  (3,  soap  1,  vide  p.  523) 1-3  pills. 

„     Aloes  et  Asafoetids  (vide  p.  523)  2-5  pills. 

„     Galbani  CompositsB  (vide  p.  523) 2-4  pills. 

Tinctura  Asafoetidse 30  min.  to  1  fl.  dr. 

B.P.  Enema  asafoetidse.  Enema  op  Asafcetida  (Enema  Fostidum). — 
Asafcetida,  30  gr. ;  distilled  water,  4  fl.  oz.  Rub  the  asafcetida  in  a  mortar  with 
the  water  added  gradually,  so  as  to  form  an  emulsion. 

U.S.P.  Mistura  Asafoetidse.  Asaecbtida  Mixture. — Bub  asafcetida,  4,  with 
water,  100. 

U.S.P.  Mistura  Magnesias  et  Asafoetidse.  Mixture  op  Magnesia  and  Asafce- 
tida (Dewee's  Carminative).  Carbonate  of  magnesium,  5  ;  tincture  of  asafcetida,  7 ; 
tincture  of  opium,  1 ;  sugar,  10  ;  distilled  water  up  to  100. 

B.P.  Spiritus  Ammosiee  Fcetidus.  Foetid  Spirit  of  Ammonia. — Asafce- 
tida, If  oz. ;  strong  solution  of  ammonia,  2  fl.  oz. ;  rectified  spirit  up  to  1  pint. 

Uses. — It  is  used  as  a  stimulant,  anti-spasmodic,  and  car- 
minative. It  is  useful  in  hysteria,  especially  that  occurring 
about  the  menopause. 

It  is  an  exceedingly  useful  remedy  in  the  form  of  enema  for 
tympanites,  but  on  account  of  its  disagreeable  odour  is  not  much 
used  for  flatulent  distension  of  the  stomach.  It  is  given  as  a 
stimulating  expectorant  in  cases  of  chronic  bronchitis  and 
pertussis. 

Galbanum,  B.  and  U.S.P.  Galbanum. — A  gum-resin,  de- 
rived from  Ferula  galbaniflua,  Ferula  rubricaulis,  and  probably 
other  species.     India  and  the  Levant. 

Characters. — In  tears  about  the  size  of  a  pea,  or  more  commonly  in 
masses  formed  by  their  agglutination ;  greenish-yellow  or  pale  brown  ex- 
ternally, milky -white  internally,  translucent,  having  a  strong  disagreeable 
odour,  and  an  acrid,  bitter  taste. 

Composition. — Gum  resin  and  volatile  oil. 
Dose. — 10-30  gr.  or  more. 

Preparations. 
B.P.  dose. 

Emplastrum  Galbani for  external  usej 

Pilula  AsafcstidEe  Composita  (vide  p.  522)..5-15  gr. 

U.S.P. 

Emplastrum  Asafoetidse 1  for  exteraal  use< 

„  Galbani  J 

Pilulai  Galbani  Composite  (vide  p.  523)  2-4  pills. 

U.S.P.—  Pilulae  Galbani  Compositse.  Compound  Pills  op  Galbanum  (vide -p.  523). 
This  pill  is  much  like  the  compound  asafcetida  pill,  B.P.,  but  contains  less  asafoe- 
tida. 

Uses. — It  has  little  antispasmodic  power,  but  is  a  stimulant 
expectorant,  used  in  chronic  bronchitis  with  much  wheezing 
and  abundant  discharge,  as  it  lessens  secretion.  It  is  also  used 
locally  as  a  stimulant  to  inflamed  joints. 

Ammoniacum,  B.  and  U.S.P.    Ammoniacum,  B,P.;  Ammo- 


934  VEGETABLE   MATEEIA  MEDICA.  [sect.  v. 

niac  U  S  P.— A  gum-resinous  exudation  from  the  stem,  after 
being  punctured  by  beetles,  of  Dorema  Ammoniacum.  Persia  and 
the  Punjaub. 

Characters.— In  roundish  tears  or  irregular  masses  formed  by  their  ag- 
glomeration without  any  intervening  dark-coloured  substance.  Ohe  tears  are 
roundish,  pale  yellowish-brown  externally,  milk-white  internally,  brittle. 
Peculiar  odour,  bitter,  acrid,  nauseous  taste.  It  is  coloured  yeUow  by  caustic 
potash,  and  a  solution  of  chlorinated  soda  gives  it  a  bright  orange  nue. 

Composition. — Gum  resin  and  volatile  oil. 
Dose. — 10  to  30  grains. 


Preparations. 


B.P. 


DOSB. 


Emplastrum  Ammoniac!  cum  Hydrargyro for  external  use. 

„  Galbani ^ 

Mistura  Ammoniaoi  (J  oz.,  water  8  fl.  oz.) 3-I  fl.  oz. 

Pilula  Scill£e  Composita  (vide  p.  523) 

„    Ipecacuanha  cum  Scilla  (vide  p.  522) 


U.S.P. 


Emplastrum  Ammoniaci "I  for  external  use. 

„  „  cum  Hydrargyro J 

Mistura  Ammoniaci  (4,  water  100) 2  fl.  dr.  or  more. 

Use.— It  is  used  for  the  same  purposes  as  galbanum,  chiefly 
as  a  stimulant  to  the  mucous  membrane  in  bronchorrhcea. 

Foeniculi  Fructus,  B.P. ;  Fceniculum,  U.S.P.  Fennel 
Peuit,  B.P. ;  Fennel,  U.S.P.— The  fruit  of  Fceniculum  capilla- 
ceum,  B.P.  {F.  vulgare,  U.S.P.)     Malta. 


Fig.  196.— Pennel. 

Characters. — Longer  than  conium  fruit,  being  about  one-quarter  of  an 
inch  long.  Slightly  curved,  elliptical,  longitudinal  ribs,  the  two  lateral  being 
double ;  taste  and  odour  aromatic.    The  footstalk  is  often  attached. 

Composition. — A  volatile  oil,  having  the  same  composition  as 
oil  of  anise. 

Preparations. 
B.P.  hose.  v.s.v. 

Aqua  Foeniculi  (1  lb.  to  1  gallon) 1-2  fl.  oz.  None. 

Pulvis  Glycyrrhizse  Compositus  (vide  p.  910) 

Use. — It  is  stimulant  and  carminative,  used  to  relieve  flatu- 
lence, and  lessen  the  griping  of  purgatives.1       ,  \ 

1  I  am  informed  that  the  wild  fennel  growing  in  South  Africa  will  completely 
drive  away  fleas  from  kennels  and  stables,  and  powdered  fennel  has  a  similar  effect 
in  this  country. 


chap,  xxxiii.]  CALYCIFL0B2E.  935 

Oleum  Fceniculi,  U.S.P-  Oil  of  Fennel.— A  volatile  oil, 
distilled  from  fennel. 

Characters. — Colourless  or  yellowish,  -with  the  odour  of  fennel,  and  a 
sweetish,  warm  taste.  Sp.  gr.  not  less  than  0-960.  Concretes  between  5° 
and  10°  C.  (41°  and  50°  F.). 

Solubility. — Soluble  in  an  equal  weight  of  alcohol. 

Composition. — Oil  of  fennel  consists  chiefly  of  anethol  (anise- 
camphor),  C10H12O,  which  exists  both  in  a  solid  and  liquid  form. 
There  is  also  a  smaller  proportion  of  an  oil  isomeric  with  oil  of 
turpentine. 

Pbeparations. 

DOSE. 

Aqua  Fceniculi Indefinite. 

Spiritus  Juniperi  Compositus 2-4  fl.  dr.  (8-16  c.c.) 

Use. — The  same  as  that  of  oil  of  anise. 

Anisi  Fructus,  B.P. ;  Anisum,  U.S.P.  Anise  Fbtjit,  B.P. ; 
Anise,  U.S.P. — The  fruit  of  Pimpinella  Anisum. 

Characters. — About  £  of  an  inch  (4  millimetres)  long,  ovate.  It  has  an 
agreeable  aromatic  odour,  and  a  sweet,  spicy  taste.  It  may  be  distinguished 
from  conium  fruit,  which  it  somewhat  resembles,  and  which  has  been  mis- 
taken for  it,  by  the  conium  fruit  consisting  usually  of  single  mericarps,  which 
are  smooth-grooved  upon  the  face  and  have  crenate  ridges  and  no  oil-tubes. 

Preparations. 

B.P.  DOSE. 

Aqua  Anisi 

Oleum    „     1_4  min. 

n.s.p. 
Oleum  Anisi 2-5  min. 

Oleum  Anisi,  B.  and  U.S.P.  Oil  op  Anise. — A  volatile 
oil  distilled  in  Europe  from  anise  fruit  or  in  China  from  the  star 
anise  fruit  (p.  840). 

Characters. — Colourless  or  pale  yellow ;  with  the  odour  of  anise,  and  a 
warm,  sweetish  taste.  Concretes  at  10°  to  15°  C  (50°-59°  F.).  Oil  of  illicium 
has  nearly  the  same  properties,  except  that  it  congeals  at  2°  C.  (35-6°  F.). 

Composition. — The  same  as  that  of  oil  of  fennel. 
Dose. — 2-5  min. 

Pbeparations. 

B.P.  DOSE. 

Essentia  Anisi 10-20  min. 

Tinctura  Camphors  Composita  '. 15  min.-l  fl.  dr. 

Tinctura  Opii  Ammoniata J-l  fl.  dr. 

U.S.P. 

Aqua  Anisi  Indefinite. 

Spiritus  Anisi 1-2  fl.  dr. 

Tinctura  Opii  Camphorata , 1-2  fl.  dr. 

Trochisci  Glycyrrhizse  et  Opii 1-3  troches. 

Use. — It  is  an  aromatic  stimulant  carminative,  and  is  used 
as  an  adjunct  to  purgatives  to  lessen  griping. 


936  VEGETABLE  MATEEIA  MEDIOA.  [sect.  v. 

B.P.  Anethi  Fructus.  Dill.  Fruit— The  dried  fruit  of 
Peucedanum  graveolens  (Aneihum  graveolens).  England,  or  middle 
and  Southern  Europe. 


ElG.  197.— DiU. 

Characters. — Oval,  flat,  about  a  line  and  a  half  in  length,  and  easily  dis- 
tinguished by  its  membranous  wings.    Aromatic  taste  and  odour. 

Composition. — Contains  a  volatile  oil. 

Pbepaeations. 
b.p.  dose.  u.s.f. 

Aqua  Anethi 1-2  fl.  oz.  None. 

(for  infants,  1-2  fl.  dr.) 
Oleum  Anethi  1-4  rain. 

B.P-  Oleum  Anethi.  Oil  of  Dill. — A  volatile  oil'  distilled 
from  the  fruit. 

Characters. — Pale  yellow  colour,  aromatic  odour,  sweetish  taste. 

Use. — The  chief  use  of  dill  water  is  in  the  flatulence  of 
children  in  one-drachm  doses.    It  is  stimulant  and  carminative. 

Carui  Fructus,  B.P. ;  Carum,  U.S.P-  Caraway  Fruit, 
B.P. ;  Caraway,  U.S.P. — The  dried  fruit  of  Carum  Carui,  B.P. 
{Carum  Carvi,  U.S.P.). 


Flo.  198.— Caraway. 

Characters. — Fruit  usually  separating  into  two  mericarps  about  one- 
sixth  inch  long,  curved,  tapering  at  each  end,  brown,  with  five  paler  longitu- 
dinal ridges ;  having  an  agreeable  aromatic  odour  and  spicy  taste. 

Composition. — A  volatile  oil,  which  consists  of  a  hydrocarhon 
carvene,  and  an  oxygenated  oil  identical  with  that  obtained 
from  oil  of  dill. 

Pbepabations. 

B.P.  DOSE. 

Aqua  Carui 1_2  fl.  oz. 

Oleum  Carui 1_4  min. 

Confectio  Opii  5.20  gr. 

Confectio  Piperis 60-120  gr. 

Pulvia  Opii  Compositus 2-5  gr. 

Tinctura  Cardamomi  Composita 1^2  fl.  dr. 

linctura  Sennse 1_4  fl'  dr. 


chap,  xxxiii.]  CALYCIFLOE^.  937 


Oleum  Cari 2-5  min. 

Spiritus  Juniperi  Compositua 2-4  fl.  dr. 

Oleum  Carui,  B.P. ;  Oleum  Cari,  U.S.P.     Oil  of  Caraway. 

The  oil  distilled  in  Britain  from  caraway  fruit,  B.P.     A  volatile 
oil  distilled  from  caraway,  U.S.P. 

Chaeactees. — Colourless  or  pale  yellow,  odour  aromatic,  taste  spicy,  and 
neutral  reaction.    It  is  soluble  in  an  equal  weight  of  alcohol. 

Preparations. 
B.P. 

Confectio  Scammonii,  2  parts  in  150  nearly 
Pilula  Aloes  Barbadensis  (vide  p.  522). 

U.S.P. 

Spiritus  Juniperi  Compositus. 

Use. — Carminative  and  stimulant.  Used  with  purgatives  to 
lessen  griping  and  to  relieve  flatulence. 

Sumbul  Radix,  B.P. ;  Sumbul,  U.S.P-  Sumbul  Boot, 
B.P. ;  Sumbul,  U.S.P. — The  dried  transverse  sections  of  the  root 
of  Ferula  Sumbul.     Imported  from  Bussia  and  India. 

Chaeactees. — Cylindrical  pieces,  varying  considerably  in  diameter  and 
thickness.  They  are  covered  on  the  outer  edge  with  a  dusky  brown  rough 
bark,  frequently  beset  with  short,  bristly  fibres.  The  cut  surface  looks  like 
felt  from  the  interior  of  the  root  consisting  of  easily  separated  fibres.  It  has 
a  strong  odour,  resembling  that  of  musk.  The  taste  is  at  first  sweetish,  be- 
coming after  a  time  bitterish. 

Composition. — A  resin  soluble  in  ether,  and  a  small  quantity 
of  an  essential  oil. 

Preparations. 

B.P.  DOSE. 

Tinctura  Sumbul  (2|  oz.  in  1  pint) 10-60  min. 

U.S.P. 

Tinctura  Sumbul  (10  per  cent.) 1-4  fl.  dr. 

Use. —  Sumbul  is  said  by  some  to  be  of  little  service;  how- 
ever, it  seems  useful  in  the  malady  for  which  it  is  usually  pre- 
scribed, viz.,  hysteria  and  nervous  conditions  occurring  in  females 
in  feeble  health  or  recovering  from  an  acute  disease. 

Sub-Order  III.— CCELOSPERM^. 

Coriandri  Fructus,  B.P. ;  Coriandrum,  U.S.P.  Coei- 
andeb  Fbuit,  B.P. ;  Coeiandee,  U.S.P. — The  dried  ripe  fruit  of 
Coriandrum  sativum. 


Fie.  199.— Coriander. 

Charactees. — Globular,  nearly  as  large  as  white  pepper,  beaked,  finely 
ribbed,  yellowish-brown ;  has  an  agreeable  aromatic  odour  and  flavour. 


938  VEGETABLE  MATEEIA  MEDICA.  [sect.  v. 

Composition. — Contains  volatile  and  fixed  oils. 

Preparations. 
b.P.  DOSE. 

Confeotio  Senna 60-120  gr. 

Oleum  Coriandri  .'. 2-5  min. 

Syrupus  Ehei 1-4  n.  dr. 

Tinetura  Ehei 1-8  A.  dr. 

Tinetura  Sennse 1-4  n.  dr. 

U.S.P. 

Oleum  Coriandri . 2-5  min. 

Oleum  Coriandri,  B.  and  U.S.P.  Oil  op  Coeiandee.— A 
volatile  oil  distilled  from  coriander. 

Chabactees. — A  colourless  or  yellowish  liquid,  having  the  characteristic 
aromatic  odour  of  coriander,  a  warm  spicy  taste,  and  a  neutral  reaction. 

Dose. — 2  to  5  min. 

Preparation. 
B.P.  DOSE. 

Syrupus  Sennaa 1-4  fl.  dr. 

Use. —  Carminative  and  stimulant.     Used  as  an  adjunct  to 

purgatives. 

CORNACE^E. 

U.S.P.  Cornus.  Coenus.  Dogwood. — The  bark  of  the  root 
of  Cornus  florida. 

Characters. — In  curved  pieces  of  various  sizes,  about  one-eighth  of  an 
inch  (3  millimetres)  thick ;  deprived  of  the  furrowed,  brown-grey,  corky 
layer ;  outer  and  inner  surface  pale-reddish,  or  light  reddish-brown,  striate ; 
transverse  and  longitudinal  fracture  short,  whitish,  with  brown,  yellow  strise ; 
inodorous ;  astringent  and  bitter. 

Dose.— 20  to  60  gr.  (1-4  gm.) 

Preparation. 

dose. 
Extractum  Cornus  Fluidum 1  fl.  dr. 

Composition. — It  contains  a  bitter  neutral  principle. 

Action. — It  acts  as  an  astringent  tonic  and  feeble  stimulant 
to  the  stomach.  It  was  formerly  used  in  ague  and  malarious 
conditions,  and  a  resinoid  substance  obtained  from  it  by  alcohol 
is  popularly  called  dogwood-quinine. 


939 


CHAPTEE  XXXIV. 
Class  II—  DICOTYLEDONES  GAMOPETALiE. 

(COEOLLIFLOE.E). 

CAPRIFOLIACEiE. 

B.P.  Sambuci  Flores.  Eldbe  Flowers. — The  fresh  flowers 
of  Sambucus  nigra.     From  indigenous  plants. 

Chaeacteks. — Flowers  small,  white,  fragrant,  crowded  in  large  cymes. 

U.S.P.  Sambucus.  Elder. — The  flowers  of  Sambucus 
canadensis. 

Characters. — In  level  tipped  cymes,  cream-coloured,  odour  peculiar, 
taste  sweetish,  aromatic,  slightly  bitter. 

Composition. — A  small  amount  of  a  light  essential  oil. 

Preparation. 
b.p.  dose.  c.s.p. 

Aqua  Sambuci 1-2  fl.  oz.  None. 

Use. — Elder-flower  water  is  used  as  a  vehicle  in  collyria  and 
lotions. 

U.S.P.  Viburnum.  Viburnum.  Black  Haw. — The  bark  of 
Viburnum  prunifolium. 

Characters.- — In  thin  pieces  or  quills,  glossy  purplish-brown,  with  scat- 
tered warts,  and  minute  black  dots  ;  when  collected  from  old  wood,  greyish- 
brown  ;  the  thin,  corky  layer  easily  removed  from  the  green  layer ;  inner 
surface  whitish,  smooth ;  fracture  short ;  inodorous ;  somewhat  astringent 
and  bitter. 

Preparation.  ■  dose. 

Extractum  Viburni  Fluidum 30-60  min. 

Uses. — It  is  said  to  be  useful  in  preventing  threatened  abor- 
tion, and  in  dysmenorrhcea.    Its  action  is  not  well  understood. 

RUBIACEiE  (CINCHONACiE). 

Sub-Okdeb  I.— CINCHONEiE. 

B.P.  Cinchona  Cortex.  Cinchona  Bare. — The  dried  bark 
of  Cinchona  Calisaya,  Cinchona  officinalis,  Cinchona  succirubra, 
Cinchona  lancifolia,  and  other  species  of  cinchona  from  which  the 
peculiar  alkaloids  of  the  bark  may  be  obtained. 

B.P.    Preparations. 
Cincnoninae  Sulpnas.  Quinlnse  Hydrochloras. 

Cinchonidinse  Sulphas.  ■•         Sulpnas. 


940 


VEGETABLE  MATEBIA  MEDICA. 


[sect.  v. 


(Salts  of  quinine  and  cinchonine  may  also  be  obtained  from 
some  species  of  Eemijia,  DC.) 

U.S.  P.  Cinchona.  Cinchona.— The  bark  of  any  species  of 
cinchona  containing  at  least  3  per  cent,  of  its  peculiar  alkaloids. 

Pbepaeation. 
u.s.p.  D0SE- 

Infusum  Cinchona  (cinchona  in  powder  6,  aromatic  sulphuric  acid  1,\  j_g  g_  oz_ 
water  q.s.  to  make  100  parts  by  percolation) J 


Pig.  200.— Bark  of  Cinchona  officinalis,  half  the  natural  size. 

U.S.P.    Cinchona    Flava.      Yellow    Cinchona    (Calisaya 
Bake),   UJ3.P. — The  bark  of  the  trunk  of  Cinchona  Calisaya, 


Tug.  2U1.— (Jmciioua  Calisaya  Bark,  half  the  natural  size. 

containing  at  least  2  per  cent,  of  quinine.     Collected  in  Bolivia 
and  Southern  Peru. 

Characters. — In  flat  pieces,  or  quills.  The  flat  pieces  are  recognised  by 
their  tawny  yellow  colour,  and  by  the  long  channelled  depressions  left  on  the 
outer  side  of  the  bark  by  the  gouge  with  which  the  epidermis  has  been  re- 
moved. Transverse  fracture  shows  numerous  very  rigid  glistening  fibres, 
short  and  very  fibrous.  Powder  cinnamon-brown,  somewhat  aromatic,  per- 
sistently bitter. 

u.s.p.  Preparations.  dose. 

Extractum  Cinchonas 8-15  gr. 

„  „         Fluidum 30-60  min. 

Tinctura  Cinchona 1-2  fl.  dr. 

Cinchonas  Rubrae  Cortex,  B.P. ;  Cinchona  Rubra,  U.S.P. 

Bed  Cinchona  Bare.     Bed  Cinchona.— The  dried  bark  of  the 
stem  and  branches  of  cultivated  plants  of  Cinchona  succirubra. 


Fig.  202.— Bed  Cinchona,  half  the  natural  size. 

Characters. — In  quills  or  incurved  pieces,  coated  with  the  periderm, 
outer  surface  brown  or  reddish-brown,  rough,  fissured  or  warty ;  inner  surface 
redder ;  fractured  surface  often  approaching  to  brick-red ;  transverse  fracture 
finely  fibrous ;  powder  red-brown ;  taste  bitter  and  astringent. 

Adulteration. — Some  of  the  brown  and  red  inferior  barks  are  occasionally 
substituted. 


CHAP.  XXXIV.] 


COEOLLIPLOEiE. 


941 


Test. — When  used,  for  purposes  other  than  that  of  obtaining  the  alkaloids 
or  their  salts,  it  should  yield  between  five  and  six  per  cent,  of  total  alkaloids, 
of  which  not  less  than  half  shall  consist  of  quinine  and  cinchonidine. 


Pbepaeations. 


B.F. 

Decoctum  Cincbonee 

Extractum  Cincbonee  Xiquidum  . 

Infusum  Cincbonee  Acidum 

REistura  Ferri  Aromatic  a 

Tinctura  Cincbonee 

„  „  Composlta 


STEENSTH.  DOSE. 

..27|  gr.  to  1  fl.  oz.  1-2  fl.  oz. 
..about  1  oz.  to  1  fl.  oz.       5-10  min. 

..22  gr.  to  1  fl.  oz.  1-2  fl.  oz. 

.1  oz.  to  16  fl.  ozv  1-2  fl.  oz. 

..88  gr.  tolfl.  oz.  i-2fl.  dr. 

..2  oz.  to  1  pint.  f-2  fl.  dr. 


U.S.P. 


Tinctura  CinchonsB  Composita 1-4  fl.  dr.  (4-16  c.e.) 

B.P.  Tinctura  Cincbonee  Composita.  Compound  Tinctuee  oe  Cinchona. 
Eed  cinchona  bark,  2  oz. ;  bitter  orange  peel,  1  oz. ;  serpentary,  f  oz. ;  saffron, 
55  gr. ;  cochineal,  30  gr. ;  proof  spirit,  1  pint. 

U.S.P.  Tinctura  CinchonsB  Composita.  Compound  Tinctuee  op  Cinchona. — 
Eed  cinchona,  10 ;  bitter  orange  peel,  8  ;  serpentaria,  2 ;  glycerin,  10  ;  alcohol 
and  water  (in  the  proportion  of  8  of  the  former  to  1  of  the  latter),  q.s.  to  make  100. 

PEOPEETIES     AND     COMPOSITION    OF    THE      ClNCHONA     BAEKS. 

The  cinchona  barks  contain  varying  quantities  of  the  following 
alkaloids : — Cinchonine  (C29H22N20),  cinchonidine  (Cl9H22N20), 
quinine  (C20H24N2O2),  quinidine  (C20H24N2O2),  quinamine  (C19H24 
N202),  conquinamine  (C19H24N202). 

Both  the  total  quantity  of  alkaloids  and  the  relative  propor- 
tions of  each  vary  considerably  in  the  barks  of  the  different 
species  of  cinchona. 

By  heating  solutions  of  the  cinchona  alkaloids  with  excess  of 
a  mineral  acid  they  may  be  converted  into  amorphous  isomeric 
alkaloids.  Quinine  yields  quinicine,  and  cinchonine  is  converted 
into  cinchonicine. 

In  addition  to  the  alkaloids,  the  cinchona  barks  contain  cer- 
tain acid  principles.  These  are : — (1)  Quinic  or  chinic  acid, 
soluble  in  water  and  alcohol,  but  sparingly  so  in  ether.  On  oxi- 
dation it  yields  quinone  or  chinone.  (2)  Cincho-tannic  acid. 
(3)  Quinovic  acid. 

Cinchona  bark  also  contains  quinovin,  which  by  means  of 
hydrochloric  acid  is  resolved  into  quinovic  acid  and  an  uncry- 
stallisable  sugar.  It  also  contains  cinchona-red,  which  is  a 
colouring  matter  abundantly  found  in  the  red  bark. 

Distinguishing  Tests  foe  Cinchona  Alkaloids. 


Quinine 
Quinidine 
Cinchonine    . 

Cinchonidine . 

Solution 

Chlorine 
water  and 
Ammonia 

Polarised 
Light 

Solubility 
in  Ether 

Solubility  in 
excess  of 
Ammonia 

Fluorescent 
Fluorescent 
Not 

Not 

Green  . 
Green  . 
Not      . 

Not      . 

Left     . 
Eight  . 
Eight  . 

Left     . 

Eeadily 
Eeadily 
Almost  in- 
soluble 
Sparingly 

Eeadily 
Sparingly 
Almost  in- 
soluble 
Almost  in- 
soluble 

942  VEGETABLE  MATEEIA  MEDICA.  [sect.t. 

U.S.P-  Quinina.  Quinine.  C20H24N2O2.3H2O  (crystallised) ; 
378. — An  alkaloid  prepared  from  different  species  of  cinchona. 

Preparation. — By  adding  to  the  solution  of  the  sulphate  a  quantity  of 
■water  of  ammonia  or  solution  of  soda,  just  sufficient  to  precipitate  the  alkaloid. 
Although  it  is  not  separately  mentioned  in  the  B.P.,it  is  used  in  the  preparation 
of  citrate  of  iron  and  quinine. 

Preparations, 
u.s.p.  DOSE. 

Perri  et  Quininae  Citras 3-5  gr.  _ 

Liquor  Ferri  et  Quinina  Citratis.. 8-45  min. 

Syrupus  Ferri  Quininse  et  Strychninse  Phosphatum 1-2  fl.  dr. 

Quininae  Sulphas,  B.  and  U.S.P.  Sulphate  of  Quinine. 
(C20H24N2O2)2H2SO4.7H2O;  872.— The  sulphate  of  an  alkaloid, 
prepared  from  the  powder  of  various  kinds  of  Cinchona  and 
Eemijia  bark. 

Preparation. — By  extraction  with  spirit  after  the  addition,  of  lime,  or  by 
the  action  of  alkali  on  an  acidulated  aqueous  infusion  with  subsequent 
neutralisation  of  the  alkaloid  by  sulphuric  acid  and  purification  of  the  result- 
ing salt. 

Characters. — Filiform,  silky,  snow-white  crystals,  of  a  pure  intensely 
bitter  taste. 

Solubility. — It  is  sparingly  soluble  in  water,  that  is  1  part  in  700  or  800 
parts,  at  common  temperatures,  yet  imparting  to  the  water  a  bluish  tint  or 
fluorescent  appearance.  Entirely  soluble  in  water  acidulated  by  sulphuric 
acid. 

Eeaotions. — Its  solutions  give  with  chloride  of  barium  a  white  precipitate 
insoluble  in  nitric  acid.  When  treated  first  with  solution  of  chlorine  and 
afterwards  with  ammonia  they  become  of  a  splendid  emerald-green  colour, 
and  solution  of  ammonia  gives  with  them  a  white  precipitate  of  quinine 
soluble  in  ether,  and  in  excess  of  the  solution  of  ammonia.  It  dissolves  in 
pure  sulphuric  acid  with  a  feeble  yellowish  tint,  and  undergoes  no  further 
change  of  colour  when  gently  warmed.  For  the  mode  of  testing  the  purity 
of  the  salt,  vide  B.P. 

Preparations. 
B.P.  DOSE. 

Ferri  et  Quininae  Citras 5-10  gr. 

Tlnctura  Quininse  Ammoniata \-'l  fl.  dr. 

Vinum  Quininse 1-1  £1.  oz. 

U.S.P.  Quininae  Bisulphas.  Bisulphate  op  Quinine. 
C20H24N2O2H2SO4.7H2O ;  548. 

Characters. — Colourless,  clear,  orthorhombio  crystals  or  small  needles, 
efflorescing  and  becoming  opaque  on  exposure  to  air,  no  smell,  very  bitter 
taste,  strongly  acid  reaction. 

Solubility  and  Reactions. — It  resembles  the  sulphate  in  its  reactions, 
but  is  much  more  readily  soluble.  It  dissolves  with  vivid  blue  fluorescence 
in  10  parts,  while  the  sulphate  requires  740  parts,  of  water  at  59°  F. 

U.S.P-  Quininae  Hydrobromas.  Hydrobeomate  of  Quinine. 
C20H24N2O2HBr.2H2O ;  440-8. 

Characters. — Colourless,  lustrous  needles,  no  smell,  very  bitter  taste,  and 
a  neutral  or  slightly  alkaline  reaction. 

Solubility. — It  is  soluble  in  about  16  parts  of  water  at  59°  F. 

Reactions. — The  solution  gives  the  reactions  of  quinine,  and  with  test 
solution  of  nitrate  of  silver  yields  a  white  precipitate  insoluble  in  diluted 
nitric  acid,  and  in  solution  of  carbonate  of  ammonium. 


chap,  xxxiv.]  COKOLLIFLOBjE.  943 

Action. — Useful  for  hypodermic  injection.  It  is  supposed 
to  produce  fewer  unpleasant  head  symptoms  than  other  prepara- 
tions of  quinine. 

Quininae  Hydrochloras,  B.  and  U.S. P.  Hydrochlorate  op 
Quinine.     C20H24N2O2HC1.2H2O ;  396-4. 

Characters. — In  crystals  like  those  of  the  sulphate,  but  generally  some- 
what larger. 

Beactions. — It  gives  the  reactions  of  quinine,  and  with  test  solution  of 
nitrate  of  silver  produces  a  white  precipitate  insoluble  in  nitric  acid,  but 
soluble  in  ammonia. 

Uses. — Like  those  of  the  bisulphate. 

Peepabation. 

B.P.  DOSE. 

Tinctura  Quininae  (1  gr.  in  1  fl.  dr.) 1-2  fl.  dr. 

U.S.  P.  Quininae  Valerianas.  Valerianate  of  Quinine. 
C20H24N2O2C6H10O2.H2O;  444. 

Characters. — "White  pearly  crystals  with  a  slight  odour  of  valerianic 
acid,  a  bitter  taste  and  a  neutral  reaction. 

Reactions. — The  solution  when  acidulated  with  sulphuric  acid  emits  the 
odour  of  valerianic  acid,  and  gives  the  reactions  of  quinine. 

Use. — As  a  tonic  in  hysteria  and  nervous  irritability.  It  is 
said  to  be  particularly  useful  in  some  forms  of  intermittent  and 
spasmodic  nervous  affections  (vide  p.  952). 

U.S.P.  Quinidinae  Sulphas.  Sulphate  of  Quinidine. 
(C2„H24N20?)2H2S04.2H20 ;  782.— It  is  chiefly  obtained  from 
Cinchona  pitayensis. 

Characters. — White  silky  needles,  no  smell,  very  bitter  taste,  with  a 
neutral  or  faintly  alkaline  reaction. 

Solubility  and  Beactions. — It  is  soluble  in  100  parts  of  water  at  59°  F. 
For  its  reactions,  vide  p.  941. 

U.S.P.  Cinchonina.     Cinchonine.     C20H24N2O;  308. 

Characters. — White,  somewhat  lustrous,  prisms  or  needles,  no  smell,  at 
first  nearly  tasteless,  but  developing  a  bitter  after-taste  and  having  an  alkaline 
reaction. 

Solubility. — Almost  insoluble  in  hot  or  cold  water,  readily  soluble  in 
diluted  acids. 

Cinchoninae  Sulphas.  B.  and  U.S.P.  Sulphate  of  Cin- 
chonine.    (C20H24N2O2H2SO4)2H2O;  750. 

Preparation. — From  the  mother-liquors  of  the  crystallisation  of  the  sul- 
phates of  quinine,  cinchonidine,  and  quinidine,  by  precipitating  with  caustic 
soda,  washing  with  spirit  until  free  from  other  alkaloids,  dissolving  in  sul- 
phuric acid,  purifying  with  animal  charcoal,  and  allowing  to  crystallise. 

Characters. — Hard,  colourless,  short,  prismatic  crystals,  with  a  vitreous 
lustre.  The  aqueous  solution  has  a  bitter  taste ;  the  acidified  solution  is  not 
fluorescent  (p.  941). 

Solubility. — Soluble  in  water  and  in  chloroform,  almost  insoluble  in 
ether  and  in  solution  of  ammonia,  readily  soluble  in  rectified  spirit  and  in 
diluted  acids. 


944  VEGETABLE  MATEEIA  MEDICA.  [sect.  v. 

Cinchonidinse  Sulphas.  B.  and  U.S.P.  Sulphate  of 
Cinchonidine.     (C20H24N2O)2H2SO4.3HO ;  768. 

Preparation. — By  concentrating  the  mother-liquors  after  the  crystalli- 
sation of  sulphate  of  quinine,  purifying  by  crystallisation  from  alcohol  and 
finally  from  hot  water. 

Characters. — In  colourless  silky  crystals,  usually  acicular. 

Solubility. — Soluble  in  water,  alcohol,  or  ether ;  almost  insoluble  in  chloro- 
form or  in  solution  of  ammonia  ;  readily  soluble  in  diluted  acids. 

Beactions. — The  solution  in  water  has  a  bitter  taste  and  a  neutral  or 
faintly  alkaline  reaction,  twists  a  ray  of  polarised  light  to  the  left ;  when 
acidified  is  not  distinctly  fluorescent.     For  other  tests,  vide  p.  941. 

U.S.P.  Chinoidinum.  Chinoidin.  (Quinoidin). — A  mixture 
of  alkaloids,  mostly  amorphous,  obtained  as  a  by-product  in  the 
manufacture  of  the  crystallisable  alkaloids  from  cinchona. 

Characters. — A  brownish-black  or  almost  black  solid,  breaking  when  cold 
with  a  resinous  shining  fracture,  becoming  plastic  when  warmed,  odourless, 
having  a  bitter  taste  and  an  alkaline  reaction. 

Solubility. — Almost  insoluble  in  water,  freely  soluble  in  alcohol,  chloro- 
form, and  diluted  acids. 

Use. — It  is  of  uncertain  composition,  and  liable  to  adulteration, 
and  is  employed  instead  of  quinine  on  account  of  its  cheapness. 

Doses  of  Cinchona  Alkaloids  and  their  Salts. 

_   .  .  fi-2  gr.  as  tonic;  2-5  gr. repeated  every  2-4  hours  as 

yumma \     antipyretic.    15-20  gr.  a  large  dose. 

Quininse  Sulpbas  The  same. 

„         Bisulphas A  little  larger. 

„         Hydrobromas The  same  as  for  quinina. 

„  Hydrochloras ....  „ 

„         Valerianas 1-2  gr. 

Quinidinse  Sulphas Same  as  quinina. 

Chinoidinum Somewhat  larger  than  of  the  crystalline  alkaloids. 

Chinonidinaa  Sulphas 1-15  gr. 

Cinchonina About  one  half  more  than  of  quinina. 

Cinchomnae  Sulphas „  „  „  „ 

The  preparations  in  thick  type  belong  both  to  the  B.P.  and  U.S.P. ;  the  others 
to  the  U'.S.P.  alone. 

Physiological  Action. 

General  Action. — A  solution  of  quinine  when  added  to 
albumen  loses  its  fluorescence  and  seems  to  enter  into  combina- 
tion -with  it,  for  the  albumen  is  rendered  less  soluble  and  more 
coagulable  (p.  58). 

It  lessens  protoplasmic  and  amoeboid  movements  (pp.  61, 
62,  65),  and  destroys  low  animal  and  vegetable  organisms,  but 
salt-water  amoebae  seem  to  withstand  the  action  of  quinine  to  a 
great  extent. 

Quinine  diminishes  oxidation  (p.  72)  and  diminishes  and 
prevents  the  development  of  a  blue  colour  on  the  addition  of  a 
few  drops  of  blood  to  a  solution  of  tincture  of  guaiac  and  ozonic 
ether  (p.  69) .  A  similar  but  less  marked  effect  is  seen  if  blood 
be  taken  from  an  animal  into  which  quinine  has  been  previously 
injected,  instead  of  mixing  the  quinine  directly  with  the  blood. 


qHAP.  xxxiv.]  COEOLLIFLOEiB.  945 

Quinirje  diminishes  and  in  large  doses  arrests  fermentation, 
especially  when  it  depends  on  organised  ferments  (as  alcoholic, 
lactic,  or  butyric  fermentations),  but  does  not  prevent  the  change 
of  starch  into  sugar  by  ptyalin  or  diastase.  It  has,  however,  an 
action  on  some  enzymes,  and  diminishes  the  action  of  pepsin  on 
albumin,  and  the  change  of  amygdalin  into  oil  of  bitter  almonds  by 
emulsin.  It  is  a  powerful  antiseptic  (p.  94),  and  a  dilute  solution 
will  preserve  meat,  milk,  butter,  or  urine  for  a  length  of  time. 
It  is  absorbed  from  all  mucous  membranes,  and  is  better  given 
in  solution,  as  some  of  the  powder  passes  out  in  the  faeces.  It 
forms  with  the  bile  a  salt  which  is  sparingly  soluble,  except 
in  excess  of  bile ;  hence  before  giving  quinine  in  malaria, 
clear  out  the  liver  by  administering  an  emetic  and  a  cholagogue 
purgative. 

Special  Action. — On  the  Alimentary  Canal. — When  taken 
into  the  mouth,  quinine  causes  a  persistent  bitter  taste  if  the 
solution  be  neutral  or  only  slightly  acid,  for  then  the  alkalinity 
of  the  saliva  precipitates  the  alkaloid;  but  if  given  with  an 
excess  of  acid,  and  a  little  water,  the  bitter  taste  soon  disappears, 
leaving  a  sweetish  one  behind.  The  bitter  taste  produces  in- 
creased flow  of  saliva  by  reflexly  influencing  the  centre  in  the 
medulla.  When  quinine  is  injected  into  the  duct  of  the  sub- 
maxillary gland  it  prevents  the  secretion  of  watery  saliva  by 
paralysing  the  ends  of  the  chorda  tympani,  or  by  acting  directly 
on  the  secretory  cells  themselves  (p.  354).  The  secretion  of  the 
thick  ropy  saliva  is  not  prevented,  for  the  sympathetic  is  not 
paralysed  except  by  large  doses  (p.  355).  The  vaso-dilator 
nerve  fibres  are  not  paralysed,  for  if  they  be  stimulated  the 
blood-vessels  dilate,  the  lymph-spaces  become  full  and  the  gland 
oedematous,  but  no  secretion  takes  place. 

When  taken  into  the  stomach  small  doses  increase  the 
appetite,  especially  in  atonic  dyspepsia,  but  if  the  stomach  is, 
irritable  quinine  in  large  doses  causes  loss  of  appetite  and  may 
produce  nausea  and  vomiting  (p.  362  etseq.).  When  it  causes 
vomiting,  the  addition  of  hydrobromic  acid  will  often  enable  it 
to  be  borne.  If  the  stomach  be  congested  the  flow  of  mucous 
secretion  will  be  increased  by  quinine. 

The  action  of  quinine  on  the  secretions  and  peristalsis  of  the 
intestines  is  unknown,  as  also  is  its  action  on  the  secretion  of 
bile,  though  it  is  certain  that  it  does  not  increase  it. 

When  absorbed  into  the  blood,  quinine  causes  contraction  of 
the  spleen,  and  in  large  doses  lessens  the  contractile  power  and 
amoeboid  movements  of  the  white  blood-corpuscles.  It  thus  checks 
the  diapedesis  of  the  white  blood-corpuscles  (p.  62). 

The  size  of  the  red  corpuscles  is  increased  (p.  63),  but  their 
power  of  giving  up  oxygen  seems  to  be  diminished,  as  is  shown 
by  the  guaiacum  test  (p.  69). 

On  the  Circulation. — Small  and  moderate  doses  increase 

3p 


946  VEGETABLE  MATERIA  MEDICA.  [sect.v, 

the  strength  of  the  circulation,  but  how  they  act  has  not  been 
ascertained. 

Large  doses  diminish  the  blood-pressure,  chiefly  by  weaken- 
ing the  heart,  but  partly  by  paralysing  the  vaso-motor  centre, 
thus  causing  dilatation  of  the  vessels.  This  paralysis  occurs 
from  very  large  doses.  It  is  evidenced  by  the  fact  that  irritation 
of  a  sensory  nerve  or  asphyxia  no  longer  produces  contraction  of 
the  vessels  and  rise  of  blood-pressure. 

The  heart's  action  is  weakened  by  quinine,  from  its  action 
on  the  motor  ganglia,  and  probably  also  on  the  muscular  fibres 
of  the  heart  itself. 

The  vagus  nerve  is  little  affected  by  moderate  doses,  but  is 
finally  paralysed  by  very  large  doses.  In  poisoning  by  quinine 
death  generally  occurs  from  failure  of  the  respiration,  and  only 
occurs  through  cardiac  paralysis  if  the  drug  be  injected  directly 
into  the  circulation  in  large  doses  ;  the  animal  then  dies  in  con- 
vulsions consequent  on  stimulation  of  the  nerve-centres  by  the 
venous  condition  of  blood  thus  produced. 

On  the  Respiration. — Small  doses  have  no  effect  on  it. 
Moderate  doses  quicken  the  respiratory  movements,  but  large 
doses  first  slow,  and  then  stop  them,  by  paralysing  the  respira- 
tory centre.  The  amount  of  oxygen  taken  in  and  of  carbon 
dioxide  exhaled  is  diminished.  This  is  due  to  the  action  of  the 
drug  on  tissue-change  and  on  the  red  blood-corpuscles  (p.  72) . 

On  Tissue-change. — Moderate  doses  diminish  tissue-change 
(p.  415)  and  lessen  the  relative  amount  of  nitrogen  and  sulphates 
in  the  urine,  but  increase  the  total  quantity.  In  fever,  especially 
when  due  to  septic  poisoning,  the  temperature  of  a  patient  is 
lowered  by  quinine.  It  is  also  lowered  in  an  animal  even  after 
section  of  the  cord  and  wrapping  up  in  cotton-wool,  showing  that 
the  fall  is  due  to  the  lessened  tissue-change  and  oxidation  in  the 
body.  When  given  in  fever  quinine  increases  the  amount  of 
nitrogen  in  the  urine. 

On  the  Nervous  System. — In  man  small  doses  give  tone 
to  the  system  generally. 

Large  doses  cause  symptoms  to  which  the  term  cinchonism 
(or  quinism)  has  been  applied ;  these  consist  in  a  feeling  of 
tightness  across  the  forehead,  ringing  in  the  ears,  deafness, 
diminution  of  the  power  of  sight  and  of  accuracy  of  feeling 
(p.  229) .  These  symptoms  may  generally  be  relieved  by  giving  30 
minims  of  solution  of  hydrobromic  acid  with  each  dose.  Ergot 
also  tends  to  prevent  or  remove  them. 

By  still  larger  doses  the  powers  of  hearing  and  sight  are 
more  affected,  complete  deafness  being  sometimes  produced. 
Giddiness,  headache,  staggering  gait,  and  muscular  weakness 
succeed,  and  the  circulation  becomes  feeble. 

With  very  large  doses  delirium  occurs  and  occasionally 
death,  sometimes  in  convulsions. 


chap,  xxxiv.]  COKOLLlFLOE^.  947 

Small  doses  stimulate,  large  doses  depress,  the  functions  of 
the  brain,  lessening  the  powers  of  thought,  but  may  stimulate 
the  motor  centres  so  as  to  cause  epileptic  hts  (p.  190),  and  I  have 
seen  one  case  in  which  an  epileptic  fit  appeared  to  be  brought  on 
by  large  doses  of  quinine. 

Spinal  Cord. — Eeflex  action  is  diminished,  especially  in  the 
frog.  Immediately  after  the  injection  of  quinine  into  the  lymph- 
sac  of  a  frog  a  great  depression  of  reflex  action  occurs.  This 
was  attributed  by  Chaperon  to  stimulation  of  Setschenow's 
centres  by  the  quinine.  It  is  probably,  however,  only  reflex 
depression,  due  to  the  local  irritation  of  the  injection.  At  a  later 
stage  of  poisoning  considerable  depression  of  the  reflex  action  is 
also  observed,  which  has  been  attributed  to  gradual  paralysis  of 
the  cord  from  feebleness  of  the  heart  and  consequent  failure  of 
the  circulation.  Sensory  and  motor  nerves  are  only  affected 
by  the  drug  when  locally  applied.  The  muscles  retain  their 
irritability  till  near  death,  but  their  capacity  for  work  as  well  as 
their  irritability  is  diminished.  The  muscular  curve  is  somewhat 
prolonged  (p.  128).  During  its  excretion  quinine  stimulates 
the  genito-urinary  tract,  and  occasionally  produces  irritability  of 
the  bladder  and  urethra.  It  is  said  to  produce  contraction  of  the 
gravid  uterus,  and  is  therefore  to  be  given  witb  care  in  pregnancy. 

Uses. — From  its  power  of  destroying  germs  and  preventing 
putrefaction,  quinine  is  used  as  a  local  antiseptic.  As  a  lotion 
it  is  useful  in  conjunctivitis,  and  in  the  diphtheritic  form  of  this 
disease  quinine  destroys  the  power  of  the  secretion  to  cause 
inflammation  when  inoculated  into  another  eye. 

Hay  fever,  which  probably  is  caused  by  the  presence  of  the 
pollen  of  grasses,  is  often  relieved  by  washing  the  nose  with  a 
saturated  aqueous  solution  of  sulphate  of  quinine  (about  \  grain 
to  1  fl.  oz.),  (p.  478).     Sometimes  it  is  quite  useless. 

Sore-throat  is  often  relieved  by  a  gargle  of  quinine  (cf .  p.  816) . 

Whooping-cough  is  often  relieved  by  quinine,  which  may  be 
inhaled  in  the  form  of  spray  of  the  strength  of  2  grains  to  the 
ounce  in  Eichardson's  ball  spray  or  4  grains  to  the  ounce  in 
Siegel's  apparatus. 

After  the  evacuation  of  an  empyema  or  pleural  effusion,  a 
solution  of  quinine  may  be  injected  as  an  antiseptic  into  the 
pleural  cavity.  It  is  a  useful  injection  (2  gr.  to  the  ounce)  in 
chronic  cystitis  and  otorrhcea. 

As  a  tonic  it  is  useful  in  general  debility ;  it  increases  the 
appetite  and  muscular  strength  ;  it  may  be  advantageously  com- 
bined with  iron. 

As  an  antiperiod-'C  it  is  used  in  ague,  malarial  fever,  and  all 
malarial  remittent  affections,  with  great  efficiency,  being  almost 
a  specific.  It  should  be  given  in  doses  of  3  or  4  grains,  three 
times  a  day,  or  in  a  single  dose  of  10  grains  just  before  a  fit  comes 
on ;  it  will  often  cut  short  a  fit  of  moderate  intensity.   An  emetic 

3  f  2 


948  VEGETABLE  MATEEIA  MEDICA.  [sect.  v. 

or  cholagogue  purgative  should  be  given  before  it  (p.  405).     In 
malarial  cachexia  without  distinct  fits,  it  is  much  less  serviceable. 

In  neuralgia  of  the  intestine,  when  due  to  malaria,  5  grains 
should  be  administered  in  one  dose,  followed  by  5  more  in  a  quarter 
of  an  hour  if  no  relief  is  obtained.  It  will  also  cure  other  forms 
of  neuralgia  not  apparently  due  to  malaria,  and  even  when  not 
of  a  periodic  character.  It  is  especially  useful  in  supra-orbital 
neuralgia. 

Intermittent  headache  is  often  greatly  relieved  by  5  grains 
of  quinine,  especially  if  calomel,  grey  powder,  or  podophyllin  be 
also  given  along  with  it  to  act  on  the  liver  (cf.  pp.  375,  406). 

As  an  antipyretic  large  doses  (5-20  gr.)  lessen  the  tempera- 
ture in  typhus,  enterie,  and  other  fevers.  It  is  better  to  give  a 
single  large  dose  once  a  day,  or  two  doses  of  5  grains  given 
within  an  hour,  between  five  and  six  in  the  evening. 

In  symptomatic  fevers  quinine  has  been  used  to  reduce  the 
temperature,  as  in  pneumonia. 

In  rheumatism  and  exanthemata  it  is  not  much  used. 

In  the  treatment  of  worms  quinine  is  useful  to  prevent  the 
accumulation  of  mucus  which  forms  a  nidus  for  the  worm. 

As  a  prophylactic  agent  against  ague  and  all  intermittent 
affections  quinine  is  invaluable. 

Warburg's  tincture,  containing  quinine  and  a  number  of 
aromatics,  is  very  useful  in  cases  of  ague  in  doses  of  one  to  four 
drachms,  and  of  collapse  from  various  causes  in  doses  of  half  an 
ounce. 

The  other  alkaloids  of  cinchona  seem  to  have  very  much  the 
same  action  as  quinine. 

Sometimes  people  who  work  with  cinchona  barks  are  attacked 
with  great  irritation  of  the  skin ;  this  is  probably  due  to  the 
mechanical  action  of  minute  spicules  of  the  bark. 
Sub-Okder  II.— IXOREjE. 
(COFFEE.) 

Ipecacuanha.  Ipecacuanha,  B.P.;  Ipecac,  U.S.P. — The  dried 
root  of  Cephaelis  Ipecacuanha.     Brazil. 


KlG.  203. — Ipecacuanha,  two-thirds  the  natural  size. 

Characters. — In  pieces  about  the  size  of  a  small  quill,  contorted  and 
irregularly  annulated.  Colour  brown,  of  various  shades.  It  consists  of  two 
parts,  the  cortical  or  active  portion,  which  is  brittle,  and  a  slender,  tough, 
white,  woody  centre.  This  hard  centre  and  the  annulated  appearance  of  the 
cortex  give  to  the  root  the  appearance  of  a  number  of  brown  beads  strung  on 
a  white  thread. 

Composition. — The  woody  centre  is  inert.  The  cortical  part 
contains  an  alkaloid,  emetine,  and  an  acid,  ipecacuanhic  acid 
which  is  a  glucoside  allied  to  tannic  acid. 


chap,  xxxiv.]  COKOLLIFLORJE.  949 

Dose. — Of  the  powdered  root,  as  emetic,  15-30  gr. ;  in  dysen- 
tery, 20-30  gr.  in  a  bolus. 

Preparations. 

B.P.  DOSB. 

Pilula  Conii  Composita  (vide  p.  522)    5-10  gr. 

Pllula  Ipecacuanha  cum  Scilla  (vide  p.  522) 5-10  gr. 

Pulvis  Ipecacuanhse  Compositus 5-14  gr. 

Trochisci  Ipecacuanhse  (i-gr.  in  each) 1-3 

Trochisci  Morphinae  et  Ipecacuanhse  (gj-gr.  mor- 
phine, ^-gr.  ipecac.) 1-6 

Vinum  Ipecacuanhse  (as  an  emetic)  3-6  fl.  dr. 

n  n  (as  an  expectorant) 5-40  min. 

U.S.P 

Extractum  Ipecacuanha  Fluidum  (as  expectorant) 5  min. 

„  „  „         (as  emetic) 25  min. 

Pulvis  Ipecacuanhas  et  Opii „ 5-15  gr. 

Trochisci  Ipecacuanha?  (£-gr.  in  each) 1-4 

Trochisci  Morphinai  et  IpecacuanhsB  (^-gr.  of  morphine, 

A-gr.  ipecac.) 

Tinctura  Ipecacuanha?  et  Opii 4-15  min. 

Syrupus  Ipecacuanha?  (as  expectorant) 2-30  min. 

„  „  (as  emetic) ^-1  fl.  oz. 

Vinum  „  (as  expectorant) 3-5  min. 

„  „  (to  relieve  vomiting) half  a  drop 

Pulvis  Ipecacuanhse  Compositus.  Compound  Powder  of  Ipecacuanha, 
B.P.  Pulvis  IpecacuanhsB  et  Opii.  Powder  of  Ipecac  and  Opium,  U.S.P.  (Dover's 
Powder). — Ipecacuanha,  1 ;  opium,  1 ;  sulphate  of  potassium,  8,  B.P.  Ipecac,  10 ; 
powdered  opium,  10 ;  sugar  of  milk,  80,  U.S.P. 

Physiological  Action. — In  frogs  small  doses  of  emetine  cause 
irregularity  of  the  heart,  with  final  stoppage  in  diastole  and  loss 
of  irritability  of  the  cardiac  muscle.  Larger  doses  paralyse  the 
central  nervous  system  and  diminish  the  contractile  power  of  the 
muscles  (p.  128). 

Locally  applied  to  the  skin  or  mucous  membranes,  it  acts  as 
an  irritant  and  may  produce  a  pustular  eruption.  In  some  per- 
sons it  has  a  peculiarly  irritating  action  on  the  respiratory  tract, 
so  that  almost  infinitesimal  quantities  of  the  powder  cause/ 
running  at  the  nose,  and  sometimes  asthma.  When  taken 
internally,  it  is  an  irritant  to  the  mucous  membrane  of  the 
stomach,  and  acts  as  a  prompt  emetic.  This  is  partly  due  to 
the  local  action  of  the  drug  on  the  ends  of  the  vagus  in  the 
stomach,  and,  when  absorbed  into  the  blood,  to  its  action  on  the 
vomiting  centre  in  the  medulla. 

Emetine  produces  in  dogs,  both  when  injected  under  the  skin 
and  when  administered  internally,  diarrhoea,  which  is  sometimes 
bloody.  The  intestinal  mucous  membrane  is  swollen,  red,  and 
ecchymosed  as  in  poisoning  by  arsenic,  antimony,  platinum,  iron, 
or  sepsine. 

When  injected  either  subcutaneously  or  into  the  veins  it  pro- 
duces death  by  cardiac  paralysis.  It  paralyses  the  vessels  first, 
and  then  the  heart,  so  that  the  blood-pressure  sinks  nearly  to 


950  VEGETABLE  MATEEIA  MEDICA.  [sect.  v. 

zero  while  each  cardiac  pulsation  is  still  powerful  and  produces 
a  considerable  wave  in  the  blood-pressure  tracing. 

The  lungs  are  often  congested,  oedematous,  or  in  a  state  of 
red  hepatisation,  especially  in  rabbits. 

In  medicinal  doses  it  increases  the  secretion  from  mucous 
membranes  often  very  markedly,  and  is  hence  used  to  increase 
the  expectoration  and  render  it  more  fluid  in  bronchitis  (p.  255). 
It  is  slightly  diaphoretic,  independently  of  the  effect  produced  by 
its  nauseating  qualities. 

Uses. — Ipecacuanha  is  used  as  an  emetic  in  cases  of  poison- 
ing and  in  overloaded  conditions  of  the  stomach ;  to  clear  out 
the  trachea  and  larynx  in  croup  and  diphtheria  (1  teaspoonful 
of  vinum  ipecacuanhas  every  £-hour,  in  a  child,  till  vomiting 
occurs) ;  to  empty  the  bronchial  tubes  in  chronic  bronchitis  when 
choked  up  with  mucus. 

In  jaundice  depending  on  catarrhal  conditions  of  the  bile- 
ducts,  it  is  useful  to  lessen  the  viscidity  of  the  mucus  ;  also  in 
jaundice  depending  on  the  presence  of  a  small  calculus. 

As  a  diaphoretic  it  is  given  in  suddenly  suppressed  menstru- 
ation, and  in  rheumatism,  muscular  or  acute,  in  the  form  of 
Dover's  Powder ;  also  in  catarrhs.  In  small  doses  it  is  often 
useful  in  vomiting  from  various  causes,  e.g.  vomiting  of  pregnancy. 

As  an  expectorant  (p.  255)  it  is  very  useful  when  the  bronchial 
secretion  is  scanty,  tough,  and  difficult  to  expectorate.  Einger 
strongly  recommends  the  spray  of  ipecacuanha  wine  in  winter 
cough  and  bronchial  asthma. 

Ipecacuanha  is  very  useful  as  an  anti-dysenteric,  especially 
in  the  acute  dysentery  of  the  tropics ;  large  doses  (30  gr.)  must 
be  given  on'  an  empty  stomach,  preceded  by  a  dose  of  laudanum 
half  an  hour  before,  to  still  the  stomach  and  prevent  vomiting. 
No  water  must  be  taken  with  it,  and  the  patient  must  he  down 
with  his  head  low. 

Precautions. — Large  doses  must  not  be  given  to  pregnant 
women,  or  to  old  people  with  atheromatous  arteries.  The  wine 
is  apt  to  lose  its  power  by  keeping,  and  hence  it  is  best  to  pre- 
serve it  in  small  sealed  bottles. 

Caffea.     Coffee.     Not  officinal. — The  seed  of  Coffea  arabica. 

Composition. — Unroasted  coffee  contains  caffeine  and  a  kind 
of  tannin  called  caffeotannic  acid.  During  roasting  a  part  of 
the  caffeine  is  volatilised  and  an  empyreumatic  substance  called 
caffeon  is  developed. 

Action. — The  action  of  coffee  is  somewhat  like  that  of  caffeine 
(p.  871),  but  differs  from  it  in  some  respects,  inasmuch  as  the 
caffeon  increases  the  peristaltic  movements  of  the  intestine,  and 
causes,  indeed,  tetanic  contraction  of  it,  while  caffeine  does  not 
alter  peristaltic  movements.  Caffeon  quickens  the  pulse,  dilates 
the  vessels  and  lowers  the  blood-pressure,  and  produces  a  sensa- 
tion of  warmth  on  the  surface.     In  some  persons  coffee  produces' 


chap,  xxxiv.]  ,  COROLLIFLOEjE.  951 

a  feeling  of  weight  in  the  abdomen  and  a  tendency  to  hzemor- 
rhoids.  As  tea  has  not  this  action,  or  has  it  only  to  a  compara- 
tively slight  extent,  it  is  probably  due  to  the  combined  action  of 
the  caffeine  and  caffeon. 

Use. — Coffee  is  used  chiefly  as  a  remedy  in  headache  and  as 
a  stimulant  in  cases  of  opium-poisoning. 

B.P.  Catechu.  Catechu.  Synonym :  Catechu  Pallidum. — 
An  extract  of  the  leaves  and  young  shoots  of  Uncaria  Gcvmbier, 
Eastern  Archipelago. 

Characters. — In  cubes  about  an  inch  square,  or  masses  formed  of  co- 
herent cubes,  externally  brown,  internally  ochrey-yellow  or  pale  brick-red, 
breaking  easily  with  a  dull  earthy  fracture.  Taste  bitter,  very  astringent 
and  mucilaginous,  succeeded  by  slight  sweetness. 

The  catechu  of  the  U.S.P.  is  an  extract  prepared  from  the  wood  of  Acacia 
Catechu,  Leguminosse  (p.  910). 

Composition. — Contains  catechu-tannic  acid  and  catechuic 
acid  or  catechin,  which  is  related  to  catechu-tannic  acid  in  the 
same  way  as  gallic  to  tannic  acid.  There  is  also  a  yellow 
colouring  matter,  quercitin. 

Adulteration. — Starch. 

Test. — The  decoction  when  cool  is  not  rendered  blue  by  iodine. 

Preparations. 
B.P.  DOSE. 

Infusum  Catechu  (catechu,  160  gr. ;  cinnamon,  30  gr. ;  water,  ^-pint)..l-l|  fl.  oz. 
Pulvls  Catechu  Compositus  (pale  catechu,  4  oz. ;  kino  and rhatany, 

of  each  2  oz. ;  cinnamon  and  nutmeg,  of  each  1  oz.)  20-40  gr. 

Tinctura  Catechu 1-2  fl.  dr. 

Trochisci  Catechu  (1  gr.  in  each) 1-3 or  more. 

Uses. — Catechu  is  employed  as  a  local  remedy  in  relaxed  sore- 
throat.  It  may  sometimes  be  chewed  with  advantage  before 
taking  food  by  persons  suffering  from  pyrosis.  Its  use  in  such 
cases  is  probably  to  diminish  the  coating  of  mucus  on  the  gastric 
mucous  membrane.  It  is  also  employed  in  diarrhoea  as  an 
astringent  (vide  also  p.  914). 

VALERIANACEiE. 

B.P.  Valerianae  Rhizoma.  Valeeian  Ehizome. — The  dried 
rhizome  and  rootlets  of  Valeriana  officinalis.  Collected  in  autumn 
from  plants  growing  wild  or  cultivated  in  Britain. 


Fio.  204.— Valerian,  hall  the  natural  size. 

U.S.P-  Valeriana.     Valeeian. — The  rhizome   and  rootlets 
of  Valeriana  officinalis. 


952  VEGETABLE   MATEEIA  MEDICA.  [sect.  v. 

Characters.— A  short,  yellowish- white  rhizome,  with  numerous  fibrous 
roots  about  two  or  three  inches  long  ;  of  a  bitter  taste  and  penetrating  odour, 
agreeable  in  the  recent  root,  becoming  fetid  by  keeping;  yielding  volatile  oil 
and  valerianic  acid  when  distilled  with  water. 

Composition. — Contains  a  volatile  oil  and  valerianic  acid. 

Peepaeaiions. 

B.P.  DOSE. 

Tnfusum  Valerianae  (2  dr.  in  f  pint) 1-2  fl.  oz. 

Tinctura  „  (2J  oz.  in  1  pint  spirit) ..1-2  fl.  dr. 

„  „  Ammoniata  (2;V  oz.  in  1  pint  aromatic 

spirit  of  ammonia) 5-4  ^-  ^r* 

tr.s.p. 

Abstractum  Valeriana 15-45  gr. 

Extractum  „        Fluidum 15-30  min. 

Tinctura  „         (20  per  cent.) 1-2  fl.  dr. 

„                    „        Ammoniata  (20,  in  aromatic  spirit  of  am- 
monia up  to  100) 1-2  fl.  dr. 

Oleum  Valeriana One  or  more  drops 

QuininsB  Valerianas 1-2  gr. 

U.S. P.  Oleum  Valerianae.  Oil  op  Valerian. — A  volatile 
oil  distilled  from  Valerian. 

Characters. — A  greenish  or  yellowish,  thin  liquid,  becoming  darker  and 
thicker  by  age  and  exposure  to  air,  having  the  characteristic  odour  of  valerian, 
an  aromatic,  somewhat  camphoraceous  taste,  and  a  slightly  acid  reaction ; 
sp.  gr.  about  0-950.    It  is  readily  soluble  in  alcohol. 

Action  and  Uses. — The  activity  of  valerian  is  chiefly  due 
to  the  volatile  oil  it  contains,  and  not  to  the  valerianic  acid. 
The  oil  in  large  doses  paralyses  both  the  brain  and  spinal  cord, 
and  lessens  the  convulsions  due  to  strychnine-poisoning,  lowers 
the  blood-pressure  and  slows  the  pulse.  It  is  employed  as  an 
antispasmodic  and  stimulant  in  cases  of  hysteria,  and  is  most 
useful  in  those  occurring  in  delicate  and  young  women. 

Valerianate  of  zinc  has  been  supposed  to  combine  the  nervine 
tonic  action  of  zinc  with  the  antispasmodic  effect  of  valerian,  but 
it  is  much  better  to  use  valerian  itself  or  its  oil  along  with  a  salt 
of  zinc,  as  the  acid  has  no  important  physiological  action.  It  is 
used  in  chorea,  especially  when  occurring  in  hysterical  persons, 
and  should  not  be  discontinued  until  symptoms  of  nausea  begin 
to  make  their  appearance.  It  is  also  employed  in  epilepsy'  and 
neuralgia. 

Valerianate  of  iron  and  valerianate  of  ammonium  have  also 
been  used  in  medicine,  and  may  be  given  in  the  same  doses  as 
the  corresponding  salt  of  zinc.  For  the  action  of  valerianate  of 
quinine,  vide  p.  943. 

COMPOSITE. 

Pyrethri  Radix,  B.P. ;  Pyrethrum,  U.S.P.  Pellitoey 
Eoot,  B.P. ;  Pyeethkum,  U.S.P.— The  dried  root  of  Anacyclus 
Pyrethrum.     The  Levant. 


chap,  xxxiv.]  COEOLLIFLOE^l.  953 

Characters. — In  pieces  about  the  length  and  thickness  of  the  little  finger, 
covered  with  a  thick  brown  bark  studded  with  black  shining  points.  It 
breaks  with  a  resinous  fracture,  and  presents  internally  a  radiated  structure. 
When  chewed  it  excites  a.  prickling  sensation  in  the  lips  and  tongue,  and  a 
glowing  heat. 

Composition. — A  resin,  the  properties  of  which  are  not  yet 
fully  known ;  also  a  volatile  oil  and  sugar. 

Preparation. 

B.P.  and  U.S.P.  dose. 

Tinctura  Pyrethrl 10-20  m. 

Action  and  Uses. — Pellitory  is  a  local  irritant,  increasing 
the  flow  of  saliva  when  taken  into  the  mouth.  It  is  used  as  a 
masticatory  in  dryness  of  the  mouth,  relaxed  conditions  of  the 
throat,  aphonia,  and  paralysis  of  the  tongue  or  throat.  It  is  also 
,  employed  as  a  masticatory  in  headache  and  neuralgia  of  the 
head  or  face.  The  tincture  diluted  with  water  may  be  used  as  a 
gargle  in  similar  conditions.  The  tincture  may  be  applied  on 
cotton  wool  to  carious  teeth  to  lessen  the  pain,  but  that  of  the 
pharmacopoeia  is  hardly  strong  enough.  It  has  been  given  inter- 
nally with  success  in  globus  hystericus  in  doses  of  10  to  20  drops 
four  times  a  day. 

U.S.P.  Absinthium.  Woemwood. —  The  leaves  and  tops  of 
Artemisia  Absinthium. 

Characters. — Leaves  about  two  inches  (5  centimetres)  long,  hoary,  silky- 
pubescent,  petiolate,  roundish-triangular  in  outline,  pinnately  two  or  three- 
cleft,  with  the  segments  lanceolate,  the  terminal  one  spatulate,  bracts  three- 
cleft  or  entire  ;  heads  numerous,  subglobose,  with  numerous  small  pale  yellow 
florets,  all  tubular  and  without  pappus  ;  odour  aromatic ;  taste  persistently 
bitter. 

Preparation. 
Vinum  Aromaticum. 

Dose. — Of  the  powder  20-40  gr.  It  may  be  given  with 
advantage  as  infusion  (1  oz.  to  2  fl.  oz.),  of  which  1-2  fl.  oz.  may 
be  given.     It  strikes  blue  with  iron  salts. 

Action. — It  contains  a  volatile  oil  and  a  bitter  principle, 
absinthin.  To  the  bitter  principle  it  owes  its  action  in  stimulat- 
ing the  digestive  organs.  The  volatile  oil  is  a  narcotic  poison. 
In  dogs  and  rabbits  it  causes  trembling,  stupor,  epileptiform 
convulsions  with  involuntary  evacuations,  and  stertorous  breath- 
ing, which  may  or  may  not  end  in  death.  Similar  symptoms 
may  be  produced  in  man. 

Use. — It  is  a  bitter  stomachic  tonic,  and  is  used  for  atonic 
dyspepsia.    It  is  said  to  be  anthelmintic. 

U.S.P.  Tanacetum.  Tansy. — The  leaves  and  tops  of  Tana- 
cetum  vulgare. 

Chakacters. — Leaves  about  six  inches  (15  centimetres)  long;  bipinna- 
tifid,  the  segments  oblong,  obtuse,  serrate  or  incised,  smooth,  dark  green,  and 
glandular ;  flower-heads  corymbose,  with  an  imbricated  involucre,  a  convex^ 


954  VEGETABLE   MATEEIA  MEDICA.  [sect.  v. 

naked  receptacle,  and  numerous  yellow,  tubular  florets;    odour  strongly 
aromatic ;  taste  pungent  and  bitter. 

Composition. — Tansy  contains  a  powerful  and  irritating  vola- 
tile oil. 

Uses. — It  is  seldom  used  in  regular  practice.  Fatal  cases  of 
poisoning  from  this  drug  have  been  reported,  the  symptoms  being 
epileptiform  convulsions  and  coma,  feeble  pulse  and  death.  Its 
action  thus  resembles  that  of  absinthe.  It  has  been  used  as  a 
diuretic  and  stimulant  in  rheumatism,  ague,  and  hysteria,  as  an 
emmenagogue  in  amenorrhcea,  and  sometimes  as  an  anthel- 
mintic.    It  is  generally  given  as  an  infusion. 

Santonica,  B.  and  U.S.P-  Santonica. — The  dried  un- 
expanded  flower-heads  of  Artemisia  maritima,  var.  Stechmanniana. 
Imported  from  Eussia. 

Characters. — Flower-heads  resembling  seeds  in  appearance,  fusiform, 
blunt  at  each  end,  pale  greenish-brown,  smooth  ;  odour  strong,  taste  bitter, 
camphoraceous.    Flower -heads  not  round  or  hairy. 

Composition. — Santonin  about  2  per  cent.,  also  essential  oil 
and  fatty  acids. 

Preparation. 
B.P.  and  U.S.P.  dose. 

Santonlnum 2-6  gr. 

B.  and  U.S.P.  Santoninum.  Santonin.  C30H18O6  or 
C16H1803. — A  crystalline  neutral  principle  prepared  from  San- 
tonica. 

Characters. — Colourless,  flat,  rhombic  prisms,  feebly  bitter,  fusible  and 
subliming  at  a  moderate  heat. 

Solubility — Scarcely  soluble  in  cold  water,  sparingly  in  boiling  water, 
but  abundantly  in  chloroform  and  in  boiling  rectified  spirit ;  not  dissolved  by 
diluted  mineral  acids. 

Beactions. — Sunlight  renders  it  yellow ;  added  to  warm  alcoholic  potash 
it  yields  a  violet-red  colour. 

Preparation. — The  santonica  is  boiled  with  milk  of  lime,  strained  and 
partially  evaporated.  Hydrochloric  acid  is  added  to  the  hot  solution,  which 
is  set  aside  to  allow  the  santonin  to  subside  and  to  separate  from  oily  matter, 
which  is  removed  by  skimming.  The  precipitate  is  washed  with  water  and 
ammonia  and  purified  by  boiling  in  spirit  with  a  little  animal  charcoal,  which 
is  separated  by  filtering.  On  the  liquid  cooling,  crystals  of  santonin  are 
deposited.    It  is  to  be  protected  from  light. 

Dose. — 1-3  gr.  for  a  child ;  2-6  gr.  or  more  for  an  adult. 

B-a  Preparations.  _.„_ 

•^>  DOSE. 

Trocbisci  Santonin!  (one  grain  in  each) 1_6  lozenges. 

U.S.P. 

Sodii  Santoninas  (p.  629)  8-10  gr. 

Trochisci  Sodii  Santoninatis 1_8  troches. 

Physiological  Action. — Large  doses  of  santonin  given  to  a 
frog  cause  paralysis  of  the  cerebrum  with  abolition  of  volun- 
tary movement,  followed  by  stimulation  of  the  medulla  causing 


chap,  xxxiv.]  C0E0LLIFL0EJ3.  955 

convulsions,  which  cease  on  section  of  the  cord.  In  man,  large 
doses  cause  headache,  giddiness,  vomiting,  and  sometimes  death 
by  convulsions,  with  a  tendency  to  paralysis  of  the  respiration 
between  the  convulsions ;  hence  in  a  case  of  poisoning  treat  with 
chloroform  to  lessen  the  convulsions,  and  keep  up  artificial  re- 
spiration. 

It  produces  a  peculiar  disturbance  of  vision,  so  that  at  first 
everything  appears  of  bluish  and  afterwards  yellowish  or  greenish- 
yellow.  The  blue  appearance  lasts  only  a  short  time,  the  yellow 
vision  lasts  much  longer.  This  condition  is  usually  regarded  as 
due  to  stimulation,  and  subsequent  paralysis,  of  those  fibres  of 
the  retina  by  which  blue  light  is  perceived.  It  is  eliminated  as  a 
sodium  salt  in  the  urine  and  colours  it  bright  yellow ;  if  the  urine 
is  rendered  alkaline  it  becomes  blood  red ;  these  colours  are  pro- 
bably due  to  some  product  of  the  oxidation  of  santonin.  The 
quantity  of  urine  is  increased  and  the  patient  has  a  constant 
desire  to  micturate ;  in  children  it  may  give  rise  to  incontinence 
of  urine. 

Uses. — It  is  used  almost  entirely  as  a  vermicide  for  round- 
worms in  doses  of  2-  5  gr.  every  other  night,  followed  by  a  purga- 
tive. It  should  be  given  three  or  four  times.  It  is  useless 
against  tape-worms.  It  has  been  frequently  used  as  an  injection 
against  thread-worms  (2-5  gr.  in  1  oz.  of  castor  oil). 

The  best  method  of  administration  probably  is  to  give  it  in 
castor  oil,  although  not  unfrequently  it  is  given  in  powder  for 
two  or  three  nights  running,  the  last  powder  being  followed  by  a 
dose  of  castor  oil  next  morning.  It  is  best  given  at  bedtime,  as 
the  effect  on  the  sight  passes  off  to  a  great  extent  during  the  night. 

Anthemidis  Flores,  B.P. ;  Anthemis,  U.S. P.  Chamomile 
Flowebs,  B.P. ;  Anthemis,  U.S.P. — The  dried  single  and  double 
flower-heads  of  the  common  chamomile,  Anthemis  nobilis,  col- 
lected from  cultivated  plants. 

Characters. — Subglobular  heads,  about  three-quarters  of  an  inch  (2  centi- 
metres) broad.  The  single  variety  consists  of  both  yellow  tubular  and  white 
strap-shaped  florets  ;  the  double  of  white  strap-shaped  fioretsonly ;  all_  aris- 
ing from  a  conical  scaly  receptacle  ;  both  varieties,  but  especially  the  single, 
are  bitter  and  very  aromatic. 

Composition. — Essential  oil,  removed  by  distillation,  also  a 
bitter  acid  in  small  quantity. 

Preparations. 
B.P.  dosb.  c.s.p. 

Extractum  Anthemidis.., 2-10  gr.  None. 

Xnfusum  „  1-4  fl.  oz. 

Oleum  „  1-4  min. 

B.P.  Infusum  Anthemidis.  Infusion  or  Chamomile. — Chamomile  flowers, 
|  oz. ;  boiling  water,  10  fl.  oz. ;  infuse  for  quarter  of  an  hour  and  strain. 

B.P.  Oleum  Anthemidis.  Oil  op  Chamomile. — The  oil 
distilled  in  Britain  from  chamomile  flowers.  ' 


956  VEGETABLE  MATERIA  MEDICA.  [sect. v. 

Characters.— Pale-blue  or  greenish-blue,  but  gradually  becoming  yellow; 
•with  the  peculiar  odour  and  aromatic  taste  of  the  flowers., 

Pkepabation. 

B.P.  DOSE. 

Extractum  Anthemldis 2-10  gr. 

Uses. — Like  other  ethereal  oils,  it  has  an  action  on  bacteria 
(p.  103)  and  on  the  vaso-motor  centre  (p.  319).  It  is_  an  aro- 
matic tonic,  stomachic,  and  carminative.  It  is  used  in  atonic 
dyspepsia,  accompanied  by  flatulence ;  also  in  summer  diarrhoea 
in  children  and  in  sick  headache. 

U.S.  P.  Matricaria.  German  Chamomile. — The  flower-heads 
of  Matricaria  Chamomilla. 

Characters.— About  three-fourths  of  an  inch  (18  .millimetres)  broad, 
composed  of  a  flattish,  imbricate  involucre,  a  conical,  hollow,  naked  recep- 
tacle, about  fifteen  white,  ligulate,  reflexed  ray-flowers,  and  numerous  yellow, 
tubular,  perfect  flowers  without  pappus. 

Action  and  Uses. — Strongly  aromatic,  bitter,  carminative, 
and  anthelmintic.  It  is  generally  used  as  an  infusion  or  decoction 
like  chamomile. 

U.S.P.  Eupatorium.  Etjpatorium.  Thorotjghwort. — The 
leaves  and  flowering  tops  of  Ewpatorium  perfoliatum. 

Characters. — Leaves  opposite,  united  at  base,  lanceolate,  from  four  to 
six  inches  (10  to  15  centimetres)  long,  tapering,  crenately  serrate,  rugosely 
veined,  rough  above,  downy  and  resinous,  dotted  beneath;  flower-heads 
corymbed,  numerous,  with  an  oblong  involucre  of  lance-linear  scales,  and 
with  from  ten  to  fifteen  white  florets,  having  a  bristly  pappus  in  a  single 
row  ;  odour  weak  and  aromatic ;  taste  astringent  and  bitter. 

Composition. — It  contains  a  volatile  oil  and  a  bitter  glucosidej 
eupatorin. 

i  Pbeparation. 

-DOSE. 

Extractum  Eupatorii  Pluidum 15-30  min 

Use. — It  is  used  as  a  tonic  and  diaphoretic.  In  large  doses 
it  causes  catharsis  and  emesis.  As  a  tonic  it  is  employed  in 
dyspepsia  and  general  debility.  As  a  diaphoretic  it  is  used  to 
prevent  any  bad  consequences  from  exposure  to  cold,  and  to  cut 
short  an  attack  of  catarrh  or  muscular  rheumatism  at  its  com- 
mencement. It  may  then  be  given  as  infusion  or  as  fluid  extract 
mixed  with  hot  water.  When  given  in  large  doses  as  an  emetic 
and  cathartic,  it  is  useful  in  causing  the  expulsion  of  tape-worm. 

Taraxaci  Radix,  B.P. ;  Taraxacum,  U.S.P.  Dandelion 
Boot,  Taraxacum. — The  fresh  and  dried  roots  of  Taraxacum 
officinale  (T.  Dens-leonis) . 

Characters. — Tap-shaped  roots,  smooth  and  dark-brown  externally, 
white  within,  easily  broken,  and  giving  out  an  inodorous,  bitter,  milky  juice, 
which  becomes  pale-brown  by  exposure. 

Composition. — They  contain  a  bitter  principle — taraxacin — 
sugar,  inulin,  and  a  considerable  quantity  of  potassium  and 
calcium  salts. 


chap,  xxxiv.]  COROLLIFLOBjE.  957 

Impurity. — Common  hawkbit  fraudulently  mixed. 

Tests. — Not  wrinkled  or  pale-coloured  externally ;  juice  not  watery ;  any 
adherent  leaves  runicate  and  quite  smooth. 

PREPARATIONS. 
B.P.  DOSE. 

Decoctum  Taraxaci  (dried  root,  1  oz. ;  water,  1  pint)... 2-4  fl.  oz. 

Extractum  „  (fresh) 5-30  gr. 

Siccus  „         (fresh) 1_2  fl.  dr.  or  more. 

U.S.P. 

Extractum  Taraxaci 30-60  gr. 

Pluidum .'...1-2  fl.  dr. 

Action  and  Uses. — It  is  supposed  to  have  a  stimulant  action 
on  the  liver,  increasing  its  secretion,  and  is  used  in  biliary  dis- 
orders and  dyspepsia.     It  has  also  a  diuretic  action. 

B.P-  Lactuca.  Lettuce. — The  flowering  herb  of  Lactuca 
virosa. 

Composition. — It  contains  lactucarium. 

Preparation. 
b.p.  dose.  tj.s.p. 

Extractum  Xiactucse 5-30  gr.  None. 

U.S.P.  Lactucarium.  Lactucarium. — The  concrete  milk- 
juice  of  Lactuca  virosa. 

Characters. — In  sections  of  plano-convex,  circular  cakes,  or  in  irregular, 
angular  pieces,  externally  grey  brown  or  dull  reddish-brown,  internally 
whitish  or  yellowish,  of  a  waxy  lustre ;  odour  heavy,  somewhat  narcotic  ; 
taste  bitter.  It  is  partly  soluble  in  alcohol  and  ether,  and  when  triturated 
with  water  it  yields  a  turbid  mixture. 

Composition. — Its  chief  ingredient  is  a  bitter  substance — 
lactucin. 

Preparations. 

DOSE. 

Extractum  Lactucarii  Pluidum 3-60  min. 

Syrupus  Lactucarii 2  fl.  dr. 

Dose. — Of  lactucarium,  5-30  gr. 

Action  and  Use. — Lettuce  has  a  somewhat  soporific  action, 
and  the  extract  has  been  used  for  sleeplessness.  Lactucarium  is 
used  instead  of  opium  to  allay  cough,  quiet  nervousness,  and 
induce  sleep  in  cases  where,  from  idiosyncrasy,  opium  is  not 
borne. 

Arnicae  Rhizoma,  B.P. ;  Arnicas  Radix,  U.S.P-  Aenica 
Ehizome,  B.P. ;  (Boot,  U.S.P.) — The  dried  rhizome  and  rootlets 
of  Arnica  montana.  Middle  and  Southern  Europe  and  North- 
west of  the  United  States. 

Characters. — Rhizome,  cylindrical,  contorted,  rough  from  the  scars  of 
the  coriaceous  leaves,  of  which  some  usually  remain  attached,  and  furnished 
with  numerous  long,  slender  fibres  ;  has  a  peppery  taste  and  peculiar  odour. 


958  VEGETABLE  MATEEIA  MEDICA.  [sect.  v. 

Composition.— Arnicin,  a  substance  having  some  of  the  pro- 
perties of  a  glucoside.  Arnica  also  contains  about  one  per  cent, 
of  an  essential  oil,  with  a  considerable  quantity  of  inulin. 


Fig.  205.— Arnica,  half  the  natural  size. 

Adulteration. — Sometimes  adulterated  with  other  and.  similar  roots. 
These  may  be  distinguished  on  close  inspection. 

Preparations. 

B.P.  DOSE. 

Tinctura  Arnicas  (1  oz.  to  1  pint) 30  min.  to  1  fl.  dr. 

TJ.S.P. 

Extractum  Arnica  Eadicis 5-10  gr. 

„  „  „       Fluidum 10-30  min. 

Tinctura         „  „       2-5  fl.  dr. 

Emplastrum  Arnicae 

U.S.P.  Arnicae  Flores.  Aenica  Flowers. — The  flower-heads 
of  Arnica  montana. 

Characters. — About  one  and  one-fifth  inch  (30  centimetres)  broad, 
depressed-roundish,  consisting  of  a  scaly  involucre  in  two  rows,  and  a  small, 
flat,  hairy  receptacle,  bearing  about  sixteen  yellow,  strap-shaped  ray  -florets ; 
and  numerous  yellow,  five-toothed,  tubular  disk-florets  having  slender, 
spindle-shaped  achenes,  crowned  by  a  hairy  pappus.  It  has  a  feeble,  aromatic 
odour,  and  a  bitter,  acrid  taste. 

Preparation, 
tj.s.p.  dose. 

Tinctura  Arnicas  Florum i_2  fl.  dr. 

Action. — Arnica,  externally,  has  a  stimulant  effect  on  the 
skin,  and  if  evaporation  be  prevented  it  will  produce  redness 
and  sometimes  an  erysipelatous  inflammation,  spreading  some 
distance. 

Internally  it  gives  rise  to  a  feeling  of  warmth  in  the  mouth, 
stomach,  and  intestines,  also  increasing  their  peristaltic  move- 
ments. In  large  doses  it  produces  partial  insensibility,  convul- 
sions, and  sometimes  syncope. 

Uses.— It  is  very  generally  used  in  bruises  and  sprains,  but 
it  has  been  shown  by  Dr.  Garrod  to  be  no  more  serviceable  than 
spirit  of  the  same  strength,  and  it  has  the  disadvantage  of  some- 
times producing  erysipelatous  inflammation.     It  has  been  used 


chap,  xxxrv.]  COEOLLIFLOE^I.  959 

internally  in  dysentery,  chronic  bronchitis,  rheumatism,  nervous 
diseases,  and  malarious  conditions.    Its  value  is  doubtful. 

U.S.  P.   Calendula.      Calendula.      Maeigold. — The  fresh, 
flowering  herb  of  Calendula  officinalis. 

_  Characters. — Stem  somewhat  angular,  rough ;  leaves  alternate,  thickish, 
hairy,  spatulate  or  oblance slate,  slightly  toothed,  the  upper  ones  sessile; 
flower-heads  nearlytwo  inches  (5  centimetres)  broad,  the  yellow  strap-shaped 
ray-florets  in  one  or  several  rows,  fertile,  the  achenes  incurved  and  muricate ; 
odour  slightly  narcotic  ;  taste  bitter  and  saline. 

Composition. — It  contains  a  bitter  principle  and  calendulin. 
Its  physiological  action  is  not  well  understood. 

Preparation. 
Tinctura  Calendulas  (used  externally). 

Uses. — It  is  used  as  an  application  to  sprains  and  bruises,  in 
somewhat  the  same  way  as  arnica. 

U.S. P.  Grindelia.  Gkindelia. — The  leaves  and  flowering 
tops  of  Grindelia  robusta. 

Characters. — Leaves  about  two  inches  (5  'centimetres)  or  less  long, 
varying  from  broadly  spatulate  or  oblong  to  lanceolate,  sessile  or  clasping, 
obtuse,  more  or  less  sharply  serrate,  pale  green,  smooth,  finely  dotted,  brittle  ; 
heads  many-flowered;  the  involucre  hemispherical,  about  half  an  inch  (12 
millimetres)  broad,  composed  of  numerous,  imbricated,  squarrosely-tipped 
scales ;  ray-florets  yellow  ligulate,  pistillate ;  disk-florets  yellow,  tubular, 
perfect;  pappus  consisting  of  about  three  awns  of  the  length  of  the  disk- 
florets  ;  odour  balsamic  ;  taste  pungently  aromatic  and  bitter. 

Composition. — It  probably  owes  its  medicinal  properties  to  a 
resin  and  volatile  oil. 

PREPARATION. 

DOSE. 

Extractum  Grindelise  Fluidum 15  min.-l  fl.  dr. 

Uses. — It  has  been  found  useful  in  spasmodic  asthma,  hay 
asthma,  asthmatic  attacks  in  bronchitis  and  emphysema,  whoop- 
ing cough,  and  in  chronic  bronchitis  or  bronchorrhoea,  especially 
in  old  persons.  It  has  also  been  found  to  give  relief  in  dyspnoea 
depending  on  cardiac  disease.  The  oleo-resin  appears  to  be 
excreted  by  the  kidneys,  and  is  useful  in  catarrh  of  the  urinary 
passages.  As  a  local  application  it  has  been  recommended  to 
relieve  the  eruption  caused  by  Rhus  Toxicodendron,  and  to  relieve 
itching  and  pain  in  vaginitis  and  in  priapism. 

The  fluid  extract  of  another  non-officinal  species,  Grindelia 
squarrosa,  growing  in  California,  has  been  recommended  as  a 
remedy  for  enlarged  spleen,  ague,  and  malarious  conditions 
generally,  in  doses  of  1  fl.  dr. 

U.S.P.  Inula.  Inula.  Elecampane. — The  root  of  Inula 
Helenium. 

Characters. — In  transverse  concave  slices  or  longitudinal  sections,  with 
overlapping  bark,  externally  wrinkled  and  brown  ;  flexible  in  damp  weather ; 


960  VEGETABLE  MATEEIA  MEDICA.  [sect.  v. 

when  dry,  breaking  with  a  short  fracture  ;  internally  greyish,  fleshy,  slightly 
radiate  and  dotted  with  numerous  shining,  yellowish-brown  resin-cells  ;  odour 
peculiar,  aromatic ;  taste  bitter  and  pungent. 

Composition. — It  contains  a  substance  closely  allied  to  starch 
—  inulin — a  bitter  neutral  principle — helenin — and  a  little 
volatile  oil. 

Administration. — The  powder  may  be  given  in  doses  of 
20-60  gr.  It  may  be  given  as  a  decoction  made  by  boiling  ^  oz. 
of  the  root  in  a  pint  of  water.     The  dose  of  this  is  1-2  fl.  oz. 

Uses. — It  is  used  chiefly  as  a  domestic  remedy  in  amenor- 
rhea, chronic  bronchitis,  and  skin  diseases.  Helenin  has  been 
said  to  be  peculiarly  destructive  to  the  tubercle  bacillus.  If 
this  statement  be  substantiated,  inula  may  be  useful  in  phthisis. 

U.S. P.  Lappa.  Lappa.  .Burdock. — The  root  of  Lappa 
officinalis. 

Characters. — About  twelve  inches  (30  centimetres)  or  more  long,  and 
about  one  inch  (25  millimetres)  thick ;  nearly  simple,  fusiform,  .fleshy,  longi- 
tudinally wrinkled,  crowned  with  a  tuft  of  whitish,  soft,  hairy  leafy  stalks ; 
grey-brown,  internally  paler ;  bark  rather  thick,  the  inner  part  and  the  soft 
wood  radially  striate,  the  parenchyma  often  with  cavities  lined  with  snow- 
white  remains  of  tissue ;  odour  feeble  and  unpleasant ;  taste  mucilaginous, 
sweetish,  and  somewhat  bitter. 

Uses. — It  has  no  marked  therapeutic  properties,  but  is  said 
to  be  alterative,  diaphoretic,  diuretic,  and  purgative.  It  is  chiefly 
used  as  a  domestic  remedy  as  a  decoction  prepared  by  boiling 
2  oz.  of  the  recent  bruised  root  in  three  pints  of  water  to  two. 
One  pint  is  taken  daily.  Burdock  is  employed  in  obstinate  skin 
diseases,  both  internally  and  in  the  form  of  poultices  of  the 
leaves.  It  is  given  also  in  syphilis,  scrofula,  rheumatism,  gout, 
and  renal  disease. 

CAMPANULACEiE. 

(LOBELIACE^E.) 

Lobelia,  B.  and  U.S. P.  Lobelia. — The  dried  flowering 
herb  of  Lobelia  inflata.  North  America,  B.P.  The  leaves  and 
tops  of  Lobelia  inflata  collected  after  a  portion  of  the  capsules 
have  become  inflated,  U.S.P. 

Characters.  —  Usually  in  compressed  oblong  rectangular  packages, 
weighing  from  half  a  pound  to  a  pound  each,  and  wrapped  in  sealed  and 
labelled  papers.  The  separate  pieces  are  of  varying  lengths,  yellowish-green, 
angular,  and  bearing  sessile  or  stalked  hairy  oval  irregularly  toothed  leaves, 
together  with  some  flowers  and  fruits.  Odour  somewhat  irritating ;  taste  at 
first  mild,  but,  after  chewing,  burning  and  acrid. 

Composition. — Lobelina,  a  yellowish  liquid  with  alkaline 
reaction,  soluble  in  water,  spirit,  and  ether,  and  possessing  the 
poisonous  properties  of  the  drug ;  also  an  acrid  principle,  lobel- 
acrin,  yielding  lobelic  acid ;  resins  and  a  volatile  oil  are  obtained 
in  minute  quantities. 


chap,  xxxiv.]  COEOLLIFLOE^I.  961 

Peepaiutions 

B.P.  DOSE. 

Tlnctura  Lobelia:  (2|oz.  in  1  pint  spirit) 10  min.  to  i  fl.  dr. 

n  it         -Etherea  (2^oz.  in  1  pint  spirit  of  ether)..10  min.  to  |fl.  dr. 

or  more. 

n.s.p. 

Acetum  LobelisB  (in  dilute  acetic  acid  10  per  cent.) ^-1  fl.  dr. 

Extractum  Lobelia  Fluidum 1_5  gr. 

Tinctura  Lobelias- (20  per  cent.) i_2  fl.  dr. 

Physiological  Action. — Taken  internally  it  causes  a  feeling 
of  burning  in  the  oesophagus,  stomach,  and  intestines ;  vomiting, 
headache,  giddiness,  and  great  prostration ;  sometimes  followed 
by.  convulsions  and  coma.  Hence  its  action  is  very  like  that  of 
tobacco,  only  differing  in  the  greater  intensity  of  the  local  burn- 
ing sensations.  It  is  often  used  to  excess  by  the  Coffinites, 
whose  theory  is  '  Heat  is  life,'  and  most  cases  of  poisoning  by  it 
are  due  to  its  employment  by  such  herbalists.  It  produces  death 
by  paralysis  of  the  respiratory  centre.  Small  doses  first  raise 
and  then  depress  the  blood-pressure  ;  large  doses  paralyse  the 
vaso-motor  centre  and  the  peripheral  ends  of  the  vagi  (Att- 
wood) . 

Uses. — It  is  chiefly  used  as  a  remedy  in  spasmodic  asthma 
and  other  affections  of  air-passages  accompanied  by  dyspnoea 
— e.g.  chronic  bronchitis  with  a  tendency  to  spasm  of  the 
bronchial  muscles.  Einger  states  that  larger  doses  must  be 
used  than  those  given  in  most  text-books;  he  recommends 
10  min.  every  ten  minutes  while  the  fit  is  on.  In  a  case  of 
poisoning,  evacuate  the  stomach;  give  demulcents  and  stimu- 
lants. 

ERICACEAE. 

Uvae  Ursi  Folia,  B.P.  Bearbebry  Leaves. — The  dried 
leaves  of  Arctostaphylos  Uva-ursi.     From  indigenous  plants. 

Uva  Ursi,  U.S.P.  Uva  Ursi.  [Bearberry.J — The  leaves 
of  Arctostaphylos  Uva-ursi. 


Fig.  206.— Uva  Ursi. 


Characters. — Obovate,  entire,  coriaceous,  shining  leaves,  about  three- 
fourth's  of  an  inch  in  length,  reticulated  beneath  ;  with  a  strong  astringent 
taste,  and  a  feeble  hay-like  odour  when  powdered. 

Composition. — Tannic  and  gallic  acids,  and  a  bitter  neutral 
extractive—  arbutin — which  is  soluble  in  warm  water. 

Adulteration. — Red  whortleberry  leaves. 

Tests. — Leaves  not  dotted  beneath  nor  toothed  on  the  margin.  . 

3d 


962  VEGETABLE   MATERIA  MEDICA.  sect.  v. 

Preparations. 
B.P.  DOSE. 

Xnfusum  TJvae  TJrsi  (1  oz.  to  1  pint) 1-2  fl.  oz. 

O.S.P. 

Extractum  Uvffi  Ursi  Fluidum 30-60  rain. 

Uses. — Bearberry  is  an  astringent  and  diuretic.  It  is  chiefly 
used  in  catarrh  of  the  bladder  and  of  other  parts  of  the  genito- 
urinary passages. 

The  utility  of  the  leaves  is  probably  due  not  to  the  tannic 
and  gallic  acids  which  they  contain,  but  to  the  arbutin.  This 
substance  is  partially  excreted  unchanged,  and  part  of  it  is  de- 
composed in  the  body,  yielding  hydroquinone  (p.  809).  The 
hydroquinone  is  excreted  by  the  kidneys  in  combination  with 
sulphuric  acid.  Hydroquinone-sulphuric  acid  is  colourless  and 
is  not  poisonous.  It  may  become  decomposed  in  the  bladder, 
and  the  hydroquinone  becoming  oxidised  will  give  a  brown  colour 
to  the  urine  and  impart  to  it  antiseptic  and  stimulant  properties, 
which  are  useful  in  catarrh  of  the  bladder.  The  quantity  of 
arbutin,  in  the  infusion,  is  too  small  to  be  very  useful,  and  yet 
if  the  infusion  be  made  stronger  it  may  disagree  with  the 
stomach.  Pure  arbutin  is  therefore  to  be  preferred,  and  may  be 
given  in  doses  of  4  gr.  or  more,  three  or  four  times  a  day,  either 
in  powder  or  in  solution. 

U.S. P.  Chimaphila.  Chimaphila.  [Pipsissbwa.J  —  The 
leaves  of  Chimaphila  umbellata. 

Characters. — About  two  inches  (5  centimetres)  long,  oblanceolate, 
sharply  serrate  above,  wedge-shaped  and  nearly  entire  toward  the  base; 
coriaceous,  smooth,  and  dark  green  on  the  upper  surface.  It  is  nearly 
inodorous,  and  has  an  astringent  and  bitterish  taste. 

Dose.— 30  to  60  gr. 

Officinal  Peepaeation. 
c.s.p.  DOSE. 

Extractum  ChimaphilsE  Fluidum 1  fl.  dr.  (4  gm.) 

Composition. — It  contains  tannin  and  several  neutral  prin- 
ciples found  in  other  Ericacete. 

Action. — It  is  astringent  and  has  a  diuretic  action. 

Use. — It  is  employed  in  disorders  of  the  urinary  passages 
and  "in  the  treatment  of  rheumatic  pains. 

U.S.P.  Oleum  Gaultherise.  Oil  of  Gaulthekia. — Oil  of 
wintergreen,  a  volatile  oil  distilled  from  Gaultheria  procumbens. 

Characters. — A  colourless,  yellow,  or  reddish  liquid,  of  a  peculiar,  strong, 
and  aromatic  odour,  a  sweetish,  warm,  and  aromatio  taste,  and  a  slightly 
acid  reaction. 

Solubility  and  Eeactions. — It  is  readily  soluble  in  alcohol.  When 
heated  to  about  80°  C.  (176°  F.)  the  oil  should  not  yield  a  colourless  distil- 
late, having  the  characteristics  of  chloroform  or  of  alcohol.     On  mixing  five 


chap,  xxxiv.]  COEOLLIFLOEjE.  963 

drops  of  the  oil  with  five  drops  of  nitric  acid,  the  mixture  should  not  aoquire 
a  deep  red  colour,  and  should  not  solidify  to  a  dark  red  resinous  mass 
(absence  of  oil  of  sassafras). 

Composition. — Oil  of  wintergreen  consists  chiefly  of  salicylate 
of  methyl,  which  forms  about  ^ths  of  it,  the  remaining  ^th 
being  a  hydrocarbon  called  gaultherilene. 

Prepabations. 

DOSE. 

Spiritus  Gaultheriffi  (oil,  3;  spirit,  97) 10-20  min. 

Syrupus  SarsaparilUe  Compositus 

Trochisci  Morphinse  et  Ipecacuanha 

Action  and  Use. — It  is  used  on  account  of  its  agreeable  smell 
and  taste  to  flavour  medicines.  It  is  also  given  as  an  anti- 
pyretic to  reduce  the  temperature  in  rheumatism,  its  antipyretic 
action  being  somewhat  the  same  as  that  of  salicylate  of  sodium 
or  salicin. 

SAPOTACE^E. 

Gutta-percha,  B.  and  U.S. P.  Gutta-pebcha. — The  con- 
crete juice  of  Dichopsis  Gutta  (Isonandtra  Gutta)  and  of  several 
other  trees  of  the  natural  order  Sapotaceae. 

Characters. — In  tough,  flexible  pieces,  of  a  light  brown  or  chocolate 
colour. 

Solubility. — Soluble,  or  nearly  soluble,  in  chloroform,  yielding  a  more 
or  less  turbid  solution. 

Pbeparation. 

b.P.  U.S.P. 

Liquor  Gutta-percha.  Liquor  Gutta-perchse. 

Use. — Chiefly  employed  on  account  of  its  physical  properties 
for  making  splints,  &c. ;  also  as  a  temporary  stopping  for  decayed 
teeth.  Gutta-percha  tissue  and  similar  articles  are  used  to  pre- 
vent the  evaporation  of  lotions,  and  to  cover  poultices  and 
fomentations. 

STYRACACiE. 

Benzoinum,  B.  and  U.S.P.  Benzoin. — A  balsamic  resin 
obtained  from  Styrax  Benzoin,  and  probably  from  one  or  more 
other  species  of  Styrax.  It  is  generally  procured  by  making  deep 
incisions  in  the  bark  of  the  trees,  and  allowing  the  liquid  that 
exudes  to  concrete  by  exposure  to  the  air.     Siam  and  Sumatra. 

Characters. — In  lumps,  consisting  of  agglutinated  tears,  or  of  a  brownish 
mottled  mass  with  or  without  white  tears  embedded  in  it ;  has  little  taste, 
but  an  agreeable  odour ;  gives  off,  when  heated,  fumes  of  benzoic  acid ;  is 
soluble  in  rectified  spirit  and  in  solution  of  potash. 

Composition. — Contains  about  14  per  cent,  of  benzoic  acid 
in  combination  with  several  amorphous  resins. 
Dose.— 10-30  gr. 

3  a  2 


964  VEGETABLE   MATEEIA  MEDICA.  [sect.  V. 

Prepabations. 

B.P.  DOSE. 

Acldnm  Bcnzoicum 10-15  gr. 

Adeps  SeDzoatus 

Tlnctura  Benzoinl  Coznposita 5-1  A.  dr. 

Unguentum  Cetacei 

U.S.P. 

Adeps  Benzoinatus 

Tinotura  Benzoini J-l  A-  dr. 

Tinctura  Benzoini  Composita J-I  A.  dr. 

Tinctura  Benzoinl  Composita.  Compound  Tincture  of  Benzoin  (Friar'6 
Balsam). — Benzoin,  2  oz. ;  prepared  storax,  1J  oz. ;  balsam  of  tolu,  g  oz. ;  Socotrine 
aloes,  160  gr. ;  rectified  spirit,  1  pint,  B.P. 

Benzoin,  12 ;  purified  aloes,  2  ;  storax,  8  ;  balsam  of  tolu,  4 ;  alcohol  up  to  100, 
U.S.P. 

Acidum  Benzoicum,  B.  and  U.S.P.  Benzoic  Acid. 
HC7H502.     (Not  chemically  pure.) 

Peepaeation. — By  heating  benzoin,  when  benzoic  acid  sublimes. 

Properties. — In  light,  feathery,  crystalline  plates  and  needles,  which  are 
flexible,  nearly  colourless,  and  have  an  agreeable  aromatic  odour,  resembling 
that  of  benzoin. 

Solubility. — It  is  sparingly  soluble  in  water,  but  is  readily  dissolved  by 
rectified  spirit ;  soluble  also  in  solutions  of  the  caustic  alkalis  and  of  lime. 

Eeactions. — When  dissolved  in  solutions  of  caustic  alkalis  or  of  lime  it 
is  precipitated  from  them  on  the  addition  of  hydrochloric  acid  unless  the 
solution  be  very  dilute.  When  heated  to  462°  P.  it  passes  off  in  vapour, 
leaving  only  &  slight  residue. 

Preparations. 
B.P.  DOSE. 

Ammonii  Benzoas  10-20  gr. 

Tinctura  Camphorae  Composita 15  min  to  1  fl.  dr. 

Tinctura  Opii  Ammoniata J-l  fl.  dr. 

Trochisci  Acidi  Benzoici 1-5  lozenges. 

U.S.P. 

Ammonii  Benzoas. 
Tinctura  Opii  Camphorata. 

Ammonii  Benzoas,  B.  and  U.S.P.  Benzoate  op  Ammonium.  NH4C,H502; 
139  (ef.  p.  643). 

Preparation. — By  dissolving  benzoic  acid  in  a  slight  excess  of  ammonia, 
evaporating  and  crystallising. 

HG,H502  +  NH4HO  =  NH40,H502  +  H20. 

Peopeeties.— In  colourless,  laminar  crystals ;  soluble  in  water  and  in 
alcohol. 

Eeactions. — It  gives  a  bulky  yellowish  precipitate  with  persalts  of  iron 
(benzoate).  Its  aqueous  solution  when  heated  with  caustic  potash  evolves 
ammonia,  and,  if  it  be  not  too  dilute,  when  acidulated  with  hydrochloric  acid 
it  gives  a  deposit  of  benzoic  acid. 

Impurities. — Fixed  salts. 

Tests. — When  heated  it  sublimes  without  any  residue. 

Physiological  Action. — Benzoic  acid  is  a  stimulant  and 
irritant  to  raw  surfaces.  It  has  an  antiseptic  action,  destroying 
low  organisms,  and  is  used  in  the  form  of  the  tincture  for  ulcers, 


chap,  xxxiv.]  COROLLIFLOBjE.  965 

wounds,  blisters,  and  chapped  hands.  It  was  owing  to  its  anti- 
septic action  that  Friar's  balsam  was  successfully  used  for  the 
treatment  of  wounds  in  the  Middle  Ages,  although  at  that  time 
its  mode  of  action  was  unknown  (p.  104). 

It  acts  as  a  stimulating  expectorant,  diminishing  the  secre- 
tion of  the  mucous  membrane. 

Benzoic  acid  when  absorbed  into  the  blood  is  excreted  by  the 
kidneys,  and  acts  as  a  diuretic.  It  does  not  diminish  the  uric 
acid.  In  the  kidneys  it  unites  with  glycocoll,  and  is  excreted  as 
hippuric  acid,  rendering  the  urine  acid  and  somewhat  irritating. 
This  is  proved  by  the  following  experiments : — 

(1)  If  you  give  benzoic  acid  it  is  found  in  the  urine  as  hip- 
puric acid,  but  in  the  blood  still  remains  as  benzoic  acid. 

(2)  If  you  give  to  a  rabbit  hippuric  acid,  it  is  excreted  as  such, 
but  is,  found  in  the  blood  as  benzoic  acid. 

(3)  If  you  tie  the  renal  arteries  and  give  benzoic  acid  no 
conversion  into  hippuric  acid  takes  place,  but  if  you  ligature  the 
ureters  the  change  takes  place,  and  hippuric  acid  is  found  in  the 
blood.     This  localises  the  seat  of  the  change  to  the  kidneys. 

Uses. — Compound  tincture  of  benzoin  (5  per  cent.)  and 
glycerine  (5  per  cent.),  in  rose  water  is  a  useful  application  or 
a  stimulant  to  the  skin  after  the  cure  of  acne.  Friar's  balsam  is 
also  useful  in  urticaria.  As  an  inhalation  (one  drachm  to  one  ounce 
in  a  pint  of  boiling  water)  it  has  a  sedative  effect  in  relieving  the 
irritation  and  cough  of  sub-acute  laryngitis  and  of  tracheitis. 
It  is  also  useful  in  bronchitis.  Benzoic  acid  is  used  in  chronic 
bronchitis  and  phthisis,  both  internally  and  as  an  inhalation, 
and  extraordinary  results  have  been  ascribed  to  its  uses ;  many, 
however,  deny  its  beneficial  effect.  It  is  used  in  catarrh  of  the 
bladder  to  acidify  the  urine.  Ammonium  benzoate  has  a  similar 
action  to  benzoic  acid. 


OLEACE^E. 

Oleum  Olivae,  B.  and  U.S. P.  Olive  Oil.— The  fixed  oil 
expressed  from  the  ripe  fruit  of  Olea  europcea.    South  of  Europe. 

Characters. — Pale-yellow,  with  scarcely  any  odour,  and  a  bland,  olea- 
ginous taste ;  congeals  partially  at  about  36°  F.  Specific  gravity  about  0*916 
at  63°  P. 

Composition. — Olein,  the  liquid  principle  of  the  oil,  and  the 
quantity  of  which  determines  its  excellence.  It  also  contains 
palmitin  and  other  fatty  compounds. 

Adulteration. — Other,  and  usually  heavier,  oils  fraudulently  added. 
Tests. — Specific  gravity.     Olive  oil  when  treated  with   sulphuric  acid 
evolves  a  small  amount  of  heat  compared  with  other  similar  oils. 

Dose. — Of  olive  oil,  1  fi.  dr.  to  1  fl.  oz.  or  more,  as  a  demul- 
cent or  laxative. 


966  VEGETABLE  MATEEIA  MEDICA.  [sect.  v. 

Preparations. 

B.P. 

Charta  Epispastioa.  Linimentum  Ammonia  (p.  516). 
EmplastrumAmmoniaeicumHydrargyro.  „  Calcis  (p.  516). 

„  Hydrargyri.  „  Camphora  (p.  516). 

„  Piois.  Unguentum  Cantharidis. 

„    '      Plumbi.  „  Hydrargyri  Compositum. 

„  Saponis  Fuscum.  „  Hydrargyri  Nitratis. 

Enema  Magnesii  Sulphatis.  „  Veratrinffl. 

U.S.P. 

Emplastrum  Plumbi.  Emplastrum  Ferri. 

„  Resinaa.  „           Galbani. 

„  AmmoniaoioumHydrargyro.  „           Hydrargyri. 

„  Arnica.-  „           Opii. 

„  Asafotidse.  „           Saponis. 

„  Belladonnas.  Unguentum  Diachylon. 

„  Capsici. 

Sapo  Durus,  B.P.     Hard  Soap.     Sapo,  U.S.P.     Soap. — 

Soap  made  with  olive  oil  and  soda. 

Characters. — Greyish-white,  dry,  inodorous;  horny  and  pnlvensable 
when  kept  in  dry,  warm  air ;  easily  moulded  when  heated ;  soluble  in  rectified 
spirit ;  not  imparting  an  oily  stain  to  paper.  Incinerated  it  yields  an  ash 
which  does  not  deliquesce. 

Dose. — As  an  antacid,  &c,  5-20  gr. 

Preparations. 

B.P. 

linimentum  Saponis  (p.  516).  Filula  Cambogice  Composita. 
Pilula  Aloes  Barbadensis  (p.  522).  „    Bhei  Composita. 

„        „      et  Asafoetidse.  „    Saponis  Composita  (p.  523). 

„        „      Socotrinse.  „     Scillffl  Composita. 

U.S.P. 

Emplastrum  Saponis.  Pilules  Aloes  et  Asafcetid*. 
Linimentum         „       (p.  517).  „     Asafoetidse. 

„  Chloroformi.  „     Opii. 

Pilula?  Aloes  (p.  523).  „     Bhei. 

Sapo    Mollis,   B.P.      Soft   Soap.    Sapo  Viridis,   U.S.P. 

Geben  Soap. — Soap  made  with  olive  oil  and  potash,  B.P.     Soap 
prepared  from  potassa  and  fixed  oils,  U.S.P. 

Characters. — Yellowish-green,  inodorous,  of  a  gelatinous  consistence. 
Soluble  in  rectified  spirit ;  not  imparting  an  oily  stain  to  paper.  Incinerated 
it  yields  an  ash  which  is  very  deliquescent. 

Dose. — As  an  antacid,  &c,  5-20  gr. 

Preparations. 

B.P.  U.S.P. 

Linimentum    Terebinthinse  Tinctura  Saponis  Viridis  (green 

(p.  516).  soap,  65  ;  oil  of  lavender,  2 ; 

alcohol  up  to  100). 

Glycerinum,  B.  and  U.S.P.  Glycerine,  B.P. ;  Glycerin, 
U.S.P.;  Glycerol. — A  sweet  principle  (B.P.).  It  is  a  trihydric 
alcohol,  C3H5(HO)3 ;  92,  obtained  by  reaction  of  fats  and  fixed 
oils  with  aqueous  fluids,  and  containing  a  small  percentage  of 
water  (not  less  than  95  per  cent,  of  absolute  glycerin,  U.S.P.) 


chap,  xxxiv.]  COBOLLIFLOBJ!.  967 

Characters. — A  clear,  colourless  fluid,  oily  to  the  touch,  without  odour, 
of  a  sweet  taste. 

Solubility. — Freely  soluble  in  water  and  in  alcohol. 

Reactions. — "When  decomposed  by  heat  it  evolves  intensely  irritating 
vapours  due  in  part  to  acrolein.     Specific  gravity  1-25. 

Dose.— One  half  to  2  fl.  dr. 

Preparations  (vide  p.  513). 
B.P. 
Bxtractum  Cinchonas  Liquidum.  Lamellae,  in  all. 

Glycerinum  Acidi  Carbollcl.  Linimentum  Iodi  (p.  516). 

„       Galilei.  „  Potassii  Iodidi  cum  Sapone. 

„       Tannic!.  Mel  Boracis. 

Aluminis.  Pilula  Aloes  et  Myrrhaa  (p.  522). 

Amyli.  „    Ehei  Composita. 

Boracis.  „     Saponis  Composita. 

Plumb!  Subacetatis.      Tinctura  Kino. 
Tragacautnse.  Unguentum  Iodi. 

U.S.P. 

Glyceritum  Amyli.  Glyceritum  Vitelli. 

Muoilago  Tragaoantha. 

Action  and  Uses. — Olive  oil  is  used  externally  in  the  form 
of  liniments  as  a  lubricating  substance,  and  in  seborrhcea  it 
may  be  applied  4  or  5  times  daily  till  the  crusts  are  removed. 
It  is  useful  alone  in  acute  attacks  of  psoriasis  and  in  acute 
eczema  capitis.  Internally  it  acts  as  a  demulcent  in  cases  of 
irritant  poisoning,  except  by  phosphorus.  In  large  doses  it  is 
slightly  laxative,  as  in  oily  salads. 

Soft  soap  is  more  alkaline  than  the  hard,  and  from  the  free 
potash  it  contains,  it  may  produce  a  caustic  effect  on  the  skin  if 
too  long  applied.  Eubbed  in  for  5  or  10  minutes  once  or  twice 
daily,  it  is  very  useful  in  chronic  and  subacute  eczema,  a  sooth- 
ing ointment  being  applied  after  its  use.  A  tincture  of  soft  soap 
(2  in  1  of  rectified  spirit)  is  a  convenient  form  of  applying  it 
to  the  hairy  scalp :  after  rubbing  in,  it  must  be  washed  off 
and  an  oily  preparation  used.  This  treatment  does  good  in 
seborrhcea,  in  scaly  forms  of  eczema  capitis,  and  in  lupus  fur- 
furacea.  Soft  soap  is  also  useful  in  sycosis  and  ichthyosis  and 
in  some  cases  of  lupus  erythematosus. 

Hard  soap  is  used  chiefly  as  a  detergent,  and  for  its 
mechanical  effect,  in  pills  and  as  an  adjunct  in  suppositories.  A 
small  piece  of  soap  cut  into  a  conical  form  and  used  as  a  suppo- 
sitory is  very  useful  in  constipation  occurring  in  infants.  Soap 
and  water  forms  a  useful  enema  for  constipation  in  adults. 

Glycerin  is  used  as  an  ingredient  in  ointments  and  lotions  in 
various  skin-diseases.  With  two  per  cent,  carbolic  acid  added, 
if  rubbed  on  in  the  bath,  it  relieves  the  itching  in  chronic  eczema. 
Five  per  cent,  glycerin  with  an  equal  part  of  Friar's  balsam  in 
rose-water  is  useful  in  acne  (vide  p.  965) ;  glycerin  soaps  are 
used  in  seborrhcea  and  acne. 


968  VEGETABLE   MATEEIA  MEDICA.  [sect.  v. 

Glycerin  acts  as  a  laxative,  and  when  used  along  with  castor 
oil  increases  its  power.  It  is  largely  destroyed  in  the  system,  has 
an  influence  on  nutrition,  and  has  been  proposed  as  a  substitute 
for  cod-liver  oil,  but  without  much  benefit.  Very  large  doses 
cause  a  red  coloration  in  the  urine,  due  to  the  colouring  matter 
of  the  blood,  without  any  free  corpuscles. 

It  is  used  as  a  laxative  in  haemorrhoids ;  as  a  solvent  of 
other  drugs,  as  borax,  tannic  acid ;  as  an  emollient  to  soften  the 
hands,  and  applied  to  sore  nipples,  fissure  of  the  tongue,  in  ad- 
vanced phthisis,  croup,  laryngitis,  &c.  It  has  been  painted  on 
in  eczema,  psoriasis,  pruritus;  also  as  a  preventive  of  bed- 
■  sores.  It  must  be  diluted  with  water,  or  it  will  irritate  the  part. 
It  has  been  proposed  as  a  substitute  for  sugar  in  diabetes. 

Manna,  B.  and  U.S.P.  Manna. — A  concrete  saccharine 
exudation  obtained  by  making  transverse  incisions  in  the  stems 
of  the  trees  of  Fraxinus  Ornus,  cultivated  in  Calabria  and  Sicily. 

Characters. — In  stalactiform  pieces  from  one  to  six  inches  in  length,  and 
one  or  two  inches  in  width,  uneven,  porous,  and  friable,  curved  on  one  side, 
of  a  yellowish-white  colour.  Odour  faint,  resembling  honey ;  taste  sweet  and 
honey  -hie,  combined  with  a  slight  acridity  and  bitterness. 

Dose. — 60  grains  to  1  ounce. 

Pkepaeation. 
u.s.p.  cose.  b.p. 

Infusum  Sennse  Compositum 2J  fl.  oz.  None. 

Composition. — It  consists  principally  of  mannite  or  mannitol, 
a  hexahydric  alcohol,  C6H8(OH)6,  together  with  common  sugar 
and  extractive  matter.  The  mannite,  which  forms  from  60  to  80 
per  cent,  of  the  manna,  may  be  extracted  by  means  of  boiling 
rectified  spirit,  from  which  it  will  afterwards  separate  on  cooling 
in  colourless,  shining  crystals.  It  requires  five  parts  of  cold 
water  for  its  solution,  and  this  does  not  undergo  vinous  fer- 
mentation in  contact  with  yeast,  being  thus  distinguished  from 
grape-sugar. 

Use. — Manna  is  used  as  a  simple  laxative. 

APOCYNACEiE. 

U.S.P.  Apocynum.  Apocynum.  Canadian  Hemp. — The 
root  of  Apocynum  cannabinum. 

Characters. — Long,  cylindrical,  somewhat  branched,  one-fourth  to  one- 
third  of  an  inch  (6  to  8  millimetres)  thick,  pale  brown,  longitudinally 
wrinkled  and  transversely  fissured ;  brittle  ;  fracture  short,  white ;  the  bark 
rather  thick  ;  the  wood  porous,  spongy,  with  delicate,  medullary  rays  and  a 
thin  pith ;  inodorous  ;  taste  bitter,  disagreeable. 

Composition. — It  contains  an  amorphous  substance — apo- 
cynin — easily  soluble  in  alcohol,  but  insoluble  in  water,  and  a 
glucoside — apocynei'n — easily  soluble  in  water. 


chap,  xxxiv.]  .  COEOLLIFLORjE.  969 

Dose.— 15-30  gr.  (1-1-95  gm.)  of  powdered  root.  A  decoc- 
tion is  more  convenient.  It  is  made  by  boiling  f  oz.  in  1£  pint 
of  water  to  1  pint.  Of  tbis  1-2  fl.  oz.  (30-60  c.c.)  may  be  given 
twice  or  tbrice  a  day. 

Action.— -In  small  doses  it  is  laxative,  in  large  doses  emetic 
and  cathartic.  Apocynin  and  apocynein  act  on  the  heart  as 
cardiac  tonics  like  digitalis,  and  are  also  diuretic. 

Use. — It  is  chiefly  used  in  dropsy. 

Quebracho  Cortex.  White  Quebracho  Bark.  Not  offici- 
nal.— The  bark  of  Aspidosjperma  Quebracho,  imported  from  the 
Argentine  Eepublic. 

Characters. — In  large  pieces,  about  three-quarters  of  an  inch  thick, 
greyish-brown  outside,  yellowish  inside,  intensely  bitter. 

Composition. — It  contains  six  alkaloids,  the  most  important 
of  which  are  quebrachine,  aspidosamine,  and  aspidospermine ; 
others  are  called  quebrachamine,  hypoquebrachin,  aspidosper- 
matin.     There  is  also  a  peculiar  kind  of  tannic  acid. 

Pbepabations. 

Tinctura  Quebracho  (1  in  5  of  proof  spirit) i-1  fl.  dr. 

Aspidospermine "l  „  _  , 

Quebrachine j  0-5-1  gm. 

Action. — Quebrachine  is  the  most  active  of  the  alkaloids; 
aspidosamine  ranks  second,  and  aspidospermine  third.  These 
three  have  a  similar  action.  Respiration  is  first  affected,  in 
warm-blooded  animals  the  fulness  and  frequency  of  breathing 
being  increased,  and  finally  respiration  is  paralysed.  In  frogs 
respiratory  paralysis,  from  an  affection  of  the  respiratory  centre, 
rapidly  follows  the  introduction  of  the  poison.  The  central 
nervous  system  is  paralysed,  the  brain  being  first  affected  so 
that  there  is  at  first  a  loss  of  voluntary  movement,  with  increase 
of  reflex  excitability;  finally  the  spinal  cord  also  is  paralysed. 
Voluntary  muscle  is  paralysed  by  the  local  action  of  all  these 
alkaloids,  and  aspidosamine  and  hypoquebrachin  paralyse  also 
the  motor  nerve  endings.1  The  heart  is  paralysed  in  cold- 
blooded animals  after  the  respiration  ;  it  is  at  first  slowed,  and 
the  peripheral  ends  of  the  vagus  are  paralysed ;  in  warm-blooded 
animals  the  cardiac  paralysis  is  said  to  be  primary.2 

Uses. — It  has  been  used  to  lessen  dyspnoea  in  asthma,  em- 
physema, and  phthisis. 

1  E.  Hamack  and  E.  Hofmann,  Zeits.f.  klin.  Med.,  Bd.  viii.  Hft.  6,  1884. 
•  G.  Gutmann,  ArcTm  f.  exper.  Paiholog.  u.  Pharmakol.,  xiv.  p.  451. 


970  VEGETABLE  MATEEIA  MEDICA.  [sect.  V. 


ASCLEPIADACEiE. 

U.S.P.  Asclepias.  Asclbpias.  Pleurisy  Eoot. — The  root  of 
Asclepias  tuberosa. 

Characters. — Boot  large  and  fusiform,  dried  in  longitudinal  or  transverse 
sections ;  from  one  to  six  inches  (25  to  150  millimetres)  long,  and  about  three 
quarters  of  an  inch  (two  centimetres)  or  more  in  thickness ;  the  head  knotty, 
and  slightly  but  distinctly  annulate,  the  remainder  longitudinally  wrinkled; 
externally  orange-brown,  internally  whitish;  tough  and  having  an  uneven 
fracture ;  bark  thin,  and  in  two  distinct  layers,  the  inner  one  whitish ;  wood 
yellowish,  with  large,  white  medullary  rays;  it  is  inodorous,  and  has  a 
bitterish,  somewhat  acrid  taBte ;  when  long  kept  it  acquires  a  grey  colour. 

Composition. — It  contains  resins  and  an  odorous  fatty 
matter. 

Dose.— 20-60  gr. 

Use. — It  may  be  used  as  a  diaphoretic  or  expectorant.  In 
large  doses  it  acts  as  an  emetic  and  purgative. 

Asclepias  Incarnata.  White  Indian  Hemp.  Not  officinal. 
America. — The  root  appears  to  act  like  digitalis,  strengthening 
the  beats  of  the  heart,  and  producing  diuresis.  A  fluid  extract 
has  been  used  in  doses  of  ^-1  fl.  dr.  every  three  hours. 

B.P.  Hemidesmi  Radix.  Hemidesmus  Eoot. — The  dried 
root  of  Hemidesmus  indicus,  Indian  sarsaparilla.     India. 


Fia.  207.— Hemidesmus. 

Characters. — Yellowish-brown,  cylindrical,  tortuous,  furrowed,  and  with 
annular  cracks ;  having  a  fragrant  odour  and  a  very  agreeable  flavour. 

Composition. — The  chemical  constituents  of  the  root  have 
not  yet  been  fully  investigated.  A  substance  supposed  to  be  a 
volatile  acid  has  been  separated  by  distillation  with  water. 

Preparation. 
B.P.  DOSE. 

Syrupus  Hemidesmi  (1  to  1(H  oz.) 1-2  ft.  dr. 

Use. — Hemidesmus  is  supposed  to  have  the  same  action  as 
sarsaparilla  (q.v.)  and  is  used  in  rheumatism  and  syphilis.  The 
syrup  is  of  little  use  except  for  flavouring. 

Condurango.  Not  officinal. — The  bark  of  Gonobbus  Cun- 
durango  from  Ecuador.  It  is  said,  however,  that  there  are 
several  species  of  plants  yielding  a  bark  known  by  the  name 
'  Condurango.' 

Characters. — Condurango  is  a  climbing  plant ;  the  bark  is  generally  of  a 
greyish  colour  outside  with  a  few  adherent  lichens,  and  occurs  in  thin,  curled 
pieces. 


chap,  xxxiv.]  COEOLLIFLOEjE.  971 

Action. — It  does  not  seem  to  have  any  definite  physiological 
action.  _  It  has  been  stated  by  Gianuzzi  to  produce  tetanus  like 
strychnine.  I  found  that  an  infusion  injected  into  the  jugular 
vein  caused  convulsions  and  death,  but  this  appeared  to  be  really 
due  to  embolism  of  the  pulmonary  vessels  by  fine  particles  sus- 
pended in  fluid,  for  when  injected  into  the  peritoneal  cavity  the 
solution  had  no  action. 

Uses. — It  has  been  recommended  as  a  remedy  in  cancer,  but 
is  useless  in  this  disease.  It  has  been  found  beneficial,  however, 
in  cases  of  dyspepsia,  and  has  been  given  also  as  an  alterative 
in  syphilis. 

LOGANIACEiE. 

Nux  Vomica.  Nux  Vomica. — The  seeds  of  Strychnos  Nux- 
vomica.    East  Indies. 

Characters, — Nearly  circular  and  flat,  about  an  inch  in  diameter,  um- 
bilicated  and  slightly  convex  on  one  side,  externally  of  an  ash-grey  colour, 
thickly  covered  with  short  satiny  hairs,  internally  translucent,  tough,  and 
horny ;  taste  intensely  bitter,  inodorous.  The  seeds  to  be  pulverised  must 
be  heated  by  steam  and  dried. 

Composition. — Two  alkaloids,  strychnine  and  brucine.  The 
former  is  much  less  soluble  in  boiling  water  than  the  latter,  and 
differs,  further,  in  not  being  coloured  by  nitric  acid,  with  which 
brucine  gives  a  brilliant  red.  Both  alkaloids  are  found  combined 
with  strychnic  or  igasuric  acid — similar  to  malic  acid. 

Dose. — Of  the  powdered  seed,  2-5  gr. 

Pbepabations. 

B.F.  COSE. 

Extractum  Nucis  Vomicae J-2  gr. 

Strvchnlna m>-t3  gr- 

Tinctura  Nucis  Vomicae 10-20  jnin. 

U.S.P. 

Abstractum  Nucis  Vomica i  gr. 

Extractum       „  , j-1  gr. 

„  „  „       Fluidum 1-5  m. 

Strychnina ro~T2  8r- 

Tinctura  Nucis  Vomica; 10-20  min. 

U.S.P.  Ignatia.  Ignatia.  Bean  of  St.  Ignatius.— The 
seed  of  Strychnos  Ignatii. 

Characters.— About  an  inch  and  a  fifth  (3  centimetres)  long,  oblong,  or 
ovate,  irregularly  angular,  dull  brownish  or  blackish,  very  hard,  horny ;  frac- 
ture granular,  irregular ;  the  albumen  somewhat  translucent,  enclosing  an 
irregular  cavity  with  an  oblong  embryo  ;  inodorous ;  very  bitter. 

Officinal  Pbepabations. 

dose. 

Abstractum  Ignatias 1  gr- 

Tinctura  Ignatia! 15  min.-l  fl.  dr. 

Composition. — Its  activity  depends  on  the  contained  brucine 
and  strychnine. 


972  VEGETABLE  MATEEIA  MEDICA.  [sect.  v. 

Strychnina,  B.  and  U.S.P.  Strychnine.  C2lH22N202 ;  334. 
An  alkaloid  prepared  from  Nux  Vomica  (B.P.)  or  Ignatia,  and  also 
occurring  in  other  plants  of  the  Nat.  Ord.  Loganiacese  (U.S.P.). 

Preparation.— Softening  the  tough  seeds  by  steam,  chopping,  drying, 
and  grinding  them.  Exhausting  the  powdered  seeds  with  rectified  spirit  which 
is  recovered  by  distillation.  Precipitating  colouring  matter  and  acids  by 
acetate  of  lead.  Precipitating  strychnine  and  brucine  from  concentrated 
solution  by  ammonia.  Dissolving  the  precipitate  in  rectified  spirit  and  crystal- 
lising out  strychnine  from  concentrated  solution.  The  brucine  being  more 
soluble  remains  in  the  mother  liquor.  The  strychnine  is  purified  by  washing 
and  boiling  with  rectified  spirit. 

Characters. — In  right  square  octahedrons  or  prisms,  colourless,  and  in- 
odorous. 

Solubility. — Sparingly  soluble  in  water,  but  communicating  to  it  its 
intensely  bitter  taste ;  soluble  in  boiling  rectified  spirit  and  in  chloroform, 
but  not  in  absolute  alcohol  or  in  ether. 

Beaction. — Pure  sulphuric  acid  forms  with  it  a  colourless  solution,  which 
on  the  addition  of  bichromate  of  potassium  acquires  an  intensely  violet  hue, 
speedily  passing  through  red  to  yellow.    A  very  active  poison. 

Impurity. — Brucine  from  imperfect  preparation,  and  mineral  matter. 

Tests. — Not  coloured  by  nitric  acid  (no  brucine),  leaves  no  ash  when 
burned  with  free  access  of  air  (no  mineral  matter). 

Pbbpabations. 

B.P.  DOSE. 

liquor  Strycbninse  Hydrocnloratis. — (Strychnine,  1  part,  with 
2  of  dilute  hydrochloric  acid,  and  24  of  spirit  to  keep  it  in  solution, 
and  water  73) 5-10  min. 

u.s.p. 

Ferri  et  Strychnina  Citras 1-3  gr. 

Syrupus  Ferri,  Quininae  et  Strychninae  Phosphatum  (p.  751) 1-2  fl.  dr. 

U.S.P.  Strychnine  Sulphas.     Sulphate  of  Strychnine. 

Physiological  Action. — Strychnine  added  to  water  contain- 
ing low  organisms  in  small  doses  increases  their  activity ;  in 
large  doses  it  lessens  it.  The  drug  lessens  oxidation  of  proto- 
plasm and  oxidation  taking  place  in  the  blood ;  it  also  lessens 
fermentation,  but  its  action  on  it  is  not  nearly  so  great  as  might 
be  expected  from  its  powerful  action  on  higher  organisms  (pp. 
61,  65,  69,  72,  89). 

General  Action. — The  most  marked  feature  in  the  general 
action  of  strychnine  is  the  great  increase  which  it  produces  in 
the  reflex  excitability  of  the  spinal  cord  and  other  reflex  nerve- 
centres,  such  as  the  vaso-motor  and  respiratory  centres.  When 
the  dose  is  large  this  increase  is  so  great  as  to  cause  convulsions 
and  death. 

Taken  in  small  doses  strychnine  gives  rise  to  a  bitter  taste 
and  increases  the  appetite;  sometimes  also  it  increases  the 
peristaltic  movements  of  the  intestines,  and  lessens  constipation. 
When  taken  in  small  doses  for  a  long  time  the  drug  produces 
increased  sensibility  of  the  sensory  nerves,  so  that  impressions 
are  felt  more  acutely  and  are  of  longer  duration,  and  the  sense 
of  touch  is  rendered  more  acute ;  the  field  of  vision  is  increased 


chap,  xxxiv.]  COEOLLIFLOB^E.  973 

and  distant  objects  are  rendered  more  distinct ;  the  sense  of 
hearing  is  also  sharpened  (pp.  226,  229).  Taken  in  larger  doses 
the  drug  produces  increased  sensibility  more  markedly,  and 
excites  sexual  desire.  If  pushed  still  further  the  drug  causes 
malaise,  anxiety,  restlessness,  twitchings  of  the  muscles,  stiffness 
of  the  neck  and  convulsions. 

After  a  dose  of  half  a  grain  of  strychnine  symptoms  of 
poisoning  appear  in  a  period  varying  from  five  minutes  to  five 
hours,  coming  on  without  vomiting  or  any  other  warning,  the 
first  symptom  being  general  convulsions  ;  the  teeth  are  clenched, 
the  pupils  dilated,  and  the  body  forced  into  the  opisthotonic 
position,  resting  on  the  head  and  feet,  with  the  hands  clenched 
and  the  arms  drawn  tightly  towards  the  body ;  the  spasms  last 
from  half  to  one  minute,  and  are  followed  by  a  period  of  relaxa- 
tion, during  which  sensibility  to  reflex  stimuli  is  enormously  in- 
creased, the  slightest  stimulus,  such  as  a  draught  of  cold  air,, 
bringing  on  a  fresh  attack  of  spasms.  Death  results  either  from 
asphyxia  occurring  during  a  spasm,  or  from  paralysis  and  col- 
lapse coming  on  during  a  period  of  relaxation.  The  diagnosis 
between  convulsions  occasioned  by  strychnine  and  ordinary 
tetanus  depends  (1)  on  the  history  of  the  case,  and  (2)  on  the 
fact  that  the  spasms  of  tetanus  are  tonic  whilst  those  of  strych-. 
nine-poisoning  are  clonic.  In  tetanus  too  the  muscles  of  the 
jaw  are  first  affected,  hence  the  term  '  lock-jaw ' ;  whilst  in 
strychnine  convulsions  these  muscles  are  not  affected  before 
others. 

The  treatment  of  strychnine  poisoning  consists  in  evacuating 
the  stomach,  if  possible  before  the  convulsions  begin ;  but,  if  this 
cannot  be  done,  .chloroform  must  be  given  and  the  stomach 
washed  out  whilst  the  patient  is  under  the  influence  of  the  an- 
aesthetic, and,  lastly,  chloral  should  be  given  by  subcutaneous 
injection  (10  gr.)  or  in  enema  (1  dr.  repeated). 

Special  Action.  On  the  Alimentary  Canal. — Strychnine 
produces,  by  its  bitter  taste,  an  increased  flow  of  saliva  ;  it  also 
increases  the  peristaltic  action  of  the  bowels. 

On  the  Blood. — When  mixed  with  the  blood  it  lessens  oxi- 
dation to  a  slight  extent,  but  probably  it  has  little  action  on 
oxidation  in  the  living  body,  from  the  small  doses  which  can 
alone  be  used. 

On  the  Circulation.  —  It  increases  the  blood-pressure. 
This  is  due  to  several  causes  :  (1)  It  stimulates  the  vaso-motor 
centre  directly,  or  else  greatly  increases  its  excitability  to  the 
ordinary  stimuli  it  receives,  even  when  the  dose  is  too  small  to 
produce  convulsions.  When  these  occur,  other  factors  help  to 
increase  the  pressure.  (2)  The  vaso-motor  centre  during  the 
convulsions  is  stimulated  indirectly  by  the  action  of  the  carbon 
dioxide  of  the  venous  blood,  which  accumulates  during  the  as- 
phyxia caused  by  the  convulsions.     (3)  The  violent  muscular 


974  VEGETABLE  MATEEIA  MEDICA.  [sect.  v. 

contractions  during  the  convulsions  increase  the  resistance  -to 
the  flow  of  blood  through  the  arteries  and  capillaries. 

After  section  of  the  cord  in  a  normal  animal,  stimulation  of 
a  sensory  nerve  no  longer  produces  vaso-motor  spasm ;  but  in 
an  animal  poisoned  with,  strychnine  it  does.  The  explanation 
of  this  is  that  strychnine  increases  the  excitability  of  the  vaso- 
motor centre  to  such  an  extent  that  that  portion  of  it  which  is 
in  the  cord  becomes  able  to  take  on  to  a  great  extent  the  normal 
functions  of  the  whole  centre  (p.  287). 

The  medicinal  use  of  strychnine  is  said  to  cause  in  some 
cases  fits  resembling  those  of  tertian  ague.1  It  is  not  improbable 
that  these  are  true  ague  fits,  due  to  malaria,  the  action  of  which 
has  been  aided  by  that  of  strychnine  on  the  vaso-motor  centre 
(cf.  p.  287,  and  action  of  opium,  p.  862). 

The  heart  is  stimulated,  but  during  the  convulsions  it  is 
slowed  in  the  frog.  In  mammals  it  is  quickened  during  the 
spasms,  but  if  curare  be  previously  given  it  is  slowed. 

Strychnine  stimulates  the  motor  ganglia  of  the  heart,  for 
Dr.  Cash  and  I  found  that  when  a  frog  is  under  the  action  of 
strychnine  a  ligature  placed  between  the  sinus  venosus  and 
auricle  did  not  stop  the  auricle  and  ventricle  as  in  Stannius' 
experiment  (p.  319),  and  if  this  experiment  has  already  been 
performed,  strychnine  injected  into  the  interior  of  the  ventricle 
causes  the  auricle  and  ventricle  to  recommence  beating.2  The 
action  of  strychnine  on  the  motor  centre  in  the  heart  is  probably 
similar  to  its  action  on  the  vaso-motor  and  respiratory  centres. 

Respiration  is  quickened  and  rendered  more  deep,  owing  to 
stimulation  of  the  respiratory  centre,  just  as  in  the  case  of  the 
vaso-motor  centre  the  spinal  part  of  the  respiratory  centre  is 
rendered  so  active  ;  if  strychnine  be  given  to  an  animal  and  the 
cord  be  divided  below  the  medulla,  respiration  is  not  entirely 
arrested,  as  it  usually  is ;  and  if  strychnine  be  given  to  an  animal 
after  division  of  the  cord,  respiration  will  recommence  (p.  236). 

On  the  Muscles. — These  are  but  little  affected  directly,  but 
indirectly  they  become  greatly  exhausted  by  the  wear  and  tear 
due  to  the  convulsions.  After  death  they  quickly  enter  into 
rigor  mortis. 

Nervous  System. — The  sensory  nerves  are  so  stimulated 
that  the  slightest  impression  is  most  distinctly  felt ;  the  action 
of  the  drug  has  not  been  shown  to  be  on  the  nerves  themselves, 
but  probably  is  due  to  stimulation  of  the  nerve-centres  (pp.  226, 
229,  and  230).  Small  doses  do  hot  affect  the  motor  nerves, 
large  doses  paralyse  them.  This  paralysis  is  partly  due  to  ex- 
haustion from  the  convulsions,  but  not  entirely,  since  if  one 
sciatic  nerve  of  the  frog  be  divided  before  poisoning,  so  as  to  pre- 

1  Lewin,  Nebenwirkungen  der  Arsneimittel,  p.  50. 

'  Brunton  and  Cash,  St.  Bartholomew's  Hospital  Reports,  vol.  xvi. 


chap,  xxxiv.]  COEOLLIPLORiE.  975 

vent  any  convulsions  in  the  corresponding  limb,  it  still  loses  its 
irritability,  though  not  so  soon  as  the  undivided  nerve. 

On  the  Brain. — Small  doses  increase  the  mental  powers 
and  sharpen  the  senses.  Large  doses  cause  anxiety  and  malaise, 
but  the  functions  of  the  cerebrum  continue  until  death,  the  mind 
remaining  clear  to  the  last.  The  convulsions  are  not  cerebral 
(pp.  179,  180). 

On  the  Spinal  Cord. — The  spinal  cord  is  greatly  stimulated, 
so  that  a  slight  stimulus  through  a  sensory  nerve  produces  not 
merely  increased  reflex  action  but,  by  increasing  the  diffusion  or 
'  radiation '  of  impulses,  causes  general  convulsions.  This  action 
of  strychnine  has  been  supposed  to  be  due  to  increased  excitability 
of  the  nerve-cells  in  the  spinal  cord,  but  is  more  probably  caused 
by  an  alteration  in  the  comparative  rate  of  transmission  of 
stimuli  from  one  cell  to  another  (pp.  161,  173).  The  con- 
vulsant  action  of  strychnine  was  first  localised  to  the  spinal  cord 
by  the  experiments  of  Magendie,  as  already  described  (p.  180). 

Strychnine  acts  more  powerfully  when  injected  into  the  rec- 
tum than  when  swallowed,  contrary  to  the  general  rule. 

Brucine,  thebaine,  and  some  other  opium  alkaloids  act  in 
the  same  way  as  strychnine. 

The  effect  of  brucine  in  producing  convulsions  has  been  said 
to  depend  on  admixture  with  strychnine.  Mr.  Shenstone  pre- 
pared some  pure  brucine,  and  in  experiments  with  this  I  have 
found  it  cause  convulsions  and  death  in  rabbits  when  injected 
subcutaneously.  It  appears  to  be  both  less  powerful  than  strych- 
nine, and  to  be  eliminated  more  rapidly,  for  when  given  to  rats 
as  a  paste  with  butter  it  caused  no  symptoms  whatever. 

Methyl-strychnine  and  methyl-brucine,  like  methyl-the- 
baine,  do  not  affect  the  cord,  but  paralyse  the  ends  of  the  motor 
nerves,  like  curare. 

Uses. — Strychnine  is  one  of  the  best  gastric  tonics  in 
dyspepsia  when  there  is  a  tendency  to  catarrh  and  congestion. 
It  probably  acts  by  perfecting  co-ordination  between  the  various 
functions  of  the  parts  concerned  in  the  processes  of  digestion 
and  assimilation.  It  probably  also  increases  the  movements  of 
the  stomach  and  gives  tone  to  the  gastric  vessels,  and  thus  re- 
lieves congestion  of  the  stomach  due  to  bronchitis,  cirrhosis, 
and  cardiac  disease  (p.  367).  As  a  tonic  it  is  very  useful  during 
convalescence  from  acute  diseases,  in  anaemia,  in  dyspepsia  due 
to  indigestible  articles  of  diet  or  excess  of  alcoholic  stimulants  ~, 
also  in  *  sick  headache  '  in  doses  of  one  minim  of  tincture  of  nux 
vomica  in  a  teaspoonful  of  water  every  ten  minutes  (Kinger). 

In  doses  of  10  min.  before  meals  I  have  found  it  prevent 
frontal  headache  in  persons  liable  to  it. 

It  also  gives  contractile  power  to  the  intestines  and  is  used 
as  an  adjunct  to  purgative  pills.  A  very  good  dinner  pill  is 
pil.  rhei  co.  gr.  iv.,  pulv.  ipecac.  £  gr.,  ext.  nucis  vom.  |  gr. ;  given 


976  VEGETABLE  MATEEIA  MEDICA.  [sect.  v. 

before  dinner.  A  few  drops  of  tincture  of  nux  vomica  just  before 
dinner  both  increase  the  appetite  and  tend  to  lessen  habitual 
constipation.  In  dilated  heart  it  is  useful  as  a  cardiac  tonic. 
It  is  useful  as  a  respiratory  stimulant  in  bronchitis,  especially 
when  there  is  a  tendency  to  failure  of  respiration. 

The  night-sweats  of  phthisis  are  usually  checked  by  taking 
10  min.  of  tincture  of  nux  vomica  at  bed-time.  The  probable 
mode  of  action  has  already  been  discussed  (p.  443).  It  may 
also  increase  the  cough  during  the  day. 

In  depression  due  to  mental  overwork  it  is  very  valuable,  as 
it  increases  the  mental  powers,  but  we  must  be  cautious  not  to 
give  it  for  too  long  a  time.  One  of  the  chief  dangers  of  giving  it 
to  overworked  men  is  that  it  increases  their  powers  temporarily 
and  they  are  tempted  to  overwork  themselves  still  more. 

In  some  forms  of  paralysis  (hemiplegia,  paraplegia,  wrist- 
drop), except  where  there  still  exist  symptoms  of  irritation,  it  is 
serviceable ;  it  is  also  useful  in  some  forms  of  local  paralysis,  as 
atony  of  the  bladder.  It  is  useful  in  infantile  paralysis  after 
the  acute  symptoms  have  passed  away. 

In  sexual  debility  it  is  often  serviceable.  Its  marked  aphro- 
disiac action  is  sometimes  inconvenient  and  interferes  with  its 
use  as  a  tonic  (p.  450).  In  some  cases  where  debility  is  asso- 
ciated with  sexual  excess,  strychnine  increases  instead  of  dimi- 
nishes the  weakness,  and  in  such  cases  bromide  of  potassium 
should  be  employed.  It  has  been  used  in  hysteria  and  chorea 
with  low  spirits.  It  is  a  cumulative  poison,  as  it  contracts  the 
renal  arteries  and  thus  prevents  its  own  excretion  (p.  40). 

Curare.  Not  officinal. — Synonyms :  Cubaea,  Wooeaei,  Wou- 
bali,  Ueaei,  Ticunas. 

This  substance  appears  to  be  an  extract  from  a  species  of 
Strychnos  mixed  with  some  mucilaginous  juice. 

Characters. — A  black  extractiform  body  some  specimens  of  which  are 
readily  soluble  in  water,  but  others  leave  an  insoluble  residue. 

Composition. — It  contains  an  alkaloid,  curarine. 

Action. — It  paralyses  the  peripheral  ends  of  motor  nerves 
even  when  given  in  very  minute  doses  (p.  147).  Larger  doses 
paralyse  the  vagus  and  the  ends  of  sensory  nerves.  As  poison- 
ing progresses  the  spinal  cord  is  paralysed,  and  finally  the 
heart.  Voluntary  muscles  appear  to  be  little  affected,  yet  their 
contractility  is  somewhat  diminished,  and  this  diminution  begins 
even  before  the  motor  nerves  themselves  are  paralysed.  The 
vessels  of  the  surface  become  dilated,  and  sometimes  a  peculiar 
erythematous  rash  appears  on  the  skin  in  dogs.  The  blood- 
pressure  is  little  affected  by  small  doses,  but  is  much  lowered 
by  large  ones.  When  injected  into  the  salivary  gland  it  causes 
intense  salivation,  which  appears  to  be  paralytic  (p.  355).  In 
men  who  have  been  slightly  poisoned  by  it,  it  has  produced  in- 


Chap,  xxxiv.]  C0E0LLIFL0EJ3.  977 

creased  secretion  of  the  sweat,  tears,  nasal  mucus,  saliva,  and 
urine,  with  a  feeling  of  weariness  and  disinclination  to  move. 
Large  doses  produce  death  by  paralysis  of  the  muscles  of  re- 
spiration, but,  the  motor  nerves  of  the  extremities  being  para- 
lysed, no  convulsions  occur.  Although  the  motor  nerves  are 
paralysed  to  such  an  extent  that  they  will  not  excite  muscular 
contractions,  even  when  the  nerve-centres  are  powerfully  stimu- 
lated by  asphyxial  blood,  they  still  cause  muscular  contractions 
when  irritated  by  an  interrupted  current  in  a  warm-blooded 
animal  poisoned  by  curare.  In  frogs  the  poisoning  may  be  so 
complete  that  no  irritation  of  the  trunk  of  a  nerve  will  excite 
contraction  in  the  muscles  supplied  by  it.  Curare  is  rapidly 
eliminated  by  the  kidneys,  and  if  artificial  respiration  be  kept 
up  complete  recovery  occurs.  I  have  succeeded  in  restoring  an 
animal  completely  by  this  means,  after  it  had  been  apparently 
dead  for  four  hours.  When  given  internally,  curare  is  so  rapidly 
eliminated  that  it  usually  produces  no  symptoms.  When  given 
in  a  very  large  dose  on  an  empty  stomach,  symptoms  of  poison- 
ing may  occur.  If  elimination  be  prevented,  by  excision  of  the 
kidneys  or  ligature  of  the  renal  vessels,  poisoning  occurs,  and  in 
this  case  death  is  usually  preceded  by  convulsions.  So  rapidly 
does  elimination  occur,  that  the  urine  of  a  frog  poisoned  by  curare 
will  paralyse  a  second  frog  injected  subcutaneously,  and  the  urine 
of  the  second  will  even  paralyse  a  third. 

Uses.— It  has  been  employed,  but  without  much  benefit,  in 
epilepsy  and  chorea,  and  has  been  used  with  success  in  traumatic 
tetanus.  In  poisoning  by  strychnine  it  is  not  so  useful  as 
chloral.  A  case  of  hydrophobia  has  been  described  by  Offenburg 
in  which  the  subcutaneous  injection  of  curare,  to  such  an  extent 
as  to  keep  the  patient  almost,  though  not  quite,  paralysed  for 
some  time,  effected  a  cure.  If  this  were  really  so  it  would  be 
most  important,  but  from  a  comparison  of  the  symptoms  de- 
scribed by  Offenburg  with  those  of  three  fatal  cases  I  have  myself 
seen,  I  am  inclined  to  think  that  his  case  was  one  of  hysteria 
mimicking  hydrophobia. 

Gelsemium,  B.  and  U.S.P.  Gelsemium.  Yellow  Jasmine. 
The  dried  rhizome  and  rootlets  of  Gelsemium  nitidum  (G.  semper- 
virens) . 

Characters. — Nearly  cylindrical,  from  J  to  6  inches  or  more  in  length, 
and' commonly  from  £  to  f  inch  in  diameter,  with  small  rootlets  attached  to, 
or  mixed  with,  the  larger  pieces ;  light  yellowish-brown  externally,  and 
marked  longitudinally  by  dark  purplish  lines ;  fracture  splintery ;  bark  thin, 
presenting  silky  fibres  in  its  liber,  and  closely  attached  to  a  pale  yellow 
porous  woody  axis,  with  evident  medullary  rays,  and  with  or  without  pith. 
Odour  somewhat  narcotic  and  aromatic ;  taste  bitter. 

Composition. — It  contains  an  alkaloid,  gelsemine. 
Dose. — 5  to  30  grains. 

8  R 


973  VEGETABLE  MATEEIA  MEDICA.  [sect.  v. 

Pkepabations. 

n.P.  DOSE. 

Extractum  Gelsemll  Alcoboltcum |-2  gr. 

Tinctura  Celsemii  5-20  min. 

v.s.v. 

Extractum  Gelsemii  Fluidum 5-20  min. 

Tinctura  Gelsemii J-2|  fl.  dr. 

Action. — When  applied  to  the  eye  it  produces  dilatation  of 
the  pupil  and  paralysis  of  accommodation.  It  appears  to  para- 
lyse the  sensory  columns  of  the  spinal  cord,  while  it  excites  the 
motor  centres  both  in  the  brain  and  cord.  The  motor  centres 
themselves  become  paralysed  subsequently.  This  action  causes 
in  frogs  paralysis,  -which  is  at  first  accompanied  by  increased 
reflex  excitability,  so  that  irritation  gives  rise  to  tremor  or 
tetanus.  Afterwards  the  reflex  excitability  completely  disap- 
pears. In  mammals  a  peculiar  affection  of  the  head  is  noticed, 
consisting  in  spasmodic  attacks  of  tremor.  The  tremor  affects 
the  fore  feet  also  and  sometimes  the  hind  legs.  A  kind  of  ataxia 
is  also  observed  in  the  fore  lege,  which  sometimes  slip  about  and 
sometimes  make  abnormal  running  movements.  This  is  suc- 
ceeded by  paralysis  of  the  voluntary  muscles  and  of  respiration. 
The  vagus  is  paralysed,  the  blood-pressure  is  diminished,  the 
pulse  rapid,  and  the  heart  weak.  Death  occurs  from  paralysis 
of  the  respiration.  In  man  large  doses  have  caused  giddiness, 
double  vision,  numbness  of  the  fingers,,  tremor  of  the  head, 
difficult  respiration,  nausea,  vomiting,  and  partial  paralysis  of 
the  tongue  and  eyes,  so  that  ptosis  occurs,  and  difficulty  is  felt 
in  moving  the  eyes  or  tongue. 

Use. — It  is  chiefly  used  in  cases  of  neuralgia  of  the  fifth 
nerve,  in  toothache,  sick  headache,  and  in  rheumatism. 

U.S. P.  Spigelia.  Spigelia.  Pinkeoot.  Maeyland  Pink. 
Caeolina  Pink. — The  rhizome  and  rootlets  of  Spigelia  mary- 
landica. 

Characters. — Ehizome  two  inches  (5  centimetres)  or  mora  long,  about 
one-eighth  of  an  inch  (8  milhmetres)  thick,  horizontal,  bent,  somewhat 
branched,  on  the  upper  side  with  cup-shaped  scars ;  on  the  lower  side  with 
numerous,  thin,  brittle  rootlets  about  four  inches  (10  centimetres)  long ;  dark 
purplish  brown  ;  somewhat  aromatic,  sweetish  and  bitter. 

It  should  not  be  confounded  with  the  underground  portion  of  Phlox 
Carolina,  the  rootlets  of  which  are  brownish-yellow,  rather  coarse,  straight, 
and  contain  a  straw-coloured  wood  underneath  a  readily  removable  bark. 

Jt'RErAUATION. 

DOSE. 

Extractum  Spigeliffl  Fluidum 10  20  min. 

Use. — It  is  very  generally  used  as  an  anthelmintic,  and  is 
best  given  with  a  cathartic,  as  senna. 


chap,  xxxiv.]  COEOLLIFLOR^E.  973 


GENTIANACE/E. 

Gentianse  Radix,  B.P. ;  Gentiana,  U.S.P.  Gentian  Eoot, 
B.P. ;  Gentian,  U.S.P. — The  dried  root  of  Gentiana  lutea. 
Mountainous  districts  of  Central  and  South  Europe. 


FxG.  208. — Gentian,  half  the  natural  size. 

Characters. — From  half  an  inch  to  one  inch  in  thickness,  several  inches 
in  length,  often  twisted,  much  wrinkled,  or  marked  with  close  transverbe 
rings ;  brown  externally,  yellow  within ;  tough  and  spongy ;  taste  at  first 
sweetish,  afterwards  very  bitter. 

Composition. — Gentio-picrin,  from  which  the  root  derives  its 
bitter  taste;  it  is  soluble  in  water.  Also  gentianin,  which  is 
tasteless  and  only  slightly  soluble  in  water. 

Pbepabations. 

B.P.  DOSE. 

Extractum  Gentianse 2-10  gr. 

Xnfusum  Gentianse  Composltum 1-2   ll.  oz. 

Tinctura  Gentianse  Composlta i--l  11.  dr. 

U.S.P. 

Extractum  Gentianse 2-10  gr. 

„  „        Fluidum 8-30  min. 

Tinctura  „         Composita 1-4  fl.  dr. 

B.P.  Infusum  Gentianse  Composltum. — Eoot,  1  part;  bitter  orange  peel, 
1  part ;  fresh  lemon  peel',  2  parts ;  and  boiling  water,  80  parts. 

Tinctura  Gentianse  Composltum.  —  Eoot,  1|  oz. ;  bitter  orange  peel,  J  oz. ; 
cardamoms,  £  oz. ;  proof  spirit,  20  ft.  oz.,  B.P.  Gentian,  8  ;  bitter  orange  peel,  4 ; 
cardamom,  2 ;  diluted  alcohol  up  to  100,  U.S.P. 

Use. — Gentian  is  a  simple,  bitter  stomachic  tonic.  It  is 
used  in  atonic  dyspepsia,  to  give  tone  to  the  stomach  and  increase 
the  appetite.    Also  used  as  a  general  tonic. 

Chirata,  B.  and  U.S.P-  Chiebtta. — The  dried  plant  Ophe- 
lia Chirata ;  collected  when  the  fruit  begins  to  form.  Northern 
India. 

Characters. — Stems  about  three  feet  long,  of  the  thickness  of  a  goose- 
quill,  round,  smooth,  pale-brown,  branched ;  branches  opposite ;  flowers 
small,  numerous,  panicled ;  the  whole  plant  intensely  bitter. 

Composition. — Ophelic  acid,  soluble  in  water  and  forming  a 
soluble  compound  with  tannic  acid;,  and  chiratin,  soluble  in 
warm  water  and  forming  an  insoluble  compound  with  tannic  acid. 
Both  substances  are  intensely  bitter. 

3  3  2 


980 


VEGETABLE  MATEEIA  MEDICA.  [sect.  v. 

Pbepakations. 
B.P.  E0SE- 

Infusum  Chlr'atse  (1  in  40  of  water  at  120°  P.) 1-|  &■  °£ 

Tinetura  Cliiratae "5  * 

U.S.P.  . 

T^xtraotum  Chiratse  Fluidum )5-3"  ™in* 

Tinctura  <!hiratae j-.in.ai. 


Fio.  209—  Cliiretta,  half  the  natural  size. 


'Uses. — 'As  a  bitter  tonic  like  gentian.    It  has  been  supposed 
by  some  to  be  specially  useful  in  disorders  of  the  liver. 


-CONVOLVULACEiE. 

B.P.  Scammonise  Radix.     Soammont  Eoot.  —The  dried  root 
of  Convolvulus  Seammonia.     Syria  and  Asia  Minor. 

Characters. — Tap-shaped  roots,  often  twisted,  sometimes  three  inches 
in  diameter  at  the  top,  brown  without,  white  within,  slightly  odorous  but 
tasteless.  Ether  agitated  with  the  powder  and  evaporated  leaves  a  residue 
having  the  properties  of  scammony  resin. 

Composition. — Eesina  Scammonise  (q.v.). 

Pbepabations. 

B.P.  DOSE. 

Resina  Seammonia- .., 3_8  gr. 


tr.s.p. 
Eesina  Scammonii. 


.4-8  gr. 


chap,  xxxiv.]  COEOLLIFLOEiE.  981 

Scammonium,  B.  and  U.S.P.  Scammony. — A  gum-resinous 
exudation  obtained  by  incision  from  tbe  living  root  of  Convolvulus 
Scammonia,  hardened  in  the  air.  Chiefly  in  Asia  Minor.  B.P. 
A  resinous  exudation  from  the  root  of  Convolvulus  Scammonia, 
U.S.P. 

Characters. — Id  irregular,  angular  pieces  or  circular  cakes,  ash-grey  and 
rough  externally ;  fresh  fracture,  resinous,  splintery,  shining,  black  when  dry ; 
odour  and  flavour  cheesy ;  causes,  when  chewed,  a  slight  prickly  sensation 
in  the  back  of  the  throat ;  easily  triturated  into  a  dirty-grey  powder,  and 
converted  with  water  into  a  smooth  emulsion. 

Composition. — Gum  and  resin. 

Adulterations. — Chalk,  starch,  wood-ashes,  and  gum. 

Tests. — It  does  not  effervesce  with  hydrochloric  acid  (no  chalk).  Boiling 
water  agitated  with  the  powder,  cooled  and  filtered,  does  not  strike  a  blue 
colour  with  tincture  of  iodine  (no  starch).  Ether  removes  from  80  to  90  per 
cent,  of  resin  ;  and  what  remains  is  chiefly  soluble  gum,  with  a  little  mois- 
ture (no  wood  ashes). 

Preparations. 

B.P.  DOSE. 

IWIstura  Scammonil §-2  11.  oz. 

Eesina  Scammonlee 3-8  gr. 

U.S.P. 

Eesina  Scammonii 4-8  gr. 

B.P.  Mistura  Scammonii.  Scammony  Mixture. — Scammony  (3  gr.)  tritur- 
ated with  milk  (1  fl.  oz.). 

Scammoniae   Resina,   B.P.     Resina  Scammonii,.  U.S.P. 

Resin  of  Scammony. 

Characters. — In  brownish,  translucent  pieces  ;  brittle ;  resinous  in  frac- 
ture ;  of  a  sweet  fragrant  odour  if  prepared  from  the  root.  It  cannot  form 
singly  an  emulsion  with  water.     Ether  dissolves  it  entirely. 

Preparation. — Extracted  from  the  root  by  percolating  with  alcohol. 

Composition. — Principally  jalapin  soluble  in  ether,  in  this 
respect  differing  from  the  convolvulin  of  jalap.  The  resin  also 
contains  other  substances  the  properties  of  which  are  imperfectly 
known.     Contains  no  gum. 

Impurity. — Guaiacum  fraudulently  added. 

Test. — The  tincture  does  not  render  the  fresh  cut  surface  of  a  potato  blue. 

Preparations. 
B.P.  dose.. 

Confectlo  Scammonii 10-30  gr.  or  more. 

Extractum  Colocynthidis  Compositum 5-15  gr. 

Pilula  Colocynthidis  Composita  (vide  p.  522)  5-10  gr. 

„  „  et  Hyoseyami  (mde  p.  522) 5-10  gr. 

Pilula  Scammonii  Composita  (vide  p.  523) 5  gr. 

Pulvis  Scammonii  Composltus 10-20  gr. 

U.S.P. 

Extractum  Colocynthidis  Compositum 5-20  gr. 

B.P.  Confectlo  Scammonii.   Confection  of  Scammony.—  Eesin  of  scammony^ 


982  VEGETABLE   MATEEIA  MEDICA.  [sect.  V. 

3  oz. ;  ginger,  1|  oz. ;  oil  of  caraway,  1  fl.  dr. ;  oil  of  cloves,  £  fl.  dr. ;  Gyrup,  3  fl. 
oz. ;  clarified  honey,  1|  oz. 

B.P.  Pulvis  Scammonii  Compositus.     Compound  PoWDEB  or  bCAMMONY.— 
Seammony  resin,  4  ;  jalap,  3 ;  ginger,  1. 

Action  and  Uses. — It  increases  the  secretion  of  the  intestines 
and  acts  as  a  drastic  purgative.  It  is  used  as  a  derivative^  in 
dropsy  and  cerebral  affections.  It  is  also  used,  in  combination 
with  other  drugs,  as  a  vermifuge  for  tape-worm  in  children.  It 
combines  with  the  .sodium  in  the  bile,  and  its  solution  in  bile  is 
necessary  to  its  action  (Buchheim). 

Jalapa,  B.  and  U.S.  P.  Jalap. — The  dried  tubercles  of 
Ipomcea  Purga  {Exogonium  Purga),  B.P.  The  tuberous  root  of 
Exogonium  Purga,  U.S. P.     Mexico. 


Fig.  210.  —Jalap,  reduced  to  £  in  size. 

Characters. — Varying  from  the  size  of  a  nut  to  that  of  an  orange,  ovoid, 
the  larger  tubercles  frequently  incised,  covered  with  a  thin,  brown,  wrinkled 
cuticle ;  presenting,  when  cut,  a  yellowish-grey  colour,  with  dark  brown  oon- 
centric  circles. 

Preparations. 
B.P.  DOSE. 

Eitractum  Jalapae 5-15  gr. 

Pulvis  Jalapae  Compositus 20  60  gr. 

Pulvis  Scammonii  Compositus 10-20  gr. 

Resina  Jalapa; 2-5  gr. 

Tinctura  Jalapae i-2  fl.  dr. 

T/.S.P. 

Abstraetum  Jalapae 7-10  gr. 

Pulvis  Jalapse  Compositus 30-60  gr. 

Besina  Jalapa?  2-5  gr. 

Pilulffl  Catharticse  Composite  (vide  p.  523) 1-3  pills. 

Pulvis  Jalapae  Compositus.  Compound  Jaulp  Powdee. — B.P.  Jalap,  5;, 
acid  tartrate  of  potassium,  9  ;  ginger,  1  part.  TJ.S.P.  Jalap,  35 ;  acid  tartrate  of 
potassium,  65. 

Jalapae  Resina,  B.  and  U.S. P.  Besin  of  Jalap. — Ex- 
tracted from  jalap  by  rectified  spirit. 

Characters  and  Solubility. — In  dark-brown  opaque  fragments,  trans- 
lucent at  the  edges,  brittle,  breaking  with  a  resinous  fracture,  readily  reduced 
to  a  pale  brown  powder,  sweetish  in  odour,  acrid  in  the  throat,  easily  soluble 
in  rectified  spirit,  but  only  partially  so  in  ether,  and  insoluble  in  oil  of  tur- 
pentine. 

Preparation. — Digesting  and  gently  heating  the  jalap  with  rectified 
spirit,  precipitating  the  resin  with  water,  evaporating  by  a  water  bath,  and 
drying. 

Composition. — The  resin  consists  of  convolvulin  in  com- 
bination with  another  resinous  substance  (gammaresin),  which 


■chap,  xxxiv.]  C0E0LLIFL0EJ3.  983 

is  the  part  dissolved  by  ether.     The  convolvulin  of  jalap  differs 
from  the  jalapin  of  scammony  in  being  insoluble  in  ether. 

Pbepakation. 

B.P. 

Pilula  Soammonii  Composita  (vide  p.  623). 

Action  and  Uses. — Jalap  is  a  hydragogue  purgative,  used 
for  constipation,  dropsy  due  to  renal  disease,  and  cerebral  affec- 
tions. It  is  best  given  with  acid  tartrate  of  potassium,  as  in  Pulv. 
Jalapse  Co.  Like  scammony,  it  is  dissolved  by  the  bile,  and 
appears  to  require  it  in  order  to  act.  It  has  no  action  when 
injected  subcutaneously,  nor  when  injected  into  the  veins.  It 
has  no  irritant  action  when  locally  applied  to  the  skin  or  mucous 
membranes  of  the  'eye  or  nose,  nor  has  it  any  diuretic  action,  or 
any  action  on  the  nervous  system. 


SOLANACE^E. 

U.S.?.  Dulcamara.  Dulcamara.  Bitteeswebt. — The  driod 
young  branches  of  Solarium  Dulcamara.  From  indigenous  plants 
which  have  shed  their  leaves. 

Characters. — Light,  hollow,  cylindrical,  about  the  thickness  of  a  goose- 
quill  ;  bitter  and  subsequently  sweetish  to  the  taste. 


a  b 

Fia.  211. — Dulcamara,    a,  reduced  &.    b,  natural  thickness. 

Composition. — It  contains  solanine,  and  less  dulcamarine, 
both  alkaloids,  amorphous,  and  of  a  bitter  taste.  It  yields  also 
sugar. 

Peepabation. 

U.S.P.  DOSE. 

Extractum  Dulcamara  Fluidum 1  fl.  dr. 

Action. — The  action  of  dulcamarine.  has  not  been  investi- 
gated. 

Solanine,  both  in  warm  and  cold-blooded  animals,  paralyses 
the  central  nervous  system  without  affecting  the  peripheral 
nerves  or  voluntary  muscles.  It  slows  the  heart  and_  respira- 
tion, lessens  sensibility,  and  causes  death  with  convulsions.  In 
warm-blooded  animals  there  is  constant  fall  of  temperature, 
and  there  is  entire  absence  of  any  action  on  the  pupil.  _  In  man 
it  produces  weakness,  laboured  breathing,  nausea,  vomiting,  and 
drowsiness,  but  no  true  sleep.      The  pupil  is  unaffected   and 


984  VEGETABLE  MATEEIA  MEDICA.  -{sect.  v. 

there  is  no'  increased  movement  of  the  bowels,  diuresis,  or  dia- 
phoresis. 

Uses. — Dulcamara  is  chiefly  used  as  an  alterative  m  scaly 
skin  diseases,  in  which  it  is  often  combined  with  antimony.  It 
has  been  recommended  by  Husemann  in  chronic  bronchial 
catarrh,  asthma,  and  whooping  cough. 

Capsici  Fructus,  B.P. ;  Capsicum,  U.S.P.  Capsicum 
Fruit,  B.P. ;  Capsicum,  U.S.P. — The  dried  ripe  fruit  of  Capsicum 
fastigiatum.     Zanzibar. 

Characters.— Pod  membranous,  from  five  to  eight  lines  long,  two  lines 
broad,  straight,  conical,  pointed,  smooth,  shining,  but  somewhat  corrugated, 
orange-red ;  intensely  hot  in  taste. 

Composition.  —  An  exceedingly  acrid,  volatile  substance, 
capsaicin,  and  an  alkaloid  resembling  coniine  in  odour. 

Adulteration. — The  powder  is  occasionally  found  adulterated  with  red 
lead. 

Test. — Digest  in  nitric  acid  and  add  sulphate  of  sodium.  There  should 
be  no  precipitate  of  sulphate  of  lead.  It  should  burn  away  without  residue 
of  lead. 

Pbepabations. 
b.p.  DOSE. 

Tinctura  Capsici , 5-20  min. 

(as  a  gargle,  -J-2  fl.  dr.  in  5  oz.  of  fluid). 

U.S.P. 

Extractum  Capsici  Fluidum 2-10  min. 

Oleoresina  Capsici ^-1  min. 

Tinctura  Capsici 8  min.  to  2  fl.  dr. 

Emplastrum  Capsici 

Action  and  Uses. — Externally  capsicum  is  an  irritant,  pro- 
ducing warmth,  redness,  and  vesication.  Internally  it  is  an 
irritant,  and  in  large  doses  will  produce  gastro-enteritis. 

It  has  been  used  for  unbroken  chilblains,  neuralgia,  and 
rheumatic  pains.  The  Emplastrum  Capsici  of  the  U.S.P.  is  a 
useful  application  in  cases  of  myalgia  and  sciatica.  Internally 
it  may  be  used  as  a  gargle  for  tonsillitis,  pharyngitis,  and  re- 
laxed sore-throat.  It  is  used  as  a  condiment,  and  to  relieve 
flatulence*  It  is  also  recommended  to  relieve  the  sinking  in 
the  epigastrium  felt  by  dipsomaniacs.  It  promotes  appetite  and 
stimulates  tbe  stomach. 

Sdb-Okdee.— ATROPEjE. 

Belladonnae  Folia,  B.  and  U.S.P.  Belladonna  Leaves. 
The  leaves  of  Atropa  Belladonna,  U.S.P.  The  fresh  leaves,  with 
the  branches  to  which  they  are  attached,  of  the  deadly  night- 
shade, Atropa  Belladonna ;  also  the  leaves  separated  from  the 
branches  and  carefully  dried ;  gathered  from  wild  or  cultivated 
British  plants  when  the  fruit  has  begun  to  form,  B.P. 


chap,  xxxiv.]  COEOLLIFLOE.B.  985 

Characters. — Leaves  alternate,  three  to  six  inches  long,  ovate,  acute, 
entire,  smooth,  the  uppermost  in  pairs  and  unequal.  The  expressed  juice, 
or  an  infusion,  dropped  into  the  eye,  dilates  the  pupil. 

Composition. — Less  than  one  per  cent,  of  atropine,  and  a 
small  proportion  of  asparagin.  More  atropine  is  obtained  from 
the  leaves  of  mature  plants  than  from  those  gathered  before 
inflorescence. 

Preparations. 
B.P.  DOSE. 

Extractum  Belladonnse  (green) £-1  gr. 

Tinctura  „  (from  dried  leaves). 5-30  min. 

Succus  j,  (from  fresh  leaves) 5-15  min. 

u.s.p. 

Extractum  Belladonna  Alcoholicum J  gr. 

Tinctura  Belladonnas! 8-30  min. 

Unguentum         „         

Belladonnas  Radix,  B.  and  U.S.P.  Belladonna  Boot. 
The  dried  root  of  Atropa  Belladonna.    Britain  or  Germany. 

Characters. — From  one  to  two  feet  long,  and  from  half  an  inch  to  two 
.  inches  thick,  branched  and  wrinkled,  brownish-white.  An  infusion  dropped 
into  the  eye  dilates  the  pupil.  Roots  which  are  tough  and  woody,  breaking 
with  a  splintery  fracture,  should  be  rejected. 

Composition.— Two  alkaloids,  atropine  and  belladonnine, 
the  former  under  one  per  cent.  Also  a  red  colouring  matter, 
atrosin. 

Preparations. 
B.P«  DOSE. 

Atropina 2B0-25  8r- 

Xilnlmentum  Belladonnse  (1  oz.  to  1  £1.  oz.,  vide  p.  516) 

Extractum  Belladonna?  Alcoholicum ^-J  gr. 

Vnguentum  Belladonnse  j  from  aleoholje  extract 

Emplastrum  „  J 

U.S.P. 

Atropina ih-20  Sr- 

Abstractum  Belladonna i  er- 

Emplastrum  „  

Extractum  , 1-2  min. 

Linimentum  „  (vide  p.  517) 

Atropina,  B.  and  U.S.P.  Atbopinb.  C17H23N03;  289.— 
An  alkaloid  obtained  from  belladonna. 

Preparation.— It  pannot  be  profitably  prepared  on  a  small  scale.  The 
chief  parts  of  the  process  are  the  precipitation  of  acid  colouring  matters  from 
a  strong  tincture  by  means  of  lime,  removal  of  the  alcohol,  addition  of  water 
and  sarbonate  of  potassium,  taking  up  the  alkaloid  from  the  alkaline  solution 
by  chloroform,  and  subsequent  purification. 

Characters. — In  colourless,  acicular  crystals. 

Solubility,— Sparingly  soluble  in  water,  more  readily  in  alcohol  and  in 
ether. 

Reactions.— Its  solution  in  water  has  an  alkaline  reaction,  gives  a  citron- 
yellow  precipitate  with  terchloride  of  gold,  has  a  bitter  taste,  and  powerfully 
dilates  the  pupil.  It  leaves  no  ash  when  burned  with  free  access  of  air.  It 
is  an  active  poison. 


986  VEGETABLE  MATEEIA  MEDICA.  [sect.  v. 

The  following  test  has  heen  proposed  for  the  members  of  the  group  of 
mydriatic  alkaloids —atropine,  hyoscyamine,  daturine,  duboisine,  and  homa- 
tropine.  To  a  small  portion  of  atropine  in  a  test-tube  add  about  2  c.c.  of  a 
5  per  cent,  solution  of  mercuric  chloride  in  50  per  cent,  of  alcohol,  and  warm 
gently.  A  precipitate  will  at  once  appear,  and  become  brick-red  in  colour. 
This  test  does  not  answer  in  dilute  solutions,  neither  does  it  turn  out  well  if 
atropine  be  added  to  the  mercury.  Other  alkaloids  give  for  the  most  part  a 
white  precipitate  (Gerrard). 

Preparations. 
B.P.  DOSE. 

Atropinse  Sulpbas joff-iS  S1' 

Liquor  Atropinse  Sulphatis 4  gr.  in  1  fl.  oz f-6  min. 

TTnguentum  Atropinse  (with  rectified  spirit  §  fl.  dr.  and 
prepared  lard  1  oz.) 8  gr.  in  1  oz 

Atropinse  Sulphas,  B.  and  U.S. P.  Sulphate  of  Atro- 
pine. 

Preparation. — By  dissolving  atropine  in  dilute  sulphuric  acid  and  eva- 
.  porating. 

Characters. — A  colourless  powder. 

Solubility  and  Beactions. — Soluble  in  water,  forming  a  solution  which 
is  neutral  to  test  paper,  and  when  applied  to  the  eye  dilates  the  pupil  as  the 
solution  of  atropine  does.  It  leaves  no  ash  when  burned  with  free  access 
of  air. 

Uses. — Intended  for  external  application.  It  is  a  powerful 
poison. 

Preparation. 
B.P.  v.s.v. 

liquor  Atropinee  Sulphatis  (1  in  100  of  camphor  water).  None. 

Xiamellse  Atropinse  (j^j  gr.  in  each). 

General  Action  op  Belladonna  ob  Atropine.  —  The  first 
toxic  symptoms  to  appear  after  a  small  dose  are  dryness  of  the 
mouth  and  headache.  After  full  doses  the  pupils  become 
dilated,  a  red  rash  appears  on  the  skin  like  that  of  scarlatina, 
and  a  delirium  of  a  peculiar  and  often  of  a  pleasant  character 
ensues,  in  which  there  is  a  great  desire  for  movement  and  ac- 
tivity, with  a  feeling  of  great  lassitude  (p.  200).  The  pulse 
becomes  rapid.     This  is  generally  followed 'by  sleep. 

With  large  doses,  the  mouth  becomes  so  dry  that  swallowing 
is  almost  impossible,  and  the  attempt  to  swallow  may  bring  on 
general  convulsions  like  hydrophobia;  these  convulsions  are 
followed  by  paralysis,  stupor,  often  alternating  with  delirium, 
coma  and  death,  preceded  by  marked  failure  of  the  heart's  action 
and  of  respiration.     Death  is  due  to  asphyxia. 

Special  Action. — Locally  applied  it  diminishes  the  sensi- 
bility of  the  sensory  nerves  (whether  applied  as  liniment  or  in- 
jected subcutaneously).  It  can  be  absorbed  from  the  skin  and 
produce  its  general  symptoms. 

It  stimulates  the  centres  in  the  brain,  but  tends  to  paralyse 
the  ends  of  the  motor  nerves,  hence  causing  that  peculiar  form 
of  delirium  in  which  a  constant  desire  for  action  is  associated 


.chap,  xxxiv.]  COEOLLIFLORiE.  987 

with  lassitude.     The  spinal  cord  is  first  stimulated,  then  para- 
lysed. 

In  a  frog  the  primary  stimulation  quickly  passes  off,  and  there 
follows  gradually  increasing  weakness  both  of  respiratory  and 
voluntary  movements,  until  these  become  entirely  abolished. 
If  the  frog  be  kept  in  this  condition  for  four  or  five  days,  this 
state  of  absolute  paralysis  passes  off  and  is  succeeded  by  a  con- 
dition of  excitement  with  violent  tetanic  convulsions  which  may 
be  brought  on  by  the  slightest  afferent  stimulus.  Yarious  ex- 
planations of  this  action  have  been  given  (vide  p.  171). 

The  endings  of  motor  nerves  in  voluntary  muscles  are  para- 
lysed by  large  doses,  but  small  doses  will  paralyse  the  efferent 
nerve-endings  which  terminate  in  peripheral  ganglia  (e.g.  vagus), 
and  in  involuntary  muscle  (p.  139).  The  converse  is  the  case 
with  curare. 

Atropine  has  no  action  on  voluntary  muscles.  Involuntary 
muscle  is  paralysed  by  large  doses  (p.  139). 

On  the  Eye. — The  pupil  is  dilated  and  the  eye  becomes 
bright,  dry,  and  injected.  The  power  of  accommodation  is  para- 
lysed, and  by  large  doses  intraocular  tension  is  increased.  For 
the  mode  of  action,  vide  pp.  220-225. 

On  the  Circulation. — The  action  of  atropine  on  the  excised 
heart  of  the  frog  affords  an  illustration  of  the  statement  I  have 
made  (p.  45),  that  in  all  probability  contradictory  observations 
frequently  depend  on  differences  in  the  temperature  at  which 
the  observations  were  made.  Thus  Bowditch  .and  Luciani  found 
the  contractions,  both  of  the  frog's  heart  containing  ganglia  and 
of  the  apex  alone  (p.  308),  were  rendered  more  powerful  by 
atropine,  while  Gnauck,  on  the  contrary,  found  that  the  contrac- 
tions of  the  ventricle  were  diminished  both  by  atropine  and 
hyoscyamine.  Kroneeker  and  Schapiro  have  found  that  these 
contradictory  observations  are  both  correct,  but  at  different 
temperatures.  When  the  temperature  is  low  (7°  to  8°  C.)  the 
ventricular  contractions  are  enlarged  by  atropine,  but  diminished 
by  it  when  the  temperature  rises  over  15°  C.  Large  doses  of 
atropine  completely  paralyse  the  intracardiac  inhibitory  appa- 
ratus, while  at  the  same  time  they  stimulate  the  vagus  centres 
in  the  medulla. 

Atropine  is  supposed  to  act  upon  inhibitory  ganglia  in  the 
heart  itself,  not  upon  the  vagus  endings,  in  which  respect  it 
differs  from  nicotine  (vide  p.  314). 

Sometimes  there  is  a  primary  slowing  of  the  pulse  rate, 
followed  by  quickening ;  but  it  is  uncertain  whether  this  is  due 
to  stimulation  of  the  vagus  centre,  or  of  the  inhibitory  apparatus 
in  the  heart. 

Small  doses  raise  the  blood-pressure  by  stimulating  the  vaso- 
motor centre  in  the  medulla,  but  lai;ge  doses  diminish  it  by 
paralysing  the  vaso-motor  centre  and  partly  by  paralysing  the 


988  VEGETABLE  MATEEIA  MEDICA.  [sect.  v. 

peripheral  vasomotor  ganglia  or  muscular  fibres  of  the  walls  of 
the  arteries  themselves  (p.  282).  Atropine  also  diminishes  the 
sensibility  of  the  heart  to  changes  of  pressure  within  it  (p.  299). 

On  Respiration. — Atropine  first  quickens,  and  then  slows 
respiration.  This  is  due  to  stimulation  and  subsequent  paralysis 
of  the  respiratory  centre  in  the  medulla.  When  injected  into 
the  jugular  vein  it  appears  to  paralyse  the  ends  of  the  sensory 
fibres  of  the  vagus  in  the  lungs,  and  thus  tends  to  slow  respira- 
tion at  first  (p.  245).  It  arrests  secretion  from  the  bronchial 
mucous  membrane  (p.  250). 

On  Secretion. — Atropine  paralyses  the  secreting  fibres  of 
the  chorda  tympani  without  affecting  the  vaso-dilator  fibres,  so 
that  when  the  chorda  tympani  is  stimulated,  either  directly  or 
reflexly,  the  flow  of  blood  to  the  gland  is  increased,  but  no  fluid 
exudes  from  the  duct  (p.  361). 

It  probably  has  a  similar  action  on  many,  if  not  all,  glands, 
including  the  sweat-glands,  milk-glands,  mucous  glands,  pan- 
creas, and  liver.  When  locally  applied  it  stops  the  secretion  of 
milk  and  sweat.  In  the  case  of  the  sweat  it  probably  paralyses 
the  efferent  sweat-fibres  which  accompany  the  vaso-motor  fibres 
and  start  from  centres  in  the  lumbar  and  lower  dorsal  parts  of 
the  cord  (Luchsinger).  It  does  not,  however,  prevent  secretion 
in  the  intestine  after  division  of  the  intestinal  nerves  (Brunton 
and  Pye- Smith). 

The  secretion  of  urine  is  sometimes  increased,  but  large  doses 
may  cause  retention  from  paralysis  of  the  bladder. 

On  the  Intestines. — Small  doses  increase  the  movements 
of  the  intestines.  This  action  is  probably  due  to  paralysis  of  the 
inhibitory  fibres  of  the  splanchnic,  since  stimulation  of  the  peri- 
pheral end  of  the  cut  splanchnic  will  cause  arrest  of  movement 
in  the  unpoisoned,  but  not  in  the  poisoned,  animal.  Moderate 
doses  completely  arrest  peristaltic  movements,  but  the  muscular 
fibres  of  the  intestine  retain  their  irritability.  Local  irritation 
causes  a  local  contraction  but  no  peristalsis.  This  is  probably 
due  to  paralysis  of  the  intestinal  ganglia. 

Large  doses  stop  the  movements  and  paralyse  the  involun- 
tary muscular  fibres  of  the  intestine,  so  that  they  only  contract 
feebly,  or  not  at  all,  when  directly  irritated. 

The  Temperature  is  increased  by  small  doses,  lessened  by 
large  ones. 

Certain  animals,  especially  pigeons  and  rodents,  such  as 
rabbits,  guinea-pigs,  and  rats,  are  peculiarly  insusceptible  to  the 
action  of  atropine.  It  is  not  improbable  that  the  insuscepti- 
bility of  rodents  to  the  action  of  atropine  depends  on  the  very 
slight  tonic  action  which  the  vagus  exerts  on  the  heart  in  them 
in  theirnormal  condition.  When  it  is  paralysed  there  is  little 
change  in  the  circulation,  while  in  dogs  the  case  is  very  different 
(p.  287).  '  J 


.chap,  xxxiv.]  COKOLLIFLORJE.       ,  989 

Methyl-  and  ethyl-atropine  paralyse  the  ends  of  the  motor 
nerves,  but  do  not  tetanise ;  they,  however,  retain  the  action  of 
atropine  on  the  eye,  heart,  &c. 

Uses. — Locally  applied,  belladonna  lessens  irritability  and 
pain,  and  is  hence  used  as  a  lotion  in  photophobia. 

Solution  of  atropine  is  employed  to  dilate  the  pupil  and  para- 
lyse accommodation  in  many  conditions  which  have  already  been 
mentioned  (p.  225).  Migrainous  attacks  frequently  depend 
upon  astigmatism,  hypermetropia,  or  other  visual  disturbances, 
and  an  attack  may  sometimes  be  cut  short  by  the  local  applica- 
tion of  atropine  to  the  eye. 

In  the  form  of  a  plaster  or  liniment  over  the  tender  spots,  it 
is  useful  in  myalgia,  neuralgia— especially  supraorbital  and  inter- 
costal neuralgia — pleurodynia,  hypersensitiveness  of  skin,  and 
irritability  of  the  chest  muscles  seen  in  phthisical  patients.  The 
-pain  arising  from  old  adhesions  due  to  pleurisy  is  relieved  by  a 
belladonna  plaster. 

In  the  form  of  ointment  it  lessens  pain  and  spasm  in  fissure 
,of  the  anus  and  the  pain  and  itching  of  haemorrhoids. 

It  is  useful  in  checking  local  sweating  on  the  head,  hands,  or 
feet,  in  the  form  of  the  liniment  two  or  three  times  a  day. 

Atropine  is  used  internally  to  check  the  sweating  of  phthisis 
and  other  exhausting  diseases,  in  doses  of  -j-J-g  gr.,  gradually  in- 
creased. It  may  be  given  in  pill,  or  mixture,  or  hypodermically. 
The  beneficial  effect  may  here  be  due  to  paralysis  of  nerves  of 
sweat-glands,  but  is  probably  due  also  to  the  stimulating  effect 
on  the  respiratory  centre  (p.  443). 

Belladonna  stops  the  secretion  of  milk,  and  is  hence  used 
locally,  in  plaster  or  with  glycerine  (1  in  4),  when  the  mother 
from  any  cause  is  unable  to  suckle  her  child,  and  the  breast 
becomes  swollen  and  inflamed. 

In  leucorrhcea  with  ulceration  of  the  os  uteri,  a  pessary  made 
up  of  2  gr.  of  ext.  belladonna,  with  7  gr.  of  tannin,  and  cacao 
butter  q.s.,  is  very  useful  (Trousseau). 

Given  internally  atropine  is  useful  in  extreme  salivation,  as 
in  mercurial  ptyalism.  In  chronic  constipation,  relief  is  often 
afforded  by  small  doses  of  £-gr.  of  the  extract  of  belladonna  ;  in 
children  the  tincture  in  a  proportionate  dose  is  more  suitable 
than  the  extract.  Its  action  here  may  be  due  to  diversion  of  a 
stimulus  from  the  inhibitory  to  the  motor  fibres  of  the  splanch- 
nic, or  to  paralysis  of  the  inhibitory  fibres  of  the  splanchnics 
(p.  386).  It  lessens  griping,  hence  it  is  a  useful  adjunct  to  pur- 
gatives. It  is  useful  in  cases  of  spasm  of  involuntary  muscles, 
as  in  lead  colic,  simple  colic,  asthma,  and  in  the  spasm  set  up  by 
renal  and  biliary  calculi  (cf.  p.  171). 

Internally  it  is  useful  in  palpitation  due  to  cardiac  strain 
(p.  299),  and  sometimes  gives  relief  in  angina  pectoris.  One  of 
the  most  useful  applications  in  all  cases  of  palpitation,  whether 


990  VEGETABLE  MATEEIA  MEDICA.  [sect.  V. 

accompanied  by  pain  or  not,  is  a  belladonna  plaster  to  the  car- 
diac region.  As  atropine,  while  it  appears  to  lessen  the  ex- 
citability of  the  ends  of  the  vagus  in  the  lung,_  excites  the 
respiratory  centre,  its  action  in  preventing  cough  is  slight  and 
uncertain.  As  it  has  the  power  of  completely  arresting  secretion 
from  the  bronchial  tubes  it  is  useful  in  cases  where  there  is  ex- 
cessive secretion,  but  where  the  bronchial  mucous  membrane  is 
already  too  dry,  it  is  injurious  (p.  250).  In  incontinence  of 
urine  in  children  belladonna  is  a  most  useful  remedy.  It 
probably  acts  by  lessening  the  irritability  of  the  bladder.  It  is 
also  very  serviceable  in  irritability  of  the  bladder  with  frequent 
micturition  in  adults  (p.  445). 

In  epilepsy  and  chorea  it  is  not  of  much  use,  but  in  frontal 
headaches  it  is  useful  in  doses  of  3  min.  of  tincture  every  three 
hours. 

Atropine  has  been  given  internally  for  urticaria;  it  some- 
times produces  striking,  though  temporary,  effects  in  hyperi- 
drosis. 

As  an  antidote  to  opium,  4  min.  of  liquor  atropinse,  B.P., 
may  be  injected  subcutaneously,  and  repeated  every  quarter  of 
an  hour  until  the  pupil  dilates. 

It  has  also  been  used  in  poisoning  by  Calabar-bean,  and  has 
been  found  useful  in  chloroform-poisoning,  when  death  is  im- 
pending from  stoppage  of  the  heart.  Doses  sufficiently  large  to 
paralyse  the  inhibitory  apparatus  must  be  used. 

Hyoscyami  Folia,  B.P. ;  Hyoscyamus,  U.S.P-  Hyoscyamus 
Leaves,  B.P. ;  Hyoscyamus,  U.S.P. — The  fresh  leaves,  with  the 
branches  to  which  they  are  attached,  of  Hyoscyamus  niger,  also 
the  leaves  separated  from  the  branches  and  carefully  dried,  col- 
lected from  plants  of  the  second  year's  growth. 

Characters. — Leaves  sinuated,  clammy,  and  hairy.  The  fresh  herb  has 
a  strong,  unpleasant  odour,  and  a  slightly  acrid  taste,  which  nearly  disappear 
on  drying.    The  fresh  juice,  dropped  into  the  eye,  dilates  the  pupil. 

Composition.  —  A  volatile  alkaloid,  hyoscyamine,  soluble 
in  water  and  spirit.  It  is  decomposed,  and  its  physiological 
action  neutralised  by  caustic  alkalis.  It  is  isomeric  with,  but 
not  identical  with,  atropine.  Nitrate  of  potassium  and  other 
inorganic  salts  are  present  in  the  leaves. 

Pkepaeations. 

B.P.  DOSE. 

Extractum  Hyoscyami 5-10  gr.  or  more. 

Succus  „  30  min.  to  1  fl.  dr.  or  more. 

Tinctura  „  30  min.  to  1  fl.  dr. 

TT.S.P. 

Abstractum  Hyoscyami. 3-5  gr. 

Extractum  „         Alcoholicum...2  gr. 

„  „        Fluidum 5-10  min. 

Tinctura  „         1  fl.  dr. 


ohaf.  xxxiv.]  COKOLLIFLOR/E,  991 

U.S.P.  Hyoscyaminae  Sulphas.  Sulphate  of  Hyoscyaminb, 
(C17H23N03)2.H2S04 ;  676.— The  neutral  sulphate  of  an  alkaloid 
prepared  from  hyoscyamus. 

It  is  found  also  in  the  seeds  of  Belladonna  Stramonium,  and 
in  Duboisia  myoporoides,  the  alkaloid  of  which  ■  (duboisine)  is 
identical  with  hyoscyamine.  Hyoscyamine  is  isomeric  with 
atropine. 

Characters. — Small  golden-yellow,  or  yellowish-white  scales  or  crystals,. 
or  a  yellowish-white,  amorphous  powder,  deliquescent  on  exposure  to  air, 
odourless,  having  a  bitter  and  acrid  taste  and  a  neutral  reaction. 

Solubility. — Very  soluble  in  water  and  in  alcohol. 

Reactions. — When  heated  on  platinum  foil,  the  salt  chars  and  is  finally 
completely  dissipated.  An  aqueous  solution  of  the  salt  is  not  precipitated  by 
test-solution  of  platinic  chloride.  With  chloride  of  gold  it  yields  a  precipi- 
tate, which,  when  recrystallised  from  boiling  water  acidulated  with  hydro- 
chloric acid,  is  deposited  on  cooling  (without  rendering  the  liquid  turbid)  in 
brilliant,  lustrous,  golden -yellow  scales  (difference  from  atropine).  The 
aqueous  solution  yields,  with  test-solution  of  chloride  of  barium,  a  white  pre- 
cipitate insoluble  in  hydrochloric  acid. 

Dose.—  -gV  gr.  to  1  gr.  _ 

Action  and  Uses. — The  physiological  action  of  hyoscyamine 
is  like  that  of  atropine  and  daturine.  Hyoscyamus  is  used 
chiefly  as  an  adjunct  to  purgatives  to  lessen  griping.  It  is  also 
used  to  lessen  spasm,  and  to  allay  pain  and  irritation  of  the 
bladder.  It  has  also  been  employed  as  a  sedative  to  the  nervous 
system. 

U.S.P.  Stramonii  Folia.  Stramonium  Leaves. — The  dried 
leaves  of  Datura  Stramonium.     Thorn  Apple. 

Characters. — Large,  ovate,  sinuous,  deeply  cut ;  of  a  heavy  odour,  which 
is  strongest  while  they  are  drying,  and  of  a  mawkish,  faintly  bitter,  nauseous 
taste. 

Composition. — A  very  small  proportion  of  daturine.  The 
other  constituents  are  chiefly  saline  and  mineral  matters. 

Stramonii  Semina,  B.P. ;  Stramonii  Semen,  U.S.P. 
Stbamonium  Seeds,  B.P. ;  Stramonium  Seed,  U.S.P. — The  dried 
ripe  seeds  of  Datura  Stramonium. 

§  S  ft  ft 

Fig.  212.— Stramonium  seeds. 

Characters.— Brownish-black,  reniform,  flat,  rough;  inodorous  unless 
bruised,  when  they  emit  a  peculiar,  heavy  smell. 

Composition.— Contains  an  alkaloid,  daturine,  identical  with 
atropine,  and  also  some  hyoscyamine. 

Pbepakaiions. 
B.P.  D0SE- 

Extractum  Stramonii i-s  8r- 

liuctura  .,  10-d0  mm- 


092  VEGETABLE  MATEEIA  MEDICA.  tsECT.  V: 

U.S.P.  B0SE- 

Extraotum  Stramonii 2-gr- 

„        Fluidum lmm. 

Tinctura  , 10-3°  min- 

TJnguentum        „  

Action  and  Use. — The  impure  alkaloid  daturine,  consisting 
of  atropine  and  hyoscyamine,  has  exactly  the  same  physiological 
action  as  atropine,  though  less  powerful. 

The  chief  use  of  stramonium  is  as  an  antispasmodic  in  cases 
of  asthma.  It  is  often  employed  in  the  form  of  cigarettes  during 
the  attack,  or  the  fumes  of  the  ignited  powder  are  inhaled.  A 
mixture  of  potassii  nitras,  potassii  chloras,  stramonium,  and 
ipecacuanha  has  been  employed  with  good  effect  in  asthma  by 
inhaling  the  fumes  of  the  ignited  mixture.  The  leaves  of  Da- 
tura Tabula,  have  been  substituted  for  Datura  Stramonium. 

Tabaci  Folia,  B.P. ;  Tabacum,  U.S.P.  Leaf  Tobacco, 
B.P. ;  Tobacco,  U.S.P. — The  dried  leaves  of  Virginian  Tobacco,' 
Nicotiana  Tabacum.     Cultivated  in  America. 

Characters. — Large,  mottled-brown,  ovate  or  lanceolate,  acuminate 
leaves,  up  to  twenty  inches  (50  centimetres)  long,  bearing  numerous  short, 
glandular  hairs  ;  having  a  peculiar,  heavy  odour  and  nauseous  bitter,  acrid 
taste ;  yielding,  when  distilled  with  solution  of  potash,  an  alkaline  fluid, 
which  has  the  peculiar  odour  of  nicotine,  and  precipitates  with  perchloride  of 
platinum  and  tincture  of  galls.    Not  manufactured. 

Composition. — A  volatile  liquid  alkaloid,  nicotine,  is  con- 
tained in  tobacco  as  a  malate,  and  is  obtained  by  distillation 
with  an  alkali.  The  leaves  contain  also  nicotianin,  or  tobacco- 
camphor,  which  crystallises  out  from  an  aqueous  distillate. 
Resin,  gum,  and  several  inorganic  compounds  are  also  present. 

General  Action. — Tobacco  stimulates  and  then  paralyses  the 
motor  nerves  of  involuntary  muscles  and  the  secreting  nerves 
of  glands.  In  consequence  of  .this  action  on  the  gastro- 
intestinal tract,  there  is  in  poisoning  by  tobacco  nausea  and 
vomiting,  with  intense  prostration  and  wretchedness.  In  con- 
sequence of  the  action  of  the  drug  on  the  heart  and  vaso-motor 
system,  there  is  paleness  of  the  face,  cold  sweats,  feebleness  of 
circulation,  and  tendency  to  faint.  The  action  of  tobacco  is  the 
same  as  that  of  its  alkaloid,  nicotine,  though  less  powerful.  In 
frogs,  nicotine,  after  a  period  of  temporary  excitement,  causes 
a  tetanic  condition  in  a  peculiar  attitude,  the  head  being  drawn 
down,  the  fore  legs  back,  and  the  hind  legs  forward ;  there  may 
be  convulsions.  This  is  followed  by  muscular  relaxation.  In 
warm-blooded  animals  there  is  excitement,  difficulty  of  breath- 
ing, followed  by  trembling,  with  expulsion  of  urine  and  faeces,, 
stupor,  staggering  gait,  convulsions,  and  death.  When  the  dose 
is  very  large,  the  animal  may  fall  with  a  loud  cry  and  the  con- 
vulsions begin  at  once,  deepening  into  muscular  paralysis  ;  and 
death  ensues  from  failure  of  respiration,  the  heart  continuing  to 
beat  after  respiration  ceases. 

Special  Action. — The  spinal  cord  is  first  stimulated  (n.  18"H. 


chap,  xxxiv.]  COKOLLIFLOR^E.  993 

giving  rise  to  convulsions,  and  is  afterwards  paralysed.  The 
convulsions  are  of  spinal  origin  in  the  frog,  as  is  shown  by  such 
experiments  as  have  been  already  mentioned  (p.  180),  but  those 
which  occur  before  death  in  mammals  are  probably  asphyxial. 

Circulation. — Nicotine  causes  a  great  diminution  of  pulse- 
rate  and  a  fall,  followed  by  a  rise,  of  blood-pressure,  the  pulse- 
rate  still  remaining  slow  ;  but  if  a  large  dose  be  given,  the  pulse- 
rate  rises  very  quietly.  The  drug  first  'Stimulates  both  the 
vagus  roots  and  its  ends  in  the  heart  (causing  slow  pulse- rate), 
and  then  paralyses  the  latter  (causing  high  pulse-rate).  It  does 
not,  however,  paralyse  the  inhibitory  ganglia  of  the  heart,  like 
atropine,  since  stimulation  of  the  sinus  will  slow  the  heart  in 
frogs  after  nicotine-poisoning.  The  primary  fall  of  blood- 
pressure  is  due  to  the  slowing  of  the  heart,  and  the  subsequent 
rise  to  contraction  of  the  peripheral  vessels. 

Alimentary  canal. — Nicotine  stimulates  peristalsis  markedly 
(p.  383). 

The  methyl  and  ethyl  derivatives  of  nicotine  have  no  teta- 
nising  influence  on  the  cord,  neither,  curiously  enough,  do  they 
paralyse  the  ends  of  the  motor  nerves. 

Uses. — Tobacco  is  used  as  an  enema  in  supposed  intussus- 
ception, and  was  formerly  used  in  the  reduction  of  strangulated 
hernia,  but  as  death  has  occurred  from  this  treatment  it  must 
be  employed  with  care. 

Owing  to  its  influence  on  the  cord,  nicotine  has  been  used  in 
tetanus  and  strychnine-poisoning,  but  is  not  of  much  use. 

Tobacco-smoking. — The  effects  produced  on  the  system  by 
tobacco-smoking  may  be  partly  due  to  nicotine,  but  are  probably 
rather  due  to  products  of  its  decomposition  such  as  pyridine  and 
collidine.  In  pipe-smoking  pyridine  (p.  810)  preponderates,  but 
when  tobacco  is  smoked  in  cigars,  where  there  is  free  access  of 
air,  the  chief  product  of  the  dry  distillation  undergone  by  the 
tobacco  is  collidine,  which  is  far  less  active  than  pyridine  (Vohl 
and  Eulenburg,  vide  p.  812). 

In  those  accustomed  to  smoke  tobacco,  it  has  a  soothing 
effect  on  the  nervous  system,  but  it  often  acts  as  a  nervous 
stimulant  to  mental  work,  as  in  reading.  In  these  cases  the 
effect  is  probably  not  due  to  the  nicotine  itself,  but  to  the 
stimulus  of  the  smoke  on  the  sensory  nerves  of  the  mouth,  which 
reflexly  stimulates  the  vaso-motor  centre,  and  dilates  the  vessels 
of  the  brain ;  since  some  people  produce  the  same  effect  by 
sucking  sweets,  or  sipping  whisky  and  water  (p.  193). 

There  is  no  doubt  that  smoking  in  excess  is  injurious.  It 
produces  a  furred  tongue,  irritation  of  the  throat,  hoarseness, 
often  dyspepsia  and  irritability  of  the  heart,  with  a  character- 
istic rhythm  and  palpitation  (smoker's  heart).  This  effect  on  the 
heart  is  like  that  produced  by  partial  paralysis  of  the  vagus,  and 
disappears  when  the  habit  is  given  up  for  a  time. 

3  s 


994  VEGETABLE   MATEEIA   MEDICA.  [sect.  v. 

Sudden  faintness  is  also  apt  to  occur,  so  that  a  previously 
strong  and  healthy  man  will  suddenly  fall  down  in  a  state  of 
syncope  without  apparent  cause,  or  the  faint  may  be  brought  on 
by  some  mental  emotion. 

The  sight  is  impaired  by  habitual  excess  in  tobacco-smoking 
(p.  228).     •  " 

Tobacco-smoking  is  often  very  useful  in  asthma,  and  a  pipe 
after  breakfast  will  often  relieve  constipation. 

Tobacco-snuff  is  used  as  an  errhine. 

SCROPHULARIACEiE. 

Digitalis  Folia,  B.P. ;  Digitalis,  U.S. P.  Digitalis  Leaf, 
B.P. ;  Digitalis,  Foxglove,  U.S.P. — The  dried  leaf  of  Digitalis 
pwrpwrea,  purple  foxglove.  Collected  from  wild  indigenous  plants, 
when  about  two-thirds  of  the  flowers  are  expanded,  B.P.  The 
leaves  of  Digitalis,  U.S.P. 

Characters. — Ovate -lanceolate,  shortly  petiolate,  rugose,  downy,  paler  on 
the  under  surface,  crenate. 

Composition. — Contains  a  number  of  active  principles  for- 
merly included  under  the  name  of  digitalin  (vide  p.  995). 

Preparations. 

B.P.  DOSE. 

Infusum  Digitalis  (3  gr.  to  1  fl.  oz.)... 2-4  fl.  dr.  or  more. 

Tlnctura  „         (54£  gr.  to  1  fl.  oz.) 5-30  min. 

U.S.P. 

Abstracted  Digitalis i-1  gr. 

Extractum         „        i~i  S1- 

„  „        Fluidum 1-2  min. 

Infusum  „       1-2  fl.  dr. 

Tinctura  5-10  min. 

Infusum  Digitalis.  Infusion  of  Digitalis. — Digitalis  leaves,  dried,  30  gr. ; 
boiling  distilled  water,  10  fl.  oz.  Infuse  in  a  covered  vessel,  for  one  hour,  and 
strain,  B.P.  Digitalis  in  No.  20  powder,  3 ;  cinnamon  in  No.  20  powder,  3  ;  boiling 
water,  185  ;  alcohol,  15 ;  water,  q.s.  Pour  the  boiling  water  on  the  mixed  powders 
and  macerate  for  two  hours  in  a  covered  vessel.  Then  strain,  add  the  alcohol  and 
pass  enough  water  through  the  strainer  to  make  the  infusion  weigh  200  parts,  U.S.P. 

Digitalinum.    Digitalin.    Not  officinal. 

Preparation. — Dissolving  out  digitalin  from  an  alcoholic  extract  of  the 
leaves  by  acetic  acid  and  water,  decolorising  by  animal  charcoal.  Neutra- 
lising by  ammonia  and  precipitating  the  digitalin  by  tannic  acid.  Eubbing 
with  oxide  of  lead  and  spirit,  to  remove  the  tannic  acid.  Dissolving  out  the 
digitalin  with  spirit,  again  decolorising  by  animal  charcoal,  evaporating,  and 
purifying  by  washing  with  ether. 

Characters. — In  porous,  mammillated  masses  or  small  scales,  white, 
inodorous,  and  intensely  bitter. 

Solubility. — It  is  readily  soluble  in  spirit,  but  almost  insoluble  in  water 
and  in  pure  ether  ;  dissolves  in  acids,  but  does  not  form  with  them  neutral 
compounds. 

Eeactions. — Its  solution  in  hydrochloric  acid  is  of  a  faint  yellow  colour, 
but  rapidly  becomes  green.  It  leaves  no  residue  when  burned  with  free 
access  of  air.    It  powerfully  irritates  the  nostrils,  and  is  an  active  poison. 


chap,  xxxiv.]  COROLLIFLOKjE.  995 

Dose.  —  - gWij  of  a  grain. 

Chemistry  of  Digitalis. — Formerly  the  active  principle  of 
digitalis  was  said  to  be  digitalin,  but  the  substances  prepared 
and  sold  by  different  manufacturers  under  this  name  varied 
much  in  their  solubility  and  in  the  intensity  of  their  physiological 
action.  The  most  important  varieties  were  Homolle's  amorphous 
digitaline,  Nativelle's  crystallised  digitaline,  and  soluble  or 
German  digitalin. 

An  examination  of  the  chemistry  of  digitalis  by  Schmiedeberg 
has  shown  that  there  are  at  least  five  principles  present  in 
it,  and  possibly  there  are  present  also  some  products  of  their 
decomposition.  They  are  all  non-nitrogenous  and,  with  the  ex- 
ception of  one,  digitoxin,  are  glucosides.  They  are  :  digitoxin, 
digitalin,  digitalein,  digitonin,  and  digitin.  The  first  three  of 
these  are  cardiac  poisons.  Digitonin  has  an  action  like  that  of 
saponin,  and  digitin  appears  to  be  inert. 

Digitoxin  is  quite  insoluble  in  water,  and  forms  the  chief  con- 
stituent in  Nativelle's  digitaline.  By  boiling  with  dilute  acids 
digitoxin  yields  toxiresin  and  digitalin  yields  digitaliresin. 

Digitalin  is  also  insoluble  in  water  and  is  the  active  principle 
of  Homolle's  digitaline.  Digitalein  differs  from  the  two  former  in 
being  readily  soluble  in  water,  and  forms  a  large  proportion  of 
the  soluble  digitalin. 

The  digitalin  of  the  B.P.  1867,  being  almost  insoluble  in 
water,  probably  consisted  chiefly  of  digitoxin  or  digitalin. 

General  Action. — In  large  doses  digitalis  causes  sickness, 
vomiting,  muscular  weakness,  diuresis,  subjective  affections  of 
vision,  laboured  respiration,  and  death ;  the  heart  usually  failing 
before  the  respiration.  The  condition  of  the  heart  after  death 
varies.  Sometimes  I  have  found  it  in  diastole  and  sometimes  in 
systole  in  dogs  poisoned  by  digitalis. 

Special  Action. — On  the  muscles.  In  a  number  of  un- 
published experiments  on  this  subject  made  in  1867-68  in  the 
laboratories  of  Professors  Briicke  and  J.  Bosenthal,  I  found  that 
soluble  digitalin  did  not  lessen  the  excitability  of  the  unweighted 
muscle  but  diminished  its  power  to  lift  a  weight.  According  to 
Schmiedeberg  and  Koppe  digitalis  paralyses  all  voluntary  muscles. 
Digitalin  causes  elongation  of  the  muscle  with  increased  elasticity 
in  the  frog. 

On  the  nervous  system.  It  has  no  marked  action  on  sensory 
or  motor  nerves.  It  has  little  action  on  the  spinal  cord.  It  has 
been  stated  to  lessen  reflex  action  in  the  frog  by  stimulation  of 
Setchenow's  centre,  but  this  may  be  due  to  reflex  irritation  from 
the  point  of  injection  (p.  171).  The  brain  is  unaffected,  and  in 
cases  of  poisoning  remains  clear  to  the  last.  (Two  of  the  pro- 
ducts of  the  decomposition  of  digitalin,  toxiresin  and  digitaliresin, 
however,  produce  convulsions  like  those  of  picrotoxin.)  Large 
doses  cause  subjective  affections  of  vision,  consisting  in  dimness, 

3  s  2 


996  VEGETABLE   MATEEIA   MEDICA.  [sect.  v. 

occasional  flashes  of  light,  or  in  the  constant  appearance  of  a 
rainbow  or  bright  light  before  the  eyes.  Locally  applied  to  the 
eye  it  produces  irritation  at  first,  and  afterwards  causes  a  halo 
to  surround  bright  objects. 

The  respiration  is  generally  somewhat  slowed,  and  occa- 
sionally before  death  may  become  excessively  slow. 

The  effects  produced  on  the  circulation  by  the  active  principles 
of  digitalis  and  by  substances  having  a  similar  action,  such  as 
oieandrin,  scillain,  adbnidin,  neriin,  convalamarin,  antiarin,  and 
helleborein,  may  be  divided  according  to  Schmiedeberg  into  four 
stages : — 

1.  Eise  of  blood-pressure,  usually  though  not  invariably 
accompanied  by  slowing  of  the  pulse. 

2.  Continued  rise  of  blood-pres3ure,  with  a  quick  pulse. 

3.  Continued  high  pressure,  with  irregularity  of  the  heart's 
action  and  pulse-rate. 

4.  Eapid  fall  of  the  blood-pressure,  sudden  stoppage  of  the 
heart,  and  death. 

The  rise  in  blood-pressure  is  regarded  by  Schmiedeberg, 
Boehm,  and  others  as  entirely  due  to  increased  action  of  the 
heart  and  not  at  all  to  contraction  of  the  vessels.  With  this 
view  I  cannot  agree,  and  I  still  hold  to  the  opinion  which  I  ex- 
pressed many  years  ago  that  the  rise  in  pressure  is  due  in  great 
measure  to  contraction  of  the  arterioles.  Not  only  is  it  more 
difficult  to  raise  the  pressure  in  the  arterial  system  by  alterations 
in  the  heart's  action  than  by  contraction  of  the  arterioles,  as  we 
find  from  experiments  on  a  schema  (p.  266),  but  the  form  of  the 
pulse-curve  under  the  action  of  digitalis  conclusively  demon- 
strates that  the  arterioles  are  contracted  (vide  p.  276).  This  has 
also  been  demonstrated  by  Donaldson  and  Stevens,1  who  found 
that  the  addition  of  digitalis  to  blood  lessens  the  flow  through 
vessels  in  which  circulation  was  artificially  maintained.  A 
similar  result  has  been  obtained  by  Einger. 

The  slow  pulse  in  the  first  stage  of  digitalis-poisoning  is 
partly  due  to  stimulation  of  the  vagus-roots  of  the  medulla,  and 
partly  to  increased  sensibility  or  actual  stimulation  of  the  ends 
of  the  nerves  in  the  heart.  This  increased  sensibility  has  been 
shown  to  exist  by  Boehm,  who  found  that  after  the  adminis- 
tration of  digitalis,  a  faradaic  current  which  previously  had  no 
action  on  the  heart  would  not  only  slow  the  pulse  but  produce 
prolonged  diastolic  arrest. 

The  rapid  pulse  in  the  second  stage  of  digitalis-poisoning 
is  due  to  paralysis  of  the  vagus-ends.  The  irregularities  in  the 
third  stage  depend  on  the  action  of  the  drug  on  the  heart  itself. 

The  action  of  digitalis  on  the  frog's  heart  is  very  peculiar. 
At  first  it  causes  the  pulsations  to  become  slower  and  more 


1  Journal  of  Physiology,  vol.  iv.  p.  ]  65. 


chap,  xxxiv.]  COROLilFLOR.E.  997 

powerful,  then  the  contraction  during  systole  becomes  peristaltic, 
and  the  dilatation  during  diastole  less  and  less  complete,  until 


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Fig.  213. — Pulse-wave,  6  before  and  a  after  injection  of  digitalis  in  a  dog. 

linally  the  ventricle  stands  quite  still,  in  such  complete  systolic 
contraction  that  its  cavity  is  entirely  obliterated.  The  auricles 
are  sometimes  distended  with  blood,  sometimes  only  moderately 
dilated.  According  to  Schmiedeberg  this  contraction  is  not 
tetanic,  but  is  rather  due  to  increased  elasticity  of  the  cardiac 
muscle  which  prevents  its  normal  relaxation  during  diastole. 
When  it  is  overcome  by  driving  a  nutrient  fluid  into  the  ventricle 
under  pressure,  or  by  partially  paralysing  the  cardiac  muscle  by 
saponin,  apomorphine,  or  hydrocyanic  acid,  the  systolic  stillstand 
is  removed,  and  pulsation  again  commences. 

Digestive  Organs. — Small  doses  of  digitalin  have  a  pleasant 
bitter  taste  but  exercise  no  marked  effect  upon  the  digestive  organs. 
Larger  doses  produce  loss  of  appetite,  nausea,  and  vomiting,  with 
rumbling  and  pain  in  the  abdomen,  and  sometimes  diarrhoea. 
This  occurs  even  when  the  drug  is  injected  subcutaneously. 

Urine. — All  observers  are  agreed  regarding  the  diuretic  power 
of  digitalis  in  cardiac  disease,  but  most  of  them  state  that  it  has 
no  such  power  in  health.  In  my  own  experiments,  however,  in 
which  I  took  the  same  quantity  of  food  by  weight  and  of  fluid  by 
measure  during  more  than  a  hundred  days,  I  found  that,  while 
small  doses  had  little  or  no  action,  marked  diuresis  occurred  when 
the  drug  was  pushed  so  as  to  produce  symptoms  of  poisoning. 
In  these  experiments  also  I  found  that  while  the  diuresis  con- 
tinued the  absolute  quantity  of  solids  excreted  daily  in  the  urine 
was  increased,  although  their  proportion  to  the  urinary  water 
was  diminished.  In  cases  of  poisoning  by  digitalis,  a  marked 
diminution  in  the  flow  of  urine  frequently  precedes  a  fatal  issue ; 
and  on  injecting  digitalis  into  the  veins  of  a  dog,  Mr.  Power  and 
I  found  that  the  secretion  of  urine  became  entirely  arrested  when 
the  blood-pressure  reached  its  maximum,  and  again  commenced 
when  the  blood-pressure  began  to  fall  (p.  430) .  It  is  probably  to 
the  power  of  digitalis  to  arrest  the  action  of  the  kidneys  and  thus 
stop  its  own  excretion  that  its  cumulative  action  is  due  (p.  42). 


998 


VEGETABLE   MATEBIA   MEDICA. 


[sect.  v. 


Effect  of  Temperature  on  the  Action  of  Digitalis.— It 

has  already  been  mentioned  (p.  47)  that  digitalis  has  sometimes 
no  action  on  the  pulse  in  pneumonia.     The  inhibitory  action  of 


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The  unbroken  line  shows  the  pulse-rate,  the  dotted  line  shows  the  temperature 
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Fig.  214. — Shows  the  effect  of  rise  of  temperature  alone.    At  the  195th  minute  both  vagi  were  cut ; 
the  section  was  not  followed  immediately  by  any  apparent  effect.    After  eight  minutes  more, 
the  pulse-rate  rose  slightly  and  then  fell. 

the  vagi  on  the  heart  is  lessened  by  heat,  but  their  peripheral 
terminations,  although  weakened,  are  not  completely  paralysed. 
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show  that  a  very  high  temperature  has  an  action  on  the  vagus 
centre  in  the  medulla  similar  to  its  action  on  the  ends  of  the 
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Fig.  215.— Shows  the  effect  of  rise  of  temperature  after  injection  of  digitalis.  At  the  45th  minute 
•75  c.c.  (12  minims)  tincture  of  digitalis  were  injected,  and  another  similar  injection  was  made 
at  the  55th  minute.  At  the  65th  minute  the  heating  was  begun.  After  section  of  the  yagi  the 
pulse  continued  to  rise,  but  not  more  rapidly  than  before.  - 

them.     This  weakening  action  is  so  great  that  it  practically 
amounts  to  paralysis,  for  when  the  temperature  rises  above  a 


chap,  xxxrv.] 


COEOLLIPLOE^!. 


999 


certain  point  the  pulse-rate  suddenly  rises  just  as  it  would  do  if 
both  vagi  were  cut.  This  is  shown  in  Fig.  214.  When  the  pulse- 
rate  has  been  thus  quickened  by  heat,  section  of  the  vagi  does 
not  render  it  any  quicker  (Figs.  215  and  216). 

Although  the  vagus  centre  is  so  much  weakened  by  the 
action  of  the  heat  that  it  ceases  to  exercise  any  inhibitory  action 
upon  the  heart,  yet  its  functional  activity  is  not  completely  de- 


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Fig.  216. — Shows  the  action  of  digitalis  when  giyen  after  the  temperature  has  already  risen.  At  the 
30th  minute  the  warming  was  begun ;  at  the  100th  minute  -75  0.0.  of  tincture  of  digitalis  was 
injected. 

stroyed  even  by  very  high  temperatures,  and  irritation  of  an 
afferent  nerve  will  still  cause  reflex  slowing  (p.  290)  of  the  pulse, 
until  immediately  before  the  death  of  the  animal  from  hyper- 
pyrexia. 

These  experiments  render  it  probable  that  the  rapid  rise  in 
the  pulse-rate,  which  a  high  temperature  occasions,  is  chiefly  of 
central  origin,  and  is  due  to  partial  paralysis  of  the  vagus  centre, 
although  diminished  action  of  the  peripheral  ends  of  the  vagus 
and  increased  action  of  the  cardiac  ganglia  also  aid  in  quicken- 
ing the  pulse. 

Although  neither  the  vagus  centre  nor  the  vagus  ends  in  the 
heart  are  completely  paralysed  by  very  high  temperatures  they 
are  yet  weakened  so  much  that  digitalis,  and  probably  all  drugs 
which  act  like  it,  such  as  adonidin  (p.  331),  no  longer  slow  the 
pulse  as  they  do  at  normal  temperatures.  This  is  shown  in  Fig. 
216,  where  the  pulse  remained  slow  until  the  temperature  rose  to 
nearly  41°  C.  and  then  suddenly  became  very  quick.  Moderately 
high  temperatures  do  not  prevent  digitalis  from  slowing  the 
heart  (Fig.  214). 

Action  of  Different  Preparations  of  Digitalis. — The  two 
most  marked  effects  of  digitalis  in  disease  are  a  reduction  in  the 
rate  of  the  pulse,  and  an  increase  in  the  amount  of  urine.  These 
effects  are  not  coincident,  and,  according  to  Christison,  the 
diuretic  action  is  less  when  the  heart  is  much  affected.  The  pre- 
paration generally  employed  to  act  on  the  heart  is  the  tinc- 
ture, while  the  infusion  is  regarded  as  the  best  diuretic.1     The 

1  The  National  Dispensatory. 


1000  VEGETABLE   MATEEIA  MEDICA.  [sect.  v. 

differences  between  the  action  of  the  infusion  and  tincture  of 
digitalis  are  probably  due,  in  part  at  least,  to  the  different  pro- 
portions in  which  the  active  principles  of  the  plant  are  dissolved 
by  alcohol  and  water. 

In  digitalis,  as  in  physostigma  (p.  904)  and  many  other 
plants,  there  is  a  mixture  of  principles  having  antagonistic 
actions.  Digitonin,  which  has  an  action  very  like  saponin  (pp. 
307,  915),  will  to  a  greater  or  less  extent  antagonise  the  action 
of  digitoxin,  digitalin,  and  digitalein.  Digitonin  is  readily 
soluble  in  water,  forming,  like  saponin,  a  solution  which  froths 
easily.  Digitalein  is  soluble  in  water,  but  digitalin  is  only  spar- 
ingly so,  and  digitoxin  is  hardly  soluble  in  water  at  all. 

The  solubility  of  these  substances  in  alcohol  is  almost  the 
converse  of  their  solubility  in  water.  Digitonin  is  sparingly 
soluble  in  alcohol,  while  digitalin  and  digitalein  are  readily 
soluble.     Digitoxin  is  only  sparingly  soluble  in  cold  alcohol. 

Prom  the  ready  solubility  of  digitonin  in  water,  infusion  of 
digitalis  will  contain  it  in  much  larger  proportion  than  digitalin 
or  digitalein.  This,  indeed,  is  readily  seen  by  putting  some  in- 
fusion of  digitalis  into  one  bottle  and  a  corresponding  dose  of 
the  tincture  diluted  with  water  until .  both  solutions  have  the 
same  bulk.  On  shaking  the  bottles,  the  infusion  will  be  found 
to  froth  much  more  strongly  and  to  retain  the  froth  much 
longer  than  the  diluted  tincture,  although  the  latter  also  froths 
strongly. 

Tincture  of  digitalis  will,  on  the  other  hand,  contain  a  larger 
proportion  of  digitalin  and  digitalein,  with  probably  a  small 
quantity  of  digitoxin. 

It  is  quite  possible,  however,  that  in  addition  to  differences 
in  the  preparations  due  to  the  menstruum,  there  may  be  differ- 
ences in  the  same  preparation  due  to  the  plants  used.  Thus  in 
Edinburgh  the  usual  dose  of  the  infusion  is  half  an  ounce,  and 
this  is  usually  readily  tolerated,  while  in  London  I  have  fre- 
quently seen  doses  of  one  or  two  drachms  produce  considerable 
gastric  disturbance.  The  infusion  of  the  U.S.P.  is  nearly  twice 
as  strong  as  that  of  the  B.P.,  and  yet  the  recognised  dose  is  con- 
siderably larger. 

Whether  these  differences  are  or  are  not  due  to  the  amount 
and  relative  proportions  of  the  active  ingredients  in  digitalis 
plants  grown  in  Scotland,  England,  and  America,  is  a  point 
which  requires  investigation,  more  especially  when  we  have  other 
examples,  e.g.  cannabis  indica,  where  there  is  a  notable  difference 
between  the  action  of  plants  of  the  same  species  growing  in  dif- 
ferent climates. 

Uses. — It  is  chiefly  used  as  a  tonic  to  the  heart,  when  its 
action  is  irregular  and  feeble,  and  in  dropsy,  especially  cardiac 
dropsy  (pp.  332,  336). 

It  is  used  in  functional  palpitation,  and  in  the  irritable  heart 


chap,  xxxiv.]  COEOLLIFLOR^E.  1001 

often  seen  in  young  soldiers,  but  its  chief  use  is  in  mitral 
disease. 

In  pure  aortic  disease,  with  hypertrophy,  it  is  not  only  in- 
jurious but  dangerous,  since  by  slowing  the  pulse-rate  it  lengthens 
the  time  during  which  blood  can  regurgitate  (pp.  333,  334). 

When  the  aortic  disease  is  accompanied  by  mitral  incompe- 
tence and  the  immediate  danger  is  that  from  the  mitral  affection, 
it  may  be  given  with  advantage  (p.  834).  In  these  cases,  whilst 
taking  the  drug  the  patient  must  be  kept  perfectly  quiet,  as  there 
is  a  great  danger  of  sudden  syncope  (p.  335). 

Digitalis  is  of  great  use  as  a  soporific  in  sleeplessness  at 
night,  accompanied  by  drowsiness  during  the  day,  for  both  these 
symptoms  depend  on  want  of  tone  in  the  vessels,  the  blood  gra- 
vitating to  the  feet  when  the  patient  is  erect  and  to  the  head 
when  in  a  lying  posture  (p.  194). 

It  is  very  useful  in  haemorrhages,  especially  when  occurring 
in  the  lungs,  and  it  has  been  added  to  cough  mixtures  to  lessen 
congestion  of  the  mucous  membrane. 

It  was  formerly  used  in  fever  and  pneumonia,  but  is  now 
discarded  as  being  of  very  little  use. 

In  delirium  tremens  it  has  been  given  in  very  large  doses,  but 
its  use  is  dangerous. 

In  dropsy  depending  on  mitral  disease,  also  in  renal  dropsy 
and  ascites,  it  has  been  used  with  good  effect. 

It  is  very  serviceable  in  some  cases  of  menorrhagia.  Its 
action  in  this  case  is  due  not  to  contraction  of  the  vessels  of  the 
uterus,  but  of  the  walls  of  the  uterus  itself,  since  digitalis  did 
not  affect  haemorrhage  from  a  fungoid  growth  in  the  cervix 
(Dickinson). 

It  is  also  useful  in  spermatorrhoea. 

Precautions. — (1)  Stop  the  administration  of  digitalis  on  the 
appearance  of  sickness  or  a  tendency  to  faint,  or  ehange  the 
preparation  of  digitalis  and  lower  the  dose. 

(2)  Do  not  give  digitalis  in  large  doses  unless  you  see  the 
patient  frequently,  and  it  is  necessary  to  push  the  drug.  Keep 
the  patient  in  bed,  and  do  not  allow  him  even  to  sit  up  in  bed, 
much  less  to  rise,  and  above  all  not  to  rise  up  and  make  water, 
as  otherwise  fatal  syncope  may  occur  (p.  265). 

Treatment  on  Poisoning. — Keep  the  patient  recumbent  and 
give  stimulants,  e.g.  alcohol.  Tannin  has  been  recommended  in 
order  to  precipitate  digitalin  in  the  stomach. 

U.S. P.  Leptandra.  Leptandra.  Culver's  Root. — The 
rhizome  and  rootlets  of  Leptandra  virginica  (Veronica  virginica). 

Characters.— Horizontal,  from  four  to  six  inches  (10  to  15  centimetres) 
long,  and  about  a  quarter  of  an  inch  (6  millimetres)  thick,  somewhat  flat- 
tened, bent  and  branched,  deep  blackish-brown,  with  cup-shaped  scars  on  the 
upper  side,  hard,  of  a  woody  fracture,  with  a  thin,  blackish  bark,  a  hard, 


1002  VEGETABLE  MATEEIA  MEDICA.  [sect.  v. 

yellowish  wood,  and  a  large,  purplish-brown,  about  six-rayed  pith ;  rootlets 
thin,  wrinkled,  very  fragile ;  inodorous ;  taste  bitter  and  feebly  acrid. 
Dose.— Of  the  root,  20-60  gr.  (1-5-4  gm.). 

Preparations. 

dose. 

Extraotum  Leptandrae 2-4  gr. 

„  „  Eluidum 30-60  min. 

Composition. — It  contains  a  resinous  principle,  leptandrin. 

Action. — It  is  an  irritant  to  the  gastro-intestinal  mucous 
membrane,  and  stimulates  the  secretion  of  bile  (p.  403).  It 
may  be  used  as  a  cathartic  in  biliousness  or  constipation. 

PEDALINEiE. 

U.S.P.  Oleum  Sesami.  Oil  op  Sesamtjm.  (Benne  Oil.) — A 
fixed  oil  expressed  from  the  seed  of  Sesamtm  indAcum. 

Characters. — A  yellowish  or  yellow,  oily  liquid,  inodorous  or  nearly  so, 
having  a  bland,  nut-like  taste,  and  a  neutral  reaction. 

Action. — Similar  to  olive  oil  (q.v.  p.  967). 

VERBENACE^E. 

Lippia  Mexicana.  Not  officinal. — An  evergreen  creeping 
shrub'  growing  in  Mexico.  The  parts  used  are  the  leaves  and 
flowers. 

Composition. — It  contains  a  volatile  oil — lippiol — a  camphor- 
like body,  and  a  substance  allied  to  quercitin. 

Action. — Lippiol  in  doses  of  3  gr.  (0-2  gm.)  caused  in  a  cat 
within  half  an  hour  slight  dilatation  of  the  pupil  and  nictitation 
(probably  due  to  gastro-enteric  irritation,  p.  218).  A  repetition 
of  the  dose  caused  vomiting,  restlessness,  and  sleep  lasting  for 
two  hours.  In  doses  of  4£  gr.  (0*3  gm.)  it  causes  warmth, 
flushing,  diaphoresis,  and  drowsiness  (Podwissotzki). 

Uses. — As  a  respiratory  sedative  in  cough.  Given  as  tinc- 
ture in  doses  of  £-1  fl.  dr. 

LABIATE. 

Rosmarinus,  U.S.P.  Eosemabt. — The  leaves  of  Rosmarinus, 
officinalis. 

Characters. — About  one  inch  (25  millimetres)  long,  rigid,  linear,  entire, 
revolute,  dark  green  above,  woolly  and  glandular  beneath ;  pungently  aro- 
matic ;  somewhat  camphoraceous. 

Preparation. 
Vinum  Aromaticum. 

Oleum  Rosmarini,  B.  and  U.S.P.  Oil  of  Eosemary.— The 
oil  distilled  from  the  flowering  tops  of  Rosmarinus  officinalis,  B.P. 
A  volatile  oil  distilled  from  rosemary,  U.S.P. 


chap,  xxxiv.]      >  COEOLLIFLOKjE.  1003 

Characters. — Colourless,  with  the  odour  of  rosemary,  and  a  warm  aro- 
matic taste. 

Dose. — 1-5  min. 

Preparations. 
B.P.  DOSE. 

Linimentum  Saponis  (p.  616) for  external  use. 

Spiritus  Rosmarlnl 10-50  min.  or  more. 

Tinctura  Lavandula  Composita i-2  fl.  dr. 

U.S.F. 

Linimentum  Saponis  (p.  517) for  external  use. 

Spiritus  Odoratus do. 

Tinctura  Lavandula  Composita £-2  fl.  dr. 

Action  and  Use. — It  is  a  stimulant  and  carminative,  and  is 
used  to  lessen  flatulence,  and  to  allay  pain  and  spasm  of  the 
intestines.  It  is  a  useful  adjunct  to  purgatives,  and  is  used  in 
hysteria. 

U.S. P.  Lavandulae.  Lavender. — The  flowers  of  Lavandula 
vera. 

Characters. — Calyx  tubular,  blue-grey,  hairy,  five-toothed,  the  upper 
tooth  largest  and  roundish-rhomboid ;  corolla  violet-blue,  hairy  and  glandular 
on  the  outside,  tubular  and  two-lipped,  the  upper  lip  two-lobed,  the  lower  lip 
three-lobed ;  stamens  four,  short,  on  the  corolla  tube ;  odour  fragrant ;  taste 
bitterish,  aromatic,  somewhat  camphoraceous. 

Pbepabation. 
Vinum  Aromaticum. 

Oleum  Lavandulae,  B.  and  U.S.P.  Oil  of  Lavendee. — 
The  oil  distilled  in  Britain  from  the  flowers  of  Lavandula  vera, 
B.P.  A  volatile  oil  distilled  from  the  flowering  tops  or  whole 
herb  of  Lavandula  vera,  U.S.P. 

Characters. — Colourless  or  pale  yellow,  with  the  odour  of  lavender,  and 
a  hot,  bitter,  aromatic  taste. 

Dose. — 1-4  min. 

Preparations. 
B.P.  dose. 

Linimentum  Camphorse  Oompositum  (p.  516) 

Spiritus  Lavandulae i-1  fl.  dr. 

Tinctura  „  Composita i-2  fl.  dr. 

U.S.P. 

Tinctura  Lavandula  Composita £-2  fl.  dr. 

Tinctura  Lavandulae  Composita,  B.  and  tr.S.P.  COMPOUND  Tincture 
of  Lavender. — Oil  of  lavender  lg  fl.  dr.,  oil  of  rosemary  10  min.,  cinnamon 
bark,  bruised,  150  gr.,  nutmeg,  bruised,  150  gr.,  red  sandal-wood  800  gr., 
rectified  spirit  2  pints,  B.P.  Oil  of  lavender  8  parts,  oil  of  rosemary  2, 
cloves  4,  nutmeg  10,  red  saunders  8,  alcohol  680,  water  270,  and  diluted 
alcohol  up  to  1,000  parts,  U.S.P. 


1004  VEGETABLE  MATEKIA  MEDICA.      , .    [seqt.  y. 

U.S.  P-  Oleum  Lavandulae  Florum.  Oil  of  Lavender 
Flowees. — A  volatile  oil  distilled  from  fresh  lavender. 

Chaeactees. — A  colourless  or  yellowish  liquid,  having  the  fragrant  odour 
of  lavender  flowers,  a  pungent  and  bitterish  taste,  and  a  neutral  reaction 
while  fresh.  Sp.  gr.  about  0-890.  It  is  readily  soluble  in  alcohol,  and  in 
acetic  acid  of  90  or  more  per  cent.  When  heated  to  about  80°  C.  (176°  F.)  it 
should  not  yield  a  colourless  distillate  having  the  characteristics  of  alcohol. 

Dose. — 1-5  min. 

Preparations. 
U.S. p.  DOsS. 

Spiritus  Lavandula  (3  parts  of  the  oil  with  97  of  alcohol). ..£-2  fl.  dr. 
Spiritus  Odoratus 

Action  and  Uses. — Lavender  is  a  stimulant  and  carmina- 
tive, and  is  used  to  lessen  flatulence,  to  relieve  colic,  and  in 
hysteria.  Tinctura  Lavandulae  Composita  is  contained  in  Liquor 
Arsenicalis. 

Oleum  Menthae  Piperitae,  B.  and  U.S.P.  Oil  of  Pepper- 
mint.— The  oil  distilled  in  Britain  from  fresh  flowering  pepper- 
mint, Mentha  piperita,  B.P. 

A  volatile  oil  distilled  from  peppermint,  U.S.P. 

Chaeactees. — Colourless  or  pale  yellow,  with  the  odour  of  peppermint ; 
taste  warm,  aromatic,  succeeded  by  a  sensation  of  coldness  in  the  mouth. 

Preparations. 

B.P.  DOSE. 

Aqua  Menthae  Piperitae  (lj  fl.  dr.  to  1  gallon) 1-2  fl.  oz. 

Essentia  Menthae  Piperitae  (1  volume  in  5) 10-20  min. 

Pilula  Ehei  Composita  (vide  p.  523)  (1  min.  in  1  dr.). ..nearly  5-10  gr. 

Spiritus  Mentbae  Piperitae  (1  volume  in  50) I  fl.  dr. 

Tinctura  Chloroformi  et  Morphines  (1  min. in  2  fl.  oz.)..5-10  min. 

Dose. — 1-5  min. 


Aqua  Mentha  Piperita 1-2  fl.  oz. 

Spiritus  Mentha  Piperita.. 10-15  min. 

Trochisoi  Mentha  Piperita  (Peppermint  Lozenges).... ad  lib. 

Action  and  Use. — Carminative  and  stimulant,  used  to  relieve 
flatulence  and  colic  ;  and  as  an  adjunct  to  purgatives,  to  lessen 
griping.  Mosquito-bites  may  be  prevented  by  rubbing  the  skin 
of  the  face  and  hands,  the  lips  and  the  margins  of  the  nostrils 
with  soap  strongly  scented  with  peppermint  or  lavender.  A 
sprig  of  peppermint  or  pennyroyal,  or  a  small  bottle  containing 
their  volatile  oils,  hung  near  the  head  during  sleep  is  said  to 
have  a  similar  effect.  Peppermint  lozenges  are  useful  in  reliev- 
ing flatulence  and  the  tendency  to  faintness  due  to  it. 

B.P.  Menthol.  C,0H20O.  Peppermint  Camphor. — A  stearop- 
tene  obtained  by  cooling  the  oil  distilled  from  the  fresh  herb  of 
Mentha  arvensis,  vars.  piperascens  et  glabrata;  and  of  Mentha 
piperita. 


chap,  xxxiv.]  COKOLLIFLOK^.  1005 

Characters.—  Colourless  ci  ystals  or  masses,  with  a  taste  and  smell  of 
peppermint  oil,  sparingly  soluble  in  water,  readily  soluble  in  alcohol,  ether, 
and  ethereal  oils.  "When  rubbed  up  with  an  equal  quantity  of  thymol  it 
forms  a  colourless  oily  liquid.  The  same  is  the  case  when  it  is  rubbed  with 
an  equal  quantity  of  pure  carbolic  acid  or  of  chloral  hydrate,  or  with  butyl- 
chloral  hydrate  in  the  proportion  of  1  part  to  2  of  menthol,  or  with  camphor 
2  parts  to  3  of  menthol.  When  boiled  with  sulphuric  acid  diluted  with  half 
its  volume  of  water  it  becomes  blue,  the  acid  becoming  brown. 

Actio?*. — It  is  a  powerful  antiseptic.  When  applied  to 
raucous  membranes  or  the  skin  it  causes  a  feeling  of  warmth  or 
burning,  replaced  by  a  feeling  of  coldness  when  the  part  is  blown 
upon. 

Uses. — It  is  chiefly  used  as  an  anti-neuralgic.  It  is  either 
applied  in  the  form  of  a  solid  pencil  rubbed  lightly  over  the  part 
where  the  pain  is  felt,  or  an  alcoholic  solution,  or  the  oily  liquids 
prepared  by  trituration  with  camphor,  carbolic  acid,  &c,  may  be 
painted  over  the  painful  spots.  These  oily  liquids  are  also  ap- 
plied on  cotton  wool  in  order  to  relieve  toothache. 

Oleum  Menthae  Viridis,  B.  and  U.S.P.  Oil  of  Speabmint. 
The  oil  distilled  in  Britain  from  fresh  flowering  spearmint, 
Mentha  viridis,  B.P. 

Characters. — Colourless  or  pale  yellow,  with  the  odour  and  taste  of 
spearmint. 

Dose. — 1-5  min. 

Preparations. 

B.P.  DOSE. 

Aquae  Mentha-  Viridis  (1|  fl.  dr.  to  1  gallon) 1-2  il.  oz. 

D.s.p. 

Aqua  Menthse  Viridis 1-2  fl.  oz. 

Spiritus  Mentha  Viridis 5-20  min. 

Action  and  Uses. — Like  other  carminatives  and  stimulants, 
to  relieve  colic,  flatulence,  and  with  purgatives  to  prevent 
griping. 

Thymol,  B.  and  U.S.P.  Thymol.  CI0H13HO,  or  CCH3. 
C3H7.CH3.OH. — A  stearoptene  obtained  from  the  volatile  oils  of 
Thymus  vulgaris  (Labiatse),  Monarda  punctata  (Labiatse),  and 
Carum  Ajowan  (Ptychotis  Ajowari)  (Umbelliferse). 

These  oils  contain  thymol  and  thymene,  C10H16,  which  is 
fluid.  The  thymol  is  separated  by  saponifying  with  caustic  soda 
and  treating  the  separated  soap  with  hydrochloric  acid,  or  from 
a  distilled  fraction  of  the  oil  by  exposure  at  a  low  temperature. 
It  may  be  purified  by  recrystallisation  from  alcohol. 

Characters. — Large  oblique  prismatic  crystals  having  the  odour  of  thyme 
and  a  pungent  aromatic  flavour.  They  sink  in  cold  water,  but  on  heating 
the  mixture  to  a  temperature  of  110°  to  125°  F.  (43-3°  to  51-7°  C.)  they  melt 
and  rise  to  the  surface.  The  crystals  volatilise  completely  at  the  temperature 
of  a  water-bath. 

Solubility. -Slightly  soluble  in  cold  water,  freely  soluble  in  alcohol, 
ether,  and  solutions  of  alkalis. 


1006  .  VEGETABLE   MATEEIA  MEDICA.  [sect.  v. 

Eeactions. — A  solution  of  thymol  in  half  its  bulk  of  glacial  acetic  acid, 
warmed  with  an  equal  volume  of  sulphuric  acid,  assumes  a  reddish-violet 
colour. 

Impurity. — Carbolic  acid. 

Test. — Water  saturated  with  thymol  when  treated  with  a  few  drops  of 
test  solution  of  ferric  chloride  should  not  give  a  blue  colour  (absence  of  car- 
bolic acid). 

Dose. — Internally,  £-10  gr.  For  spray,  1  in  800  of  hot 
water.  As  ointment,  5-30  gr.  to  1  oz.  of  petrolatum.  As  in- 
halation, 6  gr.  to  an  ounce  of  warm  water. 

Action.— In  respect  of  its  physiological  action,  thymol  ap- 
pears to  stand  between  carbolic  acid  and  oil  of  turpentine.  Like 
carbolic  acid,  it  destroys  low  organisms,  and  is  a  powerful  an- 
tiseptic. In  higher  animals  it  acts  as  a  local  irritant  and 
anaesthetic  to  the  skin  and  mucous  membranes.  When  absorbed 
it  paralyses  the  nerve-centres  in  the  cord  and  medulla,  like 
carbolic  acid,  lessening  reflex  action,  slowing  respiration,  and 
lowering  the  blood-pressure  and  temperature.  In  poisonous 
doses  it  causes  weakness,  drowsiness,  coma,  and  death.  It  differs 
from  carbolic  acid  in  being  less  volatile  and  less  easily  oxidised. 
Its  action  as  a  disinfectant  is  more  permanent,  and  at  the  same 
time  more  powerful  than  that  of  carbolic  acid.  It  is  less  irri- 
tating to  the  skin  or  mucous  membrane,  and  does  hot  act  as  a 
caustic  like  carbolic  acid,  and  is  a  less  powerful  poison  to  mam- 
mals. Its  action  on  the  nerve-centres  is  a  paralysing  one  from 
the  first,  and  is  not  preceded  by  excitement  as  in  the  case  of 
carbolic  acid.  While  in  the  body  it  appears  to  effect  tissue-meta- 
bolism, for  in  animals  poisoned  by  it  the  liver  is  found  quite 
fatty,  as  in  phosphorus-poisoning.  It  appears  to  be  eliminated 
by  the  respiratory  and  urinary  organs,  and  to  cause  irritation  of 
these  organs  during  the  process  of  excretion.  In  poisoning  by 
it  the  bronchial  mucous  membrane  is  extremely  congested,  the , 
secretion  of  mucus  increased ;  the  lungs  congested,  and  some- 
times consolidated ;  the  kidneys  inflamed,  and  the  urine  albu- 
minous or  bloody. 

Uses. — It  has  been  used  as  an  antiseptic  instead  of  carbolic 
acid  for  dressing  wounds;  as  an  application  to  skin  diseases, 
ringworm,  eczema,  psoriasis ;  as  a  gargle,  spray,  or  inhalation 
in  sore-throat,  bronchiectasis,  and  phthisis,  or  as  an  injection  in 
ozffina.  Internally  it  has  been  used  in  diabetes  and  vesical 
catarrh. 

U.S.P.  Hedeoma.  Hedeoma.  Pennyroyal. — The  leaves 
and  tops  of  Hedeoma  pulegioides. 

_  Characters. — Leaves  opposite,  short-petioled,  about  half  an  inch  (12 
millimetres)  long,  oblong-ovate,  obscurely  serrate,  glandular  beneath; 
branches  roundish-quadrangular  ;  flowers  in  small,  axillary  cymules,  with  a 
tubular-ovoid,  two-lipped  and  five-toothed  calyx,  and  a  pale-blue,  spotted, 
two-lipped  corolla,  containing  two  sterile  and  two  fertile  exserted  stamens ; 
odour  strong,  mint-like ;  taste  warm  and  pungent. 


chap,  xxxiv.]  COEOLLIFLOBJE.  1007 

Preparation, 
tj.sj.  dose. 

Oleum  Hedeomse 1-5  min. 

Composition. — It  contains  a  volatile  oil. 

Action  and  Uses. — It  is  stimulant,  carminative,  diaphoretic, 
and  emmenagogue.  It  is  used  in  flatulence  and  in  amenor- 
rhcea.  It  is  frequently  given  in  the  form  of  hot  infusion,  to 
promote  the  menstrual  flow  when  delay  or  recent  suppression 
has  occurred. 

U.S.  P.  Marrubium.  Marrubium.  Hokehound. — The  leaves 
and  tops  of  Marrubium  vulga/re. 

Characters. — Leaves  about  one  inch  (25  millimetres)  long,  opposite, 
petiolate,  roundish-ovate,  obtuse,  coarsely  crenate,  strongly  rugose,  downy 
above,  white-hairy  beneath;  branches  quadrangular,  white  tomentose; 
flowers  in  dense,  axillary,  woolly  whorls,  with  a  stiffly  ten-toothed  calx,  a 
whitish  bi-labiate  corolla,  and  four  included  stamens ;  aromatic  and  bitter. 

Composition. — It  contains  a  volatile  oil  and  a  bitter  principle, 
marrubiin. 

Dose.— 30-60  gr.  (2-4  gm.). 

Uses. — It  is  expectorant,  tonic,  diaphoretic,  and  diuretic. 
In  large  doses  it  is  laxative.  It  is  employed  in  laryngeal  and 
bronchial  catarrh,  and  in  chronic  affections  of  the  lungs  attended 
with  cough  and  copious  expectoration. 

U.S.P.  Melissa.  Melissa.  Balm. — The  leaves  and  tops  of 
Melissa  officinalis. 

Characters. — Leaves  about  2  inches  (5  centimetres)  long,  petiolate, 
ovate,  obtuse,  crenate,  somewhat  hairy,  glandular ;  branches  quadrangular ; 
flowers  in  about  four-flowered  cymules,  with  a  tubular,  bell-shaped,  five- 
toothed  calyx,  a  whitish  or  purplish  two-lipped  corolla,  and  four  stamens ; 
fragrant,  aromatic,  and  bitterish. 

Composition. — It  contains  a  small  quantity  of  a  volatile  oil. 

Uses. — It  has  scarcely  any  remedial  action,  but  is  used  in 
the  form  of  warm  infusion  or  tea  as  a  diaphoretic  in  slight 
febrile  conditions. 

U.S.P-  Origanum.  Origanum.  Wild  Marjoram. — Origanum 
vulgare. 

Characters. — Stem  branched  above,  often  purplish,  leaves  opposite,  pe- 
tiolate, about  an  inch  (25  millimetres)  long,  roundish-ovate,  obtuse,  nearly 
entire,  pellucid-punctate,  hairy  beneath ;  flowers  in  corymbs,  with  reddish 
bracts,  a  five-toothed  calyx,  a  somewhat  two-lipped,  pale  purple  corolla,  and 
four  exserted  stamens ;  aromatic,  pungent,  and  bitterish. 

Preparation. 
Vinum  Aromaticum.     Used  externally. 

Composition. — It  contains  a  volatile  oil,  which  has  been 
largely  superseded  by  the  oil  of  thyme. 

Action  and  Uses. — The  infusion  is  tonic.,  diaphoretic,  and 
emmenagogue.    It  is  also  used  externally  as  a  fomentation. 


1008  VEGETABLE   MATEEIA  MEDICA.  [sect.  v. 

U.S.P-  Salvia.  Salvia.  Sage. — The  leaves  of  Salvia  offi- 
cinalis. 

Characters. — About  two  inches  (5  centimetres)  long,  petiolate,  ovate- 
oblong,  obtuse,  finely  crenulate,  thickish,  wrinkled,  greyish-green,  soft-hairy 
and  glandular  beneath ;  aromatic,  bitterish,  somewhat  astringent. 

Preparation. 
Vinum  Aromaticum.    Used  externally  only. 

Composition. — The  leaves  contain  a  volatile  oil. 

Uses. — They  are  chiefly  used  as  a  condiment.  The  infusion 
is  tonic,  carminative,  and  slightly  astringent.  It  is  used  in 
atonic  dyspepsia,  and  to  check  hectic  sweating. 

U.S.P.  Scutellaria.  Scutellaria.  Skull-cap. — Scutellaria 
lateriflora  (whole  plant). 

Characters. — About  twenty  inches  (50  centimetres)  long,  smooth ;  stem 
quadrangular,  branched ;  leaves  opposite,  petiolate,  about  two  inches  (5  centi- 
metres) long,  ovate -lanceolate  or  ovate-oblong,  serrate ;  flowers  in  axillary, 
one-sided  racemes,  with  a  pale  blue  corolla  and  a  two-lipped  calyx,  closed  in 
fruit,  the  upper  lip  helmet-shaped ;  odour  slight ;  taste  bitterish. 

Preparation. 

U.S.P.  DOSE. 

Extractum  Scutellaria  Fluidum 1-2  fl.  dr. 

Uses. — As  a  remedy  it  has  little  value.  It  has  been  used 
as  a  nervine  tonic  in  neuralgia,  chorea,  delirium  tremens,  and 
nervous  exhaustion. 


1009 


CHAPTER  XXXV. 

Class   III.— DICOTYLEDONES  MONOCHLAMYDEiE. 

(APETALiE.) 

CHENOPODIACE^E. 

U.S.P.  Chenopodium.  Chenopoditjm.  Ameeican  Woemsbbd. 
The  fruit  of  Chenopodium  ambrosioides,  var.  anthelminticum. 

Characters. — Nearly  one-twelfth  of  an  inch  (2  millimetres)  in  diameter, 
depressed-globular,  glandular,  dull  greenish  or  brownish,  the  integuments 
friable,  containing  a  lenticular,  obtusely-edged,  glossy,  black  seed.  It  has  a 
peculiar,  somewhat  terebinthinate  odour,  and  a  bitterish,  pungent  taste. 

Dose. — 10-40  grains. 

U.S.P.  Oleum  Chenopodii. — A  volatile  oil  distilled  from 
wormseed. 

Use. — It  is  used  as  a  vermifuge  to  expel  lumbricoid  worms. 
The  powdered  seeds,  which  possess  the  active  medicinal  virtues, 
may  be  combined  with  some  agreeable  elixir,  or  the  essential  oil 
may  be  given  on  a  lump  of  sugar,  or  in  emulsion  in  doses  of  3-5 
minims. 

PHYTOLACCACEjE. 

U.S.P.  Phytolacca  Bacca.  Phytolacca  Beeet.  PokeBeeey. 
The  fruit  of  Phytolacca  decandra. 

Characters. — A  depressed-globular,  dark  purple,  compound  berry,  about 
one-third  of  an  inch  (8  millimetres)  in  diameter,  composed  of  ten  carpels, 
each  containing  one  lenticular,  black  seed ;  juice  purplish-red ;  inodorous ; 
sweet,  slightly  acrid. 

U.S.P.  Phytolacca  Radix.  Phytolacca  Boot.  Poke  Boot. 
The  root  of  Phytolacca  decandra. 

Characters. — Branched,  wrinkled,  yellowish -brown  externally,  yellowish- 
white  internally.  Transverse  sections  exhibit  numerous  concentric  rings. 
No  smell ;  taste  sweetish,  and  afterwards  acrid. 

Action. — Poke  is  emetic,  cathartic,  and  somewhat  narcotic, 
producing  in  large  doses  vomiting,  purging,  drowsiness,  dimness 
of  vision,  giddiness,  and  sometimes  convulsions.  It  has  been 
proposed  as  an  emetic  instead  of  ipecacuan,  but  its  action  is  too 
slow.  As  an  alterative  it  has  been  recommended  in  rheumatism. 
Externally  a  strong  infusion  or  decoction  of  the  root  has  been 
used  in  piles,  skin  diseases,  and  cancer. 

3t 


1010  VEGETABLE  MATEEIA  MEDICA.  {sect.  v. 


POLYGONACE^. 

Rhei  Radix,  B.P. ;  Rheum,  U.S.  P.  Bhubarb  Boot,  B.P, ; 
Ehubaeb,  U.S.P. — The  root  more  or  less  deprived  of  its  bark, 
sliced  and  dried,  of  Rheum  palmatwn,  Rheum  officinale,  and  pro- 
bably other  species.  Collected  and  prepared  in  China  and 
Thibet. 

Characters. — Trapezoidal,  roundish,  cylindrical,  or  flattish  pieces,  fre- 
quently bored  with  one  hole,  yellow  externally,  internally  marbled  with  fine 
waving  greyish  and  reddish  lines,  finely  gritty  under  the  teeth ;  taste  bitter, 
faintly  astringent  and  aromatic  ;  odour  peculiar. 

Composition. — The  chief  constituent  is  chrysophanic  acid, 
so-named  from  its  forming  briliant  yellow  crystals.  It  is  ex- 
tracted by  ether  or  alcohol,  not  by  water.  Besides  this  there  is 
also  a  glucoside  chrysophan,  which  splits  up  into  chrysophanic 
acid  and  sugar.  There  are  also  several  resinous  matters,  one  of 
which,  phaoretin,  is  purgative,  and  mineral  compounds  are  also 
present,  especially  oxalate  of  calcium.  The  astringency  of  rhubarb 
is  due  to  a  peculiar  tannic  acid  (rheo-tannic),  which  is  soluble 
in  water  and  alcohol,  but  not  in  ether. 

Impurities. — English  rhubarb  and  turmeric  fraudulently  added. 
Tests. — Odour  and  taste  (English  rhubarb).    Boracic  acid  does  not  turn 
the  yellow  exterior  brown  (turmeric). 

Dose.—  Of  the  powdered  root,  1-5  gr.  as  a  stomachic ;  10-30 
gr.  as  a  purgative. 

Preparations. 

B.P.  DOSE. 

Extractum  Rhei 5-15  gr. 

Infusum  Rhei  ($-oz.  in  ^-pint  for  1  hour) 1-2  fl.  oz. 

Pllula  Rbei  Composita  (vide  p.  523) 5-10  gr. 

Pulvis  Rbei  Compositus 5-10  gr.  (child). 

„  „  „  20-60  gr.  (adult). 

Syrupus  Rbei 1_4  fl.  dr. 

Tlnctura  Rbei 1_2  fl.  dr.  (stomachic). 

n  ii    |-1  A.  oz.  (purgative). 

Vlnum  Rbei 1_2  fl.  dr. 

TJ.S.P. 

Bheum. 

Extractum  Ehei 3_10  gr. 

Extractum  Ehei  Fluidum 1_10  min. 

Pilulse  Bhei  (vide  p.  523) 1_3  pills.  (3  gr.  each). 

Pilulse  Ehei  Composite  (vide  p.  523) 1-4  pills. 

Pulvis  Ehei  Compositus 30-60  gr. 

Syrupus  Ehei 1_4  fl.  dr.  1  .       .  ., , 

Syrupus  Ehei  Aromaticus 1-4  fl.  dr.  j  »r  children. 

Tinctura  Ehei 1_6  fl.  dr. 

Tinctura  Ehei  Aromatica 1_4  fl.  dr. 

Tinctura  Ehei  Dulcis 1_4  fl.  dr.  for  children. 

Viuum  Ehei 1_4  fl.  dr. 

Mistura  Ehei  et  Sodaa 2  dr.-3  oz. 

B.P.  Pulvis  Rbei  Compositus.  Compound  Powder  of  Ehubarb  (Gregory's 


chap,  xxxv.]  APETALiE.  1011 

Powder). — Rhubarb  root,  2  oz. ;  light  magnesia,  6  oz. ;  ginger,  1  oz.  Mix  the 
powdered  ingredients  and  pass  through  a  fine  sieve. 

B.P.  Syrupus  Rhei.  Syrup  or  Rhubarb. — Rhubarb  root  and  coriander  fruit, 
both  in  coarse  powder,  each  2  oz. ;  refined  sugar,  24  oz. ;  rectified  spirit,  8  fl.  oz. ; 
distilled  water,  24  fl.  oz.  Percolate  the  rhubarb  and  coriander  with  the  spirit  and 
water  ;  evaporate  the  filtrate  to  13  fl.  bz. ;  filter  ;  dissolve  the  sugar  in  the  nitrate. 

B.P.  Tinctura  Rhei.  Tinctuke  of  Rhubabb. — Rhubarb,  2  oz. ;  bruised  car- 
damom seeds,  y  oz. ;  coriander  fruit,  \  oz. ;  saffron,  J  oz. ;  proof  spirit,  1  pint. 

B.P.  Vlnum  Rbei.  Wine  of  Rhubarb.— Rhubarb  root,  1J  oz. ;  Canella  alba 
bark,  60  gr. ;  sherry,  1  pint. 

U.S.P.  Pulvis  Rhei  Compositus.  Compound  Powder  or  Rhubarb.— Rhubarb, 
25 ;  magnesia,  65  ;  ginger,  10  parts. 

U.S.P.  Syrupus  Rhei.  Syrup  of  Rhubarb. — Rhubarb,  90 ;  cinnamon,  18 ; 
carbonate  of  potassium,  6 ;  sugar,  600  ;  water  q.s.  to  make  1,000. 

TJ.S.P.  Syrupus  Rhei  Aromaticus.  Aromatic  Syrup  of  Rhubarb. — Aromatic 
tincture  of  rhubarb,  10 ;  syrup,  90  parts. 

U.S.P.  Tinctura  Rhei.  Tincture  of  Rhubarb. — Rhubarb,  12  ;  cardamom,  2  ; 
diluted  alcohol  up  to  100  parts. 

U.S.P.  Tinctura  Rhei  Aromatica.  Aromatic  Tincture  of  Rhubarb. — Rhubarb, 
20 ;  cinnamon,  4  ;  cloves,  4 ;  nutmeg,  2  ;  diluted  alcohol  up  to  100. 

U.S.P.  Tinctura  Rhei  Dulcis.  Sweet  Tincture  of  Rhubabb. — Rhubarb,  8 ; 
glycyrrhiza,  4 ;  anise,  4 ;  cardamom,  4 ;  diluted  alcohol  up  to  100. 

TJ.S.P.  Vinum  Rhei.  Wine  of  Rhubarb. — Rhubarb,  10  ;  calamus,  1  ;  stronger 
white  wine  up  to  100. 

Action  and  Uses. — Ehubarb  when  chewed  increases  the  flow 
of  saliva.  Small  doses  have  a  tonic  and  astringent  action 
and  are  employed  in  atonic  dyspepsia,  especially  when  there  is 
an  accumulation  of  mucus  in  the  intestinal  tube.  Large  doses 
are  purgative  in  their  action,  increasing  peristalsis.  This  is 
followed  by  an  astringent  effect.  It  is  especially  useful  in  cases 
of  diarrhoea  associated  with  worms,  or  when  there  is  some  irritat- 
ing body  in  the  intestines  :  the  cause  of  irritation  is.  removed, 
and  then  the  after-astringent  action  checks  the  diarrheea. 

U.S.P.  Rumex.  Btjmex.  Yellow  Dock. — The  root  of  Bwmex 
crispus  and  of  other  species  of  Eumex. 

Characters. — Prom  eight  to  twelve  inches  (20  to-  30  centimetres)  long, 
about  half  an  inch  (12  millimetres)  thick,  somewhat  fusiform,  fleshy,  nearly 
simple,  annulate  above,  deeply  wrinkled  below ;  externally  rusty-brown,  in- 
ternally whitish,  with  fine,  straight,  interrupted,  reddish  medullary  rays,  and 
a  rather  thick  bark ;  fracture  short ;  odour  slight,  peculiar  ;  taste  bitter  and 
astringent. 

Composition. — It  contains  tannic  acid  and  rumicine,  which 
is  identical  with  chrysophanic  acid. 

Preparation. 

dose. 
Extractum  Rumicis  Fluidum 30-60  min. 

Action. — It  is  astringent  and  bitter,  and  is  supposed  to 
possess  alterative  properties,  which  render  it  useful  in  scorbutic 
diseases. 


St2 


1012  VEGETABLE  MATEEIA  MEDICA.  [sect. 


ARISTOLOCHIACEiE. 

Serpentariae  Rhizoma,  B.P. ;  Serpentaria,  U.S.P.  Ser- 
pentary Khizome,  B.P.;  Serpentaeia,  U.S.P.— The  dried  rhizome 
and  rootlets  of  Aristolochia  Serpentaria  or  Aristolochia  reticulata. 
From  the  southern  parts  of  North  America. 


Fig.  217. — Serpentary,  half  the  natural  size. 

Characters. — A  small  roundish  rhizome,  with  a  tuft  of  numerous  slender 
rootlets,  about  three  inches  long,  yellowish,  of  an  agreeable  camphoraceous 
odour,  and  a  warm  bitter  camphoraceous  taste. 

Composition.  —  An  essential  oil,  and  resin,  tannin,  and 
sugar. 

Adulteration. — Other  roots  fraudulently  or  inadvertently  added,  distin- 
guished by  appearance  and  smell. 

Preparations. 
B.P.  DOSE. 

Inflisum  Serpentariae 1-2  fl.  oz. 

Tinctura  Cinchonas  Oomposita 1-2  fl.  dr. 

Tinctura  Serpentariae |-2  fl.  dr. 

U.S.P. 

Extractum  Serpentariae  Fluidum 10-30  min. 

Tinctura  Cinchona  Composita 1-4  fl.  dr. 

Tinctura  Serpentarias 1-3  fl.  dr. 

Action  and  Uses. — Serpentary  is  a  stimulant  tonic,  and  is 
used  in  atonic  dyspepsia  with  nervous  depression.  Owing  to  its 
having  some  diaphoretic  and  diuretic  properties,  it  is  used  in 
chronic  rheumatism. 

Asaeum  Europium  or  Asaeabacca  belongs  to  this  order ;  its 
leaves  were  formerly  used  as  an  errhine.  They  cause  powerful 
vomiting  and  purging  when  administered  internally. 


PIPERACE.E. 

Piper  Nigrum,  B.P. ;  Piper,  U.S.P.  Black  Pepper.— The 
dried  unripe  fruit  of  Piper  nigrum,  B.P.  The  unripe  fruit  of 
Piper  nigrum,  U.S.P     East  Indies. 

_  Characters. — Small,  roundish,  wrinkled;  tegument  brownish-black,  con- 
taining a  greyish-yellow  globular  seed  ;  odour  aromatic ;  taste  pungent  and 
bitterish. 

Dose. — 5  to  20  grains. 


chap,  xxxv.]  APETAL^E.  1013 

Peepabations. 
b.p.  dose.  u.s.p.  cose. 

Confectio  Opii ■ 5-20  gr.  Oleoresina  Piperis 1-2  min. 

Confectio  Piperis  60-120  gr.  or  more. 

Pulvis  Opii  Compositus 2-5  gr. 

B.P.  Confectio  Piperis.  Confection  of  Peppee.—  Black  pepper,  2;  caraway 
fruit,  3 ;  clarified  honey,  15. 

XJ.S.P.  Oleoresina  Piperis.  Oleoeesin  of  Pepper. — Exhaust  pepper  with 
stronger  ether,  remove  the  ether  by  distillation  and  evaporation,  and  separate  the 
oleoresin  from  the  piperine  in  the  residue  by  expression  through  a  muslin  strainer. 

Composition.— Piperine,  resin,  and  volatile  oil.  Piperine  is 
a  crystalline  principle,  almost  neutral,  tasteless,  inodorous,  and 
insoluble  in  water,  and  is  isomeric  with  morphine.  The  resin 
possesses  the  pungent  taste  of  the  drug,  and  gives  the  oil  its 
aromatic  smell. 

U.S.P.  Piperina.  Pipekine.  C„H19N03;  285.— A  proxi- 
mate principle  of  feebly  alkaloidal  power,  prepared  from  pepper, 
and  occurring  also  in  other  plants  of  the  Nat.  Ord.  Piperacece. 

Characters. — Colourless,  or  pale  yellowish,  shining,  four-sided  prisms, 
permanent  in  the  air,  odourless,  and  almost  tasteless  when  first  put  in  the 
mouth,  but  on  prolonged  contact  producing  a  sharp  and  biting  sensation. 
When  heated  to  about  128°  C.  (about  262°  F.),  piperine  melts,  yielding  a 
clear,  yellowish  liquid,  which,  on  cooling,  congeals  to  a  resinous  mass.  It 
has  a  neutral  reaction. 

Solubility. — It  is  almost  insoluble  in  water,  but  soluble  in  30  parts  of 
alcohol  at  15°  C.  (59°  F.),  in  1  part  of  boiling  alcohol,  and  but  slightly  soluble 
in  ether. 

Ebactions. — When  heated  on  platinum  foil,  it  takes  fire  and  is  consumed 
without  residue.  Concentrated  sulphuric  acid  dissolves  piperine  with  a  dark, 
blood-red  colour,  which  disappears  on  dilution  with  water.  When  treated 
with  cold  nitric  acid,  piperine  turns  rapidly  greenish-yellow,  orange,  and  red, 
and  gradually  dissolves  with  a  reddish  colour.  On  adding  to  this  solution  an 
excess  of  solution  of  potassa,  the  colour  is  at  first  pale  yellow,  but  on  boiling 
it  deepens  to  blood-red,  while,  at  the  same  time,  vapours  of  an  alkaline  re- 
action and  of  a  peculiar  odour  (piperidine)  are  given  off. 

Dose. — 1  to  10  grains. 

Action  and  Uses. — Pepper  is  a  stimulant  stomachic.  It  is 
used  chiefly  as  a  condiment,  but  has  been  employed  in  the  treat- 
ment of  haemorrhoids,  and,  on  account  of  its  stimulating  action 
on  mucous  membranes,  as  a  substitute  for  cubebs  in  the  treat- 
ment of  gonorrhoea.  The  action  and  uses  of  piperine  are 
similar  to  those  of  pepper. 

Cubeba,  B.  and  U.S.P.  Cubebs. — The  dried  unripe  fruit  of 
Piper  Cubeba  (Cubeba  officinalis) .     Java. 


Fig.  218.— Cubebs. 


Characters. — Is  like  black  pepper,  but  is  distinguished  from  it  by  the 
adherent  stalk  of  rather  more  than  its  own  length,  from  which  it  gets  its 


1014  VEGETABLE   MATERIA  MEDICA.  [sect.  v. 

ordinary  name  of  tailed  pepper.     It  has  a  warm  camphoraceous  taste  and 
characteristic  odour. 

Composition. — A  volatile  oil,  a  resin,  and  cubebin.  Cubebin 
is  neutral  and  crystalline.  It  does  not  seem  to  have  any  im- 
portant physiological  action.  The  resin  yields  cubebic  acid,  and 
a  volatile  oil  consisting  of  a  hydrocarbon  holding  a  camphor  in 
solution. 

Dose. — Of  the  powder  30  to  120  gr. 

Pbepabations. 

b.p.  dose.  u.s.p.  cose. 

Oleoresina  Cutoebee 5-30  min.         Cubeba 15  gr. 

Oleum  5-20  min.        Extractum  Cubebas  1  B  „n      . 

Tinctura  „        J-2  fl.  dr.  Pluidum /wum 

Oleoresina  Cubeb£e...5-30  min. 

Tinctura  OubebsB 8  min.-3  fl.  dr. 

Trochisci  Cubebse 

(each  contains  J-gr.  oleoresin). 

Oleum  Cubebas,  B.  and  U.S.P.  Oil  of  Cubebs. — A  volatile 
oil  distilled  from  cubebs. 

Characters. — Colourless  or  pale  greenish-yellow,  having  the  peculiar 
odour  and  taste  of  cubebs. 

Composition. — A  hydrocarbon  holding  a  camphor  in  solution. 

Oleoresina  Cubebse,  B.  and  U.S.P.     Oleoresin  of  Cubebs. 

Preparation. — By  extracting  cubebs  with  stronger  ether,  distilling  off  most 
of  the  ether ;  letting  the  rest  evaporate ;  transferring  the  residue  to  a  closed 
vessel  till  waxy  and  crystalline  matter  has  ceased  to  deposit,  and  then  pour- 
ing off  the  oleoresin. 

Dose. — 5  to  30  min.  (0'3  to  2  gm.)  given  in  capsules. 

Action  and  Uses. — Cubebs  owes  its  action  to  the  oil  and 
resin.  It  is  carminative  and  stimulant  to  mucous  membranes. 
It  is  used  chiefly  for  its  action  on  the  mucous  membrane  of  the 
bladder  and  urethra,  as  in  gonorrhoea  (p.  446).  It  is  used  in  the 
form  of  lozenges  for  relaxed  sore-throat,  and  as  an  errhine  for 
coryza  when  free  secretion  has  become  established.  It  is  slightly 
diuretic,  and  has  been  used  as  an  adjunct  to  other  diuretics. 
Large  doses  may  produce  gastro-enteritis,  and  it  sometimes  gives 
rise  to  a  rash  resembling  urticaria.  The  oil  has  an  action  some- 
what like  oil  of  turpentine  or  oil  of  copaiba.  The  resin  is  said 
to  be  a  more  active  diuretic  than  the  oil,  and  the  oleoresin  is 
therefore  introduced  into  the  U.S.P. 

Maticae  Folia,  Matico  Leaves,  B.P.  Matico,  Matico, 
U.S.P. — The  dried  leaves  of  Piper  angustifolium  (Artanthe  elon- 
gate).    Peru. 

Characters. — From  two  to  eight  inches  long,  veined  and  tessela^ed  on 
the  upper  surface,  downy  beneath.  They  may  be  confounded  with  digitalis 
leaves,  but  are  distinguished  by  their  marked  reticulation  in  squares. 


chap,  xxxv.]  APETALJ1.  1015 

Composition. — Essential  oil,  artanthic  acid,  tannin,  and 

resin. 

Dose. — Of  the  powder,  30-60  gr. 

Preparations. 

b.p.  dose.  u.s.p.  dose. 

Infusum  IMatlcae 1-4  fl.  oz.        Extractum  Matioo  Fluidum...i-3  fl.  dr. 

(£-oz.  in  |-pint  for  f-hour).  Tinctura  Matioo |-3  fl.  oz. 

Action  and  Uses. — Matico  is  employed  locally  as  a  styptic 
to  arrest  haemorrhage  from  small  wounds,  such  as  leech-bites. 
It  acts  mechanically,  much  in  the  same  way  as  a  spider's  web. 
It  has  been  administered  in  cases  of  vesical  catarrh  and  gonor- 
rhoea, but  is  now  not  much  used. 

MYRISTICEiE. 

Myristica,  B.  and  U.S.P.  Nutmeg. — The  kernel  of  the  seed 
of  Myristica  fragrans  deprived  of  its  hard  coat  or  shell.  Malayan 
Archipelago. 

Characters. — Oval  or  nearly  round,  about  an  inch  in  length,  marked 
externally  with  reticulated  furrows,  internally  greyish-red  with  dark  brownish 
veins.  It  has  a  strong  peculiar  odour,  and  a  bitter  aromatic  taste.  Nutmeg 
resembles  areca  nut,  especially  in  its  internal  structure,  but  the  latter  is  devoid 
of  the  strong  odour. 

Composition.— Fixed  oil  (oil  of  mace)  and  volatile  oil,  the 
latter  imparting  the  aromatic  smell  and  taste. 
Dose. — Of  powdered  nutmeg,  5-15  gr. 

Preparations. 

B.P.  DOSE. 

Oleum  IVXyrlsticaB 1-5  min. 

„  „  Expressum 1-5  min. 

Pulvis  Catechu  Compositus 20-40  gr. 

Pulvis  Creta?  Aromaticus 10-60  gr. 

Spiritus  Armoraciaa  Compositus 1-2  fl.  dr. 

Tinctura  Lavandulae  Composita |-2  fi.  dr. 

c.s.p. 

Tinctura  Lavandulae  Composita 5-2  fl.  dr. 

Pulvis  Aromaticus 10-30  gr. 

Oleum  Myristicae,  B.  and  U.S.P.  Volatile  Oil  of  Nutmeg. 
The  oil  distilled  in  Britain  from  nutmeg,  B.P.  A  volatile  oil 
distilled  from  nutmeg,  U.S.P. 

Characters.— Colourless  or  straw-yellow,  having  the  odour  and  taste  of 
nutmegs. 

Preparations. 
B.P.  DOSE. 

Pilula  Aloes  Socotrinse  (vide  p.  522)  5-10  gr. 

Spiritus  Ammonlee  Aromaticus 30  min.-l  fl.  dr. 

Spiritus  Myristicae 30-60  min. 

(Mistura  Ferri  Composita). 

U.S.P. 

Spiritus  Myristica; 1-2  fl.  dr. 


1016  VEGETABLE  MATEEIA  MEDICA.  [sect.  v. 

B.P.  Oleum  Myristicae  Expressum.  Expeessbd  Oil  op 
Nutmeg. — A  concrete  oil  obtained  by  means  of  expression  and 
heat  from  nutmegs. 

Characters. — Of  an  orange  colour,  firm  consistence,  and  fragrant  odour 
like  that  of  nutmeg. 

Preparations. 

B.P. 

Emplastrum  Calefaciens.  Emplastrum  Picls. 

Action  and  Uses. — Nutmeg  is  aromatic,  stimulant,  and  car- 
minative. The  expressed  oil  is  used  externally  as  a  stimulant, 
and  with  other  stimulants  is  contained  in  emplastrum  picis  and 
emplastrum  calefaciens.  It  is  very  little  used  in  medicine,  but 
chiefly  to  flavour  articles  of  food. 

U.S.P.  Macis.  Mace.-  The  arillus  of  the  fruit  of  Myristica 
fragrans. 

Characters. — In  narrow  bands,  one  inch  (25  millimetres)  or  more  long, 
somewhat  branched  and  lobed  above,  united  to  broader  bands  below ;  brownish- 
orange  ;  fatty  when  scratched  or  pressed ;  odour  fragrant ;  taste  warm  and 
aromatic. 

Uses. — It  contains  the  same  volatile  oil  as  nutmeg,  and  has 
the  same  uses. 

LAURINEiE. 

Cinnamomi  Cortex,  B.P. ;  Cinnamomum,  U.S.P.  Cinna- 
mon Bake,  B.P. ;  Cinnamon,  U.S.P. — The  inner  bark  of  shoots 
from  the  truncated  stocks  of  Cinnamomum  zeylanicum.  Imported 
from  Ceylon. 

Characters. — In  closely  rolled  quills,  containing  several  small  quills 
within  them,  light  yellowish-brown,  with  a  fragrant  odour  and  warm  sweet 
aromatic  taste ;  breaks  with  a  splintery  fracture. 

Composition. — A  volatile  oil  to  the  extent  of  1  per  cent,  with 
mannite,  sugar,  mucilage,  and  tannic  acid. 

Adulteration. — Cassia  Ugnea. 

Test. — Decoction  of  cassia  Ugnea  is  coloured  blue-black  by  tincture  of 
iodine. 

Preparations. 

B.P.  DOSE. 

Aqua  Cinnamomi 1-2  ft.  oz. 

Decoctum  Htematoxyli 1-2  fl.  oz. 

Infusum  Catechu 1-2  fl.  oz. 

Oleum  Cinnamomi 1-5  min. 

Pulvis  Catechu  Compositus 20-40  gr. 

Pulvls  Cinnamomi  Compositus  10-30  gr. 

Pulvis  CretsB  Aromaticus 10-60  gr. 

Pulvis  Kino  Compositus 5-20  gr. 

Tinctura  Cardamomi  Composita J-2  fl.  dr. 

Tinctura  Catechu 1-2  fl.  dr. 

Tinctura  Cinnamomi {-2  fl.  dr. 

Tinctura  Lavandula  Composita j-2  fl.  dr. 

Vinum  Opii 10-40  min, 


chap,  xxxv.]  APETAL^E.  1017 

V.S.V.  DOSE. 

Pulvis  Aromaticus 10-30  gr. 

Tinotura  Cinnamomi J_2  fl.  dr. 

Oleum  , 1_5  min. 

Tinotura  Lavandulae  Composita a~2  fl.  dr. 

Vinum  Opii 6  min. 

Pulvis    Cinnamomi    Composltus,    B.P. ;  Pulvis   Aromatlcus,   U.S. P. 

Compound  Cinnamon  Powder,  B.P. ;  Aromatic  Powdeb,  D.S.P. — Equal 
parts  of  cinnamon,  cardamoms,  and  ginger,  B.P.  Cinnamon  35,  ginger  35, 
cardamoms  15,  nutmeg  15,  TJ.S.P. 

Oleum  Cinnamomi,  B.  and  U.S.  P.  Oil  of  Cinnamon. — The 
oil  distilled  from  cinnamon  bark. 

Characters. — Yellowish  when  recent,  gradually  becoming  red,  having 
the  odour  and  taste  of  cinnamon. 

Composition. — Consists  principally  of  cinnamic  aldehyde,  or 
hydride  of  cinnamyl,  with  other  hydrocarbons,  one  of  which,  a 
camphor,  is  deposited  at  low  temperatures,  thus  causing  the 
change  in  colour.  The  oil  has  a  specific  gravity  of  from  1-025 
to  l-050,  so  that  it  sinks  in  water.    It  is  slightly  lasvulose. 

Dose. — 1-5  min. . 

Pbepakations. 

B.P.  DOSE. 

Splrltus  Cinnamomi  (oil  1,  spirit  49) J-l  fl.  dr. 

Acidum  Sulphuricum  Aroma ticum  (contains  spirit  of  cinnamon). .5-30  min. 

c.s.p. 

Aqua  Cinnamomi indefinite. 

Spiritus  Cinnamomi 5-15  min. 

Acidum  Sulphuricum  Aromaticum 5-15  min. 

Action  and  Uses. — Cinnamon  is  an  aromatic  carminative, 
and  since  it  contains  tannic  acid  slightly  astringent.  It  is 
chiefly  used  in  conjunction  with  other  astringents,  and  from  its 
agreeable  taste  is  very  frequently  employed. 

Coto  Bark.  Not  officinal. — The  bark  of  a  tree  imported 
from  Bolivia. 

Composition. — It  contains  an  alkaloid,  cotoin.  Cotoin  forms 
a  pale  yellow  powder  or  minute  crystals  sparingly  soluble  in 
water,  soluble  in  alcohol,  ether,  and  chloroform. 

Dose. —  i  to  2  gr.  every  two  or  three  hours  in  mucilage  or 
syrup.  A  solution  of  1  part  in  4  of  acetic  ether  is  recommended 
for  hypodermic  injection.  Tincture  of  coto  bark  (1  in  10)  may 
be  used  in  doses  of  10  min. 

Action. — It  appears  greatly  to  increase  intestinal  absorp- 
tion (p.  387). 

Uses. — It  is  useful  in  gastric  and  intestinal  catarrh,  in  infan- 
tile diarrhoea,  and  in  the  diarrhoea  of  phthisis.  It  is  said  also  to 
check  salivation  and  the  night  sweats  of  phthisis. 

Paracoto  Bark.  Not  officinal. — Contains  an  alkaloid 
paracotoin,  similar  in  its  actions  and  uses  to  cotoin,  but  less 
powerful. 


1018  VEGETABLE   MATEEIA  MEDICA.  [sect.  v. 

Camphora,  B.  and  U.S.  P.  Camphob. — A  stearoptene  (con- 
crete volatile  oil),  obtained  from  the  wood  of  Cinnamomum  Cam- 
phora {Camphora  officinarum).  Imported  in  the  crude  state  from 
China  and  Japan,  and  purified  by  sublimation. 

Characters. — White,  translucent,  tough,  crystalline  lumps  ;  has  a  power- 
ful penetrating  odour,  and  a  pungent  taste  followed  by  a  sensation  of  cold ; 
floats  on  water ;  volatilises  slowly  at  ordinary  temperatures. 

Solubility. — Is  slightly  soluble  in  water,  but  readily  soluble  in  rectified 
spirit  and  in  ether. 

Composition. — A  stearoptene  having  the  formula  C10H160, 
and  yielding  camphoric  acid  on  oxidation. 

Impurities. — Fixed  salts. 

Test. — Sublimes  entirely  when  heated. 

Dose. — 1  to  10  grains. 

Preparations  containing  Camp-hob. 
B.p.  DOSE. 

Aqua  Camphorse  (saturated  aqueous  solution) 1-2  fl.  oz. 

Linimentum  Aconiti  (vide  p.  516) 

„  Belladonnas  (mdey.  516) 

Linimentum  Camphorse  (vide -p.  516)  

„                        „          Composltum  (vide  p.  516) 
Linimentum  Chloroformi  (vide  p.  516) 

„  Hydrargyri  (vide-p.516) 

„  Opii  (vide  p.  516) 

Linimentum  Saponis  (vide  p.  516) 

Linimentum  Sinapis  Compositum  (vide  ■p.  516) 

Linimentum  Terebinthinse  (vide  p.  516) 

„  „  Aceticum  (vide  p.  516) 

Splritus  Camphorse  (camphor  1,  rectified  spirit  10)...  10-30  min. 

Tlnctura  Camphorse  Composita  (vide  Opium) 15  min.-l  fl.  dr. 

Unguentum  Hydrargyri  Compositum 

The  hypodermic  injections  of  apomorphine  and  ergot  contain  camphor  water. 

U.S.P.  DOSE. 

Aqua  Camphorse 1  fl.  dr. 

Linimentum  Belladonnas  (vide  p.  517) 

„  Camphorse  (vide  p.  517) 

„  Chloroformi  (videj>.  517) 

„  Saponis  (vide  p.  517) 

Spiritus  Camphorse 5-10  min. 

Tinctura  Opii  Camphorata 1-2  fl.  dr. 

Ceratum  Camphorse 

Aqua  Camphorse.  Camphor  Water,  B.  and  U.S.P. — It  is  prepared  according 
to  the  B.P.  by  tying  crushed  camphor,  |-oz.,  in  a  muslin  bag,  which  is  kept  im- 
mersed in  1  gallon  of  water  in  a  bottle  for  at  least  two  days.  The  U.S.P.  directs 
camphor  (8)  to  be  dissolved  in  alcohol  (16),  and  then  added  to  cotton  (16).  After 
the  alcohol  has  nearly  evaporated  the  cotton  is  packed  in  a  percolator,  and  distilled 
water  poured  on  till  1,000  parts  are  obtained. 

U.S.P.  Ceratum  Camphorse.  Camphob  Cerate. — Camphor  liniment,  3  j  olive 
oil,  12  ;  cerate,  85. 

Physiological  Action. — Externally  camphor  is  stimulant 
and  rubefacient. 

Internally  in  small  doses  it  acts  as  a  carminative,  in  large 


chap,  xxxv.]  APETAL.EJ.  1Q19 

doses  as  an  irritant,  causing  nausea  and  vomiting.  It  is  dia- 
phoretic and  anaphrodisiac,  and  stimulates  the  heart  (pp. 
316,  319).  It  stimulates  the  circulation,  but  may  slow  the 
pulse ;  and  stimulates  the  nerve-centres,  causing  exhilaration, 
but  finally  paralyses  them,  causing  lassitude. ,  It  produces,  in 
large  doses,  a  form  of  delirium,  and  sometimes  death,  occasion- 
ally preceded  by  epileptiform  convulsions  and  maniacal  excite- 
ment. In  small  doses  it  is  said  to  be  aphrodisiac,  and  in  large 
doses  anaphrodisiac  (p.  451).    It  lowers  the  temperature. 

Uses. — Externally,  in  the  form  of  liniment,  it  is  applied  to 
sprains,  enlarged  joints,  &c.  An  ointment  of  1  part  of  camphor 
to  8  of  lard  is  useful  in  relieving  itching  in  chronic  eczema  and 
urticaria. 

Inhalation  of  its  vapour  (£-1  dr.  in  J-pint  hot  water)  has 
been  recommended  for  coryza. 

Internally  it  is  used  in  catarrh  and  coryza.  It  is  very  useful 
in  summer  diarrhoea,  and  may  be  given  in  the  form  of  Bubini's 
solution  (1  gr.  in  2  min.  of  absolute  alcohol),  two  to  five  minims 
every  fifteen  minutes.  It  is  also  useful  in  cholera,  tympanitic 
distension  of  the  abdomen,  and  hysterical  vomiting. 

It  is  also  used  as  a  nervine  stimulant,  especially  in  debility 
of  the  respiratory  organs ;  as  a  nervine  and  cardiac  stimulant 
in  fever,  and  as  an  antispasmodic  in  epilepsy,  chorea,  pertussis, 
hysteria,  and  other  nervous  affections,  especially  those  connected 
with  the  sexual  organs. 

U.S.P.  Camphora  Monobromata.  Monobromated  Camphor. 
C10H15BrO;  230-8. 

Preparation. — By  heating  camphor  with  bromine  and  crystallising  from 
petroleum  benzin. 

Characters. — Colourless,  prismatic  needles  or  scales,  permanent  in  air, 
unaffected  by  light,  having  a  mild  camphoraceous  odour  and  taste,  and  a 
neutral  reaction. 

Solubility. — Almost  insoluble  in  water,  freely  soluble  in  alcohol,  ether, 
chloroform,  hot  benzin,  and  fixed  oils ;  slightly  soluble  in  glycerine. 

Dose. — 2  to  10  grains.  It  may  be  given  in  pills,  made  by 
rubbing  5  grains  with  1  grain  of  Canada  balsam  in  a  warm 
mortar. 

Action. — Like  other  bromides  it  produces  weakness  and 
paralysis,  stupor  and  sleep.  It  slows  the  pulse  (p.  316)  and 
respiration  and  reduces  the  temperature.  In  the  rabbit  the 
vessels  of  the  eye  and  ear  are  contracted.  When  given  for  a 
length  of  time  it  produces  marked  emaciation. 

Uses. — Monobromated  camphor  has  been  used  as  a  sedative 
instead  of  the  bromides,  but  it  is  less  efficient.  It  has  been 
recommended  in  insomnia,  chorea,  hysteria,  and  delirium  tre- 
mens. In  large  doses  it  has  caused  epileptiform  convulsions, 
like  camphor. 


1020  VEGETABLE  MATEEIA  MEDICA.  [sect.  v. 

B.P.  Sassafras  Radix.  Sassafras  Boot.— The  dried  root 
of  Sassafras  officinalis.     From  North  America. 

Chabactebs. — In  branched  pieces;  bark  externally  greyish-brown,  in- 
ternally rusty -brown,  of  an  agreeable  odour,  and  a  peculiar  aromatic  warm 
taste ;  wood  light,  porous,  greyish -yellow.  The  chips  or  shavings,  which  are 
the  officinal  form,  resemble  quassia,  but  are  browner,  and  distinguished  by 
their  smell. 

Composition. — Contains  1  to  2  per  cent,  of  a  volatile  oil. 
The  bark  contains  tannic  acid  to  a  small  extent. 

Preparation. 
B.P.  COSE. 

Decoctum  Sarsse  Compositum  (?,--oz.  to  1  pint) 2-10  fl.  oz. 

U.S.  P.  Sassafras.  Sassafras. — The  bark  of  the  root  of 
Sassafras  officinalis. 

Chabactebs. — In  irregular  fragments,  deprived  of  the  grey,  corky  layer ; 
bright  rust-brown,  soft,  fragile,  with  a  short,  corky  fracture ;  strongly  fra- 
grant ;  sweetish,  aromatic,  and  somewhat  astringent. 

U.S.  P.  Oleum  Sassafras.  Oil  op  Sassafras. — A  volatile 
oil  distilled  from  sassafras. 

Chabactebs. — A  colourless  or  yellowish  liquid  becoming  darker  and 
thicker  by  age  and  exposure  to  air,  having  the  characteristic  odour  of  sassa- 
fras, a  warm,  aromatic  taste,  and  a  neutral  reaction ;  sp.  gr.  about  l-090. 

Solubility. — It  is  readily  soluble  in  alcohol. 

Reactions. — When  treated  with  cold  nitric  acid  it  becomes  dark  red,  and 
is  finally  converted  into  a  red  resin. 

Dose. — 1-5  min. 

Preparations, 
u.s.p.  DOSE. 

Decoctum  SarsaparUlffl  Compositum 4-6  fl.  oz. 

Extractum        „  „  Fluidum 30-60  min. 

Syrupus  „  Compositus 1-4  fl.  dr. 

Action  and  Use. — Sassafras  has  a  destructive  action  on  in- 
fusoria (cf.  p.  63).  It  is  a  stimulant  diaphoretic,  and  is  used  in 
rheumatism  and  syphilis,  generally  in  combination  with  other 
drugs. 

U.S.P.  Sassafras  Medulla.  Sassafras  Pith. — The  pith  of 
Sassafras  officinalis. 

Chabactebs. — In  slender  cylindrical  pieces,  often  curved  or  coiled,  light, 
spongy,  white,  inodorous,  insipid.  Macerated  in  water  it  forms  a  mucila- 
ginous liquid,  which  is  not  precipitated  on  the  addition  of  alcohol. 

Preparation. 

dose. 
Mucilago  Sassafras  Medullte  (sassafras  pith,  2  parts  j  water,  100  parts) ..  .Ad  libitum. 

Uses. — As  a  demulcent  either  internally  or  externally. 


chap,  xxxv.]  APETAL^.  1021 

B.P.  Nectandrae  Cortex.  Bebeeru  Babe. —The  dried  bark 
of  Nectandra  Bodicei,  the  green-heart  tree.  Imported  from 
British  Guiana. 

Characters.— In  large  flat  heavy  pieces ;  external  colour  greyish-brown, 
internal,  dark  cinnamon-brown  ;  taste  strongly  and  persistently  bitter,  with 
considerable  astringency. 

Composition. — Contains  beberine,  a  peculiar  alkaloid.  Bebe- 
rine  is  a  colourless,  amorphous  substance,  soluble  in  alcohol,  but 
sparingly  soluble  in  boiling  water. 

Preparation. 
B.P.  dose.  u.s.p. 

Beberinae  Sulphas 1-10  gr.  None. 

B.P.  Beberinae  Sulphas.  Sulphate  op  Beberine. 
C36H42N206.H2S04. — Prepared  from  Nectandra  or  Bebeeru  bark. 
It  is  probably  a  mixture  of  sulphates  of  beberine,  C36H42N206, 
nectandrine,  C40H46N2O6,  and  other  alkaloids. 

Preparation. — By  exhausting  the  bark  with  diluted  sulphuric  acid,  re- 
moving most  of  the  acid  by  lime,  precipitating  the  alkaloid  with  ammonia, 
and  neutralising  with  sulphuric  acid. 

Properties. — In  dark-brown,  thin,  translucent  scales,  yellow  when  in 
powder,  with  a  strong  bitter  taste. 

Solubility. — Soluble  in  water  and  in  alcohol. 

Eeactions.— Its  watery  solution  gives  a  white  precipitate  with  chloride 
of  barium  (sulphate) ;  and  with  caustic  soda  a  yellowish-white  precipitate, 
which  is  dissolved  by  agitating  the  mixture  with  twice  its  volume  of  ether 
(beberine). 

Impurities. — Mineral  matter. 

Tests. — The  ethereal  solution,  separated  by  a  pipette  and  evaporated, 
leaves  a  yellow  translucent  residue,  entirely  soluble  in  dilute  acids.  It  is 
entirely  destructible  by  heat.     Water  forms  with  it  a  clear  brown  solution. 

Action  and  Uses. — Bebeeru  bark  is  seldom. used  in  medicine; 
both  it  and  the  sulphate  of  beberine  are  said  to  have  a  similar 
action  to  quinine  (cf.  p.  61),  and  have  been  used  as  tonics  and 
antiperiodics,  but  sulphate  of  beberine  is  but  a  poor  substitute 
for  the  cinchona  alkaloids. 


SANTALACEiE. 

Oleum  Santali,  B.  and  U.S.P.  Oil  of  Santal  (Oil  of  sandal 
wood). — A  volatile  oil'  distilled  from  the  wood  of  Santalum 
album. 

Characters. — A  pale  yellowish  or  yellow  liquid  of  a  peculiar  strongly 
aromatic  odour,  a  pungent  and  spicy  taste,  and  a  slightly  acid  reaction. 
Solubility. — It  is  readily  soluble  in  alcohol. 

Dose. — 10  to  30  min.  in  capsules  or  mixture. 
Action  and  Uses. — Its  action  and  uses  are  similar  to  those 
of  copaiba,  than  which  its  smell  is  less  disagreeable. 


1022  VEGETABLE   MATERIA  MEDICA.  [sect.  v. 


THYMELACE/E. 

Mezerei  Cortex,  B.P. ;  Mezereum,  U.S.P.  Mbzeeeon 
Bake,  B.P. ;  Mezereum,  U.S.P. —  The  dried  bark  of  Daphne 
Mezereum,  or  of  Daphne  Laureola. 

Characters. — In  long  thin  more  or  less  flattened  strips,  which  are  com- 
monly folded  or  rolled  into  disks ;  or  in  small  quills  of  various  lengths. 
Inner  surface  whitish,  silky,  very  tough,  and  covered  externally  by  an  olive- 
brown,  or  somewhat  reddish-brown,  readily  separable  corky  layer.  No 
marked  odour ;  taste  burning  and  acrid. 

Preparations. 
B.P.  tr.s.p. 

Decoctum  Sarsse  Compositum.  Decoctum  SarsaparillfB  Compositum. 

Extractum  Mezerei  JEtherenm.  Extractum    Sarsaparillse    Compositum 

Linimentum  Sinapis  Compositum  (p.  516).  Fluidum. 

(Contains  Extract.)  Extractum  Mezerei. 

„  „        Fluidum. 

Action. — Externally  it  is  irritant.  Internally  it  is  supposed 
to  be  diuretic  and  alterative. 


EUPHORBIACEjE. 

Cascarillae  Cortex,  B.P. ;  Cascarilla,  U.S.P.  Cascarilla 
Bark,  B.P. ;  Cascarilla,  U.S.P. — The  dried  bark  of  Croton  Elu- 
teria.    Bahama  Islands. 


Fin.  219.— Cascarilla. 

Characters. — In  quills,  two  or  three  inches  in  length  and  about  J  to  J 
inch  in  diameter,  dull  brown,  but  more  or  less  coated  with  white  crustaceous 
lichens ;  breaks  with  a  short  resinous  fracture ;  is  warm  and  bitter  to  the 
taste ;  and  emits  a  fragrant  odour  when  burned. 

Composition. — The  active  principle  is  cascarillin,  a  bitter 
substance,  soluble  in  hot  spirit  or  ether.  Besin,  gum,  and  a 
small  quantity  of  volatile  oil  are  also  present. 

Preparations. 

b.p.  dose.  u.s.p.  dose. 

Xnfusum  Cascarillee  (1  oz.  to  ^-pint)...l-2  fl.  oz. .      Cascarilla 30  gr. 

Tlnctura      ■    „  A_2  fl.  dr. 

Action  and  Uses. — Cascarilla  is  aromatic,  stimulant,  and 
tonic.  It  is  also  a  stimulant  to  the  mucous  membranes,  and  is 
used  as  an  expectorant  in  chronic  bronchitis.  It  is  useful  in 
atonic  dyspepsia  and  as  a  general  tonic  to  the  system. 

U.S.P.  Stillingia.  Stillingia.  Queen's  Boot. — The  root 
of  Stillingia  sylvatica.  > 


chap,  xxxv.]  APETALiE.  1023 

Characters. — About  twelve  inches  (30  centimetres)  long,  and  nearly  two 
inches  (5  centimetres)  thick,  sub-cylindrical,  slightly  branched,  compact, 
wrinkled,  tough,  greyish-brown,  breaking  with  a  fibrous  fracture,  showing  a 
thick  bark  and  porous  wood,  the  inner  bark  and  medullary  rays  with  numerous 
yellowish-brown  resin  cells ;  odour  peculiar,  unpleasant ;  taste  bitter,  acrid, 
pungent. 

Composition. — It  contains  a  resinous  substance. 

Preparation. 

DOSE. 

Extractum  StUlingite  Fluidum 15-30  min. 

Uses. — In  large  doses  it  causes  vomiting  and  purging.  It 
has  been  used  as  an  alterative  in  secondary  syphilis  and  cuta- 
neous diseases. 

Oleum  Crotonis,  B.P. ;  Oleum  Tiglii,  U.S.P.  Croton 
Oil. — A  fixed  oil  expressed  (in  Britain)  from  the  seeds  of  Croton 
Tiglium.    East  Indies 


Pis.  220.— Croton  Oil  Seeds. 

Characters. — Slightly  viscid ;  colour  brownish-yellow,  taste  aerid,  odour 
faintly  nauseous. 

Composition.  —  Very  complex.  It  contains  several  fatty 
acids.  Its  active  principles  have  not  yet  been  separated.  An 
oily  substance  named  crotonai  is  said  to  possess  the  irritant 
properties  of  croton  oil. 

Dose. — Of  the  oil  ^-1  min.  placed  on  the  tongue,  or  formed 
into  a  pill  with  crumb  of  bread.  As  an  adjunct  ^  min. 
upwards. 

B.P.    Preparation. 
Xlnlmentum  Crotonis  (vide  p.  516)  (1  volume  in  8). 

Action. — Externally  it  is  an  irritant  and  gives  rise  to  a 
pustular  eruption.  This  effect  is  increased  by  the  addition  of  an 
alkali. 

Internally  it  is  a  violent  purgative,  causing  great  congestion 
of  the  intestinal  canal,  and  may  cause  death  from  gastro-enteritis 
with  collapse. 

Uses. — Externally  it  is  used  as  a  counter-irritant  in  phthisis, 
bronchitis,  inflammation  of  the  brain  and  its  membranes,  and 
inflammation  of  the  ovary,  in  the  form  of  the  liniment. 

Internally  it  is  given  as  a  purgative  in  obstinate  constipa- 
tion (i-l.min.  in  pill).  It  is  especially  useful  in  paralysis, 
mania,  and  apoplexy,  when  there  is  a  difficulty  in  swallowing 
and  a  purgative  of  small  bulk  is  required.  It  can  be  mixed  with 
a  little  bread-crumb  and  placed  on  the  back  of  the  tongue,  and 


1024  VEGETABLE  MATEEIA  MEDICA.  [sect.  r. 

will  be  swallowed  involuntarily.  It  is  sometimes  added  to  castor 
oil  to  increase  its  effect. 

One  drop  of  croton  oil  with  1  drachm  of  chloroform  in  1 
ounce  of  glycerine  has  proved  an  effectual  anthelmintic,  removing 
tape-worm  after  other  remedies  had  failed.  It  should  be  given 
the  first  thing  in  the  morning,  and  its  efficacy  is  increased  by  a 
saline  purgative  given  overnight. 

Treatment  in  Poisoning. — Evacuate  by  stomach-pump  after 
giving  demulcents  (linseed,  oatmeal,  &c),  or  give  linseed-tea  or 
gruel,  mixed  with  mustard,  and  thus  procure  emesis. 

Oleum  Ricini,  B.  and  U.S.P.  Castor  Oil. — A  fixed  oil 
expressed  from  the  seeds  of  Ricinus  communis.     Calcutta. 


Iiq.  221.— Castor  OU  Seeds. 

Chaeactees. — Viscid,  colourless,  or  pale  straw-yellow,  having  a  slightly 
nauseous  odour,  and  a  somewhat  acrid  taste. 

Composition. — Yields  several  fatty  acids,  including  ricinoleic 
acid,  peculiar  to  castor  oil.  The  seeds  contain  an  alkaloid, 
ricinine  (not  purgative),  also  an  acid  drastic  principle,  of  which 
only  a  small  proportion  is  separated  with  the  oil. 

Dose. — One  n.  dr.  to  1  fl.  oz. 

Pkepaeations. 

B.P.  DOSS. 

Collodium  Flexile For  external  use. 

Linimentum  Sinapis  Compositum  (p.  516) „ 

Pilula  Hydrargyri  Subchloridi  Composita  (p.  522) 5-10  gr. 

U.S.P. 

Linimentum  Sinapis  Compositum  (p.  517)  For  external  use. 

Collodium  Flexile ,, 

Action  and  Uses. — Castor  oil  is  one  of  our  best  purgatives, 
as  it  leaves  no  injurious  effects,  and  can  be  given  whenever  purg- 
ing is  wanted  without  any  irritant  effect,  as  in  children,  pregnant 
women,  piles  and  fissure  of  anus,  or  after  parturition,  and  to  de- 
licate people.  Its  nauseous  taste  is  its  only  objection.  It  is 
one  of  the  best  remedies  for  acute  diarrhoea,  given  in  one  dose  of 
^  to  ^  fl.  oz.  with  5-10  min.  of  laudanum.  This  removes  any 
irritating  substances  (p.  388)  and  soothes  the  intestine.  In 
chronic  dysentery  15  min.  of  castor  oil  and  5-10  min.  of  tincture 
of  opium  given  three  times  a  day  is  a  useful  remedy.  In  lead 
colic  it  acts  as  a  preventive  to  constipation,  and  has  been  used  as 
a  curative  agent  (p.  700).  It  is  better,  however,  to  give  potassium 
iodide  and  sulphate  of  magnesium.     A  drop  of  castor  oil  dropped 


chap,  xxxv.]  APETAL^E.  1025 

into  the  eye  will  often  allay  the  irritatior  produced  by  a  particle 
of  sand,  &c.  As  a  local  application,  castor  oil  or  poultices  of 
the  leaves  of  the  castor-oil  plant,  are  used  to  the  breasts  in  order 
to  promote  the  secretion  of  milk.  The  oil  is  useful  rubbed  into 
the  skin  in  seborrhcea. 

Administration. — If  the  oil  be  given  the  first  thing  in  the 
morning  an  hour  before  breakfast,  ten  or  twenty  drops  are  gene- 
rally sufficient  to  open  the  bowels.  This  dose  may  be  given  in  a 
teaspoonful  of  peppermint- water  or  brandy.  The  brandy  should 
\>e  added  in  such  proportion  that  the  oil  neither  sinks  nor  swims 
in  the  mixture.  The  same  mixture  of  peppermint-water  and 
brandy  answers  well  as  a  vehicle  for  the  administration  of  larger 
doses  also.  In  all  cases  the  glass,  cup,  or  spoon  should  be 
thoroughly  wetted  first  with  water  or  peppermint-water  to  pre- 
vent the  oil  adhering  to  the  side.  A  little  brandy  is  then  to  be 
mixed  with  the  peppermint-water,  the  oil  carefully  poured  over 
the  middle  of  it,  and  then  more  brandy  added.  If  the  whole  be 
drunk  at  one  draught  the  taste  of  the  oil  is  not  perceived. 
Lemon-juice,  coffee,  and  the  froth  of  porter  are  also  used  as 
vehicles  for  the  administration  of  castor  oil.  It  may  also  be  given 
in  capsules,  which  are  perfectly  tasteless. 

Kamala,  B.  and  U.S.P.  Kamala.  Wueetjs. — A  powder 
which  consists  of  the  minute  glands  and  hairs  obtained  from  the 
surface  of  the  fruits  of  Mallotus  philippinensis  (Bottlera  tinctoria). 
India. 

Characters. — A  fine  granular  mobile  powder,  of  a  brick-red  colour ;  it  is 
with  difficulty  mixed  with  water. 

Composition. — -A  resin  soluble  in  alcohol  and  ether,  yielding 
a  crystalline  substance,  rottlerin. 

Impurities. — Sand  and  earthy  matters. 

Test. — When  boiled  with  alcohol  the  greater  part  is  dissolved,  forming  a 
red  solution.  Ether  dissolves  most  of  it ;  the  residue  consisting  principally 
of  tufted  hairs. 

Dose. — 30  grains  to  £  ounce. 

Action  and  Uses. — It  is  used  as  an  anthelmintic  against  tape- 
worm. It  is  very  efficacious,  killing  the  worm  and  producing  free 
purgation.     It  is  best  given  with  honey  or  thick  gruel. 

URTICACEiE. 

Sdb-Obbee  I.-ULME£. 

U.S.P-  Ulmus.  Elm.  Slippery  Elm. — The  inner  bark  of 
Ulmus  fulva. 

Characters. — In  fiat  pieces,  varying  in  length  and  width,  about  one- 
eighth  of  an  inch  (3  millimetres)  thick  ;  tough,  pale  brownish- white,  the  inner 
surface  finely  ridged ;  fracture  fibrous  and  mealy  ;  the  transverse  section  de- 
licately checkered ;  odour  slight,  peculiar ;  taste  mucilaginous,  insipid. 

3  U 


1026  VEGETABLE   MATEKIA  MEDICA.  [sect.  v. 

Pbepaeation. 
O.S.P.  D0BB- 

Muoilago  Ulmi  (slippery  elm  6,  boiling  water  100 ;  macerate  for 

two  hours  and  strain) Ad- libitum. 

Uses. — Elm  bark  is  used  as  a  demulcent,  slight  astringent 
and  tonic,  and  in  the  treatment  of  skin  diseases. 

Sub-Oedeb  II.— CANNABINE^E. 

Cannabis  Indica,  B.  and  U.S. P.  Indian  Hemp. — The 
dried  flowering  tops  of  the  female  plants  of  Cannabis  sativa,  the 
common  hemp.  (For  medicinal  use  that  which  is  grown  in  India, 
and  from  which  the  resin  has  not  been  removed,  is  alone  to  be 
employed.     It  is  known  in  India  as  Gunjah  or  Ganga.) 

Characters. — Tops  consisting  of  one  or  more  alternate  branches,  bearing 
the  remains  of  the  flowers  and  smaller  leaves  and  a  few  ripe  fruits,  pressed 
together  in  masses  of  a  dusky  green  colour  with  almost  no  taste,  but  a  cha- 
racteristic odour. 

Pkepakations. 

B.P.  DOSE. 

Extractum  Cannabis  Indicse J-l  gr.  or  more. 

Tinctura  ,,  , 5-20  mill. 

U.S.P. 

Extractum  Cannabis  Indies  Fluidum 5-10  min. 

Tinctura  „  „      10-20  min. 

Extractum        „  „      £-gr. 

U.S. P.  Cannabis  Americana.  American  Cannabis. — Can- 
nabis sativa,  grown  in  the  Southern  United  States  and  collected 
while  flowering. 

Characters. — Stem  about  six  feet  (2  metres)  long,  rough;  leaves  opposite 
below,  alternate  above,  petiolate,  digitate ;  the  leaflets  linear-lanceolate, 
serrate ;  dioecious,  the  staminate  flowers  in  pedunculate  clusters  forming 
compound  racemes ;  the  pistillate  flowers  axillary,  sessile,  and  bracteate ; 
odour  heavy ;  taste  bitter,  slightly  acrid. 

Composition. — The  active  constituent  is  a  resinoid  substance, 
cannabin.     The  tops  also  contain  a  small  quantity  of  volatile  oil. 

Action. — Its  chief  effect  is  on  the  brain,  and  is  of  a  twofold 
nature  ;  it  excites  a  form  of  delirium  and  hallucinations,  usually 
followed  by  deep  sleep. 

Small  doses  give  rise  to  delirium  with  hallucinations,  gene- 
rally of  a  gay  character,  causing  much  merriment ;  accompanied 
by  a  great  inclination  to  muscular  movement. 

The  nature  of  the  hallucinations  depends  greatly  on  the  cha- 
racter of  the  individual,  and  people  seem  to  be  able  to  determine 
their  nature,  as  in  the  case  of  opium. 

Haschish  is  an  Arabian  preparation  of  Indian  hemp,  and  is 
the  origin  of  the  word  assassin.  An  Eastern  chief  used  to  dose 
his  fanatic  followers  with  Indian  hemp,  and  they  became  imbued 
with  the  idea  that  they  would  be  taken  to  heaven  if  killed,  and 
hence  were  not  afraid  to  encounter  death. 


chap,  xxxv.]  APETALJ3.  1027 

The  dreams  produced  by  Indian  hemp  in  inhabitants  of 
Eastern  countries  are  usually  of  a  sexual  character  (p.  450),  but 
when  taken  by  the  more  civilised  people  of  Western  nations  they 
are  not  sexual,  and  are  often  of  a  disagreeable  nature. 

During  this  stage  of  hallucination,  the  person  may  conduct 
himself  rationally  and  answer  clearly  any  question  put  to  him 
(Wood) .  The  drug  produces  in  some  persons  a  curious  loss  of 
sense  of  time  and  of  space.  This  stage  is  generally  followed  by 
deep  sleep.  The  sensory  nerves  are  benumbed,  and  there  is 
frequently  tingling  and  partial  ansesthesia.  The  pupil  is  dilated. 

Respiration  may  be  either  quickened  or  slowed.  The  action 
on  the  pulse  is  very  uncertain.  Usually  it  is  first  quickened, 
then  slowed,  sometimes  vice  versa.  The  temperature  rises  or 
sinks  according  as  the  drug  produces  muscular  movement  or 
sleep.  The  urine  is  increased.  The  processes  of  digestion  are 
less  altered  by  cannabis  indica  than  by  opium,  and  the  after- 
effects of  opium  (nausea,  headache,  &c.)  are  not  produced. 

Uses.— As  a  soporific  it  is  used  instead  of  opium  when 
the  latter  does  not  agree,  or  in  old  opium-eaters  ;  also  in  cases 
of  mental  derangement ;  in  acute  and  chronic  mania  it  is  very 
useful,  especially  when  combined  with  potassium  bromide. 

It  has  been  used  in  neuralgia  to  lessen  pain ;  also  in  spasmodic 
coughs,  asthma,  &c.  In  certain  cases  of  menorrhagia  it  is  useful, 
but  its  mode  of  action  is  unknown.  Einger  recommends  it  in 
migraine,  and  S.  Mackenzie  in  constant  headache. 

B.P.  Lupulus.  Hop.  The  dried  strobiles  of  Humulus  Lupulus. 
Cultivated  in  England. 

Characters. — Strobiles  of  a  greenish-yellow  colour,  with  minute  yellow 
grains  (lupulin)  adherent  to  the  base  of  the  scales.  Odour  aromatic,  taste 
bitter. 

U.S. P.  Humulus.  Hop.— The  strobiles  of  Humulus  Lupulus. 
Characters. — Ovate,  about  an  inch  and  a  quarter  (3  centimetres)  long, 
consisting-  of  a  thin,  hairy,  undulated  axis,  and  many  obliquely  ovate,  mem- 
branous, greenish  scales,  in  the  upper  part  reticulately  veined,  and  towaro! 
the  base  parallel- veined,  glandular,  and  surrounding  a  subglobular  achene ; 
odour  aromatic  ;  taste  bitter,  aromatic,  and  slightly  astringent. 

Lupulinum,  B.  and  U.S. P.  Lupulin. — The  glandular 
powder,  separated  from  the  strobiles  of  Humulus  Lupulus. 

Characters. — Bright  brownish-yellow,  becoming  yellowish-brown,  re- 
sinous, consisting  of  minute  granules  which,  as  seen  under  the  microscope, 
are  subglobular,  or  rather  hood-shaped,  and  reticulate  ;  aromatic  and  bitter. 

"When  agitated  with  water  and  allowed  to  stand,  no  considerable  sediment 
(sand,  &c.)  should  be  deposited.  When  ignited,  lupulin  should  not  leave  more 
than  15  B.P.,  8  U.S.P.,  per  cent,  of  ash. 

Composition. — The  lupulin  of  hops  consists  of  a  bitter  prin- 
ciple, lupulite,  volatile  oil,  to  which  the  odour  of  hops  is  due, 
and  resin.   Hops  apart  from  the  grains  contain  a  kind  of  tannin. 

Dose. — 2  to  5  grains  or  more. 

3  u  2 


1028  VEGETABLE   MATEEIA  MEDICA.  [sect.  v. 


Peepabations. 

B.P.  DOSE. 

Extractum  Xiupull 5-10  gr. 

Inlusum  „       1-2  fl.  OZ. 

Tinctura  „      5-2  fl.  dr. 

u.s.p. 
Of  Humulus — 

Tinotura  Humuli 1-3  fl.  dr. 

Of  LuPULINUM — 

Extractum  LupuKni  Fluidum 10-30  min 

Oleoresina  , 2-20  gr. 

Action  and  Use. — Hops  act  as  a  bitter  tonic  and  stomachic, 
also  slightly  as  a  soporific.  In  the  form  of  bitter  beer  they  are 
used  in  some  cases  of  atonic  dyspepsia ;  and  a  supper  of  beer  and 
lettuce,  with  bread  and  butter,  is  markedly  soporific,  from  the 
combined  effect  of  the  hops  and  lettuce. 

A  hop-pillow  is  sometimes  used  in  sleeplessness  of  fevers,  but 
its  use  is  probably  due,  not  to  the  action  of  the  volatile  principle 
of  the  hops,  but  to  the  mechanical  elasticity  and  softness  of  the 
pillow.  The  crackling  of  the  leaves  in  this  pillow  may  be  stopped 
by  sprinkling  a  little  alcohol  on  them. 

Sub-Obdee  III.— MOREiE. 

B.P.  Mori  Succus.  Mulbebry  Juice. — The  juice  of  the 
ripe  fruit  of  Morus  nigra. 

Characters. — Of  a  dark  violet  colour,  with  a  faint  odour,  and  an  aci- 
dulous sweet  taste. 

Composition. — Colouring  matter,  sugar,  and  acid,  supposed 
to  be  malic. 

Pbepaeation. 

B.P.  DOSE. 

Syrupus  Mori 1  fl.  dr.  or  more. 

Use. — To  flavour  and  colour  mixtures. 

Sub-Obdee  IV.— ARTOCARPEiE. 

Ficus,  B.P.   Fig. — The  dried  fruit  of  Ficus  Carica,  Smyrna. 

Ficus,  U.S.P.  Fig. — The  fleshy  receptacle  of  Ficus  Carica, 
bearing  fruit  upon  its  inner  surface. 

Characters. — Compressed,  of  irregular  shape,  fleshy,  covered  with  an 
efflorescence  of  sugar ;  of  a  sweet,  fruity  odour,  and  a  very  sweet,  mucila- 
ginous taste.  "When  softened  in  water,  figs  are  pear-shaped,  with  a  sear  or 
short  stalls  at  the  base,  and  a  small  scaly  orifice  at  the  apex ;  hollow  inter- 
nally ;  the  inner  surface  covered  with  numerous,  yellowish,  hard  achenes. 

Composition. — Grape  sugar  (about  70  per  cent.),  a  little 
gum,  and  fatty  matter. 

Peepaeations. 
b.p.                             dose.                      u.s.p.  dose. 

Confectio  Sennse 60-120  gr.  Confectio  Sennse 60-120  gr. 


chap,  xxxv.]  APETAL^l.  1029 

Use— Figs  are  used  locally  as  poultices,  by  splitting  them 
and  applying  them  to  the  inflamed  part,  as  in  gum-boils,  dental 
abscesses,  inflamed  tonsils,  &c. 

Pigs  are  chiefly  employed  as  a  domestic  laxative.  They  are 
useful,  given  in  large  quantities,  when  a  person  has  swallowed  a 
hard  sharp  substance,  by  forming  a  bulky  mass  which  will  sheath 
the  substance  and  protect  the  intestines  from  injury.  In  such 
cases  purgatives  are  to  be  avoided. 

JUGLANDACE.E. 

U.S.P.  Juglans.  Juglans.  Butternut. — The  inner  bark 
of  the  root  of  Juglans  cinerea,  collected  in  autumn. 

Characters. — In  flat  or  curved  pieces,  from  an  eighth  to  a  quarter  of  an 
inch  (3  to  6  millimetres)  thick ;  the  outer  surface  nearly  free  from  soft  cork ; 
deep  brown ;  the  inner  surface  smooth  and  striate ;  transverse  fracture  short, 
delicately  checkered,  whitish  and  brown ;  odour  feeble  ;  taste  bitter  and 
somewhat  acrid. 

PkeAbation.  dose. 

Extractum  Jnglandis „„ 20-30  gr. 

Uses. — It  is  a  mild  cathartic,  especially  useful  in  the  treat- 
ment of  chronic  constipation,  dysentery  and  congestion  of  the 
abdominal  viscera.  It  has  a  slight  action  as  a  hepatic  stimu- 
lant (p.  403),  and  is  useful  in  malarial  conditions  (pp.  375  and 
407). 

HAMAMELACE^E. 

U.S.P.  Hamamelis.  Hamamelis.  Witch-hazel. — The  leaves 
of  Hamamelis  virginica,  collected  in  autumn. 

Characters. — Short-petiolate,  about  four  inches  (10  centimetres)  long, 
obovate  or  oval,  slightly  heart-shaped  and  oblique  at  the  base,  sinuate-toothed, 
nearly  smooth ;  inodorous  ;  taste  astringent  and  bitter. 

Composition. — It  contains  tannic  acid  and  a  bitter  principle. 

Officinal  Preparation. 

dose. 
Extractum  Hamamelidis  Flnidum 15  min.-2  fl.  dr. 

Uses. — It  is  used  as  an  external  application  to  piles,  bruises, 
and  inflammatory  swellings.  Hazeline,  or  the  fluid  extract  of 
hamamelis,  arrests  the  bleeding  from  piles  in  some  cases  almost 
like  magic.  Just  before  a  motion  a  pledget  of  cotton  about  the 
size  of  a  hazel  nut,  and  soaked  in  the  liquid,  should  be  inserted 
into  the  rectum,  and  after  the  motion,  when  the  anus  has  been 
cleansed  by  washing,  a  similar  pledget  should  be  again  intro- 
duced and  allowed  to  remain.  Internally  it  is  a  very  efficient 
haemostatic  in  bleeding  from  the  lungs  and  other  internal 
organs.  In  some  cases  of  haemoptysis  I  have  found  it  in  the 
form  of  the  non-officinal  preparation  of  it  called  hazeline  more 
efficient  than  digitalis  and  ergot,  although  in  other  cases  digitalis 


1030  VEGETABLE   MATEEIA  MEDICA.  [sect.  v. 

and  ergot  have  succeeded  better.  It  checks  the  flow  in  monor- 
rhagia when  given  during  the  period,  and  it  lessens  pain  in 
dysmenorrhcea.  In  one  case  a  patient  informed  me  that  it 
invariably  caused  seminal  emissions,  which  ceased  when  it  was 
discontinued.  In  this  action  it  resembles  strychnine  (p.  450). 
It  has  been  supposed  by  Dujardin-Beaumetz  to  owe  its  utility  to 
an  action  on  the  muscular  fibre  of  veins. 

BALSAMIFLOR^E. 

Styrax  Praeparatus,  B.P. ;  Styrax,  U.S. P.  Prepared 
Stoeax,  B.P.;  Stoeax,  U.S.P. — A  balsam  obtained  from  the  inner 
bark  of  Liquida??ibar  orientalis.  Purified  by  solution  in  spirit, 
filtration  and  evaporation. 

Characters. — A  semi-transparent,  brownish-yellow  semi-fhiid  resin,  of 
the  consistence  of  thick  honey,  with  a  strong  agreeable  fragrance  and  aro- 
matic bland  taste.  Heated  in  a  test-tube  on  the  vapour-bath,  it  becomes 
more  liquid  but  gives  off  no  moisture  ;  boiled  with  solution  of  bichromate  of 
potassium  and  sulphuric  acid,  it  evolves  the  odour  of  oil  of  bitter  almonds. 

Composition. — Styrol,  cinnamic  acid,  styracin,  and  resin. 
Cinnamic  acid  yields,  when  oxidised,  hydride  of  benzoyl  (oil  of 
bitter  almonds). 

Dose. — Of  the  prepared  resin,  5-20  gr. 
Preparations. 

B.P.  DOSE. 

Tlnctura  Benzoinl  Composita 1-1  fl.  dr. 

U.S.P. 

Tinctura  Benzoini  Composita £-1  fl.  dr. 

Use. — Its  action  and  use  are  similar  to  those  of  the  balsam 
of  Peru  (p.  902).  A  styrax  ointment  very  useful  in  scabies  is 
of  the  strength  of  one  ounce  of  liquid  styrax  to  two  ounces  of 
lard. 

CUPULIFERjE. 

B.P.  Quercus  Cortex.  Oak  Bark. — The  dried  bark  of  the 
smaller  branches  and  young  stems  of  Quercus  robur.  Collected 
in  spring,  from  trees  growing  in  Britain. 

Characters.  —  Covered  with  a  greyish  shining  epidermis,  cinnamon- 
coloured  on  the  inner  surface,  fibrous,  brittle,  and  strongly  astringent. 

U.S.P-  Quercus  Alba. — The  bark  of  Quercus  alba. 

Characters. — In  nearly  flat  pieces,  deprived  of  the  corky  layer,  about  a 
quarter  of  an  inch  thick,  pale  brown,  inner  surface  with  short  sharp  longitu- 
dinal ridges,  tough,  of  a  coarse,  fibrous  fracture,  a  faint,  tan-like  odour,  and 
a  strongly  astringent  taste. 

Composition.  —  Querci-tannic  acid  and  quercin,   a  bitter 

crystalline  substance. 

Preparation. 

B.P.  U.S.P. 

Decoctum  Quercus  (1}  oz.  to  1  pint).  Hone. 


chap,  xxxv.]  APETAL^E.  1031 

Action  and  Use.— Chiefly  used  externally  as  a  local  astrin- 
gent, e.g.  as  a  gargle  in  relaxed  sore-throat  or  as  an  injection  in 
gonorrhoea  and  leucorrhoea. 

Galla,  B.and  U.S.P-  Galls,  B.P.;  Nutgalls,  U.S.P.— Ex- 
crescences on  Quercus  lusitanica,  var.  infectoria,  caused  by  the 
punctures  and  deposit  of  an  egg  or  eggs  of  Cynips  Galla  tinctorice. 
Asia  Minor. 

Chaeactebs. — Hard,  heavy,  globular  bodies,  tuberculated  on  the  surface, 
the  tubercles  and  intervening  spaces  smooth;  of  a  bluish-green  colour  on 
the  surface,  yellowish- white  within,  with  a  small  central  cavity ;  intensely 
astringent. 

Composition. — Gallo-tannic  acid  (14  to  nearly  70  per  cent, 
according  to  the  quality  of  the  galls),  gallic  acid  (3  per  cent.), 
free  sugar  and  resin  in  minute  quantities. 

Peepabations. 

B.P.  DOSE. 

Acidum  Gallicum 2-20  gr. 

„  Tannicum 2-30  gr. 

Tlnctura  Gallae J-2  fl.  dr. 

Unguentum  Gallae  (80  gr.  to  1  oz.)  

u  .■       cum  Opio  (80  gr.  to  1  oz.  nearly) 

TJ.S.P. 

Tinctura  Gallse ; J-3  fl.  dr. 

TJnguentum  Galls  (1  part  in  10) 

Action  and  Uses. — Galls  are  used  in  the  form  of  galls  and 
opium  ointment  as  a  local  astringent  in  the  treatment  of  hasmor- 
rhoids.  The  action  of  galls  depends  on  the  contained  tannic  and 
gallic  acids  (q.v.). 

Acidum  Tannicum,  B.and  U.S.P.  Tannic  Acid.  [Tannin.J 
C27H220I7. — A  glucoside  extracted  from  galls. 

Preparation. — By  dissolving  out  the  tannic  acid  from  powdered  galls 
with  ether  mixed  with  a  very  little  water,  gently  evaporating  the  solution, 
and  drying  the  acid.  Although  tannic  acid  is  very  sparingly  soluble  in  pure 
ether,  yet  it  appears  to  dissolve  readily  in  ether  containing  a  very  little  water. 

Properties. — In  pale  yellow  vesicular  masses,  or  thin  glistening  scales, 
with  a  strongly  astringent  taste,  and  an  acid  reaction.  On  exposure  to  air  or 
by  the  action  of  dilute  acids,  it  splits  up  into  glucose  and  gallic  acid  (q.v.). 
Tannin  in  its  natural  state  appears  to  be  a  mixture  of  digallic  acid  (C14H10O9) 
with  a  glucosiae  of  digallic  acid.  Schiff  proposes  to  give  the  name  tannic 
acid  to  the  digallic  acid,  and  that  of  tannin  to  the  glucoside. 

Solubility. — It  is  readily  soluble  in  water  and  rectified  spirit;  very 
sparingly  soluble  in  ether. 

Reactions. — The  aqueous  solution  precipitates  solution  of  gelatine  yel- 
lowish-white, and  the  persalts  of  iron  of  a  bluish-black  colour. 

Impurities. — Mineral  matter. 

Tests. — It  leaves  no  residue  when  burned  with  free  access  of  air  on 
platinum  foil. 

Dose. — 2  to  10  grains. 

Pbepakations. 
B.P. 

Glycerlnum  Acldl  Tannlcl  1  part  in  6  by  weight. 

Suppositorla    „  „        3  grains  in  each. 

„  „  „         cum  Sap  one 3  grains  in  each. 

Trochlscl  „  „         ...£ -grain  in  each. 


1032  VEGETABLE   MATEEIA  MEDICA.  [sect.  v. 

Pkepabations — [continued). 


tJ.S.P. 


Collodium  Stypticum   (tannic  acid  20,  alcohol  5, 

stronger  ether  20,  collodion  55  parts) 1  part  in  5. 

Trochisci  Acidi  Tanniei 1  grain  in  each. 

Unguentum  „        „        (with  benzoated  lard) 1  part  in  10. 

Action. — When  applied  externally  to  the  unbroken  skin 
tannic  acid  has  little  or  no  action ;  but  applied  to  skin  deprived 
of  its  epidermis,  it  coagulates  the  albumin  and  causes  contrac- 
tion of  the  cells  of  the  skin.  It  coagulates  blood  and  conse- 
quently acts  as  a  local  styptic. 

It  acts  locally  on  mucous  membranes,  coagulating  the 
mucus.  On  account  of  the  dryness  in  the  mouth  produced  by 
the  drug,  it  was  concluded  that  the  vessels  are  contracted,  and 
that  the  astringent  action  is  due  to  this ;  but  Eossbach  found,  from 
direct  observation,  that  the  vessels  are  dilated  ;  in  this  particular 
tannin  differs  from  other  astringents,  such  as  nitrate  of  silver. 
This  dilatation  is  not  due  to  paralysis  of  the  coats  of  the  arteries, 
since  they  contract  on  stimulation  or  subsequent  application  of 
silver  nitrate. 

Its  astringent  action  on  the  skin  and  mucous  membranes  is 
probably  due  to  coagulation  of  albumin  and  a  '  tanning  '  of  all 
the  tissues  to  which  it  is  applied. 

"When  taken  into  the  mouth  it  causes  dryness,  coagulation  of 
mucus,  and  a  partial  paralysis  of  the  ends  of  the  sensory  nerves 
(both  the  nerves  of  ordinary  sensation  and  the  special  nerves  of 
taste),  so  that  it  destroys  to  a  great  extent  the  sense  of  taste, 
and  also  lessens  irritation  in  the  throat. 

When  taken  into  the  stomach  in  large  doses  it  is  irritant 
and  causes  vomiting.  When  given  to  animals  it  does  not  lessen 
eitber  secretion  or  peristaltic  action  of  the  intestines,  and  yet  in 
man,  even  from  small  doses,  there  is  a  dryness  of  the  faeces  and 
lessened  peristalsis ;  probably  these  different  results  are  due  to 
some  imperfection  in  the  experiments  or  to  a  difference  of  dose. 

Large  doses  cause  diarrhoea,  with  subsequent  constipation. 

It  is  absorbed  into  the  blood,  and  passes  out  as  gallic  acid  or 
some  product  of  the  oxidation  of  gallic  acid. 

It  restrains  haemorrhage  in  distant  organs,  as  the  uterus, 
lungs,  or  kidneys,  but  the  modus  operandi  is  not  known,  and 
some  authorities  deny  this  action  altogether. 

Uses. — Externally  applied  to  the  skin  tannic  acid  is  used 
in  intertrigo,  impetigo,  and  eczema,  especially  when  occurring 
behind  the  ears  in  children :  in  desquamating  chronic  eczema,- 
a  ten  per  cent,  tannic  acid  ointment  is  useful,  also  in  sycosis, 
applied  after  shaving.  In  hyperidrosis  of  the  axillae,  genitals, 
palms,  and  hands,  and  in  sweating  of  the  feet,  frequent  washing 
with  a  solution  of  tannin  in  diluted  alcohol  (1  in  250)  is  recom- 
mended. 


chap,  xxxv.]  APETAIuE.  1033 

It  is  also  applied  to  mucous  membranes,  such  as  the  external 
auditory  meatus  in  otorrhcea  (fill  the  meatus  with  glycerine  of 
tannic  acid  and  keep  it  there  by  a  pledget  of  cotton  wool).  Also 
to  the  nasal  mucous  membrane,  when  there  is  ulceration  and 
offensive  discharge.  In  this  case  it  is  applied  either  in  aqueous 
solution  by  means  of  the  nasal  douche  or  as  glycerine  of  tannic 
acid  with  a  brush.  It  is  thus  of  use  in  ozasna  after  measles  or 
scarlet  fever,  and  in  that  form  occurring  in  syphilitic  children. 
In  haemorrhages  from  the  nose  dry  tannin  may  be  snnffed  up. 

It  is  used  in  stomatitis  and  ulceration  of  gums;  and  as  a 
gargle  in  relaxed  sore-throat  or  applied  locally  as  glycerine  of 
tannic  acid.  It  is  very  useful  in  the  hacking  cough  often  met 
with  in  children,  and  also  in  adults,  which  is  due  to  an  irritation 
at  the  back  of  the  pharynx,  often  accompanied  by  inflamed  throat, 
covered  with  mucus ;  in  inflamed  tonsils  and  deafness ;  also  in 
whooping-cough  and  other  throat  affections,  either  in  the  form  of 
the  glycerine  or  as  lozenges. 

It  has  been  used,  dissolved  in  water,  or  mixed  with  olive  oil, 
as  an  injection  in  leucorrhcea,  gonorrhoea,  and  chronic  discharges 
from  the  os  uteri. 

Internally  tannin  is  used  in  hffimatemesis  and  intestinal 
hsemorrhage ;  also  as  an  antidote  to  poisoning  by  alkaloids,  but 
when  used  for  this  purpose  it  must  be  followed  by  a  purgative, 
as  the  tannates  are  all  more  or  less  soluble  in  the  juices  of.  the 
alimentary  canal.  It  is  also  used  in  poisoning  by  tartar  emetic, 
as  tannic  acid  forms-  with  antimony  an  insoluble  tannate.  It  is 
used  in  diarrhoea,  but  usually  the  more  sparingly  soluble  forms 
of  tannin,  such  as  kino,  are  preferred.  Tannic  acid  lessens  the 
amount  of  albumin  in  albuminuria. 

Acidum  Gallicum,  B.  and  U.S.P.  Gallic  Acid.  C6H2(0H)3 
(CO.OH).  H20;  188. — A  crystalline  acid  prepared  from  galls ; 
it  may  be  considered  as  salicylic  acid  in  which  two  atoms  of 
hydrogen  are  replaced  by  two  of  hydroxyl  (cf.  p.  810). 

Preparation. — From  galls,  by  pulverising,  moistening  with  water,  and 
allowing  them  to  ferment  for  six  weeks  in  a  temperature  of  60°  to  70°  F.  The 
tannin  present  in  the  galls  is  split  up  by  the  fermentation  into  gallic  acid  and 
glucose,  the  tannic  acid,  or  digallic  acid  (p.  1,031)  splitting  up  into  gallic  acid, 
C,4HI009  +  H40  =  2C7H6Os.  It  is  purified  by  solution,  and  re-solution  in 
boiling  water,  filtering  and  crystallising. 

Properties. — Crystalline,  in  acicular  prisms  or  silky  needles,  nearly  white 
or  of  a  pale  fawn-colour.     Its  taste  is  acidulous  and  astringent. 

Solubility. — It  requires  about  100  parts  of  cold  water  for  its  solution,  but 
dissolves  in  3  parts  of  boiling  water.     Soluble  also  in  rectified  spirit. 

Eeactions. — It  gives  a  bluish-black  precipitate  with  a  persalt  of  iron.  It 
leaves  no  residue  when  burned  with  free  access  of  air.  Its  aqueous  solution 
gives  no  precipitate  with  solution  of  isinglass,  and  is  thus  distinguished  from 
tannic  acid. 

Impurity. — Tannic  acid  from  imperfect  fermentation. 

Tests. — No  precipitate  with  solution  of  isinglass  (no  tannic  acid). 

Dose. — 2  to  10  grains. 


1034  VEGETABLE  MATEBIA  MEDICA.  [sect.  v. 

Pbepaeations. 

B.P.  DOSE. 

Glycerinum  Acidi  Galilei  (1  in  6) 12-60  min. 

u.s.p. 
Unguentum  Acidi  Gallioi  (with  benzoated  lard,  1  part  in  10). 

Uses. — Gallic  acid  resembles  tannic  acid  in  its  action,  but 
does  not  coagulate  albumin,  and  is  used  chiefly  in  cases  of 
hemorrhages  from  the  lungs,  or  kidneys,  or  where  the  affected 
part  can  only  be  reached  through  the  circulation. 

In  hemoptysis  it  is  useful  in  ten-grain  doses  every  two  hours. 
-Like  tannin  it  is  said  to  lessen  the  amount  of  albumin  in  the 
urine  in  albuminuria. 

U.S.P.  Castanea.  Castanba.  [Chestnut.] — The  leaves  of 
Castanea  vesca,  collected  in  September  or  October,  while  still 
green. 

Characters. — From  six  to  ten  incheB  (15  to  25  centimetres)  long,  about 
two  inches  (5  centimetres)  wide,  petiolate,  oblong-lanceolate,  acuminate, 
mucronate,  feather-veined,  sinuate-serrate,  smooth;  having  a  slight  odour, 
and  a  somewhat  astringent  taste. 

Preparation. 

dose. 
Extractum  Castanese  Fluidum , -|-1  fl.  dr. 

Uses. — It  has  been  used  in  whooping-cough.  Its  taste  is  not 
disagreeable,  but  it  has  no  extraordinary  physiological  power. 

SALICINEiE. 

U.S.P.  Salix.  Salix.  Willow. — The  bark  of  Salix  alia, 
and  of  other  species  of  Salix. 

Characters. — In  fragments  or  quills,  from  one-twenty -fifth  to  one-twelfth 
of  an  inch  (1  to  2  millimetres)  thick,  smooth ;  outer  surface  somewhat  glossy, 
brownish  or  yellowish,  more  or  less  finely  warty ;  under  the  corky  layer, 
green;  inner  surface  brownish- white,  smooth,  the  liber  separating  in  thin 
layers;  inodorous  ;  bitter  and  astringent. 

Composition. — It  contains  tannin  and  salicin. 
Use. — The  infusion  may  be  used  as  a  bitter  tonic. 

Salicinum,  B.  and  U.S.P.  Salicin.  Ci3H1807  ;  286.— A 
crystalline  glucoside  obtained  by  treating  the  bark  of  Salix  alba, 
and  other  species  of  Salix,  and  the  bark  of  various  species  of 
Populus,  with  hot  water,  removing  tannin  and  colouring  matter 
from  the  decoction,  evaporating,  purifying,  and  recrystallising. 

Characters. — Colourless  shining  crystals  with  a  very  bitter  taste. 

Solubility. — Soluble  in  about  twenty-eight  parts  of  water  or  a  similar 
quantity  of  spirit  at  common  temperatures ;  insoluble  in  ether.  It  is  much 
less  readily  dissolved  by  putting  it  into  cold  water  than  by  dissolving  it  in 
hot  water  and  allowing  the  solution  to  cool. 


chap,  xxxv.]  APETALiE.  1035- 

Reactions. — Sulphuric  acid  colours  it  red.  A  small  quantity  heated 
with  a  little  red  chromate  of  potassium,  a  few  drops  of  sulphuric  acid  and 
some  water,  yields  vapours  of  salicylic  aldehyde,  C6H4.OH  (OHO),  having  the 
odour  of  meadow-sweet.  The  crystals  melt  when  heated,  and  emit  vapours 
having  the  odour  of  meadow-sweet.     On  ignition  in  air  it  leaves  no  residue. 

The  aqueous  solution  of  salicin  should  not  be  precipitated  by  tannic  or 
picric  acids,  nor  by  iodide  of  mercury  and  potassium  (absence  of  and  difference 
from  alkaloids). 

Dose. — 3  to  20  grains. 

Action. — Its  action  is  similar  to  that  of  salicylic  acid  (p.  820). 
Salicin  is  one  of  the  sources  of  salicylic  acid,  which  may  be  pre- 
pared from  it  by  heating  with  caustic  potash  and  treating  the 
mass  with  hydrochloric  acid.  The  salicylic  acid  prepared  from 
salicin,  or  from  oil  of  wintergreen,  is  generally  purer  than  that 
made  artificially  (p.  820),  and  may  frequently  be  tolerated  by 
patients  when  the  artificial  salicylic  acid  disagrees.  Salicin  ap- 
pears to  be  decomposed  in  the  body,  and  is  eliminated  in  the 
urine  partly  as  salicin  and  partly  as  salicylic  acid,  as  salicyluric 
acid,  and  as  saligenin.  Its  action  is  less  powerful  than  that  of 
salicylic  acid,  and  its  depressing  effect  on  the  circulation  less 
marked. 

Uses. — It  is  used  as  an  antipyretic,  and  has  been  given  with 
success  instead  of  salicylic  acid  in  the  treatment  of  acute  rheu- 
matism.   It  is  useful  also  in  headaches. 


1036  VEGETABLE   MATEEIA  MEDICA.  [sect,  v. 


CHAPTER  XXXVI. 

Sub-Kingdom  I.— PHANEROGAMS. 
Class  IV— MONOCOTYLEDONES. 

ORCHIDACEiE. 

U.S.P-  Vanilla.     Vanilla. — The  fruit  of  Vanilla  planifolia. 

Characters. — From  six  to  ten  inches  (15  to  25  centimetres)  long,  linear, 
narrowed  and  bent  or  hooked  at  the  base,  rather  oblique  at  the  apex, 
wrinkled,  somewhat  warty,  dark  brown,  glossy-leathery,  one-celled,  and  con- 
taining a  blackish-brown  pulp,  with  numerous  minute  seeds,  and  more  or 
less  acicular  crystals ;  odour  and  taste  peculiar,  fragrant. 

Preparation. 

DOSE. 

Tinctura  Vanillaa A  few  drops  as  a  flavouring. 

Uses. — It  is  used  chiefly  as  a  flavouring  and  a  perfume.  It 
is  also  an  aromatic  stimulant  in  hysteria  and  low  fevers. 

U.S.P.  Cypripedium.  Cypkipedium.  Ladies'  Slippee. — The 
rhizome  and  rootlets  of  Cypripedium  pubescens,  and  of  Cypri- 
pedium parvijiorum. 

Characters. — Horizontal,  bent,  four  inches  (10  centimetres),  or  less,  long; 
about  one-eighth  of  an  inch  (3  millimetres)  thick  ;  on  the  upper  side  beset 
with  numerous  circular  cup-shaped  scars  ;  closely  covered  below  with  simple, 
wiry  rootlets  varying  from  four  to  twenty  inches  (10  to  50  centimetres)  in 
length ;  brittle,  dark  brown  or  orange-brown ;  fracture  short,  white ;  odour 
faint  but  heavy ;  taste  sweetish,  bitter  and  somewhat  pungent. 

Preparation. 

dose. 
Extractum  Cypripedii  Fluidum 15  min. 

Use. — It  has  an  antispasmodic  action  similar  to  that  of 
valerian,  but  it  is  less  powerful. 

SCITAMNACE^E. 
(ZINGIBERACEiE.) 

Zingiber,  B.  and  U.S.P.  Ginger. — The  (scraped  and  dried, 
B.P.)  rhizome  of  Zingiber  officinale.  West  Indies,  India,  and 
other  countries. 


citap.  xxxvi.]  MONOCOTYLEDONES.  1037 

Characters. — Irregular  lobed  decorticated  pieces,  three  or  four  inches 
long,  yellowish-white  but  not  chalky  on  the  surface,  with  a  short  mealy 
fracture,  hot  taste,  and  agreeable  aroma.    Powder  yellowish- white. 

PREPARATIONS. 
B.P.  EOSE. 

Confectio  Opii 5_20  gr. 

„        Scammonii 10-30  gr. 

Infusum  Sennse  1_2  fl.  oz. 

Pilula  Scillffi  Composita  (vide  p.  523) 5-10  gr. 

Pulvis  Cinnamomi  Compositus 30-60  gr. 

„     Jalaps  20-60  gr. 

»     Opii  2-5  gr. 

„     Bhei  „  20-60  gr. 

„     Scammonii  „  10-20  gr. 

Syrupus  Zingiberis  |_1  fl;  dr. 

Tlnctura  „  15  min.-l  fl.  dr. 

n  »  Portior 5-20  min. 

Vinum  Aloes 1-2  fl.  dr. 

u.s.p. 

Extractum  Zingiberis  Fluidum 10-30  min. 

Oleoresina         „  1-2  min. 

Pulvis  Aromaticus 10-30  gr. 

„     Bhei  Compositus 30-60  gr. 

Syrupus  Zingiberis , 1  fl.  dr. 

Tinctura        „ 15-75  min. 

Vinum  Aloes 1-2  fl.  dr. 

Composition. — A  yellow  volatile  oil  and  a  resin,  the  former 
having  the  odour,  and  the  latter  the  taste,  of  the  drug. 

Action. — Ginger  causes  a  feeling  of  warmth  in  the  mouth, 
and  refiexly  stimulates  the  secretion  of  saliva.  It  has  a  stimu- 
lant action  on  the  stomach,  producing  warmth  at  the  epigastrium. 
It  promotes  the  expulsion  of  flatus. 

Uses. — It  is  used  in  atonic  dyspepsia,  also  to  relieve  flatu- 
lence, and  as  an  adjunct  to  purgatives  to  lessen  griping.  It  is 
also  used  as  a  masticatory  to  increase  secretion  of  saliva,  and 
in  relaxed  conditions  of  the  throat.  Also  used  as  a  carminative 
in  colic. 

B.P.  Turmeric. — The  rhizome  of  Curcuma  longa. 

Turmeric  Tincture,  B.P. ;  Solution  of  Turmeric,  U.S.P. 

A  solution  prepared  by  macerating  1  part  bruised  turmeric  in 
6  parts  rectified  spirit,  B.P.,  or  diluted  alcohol,  U.S.P.,  in  a  closed 
vessel  for  7  days,  and  filtering. 

Turmeric  Paper,  B.  and  U.S.P.  —  Unsized  white  paper 
coloured  by  steeping  in  tincture  of  turmeric  and  drying  by 
exposure  to  the  air  without  heat. 

Action  and  Uses. — Turmeric  acts  similarly  to  ginger.  Chiefly 
used  as  a  condiment.  Turmeric  paper  is  used  as  a  test  for 
alkalis,  which  turn  it  brown. 


1038  VEGETABLE   MATEEIA  MEDICA.  [sect.  v. 

Cardamomi  Semina,  B.P.;  Cardamomum,  U.S.P.  Car- 
damoms.—The  fruit  U.S.P.  (dried  capsules,  B.P.),  of  Elettana 
Cardamomum.  Malabar.  The  seeds  are  best  kept  in  their  peri- 
carps, from  which  they  should  be  separated  when  required  for 
use,  the  pericarpal  coats  being  rejected. 


a  b 

Via.  222.— Cardamoms,    u.  Cross  section,    b.  Side  view. 

Characters.  —  Seeds  obtusely  angular,  corrugated,  reddish -brown,  inter- 
nally white,  with  a  warm,  aromatic,  agreeable  taste,  contained  in  ovate- 
oblong,  triangular,  pale-brown,  coriaceous  pericarps. 

Preparations. 
B.P.  DOSE. 

Tinctura  Cardamomi  Composita |-2  fl.  dr. 

Tinctura  Chloroformi  Composita 20-60  min. 

CONTAINED  ALSO   IN 

Extractum  Colocynthidis  Compositum.  Tinctura  Gentians  Composita. 

Pulvis  Cmnamomi  Compositus.  Tinctura  Bhei. 

Pulvis  Cretse  Aromaticus.  ,  Yinum  Aloes, 

U.S.P.  DOSE. 

Pulvis  Aromaticus 10-30  gr. 

Tinctura  Cardamomi 1-2  fl.  dr. 

„  „         Composita 1-2  fl.  dr. 

CONTAINED   ALSO   IN 

Tinctura  Bhei.  Vinum  Aloes. 

Tinctura  Gentians  Composita.  Extractum  Colocynthidis  Compositum. 

Tinctura  Cardamomi  Composita.  Compound  Tincture  of  Carda- 
moms. B.  and  U.S.P. — Cardamom  seeds  and  caraway  fruit  bruised  each 
^  oz.,  raisins  freed  from  seeds  2  oz.,  cinnamon  bark  |  oz.,  cochineal  55  gr., 
proof  spirit  1  pint.  B.P.  Cardamom  and  cinnamon,  each  20  parts,  caraway 
10,  cochineal  5,  glycerin  60,  diluted  alcohol  to  1,000  parts.     U.S.P. 

Composition. — Fixed  oil  and  aromatic  volatile  oil,  containing 
a  camphor  in  solution. 

Action  and  Uses. — Cardamoms  act  similarly  to  ginger.  They 
are  stimulant,  aromatic,  and  carminative,  and  are  less  pungent 
than  ginger.  Used  chiefly  as  a  carminative  in  flatulence,  and 
as  an  adjunct  to  other  medicines  to  lessen  griping. 

IRIDEJE. 

Crocus,  B.  and  U.S.P.  Saffron. — The  dried  stigmas  and 
top  of  the  style  of  Crocus  sativus,  B.P.  The  stigmas  of  Crocus 
sativus,  U.S.P.     Spain,  France,  and  Italy. 

Characters. — Thread-like  styles,  each  terminated  by  three  long  orange- 
brown  stigmas,  broadest  at  the  summit.     Has  a  powerful  aromatic  odour. 


chap,  xxxvi.]  .    MONOCOTYLEDONES.  1039 

Dose. — Of  dried  saffron,  20  gr.  and  upwards. 

Preparations. 

B.P.  DOSE. 

Deeoctum  Aloes  Compositmn i_2  fl.  oz. 

Pilula  Aloes  et  Myrrhs  (vide  p.  522)  5-10  gr. 

Pulvis  Cretse  Aromaticus.. 10-60  gr. 

Tinctura  Cinchonaa  Composita |_2  fl.  dr. 

Tinctura  Croci i-2  fl.  dr. 

Tinctura  Opii  Ammoniata A_l  fl.  dr. 

.,       Khei 1-2  fl.  dr.  (stomachic). 

»  4-8  fl.  dr.  (purgative). 

U.S.P. 

Tinctura  Croci >..4-2  fl.  dr. 

Composition. — The  colouring  matter  of  saffron  is  a  glueoside 
— crocin— soluble  in  water  and  easily  decomposed  by  dilute 
acids.  A  volatile  oil  is  obtainable  both  directly  from  the  drug 
and  by  the  decomposition  of  crocin.  It  possesses  the  odour  of 
saffron. 

Impurities. — Saffron  is  often  adulterated  with  parts  of  other  plants  dyed, 
and  with  coloured  chalk. 

Tests. — By  throwing  saffron  on  the  surface  of  warm  water,  the  peculiar 
form  of  the  stigma  is  at  once  seen,  and  admixture  of  other  plants  discovered. 
The  chalk  is  detected  by  its  immediately  rendering  the  water  turbid. 

Action  and  Uses. — Saffron  has  but  little  action.  It  is  used 
chiefly  as  a  colouring  agent,  and  as  a  slight  carminative. 

U.S.P.  Iris.  Iris.  Blue  Flag. — The  rhizome  and  rootlets 
of  Iris  versicolor. 

Characters. — Rhizome  horizontal,  consisting  of  joints,  two  to  four  inches 
(5  to  10  centimetres)  long,  cylindrical  in  the  lower  half,  flattish  near  the 
upper  extremity,  and  terminated  by  a  circular  scar,  annulated  from  the  leaf- 
sheaths,  grey-brown ;  rootlets  long,  simple,  crowded  near  the  broad  end ; 
odour  slight ;  taste  acrid,  nauseous. 

Preparations. 

dose. 

Extractum  Iridis 2-4  gr. 

„  „     Fluidum 5-10  min. 

Composition. — It  owes  its  medicinal  virtues  to  an  oleoresin. 

Action. — It  is  emetic  and  cathartic,  and  has  been  proved  by 
Professor  Eutherford  to  act  as  a  stimulant  to  the  liver  and  the 
intestinal  glands  (p.  403). 

Uses. — In  constipation  and  biliousness. 

LILIACE^E. 

U.S.P.  Allium.     Gaelic. — The  bulb  of  Allium  sativum. 

Characters. — Bulb  subglobular,  compound,  consisting  of  about  eight 
compressed,  wedge-shaped  bulblets,  which  are  arranged  in  a  circle  around 
the  base  of  the  stem,  and  covered  by  several  dry,  membranaceous  scales.  It 
has  a  pungent,  disagreeable  odour,  and  a  warm,  acrid  taste.  It  should  be 
preserved  in  a  dry  place,  and  used  only  in  the  fresh  state. 


1040  VEGETABLE   MATEEIA   MEDICA.  [sect.  v. 

Composition. — The  bulblets,  or  cloves  as  they  are  commonly 
termed,  owe  their  strong  taste  and  smell  to  a  volatile  oil  which 
is  sulphide  of  allyl  (C3H5)2S. 

Officinal  Preparation. 

dose. 

Syrupus  Allii 1-4  fl.  dr. 

Action. — Allyl  alcohol  is  a  powerful  antiseptic  (pp.  95  and 
102) ,  and  it  is  probable  that  oil  of  garlic  will  have  a  similar  action. 
Like  oil  of  mustard,  to  which  it  is  allied  in  chemical  composition 
(p.  864),  oil  of  garlic  is  a  powerful  irritant,  or  even  vesicant, 
when  applied  to  the  skin.  In  the  intestine  it  acts  in  small  doses  as 
a  gastric  tonic  and  carminative  ;  in  large  doses  as  an  emetic  and 
irritant,  causing  vomiting,  purging,  headache,  and  fever.  After 
absorption,  it  quickens  the  pulse  and  acts  as  a  nervine  stimulant. 
It  is  partly  eliminated  by  the  lungs,  imparting  its  peculiar  odour 
to  the  breath,  and  acting  as  an  expectorant.  It  is  diaphoretic 
or  diuretic  according  as  the  patient  is  kept  warm  or  cool.  It  is 
said  to  be  an  emmenagogue. 

Uses. — A  mixture  of  garlic  juice  and  oil,  or  bruised  garlic 
steeped  in  spirit,  is  used  as  a  counter-irritant  in  convulsions  or 
nervous  diseases  in  children,  and  also  in  skin-eruptions.  The 
syrup  may  be  used  as  a  gastric  tonic  in  atonic  dyspepsia,  and  to 
check  nervous  vomiting.  It  is  chiefly  employed  in  nervous 
coughs  of  children,  and  as  an  expectorant  in  bronchitis  after  the 
acute  stage  has  passed.  It  is  used  as  an  anthelmintic  in  cases 
of  ascarides,  and  is  given  by  the  mouth  and  also  as  an  enema. 

Convallaria  Majalis.  Lily  of  the  Valley.  Not  officinal.— 
The  flowers  and  stem  are  used,  though  the  whole  plant  contains 
the  active  principle. 

Composition. — The  flowers  and  stem  contain  two  glucosides, 
convallarin,  soluble  in  alcohol  but  insoluble  in  water,  and  con- 
vallamarin,  soluble  in  both  alcohol  and  water. 

Pbepakations. 

DOSE. 

Extractum  Convallarise 2-8  gr. 

„  „  Liquidum 2-10  min. 

Tinotura  „         5-30  min. 

Convallamarin |_2  gr. 

Action. — Convallamarin  acts  like  digitalis  (p.  996),  though 
not  so  well,  on  the  heart,  and  in  producing  diuresis  in  cardiac 
disease.     Convallarin  has  only  a  purgative  effect. 

Uses. — An  infusion  of  the  whole  plant  is  a  common  remedy 
in  Eussia  for  cardiac  dropsy.  Convallamarin  has  been  used  in 
mitral  disease  with  dropsy,  but  it  has  not  superseded  digitalis, 
though  it  is  said  to  have  no  harmful  effects. 

Scilla,  B.   and   U.S.P.      Squill. — The   sliced  (and   dried 


chap,  xxxvi.]  MONOCOTYLEDONES.  1041 

B.P.)   bulb  of  Urginea  Scilla   (U.  maritima).      Mediterranean 
coasts. 

Characters. — Bulb  pear-shaped,  weighing  from  half  a  pound  to  ten 
pounds;  outer  scales  membranous,  brownish  red  or  white;  inner  seales 
thick,  whitish,  fleshy,  juicy ;  taste  mucilaginous,  intensely  and  disagreeably 
bitter,  somewhat  acrid.  The  dried  slices  are  white  or  yellowish-white, 
slightly  translucent,  scentless,  disagreeably  bitter,  brittle  and  easily  pulveris. 
able  if  very  dry. 


H. 

Fro.  223.— Cut  piece  of  Squill,  half  the  natural  size. 

Composition. — Tbe  active  principle  is  a  glucoside,  scillitoxinj 
or  scillain.  Tbe  sciUitin  of  some  authors  is  probably  slightly 
impure  scillitbxin. 

Dose. — Of  powdered  squills,  1-3  gr. 

Pkepaeations. 

B.P.  COSE. 

Acetum  Scillss 15-40  min. 

Oxymel        ■, |-1  fl.  dr. 

Pilula  Xpecacuanhse  cum  Scilla  (vide  p.  522) 5-10  gr. 

,,       Scillse  Composlta  (vide  p.  523) 5-10  gr. 

Syrupus  Scillse J-l  fl.  dr. 

Tinctura       „       10-20  min. 

u.s.p. 

Acetum  Scillse 15  min.-l  fl.  dr. 

Extractum  Scillaa  Fluidum ...1-2  min. 

Syrupus         „      Compositus 10-30  min. 

Tinctura        „ 8-30  min. 

Syrupus         „ |-1  fl.  dr. 

TJ.S.P.  Syrupus  Scillos  Compositus.  Squill,  120 ;  senega,  120 ;  tartrate  of 
antimony  and  potassium,  3 ;  sugar,  1,200  ;  precipitated  phosphate  of  calcium,  9  ; 
diluted  alcohol  and  water,  of  each,  q.s.  to  make  2,000. 

Action  and  Uses. — Squill  and  its  active  principle,  scillitoxin, 
act  like  digitalis. 

Internally,  in  large  doses,  it  causes  vomiting  and  purging. 
"When  absorbed  into  the  blood,  it  slows  the  pulse  and  raises  the 
blood-pressure.  Like  digitalis  it  acts  as  a  diuretic,  and  also 
acts  like  it  on  voluntary  muscle  fibre.  It  is  chiefly  used  as  an 
adjunct  to  digitalis  to  produce  diuresis  in  cases  of  cardiac  dropsy ; 
also  as  an  expectorant,  when,  although  the  secretion  is  profuse, 
it  is  difficult  to  expel.  It  is  of  no  use  when  the  expectoration  is 
dry  and  deficient ;  in  such  cases  ipecacuanha  should  first  be 
given  and  followed  by  squill. 

Pilula  ipecacuanhas  cum  scilla,  10  grains  night  and  morning, 
is  a  most  useful  remedy  in  chronic  bronchitis. 

Aloe  Socotrina,  B.P. ;  Aloe,  U.S.P-  Socoteine  Aloes, 
B.P. ;  Aloes,  U.S.P. — The  inspissated  juice  of  the  leaf  of  Aloe 

3x 


1042  VEGETABLE  MATEEIA  MEDICA.  [sect.  \ 

Perryi  and  probably  other  species.    Imported  principally  by  wa; 
of  Bombay  and  Zanzibar. 

Characters. — In  hard,  opaque,  reddish-brown  or  yellowish-brown,  no 
greenish,  masses,  translucent  at  the  edges ;  breaks  with  an  irregular  o 
smooth  and  resinous  fracture  ;  has  a  bitter  taste,  and  when  breathed  on  ha 
a  saffron-like  odour ;  dissolves  entirely  in  proof  spirit,  and  during  solutioi 
exhibits  under  the  microscope  numerous  minute  crystals. 

Preparations. 
B.P.  DOSE. 

Aloln £-2gr. 

Decoctum  Aloes  Composltum  (Extract) 4 ■  gr.  in  1  fl.  oz i-2  fl.  02 

Enema  Aloes 4  gr.  in  1  fl.  oz 10  fl.  oz. 

Extractum  Aloes  Socotrlnee 1  part  from  2,  nearly 2-6  gr. 

Extractum  Colocynthidis  Compositum  (Extract)  1  part  in  2,  nearly 3-10  gr. 

Pllula  Aloes  et  Asafoetldse  (vule\>.  522) 1  part  in  4 5-10  gr. 

„  „  Myrrhee  (vide  p.  522) 1  part  in  B 5-10  gr. 

„  „     Socotrlnee  (vide  p.  522).., 1  part  in  2,  nearly 5-10  gr. 

Pilula  Khei  Composita  (vide  p.  523) 1  part  in  6 5-10  gr. 

Tlnctura  Aloes 11  gr.  to  1  fl.  oz 1-3  fl.  dr. 

Tinctura  Benzoini  Composita 8  gr.  to  1  fl.  oz J-2  fl.  dr. 

Visum  Aloes , 16|  gr.  to  1  fl.  oz 1-2  fl.  dr. 

U.S.P. 

Aloes  Purificata '. ....,.., 5-6  gr. 

Extractum  Aloes  Aquosum |-6  gr. 

B.P.  Decoctum  Aloes  Composltum.  Compound  Decoction  of  Aloes.— 
Extract  of  Socotrine  aloes,  120  gr. ;  myrrh,  90  gr. ;  saffron,  90  gr. ;  carbonate  o 
potassium,  60  gr. ;  extract  of  liquorice,  1  oz. ;  compound  tincture  of  cardamoms 
8  fl.  oz. ;  distilled  water  up  to  30  fl.  Oz. 

B.P.  Enema  Aloes.  Aloes  (Socotrine  or  Barbadoes),  40  gr. ;  carbonate  0 
potassium,  15  gr. ;  mucilage  of  starcb,  10  fl.  oz. 

B.P.  Extractum  Aloes  Socotrlnee.  Treating  with  boiling  water,  separating 
insoluble  matter  by  subsidence  and  filtration,  and  evaporating  the  clear  solution. 

B.P.  Tlnctura  Aloes.  Tincture  of  Aloes. — Socotrine  aloes,  5  oz. ;  extrac 
of  liquorice,  1|  oz. ;  proof  spirit,  to  20  fl.  oz. 

B.P.  Vlnum  Aloes.  Wine  of  Aloes. — Socotrine  aloes,  li  oz. ;  cardamom 
seeds  and  ginger,  of  each,  80  gr. ;  sherry,  up  to  2  pints. 

U.S.P.  Extractum  Aloes  Aquosum.  Aqueous  Extract  op  Aloes. — Aloes,  100 
boiling  distilled  water,  1,000.  Separate  the  insoluble  matter  by  subsidence  an< 
filtration,  and  evaporate. 

Composition. — All  kinds  of  aloes  contain  a  bitter  substance 
aloin,  to  which  their  activity  is  due.  It  has  in  each  kind  of  aloes 
a  slightly  different  composition,  and  has  received  a  name  showing 
its  source — socaloin  from  Socotrine  aloes,  barbaloin  from  Barba- 
does aloes,  and  nataloin  from  Natal  aloes.  According  to  somt 
authors  these  substances  are  isomeric ;  according  to  others  thej 
form  a  homologous  series.  Besides  aloin,  aloes  contains  resinous 
substances  and  traces  of  an  ethereal  oil. 

Barbaloin  and  nataloin  are  distinguished  from  socaloin  bj 
giving  with  a  drop  of  nitric  acid,  on  a  porcelain  slab,  a  brigh] 
crimson  colour.  With  barbaloin  this  gradually  fades,  but  it  is 
permanent  with  nataloin.  Socaloin  does  not  give  this  reaction 
Barbaloin  is  distinguished  from  nataloin  by  the  latter  giving  f 


chap,  xxxvi.]    ,  MONOCOTYLEDONES.  1043 

fine  blue  colour,  while  the  former  remains  unchanged,  on  adding 
a  minute  quantity  of  each  to  one  or  two  drops  of  strong  sul- 
phuric acid  and  then  bringing  a  glass  rod  dipped  in  nitric  acid 
so  near  that  the  vapour  shall  pass  over  the  surface. 

B.P.  Aloin.  Aloin.  C16H1807. — A  crystalline  substance 
extracted  from  aloes  by  solvents  and  purified  by  recrystallisation. 
As  obtained  from  the  different  varieties  of  aloes,  the  products 
differ  slightly,  but  their  medicinal  properties  are  similar. 

Characters. — Usually  in  tufts  of  acioular  crystals,  yellow,  inodorous, 
and  having  the  taste  of  aloes. 

Solubility  and  Reactions. — Sparingly  soluble  in  cold  water,  more  so  in 
cold  rectified  spirit,  freely  soluble  in  the  hot  fluids.  Insoluble  in  ether.  Not 
readily  altered  in  acidified  or  neutral  solutions ;  rapidly  altered  in  alkaline 
fluids. 

U.S.P-  Aloe  Purificata.     Purified  Aloes. 

Preparation. — By  melting  aloes  100,  adding  alcohol  15,  straining-  and 
evaporating. 

Characters. — Purified  aloes  is  in  irregular  brittle  pieces  of  a  dull-brown 
or  reddish-brown  colour,  and  having  the  peculiar  aromatic  odour  of  Socotrina 
aloes. 

Solubility. — It  is  almost  entirely  soluble  in  alcohol. 

Preparations. 

U.S.P.  DOSE. 

Pilulse  Aloes  (w<Zep.  523) 1  pill. 

Pilulse  Aloes  et  Asafcetidse  (vide  p.  523) 2-5  pills. 

Pilulse  Aloes  et  Ferri  (vide  p.  523)  1  pifi. 

Pilulse  Aloes  et  Mastiches  (vide  p.  523) 1  pill. 

Pilulse  Aloes  et  Myrrhse  (vide  p.  523) 1  pill. 

Tinctura  Aloes 1-4  fl.  dr. 

Tinctura  Aloes  et  Myrrhse 1-2  fl.  dr. 

Vinum  Aloes as  stomachic,  1-2  fl.  dr. ;  as  purgative,  £-1  fl.  oz. 

It  is  contained  also  in  Pilulse  Rhei  Composite  (p.  523),  Extract  urn  Colocyn- 
thidis  Compositum,  Pilulse  Cathartics  Compositse  (p.  523),  and  Tinctura  Benzoini 
Composita. 

U.S.P.  Tinctura  Aloes.  Tincture  op  Aloes. — Aloes,  10 ;  extract  of  glycyr- 
rhiza,  10 ;  diluted  alcohol  up  to  100. 

U.S.P.  Tinctura  Aloes  et  Myrrhse.  Tincture  or  Aloes  and  Myrrh.— Aloes  10 ; 
myrrh,  10 ;  alcohol,  to  100. 

U.S.P.  Vinum  Aloes.  Wine  of  Aloes. — Aloes,  6 ;  cardamom,  1  •,  ginger,  1 ; 
stronger  white  wine,  up  to  100. 

B.P.  Aloe  Barbadensis.  Barbadoes  Aloes. — The  inspis- 
sated juice  of  the  leaf  of  Aloe  vulgaris.  Barbadoes  and  Dutch 
West  Indian  Islands. 

CHARACTERS.-^-In  yellowish-brown  or  dark-brown  opaque  masses  ;  breaks 
with  a  dull  conchoidal  fracture ;  has  a  bitter,  nauseous  taste,  and  a  strong, 
disagreeable  odour. 

Composition. — Contains  barbaloi'n,  resin,  and  volatile  oil. 
Dose. — In  powder,  2-6  grains. 

3x2 


1044  VEGETABLE  MATEEIA  MEDICA.  [sect,  v 

Pbepabations. 

B.P.  DOSE. 

Aloln i-2gr. 

Enema  Aloes  (vide  supra) 4  gr.  in  1  fl.  oz 

Extractum  Aloes  Barbadensis 8  parts  from  10,  nearly...2-6  gr. 

Pllula  „  i,  (vide-p. 522)...  1  part  in  2,  nearly  5-10  gr. 

„  „      et  Ferri  (vide  p.  522) 1  part  in  5J 5-10  gr. 

Pilula  Cambogiffl  Composita  (vide  p.  522)  1  part  in  6,  nearly 5-10  gr. 

„     Colocynthidis  Composita  (vide  p.  522) 1  part  in  3,  nearly 5-10  gr. 

„  „  et  Hyosoyami  (vide  p.  522)..l  part  in  4J,  nearly 5-10  gr. 

B.P.    Extractum  Aloes  Barbadensis. — Prepared  like  extract  of  Socotrine 
aloes. 

Action  and  Uses. — It  causes  a  bitter  taste  in  the  mouth, 
and  reflex  salivation.  In  small  closes  it  seems  to  have  a  tonic 
action  like  simple  bitters.  It  increases  peristalsis  of  the  in- 
testines and  also  intestinal  secretion.  Its  action  is  particularly- 
exerted  on  the  large  intestines,  and  especially  in  the  rectum. 
This  is  shown  by  the  great  length  of  time  which  usually  elapses 
between  its  administration  and  its  action  (ten  or  twelve,  some- 
times as  much  as  twenty-four,  hours),  and  by  the  rectal  irritation 
which  it  produces,  and  which  is  evidenced  by  tenesmus,  hsemor- 
rhoidal  swelling,  and  haemorrhage.  It  increases  the  secretion  of 
bile  by  stimulating  the  liver  (Eohrig  and  Eutherford).  It  only 
acts  when  mixed  with  bile,  and  is  consequently  useless  in  jaun- 
dice, where  the  bile  does  not  enter  the  intestine,  as  is  shown  by 
the  whiteness  of  the  stools.  It  may,  however,  be  rendered  active 
by  giving  it  along  with  ox-gall.  Aloes  has  little  or  no  purgative 
action  when  given  alone  as  an  enema,  but  is  active  if  mixed  with 
ox-bile.  In  the  enema  aloes,  B.P.,  it  is  mixed  with  carbonate  of 
potassium.  Aloes  appears  to  cause  hyperemia  of  the  uterus 
and  other  pelvic  organs,  as  well  as  of  the  rectum.  In  acute  and 
chronic  poisoning  by  alo'in,  the  kidneys  are  affected,  the  tubules 
losing  their  epithelium,  while  the  glomeruli  remain  intact,  but 
become  surrounded  by  an  increase  of  fibrous  tissue.  In  both 
forms  of  poisoning  there  is  albuminuria.1  Aloes  sometimes  has 
an  aphrodisiac  action,  but  this  is  not  constant,  and  probably  is 
due  to  irritation  caused  by  haemorrhoids  (p.  448).  Aloes  differs 
from  other  purgatives  in  not  causing  subsequent  constipation, 
but  on  the  contrary  rendering  the  intestine  more  sensitive,  so 
that  the  dose  can  be  gradually  reduced.  As.it  does  not  cause 
subsequent  constipation,  it  is  a  favourite  purgative,  and  is 
contained  in  most  vegetable  purgative  pills  (except  pil.  scamm. 
co.).  As  it  acts  slowly,  it  should  be  given  a  good  while  before 
■a  motion  is  desired,  and  a  favourite  plan  is  to  give  it  as  a  dinner 
pill  just  before  the  last  meal  of  the  day,  when  it  usually  acts 
next  morning  after  breakfast.  I  have  known  people  who  have 
taken  dinner  pills  regularly  every  day  for  thirty  years  without 

1  A.  Miirset,  '  TJntersuch.  iiber  Intoxicationsnephritis,'  Archiv  f.   exp.   Path, 
imd  Pharmak.,  Bd.  xix.,  p.  310. 


chap,  xxxvi.]  MONOCOTYLEDONES.  1045 

injury  and  with  apparent  benefit.  As  it  tends  to  cause  conges- 
tion of  the  rectum,  some  authorities  prohibit  its  use  in  piles,  but 
in  small  doses,  and  if  the  piles  are  not  inflamed,  it  is  often  bene- 
ficial in  these  cases,  although  large  doses  are  injurious.  Prom 
its  action  in  causing  congestion  of  the  uterus,  it  is  used  in 
amenorrhcea  (at  the  time  when  the  catamenia  are  expected),  but 
must  be  avoided  in  pregnancy  and  rectal  inflammation.  In 
these  cases  it  is  usually  combined  with  iron  or  myrrh. 

Veratri  Viridis  Rhizoma,  B.P. ;  Veratrum  Viride,  U.S.P. 

Green  Hellebore  Ehizome,  B.P. ;  American  Hellebore,  U.S.P. 
The  rhizome  and  rootlets  of  Veratrum  viride.  United  States  and 
Canada. 

Characters.: — Rhizome  two  or  three  inches  long,  one  to  two  inches 
thick,  with  numerous  shrivelled,  light  yellowish-brown  rootlets. 


Pig.  224. — Yeratrum  viride  root,  half  the  natural  siza. 

Composition.— It  contains  several  alkaloids— jervine,  pseudo- 
jervine,  cevadine,  very  little  rubijervine,  and  traces  of  vera- 
trine  and  veratralbine.  Veratroidine,  which  was  formerly  re- 
garded as  one  of  its  constituents,  is  probably  rubijervine  and 
resin. 

Dose. — Of  the  powdered  rhizome,  1-3  gr.  or  more. 

Pbepakaiions. 

B.P.  DOSE. 

Tlnctura  Veratri  Viridis 5-20  min.  or  more. 

U.S.P. 

Extractum  Veratri  Viridis  Fluidum 1-4  ruin. 

Tinctura  „  „        5-10  min. 

Action. — In  small  doses  veratrum  viride  lessens  the  strength 
of  the  pulse  in  man  without  at  first  affecting  its  rate,  but  after- 
wards it  renders  it  very  slow,  soft,  and  compressible,  although 
sometimes  moderately  full.  At  this  stage  any  exertion  at  once 
renders  the  slow  pulse  rapid,  feeble,  small,  and  even  imper- 
ceptible. The  depression  of  the  circulation  is  accompanied  by 
muscular  weakness,  and  frequently,  though  not  always  by 
nausea  and  vomiting.     When  the  dose  is  large  these  symptoms  ; 


1046  VEGETABLE  MATEEIA  MEDICA.  [sect.  v. 

become  increased,  and  a  state  of  collapse  comes  on  with  an  ex- 
ceedingly rapid,  almost  imperceptible  pulse,  cold  clammy  skin, 
constant  nausea  and  retching,  intense  muscular  weakness,  giddi- 
ness, loss  of  vision,  and  partial  unconsciousness. 

The  action  of  veratrum  viride  is  due  to  the  jervine  and  other 
alkaloids  -which  it  contains.  It  has  been  mentioned  already  that 
veratroidine  is  not  a  pure  alkaloid,  but  as  no  further  investiga- 
tions have  been  made  on  the  alkaloids  of  veratrum  since  those  of 
Professor  H.  C.  Wood,  I  give  his  results. 

Jervine  lessens  the  functions  of  the  spinal  cord,  both  in 
frogs  and  mammals,  and  of  the  medulla  (especially  the  vaso- 
motor centre) ,  and  of  the  cardiac  ganglia,  and  at  the  same 
time  irritates  the  motor  centres  in  the  brain,  producing  convul- 
sions. Thus  the  symptoms  produced  are  muscular  weakness, 
loss  of  reflex  action,  followed  by  tremors,  lowered  blood-pressure, 
and  slow  pulse. 

Eespiration  ceases  before  the  heart,  and  death  ensues  from 
asphyxia.  There  is  invariably  salivation,  but  no  vomiting  nor 
purging.  It  has  no  action  on  the  vagus,  and  the  slow  pulse  is 
due  to  an  action  on  the  cardiac  muscle  or  its  ganglia.  Voluntary 
muscles  and  motor  nerves  are  little,  if  at  all,  affected  by  it. 

Veratroidine  differs  from  jervine  in  always  causing  vomiting 
and  purging,  and  in  producing  less  violent  convulsions.  It 
stimulates  the  vagus  centre  and  paralyses  the  vagus  ends.  It 
depresses  the  spinal  cord  and  paralyses  the  respiratory  centre, 
but  increases  the  excitability  of  the  vaso-motor  centre.  At 
first  it  slows  the  pulse  and  lowers  the  blood-pressure.  Next 
the  pulsations  become  very  powerful,  though  still  slow,  and  the 
blood-pressure  rises  to  normal.  Then  the  pulse  becomes  very- 
rapid,  and  the  pressure  rises  greatly.  This  rise  is,  however,  not 
due  to  the  direct  action  of  the  drug,  but  to  stimulation  of  the 
vaso-motor  centre  by  asphyxial  blood  from  paralysis  of  the 
respiration.  If  artificial  respiration  be  kept  up  veratroidine 
steadily  lessens  both  pulse-rate  and  blood-pressure. 

Uses. — Veratrum  viride  has  been  used  as  a  cardiac  depres- 
sant in  inflammations,  but  has  not  come  into  general  use. 

B.P.  Sabadilla.  Cevadilla. — The  dried  ripe  seeds  of  Schce- 
nocaulon  officinale  (Asagrcea  officinalis).     Mexico. 

Characters. — Fruit  about  half  an  inch  long,  consisting  of  three  light- 
brown  papyraceous  follicles,  each  containing  from  one  to  three  seeds,  which 
are  about  a  quarter  of  an  inch  long,  blackish-brown,  shining,  slightly  winged, 
possessing  an  intensely  acrid  bitter  taste.    The  seeds  only  are  officinal. 

B.P.       PeEPAPATION. 

Veratrlna. 

'Composition. — Three  alkaloids,  the  first — veratrine — being 
the  active  principle.    The  remaining  alkaloids — sabadillina  and  - 


■chap,  xxxvi.]  MONOCOTYLEDONES.  1047 

sabatrina — occur  in  very  small  quantities,  and  are  of  little  im- 
portance in  pharmacy. 

Veratrina,  B.  and  U.S.P.  Vebatkine. — An  alkaloid  or 
mixture  of  alkaloids  obtained  from  cevadilla;  not  quite  pure, 
B.P.  An  alkaloid  or  mixture  of  alkaloids  prepared  from  the 
seeds  of  Asagrcea  officinalis,  U.S.P. 

Preparation. — A  concentrated  tincture  of  the  seeds  is  poured  into  cold 
water  in  order  to  precipitate  the  alhumin.  From  the  filtered  solution  veratrine 
is  precipitated  by  ammonia,  and  purified  byre-solution  in  dilute  hydrochloric 
acid,  decolorisation  by  animal  charcoal,  and  reprecipitation  by  ammonia. 

Characters. — Pale  grey,  amorphous,  without  smell,  but,  even  in  the 
most  minute  quantity,  powerfully  irritating  the  nostrils ;  strongly  and  per- 
sistently bitter,  and  highly  acrid.    An  active  poison. 

Solubility. — Insoluble  in  water ;  soluble  in  spirit,  in  ether,  and  in  diluted 
acids,  leaving  traces  of  an  insoluble  brown  resinoid  matter. 

Impurities. — Mineral  matter,  and  sometimes  traces  of  the  other  alkaloids 
of  cevadilla. 

Test. — Heated  with  access  of  air  it  melts  into  a  yellow  liquid,  and  at 
length  burns  away,  leaving  no  residue. 

Dose.—  f^  gr. 

Pbbpabations. 

B.P. 
Vnguentum  Veratrlnee  (8  gr.  to  1  oz.)  for  external  use. 

U.S.P. 

Oleatum  VeratrinsB  (1  part  in  50). 
TJnguentum      „       (1  part  in  25). 

Action. — Large  doses  of  veratrine  cause  violent  sneezing, 
and  great  gastro- intestinal  irritation,  vomiting,  purging,  and 
symptoms  of  collapse,  the  pulse  being  rapid,  small,  and  irregular ; 
and  often  involuntary  muscular  tremors  come  on.  A  peculiar 
creeping  and  prickling  sensation  in  the  skin  generally  accom- 
panies these  symptoms. 

Externally,  applied  to  the  unbroken  skin,  it  has  no  marked 
action,  but  if  rubbed  in  with  some  fat  it  passes  through  the  epi- 
dermis and  acts  on  the  true  skin,  and  causes  first  irritation  and 
then  paralysis  of  the  ends  of  the  sensory  nerves,  producing  a 
prickling  and  creeping  sensation,  succeeded  by  numbness.  It  is 
somewhat  like  aconitine  in  this  respect.  This  effect  is  produced 
whether  applied  locally  or  taken  internally. 

Its  irritating  action  on  the  sensory  nerves  is  also  observed 
if  it  be  inhaled  into  the  nose,  when  it  causes  violent  sneezing, 
which  also  occurs  after  absorption  from  the  stomach. 

Internally. — It  has  no  marked  action  on  the  brain.  It  has 
probably  no  action  on  the  spinal  cord.  By  some  experimenters 
it  is  stated  that  convulsions  are  produced  in  frogs,  but,  from 
numerous  experiments  which  I  performed,  I  doubt  the  accuracy 
of  this  statement. 

Muscles. — The  contractile  power  is  increased,  but  the  elas- 


1048  VEGETABLE  MATEEIA  MEDICA.  [sect.,v, 

ticity  very  much  diminished.  The  period  of  contraction  is  very 
much  prolonged,  but  neither  the  latent  period  nor  the  ascent  of 
the  curve  is  affected  in  character ;  the  height  of  the  curve  is 
slightly  increased,  and  the  descent  of  the  curve  very  much  pro- 
longed, so  that  it  does  not  reach  the  abscissa  for  several  revolu- 
tions of  the  cylinder.  This  contraction  is  not  a  state  of  partial 
rigor,  since  during  its  continuance  the  development  of  heat  is 
increased  to  a  marked  degree ;  neither  is  it  a  true  tetanus,  since 
the  rheoscopic  frog  only  gives  a  single  contraction  when  its 
nerve  is  laid  on  the  poisoned  muscle.  It  is  a  prolonged  con- 
traction. To  this  alteration  in  the  muscles  is  due  the  peculiar 
behaviour  of  frogs  when  poisoned  by  veratrine.  The  frog  jumps 
readily  on  stimulation,  but  after  its  spring  it  lies  on  the  table 
with  legs  extended  for  a  long  time ;  then  it  draws  the  limbs  up 
slowly,  for  both  the  flexors  and  extensors  are  contracted,  and 
the  contraction  has  to  pass  off  from  the  extensors  before  the 
flexors  can  act.  When  it  has  drawn  its  limbs  up,  it  remains 
still  for  a  time,  to  allow  the  contraction  to  pass  off  from  the 
flexors,  after  which  it  springs  again.  Thus  the  frog  performs 
the  normal  movements  with  very  long  intervals  between  them. 
These  movements  have  probably  been  mistaken  for  convulsions. 
Temperature,  affects  the  veratrine  curve  in  a  remarkable  manner. 
As  the  muscle  is  cooled  down,  the  curve  becomes  more  and  more 
like  the  normal,  and  if  the  temperature  be  much  raised  (keeping 
below  the  heat  of  rigor  caloris)',  the  effect  also  disappears ;  thus 
extremes  of  heat  and  cold  remove  the  veratrine  effect  on  the 
muscle-curve.  The  effect  of  veratrine  on  the  muscle  is  also 
removed  by  potash  (p.  130). 

Muscles  previously  exhausted  by  over-exertion  have  their 
powers  restored  by  veratrine. 

Motor  nerves  have  their  excitability  increased  at  first; 
afterwards  their  peripheral  ends  are  paralysed.  Sensory  nerves 
have  their  peripheral  ends  first  stimulated  (causing  pricking, 
&c),  and  then  paralysed  (cf.  Aconite,  p.  832). 

Circulation. — The  effect  of  veratrine  on  the  heart-muscle  of 
the  frog  is  very  similar  to  that  on  voluntary  muscle ;  hence  the 
contractions  of  the  heart  become  slower,  and  each  systole  lasts 
a  long  time,  till  finally  the  heart  stops  in  complete  systole. 
The  effect  of  veratrine  on  the  heart  is  also  removed  by  heat  and 
by  potash  (Binger).  In  mammals,  small  doses  injected  into  the 
circulation  quicken  the  pulse  and  raise  the  blood-pressure; 
moderate  and  large  doses  slow  the  heart  and  lower  the  blood- 
pressure.  Small  doses  quicken  the  respiration ;  large  ones 
slow  it,  producing  long  pauses  like  those  which  occur  after 
section  of  the  vagi,  and  finally  paralyse  it.  These  effects  are 
probably  due  to  stimulation  at  firsts  and  afterwards  to  paralysis 
of  the  ends  of  the  vagus  in  the  lung,  and  to  paralysis  of  the 
respiratory  centre.    The  temperature  is  lowered. 


chat,  xxxvi.]    ■  MONOCOTYLEDONES.  1049 

Uses. — Locally^  it  is  used  like  aconitine  for  neuralgia,  in  the 
form  of  the  ointment  rubbed  over  the  affected  part. 

Internally,  it  is  sometimes  used  in  rheumatic  arthritis,  and 
in  sthenic  febrile  affections,  as  pneumonia;  but  its  action  is 
uncertain,  and  its  use  dangerous  ;  hence  it  is  seldom  employed. 
Possibly  one  cause  of  the  uncertainty  of  its  'action  is  the  high 
temperature  accompanying  febrile  affections,  by  which  its  action 
is  altered.  A  similar  reason  may  hold  good  for  aconite,  which 
varies  considerably  in  its  action  on  febrile  disorders  (cf.  Digitalis, 
p.  998). 

Colchici  Cormus,  B.P. ;  Colchici  Radix,  U.S.  P.  Col- 
chicum Cohm,  B.P. ;  Colchicdm  Eoot,  U.S.P.-^The  (fresh,  B.P.) 
corm  of  Colchicum  autumnale,  collected  about  the  end  of  June, 
and  the  same  stripped  of  its  coats,  sliced  transversely,  and  dried 
at  a  temperature  not  exceeding  150°  F.,  B.P. 


Fig.  225. — Slice  of  ColcMcnm. 

Characters. — Fresh  corm  about  the  size  of  a  chestnut ;  furnished  with 
an  outer  brown  and  an  inner  yellow  coat ;  internally  white,  solid  and  fleshy. 
Dried  slices  about  a  line  thick,  moderately  indented  on  one,  rarely  on  both 
sides,  firm,  flat,  whitish,  amylaceous. 

Composition.— Colchicine,   and  traces   of  veratrine ;    also 
starch,  tannin,  and  fatty  oil.     They  lose  their  odour  by  drying. 

Preparations. 

B.P.  DOSE. 

Extractum  Colchici ,-  .....j-2  gr. 

„  „  Aceticum g-2  gr. 

Vlnum  88  gr.  to  1  fl.  oz 10-30  mm. 


Colchici  Eadix. 

Extractum  Colchicr  Eadicis :....f-2  gr. 

„  „        Fluidum 2-5  mm. 

Vinum  „  „       • 8min- 

Colchici  Semina,  B.P. ;  Colchici  Semen,  U.S.P.  Col- 
chicum Seeds,  B.P.,;  Colchicum  Seed,  U.S.P.— The  seeds  of 
Colchicum  autumnale,  collected  when  fully  ripe,  usually  about  the 
end  of  July  or  beginning  of  August,  and  carefully  dried,  B.P. 
^The  seed  of  Colchicum  autumnale,  U.S.P. 


1050  VEGETABLE  MATEEIA  MEDICA.  [sect.  i. 

Characters. — About  the  size  of  white  mustard  seed,  very  hard,  of  a 
reddish-brown  colour,  and  pitted. 

•    ©     §    0 

Piq.  226.— Colchicum  Seeds. 

Composition. — 'Colchicine,  generally  regarded  as  an  alkaloid, 
soluble  in  water  and  alcohol.  Traces  of  veratrine — in  combina- 
tion with  gallic  acid — and  a  fixed  oil  are  found. 

Preparations. 

B.P.  DOSE. 

Tlnctura  Colchlci  Semlnum 5i\  gr.  to  1  11.  oz 10-30  mitt. 

u.s.p 

Extraotum  Colohioi  Seminis  Fluidum 2-10  min. 

Tinotura  „  , 15-30  min. 

Vinum  „  „        15-30  min. 

Gbneeal  Action. — The  action  of  colchicum  does  not  vary  in 
proportion  to  the  dose,  since,  when  a  certain  (fairly  large)  dose  is 
given,  an  increased  dose  does  not  seem  to  produce  a  more  marked 
effect.  It  acts  as  a  poison  both  to  cold-  and  warm-blooded 
animals,  but  its  effect  is  least  marked  on  cold-blooded  animals, 
and  more  marked  on  Carnivora  than  Herbivora.  It  has  the 
same  effect  on  the  alimentary  canal  whether  swallowed  or  sub- 
cutaneously  injected. 

When  given  in  continued  non-poisonous  doses  it  causes  an 
acrid  taste,  with  reflex  flow  of  saliva,  and  symptoms  of  gastro- 
intestinal disturbance,  viz.  irritation  of  the  fauces,  loaded  tongue, 
loss  of  appetite,  flatulence,  uneasiness,  or  pain  in  the  stomach 
and  intestines,  and  diarrhoea.  The  pulse  is  slowed,  and  there  is 
a  tendency  to  muscular  weakness. 

A  single  large  dose,  or  moderate  doses  long  continued  may 
produce  symptoms  of  acute  gastro-intestinal  inflammation,  viz. 
violent  vomiting  (vomited  matter  being  first  bilious  and  theu 
bloody)  and  purging  (the  stools  being  first  serous,  then  mucous, 
then  bloody).  Marked  symptoms  of  collapse  supervene,  the 
pulse  becomes  small,  rapid,  and  thready,  the  skin  cold  and  be- 
dewed with  sweat,  respiration  slow  and,  painful.  Death  ensues 
from  collapse,  the  brain  remaining  clear  to  the  last. 

Sometimes  nervous  symptoms  occur,  such  as  flying  pains 
over  the  body,  numbness,  and  occasionally,  though  rarely,  con- 
vulsions. 

Special  Action. — When  applied  to  the  skin  it  is  an  irritant, 
causing  redness,  prickling,  and  smarting,  and  if  taken  into  the 
nose  causes  sneezing  and  running  at  the  eyes. 

Internally. — Its  action  on  the  brain,  if  any,  is  not  well 
marked. 

In  frogs  the  spinal  cord  is  paralysed,  the  paralysis  being 
preceded  by  excitement^  sometimes  giving  rise  to  convulsions. 


chap,  xxxvi.]  M0N0C0TYLED0NE8.  1051 

In  the  higher  animals  there  is  no  excitement,  the  cord  being 
paralysed  from  the  first.  The  sensory  nerves  are  more  or  less 
paralysed.  The  motor  nerves  and  muscles  are  unaffected. 
The  circulation  is  affected,  but  the  action  is  to  a  great  extent 
reflex,  since,  if  injected  directly  into  the  circulation,  both  the 
heart  and  the  blood-pressure  are  only  slightly  altered.  Very 
large  doses  are  required  to  paralyse  the  inhibitory  fibres  of  the 
vagus,  but  ultimately  they  are  paralysed. 

The  Secretion  of  Urine. — Some  authorities  affirm  that  the 
total  solids  (both  inorganic  and  organic)  are  increased,  and  also 
the  quantity  of  water.  Some  say  that  only  the  urea  is  increased, 
others  that  the  uric  acid  is  increased,  while  others,  again,  contra- 
dict both  these  statements. 

The  probable  explanation  of  these  conflicting  statements  is 
that  the  observers  have  conducted  experiments  with  different 
diets. 

Treatment  in  Poisoning.— Evacuate  the  stomach  by  an 
emetic,  if  vomiting  is  not  induced  by  the  drug  itself ;  give  tannic 
acid  in  large  quantities  (which  acts  as  a  chemical  antidote) ; 
white  of  egg  diluted  with  water  may  be  given  freely ;  or,  if  the 
pulse  is  very  depressed,  give  stimulants  and  keep  the  patient 
warm. 

Uses. — Its  chief  use  is  in  gout,  in  the  form  of  vinum  or  tinc- 
ture, either  in  large  doses  during  the  fit,  or  in  small  ones  con- 
tinued for  a  length  of  time.  It  seems  to  act  best  when  the 
bowels  are  previously  freely  acted  on,  hence  a  very  old  and  useful 
mixture  is  colchicum,  magnesia,  and  sulphate  of  magnesium. 

In  rheumatic  arthritis  10  min.  of  tincture  with  10  gr.  of 
potassium  iodide  often  prove  useful. 

In  subacute  rheumatism  it  is  of  very  much  less  service. 

In  acute  rheumatism  it  is  hardly  ever  used,  salicylate  of 
sodium  being  more  frequently  employed. 


LILIACEiE. 
(SMILACE^.) 

Sarsse  Radix,  B.P. ;  Sarsaparilla,  U.S.P-  (Jamaica,  B.P.) 
Sarsaparilla  —  The  (dried  B.P.)  root  of  Smilax  officinalis  (Smilax 
medica,  and  other  undetermined  species  of  Smilax,  U.S.P.).  It 
is  commonly  known  as  Jamaica  Sarsaparilla,  from  having  been 
formerly  obtained. from  central  America,  by  way  of  that  island. 

Characters.— Boots  not  thicker  than  a  goose-quill,  generally  many  feet 
in  length,  reddish-brown,  covered  with  rootlets,  and  folded  in  bundles  about 
eighteen  inches  long,  scentless. 

Composition.  —  The  active  principle  is  a  crystalline  body, 
parillin  or  smilacin. 


1052  VEGETABLE  MATEEIA  MEDICA.  [sect.  v. 

Preparations. 
B.p.  HOSE. 

Secoctum  Sarsse  (2|  oz.,  water  1  pint) 2-10  fl.  oz. 

„  „       Compositum 2-10  fl.  oz. 

Estractum       „       Xilquldum 1-4  fl.  dr. 

U.S.P. 

Decoctum  Sarsaparillas  Compositum 4-6  fl.  oz. 

Extractum  „  „  Muidum 30-60  min. 

„         Fluidum 30-60  min. 

Syrupus  „  Compositus 1-4  fl.  dr. 

Secoctum  Sarsse  Compositum,  B.P.  ;  Secoctum  Sarsaparilla;  Com- 
positum, w.s. p.  Compound  Decoction  oe  Sarsaparilla. — Sarsaparilla,  cut  and 
bruised,  10  parts,  or  2 1  oz. ;  sassafras,  guaiacum  wood  and  liquorice  root,  of  each 
2  parts,  or  i  oz. ;  mezereon,  1  part,  or  1  dr. ;  boiling  water  up  to  100  parts,  or  up 
to  1  pint  after  straining. 

U.S.P.  Extractum  SARSAPARiiiLffl  Compositum  Fluidum. — Sarsaparilla,  75 ; 
glycyrrhiza,  12 ;  sassafras  bark,  10 ;  mezereum,  3 ;  glycerin,  10 ;  alcohol  and 
water,  of  each,  q.s.  to  make  100  parts. 

U.S.P.  Syrupus  Sarsaparilla:  Compositus. — Sarsaparilla,  150 ;  guaiacum 
wood,  20 ;  pale  rose,  12 ;  glycyrrhiza,  12  ;  senna,  12 ;  sassafras,  6  ;  anise,  6 ; 
gualtheria,  6 ;  sugar,  600  ;  diluted  alcohol  and  water,  of  each,  q.s.  to  make  1,000 
parts. 

Action  and  Uses. — The  action  of  sarsaparilla  is  very  much 
disputed.  Some  believe  it  to  be  diuretic,  tonic,  and  alterative. 
Others  deny  its  beneficial  action.  It  has  been  used  a  good  deal 
in  syphilis,  scrofula,  chronic  rheumatism,  gout,  and  skin  diseases, , 
but  probably  the  good  effects  are  due  to  the  drugs  with  which  it 
is  used. 

Syrupus  sarsaparillas  compositus,  U.S.P.,  is  a  convenient 
vehicle  for  iodide  of  potassium. 

PALMACE^E. 

Areca.  Akeca  Nut.  Not  officinal.  —  The  seed  of  Areca 
Catechu,  the  betel-nut  tree. 

Composition. — Oil,  containing  an  acid  in  solution,  and  red 
tannic  matter  resembling  rhatany-red. 

Dose. — As  an  astringent,  15  to  30  gr.  As  an  anthelmintic, 
i  to  |  oz. 

Use. — It  is  much  used  in  veterinary  practice,  and  occasionally 
in  ordinary  practice,  as  an  anthelmintic  for  tapeworm.  It  is 
also  astringent,  and  is  used  as  a  masticatory  (p.  193). 

AROIDE^E. 

U.S.P.  Calamus.  Calamus.  Sweet  Flag. — The  rhizome  of 
Acorus  Calamus. 

Characters.  —  In  sections  of  various  lengths,  unpeeled,  about  three- 
quarters  of  an  inch  (2  centimetres)  broad,  subcylindrical,  longitudinally 
wrinkled ;  on  the  lower  surface  marked  with  the  circular  scars  of  the  rootlets 
"f  wajy  lines  »'  externally  reddish-brown,  somewhat  annulate  from  remnants 
oi  leaf-sheaths ;  internally  whitish,  of  a  spongy  texture,  breaking  with  a  short, 


chap,  xxxvi.]  MONOCOTYLEDONES.  1053 

corky  fracture,  showing  numerous  oil-cells  and  scattered  wood-bundles,  the 
latter  crowded  within  the  subcircular  nucleus-sheath.  It  has  an  aromatic 
odour,  and  a  strongly  pungent  taste. 

Preparation. 

U.S.P.  D0SE. 

Extractum  Calami  Fluidum 15-60  min. 

Composition. — It  contains  a  volatile  oil  and  a  bitter  prin- 
ciple. 

Uses.  —  It  is  used  as  a  feeble  aromatic,  stomachic,  and 
stimulant. 

GRAMINEiE. 

_  B.P.  Farina  Tritici.  Wheaten  Floue. — The  grain  of  wheat, 
Triticum  sativum,  ground  and  sifted. 

Preparation. 
Cataplasma  Ferment!. 

Composition. — Starch  and  gluten. 
Use. — Chiefly  as  an  article  of  food. 

B.P.  Mica  Panis.  Cexjmb  of  Beead.— The  soft  part  of  bread 
made  with  wheat-flour. 

Preparation. 
Cataplasma  Carbonls  (p.  541). 

Use. — It  is  used  as  a  cataplasm,  both  alone  and  in  cataplasma 
carbonis.  It  is  also  used  as  a  basis  for  pills,  and  especially  for 
making  up  croton  oil  into  pill.  Occasionally  pills  made  of  it 
alone  are  given  as  a  placebo. 

Amylum,  B.  and  U.S. P.  Stabch. — The  starch  procured 
from  the  grains  of  common  wheat,  Triticum  sativum  (T.vulgare) ; 
maize,  Zea  Mays ;  and  rice,  Oryza  sativa. 

Characters. — In  white  columnar  or  irregular  angular  masses,  white, 
inodorous,  and  tasteless ;  easily  powdered. 

Solubility. — Insoluble  in  alcohol,  ether,  or  cold  water. 

Eeactions. — When  rubbed  in  a  Wedgwood  mortar  with  a  little  cold  dis- 
tilled water  it  is  neither  acid  nor  alkaline  to  test-paper,  and  the  filtered  liquid 
does  not  become  blue  on  the  addition  of  solution  of  iodine.  Mixed  with 
boiling  water  and  cooled,  it  gives  a  deep  blue  colour  with  iodine. 

Preparations. 
B.P.  DOSE. 

Clycerinum  Amyll 1  part  in  10  by  weight 

IHucilago  „       12  gr.  to  1  fl.  oz 

Pulvis  Tragacanthse  Compositus  1  part  in  6 ; 20-60  gr. 

Suppositoria  Acidi  Tannici  cum  Sapone. 
„  Morphiriie  cum  Sapone. 

U.S.P. 

Amylum  Iodatum  (starch,  95  parts ;  iodine,  5  parts). 
Glyceritum  Amyli  (starch,  10  parts  ;  glycerine,  90  parts). 


1054  VEGETABLE  MATEKIA  MEDICA.  [sect.  v. 

Uses. — The  glycerine  of  starch  forms  a  soothing  application 
for  chilblains  and  chapped  hands.  Amylum  iodatum  is  really  a 
preparation  of  iodine  (q.v.).  Starch  is  also  used  as  a  vehicle  for 
enemata.     Bandages  saturated  with  it  are  used  in  surgery. 

U.S.P.  Triticum.  Teiticum.  Cottoh-Gkass. — The  rhizome 
of  Triticum  repens,  gathered  in  the  spring  and  deprived  of  the 
rootlets. 

Characters. — Very  long,  but,  as  met  with  in  the  shops,  out  into  sections 
about  two-fifths  of  an  inch  (1  centimetre)  long,  and  about  one-twelfth  of  an 
inch  (2  millimetres)  thick ;  creeping,  smooth,  hollow  in  the  centre,  straw- 
yellow,  inodorous,  and  of  a  sweet  taste. 

Preparation. 

DOSE. 

Extractum  Tritici  Fluidum 1  fl.  dr.  to  1  oz. 

Uses. — It  is  used  as  a  demulcent  and  diluent,  more  particu- 
larly in  cystitis  and  irritation  of  the  urinary  passages. 

It  probably  owes  its  diuretic  effect  to  its  sugar,  and  is  best 
given  hi  the  form  of  an  infusion  or  decoction,  which  may  be  freely 
used. 

B.P.  Hordeum  Decorticatum.  Pearl  Barley. — The  husked 
seeds  of  Hordeum  distichon.    Britain. 

Characters. — White,  rounded,  retaining  a  trace  of  the  longitudinal 
furrow. 

Composition. — Starch,  albuminous  matter,  cellulose,  and  a 
small  quantity  of  fixed  oil. 

Preparation. 

Decoctum  Bordel.  Barley  Water.— Pearl  barley,  2  oz. ;  boiling  water,  30 
fl.  oz.  The  barley  is  first  washed  well  in  cold  water,  which  is  thrown  away,  and 
then  the  barley  is  boiled  for  twenty  minutes  and  strained. 

Use. — The  decoction  is  used  as  a  demulcent  drink. 

U.S.P-  Maltum.  Malt. — The  seed  of  Hordeum  distichon, 
caused  to  enter  the  incipient  stage  of  germination  by  artificial 
means  and  dried. 

Characters. — Malt  should  be  fresh,  of  a  colour  not  darker  than  pale 
amber,  and  should  have  an  agreeable  odour  and  a  sweet  taste. 

Preparation. 

dose. 
Extractum  Malti 4  fl.  dr. 

U.S.P.  Extractum  Malti.  Extkact  op  Malt. 
Preparation. — Upon  malt  in  coarse  powder,  not  finer  than  No.  12,  100 
parts,  contained  in  a  suitable  vessel,  pour  100  parts  of  water,  and  macerate 
for  six  hours.  Then  add  400  parts  of  water,  heated  to  about  30°  C.  (86°  P.), 
and  digest  for  an  hour  at  a  temperature  not  exceeding  55°  C.  (131°  ¥.). 
Strain  the  mixture  with  strong  expression.  Finally,  by  means  of  a  ■water- 
bath  or  vacuum  apparatus,  at  a  temperature  not  exceeding  55°  C.  (131°  P.) 
evaporate  the  strained  liquid  rapidly  to  the  consistence  of  thick  hon.ey. 
Keep  the  product  in  well-closed  vessels,  in  a  cool  place. 


chap,  xxxvi.]  MONOCOTYLEDONES.  1055 

Dose. — 4  fl.  dr. 

Action. — This  officinal  extract  of  malt  is  similar  to  various 
other  extracts  and  foods  prepared  from  malt.  It  is  not  only 
nutritious,  but,  on  account  of  the  diastase  contained  in  it,  acts 
as  a  digestive  ferment. 

In  large  doses  it  relaxes  the  bowels. 

Uses. — In  cases  of  imperfect  digestion  and  in  phthisis,  and 
in  general  imperfect  nutrition  in  children  or  adults. 

Saccharum  Purificatum,  B.P. ;  Saccharum,  U.S.P. 
Eefined  Sugar,  B.P. ;  Sugar,  U.S.P.  C^jHjgO,,,  or  C^H^O,, ; 
842.  The  refined  sugar  of  Saccharum  officinarum.  West  Indies 
and  other  tropical  countries. 

Characters. — Compact  crystalline  conical  loaves,  known  in  commerce  as 
lump  sugar. 

Impurities. — Salts,  foreign  matters. 
•  Tests. — U.S.P.  "White,  dry,  hard,  distinctly  crystalline  granules,  per- 
manent ia  the  air,  odourless,  having  a  purely  sweet  taste,  and  a  neutral  re- 
action. Soluble  in  0-5  part  of  water,  and  in  175  parts  of  alcohol  at  15°  C. 
(59°  P.)  ;•  in  0*2  part  of  boiling  water,  and  in  28  parts  of  boiling  alcohol ;  also 
in  80  parts  of  boiling,  absolute  alcohol,  but  insoluble  in  ether.  The  aqueous 
solution,  saturated  at  15°  C.  (59°  P.),  has  the  specific  gravity  1*345,  and  is 
miscible  with  alcohol  in  all  proportions. 

Neither  an  aqueous  nor  an  alcoholic  solution  of  sugar,  kept  in  large,  well- 
closed,  and  completely  filled  bottles,  should  deposit  a  sediment  on  prolonged 
standing  (absence  of  insoluble  salts,  foreign  matters,  ultramarine,  Prussian 
blue,  &c).  If  a  portion  of  about  1  gm.  of  sugar  be  dissolved  in  10  c.c.  of  boiling 
water,  then  mixed  with  4  or  5  drops  of  test-solution  of  nitrate  of  silver  and 
about  2  c.c.  of  water  of  ammonia,  and  quickly  heated  until  the  liquid  begins 
to  boil,  not  more  than  a  slight  coloration,  but  no  black  precipitate,  should 
appear  in  the  liquid  after  standing  at  rest  for  five  minutes  (absence  of  grape- 
sugar  and  of  more  than  a  slight  amount  of  invert  sugar). 

Use. — To  mask  the  taste  of  disagreeable  remedies.  It  is  used 
as  a  vehicle,  corrigent,  preservative,  and  antiseptic.  Syrups 
have  the  advantage  of  protecting  the  active  ingredients  against 
fermentation,  and  certain  ferruginous  preparations  against 
oxidation. 

Preparations. 

b.p. 

Confectio  Kosce  Caninae.  Mistura  Spiritus  Vini  Gallici. 

„           „     Gallicse.  Pilula  Ferri  Iodidi  (p.  522). 

„        Sennae.  Pulvis  Cretae  Aromaticus. 

Ferri  Carbonas  Saccharata.  „     Amygdalae  Compositus. 

Liquor  Calcis  Saccharatus.  „     Tragacanthaa        „ 

Mistura  Ferri  Composita,  -                   Sodii  Citro-tartras  Bffervescens. 

„       Guaiaci.  All  the  Syrups  and  Lozenges. 

U.S.P. 

Pilulas  Ferri  Carbonatis  (p.  523).  Pulvis  Cretaj  Compositus. 

„        „     Iodidi.  „     Glycyrrhizffl  Compositus. 

Ferri  Carbonas  Saccharatus.  Troches,  Syrups,  Compound  Syrups,  &o. 
Mistura  Ferri  Composita. 

B.P.  Theriaca.  Treacle.  —  The  uncrystallised  residue  of 
the  refining  of  sugar. 


1056  VEGETABLE  MATEBIA  MEDICA.  [sect,  V; 

Characters. — A  thick  brown  fermentable  syrup,  very  sweet ;  not  crystal- 
lising by  rest  or  evaporation.     Specific  gravity  about  l-40. 
Test. — Nearly  free  from  empyreumatic  odour  or  flavour. 

Pkepabations. 

B.F. 

Pilula  Aloes  et  Myrrhs  (p.  522).  Pilula  Bhei  Composita. 
„     Asafoetidse  Composita.  „      ScilUe  Composita. 

„     Conii  Composita.  Tinctura  Chloroformi  et  Morphinse. 
„     Ipecacuanhas  et  Scillte. 

Use. — To  make  up  some  of  the  pills  of  the  Pharmacopoeia. 
With  sulphur  it  is  used  as  a  domestic  laxative. 

Avense  Farina.  Oatmeal.  Not  officinal. — The  meal  pre- 
pared from  the  seeds  of  Avena  sativa,  the  common  oat. 

Composition. — The  seeds  contain  starch,  gluten,  and  gum. 
The  pericarp  contains  an  amorphous  alkaloid.  This  alkaloid  is 
soluble  in  alcohol.  It  is  more  abundant  in  dark  than  in  light 
oats.     It  probably  gives  to  them  their  bitterish  taste. 

Action. — The  alkaloid  appears  to  act  chiefly  as  a  stimulant 
of  the  motor  ganglia.  It  increases  the  excitability  of  the 
muscles,  and  in  horses  causes  excitement. 

Uses. — Oatmeal  is  chiefly  used  for  making  gruel  or  porridge, 
which,  in  addition  to  being  nutritious,  acts  as  a  demulcent  in 
coughs,  and  as  a  slight  laxative.  Warm  oatmeal  porridge  at 
bed-time  may  have  a  soporific  action  (p.  198),  though  the  ex* 
citing  action  of  the  alkaloid  may  render  panada,  indian  corn,  or 
lentils  preferable.  An  infusion,  decoction,  or  tincture  has  been 
recommended  as  a  stimulant  to  replace  opium  in  persons  ad- 
dicted to  opium-eating,  in  order  to  help  them  to  break  off  that 
habit. 


1057 


CHAPTEE  XXXVII. 
Sub-Kingdom  L— PHANEBOGAMjE. 
Division  II.— GYMNOSPERMjE. 

CONIFERS. 

Terebinthina  Canadensis,  B.  and  U.S.  P.  Canada  Balsam, 
B.P. ;  Canada  Tuepentine  (Balsam  op  Pie),  U.S.P. — The  tur- 
pentine obtained  by  incision  from  the  stem  of  Pinus  balsamea 
{Abies  balsamea),  B.P.  A  liquid  oleoresin,  obtained  from  Abies 
balsamea,  U.S.P.     Canada. 

Characters. — A  pale-yellow  ductile  oleoresin  of  the  consistence  of  thin 
honey,  with  a  peculiar  agreeable  odour,  and  a  slightly,  bitter,  feebly  acrid 
taste. 

Composition. — An  essential  oil  resembling  oil  of  turpentine, 
and  a  resin. 

Dose. — 10  to  30  grains. 

Preparations. 

B.P.  U.S.P. 

Charta  Epispastica.  Collodium  Flexile. 

Collodium  Flexile. 

Uses. — Used  in  the  preparation  of  collodion  flexile  and  of 
charta  epispastica ;  also  to  mount  microscopic  objects.  It  may 
be  given  internally  as  a  stimulant  to  mucous  membranes. 

B.P-  Thus  Americanum.  Common  Pbankincense. — The 
concrete  turpentine  which  is  scraped  off  the  trunks  of  Pinus  aus- 
tralis  and  Pinus  Tceda.     Southern  States  of  North  America. 

Characters. — A  softish  bright  yellow  opaque  solid,  resinous  but  tough, 
having  the  odour  of  American  turpentine. 

Pkepaeatiou. 
B.P.  n.s.p. 

Emplastrum  Picis.  None. 

Use. — Applied  externally  is  a  slight  stimulant.  Contained  in 
pitch-plaster. 

U.S.P.  Terebinthina.  Tuepentine. — A  concrete  oleoresin,. 
obtained  from  Pinus  australis  and  from  other  species  of  Pinus. 

3y 


1058  VEGETABLE   MATERIA  MEDICA.  [sect.  v. 

Characters. — In  tough,  yellowish  masses,  brittle  in  the  cold,  crummy- 
crystalline  in  the  interior,  of  a  terebinthinate  odour  and  taste. 

Dose.— As  a  stimulant,  antispasmodic,  or  diuretic,  5-30  min. 
As  an  anthelmintic,  2-4  fl.  dr. 

Oleum  Terebinthiiue,  B.  and  U.S.P.  Oil  of  Turpentine. 
The  volatile  oil  distilled  usually  by  the  aid  of  steam  from  the 
oleoresin  (turpentine)  obtained  from  Pinus  australis  (P.palustris), 
Pinus  Tada,  and  sometimes  Pinus  Pinaster  and  Pinus  sylvestris, 
rectified  if  necessary. 

Characters. — Limpid,  colourless,  with  a  strong  peculiar  odour,  and  pun- 
gent and  bitter  taste. 

Composition. — A  mixture  of  several  hydrocarbons  having 
the  composition  C10H16. 

Preparations. 

B.P.  DOSE. 

Confectlo  Tereblnthinae 60-120  gr. 

Enema  ,,  

Xaninientum      „  (vide  \>.  516)  

„  „  Aceticum  (vide  p.  516) 

Unguentum        „  

U.S.P. 

Linimentum  Cantharidis  (vide  p.  517)  ...1  part  in  7. 
„         Terebinthinffi  (vide  p.  517)...  1  part  in  3. 

Confectlo  Terobinthlnse.  Confection  of  Turpentine.— Oil  of  turpentine, 
1  fl.  oz. ;  liquorice  root,  1  oz. ;  honey,  2  oz. 

Enema  Tereblnthinee. — Oil  of  turpentine,  1  fl.  oz. ;  mucilage  of  starch, 
15  fl.  oz. 

Action. — Oil  of  turpentine  when  applied  to  the  skin  acts  as 
an  irritant  and  rubefacient,  causing  a  sensation  of  burning,  and 
if  applied  for  any  length  of  time,  especially  if  evaporation  be 
prevented,  it  causes  vesication. 

When  inhaled  it  produces  sneezing,  tightness  across  the 
eyes,  and  difficulty  of  breathing,  caused  reflexly  by  the  local  irri- 
tant action  of  the  drug  on  the  nasal  mucous  membrane. 

Internally  it  causes  burning  in  the  mouth,  and  reflexly  a 
profuse  flow  of  saliva,  and  in  the  stomach  it  gives  rise  to  a 
sensation  either  of  heat  or  of  cold.  In  large  doses  it  produces 
gastro-enteritis  with  vomiting  and  diarrhoea.  Ulceration  of  the 
intestine  has  been  found  after  death  from  poisoning  with  tur- 
pentine. 

After  absorption  it  causes  a  rise  and  then  a  fall  of  blood- 
pressure,  due  to  its  first  stimulating  and  afterwards  paralysing 
the  vaso-motor  centres.  Its  effect  on  the  pulse  is  uncertain, 
sometimes  it  is  slowed  and  sometimes  quickened. 

Respiration  becomes  quickened  and  spasmodic.     The  drug 
is  partly  excreted  by  the  lungs,  and  acts  on  the  mucous  mem 
brane,  lessening  its  secretion. 

The  temperature  sometimes  rises  and  sometimes  falls. 


chap,  xxxvn.]  GYMNOSPEEMjE.  1059 

It  acts  on  the  nerve-centres,  lessening  first  the  functions  of 
the  brain,  causing  a  diminution  of  voluntary  movement ;  then  the 
functions  of  the  cord,  lowering  reflex  action ;  and  lastly  those 
of  the  medulla,  causing  dilatation  of  the  vessels,  lowered  blood- 
pressure,  and  slowed  respiration. 

It  is  excreted  by  the  kidneys.  In  small  doses  it  increases 
the  quantity  of  urine,  to  which  it  gives  a  sweetish  odour  re- 
sembling that  of  violets.  In  large  doses  it  diminishes  the  quan- 
tity of  urine  and  gives  rise  to  pain  in  the  lumbar  region,  burning 
in  the  urethra,  painful  micturition,  and  even  hsematuria.  Large 
doses  of  turpentine  have  a  purgative  action. 

Uses. — Externally  it  is  used  as  a  rubefacient  and  counter- 
irritant  to  relieve  pain  or  inflammation,  as  in  chronic  rheu- 
matism affecting  either  the  joints  or  muscles,  also  in  inflam- 
mations of  internal  organs,  as  chronic  bronchitis  (liniment  over 
the  chest),  pleuritis,  and  peritonitis  with  tympanites  (by  means 
of  hot  turpentine  stupes).  It  is  also  very  useful  as  a  local  appli- 
cation in  sciatica  and  other  neuralgias.  It  is  used  as  an  inhala- 
tion (as  well  as  internally)  in  chronic  bronchitis  with  profuse 
expectoration  (p.  253),  and  is  supposed  to  be  useful  in  phthisis. 
It  has  been  used  as  a  curative  agent  in  psoriasis,  after  the  re- 
moval of  the  scales  by  alkaline  baths.  Two  drachms  to  one  ounce 
of  olive  oil  is  a  good  strength  to  begin  with ;  the  proportion  must 
be  increased  till  pure  oil  is  used,  if  the  patient  can  bear  the  ap- 
plication. The  treatment  has,  however,  been  almost  completely 
superseded  by  chrysophanic  acid  and  other  preparations. 

Internally,  in  haemorrhage  and  ulceration  of  the  intestine,  as 
in  typhoid  fever,  it  is  very  serviceable  in  doses  of  10-60  minims 
every  hour  or  two  hours,  the  action  being  watched ;  also  in 
haemorrhage  from  other  organs,  as  the  lungs,  nose,  uterus, 
kidneys  ;  but  in  haematuria  it  must  be  given  in  very  small  doses 
(5  minims),  as  large  ones  produce  harm. 

As  a  vermifuge,  to  destroy  tape-worm,  it  must  be  given  in 
large  doses,  which  are  best  combined  with  castor  oil,  as  it  then 
passes  through  the  alimentary  canal  rapidly,  and  consequently 
is  not  absorbed  and  produces  no  disagreeable  renal  symptoms. 
If  moderate  doses  are  given,  insufficient  to  produce  purgation, 
the  drug  may  be  absorbed,  and  heematuria,  nausea,  and  vomiting 
may  ensue. 

It  is  sometimes  employed  in  biliary  colic  (1  part  of  oil  of 
turpentine  with  three  of  ether). 

The  French  oil  of  turpentine  (old  and  containing  ozone)  is 
used  in  phosphorus-poisoning,  and  has  been  given  in  acute 
yellow  atrophy  of  the  liver.  New  oil  of  turpentine,  free  from 
ozone,  is  useless.  Turpentine  is  sometimes  used  as  an  anti- 
spasmodic in  hysterical  affections. 

B.P.    Oleum    Pini   Sylvestris.     Oil  of  Scotch  Fib.     Fie 

s  y  2 


1060       ,  VEGETABLE   MATEEIA   MEDICA.  [sect.  v. 

Wool  Oil. — It  is  a  colourless  liquid  obtained  by  distilling  tbe 
fresh  leaves  of  tbe  Scotch  fir,  Pinus  sylvestris. 

B.P.  Pbepakation. 

Vapor  Olei  Plnl  Sylvestris.— Eub  fir-wool  oil,  40  minims,  with  light  car 
bonate  of  magnesium,  20  grains,  and  gradually  add  sufficient  water  to  produce  one 
fluid  ounce. 

Put  one  fluid  drachm  of  this  mixture  with  half  a  pint  of  cold  water  and  half  a 
pint  of  boiling  water  into  an  apparatus  so  arranged  that  air  may  be  made  to  pass 
through  the  solution  and  may  afterwards  be  inhaled. 

Action. — Somewhat  similar  to  that  of  oil  of  turpentine. 

Uses. — It  is  used  as  a  liniment  to  rheumatic  joints  or  muscles, 
and  is  used  as  an  addition  to  baths  in  rheumatism  (p.  470).  As 
an  inhalation  (at  140°  P.)  it  is  useful  in  sore-throat  and  laryngeal 
catarrh.  The  use  of  water  which  is  too  hot  may  cause  loss  of 
voice.  It  is  a  stronger  stimulant  than  benzoin  (p.  964)  and  is 
more  useful  in  subacute  or  chronic  cases.  In  acute  cases  the 
inhalation  of  benzoin  (1  fl.  dr.  of  compound  tincture  in  10  fl.  oz. 
of  warm  water)  is  usually  preferable.  It  is  of  use  in  chronic 
bronchitis,  in  bronchiectasis,  and  in  phthisis  with  a  tendency  to 
haemorrhage. 

Terebene.  C10H16.  Not  officinal. — Isomeric  with  oil  of 
turpentine,  and  prepared  from  it  by  oxidation  with  sulphuric 
acid. 

Characters. — A  colourless  liquid,  with  the  odour  of  pine  wood,  and  a  hot 
taste. 

Solubility. — Insoluble  in  water  •  soluble  in  alcohol. 

Dose. — 10  to  20  minims. 

Administeation. — It  may  be  given  internally  in  sugar,  or  as 
an  inhalation  like  the  vapor  olei  pini  sylvestris,  B.P. ;  40  minims 
suspended  in  one  ounce  of  water  by  the  aid  of  20  grains  of  light 
carbonate  of  magnesium ;  one  drachm  to  be  inhaled  in  one  pint 
of  hot  water.  It  is  sometimes  inhaled  on  a  respirator  (10-30 
min.). 

Action. — Terebene  acts  like  oil  of  turpentine  (q.v.  p.  1059),  as 
a  stimulant  to  the  bronchial  mucous  membrane.  It  is,  however, 
more  agreeable  to  take,  and  is  said  not  to  have  the  same  ten- 
dency to  cause  renal  mischief.     It  is  antiseptic  and  deodorant. 

Uses. — Both  internally  and  by  inhalation,  terebene  has  been 
extensively  used  for  the  dyspnoea  of  emphysema  and  chronic 
bronchitis,  where  there  is  no  acute  inflammation. 

It  is  sometimes  useful  in  flatulence  due  to  fermentative 
changes  in  the  stomach. 

Sanitas.  Not  officinal.— A  disinfecting  solution  obtained 
by  acting  on  oxidised  turpentine  with  water.  Its  active  principle 
is  peroxide  of  hydrogen  (p.  540).  Its  advantages  are  that  it  is 
not  poisonous  and  does  not  stain  linen. 

U.S. P.   Oleum   Succini.     Oil   of   Ambek. — A  volatile  oil 


chap,  xxxvii.]  GYMNOSPERM.E.  1061 

obtained  by  tbe  destructive  distillation  of  amber  and  purified  by 
subsequent  rectification. 

Characters. — A  colourless  pale  yellow  thin  liquid,  having  an  empyreu- 
matic  balsamic  odour,  a  warm  acrid  taste,  and  a  neutral  or  faintly  acid  re- 
action.   Beadily  soluble  in  alcohol. 

Dose. — 5  to  10  minims  in  capsule. 

Action  and  Uses. — Externally  it  is  stimulant  and  may  be 
used  like  oil  of  turpentine.  Internally  it  is  said  to  be  anti- 
spasmodic. 

Resina,  B.  and  U.S.  P.  Eesin.  Colophony. — The  residue 
left  after  distilling  off  the  volatile  oil  from  turpentine,  U.S.P. 

Characters. — Translucent,  yellowish,  brittle,  pulverisable ;  fracture 
shining. 

Composition. — Eesin  is  the  portion  of  turpentine  fixed  by 
oxidation.  The  greater  part  of  it  consists  of  abietic  anhydride 
(C44H6204),  this  being  formed  by  the  dehydrating  of  abietic  acid 
(C44H6406),  during  the  distillation  of  the  oil.  It  is  again  trans- 
formed into  abietic  acid  by  treating  it  with  alcohol.  A  small 
proportion  of  pimaric  acid  is  obtained  from  resin. 

Pbepaeations. 
B.P.  u.s.p. 

Charta  Epispastica.  Ceratum  Eesinse. 

Emplastrum  Calefaciens.  Eniplastrum  Besinse. 

„  Cantharidis. 

»  Opii. 

„  Picis. 

„  Resinee. 

„  Sap  on  is. 

Wnguentum  Eesinse. 

„  Terebintkinte. 

Use. — Eesin  is  only  used  externally  as  a  stimulant  applica- 
tion, in  the  form  of  ointment  or  plaster. 

B.P.  Laricis  Cortex.  Laech  Bark. — The  bark,  deprived  of 
its  outer  layer,  of  Pinus  Larix  {Abies  Larix),  the  common  larch. 

Characters. — In  flat  pieces  or  sometimes  large  quills,  with  the  inner 
surface  yellow  and  fibrous,  and  the  outer  surface  reddish-brown  under  a 
greyish  epidermis.    Odour  faint,  resembling  turpentine,  taste  astringent. 

Composition. — A  peculiar  tannin  striking  olive-green  with 
salts  of  iron,  and  larixinic  acid  or  larixin. 


Pbepaeation. 

B.P. 

EOSE, 

tr.s.p. 

Not  given. 

Action  and  Use. — It  has  the  same  action  as  oil  of  turpentine. 
It  is  seldom  used  except  as  a  stimulant  expectorant  in  chronic 
bronchitis  with  abundant  secretion. 


1062  VEGETABLE  MATEEIA  MEDICA.  [sect.  v. 

Pix  Burgundica  B.  and  U.S.P.  Bukgtjndy  Pitch. -- A 
resinous  exudation  from  the  stem  of  the  spruce  fir,  Pinus  picea 
(Pinus  Abies  or  Abies  excelsa).  Melted  and  strained.  Switzer- 
land. 

Characters.— Hard  and  brittle,  yet  gradually  taking  the  form  of  the 
vessel  in  which  it  is  kept ;  opaque,  varying  in  colour,  but  generally  dull 
reddish-brown ;  of  a  peculiar  odour  and  aromatic  taste,  without  bitterness. 
Beadily  soluble  in  glacial  acetic  acid. 

Composition. — An  amorphous  resin,  mixed  with  oil  of  tur- 
pentine and  other  oils  isomeric  with  it,  and  abietic  acid. 

Preparations. 
B.P.  u.s.p. 

Emplastrum  Ferri.  Emplastrum  Picis  Burgundies. 

„         Plcis.  „  „    cum  Cantharide. 

Use. — It  is  used  as  a  stimulant  in  chronic  rheumatism  and 
bronchitis,  in  the  form  of  plasters. 

U.S.P.  Pix  Canadensis.   Canada  Pitch.   Hemlock  Pitch.— 
The  prepared  resinous  exudation  of  Abies  canadensis. 
Characters. — It  is  somewhat  softer  than  the  Burgundy  pitch. 

Preparation. 
Emplastrum  Picis  Canadensis, 

Pix  Liquida,  B.  and  U.S.P.  Tab. — A  bituminous  liquid, 
obtained  from  the  wood  of  Pinus  sylvestris  and  other  pines  by 
destructive  distillation,  B.P.  An  empyreumatic  oleoresin  ob- 
tained by  the  destructive  distillation  of  the  wood  of  Pinus  palustris, 
and  of  other  species  of  Pinus,  U.S.P. 

Characters. — Thick,  viscid,  brownish-black,  of  a  well-known  peculiar 
aromatic  odour.  Slightly  soluble  in  water,  soluble  in  alcohol,  fixed  or  vola- 
tile oils,  and  in  solution  of  potassa  or  of  soda.  Water  agitated  with  it  ac- 
quires a  pale  brown  colour,  sharp  empyreumatic  taste,  and  acid  reaction. 

Composition. — Pyroligneous  acid,  methyl  alcohol,  acetic  acid, 
and  oily  bodies,  creasote,  with  toluene,  xylene,  and  other  hydro- 
carbons. 

Dose. — Of  tar,  20  minims  to  1  drachm,  and  upwards,  made 
into  pills  with  flour,  or  given  as  tar-water  in  doses  of  1-4  fluid 
ounces. 

Preparation. 

B.P. 

TTnguentum  Plcis  Xiquidse  (tar  5  oz.,  yellow  wax  2  oz.). 

U.S.P.  DOSE. 

Syrupus  Picis  Liquids; J  11.  oz. 

Unguentum  Picis  Liquids  (equal  parts  of  tar  and  suet). 

TT.S.P.  Syrupus  Picis  Liquids.  Syrup  or  Tar. — Pour  cold  water  (12)  on  tar 
(6),  stir  frequently  for  twenty-four  hours,  and  then  throw  the  water  away.  Pour 
on  boiling  distilled  water  (50),  stir  for  fifteen  minutes,  and  then  set  aside  for  thirty- 
six  hours,  stirring  occasionally.    Decant,  filter,  and  add  sugar,  40  parts. 


chap,  xxxvii.]  GYMN0SPEB1VLE.  1063 

Action  and  Use.— Tar  acts  as  a  stimulant  both  to  the  skin 
and  to  mucous  membranes.  It  is  used  in  chronic  scaly  skin- 
diseases,  such  as  psoriasis,  and  the  scaly  stages  of  eczema.  It  is 
an  efficient  agent  in  relieving  the  itching  of  chronic  skin-affections. 
The  best  way  of  applying  tar  is  in  the  form  of  distilled  wood- 
tar,  beech,  birch,  or  juniper  tar.  These  should  be  applied  care- 
fully with  a  stiff  brush,  and  are  found  useful  in  chronic  eczema, 
psoriasis,  the  prurigo  of  Hebra,  lupus  erythematosus,  lichen 
ruber,  and  ringworm.  They  may  be  made  into  ointment  with 
vaseline  or  lard.  In  the  form  of  tar -water  or  of  vapour,  it  is 
useful  in  chronic  bronchitis  and  phthisis. 

U.S.P.  Oleum  Picis  Liquids.  Oil  of  Tab. — A  volatile  oil 
distilled  from  tar. 

An  almost  colourless  liquid  when  freshly  distilled,  but  soon 
acquiring  a  dark,  reddish-brown  colour,  having  a  strong  tarry 
odour  and  taste,  and  an  acid  reaction.  Specific  gravity  about 
0*970.     It  is  readily  soluble  in  alcohol. 

Use. — It  is  used,  dissolved  in  water  or  in  alcohol,  as  an  ex- 
ternal application  in  skin,  diseases. 

U.S.P.  Thuja.  Thuja.  Aebob  Viim. — The  fresh  tops  of 
Thvja  occidentalis. 

Characters. — Twigs  flattish,  two-edged,  the  scale-like  leaves  appressed 
and  closely  imbricate  in  four  rows,  rhombic-ovate,  obtusely  pointed,  with  a 
roundish  gland  upon  the  back ;  of  a  balsamic,  somewhat  terebinthinate  odour, 
and  a  pungently  aromatic,  camphoraceous,  and  bitter  taste. 

Dose.  —  Of  a  saturated  tincture  or  fluid  extract  1  fluid 
drachm. 

Action. — The  twigs  of  thuja,  like  those  of  savin,  may  produce 
abortion.  They  probably  have  no  direct  specific  action  on  the 
uterus  itself,  but  cause  great  gastro-intestinal  irritation,  and  thus 
act  on  the  uterus  reflexly.  The  oil  of  thuja  has  an  action  some- 
what like  camphor,  and  like  it  produces  epileptiform  convulsions 
in  warm-blooded,  and  paralysis  in  cold-blooded  animals.  Both 
camphor  and  oil  of  thuja  have  only  a  slight  action  on  the  heart. 
They  both  produce  rhythmical  contraction  and  dilatation  of  the 
vessels  (as  seen  in  the  rabbit's  ear).  Both  lessen  the  tempera- 
ture (Kohne)  (cf.  p.  1019). 

Uses.  —  It  is  diuretic,  astringent,  and  aromatic,  and  its 
volatile  oil  has  been  used  as  a  vermifuge.  It  has  been  employed 
in  the  form  of  a  decoction  in  coughs,  rheumatism,  dropsy  and 
amenorrhcea. 

U.S.P.  Juniperus.  Junipek. — The  fruit  of  Jtmiperus  com- 
munis. 

Characters. — Nearly  globular,  aboiit  one-third  of  an  inch  (8  millimetres) 
in  diameter,  dark  purplish,  with  a  bluish-grey  bloom,  a  three-rayed  furrow 
at  the  apex,  internally  pulpy,  greenish-brown,  containing  three  ovate,  some- 
what triangular,  bony  seeds,  with  several  large  oil-glands  on  the  surface ; 
odour  aromatic  ;  taste  sweet  terebinthinate,  bitterish  and  slightly  acrid. 


1064  VEGETABLE  MATEEIA  MEDICA.  [sect.  v. 

Oleum  Juniperi,  B.  and  U.S.P.  Oil  of  Junipee. — A  vola- 
tile oil  distilled  from  the  unripe  fruit  of  Juniperus  communis. 

Characters. — Colourless  or  pale  greenish-yellow,  of  a  sweetish  odour, 
and  warm  aromatic  taste. 

Dose. — 1-4  min. 

Preparations. 
B.P.  COSE. 

Splrltus  Juniperi  (with  spirit  1  volume  in  50) 30  min.-l  fl.  dr. 

(Is  contained  in  Mistura  Creasoti.) 

U.S.P. 

Spiritus  Juniperi  (3  per  cent,  in  alcohol) 30-60  min. 

„  „      Composite 2-4  fl.  dr. 

O.S.P.  Spiritus  Juniperi  Compositus.  Compound  Spirit  of  Juniper. — Oil  of 
juniper,  10 ;  oil  of  caraway,  1 ;  oil  of  fennel,  1 ;  alcohol,  1,000 ;  water  up  to  5,000. 

Action  and  Uses. — Oil  of  juniper  is  a  local  stimulant.  It  is 
contained  in  gin  and  hollands.  It  resembles  oil  of  turpentine  in 
its  action,  but  has  a  more  powerful  effect  on  the  kidneys.  It  is 
used  chiefly  as  a  diuretic  in  dropsy  depending  on  cardiac,  liver, 
or  kidney  disease.  In  the  last  case  it  must  be  employed  with 
caution.  In  a  healthy  man  it  does  not  seem  to  increase  the  flow 
of  urine.  Gin  is  flavoured  with  juniper,  and  is  frequently  em- 
ployed as  a  diuretic.  The  compound  spirit  of  juniper,  U.S.P., 
approximates  to  gin  in  strength  and  may  be  used  in  place  of  it. 

Sabinse  Cacumina,  B.P. ;  Sabina,  U.S.P.  Savin-tops, 
B.P. ;  Savine,  U.S.P. — The  (fresh  and  dried,  B.P.)  tops  of  Juni- 
perus Sabina.     Collected  in  spring. 

Characters. — Twigs  densely  covered  with  minute  imbricated  appressed 
leaves  in  four  rows ;  odour  strong,  peculiar,  and  unpleasant ;  taste  acrid, 
bitter,  resinous,  and  disagreeable. 

Composition. — The  active  principle  is  a  volatile  oil. 
Dose. — Of  dried  tops,  4-10  gr.  or  more. 

Preparations. 
B.P.  DOSE. 

Oleum  Sabinse  (from  fresh  plant) 1-5  min. 

Tinetura     20  min.-l  fl.  dr. 

Unguentum  Sablnee  (8  oz.  fresh  savin-tops,  bruised, 
are  digested  with  melted  wax,  3  oz.,  and  benzoated 
lard,  16  oz.,  for  20  minutes,  and  strained). 

U.S.P. 

Extractum  Sabinne  Fluidum 5-15  min 

Oleum  Sabinas,  B.  and  U.S.  P. — A  volatile  oil  distilled  from 
the  fresh  tops  of  Juniperus  Sabina. 

Characters. — Colourless  or  yellowish,  becoming  darker  and  thicker  by 
age  and  exposure  to  air,  peculiar  odour,  pungent,  bitterish,  and  camphoraceous 

taste. 

Dose. — 1  to  4  minims. 

Action  and  Uses. — Savine  owes  its  properties  to  its  oil. 


chap,  xxxvii.]  GYMNOSPEEMjE.  1065 

Externally  it  is  used  as  an  irritant  to  keep  open  issues  or 
blisters. 

Internally  it  produces  symptoms  of  violent  gastro-intestinal 
irritation,  with  either  stoppage  of  the  urine  or  hematuria  and 
difficulty  in  micturition.  In  women  it  causes  congestion  of  the 
pelvic  organs,  and  has  been  used  criminally  to  procure  abortion ; 
in  these  cases  gastro-enteritis  and  death  have  occurred.  Small 
doses  may  be  used  as  an  emmenagogue  when  menstruation  is 
deficient  and  the  patient  is  not  pregnant. 


10f76  VEGETABLE  MATEEIA  MEDIOA.  [sect.  v. 


CHAPTER  XXXVin. 

Sub-Kingdom  II.— CRYPTOGAMJ3. 

FILICES. 

Filix  Mas,  B.P. ;  Aspidium,  U.S.  P.  Male  Fern.— The 
rhizome  with  the  persistent  bases  of  the  petioles  of  Aspidium 
Filix  mas.  Collected  late  in  the  autumn,  divested  of  its  scales, 
roots,  and  all  dead  portions,  and  carefully  dried  with  a  gentle  heat. 
Should  not  be  used  if  more  than  a  year  old,  B.P.  The  rhizome 
of  Aspidium  Filix-mas  and  of  Aspidium  ma/rginale,  U.S. 

Chabactbes. — Tufted,   scaly,  greenish-brown ;   powder  greenish-yellow, 
with  a  disagreeable  odour,  and  a  nauseous,  bitter,  somewhat  astringent  taste. 

Composition. — A  dark  green  oil  which  deposits  crystals  of 
filicic  acid,  also  traces  of  volatile  oil.  The  filicic  acid  is  regarded 
as  the  chief,  though  not  the  only,  active  principle ;  tannin,  resin, 
and  sugar  have  been  found  in  the  rhizome. 

Dose.— Of  the  powder,  60-180  gr. 

Preparations. 
B.P.  DOSE. 

Extractum  Fillets  Xlquidum 15  min.-l  fl.  dr. 

U.8.P. 

Oleoresina  Aspidii 30-60  min. 

Action  and  Uses. — The  liquid  extract  is  one  of  the  best  an- 
thelmintics against  tape-worm,  killing  the  Bothriocephalus  lotus, 
Ttmia  solium,  and  Taenia  mediocanellata.  Pomegranate  root  bark 
is  said  to  kill  the  latter  with  greater  certainty.  The  dose  often 
given  is  too  small,  and  hence  failure  is  attributed  to  the  drug 
when  it  really  depends  on  the  smallness  of  the  dose.  Single 
doses  of  3J.-3JSS.  of  the  liquid  extract  will  often  cure  at  once. 

Method  of  Administration. — Allow  the  patient  to  take  no 
food  after  five  or  six  in  the  evening  except  a  little  bread-and- 
milk.  Just  before  bed- time  give  sj.  of  the  liquid  extract  in  3J.  of 
mucilage,  and  let  the  patient  He  down  immediately  and  go  to 
sleep.  This  often  prevents  the  vomiting  which  sometimes  occurs. 
Next  morning  administer  a  purgative,  and  repeat  the  treatment 
until  the  worm  comes  away. 

Another  method  is  to  give  a  dose  of  castor  oil  at  night  (with 


chap,  xxxviii.]  CEYPTOGAM^J.  1067 

the  same  conditions  of  feeding)  and  early  next  morning  give  a  dose 
of  liquid  extract  (388.-3.),  and  abstain  from  food  till  after  the 
bowels  have  acted. 

LICHENES. 

Cetraria,  B.  and  U.S.P.  Iceland  Moss.— The  entire  lichen, 
Cetraria  islandica.    North  of  Europe. 

Characters—  Foliaceous,  lobed,  crisp,  cartilaginous,  brownish-white, 
paler  beneath ;  taste  bitter  and  mucilaginous.  A  strong  decoction  gelatinises 
on  cooling. 

Composition. — Lichenin  and  cetrarin  or  cetraric  acid.  The 
former  constitutes  70  per  cent,  of  the  moss.  It  swells  in  cold,  and 
dissolves  in  hot  water,  gelatinising  on  cooling.  The  latter,  which 
is  the  bitter  principle,  is  obtained  in  white  acicular  crystals,  and 
forms  soluble  salts  with  alkalis. 

Preparations. 

B.P.  DOSE. 

Secoctum  Cetrarlae (1  oz.  to  1  pint) 1-2  fl.  oz. 

U.S.P. 

Decoctum  Cetrarice 2-4  fl.  oz. 

Action  and  Uses. — It  is  demulcent,  nutritious,  and  slightly 
tonic. 

B.P.  Litmus. — A  blue  pigment  prepared  from  various 
species  of  Eoccella. 

Litmus  Paper,  Blue,  B.  and  U.S.P. — Unsized  white  paper 
steeped  in  tincture  of  litmus,  and  dried  by  exposure  to  the  air. 

Litmus  Paper,  Red,  B.  and  U.S.P. — Unsized  white  paper 
steeped  in  tincture  of  litmus  which  has  been  previously  reddened 
by  the  addition  of  a  very  minute  quantity  of  sulphuric  acid,  and 
dried  by  exposure  to  the  air. 

Litmus  Tincture,   B.P. ;  Solution  of  Litmus,  U.S.P.— 

A  solution  prepared  by  macerating  1  part  of  litmus,  in  powder,' 
in  10  parts  of  proof  spirit,  B.P.,  or  diluted  alcohol,  U.S.P.,  in  a 
closed  vessel  for  two  days,  and  filtering. 

Use. — Eed  litmus  paper  is  used  as  a  test  for  alkalis,  and  blue 
litmus  as  a  test  for  acids. 

FUNGI. 

Muscarinae  Nitras.  Not  officinal. — An  alkaloid,  C5H16N03, 
prepared  from  the  Fly  Agaric,  Amanita  muscaria,  a  fungus  grow- 
ing in  all  parts  of  the  world. 

Muscarine  can  be  prepared  artificially  from  cholin,  C6H15N02, 
by  oxidation  with  nitric  acid  :  it  differs  from  cholin  by  having 
one  atom  of  oxygen  more,  and  may  be  represented  in  a  constitu- 


1068  VEGETABLE  MATEEIA  MEDICA.  [sect,  v 

f(CH»)i 
tional  formula  as  N-  CH2.    CH(OH)2.    Betain  (trimethylglycin), 

OH 
C6H13N03,  is  also  related  to  muscarine  and  cholin,  and  is  said  to 
have  been  produced  by  oxidation  of  the  latter.  Cholin  and 
artificial  muscarine  have  a  similar  action,  which  differs  from  that 
of  natural  muscarine,  in  paralysing  the  ends  of  motor  nerves  like 
curare.  Artificial  muscarine  is  500  times  as  strong  as  cholin, 
and  50  times  more  lethal  in  its  action.1  It  is  not  completely 
antagonised  by  atropine  as  natural  muscarine  is. 

Characters. — A  viscid,  yellowish-brown  liquid,  soluble  in  water,  and 
giving  the  reactions  of  an  alkaloid  (p.  504). 

Dose. —  £  to  f  grain,  hypodermically. 

Action. — Muscarine  is  a  myotic  (p.  219),  and  an  antihidrotic 
(p.  441)  and  sialagogue  (p.  357).  It  has  a  powerful  action  on 
the  heart,  paralysing  the  cardiac  muscle  (p.  316)  and  stimulating 
the  inhibitory  ganglia  (p.  317).  It  is  a  general  emetic  (p.  373), 
and  diminishes  the  activity  of  the  respiratory  centre  (p.  241). 
Its  action  is  completely  neutralised  by  atropine  (p.  495). 

Uses. — Hypodermically,  muscarine  has  been  used  in  checking 
night-sweats. 

Agaricus  albus.     Not  officinal. 

Characters. — It  occurs  in  white  irregular  pieces,  light  and  friable,  with 
a  sweetish  and  afterwards  bitter  taste. 

Dose.— 2  to  30  gr. 

Composition. — A  white,  crystalline  body,  agaricin,  and  various 
other  ill-defined  principles. 

Preparations. 

DOSE. 

Extractum  Agarici 3-6  gr. 

Tinctura  „      (1  in  10) 20-60  min. 

Agaricin Jj-£  gr. 

Action. — In  large  doses,  agaric  is  purgative  and  sometimes 
emetic.    It  acts  in  smaller  doses  as  an  antihidrotic  (p.  441). 

Uses. — In  the  form  of  extract  or  of  agaricin,  it  has  been  found 
useful  in  checking  night-sweating  in  phthisis. 

Ergot,  B.  and  U.S.  P.  Ebgot.  Ergot  of  Eye. — The 
sclerotium  (compact  mycelium  or  spawn)  of  Claviceps  purpurea, 
produced  between  the  palese  and  replacing  the  grain  of  Secale 
cereale,  the  common  rye,  Nat.  Ord.  Graminacece. 

Characters. — Somewhat  fusiform,  subtriangular,  curved,  with  a  longi- 
tudinal furrow  on  the  concave  side,  obtuse  at  the  ends,  about  an  inch  long, 
purplish  black  outside,  pinkish  within,  solid,  breaking  with  a  short  fracture, 
odour  peculiar,  but  strong  if  the  powder  be  triturated  with  solution  of  potash, 
taste  oily  and  disagreeable. 

1  Boehm,  Arch.f.  exp.  Path.  u.  Pharm.,  Ed.  19,  p.  87. 


chap,  xxxviii.]  CBYPTOGAMjE.  1069 

Preparations. 
b.p.  strength.  hose. 

Extractum  Ergotae  Xiiquidum  ..1  oz.  to  1  fl.  oz 10-30  min. 

Xnfusum  , 11  gr.  to  1  fl.  oz 1-2  fl.  oz. 

Tlnctura  , 109  gr.  to  1  fl.  oz 10  min.-l  fl.  dr. 

U.S.P. 

Extractum  Ergots  Fluidum 100  gm.  in  lOOo.e.  ...  30-60  min. 

Vinum  15  parta  in  100 2-4  fl.  dr. 

Extractum      5  times  strength  of  fluid  extract  ...3-12  gr. 

B.P.  Ergotinum.  Ergotin.  —Purified  extract  of  ergot,  com- 
monly called  ergotin  or  ergotine,  or  Bonjean's  ergotine. 

Preparation. — By  evaporating  the  fluid  extract  of  ergot,  4  fl.  oz.,  by  a 
water-bath  to  a  syrupy  consistence,  and  when  cold  mixing  with  4  fl.  oz.  of 
spirit.  Let  it  stand  for  half  an  hour,  then  filter,  and  evaporate  the  filtered 
liquid  to  the  consistence  of  a  soft  extract. 

Composition. — The  chemical  composition  of  ergot  is  still  very 
imperfectly  known,  -and  the  active  principle  (or  principles)  to 
which  its  most  important  action,  that  of  causing  contraction 
of  the  uterus,  is  due,  has  not  heen  satisfactorily  isolated.  The 
active  principles  were  formerly  said  to  be  ergotin  and  ecbolin, 
but  these  do  not  seem  to  be  pure  substances.  The  term  ergotin 
has  been  applied  to  several  substances.  According  to  Schmiede- 
berg,  two  pure  principles  have  been  isolated — ergotinic  acid 
and  an  alkaloid,  ergotinine.  According  to  Dragendorff  and 
Podwyssotzki,  the  active  principles  are  sclerotinic  acid  and  a 
colloid  substance,  scleromucin.  Sclerotinic  acid  is  impure 
ergotinic  acid.  In  addition  to  ergotinic  acid,  ergotinin,  and  pro- 
bably several  other  principles,  ergot  contains  about  35  per  cent. 
of  oil,  a  peculiar  sugar  (mykose),  and  two  colouring  matters, 
scleroxanthin  and  sclero-erythrin. 

The  most  recent  researches  are  those  of  Robert,  who  states  that 
ergot  contains  three  active  principles  :  ergotinic  acid,  sphacelinic 
acid,  and  an  alkaloid,  cornutine. 

Dose. — 2  to  5  grains. 

Preparation. 

Injectlo  Ergotlni  Hypodermica  (ergotin  1,  camphor  water  2  parts ;  mix  by 
stirring  together  just  before  using). 

Dose  (by  subcutaneous  injection),  3-10  min. 

Geneeal  Action. — There  is  a  great  difference  of  opinion  as 
to  the  action  of  ergot,  due  to  its  preparations  undergoing  change 
so  rapidly,  and  hence  not  being  of  the  same  strength.  They 
become  quite  inactive  if  kept  for  any  length  of  time.  In  certain 
parts  of  Germany,  where  rye-bread  is  much  used,  epidemics  of 
ergotism  have  occurred.  These  epidemics  depend  both  upon 
the  continued  large  doses  of  ergot  and  upon  the  deficiency  of 
food,  the  nutritive  part  of  the  rye  being  replaced  by  the  fungus. 
The  deficiency  of  food  is  probably  an  important  factor,  since 
continued  therapeutic  doses  of  ergot  rarely  produce  ergotism, 
though  occasionally  they  do  so. 


L070  VEGETABLE   MATERIA  MEDIOA.  [sect.  v. 

There  are  two  varieties  of  symptoms  seen  in  ergotism :  (1)  the 
gangrenous;  (2)  the  anaesthetic  or  convulsive.  Both  begin 
with  gastro-intestinal  disturbance,  causing  loss  of  appetite, 
lausea,  vomiting,  and  diarrhoea. 

The  gangrenous  symptoms  are  redness  of  the  skin  followed 
3y  well-marked  gangrene  in  the  part.  The  cause  of  this  gan- 
grene is  probably  stasis  due  to  the  great  contraction  of  the  small 
jlood-  vessels. 

The  nervous  symptoms  are  giddiness,  with  symptoms  of 
irritation  and  paralysis  of  sensory  nerves,  or  more  probably  of 
sensory  centres,  e.g.  the  posterior  columns  of  the  spinal  cord. 
The  irritation  is  indicated  by  a  sensation  as  of  insects  crawling 
Dver  the  skin,  flying  pains,  &c,  the  paralysis  by  loss  of  sensa- 
tion in  the  hands  and  feet.  Sclerosis  has  been  found  in  the 
postero-lateral  columns  of  the  cord  in  such  cases.  Spasms  may 
accur,  and  even  convulsions  of  an  epileptic  nature. 

Special  Action. — Ergotinic  acid  causes  ascending  paralysis 
Df  the  spinal  cord  and  brain,  both  in  frogs  and  mammals,  with 
loss  of  voluntary  motion,  paralysis  of  the  vaso-motor  centre,  and 
fall  of  blood-pressure,  while  respiration  and  reflex  irritability 
eontinue.  It  does  not  appear  to  have  the  power  of  increasing 
the  uterine  contractions,  and  so  cannot  be  regarded  as  the  most 
important  constituent  of  ergot.  Ergotinine  is  also  not  the 
active  principle,  as  it  is  present  in  very  small  quantity  in  ergot, 
and  is  to  some  extent  removed  by  ether  without  the  ergot  losing 
its  power. 

Sphacelinic  acid  causes  at  first  great  spasmodic  contraction 
of  the  blood-vessels,  with  rise  of  blood-pressure  and  subsequently 
symptoms  of  gangrene.  The  heart  is  unaffected.  The  gangrene 
in  fowls  appears  to  be  due  to  permanent  occlusion  of  the  smaller 
arteries  by  a  hyaline  substance,  which  is  formed  during  the  time 
they  are  spasmodically  contracted.  In  rabbits,  guinea-pigs,  and 
cats  the  substance  is  not  formed,  and  no  gangrene  appears,  but 
their  walls  degenerate,  and  blood  is  effused  into  various  organs. 
When  brought  into  contact  with  the  intestine,  sphacelinic  acid, 
or  its  sodium  salt,  causes  an  inflammatory  condition  resembling 
that  of  typhoid  fever,  and  ergot  should  therefore  be  avoided  in 
this  disease.  Sphacelinic  acid  causes  tetanus  of  the  uterus 
(Robert).  Cornutine  causes  spastic  rigidity  in  frogs,  lasting 
many  days,  even  when  given  in  very  minute  doses  (-^  of  a  milli- 
gramme) .  In  warm-blooded  animals  half  a  milligramme  causes 
salivation,  vomiting,  diarrhoea,  and  active  movements  of  the 
uterus,  which  are  clonic  and  not  tonic.  The  vessels  are  con- 
tracted and  the  blood-pressure  raised.  Sphacelinic  acid  and 
cornutine  are  therefore  the  principles  which  cause  uterine  con- 
traction (Robert) .  As  these  active  principles  have  not  yet  found 
their  way  into  common  use,  it  will  be  better  for  practical  pur- 
poses at  present  to  take  the  results  of  experiments,  not  with 


chap,  xxxviii.]  CBYPTOGAMjE.  1071 

pure  principles  isolated  from  ergot,  but  only  of  an  extract  such 
as  Bonjean's  ergotin,  although  it  is  evident  that  the  effects  of 
different  preparations  may  vary  according  to  the  proportions  of 
ergotinic  acid,  sphacelinic  acid,  and  cornutine  which  they  con- 
tain. Thus  if  there  be  much  ergotinic  acid,  the  blood-pressure 
may  be  reduced,  while  if  much  sphacelinic  acid  and  cornutine  be 
present  the  blood-pressure  will  be  raised. 

Action  of  Extract  of  Erg:ot.—A  solution  of  Bonjean's  ergotin 
injected  into  animals  causes  an  affection  of  the  nervous  system 
indicated  by  inco-ordination,  anaesthesia,  and  paralysis;  and 
death  is  due  to  paralysis  of  respiration. 

The  muscles  are  unaffected ;  the  motor  nerves  are  not  para- 
lysed, but  on  the  contrary  have  their  power  somewhat  increased. 

The  sensory  nerves  are  paralysed,  but  it  is  uncertain  whether 
the  action  is  central  or  peripheral.  The  spinal  cord  is  paralysed. 

Circulation.  Heart. — Its  action  on  the  frog's  heart  is  not 
well  marked ;  sometimes  the  injection  of  ergot  produces  slowing 
of  the  pulse-rate  with  stoppage  in  diastole,  and  in  these  cases 
direct  mechanical  irritation  immediately  after  the  poisoning  does 
not  cause  the  heart  to  contract. 

Slowing  and  diastolic  arrest  occur  after  section  of  the  vagi,  but 
not  after  administration  of  atropine ;  hence  they  are  due  to  the 
action  of  the  ergot  on  the  inhibitory  apparatus  in  the  heart  itself. 

Vaso-motor  System. — The  blood-pressure  is  considerably 
raised.  When  injected  into  the  jugular  vein,  the  blood-pressure, 
according  to  Holmes,  is  first  lowered  and  then  raised  consider- 
ably, which  he  explains  by  supposing  that  the  ergot  passing  to 
the  right  side  of  the  heart  causes  contraction  of  the  vessels  of 
the  lungs  (by  acting  on  their  muscular  walls),  and  hence  lessens 
the  supply  to  the  aortic  system  and  produces  a  fall  of  blood- 
pressure  ;  but  when  it  reaches  the  medulla  it  stimulates  the  vaso- 
motor centre,  and  causes  contraction  of  the  vessels  throughout 
the  body  and  consequent  rise  of  blood-pressure.  This  explana- 
tion is  confirmed  by  the  fact  that  if  ergot  is  injected  into  the 
femoral  artery,  instead  of  a  fall  occurring  at  first  there  is  a  rise 
due  to  contraction  of  vessels  in  the  limb,  then  a  fall  as  soon  as 
the  blood  reaches  the  lungs,  and  lastly  a  final  rise. 

This  explanation  is  not  accepted  by  Wood,  who  considers 
that  the  primary  fall  is  due  to  the  sudden  introduction  of  a  large 
quantity  of  ergot  into  the  heart  causing  temporary  paralysis, 
which  will  pass  off  as  the  drug  is  removed  by  the  circulation. 

The  final  rise  of  blood-pressure  no  doubt  is  due  to  the  action 
on  the  medulla,  for,  if  the  cord  be  divided,  very  little  rise  follows 
the  injection  of  ergot. 

One  other  factor,  which  usually  receives  very  little  attention, 
must  be  taken  into  account  (as  well  in  this  drug  as  in  many 
others),  viz.  the  effect  on  the  blood-pressure  of  contraction  of  the 
internal  viscera,  as  the  intestines  or  uterus,  for  by  contraction 


1072  VEGETABLE  MATEEIA  MEDICA.  [sect.  v. 

their  blood  will  be  driven  out,  and  a  rise  of  blood-pressure  pro- 
duced without  any  action  on  the  vessels. 

Respiration  is  usually  slowed  from  the  beginning,  but  in 
some  animals  (dogs)  it  is  first  quickened  and  then  slowed.  Death 
is  due  to  paralysis  of  the  respiratory  centre. 

Secretion. — The  urine  is  increased  in  quantity,  and  the 
bladder  tends  to  contract,  due  to  the  effect  of  the  drug  on  its 
unstriped  fibres. 

Alimentary  Canal. — Ergot  markedly  increases  the  peristaltic 
movements  of  the  intestine. 

Uterus. — Ergot  causes  contraction  of  the  uterus,  especially 
of  the  pregnant  uterus.  This  contraction  is  not  usually  so  much 
rhythmical  as  tetanic  in  nature,  with  occasional  increases  in 
violence.  There  is  no  complete  relaxation  between  the  spasms, 
as  in  the  ordinary  labour-pains.  This  is  probably  due  to  an 
action  on  the  unstriped  fibres  of  the  uterus,  since  ergot  causes 
contraction  of  involuntary  fibres  throughout  the  body,  but  it 
may  be  due  wholly  or  in  part  to  an  action  on  the  uterine  centre 
in  the  spinal  cord. 

Uses.— Ergot  is  chiefly  used  in  medicine  for  two  purposes: 
(1)  to  cause  contraction  of  the  uterus ;  (2)  to  check  haemorrhage 
by  causing  contraction  of  the  vessels. 

It  is  sometimes  used  to  hasten  delivery  when  the  power  of 
the  uterine  contractions  is  not  sufficient  to  expel  the  foetus.  But 
the  tetanic  nature  of  the  contraction  produced  by  ergot  must  be 
borne  in  mind.  It  does  not  increase  the  power  of  the  labour- 
pains,  but  only  the  tonic  contraction  of  the  uterus.  It  should  be 
carefully  avoided  if  there  be  any  mechanical  obstruction  to  deli- 
very, such  as  a  rigid  and  undilated  os  uteri,  a  contracted  pelvis,  or 
an  abnormal  presentation,  for  in  such  cases  it  may  so  far  interfere 
with  the  circulation  in  the  uterus  and  placenta  as  to  asphyxiate 
the  foetus,  or  cause  such  contraction  of  the  uterus  as  to  produce 
rupture  of  its  walls.  After  the  child  is  expelled,  the  tetanic 
nature  of  the  contraction  produced  by  ergot  is  useful,  and  hence 
it  is  used  to  prevent  post-partum  haemorrhage.  In  these  cases, 
it  is  administered  either  in  the  form  of  powdered  ergot  in  warm 
water,  or  of  the  liquid  extract,  or  by  subcutaneous  injection  of 
ergotin.  The  last  method  gives  the  most  rapid  results,  but  if 
the  ergotin  is  injected  just  beneath  the  skin  it  causes  irritation 
and  may  lead  to  an  abscess,  hence  it  should  be  injected  deep 
into  a  muscle,  such  as  the  gluteus  maximus. 

Ergot  is  also  used  very  largely  in  the  practice  of  gynaecology, 
for  example,  in  chronic  metritis,  in  sub-involution  of  the  uterus, 
after  abortions,  to  promote  the  expulsion  of  retained  membranes, 
and  in  all  atonic  conditions  of  the  uterus. 

It  is  also  used  in  certain  cases  of  leucorrhoea,  also  in  atony 
of  the  bladder  and  enlarged  prostate. 

It  is  used  to  check  hemorrhage  in  fibroid  tumours  of  the 


chap,  xxxvin.]  CBYPTOGAMiE.  1073 

uterus  ;  in  haemoptysis  (either  internally  3ss.  of  liquid  extract 
every  two,  three,  or  four  hours,  or  subcutaneously  injected).  In 
haematemesis  also  it  is  sometimes  useful. 

In  some  cases  of  chronic  constipation  it  is  useful,  and  appears 
to  give  tone  to  the  bowel. 

Subcutaneous  injections  of  ergotin  have  been  used  in  pur- 
pura, erythema,  and  in  the  prurigo  of  Hebra.  Temporary  im- 
provement sometimes  follows  the  internal  administration  of 
ergotin  in  urticaria. 

U.S.P.  Ustilago.  Ustilago.  Corn-smut. — Ustilago  Maydis 
(Nat.  Ord.,  Fungi),  grown  upon  Zea Mays  (Nat.  Ord.,  Graminacece) . 

Ustilago  should  be  preserved  in  a  dry  place,  and  should  not 
be  kept  longer  than  a  year.  This  fungus  is  a  form  of  smut 
growing  upon  maize. 

Characters. — Irregular,  globose  masses,  sometimes  six  inches  (15  centi- 
metres) thick,  consisting  of  a  blackish  membrane, '  enclosing  innumerable 
brownish-black,  globular  and  nodular  spores ;  odour  and  taste  unpleasant. 

Dose. — 1-1  dr.  (1-4  gm.). 

Action. — It  resembles  ergot  in  its  action,  and  probably  also 
contains  the  same  active  principles. 

B.P.  Cerevisias  Fermentum.  Beer  Yeast. — The  ferment 
obtained  in  brewing  beer,  and  produced  by  Saccharomyces  (Torula) 
cerevisim. 

Characters. — Viscid,  semi-fluid,  frothy,  exhibiting  under  the  microscope 
numerous  round  or  oval  confervoid  cells  (p.  83). 


Dose. —  ^-1  oz. 


Pkepabation. 


Cataplasma  rermenti.  Yeast  Poultice. — Mix  beer  yeast,  6  fl.  oz.,  with 
water  at  100°  F.,  6  fl.  oz.,  stir  in  wheaten  flour,  14  oz.,  and  place  the  mass  near 
the  fire  till  it  rises. 

Use. — It  has  been  given  internally  along  with  camphor  and 
nitrous  ether,  in  typhoid  fever  and  dysentery,  and  to  persons 
suffering  from- boils.  The  poultice  is  applied  to  sloughing  sores. 
It  is  apt  to  cause  much  pain. 

ALGiE. 

U.S.P.  Chondrus.  Chondrus.  Irish  Moss. — Chondrus 
crispus  and  Chondrus  mammillosus. 

Characters. — Yellowish  or  white,  horny,  translucent;  many -forked; 
when  softened  in  water,  cartilaginous ;  segments  flat,  wedge-shaped,  or 
linear  ;  at  the  apex  emarginate  or  two-lobed  ;  it  has  a  slight  seaweed  odour, 
and  a  mucilaginous,  somewhat  saline  taste.  One  part  of  it  boiled  for  ten 
minutes  with  thirty  parts  of  water,  yields  a  solution  which  gelatinises  on 
cooling. 

Dose. — 2-4  dr. 

Use. — It  is  a  demulcent,  which  is  useful  in  bronchia  and 
catarrhal  affections. 

3z 


SECTION  VI. 

ANIMAL   KINGDOM. 


3  Z2 


1077 


CHAPTER  XXXIX. 

Class  MAMMALIA. 

Order  RODENTIA. 

Castoreum.  Castor.  Not  officinal. —  The  dried  preputial 
follicles  and  their  secretion,  obtained  from  the  beaver,  Castor 
Fiber,  and  separated  from  the  somewhat  shorter  and  smaller  oil- 
sacs  which  are  frequently  attached  to  them.  Hudson's  Bay 
Territory. 

Characters. — Follicles  in  pairs,  about  three  inches  long,  fig-shaped,  firm, 
and  heavy,  brown  or  greyish-black ;  containing  a  dry  resinous  reddish-brown 
or  brown  highly  odorous  secretion,  in  great  part  soluble  in  rectified  spirit, 
and  in  ether. 

Composition. — Several  fats,  salicin,  a  bitter  .resin,  and  bitter 
volatile  oil. 

Dose. — 5-10  gr. 

Preparation. 

dose. 
Tinctura  Castorei 22  gr.  to  1  fl.  oz J-l  fl.  dr. 

Action  and  Uses. — Castor  is  used  chiefly  as  an  antispasmodic 
and  stimulant.  It  may  be  given  in  hysteria  and  epilepsy.  Its 
action  is  very  like  that  of  musk. 

Order  RUMINANTIA. 

Moschus,  B.  and  U.S.P.  Mtjsk. —  The  inspissated  and 
dried  secretion  from  the  preputial  follicles  of  Moschus  moschiferus. 
Central  Asia. 

Characters. — In  irregular  reddish-black  rather  unctuous  grains ;  having 
,  a  strong,  peculiar,  very  diffusible  odour,  and  a  bitter  aromatic  taste  ;  con- 
tained in  a  round  or  slightly  oval  membranous  sac,  about  two  inches  in 
diameter,  covered  on  the  outer  side  with  stiff,  greyish  hairs  arranged  in 
a  concentric  manner  around  its  central  orifice. 

Composition. — An  odoriferous  substance  not  yet  isolated, 
fats,  resins,  and  salts. 

Dose. — 5-10  gr.  and  upwards. 

U.S.P.  Preparation. 

dose. 
Tinctura  Moschi 20-50  min. 


1078  ANIMAL  KINGDOM.  [sect.  vi. 

Uses. — Musk  is  often  employed  in  hysteria,  although  its 
physiological  action  has  not  been  investigated.  It  is  more  power- 
ful in  its  action  than  castor.  It  is  used  as  an  antispasmodic 
and  stimulant.  It  is  a  powerful  stimulant,  and  excellent  results 
have  been  obtained  in  cases  of  collapse,  when  due  to  paralysis  of 
the  respiration.  It  has  also  been  given  in  asthenic  pneumonia, 
bronchitis,  fever,  and  gangrene  of  the  lungs,  on  account  of  its 
power  of  stimulating  the  respiratory  centre  and  covering  the 
disagreeable  odour  of  the  sputa.  There  is  a  temptation  to  give 
it  in  small  doses  on  account  of  its  high  price,  and  probably  many 
failures  are  due  to  this.  In  cases  where  it  is  prescribed  at  all  it 
should  be  given  freely,  and  in  many  instances  it  seems  to  be  of 
great  service. 

Sevum  Prasparatum,  B.P. ;  Sevum,  U.S.P.  Prepared 
Suet,  B.P. ;  Suet,  U.S.P. — The  internal  fat  of  the  abdomen  of 
the  sheep,  Ovis  Aries,  purified  by  melting  and  straining. 

Characters. — White,  smooth,  almost  scentless ;  fusible  at  103°  F. 
Composition. — Consists  principally  of  stearin. 

B.P.  Pkerabations. 
Emplastrum  Cantbaridis.  Ungnentum  Hydrargyri. 

Use. — Used  in  the  preparation  of  certain  unguenta  and 
emplastra. 

Lanolin.  Not  officinal. — The  purified  fat  of  sheep's  wool. 
It  is  also  found  in  other  tissues  containing  keratin. 

Characters. — Pure  lanolin  is  of  a  consistence  between  resin  and  fat,  but 
it  rapidly  takes  up  100  per  cent,  of  water.  It  is  yellowish-brown,  becoming 
darker  on  exposure,  and  has  a  faint  smell.  ' 

Beactions. — It  is  a  very  stable  compound,  remaining  unchanged  after 
boiling  with  alkalis.  "When  dissolved  in  anhydrous  acetic  acid  and  a  small 
quantity  of  strong  sulphuric  acid  added,  a  rose  colour  is  developed,  rapidly 
becoming  dark  blue  and  tben  green.1 

Impurities. — It  ought  not  to  contain  more  than  0-l  to  0*5  per  cent,  of  free 
fatty  acid,  since  the  presence  of  a  greater  amount,  especially  of  the  lower 
fatty  acids,  is  likely  to  produce  irritation  of  the  skin. 

Composition. — Lanolin  is  a  cholesterin-fat,  having  choles- 
terin,  instead  of  glycerin,  combined  with  the  fatty  acid. 

Uses. — Lanolin  is  recommended  by  O.  Liebreich  as  a  basis 
for  ointments,  and  as  more  valuable  than  glycerin-  or  petroleum- 
fats  (vaselin),  because  of  its  unirritating  qualities  when  pure, 
but  chiefly  from  its  great  absorbability  when  rubbed  into  the 
slan.  This  property  is  perhaps  connected  with  the  fact  that 
lanolin,  in  the  animal  kingdom,  is  closely  associated  with  keratin- 

1  Oscar  Liebreich,  'Ueber  das  Lanolin,  eine  neue  Salbengrundlage,'  Berlin, 
klin.  Wochens.,  1885,  No.  47. 


chap,  xxxix.]  ANIMAL  KINGDOM.  1079 

forming  cells.  Ointments  containing  carbolic  acid  and  corrosive 
sublimate  rapidly  produce  tbe  physiological  effects  of  the  drug, 
when  rubbed  into  the  skin. 

Lanolin  has  been  found  useful  in  the  pruritus  of  old  people 
and  m  seborrhea  sicca  and  other  skin  diseases,  but  its  chief  use 
is  in  the  application  of  drugs  to  the  skin  by  means  of  ointments.1 
An  ointment  with  iodide  of  potassium  is  useful  in  relieving  the 
swelling  and  pain  of  chronic  joint-affections. 

B.P.  Sapo  Animalis.  Ctjed  Soap. — A  soap  made  with  soda 
and  a  purified  animal  fat,  consisting  principally  of  stearin. 

Characters.— White  or  with  a  very  light  greyish  tint ;  dry ;  nearly 
inodorous;  horny  and  pulverisable  when  kept  in  dry,  warm  air.  Easily 
moulded  when  heated.    It  does  not  impart  a  greasy  stain  to  paper. 

Solubility.— Soluble  in  rectified  spirit ;  soluble  also  in  hot  water,  the 
solution  being  neutral  or  only  slightly  alkaline  to  test-paper 

Preparations  in  which  Cubd  Soap  is  dsed. 

Emplastrum  Besinse. 
„  Saponis. 

„  „        Fuscum. 

Extractum  Colocynthidis  Compositum. 
Linimentum  Potassii  Iodidi  cum  Sapone  (vide  p.  516). 
Pilula  Phosphori  (vide  p.  522). 

„     Scammonii  Composita  (vide  p.  523). 
Suppositoria  Acidi  •Carbolici  cum  Sapone. 
„         Morphinse  cum  Sapone. 
„         Acidi  Tannici  cum  Sapone. 

B.P.  Lac.     Milk. — The  fresh  milk  of  the  cow,  Bos  Taurus. 
Composition. — Fat  (butter),  casein,  milk,  sugar,  and  water. 

Preparation  in  which  Milk  is  used. 
Mistura  Scammonii. 

Uses. — Milk  is  not,  strictly  speaking,  a  medicine,  but  rather 
an  article  of  diet:  it,  however,  plays  an  important  part  in 
medicine,  as  we  rely  on  it  to  a  great  extent  in  cases  of  fever  and 
dyspepsia. 

Great  attention  ought  to  be  paid  to  the  milk  given  to  infants 
if  they  are  fed  from  the  bottle,  for  the  milk  may  begin  to  ferment 
before  it  reaches  the  stomach,  and,  if  it  does,  it  is  likely  to  cause 
vomiting  and  diarrhoea,  and  may  even  act  as  a  nervous  poison, 
paralysing  the  nerve-centres.  The  best  way  to  prevent  this  is 
not  to  have  any  tubes  to  the  bottles,  but  to  have  the  teat  fixed 
directly  to  the  bottle,  and  to  scald  the  bottle  well  after  every 
meal.  The  teats  should  also  be  soaked  in  some  antiseptic,  such 
as  permanganate  of  potassium  and  water,  when  not  in  use. 
When  milk  is  drunk  in  any  quantity,  the  rennet-ferment  in  the 

*     '  Liebreich, '  Ueber  den  med.  Gebrauch  des  Lanolin,'  Deutsch.  med.  Woclten- 
schri/t,  1886,  No.  28.      


1080  ANIMAL  KINGDOM.  [sect.  vi. 

stomach  produces  large  curds,  which  are  sometimes  hard  like  felt, 
and  are  very  indigestible  and  irritating  to  the  stomach ;  hence, 
in  typhoid  fever,  the  possibility  of  these  curds  should  be  borne 
in  mind.  The  milk  will  not  readily  curdle  if  mixed  with  its  own 
bulk  of  water  or  soda-water,  or  (if  diarrhoea  be  present)  with 
lime-water.  One  may  often  with  advantage  use  koumiss,  which 
is  made  in  the  steppes  of  Tartary  by  fermenting  mares'  milk. 
Phthisis  is  so  rare  in  Tartary,  that  Eussians  suffering  from  it 
go  to  the  steppes,  and  numbers  have  been  cured.  No  doubt 
other  factors  aid  the  cure,  such  as  climate  and  change  of  air ; 
but  even  in  the  same  conditions  of  life  koumiss  often  helps  to 
keep  the  disease  in  check.  It  can  be  made  artificially  from 
grape-sugar  and  cows'  milk  which  is  allowed  to  ferment.  It  is 
a  good  stimulant.  It  contains  lactic  acid,  alcohol,  casein,  and 
fat  thrown  down  in  small  flakes.  Kephir  is  made  by  fermenting 
the  milk  of  cows,  sheep,  or  goats ;  it  is  very  much  like  koumiss, 
and  may  be  used  for  the  same  purposes.     It  contains  alcohol. 

Milk  may  be  used  with  ferments  such  as  pepsin  or  pancrea 
tin.     The  mixture  is  allowed  to  stand  for  a  time,  and  then  boiled 
to  stop  the  fermentation. 

Cows'  milk  diluted  with  one  or  more  parts  of  water  and  a 
little  milk-sugar  added,  forms  a  good  substitute  for  human  milk 
as  food  for  infants. 

Saccharum  Lactis,  B.  and  U.S.  P.  Sugar  of  Milk. — 
C12H24012  or  C24H24024 ;  360. — A  peculiar  crystalline  sugar,  ob- 
tained from  the  whey  of  cows'  milk  by  evaporation  and  purified 
by  re-crystallisation. 

Characters. — Usually  in  cylindrical  masses,  two  inches  in  diameter, 
with  a  cord  or  stick  in  the  axis,  or  in  fragments  of  cakes ;  greyish-white, 
crystalline  on  the  surface  and  in  its  texture,  translucent,  hard,  scentless, 
faintly  sweet,  gritty  when  chewed. 

Solubility. — Soluble  in  7  parts  of  water  at  15°  C.  (59°  F.),  and  in  1  part 
of  boiling  water ;  insoluble  in  alcohol,  ether,  or  chloroform. 

Eeactions. — On  adding  to  a  solution  of  sugar  of  milk  in  an  equal  weight 
of  boiling  water  some  solution  of  soda,  the  liquid  turns  brownish,  and,  on 
further  addition  of  test-solution  of  sulphate  of  copper,  a  brick-red  precipitate 


Impurity. — Cane-sugar. 

Test. — If  1  part  of  sugar  of  milk  be  sprinkled  upon  5  parts  of  sulphuric 
acid  contained  in  a  flat-bottomed  capsule,  the  acid  should  acquire  not  more 
than  a  greenish  or  reddish,  but  no  brownish  or  brownish-black  colour  within 
one  hour  (absence  of  cane-sugar). 

Pkspakaxion. 

B.P. 

Pulvis  Elaterini  Compositus. 

Uses. — Sugar  of  milk  is  used  as  a  diluent  in  the  abstracts-, 
denarcotised  opium,  &c,  of  the  U.S.P.  It  is  harder,  less  sweet, 
and  less  soluble  than  cane-sugar,  and  hence  is  a  better  excipient 
and  diluent  for  powders  that  require  trituration. 


chat,  xxxix.]  ANIMAL  KINGDOM.  1081 

B.P-  Pepsin.  Pepsin. — A  preparation  of  the  mucous  lining 
of  a  fresh  and  healthy  stomach  of  the  pig,  sheep,  or  calf. 

Preparation. — The  stomach  of  one  of  these  animals  recently  killed  having 
been  cut  open,  and  laid  on  a  board  with  the  inner  surface  upwards,  any  ad- 
hering portions  of  food,  dirt,  or  other  impurity,  are  to  be  removed  and  the 
exposed  surface  slightly  washed. with  cold  water;  the  cleansed  mucous  mem- 
brane is  then  to  be  scraped  with  a  blunt  knife  or  other  suitable  instrument ; 
and  the  viscid  pulp  thus  obtained  is  to  be  immediately  spread  over  the  sur- 
face of  glass  or  glazed  earthenware,  and  quickly  dried  at  a  temperature  not 
exceeding  100°  P. 

Dose. — 2-10  gr.  given  with  a  meal. 

U.S.  P.  Pepsinum  Saccharatum. — Pepsin,  the  digestive 
principle  of  the  gastric  juice,  obtained  from  the  mucous  mem- 
brane of  the  stomach  of  the  hog,  and  mixed  with  powdered  sugar 
of  milk. 

Characters.— Saccharated  pepsin  is  a  white  powder  of  a  slight  but  not 
disagreeable  odour  and  taste,  and  a  slightly  acid  reaction. 

Solubility. — It  is  not  completely  soluble  in  water,  leaving  floccules  of 
pepsin  floating  in  the  solution,  which,  however,  dissolve  on  the  addition  of  a 
small  quantity  of  hydrochloric  acid. 

Impurities. — Strong  turbidity  of  the  acidulated  solution  indicates  the 
presence  of  mucus,  which  also  imparts  to  the  saccharated  pepsin  a  disagree- 
able odour  and  taste,  and  will  eventually  impart  to  it  an  ammoniacal  odour. 

XJ.S.P.  Pbeparation. 

DOSE. 

Liquor  Pepsini 2-4  11.  dr. 

Uses. — Pepsin  is  given  as  an  aid  to  digestion,  when  the 
ordinary  stimuli  do  not  excite  sufficient  secretion,  and  the 
digestive  ferment  is  insufficient.  Such  cases  occur  during  a 
long  illness  or  during  recovery  from  an  acute  disease,  in  old 
people,  and  in  people  with  atrophy  of  the  mucous  membrane  and 
glands  of  the  stomach,  due  to  alcoholic  excesses  or  long-continued 
dyspepsia.  It  may  be  given  either  with  or  just  after  meals.  It 
has  no  influence  on  farinaceous  foods  or  fat,  but  only  acts  on 
gelatinous  and  albuminous  matter;  hence  it  is  no  use  giving  it 
after  farinaceous  or  fatty  food. 

In  these  cases  the  secretion  of  acid  is  usually  defective,  and  a 
little  dilute  hydrochloric  acid  given  along  with  pepsin,  and  again 
about  two  hours  after  meals,  is  very  useful. 

In  some  cases  of  asthma,  dependent  on  insufficient  digestion, 
pepsin  is  very  useful.  Pepsin  wines  and  essences  usually  contain 
little  or  no  pepsin,  and  have  little  digestive  power,  but  they  con- 
tain rennet,  and  are  frequently  of  use  in  indigestion  in  children ; 
they  also  appear  serviceable  in  adults. 

U.S.P.  Fel  Bovis.  Ox-gall.  —  The  fresh  gall  of  Bos 
Taurus. 

Characters. — A  brownish-green,  or  dark  green,  somewhat  viscid  liquid, 
having  a  peculiar  odour,  a  disagreeable  bitter  taste,  and  a  neutral  or  faintly 
alkaline  reaction.    Specific  gravity  1-018  to  1-028. 


1082  ANIMAL  KINGDOM.  [sect.  vi. 

Eeaotions. — A  mixture  of  2  drops  of  ox-gall  and  10  c.o.  of  water,  when 
treated  first  with  a  drop  of  freshly  prepared  solution  of  1  part  of  sugar  in  4 
parts  of  water,  and  afterwards  with  sulphuric  acid  until  the  precipitate  first 
formed  is  redissolved,  gradually  acquires  a  cherry-red  colour,  changing  suc- 
cessively to  carmine,  purple,  and  violet. 

Pkeeakatiohs. 
u.s.p.  DOSE. 

Fel  Bovis  Inspissatum 

„        „     I'urilieatum 8-15  gr. 

U.S.P.  Fel  Bovis  Inspissatum.     Inspissated  Ox-gall. 

Peepaeation. — Heat  the  ox-gall  to  a  temperature  not  exceeding  80°  C. 
(176°  P.),  strain  it  through  muslin,  and  evaporate  the  strained  liquid,  on  a 
water -bath,  in  a  porcelain  capsule,  from  100  parts  to  15  parts. 

Fel  Bovinum  Purificatum,  B.P. ;  Fel  Bovis  Purificatum, 
U.S.P.  Pueified  Ox-bile. — The  purified  gall  of  the  ox,  Bos 
Taurus. 

Peepaeation. — Mix  fresh  ox-bile  (1  pint)  and  rectified  spirit  (2  pints)  by 
agitation  in  a  bottle,  and  set  aside  for  twelve  hours  until  the  sediment  sub- 
sides. Decant  the  clear  solution,  and  evaporate  it  in  a  porcelain  dish  by  the 
heat  of  a  water-bath,  until  it  acquires  a  suitable  consistence  for  forming  pills, 
B.P.  Evaporate  ox-gall  3  parts  in  a  water-bath  to  1  part.  Add  alcohol  1 
part.  After"  twenty-four  hours  decant,  filter,  distil  off  the  alcohol,  and  eva- 
porate to  a  pilular  consistence,  U.S.P. 

Chaeactees. — A  yellowish-green  substance,  having  a  taste  partly  sweet 
and  partly  bitter. 

Solubility. — It  is  soluble  in  water  and  in  spirit. 

Eeactions. — A  solution  of  one  or  two  grains  of  it,  in  about  a  fluid  drachm 
of  water,  when  treated,  first  with  a  drop  of  freshly  made  syrup  consisting  of 
one  part  of  sugar  and  four  of  water,  and  then  with  sulphuric  acid  cautiously 
added  until  the  precipitate  at  first  formed  is  redissolved,  gradually  acquires 
a  cherry-red  colour,  which  changes  in  succession  to  carmine,  purple,  and 
violet.  Its  watery  solution  gives  no  precipitate  on  the  addition  of  rectified 
spirit. 

Composition. — Taurocholic  and  glycocholic  acids,  mucus, 
cholesterin,  fats,  and  salts. 

Dose. — Of  purified  bile,  5-10  gr.  or  more,  formed  into  pills 
or  given  in  small  gelatin  capsules.  When  the  object  is  to  affect 
the  intestines  rather  than  the  stomach,  the  latter  mode  is  prefer- 
able. 

Action  and  Uses. — Bile  precipitates  pepsin  and  interferes 
with  the  digestion  of  albuminous  substances  in  the  stomach.  It 
seems  also  to  irritate  the  mucous  membrane  and  gives  rise  to 
headache  and  vomiting.  It  does  not  aid  the  digestion  of  fari- 
naceous food.  It  quickens  the  absorption  of  fats,  it  prevents  to 
some  extent  putrefactive  changes  in  the  intestinal  contents,  and 
it  quickens  peristaltic  action.  Some  purgatives,  such  as  aloes 
and  jalap,  only  act  when  mixed  with  bile.  It  is  therefore  a  use- 
ful adjunct  to  them  in  cases  of  jaundice  with  deficiency  of  bile  in 
the  intestine.  It  is  sometimes  used  in  dyspepsia  with  constipa- 
tion, and  is  given  by  some- along  with  opium  in  order  to  prevent 


chap,  xxxix.]  ANIMAL  KINGDOM.  1083 

the  constipating  effect  of  the  latter.  Its  action  in  preventing 
putrefactive  changes  in  the  intestine  may  sometimes  be  useful 
in  cases  of  indigestion  where  these  occur  (pp.  101,  378),  and 
where  the  flatus  has  consequently  a  very  disagreeable  odour.  In 
order  to  prevent  its  local  action  on  the  stomach,  it  may  be  given 
as  pills  coated  with  keratin. 

Keratin.    Not  officinal. 

Preparation. — Horn-turnings  are  digested  with  artificial  gastric  juice 
until  all  the  matter  soluble  in  them  has  been  removed.  They  are  then 
allowed  to  lie  for  some  weeks  in  ammonia  or  glacial  acetic  acid,  which 
gradually  dissolves  them.  The  solvent  is  then  allowed  gradually  to  evaporate- 
until  a  mucilaginous  solution  is  obtained. 

Characters. — The  solution  resembles  gum  in  appearance,  and  when  dry 
forms  yellow  or  yellowish-brown  scales.  When  dried,  keratin  is  absolutely 
insoluble  in  gastric  juice,  but  dissolves  readily  in  the  juices  of  the  intestine. 

Uses. — To  coat  pills  containing  any  substance  which  we  wish 
to  act  upon  the  intestine  without  acting  on  the  stomach.  These 
are : — 

1.  Such  substances  as  irritate  the  gastric  mucous  membrane 
when  long  used,  e.g.  arsenic,  all  anthelmintics,  salicylic  acid, 
creasote,  chrysarobin,  copaiba,  cubebs,  digitalis,  preparations 
of  iron  (and  especially  the  iodide  and  chloride),  preparations  of 
mercury  (especially  the  perchloride  and  periodide),  opium,  phos- 
phorus, quinine,  tartarated  antimony. 

2.  Such  substances  as  impair  digestion  in  the  stomach  by 
forming  insoluble  precipitates  with  pepsin  and  peptones,  e.g. 
tannic  acid,  alum,  acetate  of  lead,  subnitrate  of  bismuth,  nitrate 
of  silver,  corrosive  sublimate. 

3.  Such  substances  as  are  partly  rendered  inert  by  the 
gastric  juice,  and  partly  decomposed  in  an  undesired  manner, 
e.g.  alkalis,  soap,  bile,  calcium  sulphide,  ferric  sulphide,  char- 
coal, nitrate  of  silver,  iodide  of  iron,  green  and  red  iodides  of 
mercury,  &c. 

4.  Medicines  which  we  wish  to  introduce  into  the  duodenum 
in  as  concentrated  a  form  as  possible,  e.g.  kousso,  extract  of  male 
fern,  santonin,  nitrate  of  silver,  acetate  of  lead  or  tannin  in 
ulceration  of  the  bowels,  bile,  charcoal,  soaps,  and  alkalis,  &c. 

5.  Medicines  of  which  we  desire  the  remote  without  the  local 
action,  e.g.  iron,  quinine,  arsenic  in  gastric  catarrh,  in  anaemia, 
in  cardialgia  and  gastric  ulcer. 

Mode  of  Application. — The  medicine  is  thoroughly  mixed 
with  marsh-mallow  powder,  liquorice  powder,  or  charcoal,  and  a 
few  drops  of  almond  oil.  It  is  then  made  into  a  pill-mass  with 
cacao-butter.  After  the  pills  have  been  made  of  the  proper  size 
they  are  covered  with  a  thin  coating  of  cacao-butter,  and  then 
with  one,  or  better  still  with  two  or  three  coats  of  keratin. 

Usually  the  solution  of  keratin  in  ammonia  is  employed,  but 


1084  ANIMAL  KINGDOM.  [sect.  vi. 

the  solvent  least  likely  to  decompose  the  medicine  may  be  em- 
ployed, and  thus  the  acetic  acid  solution  may  be  used  for  the 
chloride  of  iron  or  mercury,  or  salicylic  acid. 


Order  PACHYDERMATA. 

Adeps  Prajparatus,  B.P. ;  Adeps,  U.S.P-  Prepakeu 
Laed,  B.P. ;  Laud,  U.S.P. — The  purified  fat  of  the  hog,  Sus 
Scrofa,  B.P. ;  the  prepared  internal  fat  of  the  abdomen  of  Sus 
Scrofa  purified  by  washing  with  water,  melting,  and  straining, 
U.S.P. 

Characters. — A  soft  white  fatty  substance,  melting  at  about  100°  F.  Has 
no  rancid  odour 

Solubility. — It  dissolves  entirely  in  ether. 

Eeactions. — Distilled  water  in  which  it  has  been  boiled  should  not  ac- 
quire an  alkaline  reaction  (absence  of  alkalis).  A  portion  of  the  water  when 
cooled  and  filtered,  and  another  portion  acidulated  with  nitric  acid,  should 
give  no  precipitate  with  nitrate  of  silver  (absence  of  salt),  and  is  not  rendered 
blue  by  the  addition  of  solution  of  iodine  (no  starch).  "When  heated  for  several 
hours  on  the  water-bath,  under  frequent  stirring,  lard  should  not  diminish 
sensibly  in  weight  (absence  of  water). 

Impurities. — Bancidity  due  to  acrid  fatty  acids,  alkalis,  common  salt, 
starch,  water. 

Preparations. 

S.P. 

Adeps  Benzoatus.  Unguentum  Hydrargyri  Nitratis. 

Emplastrum  Cantharidis.  „  Iodi. 

Unguentum  Hydrargyri.  „         Terebinthinsa. 

C.s.p. 
Adeps  Benzoinatus.  Unguentum  Acidi  Tannici. 


Ceratum  Kesinas. 

Unguentum. 

Ceratum. 

Camphors. 
Cantharidis. 
Extracti  Cantharidis. 
Plumbi  Subacetatis. 
Sabina). 
Unguentum  Acidi  Carbolici. 
Hydrargyri. 

„  Oxidi  Flavi. 

„  „    Eubri. 

Mezerei. 
Acidi  Galliei. 


Belladonna;. 

Chrysarobini. 

Gallas. 

Hydrargyri  Ammoniato. 

Iodi. 

Iodoformi. 

Plumbi  Carbonatis. 

Iodidi. 
Potassii      „ 
Stramonii. 
Sulphuris. 

„  Alkalinum. 

VeratrinsB. 
Zinci  Oxidi. 


Adeps   Benzoatus,   B.P. ;  Adeps    Benzoinatus,    U.S.P. 
Benzoated  Laed. 

Preparation. — By  mixing  powdered  benzoin  (2  parts,  U.S.P. ;  2  drachms, 
B.P.)  with  melted  lard  (100  parts,  U.S.P. ;  1  lb.  B.P.)  and  straining.  The 
benzoin  prevents  the  lard  from  becoming  rancid. 


chap,  xxxix.]  ANIMAL  KINGDOM.  1085 


Preparations. 

b.p. 

Unguentum  Aconitinas.                             Unguentum  Plumbi  Acetatig 
„        Atropinse.                                           „        Potassii  lodidi. 
„        Belladonnas.                                       „        Sabinaa.   . 
„        Calamin83.                                          „        Simplex, 
j         Chrysarobini.                                     „        Staphysagriaa. 
,         Gallse.                                                 „        Snlphuris. 
„        Hydrargyri  Subohloridi.                    „        Zinci. 
„        lodoformi. 

Uses. — Lard  is  emollient.  It  is  used  in  the  preparation  of 
ointments,  and  spread  upon  poultices  to  prevent  them  from 
getting  dry  or  sticking  to  the  surface  of  the  body. 


Order  CETACEiE. 

Cetaceum,  B.  and  U.S.P.  Spermaceti. — A  peculiar  con- 
crete, fatty  substance  obtained  from  Physeter  macrocephalus, 
U.S.P.  Nearly  pure  cetine,  obtained,  mixed  with  oil,  from  the 
head  of  the  sperm  whale,  Physeter  macrocephalus,  inhabiting  the 
Pacific  and  Indian  Oceans.  It  is  separated  from  the  oil  by 
nitration  and  pressure,  and  afterwards  purified,  B.P. 

Characters.  —  Crystalline,  pearly- white,  glistening,  translucent,  with 
little  taste  or  odour,  reducible  to  powder  by  the  addition  of  a  little  rectified 
spirit.     Scarcely  'unctuous  to  the  touch ;  does  not  melt  under  100°  F. 

Preparations. 

B.P. 

Unguentum  Cetacei.  Charta  Epispastiea. 

U.S.P. 

Ceratum  Cetacei.  Unguentum  Aquse  Bosse. 

Use. — It  is  used  as  an  emollient  external  application. 


Class  AVES. 
Order  GALLIN^E. 

B.P.  Ovi  Albumen.     Egg  Albumen. — The  liquid  white  of 
the  egg  of  Gallm  Banckiva,  var.  domesticus. 

Characters. — Transparent,  viscid,  soluble  in  water,  coagulable  on  heating 
to  160°  P.  When  coagulated  it  is  opaque  and  insoluble  in  water.  It  is 
coagulated  by  ether. 

•  U.S.P.  Test-Solution  of  Albumen. — A  solution,  recently  prepared  by 
triturating  the  white  of  one  egg  with  100  cubic  centimetres  of  distilled  water, 
and  filtering  through  cotton  moistened  with  distilled  water. 

Ovi  Vitellus,  B.P. ;  Vitellus,  U.S.P.     Yolk  of  Egg.— The 
yolk  of  the  egg  of  Gallus  Banckiva,  var.  domesticus. 


1086  ANIMAL  KINGDOM.  [sect.  vi. 

Peepabations. 

B.P.  U.S.P. 

Mistura  Spiritus  VIni  Gallicl.  Glyoeritum  Yitelli. 

Properties.  —  Yellow,  coagulated  on  heating,  contains 
vitellin,  also  cholesterin,  and  fats,  together  with  salts  of  cal- 
cium, &c. 

B.P.  Mistura  Spiritus  Vini  Gallici. 

Preparation. — By  rubbing  up  the  yolk  of  the  egg  with  J  oz.  of  fine  sugar, 
then  adding  one  wineglassful  (2  fi.  oz.)  of  brandy  and  another  of  cinnamon- 
water,  and  beating  them  all  up  together. 

Uses. — White  of  egg  forms  insoluble  albuminates  with  a 
number  of  metals,  and  hence  is  employed  as  an  antidote  in 
cases  of  poisoning  (especially  in  the  cases  of  corrosive  sublimate 
and  sulphate  of  copper) ;  in  these  cases  the  albuminates  generally 
dissolve  readily  enough  in  the  gastric  juice,  and  therefore  you 
must  give  an  emetic  at  once. 

The  white  and  yolk  of  egg  are  useful  as  nutritious  articles  of 
diet,  and  in  the  form  of  egg-flip  (mistura  spiritus  vini  gallici)  is 
much  used  in  exhausted  conditions  of  the  system  (p.  773).  One 
case  in  which  eggs  are  very  useful  is  cancer  of  the  rectum,  since, 
being  entirely  absorbed  in  the  alimentary  canal,  disturbance  in 
the  rectum  is  avoided.  A  good  mixture  is  the  white  of  three 
eggs,  the  yolk  of  two,  and  a  quarter  of  a  pint  of  beef-tea,  beat 
up  separately  and  then  together,  put  in  hot  water  until  set,  and 
given  in  two  or  three  portions. 

Eggs  are  often  mixed  with  a  little  pancreatin,  and  adminis- 
tered as  enemata. 

Class  PISCES. 

Order  STURIONES. 

Isinglass,  B.P. ;  Ichthyocolla,  U.S.P. — The  swimming- 
bladder  or  sound  of  Acipenser  Huso,  and  other  species  of  Aci- 
penser. 

Properties. — In  fine  shreds,  B.P. ;  in  separate  sheets,  &c,  U.S.P. 

Composition.— It  consists  of  gelatine,  which  is  precipitated 
by  tannic  acid. 

Pkepaeations. 

B.P.  U.S.P. 

Solution  of  Gelatine.  Emplastrum  Ichthyocollfe  (Court  Plaster). 

Uses. — Gelatine  baths  are  useful  in  soothing  the  irritation 
of  the  skin  in  urticaria.  Gelatine  is,  however,  chiefly  used  as  a 
food  in  soups  and  in  jellies  for  convalescents  and  those  suffering 
from  chronic  diseases.  It  will  not,  however,  supply  the  place  of 
ordinary  albumen  as  a  food. 


chap,  xxxix.]  ANIMAL  KINGDOM.  1087 


Order  TELEOSTE./E.    Fam.  GADID^E. 

Oleum  Morrhuae,  B.  and  U.S.P.  Cod-Liveb  Oil.— A  fixed 
oil  extracted  from  the  fresh  livers  of  the  cod,  Gadus  Morrhua, 
B.P.  (or  of  other  species  of  Gadus,  U.S.P.),  by  the  application  of 
a  heat  not  exceeding  180°  F. 

Chabacteks. — Pale  yellow,  with  a  slight  fishy  odour,  and  bland  fishy 
taste. 

Test. — A  drop  of  sulphuric  acid  added  to  a  few  drops  of  the  oil  on  a 
porcelain  slab  develops  a  violet  colour,  which  soon  passes  into  a  yellowish  or 
brownish  red. 

Composition. — Contains  olein  (7  per  cent.),  palmitin  (25  per 
cent.),  and  some  stearin,  also  minute  traces  of  iodides,  and  a 
peculiar  substance  probably  allied  to  biliary  acids. 

Dose. — From  1  to  8  fl.  dr. 

Action. — Cod-liver  oil  is  rather  a  food  than  a  medicine,  and 
its  therapeutical  use  depends  on  two  properties,  viz.  its  ready 
absorption  and  its  ready  assimilation. 

Its  ready  absorption  is  probably  partly  due  to  the  presence 
of  biliary  matters  in  the  oil,  since  oil  passes  more  readily  through 
a  membrane  when  it  is  moistened  with  bile.  If  you  take  two 
loops  of  intestine  and  fill  one  with  ordinary  oil  and  the  other 
with  cod-liver  oil,  and  replace  them,  the  one  with  cod-liver  oil 
will  lose  more  in  the  same  time  than  that  containing  ordinary 
oil. 

It  is  readily  assimilated,  and  hence  it  is  used  in  all  diseases 
where  nutrition  is  slow,  as  in  enlarged  glands,  catarrhal  pneu- 
monia, bronchitis,  &c.  By  means  of  its  property  of  stimulating 
nutrition,  cod-liver  oil  improves  all  the  functions  of  the  body, 
but  has  no  specific  action  on  any  of  the  organs  themselves. 
When  large  quantities  of  the  oil  are  taken  into  the  stomach  they 
cause  vomiting,  but  if  the  oil  be  finely  divided  previously,  it  can 
be  taken  without  discomfort.  Hence  it  is  advisable,  when  giving 
it  in  any  quantity,  to  make  it  into  an  emulsion.  Potash  in 
sometimes  used,  but  in  the  stomach  the  potash  is  probably  neu- 
tralised, the  emulsion  decomposed,  and  the  oil  liberated.  A 
better  method  is  to  mix  it  with  an  equal  volume  of  mucilage  of 
acacia  and  a  few  drops  of  oil  of  lemon  ;  this  emulsion  is  not  de- 
composed by  the  acid  of  the  stomach.  The  oil  can  also  be  mixed 
with  isinglass  and  taken  as  jelly.  Some  people  take  it  best  by 
putting  a  little  salt  on  the  tongue  before,  and  eating  a  piece  of 
bread  after  the  oil.  It  is  often  digested  if  taken  with  a  little 
ether,  for  the  ether  stimulates  the  pancreatic  secretion. 

The  oil  must  not  be  pressed  if  it  causes  nausea  or  diarrhoea 
— for  it  is  a  food  and  not  a  medicine,  and  must  not  be  given  if 
detrimental  to  the  appetite. 

It  can  sometimes  be  taken  in  a  single  dose  at  bed-time,  when 
it  cannot  be  retained,  during  the  day.    It  is  rarely  well  borne 


1088  ANIMAL  KINGDOM.  [sect,  to 

when  taken  on  an  empty  stomach,  hut  is  best  retained  when 
given  not  immediately  after,  but  from  half  an  hour  to  two  hours 
after  a  meal.  Probably  the  partially  digested  food  then  forms  it 
into  an  emulsion. 

Uses. — Externally,  cod-liver  oil  is  a  good  application  for 
the  removal  of  scales  in  seborrhcea,  eczema,  and  psoriasis.  In 
wasting  diseases  of  children,  when  it  cannot  be  borne  by  the 
mouth,  it  may  be  rubbed  into  the  skin  twice  daily. 

Internally,  cod-liver  oil  is  used  in  all  diseases  arising  from 
defective  nutrition  and  in  all  scrofulous  conditions  (of  the  skin, 
bones,  &c),  and  as  a  food  during  chronic  illnesses  and  in  con- 
valescence from  acute  diseases. 

In  children  emaciated  with  diarrhoea,  a  useful  mixture  is 
vinum  ferri  and  cod-liver  oil ;  it  must  not  be  given  in  such 
quantities  as  to  increase  the  diarrhoea.  Often  it  will  also  re- 
lieve constipation  in  children. 

Its  nutritive  properties  are  especially  directed  to  glandular 
tissues ;  hence  it  is  used  in  all  cases  of  enlarged  glands,  as  in 
tabes  mesenterica. 

In  malnutrition  of  the  heart,  and  defective  circulation,  it 
improves  the  condition  of  the  heart,  increases  the  red  corpuscles, 
and  to  some  extent  also  the  white  corpuscles ;  hence  it  is  useful 
in  old  people  with  giddiness  and  a  tendency  to  syncope. 

It  is  also  used  in  chronic  rheumatism  and  tertiary  syphilis. 

It  is  also  a  tonic  to  the  nervous  system,  and  is  of  great  ser- 
vice in  cases  of  nervous  debility  consequent  on  hard  work,  worry, 
or  acute  disease.  It  is  used  in  neuralgia  with  iron  and  port  wine. 
In  hysteria  in  middle-aged  persons  it  is  often  serviceable. 

In  rickets  it  may  be  given  alone  or  in  combination  with 
phosphate  of  calcium. 

In  inflammations,  as  bronchitis,  newly  developed  cells  are 
present  in  great  abundance,  but  nutrition  is  so  defective  that 
they  cannot  take  on  the  character  and  functions  of  mucous  cells, 
and  hence,  in  order  to  allow  them  to  form  a  new  mucous  mem- 
brane, they  must  be  supplied  with  a  readily  assimilable  nutritive 
material ;  this  is  probably  the  explanation  of  the  benefit  obtained 
by  the  use  of  cod-liver  oil  in  bronchitis  and  other  diseases  de- 
pendent on  malnutrition. 

In  chronic  bronchitis,  with  violent  cough  and  abundant 
sweetish  expectoration,  it  gives  great  relief. 

In  phthisis  it  is  of  great  service,  and  is  used  in  all  stages  of 
the  disease  except  when  the  temperature  is  very  high  ;  especially 
is  it  useful  in  the  first  stage,  where  there  is  little  consolidation. 
Under  its  use  the  patient  gains  flesh,  keeps  the  disease  in  check, 
and  even  sometimes  becomes  cured. 

In  catarrhal  conditions  of  other  mucous  membranes  besides 
those  of  respiration  it  is  very  useful,  as  in  ozsena  in  children 
recovering  from  measles,  and  in  otitis  after  scarlet  fever. 


chap,  xxxix.]  ANIMAL  KINGDOM.  1089 

Class  INSECTA. 
Order  HYMENOPTERA. 

Mel,  B.  and  U.S.P.  Honey. — A  saccharine  secretion  de- 
posited in  the  honeycomb  by  Apis  mellifica,  the  hive-bee. 

Chaeactees. — When  recently  separated  from  the  honeycomb)  it  is  a 
viscid  translucent  liquid,  of  a  brownish-yellow  colour,  which  gradually  be- 
comes partially  crystalline  and  opaque.  It  has  a  peculiar  heavy  odour,  and 
a  very  sweet  taste. 

Composition. — Chiefly  glucose  and  levulose. 

Impueities. — Starch,  common  salt,  sulphates,  grape  sugar,  and  other 
foreign  substances. 

Test. — Water  boiled  with  it  for  five  minutes  and  allowed  to  cool  does  not 
become  blue  or  green  with  the  solution  of  iodine  (absence  of  starch). 

If  1  part  of  honey  be  dissolved  in  4  parts  of  water,  a  clear  solution  should 
result,  which  should  not  be  rendered  more  than  faintly  opalescent  by  a  few 
drops  of  test-solution  of  nitrate  of  silver  (chloride),  or  of  nitrate  of  barium 
(sulphate).  If  a  small  portion  of  honey  be  diluted  with  1  volume  of  water 
and  then  gradually  mixed  with  5  volumes  of  absolute  alcohol,  it  should  not 
become  more  than  faintly  opalescent  and  should  neither  become  opaque,  nor 
deposit  a  slimy  substance  at  the  bottom  and  along  the  sides  of  the  test-tube. 
When  incinerated  in  small  portions  at  a  time,  in  a  platinum  crucible,  it 
should  not  leave  more  than  0"2  per  cent.'of  ash  (any  larger  percentage  of 
ash  and  failure  to  respond  to  the  preceding  tests  indicating  the  presence  of 
glucose  or  other  foreign  admixtures). 

Officinal  Preparations. 

B.P.  DOSE. 

Mel  Depuratum  (melted  and  strained) Ad  lib. 

Of  Mel  Depuratum— 

MelBoracis 

Oxymel  (honey  40,  acetic  acid  5,  water  5) 1  fl.  dr.-l  fl.  oz. 

„      Scillae 

Confectio  Piperis 

„        Scammonii   

„        Terebinthinse 

U.S.P. 

Mel  Despumatum  (warmed  and  strained)  

Confectio  Kosce 

Mel  Boso? 

Use. — It  is  slightly  laxative — chiefly  used  as  a  vehicle. 
Oxymel  is  the  old-fashioned  household  remedy  of  honey  and 
vinegar,  and  is  used  for  colds  and  sore-throats. 

Cera  Flava,  B.  and  U.S.P.  Yellow  Wax. — The  prepared 
honeycomb  of  the  hive-bee,  Apis  mellifica,  B.P. ;  a  peculiar  con- 
crete substance  prepared  by  Apis  mellifica,  U.S.P. 

Chaeactees.— Yellowish  or  yellowish-brown,  solid,  firm,  breaking  with  a 
granular  fracture,  having  an  agreeable  honey -like  odour. 

Composition. — Cerin  and  myricin. 

Imptjeities. — Fats,  fatty  acids,  Japan  wax,  resin,  soap,  and  paraffin. 
Tests.— B.P.     Not  unctuous  to  the  touch ;  does  not  melt  under  140°  F. 
(absence  of  fats) ;  yields  nothing  to  cold  rectified  spirit  (absence  of  resin;,  but 

i  A 


1090  ANIMAL  KINGDOM.  [sect,  vi, 

is  entirely  soluble  in  oil  of  turpentine.     Boiling  water  in  which  it  has  been 
agitated,  when  cooled,  is  not  rendered  blue  by  iodine  (absence  of  starch). 

U.S.P.  If  1  gin.  of  wax  be  boiled,  for  half  an  hour,  with  40  gm.  of  solu- 
tion of  soda  (specific  gravity  1-180),  the  volume  being  preserved  by  the 
occasional  addition  of  water,  the  wax  should  separate,  on  cooling,  without 
rendering  the  liquid  opaque,  and  no  precipitate  should  be  produced  in  the 
filtered  liquid  by  hydrochloric  acid  (absence  of  fats  or  fatty  acids,  Japan  wax, 
resin) ;  nor  should  the  same  reagent  produce  a  precipitate  in  water  which 
has  been  boiled  with  a  portion  of  the  wax  (absence  of  soap).  If  5  gm.  of  wax 
be  heated  in  a  flask,  for  fifteen  minutes,  with  25  gm.  of  sulphuric  acid  to 
160°  0.  (320°  F.),  and  the  mixture  diluted  with  water,  no  solid,  wax-like  body 
should  separate  (absence  of  paraffin). 

OlTlCINAIi  PbEPABATIONS. 
B.P.  U.S.P. 

Cera  Alba.  Ceratum  BesinaB. 

Emplastrum  Calefaciens.  „      Cantharidis. 

„  Cantharidis.  „      Extracti  Cantharidis. 

„  Galbani.  „      SabinsB. 

„  Picis.  Unguentum 

„  Saponis  Fuscum.  „  Acidi  Carbolici. 

Pilula  Phospbori  (p.  522).  „  Mezerei. 

Unguentum  Cantharidis. 

„        Hydrargyri  Compositum. 

„        Picis  Liquids. 

„        Besinss. 

„        SabinsB. 

„        Terebinthinte. 

Use. — To  give  proper  consistence  to  ointments. 

Cera  Alba,  B.  and  U.S.P.  White  Wax.  —  Yellow  wax 
bleached  by  exposure  to  moisture,  air,  and  light. 

Characters. — Hard,  nearly  white,  translucent.  Not  unctuous  to  the 
touch ;  does  not  melt  under  150°  F. 

OiTicmAii  Preparations. 
B.P.  U.S.P. 

Charta  Epispastica.  Ceratum. 

Unguentum  Cetacel.  Compound  Cerates — 

,,  Simplex.  Ceratum  Camphor®. 

„      Cetacei. 
„      Plumbi  Subacetatis. 
Unguentum  Aqua?  Bosffi. 

Use. — In  the  preparation  of  the  above  ointments  and  sup- 
positories. 

Order  HEMIPTERA. 

Coccus,  Cochineal,  B.  and  U.S.P.  The  dried  female  of 
Coccus  cacti,  reared  on  Opuntia  cochinillifera,  and  on  other  species 
of  Opuntia.     Mexico  and  Teneriffe. 

Characters. — Ovate,  plano-convex,  about  one-fifth  of  an  inch  (5  milli- 
metres) long ;  wrinkled,  of  a  purplish-grey  or  purplish-black  colour ;  easily 
pulverisable,  yielding  a  dark-red  powder.     Odour  faint ;  taste  slightly  bitter. 

Composition. — It  contains  a  red  colouring  matter  soluble 
in  water,  alcohol,  or  water  of  ammonia,  slightly  soluble  in  ether, 
insoluble  in  fixed  and  volatile  oils. 


chap,  xxxix.]  ANIMAL  KINGDOM.  1091 

^Reactions. — On  macerating  cochineal  in  water,  the  insect  swells  up,  but 
no  insoluble  powder  should  be  separated.  The  greyish- white  insect  quickly 
becomes  black  when  warmed  before  the  fire. 

Preparations. 

B.P.  DOSE. 

Tinctura  Cocci  (2J  oz.  in  1  pint).  Ad  lib. 

„        Cardamomi  Composita. 
„         Cinchona)  ,, 

Uses. — It  has  little  medicinal  value ;  it  is  used  to  give  an 
attractive  colour  to  various  liquid  preparations. 

Order  COLEOPTERA. 

Cantharis,  B.  and  U.S.P.  Canthabides.  Spanish  Flies. — ■ 
The  beetle,  Cantharis  vesicatoria,  dried.     Hungary. 

Characters. — From  eight  to  ten  lines  long,  furnished  with  two  wing- 
covers  of  a  shining  metallic-green  colour,  under  which  are  two  membranous 
transparent  wings  ;  odour  strong  .and  disagreeable  ;  powder  greyish-brown, 
containing  shining  green  particles.    Free  from  mites. 

Composition. — Cantharidin,  a  tasteless,  inodorous  substance, 
which  may  be  crystallised  from  an  alcoholic  extract.  It  is  in- 
soluble in  water  and  cold  alcohol,  although  it  may  be  extracted 
from  the  cantharides  by  both  when  in  conjunction  with  the 
yellow  colouring-matter.  The  other  ingredients  are  unimportant. 

Preparations. 
b.p.  strength.  dose. 

Acetum  Cantbarldis 2  oz.  to  1  pint 

Charta  Eplspastlca  

Emplastrum  Calefaclens 1  part  in  24,  nearly 

„  Cantbarldis 1  part  in  3 

liquor  Epispasticus 1  oz.  to  2£  fl.  oz 

Tinctura  Cantbarldis 5\  gr.  to  1  fl.  oz 5-20  min. 

Unguentum         „  1  part  to  7,  nearly 

U.S.P. 

Ceratum  Cantharidis. 

„      Extracti  Cantharidis. 
Charta  Cantharidis. 
Collodion  cum  Cantharide. 
Linimentum  Cantharidis  (p.  517). 
Tinctura  Cantharidis. 

Action. —  Externally  the  preparations  of  cantharides  pro- 
duce, when  applied  to  the  skin,  tingling,  redness,  and  vesication ; 
if  the  action  is  prolonged,  the  vesicles  coalesce  into  a  large  bleb 
filled  with  serum,  and  if  left  on  too  long  the  true  skin  becomes 
irritated,  and  suppuration,  ulceration,  and  sven  sloughing  occur. 

Internally  the  drug  causes  irritation  of  the  alimentary  canal, 
with  a  feeling  of  warmth  in  the  mouth,  oesophagus,  and  stomach, 
loss  of  appetite,  and  (if  its  use  be  prolonged,  or  if  a  single  large 
dose  be  given)  burning  and  pain  in  the  stomach  (increased  by 

4  A  2 


1092  ANIMAL  KINGDOM.  [sect.  vi. 

pressure),   nausea,  vomiting,   and  diarrhoea  (the  vomited  and 
ejected  matters  often  being  mixed  with  blood). 

It  affects  the  trachea  and  larger  bronchi,  causing  congestion 
and  irritation. 

It  affects  the  kidneys  and  urinary  passages,  causing  pain  in 
the  loins,  burning  in  the  bladder  and  along  the  urethra,  irritation 
of  the  glans  penis,  and  sometimes  increased  sexual  appetite.  If 
continued  for  a  long  time,  it  causes  great  pain  in  the  kidneys, 
painful  erections  of  the  penis,  difficulty  of  micturition  or  sup- 
pression of  urine,  the  latter  often  containing  albumen  or  blood. 

The  nervous  system  is  usually  not  affected  by  small  doses, 
but  large  doses  cause  headache  and  quickened  pulse  and  respira- 
tion. 

Very  large  doses  produce  insensibility,  paralysis  of  respira- 
tion, and  death  with  asphyxial  convulsions. 

The  salivary  glands  and  the  back  of  the  throat  become  so 
much  swollen  that  swallowing  is  difficult,  and  the  attempt  to 
swallow  may  give  rise  to  convulsions,  like  hydrophobia. 

Urinary  Organs. — The  inflammation  caused  by  cantharides 
begins  in  the  glomeruli,  and  not  in  the  straight  tubes  as  is  often 
stated. 

The  first  condition  of  the  kidneys  noticed  after  the  adminis- 
tration of  cantharides  is  extravasation  of  leucocytes  into  the 
glomeruli  and  an  exudation  of  a  fibrinous  matrix ;  next,  following 
in  order,  we  notice  : — • 

(1)  The  glomeruli  and  the  proximate  tubules  are  filled  with  a 
granular  fluid. 

(2)  The  cells  of  the  capsule  become  swollen. 

(3)  The  cells  of  the  collecting  tubes  are  affected,  and  become 
swollen. 

(4)  The  cells  of  the  whole  urinary  tubule  become  swollen. 

(5)  In  the  straight  collecting  tubes  the  cells  become  multi- 
plied, and  are  thrown  off  so  that  the  lumen  becomes  full  of 
exuded  cells. 

Treatment  in  Poisoning. — Evacuate  the  stomach,  give 
mucilaginous  drinks  to  lessen  the  gastro-intestinal  irritation,  but 
avoid  oils  or  fats,  which  increase  the  solubility  of  cantharidin 
and  the  dangers  arising  from  its  absorption.  Use  opium  and 
sitz-baths  to  relieve  the  strangury. 

Uses. — It  is  used  externally  as  an  irritant  and  counter- 
irritant,  and  iutemally  for  its  effect  on  the  genito-urinary 
tract. 

Externally  as  irritant — 

(1)_  To  increase  the  supply  of  blood  to  a  part,  and  hence  im- 
prove its  nutrition,  as  in  chronic  ulcers  in  the  leg. 

(2)  To  cause  disappearance  of  inflammatory  products  in 
chronic  inflamed  joints  and  swellings ;  also  in  acutely  inflamed 


CHAP.  XXXIX.] 


ANIMAL  KINGDOM. 


1093 


joints,  as  in  acute  rheumatism;,  in  the  form  of  a  blister  above 
and  below  the  joint.  In  chronic  rheumatism  a  large  and  strong 
blister  should  be  used. 

As  counter-irritant  it  is  used  in  pleurisy  and  pneumonia, 
and  often  relieves  the  pain  almost  immediately. 

It  is  also  used  in  acute  inflammation-  of  the  heart  and  peri- 
cardium. It  is  better  not  to  apply  the  blister  directly  over  the 
affected  part,  but  a  little  to  one  side,  since  there  is  a  risk  of 
getting  the  vessels  just  underneath  it  congested  instead  of  anaemic. 

In  affections  of  other  serous  membranes,  as  in  meningitis, 
and  often  in  inflammation  of  the  brain  itself,  the  application  of  a 
blister  is  very  useful. 


Phthisis 

Pericarditis,  or  pleurisy 

Plying  blister,  or  sina-  \ 
pism,  in  pleurisy  or  )• 
pneumonia J 

Vomiting    

Chronic  thickening  aftel| 
peri-typhlitis 


BTarian  irritation. 


Acute  rheumatism  ... 


Goat. 


hysterical 


Pig.  226.— Diagram  of  the  body  showing  some  of  the  points  where  blisters  or  sinapisms  are  usually 

applied.    Front  yiew. 

When  applied  to  the  nape  of  the  neck,  it  often  relieves  giddi- 
ness and  disturbed  cerebral  functions  dependent  on  tertiary 
syphilis,  diseases  of  the  ear,  or  of  the  semicircular  canals. 

It  is  occasionally  useful  to  keep  up  the  irritation  by  means  of 
savine  ointment  applied  to  the  blistered  surface. 

It  is  also  locally  applied  to  the  perineum  in  inflammation  of 


1094 


ANIMAL  KINGDOM. 


[SECT.  Vli 


the  prostate,  and  over  the  tender  region  in  inflammation  of  the 
ovary. 

A  blister  sometimes  relieves  the  pain  of  sciatica  and  the  ten- 
derness of  nerves  in  peripheral  paralysis ;  and  a  blister  the  size  of 
a  shilling  may  be  applied  over  each  tender  spot  in  these  diseases. 
In  sciatica  a  row  of  such  small  blisters,  or  a  long  narrow  blister 
along  the  course  of  the  nerve,  is  sometimes  better  than  single 
small  blisters.  A  blister  is  a  useful  application  applied  under 
the  ear  in  paralysis  of  the  facial  nerve  due  to  cold. 

Internally,  in  small  doses  of  1  or  2  min.  of  tincture,  it  checks 
hematuria ;  in  larger  doses  it  increases  the  disease. 

In  Bright's  disease,  after  the  acute  stage  has  passed,  but  a 
little  albumen  and  blood  still  remain  in  the  urine,  it  is  very 
useful  in  doses  of  1-3  min.  every  three  hours. 


Epistaxis,  cerebral  con- 
gestion, delirium,  and] 
tendency  to  coma,  or 
constant  wakefulness 
in  fever,  headache! 
giddiness,       tinnitus 


Haemoptysis ■ 

Intercostal  neuralgia  . . . . 


Rheumatic  gout 


"Sciatica 


(Headache,  giddiness, 
tinnitus  anrium,  oph- 
thalmia. 


Flying  blister,  or  sina- 
pism in'  pleurisy  or 
pneumonia. 

Dysmeriorrhcea,  spinal 
irritation,  leucorrhcea. 


Pig.  257.— Diagram,  like  Pig.  226.    Bock  view. 


_  In  cystitis,  especially  where  there  is  inability  to  retain  the 
urine,  and  also  in  ordinary  incontinence  of  urine,  it  is  useful ; 
though  in  both  cases  atropine  generally  acts  better. 

A  drop  of  tincture  three  times  a  day  will   often  relieve 
chordee. 


chap,  xxxix.]  ANIMAL  KINGDOM.  1095 

Precautions.  —  (1)  Do  not  use  the  blisters  on  debilitated 
persons,  and  children ;  or  do  not  keep  them  on  long,  but  just 
sufficient  to  start  the  blister,  and  then,  after  two  or  three  hours, 
put  on  a  poultice  to  make  the  blister  rise. 

(2)  Be  careful  of  its  use  both  externally  and  internally  in 
Bright's  disease. 

Class  ANNELIDA. 

B.P.  Hirudo.  The  Leech. — (1)  Sanguisuga  medicinalis,  the 
speckled  leech ;  (2)  S.  officinalis,  the  green  leech.  Collected  in 
Spain,  France,  Italy,  and  Hungary. 

Charaotees. — Body  elongated,  two  or  three  inches  long,  tapering  at  each 
end,  plano-convex,  wrinkled  transversely ;  back  olive-green  with  six  rusty-red 
longitudinaj  stripes.  (1)  Belly  greenish-yellow,  spotted  with  black ;  (2)  belly 
olive-green,  not  spotted. 

Action. — At  the  anterior  extremity  the  leech  has  a  sucking 
disc,  in  the  middle  of  which  is  a  triradiate  mouth  furnished  with 
sharp  teeth.  Fixing  itself  to  the  surface  by  its  disc,  it  saws 
through  the  skin  and  sucks  the  blood.  This  process  is  facilitated 
by  the  power  of  destroying  the  coagulability  of  the  blood  which 
the  secretion  from  the  pharynx  of  the  leech  possesses  (Haycraft). 
This  secretion  is  probably  the  cause  of  the  ecchymoses  which 
frequently  occur  at  the  bites  as  well  as  of  the  persistent  haemor- 
rhage they  sometimes  occasion. 

Uses. — Leeches  may  be  employed  as  a  substitute  for  general 
blood-letting  in  women  and  children.  They  are  more  generally 
employed  for  the  purpose  of  local  depletion  in  inflammation. 
The  irritation  occasioned  by  the  bites  has  probably  a  certain 
counter-irritant  action  (p.  341),  but  the  relief  they  afford  is 
chiefly  due  to  the  depletion.  They  are  useful  in  bruises,  frac- 
tures, inflamed  joints,  meningitis,  otitis,  ophthalmia,  persistent 
headache,  laryngitis,  pleurisy,  pneumonia,  pericarditis,  hepatitis, 
orchitis,  and,  haemorrhoids. 

Application. — Each  leech  draws  on  an  average  about  one 
and  a  half  fluid  drachm  of  blood.  By  applying  fomentations 
afterwards,  as  much  again,  or  even  more,  may  be  withdrawn. 
Care  should  be  taken  that  leeches  which  have  been  applied  to 
anyone  suffering  from  an  infective  disease  should  not  be  used 
again,  lest  they  convey  the  virus.  When  they  are  to  be  applied 
to  a  mucous  membrane,  such  as  the  tonsil,  they  should  be  put 
in  a  leech-glass.  This  is  a  small  syringe  large  enough  to  hold 
a  leech.  The  head  of  the  animal  is  introduced  first,  and  the 
body  gently  pushed  down  with  a  piston.  The  nozzle  of  the 
leech-glass  is  large  enough  to  allow  the  head  of.  the  animal  to 
protrude,  but  not  to  allow  the  body  to  follow. 

Leeches  may  be  applied  to  the  skin  by  simply  confining  them 
to  the  spot  with  a  pill-box ;  or  a  piece  of  blotting-paper,  with 


1096  ANIMAL  KINGDOM.  [sect.  vi. 

holes  in  it  at  the  points  where  we  wish  the  leeches  to  fix,  may  be 
laid  on  the  skin,  and  the  leeches  kept  over  this  by  a  wine-glass 
or  tumbler.  It  is  sometimes  difficult  to  make  leeches  bite.  The 
skin  should  be  carefully  washed,  and  thoroughly  dried  and 
warmed,  and,  if  necessary,  shaved.  The  room  should  be  well 
ventilated  and  free  from  tobacco-smoke,  and  from  the  fumes  of 
vinegar  or  disinfectants.  Leeches  should  be  dried  in  a  soft 
warm  cloth  and  then  applied.  If  a  single  one  is  to  be  used,  the 
body  may  simply  be  held  in  the  cloth,  and  the  head  allowed  to 
reach  the  skin.  A  slight  movement  of  withdrawal  being  now 
made,  the  leech  will  probably  fix.  Care  should  be  taken  not  to 
withdraw  it  so  strongly  as  to  tear  it  from  its  hold.  When  diffi- 
culty is  still  experienced  in  making  the  leeches  bite,  a  little 
warm  milk,  sweetened  with  sugar,  may  be  rubbed  over  the  skin, 
or  a  drop  of  blood  extracted  from  the  finger  by  a  needle  may  be 
used  for  the  same  purpose.  Usually  leeches  fall  off  when  they 
are  full,  but  if  they  do  not  they  can  be  detached  by  sprinkling 
salt  over  them.  If  it  is  desirable  to  encourage  the  bleeding, 
warm  fomentations,  poultices,  or  cupping-glasses  may  be  em- 
ployed. The  bleeding  may  be  stopped  by  applying  a  small 
piece  of  absorbent  cotton-wool,  or  of  lint  rolled  into  a  hard  cone 
and  fixed  over  the  bite  with  a  compress  and  bandage.  Cobwebs 
used  in  the  same  manner  are  very  efficacious.  If  these  are  in- 
sufficient, a  piece  of  absorbent  cotton-wool  dipped  in  strong  solu- 
tion of  perchloride  of  iron  and  dried,  or  the  styptic  collodion  of 
the  U.S.P.,  may  be  applied.  When  other  means  fail  a  pointed 
stick  of  nitrate  of  silver  may  be  pushed  into  the  bite,  or  the  bite 
may  be  transfixed  with  a  needle  and  a  silk  thread  passed  in  a 
figure-of-8  around  it.  If  possible,  leeches  should  not  be  applied 
at  night,  especially  to  feeble  individuals  or  children,  unless  the 
patients  are  carefully  watched,  as,  if  haemorrhage  from  the  bite 
should  occur,  it  might  not  be  noticed  until  much  blood  had  been 
lost.  Leeches  should  not  be  applied  over  loose  cellular  tissues 
where  pressure  cannot  be  applied.  In  inflammation  of  the  eyes 
they  should  be  applied  to  the  temples,  and  not  to  the  eyelids  ; 
and  in  inflammation  of  the  testicles  to  the  perineum,  and  not  to 
the  scrotum.  As  the  marks  of  the  bites  are  permanent,  care 
should  be  taken  to  apply  leeches,  if  possible,  where  the  marks 
will  not  appear.  Thus,  in  applying  them  to  the  temples  the  hair 
may  be  shaved  off  a  spot  and  the  leeches  applied.  When  the 
hair  grows  the  marks  will  be  hidden.  In  applying  them  to  the 
chest  in  girls  they  should,  if  possible,  be  placed  so  low  down  that 
the  marks  will  not  be  seen  when  evening  dress  is  worn. 

If  leeches  should  get  into  any  mucous  cavity — nose,  stomach, 
or  rectum — they  may  be  dislodged  by  the  injection  of  strong 
brine. 


APPENDIX. 


Methylal.  Methylbnedimethyl  Ether.  CH2(OCH3)2.  Not 
officinal. 

Characters. — A  mobile,  colourless,  volatile  liquid,  boiling  at 
42°  C. ;  sp.  gr.  0-8551.  Odour  like  chloroform  and  acetic  ether, 
with  a  burning  aromatic  taste. 

Pkepaeation. — By  distilling  methyl  alcohol  with  an  oxidising  mixture  of 
dioxide  of  manganese  and  sulphuric  acid,  and  adding  potash  to  the  distillate 
to  separate  methyl  formate. 

Dose. — 1  gramme  (15  gr.). 

Action  and  Use. — It  is  a  local  anaesthetic.  It  produces  in  dogs 
anaesthesia,  followed  by  deep  sleep.  It  is  rapidly  eliminated,  and 
is  said  not  to  produce  any  bad  after-effects.  It  is  recommended 
as  a  local  anaesthetic  to  the  skin,  and  as  an  analgesic  to  the 
stomach ;  but  as  yet  it  has  not  been  much  employed. 

Urethane.     Ethyl  Carbamate.    Not  officinal. 

Urethane  is  a  general  term  for  the  ethereal  salts  of  carbamic 
acid ;  but  ethyl  carbamate  is  the  most  important  of  them,  so  it 
is  usually  called  par  excellence  urethane,  just  as  ethylic  ether  is 
usually  called  simply  ether. 

0— 

Carbamic  acid,  C0.NH2.0H,  or  — C — 0— H,  is  not  known  in 

NH2 
the  free  state.    Its  ammonium  salt  forms  an  important  con- 
stituent of  the  officinal  ammonium  carbonate.     The  general 

0— 

formula  for  the  salts  of  carbamic  acid  is  — C — 0 — B' •  and  of 

NH2 
0— 

ethyl  carbamate,  (urethane)  —  C— 0— (^H^).      Ammonium 

NHa 


1098  APPENDIX. 

0— 

carbamate  is  — C — 0 — (^NH4~~\  and  its  relationship,  as  well  as 


NH2 
that  of  urethanes,  to  urea  is  seen  by  referring  to  its  rational 
0— 

formula,— C—NH2  (see  p.  636). 

i 

NH2 

Preparation. — From  commercial  ethyl  chlorocarbonate,  by  adding  solu- 
tion of  ammonia,  which  converts  it  into  ethyl  carbamate  (urethane).  This 
is  removed  by  ether,  which,  with  the  water,  is  then  distilled  off.  The  ure- 
thane which  remains  is  purified  by  distilling,  and  then  dried  over  sulphuric 
acid. 

Dose. — 4-8  gr.,  repeated  ;  or  15-30  gr.,  or  more,  in  one  dose. 

Action. — The  value  of  this  drug  and,  though  to  a  less  extent, 
of  other  urethanes  as  a  hypnotic  was  discovered  by  Schmiedeberg, 
from  the  consideration  that  the  alcohol  radical  in  it  ought  to 
exert  a  sedative  or  paralysing  action  on  the  cerebrum  (p.  764) ; 
while  the  amidogen  in  it  ought  to  have  a  somewhat  stimulating 
action  on  the  medulla  and  cord  (p.  602).  It  ought,  therefore,  to 
have  a  soporific  action,  like  chloral,  and  yet  be  free  from  the 
danger  of  paralysing  the  respiratory  centre  or  heart. 

In  frogs,  doses  of  20  to  30  milligrammes  cause  a  condition 
in  which  the  animals  are  very  readily  hypnotised  without  affect- 
ing the  respiration  or  co-ordination  of  movement.  Larger  doses 
diminish  voluntary  motion  without  affecting  reflex  excitability, 
which  is,  however,  paralysed  by  still  larger  doses. 

In  warm-blooded  animals,  the  same  symptoms  are  produced; 
and  may  be  ascribed  to  a  blunting  of  the  functions  of  the  cere- 
bral hemispheres,  diminution  of  voluntary  motion,  and  of  the 
perception  of  sensory  stimuli,  ending  in  deep  narcosis.  In  dogs, 
urethane  causes  a  staggering  gait,  and,  in  large  doses,  vomiting. 
Urethane  stimulates  the  respiration  and,  unlike  chloral,  does  not 
diminish  the  blood-pressure  or  affect  the  heart.1 

Uses. — Urethane  is  a  pure  hypnotic,  and  may  be  used 
instead  of  bromide  of  potassium  and  chloral  in  those  cases  in 
which,  from  overwork,  worry  or  other  cause,  there  is  an  inability 
to  sleep  (p.  199).  Urethane  produces  the  necessary  tranquillity 
conducive  to  normal  sleep.  It  is  best  given  in  small  doses 
frequently  repeated  (4  gr.),  as  vomiting  may  occur  from  large 
doses.  It  has  the  advantage  over  chloral  of  not  affecting  the 
circulation  and  stimulating,  instead  of  depressing,  the  respira- 
tion.   It  may  be  given  in  cases  of  heart-disease  and  of  Bright's 

1  Schmiedeberg,  Pract.,  vol.  sxsv.,  p.  275. 


APPENDIX.  1099 

disease.  When  the  tension  is  high,  however,  it  may  he  less 
active  than  chloral,  as  it  does  not  lessen  the  tension  like  chloral, 
and  thus  does  not  reduce  the  flow  of  blood  through  the  brain. 
It  is  an  antidote  to  strychnine. 

Iodol 


.     Teteaiodpyeeol. 

C4I4NH.     Not  officinal. 

Pyrrol. 

.H 

Iodol. 
I 

H_(|=C/NH 
H— C=C 

I- .0=0 

H  I 

Chaeactees. — Light  brown  tasteless  crystalline  powder,  with 
a  faint  smell  somewhat  like  thymol. 

Solubility. — Insoluble  in  water,  soluble  in  3  parts  of  alcohol,  readily 
soluble  in  ether  and  chloroform,  sparingly  soluble  in  oils  by  means  of  warmth. 
Glycerine  may  be  added  to  the  alcoholic  solution  without  causing  a  pre- 
cipitate. 

Action. — Like  iodoform  (p.  805) .  It  may  be  given  internally, 
in  doses  of  3  grains  daily,  without  causing  any  irritation  of  the 
intestinal  canal. 

Use. — It  is  useful  as  a  dressing  in  venereal  sores,  adenitis 
and  periadenitis.  It  may  be  applied  as  a  powder,  sprinkled  over 
the  surface  of  the  sore,  or  suspended  in  glycerine,  dissolved  in 
spirit,  or  as  an  ointment. 

Strophanthus  hispidus.  [KomM,  Inee.]  Not  officinal. 
A  plant  belonging  to  the  natural  order  Apocynacece,  and  the 
seeds  of  which  are  used  in  Africa  as  an  arrow-poison. 

Description. — The  ripe  follicles  are  9  to  12  inches  long  and  enclose  100 
to  200  seeds,  which  contain  the  greatest  proportion  of  the  active  principle. 
The  seeds  are  oval,  and  are  readily  recognised  by  their  comose  appendages. 

Composition. — The  active  principle  is  strophanthin,  of  which 
the  seeds  contain  from  8  to  10  per  cent.  It  is  a  crystalline 
glucoside,  with  a  strongly  bitter  taste  and  a  slightly  acid  reaction ; 
readily  soluble  in  water  and  rectified  spirit,  practically  insoluble 
in  ether,  chloroform,  benzene,  and  petroleum  spirit.  It  yields, 
on  heating  with  sulphuric  acid,  glucose  and  an  insoluble  body, 
strophanthidin. 

Pbepaeations. 

DOSE. 

Tinctura  Strophanthi  (1  in  20  ') 5-10  rain,  or  |  to  2  rain,  frequently  repeated. 

Strophanthin jig-Jg  gr.  hypodermically. 

1  A  stronger  tincture,  1  in  8,  corresponding  to  the  tincture  of  digitalis,  has  been 
chiefly  used  hitherto ;  but  a  tincture  1  in  20  is  recommended  by  Fraser,  and  a 
formula  for  preparing  it  is  given  by  him  in  the  British  Medical  Journal,  Jan.  22, 
1887,  p.  151. 


1100  APPENDIX. 

Action  and  Uses. — Strophanthin,  according  to  Fraser,  is  a 
muscle-poison,  increasing  primarily  the  contractile  power  of  all 
striated  muscles  ;  the  contraction  becoming  more  complete  and 
prolonged.  It  is  a  cardiac  tonic  (p.  331),  increasing  the  length 
of  the  systole,  and  slowing  the  rhythm,  acting  like  digitalis  and 
producing  a  similar  standstill  in  systole.  Its' action  on  the  heart 
is  much  more  powerful  than  that  of  digitalis.  Strophanthus 
causes  a  rise  of  blood-pressure,  due  chiefly  to  the  heart,  since  it 
does  not  produce  so  marked  a  contraction  of  arterioles  as  digi- 
talis. In  the  normal  animal  it  is  sometimes  diuretic  (p.  432) 
and  antipyretic.  Strophanthus  has  been  used  as  a  tincture  in 
cases  of  cardiac  disease  similar  to  those  in  which  digitalis  is 
serviceable.  It  is  most  beneficial  in  cases  of  mitral  disease  with 
great  anasarca,  in  which  it  reduces  the  frequency  of  the  pulse  and 
makes  it  regular,  while  producing  great  diuresis.  Strophanthin, 
hypodermically,  acts  in  a  similar  manner.  Strophanthus  is  said 
not  to  cause  great  sickness  or  gastro-intestinal  irritation,  and 
to  have  no  cumulative  effect.  The  exact  utility  of  the  drug 
has,  however,  not  yet  been  determined,  as  it  has  not  been  suffi- 
ciently tried  in  cases  of  heart-disease. 

Dead  Space. — This  name  has  been  given  by  0.  Liebreich  to 
the  part  of  a  fluid  in  which  no  reaction  occurs  between  sub- 
stances dissolved  in  it.  Chloral  hydrate  and  sodium  carbonate 
in  solution  decompose  each  other,  chloroform  and  sodium  formate 


Surface  of  liquid. 
Dead  space. 


Space  of  reaction. 


Pig.  228.— Diagram  showing  the  dead  space  and  space  of  reaction  in  a  mixture  of  solutions  of 
chloral  hydrate  and  sodium  carbonate. 

being  produced,  but  this  reaction  does  not  occur  equally  through- 
out the  whole  solution.  If  the  solution  be  mixed  in  a  test-tube 
the  fluid  will  be  seen  to  become  milky,  from  the  formation  of 
minute  globules  of  chloroform;  but  just  below  the  surface  of 
the  fluid  this  reaction  does  not  occur,  and  a  clear  space  is  ob- 
'served,  a  section  of  which  has  a  bi-concave  formation,  as  it  is 
bounded  above  by  the  concave  level  of  the  fluid  and  below  by  the 
convex  surface  of  that  part  of  the  liquid  in  which  no  action 
occurs. 

If  the  mixture  fs  placed  in  horizontal  capillary  .tubes,  the 


APPENDIX.  1101 

dead  space  in  which  no  reaction  occurs  is  at  each  end  of  the 
liquid ;  if  the  entire  length  of  the  column  of  liquid  in  the  tube  is 
shorter  than  the  combined  length  of  the  two  dead  spaces  no 
reaction  occurs  at  all.  This  absence  of  reaction  renders  it 
probable  that  the  chemical  processes  which  occur  in  the  confined 
space  of  a  living  cell  may  be  very  different  from  those  in  an 
ordinary  test-tube,  on  account  of  the  difference  in  physical  con- 
ditions as  well  as  from  the  complex  phenomena  which  we  are 

Space  ot 
Dead  space,    reaction.    Dead  space. 


Fig.  229.— Diagram  showing  the  two  dead  spaces  in  a  capillary  tube, 


accustomed  to  class  as  vital.  The  same  absence  of  reaction  in 
certain  parts  of  a  liquid  can  be  observed  with  other  mixtures, 
and  a  convenient  one  for  demonstration  is  a  mixture  of  iodic 
acid,  sulphurous  acid,  and  starcb.  When  these  substances  are 
mixed,  iodine  is  set  free,  and  an  intense  blue  colour  produced. 
If  they  are  mixed  in  a  large  beaker  the  reaction  occurs  more 
quickly  than  if  they  are  contained  in  a  narrow  glass  tube.  In  a 
tube  also  it  can  be  seen  that  the  reaction  begins  in  the  centre,  so 

Column  of  fluid  without  reaction. 


Fia.  230. — Diagram  showing  the  absence  of  reaction  in  a  capillary  tube  where  the  column  of  liquid 
is  shorter  than  the  length  of  the  two  dead  spaces  in  a  tube  of  that  size. 

that  occasionally  one  may  notice  a  blue  thread  occupying  the 
centre  of  the  liquid,  while  that  part  of  it  which  lies  adjacent 
to  the  walls  of  the  tube  is  still  colourless.  When  a  series  of 
vesicles  made  of  membranes  such  as  calves'  peritoneum  are  filled 
with  the  mixture  just  mentioned,  it  can  be  seen  that  the  reaction 
occurs  quicker  in  the  larger  spheres,  and  that  it  generally 
begins  in  the  centre  of  the  fluid.  When  one  vesicle  is  contracted 
in  the  centre  by  a  ligature,  so  as  to  form  two  smaller  vesicles 
connected  with  each  other,  two  centres  of  reaction  may  be 
frequently  observed  instead  of  one.  Although  this  discovery  has 
not  yet  been  fully  worked  out,  it  promises  to  have  a  most 
important  bearing  on  our  ideas  regarding  the  action  of  drugs  in 
living  tissues. 


ADDITIONS   MADE   IN   1890 

TO   THE 

BEITISH   PHAEMACOPCEIA  OF  1885. 


A  complete  alphabetical  list  of  them  is  given  at  p.  li.  Although 
the  medicinal  substances  contained  in  the  British  Pharmacopoeia 
of  1885  are  considered  in  the  body  of  this  Pharmacology  under 
the  natural  divisions  of  the  mineral,  vegetable,  and  ariimal 
kingdoms  to  which  they  belong,  it  is,  I  think,  easier  to  remember 
the  additions  by  grouping  them  together  according  to  their  uses. 

Laxatives,  Cholagogues,  and  Rectal  Sedatives. 

By  far  the  most  numerous  additions  are  simple  laxatives, 
and  with  these  we  may  associate  cholagogues  and  remedies  foi 
the  treatment  of  piles  and  painful  conditions  of  the  rectum. 

Laxatives. 

Trochisci  Sulphuris. 

Pulvis  Sodse  TartaratsB  Effervescens. 

Sodii  Phosphas  Effervescens. 

Sodii  Sulphas  Effervescens. 

Magnesii  Sulphas  Effervescens. 

Mistura  Olei  Bicini. 

Suppositoria  Glycerini  (gelatine  basis). 

Cholagogues. 

Euonymi  Cortex. 
Extraetum  Euonymi  Siccum. 
Hydrastis  Ehizoma. 

Extraetum  Hydrastis  Liquidum. 

Tinctura  Hydrastis. 


[1104]  ADDITIONS  MADE  IN  1890  TO  THE 


Remedies  for  Piles. 

Hamamelidis  Cortex. 

Tinctura  Hamamelidis. 
Hamamelidis  Folia. 

Extraetum  Hamamelidis  Liquidum. 
Unguentum  Hamamelidis. 

Rectal  Sedative. 

Unguentum  Conii. 

Laxatives. 

Trochisci  Sulphwis.  Sulphue  Lozenges.  Each  lozenge  contains 
Precipitated  Sulphur,  5  grs. ;  Acid  Tartrate  of  Potassium,  1  gr. ;  Befined 
Sugar,  in  powder,  8  grs. ;  Gurn  Acacia,  in  powder,  1  gr. ;  Tincture  of  Orange 
Peel,  1  ll\ ;  Mucilage  of  Acacia,  1  li\. 

Dose. — 1  to  6  lozenges  (generally  given  at  night). 

Uses. — See  pp.  546  and  547.  These  lozenges,  introduced  by 
Sir  Alfred  Garrod,  are  not  only  useful  as  a  laxative  in  cases  of 
habitual  tendency  to  constipation,  but  are  alterative  in  rheumatic 
and  gouty  patients. 

The  advantages  of  effervescing  preparations  are  that  they  are 
less  nauseous,  pleasanter  to  take,  and  less  heavy  on  the  stomach 
than  simple  solutions  of  the  purgative  salts. 

The  effervescent  quality  is  given  by  the  liberation  of  carbonic 
acid  from  bicarbonate  of  sodium  by  tartaric  or  citric  acid.  In 
Seidlitz  powder  tartaric  acid  only  is  used  for  this  purpose,  but  in 
the  other  three  effervescent  preparations  a  mixture  of  tartaric 
and  citric  acids  is  employed.  Eeaction  between  the  bicarbonate 
and  acid  is  prevented  in  Seidlitz  powders  by  keeping  them  apart 
until  required. 

Pulvis  Sodse  Tartaratae  Effervescens.  Effervescent  Tartarated 
Soda  Powder  (Seidlitz  Powder).  Tartarated  Soda,  in  dry  powder,  120  grs.; 
Bicarbonate  of  Sodium,  in  dry  powder,  40  grs.  Mix,  and  wrap  in  blue  paper. 
Tartaric  Acid,  in  dry  powder,  38  grs.     Wrap  in  white  paper. 

Dose. — The  former  powder,  dissolved  in  nearly  half  a  pint  of  cold  or 
warm  water,  and  the  latter  powder  then  added. 

Action  and  Uses. — See  pp.  624  and  394. 

In  the  next  three  preparations  reaction  between  the  bicar- 
bonate and  acid  is  prevented  by  mixing  them  dry  and  keeping 
them  in  well-closed  bottles  so  as  to  prevent  the  access  of  moisture, 
for  no  reaction  will  occur  unless  a  certain  amount  of  water  is 
present. 

The  water  of  crystallisation  is  first  driven  off  from  the  crystals 


BRITISH  PHAEMACOP(EIA  OF   1885.  [1105] 

of  the  purgative  salt,  and  it  is  then  mixed  with  the  powdered 
bicarbonate  and  acid  in  a  pan  at  200°  to  220°  F.  until  the 
powder  becomes  granular,  and  then  the  granules  of  proper  size 
are  separated  by  sieves  and  bottled. 

Magnesii  Sulphas  Effervescens.  EFFEEVESCENT  SULPHATE  OF  MAGNE- 
JITJM.  Synonyms.— Magnesias  Sulphas  Effervescens  ;  Effervescent  Sulphate 
of  Magnesia;  Effervescent  Epsom  Salt.  Sulphate  of  Magnesium,  100; 
Bicarbonate  of  Sodium,  72 ;  Tartaric  Acid,  38 ;  Citric  Acid,  25 ;  Eefined 
Sugar,  21.     The  final  product  should  weigh  about  200. 

Dose. — \  to  1  ounce. 

Uses.— See  pp.  659,  391,  685,  and  689. 

Soda  Pbospbas  Effervescens.  Effervescent  Phosphate  of  Sodium. 
Synonyms.— Sods  Phosphas  Effervescens ;  Effervescent  Phosphate  of  Soda. 
Phosphate  of  Sodium,  100 ;  Bicarbonate  of  Sodium,  100 ;  Tartaric  Acid,  54 ; 
Citric  Acid,  36.    The  final  product  should  weigh  about  200. 

Dose. — 5  to  £  ounce. 

Uses.— See  pp.  626,  403,  and  405. 

Sodll  Sulphas  Effervescens.  Effervescent  Sulphate  of  Sodium. 
Synonyms. — Sodae  Sulphas  Effervescens;  Effervescent  Sulphate  of  Soda. 
.Sulphate  of  Sodium,  100 ;  Bicarbonate  of  Sodium,  100  ;  Tartaric  Acid,  54 ; 
Citric  Acid,  36.     The  final  product  should  weigh  about  200. 

Dose. — ^  to  £  ounce. 

Uses.— See  pp.  625  and  405. 

The  next  preparation  is  designed  to  render  that  valuable 
medicine,  castor  oil,  less  nauseous  and  repulsive  to  patients. 

Mistura  Olei  Rlclni.  Castor  Oil  Mixture.  Castor  Oil,  180 ;  Oil  of 
Lemon,  5 ;  Oil  of  Cloves,  1 ;  Syrup,  45 ;  Solution  of  Potash,  30 ;  Orange 
Flower  Water,  q.s.  to  produce  480. 

First,  mix  in  a  mortar  the  oils,  then  £  of  the  potash,  next  the  syrup, 
then  another  J  of  the  potash,  then  £  the  water,  the  rest  of  the  potash,  and, 
lastly,  the  water  up  to  the  required  volume.  Each  ounce  contains  3  fl. 
drachms  of  castor  oil. 

Dose. — £  to  2  fluid  ounces. 

Uses. — See  p.  1025.  It  may  be  used  in  doses  of  30  to  60 
mimims  in  chronic  diarrhoea  and  dysentery,  or  even  as  a  laxa- 
tive on  rising  (p.  1025). 

The  next  laxative  preparation  is  one  of  an  entirely  different 
kind  from  the  preceding.  The  others  cause  an  evacuation  by 
acting  on  the  whole  intestine  (p.  388),  but  glycerine  suppositories 
act  only  on  the  rectum.  Their  introduction  depends  on  the  fact 
that  while  faecal  matters  or  food  in  the  descending  colon  or 
sigmoid  flexure  do  not  excite  a  desire  to  evacuate  the  bowels,  this 
desire  occurs  when  the  rectum  is  distended  or  irritated.# 

The  normal  stimulus  to  the  rectum  is  supplied  by  the  descent 
of  fs&eal  matter  into  it;  but  in  the  absence  of  this  it  can  be 
stimulated  either  by  distension  by  enemata  or  irritation  by  drugs. 

[4  Aj 


[1106J  ADDITIONS  MADE   IN   1890  TO   THE 

This  has  been  long  known  to  nurses,  and  soap  suppositories  are 
commonly  used  for  infants  (p.  967). 

In  1887  Vamossy  discovered  that  injections  of  1  or  2  fluid 
drachms  of  glycerine  into  the  rectum  have  a  similar  action,  and 
in  a  few  minutes  bring  on  in  adults  a  desire  to  evacuate  the 
bowels.  Glycerine  is  now  very  extensively  used  as  a  laxative, 
small  syringes  made  specially  for  the  purpose,  and  holding  1  or 
2  fluid  drachms,  being  employed.  It  has  the  advantage  over 
ordinary  purgatives  that  it  acts  in  a  few  minutes,  so  that  if  a 
patient  on  trying  to  obtain  a  movement  finds  that  he  is  consti- 
pated, he  simply  uses  an  injection  of  glycerine  instead  of  having 
to  wait  hours  before  an  ordinary  purgative  taken  by  the  mouth 
will  act. 

In  place  of  injecting  pure  glycerine,  a  suppository  containing 
it  may  be  used,  and  as  some  persons  require  more  and  some  less, 
the  suppositories  of  the  Pharmacopoeia  are  made  in  different 
sizes.     In  order  to  make  them  gelatine  has  been  introduced. 

Geiatinum.  Gblatine.  The  air-dried  product  of  trie  action  of  boiling 
water  on  gelatigenous  animal  tissues,  such  as  skin,  tendons,  ligaments,  and 
bones. 

Characters. — In  translucent  sheets  or  shreds.  The  solution  in  hot  water 
is  colourless  and  inodorous,  and  solidifies  to  a  jelly  on  cooling.  Gelatine  is 
insoluble  in  alcohol  and  ether.  It  dissolves  in  acetic  acid.  Its  aqueous  solu- 
tion is  not  precipitated  by  diluted  acids,  alum,  acetate  of  lead,  or  perchloride 
of  iron  ;  it  is  precipitated  by  tannin. 

Uses.— See  p.  1086.  It  is  introduced  into  the  '  Additions '  in 
order  to  make  glycerine  suppositories. 

Suppositoria  Glycerinl.  Glycerine  SUPPOSITORIES.  Gelatine  cut 
small,  £  ounce  ;  Glycerine,  by  weight,  2J  ounces  ;  Distilled  Water,  q.s. 

Soften  the  gelatine  with  water,  then  add  the  glycerine.  Dissolve  over  a 
water-bath,  and  evaporate  until  the  mixture  weighs  1560  grains.  Pour  the 
product  into  suppository  moulds  holding  thirty,  sixty,  or  one  hundred  and 
twenty  grain-measures,  or  having  other  capacities,  as  required.  Each  sup- 
pository contains  seventy  per  cent,  by  weight  of  glycerine. 

Cholagogues. 

We  have  two  cholagogues  in  the  '  Additions,'  euonymus 
(p.  894)  and  hydrastis  (p.  838),  both  of  which  are  officinal  in  the 
United  States  Pharmacopoeia,  and  have  therefore  been  noticed 
in  this  book. 

'  Euonymi  cortex.  Euonymus  Bark.  The  dried  root  bark  of  Euonymus 
atropurpureus. 

Characters. — See  p.  894. 

Preparation. — Extractum  Euonymi  8iccum. 

Extractum  Euonymi  siccum.  Dry  Extract  of  Euonymus  (com- 
monly known  as  '  Euonymin ').  This  is  a  new  form  of  extract.  It  is  pre- 
pared by  exhausting  the  powdered  bark  with  diluted  spirit,  mixing  with  milk 
sugar,  and  evaporating  to  dryness. 

Dose. — 1  to  4  grains. 


BRITISH  PHARMACOPEIA  OF  1885.  [1107] 

Action  and  Uses.— See  p.  894.  In  large  doses  euonymin  is 
said  to  be  a  cardiac  poison. 

mi.  H/?rastis  Rhlzoma.     Hydrastis  Ehizome.     Synonym.— Golden  Seal. 
The  dried  rhizome  and  rootlets  of  Hydrastis  canadensis. 

Characters.— See  p.  839.  In  the  '  Additions  '  they  are  somewhat  diffe- 
rently given. 

Preparations. 
Extraetum  Hydrastis  Liquidum,  1  part  in  1  fluid  part.    Dose.— 5-30  17\.. 
Tinctura  Hydrastis,  1  part  in  10  fluid  parts.    Dose.— 20  111.-1  fl.  drachm. 

_  Action.— Berberine  (p.  838)  is  by  no  means  a  powerful 
poison  in  man,  as  much  as  twenty  grains  having  been  taken 
with  nothing  more  than  a  laxative  action.  In  animals  it  in- 
creases intestinal  peristalsis,  first  stimulates  and  then  paralyses 
the_  spinal  cord  and  bulb,  producing  trembling,  quickened  respi- 
ration, raised  blood-pressure,  and  slower  pulse,  followed  by 
paralysis  of  the  hind  legs,  slow  respiration,  low  blood-pressure, 
quick  pulse,  dyspnoea,  convulsions  and  death.  During  its  excre- 
tion it  irritates  the  kidneys  and  produces  albuminuria  (compare 
Colocynth,  p.  928). 

Hydrastine  has  some  action  as  a  local  anasthetic.  In  frogs 
it  produces  stiffness,  hypersesthesia,  paralysis,  loss  of  sensation 
(by  acting  on  the  cord  and  sensory  nerves),  convulsions  and 
diastolic  arrest  of  the  heart. 

In  mammals  it  stimulates  the  spinal  cord  and  bulb,  and 
afterwards  depresses  them. 

Hydrastis  and  its  active  principles  have  a  powerful  ecbolic 
action. 

Uses. — See  p.  839.  It  is  said  to  be  especially  useful  in 
catarrh  of  the  mucous  membranes  of  the  nose,  stomach,  intes- 
tines, bile  ducts,  urethra,  uterus,  and  vagina.  Bartholow  recom- 
mends it  as  one  of  the  best  remedies  for  gastric  catarrh  due  to 
chronic  alcoholism,  and  in  sufficient  doses  as  a  substitute  for  the 
alcoholic  stimulant.  Five  to  fifteen  minims  of  either  extract  or 
tincture  before  meals  are  said  by  him  to  remove  chronic  gastric 
catarrh  and  the  headache  which  often  accompanies  it.  It  is  also 
very  useful  in  duodenal  catarrh,  jaundice,  and  chronic  intestinal 
catarrh.  In  dysmenorrhcea,  menorrhagia,  and  hemorrhage  frpm 
uterine  fibroids  it  seems  to  be  very  useful. 

The  fluid  extract  is  beneficial  as  a  local  application  to  folli- 
cular pharyngitis,  chronic  nasal  or  pharyngeal  catarrh,  gonor- 
rhoea, uterine  or  vaginal  leucorrhcea,  ulceration  of  the  cervix 
uteri,  rectal  ulceration  or  hemorrhage,  and  fissure  of  the  anus. 

Rectal  Astringents  and  Sedatives. 

Proprietary  preparations  of  hamamelis,  under  the  name  of 
Pond's  extract  and  hazeline,  have  been  much  used  for  several 
years  in  the  treatment  of  piles,  and  liquid  extract  of  hamamelis 

[4"A21 


[1108]  ADDITIONS  MADE  IN  1890  TO  THE 

is  contained  in  the  U.  S.  P.  (see  p.  1029).  This  is  made  from 
the  leaves,  and  the  '  Additions '  contain  not  only  the  leaves  and 
liquid  extract,  but  also  the  bark,  a  tincture  from  it,  and  an 
ointment. 

Hamamelidis  Cortex.  Hamamelis  Bark.  Synonym. — Witch  Hazel 
Bark.     The  dried  bark  of  Hamamelis  virginica. 

Characters. — In  quills  or  slightly  curved  pieces  from  two  to  six  or  eight 
inches  long  and  about  one-tenth  of  an  inch  in  thickness,  covered  with  a 
silvery-grey  or  whitish  easily  detached  scaly  outer  bark  marked  with  lenticels. 
Internally,  cinnamon-brown  or  brownish-red  and  finely  striated  longitu- 
,  dinally ;  transverse  fracture  coarsely  fibrous ;  tough ;  taste  slightly  astrin- 
gent ;  no  strongly  marked  odour. 

Preparation. 
Tinctura  Hamamelidis,  1  part  in  10  fluid  parts.    Dose. — 5-60  tit. 

Hamamelidis  Folia.     Hamamelis  Leaves.     Synonym. — Witch  Hazel 

,  Leaves.    The  dried  leaves  of  Hamamelis  virginica. 

Characters. — See  p.  1029.    They  are  said  to  have  a  slight  tea-like  odour. 

Preparation. 
Extractum  Hamamelidis  Liquidum,  1  part  in  1  fluid  part. 

irnguentum  Hamamelidis.  Ointment  of  Hamamelis.  Liquid  Extract 
of  Hamamelis,  1 ;  Simple  Ointment,  9. 

Uses. — See  p.  1029.  In  place  of  introducing  a  pledget  of; 
cotton  wool  soaked  in  a  preparation  of  hamamelis^  the  liquid 
extract,  tincture,  or  one  of  the  proprietary  preparations  already 
mentioned  may  be  injected  with  a  small  glycerine-syringe  in 
cases  of  internal  piles.  The  proprietary  preparations  appear  to , 
me  to  cause  less  local  irritation  than  those  of  the  '  Additions.' ! 
In  cases  of  external  piles  the  hamamelis  is  best  applied  by  means 
of  absorbent  wool,  which  is  superior  to  cotton  wool,  inasmuch  as 
it  forms  a  kind  of  felt,  and  will  remain  in  place  between  the 
folds  of  the  nates  for  several  hours,  while  cotton  wool  soon  falls 
away  from  its  position.  The  preparations  may  be  diluted  with 
water  if  too  irritating,  but  are,  I  think,  best  used  undiluted. 
They  not  only  lessen  hemorrhage,  but  relieve  dragging  pain  and 
discomfort  when  the  piles  do  not  bleed.  They  may  be  injected 
in  larger  quantities  in  cases  where  there  is  congestion  of  the 
upper  part  of  the  rectum  at  its  junction  with  the  sigmoid  flexure. 

The  ointment  may  be  used  for  either  external  or  internal 
piles,  or  for  rectal  congestion. 

Unguentum  Conll.  Ointment  of  Hemlock.  Juice  of  Hemlock,  2  fl. 
oz. ;  Hydrous  Wool  Pat,  f  oz. ;  Boric  Acid,  in  fine  powder,  10  grs. 

Evaporate  the  juice  to  two  fluid  drachms  at  a  temperature  not  exceeding 
140°  F.  (60°  C.) ;  add  the  boric  acid  and  the  hydrous  wool  fat,  and  mix 
thoroughly. 

Uses. — See  p.  932.  It  lessens  the  itching  in  pruritus  ani, 
and  when  introduced  into  the  rectum  it  eases  the  pain  in  cancer 
and  other  painful  conditions  of  the  bowel. 


BEITISH  PHARMACOPEIA  OF  1885.  [1109] 

Remedies  of  the  Aromatic  Series. 

Sodii  Benzoas 

IPhenazonum  (antipyrine). 
Acetanilide  (antifebrin). 
Phenacetin. 
Glusidum  (saccharin). 

Next  in  number  to  the  laxatives  come  bodies  belonging  to  the 
aromatic  series  (p.  807).  With  the  exception  of  benzoate  of 
sodium,  these  are  prepared  synthetically,  and  three  of  them, 
phenazone  (antipyrine),  acetanilide  (antifebrin),  and  phenacetin, 
are  not  only  the  most  valuable  antipyretics  we  possess,  but  they 
have  an  extraordinary  power  to  relieve  pain.  They  have  thus 
to  a  considerable  extent  replaced  quinine  as  antipyretics,  and 
morphine  as  analgesics.  Their  introduction  into  the  'Additions ' 
goes  far  to  justify  the  prediction  which  I  ventured  to  make  at 
p.  757,  that  organic  compounds  artificially  prepared  will  '  in  the 
future  probably  replace  to  a  great  extent,  and  perhaps  entirely, 
the  Vegetable  Materia  Medica.' 

Sodii  Benzoas.  Benzoate  of  Sodium.  NaC7H502.  Synonyms. — Sodae 
Benzoas ;  Benzoate  of  Soda.  This  salt  may  be  obtained  by  neutralising 
benzoic  aeid  with  solution  of  carbonate  of  sodium  and  evaporating  to  dryness. 

Characters  and  Tests. — A  white  obscurely  crystalline  or  amorphous 
powder,  inodorous  or  having  a  faint  benzoic  odour,  of  a  sweetish  alkaline 
taste,  and  a  faint  alkaline  reaction.  Very  soluble  in  water ;  soluble  in 
twenty-four  fluid  parts  of  rectified  spirit,  and  in  twelve  of  boiling  rectified 
spirit.  An  aqueous  solution  gives  a  yellowish  or  flesh-coloured  precipitate 
when  mixed  with  solution  of  persulphate  of  iron. 

Dose. — 10  to  30  grains. 

Uses. — Sodium  benzoate  is  an  hepatic  stimulant  (p.  403),  and 
being  antiseptic  (pp.  78  and  964)  and  at  the  same  time  very 
slightly  poisonous  may  be  used  in  a  5  or  10  per  cent,  solution  as  a 
spray  for  the  purpose  of  destroying  the  disease  germs  and  relieving 
the  symptoms  in  tonsillitis,  sore  throat  of  scarlet  feyer,  diphtheria, 
whooping-cough,  and  phthisis.  It  may  be  also  given  internally 
in  these  diseases.  In  rheumatic  fever  it  lowers  the  temperature 
and  lessens  pain  in  much  the  same  way  as  salicylate  of  sodium,  and 
may  also  cause  symptoms  of  intoxication,  drowsiness,  delirium, 
profuse  sweating,  and  even  collapse  in  large  doses  (2^-4  drachms 
per  diem).  Its-  administration  in  ulcerative  endocarditis  is 
sometimes,  though  unfortunately  not  always,  followed  by  marked 
improvement  in  the  patient's  condition.  It  has  been  given  in 
urasmia  with  good  effect. 

The  power  of  reducing  temperature  and  relieving  pain,  which 
bodies  belonging  to  the  aromatic  series  of  carbon  compound's 
very  generally  possess,  is  well  marked  in  salicylic  acid  and  sali- 
cylate of  sodium,  which  not  only  reduce  temperature  but  relieve 
headache  (p.  629)  and  the  pains  of  rheumatism.   Both  properties 


;illO]  ADDITIONS   MADE   IN   1890  TO   THE 

appear  to  become  considerably  greater  in  compounds,  where  the 
benzene  nucleus  (p.  807)  is  linked  with  nitrogen,  as  in  acetanilide, 
phenacetin,  and  phenazone. 

Acetanilldum.  Acetanilide.  C8H9NO.  Synonym. — Phenyl-acetamide, 
C6H6-NH-C?H,0.  Commonly  known  as  '  Ant'ifebrin.'  A  crystalline  sub- 
stance obtainable  by  the  action  of  glacial  acetic  acid  on  aniline,  and  subse- 
quent purification. 

Its  graphic  formula  is 

H    H 

II 

I      I  i 

H    H  0 

Characters  and  Tests. — Much  the  same  as  those  on  p.  825,  but  it  is  also 
said  to  be  freely  soluble  in  benzol  and  chloroform.  Heated  with  solution  of 
potash  and  a  few  drops  of  chloroform,  the  unpleasant  odour  of  phenyl- 
isonitrile  is  developed. 

Dose. — 3  to  10  grains. 

Action  and  Uses. — See  p.  825.  In  addition  to  its  antipyretic 
power  it  was  found  by  Lepine  to  relieve  the  pains  of  locomotor 
ataxy,  and  it  is  now  frequently  used  to  relieve  neuralgic  pains  in 
general. 

Phenacctlnum.  Phenacetin.  O10H13NO2.  A  crystalline  substance 
produced  by  the  action  of  glacial  acetic  acid  on  para-phenetidin,  a  body  ob- 
tained from  phenol. 

H    H  H    H 


H-O-CJ/  >C-H  C2H5-0-C/  >C-N< 


H    H  H   H 

Phenol.  Para-phenetidin. 

H    H 

I      I 

%c_c/         \c_  CH3 

II 
0 

Acet.  para-phen  tidin  or  Phenacetin. 

By  comparing  the  graphic  formula  given  above  with  that  of 

acetanilide,  it  will  be  seen  that  the  difference  between  the 

two  bodies  consists  in  phenacetin  containing  the  group  (JaHsO) 

in  place  of  the  atom  of  H  in  the  para  position  (p.  809)        

in  acetanilide 


BEITISH  PHARMACOPCEIA  OF   1885.  [1111] 

Characters  and  Test3. — Colourless,  tasteless,  inodorous,  glistening  scaly 
crystals.  Melting-point,  275°  P.  (135°  C).  Sparingly  soluble  in  cold  water, 
more  freely  in  boiling  water,  and  in  about  sixteen  fluid  parts  of  rectified  spirit. 

One  grain  boiled  with  twenty  minims  of  hydrochloric  acid  for  about  half 
a  minute  yields  a  liquid  which,  diluted  with  ten  times  its  volume  of  water, 
cooled  and  filtered,  assumes  a  deep-red  coloration  on  the  addition  of  solution 
of  chromic  acid. 

Dose. — 5  to  10  grains. 

Action  and  Uses. — Like  acetanilide  and  phenazone  it  lowers 
temperature  and  lessens  pain.  Its  action  appears  to  be  less 
rapid  and  more  prolonged  than  that  of  the  others,  and  it  has 
less  tendency  to  cause  collapse.  It  appears  also  to  have  a  slight 
soporific  effect,  so  that  it  sometimes  tends  to  cause  sleep  when 
'  given  at  night. 

Phenazonum.  Phenazone.  Commonly  known  as  '  antipyrine,'  which 
is  a  registered  trade-mark  in  the  United  Kingdom.  Synonym.— Phenyl- 
dimethyl-pyrazolone,  C<jH5(CH3)2C3HN20.  A  crystalline  substance  obtain- 
able from  phenyl-hydrazine. 

Characters. — See  p.  824.  Colourless  and  inodorous  scaly  crystals  with  a 
bitter  taste  ;  freely  soluble  in  water,  rectified  spirit,  and  chloroform ;  less 
soluble  in  ether. 

The  constitution  of  phenazone  has  now  been  shown  by  the 
discoverer  Knorr  himself  not  to  be  what  he  supposed  and  what 
is  given  at  p.  824,  but  rather  what  is  shown  in  the  graphic 
formula  given  here. 

H  H  CH3CH3 

I  III 

\c/  \c-n/  h-c^  \c-n<      II 

I  I      \H  I  II      xc-c 

A  A  /cv  /c\     11  1 

H/  \c/  \h  h'  Nk   \h   0  h 

H  .  H 

Phenylhydrazine.  Phenazone. 

For  the  sake  of  comparison  the  graphic  formula  of  phenyl- 
hydrazine  from  which  it  is  derived  is  also  given  here. 

Dose. — 3  to  20  grains.  • 

Action  and  Uses— It  has  a  certain  local  anaesthetic  action, 
and  it  is  a  powerful  analgesic,  removing  headache  and  relieving 
the  pain  in  locomotor  ataxy,  dysmenorrhea,  angina  pectoris,  and 
sciatica,  tic,  or  other  forms  of  neuralgia.  In  phthisis,  where  the 
daily  rise  of  temperature  seems  only  to  distress  and  weaken  the 
patient  without  destroying  the  tubercle  bacilli  (cf.  p.  102),  ten 
grains  of  antipyrine,  given  just  as  the  temperature  begins  to  rise, 
is  sometimes  very  useful. 

Incompatibles.— Spirit  of  nitrous  ether  or  other  nitrites,  and 
cinchona  alkaloids. 


[1112]  ADDITIONS  MADE  IN  1890  TO  THE 

This  incompatibility  is  important,  as  antipyrine  is  not  unlikely 
to  be  given  along  with  nitrous  ether,  quinine,  or  bark  in  febrile' 
conditions  or  neuralgia,  or  with  nitrite  of  amyl  in  angina  pectoris. 

Giusldum.  Gluside.  Commonly  known  as  '  Saccharin.'  Synonyms. 
— Glucusimide;  Benzoyl-sulphonic-imide,  C6H4COS02"NH.  A  sweet  imide 
derivable  from  the  toluene  of  coal-tar. 

Characters  and  Tests. — A  light,  white,  minutely  crystalline  powder,  hav- 
ing an  intensely  sweet  taste  in  dilute  solutions.  It  is  but  slightly  soluble  in 
cold  water  or  chloroform,  more  so  in  boiling  water,  rectified  spirit,  or  glycerine. 
It  is  very  soluble  in  diluted  solution  of  ammonia ;  also  in  solution  of  bicar- 
bonate of  sodium  with  evolution  of  carbonic  acid  gas.  The  latter  solution, 
when  warmed  and  made  neutral  and  evaporated  to  dryness,  yields  '  soluble 
gluside  '  or  '  soluble  saccharin,'  which  is  very  soluble  in  water,  one  hundred 
parts  of  gluside  yielding  nearly  one  hundred  and  thirteen  of  neutral '  soluble, 
gluside.'  On  fusing  with  caustic  soda,  dissolving  in  water,  faintly  acidulating' 
with  hydrochloric  acid,  and  adding  a  few  drops  of  solution  of  perchloride  of 
iron,  a  reddish-brown  or  purplish  colour  is  produced. 

Non-Offioial  Preparations. — Elixir  Saccharini. 

Saccharin,  24  grs. ;  Bicarbonate  of  Sodium,  12  grs. ;  Bectified  Spirit, 
1  dr. ;  Distilled  Water,  7  dr.     20  min.  contain  1  gr.  of  saccharin. 

Tabellse  Saccharini. 
Each  contains  £  gr.  saccharin  with  bicarbonate  of  sodium. 

Action  and  Uses. — To  sweeten  food  instead  of  sugar  in  cases 
of  diabetes  and  to  render  medicines  more  palatable.  The  tabellse 
(non-official)  are  convenient  for  sweetening  tea,,  coffee,  or  lemonade 
in  diabetes.  About  £  of  a  grain  of  saccharin  or  20  minims  of  the 
elixir  per  ounce  is  sufficient  to  flavour  mixtures  containing  bro- 
mide or  iodide  of  potassium  or  ammonium,  chloride  of  ammonium, 
salicin,  salicylate  of  sodium,  cascara  sagrada,  nux  vomica  or 
strychnine.  Even  this  quantity  is  too  large  for  many  patients, 
who  complain  of  the  persistent  sweetness  remaining  in  the  mouth. 

Although  there  was  at  one  time  a  great  outcry  about  the 
dangerous  properties  of  saccharin,  there  is  no  satisfactory  evidence 
of  its  being  more  injurious  than  sugar,  even  when  taken  in  large 
quantities  and  for  long  periods.  Its  excessive  use  has  produced 
dyspepsia,  but  sugar  is  liable  to  the  same  objection.  Like  other 
bodies  of  the  aromatic  series  it  has  an  antiseptic  tendency  and 
has  been  used  to  prevent  decomposition  of  the  urine  in  chronic 
cystitis  (p.  446). 

Narcotics  and  Hypnotics. 

We  have  three  narcotic  additions.  Two  of  them,  paralde- 
hyde and  sulphonal,  are  new  and  useful  hypnotics,  made 
artificially,  and  frequently  employed  instead  of  opium  or  its 
preparations  to  produce  sleep. 

But  we  have  no  drug  yet  of  synthetic  origin  which  has  such 
a  universal  and  powerful  action  as  morphine  in  relieving  pain 
and  causing  sleep,  although  phenazone  and  its  congeners  to  a 
certain  extent  replace  it  as  an  analgesic,  and  paraldehyde  and 


BRITISH  PHARMAGOPCEIA  OP  1885.  [11-13] 

eulphonal  as  a  hypnotic.  In  consequence  of  this  another  prepa- 
ration of  morphine,  the  Liquor  Morphinae  Sulphatis,  is  contained 
in  the  '  Additions,'  notwithstanding  the  large  number  of  its  pre- 
parations already  present  in  the  British  Pharmacopoeia. 

liquor  Ittorphinse  Sulphatis.  SOLUTION  OF  SULPHATE  OF  MORPHINE. 
Is  a  1  per  cent,  solution.  Sulphate  of  Morphine,  1 ;  Beotified  Spirit,  25 ; 
Distilled  Water,  up  to  100. 

Dose. — 10  to  60  minims. 

Action  and  Uses. — See  p.  848. 

Paraldenydum.  Paraldehyde.  C6H12Os.  A  product  of  the  polymeri- 
sation of  aldehyde  by  various  acids  or  salts. 

Characters  and  Tests. — A  clear  colourless  liquid  having  a  characteristic 
ethereal  odour  and  a  burning  and  afterwards  a  cooling  taste.  Soluble  in  10 
of  water  at  60°  F.,  less  soluble  in  hot  water.  Mixes  in  all  proportions  with 
rectified  spirit  a'nd  ether. 

Dose. — £  to  1£  fluid  drachms. 

Action  and  Uses. — See  p.  779. 

Suiphonai.  Sulphonal.  C7H16S204.  Synonym. — Diethylsulphon- 
dimethyl-methane  (OHs)2C(S02C2H5)2. 

Characters  and  Tests. — -Colourless,  inodorous,  nearly  tasteless  crystals ; 
neutral  to  test  paper  ;  melting  at  258°  F.  (125-5°  C).  Soluble  in  fifteen  parts 
of  boiling  water  and  in  about  four  hundred  and  fifty  parts  of  cold  water. 
Soluble  in  about  fifty  fluid  parts  of  cold  rectified  spirit,  and  very  soluble  in 
boiling  alcohol ;  soluble  in  ether.  Ignited  with  free  access  of  air,  it  burns 
without  residue.  If  a  mixture  of  a  few  grains  with  an  equal  weight  of 
cyanide  of  potassium  be  heated,  the  odour  of  mercaptan  is  evolved,  and  when 
to  the  solution  of  the  product  in  water  excess  of  hydrochloric  acid  and  a 
few  drops  of  solution  of  perchloride  of  iron  are  added,  a  reddish  colour  is 
developed. 

Dose. — 15  to  40  grains. 

Action  and  Uses. — This  is  a  useful  hypnotic,  producing 
sleep,  and  in  most  cases  having  no  disagreeable  after  effects, 
even  when  used  continuously  for  a  length  of  time.  It  occasion- 
ally produces  a  kind  of  ataxia,  the  hands  trembling  and  the  gait 
becoming  stumbling,  but  these  symptoms  quickly  pass  off. 

As  it  is  very  sparingly  soluble,  it  is  best  to  give  it  a  consider- 
able time  before  sleep  is  desired.  One  good  way  is  to  give  ten 
grains  about  5-7  p.m.,  and  ten  more  at  10  or  11  p.m.  It  may 
be  given  in  hot  milk,  beef-tea,  soup,  or  brandy  and  water. 

Mydriatics,  Local  Anaesthetics,  and  Stimulants. 

Cocaine  may  be  said  to  belong  to  all  three  of  these  classes, 
and  we  have  a  new  preparation  of  it,  liquor  cocainae  hydro- 
chloratis,  which  may  either  be  used  as  a  local  application  to  the 
eye,  throat,  or  other  mucous  surfaces,  or  as  a  hypodermic  injec- 
tion, or  it  may  be  given  internally. 

liquor  Cocainae  Hydrochloratis.  SOLUTION  OF  H/YDROCHLORATE  OF 
Cocaine.  This  is  a  10  per  cent,  solution  of  hydrochlorate  of  cocaine  in  water, 
with  enough  salicylic  acid  to  prevent  decomposition.     It  contains  Hydro- 


[1114]  ADDITIONS  MADE   IN  1890  TO   THE 

chlorate  of  Cocaine,  33  grains  or  100  parts ;  Salicylic  Acid,  £  grain  or  1J  parts , 
Distilled  Water,  up  to  6  fi.  drachms  or  1000  fluid  parts. 
Dose. — 2  to  10  minims. 

Action  and  Uses. — See  p.  872. 

Homatroplnee  Hydrobromas.  Hydrobromate  of  Homatropine. 
C16H21N03,HBr.    The  hydrobromate  of  an  alkaloid,  prepared  from  tropine. 

Constitution. — Ladenburg  has  found  that  atropine  can  be- 
split  up  into  tropine  and  tropic  acid,  and  is  formed  again  by  re- 
combining  these  bodies.  When  other  acids  are  used  instead  of 
tropic  acid  to  combine  with  tropine,  bodies  are  formed,  termed 
tropeines,  which  resemble  atropine  in  many  respects,  although 
differing  from  it  in  others.  Homatropine  is  one  of  these  bodies, 
and  it  is  formed  by  the  combination  of  oxytoluylic  acid  with 
tropine. 

Characters  and,  Tests.— A.  white  crystalline  powder  or  aggregation  of 
minute  prismatic  crystals,  soluble  in  six  parts  of  cold  water,  and  in  one 
hundred  and  thirty-three  of  ethylic  alcohol.  The  dilute  aqueous  solution 
powerfully  dilates  the  pupil  of  the  eye.  A  two  per  cent,  aqueous  solution  is 
not  precipitated  by  the  cautious  addition  of  solution  of  ammonia  previously 
diluted  with  twice  its  volume  of  water.  About  a  tenth  of  a  grain  moistened 
with  two  minims  of  nitric  acid  and  evaporated  to  dryness  on  the  water-bath 
yields  a  residue  which  is  coloured  yellow  by  an  alcoholic  solution  of  potash. 
It  also  gives  Gerrard's  test  for  the  mydriatic  alkaloids,  p.  986. 

Dose.—±  to  Jj  grain. 

Action  and  Uses. — It  dilates  the  pupil  like  atropine,  but 
is  preferable  to  atropine,  as  its  action  passes  off  much  more 
quickly.    It  may  also  be  used  internally  like  atropine. 

Remedies  acting  on  the  Respiratory  System. 

We  have  three  remedies  in  this  class. 

Acetum  Ipecacuanhas,     Vinegar  OF  Ipeoacuanha.     Ipecacuanha,  1 ; 
Diluted  Acetic  Acid,  23.     Prepared  by  maceration  and  percolation. 
Dose. — 5  to  40  minims  as  an  expectorant. 

Action  and  Uses. — See  p.  950. 

Picrotoxinum.  Picrotoxin.  Obtainable  from  the  seeds  of  Anamirta 
paniculata  by  exhaustion  with  alcohol,  evaporation,  and  purification. 

Characters  and  Tests. — Colourless  and  inodorous  prismatic  crystals, 
possessing  a  bitter  taste.  It  melts  at  378°  P.  (192-2°  C).  It  is  soluble  in 
three  hundred  and  thirty  parts  of  cold  water,  leaving  only  a  trace  of  residue, 
in  thirty-five  parts  of  boiling  water,  also  in  three  of  boiling  and  thirteen  of 
cold  rectified  spirit.  It  is  soluble  in  ten  parts  of  solution  of  potash,  and  the 
resulting  liquid,  on  boiling,  immediately  reduces  Fehling's  solution.  (This 
reduction  is  due  to  the  glucose  formed  by  the  decomposition  of  the  glucoside.) 
Its  aqueous  solution  is  not  precipitated  by  solutions  of  perchloride  of  mercury, 
perchloride  of  platinum,  or  tannic  acid  (difference  from  alkaloids).  It  dis- 
solves in  sulphuric  acid  with  a  saffron-yellow  colour. 

Dose.— ^  to  i  grain. 

Action  and  Uses. — See  p.  842.  Its  chief  use  is  to  prevent 
night  sweats  in  phthisis. 


BRITISH  PHARMACOPOEIA  OF  1885.  [1116], 

Stramonll  Folia.  Stramonium  Leaves.  The  dried  leaves  of  Datura 
Stramonium. 

Characters. — Ovate,  petiolate,  about  six  inches  long,  smooth,  pointed,  un- 
equal at  the  base,  one  side  deourrent  down  the  petiole,  coarsely  and  sinuately 
angular-toothed,  minutely  wrinkled,  dark  green.  The  upper  surface  usually 
brownish-green  and  of  a  darker  shade  than  the  under  surface  ;  odour  faintly 
narcotic;  taste  unpleasant,  saline  and  bitter. 

Action  and  Uses. — The  fumes  of  the  leaves,  when  burned  as 
cigarettes  or  in  powder  mixed  with  potassic  nitrate,  are  useful 
in  lessening  the  spasm  of  spasmodic  asthma.  • 

Cardiac  and  Vascular  Remedies. 

We  have  one  new  cardiac  tonic,  strophanthus,  one  new 
vascular  remedy,  nitrite  of  sodium,  which,  like  all  the  nitrites 
(vide  pp.  331  and  788),  dilates  the  arterioles,  and  liquor  trini- 
trini,  which  is  a  solution  of  nitroglycerine. 

liquor  Trlnltrlnl.  Solution  op  Tkinitein.  Synonyms. — Liquor 
Nitroglycerin! ;  Solution  of  Nitroglycerine ;  Liquor  Glonoini ;  Solution  of 
Glonoin.  Is  a  1  per  cent,  solution,  containing  Pure  Nitroglycerine,  1  part 
by  weight ;  Eectified  Spirit,  up  to  100  fluid  parts. 

Dose. — £  to  2  minims. 

Action  and  Uses. — See  p.  788. 

SodU  witris.  Nitrite  of  Sodium.  NaN02.  Synonyms. — Sodse  Ni- 
tris ;  Nitrate  of  Soda. 

Characters. — A  white  or  yellowish -white  deliquescent  crystalline  salt, 
very  soluble  in  water.  The  solution  is  neutral  or  slightly  alkaline,  and  when 
mixed  with  diluted  sulphuric  acid  yields  a  gas  which  forms  ruddy  fumes  in 
contact  with  the  air. 

Dose. — 2  to  5  grains. 

Action  and  Uses. — The  same  as  those  of  nitroglycerine. 

Strophanthus.  Strophanthus.  The  mature  ripe  seeds  of  Strophanthus 
hispidus,  freed  from  the  awns. 

Characters. — Oval  acuminate,  about  three-fifths  of  an  inch  long  and  one- 
sixth  of  an  inch  broad,  base  blunt,  apex  tapering,  flattened ;  greenish-fawn 
in  colour ;  covered  with  appressed  silky  hairs ;  one  side  with  a  longitudinal 
ridge  running  from  the  centre  to  the  pointed  apex. 

Preparation. 
Tinctura  Strophanthi,  1  part  in  20  fluid  parts.    Dose.— 2  to  10  minims. 
(The  fat  is  first  extracted  by  ether,  and  then  the  seeds  are  extracted  with 
spirit.) 

Action  and  Uses. — See  p.  1100. 

Haematinics. 

Pllula  Ferrl.  Iron  Pill.  Commonly  known  as  '31aud's  Pill.'  Sulphate 
of  Iron,  120 ;  Carbonate  of  Potassium,  72 ;  Eefined  Sugar,  in  powder,  24 ; 
Tragacanth,  in  powder,  8 ;  Glycerine,  4£  ;  Distilled  Water,  a  sufficiency. 

Each  5-grain  pill  contains  about  1  grain  of  carbonate  of  iron. 

Dose. — 1  to  4  pills. 


[1116]  ADDITIONS  MADE  IN  1890  TO  THE 

Action  and  Uses. — This  is  one  of  the  best  hsematmics  we 
have  (see  p.  742).  It  is  supposed  that  the  presence  of  the 
potash  which,  as  well  as  iron,  is  an  ingredient  of  the  red  blood 
corpuscles,  gives  this  pill  an  advantage  over  the  Pil.  Per.  Carb. 

Syrupus  Perrl  Subchloridi.  Syrup  OF  SuBCHLORIDE  OF  Iron. 
Synonym. — Syrup  of  Ferrous  Chloride.  Iron  Wire,  300  grs.  dissolved  in 
water  8  dr. ;  Hydrochloric  Acid,  2  fl.  oz.  Then  add  Citric  Acid,  10  grs., 
filter,  and  pour  through  filter  Distilled  Water  2  drs.  into  Syrup  q.s.  to  make 
1  pint. 

Dose. — \  to  1  fluid- drachm. 

Action  and  Uses. — See  p.  740. 

Remedies  for  the  Skin  and  Mucous  Membranes. 
Emollients. 

Adeps  lanae.  Wool  Fat  (Anhydrous  Lanoline).  The  purified  cho-> 
lesterin-fat  of  sheep's  wool. 

Characters  and  Tests. — A  yellowish  tenacious  unctuous  substance ; 
almost  inodorous ;  with  a  melting-point  varying  from  100°  F.  (ST'S0  C.)  to 
112°  F.  (44-4°  C.) ;  readily  soluble  in  ether  and  in  chloroform,  sparingly 
soluble  in  rectified  spirit.  The  solution  in'chloroform  poured  gently  over  the, 
surface  of  sulphuric  acid  acquires  a  purple-red  colour. 

Adeps  Lanae  Hydrosus.  Hydrous  Wool  Fat.  Commonly  known  as 
'  Lanoline,'  which  is  a  registered  trade-mark  in  the  United  Kingdom.  Melt 
Wool  Fat  70  in  a  warm  mortar,  and  stir  in  Water  80,  gradually  and 
thoroughly. 

Characters  and  Tests. — Yellowish-white ;  free  from  rancid  odour.  When 
heated  it  separates  into  an  upper  oily  and  lower  aqueous  layer. 

Preparation  in  which  Hydrous  Wool  Fat  is  used. 
Unguentum  Conii. 

Action  and  Uses. — See  p.  1078. 
Analgesic. 

Emplastrum  Menthol.  Menthol  Plaster.  Melt  Yellow  Wax  1  and 
Besin  7  together,  and,  as  it  cools,  stir  in  Menthol  2. 

Action  and  Use. — See  p.  1004.  To  relieve  pain  in  lumbago, 
intercostal  neuralgia,  sciatica,  &c. 

Astringent. 

Eucalypti  Gummi.  Eucalyptus  Gum.  A  ruby-coloured  exudation,  or 
so-called  red  gum,  from  the  bark  of  Eucalyptus  rostrata  and  some  other 
species.     Imported  from  Australia. 

Characters  and  Tests. — From  eighty  to  ninety  per  cent,  of  it  is  soluble 
in  cold  water,  forming  a  neutral  solution.  It  is  almost  entirely  soluble  in 
rectified  spirit. 

Dose. — 2  to  10  grains. 

_  Action  and  Uses. — It  is  a  powerful  astringent  (see  p.  849). 
It  is  useful  in  relaxed  sore  throat,  nasal  catarrh,  nasal  hssmor- 
rhage,  leucorrhcea,  and  diarrhoea. 


BRITISH  PHARMACOPOEIA  OF  1885.  [1117] 

Administration. — The  powdered  gum  £  grain,  mixed  with 
£  grain  starch,  may  be  applied  by  an  insufflator  to  the  nose  or 
throat  to  stop  haemorrhage  or  relieve  congestion.  A  solution  of 
3  or  4  grains  to  the  ounce  of  water  may  be  used  as  a  gargle,  or 
as  an  injection  in  leucorrhcea  and  diarrhoea,  and  one  of  10  grains 
to  the  ounce  may  be  injected  into  the  nose  or  applied  to  wounds 
to  stop  haemorrhage.  It  is  made  up  also  in  lozenges,  which  are 
useful  in  relaxed  throats.  In  cases  of  diarrhoea  it  may  be  given 
in  solution  (see  Rhatany,  p.  869),  or  in  the  form  of  pill  with 
mucilage  and  glycerine. 

Stimulant. 

Oleum  Cadinum.  Oil  of  Cade.  Synonyms. — '  Huile  de  Cade ' ; 
Juniper  Tar  Oil.  An  empyreumatic  oily  liquid  obtained  by  the  destructive 
distillation  of  the  woody  portions  of  Juniperus  Oxycedrus  and  some  other 
species. 

Characters. — A  dark  reddish-brown  or  nearly  black  more  or  less  viscid 
oily  liquid  with  a  not  unpleasant  empyreumatic  odour  and  an  aromatic  bitter 
and  acrid  taste.  Specific  gravity  about  0-990.  It  is  soluble  in  ether  and 
chloroform ;  partially  soluble  in  cold,  almost  wholly  in  hot  rectified  spirit. 
In  water  it  is  vdry  slightly  soluble.  The  filtered  aqueous  solution  is  almost 
colourless  and  possesses  an  acid  reaction. 

Action  and  Uses. — See  p.  1063,  use  of  Distilled  Juniper 
Tar. 


ADDITION  TO  APPENDIX  II. 

Solution  of  Potassio-Cupric  Tartrate.1 

No.  1. 
Take  of 

Sulphate  of  Copper 846-4  grains 

Distilled  Water a  sufficiency 

Dissolve  the  sulphate  of  copper  in  a  portion  of  the  water,  and  dilute  the 
solution  with  more  of  the  water  to  the  volume  of  5000  grain-measures. 

No.  2. 
Take  of 

Caustic  Soda If  ounce 

Tartarated  Soda 4  ounces 

Distilled  Water a  sufficiency 

Dissolve  the  caustic  soda  and  tartarated  soda  in  a  portion  of  the  water, 
and  dilute  the  solution  with  more  of  the  water  to  5000  grain-measures. 

When  required  for  use,  mix  equal  volumes  of  the  solutions  No.  1  and 
No.  2. 

Uses. — When  boiled  with   glucose   a  yellow  precipitate  is 
thrown  down.     It  is  therefore  used  as  a  test  for  this  substance. 

1  Solution  of  Potassio-Cuprio  Tartrate  is  commonly  known  as  'Fehling's 
Solution.' 


1103 


GENERAL   INDEX. 


A. 

Abdomen,  mustard  stupes  or  poultices 
applied  to  the  lower  part  of  the,  act  as 
indirect  emmenagogues,  453 
Abernethy,  Mr.,  reference  to,  689 
Abney  and  Festing,  reference  to,  28 
Abortion,  emetics  to  be  avoided  where  a 
tendency  to,  exists,  376  ;  the  twigs  of 
thuja  may  produce,  1063 
Abscesses,  especially  of  the  liver,  caustics 

employed  to  open,  346 
Absinthe,   as  a  spinal  stimulant,   181 ; 

action  of,  on  the  brain  of  dogs,  188 
Absorption  and  excretion  of  drugs,  dia- 
grams illustrative  of,  39  and  40;  effects 
of  rapid  or  delayed,  39 
Abstracts,  503 

Abstractum  Aconiti,  503,  832 
Belladonnas,  503 
Conii,  603,  931 
Digitalis,  503,  994 
Hyoscyami,  503,  990 
Ignatise,  503,  971 
Jalapae,  503,  982 
Nucis  Vomicae,  503,  971 
Podophylli,  503,  838 
Senegas,  503,  868 
Valerianae,  503,  952 
Acetate  of  aluminium,  action  of,  on  en- 
zymes, 78 ;  on  bacteria,  91 
Ammonium,  as  a  vascular  stimulant, 

330 
Copper,  674 
Ethyl,  783 
Lead,  703 
Morphine,  847 
Potassium,  609 
Sodium,  624 
Zinc,  672 
Acetates,  test  for,  594 
Acetic  acid,  action  of,  on  bacteria,  94 ; 
of  the  vapour  of,  on  the  general  circu- 
lation, 194  ;  action  of,  on  the  respira- 
tory   mucous   membrane,  253 ;    as  a 
vesicant,  344 ;  as  a  caustic,  344 ;  as  a 
poison  with  its  antidotes,  487 ;  proper- 
ties aDd  uses  of,&c,  576 ;  preparations 
containing,  577 ;  glacial  ditto,  577 


Acetone,    action    of,  on  bacteria,    93, 

95 
Acetum,  503,  578 

Cantharidis,  503,  577,  1091 
Lobelias,  503,  961 
Opii,  503,  845 
Sanguinariae,  503,  863 
Scillse,  503,  577,  1041 
Acid  Bath,  the,  469 

Dilute  nitro-hydrochloric,  as  a  hepa- 
tic stimulant,  403 
Ergotinic,  1070 
Hsematin,  72 

Radicals  in  metallic  salts,  general 
tests  for,  593 ;  list  of  tests  for  the 
different  acids,  594,  595 
Solution  of  nitrate  of  mercury,  695 
Sphacelinic,  1070 
Tartrate  of  potassium,  610 
Acidity,  corrected  by  antacids,  369 
Acids,  action  of,  on  the  secretion  of  the 
respiratory  mucous  membrane,  253  ;  as 
stimulating  expectorants,  255;  action 
of  dilute,  on  the  frog's  heart,  307 ;  on 
the    capillaries,    280,    318,    337;    as 
caustics,    344 ;    as    astringents,    349 
as  styptics,  350;  as  sialagogues,  357 
as  artificial  digestive  substances,  364 
action  of,  as    irritant  poisons,    395 
strong,  may  produce  death  weeks  after 
they  have  been  swallowed,  398 ;  as  anti- 
hidrotics,  441 ;   as  poisons,  with  their 
antidotes,  487 ;  general  characters  and 
properties  of,  565;  general  action  of, 
on  the  tissues,  567 ;  on  the  skin,  568  ; 
in  the  mouth,  568 ;   in  the  stomach, 
569;  on  the  bile  and  liver,  570 ;  morbid 
anatomy  of  poisoning  by,  570 
Acids,  mineral,  action  of,  on  albumen,  58  ; 
on  protoplasm,  60 ;  on  infusoria,  65 ; 
as  sialagogues,  356 
Acids,  physiological  action  of — ■ 
Arsenic,  27 
Bromic,  27 
Hydriodic,  27 
Hydrochloric,  27 
Iodic,  27 
Phosphoric,  27 


1104 


GENERAL  INDEX. 


Acids,  physiological  action  of — 
Selenic,  27 
Sulphuric,  27 
Acids,  preparation,  properties,  action,  and 
uses  of — 
Acetic,  666,  576 

Glacial,  566,  577 
Arsenious,  567 
Benzoic,  567 

Boracic  or  boric,  566,  581 
Carbolic,  567 
Carbonic,  566,  583 
Chromic,  582 
Citric,  566,  580 
Dilute  hydrobromic,  567 

Hydrocyanic,  566,  686 
Phosphoric,  567,  579 
Gallic,  567, 1033 

Hydrochloric,  or  muriatic,  566,  572 
Lactic,  589 
Nitric,  566,  574 
Nitro-hydrochloric,  575 

Dilute,  575 
Oleic,  567,  590 
Oxalic,  567,  581 
Phosphoric,  516,  579 
Salicylic,  567,  819 
Sulphuric,  567,  570 

Aromatic,  571 
Dilute,  571 
Sulphurous,  567,  571 
Tannic,  567,  1031 
Tartaric,  566,  580 
Vinegar,  578 
Acidum  Aceticum,  576 

Dilutum,  577 
Glaciale,  577 
Arseniosum,  719 
Benzoicum,  964 
Carbolicum,  813 

Crudum,  812 
Liquefactum,  813 
Chrysophanicum,  895,  909 
Gallicum,  1031 
Hydriodicum  (syrupus),  574 
Hydrobromicum  Dilutum,  573 
Hydrochloricum,  572 

Dilutum,  573 
Hydrocyanicum  Dilutum,  586 
Meconicum,  846 
Nitricum  Dilutum,  575 
Nitro-hydrochloricum,  575 

Dilutum,  573,  575 
Phosphoricum,  579 
Pyrogallicum,  819 
Salicylicum,  819 
Sulphuricum  aromaticum,  571,  1017 

Dilutum,  571 
Tannicum,  1031 
Tartarioum,  580,  610 
Aconite  leaves,  831 ;  root,  831 
Aconitine  or  Aconitia,  action  of.  on  oxida- 
tion, 70;  effects  of,  on  muscle,  158  ;  as 
a  sedative,  157 ;  as  an  anodyne,  201 ,  203 ; 


action  of,  on  the  respiratory  centre, 
233,  241 ;  on  the  vagus-roots,  296 ;  on 
the  vagus-centre,  317 ;  on  the  heart, 
339 ;  Ringer's  mode  of  using;,  339 ;  as 
a  poison,  with  its  antidote,  488;  an- 
tagonism of,  to  other  drugs,  495  ;  pre- 
paration, characters,  and  tests  of,  832 ; 
general  action  of,  in  frogs,  832;  in 
man,  833;  on  the  heart,  833;  action 
of,  on  individual  organs,  833;  on  the 
muscles,  motor   and    sensory  nerves, 

833,  834;  on  the  spinal  cord,  brain, 
and  vaso-motor  centre,  833,  834 ;  on 
the  heart  and  respiration,  834 ;  on  the 
temperature,  the  stomach,  and  the  se- 
cretion of  the  salivary  gland,  834 ;  on 
the  pupil  of  the  eye  and  the  tissues, 

834,  835 ;  therapeutic  use  of,  locally, 
835 ;  for  the  stomach,  in  febrile  con- 
ditions, in  cardiac  disease,  and  on  the 
nervous  system,  835 ;  mode  of  applica- 
tion, 835 

Aconitum,  properties,  composition,  and 
preparation  of,  831 

Actual  cautery,  as  a  styptic,  350 

Adami,  reference  to,  424 

Adeps  benzoatus,  964,  1084 
Benzoinatus,  964,  1084 

Adonidin,  as  a  cardiac  tonic,  331 

Adonis  vernalis,  as  a  cardiac  tonic,  331; 
as  a  refrigerant  diuretic,  432,  compo- 
sition, action,  and  use  of,  837 

Aeby,  reference  to,  131 

jEther  purus,  780 

Agaricus  albus,  as  an  antihidrotic,  441, 
action  and  uses,  1068 

Ague,  utility  of  quinine  in,  1 ;  produced 
by  the  iaHllas  mala/rice,  99 ;  impor- 
tance of  emetics  and  purgatives  in 
aiding  the  action  of  antiperiodics  in 
the  cure  of,  108  ;  value  of  emetics  in, 
before  the  administration  of  quinine, 
375 ;  sometimes  cured  by  emetics  alone, 
without  quinine,  375 ;  action  of  opium 
in,  862 ;  brought  on  by  strychnine,  974 

Air-baths,  471 

Air-passages,  value  of  emetics  in  remov- 
ing obstructions  from  the,  375 

Albertoni,  reference  to,  187 

Albumen,  nature  of,  and  action  of  drugs 
on,  67 ;  effects  of  acids  and  organic 
alkaloids  on,  58 ;  action  of  quinine  on, 
944 ;  test  solution  of,  1085 ;  albumen 
of  eggs,  1085 

Albuminous  solutions,  action  of  alcohol 
on,  767 

Albuminuria,  action  of  drugs  on,  434; 
how  far  caused  in  apparently  healthy 
persons  by  mercurials,  665 

Alchemilla,  action  of,  on  the  bladder, 
445 

Alcohol,  effects  of,  on  the  blood,  72; 
change  undergone  "by,  when  boiled 
with  sulphuric  acid,  73  ;  action  of,  on 


GENEEAL  INDEX. 


1105 


enzymes.  79 ;  on  bacteria,  91,  93,  95 ; 
appears  to  arrest  the  action  of  zymotic 
diseases,  103;  and  preserves  animal 
matter,  103;  action  of,  on  medusae, 
111;  on  annnlosa,  115;  on  muscles, 
128 ;  general  nervous  system,  146;  as 
a  spinal  depressant,  165  ;  on  the  brain 
of  the  lower  animals,  187 ;  on  psychi- 
cal processes,  192 ;  a  typical  stimulant 
on  the  action  of  the  brain,  195 ;  differ- 
ent action  of,  in  different  doses,  on  the 
brain,  195 ;  has  both  stimulant  and 
narcotic  action  on  the  brain,  200  ; 
as  an  antispasmodic,  213 ;  action  of, 
on  frogs,  215;  on  the  respiratory  cen- 
tre, 241 ;  on  the  vaso-motor  centre, 
287;  on  the  motor  ganglia,  316;  as  a 
cardiac  stimulant,  328;  as  a  vascular 
stimulant,  330 ;  as  a  rubefacient,  344  ; 
as  an  astringent,  349  ;  as  a  local  seda- 
tive, 376 ;  as  an  antipyretic,  421 ;  as  a 
stimulant  diuretic,  433  ;  as  an  aphro- 
disiac, 450 ;  as  a  poison  with  its  anti- 
dote, 488 ;  antagonism  of,  to  strych- 
nine, 495 
Alcohol,  775 

Absolute,  775 

Amylic,  777 

Diluted,  776 

Ethylicum,  766,  775 

Proof  spirit,  776 

Rectified  spirit,  776 

Red  wine,  777 

Sherry,  776 

Spirit  of  French  wine,  776 

White  wine,  777  ;  stronger,  777 
Alcohol,  ethyl, general  source  and  prepara- 
tion of,  766 ;  impurities  and  tests  of,  766, 
767;  general  action  of,  767;  on  albumin- 
ous solutions,  767  ;  on  the  skin,  mouth, 
stomach,  intestine,  and  blood,  767 ; 
and  tissues,  767 ;  dispute  as  to  whether 
it  can  be  regarded  as  a  food,  767  ;  its 
action  on  the  circulation  and  tempera- 
ture, 768  ;  on  the  nervous  system,  769 ; 
and  cranial  circulation,  769 ;  on  the 
nervous  tissues,  on  the  judgment  and 
emotions,  769,  770 ;  on  the  motor  cen- 
tres, the  speech,  and  the  cerebellum, 
770 ;  on  the  spinal  cord,  the  respiratory 
centre,  the  vaso-motor  centre,  and  the 
heart,  770 ;  the  importance  of  a  proper 
diagnosis  of  drunkenness  from  effects 
of  opium  and  apoplexy,  770 ;  effect  of 
impurities  on  the  action  of,  770 ;  effects 
of  chronic  poisoning  by,  770 ;  on  the 
bowels,  skin,  liver,  kidneys,  and  ner- 
vous system,  771 ;  nature  and  effects 
of  delirium  tremens,  771;  and  treat- 
ment of,  772 ;  causes  of  chronic  alco- 
holism, 772 ;  uses  of,  773 ;  its  weakness 
as  a  stimulant  compared  with  beef- 
tea,  774 ;  action  of,  as  a  stimulant,  774  ; 
and  on  the  urine,  775 ' 


Alcohol,  methyl,  preparation,  characters, 
and  uses  of,  766 

Alcoholism,  causes  of  chronic,  772 

Alcohols,  list  of  the  principal,  with  their 
respective  toxic  powers,  764,  765 ; 
action  of,  on  the  general  system,  764 
et  seq. 

Aldehydes,  properties,  action,  uses  of— 
acetic  aldehyde,  778  :  and  paraldehyde, 
778 

Alder,  black,  894 

Ale,  intoxicating  effects  of  a  single  glass 
of,  when  sucked  through  a  straw 
194 

Algfe,  1073 

Alimentary  canal,  action  of  quinine  on 
the,  945 ;  of  sulphate  of  strychnine  on 
the,  973 ;  of  tobacco,  992  ;  of  extract 
of  ergot,  1071 

Alkalies,  action  of,  on  protoplasm,  60; 
on  infusoria,  65;  on  muscle,  135  et  seq.; 
on  the  secretions  of  mucus  from  the 
trachea,  252 ;  on  the  amount  and  nature 
of  moist  rales  in  the  lungs,  252  ;  as  a 
depressant  expectorant,  255 ;  dilute,  on 
the  frog's  heart,  306 ;  on  the  capillaries, 
318;  as  caustics,  344  ;  as  sialagogues, 
357  ;  arrest  secretion  of  saliva,  361 ; 
dilute,  increase  the  action  of  the  gas- 
tric juice,  363 ;  strong,  may  produce 
death  weeks  afterithas  been  swallowed, 
398 ;  as  poisons  with  their  antidotes, 
487 

Alkalis,  metals  of  the,  596 ;  (1)  alkaline 
salts,  general  characters  and  reactions 
of  the,  597  ;  their  physiological  action, 
697 ;  and  general  action,  597 ;  on  the 
skin,  as  caustics,  rubefacients,  and 
vesicants,  597,  598;  in  the  mouth,  598; 
in  the  stomach,  598 ;  on  the  gastric 
juice,  598 ;  as  antidotes  in  poisoning 
by  acids,  metals,  and  alkaloids,  599  ; 
their  action  on  the  blood,  599 ;  as 
alteratives,  diuretics,  and  antacids, 
599 ;  (2)  general  action  of  the  group 
of  chlorides,  599  ;  on  the  stomach  and 
other  parts  of  the  body,  600,  601 ;  (3) 
general-  action  of  the  sub-group  of 
sulphates,  602 ;  comparative  action  of 
the  alkaline  metals,  602 

Alkaline  bath,  470 

Bromides,  as  antispasmodics,  214 
Haematin,  72 

Sulphur  ointment,  constituents  of, 
544 

Alkaloids,  action  of,  on  the  general  sys- 
tem, 32 ;  on  albumen,  58 ;  on  proto- 
plasm, 61 ;  on  bacteria,  89  ;  formed  by 
putrefaction,  99 ;  Albertoni's  investi- 
gations as  to  the  action  of  the  coto,' 
386 ;  antidotes  to,  488 ;  objection  to 
the  extremely  small  doses  of,  required 
to  produce  marked  physiological  action, 
492 ;  antagonistic  action  of  certain,  to 

4    B 


1106 


GENEEAL  INDEX. 


morphine,  494,  495;  nature   of,  503; 
properties    and    reactions,    504  ;    of 
opium,  858 
Alkaloids,  cinchona,  and  their  salts,  944 

of  opium,  action  of  the,  858 
Allspice  and  oil,  as  carminatives,  379 

Oil  of,  923 
AUyl  alcohol,  action  of,  on  bacteria,  95  ; 
extraordinary  effect  of,  102  ;  vide  also 
1040 
Almond,  bitter,  916 
Oil  of,  916 
Oil,  as  a  demulcent,  347 ;  nature 

of,  916 
Oil  of,  expressed,  916 
Aloes,  as  a  purgative,  389 ;  as  a  cbola- 
gogue,  390 ;  as  a  hepatic  stimulant, 
403 ;  characters,  preparations  con- 
taining, and  composition  of,  1041- 
1044 
Barbadoes,  1043  ;  action  of,  in  the 
mouth,  the    intestines,    and    the 
rectum,  1044 ;  on  the  bile  and  the 
uterus,  1044 ;    as  an  aphrodisiac 
and  a  purgative,  1 044 
Purified  (Purificata),  1043 
Socotrine,  1041 
Aloin,  505 ;   nature  and  action  of,  1043, 

1044 
Alteratives,  nature  of,  413 ;  list  of  the 
principal,  413 ;  action  of,  413-415 ; 
uses  of,  415  ;  alkalies  as,  599  ;  lappa 
as,  960 ;  solanine  as,  984  ;  rumex  as, 
1011 ;  Phytolacca  root  as,  1009  ;  stil- 
lingia  as,  1023  ;  sarsaparilla  as,  1052 
Althaea  (marsh-mallow),  characters,  com- 
position, and  uses  of,  875 ;  a  useful 
demulcent,  347,  875 
Alum,  action  of,  on  bacteria,  94  ;  on  the 
mucous  membranes,  288  ;  as  a  caustic, 
344  ;  as  an  astringent,  349  ;  as  a  styp- 
tic, 350  ;  as  a  local  emetic,  373  ;  as  a 
local  sedative,  376 ;  as  a  vermicide, 
408 ;  action  of,  on  the  skin,  655 ;  as 
an  astringent,  655  ;  as  a  styptic,  655 ;  a 
caustic,  and  an  emetic,  655;  properties, 
action,  and  uses  of,  654-656 ;  of  dried 
ditto,  655 
Aluminium,  symbol  and  atomic  weight 
of,  9 ;  physiological  action  of,  27 ; 
action  of,  on  the  mouth  and  stomach, 
568,  569  ;  general  sources,  reactions, 
&c,  of  the  salts  of,  654 ;  hydrate  of, 
656  ;  sulphate  of,  656 
Amanita   muscaria,  as  an  antihidrotic, 

441 
Amber,  oil  of,  action  and  uses  of,  1060 
American  cannabis,  1026 

Wormseed.  See  Chenopodium 
Ammonia,  nature  of,  and  changes  it 
undergoes,  15  ;  physiological  action  of, 
27  ;  action  of,  on  bacteria,  93  ;  on  the 
muscles,  126  et  seq. ;  as  a  spinal  stimu- 
lant, 181  ;  stimulating  effects  of  the 


vapour  of  strong,  and  of  caibonate  of, 
on  the  general  circulation,  194 ;  action 
of,  on  the  ear,  229  ;   on  the  respiratory 
centre,  240 ;    and  movements,  244 ;    of 
strong  liquor  of,  on  the  secretion  of 
the    mucous    membranes,    253;-  as  a 
stimulating   expectorant,  255 ;    carbo 
nate  of,  as  an  emetic  in  chronic  bron 
chitis,  255 ;   action  of,  on  the  vagus 
centre,  317;  on  the  accelerating  centre, 
318 ;   action  of  salts  of,  on  the  vaso> 
motor  centre,  319  ;  as  a  cardiac  stimu 
lant,  328  ;   as  a  rubefacient,  344 ;  arO' 
matic  spirit  of,  as  a  direct  antacid, 
370 ;    action   of,  on  the   uterus,  454 
vapour  of,  as  a  poison,  with  its  antidote, 
486 
Ammonia,   character,    action,    and  uses 
of— 
Aromatic  spirit  of,  641 
Spirit  of,  639 

Water  of,  640  ;  stronger,  638 
Ammonium,  Acetate  of,  641 
Benzoate  of,  643 
Bromide  of,  556 
Carbonate  of,  640 
Chloride  of,  637 
Citrate  of,  712 
Iodide  of,  664 
Solution  of  acetate  of,  641 
Solution  of  citrate  of,  642 
Sulphate  of,  642 
Sulphide  of,  643 
Valerianate  of,  643 
Ammoniac,  933 
Ammoniacum,  as  an  antispasmodic,  214; 

characters  and  uses  of,  934 
Ammonias,  compound,  action  on  general 
nervous  system,  144 ;  action  on  muscle, 
636 
Ammoniated  mercury,  694 
Ammonii  benznas,  563, 964 
Iodidum,  567 
Phosphas,  642 
Ammonio-ferric  sulphate,  or  ammonio- 

ferric  alum,  749 
Ammonium,  sulphate  of  iron  and,  749 
Benzoate,  as  a  hepatic  stinralant,  403 
Bromide,  action  of,  on  the  spinal 

cord,  173 
Carbonate,  as  a  cardiac  stimulant, 
328  ;  as  a  direct  antacid,  370 ;  as  a 
local  emetic,  373 
Chloride,  action  of,  on  bacteria,  93  ; 
on  muscle,  127  et  teq. ;  on  the  ear, 
229  ;  as  a  stimulating  expectorant, 
255 ;  antagonism  of,  to  chloral,  495; 
character,  action,  and  uses  of,  637 ; 
on  the  liver,  638 
Nitrate  of,  642 
Phosphate  of,  642 

Salts,  characteristics  of,  633  ;  sources, 
reactions,  and  preparations  of,  634; 
impurities,  tests  of,  634  ;  action  of, 


GENERAL  INDEX. 


1107 


636  ;  figure  showing  the  paralysing 
action  of  ammonium  sulphate  on 
muscle,  636 
Sulphide,  action  of,  on  bacteria,  94 
Amoebae,  nature  of,  action  of  drugs  on, 
and  method  of  experimenting  on,  59  ei 
seq.;  an  amoeba,  figured  at  two  different 
periods  during  movement,  74  ;  struggle 
for  life  between  the,  and  bacilli,  84 ;  the 
protoplasm  of,  contracts  in  any  direc- 
tion, 117;  anassthetics  act  as  poisons 
to,  206 
Amphioxus,  mechanism  of  respiration  in 

the,  232;  diagram  of  an,  233 
Amygdala,  915 

Amylamine,  action  on  muscle,  636 
Amyl  nitris,  784 

Amyl,  nitrite  of,  use  of,  in  diminish- 
ing tension  and  removing  pain  in  an- 
gina pectoris,  4 ;  difference  of  action 
of,  in  different  animals,  64 ;  action 
of,  on  blood,  71  j  action  of,  on  me- 
dusae, 111 ;  on  psychical  processes, 
191 ;  on  the  dog  and  rabbit,  288  ;  as  a 
poison,  with  its  antidote,  490 ;  antago- 
nism of,  to  strychnine,  492;  prepara- 
tion, characters,  and  tests  of,  784,  785  ; 
physiological  action  of,  785 ;  on  the 
blood,  blood-pressure,  respiration,  and 
pulse,  785  ;  on  the  muscles  and  motor 
nerves,  786  ;  on  the  nervous  system  and 
urine,  786  ;  uses  of,  786  ;  as  a  remedy 
in  spasmodic  conditions,  786 ;  in  angina 
pectoris,  headache,  &c,  786;  pulse- 
tracings  illustrative  of  the  action  of, 
in  angina  pectoris,  787 ;  in  epilepsy  and 
ague,  considerations  regarding  the  ad- 
ministration of,  788 
Amylum  iodatum,  1053 
Amyridaceae,  893 
Anacardiae,  897 

Anaemia,  causes  functional  inactivity  of 
the  cerebro-spinal  system,  197 ;  loss  of 
albumen  through  the  kidneys,  and  de- 
ficiency of  fatty  food  cause  of,  412 ;  a 
deficiency  of  iron  in  the  blood  in, 
412 
Anaesthesia,  various  modes  of  inducing, 
204,  205  ;  may  be  caused  by  the  direct 
action  of  drugs  on  the  nerve-cells,  205  ; 
dangers  arising  from  the  efforts  to 
induce,  207;  action  of,  and  mode  of 
using  in  animals,  210 ;  history  of  the 
discovery  of,  211 
Anaesthetics,  nature  and  uses  of,  157, 203, 
action  of,  on  the  motor  centres  of  the 
brain,  187  ;  difference  between  ano- 
dynes and,  203  ;  divided  into  local  and 
general,  204 ;  chief  local  and  general, 
204-205  ;  usual  action  of  general  anass- 
thetics, 205  ;  the  action  of,  divided  into 
four  stages — the  stimulant,  206 ;  the 
narcotic,  206  ;  the  anaesthetic,  207 ;  and 
the  paralytic  stage,  207 ;  uses  of,  207  ; 


dangers  of,  207,208;  mode  of  adminis- 
tering, 209 ;  action  of  on,  and  mode  of 
using  in,  animals,  210  ;  history  of  the 
discovery  of  the  uses  of,  211 :  action  of, 
on  the  eye,  219  ;  may  obstruct  respira- 
tion, 238 ;  fallacies  from,  in  ascertain- 
ing the  action  of  drugs  on  the  circu- 
lation, 269 ;  action  of,  on  the  motor 
ganglia,  316 ;  as  poisons,  with  their 
antidotes,  488 ;  iodide  of  ethyl  as  an 
anaesthetic,  790 ;  iodoform  as,  805 ; 
erythroxylon  and  hydrochlorata  of 
cocaine  as,  878 
Analgesics.  See  Anodynes 
Anaphrodisiacs,  nature  and  action  of,  447- 
452;  diagrams  illustrating  the  action 
of,  448,  449 ;  general  considerations 
regarding,  451-452;  camphor  as  an, 
1019 
Anemonin,  836 

Aneurism,  emetics  to  be  avoided  in  per- 
sons suffering  from,  375 
Angina  pectoris,  4 ;  nitrite  of  amyl  di- 
minishes tension  and  removes  pain  in,  4 
Aniline  red,  822 

Sulphate,  action  of,  on  the  cardiac 
muscle,  316 
Animal  charcoal,  542  ;  purified,  542 
Animal  kingdom,  1077-1096;  class  mam- 
malia, order  rodentia,  1077 ;  order  ru- 
minantia,  1077 ;  order  pachydermata, 
1084 ;  order  cetacea,  1085  ;  class  aves, 
order  gallinae,  1085  ;  class  pisces,  order 
sturiones,  1086 ;  order  teleosteas,  family 
gadidae,    1087 ;    class    insecta,    order 
nymenoptera,  1089  ;  order  hemiptera, 
1090 ;  order  coleoptera,    1091 ;   class 
annelida,  1095 
Animals,  utility  of,  for  experiments  in 

medicine,  51-56 
Anise,  character  of,  935 ;  oil  of,  840,  935  ; 

as  a  carminative,  379,  935 
Anise  fruit,  character  of,  and  prepara- 
tions, 935 
Annelida,  1095 

Annulosa,  action  of  drugs  on,  114 
Anodynes,    two    classes   of,    local    and 
general,  201 ;  nature,  action,  and  uses 
of,  201-202  ;  adjuncts  to,  203 
Antacids,  nature   and  action  of,    369 ; 
divided  into  direct  and  indirect,  or 
remote,   369;    action  of   alkalies  as, 
598  ;  slaked  lime  as  an  antacid,  649 
Antagonistic  action  of  drugs,  492-496 
Anthelmintics,  nature  of,  408  ;  divided 
into  two  kinds,  408 ;  list  of  the  chief, 
408 ;  adjuncts  to,  408  ;  uses  of,  409  ; 
benzin  as  an,  762  j  azedarach  as,  894 ; 
kousso  as  a,  921 ;  pomegranate  root 
bark  as,  926 ;  pumpkin  seed  as,  930 ; 
wormwood  as,  953  ;  tansy  as,  954  ;  san- 
tonin as,  955 ;  spigelia  as  an,  978 ;  oleum 
chenopodii  as,  1009  ;  kamala  as,  1025 ; 
oil  of  turpentine  as,  1059 ;  thuja  as, 

4  n  2 


1108 


GENERAL  INDEX. 


1063 ;  areca  nut  as,  1052  ;  male  fern 
as,  1066 

Anthrax,  produced  by  the  bacillus  an- 
thracis,  99 

Anthrax  bacilli.    See  Bacilli 
,   Antiarine,  action  of,  on  molhisca,   114 ; 
on  the  frog's  heart,  307 ;  on  the  cardiac 
muscle,  316  ;  as  a  cardiac  tonic,  331 

Antidotes,    alkalies    serviceable   as,    in 
poisoning  by  acids,  metals,  and  alka- 
1       loids,  599 

Antidotes,  nature  and  action  of,  486  ; 
list  of  the  more  common  poisons  with 
their  antidotes,  486-491 ;  to  poisonous 
gases,  486  ;  to  acids  and  alkalies,  487  ; 
to  alkaloids,  &c,  488 

Antidysenteric,  ipecacuanha  as  an,  950 

Antifebrin,  action  and  uses,  825 

Antihidrotics,  or  anhidrotics,  nature, 
action,  and  uses  of,  441-443  ;  on  the 
sweat-glands,  441 ;  on  the  secreting 
cells  and  nerves,  441  ;  on  the  sweat- 
centres  and  on  the  circulation,  441 ; 
diagram  illustrating  the  action  of, 
442 

Antimonial  preparations  are  depressant 
expectorants,  255 

Antimonii  et  potassii  tartras,  726,  730 
Oxidum,  726,  729 
Sulphidum,  726, 727 

Purificatum,  726,  727 

Antimonium  nigrum,  726 
Sulphuratum,  726,  727 
Tartaratum,  610,  726 

Antimony,  symbol  and  atomic  weight  of, 
9  ;  its  relations  to  other  members 
of  a  group,  16 ;  action  of,  on  muscle, 
127  et  seq. ;  of  large  doses  of,  on  the 
lungs,  238  ;  on  the  motor  ganglia,  316  ; 
on  the  vaso-motor  nerves,  318;  tar- 
tarated,  as  a  pustulant,  344 ;  as  a 
caustic,  344  ;  destroys  the  glycogenic 
function  of  the  liver,  402 ;  has  a 
special  action  on  tissue-change,  415  ; 
in  poisoning  by,  action  of,  on  the 
urine,  415  ;  employed  in  diseases  of  the 
respiratory  organs,  416 ;  as  a  poison 
with  its  antidote,  488  ;  general  sources 
and  reactions  of,  721 ;  action  of,  on  the 
skin  and  stomach,  722 ;  effects  of  poi- 
soning from,  722  ;  and  mode  of  treat- 
ment, 722 ;  account  of  the  dispute  that 
has  arisen  regarding  the  mode  in 
which  tartar  emetic  causes  vomiting, 

723  ;  action  of,  on  the  heart  of  a  frog, 
724 ;  on  the  circulation,  blood-pressure, 
and  temperature,  724  ;  on  the  respira- 
tion, spinal  cord,  motor  and  sensory 
nerves  and  muscles,  724 ;  produces 
fatty  degeneration  of  various  organs, 

724  ;  rapidity  of  its  action  on  the  skin 
of  frogs,  724 ;  diagram  of  vertical 
section  of  the  epidermis  of  a  frog 
poisoned  by,  725  ;  how  eliminated,  726  j 


uses  of,  725  ;  as  an  emetic,  725 ;  how 
tolerance  of  the  drug  is  produced,  44, 
725 ;  as  a  nauseant,  726 ;  as  an  ex- 
pectorant, 726  ;  as  sedative,  726 ;  as  a 
diaphoretic,  726 ;  preparations  contain- 
ing, 726 

Antimony,  properties,  action,  and  uses 
of— 

Oxide  of,  729 

Purified  sulphide  of,  727 

Solution  of  chloride  of,  729 

Sulphurated,  727 

Tartarated,  730 

Tartrate  of,  and  potassium,  730 

Antineuralgic,  peppermint  camphor  as 
an,  1005 

Autiperiodics,  list  of  the  chief,  107 ;  their 
action,  uses,  and  adjuncts,  107  ;  eme- 
tics and  purgatives  aid  the  action  of, 
108 ;  they  rarely  succeed  without  them 
if  the  functions  of  the  liver  are  dis- 
turbed, 108  ;  lemon-juice  as  a  powerful, 
891 ;  quinine  as,  947 ;  sulphate  of 
beberine  as,  1021 

Antipyretics,  or  febrifuges,  divided  into 
two  great  classes,  418 ;  their  nature, 
416;  action,  419;  and  uses,  420; 
aromatic  series  as  antipyretics,  811 ; 
resorcin  as,  818 ;  chinoline  as,  823 ; 
kairin  as,  824  ;  antipyrin  as,  824 ; 
thallin  as,  825 ;  antifebrin  as,  825 ; 
quinine  as,  948 ;  oil  of  gaultheria  as, 
963  ;  salicin  as,  1035 

Antipyrin,  characters,  824 ;  action  of, 
in  reducing  temperature,  causing  pro- 
fuse perspiration,  and  slightly  increas- 
ing the  blood-pressure,  824  ;  uses  of, 
in  febrile  diseases  generally,  825 

Antiscorbutic,  lemon-juice  as  an,  891 

Antiseptic,  what  is  required  in  an,  89 

Antiseptics,  nature  and  action  of,  103; 
list  of,  91 ;  uses  of,  104, 106 ;  externally, 
104 ;  internally,  106  ;  calomel  as  an 
antiseptic,  106 ;  corrosive  sublimate  as, 
693  ;  chloral  hydrate  as,  791 ;  iodoform 
as,  805 ;  iodol  as,  1099 ;  the  aromatic 
series  of  the  carbon  compounds  as,  811 ; 
naphthalin  as,  446,  822  ;  chinoline  as, 
823 ;  cubebs  as,  446 ;  terpenes  as,  446 ; 
cheken  as,  923  ;  oil  of  myrtle  as,  924 ; 
oil  of  eucalyptus  as,  925 ;  quinine  as, 
945 ;  arbutin  as,  962  ;  benzoic  acid  as, 
964;  peppermint-camphor  as,  1005; 
thymol  as,  1006  ;  garlic  as,  1040 

Antisialics,  nature  and  action  of,  360, 361 

Antispasmodics,  nature,  action,  and  uses 
of,  212,  214  ;  action  of,  and  list  of, 
generally,  214;  adjuvants  to,  214; 
acetic  ether  as  an  antispasmodic,  784; 
iodide  of  ethyl  as,  790  ;  caulophyllum 
as,  843  ;  oil  of  rue  as,  881 ;  oil  of  caje- 
put  as,  924 ;  asafoetida  as,  933 ;  valerian 
as,  952 ;  stramonium  leaves  as,  992 ; 
cypripodium  as,  1036 


GENERAL  INDEX. 


1109 


Antizymotics,  nature  and  action  of,  103 
Aortic  regurgitation.   See  Regurgitation, 

aortic 
Aortic  stenosis     See  Stenosis,  aortic 
Aphrodisiacs,  nature  and  action  of,  447, 
450;  diagrams  illustrating  the  action 
of,  448,  449 
Apncea,  nature  and  cause  of,  237,  240 
Apocynaceas,  968 

Apocynum,  characters  and  action  of,  968  ; 
as  a  laxative,  a  cardiac  tonic,  and  a 
diuretic,  969 
Apomorphina,  504 

Apomorphine,  action  of,  on  muscle,  127  ; 
on  the  cerebellum,  215  ;  may  lead  to 
obstruction  of  the  bronchi,  238 ;  action 
of,  on  the  respiratory  centre,  240 ;  on 
the  mucous  membranes,  253  ;  caution 
required  in  the  administration  of,  in 
catarrhal  conditions,  254  ;  as  a  depres- 
sant expectorant,  255  ;  effect  of,  on  the 
frog's  heart,  307 ;  on  the  cardiac  muscle, 
316 ;  as  a  general  emetic,  373 
Apomorphine,  hydrochlorate  of,  charac- 
ters of,  848  ;  action  of,  as  an  emetic,  on 
the  motor  centres  in  the  brain  and  the 
respiratory  and  vomiting  centres  in  the 
medulla,  849;  on  muscular  fibre,  the 
pulse,  849 ;  and  the  secretion  of  bron- 
chial mucus,  849;  opium  versus,  859 
Apoplexy,  diagnosis  between  opium- 
poisoning,  intoxication,  and,  853 
Apples,  stewed,  as  a  laxative,  389 
Aqua  Ammonias,  506,  640 

fortior,  506,  638 
Amygdalaa  amaroe,  606,  916 
Anethi,  506,  936 
Anisi,  506,  935 
Aurantii  floris,  506,  888 
Aurantii  florum,  506,  888 
Camphors,  506,  1018 
Carui,  506,  936 
Chlori,  506,  550 
Chloroformi,  506, 796 
Cinnamomi,  506,  1017 
Creasoti,  506,  817 
Distillata,  506 
Fceniculi,  506, 934 
Laurocerasi,  506,  918 
Menthse  piperita,  506,  1004 
Menthae  viridis,  506,  1005 
Pimentas,  506,  923 
Eosae,  506,  920 
Sambuci,  506,  939 
Aqueous  solution  of  ferric  nitrate,  747 
Aquifoliaceae,  894 
Araroba  powder,  909 
Arbutin,  as  an  astringent,  349  ;  action  of, 
on  the  kidneys,  436 ;  as  an  antiseptic,  962 
Areca  nut,  as  a  vermicide,  408  ;   nature 

of,  1052 
Argenti  et  potassii  nitras,  677 
Oxidum,  648,  679 
Iodidum,  557 


Argentum.    See  Silver 

Aristolochiaceas,  1012 

Arnica,  as  a  rubefacient,  344 

Camphor,  action  of,  on  the  cardiac 
'  muscle,  316 
Flowers,  characters,  action,  and  uses 

of,  958 
Rhizome  (root),  957 

Arnstein,  reference  to,  313 

Aroidese,  1052 

Arseniate  of  iron,  751 

Arseniate  of  sodium — properties,  action, 
and  uses  of,  720 

Arsenic,  symbol  and  atomic  weight  of, 
9  ;  effect  of  habit  in  eating,  44  ;  use  of 
a  small  dose  of,  for  gastric  neuralgia, 
43 ;  action  of,  on  bacteria,  93 ;  as  an 
antiperiodic  is  sometimes  more  power- 
ful than  quinine,  107 ;  action  of,  on 
muscle,  127  et  seq. ;  on  the  ends  of  the 
vaso-motor  nerves,  284 ;  on  the  motor 
ganglia,  316  ;  on  the  vaso-motor  nerves, 
318  ;  almost  tasteless  as  a  poison,  398  ; 
secondary  effects  of,  as  a  poison,  398 ; 
destroys  the  glycogenic  function  of  the 
liver,  402;  as  an  alterative,  413;  has 
a  special  action  on  tissue-changes,  415; 
in  poisoning  by,  action  of,  on  the  urine, 
415 ;  used  in  nervous  debility,  416  ;  in 
diseases  of  the  skin,  416;  in  some 
chronic  conditions  of  the  respiratory 
organs,  416 ;  as  a  poison,  with  its  anti- 
dote, 488;  character  and  general 
sources,  712 ;  action  of,  on  the  skin, 
mouth,  stomach,  and  nervous  system, 
713 ;  treatment  in  cases  of  poisoning 
by,  714;  how  chronic  poisoning  by, 
may  occur,  714 ;  how  the  system  may 
become  habituated  to  it,  as  seen  in  the 
arsenic-eaters  of  Styria,  714 ;  action  of, 
on  the  blood,  pulse,  and  heart,  715 ; 
on  the  blood-pressure  in  animals,  715 ; 
causes  paralysis,  715;  peculiarity  of 
its  action  on  the  skin,  716 ;  diagrams 
illustrating  the  epidermis  of  a  frog 
before  and  after  poisoning  by,  715 ; 
uses  of,  in  various  diseases,  716,  717 ; 
diagram  of  section  of  lung  of  a  guinea- 
pig  poisoned  by  arsenious  acid,  716; 
probable  mode  of  action  of,  in  phthisis, 
717,  718 ;  mode  of  administration  of, 
718 

Arsenic  acid,  physiological  action  of,  27 

Arsenic,  iodide  of,  nature  and  use  of,  720; 
solution  of,  and  mercury,  721 

Aisenici  iodidum,  557 

Arsenii  iodidum,  557 

Arsenious  acid,  effects  of,  on  the  blood, 
73 ;  as  a  local  sedative  (in  minute 
doses),  376  ;  properties,  preparations, 
and  uses  of,  719,  720 

Arsenium,  712 

Arteries,  nature  and  functions  of,  262  ; 
blood  only  available  for  the  nutrition 


1110 


GENEKAL  INDEX. 


of  cells  while  in  the,  262 ;  action  of 
the  pressure  of  the,  on  the  circulation 
of  the  blood,  263  ;  action  of  the  heart 
on  the,  263 ;  effect  of  an  upright  and 
of  a  horizontal  position  on  the  circula- 
tion of  the  blood  in  the,  263  ;  arrest  of 
circulation  in  the,  the  cause  of  fainting 
and  shock,  264-265 ;  schema  of  the 
circulation  from  the  heart  to  the  veins 
and  the,  265-267;  action  of  blood- 
pressure  on  the,  267 ;  method  of  as- 
certaining the  blood-pressure  in  the, 
268-270  ;  causes  of  alterations  in 
blood-pressure  of  the,  270 ;  how  it  may 
be  raised  and  lowered,  271 ;  relation  of 
blood-pressure  to  pulse-rate  and  the, 
271-275 ;  effect  of  the,  on  pulse-curves, 
275-277  ;  investigation  of  the  action  of 
drugs  on  the,  277-279 ;  another  method 
of  ascertaining  this,  281-283 

Arterioles,  action  of  the,  on  the  blood- 
pressure,  263 ;  effects  of  rapid  dilata- 
tion of  the,  264  ;  schema  of  the  circu- 
lation in  the,  265-267 ;  circulation  in 
the,  in  the  living  body,  267 ;  blood- 
pressure  in  the,  and  method  of  ascer- 
taining it,  268-270 ;  diagram  of  the 
apparatus  employed  in  this,  269  ;  alter- 
ations in  blood-pressure  in  the,  270 ; 
relation  of  pulse-rate  and  the,  to 
blood  -  pressure,  271-275  ;  diagrams 
illustrative  of  this,  272-273  ;  effect  of 
the,  on  pulse-curves,  275-277  ;  inves- 
tigation of  the  action  of  drugs  on  the, 
277-283  ;  two  modes  of  estimating  the 
contraction  of  the,  278  j  the  method 
of  direct  observation,  278  ;  the  method 
of  measurement  by  rate  of  flow,  281 ; 
mode  of  ascertaining  whether  a  rise 
or  fall  in  blood-pressure  is  due  to  the 
heart  or  to  the,  292 ;  action  of  digitalin 
on  the,  996 

Artocarpeae,  1,028 

Asafoetida,  as  an  antispasmodic,  213,  214  ; 
as  a  carminative,  379  ;  characters  and 
uses  of,  932,  933  ;  as  an  antispasmodic, 
carminative,  and  expectorant,  933 

Asarnm  Europasum  or  asarabacca,  action 
of,  internally,  1,012 

Ascidians,  action  of  drugs  on,  114 ;  dia- 
gram of  an  ascidian,  233 

Asclepiadaceas,  970 

Asclepias,  characters  and  use  of,  970  ;  as 
a  diaphoretic,  or  expectorant,  970 

Asclepias  incarnata,  as  cardiac  tonic 
and  diuretic,  970 

Asparagus,  as  a  stimulant  diuretic,  433 

Asphxyial  blood,  stimulating  effects  of, 
on  the  medulla,  298  ;  on  sweat  centres, 
438 

Astringents,  action  of,  on  the  mucous 
membranes,  253 ;  sulphate  of  copper 
as  an  astringent,  344,  675 ;  nature, 
action,  and  uses  of,  349,377;  slaked 


lime  as  an  astringent,  648 ;  alum  as, 
655 ;  salts  of  zino  as,  668 ;  geranium 
as,  881 ;  rhatany  root  as,  869 ;  prinos 
as,  894  ;  rhus  glabra  (sumach)  as, 
898 ;  myrrh  as,  893  ;  kino  as,  902 ;  log- 
wood as,  908 ;  catechu  as,  914  ;  rubus 
or  blackberry  as,  919  ;  pale  catechu  as, 
951  ;  bearberry  as,  962  ;  chimapbila 
as,  962;  salvia  as,  1,008;  rhubarb  as, 
1,011 ;  rumex  as,  1,011 ;  oil  of  cinna- 
mon as,  1,017;  the  bark  of  quercus 
alba  as,  1,031 ;  galls  or  nutgalls  as, 
1 ,031 ;  elm  bark  as,  1,026 

Atheroma,  emetics  to  be  avoided  in 
persons  suffering  from,  375 

Atomic  weight  of  the  elements,  9,  10; 
arrangement  according  to,  16 

and  physiological  action,  relation 

between,  281 

and  smell,  relation  of,  29 

and  taste,  30 

Atonic  dyspepsia,  slight  stimulants  pro- 
duce appetite  in,  363 

Atropeae,  984 

Atropines  Sulphas,  986 

Sulphatis,  Liquor,  986, 
TJnguentum,  986 

Atropina,  504,  985,  986 

Atropine,  physiological  action  of,  on  the 
motor  or  efferent  nerves,  26;  effect  of 
large  and  small  quantities  of,  on  the 
pulse,  36  ;  action  of,  on  oxidation,  69 ; 
on  medusae,  111 ;  on  annulosa,  116;  on 
muscles,  139,  141,  155,  157 ;  as  a  seda- 
tive, 157 ;  action  of,  on  the  spinal  cord, 
163,  172;  on  the  brain  of  the  lower 
animals,  188 ;  as  a  local  and  general 
anodyne,  201 ;  as  a  mydriatic,  216,  219 
et  seq. ;  action  of,  on  the  respiratory 
centre,  240;  on  the  vagus,  244;  when 
injected  into  the  jugular  vein,  245  ;  has 
a  slight  and  uncertain  action  on  the 
respiratory  centre,  250  ;  but  a  powerful 
effect  in  completely  arresting  the  se- 
cretion from  the  bronchial  tubes,  250 ; 
cases  in  which  it  is  useful  as  a  pul- 
monary sedative  when  combined  with 
apomorphine,  250 ;  diagram  of  pulse 
and  blood-pressure  curve  caused  by  the 
actions  of,  on  the  heart,  272 ;  action 
on  the  vessels,  282 ;  destroys  the  in- 
hibitory action  of  the  vagus  on  the 
heart  in  dogs  and  rabbits,  287;  acts 
on  the  heart  through  the  vagus-roots, 
297 ;  might  be  useful  in  lessening  pain 
or  palpitation  of  the  heart  in  persons 
with  high  blood-pressure,  299 ;  with 
muscarine,  restores  the  pulsations  in 
the  heart-apex  of  the  frog,  306  ;  rapid 
action  of,  on  the  heart  of  the  frog, 
309;  on  the  inhibitory  power  of  the 
vagi,  310,  311 ;  neutralises  the  action 
of  muscarine  on  the  heart,  314 ;  action 
of,  on  the  vagus  centre,  317 ;  on  the 


GENEEAL  INDEX. 


1111 


vaso-motor  centre,  319;  as  a  cardiac 
stimulant,  328  ;  effect  of,  on  the 
secreting  cells  of  a  gland,  355 ;  the 
most  powerful  of  all  antisialics,  361 ; 
paralysing  action  of,  counteracted  by 
physostigmine,  361 ;  as  a  local  seda- 
tive, 376 ;  action  of,  on  the  intestines, 
383 ;  as  an  antihidrotic,  441 ;  strong 
solutions  of,  applied  to  the  conjunctiva, 
477;  as  a  poison,  with  its  antidote, 
488;  antagonistic  action  of,  to  other 
drugs,  492-495  ;  general  action  of 
belladonna  or,  in  large  and  small  doses, 
986 ;  special  action  of,  locally  applied, 
986 ;  on  the  brain,  the  spinal  cord,  and 
the  motor  nerves,  986,  987;  on  the 
muscles,  the  eye,  and  the  circulation, 
987 ;  on  the  urine,  988  ;  on  the  intes- 
tines in  large  and  small  doses,  988; 
and  on  the  temperature,  988 ;  certain 
animals  insusceptible  to  the  action  of, 
988;  uses  of,  989;  as  an  antidote  to 
opium,  990 

Aurantias,  887 

Auricular  septum,  view  of  the,  in  the 
frog,  300 

Aves,  1085 

Azedarach,  nature  and  use  of,  894  ;  chiefly 
as  an  anthelmintic,  894 

B. 

Bacilli,  action  of  drugs  on  particular 
species  of,  92  ;  mode  of  experimenting 
on  the  action  of  drugs  on  reproduction 
of,  92 ;  power  of  the  spores  of  Bacillus 
antlvracis  to  resist  certain  substances 
usually  fatal  to  life,  94,  95 ;  action  of 
drugs  on  the  development  and  growth 
of,  95.    See  also  Bacteria    ' 

Bacillus,  the  laetic  ferment  a,  79 ;  treat- 
ment for  destroying  the  tubercle  bacil- 
lus, 533,  717' 

Bacillus  Anthrads,  nature  and  action  of, 
717 

Bacillus  tuberculosis,  difference  between 
the  action  of,  and  that  of  Bacillus 
anthracis,  717 

Bacteria,  killed  by  creasote,  79 ;  origin 
and  nature  of,  80  ;  diagram  of  the  dif- 
ferent kinds  of ,  83 ;  diseases  caused  by, 
82  ;  importance  of  a  knowledge  of, 
in  relation  to  disease,  82 ;  divided  by 
Pasteur  into  two  classes,  82 ;  life- 
history  of,  82,  84  ;  struggle  for  exist- 
ence between  the  different  species 
of,  84,  85  ;  between  the  organism 
and,  85 ;  diagrams  illustrating  this 
struggle,  86,  87;  action  of  phagocytes 
on,  85 ;  action  of  drugs  on  the  move- 
ments of,  88;  and  on  the  reproduc- 
tion of,  in  general,  89 ;  the  most  de- 
structive substances  to,  89 ;  mode  of 
experimenting  to  test  the  effects  of 


drugs  in  destroying  the  germs  of,  89, 
90 ;  comparative  action  of  different 
drugs  on,  91 ;  action  of  drugs  on  par- 
ticular species  of,  92 ;  mode  of  experi- 
menting on  the  action  of  drugs  on  the 
reproduction  of,  92  ;  results  of  Koch's 
experiments  on,  with  three  groups  of 
disinfectants,  93,  94 ;  action  of  drugs 
on  the  development  and  growth  of,  95 ; 
table  showing  the  strength  of  various 
disinfectants  required  to  prevent  the 
development  of,  95  ;  influence  of  tem- 
perature on  the  action  of  antiseptics- 
on,  96  ;  alterations  in  by  heat  and  soil, 
96  ;  possible  identity  of  different  forms 
of,  97 ;  may  be  modified  by  cultivation, 
98 ;  action  of,  and  their  products  on 
the  animal  body,  98 ;  list  of  diseases 
caused  by,  99;  alkaloids  formed  by, 
99 ;  absorption  of  elimination  of  these 
alkaloids,  101 ;  effect  of  drugs  on  the 
action  of,  in  the  animal  body,  102 ;  de- 
composition of  food  in  the  mouth  due 
to,  352 ;  action  of  salicylic  acid  on,  820. 
See  also  Antiseptics 
Bael  fruit,  beneficial  action  of,  in  dysen- 
tery, 387  ;  characters,  composition,  and 
uses  of,  891,  892 
Baker,  Morrant,  reference  to,  856 
Balm.  See  Melissa 
Balsam,  Canada,  1057 
Of  Copaiba,  912 
Fir,  1057 

Peru,  as  a  stimulant  expectorant, 
,  255 ;  nature,  action,  and  uses 

of,  902,  903 
Tolu,  as  an  expectorant,  255,  903 
Balsamiflorse,  1030 

Baptisin,  as  a  hepatic  stimulant,  403, 405 
Barbalo'in,  nature  and  reaction  of,  1042 
Barium,  symbol  and  atomic  weight  of, 
9 ;  its  relation  to  other  members  of  a 
group,  16 ;  physiological  action  of,  27 ; 
salts  of,  action  of,  on  muscles,  129, 135, 
136,   142;    causes  contraction  of   the 
vessels,  281 ;  action  of,  on  the  heart  of 
the  frog,  307 ;  salts  of,  action  of,  on 
the  cardiac  muscle,  316 ;  and  on  the 
capillaries,   318 ;    antagonism    of,  to 
other  drugs,  492-495 
Barium  chloride,  action  of,  on  bacteria,  93 
Bark,  Angostura,  881 
Bebeeru,  1021 
Calisaya,  940 
Canella  alba,  867 
Casca,  915 
Cascarilla,  1022 
Cinchona,  939 
Cinchona,  Bed,  940 

Yellow,  940 
Cinnamon,  1016 
Coto,  1017 
Cotton  root,  872 
Larch,  1061 


1112 


GENERAL  INDEX. 


Bark— 

Mezereon,  1022 
Oak,  1030 
Paracoto,  1017 
Pomegranate  root,  926 
Quebracho,  White,  969 
Sacred,  895 
Sassy,  916 
Soap,  918 

Barley,  pearl,  1054 

Baryta  salts,  as  poisons,  with  antidote,  488 

Basham's  mixture,  745 

Baths,  cold,  as  anaphrodisiacs,  451 ;  hot 
foot,  hip,  and  mustard,  as  indirect 
emmenagogues,  453 ;  may  be  either 
local  or  general,  459  ;  three  chief  kinds, 
459,  460 ;  the  cold  bath,  460-462 ;  the 
cold  pack,  463  ;  cold  sponging,  463  ; 
cold  douche,  463 ;  the  spinal  douche, 
464  ;  the  ascending  douche,  464  ;  sitz 
bath,  464,  465  ;  cold  foot-bath,  465 ; 
cold  compresses,  465  ;  tepid  baths,  466 ; 
warm  baths,  466  ;  hot  baths,  467  ;  hot 
foot-bath,  467 ;  hot  sitz  bathe,  467  ; 
poultices,  468  ;  medicated  baths,  469  j 
sea-bathing,  469 ;  carbonic  acid  bath, 
469, 583 ;  acid  bath,  469  ;  alkaline  bath, 
470 ;  sulphurated  bath,  470 ;  mustard 
bath,  470 ;  pine  bath,  470 ;  vapour 
baths,  470 ;  calomel  fumigation,  471 ; 
air  baths,  471 ;  the  Turkish  bath,  471 ; 
friction  and  inunction,  472-474 

Bat's  wing,  Luchsinger's  experiment  with 
a,  138 

Baxt,  reference  to,  854 

Baxter,  B.,  reference  to,  61 

Beads,  jumble,  903 
Prayer,  903 

Bean  of  St.  Ignatius,  971 

Bearberry,  and  bearberry  leaves,  961 

Beaumont,  Dr.,  references  to  his  observa- 
tions on  the  case  of  Alexis  St.  Martin, 
369,  407 

Bebeerine,  action  of,  on  bacteria,  89  ;  as 
an  antiperiodic,  107 

Bebeeru  bark,  as  an  antiperiodic,  107 ; 
characters  and  composition  of,   1021 

Beberinse  sulphas,  1021 

Beberine,  sulphate  of,  properties,  action, 
fvnd  uses  of,  1021 

Beef -tea  versus  alcohol,  as  a  stimulant,  774 

Beer  yeast,  1073 

Belladonna,  difference  of  action  of,  in 
men,  rabbits,  and  dogs,  64 ;  as  a  seda- 
tive, 157;  action  of,  on  frogs,  171;  as 
a  spinal  stimulant,  182 ;  as  a  narcotic, 
200  ;  as  a  local  and  general  anodyne, 
201,  202  ;  as  a  mydriatic,  219  ;  action 
of,  on  the  respiratory  centre,  250 ;  on 
palpitation  of  the  heart,  338 ;  as  a  local 
sedative,  376 ;  as  a  purgative,  386  ;  as 
an  antihidrotic,  441 ;  its  action  in  in- 
continence of  urine,  445 ;  as  .'•  poison, 
with  its  antidote,  488  ;  antagonism  of, 


to  opium,  494  ;  preparations,  986  j  ac- 
tion, 986 ;  uses,  989 

Belladonna  leaves,  984 

Boot,  985.     For  general  action  of 
belladonna,  see  Atropine 

Belladonnine,  as  a  mydriatic,  219 

Bennett,  Hughes,  reference  to,  160 

Benzin,  properties  and  uses  of,  762 

Benzoates,  test  for,  594 

Benzoate  of  ammonium,  643,  964 
of  lithium,  632 

of  sodium,  action  of,  on  enzymes,  78  ; 
on  bacteria,  94,  95 ;  uses  of,  628 

Benzoated  lard,  1084 

Benzoic  acid,  action  of,  on  enzymes,  78 ; 
on  bacteria,  91, 94, 95 ;  as  a  stimulating 
expectorant,  255 ;  action  of,  on  the 
kidneys,  436 ;  preparation  and  proper- 
ties of,  964  ;  action  of,  as  an  antiseptic, 
964;  as  diaphoretic,  965  ;  uses  of,  965 

Benzoin,  as  a  stimulating  expectorant, 
256  ;  characters  of,  963 ;  and  prepara- 
tions of,  964 ;  compound  tincture  of,  964 

Benzol,  action  of,  on  bacteria,  93 

Benzoyltropine,  as  a  mydriatic,  219,  223 

Berberidacese,  842 

Berberine,  character  and  action  of,  837, 
838,  841,  883 

Bergamot,  oil  of,  characters  and  uses  of, 
890 

Bergmann,  reference  to,  100 

Bernard,  Claude,  references  to,  38,  and  n., 
56,  147,  150,  358,  850 

Bernstein,  references  to,  174,  235,  237 

Bert,  Paul,  reference  to,  94 

Beryllium,  symbol  and  atomic  weight  of, 
9  ;  physiological  action  of,  27 

Bezold,  Von,  references  to,  285,  288,  296 

Bicarbonates,  test  for,  594 

Bicarbonate  of  potassium,  608 

of  sodium,  action  of,  on  the  gastric 
juice,  364 ;  nature  of,  622 

Bichloride  of  ethidene,  as  a  general  anes- 
thetic, 205  ;  of  methylene,  as  a  general 
anaesthetic,  205  ;  nature  of,  795 

Bichromate  of  potassium,  as  a  poison, 
with  its  antidotes,  489 ;  nature  and 
uses  of,  616 

Biedermann,  reference  to,  133 

Bigelow,  Dr.,  reference  to  his  use  of  ether, 
212 

Bile,  utility  of  emetics  to  expel,  from  the 
gall-bladder,  374;  and  to  remove  it 
from  the  body  in  cases  of  biliousness, 
fevers,  and  agues,  376 ;  nature  and 
functions  of  the,  399-406 ;  use  of  chola- 
gogues  in  removing  the,  from  the  body, 
407 ;  action  of  acids  on  the,  670 ;  of 
pilocarpine,  885  ;  of  leptandra,  1002 ; 
of  aloes,  1044  ;  puriaed  ox-bile,  1082 ; 
its  composition,  action,  and  uses,  1082 

Bin-oxalate  of  potassium  (salts  of  lemon 
or  sorrel),  as  a  poison,  with  its  anti- 
dote, 487 


GENERAL  INDEX. 


1113 


Binz,  Prof.,  references  to,  62, 72, 166,  549, 

874 
Birds,  action  of  opium  on,  851 
Bismuth,  properties,  preparation,  action, 
and  uses  of — 
Carbonate  of,  731,  733 
Citrate  of,  733 

and  ammonium,  734 
Common,  730-732 
Oxide  of,  731 
Purified,  732 
Solution  of  citrate  of,  and  ammonium, 

733 
Subcarbonate  of,  733 
Sub-nitrate  of,  731,  732 
Bismuth,  symbol  and  atomic  weight  of, 
9  ;  a  mild  irritant  to  the  stomach,  363 ; 
salts  of,  as  a  local  sedative,  376 
Bismuth  subnitrate,  as  an  astringent,  349 
Bismuth!  et  ammonii  citras,  734 

Citratis  liquor,  733 
Carbonas,  732 
Citras,  732 
Subnitras,  732 
Bisulphide  of  carbon,  action  of,  on  bac- 
teria, 93  ;  action  and  uses,  760 
Bisulphite,  test  for,  595 
Bisulphite  of  sodium,  630 
Bitartrate,  test  for,  595 
Bites  of  venomous  serpents  or  of  rabid 
dogs,  utility  of  caustics  in,  347 ;   ne- 
cessity for  care  in  cauterising  for  dog- 
bites,  347 
Bitters,  action  of,  364 
Bittersweet.    See  Dulcamara 
Blackberry,  919 
Black  Haw,  939 
Pepper,  1012 
Wash,  691 
Bladder,  diagram  to  show  the  effects  on 
the    cerebral    circulation   of    rapidly 
emptying  the,  264 ;  action  of  drugs  on 
the,  443-445  j  situation  of  the  nerve- 
centre  of  the,  444 ;  and  of  the  cerebral, 
444 ;   action  of  vesical  sedatives  on, 
444;  and  vesical  tonics,  445;  urinary 
sedatives  and  astringents,  446  ;  treat- 
ment of  inflammation  cf  the,  446  ;  re- 
sult of  distension  of  the,  and  of  stone 
in  the,  451 ;  utility  of  pareira  root  in 
chronic  catarrh  of  the,  842 ;  action  of 
buchu  leaves  on  the  mucous  membrane 
of  the,  882  ;  of  pilocarpine,  884,  885 ; 
of  physostigmine,  907 
Blagdon,  Sir  Charles,  reference  to,  440 
Blake,  reference  to,  26 
Blastomycetes,  83 
Blatta  orientalis,  as  a  stimulant  diuretic, 

433 ;  as  an  aphrodisiac,  450 
Bleeding,  local,  or  by  leeches  or  by  wet 
cupping,  usefulness  of,  in  inflammation 
and  fever,  420;  as  an  anaphrodisiac, 
451 
Blisters,  probable  action  of,  in  inflam- 


mation, 342,  343 ;  various  diseases  in 
which  they  are  useful,  345 ;  as  anti- 
pyretics, 418 

Blood,  red  corpuscles  of  the,  effect  of 
heat  and  cold  on,  63 ;  action  of  drugs 
on  the,  70;  effects  of  oxygen  and  other 
gases  on  the,  69-71;  various  consti- 
tuents of  the,— haemoglobin,  70-72; 
oxy-hasmoglobin,  70-72 ;  haematin,  70- 
71 ;  methamaoglobin,  71-72  ;  effects  of 
carbonic  acid  on  the,  70 ;  of  hydro- 
cyanic acid,  70 ;  of  nitrites,  71 ;  altera- 
tions effected  in  the  interchange  be- 
tween the  air  and  the,  72 ;  poisoning 
of  the,  produced  by  the  bacillus  septic- 
eemias,  99-100  ;  action  of,  on  the  brain, 
192-200 ;  state  of  the,  in  respiratory 
complications,  237-240;  effect  of  ex- 
cessive venosity  of  the,  on  the  respira- 
tory centres,  237-238 ;  condition  of  the, 
in  suffocation,  and  in  nitrite  and  car- 
bonic oxide  poisoning,  239,  240 ;  differ- 
ence in  the  quality  of,  in  the  arteries  and 
in  the  veins,  262 ;  importance  of  the  pres- 
sure of  the  arteries  and  veins  on  the 
circulation  of  the,  263 ;  action  of  the 
heart  in  reference  to  the,  263  ;  fainting 
and  shock  caused  by  the  sudden  arrest 
of  the  supply  of,  to  the  brain,  264,  265 ; 
schema  of  the  circulation  of  the,  265- 
267 ;  diagram  illustrating  this,  266  ; 
circulation  of  the,  in  the  living  body, 
267 ;  nature  of  arterial  tension,  or 
blood-pressure,  267  ;  method  of  ascer- 
taining the  blood-pressure,  268 ;  altera- 
tions in  blood-pressure  and  their  causes, 
270 ;  how  this  pressure  may  be  raised 
and  lowered,  271 ;  relation,  of  pulse-rate 
and  arterioles  to  blood-pressure,  271- 
275  ;  diagrams  illustrative  of  blood- 
pressure,  272  et  seq.;  effect  of  the 
arterioles  on  blood-pressure  and  pulse- 
rate,    275-277;    investigation  of   the 

'  action  of  drugs  on  the  blood-vessels, 
277-280 ;  another  method  of  ascertain- 
ing this,  281-283 ;  venous,  causes  con- 
traction, and  oxygenated,  dilatation  of 
the  vessels,  282 ;  action  of  other  parts 
on  blood- pressure,  285 ;  reflex  contrac- 
tion of  blood-vessels,  285 ;  action  of 
drugs  on  this  reflex  contraction,  286 ; 
comparative  effect  of  heart  and  vessels 
on  blood-pressure  in  different  animals, 
287-288  ;  influence  of  nerves  on  blood- 
pressure,  289-292  ;  causes  of  alteration 
in  blood-pressure  and  pulse-rate,  293  ; 
action  of  the  heart  on  blood-pressure, 
292 ;  action  of  styptics  on  the,  350 ; 
coagulation  of  the,  caused  by  alum, 
lead  acetate,  and  ferric  chloride,  350 ; 
action  of  hsematinics  in  improving  the 
quality  of  the,  412 ;  nature  and  action 
of  the  red  corpuscles  of  the,  412  ;  the 
various  constituents  of,  412;  pressure 


1114 


GENERAL  INDEX. 


of  the,  in  the  glomeruli,  and  the  com- 
position of  the,  two  factors  in  the 
rapidity  of  the  secretion  of  urine,  427, 
430;  experiment  with  digitalis  on 
blood-pressure,  430,  431 ;  action  of  hy- 
drocyanic acid  on  the,  587  ;  of  caustic 
alkalies  injected  into  the,  599  ;  action 
of  the  metals  on  the,  665  ;  of  mercury, 
685 ;  of  salts  of  iron,  740 ;  of  alcohol, 
767 ;  of  spirit  of  ether,  782  ;  of  nitrite 
of  amyl,  785 ;  of  nitro-glycerine,  789  j 
of  choral  hydrate,  792;  of  purified 
chloroform,  797,  799  ;  of  carbolic  acid, 
814;  of  creasote,  817;  of  antipyrin, 
824 ;  of  erythroxylon,  879  ;  of  caffeine, 
871 ;  of  Jamaica  dogwood,  913 ;  of  oil 
of  eucalyptus,  925 ;  of  quinine,  945 ; 
of  oil  of  valerian,  952 ;  of  sulphate  of 
strychnine,  974;  of  curare,  976;  of 
gelsemium,  978  ;  of  tobacco,  993 ;  of 
digitalin,  996 ;  of  thymol,  1006 ;  of 
tannic  acid,  1032 

Blood-letting,  as  a  local  anodyne,  201 

Bloodroot.    See  Sanguinaria 

Blue  cohosh,  842 

Bocci,  reference  to,  401 

Body,  Remedies  Acting  on  the 
Surface  of  the,  340-351.  See 
Remedies,  &o. 

Boehm,  references  to,  124,  245,  284,  315, 
836,996 

Boerhaave,  reference  to,  444 

Boisbaudran,  L.  de,  on  molecules,  27 

Bon,  M.  Gustavle,  reference  to,  103 

Bones,  action  of  phosphorus  on  the,  710 

Boracic  acid,  action  on  bacteria,  94,  95  ; 
nature  and  properties  of,  581 

Borates,  test  for,  594 

Borax,  action  of,  on  enzymes,  78 ;  on 
bacteria,  91,  94,  95;  as  an  antiseptic 
for  cleansing  the  teeth,  352 ;  as  an  anti- 
sialic,  361 ;  as  a  direct  emmenagogue, 
453 ;  nature  and  uses  of,  624 ;  its  de- 
rivatives, glycerinum  boracis  and  mel 
boracis,  S24 

Boric  or  boracic  acid,  properties  of,  &c, 
581 

Borneol,  action  of,  on  the  brain  and 
spinal  cord,  213  ;  on  the  cardiac  muscle, 
316 

Boron,  symbol  and  atomic  weight  of,  9 

Borosalicylate  of  sodium,  91 

Botkin,  Jnr.,  reference  to,  29 

Bouchard,  reference  to,  101,  401 

Bouley,  reference  to,  369 

Bowditch,  reference  to,  304 

Bowels.    See  Intestines. 

Bowman,  reference  to,  422-423 

Brain,  Action  of  Drugs  on  the,  183- 
215 ;   in  the  frog,   183 ;  in  mammals. 
184 ;    of  frogs,    rabbits,   guinea-pigs, 
monkeys,    dogs,  and    cats,    183-186 
diagram  of  the  brain  of  a  frog,  184 
diagram  of  the  brain  of  a  monkey,  185 


arrangement  of  the  motor  and  sensory 
centres  of  the,  in  the  lower  animals, 
186  ;  depressant  action  of  drugs  on  the 
motor  centres  of  the,  187  ;  method  of 
investigating  the  action  of  drugs  on  the 
excitability  of  the,  187 ;  irritant  action 
of  drugs  on  the  motor  centres  of  the,, 
188-190 ;  action  of  drugs  on  the  sensory 
and  psychical  centres  of  the,  191-212  ; 
effect  of  drugs  upon  the  time  required 
for  mental  processes,  191 ;  drugs  which 
increase  the  functional  activity  of  the, 
192  ;  nerve  stimulants,  192 ;  cerebral 
stimulants,  192  ;  effects  of  posture  and 
mastication  on  the  action  of  the,  192 : 
stimulating  effects  of  smoking,  sips  of 
alcohol,  and  tea  and  coffee  on  the,  193- 
194 ;  suction  causes  an  increased  sup- 
ply of  blood  to  the,  194 ;  diagrams  illus- 
trating action  on  circulation  of,  by  pos- 
ture, mastication,  and  sucking,  193  ; 
exercise  causes  increased  activity  in 
the,  194 ;  sipping  a  powerful  stimulant 
to  the,  194  ;  alcohol  one  of  the  typical 
stimulants  of  the,  195 ;  direct  action 
of  strychnine  and  caffeine  on  the,  195 ; 
drugs  which  lessen  the  functional  ac- 
tivity of  the,  195-211 ;  hypnotics  or 
soporifics  induce  sleep,  196 ;  effects  of 
different  degrees  of  sleep  on  the,  196- 
197  ;  action  of  hypnotics  on  the,  196- 
200  ;  of  narcotics,  200 ;  peculiar  action 
of  alcohol  on  the,  200 ;  peculiar  physio- 
logical conditions  of  the,  200 ;  action 
of  anodynes  or  analgesics,  201-203; 
causes  and  transmission  of  pain,  202 ; 
adjuncts  to  anodynes,  203 ;  action  of 
anaesthetics  on  the,  203-210;  of  anti- 
spasmodics, 212 ;  of  drug's  on  the  cere- 
bellum, 215 ;  different  kinds  of  spirits 
appear  to  affect  different  parts  of  the, 
215 ;  fainting  and  shock  caused  by 
arrest  of  the  supply  of  blood  to  the, 
264,  265;  action  of  the,  on  vomiting, 
371 ;  action  of  bromide  of  potassium 
on  the,  554  ;  of  strong  solution  of 
ammonia,  639  ;  of  alcohol,  769 ;  of 
spirit  of  ether,  782  ;  of  chloral  hydrate, 
792  ;  of  hydrochlorate  of  apomorphine, 
849 ;  of  codeine,  850 ;  of  opium,  854 ; 
of  sanguinaria,  863;  of  citrate  of  caf- 
feine, 871 ;  of  oil  of  eucalyptus,  925  ; 
of  corri'me,  932  ;  of  oil  of  valerian^  952 ; 
of  strychnine,  975 ;  of  belladonna  or 
atropine,  986 

Brandy  as  a  cardiac  stimulant,  328; 
nature,  &c,  of,  773,  776 

Bread,  as  a  demulcent,  347;  crumb  of, 
1053 

Brefeld,  his  classification  of  organised 
ferments,  81 

Brieger,  references  to,  99,  101 

Bromal-hydrate,  antagonism  of,  to  atro- 
pine,-495 ;  nature,  action,  and  use  of,  795 


GENERAL  INDEX. 


1115 


Bromic  acid,  physiological  action  of,  27 
/Bromides,  test  for,  594 

Bromide  of  Ammonium  as  a  hypnotic, 
199 ;    as  an  anaphrodisiac,    451  ; 
nature  of,  556 
Calcium,  as  a  hypnotic,  199,  558 
Ethyl,  205,  789 
Lithium,  556 
Potassium,  553 
Sodium,  555 
Zinc,  as  a  hypnotic,  199,  672 

Bromide  of  potassium,  action  of,  on  the 
motor  centres  of  the  brain,  187 ;  lessens 
the  functional  activity  of  the  brain,  196 ; 
as  a  hypnotic,  199 ;  as  an  anodyne,  202 ; 
as  an  antispasmodic,  213  ;  action  of,  as 
an  antispasmodic,  214  ;  on  the  vessels 
of  circulation,  286;  as  an  anaphro- 
disiac, 451 ;  action  of,  553 ;  action  of,  on 
the  spinal  cord  and  the  brain,  553 ;  uses 
in  nervous  diseases  and  as  a  hypnotic, 
554 ;  allays  excitability  and  irritability, 
554 ;  in  epilepsy  and  sickness,  espe- 
cially in  pregnancy  and  sea-sickness, 
555  ;  as  an  anaphrodisiac,  655 

Bromide  of  sodium,  as  a  hypnotic,  199 

Bromides,  mixed,  556 

Bromine,  symbol  and  atomic  weight  of,  9 ; 
action  of,  on  infusoria,  65 ;  on  enzymes, 
78 ;  on  bacteria,  89, 91, 93, 95 ;  as  a  caus- 
tic, 344  ;  as  a  poison,  with  its  antidote, 
486 ;  characters,  test,  and  uses  of,  552 

Bromo-camphor,  antispasmodic  powers 
of,  213 

Bromoform,  as  a  general  anaesthetic,  205 

Bronchial  asthma,  pathology  of,  259; 
treatment,  260 

Bronchial    tubes,    atropine    completely 

■  arrests  the  secretion  from  the,  250; 
action  of  drugs  on,  259 

Bronchitis,  chronic,  cod-liver  oil  affords 
more  relief  in,  than  any  of  the  ordinary 
expectorants,  254 ;  importance  of  an 
emetic  in,  255;  ipecacuanha,  either 
alone  or  combined  with  squills,  as  ex- 
pectorant in,  255 ;  with  great  depression 
and  feeble  circulation,  carbonate  of 
ammonium  to  be  preferred,  255 ;  import- 
ance of  warmth  and  moisture  in,  255  ; 
of  respirators,  warm  clothing,  &c,  in, 
256 ;  value  of  certain  plasters  in,  256  ; 
tartar  emetic  ointment  and  croton-oil 
liniment  sometimes  of  use  in,  346 

Bronchitis  kettle,  nature  and  use  of,  481 

Broom,  as  a  refrigerant  diuretic,  432 ; 
broom  and  broom-tops,  characters  and 
composition  of,  900;  physiological 
action  and  therapeutical  uses  of,  900 

Brown-Sequard,  reference  to,  244 

Brucine,  effects  of,  on  the  blood,  72 ; 
as  a  spinal  stimulant,  181 ;  action  of, 
on  the  respiratory  centre,  240 ;  an- 
tagonism of,  to  chloral,  495 ;  acts  like 
strychnine.  975 


Brficke,  Professor,  reference  to,  995 
Brunton,  Dr.  L.,  references  to,  29,  37,  42, 

47,  55,   124,   129,   150,   176,   186,  228, 

273,  276,  288,  294,  296,  312,  381,  401, 

430,  431,  493,  497,  606,  900 
Bryonia,  or  bryony,  characters  and  use 

of,  as  a  hydragogue  cathartic,  930 
BubnofE,  reference  to,  837 
Buchheim,  references  to,  37,  150 
Buchner,  reference  to,  98 
Buchu,  as   a  stimulant   diuretic,    433 ; 

action  of,  on  the  bladder,  445 ;  buchu 

leaves,  nature,  action,  and  use  of,  882 
Buckthorn,   nature,  action,  and  use  of, 

895 
Burdock,  960 
Burgundy  pitch,  1062 
Burnett,  Sir  W.,  reference  to,  671 ;  his 

disinfecting  fluid,  as  a  poison,  with  its 

antidote,  488 
Burseracese,  893 
Butternut.    See  Juglans 
Butyl-chloral,  as  a  general  anodyne,  201, 

202;  characters,  action,  and  uses  of, 

794 
Butyric  acid,  action  of,  on  bacteria,  93 
Buxine,  as  a  spinal  stimulant,  181 
Byttneriacese,  875 


C. 


Cabbage-rose  petals,  920 

Cacao-butter,  876 

Cadaverine,  100 

Cadmium,  symbol  and  atomic  weight  of, 

.  9  ;  its  relation  to  other  members  of  a 
group,  16  ;  physiological  action  of,  27  ; 
effect  of,  on  muscle,  127  et  seg. ;  causes 
slight  contraction  of  the  vessels,  281 ; 
cadmium  sulphate,  as  an  astringent, ' 
349 

Csesalpinise,  909 

Cassium,  symbol  and  atomic  weight  of, 
9 ;  its  relation  to  other  members  of  a ' 
group,  16  ;  physiological  action  of,  27 

Caffeina,  504 

Caffeinas  citras,  504,  870 

Caffeine,  action  of,  on  oxidation,  70 ;  on 
medusae,  111;  on  annulosa,  116;  on 
muscles,  130, 136  et  seq. ;  on  the  spinal 
cord,  160;  as  spinal  stimulant,  181; 
on  the  brain,  195 ;  on  the  accelerating 
centre,  318 ;  on  the  vaso-motor  centre, 
319  ;  on  the  cardiac  muscle,  316 ;  as  a 
cardiac  tonic,  331 ;  as  a  hydragogue 
diuretic,  432 ;  antagonism  of,  to  mor- 
phine, 494,  496;  (theine,  guaranine) 
characters  of,  870;  action  of,  on  the 
nerve-centres,  and  on  muscular  fibre, 
871 ;  on  frogs  and  warm-blooded 
animals,  871 ;  on  the  brain,  medulla, 
respiration,  blood-pressure,  and  pulse, 
871 ;  on  the  salivary  secretion  and  the 


1116 


GENERAL  INDEX. 


intestines,  871 ;   on  the  temperature, 
872 ;  as  a  diuretic,  872 

Cahours,  reference  to,  150 

Cajuput  oil,  as  a  rubefacient,  344- ;  and 
carminative,  379 ;  oil  of,  characters  and 
uses  of,  924  ;  as  a  powerful  stimulant, 
antispasmodic,  and  rubefacient,  924 

Calabar  bean  as  a  myotic,  219;  as  a 
poison,  with  its  antidote,  488  ;  charac- 
ter, composition,  and  preparations  of, 
904.    See  also  Physostigma 

Galabarine,  as  a  spinal  stimulant,  181 ; 
antagonism  of,  to  chloral,  495 

Calamine,  prepared,  670 

Calamus,  1052 

Calcit  hydras,  647,  648 

Calcium,  symbol  and  atomic  weight  of, 
9  ;  its  relation  to  other  members  of  a 
group,  16;  and  specially  to  lithium, 
17 ;  physiological  action  of,  27 ;  action 
of,  on  the  muscles,  134,  142;  causes 
great  contraction  of  the  vessels,  281 ; 
salts  of,  and  distilled  water  prolong 
the  beating  of  the  frog's  heart,  306 

Calcium  salts,  sources  and  reactions  of, 
646 ;  general  preparation  of,  647  ;  im- 
purities and  tests  of,  647 ;  characters 
and  uses  of,  646  et  self. 
Bromide  of,  556 

Chloride  of,  action  on  bacteria,  93, 651 
Hypophosphite  of,  653 
Precipitated  Carbonate  of,  651 
Phosphate  of,  652 
See  also  under  Lime 

Calendula  (marigold),  959 

Calomel,  antiseptic  power  of,  106 ;  action 
of,  on  the  stomach,  369  ;  on  the  pan- 
creatic juice,  408 ;  as  a  diuretic,  432, 
686 ;  its  action  and  uses,  691 

Calomel  fumigation,  471 

Calumba  and  Calumba  root,  characters, 
composition,  and  preparations  of,  840 ; 
actions  and  uses  of,  841 

Calycifloras  (sub-class  III.),  899 

Camphor,  action  of,  on  bacteria,  95  ;  on 
ascidians,  114  ;  and  on  annulosa,  116  ; 
curious  exciting  action  of,  on  the  brain 
and  the  medulla,  190 ;  action  of,  as  an 
antispasmodic,  213  ;  on  the  ear,  229  ; 
on  the  vaso-motor  centre,  319 ;  on  the 
cardiac  muscle,  316;  as  a  cardiac 
stimulant,  326,  329 ;  as  a  popular 
remedy  to  cut  short  coryza  or  catarrh, 
331 ;  compound  liniment  of,  and  cam- 
phor, as  a  rubefacient,  344 ;  as  an 
anaphrodisiac,  451 ;  use  of,  in  lini- 
ments, 515 ;  characters,  composition, 
and  preparations  of,  101 8  ;  action  of, 
as  a  stimulant  and  rubefacient,  1018 ; 
as  a  diaphoretic  and  anaphrodisiac, 
101 9 ;  action  of,  on  the  heart,  nerve- 
centres,  and  the  temperature,  1019 ; 
uses  of,  externally  and  internally, 
1019 


Camphor,  monobromated,  characters  of. 
1019  ;  action  and  uses  of,  1019 ;  as  a 
sedative,  1019 

Campylospermas,  930 

Canada  Balsam,  1057 
Pitch,  1062 
Turpentine,  1057 

Canadian  hemp.    See  Apocynum 

Canellaceze,  867 

Canella  bark,  an  aromatic  bitter  ,  and 
tonic,  867 

Cannabin,  action  of,  on  brain  of  dogs,  188 

Cannabinese,  1026 

Cannabis,  AmericaD,  1026 

Cannabis  indica,  as  a  hypnotic,  199  ;  as  an 
anodyne,  202  ;  action  of,  in  producing 
visions,  228 ;  doubtful  value  of,  as  an 
aphrodisiac,  450  ;  as  a  poison,  with  its 
antidote,  488;  character,  action,  and 
uses  of,  1026 

Cantharides,  as  a  vesicant,  344 ;  as  a 
stimulant  diuretic,  433  ;  action  of,  on 
the  kidneys,  435  ;  produces  both  albu- 
minuria and  hsematuria,  435  ;  its  action 
on  the  urine,  445  ;  as  an  aphrodisiac, 
450;  as  a  direct  emmenagogue,  453; 
as  a  poison,  with  their  antidotes,  488 ; 
character  and  composition  of,  1091 ; 
action  of,  externally  and  internally, 
1091;  on  the  salivary  glands  and  on 
the  urinary  organs,  1092  ;  uses  of,  ex- 
ternally as  an  irritant  and  a  counter- 
irritant,  1092 ;  with  diagrams,  1093, 
1094 ;  and  internally,  1094 ;  precautious, 
1094 

Capillaries,  list  of  drugs  by  which  they 
are  stimulated,  depressed,  or  paralysed, 
318;  a  certain  abnormal  condition  of 
the,  one  of  the  chief  causes  of  dropsy, 
337 

Caprifoliacese,  939 

Capsicum,  as  a  rubefacient,  344 

Fruit,  characters  and  composition  of, 
984  ;  action  and  uses  of,  984 

Caraway,  as  a  carminative,  937 
Fruit,  936 
Oil  of,  937 

Caraway  and  oil,  as  a  carminative,  379 

Carbolic  acid,  action  of,  on  enzymes,  78; 
on  bacteria,  91-92 ;  as  a  deodorizer, 
104 ;  its  superiority  for  removing  smell 
from  the  hands,  106 ;  as  a  sedative  and 
an  anaesthetic,  157 ;  one  of  the  chief 
local  anaesthetics,  204 ;  action  of,  on 
the  vaso-motor  centre,  319  ;  as  a  caus- 
tic, 344  ;  as  an  astringent  for  the  teeth, 
352  ;  liquefied  as  a  remedy  for  tooth- 
ache, 353  ;  as  a  local  gastric  sedative, 
376 ;  as  a  poison,  with  its  antidote, 
489  ;  antagonism  of,  to  chloral,  495  ;, 
characters,  tests,  and  preparations  of, 
813;  action  of,  as  a  deodorizer  and 
disinfectant,  813 ;  on  the  skin  and 
mucous  membranes,  814;  on  the  blood, 


GENERAL  INDEX 


1117 


muscle,  nerve,  and  medulla  oblongata, 
814;  on  the  spinal  cord,  respiratory 
and  vaso-motor  centres,  814;  on  the 
cerebral,  sweat  and  salivary  centres, 
814;  on  the  temperature,  814;  how 
excreted,  815 ;  poisoning  of,  treatment, 
815 ;  uses  of,  815-816 

Carbon,  symbol  and  atomic  weight  of,  9  ; 
found  in  three  forms,  and  in  various 
compounds,  14 ;  its  relation  to  other 
members  of  a  group,  16 ;  its  forms, 
541-543 

Carbon,  bisulphide  of,  character,  action, 
and  uses  of,  760 

Carbon  compounds,  fatty  series,  759  et 
teg. ;  properties  and  general  action  of, 
759,  760;  aromatic  series,  807-826; 
general  characters  of,  807  ez  seg. ; 
action  of,  811 ;  their  antiseptic  and 
antipyretic  power,  811.  See  Hydro- 
carbons 

Carbon  monoxide.   See  Carbonic  oxide 

Carbonates,  test  for,  594 

Carbonate  of  Ammonium,  640 
Bismuth,  733 
Lead,  703 
Lithium,  631 
Magnesium,  658,  660 
Potassium,  604,  607 
Sodium,  618,  621 
Zinc,  667,  670 

Carbonate  of  sodium,  action  of,  on  the  ear, 
229  ;  on  the  mucus  from  the  trachea, 
252 ;  as  »  poison,  with  its  antidote, 
487 

Carbonic  acid,  action  of ,  on  protoplasm, 
61 ;  as  a  local  anodyne,  201 ;  action  of, 
on  the  blood,  283 ;  as  a  refrigerant 
diuretic,  432 ;  as  a  poison,  with  its 
antidote,  487  ;  as  choke-damp,  with  its 
antidotes,  487 ;  properties  of  carbonic 
acid,  583 ;  action  and  uses  of,  583 ; 
effects  of,  in  the  mouth,  the  stomach, 
and  the  intestinal  canal,  583  ;  poison- 
ing by,  584 ;  has  three  stages — dyspnoea, 
convulsions,  and  paralysis,  584 ;  its 
treatment,  585 

Carbonic  oxide,  compound  with  hasmo- 
globin,  72;  action  of,  on  muscles,  127 
et  teg. ;  on  the  vagus-centre,  317 ;  effects 
of  poisoning  by,  on  the  colour  of  the 
blood,  240 ;  as  a  poison,  with  its  anti- 
dote, 486 

Cardamoms,  as  carminatives,  379 ;  as 
stimulants  and  carminatives,  1038 

Cardiac  muscle,  drugs  which  stimulate  or 
depress,  316 

Cardiac  poisons,  action  of  different  kinds 
of,  308,  316 

Cardiac  sedatives,  nature  and  action  of, 
338,  339 

Cardiac  stimulants,  nature  and  action  of 
and  list  of  the  principal,  328 

Cardiac  tonics,  249;    nature  of,  and  list 


of  the  principal,  331;  conditions  and 
diseases  of  the  heart  in  which  they  are 
most  useful,  332-334  ;  the  question  as 
to  the  use  of  digitalis  in  aortic  re- 
gurgitation considered,  333-334;  risks 
attending  the  administration  of  digi- 
talis and  other  cardiac  tonics,  335 ; 
cimicifuga  (black  snakeroot)  as  * 
cardiac  tonic,  837 ;  apocynin  and 
apocynein  as,  969 

Carlsbad  water,  probable  cause  of  its 
efficacy  in  hepatic  diseases,  407;  nature 
and  uses  of,  625 

Carminatives,  nature  of  the  action  they 
exert  on  the  stomach,  378,  379 ;  list  of 
the  chief,  379 ;  their  principal  uses, 
379;  cloves  as,  922  ;  asafoetida  as,  933 ; 
fennel  fruit  as  a,  934  ;  oil  of  anise  as, 
935  ;  oil  of  dill  as,  936 ;  oil  of  caraway 
as,  937  ;  oil  of  coriander  as,  938  ;  oil 
of  chamomile  as,  956  ;  oil  of  rosemary 
as,  1003 ;  oil  of  lavender  flowers  as, 
1004 ;  oil  of  peppermint  as,  1004  ;  oil 
of  spearmint  as,  1005 ;  hedeoma  or 
pennyroyal,  1007;  expressed  oil  of 
nutmeg  as,  1016 ;  oil  of  cinnamon  as, 
1017  ;  garlic  as,  1040  ;  cardamons  as, 
1038 ;  saffron  as,  1039 

Carolina  pink.    See  Spigelia 

Carron  oil,  origin,  composition,  and  uses 
of,  649 

Carrot  as  a  stimulant  diuretic,  433 

Casca  bark  (sassy  bark),  composition, 
action,  and  uses  of,  915 

Cascara  Sagrada  as  a  purgative,  389,  895 

Cascarilla,  1022 ;  cascarilla  bark  as  a 
stimulant,  tonic,  and  expectorant,  1022 

Cash,  Dr.,  references  to,  45,  124,  129, 
135,  137,  142,  150,  280,  281,  493,  606, 
974 

Cassia,  as  a  laxative,  389 ;  cassia  pulp, 
characters  and  use,  911 ;  purging  cassia, 
911 

Cassia  fistula,  911 

Castanea,  characters  and  uses  of,  1034 

Castor,  antispasmodic  action  of,  214 ;  its 
characters  and  therapeutics,  1077 

Castor  oil,  nauseous  taste  of,  owing 
almost  entirely  to  its  odour,  230 ;  as  a 
purgative,  389,  1024;  as  a  vermifuge, 
408 ;  characters  and  preparations  of, 
1024 ;  composition,  action,  and  uses  of, 
1024 ;  mode  of  administration,  1025 

Cat,  easiest  mode  of  anaesthetising,  210 ; 
diagram  of  curve  of  the  pulse  and 
blood-pressure  in  a,  after  division  of 
the  spinal  cord  and  injection  of  ery- 
throphlceum,  273 

Catalysis,  effects  of,  on  different  sub- 
stances, 73 

Cataplasma  carbonis,  506,  541,  1053 
Conii,  506.  931 
Fermenti,  506,  1053,  1073 
Lini,  506,  877 


1118 


GENEEAL  INDEX. 


Cataplasma— i 

Sinapis,  506,  864 
Sodse  chlorinate,  606,  551 
Cataplasms,  or  poultices,  506 
Catarrh,  with  copious  secretion  of  mucus, 
a  combination  of  morphine  and  atro- 
pine useful  in,  250 ;  camphor  a  popular 
remedy  in  common,  331 
Catechu,  as  an  astringent,  349;    for  the 
teeth  and  gums,  352,  characters,  com- 
position and  uses  of,  914,  951 
Cathartics.    See  Purgatives 
Catheter,  importance  of  cleansing  and 

disinfecting,  105 
Caulophyllum  (blue   cohosh),  character, 

composition,  and  uses  of,  842 
Caustic  Ammonia,  as  a  poison,  with  its 
antidote,  487 ;  caustic  lime,  as  ditto, 
487 ;  caustic  potash,  or  soda,  as  ditto, 
487 

Lunar,  676 

Mitigated,  677 
Potash,  608 
Soda,  621 
Caustics,  nature  and  uses  of,  346  ;  general 
action  of  the  alkaline  group  of  metals 
as,  597  ;  alum  as  a  caustic,  654 
Celandine.    See  Chelidonium 
Celastrineae,  894 
Cells  how  kept  alive,  and  cause  of  death 

of,  262 
Cera  alba,  1090 
Cerates,  or  ointments,  506 
Ceratum,  506,  1081,  1090 

Camphorse,  606, 1018, 1090 
Cantharidis,  506,  1084,  1090,  1091 
Cetacei,  506,  1086,  1090 
Extracti  cantharidis,  506, 1084, 1090, 

1091 
Plumbi  subacetatis,  506,  704,  1084, 

1090 
Eesinse,  506,  1061,  1018,  1090 
Sabinaj,  506,  1084,  1090 
Cerebellum,  action  of  drugs  on  the,  216  ; 
different  kinds  of  spirits  appear  to  affect 
different  parts  of  the,  215 ;  action  of 
alcohol  on  the,  770 
Cerebral    affections,  blisters   useful  in, 
346  ;  circulation,  diagram  to  show  the 
effects  on,  of  rapidly  emptying  the 
bladder,  264 ;  stimulants,  nature  and 
action  of,  192-195  ;  action  of  carbolic 
acid  on  the  cerebral  centres,  814  ;  tea 
as  a  powerful  stimulant,  870 
Cerium  oxalate,  as  a  local  sedative,  376 ; 
characters,  uses,  &c.  of,  657 
Symbol  and  atomic  weight  of,  9  j 
physiological  action  of,  27 
Cetacese,  1085 
Cevadilla,  1046 

Chalk,  as  an  astringent,  349  ,  as  a  denti- 
frice, 352 ;  as  a  direct  antacid,  370 
Chalk,  prepared,  647-650;  officinal  pre- 
parations of,  650  ;  mixture  of,  650  ; 


aromatic  powder  of,  650 ;  compound 
powder    of,    650;   lozenges   of,    660; 
hydrargyrum  cum  creta  contains,  650 
Chamomile,  characters  and  uses  of,  955 
German,  956 ;  a  bitter,  carminative, 
and  anthelmintic,   956;  infusion 
of,  956 
Oil  of,  955 ;  a  tonic,  stomachic,  and 
carminative,  956 
Chaperon's    experiments   on   inhibitory 

paralysis,  166 
Charcoal,  reputed  power  of,  for  attracting 
oxygen,  73 ;  as  a  deodorizer,  or  anti- 
septic, 106  ;  as  a  dentifrice,  352  ;  action 
of,  on  the  stomach,  378 ;  chief  action 
of,  541 
Charcoal,  animal,  preparation  and  con- 
stituents of,  542 
Purified  animal,  preparation,  cha- 
racters, and  uses  of,  542 
Wood,  its  preparation,   characters, 
action,  and  uses,  541 ;  poultice  of, 
how  to  make,  541 
Charcoal  fumes,  as  a  poison,  with  its  anti- 
dote, 487 
Charta  Cantharidis,  506, 1091 

Bpispastica,   506,   966,   1057,   1061, 

1085,  1090,  1091 
Potassii  nitratis,  507 
Sinapis,  507,  864 
Cheken,  composition,  action,  and  uses  of, 

923 
Chelidonium     (celandine),     characters, 

composition,  and  uses  of,  863 
Chemical  constitution  and  physiological 
action,  connection  between,  30 ;  the 
most  important  subject  in  pharmaco- 
logy, 32 
Chemical  reactions,  number  and  nature 
of ,  24 ;  of  the  metallic  elements  divided 
into  two  groups,  24  ;  which  only  occur 
between  two  bodies  when  a  third  is 
present,  73 
Chenopodiaceaa,  1009 
Chenopodii,  oleum,  as  a  vermifuge,  1009 
Chenopodium,  characters  of,  1009 
Cherry-laurel  water,  as   a   poison,   with 
its  antidote,  489 ;  cherry-laurel  leaves, 
nature,  action,  and  use  of,  917 
Cherry,  wild,  as  a  nervous  sedative  and 

tonic,  917 
Chestnut.    See  Castanea 
Chilies,  as  carminatives,  379 
Chill,  or  cold,  utility  of  vascular  stimu- 
lants in,  330 ;  action  of,  on  bronchi,  252 
Chimaphila  (pipsissewa),  as  a  stimulant 
diuretic,  433 ;   as  an  astringent  and 
diuretic,  962 
Chinicine,  constitution  of,  824 
Chinoidin  (quinoidin),  944 
Chinoidinum,  605,  944 
Chinoidinae  sulphas,  944 
Chinoline,  823 
Chiretta,  as  a  bitter  tonic,  980 


GENEEAL  INDEX. 


1119 


Chloral,  action  of,  on  muscle,  128  etseq.; 
as  a  sedative,  157;  diagram  to  show 
the  action  of,  on  the  spinal  cord,  160 ;  a 
useful  hypnotic,  199  ;  as  a  general  ano- 
dyne, 201,  202 ;  action  of,  on  the  respi- 
ratory centre,  241 ;  on  the  brain,  244  ; 
on  the  vessels  and  circulation,  282  ;  on 
the  vaso-motor  centre,  287, 319 ;  on  the 
motor  ganglia,  316  ;  on  the  intestines, 
387 ;  as  a  poison,  with  its  antidotes,  489 ; 
antagonistic  action  of,  and  strychnine 
and  picrotoxine,  494-495  ;  antagonism 
of,  to  other  drugs,  492-496 

Chloral  hydrate,  action  of,  on  the  nervous 
system,  204  ;  on  the  vagus  centre,  317  ; 
antagonism  of,  to  atropine,  495  ;  pre- 
paration and  characters  of,  790 ;  action 
of,  791,  792;  as  an  antiseptic,  in  the 
mouth,  and  when  injected  under  the 
skin,  791 ;  first  introduced  into  medi- 
cine by  Oscar  Liebreich,  791 ;  his  spe- 
culations regarding  its  action,  791 ;  its 
action  in  the  body,  791 ;  in  frogs  and 
mammals,  792 ;  on  the  temperature, 
respiration,  and  blood,  792 ;  on  the  cir- 
culation, 792 ;  on  muscles  and  motor 
nerves,  792 ;  on  the  spinal  cord,  792 ; 
on  the  brain,  792 ;  treatment  of  poison- 
ing by,  793  ;  chronic  chloralism,  793  ; 
uses  of,  793 

Chlorate  of  potassium,  action  of,  on  bac- 
teria, 91,  95  ;  as  a  remedy  for  tooth- 
ache, 353  ;  as  an  antisialic,  361 ;  action 
of,  on  the  kidneys,  435 ;  characters, 
action,  and  uses  of,  613-614 

Chlorate  of  sodium,  627 

Chlorides,  test  for,  594 

Chloride  of  Ammonium,  637 
Calcium,  651 
Gold,  754 

Gold  and  Sodium,  754 
Iron,  745 

Sodium,  599-601,  620 
Tin, 706 
Zinc,  667 

Chloride  of  lime,  action  of,  on  enzymes, 
78,  79  ;  on  bacteria,  93 

Chloride  of  sodium,  action  of,  on  bacteria, 
95 ;  action  of,  as  compared  with  bro- 
mide of  potassium,  214  ;  on  the  pulsa- 
tions of  the  frog's  heart,  306  ;  effects 
of  excess  of,  in  the  blood,  412  ;  one  of 
the  most  important  constituents  of  the 
body,  413 

Chlorides,  general  action  of  the  group  of, 
599-601 

Chlorinated  lime,  action  on  bacteria,  91 ; 
characters  of,  &c,  650;  solution  of, 
550 ;  inhalation  of,  551 

Chlorinated  £/da,  solution  of,  551;  as  a 
cataplasm  of,  551 

Chlorine,  symbol  and  atomic  weight  of,  9 ; 
its  relation  to  other  members  of  a  group, 
16  j  action  of,  on  infusoria,  65  ;  on  en- 


zymes, 77-79  ;  on  bacteria,  91, 95  ;  as  a 
poison,  with  its  antidote,  486 ;  general 
source,  characters,  and  mode  of  pre- 
paration of,  547-552  ;  action  of,  549  ; 
chlorine  water,  tests  and  uses  of,  550 ; 
chlorinated  lime,  its  characters  and 
uses,  550  ;  solution  of  chlorinated  lime, 
551 ;  inhalation  of  chlorine,  550 ;  solu- 
tion of  chlorinated  soda,  551 ;  poultice 
of  ditto,  552  ;  uses  of  ditto,  652 

Chlorine  water,  action  of,  on  bacteria, 
93 ;  nature,  action,  and  uses  of,  650 

Chloroform,  efiects  of,  on  the  blood,  72  ; 
on  enzymes,  78 ;  on  bacteria,  91,  93 ; 
on  medusa?,  Ill ;  on  mammals  and 
leeches,  115  ;  on  muscle,  128  etseq. ;  as 
a  sedative,  157  ;  diagram  to  show  the 
action  of,  on  the  spinal  cord,  160 ;  action 
of,  on  psychical  processes,  191 ;  action 
of,  as  an  anaesthetic,  204  et  seq. ;  acts 
directly  on  the  nerve-cells,  205 ;  dangers 
arising  from  the  use  of,  207-208 ;  mode 
of  administering,  209 ;  action  of,  on  the 
respiratory  centre,  241 ;  on  the  brain, 
244  ;  on  the  vagus  centre,  317  ;  on  the 
vaso-motor  centre,  319 ;  on  the  motor 
ganglia,  316 ;  as  a  cardiac  stimulant, 
328 ;  as  a  rubefacient,  344 ;  as  a  siala- 
gogue,  357 ;  as  a  local  sedative,  376 ; 
as  a  carminative,  379  ;  as  a  poison,  with 
its  antidotes,  488;  antagonism  of,  to 
amyl  nitrite,  495 ;  chlorinated  lime  used 
in  the  preparation  of,  650 ;  purified, 
preparation,  795  ;  tests,  796 ;  prepara- 
tions of,  796 ;  action  of,  796 ;  when 
mixed  with  albumen,  796 ;  a  powerful 
solvent  of  protogon,  796  ;  on  the  blood 
and  skin,  797  ;  on  the  mouth,  stomach, 
and  intestines,  797 ;  the  nervous  sys- 
tem, 797 ;  its  action  divided  into  three 
stages,  797  ;  its  action  on  the  respira- 
tion, pulse,  heart,  and  blood-pressure, 
798 ;  on  the  nervous  system,  799 ; 
dangers  in  the  administration  of,  799  ; 
precautions  to  be  taken,  800-802  ;  uses 
of,  and  various  plans  for  administering, 
802,  803.    See  also  Anaesthetics 

Chloropiorin,  action  of,  on  bacteria,  94 

Cholagogues,  may  act  as  indirect  gastric 
tonics,  365,  369  ;  nature  and  action  of, 
390,  400 ;  experiments  with,  404-407  ; 
adjuncts  to,  406 ;  uses  of,  407  ;  remove 
bile  from  the  body,  407 

Cholera,  corrosive  sublimate  in,  692 ; 
possible  use  of  napthalin  in,  822 

Chondrus,  1073 

Christison,  Sir  Eobert,  references  to,  42, 
852,  855,  999 

Chrome  alum,  action  of,  on  bacteria,  94 

Chromic  acid,  action  of,  on  bacteria,  94, 
95 ;  as  a  caustic,  344 ;  how  prepared, 
566 ;  characters  and  a.ction  of,  as  a 
disinfectant  and  caustic,  582 

Chromium,symbolsandatomicweightof,9 


1120 


GENEEAL  INDEX. 


Chrysarobin,  BOB ;  characters  and  uses  of, 

909 
Chrysarobinum,  BOS,  909 
Cicutine,  as  an  antisialic,  361 
Cicutoxine,  action  of,  on  the  accelerating 
centre,  319  ;  on  the  vaso-motor  centre, 
319 
Cimicif  iiga  (black  snakeroot),  characters 
and  composition  of,  837 ;  action  and 
uses  of,  838 ;  as  a  stomachic,  a  cardiac 
tonic,  and  an  expectorant,  838 
Cinchona  bark  and  its  alkaloids  the  chief 
antiperiodics,  107 ;  the  former  almost  a 
specific  in  intermittent  fevers,  periodic 
headaches,  neuralgias,  &c,  107 ;  cin- 
chona alkaloids  and  their  salts,  944  ; 
action  and  uses  of,  944-948 
Cinchona,  characters,  &c.;  of,  939 
Bark,  red,  940 
Calisaya  bark,  yellow,  940 
Cinchona,  properties  and  composition  of 
the  cinchona  barks,  940 ;  physiological 
action  of,  944-948 ;  uses  of,  947,  948 
Cinchonaceas,  939 
Cinchonese,  939 

Cinchonidinse  sulphas,  505,  939,  944 
Cinchonidine,  an  antiperiodic,  107 ;  sul- 
phate of,  944 
Cinchoninse  sulphas,  505,  939,  943 
Cinch  onine,  943 

Action  of,  on  oxidation,  92 ;  on  the 
blood,  72;  as  an  antiperiodic,  107; 
action  of,  on  muscle,  128 
Sulphate  of,  943 
Cinnamic  acid,  action  of,  on  bacteria,  94 ; 

on  the  kidneys,  436 
Cinnamon    and    oil,  as  a    carminative, 

379 
Cinnamon,  characters  and  composition  of, 
1016 
Aromatic  powder  of,  1017 
Bark,  1016 

Powder,  compound,  101 
Oil  of,  1017 ;  as  a  carminative  and 
an  astringent,  1017 
Circulation,  action  of  drugs  on 
the,  262-339;  nature  of  the,  in  the 
arteries  and  veins,  262 ;  effect  of  blood- 
pressure  on  the,  263 ;  arrest  of  the, 
causes  fainting  and  shock,  264 ;  schema 
of  the,  265-267 ;  diagram  illustrative 
of  this,  266;  nature  of  the,  in  the 
living  body,  267 ;  effects  of  variation 
in  blood-pressure  on  the,  267,  268 ; 
method  of  ascertaining  this,  268  ;  al- 
terations in  blood-pressure  in  the,  270; 
relation  of  pulse-rate  and  arterioles 
to  blood-pressure  in  the,  271-277 ;  dia- 
gram of  the,  275 ;  method  for  main- 
taining artificial,  in  the  rabbit's  ear, 
280;  in  the  frog,  280;  method  of 
measurement  of  the,  by  the  rate  of 
flow,  281-283;  action  of  potassium 
salts  on  the,  606 ;  of  strong  solution 


of  ammonia,  638  ;  of  the  heavy  metals, 
663;  of  the  salts  of  iron,  663;  of 
antimony,  724  ;  of  alcohol,  768  ;  and  on 
the  cranial,  769 ;  of  the  spirit  of  ether, 
781  ;  of  chloral  hydrate,  792  ;  of  sali- 
cylic acid,  820 ;  of  anemonin,  837  ;  of 
opium,  855,  861 ;  of  pilocarpine,  885  ; 
of  quinine,  945 ;  of  strychnine,  973  ;  of 
belladonna  or  atropine,  992 ;  of  tobacco, 
993 ;  of  veratrine,  1048 ;  of  colchicum, 
1051 ;  of  extract  of  ergot,  1071 

Citrate  of  bismuth,  733  ;  and  ammonia, 
734 
Caffeine,  870 
Iron,  748 

and  ammonium,  748 
Lithium,  632 
Magnesium,  389,  661 
Potassium,  609 
Quinine,  749 
Strychnine,  749 

Citrates,  test  for,  594 

Citric  acid,  properties  of,  &c,  580 ;  syrup 
of  ditto,  581 

Citrine  ointment,  695 

Citro-tartrate  of  sodium  (effervescent), 
623 

Clover,  Mr.,  his  plan  of  administering 
chloroform,  804 

Cloves,  characters,  action,  and  use  of, 
922 ;  as  a  carminative,  922 ;  oil  of, 
922 

Cloves  and  oil,  as  a  carminative,  379 

Clysters,  injections,  or  enemas,  508 

Coal  gas,  as  a  poison,  with  its  antidotes, 
487 

Coats,  reference  to,  278 

Cobalt,  symbol  and  atomic  weight  of,  9 ; 
physiological  action  of,  27 ;  causes 
slight  contraction  of  the  vessels,  281 

Cobra  poison,  action  of,  on  the  infusoria, 
65  ;  convulsions  caused  by,  189 

Coca.     See  Erythroxylon 

Cocainse  Hydrochloras,  504,  877 

Cocaine,  action  of,  on  muscle,  128  ;  on 
the  eye,  226  ;  antagonism  of,  to  mor- 
phine, 494,  495  ;  characters,  action,  and 
uses  of,  877,  878  ;  as  a  local  anesthetic, 
157, 878 ;  action  of,  on  the  nerve-centres 
in  man,  878  ;  is  said  to  lessen  fatigue, 
878;  on  animals,  on  the  spinal  cord, 
the  respiration,  the  pulse,  blood-pres- 
sure, and  temperature,  879 ;  uses  of, 
879 

Cocaine  hydrochlorate,  characters,  action, 
and  uses,  877.     See  also  Cocaine 

Coccus,  1090 

Cochineal,  1090 ;  its  characters  and  uses, 
1090 

Codeina,  504,  844 

Codeine,  action  of,  on  oxidation,  69; 
antagonism  of,  to  chloral,  495  ;  charac- 
ters of,  849 ;  action  of,  on  the  nerves 
and  abdominal  viscera,  850;   on  tha 


GENERAL  INDEX. 


1121 


spinal  cord  and  motor  centre  in  the 
brain,  850;  uses  of,  850;  action  and 
use  of,  in  diabetes,  850 
Codeines,  artificial,  859 
Cod-liver  oil,  one  of  the  most  efficient 
expectorants,  254 ;  great  virtue  of,  in 
chronic  bronchitis,  254;    a  powerful 
hsmatinic,  411 ;  as  an  alterative,  413  ; 
as    an    indirect    emmenagogue,    463; 
character,    composition,  physiological 
and  therapeutic  action  of,  1087 
Coelospermas,  937 
Coffese,  948 
Coffee,  composition,  action,  and  use  of, 

950 
Conn's  solution  for  experimenting  with 

bacteria,  90 
Colchici  radix,  1049 

Colchicine,  action  of,  on  the  respiratory 
centre,  241 ;  as  a  hepatic  stimulant 
403,  405  ;  as  an  alterative,  413 ;  used 
in  gout,  416 ;  as  a  refrigerant  diuretic, 
432;  as  a  poison,  with  its  antidote, 
489 
Colchicum  corm,  1049 
Boot,  1049 

Seeds,  1049 ;  general  action  of,  1050 ; 
special  action  of,  on  the  skin,  brain, 
and  spinal  cord,  1050  ;  on  the  sen- 
sory and  motor  nerves  and  the 
muscles,  1051 ;  on  the  circulation 
and  the  secretion  of  urine,  1051, 
uses  of,  1051 ;  treatment  in  poison- 
ing by,  1051 
Cold,  effects  of,  on  the  action  of  drugs, 
44-46 ;    on  protoplasmic    movements, 
60 ;  on  the  action  of  infusoria,  64  ;  on 
muscle,  119,  123,  138;  extreme,  as  an 
anaesthetic,    157  ;    on    the    action    of 
strychnine,  175 ;  in  preventing  and  in- 
ducing sleep,  199 ;  as  a  local  anodyne, 
201 ;  applied  to  the  surface  of  a  painful 
part,  relieves  the  pain,  203  ;  one  of  the 
chief  local  anaesthetics,  204 ;  action  of, 
on  the  respiratory  centres,  241  ;    in 
causing  congestion,  252 ;  apparatus  for 
ascertaining  the  effect  of,  on  the  vessels 
of  the  frog's  lung,  280 ;  instrument  for 
showing  the  action  of,  on  the  frog's 
heart,  301 ;  one  of  the  most  powerful 
of  vascular  and  cardiac  sedatives,  339  ; 
action  of,  on  inflammation,  341 ;  dia- 
gram to  show  the  effects  of,  in  lessen- 
ing the  pain  of  inflammation,  342 ;  as 
an  antipyretic,  418,  420;  local  appli- 
cation of,  464 
Cold    bath,  as  an    anaphrodisiac,  451 ; 
various  uses  of,  and  risks  attending, 
460-463 
Compresses,  465 
Douche,  ascending,  464 

Spinal,  464 
Douches,  463 
Foot  bath,  465 


Cold  Pack,  463 

Colds,  arrest  of,  256 

Coleoplera,  1091 

Collidine,  in  treatment  of  asthma,  261 

Collodion,  as  a  demulcent,  347 ;  and  a 

styptic,  350 
Collodion,  characters,  action,  and  uses  of, 
874 
Blistering,  874 
Cantharidal,  874 
Flexible,  874 
Styptic,  874 
Collodions,  507 
Collodium,  507,  780 

Flexile,  507,  780,  874,  1024,  1057 
Cum  cantharide,  507,  874,  1091 
Stypticum,  507,  874,  1032 
Vesicans,  874 
Colocynth,  927 

Colocynth  as  a  drastic  purgative,  389  ; 
as  a  hepatic  stimulant,  403,  405  ;  colo- 
cynth pulp,  composition,  action,  and 
therapeutics  of,  927,  928  ;  a  powerful 
cathartic  and  diuretic,  927,  928 
Cologne  water,  for  perfuming,  890 
Colophony,  1061 
Coma,  condition  of  the  veins  and  brain 

during,  197 
Composite,  952 

Compound  radicals,  nature  of,  24;  most 
of  them  possess  a  paralysing  action  on 
the  motor  nerves,  32 
Condurango,  characters,  action,  and  uses 

of,  970 
Confectio  opii,  507,  844,  901,  936,  1013, 
1037 
Piperis,  507,936,  1013,  1089 
Rosas,  507,  920,  1089 

Caninse,  507,  920,  1055 

Gallicge,  507,  920,  1055 

Scammonii,  507,  922,  936,  981,  1037. 

1089 
Sennse,  507,  899,  910,  911,  917,  938. 

1028,  1055 
Sulphuris,  507,  544,  610,  901 
Terebinthinae,  507,  899,  1058,  1089 
Confections,  electuaries,  or  conserves,  607 
Congestion  of  the  internal  organs  arising 
from    cold,   252;    utility  of   vascular 
stimulants  in,  330 
CoDiferas,  1057 

Coniine,  effects  of,  on  oxidation,  69; 
action  of,  on  the  spinal  cord,  163  ;  as  a 
general  anodyne,  201 ;  on  the  inhibitory 
powers  of  the  vagi,  310.  See  Hemlock 
Conium,  as  a  local  and  general  anodyne, 
201 ;  the  vapour  of,  has  a  local  sedative 
action  on  the  lung,  249 ;  as  an  an- 
aphrodisiac, 451 ;  as  a  poison,  with  its 
antidotes,  489 ;  nature,  actions,  and 
uses  of,  931 
Conjunctiva  of  the  eye,  action  of  drugs 

on  the,  216 
Constipation,  cause  of,  and  icmedies  for, 

4  c 


1122 


GENEEAL  INDEX. 


384 ;  diagram'  to  show  how  ovarian 
irritation  probably  causes,  3SB  ;  action 
of  opium  in,  386 ;  and  of  small  doses  of 
belladonna,  386 

Contraction  of  the  pupil  of  the  eye,  origin 
and  nature  of,  222 

Convallamarin,  as  a  cardiac  tonic,  331 

Convallaria  majalis,  as  a  cardiac  tonic, 
331 ;  composition,  action,  and  uses 
1040 

Convolvulacese,  980 

Convulsions  produced  by  poisoning,  34 
and  by  strychnine  and  other  drugs 
acting  on  the  spinal  cord,  171-181;  by 
the  absence  or  excess  of  oxygen,  176 
whether  convulsions  are  caused  by  the 
action  of  poison  on  the  brain  or  the 
spinal  cord,  179  ;  certain  drugs,  when 
taken,  are  the  cause  of,  187  ;  they  are 
usually  of  spinal  or  cerebral  origin,  188 ; 
asphyxial  convulsions,  189;  experiments 
to  ascertain  whether  they  are  asphyxial 
or  not,  189  ;  excitement  of  the  respira- 
tory centre  causes,  237 ;  asphyxial,  only 
occur  in  warm-blooded  animals,  237  ; 
carbolic  acid  produces  convulsions  in 
frogs,  814 

Copaiba,  as  a  stimulant  diuretic,  433 ; 
value  of,  in  inflammation  of  the 
bladder,  446 

Copaiva,  or  copaiba,  characters,  &c,  of, 
912 ;  balsam  of,  912 ;  oil  of,  characters, 
action,  and  uses  of,  912        ' 

Copper,  sources,  reactions,  uses,  &c,  of, 
674 
Acetate  of,  676 

Test  solution  of,  676 
Nitrate,  674 
Sub-acetate  of,-676 
Sulphate  of,  675 

Anhydrous,  675 
Test   solution    of    am- 
monio-,  676 

Copper  sulphate,  action  of,  on  enzymes, 
78;  on  bacteria,  93  ;  on  annulosa,  116; 
as  acaustic,  344,  675;  as  an  astringent, 
349 ;  as  a  local  emetic,  373  ;  character, 
action,  and  uses  of,  674-76 

Copper,  symbol  and  atomic  weight  of,  9  ; 
physiological  action  of,  27 ;  action  of, 
on  muscle,  127  et  seq. ;  causes  powerful 
contraction  of  the  vessels,  281 ;  double 
salts  of,  action  of,  on  the  cardiac 
muscle,  316;  on  the  capillaries,  318  ;  as 
a  poison,  with  its  antidote,  489 ;  nature, 
action,  and  uses  of,  674-76 

Coriander,  characters  of,  937 
Fruit,  937 

Oil  of,  a  carminative  and  stimulant, 
379, 938 

Cornacese,  938 

Cornea,  chief  drugs  employed  in  disease 
of  the,  216 ;  action  of  alum  on,  216, 
655 


Corn-smut,  1073 

Cornus,  characters  and  action  of,  938 

Cornutine,  1069 

CorolliSorffi,  939 

Corrosive  chloride  of  mercury,  692 

Corrosive  sublimate,  action  of,  on  in- 
fusoria, 65 ;  on  enzymes,  78,  79  ;  on 
bacteria,  89,  91,  93,  95;  extraordinary 
destructive  power  of,  might  be  useful 
in  destroying  bacilli,  102 ;  owes  its 
curative  power  in  cases  of  infantile 
dysentery  to  its  antiseptic  action,  106 ; 
the  only  trustworthy  disinfectant  for 
destroying  septic  organisms,  106 ;  as  a 
poison,  with  its  antidotes,  4S9 ;  nature 
and  uses  of,  692,  693 ;  one  of  the  most 
powerful  antiseptics  known,  693 ;  use 
of,  in  cholera,  692 ;  poisoning  by,  and 
treatment  for,  693 

Coto  alkaloids,  action  of,  on  the  intes- 
tines, 386 ;  Albertoni's  investigations 
regarding  the  action  of  the,  386 

Coto  bark,  composition,  action,  and  uses 
of,  1017  ;  paracoto  bark,  1017 

Cotoine,  action  of,  on  the  intestines,  387 

Cotton,  gun,  preparation  and  uses  of,  873 
Boot  bark,  characters,  action,  and 

uses  of,  872 
Seed  oil,  characters  and  uses  of,  872 
Wool,  what  derived  from,  873 

Couch-grass,  as  a  demulcent,  1054 

Cough,  chest  and  stomach,  pathology  of, 
remedies  for,  and  general  treatment 
of,  246-261 ;  diagram  of  the  afferent 
nerves  by  which  it  may  be  excited, 
247;  action  and  use  of  expectorants 
in,  250,  255;  of  emetics,  255;  of 
warmth  and  moisture,  255 ;  of  respi- 
rators, 256  ;  of  warm  clothing,  friction, 
liniments,  poultices,  and  plasters,  256 ; 
selection  of  remedies  in  treatment  of, 
257  ;  action  of  lactucarium  in  allaying, 
957 

Cowling,  Dr.,  his  rule  for  dosage,  497 

Cramps  of  the  muscles,  cause  and  general 
treatment  of,  212,  213 

Cranesbill,  881 

Cranial  circulation,  192 ;  action  of  alcohol 
on  the,  769 

Cream  of  tartar,  nature  and  uses  of,  610 

Creasote,  action  of,  on  infusoria,  65  ;  no 
effect  on  ptyalin,  77 ;  on  enzymes,  78, 
79 ;  on  yeast  and  bacteria,  79 ;  as  a 
local  anodyne,  201 ;  as  a  remedy  for 
toothache,  353 ;  as  a  local  sedative, 
376 ;  as  a  poison,  with  its  antidote, 
489 ;  characters,  tests,  and  preparations 
of,  817;  action  of,  as  a  muscular 
poison,  817;  on  the  blood,  skin,  and 
mouth,  817  ;  on  the  pulse,  respiration, 
and  urine,  817;  uses  of,  817 

Creta,  647.     See  also  Chalk 

Croix,  N.  de  la,  results  of  his  experiments 
with  different  drugs  on  bacteria,  90, 91 


GENERAL  INDEX. 


1123 


Croton  oil,  as  a  pustulant,  344;  as  a 
drastic  purgative,  389;  as  a  poison, 
with  its  antidote,  489 ;  action  of,  ex- 
ternally and  internally,  1023  ;  use  of, 
ditto,  1023 ;  treatment  of  poisoning  by, 

Cruciferse,  864 

Crura- Brown,  reference  to,  150,  859 

Crumb  of  bread,  1053 

Cryptogams  (sub-kingdom  II.),  1066- 
1073;  Alices,  1066;  lichens,  1067; 
fungi,  1067  ;  algas,  1073 

Cubeba,  1013 

Cubebs,  as  a  sialagogue,  357 ;  as  a  stimu- 
lant diuretic,  433  ;  characters  and 
composition  of,  1013 
Oleoresin  of,  preparation,  action, 
and  uses  of,  1014 ;  as  a  stimulant 
diuretic,  1014 
Oil  of,  1014 

Cucumber  fruit,  squirting,  928 

Cucurbitaceae,  927 

Culver's  root.    See  Leptandra 

Cumarin,  action  of,  on  the  cardiac  muscle, 
as  an  antipyretic,  316 

Cupping,  wet,  420 

Cupulifene,  1030 

Curare,  physiological  action  of,  on  the 
endings  of  efferent  nerves,  26 ;  when 
applied  externally  and  internally,  33, 
34 ;  opposite  effect  of,  when  differently 
administered,  38 ;  effects  of,  on  the 
blood,  73 ;  on  mollusca,  114 ;  on  muscle, 
122,  128,  146,  147  ;  list  of  drugs  which 
have  a  similar  action  to,  on  the  motor 
nerves,  150,  151 ;  exact  localisation  of 
action,  151 ;  on  the  muscles  of  respira- 
tion, 238;  on  the  vaso-motor  nerves, 
284 ;  on  the  inhibitory  power  of  the 
vagi,  310;  on  the  vagus  ends  in  the 
heart,  317 ;  on  the  nerves  of  the  sali- 
vary gland,  355;  action  of  the  liver 
on,  405 ;  as  a  poison,  with  its  anti- 
dote, 489  ;  characters,  composition,  and 
action  of,  976;  on  the  motor  nerves, 
vagus,  and  sensory  nerves,  976  ;  on  the 
spinal  cord,  muscles  and  vessels,  976  ; 
on  the  blood-pressure  and  on  salivation, 
976 ;  effects  of,  on  the  general  system, 
977  ;  uses  of,  977 

Curd  soap,  1079 

Cusparia  or  Angostura  bark,  character, 
881 ;  composition,  tests,  action,  and  use, 
882 

Cyanide  of  potassium,  action  of,  on 
medusae,  112;  as  a  poison,  with  its 
antidote,  489 

Cyanide  of  silver,  679 ;  of  mercury,  697 ; 

Cyanogen,  action  of,  on  the  motor  ganglia, 
316 

Cydonium,  characters  and  use  of,  921 

Cypripedium,  characters  and  use  of,  as  an 
antispasmodic,  1036 


Da  Costa,  Dr.,  reference  to,  338 
Dandelion,  protoplasm   of,    experiment 

with,  on  oxygen,  69 
Dandelion  root,  characters  and  action  of, 
956 ;  on  the  liver,  and  as  a  diuretic,  957 
Dastre,  reference  to,  277,  298 
Daturine,  as  a  mydriatic,  219;  action  of, 
on  the  vagus  centre,  317  ;  on  the  vaso- 
motor centre,  319;  on  the  inhibitory 
ganglia,  317 ;  antagonism  of,  to  mor- 
phine, 496;  nature,  action,  and  use  of, 
991 
Davy,  Sir  H.,  split  up  some  supposed 
elements  into  oxygen  and  a  metal,  1 1 ; 
his  observation  on  the  properties  of 
nitrous  oxide,  211 
Dead  space,  1100  (Appendix) 
Decoction  of  lemon,  as  an  antiperiodic, 

891 
Decoctions,  507 

Decoctum,  Aloes  compositum,  507,  893, 
899,  1039,  1042 
Cetrarias,  507,  1067 
Cinchonas,  507,  941 
Granati  radicis,  507,  926 
Hsematoxyli,  507,  908,  1016 
Hordei,  507,  1054 
Papaveris,  507,  843 
rareiras,  507, 841 
Quercus,  507,  1030 
Sarsa;,  508, 1052 
Sarsaa  compositum,  508,    880,   899, 

1020, 1022, 1052 
Sarsaparillse  compositum,  508,   880, 

1020,  1022,  1052 
Scoparii,  508, 900 
Taraxaci,  508,  957 
Delirium  tremens,  cause,  symptoms,  and 

treatment  of,  771,  772 
Delphinine,  action  of,  on  the  frog's  heart, 
306  ;  on  the  accelerating  centre,  318  ; 
on  the  vaso-motor  centre,  319  ;  nature, 
action,  and  use  of,  836 
Demulcents,  nature,  action,  and  thera- 
peutic uses  of,  347,  348  ;  althfea  as  a, 
875 ;    linseed  as  a    demulcent,   876  ; 
liquorice  root  as    a  demulcent,  900-; 
gum  acacia,  orarabica,asa,914  ;  quince 
seed  as  a,  922  ;  sassafras  pith  as  a,  1020 ; 
elm  as,  1026,   triticum  as,  1054;   Ice- 
land moss  as,  1067  ;  chondrus  as,  1073 
Deodorisers  or  deodorants,  nature  and 
action  of,  103, 106  ;  iodoform  as  a,  805 ; 
carbolic  acid  as  a,  813 
Desmobacteria,  83 
Dew-Smith,  reference  to,  114 
Diabetes,  action  of  codeine  in,  850 
Diaphoretics,  action  of,  on  the  secretion 
of  sweat,  437 ;  antimony  as  a  diapho- 
retic, 726;  eupatorium  as  a,  956  ;  ipe- 
cacuanha as,  950;  asclepias  as  a,  970; 
melissa  or  balm  as,  1007 ;  origanun 

4  c  2 


1124 


GENEBAL  INDEX. 


as,  1007;  camphor  as,  1019;  oil  of 
sassafras  as,  1020 ;  serpentary  root  as, 
1012 

Diarrhoea,  astringents  have  a  powerful 
effect  in  checking,  350 

Diastase,  75 

Dickenson,  reference  to,  1001 

Didyraium,  symbol  and  atomic  weight  of, 
10 

Diedrich,  references  to,  857 

Diediilin,  reference  to,  150 

Digestive  System,  Action  of  Detjgs 
on  THE,  352-409  ;  on  the  teeth,  352  ; 
on  the  saliva,  as  sialagogues,  353-359 ; 
on  thirst,  as  refrigerants,  360 ;  on  the 
salivary  secretion,  as  antisialics,  360 ; 
on  the  appetite,  as  gastric  tonics,  361- 
369 ;  on  acidity,  as  antacids,  369 ;  on 
vomiting,  as  emetics,  370-376  ;  on  the 
stomach,  as  gastric  sedatives,  376 ;  on 
the  gases  of  the  stomach,  as  carmina- 
tives, 378,  379  ;  on  the  intestines,  379- 
388;  as  purgatives,  388-395;  as  irri- 
tant poisons,  395-399 ;  on  the  liver, 
399-407  ;  on  the  pancreas,  407  ;  on  the 
intestines,  as  anthelmintics,  408 

Digestive  tract,  application  of  drugs  to 
the,  482-485;  by  the  mouth  and 
pharynx,  482  ;  as  masticatories,  482  : 
as  gargles,  482  ;  by  the  stomach,  482; 
by  the  stomach-pump,  483 ;  by  the 
gastric  syphon,  483 :  to  the  intestine, 
484  ;  as  enemata,  484  ;  as  suppositories, 
484 ;  action  of  opium  on  the,  860 ; 
action  of  digitalin  on  the,  !)97 

Digestives,  when  necessary,  411 

Digitalin,  effects  of,  on  medusae,  111  ;  ac- 
tion of,  on  the  vision,  228  ;  on  the  frog's 
heart,  307;  on  the  vagus  centre,  317  ; 
on  the  cardiac  muscle,  316 ;  as  a  cardiac 
tonic,  331 ;  antagonistic  action  of,  494, 
495 ;  preparation  and  characters,  994 ; 
chemistry  of,  995  ;  general  action  of, 
995  ;  special  action  of,  on  the  muscles, 
nervous  system,  and  spinal  cord,  995  ; 
on  the  brain,  respiration,  and  blood- 
pressure,  996;  on  the  heart  and  arteri- 
oles, 996  ;  diagram  of  a  pulse-wave 
before  and  after  injection  of,  in  a  dog, 
997 ;  on  the  vagus-roots  and  ends,  996 ; 
peculiar  action  of,  on  the  frog's  heart, 
996 ;  on  the  digestive  organs  and  the 
urine,  997:  effect  of  temperature  on  the 
action  of,  998  ;  diagram  showing  effects 
of  rise  of  temperature  alone,  998  ;  ditto, 
showing  effects  of  rise,  after  injection 
of,  998  ;  ditto,  showing  action  of,  after 
temperature,  999 ;  action  of  different 
preparations  of,  999;   uses   of,    1000; 

•  precautions,  1001 ;  treatment  of  poison- 

.  ing  by,  1001 

Digitalimrm,  994 

Digitalis,  effect  of  varied  quantities  of,  on 
the  pulse,  37 ;  cumulative  action  of,  42; 


has  sometimes  no  action  on  the  pulse  in 
pneumonia,  47;  acts  differently  on  the 
heart  of  a  frog  from  that  of  mammals, 
54 ;  action  of,  on  oxidation,  70 ;  on 
mollusca,  114;  action  of,  on  the  brain, 
198  ;  as  a  cardiac  tonic,  249 ;  as  a  vas- 
cular tonic,  254  ;  diagram  showing  the 
blood-pressure  and  form  of  the  pulse- 
wave  before  and  after  the  injection  of, 
in  the  dog,  276 ;  on  the  vagus  centre, 
317;  on  the  cardiac  muscle,  316;  on 
the  capillaries,  318  ;  on  the  heart,  as  a 
cardiac  tonic,  331,  333 ;  the  question  of 
the  use  of,  in  aortic  regurgitation  con- 
sidered, 333  ;  caution  to  be  observed  in 
the  use  of,  as  a  cardiac  tonic,  335  ;  as  a 
vascular  tonic,  336  ;  as  a  sedative,  339  ; 
as  a  s'yptic  acting  on  the  blood-vessels, 
350 ;  has  the  power  of  lessening  or  ar- 
resting hscmorrhage,  351;  as  a  general 
emetic,  373  ;  experiment  with,  on  blood- 
pressure,  430 ;  as  a  hydragogue  diu- 
retic, 432;  as  ananaphrodisiac,451;  asa 
direct  emmenagogue,  453 ;  as  a  poison, 
with  its  antidotes,  489 ;  antagonism  of, 
to  other  drugs,  494,  495 

Digitalis  (foxglove),  characters,  &c,  of, 
994 

Leaf,  994 

Digitin,  composition  of,  995 

Digitonin,  composition  of,  995 

Digitoxin,  composition  of,  995 ;  action 
of,  on  the  cardiac  muscle,  316 ;  as  a 
cardiac  tonic,  331.     See  Digitalis 

Dilatation  of  the  pupil  of  the  eye,  origin 
and  nature  of,  219-222 

Dilator  muscle  of  the  iris,  nature  and 
functions  of,  217 

Dill,  as  a  stimulant  diuretic,  433 

Dill  and  oil,  as  a  carminative,  379 

Dill,  fruit,  characters   and  use  of,  as  a 
carminative,  936 
Oil  of,  936 

Dimethylamine,  100 

Dimethyl-coniine,  932 

Diosmese,  882 

Diseases  caused  by  mould-fungi,  82  ;  by 
bacteria,  82 

Disinfectants,  Koch's  experiments  on  bac- 
teria with,  92-96  ;  nature  and  action  of , 
103,  106  ;  superheated  steam  the  best 
disinfectant  under  ordinary  circum-. 
stances,  1 06 ;  borax  as  a  disinfectant, 
625;  carbolic  acid  as  a,  813;  thymol 
as,  1006 

Distilled  water,  action  of,  on  bacteria, 
93 ;  and  calcium  salts,  on  the  frog's 
heart,  306 ;  as  a  lithontriptic,  436 

Diuretics  nature  and  mode  of  action  of, 
431 ;  list  of  refrigerant,  hydragogue, 
and  stimulant,  432,  433 ;  saline,  action 
of,  433;  uses  of,  433;  adjuvants  to, 
434 ;  alkalies  as,  599  ;  iodide  of  ethyl  as 
a  diuretic,  790  ;  caulophyllum  as,  843  ; 


GENERAL  INDEX. 


1125 


caffeine  as  a,  872  ;  tansy  as,  954  ;  dan- 
delion root  as,  957  ;  uva  ursa  as,  962 ; 
chimaphila  as,  962 ;  benzoic  acid  as, 
965  ;  serpentary  root  as,  1012  ;  thuja 
as,  1063 ;  oil  of  juniper  as,  1064 ;  sar- 
saparilla  as,  1052;  garlic  as,  1040  j 
squill  as.  1041 

Di-toluyl-diethyl  ammonium  iodide,  ac- 
tion on  motor  nerves,  150 

Dogiel,  references  to,  287,  295 

Dog-rose,  fruit  of  the,  920 

Dogs,  experiments  with  drugs  on,  54-56  ; 
Majendie's  series  of  experiments  on  the 
action  of  strychnine  on  the  reflex  powers 
of  the  spinal  cord  of,  177  et  seq. ;  easiest 
way  of  anaesthetising,  210;  diagram  of 
a  stopcock  by  which  air  or  vapour,  or 
two  kinds  of  gas,  may  be  given  to,  211 ; 
diagram  showing  the  blood-pressure  and 
form  of  the  pulse- wave  before  and  after 
the  injection  of  digitalis  in,  276  ;  action 
of  the  heart  in,  287 ;  difference  be- 
tween rabbits  and,  in  this  respect,  287 ; 
cause  of  the  stoppage  of  the  heart  in, 
297 ;  effects  of  large  doses  of  opium 
injected  into,  384  ;  diagram  of  a  pulse- 
wave  before  and  after  injection  of  digi- 
talis in,  997  ;  action  of,  on,  997 

Dogwood,  938  ;  dogwood  quinine,  938 
Jamaica,  action  and  use  of,  913 

Donaldson,  reference  to,  996 

Donovan's  solution,  721 

Dosage,  the  rules  which  affect  correct, 
497 

Dose,  nature,  size,  and  effects  of  a,  on  the 
system,  37 ;  rules  which  regulate  the 
amount  of  a,  for  children  and  adults, 
497;  Dr.  Young's  rule,  497;  Dr. 
Cowling's,  497 ;  the  author's  proposed 
modification  of  Dr.  Cowling's,  497 

Douche,  nasal,  diagram  of  a,  478 

Douches,  cold,  nature  and  uses  of,  463 ; 
the  spinal,  464 ;  the  ascending,  464 

Dover's  powder,  as  a  vascular  stimulant, 
330,  331 ;  as  a  sudorific,  421 ;  in  com- 
bination with  mercury,  688 ;  ten  grains 
of,  useful  when  a  cold  is  coming  on, 
860 ;  will  cause  diaphoresis,  861 

Dropsy,  the  pathology  of,  336,  337 ;  dia- 
gram of  Ranvier's  experiment  on,  336 ; 
the  principal  causes  of,  336  ;  and  drugs 
that  are  useful  in,  336, 337  ;  usefulness 
of  upward  friction  in,  345 

Drugs,  reaction  between,  and  the  various 
parts  of  the  body,  6 ;  changes  under- 
gone by,  in  the  body,  5 ;  physiological 
action  of,  depends  chiefly  upon  their 
power  of  acting  on  one  tissue  or  organ 
first,  26 ;  the  effects  produced  by  large 
and  moderate  doses  of  veratrine  on 
the  frog  an  example  of  this,  26 ;  effect 
of  artificially  modifying  the  chemical 
constitution  of,  32;  circumstances 

WHICH    AFFECT  THE  ACTION   OF,  ON 


the  organism,  33-56  ;  direct  and  in- 
direct action  of,  34  ;  local  and  remote 
action  of,  33 ;  relation  of  effect  to 
quantity  employed,  36 ;  the  doctrine 
of  homoeopathy  in,  36  ;  the  dose,  37  ; 
size,  37  ;  and  mode  of  administration 
of,  38  ;  difference  betwixt  venous  and 
subcutaneous  injection  and  absorption 
by  the  stomach,  38-40  ;  action  of  the 
liver  on,  39  ;  absorption  and  excretion 
of,  39-40;  cumulative  action  of,  41; 
effect  of  different  preparations  of,  42  ; 
of  fasting  on  the  action  of,  43  ;  of 
habit,  43 ;  of  temperature,  44  ;  effect 
of  temperature  on  the  action  of,  on 
the  spinal  cord,  46 ;  the  proper  de- 
finition of  the  action  of,  is  the  re- 
action between  them  and  the  various 
parts  of  the  body  at  a  certain  tem- 
perature, 47 :  effects  of  climate  on, 
48  ;  time  of  day,  48 ;  season,  48  ;  and 
disease,  49 ;  use  of  experiments  in  the 
administration  of,  49  ;  effects  of  idio- 
syncrasies on  the  power  of,  51 ;  objec- 
tions to  experiments,  53  ;  difference  in 
the  effect  of,  on  men  and  animals,  and 
on  different  animals,  53-55  ;  erroneous 
deductions  from,  55,  56;  action  of, 
on  protoplasm,  blood,  and  low 
ORGANISMS,  57-108;  on  albumen,  57; 
on  protoplasmic  movements,  59-63 ; 
on  infusoria,  63-65 ;  relations  of  mo- 
tion and  oxidation  to,  65-70 ;  action 
of,  on  oxidation,  69 ;  on  the  blood,  70- 
73  ;  on  enzymes,  75-79  ;  on  the  move- 
ments of  bacteria,  88 ;  on  the  repro- 
duction of  bacteria  in  general,  89  ;  and 
on  the  destruction  of  the  germs,  89  ; 
table  of  the  comparative  action  of 
different,  on  bacteria,  90,  91 ;  action 
of,  on  particular  species  of,  92 ;  mode 
of  experimenting  on  the  action  of,  on 
the  reproduction  of  bacteria,  92 ; 
Koch's  experiments  with  three  groups 
of  disinfectants  on  bacteria,  93  ;  action 
of,  on  the  development 'and  growth  of 
bacilli,  95  ;  strength  of  various  disin-- 
fectants  required  to  prevent  the  de- 
velopment of  anthrax  bacilli,  95 ; 
effect  of,  on  the  action  of  bacteria  in 
the  animal  body,  102  ;  action  of,  on 
invertebrata,  109-116;  on  the  me- 
dusae, 109-113;  on  mollusca,  114;  on 
ascidians,  114;  on  annulosa,  114;  on 
MUSCLE,  117-143 ;  on  voluntary 
muscle,  117  ;  as  poisons  to  the  muscles, 
126-131 ;  the  action  of,  on  muscle 
is  relative,  not  absolute,  136;  on  in- 
voluntary muscular  fibre,  137 ;  hypo- 
thetical considerations  regarding  the 
action  on  muscles,  141 ;  on  nerves 
144-158;  on  motor  nerves,  146;  on 
motor  nerve-endings,  147 ;  on  the 
trunks  of  motor  nerves,  154  ;  on  sen- 


GENERAL  INDEX. 


>ry  nerves,  155 ;  on  the  peripheral 
ids  of  the  sensory  nerves,  157  ;  ON 
he  SPINAL  coed,  159-182  ;  on  the 
mducting  power  of  the  cord,  159 ;  on 
ie  reflex  action  of  the  cord,  160,  163  ; 
irect,  indirect,  and  inhibitory  paraly- 
s  of  the  cord  by,  164-171 ;  explana- 
on  of  the  action  of  certain  drugs  on  a 
iven  hypothesis,  171-177  ;  stimulating 
3tipn  of,  on  the  reflex  powers  of 
ie  cord,  177-181 ;  ON  THE  BRAIN, 
33-215  ;  depressant  action  of,  on  the 
iot'  r  centres,  187;  irritant  action  of , 
i  the  motor  centres  in  the  brain,  188 ; 
;tion  of,  on  the  sensory  and  psychical 
intres  in  the  brain,  191-215;  drugs 
hich  increase  the  functional  activity 
:  the  brain,  192 ;  nerve  stimulants, 
)2  ;  cerebral  stimulants,  192  ;  which 
ssen  the  functional  activity  of  the 
rain,  195 ;  hypnotics,  or  soporifics, 
)6 ;  narcotics,  200 ;  anodynes,  or 
lalgesics,  201 ;  anesthetics,  203-211 ; 
itispasmodics,  212 ;  action  of  drugs 
i  the  cerebellum,  215 ;  on  the 
kgans  op  special  sense,  216-231 ; 
i  the  eye,  216;  on  the  conjunctiva, 
16  ;  on  the  lacrimal  secretion,  217 ; 
l  the  pupil,  217-223  ;  on  accommo- 
I'ion,  225;  on  intra-ocular  pressure, 
!6  ;  on  the  sensibility  of  the  eye,  227  ; 
.  producing  visions,  228  ;  on  hearing, 
!8  ;  on  smell,  230 ;  on  taste,  230  ;  ON 
SSPIRATION,  232-261 ;  action  of,  when 
jected  into  the  jugular  veins,  239  ;  on 
ie  respiratory  centre,  240-244 ;  on  the 
spiratory  nerves,  244-257 ;  ON  THE 
rculAtion,  262-339 ;  method  of 
icertaining  the  action  of,  on  the  cir- 
llation,  268-270 ;  diagrams  illustra- 
ve  of  this,  272-276 ;  investigation  of 
ie  action  of,  on  the  arterioles,  277- 
10;  another  method  of  ascertaining 
e  action  of,  on  the  blood-vessels, 
(0-283  ;  action  of,  on  the  vaso-motor 
id  vaso-dilating  nerves,  283  ;  on  reflex 
infraction  of  vessels,  286 ;  as  the 
luse  of  alteration  in  blood-pressure 
id  pulse-rate,  293  ;  on  the  pulse-rate, 
)5  ;  on  the  cardio-inhibitory  functions 

the  vagus,  295  ;  on  the  reflex  stimu- 
tion  of  the  vagus,  296 ;  on  vagus- 
ots,  297 ;  on  the  heart  of  the  frog, 
19-305;  on  the  muscular  substance 

the  heart,  305-310;  on  the  vagus  in 
e  frog,  310 ;  on  inhibition  of  the 
>art,  310-312 ;  theories  regarding  the 
ode  of  action  of,  upon  the  heart,  312- 
5;  diagram  to  illustrate  the  action 
,  on  the  various  parts  of  the  cir- 
latory  apparatus,  315;  on  the  vagus- 
ntre,  317 ;  on  the  acce'erating  and 
so-motor  centres,  318,  319  ;  on  the 
gus-ends  in  the  heart,  317;  on  the 


inhibitory  and  motor  ganglia,  316, 
317;  on  the  cardiac  muscle,  316;  on 
the  vaso-motor  nerves,  318 ;  on  the 
capillaries,  318 ;  various  experiments 
with,  on  the  heart  of  a  frog,  319-328  ; 
therapeutic  use  of,  acting  on  the  circu- 
lation, 328-339  ;  as  cardiac  stimulants, 
328  ;  as  vascular  stimulants,  330 ;  as 
cardiac  tonics,  331-335 ;  as  vascular 
tonics,  335  ;  as  cardiac  sedatives,  338 ; 
as  vascular  sedatives,  339 ;  action  of, 

ACTING    ON    THE     SURFACE    OF    THE 

body,  340-351 ;  as  irritants  and  coun- 
ter-irritants, 340-347 ;  as  rubefacients, 
344,  345  ;  as  vesicants ;  344,  345 ;  as 
pustulants  and  caustics,  344,  346 ;  as 
emollients  and  demulcents,  347-348 ; 
as  astringents,  349-350 ;  as  styptics,  350, 
351  ;    ACTION  OF,  ON   THE   DIGESTIVE 

system,  352-409 ;  on  the  teeth,  352 , 
as  sialagogues,  353-359 ;  as  refri- 
gerants, 360;  as  antisialics,  360;  as 
gastric  tonics,  361 ;  on  the  secretion 
of  the  stomach,  363 ;  on  the  move- 
ments of  the  stomach,  365 ;  as  antacids, 
369 ;  as  emetics,  370-376 ;  as  gastric 
sedatives  and  anti-emetics,  376 ;  as 
carminatives,  378,  379 ;  action  of,  on 
the  intestines,  379-409  ;  on  absorption 
from  the  intestines,  386  ;  as  intestinal 
astringents,  387;  as  purgatives,  388- 
395 ;  as  irritant  poisons,  395-399 ; 
action  of,  on  the  liver,  399  ;  as  hepatic 
stimulants,  402 ;  as  cholagogues,  404- 
407 ;  as  hepatic  depressants,  407 ; 
action  of,  on  the  pancreas,  407;  as 
anthelmintics,  408  ;  ON  TISSUE- 
CHANGE,  410-421  ;  as  tonics,  410 ;  ON 
excretion,  422-445,  on  the  kidneys, 
422  et  set/. ;  as  diuretics,  431-434;  in 
albuminuria,  434;  as  lithontriptics, 
436 ;  on  the  skin  as  diaphoretics  and 
sudorifics,  437-441 ;  as  antihidrotics  or 
anhidroses,  441-443  ;  on  the  bladder, 

443-446;  ON  THE  GENERATIVE  SYS- 
TEM, 447-456  ;  as  aphrodisiacs  and 
anaphrodisiacs,  447-453  ;  as  emmena- 
gogues  and  ecbolics,  452-455;  upon 
milk,  455,  456  ;  METHODS  OF  ADMINIS- 
TERING, 457-485  ;  by  the  skin,  457  et 
seq.;  as  baths,  459;  cold  baths,  460- 
466;  warm  baths,  466;  medicated 
baths,  469 ;  vapour  baths,  470;  air 
baths,  471 ;  friction  and  inunction, 
472;  endermic  application  of,  474; 
hypodermic  administration  of,  474; 
application  of,  to  the  eye,  477 ;  to  the 
ear,  477;  to  the  nose,  478;  to  the 
larynx,  479  ;  to  the  lungs,  481 ;  to  the 
digestive  tract,  482;  to  the  urethra, 
484  ;  to  the  vagina  and  uterus,  485  ; 
as  antidotes,  486-491;  antagonistic 
action  of,  492-496  ;  table  showing  the 
antagonism  ofj  495-496 


GENEEAL  INDEX. 


1127 


Drunkenness,  general  eflects  of,  767  et 
seq. ;  causes  and  treatment  of,  772 

Duboisine,  action  of,  as  a  mydriatic,  219; 
on  the  respiratory  centre,  240 ;  on  the 
inhibitory  ganglia,  317 

Dujardin-Beaumetz,  reference  to,  1030 

Dulcamara,  characters,  action,  and  uses 
of,  983 ;  action  of,  on  the  nervous  sys- 
tem, heart,  respiration,  and  tempera- 
ture, 983 ;  as  an  alterative,  984 

Dumas,  M.,  points  out  a  curious  relation- 
ship between  the  potassium  and  the 
lithium  group  of  elements,  17 

Dyad  metals,  644  et  seq. 

Dyspepsia,  atonic,  slight  stimulants  pro- 
duce appetite  in,  363 

Dyspnoea,  nature  and  cause  of,  237-240  ; 
action  of  aconitine  on,  833 

E. 

Eae,  various  diseases  of  the,  and  their 
treatment,  228.  229 ;  action  of  salicylic 
acid  on  tbe,  820 ;  application  of  drugs 
to  the,  477;  diagram  of  a  vulcanite 
syringe  for  injecting  solutions  into 
the,  477 ;  action  of  pilocarpine  on  the, 
884 

Eau  de  Cologne,  as  a  cardiac  stimulant, 
328 ;  as  a  general  stimulant,  890 ;  uses 
of,  in  headache,  fainting,  &c,  773 

Ecbolics,  nature  and  action  of,  452  ;  list 
of  the  chief,  464;  uses  of,  454;  ad- 
juncts to,  455 

Eckhard,  references  to,  174,  175,  284 

Egg-albumin,  1085 
Yolk  of,  1085 

Elaterin,  characters  and  action  of,  929  ; 
a  powerful  hydragogue  cathartic,  929 ; 
action  of,  on  the  nervous  system,  929 

Elaterinum,  505 

Elaterium,  as  a  drastic  purgative,  389 ; 
and  a  hydragogue,  390 ;  characters  and 
composition  of,  929 

Elder,  characters  and  uses  of,  939 
Flowers,  939 

Elecampane,  959 

Electricity,  effects  of,  on  the  protoplasmic 
movements,  60,  61 ;  on  the  action  of 
infusoria,  64 

Elements  composing  the  earth,  list  of 
the,  with  their  symbols  and  atomic 
weights,  9,  10;  nature  of  the,  1 1 ; 
recent  spectroscopic  researches  prove 
them  to  be  compounds,  13;  dissociation 
of  the,  12 ;  spectrum  analysis  of  the, 
11-15  ;  evolution  of  the,  15 ;  classifica- 
tion of  the,  15 ;  according  to  their 
atomic  weight,  16  ;  in  groups,  17 ;  in 
series,  17  ;  Mendelejeff's  classification, 
19  ;  differences  between  the  even  and 
the  uneven  series,  18;  the  classification 
in  series  not  yet  perfect,  20 ;  general 
relations  of  the,  20-32 ;   organic  radi-  ' 


cals,  20;  chemical  reactions  of  the,  24; 
physiological  reactions  of  the,  24 ;  the 
latter  divided  into  groups,  25  ;  relation 
between  atomic  weight  and  physio- 
logical action,  28 ;  between  spectro- 
scopic characters  and  physiological 
action,  27 ;  connection  between  che- 
mical constitution  and  physiological 
action,  32 ;  relation  between  isomorph- 
ism and  physiological  action,  26  ; 
Blake's  division  of  the,  into  nine 
groups,  according  to  their  physiological 
action,  27  ;  his  classification  and  con- 
clusions cannot  be  accepted  as  final,  27 

Elemi,  nature  and  use  of,  893 

Elixir  aurantii,  508,  889 

Elixirs,  508 

Elm,  characters  and  uses  of,  1025  ;   as  a 
demulcent,  astringent,  and  tonic, 
1026 
Slippery,  1025;  characters  of,  1025 

Embrocations  or  liniments,  515 

Emetics,  aid  the  action  of  antiperiodics, 
and  sometimes  cure  ague  without  their 
aid,  108 ;  powerful  adjuncts  to  ex- 
pectorants, 255 ;  nature  and  action  of 
370 ;  divided  into  two  classes,  local 
and  general,  373 ;  the  various  uses  of, 
374-376  ;  in  simply  emptying  the 
stomach,  374  ;  in  expelling  foreign 
bodies  from  it,  374 ;  in  removing  the 
contents  of  it,  374 ;  in  removing  poison 
from  it,  374 ;  and  bile,  374 ;  and  ob- 
structions from  the  air-passages,  375 
contra-indications  of,  375 ;  anti-,  376 
salt  as  an  emetic,  620 ;  alum  as,  655 
sulphate  and  acetate  of  zinc  as,  668 
sulphate  of  copper  as,  344,  675 ;  sub- 
sulphate  of  mercury  as,  690 ;  antimony 
as,  725 ;  hydrochlorate  of  apomorphine 
as,  849 ;  mustard  as  a  prompt  and 
direct,  865  ;  ipecacuanha  as  an,  950 ; 
Phytolacca  root  as,  1009 ;  iris  as,  1039 

Emetine*  action  of,  on  muscle,  128 ;  as  a 
depressant  expectorant,  255 ;  action  of, 
on  the  cardiac  muscle,  316 ;  as  a  general 
emetic,  373 

Emmenagogues,  nature  and  action  of, 
452 ;  list  of  indirect  and  direct,  453  ; 
caulophyllum  as  an  emmenagogue, 
843;  oil  of  rue  as  an,  881 ;  tansy  as 
954  ;  hedeoma  or  pennyroyal  as,  1007 ; 
origanum  as,  1007 

Emollients,  nature,  action,  and  thera- 
peutic uses  of,  347,  348 

Emphysema,  with  copious  secretion  of 
mucus,  a  combination  of  morphine  and 
atropine  useful  in,  250 

Empirical  therapeutics,  explanation  and 
example  of,  3 

Emplastrum  ammoniaci,  508,  934 

cum  Hydrargyro, 
508,  686,  702, 
934,  966 


1128 


GENEEAL  INDEX, 


Emplastram  Arnicse,  508,  958,  966 
Asafoetidse,  508,  702,  933,  966 
Belladonna,  508,  966,  985 
Calefaciens,  508,  1016,  1061,  1090, 

1091 
Cantharidis,  508,  1061,  1078,  1084 
Capsici,  508,  966,  984 
Ferri,  508,  702,  743,  966 
Galbani,  508,  702,  933,  966,  1090 
Hydrargyri,  508,  686,  966 
Ichthyocollae,  508,  1086 
Opii,  508,  702,  844,  845,  966, 1061 
Picis,   508,    966,    1016,   1057,   1061, 
1062,  1090 
Burgundies;,  508, 1062 
Canadensis,  508,  1062 
cum  Cantharide.  508,  1062 
Plumbi,  508,  702,  966 

Iodidi,  508,  705 
Kesinse,  508,  702,  96R,  1061,  1079 
Saponis,   508,   578,  702,  966,   1061, 
1079 

Fuscum,  966, 1079,  1090 
Endernric  application  of  drugs,  474 
Endocarditis,  ulcerative,  micrococci  pre- 
sent in,  99 
Enema  Aloes,  509,  1042,  1044 
Asafoetidae,  509,  932 
Magnesii  sulphatis,  509,  966 
Opii,  509,  844 
Tabaci,  509 

Terebinthinffi,  509,  1058 
Enemas,  injections,  or  clysters,  508 ;  na- 
ture and  uses  of,  484 
Engelmann,  reference  to,  138 
Enzymes,  nature  of,  75  ;  action  of  drugs 
on,  76 ;   functions  of,  76  ;  list  of  the 
chief,  in  the  animal  body,  76  ;  method 
of  ascertaining  the  action  of  drags  on, 
76 ;    table  and  diagram   showing  the 
different  action  of  drugs  on  different, 
78,  79 ;    methods  of  liberating  from 
zymogens,    80 ;    alteratives    supposed 
to  alter  in  some  way  the  action  of, 
413 
Epidermic  application  of  drugs,  457 
Epsom  salts,  659 

Erbium,  symbol  and  atomic  weight  of,  10 
Ergot,  action  of,  on  the  vaso-motor  centre, 
319  ;  on  the  motor  ganglia,  316  ;  as  a 
vascular  cedative,  339 ;  as  a  styptic 
acting  on  the  blood-vessels,  350 ;  has 
the  power  of  lessening  or  arresting 
haemorrhage,  351 ;  as  a  direct  emmena- 
gogue,  453  ;  one  of  the  chief  ecbolics, 
454 ;  as  a  poison,  with  its  antidotes, 
489  ;  its  characters,  composition,  and 
general  action,  1068,  1069 ;  special 
action,  1070 
Ergot,  characters  and  preparations,  1068, 

1069 
Ergotin,  extract  of,  its  action  on  the 
nervous  system,  muscles,  and  sensory 
nerves,  1071  j   on  the  circulation  and 


heart,  1071 ;  on  the  vaso-motor  system, 
respiration,  and  secretion,  1071 ;  on 
the  alimentary  canal  and  uterus,  1072 ; 
therapeutics,  1072 

Ergot  of  rye,  1068 

Ergotinic  acid,  1069 

Ergotinin,  1069 

Ergotinum,  505 

Ergotism,  symptoms  of,  1069, 1070 

Ericaceae,  961 

Erysipelas,  caused  by  micrococci,  99 

Erythrophlcein,  as  a  cardiac  tonic,  331 

Erythrophlceum,  state  of  the  pulse  and 
blood-pressure  in  a  cat  after  division 
of  the  spinal  cord  and  injection  of, 
273 ;  action  of,  on  the  vagus-roots, 
296  ;  on  the  cardiac  muscle,  316  ;  as  a 
cardiac  tonic,  331 ;  diagram  showing 
the  effect  of,  upon  the  blood-pressure 
and  secretion  of  urine,  430 ;  as  a  hy- 
dragogue  diuretic,  432 

Erythroxylaceae,  877 

Erythroxylon  (coca),  characters  and  com- 
position of,  877 ;  action  of,  as  a  power- 
ful local  anaesthetic,  878 ;  on  the  nerve- 
centres,  respiration,  pulse,  and  blood- 
pressure,  878,  879  ;  on  mammals,  878 ; 
on  the  secretion  of  saliva  and  sweat, 
879;  on  the  urine  and  temperature, 
879 ;  uses  of,  879 

Escharotics,  acids  as,  568 

Esmarch,  reference  to,  801 

Essences,  509 

Essentia  Anisi,  509,  935 

Menthas  piperita;,  509,  1004 

Ether,  action  of,  on  bacteria,  93 ;  on 
annulosa,  115  ;  on  muscle,  128  et  seg. ; 
on  psychical  processes,  191;  nature  of 
narcosis  by,  204 ;  first  used  as  an  an- 
aesthetic in  dentistry,  212  :  as  an  anti- 
spasmodic, 21 3 ;  action  of,  on  the 
respiratory  centre,  241  ;  on  the  brain, 
244  ;  on  the  vaso-motor  centre,  319 ; 
on  the  motor  ganglia,  316 ;  as  a  cardiac 
stimulant,  328,  329 ;  as  a  vascular 
stimulant,  330 ;  as  a  rubefacient,  344  : 
as  a  sialagogue,  357  ;  as  a  local  seda- 
tive, 376 ;  and  acetic  acid,  as  a  carmi- 
native, 379 ;  action  of,  on  the  vascularity 
of  and  absorption  in  the  intestines, 
386 ;  as  a  poison,  with  its  antidotes, 
488 ;  its  preparation,  character,  and 
uses,  780 ;  action  of,  on  the  skin,  781 ; 
mouth,  stomach,  and  intestine,  781 ; 
cerebral  hemispheres,  spinal  cord,  and 
medulla  oblongata,  782  ;  muscles, 
nerves,  and  blood,  782 ;  and  heart, 
782;  difference  between  chloroform 
and,  782 

Ether,  simple  and  saline — 
Acetic,  780,  783 
Amyl,  nitrite  of,  784 
Compound  spirit  of,  783 
Nitre-glycerine  (glonoine),  788 


GEKEEAL  INDEX. 


1129 


Ether,  oil  of,  783 
Pure,  780 
Spirit  of,  781 

Nitrous,  784 
Stronger,  781 

Ether  spray  as  an  anesthetic,  157 

Ethereal  oils,  action  of,  on  bacteria,  103 

Ethyl,  iodide  of,  preparation  and  charac- 
ters of,  790 ;  action  and  uses  of,  as  an 
anaesthetic,  alterative,  diuretic,  anti- 
spasmodic, 790;  mode  of  administra- 
tion, 790 

Ethyl-atropine,  action  of,  on  the  motor 
nerves,  &c,  989 

Ethyl-carbamate.    See  Urethane 

Eucalyptol,  action  of,  on  bacteria,  95  ;  as 
a  disinfectant,  106 ;  and  antiperiodic, 
107  ;  as  a  vermicide,  408 

Eucalyptus,  character,  action,  and  uses  of, 
925;  oil  of,  925 ;  action  of,  as  an  anti- 
septic, 925  ;  on  the  blood,  spleen,  and 
skin,  925 ;  effects  of,  when  swallowed, 
925 ;  action  of,  on  the  nerve-centres, 
spinal  cord,  925 ;  brain,  medulla,  and 
heart,  925 ;  on  the  temperature,  925 
how  excreted,  and  uses  of,  926 

Eucalyptus  oil,  action  of,  on  enzymes,  78 
on  bacteria,  91 ;  use  in  blood-poisoning, 
106,  926 

Eulenberg,  references  to,  40,  204 

Euonymin,  as  a  cholagogue,  390;  as  a 
hepatic  stimulant,  403 

Euonymus  (wahoo),  nature  and  action  of, 
894 ;  acts  as  a  hepatic  stimulant,  &c., 
895 

Eupatorium,  characters  and  use  of,  956 ; 
as  a  tonic,  diaphoretic,  emetic,  and 
cathartic,  956 

Euphorbiaceae,  1022 

Euphorbium,  action  of,  on  the  nose,  245  ; 
as  a  vesicant,  344 

Eustachian  tube,  the,  some  diseases  of, 
and  their  treatment,  229 

Evolution  of  species  and  of  elements,  15 

Ewald,  A.,  reference  to,  176 

Ewers,  references  to,  245,  296 

Excretion,  Action  of  dbugs  on,  422- 
446 

Expectorants,  nature  and  action  of,  250- 
255  ;  action  of,  on  the  secretions  of  the 
air-passages  and  the    mucous   mem- 
branes, 250,  251 ;    on  the  expulsive 
mechanism,  254;  list  of  depressant, 
255 ;  of  stimulating,  255 ;  adjuncts  to, 
255  ;  antimony  as  an  expectorant,  726 
cimicifuga  (black  snakeroot)  as   an, 
838  ;  senega  root  as  a  stimulating,  868 
myrrh  as,  893  ;  balsam  of  Peru  as,  903 
balsam  of  Xolu  as,  903 ;  cheken  as,  923 
galbanum  and  ammoniacum  as,  933 
ipecacuanha  as,  950 ;  benzoic  acid  as, 
965  ;  marrubium  as,  1007  ;  cascarilla 
bark  as,  1022 ;  garlic  as,  1040 ;  squill 
as,  1041 


Experiments,  use  of,  49 ;  upon  healthy 
man,  51 ;  fallacies,  52  ;  in  disease,  52  ; 
objections  to,  answered,  53-55 ;  erro- 
neous deductions  from,  55,  56  ;  mode 
of  conducting,  for  examining  the  action 
of  drugs  on  infusoria,  63 ;  for  testing 
the  oxidising  power  of  protoplasm, 
68 ;  the  action  of  drugs  on  oxidation, 
69 ;  the  action  of  drugs  on  alcoholic 
fermentation,  81 ;  on  the  movements 
of  bacteria,  88 ;  on  the  destruction  of 
germs,  89  ;  on  the  action  of  drugs  on 
the  reproduction  of  bacilli,  92 ;  and  on 
the  development  and  growth  of  bacilli, 
95  ;  for  testing  the  action  of  drugs  on 
the  motor  nerves,  147-149 ;  on  the 
reflex  action  of  the  spinal  cord,  163, 
164  ;  on  the  respiratory  centre,  240 ;  on 
the  action  of  drugs  on  the  circulation, 
262-268  ;  on  blood-pressure,  268-270 ; 
on  the  action  of  heat  and  cold  on  the 
frog's  lung,  278-280  ;  on  the  action  of 
the  heart  on  blood-pressure,  292;  on 
the  heart  of  the  frog,  299-303 ; 
Stannius's,  on  the  action  of  the  various 
cavities  on  the  frog's  heart,  319 ;  Ean- 
vier's,  on  dropsy,  336 
Expressed  oil  of  nutmeg,  1016 
Extract  of  ergot,  1069 
Extract  of  malt,  1054 
Extracts,  509 ;  fluid  or  liquid  extracts, 

510 ;  fresh  or  green  extract,  512 
Extractum,  Aconiti,  510,  513,  831,  832 
Fluidum,  511,  832 
Alcoholicum,  985 
Aloes  aquosum,  510,  1042 
Barbadensis,  510,  1044 
Socotrinas,  510,  1012 
Anthemidis,  510,  955 
Arnicas  Radicis,  510,  958 

Fluidum,  511,  958 
Aromaticum  fluidum,  511 
Aurantii  amari,  511 

Fluidum,  888 
Belse  liquidum,  510,  892 
Belladonnas,  985 

Belladonnas  fluidum,  510,  511,  513 
Alcoholicum,  510,  985 
Brayeras  fluidum,  511,  921 
Buchu  fluidum,  511,  882 
Calami  fluidum,  511,  1053 
Calumbas,  841 

Fluidum,  841 
Cannabis  Indicas,  1026 

Fluidum,  510,  511,  1026 
Capsici  fluidum,  511,  984 
Castaneas  fluidum,  511,  1034 
Cheken  fluidum,  924 
Chimaphila,  962 

Fluidum,  511,  962 
Chiratae  fluidum,  611,  980 
Cimicifugas  fluidum,  511,  837 
Cinchonas,  940 

Liquidum,  941,  967 


1180 


GENEBAL  INDEX. 


Extractum   Cinchonae    Flava?   liquidum, 
510 

Fluidum,  510,511,940 
Coose  liquidum,  877 
Colchici,  510,  513,  1049 

Aceticnm,    510,   513,   577, 

1049 
Eadicis,  1049 
Eadiois  fluidum,  510,  511, 

1049 
Seminis  fluidum,  511,  1050 
Colocynthidis,  510,  928 

Compositum,  510, 928, 
981,  1042,  1043,  1038, 
1079 
Conii,  931 

Alcoholicum,  510,  931 
Fluidum,  510,  511, 513,  931 
Cornus  fluidum,  511,  938 
CubebiE  fluidum,  511,  1014 
Cypripedii  fluidum,  511, 1036 
Digitalis,  994 

Fluidum,  511,  994 
Dulcamara?  fluidum,  511,  983 
Ergotse,  1069 
Ergota?  fluidum,  510,  511,  1069 

Liquidum,  510,  1009 
Erythroxyli  fluidum,  511,  877 
Eucalypti  fluidum,  511,  925 
Euonymi,  510,  895 
Eupatorii  fluidum,  511,  956 
Filicis  liquidum,  511,  1066 
Frangula?  fluidum,  511,  896 
Gelsemii  alcoholicum,  978 

Fluidum,  51 1,  978 
Gentiana?,  979 

Fluidum,  510,  511,  979 
Geranii  fluidum,  511,  881 
Glycyrrhiza?,  899 

Fluidum,  510,  511,899 
Glycyrrhizae  Liquidum,  511,  899 

'  Purum,  510,  899 
Gossypii  radicis  fluidum,  511,  872 
Grindelia?  fluidum,  511,  959 
Guarana?  fluidum,  511,  897 
Ha?matoxyli,  510,  908 
Hamamelidis  fluidum,  511,  1029 
Hydrastis  fluidum,  511,  839 
Hyoscyami,  990 

Alcoholicum,  510,  990 
Fluidum,  510,  511,  513, 
990 
Ipecacuanhas  fluidum,  511,  949 
Iridis,  1039 

Iridis  fluidum,  510,  511, 1039 
Jaborandi,  883 
Jalapa?,  510,  982 
Juglandis,  510,  1029 
Krameria?,  868 

Fluidum,  511,  868 
Lactuca?,  510,  513,  957 
Lactucarii  fluidum,  511,  957 
Leptandra?,  1002 

Fluidum,  510,  511,  1002 


Extractum  Lobelia?  fluidum,  511,  961 

Lupuli,  610,  1028 

Lupulini  fluidum,  511,  1028 

Malti,  510, 1054 

Matica?  fluidum,  511, 1015 

Matico  fluidum,  1015 

Mezerei,  1022 

Mezerei  mhereum,  510,  1022 

Fluidum,  510,  511, 1022 

Nucis  Vomica?,  971 

Fluidum,  510,511,971 

Opii,  510,  844 

Liquidum,  511,  844 

Papaveris,  510,  843 

Pareira?,  841 

Fluidum,  510,  511, 841 
Liquidum,  511,  841 

Physostigmatis,  510,  904 

Pilocarpi  fluidum,  511,  883 

Piscidia?  erythrina?  fluidum,  913 

Podophylli,  838 

Fluidum,  510,  511,838 

Pruni  virginiana?  fluidum,  511,  917 


Fluidum,  510,  512,  892 
Khamni  frangula?,  896 

Liquidum,  896 
Rhei,  1010 

Fluidum,  510,  512,  1010 
Ehois  glabra?  fluidum,  512,  898 
Eosa?  fluidum,  512,920 
Eubi  fluidum,  512,  919 
Eumicis  fluidum,  512,  1011 
Sabina?  fluidum,  512,  1064 
Sanguinaria?  fluidum,  512,  863 
Sarsse  liquidum,  511,  1052 
Sarsaparillse  fluidum,  512,  1052 
Sarsaparilla?    compositum    fluidum, 

612,  1020,  1022,  1052 
Scilla?  fluidum,  512, 1041 
Scutellaria?  fluidum,  512, 1008 
Senegas  fluidum,  512,  868 
Senna?  fluidum,  512,  910 
Serpentaria?  fluidum,  512,  1012 
Spigelia?  fluidum,  512,  97S 
Stillingia?  fluidum,  512,  1023 
Stramonii,  992 

Fluidum,  510,  612,  992 
Taraxaci,  957 

Fluidum,  510, 512, 613,  957 
Tritici  fluidum,  512,  1054 
Uva?  ursi  fluidum,  512,  962 
Valeriana?  fluidum,  512,  952 
Veratri  viridis  fluidum,  512,  1045 
Vibumi  fluidum,  512,  939 
Xanthoxyli  fluidum,  512,  883 
Zingiberis  fluidum,  612,  1037 
Eye,  action  of  drugs  on  the,  216-228 ; 
chief  drugs  employed  in  the  treatment 
of  disease  of  the  cornea,  216 ;  on  the 
conjunctiva,    216;    on    the    lacrimal 
secretion,  217;  projection  of  the  eye- 
ball, 217 ;  on  the  pupil,  217  ;  diagram 
to  show  the  nervous  supply  of  the,  218 ; 


GENEKAL  INDEX. 


1131 


the  iris  of  the,  and  the  two  muscles  of 
which  it  consists — the  sphincter  and 
the  dilator,  217,  218  ;  drugs  which  act 
on  the  iris — mydriatics  and  myotics, 
219;  causes  and  consequences  of  the 
dilatation  of  the  pupil  of  the,  219-221 ; 
and  of  the  contraction  of  the,  221  ; 
action  of  drugs  on  accommodation, 
223  ;  on  intra-ocular  pressure,  223  ; 
uses  of  mydriatics  and  myotics,  225 ; 
action  of  drugs  on  the  sensibility  of 
the,  227 ;  in  producing  visions,  228 ; 
application  of  drugs  to  the,  477  ;  action 
of  purified  chloroform  on  the  eye,  799  ; 
of  aconitine,  834 ;  of  opium  on  the 
pupil  of  the,  854 ;  of  cocaine,  878  ;  of 
pilocarpine,  885  ;  of  Jamaica  dogwood 
on  the  pupil  of  the,  913 ;  of  gelsemium, 
978  ;  of  belladonna  or  atropine,  987 ; 
of  Indian  hemp  or  American  cannabis, 
on  the  pupil  of  the,  1027 


F. 


Fainting,  cause  of,  264 ;  effect  of  empty- 
ing the  bladder  on,  264  ;  treatment  of, 
265 

Farina  lini,  876 

Fasting,  rapid  effect  of  drugs  when 
taken,  43 

Fats,  as  emollients,  347 

Fatty  degeneration,  due  to  a  twofold 
action,  415 ;  of  the  liver,  stomach,  and 
kidneys  produced  by  phosphorus,  711 ; 
what  this  chiefly  depends  on,  711 ;  of 
the  vessels,  and  its  result,  711 ;  of  the 
liver  and  other  organs  produced  by 
arsenic,  715 

Febrifuges.    See  Antipyretics 

Feet,  cold,  remedy  for,  199 

Feitelberg,  reference  to,  337 

Fel  bovis  inspissatum,  1082 
Purificatum,  1082 

Fennel   as   a   carminative,    379  ;    as    a 
stimulant  diuretic,  433 ;   charac- 
ters, composition,  and  uses  of,  934 
Fruit,  characters  and  use   of,  as  a 
stimulant  and  carminative,  934 

Ferments,  inorganic,  74 ;  organic  and 
organised,  74 ;  nature  of,  75 ;  the  pro- 
cess of  fermentation  divided  into  two 
kinds,  75  ;  diastatio  amylotic,  76;  in- 
versive,  76 ;  proteolytic,  76 ;  action  of 
drugs  on,  75-79;  yeast  and  bacteria, 
80  et  seq. ;  description  of  the  chief 
organised,  80  et  seg. ;  Brefeld's  classi- 
fication of,  81 ;  diagram  illustrating 
the  principal  organised,  83.  See  also 
Yeasts,  Mound-fungi,  Bacteria,  Ba- 
cillus, &c. 

Fern,  male,  its  characters,  physiological 
action,  and  therapeutics,  1066 ;  method 
of  administration,  1066 


Ferri  arsenia",  720 

Carbonas  Saccharata,  1055 
'  et  Ammonii  citras,  743 
et  Quininse  citras,  748,  942 
et  Strychninse  citras,  748,  972 
Sulphas  Exsiccata,  741 
Ferric  chloride,  action  of,  on  bacteria, 

93 ;  as  an  astringent,  349  ;  as  a  styptic, 

350 
Ferrier,  Dr.,  references  to,  173,  186,  201, 

215,  228,  230 ;  composition  and  use  of 

his  snuff,  731 
Ferrocyanide  of  potassium,  616 
Ferrous  salts,  physiological  action  of,  27 
Ferrous  sulphate,  action  of,  on  bacteria,  93 
Ferrum  tartaratum,  610,  743 
Fever,  remittent,  depends  on  the  presence 

of  a  spirillum  in  the  blood,  107 
Fibres,  efferent  and  afferent,  position  and 

functions  of  the,  356 
Fibrin,  condition  of,  when  digested  with 

pancreatic  juice,  408 
Fibrin,  effects  of  heating,  75 ;   and  of 

pepsin  on,  75 
Fick,  A.,  his  kymograph,  269 
Fick,  J.,  reference  to,  124 
Figs,  as  demulcents,  347 ;  as  laxatives, 

389 ;  characters,  composition,  and  uses 

of,  1029 
Filices,  1066 

Filix  mas,  as  a  vermicide,  408 
Fir-wool  oil,  action  and  use  of,  1 059 
Fire-damp,  as  a  poison,  with  its  antidote, 

487 
Fish,  mechanism  of  respiration   in   the, 

232  ;  diagram  of  a,  233 
Flag,  blue,  1039 ;  as  an  emetic  or  cathar- 
tic, and  a  stimulant,  1039 
Flag,  sweet,  as  a  stomachic  stimulant, 

1053 
Flaxseed,  876 ;  oil  of,  877 
Flea-powders,  fennel,  934 ;  pyrethrum,  952 
Flies,   Spanish,  1091 ;   external  and  in- 
ternal action  of,  1091  ;  in  very  large 

doses,  1092  ;    on   the  salivary  glands, 

1092 ;   on  the  urinary  organs,   1092 ; 

external  and  internal  use  of,  1092 ;  as 

an  irritant  and  counter-irritant,  1092  ; 

precautions,  1094 
Floel,  reference  to,  383 
Flour,  wheaten,  1053 
Flourens,  reference  to,  236 
Flowers    of    sulphur,    its    preparation, 

characters,  &c.,  543 
Fluorine,  symbol  and  atomic  weight  of, 

10 ;  its  relation  to  other  members  of  a 

group,  16 
Fodor,  reference  to,  85 
Fokker,  reference  to,  102 
Food,  discussion  as  to  whether  alcohol 

can  be  deemed  a,  767 
Foot-baths,   warm,   utility  of,  as  direct 

emmenagogues,  453 
Formad,  reference  to,  98 


1132 


GENEEAL  INDEX. 


Formic  acid,  action  of,  on  bacteria,  94 

Foster,  M.,  references  to,  114,  175,  177 

Fothergill,  Dr.  Milner,  his  plan  of  "pre- 
paring hydrobromic  acid,  567 

Franck,  F.,  reference  to,  186,  187 

Francois-Franck  and  Brissaud,  reference 
to,  193 

Frankincense,  common,  characters  and 
use  of,  1057 

Fraser,  references  to,  150,  171-173,  296, 
492,  1100 

Freusberg.  reference  to,  181 

Friars'  balsam,  965 

Friction,  one  of  the  simplest  rubefacients, 
344 ;  value  of  friction  of  the  skin,  as 
an  adjunct  to  cold  baths,  461 

Fritsch,  reference  to,  186 

Frogs,  effects  of  large  and  small  doses  of 
veratrine  on,  26 ;  and  of  various  poisons, 
when  modified  by  heat  or  cold,  45,  46 ; 
various  experiments  on,  54-56 ;  action 
of  quinine  on  the  mesentery  of,  62 ; 
action  of  veratrine  on,  128 ;  experiment 
on  the  sartorius  of,  132 ;  rhythmical 
action  of  the  ventricle  of  the  heart  of, 
138 ;  experiment  on  the  leg  of,  147 ; 
explanation  and  diagram  of  the  mode 
of  experimenting  on  the  sensory  nerves 
in,  148 ;  experiment  on  the  gastro- 
cnemius of,  161-163  ;  mode  of  experi- 
menting on  the  action  of  drugs  on  the 
reflex  action  of  the  spinal  cord  of,  163 ; 
on  the  heart  of,  164;  diagram,  showing 
the  nervous  system  of ,  166;  experiments 
with  quinine  on  the  spinal  cord  of,  166 ; 
experiments  with,  167-174  ;  on  the  sar- 
torius of,  176 ;  experiments  on  the  ner- 
vous system  of  the,  183;  diagram  of 
the  higher  nerve-centres  of,  184  ;  Pre- 
vost's  experiment  with  chloroform  on 
the  brain  of,  206 ;  the  easiest  way  of 
ansesthetising,  209-211 ;  action  of  alco- 
hol on,  215 ;  on  convulsions  in,  237 ; 
diagram  to  illustrate  the  effects  of  the 
horizontal  and  vertical  position  of  the, 
in  shock,  263;  experiments  on  the 
arterioles  of,  278  ;  as  to  the  effects  of 
drugs  on  the  vessels  of,  278  ;  and  as  to 
the  effect  of  heat  and  cold  on  the  lung 
of,  279;  diagram  illustrative  of  this, 
279;  method  of  maintaining  artificial 
circulation  in,  280;  method  of  measure- 
ment by  the  rate  of  flow,  281 ;  experi- 
ments on  the  outflow  of  blood  from 
divided  vessels  in,  while  the  nervous 
system  is  intact,  285 ;  heart  beats  in 
the,  when  imperfectly  filled,  292  ;  the 
heart  of,  299  ;  diagram  of  the  heart  of, 
299 ;  diagram  of  the  auricular  septum 
in,  300 ;  action  of  drugs  on  the  heart 
of,  301 ;  instrument  for  showing  the 
action  of  heat  and  cold,  and  of  poisons 
on  the  heart  of,  301 ;  effect  of  heat  and 
cold  on  the  action  of  the  heart  of,  301  ; 


Ludwig  and  Coats's  apparatus  for  ob- 
serving alterations  in  the  pulsations 
and  rhythm  of  the  heart  of,  302) 
Williams's,  303;  tracings  showing 
changes  in  the  pulsations  of  the  apex 
of  the  heart  of,  306 ;  irritation  of  the 
vagus  of,  causes  stillstand  of  the  heart 
of,  310;  actions  of  two  classes  of  poi- 
sons on  the  vagus  of,  311 ;  difference 
between  the  action  of  the  accelerating 
nerves  and  the  inhibitory  fibres  of  the 
vagus  of ,  312;  Stannius's  experiments 
on  the  heart  of,  319-322;  diagrams 
illustrative  of  these,  319-321 ;  Gaskell's 
experiments  on,  321 ;  with  illustrative 
diaaram,  321 ;  general  considerations 
regarding  the  heart  of,  322,  323  ;  vagus 
stimulation  on  the  heart  of,  divided 
into  five  classes,  324,  325 ;  diagrams 
illustrative  of  this,  324,  325;  hypothesis 
regarding  the  action  of  the  vagus  on 
the  heart  of,  325 ;  with  illustrative  dia- 
grams, 326,  327;  inhibition  in  the  heart 
of,  326 ;  experiments  with,  as  to  the 
antagonism  of  drugs,  493  ;  action  of 
chlorides  on  the  nervous  system  of, 
602,  645 ;  of  soda  on,  620 ;  action  of 
barium  on,  645 ;  of  mercury,  685 ;  of 
phosphorus,  712 ;  of  arsenic  on  the  skin 
of,  715  ;  diagrams  of  the  epidermis  of, 
before  and  after  poisoning  by  arsenic, 
715  ;  action  of  antimony  on  the  heart 
and  skin  of,  724 ;  diagram  of  the  ver- 
tical section  of  the  epidermis  of  a, 
poisoned  by  antimony,  725 ;  of  solution 
of  perchloride  of  platinum  on,  755  ;  of 
salts  of  iron  on,  when  injected  subcu- 
taneously,  739 ;  of  nitrite  of  amyl, 
788  ;  of  chloral  hydrate,  792  ;  of  iodo- 
form, on  the  heart  of,  805 ;  carbolic 
acid  produces  convulsions  in,  814; 
action  of  resorcin  on,  818  ;  of  aconitia, 
832  ;  of  staphisagrine,  836  :  of  opium, 
851 ;  of  caffeine,  871;  of  quinine,  949  ; 
of  belladonna  or  atropine,  987 ;  of 
nicotine,  993  ;  of  digitalis  on  the  heart 
of,  996 ;  of  veratrine  on  the  heart 
muscle  of  the,  1048;  of  colchieum  on 
the  spinal  cord  of  the,  1050;  and  of 
ergot  inic  acid,  1070;  of  cornutine,  1070 
Fruit,  Anise,  935 

Bael,  891 

Capsicum,  984 

Caraway,  936 

Coriander,  937 

Dill,  936 

of  the  Dog-rose,  920 

Fennel,  934 

Hemlock,  931 

Squirting  cucumber,  928 
Fuchsin,  822 
Fuller's  earth,    as    a    demulcent,    347; 

nature  and  uses  of,  654 
Fungi,  1067 


GENEEAJj  INDEX, 


1133 


G. 

Gadidje,  1087 

Gadinine,  100 

Galactagogues,  456 

Galbanum,  as  an  antispasmodic,  214; 
characters  and  use  of,  as  a  stimulant 
expectorant,  933 

Gall,  ox,  inspissated,  1082 

Gallic  acid,  1033;  properties  and  uses  of, 
1033 

Gallioi,  mistura  spiritus  vini,  1086 ;  its 
therapeutics,  1086 

Gallinse,  1085 

Gallium,  symbol  and  atomic  weight  of, 
10 ;  properties  of,  20 

Galls,  as  an  astringent,  349 ;  characters, 
action,  and  uses  of,  1031 

Gamboge,  as  a  drastic  purgative,  389 ; 
and  a  hydragogue,  390;  characters, 
action,  and  uses  of,  869 

Gamgee,  A.,  reference  to  his  Physiological 
Cliemistry,  67 

Ganglia,  motor  cardiac,  289  ;  inhibitory, 
289 ;  diagram  to  show  the  supposed 
relation  of  motor,  in  the  heart  to  ac- 
celerating fibres,  290;  Remak's  and 
Bidder's,  300,  304,  308;  motor, .,  in- 
hibitory, and  quickening,  supposed  to 
be  present  in  the  nervous  system  of,  the 
frog,  312-314;  inhibitory  and  motor, 
of  the  heart,  316, 317 ;  functions  of  the 
cardiac,  323 

Gargles,  method  of  using,  482 

Garlic,  as  a  stimulating  expectorant,  255  ; 
action  of,  1040 ;  as  an  antiseptic,  irri- 
tant, and  carminative,  1040 ;  as  a 
■stimulant,  expectorant,  and  diuretic, 
1040 

Gartner,  reference  to,  42 

Gases,  action  of  different,  on  the  frog's 
heart,  308 ;  poisonous  gases,  with  their 
antidotes,  486,  487 

Gaskell,  references  to,  111,  276,  280,  284, 
295,  307,  311,  313,  321,  322-326 

Gastric  juice,  action  of  acids  on  the,  569 
Sedatives,  and  anti-emetics,  nature, 
number,  and  uses  of,  376,   377 ; 
divided  into  local  and  general,  376; 
adjuvants  to,  376 
Stimulants,  alkalies  as,  598 
Syphon,  nature  and  uses  of,  483 
Tonics,  nature  and  action  of,  361  et 
seq. ;  purgatives  and  cholagogues 
may  act  as  indirect,  369  ;  states  in 
which  they  are  indicated,  411 

Gastro-salivary  circulation,  diagram  of, 
359 

Gaultheria,  oil  of ,  characters,  962;  action, 
and  use  of,  as  an  antipyretic,  963 

Gelatine,  as  a  demulcent,  347  ;  solution 
of,  1086 

Gelatine  discs,  615 

Gelsemine,  as  a  spinal  stimulant,  181;  as 


a  local  and  general  anodyne,  201 ;  as  a 
mydriatic  and  myotic,  219 ;  action  of, 
on  the   respiratory  centre,   233,  241. 
See  Gelsemium 
Gelsemium,  as  a  poison,  with  its  antidote, 
490 ;  antagonism  of,  to  opium  and  atro- 
pine, 495 ;  characters  and  action  of, 
977;  on  the  eye,  the  spinal  cord,  and 
the  motor  centres,  978 ;  on  the  head, 
the  vagus,  the  blood,  pulse,  and  heart, 
978 ;  uses  of,  978 
Geltowsky,  references  to,  61 
Generative  system,  action  op  dbtjgs 
on  the,  447-456  ;   action  of  the  cere- 
bral  and  spinal  centres  on  the,  447  ; 
action  of   drugs  on  the,  as  aphrodi- 
siacs, 449;  as  anaphrodisiacs,  451  ;  as 
emmenagogues,  452 ;  and  as  ecbolics, 
454  ;  action  of  drugs  upon  milk,  455 
Genito-urinary  tract,  action  of  opium  on, 

861 
Gentian,  979 

Eoot,  characters  and  composition  of, 
979  ;  preparation  and  use  of,  979 
Gentianacese,  979 
Geraniacese,  881 

Geranium  (cranesbill),  characters,  compo- 
sition, and  action  of,  as  an  astringent, 
881 
Gianuzzi,  references  to,  239,  971 
Giant  cells,  action  of  iodoform  on,  805 
Gilbert,  reference  to,  136 
Gin,  as  a  cardiac  stimulant,  328  ;  and  as 

a  stimulant  diuretic,  433 
Ginger,  as    a    carminative,  379  ;    as  a 
sialagogue,  357 ;  characters,  action, 
and  uses  of,  1037  ;  as  a  carminative, 
1037 
Gingerbread,  as  a  laxative,  389 
Glanders,  caused  by  a  species  of  bacillus, 

99 
Glands,   poisonous  action  of  the  heavy 

metals  on  the,  664 
Glandular  system,  antagonistic  action  of 

drags  on  the,  494 
Glauber's  salt,  625 

Glaucoma,  nature  pf,  and  mode  of  treat- 
ment, 226 
Glomeruli,  the  result  of  arterial  pressure 
on  the,  427,  428 ;  ppisonous  action  of 
the  heavy  metals  on  the,  665 
Glycerine,  action   of,   on   enzymes,   78 : 
on  bacteria,  93  ;  as  a  demulcent,  347 ; 
characters  and  uses  of,  966,  967 
Glycerines,  513 
Glycerinum,  513,  966 

Acidi  Carbolici,  513,  813,  967 
Gallici,  513,  967, 1034 
Tannici,  513,  967,  1031 
Aluminis,  513,  967 
Amyli,  513,  967,  1053 
Boracis,  513,  624,  967 
Plumbi  Subacetatis,  513, 967 
Tragacanthae,  513,  967 


1134 


GENEBAL  INDEX. 


Glyceritum  vitelli,  613, 967,  1086 

Glycogen,  formed  and  stored  up  by  the 
liver,  402 ;  glycogenic  function  of  the 
liver  destroyed  by  phosphorus,  arsenic, 
and  antimony,  402 

Glycyrrhizinurn  ammoniatum,  899 

Goa  powder,  909 

Gold,  symbol  and  atomic  weight  of,  10  ; 
as  an  alterative,  413;  properties, 
action,  and  uses  of,  free  from  metallic 
impurities,  753  ;  solution  of  chloride 
of,  754 ;  chloride  of,  and  sodium,  754 

Goltz,  reference  to,  183,  285 

Gonorrhoea,  caused  by  micrococci,  99 

Gout,  rheumatic.    See  Rheumatic  Gout 

Granville,  Mortimer,  his  proposed  mode 
of  relieving  pain,  203 

Grass,  couch,  1054 

Graves,  Dr.,  reference  to,  726 

Grawitz,  reference  to,  81 

Griffith's  mixture,  742 

Grindelia,  characters  and  uses  of,  959 ;  in 
asthma,  dyspnoea,  and  as  a  local  appli- 
cation, 959 

Groups,  arrangement  of  the  elements  in, 
16 

Griitzner,  reference  to,  42 

Guaiac  resin,  and  tincture  of  guaiac,  ex- 
periments with,  on  oxygen,  68,  69  ;  as 
a  stimulant  diuretic,  433 

Guaiaci  resina,  525 

Guaiacum,  as  an  alterative,  413 ;  as  a  di- 
rect emmenagogue,  453  ;  guaiacum  re- 
sin, characters,  composition,  action,  and 
uses  of,  chiefly  in  the  treatment  of  ton- 
sillitis, 880 ;  guaiacum  wood,  nature 
and  composition  of,  880 

Guanidine,  action  of,  destroyed  by  ex- 
tremes of  heat  or  cold,  45 ;  effect  of 
temperature  on,  extraordinary,  175 ; 
action  of,  on  the  motor  ganglia,  316  ;  on 
the  cardiac  muscle,  316 

Guarana,  characters,  composition,  and 
uses  of,  897 

Guareschi,  references  to,  101,  401 

Guinea-pigs,  the  cerebral  hemispheres  of, 
more  developed  than  in  the  frog,  184 

Gum,  as  a  demulcent,  347 

Gum  acacia,  characters,  &c,  and  use  of, 
913 ;  gum  arabio,  913 

Gumchi,  903 

Gun-cotton,  preparation  and  use  of,  873 

Gutta-percha,  characters  and  use  of,  963 

Guttiferse,  869 

Gymnosperms,  1057 


Habit,  effect  of,  on  the  action  of  drugs, 

43 
Hsematemesis,  value  of  astringents  and 

styptics  in,  350 
Hsematin,  nature  and  spectrum  of,  71 


Hasmatinics,  or  blood-tonics,  nature,  ac- 
tion and  uses  of,  411 

Hsematuria,  value  of  astringents  and 
styptics  in,  350 

Haemodromometer,  Marey's,  294 

Hemoglobin,  solution  of,  60 ;  power  of, 
70 ;  spectroscopic  examination  of,  70, 
72 ;  action  of,  on  the  frog's  heart,  308  ; 
treatment  to  be  adopted  when  there  is 
a  deficiency  of  in  the  blood,  411 ;  the 
quantity  of,  increased  by  haamatinics, 
412 

Haemoptysis,  value  of  astringents  and 
styptics  in,  350 

Haemorrhage,  action  of  astringents  and 
styptics  in  lessening  or  arresting,  350, 
351 ;  importance  of  absolute  quiet  in 
severe,  351 ;  emetics  to  be  avoided  in 
persons  suffering  from,  375 

Hall,  Marshall,  reference  to,  246 

Halogen  elements,  the  general  source, 
characters,  and  mode  of  preparation  of, 
547-564 

Haloid  Compounds — 

Bichloride  of  methylene,  795 
Bromal  hydrate,  794 
Bromide  of  ethyl,  789 
Chloral,  790 

„       hydrous,  790 
Chloroform,  795 

„        Purified,  796 
Hydrate  of  butyl-chloral,  794 
Hydrate  of  chloral,  790 
Iodide  of  ethyl,  790 

Hamamelacese,  1029 

Hamamelis,  as  a  vascular  sedative,  339  ; 
characters  and  use  of,  1029 

Hamilton,  Dr.  McLean,  his  plan  of  pre- 
paring hydrobromic  acid,  567 

Harley,  reference  to,  72 

Harnack,  references  to,  119, 127, 150,  296, 
304,  307,  312 

Haycraft,  reference  to,  30 

Haywood,  Dr.,  reference  to  his  use  of 
ether,  212 

Head,  action  of  gelsemium  on  the,  978 

Hearing,  action  of  drugs  on,  228 

Heart  and  vessels,  comparative  effect  of, 
on  blood-pressure  in  different  animals, 
287, 288  ;  in  dogs  and  rabbits,  287,  288 ; 
action  of  the,  on  blood-pressure,  292 ; 
various  modes  of  estimating  the  action 
of  the,  on  the  circulation,  292-294 ; 
cause  of  the  stoppage  of  the,  in  rabbits, 
dogs,  and  men,  296  ;  stimulation  of  the, 
by  increased  blood-pressure,  298  ;  dif- 
ference betwixt  the  tortoise  and  the 
mammalian  heart,  298  ;  palpitation  of 
the,  299;  the,  of  the  frog,  299;  dia- 
gram of  the  heart  of  the  frog,  300  j 
action  of  drugs  on  the,  of  the  frog,  301 ; 
instrument  for  showing  the  action  of 
heat  and  cold,  and  of  poisons  on  the 
frog's  heart,  301 ;  diagram  of  Ludwig 


GENEEAL  INDEX. 


1135 


and  Coats's  frog-heart  apparatus,  302 ; 
diagram  of  Williams's  apparatus  for  in- 
vestigating the  action  of  drugs  on  the 
heart  of  the  frog,  303  ;  action  of  drugs 
on  the  muscular  substance  of  the,  305  ; 
apparatus  for  ascertaining  the  action  of 
drugs  on  the  muscular  substance  of  the, 
305  ;  tracings  showing  changes  in  the 
action  of  the  frog's  heart,  306 ;  difference 
between  the  heart-apex  and  the,  308 ; 
diagram  to  show  the  difference  in  the 
mode  of  experimenting  with  the  heart 
and  with  the  apex  alone,  308 ;  diagram 
showing  the  periodic  rhythm  of  the, 
309 ;  tracings  of  the  pulsations  of  a  ven- 
tricle of  the,  310 ;  action  of  drugs  on  inhi- 
bition ofthe,  310;theories  regarding  the 
mode  of  action  of  drugs  upon  the,  312  ; 
hypothetical  view  of  the  nervous  system 
of  the,  312,  314 ;  diagram  of  the  hypo- 
thetical nervous  apparatus  in  the,  313 ; 
detailed  description  of  the  physiology  of 
the,  316-328  ;  diagram  of  the  heart  and 
vessels  to  illustrate  the  action  of  drugs 
on  thecirculatqry  apparatus  of  the,  315  ; 
drugs  which  stimulate,  or  depress,  or 
paralyse  the  vagus-centre  of  the,  317; 
the  accelerating-centre,  318  ;  the  vaso- 
motor centre,  319;  the  vagus-ends  in 
the,  317  ;  the  inhibitory  and  motor 
ganglia,  316  ;  the  cardiac  muscle,  316  ; 
the  vaso-motor  nerves,  318  ;  the  capil- 
laries, 318 ;  Stannius's  experiments  re- 
garding the  action  of  the  various  cavities 
of  the  frog's,  319-322 ;  diagrams  illus- 
trative of  this,  319-321 ;  Gaskell's  ex- 
periments on  the  same  subject,  321  ; 
diagram  to  illustrate  this,  321 ;  general 
considerations  regarding  the,  322,  323 ; 
regulating  action  of  the  nervous  system 
of  the,  324,  325  ;  diagrams  illustrating 
this,  324,  325 ;  hypothesis  regarding 
the  action  of  the  vagus  of  the,  325; 
illustrative  diagrams,  327 ;  inhibition  of 
the,  326 ;  no  satisfactory  explanation 
"  can  as  yet  be  given  of  the  action  of 
drugs  on  the,  328  ;  knowledge  in  this 
respect  at  present  in  a  progressive  state, 
328 ;  drugs  which  act  on  the  circulation 
of  the,  their  divisions  and  subdivisions, 
328  ;  cardiac  stimulants,  328  ;  vascular, 
330;  cardiac  tonics,  331 ;  various  con- 
ditions and  diseases  of  the,  in  which 
tonics  are  most  useful,  332-335 ;  the 
question  ofthe  use  of  digitalis  in  aortic 
regurgitation  considered,  333 ;  pre- 
cautions as  to  position  of  the,  during 
the  administration  of  cardiac  tonics, 
334 ;  action  of  sedatives  on  the,  338  ; 
diagram  to  show  the  nervous  mecha- 
nism by  which  the  action  of  the,  may 
be  depressed  by  irritation  of  the 
stomach,  396 ;  action  of  manganese  salts 
on  the,  753  ;  of  alcohol,  769;  of  spirit  of 


ether,  782 ;  of  bromal  hydrate,  795 ; 
of  purified  chloroform,  799-803;  of 
iodoform, 805 ;  of  aconitine,  833,  834  ;  of 
staphisagrine,836;ofquillaia(saponin), 
919;  of  quinine,  946;  of  ipecacuanha, 
949;  of  strychnine,  974  ;  of  gelsemium, 
978;  of  solanine,  983 ;  of  tobacco,  992  ; 
of  digitalin,  996 ;  of  camphor,  1019  ;  of 
extract  of  ergot,  1071 

Heat,  effect  of,  on  the  power  of  poisons, 
44,  48 ;  power  of,  to  preserve  life  in 
narcotic  poisoning,  47;  effects  of,  in 
accelerating  death  from  muscular  and 
metallic  poisoning,  47 ;  effect  of,  on 
protoplasmic  movement,  60;  on  the 
action  of  infusoria,  64 ;  on  mould-f  nngi, 
82 ;  on  bacteria,  88  ;  as  a  disinfectant, 
106 ;  effects  of,  on  muscle,  1 18, 123, 131, 
138 ;  on  the  action  of  strychnine,  175  ; 
in  inducing  sleep,  198;  as  a  local 
anodyne,  201 ;  dry,  in  the  form  of  a 
poultice,  relieves  pain,  203 ;  action  of, 
on  the  respiratory  centre,  240;  appa- 
ratus for  ascertaining  the  effect  of,  on 
the  vessels  of  the  frog's  lung,  279; 
instruments  for  showing  the  action  of, 
on  the  frog's  heart,  301 ;  the  most 
powerful  of  all  cardiac  stimulants,  329  ; 
as  a  vascular  stimulant,  330 ;  action  of, 
on  inflammation,  341 ;  diagram  to  show 
the  effect  of,  in  lessening  the  pain  of 
inflammation,  342 ;  as  a  vesicant,  344 ; 
as  an  emollient,  347 

Hedeoma,  or  pennyroyal,  characters  of, 
1006 ;  action  and  uses  of,  1007 ;  as  a 
carminative,  diaphoretic,  and  emmena- 
gogue,  1007 

Heidenhain,  originates  the  name  of 
zymogens,  80;-  references  to,  404,  423, 
426 

Hellebore,  American,  1045 ;  hellebore 
rhizome,  green,  1045 ;  action  of,  on  the 
pulse,  1045 

Helleborin,  action  of,  on  ascidians,  114  ; 
on  the  frog's  heart,  307 ;  on  the  cardiac 
muscle  316 ;  as  a  cardiac  tonic,  331 

Hemiptera,  1090 

Hemidesmus  root,  characters,  compo- 
sition, and  use  of,  970 

Hemlock  (conium),  composition,  action, 
and   therapeutics  of,   931;   para- 
lysing power  of,  932 
Fruit,  931 
Leaves,  930 
Pitch,  1062 

Hemp,  Indian,  as  a  hypnotic,  199 ;  as  a 
narcotic,  200;  character,  action,  and 
uses  of,  1026;  on  the  sensory  nerves, 
the  pupil,  and  respiration,  1027 ;  on  the 
pulse,  temperature,  urine,  and  diges- 
tion, 1027 ;  uses  of,  as  a  soporific,  1027 

Henle's  loop,  424,  426,  435 

Hepatic  stimulants,  nature  of,  400;  action 
of,  402 ;  importance  of  combining  in- 


1186 


GENEBAL  INDEX. 


testinal  and,  405;  cholagogues  and, 
407;  depressants,  407;  resin  of  podo- 
phyllum as  a,  838;  enonynms  (wahoo) 
as  a,  895 ;  juglans  as  a,  1029 
Hermann,  references  to,  34, 39,  41,  74, 308 
Hernia,  emetics  to  be  used  with  caution 

in  persons  suffering  from,  376 
Hip-baths,  and  mustard  hip-baths,  utility 

of,  as  indirect  emmenagogues,  453 
Hips  (fruit  of  the  dog-rose),  920 
Hirt,  reference  to,  296 
Histozyme,   a    recently  discovered  fer- 
ment, 76 
Hitzig,  reference  to,  186 
Hock,  as  a  stimulant  diuretic,  433 
Hoffmann,  reference  to,  304 
Hoffman's  anodyne,  783 
Holmgren,  reference  to,  278 
Holmium,  symbol  and  atomic  weight  of. 

10 
Homatropine,  as  a  mydriatic,  219 
Homoeopathy,  the  principle  of,  36 
Homolle's  digitaline,  995 
Honey,  as  a  demulcent,  347 ;  as  a  laxa- 
tive, 389 ;  its  characters,  composition, 
Sec,  1089 
Honeys,  518 

Hoppe-Seyler,  references  to,  74,  75 
Hops,  as  a  hypnotic,  199 ;  characters  of, 

1027 
Horehound.    See  Marrubium 
Horseradish,  as  a  sialagogue ;   357 ;  as  a 
carminative,    379;    as     a    stimulant 
diuretic,  433;  horseradish  root,  charac- 
ters, composition,  and  uses  of,  866 
Hot  baths,  467 ;  hot  foot-baths,  467 ;  hot 

sitz  baths,  467 
Howard's  plan  of  artificial  respiration, 

802 
Hufner,  reference  to,  423 
Hughlings  Jackson,  reference  to,  145 
Humboldt,  Alexander  von,  reference  to, 

45 
Humulus,  or  hop,  1027 
Hunter,  John,  reference  to,  277 
Husemann  on  lithium,  28 
Hydragogues.    See  Purgatives 
Hydrargyri  Chloridum  mite,  686 
Cyanidum,  687 
Iodidum  rubrum,  557,  687 

Viride,  687 
Oxidum  flavum,  686 
Rubrum,  686 
Perchloridum,  620,  687,  690 
Persulphas,  687,  690 

Flava,  687 
Subchloridum,  620,  686,  690 
Sulphidum  rubrum,  686 
Hydrargyrum,  686 

Ammoniatum,  637 
Corrosivum,  687 
Cum  cret&,  686 
Hydrastin,  as  a  hepatic  stimulant,  403 
Hydrastis    (golden    seal),   as    a   direct 


emmenagogue,  453 ;  as  an  ecbolic, 
454  ;  characters/composition,  and  uses 
of,  839 ;  as  a  hepatic  stimulant  and  as 
an  antiperiodic,  839 
Hydrate,  bromal,  preparations  and  charac- 
ters, 794  ;  action  of,  795  ;  irritates  the 
eyes  and  causes, running  at  the  nose, 
795  ;  has  a  narcoticaction  like  chloral, 
and  a  powerful  paralysing  action  on  the 
heart,  795  ;  causes  salivation  and  pro- 
fuse secretion  from  bronchial  mucous 
membrane,  795 ;  uses  of,  795 
Hydrate,  of  aluminium,  656 

Butyl  chloral,  action  of,  on  the  vagus- 

centre,317;  character,  action, uses, 

and  administration  of,  794 

Of  chloral,  action  of,  on  bacteria,  95 

Hydriodic  acid,  physiological  action  of,27 

Hydrobromic  acid,  action  of,  on  the  ear, 

229 ;  how  prepared,  567 
Hydrocarbons,  fatty  series,  761 ;  chemical 
nature  and  physical  character  of  the, 
761 ;  boiling-point  of  the,  761 ;  physio- 
logical action  of  those  belonging.to  the 
marsh  gas  series,  761.  See  under  the 
different  names  of  the  series. 
Hydrochlorate  of  apomorphine.  See  Apo- 

morphine,  hydrochlorate  of 
Hydrochlorate  of  morphine.     See  Mor- 
phine, hydrochlorate  of 
Hydrochlorate  of  cocaine.     See  Cocaine 

and  Cocaine  hydrochlorate 
Hydrochlorate  of  pilocarpine,  characters 

of,  884.    See  also  Pilocarpine 
Hydrochlorate  of  rosaniline,  preparation, 

characters,  actions,  and  uses  of,  822 
Hydrochloric  acid,  physiological  action 
of,  27 ;  action  of,  on  the  protoplasmic 
movements,  60  ;  on  enzymes,  78 ;  on 
bacteria,  93,  95 ;  as  a  caustic,  344 ; 
arrests  secretion  of  saliva,  361 ;  as  a 
poison,  with  its  antidote,  487  ;  proper- 
ties and  uses  of,  572;  preparations 
containing  free,  573 
Hydrocyanic  acid,  forms  »  compound 
with  haemoglobin,  70;  nature  and 
spectrum  of  this  compound,  71  ;  effects 
of,  on  the  blood,  72 ;  on  bacteria,  95  ; 
as  a  local  anodyne,  201 ;  action  of,  on 
the  respiratory  centre,  234;  on  the 
muscles  of  respiration,  238  ;  effects  of 
poisoning  by,  on  the  colour  of  the 
blood,  240 ;  the  vapour  of,  has  a  local 
sedative  action  on  the  lung,  249 ;  action 
of,  on  the  vagus-centre,  317 ;  on  the 
motor  ganglia,  316;  on  palpitation  of 
the  heart,  338 ;  as  a  local  and  general 
sedative,  376  ;  as  a  poison,  with  its 
antidote,  487  ;  antagonism  of,  to  atro- 
pine, 492,  495;  preparation,  properties, 
action,  and  uses  of,  566  et  sen. ;  action 
of,  on  the  skin,  586  ;  on  the  blood,  587 ; 
on  respiration,  587 ;  on  the  heart,  587 ; 
on  the  arteries  and  nerves,588 ;  diagram 


GENEEAL  INDEX. 


1137 


to  show  the  effect  of,  when  applied 
locally,  589 ;  uses  of,  589 

Hydrogen,  symbol  and  atomic  weight  of, 
10 ;  its  preparation  and  uses,  537 

Hydrogen,  peroxide  of,  rapidly  decom- 
posed by  finely-divided  platinum,  73  ; 
power  of  certain  metals  to  absorb,  73  ; 
its  preparation,  properties,  action,  and 
uses,  540 

Hydroquinone,  characters,  action,  and 
uses  of,  818 

Hymenoptera,  1089 

Hyoscyaminae  sulphas,  504 

Hyoscyamine,  as  a  general  anodyne,  199  ; 
action  of,  on  the  vagus-centre,  317 ; 
on  the  vaso-motor  centre,  319;  and 
inhibitory  ganglia,  317 ;  as  an  anti- 
hidrotic,  441 ;  as  a  vesical  sedative, 
445 ;  as  a  poison,  with  its  antidotes, 
490  ;  antagonism  of,  to  morphine,  496 

Hyoscyamine,  sulphate  of,  characters, 
action,  and  uses  of,  991 

Hyoscyamus,  a  hypnotic,  199  ;  as  a  nar- 
cotic, 200  ;  as  a  general  anodyne,  201 ; 
action  of,  on  the  vagus-centre,  317  ;  on 
the  vaso-motor  centre,  319 ;  on  the 
inhibitory  ganglia,  317 ;  characters, 
composition,  and  preparation  of,  990 

Hyoscyamus  leaves,  990 

Hyphomycetes,  82 

Hypnone,  characters,  action,  and  uses, 
779 

Hypnotics,  or  soporifics,  nature  and 
action  of,  on  the  brain,  196-200 ;  list 
of  the  chief,  199  ;  bromide  of  potassium 
as  a  hypnotic,  554 

Hypodermic  administration  of  drugs, 
474 ;  advantages  of  this  method,  475  ; 
nature  and  method  of  the  injections, 
475;  diagram  of  a  syringe  for  hypoder- 
mic injection,  475;  objections  to  hy- 
podermic injections,  476  ;  method  of 
obviating  these;  476 ;  account  of  the 
syringe  employed  by  Koch,  476 ;  in- 
jections of  apomorphine,  ergotin,  and 
morphine,  514 

Hypophosphite  of  sodium,  627;  of  cal- 
cium, 653 ;  of  iron,  752 

Hyposulphite,  test  for,  594 ;  of  sodium,  630 

Hysterical  paralysis  of  the  limbs  and 
hysterical  aphonia,  usefulness  of  blis- 
ters in,  346 


Ice,  as  an  anaesthetic,  157 ;  action  of, 
externally,  on  the  mucous  membrane, 
252 ;  the  most  powerful  of  local  seda- 
tives, 376 ;  as  a  cardiac  sedative,  339  ; 
as  a  styptic,  350 ;  as  an  anaphrodisiac, 
451 

Iceland  moss,  as  a  demulcent,  347 ;  com- 
position of,  1067 

Ichthyocolla,  1086 


Idiosyncrasy,  effects  of,  on  the  action  of 

drugs,  51 
Ignatia,  characters  and  composition  of, 

971 
Image,  Mr.,  of  Bury  St.   Edmunds,  his 

plan  of  administering  chloroform,  803 
Indian  hemp,  1026 

White,  970  ;  acts  like  digi- 
talis, 970 
Liquorice,  903 
Indiarubber  bag  for  holding  hot  water, 
utility  of,  to  invalid  travellers,   329 
and  n. 
Indigo,  preparation  and  use  of,  915 
Indol,  action  of,  on  bacteria,  94 
Inflammation,  chronic  and  acute,  action 
of    irritants   and  counter-irritants  in, 
340-347  ;  diagrams  illustrative  of  the 
action  of  irritants  in,  342,  343  ;  of  the 
joints,  utility  of  friction  in,  345 
Infusions,  513 

Infusoria,  nature  of,  and  action  of  drugs 
on,  63  et  seq. ;  mode  of  experimenting 
on,  63  ;  effects  of  heat,  cold,  and  saline 
solutions  on,  64 ;  of  acids,  alkalies,  and 
other  drugs  on,  65  ;  oxidation  of,  65-68 
Infusum  Anthemidis,  514,  955 
Aurantii,  514,  888 

Compositum,  514,  888,  890, 
922 
Brayerae  (Cusso),  514,  921 
Buchu,  514,  882 
Calumbse,  514,  841 
Caryophilli,  514 
CascarilhE,  514,  1022 
Catechu,  514,  951, 1016 
Cheken,  924 
Chiratae,  514,  980 
Cinchonas,  514,  940 

Acidum,  514,  571,  941 
Cusparise,  514,  882 
Cusso,  514,  921 
Digitalis,  514,  994 
Dulcamaras,  983 
Ergotae,  514,  1069 
Gentianse  compositum,  514,  888,  890, 

979 
Jaborandi,  514,  883 
Kramerias,  514,  868 
Lini,  514,  876,  899 
Lupuli,  514,  1028 
Maticse,  514,  1015 
Pruni  Virginianae,  514 

Fluidum,  917 
Quassias,-  514,  892 
Bhei,  514,  1010 
Bosae  Acidum,  514,  571,  920 
Senegas,  514,  867 
Sennaa,  514,  910,  1037 

Compositum,    514,  659,   910, 
968 
Serpentariae,  514,  1012 
Uvas  ursi,  514,  962 
Valerianae,  514,  952 

4  D 


1138 


GENEEAL  INDEX. 


Inhalations,  533;  of  chlorine,  550 
of  vapours  for  the  lungs,  481,  533 

Inhalers  for  the  lungs,  481 

Inhibition,  and  the  action  of  drugs  on 
inhibitory  centres,  nature  of,  167-171 

Injectio  apomorphinas,  849 

Ergotini  hypodermica,  1069 
Morphinse  hypodermica,  515,  844,  848 

Injections,  enemas,  or  clysters,  508 

INOEGANIC  MATBEIA  MEDICA,  537 

Insect  powder,  as  a  poison,  with  its  anti- 
dotes, 490 

Insecta,  1089 

Insufflator,  for  applying  powders  to  the 
larynx,  diagram  of  an,  480 

Intestines,  difference  between  the  vessels 
of  the,  and  those  of  the  muscles,  276  ; 
action  of  drugs  on  the,  379 ;  move- 
ments and  secretion  of  the,  379  ;  cause 
of  these,  379 ;  paralytic  secretion  of 
the,  380;  diagram  illustrative  of  the 
effect  of  section  of  the  nerves  on  secre- 
tion from  the,  380;  certain  nerve- 
centres  possess  the  power  of  restraining 
the  secretion  from  the,  380;  nervous 
arrangements  and  nerve-centres  of  the, 
381 ;  natural  and  artificial  circulation 
in  the,  382 ;  diagrams  illustrating  the 
effects  of  artificial  circulation  in  the, 
382 ;  action  of  peptones,  nicotine,  and 
atropine,  382, 383 ;  of  opium,  383 ;  differ- 
ence between  the  action  of  soda  and 
potash  on  the,  with  diagrams,  383; 
effects  of  morphine  on  the,  384 ;  and 
of  sodium  salts,  384;  cause  of  con- 
stipation of  the,  and  remedies  for,  384, 
385;  diagram  to  show  how  ovarian 
irritation  probably  causes  constipation, 
386  ;  action  of  opium  as  a  purgative  on 
the,  386;  small  doses  of  belladonna 
also  act  as  purgatives  on  the,  386; 
action  of  drugs  on  absorption  from  the, 
386 ;  action  of  astringents  on  the,  in 
diarrhoea,  387 ;  diagram  illustrating 
diarrhoea  depending  on  the  presence  of 
scybala  in  the,  388  ;  nature  and  action 
of  various  kinds  of  purgatives  on  the, 
388-395  ;  of  irritant  poisons,  395  ;  dia- 
gram of  the  liver,  stomach,  and,  404  , 
application  of  drugs  to  the,  484;  as 
enemata,  484;  as  suppositoiies,  484; 
action  of  strong  solution  of  ammonia 
on  the,  639 ;  acfiion  of  iron  on  the,  663 
of  copper,  666 ;  of  alcohols,  765,  766 
770 ;  of  salts  of  iron,  739 ;  of  gold,  754 
of  spirit  of  ether,  781  ;  of  purified 
chloroform,  797;  of  opium,  856;  of 
sanguinaria,  863  ;  of  caffeine,  871 ;  of 
pilocarpine  on  the  glands  of  the,  885  ; 
of  physostigmine,  907 ;  of  quillaia 
(saponin),  918  ;  of  ipecacuanha,  949  ; 
of  sulphate  of  strychnine,  972;  of 
belladonna  or  atropine,  988  ;  of  aloes. 
1044 


Intoxication,  diagnosis  between  opium- 
poisoning,  apoplexy,  and,  852 
Inula  (elecampane),  characters  and  uses 

of,  959 
Inunction  of  drugs,  method  of  employing, 
473 
of  the  skin,  advantage  to  be  derived 
from,  474 
Invertebrata,  action  of  drugs  on,  109-116 
Iodic  acid,  physiological  action  of,  27 
Iodide,  test  for,  594 

Iodide  of  ammonium,  action  of,  on  the 
ear,  229  ;   preparation,  character, 
and  uses  of,  563 
Ethyl-strychnine,  361 
Lead,  705 
Mercury,  green,  696 

Bed,  696 
Potassium,  559 
Silver,  680 
Sodium,  563 
Sulphur,  557 
Zinc,  673 
Iodide  of  potassium,  action  of,  on  the 
ear,  229 ;   on  the  sense  of  smell,  230 ; 
on  taste,  231 ;  difference  between  large 
and  small   doses  of,   on  the  secretion 
of  mucus,  253;   as   an   anaphrodisiae, 
451 ;  nature,  action,  and'  uses  of,  559- 
563 
Iodides,  the,  as  alteratives,  413 
Iodine,  symbol  and  atomic  weight  of, 
10 ;  its  relation  to  other  members  of  a 
group,  16;   action  of,  on  infusoria,  65 
on  enzymes,  78,  79 ;  on  bacteria,  89,  91 
94,  95 ;  on  taste,  231 ;  on  quinine,  231 . 
and  its  preparations,  as  rubefacients! 
344;    and    its    compounds,    as    siala- 
gogues,  357  ;  as  an  alterative,  413 ;  has 
little    influence   on  the  excretion  of 
urea,  415  ;  vapour  of,  as  a  poison,  with 
its  antidote,  486 ;  characters,  tests,  and 
preparations  of,  557 ;  iodide  of  sulphur, 
characters  and  uses  of,  557;  ointmem) 
of,  558 ;  physiological  action  of  iodine, 

558  ;  uses  of,  559  ;   as  an  aphrodisiac, 

559  ;  as  an  anaphrodisiae,  559 
Iodine  water,  action  of,  on  bacteria,  93 
Iodism,  symptoms  of,  558,  561 
Iodoform,  a  local  anaesthetic,  204;  pre- 
paration and  characters  of,  804  ;  mode 
of  administration,  804 ;    action  of,  as 
an  antiseptic,  a  deodoriser,  and  a  local 
anesthetic,   805;    action    of,  on    the 
heart  and  nervous  system,  805;    on 
giant  cells,  805 ;  uses  of,  805 

Iodoformum,  557 

Iodol,  action  and  uses  (Appendix),  1099 

Ipecac,  948 

Ipecacuanha,  causes  vomiting  in  man,  but 
not  in  rabbits,  54 ;  action  of,  on  the 
nose,  245  ;  one  of  the  most  useful  ex- 
pectorants in  sufficient  doses,  254  ;  as  a 
depressant  expectorant,  255  ;  as  a  local 


GENEKAL  INDEX. 


1139 


emetic,  373,  375 ;  as  a  hepatic  stimu- 
lant, 403 ;  as  an  antihidrotic,  441 ; 
characters,  composition,  and  prepara- 
tions of,  948  ;  physiological  action  of, 
on  frogs,  949 ;  locally,  949 ;  on  the 
stomach  and  intestine,  949 ;  on  the 
vessels,  heart,  and  lungs,  949  ;  uses  of, 
—as  an  emetic  and  diaphoretic,  950  ; 
as  an  expectorant  and  anti-dysenteric, 
950;  precautions,  950 
Ipecacuanha  powder,  as  a  sudorific,  421 
Iridacea?,  1038 

,  Iridin,  as  a  cholagogue,  390  ;  as  a  hepatic 
stimulant,  403 
Iridium,  symbol  and  atomic  weight  of, 

10  ;  physiological  action  of,  27 
Iris  of  the  eye,  structure  and  action  of 

the,  217 
Iris,  the,  or  blue  flag,  1039 
Irish  moss,  1073 

Iron,  symbol  and  atomic  weight  of,  10  ; 
effects  of  large  and  small  doses  of,  on 
the  muscles,  127 ;  causes  slow  contrac- 
tion of  the  vessels,  281 ;  action  of,  on 
the  vaso-motor  nerves,  318  ;  as  a  vas- 
cular tonic,  336 ;  action  of,  on  the 
liver,  405  ;  as  a  vermicide,  408  ;  action 
of,  on  the  general  system,  663 ;  pro- 
perties, sources,  and  reactions  of,  735, 
736;  general  preparations  of,  736-738; 
action  of,  738 ;  on  the  skin,  mouth, 
stomach,  and  intestines,  739  ;  on  the 
blood  and  tissues,  739  ;  on  the  nervous 
system,  739 ;  on  frogs  and  mammals, 
739 ;  how  eliminated,  740 ;  the  strong 
solution  of  the  perchloride  of,  one  of 
the  most  powerful  styptics,  746 ;  the 
liquor  and  tincture  of,  more  often  em- 
ployed than  any  other  preparation  of, 
746 
Iron,  properties,  preparations,  action,  and 
uses  of — 
Ammonio-f  erric,  sulphate  of,  or  alum, 

749 
Aqueous  solution  of  citrate  of,  748 
Arseniate  of,  751 
Citrate  of,  748 

and  Ammonium,  748 
Quinine,  749 
Strychnine,  749 
Chloride  of,  745 
Compound  mixture  of,  742 
Hydrated  oxide  of,  743 

with  magnesia,  743 
Peroxide  of,  744 
Hypophosphite  of,  752 
Lactate  of,  750 

Mixture  of  acetate  of,  and  ammo- 
nium, 745 
Nitrate  of,  747 
Oxalate  of,  750 
Phosphate  of,  751 
Pyrophosphate  of,  752 
Eeduced,  744 


Iron,  saccharated  Carbonate  of,  742 
Iodide  of,  750 
Solution  acetate  of,  744;    of   basic 
sulphate  of,  743 
Chloride  of,  745 
Qitrate  of,  and  quinine, 
749 
Solution  of  Pernitrate  of,  747 
Persulphate  of,  742 
Subsulphate  of,  743 
Tersulphate  of,  742 
Strong  solution  of  acetate,  of,  745 

Perchloride  of,  745 
Sulphate  of,  741 

and  ammonium,  749 
Dried,  741 
Granulated,  741 
Precipitated,  741 
Syrup  of  bromide  of,  751 
Syrup  of  iodide  of,  750 
Tartrate  of,  and  ammonium,  747 

Potassium,  747 
Tartarated,  747 
Valerianate  of,  752 
Irritants  and  counter-irritants,  340-347 ; 
divided   into   four  classes,   340 ;  dia- 
grams illustrating  the  action  of,  342, 
343  ;  rubefacients,  and  their  action  on 
chronic  and  acute  inflammation,  340- 
345 ;  list  of  the  principal,   344  ;  vesi- 
cants  and  their  action,   344  ;  pustu- 
lants,  344  ;  and  caustics,  344  ;  oil  of 
copaiva  as   an  irritant,  912  ;  quillaia 
(saponin)  as  an,  918  ;  oil  of  myrtle  as, 
924 ;  camphor  as,  1019  ;  garlic  as,  1040 
Isinglass,   as   a  demulcent,  347 ;  nature 

and  properties  of,  1086 
Isomorphism  and  physiological  action, 

relation  between,  26 
Ivy,  poison,' 898 


J. 


Jaborandi,  as  a  myotic,  219  ;  as  a  de- 
pressant expectorant,  255  ;  as  a  siala- 
gogue,  357  ;  as  an  antihidrotic,  441 ; 
antagonism  of,  to  atropine,  495 ;  ex- 
tract, 510 ;  characters,  action,  and  uses 
of,  883,  884 
Jackson,  Dr.,  advises  the  use  of  sulphuric 

ether  as  an  anaesthetic,  212 
Jalap,  as  a  drastic  purgative,  389 ;,  as  a 
hepatic    stimulant,   403;   as   a 
cholagogue,  405  ;  characters  of, 
982 
Resin  of,  characters,  action,  and 
uses  of,  982 
Jamaica  dogwood,  action  and  use  of,  913 

Sarsaparilla,  1051 
James's  powder,  726,  729 
Jankowski,  reference  to,  337 
Jaw,  lower,  action  of  phosphorus  on  the, 
710 

4  n  2 


1140 


GENEEAL  INDEX. 


Jequirity  seeds,  character,  action,  and 
uses  of,  903 

Jervine,  action  of,  on  the  spinal  cord  and 
the  medulla,  1046  ;  the  cardiac  ganglia 
and  the  brain,  1046 

Joints,  inflammation  of  the,  utility  of 
friction  in,  345 ;  and  of  vesicants,  345  ; 
tartar  emetic  ointment  and  croton-oil 
liniment  sometimes  useful  in,  346 

Jolyet,  references  to,  150,  361 

Juglandacese,  1029 

Juglandin,  as  a  hepatic  stimulant,  403 
'  Juglans,  characters  and   uses  of,   1029  ; 
as  a  cathartic  and  hepatic  stimulant, 
1029 

Jugular  veins,  action  of  poisons  when  in- 
jected into  the,  178,  239,  244 

Juices,  526 

Jumble  beads,  903 

Juniper,  as  a  stimulant  diuretic,  433 ; 
composition  of,  1063 ;  oil  of,  1064 ;  as 
a  stimulant  and  diuretic,  1064 


Kairin,  action  of,  as  an  antipyretic,  and 
uses  of,  824 

Kamala,  as  a  vermicide,  408  ;  characters, 
action,  and  uses  of,  1025  ;  as  an  anthel- 
mintic, 1025 

Kaolin,  or  China  clay,  action  of,  in  in- 
flammation of  the  urethra,  446 ;  nature 
and  uses  of,  654 

Kava,  as  a  local  anaesthetic,  157 ;  as  a 
stimulant  diuretic,  433 

Kephir,  1080 

Keratin,  its  preparation,  characters,  and 
uses,  1083;  its  mode  of  application, 
1083 

Ketones,  nature,  779  ;  hypnone,  779 

Kidneys,  precautions  to  be  taken  regard- 
ing the  state  of  the,  411  ;  action  of 
drugs  on  the,  422-436 ;  the  threefold 
functions  of  the,  422 ;  three  structures 
connected  with  these  functions,  422  ; 
nature  and  process  of  secretion  in  the, 
422-436  ;  diagram  of  the  urinary 
tubules  in  different  classes  of  animals, 
423 ;  diagram  of  the  circulation  in  the 
kidney  of  the  newt,  425 ;  diagram- 
matic sketch  of  the  blood-vessels  in  a 
mammalian  kidney,  425;  diagram  of 
the  tubules  and  vascular  supply  of  the, 
426  ;  circumstances  modifying  the 
secretion  of  urine  by  the,  427  ;  relation 
between  sweat-glands  and  the,  439 ; 
action  of  the  heavy  metals  on  the,  664  ; 
the  possible  effect  of  mercury  on  the, 
665 ;  action  of  phosphorus  on  the, 
711 ;  of  alcohol,  765,  771 ;  of  pilocar- 
pine, 885,  887  ;  of  tannic  acid,  1032 ;  of 
oil  of  turpentine,  1059 


Kiedrowski,  reference  to,  588 

Kino,  as  an  astringent,  349  ;  nature, 
action,  and  uses  of,  902 

Klein,  on  bacteria,  81 ;  reference  to,  98 

Knoll,  reference  to,  244 

Kobert,  references  to,  126, 127 

Koch,  on  bacteria,  81 ;  reference  to,  90 ; 
his  experiments  on  bacteria  with  dis- 
infectants, 92-95;  references  to,  102, 
105 ;  account  of  a  syringe  employed 
by,  476 

Kohler,  F.,  reference  to,  98 

Kolliker,  references  to,  146,  150 

Koppe,  references  to,  294,  492 

Koumiss,  1080,   nature  and  use  of,  1080 

Kousso,  as  a  vermicide,  408 ;  nature, 
action,  and  use  of,  921 

Kowalewsky,  reference  to,  294 

Kraepelin,  reference  to,  191 

Krameria,  868 

Krameriae,  868 

Kratchmer,  reference  to,  244 

Kronecker,  references  to,  46,  124,  125, 
406 

Krukenberg,  references  to  his  researches 
on  the  medusae,  109,  112,  114,  115 

Kuhne,  Professor,  references  to,  45,  61  ; 
his  discovery  of  ferment  -  yielding 
bodies,  80  ;  references  to,  132, 153, 176 

Kunde,  reference  to,  175 

Kuntzer,  reference  to,  715 

Kymograph,  the,  for  ascertaining  blood- 
pressure,  description  and  diagram  of, 
268-269 


LABIATES,  1002 

Laburnum,  as  a  poison,  with  its  antidote, 

490 
Lac  sulphuris,  544 
Lacrimal  secretion,  action  of  drugs  on 

the,  217 
Lactate  of  iron,  750 
Lactic  acid,  action  of,  on  bacteria,  94  ;  a 

hypnotic,  199  ;  properties  of,  &c,  589 
Lactucarium,  character,  action,  and  use 

of,    957 ;    has  a  soporific  action  aud 

allays  cough,  957 
Lamella;,  515 

Atropinse,  515,  986 
Cocainse,  515,  878 
Physostigminas,  515,  904 
Langendorf,  reference  to,  242 
Langley,  reference  to,  354 
Lanolin,  composition  and  uses,  1078 
Lanthanum,  symbol  and  atomic  weight 

of,  10 
Lappa,  characters  and  uses  of,  960 ;  as  an 

alterative,  and  in  skin  diseases,  960 
Larch  bark,  1061 
Lard,  prepared,  1084 

Benzoated,   1084 ;    as  an  emollient, 
1085 


GENERAL  INDEX. 


1141 


LaryDx,  irritation  of  the,  a  cause  of 
cough,  247-249 ;  application  of  drugs 
to  the,  479 ;  diagram  of  insufflator  for 
applying  powders  to  the,  480  ;  various 
modes  of  applyingdifferent  drugs  to,  480 
Laudanum,  use  of,  in  maintaining  anaes- 
thesia, 211 
Laurineae,  1016 

Lautenbach,  references  to,  399,  401 
Lavender,  characte.s  of,  1003 
Oil  of,  characters  of,  1003 

Flowers,    1004  ;     characters, 
action,  and  uses  of,  1004  ; 
as  a  stimulant  and  carmina- 
tive, 1004 
Laxatives.    See  Purgatives 
Lead,  symbol  and  atomic  weight  of,  10  ; 
action  of,  on  the  kidneys,  435  ;  sources 
and  reactions  of,  698  ;  action  of,  699  ; 
in  the  mouth,  stomach,  and  intestine, 
699  ;  general  sources  of  lead-poisoning, 
699  ;  treatment  for,  699 ;  symptoms  of 
chronic  poisoning  by,  700 ;  lead  colic 
and  cramps,  700 ;  paralysis,  700 ;  known 
as  wrist-drop,  700 ;  action  on  brain  and 
eye,   701 ;   action  of,  on  the  general 
system,    701 ;    how  eliminated,    701 ; 
uses,  701 
Lead,  acetate  of,  action  of,  on  bacteria, 
94  ;  as  a  vascular  sedative,  339 ;  as  an 
astringent,  349 ;  as  a  styptic,  350 ;  as 
a  poison,  with  its  antidote,  490 
Lead,  acetate  of,  703 
Carbonate  of,  703 
Iodide  of,  705 
Nitrate  of,  705 
Oxide  of,  702 
Plaster  of,  702 

Solution  of  subacetate  of,  704 
Leaf,  digitalis,  994 

Tobacco,  992 
Leaves,  Aconite,  831 
Bearberry,  961 
Belladonna,  984 
Buchu,  882 
Cherry-laurel,  917 
Hemlock,  930 
Hyoscyamus,  990 
Matico,  1014 
Stramonium,  991 
Leech,  the,  1095 ;  action  of  chloroform  on, 
115 ;  to  genitals  and  thighs,  as  indirect 
emmenagogue,    453  ;    its   action  and 
uses,  1095 
Leguminosse,  899 
Lemon,  decoction  of,  891 

Juice,  characters,  preparations,  and 
uses   of,   891  ;    it  is  refrigerant, 
antiscorbutic,    and    a     powerful 
antiperiodic,  891 
Peel,   characters,   composition,  and 
preparations  of,  890 
Lemons,  oil  of,  characters,  preparation, 
and  action  of,  890 


Leprosy,  produced  by  the  bacillus  lepras, 

y9 
Leptrandra,   characters,  and  action  of, 
1001 ;  oh  the  bile  and  as  a  cathartic, 
1002 
Leptandrin,  as  a  hepatic  stimulant,  403 
Lettuce,  experiments    with  the    proto- 
plasm of,  and  water  on  oxygen,  69 ;  as 
a  hypnotic,  199 ;  composition  of,  957 
Leucin,  action  of,  on  bacteria,  9 1 
Leucocytes,  nature  of,  action  of  drugs  on, 
and  method  of  experimenting  on,  60 
et  seq. ;  diagram  to  illustrate  the  action 
of  quinine  on,  62 ;  the  protoplasm  of, 
contracts  in  any  direction,  117;  anaes- 
thetics act  as  poisons  to,  206 
Leucoroaines,  101 ;  absorption  and  eli- 
mination, 101 
Lewin,  reference  to,  974 
Lichens,  1067 

Liebreich,  references  to,  791,  1078 
Liliaceas,  1039 

Lime,  as  a  caustic,  341 ;  as  an  astringent, 
349  ;  composition  of,  648  ;  character, 
tests  and  preparations  of,  647 ;  as  an 
astringent  and.  as  an  antacid,  649 
Lime,  chlorinated,  550,  551,  653 
Liniment  of,  649 
Phosphate  of,  652 
Saccharated  solution  of,  648 
Slaked,  648 
Sulphurated,  653 
Syrup  of,  648 
Lime  salts.    See  Calcium  salts 
Lime  water,  action  of,  on  bacteria,  93  ; 
as  a  direct  antacid,  370 ;  as  a  vermicide, 
408 ;  composition  of,  648 
Limonis  succus,  527 
Lineas,  876 
Liniments,  or  embrocations,  515  ;  list  of, 

with  ingredients,  516, 517 
Linimentum  Aconiti,  516,  832,  1018 
Ammonias,  516,  873,  966 
Belladonnas,  516,  985,  1018 

Fluidum,  985 
Calcis,  516,  648,  873,  966 
Camphoras,  516,  873,  1018 
Camphoras    compositum,  516,    638, 

1003, 1018 
Cantharidis,  517, 1058, 1091 
Chloroformi,  516,  796,  966,  1018 
Crotonis,  516,  924, 1023 
Hydrargyri,  516,  686,  1018 
Iodi,  516,  557,  967 
Opii,  516,  844,  1018 
Plumbi  subacetatis,  517,  704,  873 
Potassii  iodidi  cum  sapone,  516,  557, 

891,  967, 1079 
Saponis,  516,  966, 1003, 1018 
Sinapis  compositum,  516,  865,  1018, 

1022,  1024 
Terebinthinae,  616,  966, 1018, 1058 
Terebinthinae   aceticum,    516,   577, 
1018,  1058 


1142 


GENEKAL  INDEX. 


Linseed,  and  linseed  tea,  as  demulcents, 
317 ;  composition,  action,  and  use  of, 
876;  chief  use  is  as  a  demulcent, 
876 

Meal,  876 
Oil,  877 
Poultice,  877 
Lippia  Mexieana,  composition,    action, 

and  uses  of,  1002 
Liqueurs,  as  cardiac  stimulants,  328 
Liquor  Acidi  Arseniosi,  517,  720 
Chromici,  517 
Ammonias,  328,  638 

Fortior,  517 
Ammonii  acetatis,  517,  635 

Fortior,  517 
Citratis  Fortior,  517,  638 
Antimonii    chloridi,   517,  573,  726, 

727 
Arsenicalia,  617,  719 
Arsenici  hydrochlorici,  517,  719 
Arsenici  et  hydrargyri  iodidi,  517, 687 
Atropinse  sulphatis,  517,  986 
Bismuthi  et  ammonii  citratis,  517, 

732 
Calcii  chloridi,  517,  651 
Calcis,  517,  648 
Calcis  chlorinate,  517,  551 

Saccharati,  517,  648, 1055 
Chlori,  517 

Epispasticus,  517,  577,  784,  1091 
Ferri  acetatis,  745 

Fortior,  517,  745 
Chloridi,  517 
Citratis,  517 
Dialysati,  517 
et  Quininse  citratis,  517,  748, 

942 
Nitratis,  517 
Perchloridi,  517,  745 

Fortioris,  517 
Pernitratis,  518,  575 
Persulphatis,  518 
Subsulphatis,  517 
Tersulphatis,  517 
Gutta-percha,  617,  963 
Hydrargyri  nitratis,  687 

Acidi,   518,  576, 
687,  695 
Perchloridi,  518,  687,  693 
Iodi,  518,  560 

Iodi  compositus,  517,  657,  560 
Lithiae,  370 

Lithise  effervescens,  518,  631 
Magnesii  carbonatis,  518,  661 

Citratis,  518,  661 
Morphine  acetatis,  518,  577,  848 
Bimeconatis,  518,  846 
Hydrochloratis,  518,  573, 
847 
Nitro-glycerini,  788 
Pepsini,  517,  1081 
Plumbi  subacetatis,  517,  702,  703 

Dilutus,  517, 704 


Liquor— 

Potassse,  370,  518,  607,  608 

Effervescens,  518,  609 
Potassa?  permanganatis,  518 
Potassii,  517 

Arsenitis,  517,  720 
Citratis,  517 
Sods,  370,  517,  622 
Sodii  Arseniatis,  517,  518,  720 
Chlorinate,  517 
Effervescens,  518,  622 
Ethylatis,  518,  619 
Silicatis,  518,  627 
Strychninse  hydrochloratis,  618 
Zinci  chloridi,  518,  669,  671 
Liquorice,    as    a     stimulating     expec- 
torant, 255 
Liquorice  root,  characters  and  composi- 
tion of,  899 ;  preparation,  action,  and 
uses  of,  899 
Lister,  Sir  Joseph,  originates  the  anti- 
septic mode  of  treatment,  104  ;  on  the 
untoward  consequences  of  operations, 
816 
Lithium,  benzoate  of,  632 
Bromide  of,  556 
Carbonate  of,  631 
Citrate  of,  632 
Salicylate  of,  632 
Lithium,  symbol  and  atomic  weight  of, 
10;  more  poisonous  than   sodium  or 
potassium,   28;   its  relation   to   other 
members  of  a  group,  16 ;  physiological 
action  of,   27 ;  causes   contraction  of 
the    vessels,    281 ;    sources,   reaction, 
impurities,   and    tests   of,    630,    631; 
general  action  of,  631 
Lithium,  bicarbonate,  as  a  remote  antacid, 
370 
Carbonate,    as    a     direct    antacid, 

370 
Citrate,  as  a  remote  antacid,  370 
Lithontriptics,  nature  and  uses  of,  436 
Litmus,  1067 

Paper,  blue,  1067 
Red,  1067 
Solution  of,  1067 
Tincture,  1067 
Littlejobn,  Dr.,  reference  to,  385 
Liver,  effect  of  the,  on  the  action  of 
drugs,   39,   44;  caustics  employed  to 
open  abscesses  of  the,  346 ;  action  of 
drugs  on  the,  399  ;  important  function 
of  the,  in  the  general  system,   399; 
action    of    hepatic    stimulants     and 
cholagogues  on,  400;  power   of  the, 
m  destroying  the  poisonous  properties 
of  some  vegetable  alkaloids,  401 ;  five 
principal  functions  of  the,   402 ;  ex- 
periments   on  the  action  of  hepatic 
stimulants,  402 ;  list  of  these  stimulants, 
403 ;  diagram  of  the  stomach,  intes- 
tines, and,  404;  experiments  on  the 
action  of  cholagogues,  404-406;  im- 


GENEEAL  INDEX. 


1148 


portance  of  combining  hepatic  and 
intestinal  stimulants  to  ensure  com- 
plete cholagogue  effect,  405  ;  adjuncts 
to  cholagogues,  406 ;  uses  of  hepatic 
stimulants  and  cholagogues  on  the, 
407  ;  action  of  hepatic  depressants 
on  the,  407 ;  action  of  acids  on  the, 
570  ;  of  chloride  of  ammonium,  638  ; 
of  mercury,  684;  of  phosphorus,  710; 
of  alcohol,  765,  771  j  of  dandelion, 
957 
Liversedge,  reference  to,  80 
Lobelia,  as  a  depressant  expectorant,  255 ; 
as  a  poison,  with  its  antidote,  4H0 ; 
characters  and  composition  of,  960 ; 
action  of,  on  the  respiratory  centre, 
the  blood-pressure,  the  vaso-motor 
centre,  and  the  vagi,  961 ;  uses  of, 
961 
Lobeliaeese,  960 

Lobeline,  as  a  myotic,  219  ;  as  a  depres- 
sant expectorant,  255  ;  action  of,  on  the 
vagus-ends  of  the  heart,  317 
Lockyer,  J.  N.,  propounds  the  hypothesis 
that  all  the  elements  are  compounds, 
1 1 ;  reference  to,  28 
Loganiaceas,  971 
Logwood,  characters,    composition,  and 

uses  of,  908 
Long,  Dr.  C.  W.,  first  uses  ether  as  an 

ansesthetic,  211 
Loos,  reference  to,  150 
Lotiones,  618 
Lotio  Hydrargyri  flava,  518,  648,  686 

Nigra,  518,   648,    686, 
691 
Loven,  reference  to,  292 
Lozenges,  531 
Luchsinger,  references  to,  45, 46, 115, 138, 

139,438,988 
Luciani,  reference  to,  308 
Ludwig,  references  to,  177,  1 81,  268,  278, 
280,  282,  292,  294,  322,  399,  422,  423, 
426,  427 
Ludwig  and  Coats's  apparatus  for  experi- 
menting on  the  frog's  heart,  302,  303, 
304,  310 
Lumbar  genital  centre,  connection  of  the, 

with  the  generative  organs,  447 
Lunar  caustic,  676 

Lungs,  application  of  drugs  to  the,  481, 
by  inhalation  of  vapours,  481 ;  by  the 
bronchitis  kettle,  481 ;  and  by  smoke, 
481 ;  action  of  gold  on  the,  754 ;  of 
ipecacuanha,  950 
Lupuline,  as  a  general  anodyne,  201, 
202 ;  characters,  composition,  action, 
and  uses  of,  1027  ;  as  a  tonic,  stomachic, 
and  soporific,  1028 
Lupulinum,  1027 

Lupulus,  as  a  general  anodyne,  201 
Lussana,  reference  to,  405 
Lymph,  an  abnormal  condition  of,  one  of 
the  chief  causes  of  dropsy,  336 


M. 

Mace,  as  a  carminative,  379  ;  characters 
and  uses  of,  1016 

McKendrick,  reference  to,  278 

Mackenzie,  J.  N.,  reference  to,  248 

Maclagan,  Dr.  Craig,  reference  to,  714  - 

Magenta,  822 

Magnesia,  as  a  direct  antacid,  370 ;  as  a 
laxative  and  purgative,  389 ;  carbonate 
of,  as  a  purgative,  389 ;  characters  and 
action  of,  659,  660;  sulphate  of,  659  ; 
enema  of  sulphate  of,  659  ;  carbonate 
of,  660;  light  ditto,  660;  solution  of 
carbonate  of,  661 ;  solution  of  citrate 
of,  661;  light  and  heavy  magnesia 
661 

Magnesium,  symbol  and  atomic  weight 
of,  10 ;  its  relation  to  other  members 
of  a  group,  16  ;  physiological  action  of, 
27 ;  causes  contraction  of  the  vessels, 
281 ;  sources,  reactions,  and  prepara- 
tions of,  658 ;  impurities,  tests,  and 
action  of,  659  ;  sulphate  of,  659 ;  car- 
bonate of,  660 

Magnesium,  carbonate  and  bi-carbouate 
as  a  direct  antacid,  370 

Magnoliaceae,  840 

Majendie's  experiments  on  the  spinal 
cord,  174;  references  to,  373,  975 

Malaria,  and  all  diseases  of  malarious 
origin,  quinine  and  cinchona  bark  are 
almost  speoifics  in,  107 ;  condition  of 
vaso-motor  centre  in,  862 

Malpighian  corpuscles,  the,  422,  424,  425, 
427 

Malt,  extract  of,  1054 ;  as  a  digestive  fer- 
ment, 1055 

Malvaceae,  872 

Mammalia,  1077 

Mammals,  action  of  nitro-glycerine  on, 
788  ;  of  chloral  hydrate,  792 ;  of  opium, 
852  ;  of  erytbroxylon,  878 

Mammary  glands,  action  of  drugs  on, 
455.     (  Vide  also  Milk.) 

Manganese,  symbol  and  atomic  weight 
of,  10;  as  an  indirect  emmenagogue, 
453 ;  properties,  action,  and  uses  of 
black  oxide  of,  753;  of  sulphate  of. 
753 

Manna,   as  a  laxative,   389 ;  characters,  > 
composition,  and  use  of,  968;    as  a 
laxative,  968 
Manometers,  fallacies  of  mercurial,  269 

Mansell's  solution  of  iron,  743 
Marble,  white,  647 

Marey,  references  to,  128,  298 
Marey's  levers,  243 ;  pneumograph,  243 ; 
and  hsemodromometer,  294 

Marigold,  959 

Marjoram,  wild.     See  Origanum 
Marrubium,  characters  and  use  of,  1007  ; 
as  an  expectorant,  1007  ;  and  in  large 
doses  as  a  laxative,  1007 


1144 


GENEEAL  INDEX. 


Marsh  damp,  as  a  poison,  with  its  anti- 
dote, 487 

M  arsbmallow.     See  Althaea 

Marx,  reference  to,  41 

Maryland  pink.    See  Spigelia 

Massa  copaibas,  618,  912 
•     Ferri  carbonatis,  518 
Hydrargyri,  518,  686,  688 

Massage,  action  of,  on  muscles,  131 

Masses,  518 

Mastication,  arteries  of  the  brain  dilated 
in  arjimals  by  the  movements  of,  193 

Masticatories,  nature  and  use  of,  482 

Mastiob,  characters,  composition,  and 
uses  of,  897 

Materia  medica,  definition  of,  3 
Inorganic,  537  et  seq. 
Organic,  759  et  seq. 
Proper,  3 
Vegetable,  827  et  seq. 

Matico,  as  a,  styptic,  350,  1015;  and 
stimulant  diuretic,  433  ;  characters, 
action,  and  uses  of,  1014 ;  leaves, 
1014 

Maynard,  reference  to,  217 

Mays,  reference  to,  305 

Meconic  acid,  846 

Medicated  baths,  469 

Medicine,  materia  medica  gives  an  ac- 
count of  the  various  remedies  used  in, 
3 ;  preventive  medicine,  or  prophylaxis, 
growing  importance  of,  5  ;  cause  of  the 
rapid  advance  of,  5 

Medulla  oblongata,  nature  and  functions 
of,  232  et  seq. ;  diagram  representative 
of  various  groups  of  ganglion  cells  or 
'  centres,'  in  the,  235 ;  experiments  on 
the,  244 ;  blood-vessels  relax  after  sec- 
tion of  the,  262  ;  stimulating  effect  of 
asphyxial  blood  on  the,  298  ;  the  nerve- 
centre  which  regulates  the  secretion 
of  the  saliva  situated  in  the,  356  ;  the 
nerve-centre  which  regulates  the  move- 
ments of  vomiting  is  situated  in  the, 
370 ;  the  nervous  centre  for  the  renal 
arteries  in  the,  429  ;  action  of  spirit 
of  ether  on  the,  782 ;  of  carbolic  acid, 
814  ;  of  aconitine,  834  ;  of  delphinine, 
836  ;  of  hydrochlorate  of  apomorphine, 
849  ;  of  caffeine,  871 ;  of  physostig- 
mine,  905 ;  of  oil  of  eucalyptus,  925  ; 
of  thymol,  1006 

Medusae,  action  of  drugs  on,  109-112; 
effect  of  stimuli  on  the  rhythmical 
movements  of,  109-111 ;  and  of  vari- 
ous poisons  on,  111,  112 ;  general  re- 
sults of  various  experiments  on,  112, 113 

Mel  boracis,  518,  624,  967, 1089 
Depuratum,  518, 1089 
Despumatum,  518,  1089 
Rosas,  518,  920, 1089 
Meliacese,  894 

Melitsa,  character,  composition,  and  uses 
as  a  diaphoretic,  1007 


Mendelejeff,  perfects  the  classification  of 
the  elements  in  series,  17-20;  table 
of  his  arrangement,  19  ;  his  predictions 
regarding  gallium,  18;  reference  to  his 
classification,  592 

Menispermacese,  840 

Menispermum  (Canadian  moonseed), 
characters,  composition,  and  uses  of, 
840 

Menstruation,  action  of  emmenagogues 
on,  452 

Menthol,  action  of,  on  the  brain  and 
spinal  cord,  213 ;  as  a  rubefacient,  344 

Mercurial  cachexia,  683;  tremors,  683; 
and  paralysis,  683 

Mercurial  preparations,  as  cholagogues, 
390 

Mercurialism,  nature  and  cause  of,  682 ; 
one  of  the  best  preparations  for  pro- 
ducing, 689 

Mercuric  chloride,  effects  of,  on  the 
blood,  73 ;  on  annulosa,  116 ;  as  a 
caustic,  344;  as  a  hepatic  stimulant, 
403 

Mercuric  nitrate,  as  a  caustic,  344 

Mercury,  symbol  and  atomic  weight  of, 
10;  physiological  connection  between 
calcium  and,  20  ;  action  of,  on  muscle, 
127  ;  on  the  vaso-motor  nerves,  318 ; 
and  its  compounds  as  a  sialagogue, 
357 ;  as  a  cholagogue,  405  ;  as  an 
alterative,  413 ;  its  power  in  fibrinous 
and  syphilitic  deposits,  415  ;  used  to 
break  up  deposits  of  lymph,  and  to 
prevent  adhesions  in  iritis  and  peri- 
carditis, 416 ;  and  in  the  treatment  of 
the  secondary  stage  of  syphilis,  416; 
action  of,  on  the  kidneys,  435  ;  sources 
and  reactions  of,  680 ;  general  impuri- 
ties and  tests,  681 ;  general  action  of, 
681-686;  on  the  skin,  681 ;  effects  of, 
on  the  body,  termed  'mercurialism,' 
682 ;  action  of,  on  the  mouth,  682 ; 
salivation,  682 ;  causes  fever,  682 ;  the 
fumes  of,  produce  a  state  called  mer- 
curial cachexia,  683 ;  which  results  in 
mercurial  tremors  in  the  muscles,  683  ; 
and  paralysis,  683 ;  mental  powers  also 
affected,  683 ;  special  action  of,  on  the 
brain,  683  ;  action  of,  modified  by  sex, 
age,  and  idiosyncrasy,  684 ;  action  of, 
on  the  stomach,  684;  the  liver,  684, 
685;  and  blood,  685;  has  the  power 
of  causing  the  absorption  of  fibrinous 
exudations,  685 ;  action  of,  on  the 
pulse,  685 ;  on  respiration,  686 ;  and 
the  temperature,  686 ;  cause  of  the 
salivation  produced  by,  686 ;  action  of, 
on  the  urine,  686 

Mercury,  nature,  preparations,  action,  and 
uses  of,  686-690 
Acid  solution  of  nitrate  of,  695 
Ammoniated,  694 
Black  lotion  of,  691 


GENERAL  INDEX, 


1145 


Mercury — ■ 

Corrosive  chloride  of,  692 

Cyanide  of,  697 

Green  iodide  of,  696 

Mild  chloride  of,  691 

Ointment  of  nitrate  of,  695 

Perchloride  of,  692 

Persulphate  of,  690 

Red  iodide  of,  696 

Red  oxide  of,  694 

Red  sulphide  of,  697 

Subchloride  of,  691 

Yellow  oxide  of,  694 

Yellow  subsulphate  of,  690 
Metallic  salts,  as  poisons,  with  their  anti- 
dotes, 490 ;  general  tests  for  the  acid 
radicals  in,  593 ;  list  of  tests  for  the 
different  acids,  594 
Metals,  general  classification  of  the,  592 ; 
I.,  monad  metals,  592;  1,  metals  of  the 
alkalis,  596;  2,  ammonia,  596 ;  general 
characters  and  reactions,  596  ;  physio- 
logical action,  596  ;  general  action  of 
the  alkaline  group,  597-599 ;  and  of 
the  group  of  chlorides,  599-602; 
general  action  of  the  sub-group  of 
sulphates,  602  ;  comparative  action  of 
the  alkaline  metals,  602;  1,  metals 
of  the  alkalis — potassium,  603-617 ; 
sodium,  617-630;  lithium,  630-633; 
monad  metals,  group  2,  ammonium 
salts,  633-643 ;  II.,  dyad  metals,  614  ; 
reactions  of  the  metals  in  class  II.,  645  ; 
group  1,  metals  of  the  alkaline  earths, 
646 ;  general  action,  645 ;  calcium, 
646-653  ;  appendix  to  group  2,  alumi- 
nium, 654-657 ;  and  cerium,  657 ;  group 
2,  magnesium,  658-661 ;  general  action 
of  heavy  metals  on  the  circulation,  in- 
testinal canal,  blood,  tissue,  muscles, 
nerves,  nerve-centres,  and  glands,  662- 
665  ;  group  3,  665  ;  general  action  of, 
on  the  system,  665 ;  zinc,  667-674 ; 
copper,  674-676  ;  qadmium,  676 ;  argen- 
tum,  676-680 ;  mercury,  680-697  ;  lead 
and  tin,  698-706 
Methsemoglobin,     origin,     nature,     and 

changes  of,  71,  72 
Methyl,  effect  of  the  introduction  of,  into 
the  molecule  of  strychnine,  brucine, 
and  thebaine,  32 
Methyl-atropine,     -codeine*    -morphine, 
-nicotine,    -quinine,    and    -veratrine, 
paralysing  action  of,  32 
Methyl-atropine,  action  of,  on  the  motor 

nerves,  &c,  989 
Methyl-coni'ine,  action  of,  on  the  spinal 

cord,  932 
Methylal,  action  and  uses   (Appendix), 

1097 
Methylene,    bichloride    of,    preparation, 

character,  and  action  of,  795 
Methyloxychinicine,  constitution  of,  824 
Methyl-strychnine,  action  of,  on  muscle, 


144 ;   on  the  vagus-ends  in  the  heart, 
317;  characters  of,  975 
Methyl-tri-ethyl  stibonium    iodide,    ac- 
tion on  motor  nerves,  150 
Methyl-tri-ethylstiboniumhydrate,action 

on  motor  nerves,  150 
Metschnikoff,  reference  to,  85 
Meyer,  reference  to,  276 
Meyer,  Hermann,  reference  to,  77 
Meyer,  Lothar,  his  labour  in  completing 
the  classification  of  the  elements  in 
series,  17 
Meyer,  R.,  reference  to,  248 
Meyer,  Sigmund,  reference  to,  139 
Mezereon,  as  a  vesicant,  344 ;  as  a  siala- 

gogue,  357 
Mezereon  bark,  character,  preparations, 

and  action,  1022 
Mezereum,  as  an  alterative,  413 ;  charac- 
ter, preparations,  and  action,  1022 
Microbacteria,  83 

Microbes,  recent  increase  in  knowledge 

of,   5 ;    destruction  or  prevention  of, 

diminishes  disease,  5 ;  references  to, 

99,  104 

Micrococci,  references  to,  83,  84,  85,  90, 

98  ;  list  of  diseases  caused  by,  99 
Microzymes,  references  to,  92,  93,  106 
Milk,  action  of  drugs  upon,  455  ;   what 
the  character  of  the,  depends  upon, 
455 ;  substances  excreted  by  the,  455  ; 
various    drugs    administered    to    the 
mother  react  upon  the  child  through 
the,  456;    action   of    pilocarpine  on 
the  secretion  of,  884  ;  its  composition, 
therapeutics,  and  use,  1079 
Milk,  sugar  of,  its  characters,  1080  j  and 

uses,  1080 
Milk  of  sulphur,  544 
Mills,  Mr.,  reference  to,  800 
Mimosese,  913 

Mistura  ammoniaci,  519,  934 
Amygdalas,  519,  915 
Asafcetidse,  519,  933 
Ohloroformi,  519,  796 
Creasoti,  519,  578,  817 
Cretse,  519,  914 

Ferri  aromatica,  519,  841,  922,  941 
Composita,  519,  893,  1015,  1055 
et  ammonii  acetatis,  519,  746 
Glycyrrhizae  composita,  519,  784 
Guaiaci,  519, 880,  914,  1055 
Magnesias  et   asafoetidas,  519,  661, 

933 
Potassii  citratis,  519,  890,  891 
Rhei  et  sodse,  519,  622,  1010 
Scammonii,  519,  981,  1079 
Sennas  composita,  519,  899,  910 
Spiritus  vini  gallici,  519,  776,  1055, 
1086 
Mixtures,  518 

Molecules,  origin  and  nature  of,  11; 
simple  and  complex,  11, 12;  condition 
of,  in  a  solid  and  gaseous  state,  12 ;  the 


1146 


GENEEAL  INDEX. 


vibrations   of,    determined   by    their 
weight,  27 
Mollusoa,  action  of  drugs  on,  114  ;  effects 

of  various  poisons  on,  114 
Molybdenum,  symbol  and  atomic  weight 
of,  10 ;  its  relation  to  other  members 
of  a  group,  16 
Mommsen,  reference  to,  1 55 
Monobromo-camphor,  as  a  hypnotic,  199  ; 
action    of,    on    the    cardiac    muscle, 
316 
Morat,  references  to,  277,  298 
Morese,  1028 
Mori  succus,  527,  1038 
Morphine,  acetate  of,  character  and  pre- 
parations of,  847 
Hydrochlorate  of,  ditto,  ditto,  847 
Morphina,  504 
Morphinse  acetas,  504,  844 
Acetatis,  liquor,  844 
Bimeconatis,  liquor,  604,  844 
Hydrochloras,  504,  844 
Hydrochloratis,  liquor,  844 
Sulphatis,  504,  844 
Morphine,  effect  of  habit  on  the  quantity 
that  can  be   taken.  44  ;  action  of,  on 
oxidation,  69  ;  on  the  blood,  72  ;  as  a 
sedative,  157  ;  action  of,  on  the  spinal 
cord,  163,  172,  173  ;  as  a  spinal  stimu- 
lant, 182  ;  as  a  powerful  hypnotic,  199; 
induces  sleep  and  lessens  pain,  199 ;  as 
a  local  and  general  anodyne,  201 ;  as  a 
myotic,  219  ;  action  of,  in  diminishing 
the    excitability    of    the    respiratory 
centre,  260 ;  and  when  combined  with 
atropine,   250 ;  as  an  antisialic,   361  ; 
as  a  local  and  general  sedative,  376 ; 
action  of,  on  the  intestines,  384 ;  action 
of,  on  urea,  414;  value  of,  in  laryngeal 
phthisis,  479 ;  as  a  poison,  with  its 
antidote,  490 ;  antagonistic  action  of, 
to  certain  alkaloids,   494,  496 ;  as  an 
injection,  514  ;  characters,  reactions  of, 
&c,  846  ;  opium  verms,  859 
Morphine,   Acetate    of,    character    and 
preparations  of,  847 
Hydrochlorate  of,  characters  of,  &c, 
847 

Apo-,  characters,  action,  and 
uses  of,  848,  849 
Sulphate  of,  preparations  of,  848 
Morshead,  reference  to,  220 
Morton,  Mr.,  his  use  of  ether  in  dentistry, 

212 
Moseley,  reference  to,  115 
Moss,  Iceland,  its  characters,  composition, 

and  therapeutics,  1067 
Moss,  Irish,  characters  and  use  of,  1073 
Mosso,  references  to,  101,  128,  151,  282, 

401 
Motion  and  oxidation,  relations  of,  in  the 

animal  economy,  66 
Motor  ganglia,  action  of  Oatmeal  on  the, 
1056 


Motor  Nerves.     See  Nerves 

Mould-fungi,  origin,  nature,  and  effects 
of,  82  ;  diseases  caused  by,  82 

Mouth,  application  of  drugs  to  the,  482 ; 
as  washes,  482 ;  as  caustics,  by  rubbing, 
482;  as  masticatories,  482  ;  as  gargles, 
482 ;  action  of  acids  in  the,  568 ;  action 
of  alkalies  in  the,  598 ;  of  the  metals, 
zinc,  copper,  cadmium,  and  silver,  665 ; 
of  silver,  678;  of  alcohol,  765;  of 
spirit  of  ether,  781 ;  of  chloral  hydrate, 
791 ;  of  purified  chloroform,  797  ;  of 
creosote,  817;  of  tannic  acid,  1032 ;  of 
aloes,  1044 

Mucilages,  519 

Mucilaginous  remedies,  useful  in  cases  of 
irritating  cough,  249 

Mucilago  Acacia?,  619,  914 
Amyli,  519,  1053 
Cydonii,  519,  922 
Sassafras  medulla?,  519,  1020 
Tragacanthas,  519,  901,  967 
Ulmi,  519,  1026 

Mucous  membranes,  action  of  morphine 
and  atropine  on  the  secretions  of  the, 
250;  character  and  action  of  the  se- 
cretion of  the,  251 ;  of  heat  and  cold  on 
the  circulation  and  secretion  of  the, 
252 ;  of  drugs  on  the  secretion  of  the, 
252-254 ;  drugs  which  increase  the 
ciliary  motion  in  the  tracheal,  254 ; 
action  of  chloride  of  ammonium  on 
the  gastric,  637 ;  of  tannic  acid,  1032 

Mulberry  juice,  characters  and  use  of, 
1028 

Murrell,  references  to,  716,  721 

Muscarine,  formed  by  putrefaction,  100; 
action  of,  on  mollusca,  114 :  as  a 
myotic,  219 ;  action  of,  on  the  respira- 
tory centre,  241,  245 ;  on  the  frog's 
heart,  307 ;  on  the  inhibitory  power  of 
the  vagi,  311;  on  the  ganglia,  3^3; 
action  of,  neutralised  by  atropine,  3 14; 
action  of,  on  inhibitory  ganglia,  317; 
on  the  cardiac  muscle,  316;  as  a  siala- 
gogue,  357  ;  as  a  general  emetic,  37  H; 
as  an  antihidrotic,  441 ;  antagonism 
of,  to  atropine,  492-496 ;  artificial  and 
natural  muscarine,  1067 ;  action  and 
uses,  1068 

Muscarine  nitrate,  1067 

Muscle,  action  of  drugs  on,  117-143  ;  on 
voluntary,  117 ;  elasticity,  extensibility, 
and  retractility  of ,  117,118;  irritability 
of,  119 ;  contraction  of,  119 ;  latent 
period  of,  120 ;  muscle-dynamite,  na- 
ture and  action  of,  120 ;  summation  of 
stimuli,  122;  contraction,  122;  fatigue, 
123;  contracture  of,  124;  tetanus,  125; 
poisons,  126-131 ;  massage  of,  131 ; 
propagation  of  the  contraction  wave 
in,  131 ;  rhythmical  contraction  of,  131 ; 
connection  between  chemical  constitu- 
tion and  physiological  action  on,  134 ■; 


GENEEAL  INDEX. 


1147 


action  of  drugs  on,  relative,  not  abso- 
lute, 136 ;  action  of  drugs  on  involun- 
tary muscular  fibre,  137;  contraction, 
137;  effect  of  stimuli  on  the,  138;  of 
cold  and  heat,  138;  relation  of  the 
contractile  tissue  to  the  nerves,  139  - 
propagation  of  contraction  waves,  139; 
effects  of  stimulation  of  the  vagus 
and  a  weak  interrupted  current,  140 ; 
artificial  rhythm,  140;  hypothetical 
considerations  regarding  the  action  of 
drugs  on  muscle,  141 

Muscles,  spasms  and  cramps  of  the,  na- 
ture, cause,  and  general  treatment  of, 
212-214;  of  the  eye,  216  et  seq.;  of 
respiration,  235;  difference  between 
the  vessels  of  the  intestines  and  those 
of  the,  276  ;  the  vaso-motor  centre  has 
no  power  over  the  vessels  of  the,  276  ; 
action  of  chlorides  on  the,  602  ;  of  am- 
monium salts,  602 ;  of  potassium  salts, 
605 ;  of  ammonium  chloride,  636 ; 
poisonous  action  of  the  heavy  metals 
on  the,  664  ;  of  platinum,  755  ;  of  spirit 
of  ether,  782  ;  of  nitrite  of  amyl,  786 ; 
of  nitro-glycerine,  789  ;  of  chloral  hy- 
drate, 792;  hydrochlorate  of  apomor- 
phine  on  the  fibres  of  the,  849 ;  of 
caffeine  on  ditto,  871 ;  of  pilocarpine 
on  muscles  and  muscular  fibre,  884, 
885 ;  of  physostigmine  on  ditto,  905  ; 
of  quinine,  947 ;  of  strychnine,  974 ;  of 
curare,  976  ;  of  belladonna  or  atropine, 
987  ;  of  digitalin,  995 ;  of  veratrine, 
1047 ;  of  oatmeal,  1056 

Muscular  contraction,  apparatus  for  re- 
gistering, 120 ;  muscular  poisons,  num- 
ber and  action  of,  126-131 ;  muscular 
fibre,  importance  of  the  action  of  chlo- 
roform and  ether  on,  206  ;  nerves  die 
sooner  than  the,  281 

Mushrooms,  as  poisons,  with  their  anti- 
dotes, 490 

Musk,  antispasmodic  action  of,  213,  214, 
1077  ;  as  an  antispasmodic  and  stimu- 
lant, 1078  ;  its  action  on  the  respiratory 
centre,  1078 

Mustard  leaves  and  liniment  of,  as  rube- 
facients, 344, 345 ;  as  a  sialagogue,  357 ; 
as  a  local  emetic,  373  ;  as  a  carminative, 
379 ;  as  a  stimulant  diuretic,  433 ; 
baths,  poultices,  and  stupes,  as  indirect 
emmenagogues,  453 ;  bath,  470 ;  pow- 
dered, 864;  white,  864;  black,  864; 
characters  and  compositions  of  the 
powdered,  864  ;  preparations  of,  864 

Mustard,  oil  of,  action  of,  on  enzymes,  78 ; 
on  bacteria,  91,  94,  95 ;  as  a  vesicant, 
344,  865  ;  characters  and  preparations 
of,  865 ;  action  of,  on  the  skin,  and 
internally  as  a  prompt  emetic,  865  ;  it 
is  "also  used  externally  as  a  counter- 
irritant,  in  the  form  of  a  poultice,  Sec, 
865 


Mycoderma  vini,  nature  and  action  of, 

81 
Mydaleine,  100 
Mydriatics,  and  their  action  in  dilating 

the  pupil  of  the  eye,  219-222 
Myositis,  infective,   micrococci  present 

in,  99 
Myotics,  and  their  action  in  contracting 

the  pupil  of  the  eye,  219-223 
Myristicacese,  1015 
Myrrh,  as  a  direct  emmenagogue,  463  ; 

characters  and  composition  of,  893 ; : 

action  and  uses  of,  as  an  astringent 

and  expectorant,  893 
Myrtaceae,  1015 
Myrtle,  oil  of,  action  and  uses  of,  924 ; 

is  an  antiseptic,  rubefacient,  internal 

irritant,  and  expectorant,  924 


N. 


Naegeli,  references  to,  81,  98 

Naphthalin,  action  as  a  urinary  sedative, 
446  ;  source  and  characters  of,  821  ; 
mode  of  administration,  821 ;  action 
of,  in  destroying  low  organisms  and 
preventing  the  germination  of  their 
spores,  822  ;  as  an  antiseptic,  and  when 
used  internally,  822 ;  uses  of,  822 

Naphthol,  characters,  action,  and  uses  of, 
822 

Narcotics,  nature  and  action  of,  200 

Nasal  douche,  diagram  of  a,  478 

Nataloin,  nature  and  action  of,  1042 

Nativelle's  digitalin,  995 

Nauseant,  antimony  as  a,  726 

Nerein,  action  of,  on  the  cardiac  muscle, 
316 

Neroli,  oil  of,  888 

Nerve-centre,  the,  which  regulates  the 
movements  of  vomiting,  370 

Nerve-centres,  in  respiration,  nature  and 
functions  of  the,  234-245  ;  for  the  secre- 
tion of  sweat  situated  in  the  spinal 
cord,  437  ;  how  they  may  be  stimulated, 
438 ;  situation  of  the,  for  the  move- 
ments of  the  bladder,  444  j  -action  of 
potassium  salts  on  the,  606 ;  poisonous 
action  of  the  heavy  metals  on  the,  664  ; 
action  of  gold  on  the,  754  ;  of  alcohol, 
769 ;  of  erythroxylon,  878  ;  of  caffeine, 
871 ;  of  hydrochlorate  of  pilocarnine, 
884,  885 ;  of  physostigmine,  905* ;  of 
quillaia  (saponin),  919  ;  of  oil  of  euca- 
lyptus, 925  ;  of  thymol  on  the,  of  the 
cord  and  medulla,  1006  ;  of  camphor, 
1019 ;  of  oil  of  turpentine,  1059 

Nerve-stimulants  divided  into  two  kinds, 
192  ;  tonics,  when  necessary,  411 

Nerves,  relation  of  the  contractile  tissue 
to  the,  139  ;  action  of  drugs  on,  144- 
158  ;  on  motor,  146-155  ;  paralysis  of 
the  motor  endings  of  the,  143,  147 ; 


1148 


GENEEAL  INDEX. 


paralysis  may  be  due  to  disturbance  of 
rhythm  between  muscle  and,  143  ;  ex- 
periments illustrative  of  paralysis,  147- 
149  ;  list  of  drugs  which  have  the  same 
paralysing  action  on  the,  as  curare,  150, 
151 ;  irritation  of  the  motor  endings  of 
the,  by  drugs,  154 ;  action  of  drugs  on 
the  trunks  of  the  motor,  154  ;  on  sen- 
sory, 155  ;  the  general  action,  155  ;  the 
local  action,  156 ;  action  and  uses  of 
local  sedatives  and  anaesthetics  on, 
157  ;  and  of  drugs  on  the  peripheral 
ends  of  the  sensory,  157 ;  pain  ascribed 
to  vibration  of,  or  of  the  sheaths,  203  ; 
action  of  anaesthetics  on  the,  203  et 
seq. ;  the  chief  afferent,  expiratory, 
and  inspiratory,  241-244 ;  of  drugs  on 
the  respiratory,  244;  the,  die  sooner 
than  the  muscular  fibres,  281;  action 
of  drugs  on  the  vaso-motor  and  vaso- 
dilating, 283 ;  action  of  the,  on  the 
vessels  of  circulation,  286 ;  influence  of, 
on  blood-pressure.  2s9-292  ;  inhibitory 
nerves,  289 ;  quickening  nerves,  290 ; 
vaso-motor  nerves,  291  ;  depressor 
nerves,  291 ;  action  of  drugs  on  the  ac- 
celerating, 298 ;  action  of  the,  on  the 
secretion  of  saliva,  353-359 ;  diagrams 
illustrating  this  action,  354,  355,  359 ; 
action  of  the  afferent  on  vomiting,  371 ; 
diagram  showing  the  afferent,  by  which 
the  vomiting  centre  may  be  excited, 
372 ;  of  the  kidney,  428, 429 ;  action  of 
ammonium  salts  on  motor,  602 ;  of 
•potassium  salts  on  ditto,  606 ;  of  strong 
solution  of  ammonia,  639 ;  poisonous 
action  of  the  heavy  metals  on  the,  664 ; 
action  of  silver  on  the,  678  ;  of  salts  of 
iron,  739  ;  of  manganese  salts,  753  ;  of 
alcohol,  769-770;  of  spirit  of  ether, 
782 ;  of  nitrite  of  amyl,  786  ;  of  chloral 
hydrate,  792 ;  of  purified  chloroform, 
797  ;  of  carbolic  acid,  814 ;  of  codeine, 
850 ;  of  opium  on  the  sensory,  854  ;  of 
pilocarpine  on  the  efferent  and  other, 
884,  885 ;  of  physostigmine  on  the 
motor  and  sensory,  905  ;  of  sulphate  of 
strychnine  on  the  sensory,  972 ;  of  bel- 
ladonna or  atropine  on  the  motor,  987  ; 
of  tobacco  on  the  motor  and  secreting, 
992 ;  of  Indian  hemp  on  the  sensory, 
1027 ;  of  veratrine,  1048 ;  of  colchicum, 
1051 ;  of  extract  of  ergot,  1071 

Nervine  tonics,  zinc  salts  as,  668 ;  sul- 
phate of  copper  as,  675 

Nervous  debility  and  irritability,  relieved 
by,  mustard  applications,  345 

Nervous  ganglion  in  some  lower  organ- 
isms, nature  and  functions  of  the,  232 
et  seq. 

Nervous  system,  general  action  of  drugs 
on,  144 ;  general  irritability  of  the, 
generally  precedes  an  attack  of  gout, 
214 ;  regulating  action  of  the,  324-326; 


action  of  silver  on  the,  678  ;  of  purified 
chloroform  on  the,  799 ;  of  iodoform 
805 ;  of  aconitine,  835 ;  of  opium  on 
the  central,  851,  854,  861 ;  of  pilocar- 
pine, 884 ;  of  elaterin,  929 ;  of  quinine, 

.  946 ;  of  strychnine,  974 ;  of  solanine, 
983 ;  of  tobacco,  992 ;  of  digitalin,  995; 
of  extract  of  ergot,  1071 

Neuralgia,  blisters  and  cautery  of  great 
use  in,  345 

Neuralgic  pains,  relieved  by  rubefacients, 
345 

Neuridine,  100 

Neurine,  100 

Newlands,  Mr.,  makes  the  first  natural 
classification  of  the  elements,  17 ; 
points  out  a  curious  relationship  be- 
tween the  lithium  and  calcium  group 
of  elements,  17 ;  and  notes  that  the 
eighth  element  is  a  kind  of  repetition 
of  the  first,  17 

Newman,  reference  to,  278 

Newt,  diagram  of  the  circulation  in  the 
kidney  of  the,  425 

Nicati  and  Bietsch,  reference  to,  100 

Nickel,  symbol  and  atomic  weight  of, 
10 ;  physiological  action  of,  27  ;  causes 
slight  contraction  of  the  vessels, 
281 

Nicotine,  action  of,  on  oxidation,  70,  72 , 
on  medusas,  111 ;  on  mollusca,  114  ;  on 
ascidians,  114 ;  on  the  spinal  cord,  163 ; 
as  a  spinal  stimulant,  181 ;  as  a  myotic, 
219 ;  on  the  respiratory  centre,  241 ;  on 
the  vessels  of  circulation,  282  ;  on  the 
vagus-roots,  296  ;  on  the  heart  of  the 
frog,  309  ;  on  the  inhibitory  power  of 
the  vagi,  310 ;  on  the  vagus-centre, 
317  ;  on  vagus-ends  in  the  heart,  317  ; 
action  of,  on  the  intestines,  383 ;  on  the 
sweat  centres,  439  ;  antagonism  of,  to 
morphine,  496.     See  also  Tobacco 

Niobium,  symbol  and  atomic  weight 
of,  10 

Nitrates,  test  for,  594 

Nitrate  of  Ammonium,  642 
Copper,  674 
Iron,  747 
Lead,  705 
Potassium,  612 
Potassium  paper,  612 
Silver,  676 

And  potassium,  677 
Diluted,  677 
Moulded,  677 

Nitrate  of  pilocarpine,  preparation,  cha* 
racters,  and  tests,  883.  See  also  Pilo- 
carpine 

Nitrate  of  silver,  action  of,  on  the  mucous 
membrane,  253 ;  difference  of  the  ac- 
tion of,  on  the  mucous  membrane  and 
on  the  trachea,  253;  value  of,  in 
laryngeal  phthisis,  480 

Nitric  acid,  as  a  caustic,  344  ;  as  a  poison, 


GENEEAL  INDEX. 


1149 


with  its  antidote,  487  j  properties  and 
uses  of,  574 

Nitrite  of  amyl,  ethyl,  &o.  See  Amyl, 
Ethyl,  &c,  nitrite  of 

Nitrites,  effects  of  mixing,  with  freshly- 
drawn  blood,  71 ;  of  poisoning  by,  on 
the  colour  of  the  blood,  240 ;  on  the 
capillaries,  318 ;  all  nitrites  act  as 
vascular  stimulants,  331 

Nitro-benzol,  as  a  poison,  with  its  anti- 
dote, 490 

Nitrogen,  707 ;  symbol  and  atomic  weight 
of,  10 ;  its  relation  to  other  members 
of  a  group,  16  ;  experiments  as  to  the 
excretion  of,  in  the  body,  414 ;  com- 
pounds, with  hydrogen,  carbon  and 
oxygen,  707  ;  and  compounds,  708 

Nitrogen  monoxide,  nature,  action,  uses, 
and  mode  of  administration  of,  708 

Nitre-glycerin,  as  a  poison,  with  its  anti- 
dote, 490 

Nitro-glycerin  (glonoine),  preparation 
and  properties  of,  788;  action  of, 
similar  to  that  of  nitrite  of  amyl  and 
other  nitrites,  789 ;  in  frogs  and 
mammals,  788 ;  on  the  blood  and 
blood-pressure,  789  ;  why  it  acts  more 
powerfully  than  other  nitrites,  789 ; 
uses  of,  789 

Nitrohydrochloric  acid,  properties  and 
uses  of,  &c,  575 ;  dilute  ditto,  575 ; 
action  of,  on  the  urine,  436 

Nitrous  ether,  as  a  vascular  stimulant, 
330 ;  as  a  refrigerant  diuretic,  432 

Nitrous  oxide,  as  an  anaesthetic,  205  et 
seq. ;  nature  and  action  of,  708 

Nose,  application  of  drugs  to  the,  478  ; 
as  snuff,  478  ;  by  insufflation,  478  ;  by 
the  nasal  douche,  478 ;  diagram  of 
nasal  douche,  478 ;  action  of  pilocarpine 
on  the,  884 

Nothnagel,  references  to,  360,  384,  837 

Nowak,  reference  to,  136 

Nussbaum,  reference  to,  424 

Nut,  areca,   1052 ;   as  an  anthelmintic, 

,     1052 

Nutgalls,  action  and  uses  of,  1031 

Nutmeg,  characters  and  composition  of, 
1015  ;  volatile  oil  of,  1015 ;  expressed 
oil  of,  as  a  stimulant  and  carminative, 
1016 

Nutmeg  and  oil,  as  carminatives,  379 

Nutrition,  remedies  which  improve,  413  ; 
what  healthy  nutrition  depends  on,  413 

Nux  vomica,  as  a  stimulating  expecto- 
rant, 255  ;  as  a  cardiac  tonic,  331 ;  as 
an  antihidrotic,  441 ;  characters,  com- 
position, and  preparations  of,  971 


Oak-bark,  as  an  astringent,  349 ;  action 
and  use  of,  1030 


Oatmeal,  1056 ;  action  and  uses  of,  1050 
(Esophagus,  the,  of  various  animals,  mus- 
cular structure  of,  139 
Offenburg,  reference  to,  977 
Officinal  preparations.    See  the  different 

drugs 
Oil,  castor.     See  Castor  oil 
Oil,  cod-liver,  1087  :  its  characters  and 
composition,   1087 ;    its  physiological 
action,  1087  ;  powers  of  absorption  and 
assimilation,  1087;  uses,  1088 
Oil,  ethereal,  783 
Oil  of  allspice,  923 

Almonds,  916 

Bitter,  490,  916 

Amber,  1060 

Anise,  935 

Bergamot,  characters  and  use  of,  889 

Cajuput,  924 

Caraway,  937 

Castor,  1024 

Chamomile,  955 

Cinnamon,  1017 

Cloves,  95,  922 

Copaiva,  912 

Coriander,  938 

Croton,  1023 

Cubebs,  1014 

Dill,  936 

Eucalyptus,  925 

Firwool,  1060 

Flaxseed,  877 

Gaultheria,  962 

Juniper,  1064 

Lavender,  1003 

Flowers,  1004 

Lemons,  890 

Mace,  128 

Mustard.    See  Mustard  oil 

Myrtle,  924 

Neroli,  887 

Nutmeg,  expressed,  1016 
Volatile,  1015 

Olive,  965 

Orange  flowers,  887 
Peel,  889 

Peppermint,  1004 

Pimenta,  923 

Kose,  920 

Rosemary,  319,  1002 

Eue,  881 

Santal,  1021 

Sassafras,  1020 

Scotch  fir,  1059 

Sesamum,  1002 

Spearmint,  1005 

Tar,  1063 

Theobroma,  875 

Turpentine,  93,  253,  328,  344,  1058 

Valerian,  952 

Oil  of  turpentine,  action  of,  on  bacteria, 

95 ;  of  the  vapour  of,  on  the  mucous 

membrane,  253 ;    great  therapeutical 

value  of  the  vapour  of,  in  bronchitis, 


1150 


GENEEAL  INDEX. 


253 ;  as  a  cardiac  stimulant,  328 ;  as  a 
rubefacient,  344 ;    as  an  antidote  to 
phosphorus,  491 
Oils,  ethereal,  action  of,  on  bacteria,  103; 
on  the  vaso-motor  centre,  319;  aromatic 
volatile,  as   cardiac  stimulants,  328 ; 
volatile,  as  rubefacients,  344;  as  an 
antidote  to  phosphorus,  490 
Oils,  fixed  and  volatile,  519,  521 
Ointment,  sulphur,  544 ;  alkaline  sulphur, 
544 ;    various   kinds    of    iodine,    557 ; 
iodide  of  sulphur,  557.     See  TJnguen- 
tum 
Ointments,  their  nature,  number,  and 

uses,  532 
Oleaceae,  965 
Oleate  of  mercury,  591 
of  Veratrine,  591 
of  Zinc,  670 
Oleates,  521 

Oleatum  hydrargyri,  521,  591,  687,  694 
Veratrinae,  521,  591,  1047 
Zinci,  521,  670 
Oleic  acid,  action  of,  on  bacteria,  94 ; 

properties  and  uses  of,  590 
Oleoresina  Aspidii,  521,  1066 
Capsici,  521,  984 
Cubebaa,  521,  1014 
Lupulini,  521,  1028 
Piperis,  521, 1013 
Zingiberis,  521,  1037 
Oleoresins,  521 
Oleum  Adipis,  520 

^thereum,  520,  783 
Amygdalae,  520,  916 

Amaras,  520 
Expressum,  520 
Anethi,  520,  936 
Anisi,  520,  840,  935 
Anthemidis,  520,  955 
Aurantii  corticis,  520,  889 

Florum,  520 
Bergamii,  520,  889 
Cajuputi,  520,  924 
Cari,  520,  937 
Carui,  520,  936 
Caryophylli,  520,  922 
Chenopodii,  520,  1009 
Cinnamomi,  520,  1016 
Copaibae,  520,  912 
Coriandri,  520,  938 
Crotonis,  1023 
Cubebse,  520,  1014 
Erigerontis,  521 
Eucalypti,  521,  925 
Foeniculi,  521 
Gaultherise,  521,  962 
Gossypii  seminis,  S20,  872 
Hedeomae,  521,  1007 
Juniperi,  520,  521 
Lavandulae,  520,  521 

Florum,  521 
Limonis,  520,  521,  890 
Lini,  876 


Oleum — 

Mentha?  piperitae,  520,  521 

Viridis,  520,  521 
Morrhuae,  520 
Myrciae,  521 
Myristicse,  520,  521, 1015 

Expressum,     520,    1015, 

1016 
Myrti,  924 
Olivae,  520,  965 
Phosphoratum,  520,  710,  916 
Picis  liquidae,  521 
Pimente,  520,  521,  923 
Pini  Sylvestris,  520 
Eicini,  520 
Bosfe,  521,  920 
Rosmarini,  520,  621 
Eutae,  520.  521,  881 
Sabinae,  520,  521,  1064 
Santali,  520,  521,  1021 
Sassafras,  521,  1020 
SesamI,  520, 1002 
Sinapis,  520,  865 

Volatile,  521,  865 
Succini,  521 
Terebinthinae,  520,  521 
Theobromae,  520 
Theobromatis,  875 
Thymi,  521 
Tiglii,  520,  1023 
Valeriana!,  521,  952 
Oleum  animale,  action  of,  on  bacteria,  94 
Oleum  menthae  piperitae,  action  of,  on 

bacteria,  94 
Oleum  pini  pumilionis,  as  a  stimulating 

expectorant,  255 
Oleum  pini  sylvestris,  as  a  stimulating 

expectorant,  255 

Olive  oil,  as  a  demulcent,  347 ;  characters, 

965  ;  composition,  and  preparations  of, 

965 ;  action  and  uses  of,  967 

Onion,  as  a  stimulating  expectorant,  255 

Ononis  spinosum,  as  a  stimulant  diuretic, 

433 
Operations,  surgical,  Sir  Joseph  Lister  on 

the  best  mode  of  performing,  815 
Ophthalmia,  gonorrhoea!,  contagious,  and 
neonatorum,  caused  by  micrococci,  99 
Opium,  effect  of  habit  on  the  quantity 
that  can  be  taken,  44 ;  abnormal  effects 
of,  in  some  cases  of  fever,  47 ;  some 
persons  very  slightly  affected  by,  5 1 ; 
as  a  sedative,  157  ;  as  a  spinal  stimu- 
lant, 182 ;  different  actions  of,  in  differ- 
ent doses,  on  the  brain,  195 ;  one  of 
the  most  powerful  hypnotics,  199 ;  in- 
duces sleep  and  lessens  pain,  199  ;  as 
a  local  and  general  anodyne,  201,  211  } 
as  a  myotic,  219 ;  action  of,  on  the 
respiratory  centre,  241 ;  on  the  brain, 
244 ;  in  diminishing  the  excitability  of 
the  respiratory  centre,  250  ;  action  of, 
on  the  vessels  of  circulation,  284  ;  as  a 
vascular  sedative,  339 ;  as  an  antisialic, 


GENERAL  INDEX. 


1151 


361 ;  as  a  local  and  general  sedative, 
376  ;  action  of,  on  the  intestines,  383, 
384,  387;  as  a  purgative,  386;  as  a 
vesical  sedative,  445 ;  as  a  poison  with 
its  antidotes,  490 ;  antagonistic  action 
of,  and  belladonna,  494;  antagonism 
of,  to  other  drugs,  494, 497 ;  characters 
and  preparations  of,  844;  alkaloids 
of,  846 ;  physiological  action  of,  851 ; 
general  action  of,  exclusively  on  the 
central  nervous  system,  851;  and  in 
mammals  especially  on  the  brain,  851 ; 
in  the  frog  it  acts  on  the  motor  ganglia 
of  the  heart,  851 ;  action  of,  on  frogs, 
851 ;  on  birds,  851 ;  on  mammals,  852 ; 
on  man,  it  acts  chiefly  on  the  brain, 
852  ;  in  producing  sleep,  and  in  large 
doses,  death,  852;  diagnosis  between 
poisoning  by,  and  intoxication  and 
apoplexy,  852 ;  treatment  in  poisoning 
by,  853  ;  precautions,  853 ;  treatment 
of  the  symptoms  after  an  ordinary 
dose,  854  ;  action  of,  on  special  organs, 
854  ;  on  the  sensory  nerves,  the  spinal 
cord,  and  the  brain,  854 ;  on  the  pupil, 
854 ;  the  circulation,  and  the  vaso- 
motor centre  in  the  medulla,  854 ;  has 
a  peculiar  action  on  the  peripheral 
vaso-motor  apparatus,  854;  on  secre- 
tion, 855  ;  on  sweat  and  the  urine,  855  : 
on  the  intestines,  856 ;  elimination, 
,  856 ;  circumstances  modifying  the 
action  of,  856;  sex  and  idiosyncrasy, 
856  ;  habit,  857  ;  opium-eating,  857  ; 
action  of,  in  disease,  858 ;  and  in 
combination  with  other  drugs;  858 ; 
action  of  the  alkaloids  of,  858 ;  the 
morphine  group  and  the  codeine  group, 
858 ;  how  codeines  are  produced,  859 ; 
action  of  apomorphine  and  morphine, 
859  ;  therapeutics — general  uses  and 
local  uses,  859 ;  on  the  digestive  system, 
860;  the  respiratory  tract,  860;  the 
circulatory  system,  861 ;  the  genito- 
urinary tract,  861 ;  the  skin,  861 ;  two 
most  important  uses  of  opium  and 
morphine  to  relieve  pain  and  produce 
sleep,  861 ;  action  of,  on  the  nervous 
system,  861 ;  contra-indications,  862 
Opium  denarcotisatum,  845 
Opium- eating,  the  effects  of,  284 
Opium,  powdered,  preparations  and  com- 
position of,  845 
Orange,  bitter,  888 
Flower  water,  888 

Flowers,  character,  composition,  and 
uses  of,  887 
Oil  of,  887 
Peel,  bitter,  888 
Oil  of,  889 
Sweet,  Oil  of,  889 
Orchidacese,  1036 

Organism,  the  animal,  general  relations 
between,  and  substances  affecting  it 


9-32  ;  circumstances  which  aflEect  the 
action  of  drugs  on  the,  33-56 ;  effects 
of  oxidation  on,  65  et  seq. ;  relations  of 
motion  and  oxidation  in,  65 ;  excess 
of  temperature  injurious  to,  102 

Origanum,  characters,  action,  and  uses 
of,  1007 ;  as  a  diaphoretic  and  em- 
menagogue,  1007 

OrthospermiE,  932 

Osmic  acid,  action  of,  on  bacteria,  94, 95  ; 
as  a  caustic,  344 

Osmium,  symbol  and  atomic  weight  of, 
10  ;  physiological  action  of,  27 

Ovarian  irritation,  diagram  showing  how, 
probably  causes  constipation,  386 

Oxalates,  test  for,  595 

Oxalate  of  cerium,  657  ;  of  iron,  750 

Oxalic  acid,  as  a  poison,  with  its  anti- 
dote, 487  ;  nature  and  use  of,  581 

Ox-bile,  purified,  1082 

Ox-gall,  1081 ;  inspissated,  1082 

Oxidation,  relations  of  motion  and,  65  ; 
of  protoplasm,  67  ;  action  of  drugs  on, 
69 ;  methods  of  ascertaining  the  effects 
of  drugs  on,  72 

Oxide  of  Lead,  702 

Manganese,  black,  753 
Mercury,  red,  694 

Yellow,  694 
Silver,  679 
Zinc,  669 

Oxygen,  symbol  and  atomic  weight  of, 
10 ;  broken  up  by  electricity,  and 
forms  a  new  element,  ozone,  13 ;  its 
relation  to  other  members  of  a  group, 
16;  necessary  for  protoplasmic  life, 
61 ;  power  of  protoplasm  over,  68 ; 
action  of  haemoglobin  on,  70;  effects 
of  other  gases  on,  70;  of  carbonic 
oxide  on,  70 ;  of  charcoal,  73 ;  effects 
of,  on  mould-fungi,  82 ;  on  bacteria, 
82 ;  excess  or  absence  of,  causes 
tetanus,  176 ;  effects  of  the  presence  or 
absence  of,  on  the  blood,  235-240 ;  its 
preparation,  537 ;  properties,  physio- 
logical action,  and  uses,  537,  538 

Oxyhemoglobin,  70,  72 

Oxymel,  518,  577,  1089 

Scillse,  518,  577,  1041,  1089 

Ozone,  origin  and  nature  of,  13 ;  action 
of,  on  albumen,  58 ;  power  of  proto- 
plasm in  forming,  69 ;  action  of  phos- 
phorus in  forming,  69 ;  nature  and 
uses  of,  539,  540  ;  diagram  illustrating 
the  formation  of,  by  electricity,  539 


P. 


Pachyderwata,  1084 

Paget,  Sir  James,  reference  to  his  lecture 

on  '  Elemental  Pathology,'  50 
Pain,  origin  and  nature  of,  201 ;  where 

seated,  201 ;  how  caused,  and  how  re- 


1152 


GENEEAL  INDEX. 


lieved,  202  ;  action  and  uses  of  ano- 
dynes in,  202,  203;  relieved  by  an 
effort  of  the  attention,  203  ;  action  of 
anaesthetics  in  relieving,  203  et  seq. ; 
and  of  electricity  and  cold,  203 ;  Mor- 
timer Granville's  treatment  of,  203 ; 
action  of  anassthetics  in  alleviating  or 
destroying,  203  et  seq. 
Pale  rose,  composition  and  uses  of,  920 
Palladium,  symbol  and  atomic  weight  of, 

10 ;  physiological  action  of,  27 
Palmaceae,  1052 

Palmitic  acid,  action  of,  on  bacteria,  94 
Palpitation,  of  the  heart,  effect  of  blood- 
pressure  on,  299 ;  the  principal  drugs 
which  diminish  it,  339 
Pancreas,  action  of  drugs  on  the,  407 
Pancreatic  juice,  importance  of  the,  in 
the  process  of  digestion,  407 ;  effects 
of  the  secretion  of  the,  408 ;  and  of 
different  drugs  on  the,  408 
Pancreatin,  utility  of,  in  aiding  digestion, 

364 
Papain,  927 
Papaveraceas,  843 
Papayaceae,  927 

Papayotin,  preparation,  action,  and  uses 
of,  927  ;  digestive  power  of,  on  mus- 
lar  fibre  and  connective  tissue,  927 
Paper,  litmus,  blue,  1067 

Eed,  1067 
Paper,  turmeric,  1037  j  as  a  test  for  al- 
kalies, 1037 
Papers,  506 
Papilionaceae,  899 
Papillon,  M.,  reference  to,  28 
Paracoto  bark,  1017 

Paracotoine,  action  on  intestinal  secre- 
tion, 387 
Paraffin,  as  an  emollient,  347 
Paraffin,  hard,  763 ;  soft,  764 
.  Paraldehyde,  a  hypnotic,  199  ;  a  general 

anassthetic,  205 
Paralysis,  of  the  respiration  and  heart, 
danger  from  anaesthetics,  '207  :  treat- 
ment necessary  when  this  occurs,  207  ; 
of  the  sphincter  muscle  of  the  iris  of 
the  eye,  220 ;  and  of  the  dilator  muscle 
of  the  same,  221 
Parasiticide,  balsam  of  Peru  as  a,  902 
Pardington,  Dr.,  reference  to,  167 
Pare,  Ambrose,  reference  to,  104 
Pareira  brava,  as  a  stimulant  diuretic, 

433  ;  action  of,  on  the  bladder,  445 
Pareira  root,  characters  and  composition 

of,  841 ;  action  and  uses  of,  842 
Parsley,  as  a  stimulant  diuretic,  433 
Pasteur,divides  bacteria  into  two  classes,  82 
Paton,  reference  to,  900 
Pavy,  reference  to,  850 
Pearl  barley,  1054 
Pedalineae,  1002 

Pellitory  root,  characters,  action,  and  uses 
of,  952 


Pennyroyal,  1006 
Pentad  elements,  707-734 
Pepper,  as  a  carminative,  379 
Pepper,  black,  as  a  stimulant  diuretic, 
433  ;  characters,  composition,  and  pre- 
parations of,  10i2 ;  action  and  uses  of, 
1013 ;  as  a  stomachic,  &c,  1013 
Peppermint-camphor,  characters,  action, 
and  uses  of,  1004 ;  as  an  antiseptic  and 
antineuralgic,  1005 
Peppermint  and  oil,  as  a  carminative, 

379 
Peppermint  oil,  action  of,  on  bacteria,  95 ; 
characters,  action,  and  use  of,  1 004 ;  as 
a  carminative  and  stimulant,  1004 
Pepsin,    action    of,   on    fibrin,    75,    76; 
action  of,  as  an  artificially  digestive 
substance,  364;  nature  of,  1081 
Pepsinum  saceharatum,  1081 ;  its  thera- 
peutics, 1081 
Peptogens,  their  action  in  increasing  the 

gastric  juice,  363 
Peptones,  action  of  on  the   intestines, 

382 ;  action  of  the  liver  on,  399 
Perchloride  of  mercury,  692 
Perinaaum,  a  wet  sponge  applied  to  the, 

causes  the  evacuation  of  urine,  444 
Peristalsis,  and  mode  of  increasing,  212; 
some    hepatic    stimulants    which    in- 
crease, 405 
Permanganate  of  potassium,  action  of,  on 
bacteria,  95  ;  as  a  powerful  antiseptic, 
may  be  used  to  wash  out  abscesses,  and 
as  a  lotion  for  ulcers  or  wounds,  105  ; 
action  of,  on  muscle,  121 ;  characters, 
action,  and  uses  of,  614,  615 
Peroxide  of  hydrogen,  preparation  pro- 
perties, action,  and  uses  of,  540 
Perspiration,  antipyrin    causes  profuse, 
824.    See  also  Skin,  action  of  drugs 
on  THE 
Peru,  balsam  of,  as  a  parasiticide,  902 
Pessaries,  nature  and  uses  of,  485 
Petals,  cabbage-rose,  920 
Bed  poppv,  862 
Eed  rose,  920 
Petrolatum,  532 ;  properties  and  uses  of, 

763 
Petroleum  benzin,    or  ether,  properties 
and  uses  of,  762 ;  petroleum  ointment, 
763 
Petroleum  ether,  action  of,  on  bacteria, 

93 
Pettenkofer,  reference  to,  404,  414 
Phagocytes,  85 

Pharmaceutical  preparations,  501-534 ; 
general  principles  which  govern,  501, 
502  ;  the  following  are  the  principal 
abstracts,  503  ;  vinegars,  503 ;  alka- 
loids, 503 ;  waters,  505 ;  cataplasms 
or  poultices,  506  ;  cerates,  506  ;  papers, 
506  ;  collodions,  607  ;  confections, 
electuaries,  or  conserves,  507;  decoc- 
tions, 507  ;  elixirs,  508 ;  plasters,  508  j 


GENEEAL  INDEX. 


1153 


injections,  enemas,  or  clysters,  508  ; 
essences,  509 ;  extracts,  509-513  ;  fluid 
or  liquid  extracts,  510  ;  fresh  or  green 
extracts,  512;  glycerines,  513;  infu- 
sions, 513;  hypodermic  injections,  511; 
liniments  or  embrocations,  515  ;  solu- 
tions, 617 ;  masses,  518 ;  honeys,  518  ; 
mixtures,  518;  mucilages,  519;  oils, 
fixed  and.  volatile,  519 ;  oleates,  521  ; 
oleoresins,  521 ;  pills,  521 ;  powders, 
524;  resins,  624 ;  spirits,  525  ;  supposi- 
tories, 526  ;  juices,  526 ;  syrups,  627 ; 
tinctures,  528-531 ;  triturations,  531; 
ointments,  632 ;  vapours,  inhalations, 
633 ;  wines,  534 
Pharmacology,  definition  of,  3 ;  one  of 
the  most  important  subdivisions  of 
materia  medica,  3  ;  rapid  advances  of, 
of  late  years,  5 ;  difficulty  students 
find  in  dealing  with,  5  ;  the  great 
object  of,  20 ;  the  connection  between 
chemical  constitution  and  physiologi- 
cal action  the  most  important  one  in, 
32  ;  importance  of  comparative,  50 ; 
inhibition,  and  the  action  of  drugs  on 
inhibitory  centres  play  »  very  impor- 
tant part  in,  167-171 
Pharmacy,  definition  of,  3,  501 
Pharyngeal  irritation  the  probable  origin 

of  the  so-called  stomach  cough,  248 
Pharynx,  structure  and  functions  of,  248  ; 
cough  caused  by  irritation  of  the,  248  ; 
application  of  drugs  to  the,  481  ;   as 
washes,  482  ;  as  caustics,  482 
Phenol.    See  Carbolic  acid 
Phenyl- alcohol.    See  Carbolic  acid 
Phenyl-methyl-amyl  ammonium  hydrate, 
,    action  on  motor  nerves,  150 
Phenyl-dimethyl-ethyl  ammonium  iodide, 

action  on  motor  nerves,  150 
Phenyl-tri-ethyl  ammonium  iodide,  action 

on  motor  nerves,  150 
Phosphates,  test  for,  695 
Phosphate  of  sodium,  as  a  cholagogue 
purgative,  405 ;  nature  of,  626 ;  as  a 
saline  purgative,  389 ;  of  ammonium, 
642  ;  of  calcium,  652  ;  of  iron,  751 
Phosphides,  test  for,  595 
Phosphide  of  zinc,  673 
Phosphoric  acid,  physiological  action  of, 
27;   as  a  poison,  with  its  antidotes, 
487  ;  properties,  &c,  579  ;  dilute  ditto, 
579 
Phosphorus,  symbol  and  atomic  weight 
of,  10;  occurs  in  two  forms,  red  and 
yellow,  14 ;  in  combination  sometimes 
pentad  and  sometimes  triad,  14;  its 
relation  to  other  members  of  a  group, 
16  ;  secondary  effects  of,  as  an  irritant 
poison,  on  the  system,  398 ;  destroys 
the  glycogenic  function  of  the  liver, 
402 ;  has  a  special  action  on  tissue- 
change,  415;  in  poisoning  by,  action 
of,  on  the  urine,  415 ;  used  in  nervous 


debility,  416  ;  as  a  poison,  with  its 
antidotes,  490 ;  preparation  and  cha- 
racters of,  709  ;  action  of,  710 ;  on  the 
liver  and  bones,  710 ;  on  the  lower  jaw, 
710  ;  in  poisonous  doses,  711 ;  produces 
fatty  degeneration  of  the  liver,  stomach, 
and  kidneys,  711 ;  treatment  in  cases 
of  poisoning  by,  711 ;  cause  of  the 
fatty  degeneration,  711  ;  action  of 
compounds  containing,  712 ;  uses  of, 
712 

Phthisis,  caused  by  the  haeillws  tuber- 
culosis, 99 ;  when  accompanied  by  a 
copious  secretion  of  mucus,  a  combina- 
tion of  morphine  and  atropine  useful 
in,  250 ;  the  atropine  beneficial  also  in 
lessening  sweating  in,  250;  alkalies  use- 
ful in  diminishing  the  moist  rales  heard 
in  the  lungs  in,  252;  tartar  emetic 
ointment  and  croton-oil  liniment  some- 
times useful  in,  346  ;  on  the  night- 
sweats  of,  442 ;  diagram  illustrating 
the  action  of  antihidrotics  in  diminish- 
ing sweating  in,  442 ;  probable  mode 
of  action  of  arsenic  in,  717 ;  how  the 
disease  originates  and  increases,  717 

Physiological  action,  relation  between 
atomic  weight  and,  28  ;  between  spec- 
troscopic characters  and,  27 ;  between 
isomorphism  and,  26  ;  Blake's  division 
of  the  elements  into  nine  groups,  ac- 
cording to  their,  27 

Physiological  reactions,  24 ;  divided  into 
groups,  25 

P-iysostigma,  lethal  dose  of,  38 ;  action 
of,  on  muscle,  130  et  seq. ;  effects  of  a 
solution  of,  applied  locally  to  the  nerve- 
trunk,  155 ;  action  of,  on  the  motor 
centres  of  the  brain,  188 ;  as  a  myotic, 
219 ;  on  the  respiratory  centre,  241, 
245 ;  on  the  blood-pressure,  285 ;  chiefly 
affects  the'heart,  296 ;  action  of,  on  the 
vagus,  297 ;  on  the  frog's  heart,  307 ; 
on  the  ganglia,  313,  31-4 ;  on  the  vagus- 
ends  in  the  heart,  317 ;  on  the  cardiac 
muscle,  316;  action  of,  on  the  secre- 
tory and  sympathetic  nerves,  357,  358 ; 
as  a  sialagogue,  357 ;  as  an  antisialic, 
361 ;  the  paralysing  action  of  atropine 
counteracted  by,  361  ;  as  a  hepatic, 
stimulant,  403 ;  as  a  poison,  with  its 
antidotes,  491  ;  antagonism  of,  to 
atropine,  492-496 ;  antagonistic  action 
of,  493-496 ;  nature,  physiological  ac- 
tion, and  therapeutics  of,  904-908.  See 
also  Physostigmine 

Physostigmine,  504 

Physostigminai  salicylas,  504 

Physostigmine,  character,  tests,  and  pre- 
paration of,  904,  905 ;  action  of,  on 
the  muscular  fibre  and  nerve-centres, 
905 ;  general  action  on  the  muscles, 
spinal  cord,  medulla,  and  motor  and 
sensory  nerves,  905 ;  on  the  brain,  eye, 

4  E 


1154 


GENEEAL  INDEX. 


respiration,  and  circulation,  905,  906 ; 
nn  muscle, stomach,  and  intestines,  907 ; 
on  the  spleen,  bladder,  and  uterus,  907 ; 
on  the  secretions  and  secreting  cells, 
907 ;  uses  of,  908  ;  treatment  of  poison- 
ing by,  908 

Physostigmine,  salicylate  of,  characters 
of,  904 

Phytolacca  berry,  1009 

Koot,  1009;  characters,  and  action 
of,  1009;  as  an  emetic,  narcotic, 
and  alterative,  1009 

Phytolaccacese,  1009 

Phytolaccin,  as  a  hepatic  stimulant,  403 

Picric  acid,  action  of,  on  bacteria,  91,  95 

Picrotoxin,  effect  of  temperature  on  the 
action  of,  46 ;  action  of,  on  oxidation, 
70 ;  powerful  convulsant  action  of, 
190;  action  of,  on  the  accelerating 
centre,  318  ;  as  an  antihidrotic,  441 ; 
as  a  poison,  with  its  antidotes,  491 ; 
antagonism  of,  to  chloral,  495  ;  charac- 
ters of,  842  ;  action  of,  on  the  medulla, 
motor  centres,  spinal  cord,  and  tem- 
perature, 842 ;  uses  of,  842 

Piorotoxinum,  505 

Pills,  521 ;  list  of,  with  ingredients,  522, 
623 

Pilocarpine,  effects  of  cold  on  the  action 
of,  46 ;  as  a  myotic,  219;  action  of,  on 
the  mucous  membrane,  253;  as  a  de- 
pressant expectorant,  255 ;  effect  of, 
on  the  frog's  heart,  307  ;  on  the  cardiac 
muscle,  316;  as  a  sialagogue,  357; 
action  of,  on  the  peripheral  ends  of  the 
sweat  nerves,  438 ;  as  an  antihidrotic, 
441 ;  as  a  poison,  with  its  antidote, 
491 ;  antagonism  of,  to  atropine,  494, 
495  ;  action  of,  on  the  nerves,  nerve- 
centres,  and  muscular  fibre,  884,  885 ; 
and  on  all  the  secretions  of  the  body, 
884 ;  on  the  bladder,  uterus,  and 
spleen,  885 ;  on  the  circulation  and 
vessels,  885 ;  on  the  respiration  and 
temperature,  886;  on  the  eye,  skin, 
and  throat,  886 ;  its  chief  use  in 
dropsy,  887  J  contra-indications,  887 

Pilocarpine  hydrochloras,  504,  884 
nitras,  883 

Pilocarpus  (jaborandi),  characters  of,  883 

Pilula  Aloes,  523,  966,  1043 

Aloes  Barbadensis,   522,   937,   966, 
1044 
et  Asafretidse,  522,  932,  966, 

1042,  1043 

et  Ferri,  522, 741,  1043,  1044 
et  Mastiches,  523,  897,  920, 

1043 
et  Myrrhse,  523, 893,  967, 1042, 

1043,  1039,  1056 
SocotrinEe,  522,  966,  1042 

Antimonii  composite,  523,  686,  691, 

726,  728,  880 
Asafoetidaj,  523,  933,  966 


Pilula  Asafoetidse — 

Composita,  522,  893,  932, 
933,  1056 
Cambogise  composita,  522,  869,  966, 

1044 
Catharticse  composite,  523,  686,  691, 

869,  928,  982,  1043 
Colocynthidis  composita,   522,  611, 
922,  928,  981, 1044 

et   hyoscyami,    522, 
611,  922,  928, 981, 
1044 
Conii  composita,  522,  931,  949, 1056 
Ferri  carbonatis,  522,  742,  1055 
Iodidi,  522,  557,  750,  899,  1055 
Composite,  523,893 
Galbani  composite,  523.  893,  933 
Hydrargyri,  522,  686,  899 

Subchloridi     composita, 
522, 686,  691,  726,  728, 
880,  1024 
Ipecacuanha?  cum  scillS,  522,  611, 

844,  934,  949,  1041, 1056 
Opii,  523,  845,  966 
Phosphori,    522,    710,    903,    1079, 

1090 
Plumbi  cum  opio,  522,  703, 844 
Khei,  523, 966, 1010 
Composita,   523,  893,  966,    1004, 
1010,  1042,  1043, 1056 
Saponis  composita,  523,  844,  966 
Scammonii  composita,  523,  981, 983, 

1079 
Scillse  composita,  623, 934, 966, 1041, 
1037,  1056 
Pimenta,  923 

Oil  of,  923 
Pimento,  characters  and  composition  of, 
923 
Oil  of,  923 
Pine  bath,  470 
Pinkroot.    See  Spigelia 
Piperaceae,  1012 
Piperine,  504 ;  character,  action,  and  uses 

of,  1013 
Pisces,  1086 
Pitch,  Burgundy,  1062 
Canada,  1062 
Hemlock,  1062 
Pitres,  references  to,  186, 187 
Piturine,  as  a  mydriatic,  219 
Plasters,  508 ;  utility  of,  in  chest  com- 
plaints and  in  bronchitis,  256 
Platinum,  symbol  and  atomic  weight  of, 
10  ;  physiological  action  of,  27  ;  action 
of,   on  muscle,  127 ;  causes  powerful 
contraction  of  the  vessels,  281 ;  proper- 
ties, action,  and  uses  of  foil,  754;  of 
solution  of  perchloride  of,  754 ;  of  pla- 
tinum black, 755 
Pleurisy,  tartar  emetic  ointment  and  cro> 
ton-oil  liniment  sometimes  useful  in, 
346 
Pleurisy  root.    See  Asclepias 


GENERAL  INDEX. 


1155 


Plumbi  aoetas,  703 

lodidum,  557,  705 
Pneumonia,  contagious,  micrococci  pre- 
sent in,  99 
Podophylli  resina,  838 
Podophyllin,  as  a  drastic  purgative,  390 ; 
and  as  a  cholagogue,  390  ;  as  a  hepatic 
stimulant,  406.    See  also  Podophyllum 
root,  and  resin  of  podophyllum 
Podophyllum  root,  characters,  properties, 
and    composition    of,  838 ;  resin    of, 
nature,  properties,  and  uses  of,  838 
Poisoning,  what  is  necessary  to  be  done 
in  all  cases  of,  before  administering 
the    antidote,    486 ;    by    acids,    570 ; 
chronic,  by  copper,  666 ;  by  phosphorus, 
and  its  treatment,  710,  711 ;  by  arsenic, 
and  its  treatment,  713,  714 ;  chronic, 
by  arsenic,   714  ;  by  antimony,  722  ; 
chronic  alcoholic,  770 ;  treatment  of, 
by  chloral,  793 ;  by  opium,  853 ;  by 
physostigmine,  908  ;  by  strychnine,  and 
its  treatment,  973;  by  belladonna  or 
atropine,  990 ;  by  digitalis,  and  its 
treatment,  1001 ;  by  croton  oil,  and  its 
treatment,  1023  ;  by  colchicum,  1051; 
treatment  of,  by  cantharides,  1092 
Poisonous  gases,  with  their  antidotes,  486 
Poisons,  effect  of  heat  on  the  power  of, 
44-48  ;  different  effects  of,  on  different 
animals,  43-49  ;  effects  of  various,  on 
medusas,  111,  112;  list  of  muscular, 
126-131 ;   effects  of  certain,   on    the 
colour  of  the  blood,  240 ;  on  the  mus- 
cular   fibre  of  the  ventricle  of  the 
heart,  307 ;  on  the  heart  itself,  308 ; 
of  two  classes  of,  on  the  vagus,  310- 
314  ;  list  of  cardiac,  316 ;  most  suitable 
emetics    for    removing,     from      the 
stomach,  374 ;  action  of  various  irri- 
tant, on  the  general  system,  395-397 ; 
peculiarities  in  the  action  of  different 
irritant,  397;  secondary  effects  of  irri- 
tant poisoning,  398 ;  list  of  the  more 
common,  with  their  antidotes,  486-491 ; 
carbonic  acid   as  a,  584;  has  three 
stages—  dyspnoea,  convulsions,  paraly- 
sis, 584  ;  copper  as  a,  666 
Poke  berry.     See  Phytolacca  berry 

Eoot.    See  Phytolacca  root 
Politzer,  reference  to,  153 
Polygalacese,  867 
Polygonacese,  1010 
Pomese,  921 

Pomegranate,    as    a    vermicide,    408 ; 
characters,  composition,  and  use  as  an 
anthelmintic,  926 
Root  bark,  926 
Poppy  capsules,  character  of,  843 ;  com- 
position, action,  and  uses  of,  843 
Poppy  petals,  red,  characters,  composi- 
tion, and  use  of,  862 
Potash,    physiological    action    of,    27; 
action  of,  on  protoplasm,  61 ;  perman- 


ganate of,  effect  of,  on  infusoria,  65 ; 
on  bacteria,  91 ;  on  muscle,  121 ;  salts 
of,  effects  of,  on  muscular  contraction, 
129 ;  action  of,  on  the  ends  of  the 
vaso-motor  nerves,  284 ;  action  of, 
combined  with  other  ingredients,  on 
the  frog's  heart,  307 ;  as  a  caustic, 
344 ;  difference  between  the  action  of, 
and  soda,  on  the  intestines,  383 ;  used 
in  gout,  416 
Potassse  liquor,  singular  effect  of  a  single 

drop  of,  492 
Potassium  salts,  preparation,  nature,  and 

uses  of  the  following — 
Potassium  acetate,  605,  609 
Acid  tartrate,  605,  610 
Bicarbonate,  604,  608 
Bichromate  of,  605,  616 
Bitartrate  of,  610 
Bromide,  553-555,  605 
Carbonate,  604,  607 
Caustic  potash,  604,  608 
Chlorate,  605,  613 
Citrate,  605,  609 
Cyanide,  605 
Perrocyanide,  605,  616 
Hypophosphite,  605 
Iodide,  659,  605 
Liquor  potassse,  604,  607 

Potassii,  604 
Nitrate,  605,  612 
Permanganate,  605,  614 
Potassa  cum  calce,  606,  648 
Sulphate,  605,  611 
Sulphite,  604 
Sulphurata,  543,  605,  615 
Tartrate,  605,  611 
Tartrate  (acid),  610 
Potassium  salts,  action  of,  on  the  cardiac 
muscle,  316 ;  on  the  vaso-motor  nerves, 
318;   on  the  capillaries,  318;  as  re- 
frigerant diuretics,  432 ;  antagonism  of, 
to  barium,  493,  495 ;  general  sources 
and  reactions  of,  603,  604  ;  action  of, 
on  the  general  system,  605,  607 
Potassium,  symbol  and  atomic  weight  of, 
10 ;  its  relation  to  other  members  of  a 
group,  16 ;  and  specially  to  lithium,  17; 
action  of,  on  muscles,  127,  129,  135, 
142,  143 ;  on  the  vaso-motor  centre, 
319 
Potassium  acetate,  action  of,  on  bacteria, 
94 ;  as  a  remote  antacid,  370  ;  as  a  re- 
frigerant diuretic,  432 
Potassium  bicarbonate,  as  a  direct  ant- 
acid, 370 
Potassium  bichromate,  action  of,  on  bac- 
teria, 94 
Potassium  bitartrate,  as  a  remote  ant- 
acid, 370 ;  as  a  saline  purgative,  389 ; 
a  hydragogue,  390 ;  and.  a  refrigerant 
diuretic,  432 
Potassium  bromide,  action  of,  on  bac- 
teria, 93  ;  on  the  nervous  system,  204 
4  E  2 


1156 


GENERAL  INDEX. 


Potassium  carbonate,  as  a  direct  antacid, 
370 

Chlorate,  action  of,  on  bacteria,  94  j 
as  a  refrigerant  diuretic,  432 

Potassium  chloride,  causes  great  con- 
traction of  the  vessels,  281 ;  neutralises 
the  action  of  veratrine  in  certain  cases, 
308 

Potassium  chromate,  action  of,  on  bac- 
teria, 94 

Potassium  citrate,  as  a  remote  antacid, 
370  ;  and  refrigerant  diuretic,  432 

Potassium  iodide,  action  of,  on  bacteria, 
93  ;  as  a  depressant  expectorant,  255 

Potassium  nitrate,  as  a  refrigerant  diu- 
retic, 432 

Potassium  permanganate,  action  of,  on 
bacteria,  94 

Potassium  picrate,  effects  of,  in  destroy- 
ing bacteria,  89 

Potassium  sulphate,  as  a  hepatic  stimu- 
lant, 403 

Potassium  tartrate,  as  a  remote  antacid, 
370  ;  as  a  saline  purgative,  389  ;  and 
sodium,  as  ditto,  389 

Potato  and  potato  water,  experiments 
with,  on  oxygen,  69 

Poultice,  action  of  a  warm,  on  the 
mucous  membrane,  252;  and  on  the 
chest,  256  ;  use  of  a  warm,  in  inflam- 
mation, 841,  342;  as  an  emollient, 
347 ;  uses  of,  and  how  to  apply  different 
kinds  t)f,  with  diagram,  468  ;  a  linseed, 
877 

Poultices,  or  cataplasms,  506 

Powders,  524 

Power,  Mr.,  references  to,  430,  997 

Prayer-beads,  903 

Precipitated  sulphur,  its  preparation, 
&c,  644 

Pregnancy,  best  mode  of  treating  the 
vomiting  of,  377 

Preventivemedicine,  growing  importance 
of,  5  ;  chiefly  owing  to  recent  increase 
in  knowledge  of  microbes  and  their 
action  in  causing  disease,  5 

Prevost  on  poisoning  by  mercury,  20 

Preyer,  references  to,  150,  492 

Prickly  ash,  883 

Prinus,  (black  alder),  characters  and 
action  of,  as  an  astringent,  894 

Prolapsus  of  the  uterus,  emetics  to  be 
used  with  caution  in  persons  suffering 
from,  376 

Prophylactic,  quinine  as  a,  948 

Prophylaxis.    See  Preventive  medicine 

Protoplasm,  action  of  drugs  on,  59-63  ; 
method  of  experimenting  on  amoebae 
and  leucocytes,  59,  60  ;  relation  of  mo- 
tion and  oxidation  to,  65;  oxidation 
of,  67  ;  oxygen-carrying  power  of,  68  ; 
potassium  salts  poison  or  destroy,  605 

Protoplasmic  poison,  anaesthetics  act  as 
a,  206 ;  and  potassium  salts,  605 


Prune,   composition    and    use  of,  917 

Virginian  prune,  or  wild  cherry,  917 
Prunes,  as  a  laxative,  389 
Prussic  acid,  586 

Ptomaines,  alkaloids  formed  by  putrefac- 
tion, 99  ;   absorption  and  elimination, 
101;  action  of,  on  muscle,  128;  how 
formed,  401 
Ptyalin,  75 

Puerperal  fever,  micrococci  present  in, 
99  ;  singular  cause  of  an  epidemic,  104 
Pulmonary  sedatives,  nature,  number,  and 
uses  of,  246-250;   divided  into  three 
classes,  246 
Pulsatilla,  characters  and  composition  of, 
836  ;  action  of  the  oil  of,  as  a  vesicant, 
836 ;  pure  anemonin  has  a  depressant 
action  on  the  circulation,  respiration, 
and  spinal  cord,  836;  causing  feeble 
pulse,  slow  respiration,  paralysis,  dys- 
pnoea, and  death,  837 ;  uses  of,  as  a 
diaphoretic  and  emmenagogue,  837 
Pulse-rate,  relation  of,  and  arterioles,  to 
blood  pressure,  271;    diagrams   of  a 
pulse-curve,  272  ;  effect  of  the  arteri- 
oles on  pulse-curves,  275 ;    effect  of 
drugs  on  the,  295 ;  of  irritant  poisons 
on,  397 ;    of  arsenic,  715 ;   of  nitrite 
of  amyl,  785 ;  of  chloral  hydrate,  791 ; 
of  purified  chloroform,  798 ;  of  carbolic 
acid,  814 ;  of  creosote,  817 ;  of  staphi- 
sagria,  836 ;    of    anemonin,    837 ;    of 
hydrochlorate  of  apomorphine,  849 ;  of 
erythroxylon,  879 ;   of    caffeine,  871 ; 
of  Jamaica  dogwood,  913;   of  oil  of 
valerian,  952 ;  of  gelsemium,  978 ;  of 
tobacco,  993 ;    of  camphor,  1019 ;   of 
Indian   hemp  or  American  cannabis, 
1027;   of  squill,  1041;   of  hellebore, 
1045 ;  of  veratrine,  1047 
Pulvis  amygdalae  compositus,  524,  914, 
915,  1065 
Antimonialis,  524,  652,  726,  729 
Aromaticus,  524,  1015,  1016,  1037, 

1038 
Catechu  compositus,  524,  868,  902, 

951,  1015,  1016 
Cinnamomi  compositus,  524,  1016, 

1037,  1038 
Cretse   aromaticus,  524,  650,  1015, 
1016,  1038,  1039, 1055 
Aromaticus  cum  opio,  524,  650, 

844 
Compositus,  524,  650,  1055 
Effervescens  compositus,  624 
Elaterini  compositus,  524,  929, 1080 
GlycyrrhizsB    compositus,  524,   643, 

899,  910,  934,  1055 
Ipecacuanhas  compositus,  524,  611, 
844,  949 
Et  opii,  524,  845,  949 
Jalapae  compositus,  524,   610,   982, 

1037 
Kino  compositus,  524,  844,  902, 1016 


GENEEAL  INDEX. 


1157 


Pulvig — 

Morphines  oompositus,  524,  848 
Opii  oompositus,  624,  844,  901,  936, 

1037 
Rhei  oompositus,  624, 661, 1010, 1037 
Scammonii  oompositus,  524, 982, 1037 
Tragacanthae  oompositus,  524,   901, 
914,  1053,  1055 

Pumpkin  seed,  composition  and  uses  of, 
as  an  anthelmintic,  930 

Pupil  of  the  eye,  structure  of,  and  action 
of  drugs  on  the,  216-227 

Purgatives,  aid  the  action  of  antiperi- 
odics,  and  sometimes  cure  ague  with- 
out them,  108  ;  nature  of,  388 ;  divided 
into  laxatives  (list  of  the  chief),  389 ; 
simple,  389 ;  drastic,  389 ;  saline,  389  j 
hydragogues,  389 ;  and  oholagogues 
390;  action  of,  390;  Dr.  Hay's  re- 
searches into  the  action  of,  391-394  ; 
the  various  uses  of,  394, 395 ;  to  remove 
fecal  matters  from  the  intestinal  tube, 
394  ;  to  remove  liquid  from  the  body, 
394 ;  to  lower  the  temperature  in  fever, 
395 ;  to  lower  the  blood-pressure,  395  ; 
they  act  as  hepatic  depressants,  407  ; 
as  antipyretics,  421  ;  as  anaphrodisiaos, 
451 ;  as  indirect  emmenagogues,  453  ; 
resin  of  podophyllum  as  a,  839  ;  gam- 
boge as  a,  869  ;  buckthorn  as  a,  896  ; 
senna  as  a,  910;  tamarind  as  a,  911 ; 
olive  oil  as,  967  ;  manna  as,  968  ;  rhu- 
barb as,  1011 ;  castor  oil  as,  1024  ;  oil 
of  turpentine  as,  1059  ;  aloes  as,  1044 ; 
treacle  as,  1056  ;  oatmeal  as,  1056 

Putrefaction,  alkaloids  formed  by,  100, 
101 ;  antiseptics  arrest  the,  104,  105 

Putrescine,  100 

Pyaemia,  micrococci  present  in,  99 

Pye,  Mr.,  references  to,  296,  430 

Pye-Smith,  Dr.,  references  to,  381,  988 

Pyrethrum,  952 

Pyrethrum,  as  a  sialagogue,  357 

Pyridine,  in  treatment  of  asthma  (as 
tobacco-smoke),  261 ;  action  and  uses, 
823 

Pyrocatechin,  characters,  action  and  uses 
of,  819 

Pyrophosphate  of  iron,  752 

Pyrophosphate  of  sodium,  628 ;  action  of, 
on  the  nerve-centres  of  the  spinal  cord, 
&c,  712 

Pyroxylin,  873 

Pyroxylinum,  873 

o. 

Quassia,  as  a  vermicide,  408 

Quassia    and    quassia   wood,  properties 

and  composition  of,  892 ;  action  and 

uses  of,  892 ;  is  simply  a  pure  bitter 

stomachic,  892 
Quebracho,  as  a  depressant  expectorant, 

255 


Quebracho  bark,  white,  characters,  action, 

and  uses  of,  969 
Queen's  root.    See  Stillingia 
Quercus  alba,  the  bark  of,  1030 ;  char- 
acters, action  and  use  of,  as  a  local 
astringent,  1031 
Quillaia  (saponin),  characters,  composi-   ■ 
tion,  action,  and  uses  of,  918  ;  action 
of,  as  a  local  irritant,  918 ;  produces 
local  paralysis  and  anaesthesia,  918 ; 
action  of,  on  the  voluntary  muscles, 
the  intestine,  and  the  heart,  918 ;  on 
digitalis,  and  on    the    nerve-oentres, 
919 
Quince  seed,  characters  and  use  of,  921 
Quinicine,  constitution  of,  824 
Quinidinse  sulphas,  504,  944 
Quinidine,  sulphate  of,  943 
Quinina,  504,  944 
Quininae  sulphas,  504,  939,  944 
Bisulphas,  944 
Hydrobromas,  944 
Hydrochloras,  943 
Valerianas,  944,  952 
Quinine,  example  of  the  empirical  use  of, 
3 ;  utility  of,  in  ague,  3  ;  action  of,  on 
protoplasmic  movements,    61-63 ;    on 
the  mesentery  of  a  frog,  62 ;   on  in- 
fusoria, 65;  effects  of,  on  oxidation,  69, 
72 ;  on  bacteria,  89,  94,  95  ;  as  a  disin- 
fectant, 106 ;  as  an  antiperiodic  almost 
a  specific  in  intermittent  fevers,  peri? 
odio  headaches,  neuralgias,  &c,  107; 
action  of,  on  ascidians,  114  ;  on  annu- 
losa,  114;  on- muscle,  128  etseg.;  on 
the  spinal  cord  of  a  frog,  166;  on  the 
ear,*229 ;  on  taste,  230  ;  on  the  respi- 
ratory centre,  241 ;  on  the  frog's  heart, 
306;  on  the  motor  ganglia,  316;   on 
the  capillaries,  318 ;  on  the  secreting 
cells  of  a  gland,  354  ;  arrests  secretion 
of  saliva,  361 ;  lessens  tissue-change, 
415  ;  as  an  antihidrotic,  441 ;  value  of, 
in  the  high  temperature  of  the  night 
sweats  of  phthisis,  443 ;   as  a  direct 
emmenagogue,  453 ;  one  of  the  chief 
ecbolics,  454 ;    as  a  poison,  with   its 
antidotes,  489 ;  antagonism  of,  to  atro- 
pine, 495 
Quinine,  characters  and  action  of,  942 
Bisulphate  of,  942 
Hydrobromate  of,  942 
Hydrochlorate  of,  943  • 
Sulphate  of,  942 
Valerianate  of,  943 
Physiological  action  of — general  ac- 
tion, 944-948 ;  special  action — on 
the  alimentary  canal,  945 ;  on  the 
stomach,  945 ;  on  the  blood,  945  ; 
on  the  circulation,  945 ;    on   the 
heart    and    respiration,  946;    on 
tissue«change,  and  on  the  nervous 
system,  946;  on  the  spinal  cord, 
947  J  on  the  muscles  and  uterus, 


1158 


GENEEAL  INDEX. 


947 ;  uses — as  an  antiseptic,  a 
tonic,  and  an  antiperiodic,  947  ;  as 
an  antipyretic  and  a  prophylactic, 
948 ;  Warburg's  tincture,  948 


K. 


Babbits,  experiments  with  drugs  on, 
54-56  ;  two  kinds  of  muscles  in,  red 
and  white,  119;  number  of  stimuli 
necessary  to  cause  tetanus  in  the  latter, 
125  ;  Stenson's  experiment  on  the  ab- 
dominal aorta  of,  164;  the  cerebral 
hemispheres  of,  more  developed  than 
those  of  the  frog,  184;  effect  of  the 
removal  of  the  cerebrum  on,  184 ; 
easiest  way  of  anaesthetising,  210,  211 ; 
effect  of  injecting  drugs  into  the 
jugular  vein  of,  239 ;  effect  of  the 
inhalation  of  tobacco-smoke  on,  244 ; 
experiment  on  the  ear  of,  279 ;  method 
of  maintaining  artificial  circulation  in 
the  ear  of,  280  ;  action  of  the  heart  in, 
287-289  ;  difference  between  dogs  and, 
in  this  respect,  287 ;  the  vagus  centre 
in,  stimulated  through  the  nasal  nerves, 
296 ;  Ziilzer's  experiments  with,  342  ; 
experiments  with,  as  to  the  antagonism 
of  drugs,  493 

Kabuteau,  reference  to,  28 

Radicals,  compound,  nature  of,  20;  of 
carbon,  22,  23 ;  of  nitrogen,  23 ;  of 
phosphorus,  arsenic,  antimony,  and 
.  sulphur,  24 ;  most  of-  them  possess  » 
paralysing  power  over  the  motor 
nerves,  32 

Eaisins,  composition  and  uses  of,  896 

Males,  moist,  nature  and  treatment  of,  252 

Eanke,  reference  to,  175 

Eanunculacea?,  831  et  sej. 

Eanvier,  L.,  references  to,  50,  176,  336, 
337 

Raspberry,  characters  and  use  of,  919 

Eat  paste,  as  a  poison,  with  its  antidote, 
491 

Rational  therapeutics,  explanation  and 
example  of,  3 

Rattle-snake  poison,  action  of,  on  the  red 
corpuscles  of  the  blood,  63 

Rectum,  action  of  aloes  on  the,  1044 

Red  cinchona,  940 
Bark,  940 

Red  poppy  petals,  characters,  composi- 
tion, and  use  of,  862 

Red  rose,  and  red  rose  petals,  920 

Red  sandal-wood,  901 

Red  saunders,  nature  and  use  of.  901 

Refined  silver,  676 

Refrigerants,  nature  and  uses  ol,  360; 
tamarind  as  a,  911 

Regnard,  reference  to,  94 

Regurgitation,  mitral  and  tricuspid,  na- 
ture and  cause  of,  332 ;  value  of  digi- 


talis and  other  cardiac  tonics  in,  332, 
333 ;  the  question  of  the  use  of  digi- 
talis in  aortic  regurgitation  considered, 
333  ;  diagram  to  illustrate  the  tendency 
to  syncope  in  aortic,  334 

Reichert,  reference  to,  588 

Remedies  acting  on  the  surface  op 
the  body,  340-351 ;  irritants  and 
counter-irritants,  340-347;  subdivided 
into  four  classes,  340 ;  rubefacients  and 
their  uses  in  chronic  and  acute  inflam- 
mation, 340-345 ;  diagrams  illustra- 
tive of  the  action  of,  341-343 ;  list  of 
the  principal  rubefacients,  344;  friction 
one  of  the  simplest,  344 ;  vesicants  and 
their  uses,  345;  pustulants,  346;  and 
caustics,  346  ;  general  uses  of  caustics, 
346 ;  emollients  and  demulcents,  347 ; 
list  of  the  principal  demulcents,  347 ; 
and  emollients,  347 ;  action  of  demul- 
cents and  emollients,  347,  348  ;  their 
therapeutic  uses,  348;  astringents, 
local  and  remote,  and  their  uses,  349, 
350;  styptics  and  their  action,  350, 
351 

Resin,  composition  and  use  of,  1061 

Resin  of  podophyllum,  preparation,  cha- 
racters, and  composition  of,  838 ;  action 
of,  as  a  drastic  purgative,  and  a  hepatic 
stimulant,  839  ;  uses  of,  839 

Resin  of  scammony,  981 
Jalap,  982 

Resina  Copaibse,  525, 912 
Guaiaci,  525 
Jalapas,  525,  982 
Podophylli,  525,  838 
Scammonias,  525,  980,  981 
Scammonii,  525,  980,  981 

Resins*  524 

Eesorcin,  characters  of,  818 ;  action  of, 
as  an  antiseptic,  818  ;  on  frogs,  warm- 
blooded animals,  and  man,  818;  uses 
of,  818 ;  utility  of,  as  an  antipyretic,  818 

Respiration,  action  of  drugs  on,  232- 
261 ;  respiratory  stimulant  s  and  depres- 
sants, 232 ;  mechanism  of,  in  some  of 
the  lower  organisms,  232, 233 ;  diagrams 
illustrative  of  this,  233 ;  in  the  higher 
organisms,  234  ;  muscles  of,  235  ;  cen- 
tres of,  234-237 ;  certain  conditions  of, 
called  apnoea,  dyspnoea,  and  convul- 
sions, 237  ;  action  of  certain  conditions 
of  the  blood  on,  237,  238  ;  result  of  the 
presence  or  absence  of  air  on  external 
and  internal,  238-240 ;  action  of  drugs 
on  the  centre  of,  240-244  ;  diagram 
showing  position  of  the  centre  of,  and 
the  afferent  nerves  which  influence  it, 
242 ;  method  of  testing  the  movements 
of,  243  ;  action  of  drugs  on  the  nerves 
of,  244 ;  of  irritant  poisons  on,  397 ; 
action  of  hydrocyanic  acid  on,  588; 
of  strong  solution  of  ammonia,  639  ;  of 
mercury,   686 ;  of  gold,  754 ;  purified 


GENEEAL  INDEX. 


1159 


chloroform,  798-800 ;  of  creasote,  817  ; 
of  salicylic  acid,  820 ;  of  antipyrin, 
824 ;  of  aconitine,  834 ;  of  staphisagrine, 
or  stavesacre,  836 ;  of  anemonin,  837  ; 
of  erythroxylon,  879  ;  of  cafieine,  871 ; 
of  pilocarpine,  885 ;  of  pbysostigmine, 
906 ;  of  quinine,  946 ;  of  strychnine, 
974  ;  of  solanine,  983 ;  of  belladonna 
or  atropine,  988  ;  of  digitalin,  996 ;  of 
thymol,  1006  ;  of  monobromated  cam- 
phor, 1019  ;  of  Indian  hemp  or  American 
cannabis,  1027 ;  of  oil  of  turpentine, 
1058  ;  of  veratrine,  1048 ;  of  extract  of 
ergot,  1072 

Eespiratory  centre,  nature  and  functions 
of,  233-237;  action  of  drugs  on  the, 
240, 241 ;  diagram  showing  the  position 
of  the,  and  the  afferent  nerves  which 
influence  it,  242 ;  action  of  drugs 
on  the  respiratory  nerves,  244;  of 
sternutatories,  245  ;  of  pulmonary  se- 
datives, 246-250 ;  drugs  which  increase 
the  activity  of  the,  254 ;  connection  of 
the,  with  the  sweat-glands,  443 ;  action 
of  gold  on  the,  754 ;  of  alcohol,  770 ;  of 
carbolic  acid,  814 ;  of  quillaia  (saponin), 
919  ;  of  musk,  1078 

Bespiratory  passages,  in  disease  of  the, 
warmth  usually  applied  by  means  of 
inhalation,  348 ;  action  of  gold  on  the, 
754 
.  Bespiratory  sedatives,  246 

Bespiratory  tract,  remedies  which  If  ssen 
irritation  of,  249  ;  action  of  opium  on 
the,  860 

Betina,  action  of  drugs  on,  226,  227 

Bhamneaj,  895 

Ehamnus  Frangula,  895 
Purshiana,  895 

Ehamnus,  as  a  purgative,  389 

Bhatany  root,  composition,  action,  and 
use  of,  chiefly  as  an  astringent,  868 
,  Eheochord,  Du  Bois-Beymond's,  119 

Eheum,  1010 

Rheumatic  gout,  remarkable  instance  of 
accidental  cure  in,  341 

Bhodium,  symbol  and  atomic  weight  of, 
10 

Bhubarb,  as  a  sialagogue,  357  ;  as  a  pur- 
gative, 389 ;  and  as  a  cholagogue,  390 ; 
as  a  hepatic  stimulant,  403 ;  as  a  cho- 
lagogue purgative,  405 

Bhubarb,  1011 

Boot,  characters  and  composition  of, 
1010  ;  action  and  uses  of,  1011 ;  as  a 
tonic,  astringent,  and  purgative,  1011 

Ehus  aromatica,  in  incontinence  of  urine, 
898 

Ehus  glabra  (sumach),  nature  and  uses 
of,  as  an  astringent,  898 

Ehus  toxicodendron  (poison  ivy),  as  a 
vesicant,  344;  characters,  action,  and 
uses  of,  898 

Eibbert,  reference  to,  424  and  ». 


Eichardson,  B.  W.,  reference  to,  708 

Eichet,  reference  to,  125 

Eigollot's  mustard  leaves,  usefulness  of, 

864,  865 
Einger,  Dr.  S.,  references  to,  46, 219,  306, 
308,  339,  493,  568,  671,  688,  716,  975, 
996 
Roberts,  Sir  W.,  reference  to,  363 
Bochelle  salt,  as  a  hepatic    stimulant, 

403  ;  nature  and  uses  of,  624 
Rodentia,  1077 
Rohrig,  reference  to,  402 
Bomanes,  references  to  his  researches  on 

the  medusas,  109,  110,  112 
Root,  Aconite,  831 
Arnica,  957 
Bark,  cotton,  872 
Bark,  pomegranate,  926 
Belladonna,  985 
Black  snake-,  837 
Blood,  863 
Calumba,  840 
Colchicum,  1049 
Culver's,  1001 
Dandelion,  956 
Gentian,  979 
Hemidesmus,  970 
Horse-radish,  866 
Liquorice,  899 
Pareira,  841 
Pellitory,  952 
Phytolacca,  1009 
Pink-,  978 
Pleurisy,  970 
Podophyllum,  838 
Poke,  1009 
Queen's,  1022 
Rhatany,  868 
Rhubarb,  1010 
Sassafras,  1020 
Scammony,  980 
Senega,  867 
Sumbul,  937 
Rosacese,  915 
Rosaniline,  920 
Rose,  dog-,  fruit  of  the,  920 

Oil  of,  characters,  &c,  of,  920 
Pale,  920 
Red,  920 

Petals,  920 
Roseaj,  920 
Roseine,  822 
Rosemary,  characters  of,  1002 

Oil  of,  characters,  actions  and  use  of, 
1002  ;  as  a  stimulant  and  carmi- 
native, 1003 
Rosenberger,  on  bacteria,  85 
Rosenthal,   Professor  J.,  references  to, 

127,  174,  242,  995 
Rossbach.i  references  to,  59,  64  ;  on  bac- 
teria, 85,  248,  252,  253,  417,  440,  493, 
606,  873,  1032 
Rovighi,  reference  to,  190 
Boy's  tonometer,  269 


1160 


GENEBAL  INDEX. 


Rubefacients,  and  their  action  in  chronic 
and  acute  inflammation,  340-344 ;  list 
of  the  principal,  344 ;  friction  one  of 
the  simplest,  344 ;  acids  as,  568  ;  oil  of 
rue  as  a,  881 ;  oil  of  myrtle  as  a,  924 ; 
oil  of  cajeput,  924 ;  camphor  as,  1018 

Rubiaceae,  939 

Rubidium,  symbol  and  atomic  weight  of, 
10 ;  physiological  action  of,  27 ;  action 
of,  on  the  muscles,  135,  142 

Rubus,  characters  and  uses  of,  919 

Rue,  as  a  direct  emmenagogue,  453 

Rue,  oil  of,  nature  and  use  of,  881 ;  is 
a  rubefacient,  antispasmodic,  and  an 
emmenagogue,  881 

Rumex,  characters  of,  1011 ;  action  of  as 
an  astringent,  1011 

Ruminantia,  1077 

Russell  and  Lapraik,  reference  to,  28 
.Russian  bath,  account  of  the  so-called, 
470 

Rutaceas,  881 

Ruteas,  881 

Ruthenium,  symbol  and  atomic  weight 
of,  10 

Rutherford,  reference  to,  402,  407,  839 

Rye,  ergot  of,  1068 


S. 


Saccharated  carbonate  of  iron,  742 
Ferrous  carbonate,  742 
Iodide  of  iron,  750 

Saccharine,  properties  and  uses,  826 

Saccharine  substances  are  stimulating 
expectorants,  256 

Saccharine  solution  of  lime,  as  a  direct 
antacid,  370 

Sachs,  reference  to,  151 

Saffron,  1038  ;  as  a  colouring  agent  and 
carminative,  1039 

Sage.    See  Salvia 

St.  Bartholomew' &  Hospital  Reports,  re- 
ference to,  167,  n. 

Sal  volatile,  as  a  cardiac  stimulant,  328  ; 
composition  and  uses,  641 

Salad  oil  (French),  action  of,  on  bacteria, 
93 

Salicaceae,  1034 

Salicin,  character,  action,  and  uses  of, 
1034  ;  as  an  antipyretic,  1035 

Salicinum,  505 

Salicylates,  test  for,  595 

Salicylate  of  lithium,  632 

Salicylate  of  sodium,  action  of,  in  produc- 
ing visions,  228  ;  on  the  ear,  229  ;  nature 
of,  628 

Salicylates,  antiperiodics,  107 

Salicylic  acid,  action  of,  on  enzymes,  78 ; 
bacteria,  91,  94,  95;  an  antiperiodic, 
107 ;  on  the  vaso-motor  centre,  3]  9  ; 
on  the  cardiac  muscle,  316 ;  on  the 
pancreatic  juice,  408 ;  characters  and 


tests  of,  820 ;  action  of,  in  preventing 
the  development  of  bacteria,  820 ;  on 
the  temperature,  pulse  rate,  blood- 
pressure  and  respiration,  and  the  ears, 
820 ;  on  the  circulation,  820 ;  how 
excreted,  820;  uses  of,  820;  natural 
versus  artificial,  1035 

Saline  solutions,  effects  of,  on  infusoria, 
64 

Saliva,  cause  of,  and  mode  of  secretion, 
353-357 ;  diagram  representing  the 
general  relation  of  nerves  to  the  se- 
creting cells  and  vessels  of  a  gland,  354 ; 
diagram  to  show  the  nerves  by  which 
the  secretion  may  be  excited,  355  ; 
various  causes  which  stimulate  the 
secretion  of,  356  ;  action  of  sialagogues 
on  the  secretion  of,  357 ;  excretion  by 
the,  358 ;  diagram  of  the  gastro-salivary 
circulation,  359 ;  uses  of,  359 ;  action  of 
erythroxylon  on  the  secretion  of,  879 ; 
of  caffeine  on  ditto,  871 ;  of  Jamaica 
dog-wood,  913  ;  of  pellitory  root,  953 

Salivary  centres,  action  of  carbolic  acid 
on  the,  814 

Salivary  glands,  action  of  drugs  on,  353 ; 
of  cantharides  on  the,  1092 

Salivation,  produced  by  mercury,  682 ; 
what  it  is  in  part  due  to,  686  ;  action 
of  gold  in  producing,  754 ;  of  curare, 
976 

Salix,  characters,  composition,  and  use  of, 
1034 

Salt,  effects  of  common,  on  protoplasmic 
movement,  60 ;  ori  bacteria,  93  ;  as  a 
local  emetic,  373 ;  as  a  refrigerant 
diuretic,  432  ;  effects  of,  in  large  quan- 
tities, on  the  general  system,  600 

Salts,  inorganic,  isomorphic,  ferrous, 
manganous,  ferric,  physiological  action 
of,  27 ;  of  barium,  action  of,  on 
muscles,  130;  of  zinc  and  copper, 
action  of,  on  the  respiratory  centre, 
241 ;  results  of  experiments  with  seve- 
ral metallic,  281 ;  of  calcium  and  dis- 
tilled water,  prolong  the  beating  of 
the  frog's  heart,  306 

Salts  of  the  cinchona  alkaloids,  944 

Salts  of  the  heavier  metals  as  astringents, 
349 

Salvia,  characters,  action,  and  uses  of, 
1008 ;  as  a  tonic,  carminative,  and  an 
astringent,  1008 

Samarium,  symbol  and  atomic  weight  of, 
10 

Sandal  wood,  red,  901 

Sanguinaria  (bloodroot),  action  of,  on 
the  vaso-motor  centre,  319 ;  as  an 
alterative,  413;  characters  and  com- 
position of,  863;  action  of,  on  the 
intestinal  canal,  and  the  medullary 
centres,  863 ;  on  the  brain  and  spinal 
cord,  863 ;  chiefly  used  as  a  stimulant 
expectorant,  863 


GENEEAL  INDEX. 


1161 


Sanitas,  nature  and  use  of,  1060 

Santal,  oil  of,  characters,  action,  and  use 
of,  1021 

Santalaceae,  1021 

Santini,  reference  to,  190 

Santonica,  as  a  vermicide,  408 ;  as  a 
stimulant  diuretic,  433 ;  characters 
and  composition  of,  954 

Santonin,  as  a  vermicide,  408 ;  characters 
and  preparation  of,  954 ;  action  of,  on 
the  cerebrum  and  medulla  of  the  frog, 
954;  effects  of  large  doses  on  man, 
955;  action  of,  on  the  vision  and  on 
the  urine,  955 ;  used  only  as  a  vermi- 
cide, 955 

Santoninate  of  sodium,  629 

Santoninum,  505,  954 

Sapindaceas,  897 

Saponin,  action  of,  on  the  respiratory 
centre,  241 ;  on  the  nose,  245 ;  as  a 
stimulating  expectorant,  255  ;  action 
of,  on  the  vagus-ends  of  the  heart, 
317;  on  the  inhibitory  ganglia,  317; 
on  the  cardiac  muscle,  316 ;  on  the 
heart,  338 ;  antagonistic  action  of, 
494-496 ;  nature,  action,  and  uses  of, 
918.     Vide  also  Quillaia 

Sapotacese,  963 

Saprine,  100 

Sarsaparilla,  as  an  alterative,  413 ;  as  a 
stimulant  diuretic,  433;  nature  and 
action  of,  1051 ;  as  a  diuretic,  tonic, 
and  alterative,  1052 

Sassafras,  characters  of,  1020 

Oil  of,  1020  ;  action  and  use  of,  as  a 

diaphoretic,  1020 
Pith,  characters  and  uses  of,  1020 ; 

as  a  demulcent,  1020 
Boot,  characters  and  composition  of, 
1020 

Sassy  bark,  action  of,  on  the  nose,  245 ; 
composition,  action,  and  use  of,  915 

Savin,  as  a  stimulant  diuretic,  433 ;  as 
a  direct  emmenagogue,  453 ;  as  a  chief 
ecbolic,  454 ;  as  a  poison,  with  its 
antidotes,  491 

Savine,  1064 

Tops,  1064 

Saunders,  red,  nature  and  use  of,  901 

Scammony,  as  a  drastic  purgative,  389  ; 
as  a  vermifuge,  408 

Scammony,  characters,  &c,  of,  980 

Eesin  of,  981 ;  action  and  use  of,  as 
a  drastic  purgative  and  a  vermi- 
fuge, 982 
Root,  980 

Scandium,  symbol  and  atomic  weight  of, 
10 

Scharrenbroich,  reference  to,  72 

Schiif,  Professor,  references  to,  236,  297, 
363,  399,  715 

Schizomycetes,  82.    See  Bacteria 

fichlesinger,  reference  to,  102 

Schmidt-Mulheim,  reference  to,  399 


Schmiedeberg,  Professor,  references  to, 
56. 100, 142, 294, 312, 492, 995,  997, 1098 

Schbnlein,  reference  to,  133 

Schroeder,  Von,  reference  to,  859 

Schroff,  Von,  references  to,  151,  158, 
228 

Schroff  (junr.),  reference  to,  863 

Schulte,  reference  to,  72 

Schultzen,  Otto,  reference  to,  850 

Schweigger-Seidel,  reference  to,  426 

Scillain,  action  of,  on  the  cardiac  muscle, 
316 ;  as  a  cardiac  tonic,  331 

Scoparin,  900 

Scurvy,  due  to  imperfect  nutrition,  412 ; 
is  supposed  to  be  due  to  a  deficiency 
of  potassium  salts  in  the  blood,  412  ;  is 
removed  by  fresh  vegetables  or  lime- 
juice,  412 

Scutellaria,  1008  ;  characters  and  uses  of, 
1008 ;  has  been  used  as  a  nervine  tonic, 
1008 

Scybala,  diagram  illustrating  diarrhoea 
depending  on  the  presence  of,  in  the 
intestine,  388 

Sea-bathing,  469 

Secretion,  from  the  bronchial  tubes,  250 ; 
from  the  air-passages,  251 ;  nature  of 
the,  from  the  mucous  membrane,  251  ; 
action  of  drugs  on  the,  252  ;  action  of 
belladonna  or  atropine  on,  250,  988 

Secretion,  in  the  stomach,  action  of  drugs 
on, 363 

Secretions,  action  of  opium  on  the,  853 ; 
physostigmine,  907 

Sedatives,  nature  and  uses  of,  157  ;  pul- 
monary, 246-250  ;  cardiac,  338,  339  j 
vascular,  339 ;  gastric,  376 ;  vesical* 
444 ;  urinary,  445 

Seed,  American  worm-,  1009 
Oil,  cotton,  872 
Oil  of  flax,  877 
Pumpkin,  930 
Quince,  921 

Seeds,  Colchicum,  1049 
Jequirity,  903 
Stramonium,  991 

Seegen,  Professor,  references  to,  399,  538 

Selective  action  of  drugs,  34 

Selenic  acid,  physiological  action  of,  27 

Selenium,  symbol  and  atomic  weight  of, 
10 

Senega  root,  composition,  preparation, 
action,  and  use  of,  867,  868 ;  as  a 
stimulating  expectorant,  diuretic,  and 
diaphoretic,  868  ;  as  a  general  emetic, 
373.    See  also  Saponin 

Senna,  characters,   composition,  action, 
and  uses  of,  909 
Alexandrian,  909 
Tinnevelly,  909 

Sensation,  anaesthetics  destroy,  203 

Septic  poisoning,  and  bacteria,  88 ;  effects 
of,  and  modes  in  which  it  may  be  pro- 
duced, 104,  105 


1162 


GENEEAL  INDEX. 


Series,  arrangement  of  the  animal  king- 
dom and  of  the  elements  in,  17  j  Men- 
delejeff  and  Meyer  the  perfeoters  of 
this  system  of  classification,  17 ;  Men- 
delejeff's  classification  in,  19 ;  differ- 
ence in  the  even  and  uneven  series,  18 ; 
irregularities  in  the  system,  18,  20 

Serpentaria,  1012 

Serpentary  Rhizome,  characters,  action, 
and  uses  of,  1012 ;  as  a  tonic,  diapho- 
retic, and  diuretic,  1012 

Serum,  and  blood,  action  of,  on  the  frog's 
heart,  308,  309 

Sesamum,  oil  of,  characters  and  action 
of,  1002 

Setschnow's  centres,  165 ;  experiment  on 
a  frog,  166 

Severini,  reference  to,  282 

Shenstone,  Mr.,  reference  to,  975 

Sherry,  characters  and  uses  of,  776  :wine, 
896 

Shorthouse,  Dr.,  reference  to,  215 

Sialagogues,  nature  and  action  of,  353- 
356  ;  diagrams  illustrative  of  the 
nerves  and  glands  acted  on  by,  354, 
355 ;  divided  into  three  classes,  reflex, 
specific,  and  mixed,  356,  357 

Sialics,  and  anti-,  nature  and  action  of, 
360 

Silicon,  symbol  and  atomic  weight  of, 
10 ;  its  relation  to  other  members  of  a 
group, 16 

Silver,  symbol  and  atomic  weight  of,  10 ; 
physiological  action  of,  27 

.  Silver,  characters,  action,  and  uses  of — 
Cyanide  of,  679 
Iodide  of,  680 
Nitrate  of,  676 

Diluted,  677 
Moulded,  677 
Oxide  of,  679 
Refined,  676 

Silver  nitrate,  as  a  caustic,  344 ;  as 
an  astringent,  349;  as  a  local 
sedative,  376 

Simarubacese,  892 

.  Simpson,  Sir  J.  Y.,  his  mode  of  adminis- 
tering chloroform,  209 ;  and  discovery 
of  the  use  of,  as  an  anesthetic,  212 

Sipping,  the  action  of,  a  powerful  stimu- 
lant to  the  brain,  194;  increases  the 
secretion  of  the  bile,  406 ;  and  abolishes 
the  inhibitory  action  of  the  vagus  on 
the  heart,  406  ;  the  value  of  Carlsbad 
water  in  hepatic  disease  is  probably 
owing  to  its  being  taken  in  sips,  407 

,Sitz  bath,  cold,  464;  hot,  467 

Skatol,  action  of,  on  bacteria,  94 

Skin,  Action  of  Detjgs  on  the,  437-443; 
as  diaphoretics  and  sudorifics,  437; 
effects  of  warmth  on  the,  437 ;  excretion 
by  the  sweat-glands,  439  ;  relation  be- 
tween sweat-glands  and  kidneys,  439  ; 
action  of  the,  in  regulating  tempera- 


ture,440;  antihidrotics,  or  anhidrotics, 
441 ;  diagram  to  illustrate  the  action 
of  anhidrotics,  442;  the  night-sweats 
of  phthisis,  442 ;  cause  of  profuse  sweat- 
ing, 443  ;  application  of  drugs  by  the, 
457 ;  three  methods  of  applying  drugs 
to  the — (1)  by  epidermic  application, 
457-459 ;  power  of  absorption  of  the, 
458,  459 ;  by  baths,  459 ;  the  cold  bath, 
460 ;  objects  of  the  cold  bath,  460-463 ; 
the  cold  pack,  463 ;  cold  sponging,  463; 
cold  douches,  463 ;  the  sitz  bath,  464; 
cold  foot-bath,  465 ;  cold  compresses, 
465;  tepid  baths,  466;  warm  baths, 
466 ;  hot  baths,  467 ;  hot  foot-bath, 
467;  hot  sitz  bath,  467;  poultices, 
468 ;  medicated  baths,  469 ;  acid  bath, 
469 ;  alkaline  baths,  470 ;  sulphurous 
baths,  470;  the  mustard  bath,  470; 
the  pine  bath,  470;  vapour  baths,  470; 
calomel  fumigation,  471 ;  air  baths, 
471 ;  the  Turkish  bath,  471 ;  by  friction, 
472;  by  inunction,  473;  (2)  by  endermic 
application,  474;  (3)  by  hypodermic 
application,  474;  diagram  of  syringe 
for  hypodermic  injection,  475;  ob- 
jections to  hypodermic  injections,  476; 
action  of  hydrocyanic  acid  on  the, 
586  ;  of  alkalies,  697  ;  soda  as  a  stimu- 
lant to  the,  620 ;  of  dried  alum,  655  J 
of  nitrate  of  silver,  677 ;  of  arsenic, 
713 ;  of  antimony,  722 ;  of  iron  salts, 
739 ;  of  alcohol,  767,  772  ;  of  spirit  of 
ether,  781 ;  of  purified  chloroform,  797 ; 
of  opium,  861 ;  of  mustard,  865 ;  of 
pilocarpine,  886  ;  of  chrysarobin,  909 ; 
of  oil  of  copaiva,  913 ;  of  Jamaica  dog- 
wood, 913  ;  of  oil  of  eucalyptus,  925  ; 
of  ipecacuanha,  949 ;  of  tannic  acid, 
1032 ;  of  colchicum,  1050 

Skull-cap.     See  Scutellaria 

Sleep,  remedies  which  induce,  196 ;  the 
cerebro-spinal  system  functionally  in- 
active in,  196;  certain  parts  of  the 
nervous  system  may  still  remain  active, 
196 ;  the  inactivity  caused  by  anssmia, 
197  ;  state  of  the  arteries  of  the  brain 
during,  197 ;  and  in  normal,  197 ;  the 
brain  anemic  during,  197  ;  two  things 
necessary  to  produce,  197 ;  to  lessen 
circulation  in  the  brain,  and  to  lessen 
its  functional  activity,  197 ;  position 
may  sometimes  induce,  197 ;  cold  to 
the  abdomen  prevents,  and  warmth 
procures,  198  ;  warmth  to  the  stomach 
in  the  shape  of  warm  food  and  drinks, 
causes,  198 ;  efficacy  of  the  wet  pack 
in  inducing,  198;  cold  feet  prevent, 
199;  and  cooling  the  surface  of  the 
body  sometimes  induces,  199  ;  opium 
and  morphine  the  chief  hypnotics  or 
inducers  of,  199  ;  list  of  the  principal 
hypnotics,  199 ;  nature  of  the  reflexes 
in  ordinary  and  mesmeric,  204 


GENEEAL  INDEX. 


1163 


'Slippery  elm,  1025 
Smell,  action  of  drugs  on,  230 
Smelling  salts,  stimulating  action  of,  on 

the  brain,  194 
Smells,  remedies  for  destroying  disagree- 
able, 103-107 
Smilaceae,  1051 
Smoke,  utility  of  inhaling  certain  kinds 

of,  in  asthma,  481 
Smut,  corn,  characters    and  action  of, 

1073 
Snail,  structure  of  the  heart  of  the,  322 
Snake-bite,  as  a  poison,  with  its  antidote, 
491 ;  action  of  strong  solution  of  am- 
monia in,  639 
Snake-poison,   effects  of,  on  the  blood, 

72 ;  action  of  ammonia  in,  329 
Sneezing,  drugs  which  cause,  their  num- 
ber, nature,  and  uses,  245,  246 
Snuff,  Ferrier's,  composition  and  uses  of, 

731  and  n. 
Soap,  as  an  emollient,  347 
Soap,  curd,  1079 
Soap,  hard,  characters,  &c,  of,  966 

Soft,  966,  967 
Soap,  soft,  action  of,  on  bacteria,   94, 

95 
Socaloin,  nature  and  action  of,  1042 
Soda,  as  a  caustic,  344 ;   difference  be- 
tween the  action  of,  and  potash  on  the 
intestines,  383 
Sodium   Salts,  nature,  action,  and  uses 
of— 
Arseniate  of,  720 
Biborate  of,  624 
Bisulphite  of,  630 
Borate  of  (borax),  624 
Bromide  of,  555 
Caustic,  621 
Chlorate  of,  627 
Chloride  of,  618 
Hyposulphite,  630 
Iodide  of,  663 
Nitrate  of,  618 
Pyrophosphate  of,  628 
Salicylate  of,  628 
Santoninate  of,  629 
Solution  of  soda,  622 
Sulphite  of,  629 
Sulphocarbolate  of,  626 
Tartarated,  624 
Valerianate  of,  630 
Sodium  salts,  sources  of,  617 ;  reactions 
of,  617 ;  preparations  of,  618 ;  impuri- 
ties of,  618;   tests  for  impurities  in, 
619;    general   action    of,  619;    their 
action,  in  large  doses,  on  muscle  and 
nerve,  619  ;  action  of,  on  the  intestines, 
383  ;  as  refrigerant  diuretics,  432 
Soda  tartarata,  610 

Sodium  hyposulphite,  action  of,  on  bac- 
teria, 89 
Sodium  sulphate,  action  of,  on  bacteria, 
89 


Sodii  arsenias,  720 

Arseniatis,  liquor,  720 
Citro-tartras  effervescens,  622,  1055 
Iodidum,  657 
Salicylas,  820 
Santoninas,  954 
Valerianae,  778 
Sodium,  symbol  and  atomic  weight  of, 
10 ;  its  relation  to  other  members  of  a 
group,  16  ;  physiological  action  of,  27 ; 
character  and  preparation  of,  617 
Sodium  Acetate,  as  a  remote  antacid,  370, 
624 

Benzoate,   as  a  hepatic  stimulant, 

403, 628 
Bicarbonate,  action  of,  on  the  ear, 

229  ;  as  a  direct  antacid,  370,  623  ; 

preparation,  characters,  and  uses 

of,  622 
Carbonate,  as  a  direct  antacid,  370 ; 

preparation,  characters,  and  uses 

of,  621 
Chloride,  as  a  vermicide,  408 ;  how 

prepared,  618 
Citrate,  as  a  remote  antacid,  370 
Ethylate  (liquor),  618 
Hypophosphite,  627 
Phosphate,  as  a  hepatic  stimulant, 

403,  626 
Salicylate,  as  a  hepatic  stimulant,  403 
Santoninate,    as    an   anthelmintic, 

629 
Sulphate,  as  a   hepatic   stimulant, 

403;    antagonism  of,  to  barium, 

495 
Valerianate,  618 
Sokoloff,  reference  to,  138 
Solanacese',  983 
Solution  of — 

Acetate  of  ammonium,  641 

Iron,  744 
Ammonia,  640 

Basic  ferric  sulphate  of  iron,  743 
Bichromate  of  potassium,  616 
Carbonate  of  magnesium,  661 
Chloride  of  calcium,  651 
Chloride  of  iron,  745 
Chloride  of  tin,  706 
Chloride  of  zinc,  671 
Chlorinated  lime,  551 
Citrate  of  ammonium,  642 
Citrate  of  bismuth,  733 
Citrate  of  iron  and  quinine,  749 
Citrate  of  magnesium,  661 
Gelatine,  1086 

Iodide  of  arsenic  and  mercury,  721 
Litmus,  1067 

Perchloride  of  iron  (strong),  745 
Permanganate  of  potassium,  614 
Pernitrate  of  iron,  747 
Persulphate  of  iron,  742 
Potash,  607 

Bed  prussiate  of  potash,  617 
Soda,  622 


1164 


GENERAL  INDEX. 


Solution  of — 

Subacetate  of  lead,  704 
Subsulphate  of  iron,  743 
Tersulphate  of  iron,  742 
Turmeric,  1037 
Yellow  prussiate  of  potash,  617 

Solution,  test-,  of  albumen,  1085 

Solutions,  517 

Sonnenschein,  reference  to,  101 

Soporific,  Indian  hemp  or  American  can- 
nabis as  a,  1027  ;  lupulin  as,  1028 

Soporifics,  196.    See  Hypnotics 

Space,  dead,  1100  (Appendix) 

Spanish  flies,  1091 

Sparteine,  action  of,  on  inhibitory  gan- 
glia, 317 

Spasm,  nature  and  cause  of,  212 ;  general 
mode  of  treatment,  212-214  ;  list  of 
antispasmodics  and  adjuvants,  213- 
214 

Spearmint  and  oil,  as  a  carminative,  379 

Spearmint,  oil  of,  characters,  action,  and 
use  of,  1005;  as  a  carminative  and 
stimulant,  1005 

Spectrum  of  simple  and  compound  bodies, 
12;  of  calcium  chloride,  12;  of  lithium, 
13 ;  of  calcium,  13 ;  haemoglobin  and 
its  derivatives,  72 

Spence,  Dr.  A.  J.,  reference  to,  181 

Spermaceti,  1085  ;  as  an  emollient,  1085 

Sphacelinic  acid,  1070 

Sphaerobacteria,  83 

Sphincter  muscles  of  the  iris,  nature  and 
functions  of,  217 

Spider's- web,  as  a  styptic,  350 

Spigelia,  characters  and  use  of,  978 ;  as 
an  anthelmintic,  978 

Spinal  centre  for  respiration,  236 ;  vaso- 
motor, 287 ;  for  secretion  of  sweat,  437  j 
for  the  generative  organs,  447 

Spinal  cord,  action  of  drugs  on  the,  159- 
182;  the  three  functions  of  the,  159 ; 
action  of  drugs  on  the  conducting 
*  power  of  the,  1 59 ;  mode  of  testing  this, 
159  ;  mode  of  ascertaining  the  power 
of  the,  to  conduct  sensory  impressions, 
159;  and  reflex  stimuli,  160;  and  of 
the  time  required  for  transverse  and 
longitudinal  conduction,  161 ;  diagrams 
illustrative  of  this,  161,  162;  mode  of 
experimenting  on  the  action  of  drugs 
on  the  reflex  action  of  the,  163  ;  direct, 
indirect,  and  inhibitory  paralysis  of 
the,  by  drugs,  164 ;  list  of,  and  uses  of, 
depressants  for  the,  165 ;  inhibitory 
paralysis  of  the,  165;  experiments  il- 
lustrative of  this,  166  ;  diagram  to 
illustrate  inhibition  in  the,  169 ;  ex- 
planation of  the  actions  of  certain 
drugs  on  the,  on  the  author's  hypothe- 
sis, 171-177 ;  stimulating  action  of 
drugs  on  the  reflex  powers  of  the,  177 ; 
Magendie's  series  of  experiments  on 
the  action  of  poison  on,  177-181  j  dia-  | 


gram  illustrating  Magendie's  method 
of  investigating  the  mode  of  action  of 
strychnine  on,  179 ;  stimulants  for  the, 
and  their  uses,  181 ;  antagonism  be- 
tween drugs  acting  on  the  respiratory 
centre  and  the,  494  ;  action  of  ammo- 
nium salts  on  the,  603  ;  of  bromide  of 
potassium,  553 ;  of  ammonium  chloride, 
636;  of  manganese  salts,  753;  of  spirits 
of  ether,  782;  of  nitroglycerin,  789; 
of  chloral  hydrate,  792;  of  carbolic 
acid,  814  ;  of  aconitine,  833  ;  of  delphi- 
nine,  836 ;  of  codeine,  850 ;  of  opium, 
854 ;  of  sanguinaria,  863 ;  of  ery- 
throxylon,  879 ;  of  physostigmine,  905 ; 
of  Jamaica  dogwood,  913 ;  of  oil 
of  eucalyptus,  925 ;  of  coni'ine,  932 ;  of 
quinine,  947 ;  of  oil  of  valerian,  952 ; 
of  strychnine,  975  ;  of  curare,  976 ;  of 
gelsemium,  978 ;  of  belladonna  or  atro- 
pine, 987 ;  of  tobacco,  992 ;  of  digital™, 
995;  of  thymol,  1006;  of  colchicum, 
1050 
Spinal  depressants,  number,  nature,  and 

uses  of,  165  ;  stimulants,  181 
Spirit,  proof,    776 ;    rectified,    776 ;   of 

French  wine,  776 
Spirit  of  chloroform,  as  a  cardiac  stimu- 
lant, 328 
Spirit  of  ether,  as  a  cardiac  stimulant, 

328 
Spirits,  525 

Spirits,  as  a  carminative,  379 
Spiritus  setheris,  525,  780 

Compositus,   525,    780, 

783 
Nitrosi,  525 
Ammonias,  525,  638 

Aromaticus,  525, 638, 640, 

641,  891,  1015 
Fcetidus,  525,  638,  932 
Anisi,  525,  935 
Armoracife,    compositus,    525,    866 

888,  1015 
Aurantii,  525,  889 
Cajuputi,  525,  924 
Camphorae,  525,  1018 
Chlproformi,  525,  796 
Cinnamomi,  1017 
Cinnamonii,  525 
Frumenti,  525 
Gaultheriae,  526,  963 
Juniperi,  526,  1064 

Compositus,  526,  937, 1064 
Lavandulas,  526,  1003 
Limonis,  526,  890 
Menthse  piperitaa,  525,  526,  1004 

Viridis,  626,  1005 
Myrciss,  526,  889,  923 
Myristicse,  625,  526,  1015 
Odoratus,  626,  887,  890,  891,  1003, 

1004 
Rectificatus,  525 
Eosmarini,  525,  1003 


GENERAL  INDEX. 


1165 


Spiritus — 

Tenuior,  526 
Vini  gallici,  626 
Spiritus  vini  gallici,  niistura,  1086 
Spirobacteria,  83 
Splanohnios,  the,  and  the  kidneys,  428, 

429 
Spleen,  action  of  alcohol  on  the,  766; 

action  of  physostigmine,  907  ;  of  oil  of 

eucalyptus,  925 
Squills,  action  of,  on  the  blood-vessels, 

,249;    as    a,   stimulating   expectorant, 

255 ;   as  a,  cardiac  tonic,  331 ;   as  a 

general  emetic,  373 ;  as  a  hydragogue 

diuretic,  432 ;  action  and  use  of,  1040 ; 

in  large  doses,  1041 ;  on  the  pulse,  and 

as  a  diuretic  and  expectorant,  1041 
Squirting  cucumber  fruit,  928 
Stannius,  reference  to,  974 
Stannius's  experiments  as  to  the  actions 

of  the  various  cavities  of  the  frog's 

heart,  319-322 
Staphisagria,   or  stavesacre,    characters 

and  composition  of,  836 ;  action  of,  in 

frogs,  836  ;  delphinine  acts  like  aconi- 

tine  on  the  pulse  and  respiration,  836 ; 

on  the  spinal  cord  and  medulla,  836 ; 

on  the  vagus  and  the  heart,  836 ;  uses 

of,  836 
Star-anise,  characters  and  composition  of, 

840 
Starch,  1053 ;  characters  and  uses,  1053 
Starch,  is  converted  into  dextrin    and 

sugar  by  boiling  with  acids,  73 ;  as  a 

demulcent,  347 
Stavesacre,  836 

Stearic  acid,  action  of,  on  bacteria,  94 
Stenhouse,  Dr.,  reference  to,  900 
Stenosis,  mitral,  cardiac  tonics  useful  in, 

333;  aortic,  digitalis  of  doubtful  use 

in,  333 
Stenson's  experiment  on  the  abdominal 

aorta  of  a  rabbit,  164 
Stercoraemia,  101 
Sterculiaceae,  875 
Sternutatories     or     errhines,     number, 

nature,  and  uses  of,  245,  246  ;  contra- 
indications of,  246 ;  must  be  used  with 

caution  in  certain  cases,  246 
Stevens,  reference  to,  996 
Stewed  apples,  as  a  laxative,  389 
Stillingia,  as  an  alterative,  413;  characters 

and  uses  of,   1023 ;  as  an  alterative, 

1023 
Stimulant,  beef-tea  versus  alcohol  as  a, 

774 
Stimulants,    spinal,    181 ;    nerve,    192 ; 

cerebral,  192;  cardiac,  328;  vascular, 

330 ;  hepatic,  403  ;  diuretic,  433 
Stirling,  reference  to,  125 
Stolnikow,  reference  to,  859 
Stomach,  impaired  power  of  the,  in  the 

aged,  352 ;  action  of  drugs  on,   361 ; 

normal  and  abnormal    condition    of, 


362  ;  irritability  of  the,  363  ;  diagram 
to  illustrate  the  supposed  nervous  con- 
nections of  the,  362 ;  three  factors  in 
the_  process  of  digestion  in  the,  363 ; 
action  of  drugs  on  secretion  in  the, 
363 ;  drugs  which  stimulate  the  secre- 
tion of  the  gastric  juice,  363 ;  impor- 
tance of  thorough  mastication,  364  j 
supply  of  artificially  digestive  sub- 
stances to  the,  364 ;  action  of  drugs  on 
the  movements  of  the,  with  classes  of 
drugs,  365 ;  absorption  from  the,  368 ; 
action  of  calomel  on  the,  369 ;  use  of 
gastric  sedatives  in  relieving  pain  in 
the,  376 ;  and  vomiting  from  the,  376  ; 
list  of  sedatives  which  have  the  most 
powerful  action  on  the,  in  certain  cir- 
cumstances, 377 ;  action  of,  in  expelling 
gases  from  the,  378  ;  drugs  which  tend 
to  prevent  fermentation  in  the,  378 ; 
they  remove  pain  and  distension  of, 
and  dimmish  local  spasm,  379 ;  action 
of  irritant  poisons  on  the,  395-397 ; 
diagram  to  show  the  nervous  mecha- 
nism by  which  the  action  of  the  heart 
may  be  depressed  by  irritation  of  the, 
396;  diagram  of  the  liver,  intestines, 
and,  404 ;  application  of  drugs  to  the 
482  ;  the  stomach-pump,  483 ;  the  gas- 
tric syphon,  and  its  use,  483  ;  action  of 
acids  in  the,  569  ;  of  alkalies,  598  ;  of 
the  metals  zinc,  copper,  cadmium,  and 
silver,  666;  of  nitrate  of  silver,  678; 
of  mercury,  684 ;  of  phosphorus,  711 ; 
of  arsenic,  713 ;  of  antimony,  722  ;  of 
iron  salts,  739  ;  of  gold,  754 ;  of  alco- 
hol, 765,  766  ;  of  spirit  of  ether,  781 ; 
of  chloral  hydrate,  791 ;  of  purified 
chloroform,  797  ;  of  creasote,  818  ;  of 
aconitine,  835  ;  of  pilocarpine,  885 ;  of 
physostigmine,  907;  of  quinine,  945; 
of  tannic  acid,  1032  ;  of  oil  of  turpen- 
tine, 1058 

Stomach  cough,  probable  origin  of  the 
so-called,  248 ;  rationale  of  the,  248 

Stomachic,  black  pepper  as  a,  1013;  lupu- 
lin  as,  1028 

Storax,  characters,  composition,  and  use 
of,  1030;  prepared,  1030 

Stramonium,  as  a  narcotic,  200;  as  » 
general  anodyne,  201 ;  action  of,  on 
the  lungs,  on  the  respiratory  centre, 
and  on  the  ends  of  the  vagi,  249,  250  ; 
on  the  vagus-centre,  317 ;  on  the  vaso- 
motor centre,  319 ;  as  a  poison,  with  its 
antidote,  491 

Stramonium  leaves,  characters  of,  991 
Seed,  991 

Seeds,  characters,  action,  and  use  of, 
991 ;  as  an  antispasmodic,  992 

Strieker's  stage,  uses  of  a,  60 

Stromuhr,  Ludwig's,  294 

Strontium,  symbol  and  atomic  weight  of, 
10 ;  physiological  action  of,  27 ;  action 


1166 


GENEEAL  INDEX. 


of,,  on  the  muscles,  135,  142 ;  causes 
contraction  of  the  vessels,  281 

Strophanthin,  as  a  cardiac  tonic,  331 
as  a  refrigerant  diuretic,  432 

Stropbanthus  hispidus,  action  of,  on  the 
cardiac  muscle,  316;  as  a  cardiac 
tonic,  331 ;  composition,  action,  and 
uses,  1099  (Appendix) 

Strychnina,  605,  972 

Strychnine,  cumulative  action  of,  42; 
effect  of,  on  protoplasm,  61 ;  has  little 
power  on  infusoria,  65  ;  effects  of,  on 
oxidation,  69, 72 ;  action  of,  on  medusas, 
lll;onmollusca,114;  onascidians,  114; 
and  on  annulosa,  115;  on  muscle,  122, 
144  ;  effect  of,  on  the  spinal  cord,  162, 
172 ;  effect  of,  in  causing  tetanus,  173, 
174, 175  ;  Magendie's  series  of  experi- 
ments on  the  action  of,  177-181 ;  as  a 
spinal  stimulant,  182 ;  action  of,  on 
the  brain  of  dogs,  188 ;  and  of  men 
195 ;  on  the  retina,  227 ;  on  the  ear, 
229  ;  on  taste  and  the  sense  of  smell, 
230 ;  on  the  respiratory  centre,  240 ; 
as  a  stimulating  expectorant,  255 ; 
action  of,  on  the  vaso-motor  centre, 
287,  319  ;  as  a  cardiac  tonic,  331 ;  as 
a  vascular  tonic,  336  ;  fails  to  poison 
when  the  vagi  are  divided,  369 ;  as  an 
antihidrotic,  441 ;  action  of,  in  lessen- 
ing the  night-sweats  in  phthisis,  443 ; 
as  an  aphrodisiac,  450 ;  as  an  indirect 
emmenagogue,  453 ;  as  a  poison,  with 
its  antidote,  491 ;  antagonism  of,  to 
other  drugs,  494-496;  antagonistic 
action  of,  to  chloral,  494-496 

Strychnine,  preparation  and  characters 
of,  972 
Sulphate  of,  action  of,  on  low  orga- 
nisms, oxidation,  and  fermenta- 
tion, 972 ;  on  the  reflex  nerve- 
centres,  on  the  intestines  and 
sensory  nerves,  972 ;  poisoning  by, 
and  treatment  for,  973 ;  action  of 
on  the  alimentary  canal,  on  the 
blood  and  circulation,  on  the 
heart,  973 ;  on  the  respiration  and 
muscles,  974  ;  on  the  nervous  sys- 
tem and  brain,  974  ;  on  the  spinal 
cord,  975  ;  uses  of,  975 

Stuart,  Anderson,  references  to,  127,  142 

Sturiones,  1086 

Styptics,  action  of,  350  ;  action  of  cold  to 
surface  of  body,  351 ;  of  hot  water  as 
a,  351 ;  dried  alum  as  a,  655 ;  strong 
solution  of  perchloride  of  iron  one  of 
the  most  powerful  styptics,  746 ;  matico 
as  a,  1015 

Styracacese,  963 

Styria,  arsenic- eaters  of,  account  of  the, 
714 

Subchloride  of  mercury,  691 

Sublimed  sulphur,  its  preparation,  cha- 

.   racters,  &c,  543 


Subnitrate  of  bismuth,  732 

Subsulphate  of  mercury,  as  a  local  emetic, 

373 
Succus  belladonnas,  527,  985 
Conii,  527, 931 
Hyoscyami,  527,  990 
Limonis,  527 
Mori,  527 
Scoparii,  527,  900 
Taraxaci,  527, 957 
Sudorifics,  action  of,  on  the  secretion  o£ 

sweat,  437 
Suet,  1078  ;  prepared,  1078 
Suffocation,  cause  of,  239  ;  produced  by 
the  action  of  certain  poisons  on  the 
respiratory  tract,  398 
Sugar,  1055  ;  as  a  vehicle  and  corrigent, 
1055 ;  preservative  and  antiseptic,  1055; 
sugar,  refined,  1055 
Sugar  of  milk,  1080 
Sulphaemoglobin,  72 
Sulphate  of  Aluminium,  656 
Ammonium,  642 
Atropine,  986 
Beberine,  1021 
Copper,  675 
Hyoscyamine,  991 
Iron,  741 

and  Ammonium,  749 
Dried,  741 
Granulated,  741 
Precipitated,  741 
Magnesium,  659 
Morphine,  848 
Quinidine,  943 
Quinine,  942 
Potassium,  611 
Sodium,  625 
Strychnine,  972 
Zinc,  671 
Sulphate  of  aluminium,  action  of,  on  bac- 
teria, 93 
Sulphate  of  beberine,  action  of,  on  proto- 
plasm, 61 
Sulphate  of  potassium,  as  a  cholagogue 

purgative,  405 
Sulphate  of  potassium,  sodium,  and  mag- 
nesium, as  saline  purgatives,  389 
Sulphate  of  sodium,  as  a  cholagogue  pur- 
gative, 405 
Sulphates,  general  action  of,  602 
Sulphide  of  mercury,  red,  697 
Sulphites,  test  for,  595 
Sulphite  of  sodium,  629 
Sulphocarbolate  of  sodium,  626 

of  zinc,  672 
Sulphocyanide  of  potassium,  action  of,  on 

mollusca,  114 
Sulpho-vinate  of  sodium,  as  a  saline  pnr- 

gative,  389 
Sulphur,  symbol  and  atomic  weight  of, 
10 ;  its  relation  to  other  members  of  a 
group,  16 ;  as  a  stimulating  expectorant, 
255 ;  as  a  laxative  and  purgative  d89 


GENEEAL  INDEX. 


1167 


Sulphur  and  its  elements,  543-547 ;  sub- 
limed sulphur,  flowers  of  sulphur,  543 ; 
confection  of  sulphur,  544;  sulphur 
ointment,  544 ;  washed  sulphur,  544  ; 
alkaline  sulphur  ointment,  544;  preci- 
pitated sulphur,  lac  sulphuris,  or  milk 
of  sulphur;  544 ;  use  of  sulphur  in  skin 
diseases,  544 ;  sulphuretted  hydrogen, 
or  hydrogen  sulphide,  545;  general 
action  of  sulphuretted  hydrogen,  545 ; 
special  action,  546 ;  'action  and  uses  of 
sulphur,  546 ;  iodide  of,  557 

Sulphur  lotum,  544 
Precipitatum,  544 

Sulphurated  potash,  615 

Sulphuretted  hydrogen,  action  of  water 
of,  on  bacteria,  94 ;  as  a  poison,  with  its 
antidote,  486  ;  its  preparation  and  pro- 
perties, 545, 546 

Sulphuric  acid,  physiological  action  of, 
27 ;  direct  and  local  action  of,  34 ; 
effects  of,  on  alcohol,  73  ;  on  bacteria, 
91,  93  ;  as  a  caustic,  344  ;  as  a  poison, 
with  its  antidote,  487 ;  properties  and 
uses  of,  570 

Sulphuris  iodidum,  544,  557 

Sulphurous  acid,  action  of,  on  enzymes, 
78 ;  on  bacteria,  91 ;  properties  and  uses 
of,  570 

Sulphurous  bath,  uses  of  a,  470 

Sumach  as  an  astringent,  898.  See  also 
Rhus  glabra 

Sumbul,  as  an  antispasmodic,  214  ;  cha- 
racters and  use  of,  chiefly  in  hysteria, 
937 

Boot,  937 

Suppositoria  acidi  carbolici  cum  sapone, 
526,  813,  1079 
Acidi  tannici,  526,  875,  1031,  1053 

cum  Sapone,  626,  1079 
Hydrargyri,  526,  686,  875 
Iodoformi,  526,  804,  875 
Morphinae,  526, 847,  875 

cum  Sapone,  626,  847,  1053, 
1079 
Plumbi  composita,  526,  703,  875 

Suppositories,  nature  and  uses  of,  484  ; 
list  of,  and  composition,  526 

Surgical  operations,  use  of  antiseptics  in, 
104 ;  Sir  Joseph  Lister  on  the  best 
mode  of  performing,  815 

Sustschinsky,  reference  to,  313 

Sweat,  mode  of  secretion  of,  437  ;  various 
causes  which  arrest  or  increase  the 
secretion  of,  437;  excretion  by  the 
sweat-glands,  439;  relation  between 
the  sweat-glands  and  the  kidneys,  439 ; 
uses  of  diaphoretics  and  sudorifics  in 
increasing  the  secretion  of,  437 ;  action 
of  antihidrotics  on  the  secretion  of  the, 
441 ;  the  night-sweats  of  phthisis,  442 ; 
diagram  to  illustrate  the  action  of 
antihidrotics,  442;  connection  of  the 
respiratory    centre    with    the  sweat- 


glands,  443  ;  various  drugs  which  act 
on  the  secretion  of,  443 ;  action  of  car- 
bolic acid  on  the  sweat  centres,  814 ; 
action  of  opium  on  the  secretion  of, 
855 ;  and  of  erythroxylon,  879 
Sylvester's  plan  of  artificial  respiration, 

802 
Syncope,  caused  by  sudden  change  of  pos- 
ture, 205 ;  by  the  use  of  anaesthetics, 
207-210;  by  fainting  and  shock,  264, 
265 ;  by  the  incautious  use  of  cardiac 
tonics,  335;   by  the  lowness  of   the 
blood-pressure,  334;  by  the  adminis- 
tration of  digitalis,  335 
Syphon,  gastric,  nature  and  uses  of,  483 
Syringe,  diagram  of  a,  for  hypodermic 
injection,  475 ;    of    a   vulcanite,  for 
injecting  solutions  into  the  ear,  477 ;  of 
a  vulcanite,  for  injecting  solutions  into 
the  urethra,  484 
Syrupus  Acaciae,  527,  914 
Acidi  citrici,  527,  581 
Hydriodici,  627 
Allii,  527,  1040 
Althaeas,  527,  875 
Amygdalae,  627,  915 
Aurantii,  527,  888 

Floris,  527, 888 
Florum,  888 
Calcii  lactophosphatis,  527,  652 
Calcis,  527,  648 
Cheken, 924 
Chloral,  527,  791 
Ferri  Bromidi,  527 

Iodidi,  527,  557,  750 
Phosphatis,  527,  579,  751 
Quininae  et  Strychninae  Phos- 
phatum,  527,  751,  942,  972 
Hemidesmi,  527,  970 
Hypophosphitum,  627,  627,  653 

cum  feiTO,  527, 750 
Ipecacuanb.se,  527,  949 
Krameriae,  527,  868 
Lactucarii,  527,  957 
Limonis,  527,  581,  890,  891 
Mori,  527, 1028 
Papaveris,  527,  843 
Picis  Liquidae,  527,  1062 
Pruni  Virginianae,  527 

Fluidum,  917 
Bhei,  527,  528,  938, 1010,  1011 

Aromaticus,  528,  922,  1010 
Bhceados,  528,  862 
Eosae,  528, 920 

Gallicae,  627,  920 
Eubi,  528 

Idsei,  528,  919 
Sarsaparillae  compositus,   528,    910, 

920,  963,  1020,  1052 
Sciihe,  527,  528, 1041 

Compositus,  528, 726,  730, 868, 
1041 
Senegae,  528,  868 
Sennae,  627,  528,  910,938 


1168 


GENERAL  INDEX. 


Syrupus — 

Tolutanus,  527,  628,  903 
Zingiberis,  527,  528,  1037 

Syrups,  527 

Szpilman,  reference  to,  139 


TABLETS,  628 

Tamarind,  character,  composition,  and 
use  of,  911 

Tannate  of  sodium,  action  of,  on  the 
kidneys,  435 

Tannic  acid,  as  an  astringent,  349  ;  pre- 
paration and  properties  of,  1031 ; 
action  of,  on  the  skin,  mucous  mem- 
branes, mouth,  and  stomach,  1032 ;  on 
the  blood  and  kidneys,  1032  ;  uses  of, 
externally  and  internally,  1032 

Tannin,  action  of,  on  bacteria,  94;  on 
the  mucous  membranes,  253  ;  as  a 
styptic,  350 ;  as  a  vermicide,  408 ; 
action  of,  on  the  kidneys,  435;  indi- 
_gestibleness  of  tea  partly  due  to  the 
tannin  it  contains,  870 

Tansy,  characters  and  uses  of,  953 ;  as 
a  diuretic,  stimulant,  emmenagogue, 
and  anthelmintic,  954 

Tantalum,  symbol  and  atomic  weight  of, 
10 

Tar,  as  a  stimulating  expectorant,  255  ; 
action  and  use  of,  1063 ;  as  a  stimulant, 
1063 

Tar,  oil  of,  1063 

Taraxacum,  956 

Taraxacum,  as  a  stimulant  diuretic,  433 

Tartar  emetic,  effects  of,  on  the  blood, 
73 ;  as  a  depressant  expectorant,  255  ; 
action  of,  on  the  system,  in  causing 
vomiting,  373;  as  a  general  emetic, 
373 ;  nature  and  use  of,  725,  726 ; 
ointment,  730 

Tartarated  soda,  as  a  remote  antacid, 
370 

Taitaric  acid,  as  a  poison,  with  its  anti- 
dote, 487  ;  properties  of,  &c,  680 

Tartrates,  test  for,  695 

Tartrate  of  iron  and  ammonium,  747 
Potassium,  747 
Potassium,  611,  624 
Sodium,  624 

Taste,  action  of  drugs  on  the  sense  of, 
230 

Tea,  characters,  action,  and  uses  of,  869 ; 
a  powerful  cerebral  stimulant,  870 ; 
indigestibleness  of,  partly  due  to  the 
tannin  it  contains,  870 

Teeth,  danger  of  extracting  the,  with 
chloroform,  in  certain  cases,  208 ; 
action  of  drugs  on  the,  352 ;  import- 
ance of  the,  for  mastication,  352 ;  what 
the  decay  of  the,  is  chiefly  due  to, 
352,    652;    the  best   substances    for 


cleansing  the,  352  ;  and  for  protecting 
and  preserving  the  gums,  353,  598 ; 
remedies  for  toothache,  353,  652,  815, 
817,  860 

Teleostese,  1087 

Tellurium,  symbol  and  atomic  weight  of, 
10 ;  its  relation  to  other  members  of  a 
group,  16 

Temperature,  effect  of,  on  the  action  of 
drugs,  44-48 ;  on  the  secreting  nerves, 
46  ;  of  the  body  half  a  degree  higher 
in  India,  48 ;  effects  of,  on  ferments, 
75 ;  on  mould-fungi,  82  ;  on  bacteria, 
88  ;  excess  of,  injurious  to  the  human 
organism,  but  destructive  of  bacteria, 
102;  effects  of,  on  the  rhythmical 
action  of  medusae,  110 ;  on  mollusca, 
114  ;  on  muscles,  128  etgeq. ;  effects  of, 
on  the  poisonous  action  of  guanidine, 
175  ;  the,  of  warm-blooded  animals ; 
416;  action  of  antipyretics  on,  416; 
action  of  the  skin  in  regulating  the, 
440 ;  action  of  salicylate  of  sodium  on 
the,  629 ;  of  mercury  on  the,  686 ;  of 
alcohol,  768  ;  of  chloral  hydrate,  792 ; 
of  carbolic  acid,  814 ;  of  salicylic  acid, 
820;  of  aconitine,  834;  of  erythroxylon, 
879  ;  of  caffeine,  872  ;  of  pilocarpine, 
886 ;  of  oil  of  eucalyptus,  925 ;  of 
solanine,  983  ;  of  belladonna  or  atro- 
pine, 988 ;  effects  of,  on  the  action  of 
digitalin,  998;  on  thymol,  1006;  of 
camphor,  1019;  of  Indian  hemp  or 
American  cannabis,  1027 ;  of  oil  of 
turpentine,  1058 ;  of  thuja,  1063 ;  of 
veratrine,  1048 

Tents,  nature  and  uses  of,  485 

Tepid  baths,  466 

Terbium,  symbol  and  atomic  weight  of, 
10 

Terebene,  action  and  uses,  1060 

Terebinthaceae,  897 

TernstromiaceEe,  869 

Tetrachloride  of  carbon,  as  an  anaes- 
thetic, 205 

Tetra-amyl-ammonium  iodide,  action  on 
motor  nerves,  150 

Tetra-ethyl-ammonium  iodide,  action  on 
motor  nerves,  150 

Tetra-ethyl-arsonium  iodide,  action  on 
motor  nerves,  150 

Tetra-ethyl-arsonium  and  zinc  double- 
iodide,  action  on  motor  nerves,  150 

Tetra  -  ethyl  -  arsonium  and  cadmium 
double  iodide,  action  on  motor  nerves, 
1P0 

Teua-methyl-ammonium  iodide,  action 
on  motor  nerves,  160 

Thalamiflorse,  831  et  seq. 

Thallin,  character  and  action  of,  825 

Thallium,  symbol  and  atomic  weight  of, 
10  ;  physiological  action  of,  27 

Thebaine,  as  a  spinal  stimulant,  181  j 
action  of,  on  the   respiratory  centre, 


GENEEAL  INDEX. 


1169 


240  ;  on  the  vaso-motor  centre,  319  ; 
antagonism  of,  to  chloral,  495,  496 
acts  like  strychnine,  975 

Theine,  action  on  sensory  nerves,  156; 
local  anesthetic  action  of,  870  j  dif- 
ferent, from  caffeine,  871  and  n. 

Theobroma,  oil  of  (cacao-butter),  charac- 
ters, uses.  &c,  of,  875 

Theobromine,  action  of,  on  muscles,  130 

Therapeutics,  definition  of,  (1)  may  be 
either  empirical  or  rational,  3 ;  ex- 
planation and  example  of  empirical 
therapeutios,  3  ;  and  also  of  rational, 
3,  4,  first  stage  of  rational,  4;  what 
should  follow  this,  4 

Thermometer,  importance  of  cleansing 
and  disinfecting,  105 

Theveresine,  action  of,  on  the  cardiac 
muscle,  316 

Thevetin,  action  of,  on  the  cardiac 
muscle,  316 

Thighs,  utility  of  mustard  stupes,  poul- 
tices, and  leeches,  to  the,  as  indirect 
emmenagogues,  453 

Thirst,  two  kinds  of,  local  and  general, 
360 ;  nature  of  local,  and  how  it  is 
lessened  or  quenched,  360;  general, 
and  the  means  of  alleviating,  360 

Thomas,  reference  to,  47 

Thorium,  symbol  and  atomic  weight  of,  10 

Thorough  wort,  956 

Throat,  action  of  pilocarpine  on  the,  886 

Thuja,  characters  and  action  of,  1063 ;  in 
producing  abortion,  convulsions,  and 
paralysis,  1063;  on  the  vessels  and 
temperature,  1063 ;  uses  of,  as  a  di- 
uretic, astringent,  aromatic  and  vermi- 
fuge, 1063 

Thulium,  symbol  and  atomic  weight  of,  10 

Thymelaceae,  1022 

Thymol,  action  of,  on  enzymes,  78 ;  on 
bacteria,  91,  94,  95 ;  preparation  and 
characters  of,  1005 ;  action  of,  as  a  dis- 
infectant, and  on  the  nerve-centres  of 
the  medulla  and  cord,  1006 ;  on  the 
respiration,  blood-pressure,  and  tem- 
perature, 1006 ;  how  eliminated,  1006 ; 
uses  of,  as  an  antiseptic,  1006  • 

Ticunas.     See  Curare 

Tin,  symbol  and  atomic  weight  of,  11  ; 
causes  powerful  contraction  of  the 
vessels,  281 ;  general  action  of,  698 ; 
nature  and  uses  of  granulated,  706  ;  of 
solution  of  chloride  of,  706 

Tinctura  Aconiti,  628,  529,  832 

Aloes,  528,  529,  899,  1042,  1043 

et  Myrrhae,  529,  893,  1043 
Arnicas,  528,  958 

Florum,  529,  958 
Eadicis,  529,  958 
Asafoetidas,  528,  932 
Aurantii,  528,  888 

Eecentis,  528,  888 
Amari,  529, 888 


Tinctura — 

Aurantii,  dulcis,  629,  889 
Belladonnas,  528,  530,  985 
Benzoini,  630,  964 

Composita,  628,    530,  903, 
964,  1030,  1043 
Bryonia,  530,  930 
Buchu,  528,  882 
CalendulaB,  969 
Calumbae,  628,  530,  841 
Camphorae  composita,  528,  844,  935, 

964,  1018 
Cannabis  indies,  528,  530,  1026 
Cantharidis,  529,  530,  1091 
Capsici,  529,  530,  984 
Cardamomi,  630,  1038 

Composita,  529, 530,  896 
936,  1016,  1038,  1091 
Cascarillae,  529, 1022 
Castorei,  1077 
Catechu,  629, 1016 

Composita,  530,  914 
Chiratae,  629,  530,  980 
Chloroformi    composita,    529,    796, 
1038 
et  Morphines,  529,  586, 
780,  847,  1004,  1056 
Cimicifugaa,  529,  630,  837 
Cinchonas,  529,  530,  940 

Composita,  529,  530,  888, 
941,  1012,  1039,  1091 
Cinnamomi,  529,  530,  1016 
Cocci,  529,  1091 
Colchici,  530 

Seminum,  529,  1050 
Seminis,  1050 
Conii,  529,  530,  931 
Convallarias,  1040 
Croci,  529,  530,  1039 
Cubebas,  529,  530, 1014 
Digitalis,  529,  530,  994 
Ergotas,  529,  1069 
Erythrophlcei,  915 
Ferri  Acetatis,  529,  530,  577,  745 
Chloridi,  530,  746 
Perchloridi,  529,  745 
Gallas,  529,  530,  1031 
Gelsemii,  529,  630,  978 
Gentianje  composita,  529,  530,  888, 

979,  1038 
Guaiaci,  530,  880 

Ammoniata,  629,  530,  641, 
880 
Herbarum  recentium,  530 
Humuli,  530,  1028 
Hydrastis,  530,  839 
Hyosoyami,  529,  630,  990 
Ignatiae,  530,  971 
Iodi,  529,  530,  557,  560 
Ipecacuanhas  et  Opii,  530,  845,  949 
Jaborandi,  529,  883 
Jalapae,  529,  982 
Kino,  529,  530,  902,  967 
Kramerias,  529;  530,  868  ' 

4  F 


1170 


GENEBAL  INDEX. 


Tinctura — 

Lariois,  529,  1061 

Lavandulae  composita,  529,  630,  901, 

922, 1003.  1015,  1016 
Limonis,  529,  890 
Litmus,  1067 
Lobelias,  529,  530,  961 

mherea,  529,  781,  961 
Lupuli,  629, 1028 
Matkte,  530,  1015 
MoscM,  530,  1077 
Myrrhae,  529,  530,  893 
Nuois  vomicae,  529,  630,  971 
Opii,  529,  530,  844 

Ammoniata,  529,  638,  845,  935 

964,  1039 
Camphorata,  530, 845,  935,  964, 

1018 
Deodorata,  530,  845 
Physostigmatis,  530,  904 
Podophylli,  529,  839 
Pyrethri,  529,  530,  953 
Quassias,  529,  530,  892 
Quebracho,  969 
Quininas,  529,  943 

Ammoniata,  529,  942 
Rhei,  529,  530,  938,  1010,  1038,  1039 
Aromatica,  530,  922,  1010 
Dulcis,  530,  1010 
Sabinas,  529, 1064 
Sanguinarias,  530,  863 
Saponis  viridis,  530,  966 
Scillse,  529,  530,  1041 
Senegas,  529,  867 
Sennas,  529,  910,  936,  938 
Serpentarias,  529,  530,  1012 
Stramonii,  529,  530,  991 
Sumbul,  529,  530,  937 
Tolutana,  529,  530,  903 
Turmeric,  1037 
Valerianae,  529,  530,  952 

Ammoniata,  529, 530, 641, 
952 
Vanillas,  630,  1036 
Veratri  viridis,  529,  530,  1045 
Zingiberis,  529,  630, 1037 

Fortior,  529,  1037 
Tinctures,  528-531 

Tissue-change,  action  of  drugs  on, 
410-421  ;  of  tonics,  410;  of  hasmatinics 
or  blood  tonics,  412  ;  of  alteratives  and 
their  action  on  the  tissues,  413-416;  of 
antipyretics,  or  febrifuges,  416;  list  of 
the  chief,  their  action,  419  ;  and  their 
uses,  420  ;  experiments  as  to  the  action 
of  drugs  on,  414;  action  of  the  heavy 
metals  on,  664 ;  of  silver,  678  ;  of  salts 
of  iron,  739 ;  of  alcohol,  767  ;  of  quinine, 
946 
Titanium,  symbol  and  atomic  weight  of, 

11 
Tobacco,  effect  of  the  inhalation  of  the 
smoke  of,  on  a  rabbit,  244 ;  snuff,  action 
of,  on  the  nose,  246;   the  vapiur  of 


tobacco  has  a  local  sedative  action  on 
the  lung,  249 ;  tobacco  as  asialagogue, 
357  ;  as  a  poison,  with  its  antidote,  491 

Tobacco,  992  ;  tobacco  leaf,  character  of, 
992 ;  general  action  of,  992 ;  on  the 
motor  and  secreting  nerves,  the  in- 
testine, the  heart  and  vaso-motor  sys- 
tem, 992  ;  in  frogs  and  warm-blooded 
animals,  992  ;  special  action  of,  on  the 
spinal  cord,  circulation,  and  vagus,  993 ; 
on  the  blood-pressure,  heart,  and  ali- 
mentary canal,  993 ;  uses  of,  993 ;  on 
the  effects  of  tobacco-smoking,  993 

Toldt,  reference  to,  136 

Tolu,  balsam  of,  characters  and  uses  of, 
as  an  expectorant,  903 

Toluyl-di-ethyl-amyl  ammonium  iodide, 
action,  on  motor  nerves,  150 

Toluyl-tri-ethyl  ammonium  hydrate  and 
iodide,  action  on  motor  nerves,  150 

Tonics,  as  adjuvants  to  antispasmodics, 
214 ;  list  of  cardiac,  331-335 ;  of  vas- 
cular, 336 ;  of  gastric,  361 ;  nature  and 
action  of,  410 ;  subdivisions  of,  410 ; 
states  in  which  gastric,  digestive,  vascu- 
lar, and  nerve  tonics  are  indicated,  411 ; 
hasmatinics,  or  blood  tonics,  412  ;  their 
mode  of  action  on  the  blood,  412 ; 
alteratives  and  their  action,  413-416  ; 
nature,  action,  and  uses  of  antipyretics, 
or  febrifuges,  416-421 ;  quassia  as  a 
tonic,  892 ;  cheken  as,  923 ;  quinine 
as  a,  947 ;  wormwood  as,  953 ;  oil  of 
chamomile  as,  956 ;  eupatorium  as,  956 ; 
rhubarb  as,  1011 ;  sulphate  of  beberine 
as,  1021 ;  serpentary  root  as,  1012 ; 
cascarilla  bark  as,  1022  ;  elm  as,  1026  ; 
lupulin  as,  102S ;  sarsaparilla  as,  1052 ; 
Iceland  moss  as,  1067 

Tonometer,  Roy's,  269 

Toothache,  may  frequently  be  removed 
by  means  of  a  brisk  purgative,  203 ; 
various  remedies  for  alleviating,  353, 
815,  817,  860 

Tortoise,  experiments  on  the  muscular 
structure  of  the,  125,  140;  difference 
betwixt  the  mammalian  heart  and  that 
•of  the,  298 

Tragacanth,  characters,  composition,  and 
uses  of,  900 

Traube,  references  to,  37,  296 

Traube's  curves,  nature  of,  268 

Treacle,  as  a  laxative,  1056 

Tremor,  pathology  of,  133 ;  treatment  of, 
134 

Trephining,  utility  of,  in  investigating 
the  functions  of  the  brain,  187,  197 

Trichlorhydrin,  as  an  anaesthetic,  205 

Triethylamine,  from  putrefaction,  100 

Trimethylamine,  action  of,  on  bacteria, 
94  ;  formed  from  putrefaction,  100 

Triticum,  1054 

Trituratio  Elaterini,  531,  929 

Triturations,  531 


GENEEAL  INDEX. 


1171 


Trochisci,  914 

Aoidi  tannioi,  531,  1031 
Ammonii  chloridi,  '531,  537 
Benzoici,  964 
Bismuthi,  531,  732,  733 
Catechu,  531,  914,  951 
Cretas,  531,  650 
Cubebas,  531,  1014 
Ferri,  531,  743,  744 
Redacti,  531 
Glycerrhizas  et  opii,  531,  845,  935 
Ipeoacuanhje,  531,  949 
Kramerias,  532,  868 
Magnesias,  532 
Menthas  piperitas,  532, 1004 
Morphinas,  532,  847 

et    Ipecacuanha,     532,    949, 
847,  848 
Morphinas  et  Ipecacuanhas,  532,  847 
Opii,  532,  845,  899 
Potassii  chloratis,  532,  613 
Santonini,  532 
Sodii  bicarbonatis,  632,  622 

Santoninatis,  532,  629,  954 
Zingiberis,  532 
Trypsin,  action  of,  on  fibrine,  75,  76 
Tungsten,  symbol  and  atomic  weight  of, 
11;  its  relation  to  other  members  of  a 
group,  16 
Turck's    method    of   experimenting    on 

reflex  action,  163 
Turmeric,  1037 ;  as  a  condiment,  1037 
Paper,  1037 
Solution  of,  1037 
Tincture,  1037 
Turpentine,  as  a  stimulating  expectorant, 
255  ;    action  of,    on    the  vaso-motor 
centre,  319  ;  as  a  vermicide,  408  j  as  a 
stimulant  diuretic,  433 
Turpentine,   oil   of,    action   of,    on   the 
mucous  membranes,  253  ;  importance 
of,   in  bronchitis,  253 ;    as   a  poison, 
with  its  antidote,  491 
Turpentine,  characters  of,  1057 
Canada,  1057 

Oil  of,  characters  and  action  of, 
1058 ;  when  inhaled  and  inter- 
nally, 1058  ;  on  the  stomach,  res- 
piration, and  temperature,  1058 ; 
on  the  nerve-centres  and  the  kid- 
neys, 1059;  use  of,  externally 
and  internally,  and  as  a  vermifuge, 
1059 
Turpentine  water,  action  of,  on  enzymes, 

78 
Tweedy,  Mr.  J.,  references  to,  216,  224 


U. 


Ulcers,  chronic,  use  of  vesicants   in, 

345  ;  of  astringents,  350 
Ulmeas,  1025 
Umbelliferas,  1025 


Unguentum,  1084,  1090 
Acidi  Borici,  532 

Carbolici,   532,   763,    764,    813, 

1084,  1090 
Gallici,  532,  1034, 1084 
Salicylici,  532,  763,  764,  820 
Tannici,  532,  1031,  1084 
iiconitinas,  532,  832,  1085 
Antimonii  tartarati,  532,  726,  730 
Aquas  rosas,  532,  920,  91 6,  1085, 1090 
Atropines,  532,  1085 
Belladonnas,  532,  985,  1084 
Calaminas,  532,  1085 
Cantharidis,  532,  966,  1090,  1091 
Chrysarobini,  532,  909,  1084 
Cetacei,  532,  916,  964,  1085,  1090- 
Creasoti,  532,  817 
Diachylon,  532,  702,  966 
Elemi,  532,  894 
Eucalypti,  532,  763,  764,  925 
Gallas,  532,  1031,  1084 

cum  Opio,  532,  845,  1031 
Glycerini   plumbi   subacetatis,   532, 

763,  764 
Hydrargyri,  532,  686,  1078 

Ammoniati,     532,     687, 

695,  1084 
Compositum,    532,    686, 

966,  1018,  1090 
Dilutum,  532 
Iodidi  rubri,   532,   687, 

696 
Nitratis,   532,  575,  687, 

966,  1084 
Nitratis,   dilutum,    687, 

764 
Oxidi    flavi,  532,   686, 
694,  1084 
Eubri,  532,  686, 
694,  763,  1084 
Subchloridi,    532,   686, 
691,  1085 
lodi,  532,  557,  560,  967,  1084 
Iodoformi,  532,  804,  1084 
Mezerei,  532,  1034,  1090 
Paraffinum,  764 
Picis  Liquidas,  532,  1062,  1090 
Plumbi  Acetatis,  533,  703,  1085 

Carbonatis,    532,    633,    703, 

1084 
Iodidi,  533,  557,  705,  1084 
Potassas  sulphuratas,  533, 615, 763, 764 
Potassii  iodidi,  533,  557, 1084 
Eesinas,  533,  916,  1061,  1090 
Sabinas,  533, 1064,  1085,  1090 
Simplex,  533,  916,  1090 
Staphis?grias,  533,  836,  1085 
Stramonii,  532,  992,  1084 
Sulphuris,  532,  533,  544,  1084 

Alkalinum,  532,  544,  1084 
Iodid,  533,  557,  763,  764, 
1084 
Terebinthinas,  533  1058,  1061,  1084, 

4f'2 


1172 


GENEEAL  INDEX. 


Unguentum — 

Veratrinse,  632,   533,  763,  761,  966, 

1084 
Ziuci,  533,  669 

Oleati,  533,  669,  764 
Oxidi,  632,  669,  1084 

Uranium,  symbol  and  atomic  weight  of,  11 

Urari.     See  Curare 

Urea,  drugs  which  act  on  the  excretion 
of,  414  ;  excreted  by  the  tubules,  424 

Urechitine,  as  a  general  emetic,  373 

Ureter,  rhythmical  contraction  of  the,  138 

Urethane,  composition  (Appendix),  1097 ; 
action  and  uses  of,  1098 

Urethra,  drugs  employed  in  inflamma- 
tion of  the,  446 ;  application  of  drugs 
to  the,  484 ;  diagram  of  a  vulcanite 
syringe  for  injecting  solutions  into  the, 
484 

Uric  acid,  effects  of,  on  the  blood,  72; 
action  of  lithontriptics  on,  436 

Urinary  sedatives  and  astringents,  445  ; 
urinary  organs,  action  of  cantharides 
on  the,  1092 

Urine,  circumstances  modifying  the  se- 
cretion of,  427-436 ;  the  rapidity  of 
the  secretion  of,  depends  on  two  fac- 
tors, 427;  arterial  pressure  in  the 
glomeruli  and  the  composition  of  the 
blood,  427-429 ;  curves  showing  the 
effect  of  erythrophloeum  on  blood- 
pressure  and  secret  ion  of  the,  430 ; 
action  of  lithontriptics  on  the,  436 ; 
how  evacuation  of  the,  is  promoted, 
444 ;  action  of  the  bladder  on  the,  443- 
445 ;  action  of  mercury  on  the,  686  ; 
of  nitrite  of  amyl,  786  ;  of  belladonna 
or  atropine,  988 ;  of  Indian  hemp  or 
America  cannabis,  1027;  of  colchicum, 
1051 ;  of  extract  of  ergot,  1072 

Urticacese,  ulmeaa  (ulmaceas),  1025 

Ustilago,  1073 

Uterus,  action  of  ecbolics  on,  454 ;  the 
involuntary  muscular  fibres  of  the, 
controlled  by  two  nerve-centres,  454  ; 
nature  of  the  nerves  which  stimulate 
the,  454 ;  mode  of  aiding  the  expulsive 
power  of  the,  454 ;  application  of 
drugs  to  the,  485 ;  as  pessaries,  485 ; 
as  caustics,  485 ;  utility  of  tents  in- 
serted in,  485  ;  action  of  borax  on  the, 
625 ;  of  pilocarpine,  885 ;  of  physos- 
tigmine,  907  ;  of  quinine,  947 ;  of  aloes, 
1045  ;  of  extract  of  ergot,  1072 

Uva  ursa  (bearberry),  action  of,  on  the 
bladder,  445  ;  as  an  astringent,  349 ; 
as  a  stimulant  diuretic,  433 ;  characters 
and  uses  of,  961,  962  ;  as  an  astringent 
and  diuretic,  962 

V. 
Vagina,  application  of  drugs  to  the,  485  ; 
as  pessaries,  485  ;  as  caustics,  485 


Vagus,  effects  of  stimulation  of  the,  140 ; 
contains  both  expiratory  and  inspira- 
tory fibres,  241;  diagram  illustrating 
this,  242;  reference  to  the,  243; 
experiments  on  the,  244 ;  cough  chiefly 
excited  by  branches  of  the,  247 ;  heart's 
beats  chiefly  regulated  by  the  in- 
hibitory fibres,  of  the,  295;  action 
of  drugs  on  the  cardo-inhibitory  func- 
tions of  the,  295 ;  reflex  stimula- 
tion of  the,  296 ;  quickened  pulse 
may  be  caused  by  paralysis  of  the, 
297 ;  action  of  drugs  on  roots  of  the, 
297;  irritation  of  the,  causes  still- 
stand  of  the  heart,  310  ;  action  of  two 
classes  of  poisons  on  the,  311  ;  position 
of  the  accelerating  nerves  of  the,  in 
frogs  and  warm-blooded  animals,  311 
and  n. ;  vagus-centre  in  the  heart,  317  ; 
and  ends,  317 ;  nature  of  the  action  of 
the,  upon  the  heart,  324 ;  antagonistic 
action  of  certain  drugs  on  the,  493  ;  of 
delphinine,  836 ;  of  cocaine,  879 ;  of 
pilocarpine,  885 ;  of  tobacco,  993 ;  of 
digitalin  on  the  roots  and  ends  of  the, 
996 

Valerianic  acid,  action  of,  on  bacteria,  94 

Valerian,  antispasmodic  action  of,  213, 
214 

Valerian,  characters,  &c,  951 

Oil  of,  952  ;  action  of,  on  the  brain 
and  spinal  cord,  952  ;  on  the  blood- 
pressure    and   the  pulse,  952;   as 
an  antispasmodic,  952 
Rhizome,  951 

Valerian  and  oil,  as  a  carminative,  379 

Valerianaceas,  951 

Valerianate  of  sodium,  630 ;  of  zinc,  630, 
673,  952;  of  iron,  752;  of  quinine, 
943,  944,  952 

Vanadium,  symbol  and  atomic  weight 
of,  11 

Vanilla,  characters  and  action  of,  1036 ; 
as  an  aromatic  stimulant,  1036 

Vapor  Acidi  Hydrocyanici,  533,  586 
Chlori,  533,  551 
Coninse,  533,  931 
Creasoti,  533,  817 
Iodi,  533,  557 
Olei  Pini  Sylvestris,  533,  1060 

Vapour  baths,  470 

Vapours,  inhalations,  533 

Vascular  stimulants,  nature  and  uses  of, 
330  ;  tonics,  336  ;  arid  sedatives,  339  ; 
when  vascular  tonics  are  serviceable, 
411  ;  antipyretics,  more  useful  in  sym- 
ptomatic fevers  than  in  specific  ones, 
420 

Vaseline,  properties  and  uses  of,  763 

Vaso-motor  and  vaso-dilating  nerves, 
action  of  drugs  on,  283 ;  tbe  vaso- 
motor centre  paralysed  by  various 
drugs,  287 ;  action  of,  on  the  smaller 
arteries  and  capillaries,  291 ;  how  the 


GENERAL  INDEX. 


1173 


activity  of  the  vaso-motor  centre  may 
be  increased,  291 ;  vaso-motor  centre 
of  the  heart,  319 ;    and  nerves,  318 
action  of  the  salts  of  iron  on  the,  740 
of  platinum  on  the,  of  mammals,  755 
of  alcohol,  769  ;  of  carbolic  acid,  814 
of  aconitine,   835;    of   opium   on  the 
peripheral,  854  ;  of  quillaia  (saponin), 
919  ;    of  tobacco,  992 ;    of  extract   of 
ergot,  1071 

Vegetable  alkaloids,  poisonous  properties 
of  some,  destroyed  by  the  liver,  401 

Vegetable  bitters,  strong  infusions  of,  as 
local  emetics,  373 

Vegetable  Kingdom,  Introduction,  830 

Veins,  nature  and  functions  of,  262 ; 
blood  in  the,  useless  for  nutrition,  262  ; 
action  of  the  nervous  system  on  the, 
262;  of  the  heart,  263;  effect  of  an 
upright  and  of  a  horizontal  position  on 
the  circulation  of  the  blood  in  the, 
263,  264 ;  arrest  of  circulation  in  the, 
the  cause  of  fainting  and  shock,  264, 
265  :  schema  of  the  circulation  from 
the  heart  to  the  arterial  system  and 
the,  265-267  ;  action  of  blood-pressure 
on  the,  267 ;  method  of  ascertaining 
the  blood-pressure  on  the,  268-270  j 
causes  of  alterations  in  blood-pressure 
in  the,  270;  how  blood- pressure  may 
be  raised  and  lowered  in  the,  271 

Venesection,  as  an  antipyretic,  420 

Veratrina,  504,  505,  1045 

Veratrine,  effects  produced  by  different 
doses  of,  on  frogs,  26  ;  effects  of  heat 
or  cold  on  the  action  of,  45  ;  action  of, 
on  oxidation,  70  ;  on  medusas,  111 ;  on 
mollusca,  114  ;  on  aseidians,  114  ;  on 
annulosa,  116 ;  power  of,  for  restoring 
muscle  after  fatigue,  121 ;  as  a  mus- 
cular poison,  128,  158 ;  as  a  sedative, 
157 ;  action  of,  on  the  spinal  cord, 
163;  as  an  anodyne,  201;  on  the  re- 
spiratory centre,  241 ,  245 ;  action  of, 
on  the  vagus-roots,  296 ;  on  the  heart 
of  the  frog,  308;  on  the  vaso-motor 
centre,  319 ;  on  the  cardiac  muscle, 
316 ;  as  a  poison,  with  its  antidote, 
491 ;  antagonism  of,  to  opium,  491 ; 
physiological  action  of,  in  large  doses 
and  externally,  1046,  1047 ;  inter- 
nally, action  of,  on  the  brain,  spinal 
cord,  and  muscles,  1047  ;  on  the  motor 
and  sensory  nerves,  the  circulation, 
and  the  pulse,  1048 ;  on  blood-pressure, 
respiration,  and  temperature,  1048; 
uses  of,  locally  and  internally,  1049 

Veratroidine,  1046;  action  of,  on  the 
vagus-centre  and  -ends,  1046 ;  on  the 
spinal  cord  and  respiratory  centre, 
1046 ;  on  the  vaso-motor  centre,  blood- 
pressure,  and  the,  pulse,  1046 

Veratrum  album,  action  of,  on  the  nose, 
215 


Veratrum,  viride,  action  of,  on  the  vagus- 
centre,   317 ;    on  the  cardiac  muscle, 
316  ;  on  palpitation  of  the  heart,  339 ; 
nature  and  action  of,  1045 
Verbenacese,  1002 
Vermicides.    See  Anthelmintics 
Vermifuges.    See  Anthelmintics 
Vesical  sedatives  and  tonics,  action  of, 

on  the  bladder,  444,  445 
Vesicants,   345 ;  strong  solution  of  am- 
monia as  a,  638 
Vesication,  produced  by  acids,  568 
Vessels,  blood,  262  ;  reflex  contraction  of 
the,  285  ;    experiments  with  bromide 
of  potassium   on  the,  286 ;    action  of 
drugs  on  this  reflex  contraction,  286  ; 
comparative  effect  of  heart  and,  on 
blood-pressure    in   different    animals, 
287 ;    influence   of   nerves  on  blood- 
pressure   in   the,  289-292;   action    of 
pilocarpine  on,  885 ;  of  thuja  on,  1063. 
See  Arteries  and  Arterioles 
Viburnum  (black  haw),  characters  and 

uses  of,  939 
Vienna  paste,  as  a  caustic  to  extirpate 

malignant  growths,  346 
Vignal,  reference  to,  402 
Vinegar,  properties  and  uses  of,  &c,  578 
Vinegar,  aromatic,  stimulating  action  of, 
on  the  brain,  194;  action  of  the,  on  the 
heart  in  man,  287 ;  in  dogs  and  rabbits, 
287,  288 
Vinegars,  503 

Vini  gallici,  mistura  spiritus,  1086 
Vinum  aloes,  534,  1042,  1043,  1037,  1038 
Album,  534,  896 

Fortius,  534,  896 
Antimoniale,  534, 726,  730 
Antimonii,  534,  726,  730 
Aromaticum,  534,  953,  1002, 1007 
Aurantii,  888 
Colchici,  534,  1049 

Radicis,  534, 1049 
Seminis,  534,  1050 
Ergotaj,  534, 1069 
Ferri,  534,  740 
Ferri  Amarum,  534,  749 
Citratis,  534,  748 
Ipecacuanhas,  543,  949 
Opii,  534,  845,  922,  1017 
Quininse,  534,  581,  942 
Rhei,  534,  867,  1010 
Rubrum,  534,  896 
Xericum,  634,  896 
Viola  tricolor  (pansy),  characters,  compo- 
sition, and  uses  of,  866 
Violarieae,  866 
Virchow,  reference  to,  176 
Visions,  action  of  drugs  in  producing,  228 
Vitaceas,  896 
Voit,  reference  to,  414 
Volatile  oils,  520 

Vomiting,    relieved    by   blisters,    345; 
description  of  the  act  of,  370;  and  of 


1174 


GENEEAL   INDEX. 


the  nerve-centre  which  regulates  the 
act  of,  370 ;  action  of  the  brain  and 
afferent  nerves  on,  371 ;  diagram  show- 
ing the  afferent  nerves  by  which  the 
vomiting  centre  may  be  excited,  372  ; 
the  action  of  drugs  in  causing,  372- 
374 ;  the  various  uses  of  emetics  in 
causing,  373-376;  action  of  the  most 
powertul  sedative  in  persistent,  is  ice, 
376 ;  gastric  sedatives  in  relieving, 
376  ;  list  of  sedatives  useful  in  vomit- 
ing arising  from  different  causes,  377  ; 
the  action  of  irritant  poisons  on  the 
stomach  gives  rise  to,  396 ;  action  of 
pilocarpine  on,  885 


W. 

Waebueg'S  tincture,  948 

Warm,  foot,  and  hip  baths,  utility  of,  as 
indirect  emmenagogues,  453 ;  warm 
baths,  466 

Warm-blooded  animals,  action  of  tobacco 
on,  992  ;  of  thuja  on,  1063 

Warm  clothing,  importance  of,  to  delicate 
people,  256 

Warmth.     See  Heat 

Warmth  and  moisture,  importance  of, 
in  rooms  occupied  by  patients  having 
bronchial  or  chest  complaints,  256 ;  as 
an  emollient,  347 ;  poultices  made  of 
substances  which  retain,  348 ;  action 
of,  on  the  circulation  of  the  blood  and 
the  secretion  of  sweat,  437 

Warren,  Dr.,  reference  to  his  use  of  ether, 
212 

Washed  sulphur,  its  preparation,  &c,  544 

Wassilieff,  reference  to,  106 

Water,  lukewarm,  as  a  local  emetic,  373  ; 
in  large  quantities,  as  refrigerant  diu- 
retics, 432 

Water  of  ammonia,  640 

Waters,  nature  of,  uses,  and  doses,  505 

Watts 's  modification  of  Mendelejeff's 
tables,  reference  to,  592 

Wax,  white,  1090 

Yellow,  1089 ;   its  characters,  com- 
position, tests,  and  uses,  1089 

Weber,  E.  H.,  reference  to,  219 

Wedenskii,  reference  to,  132 

Wells,  Mr.  H.,  his  use  of  nitrous  oxid  as 
an  anaesthetic,  211 

Wegner,  reference  to,  710 

Wernitz,  reference  to,  77 

Wheaten  flour,  1053 

White,  reference  to,  142 
Indian  hemp,  970 
Precipitate,  694 
Quebracho  bark,  969 
Wax,  1090 

Wild  marjoram.     See  Origanum 

Wilhite,  Dr.,  reference  to  his  use  of 
ether,  211 


Williams's  apparatus  used  in  researches 
on  digitalin,  303,  304 

Willow.     See  Salix 

Wine,  spirit  of  French,  776;  red  wine, 
777,  896 ;  white  wine,  777,  896 ; 
stronger  ditto,  777 ;  sherry,  776,  896 

Wines,  534 

Wines,  strong,  as  cardiac  stimulants,  328 

Witchhazel.     See  Hamamelis 

Witkowski,  reference  to,  119 

Wood,  Dog-,  913 

Guaiacum,  880 
Log-,  908 
Quassia,  892 
Red  sandal-,  901 
Worm-,  953 

Wood,  H.  C,  reference  to,  98 

Wood  charcoal,  its  preparation  and  char- 
acters, 641 ;  its  action,  uses,  and  ad- 
ministration, 541,  542 

Wood  tar,  as  a  stinrojatingexpectorant,  255 

Woorari.     See  Curare 

Worms,  the  three  chief  kinds  which  infest 
the  intestines,  408  ;  list  of  the  principal 
vermicides,  408  ;  and  vermifuges,  408  ; 
and  their  adjuncts,  408 

Wormseed,  American.    See  Chenopodium 

Wormwood,  nature,  action,  and  use  of, 
953 ;  as  a  stomachic  tonic  and  anthel- 
mintic, 953 

Wounds,  value  of  astringents  in,  350 ;  of 
styptics,  350 

Wourali.    See  Curare 

Wundt,  references  to,  160,  162,  174,  176 

Wurrus.    See  Kamala 


Xanthine,  action  of,  on  muscles,  130 
Xanthoxylinse,  883 

Xanthoxylum  (prickly  ash),  as  an  altera- 
tive, 413 ;  characters  and  use  of,  883 
Xylol,  action  of,  on  bacteria,  94 

T. 

Yeast,  beer,  character  and  uses  of,  1073 
Yeasts,  origin  and  nature  of,  81 
Yellow  cinchona  bark,  940 

Calisaya  bark,  940 

Dock.    See  Eumex 

Jasmine,  977 
Yellow  wax,  1089 
Yolk  of  egg,  1085 

Young,  Dr.,  his  table  for  dosage,  497 
Ytterbium,  symbol  and  atomic  weight  of,  ■ 

11 
Yttrium,  symbol  and  atomic  weight  of, 
11 ;  physiological  action  of,  27 

Z. 

Zabludowski,  reference  to,  13 


GENEEAL  INDEX. 


1175 


Ziegler's  Pathological  Anatomy,  reference 
to,  as  translated  and  edited  by  Mac- 
Alister,  84 
Zino,  symbol  and  atomic  weight  of,  11 ; 
physiological    action  of,  27 ;    double 
salts    of,  action   of,  on   the    cardiac 
muscle,  316  ;  on  the  capillaries,  318 
Zinc,  nature,  characters,  and  uses  of — 
Acetate  of,  672 
Bromide  of,  672 
Carbonate  of,  670 

Precipitated,  671 
Chloride  of,  671 
Iodide  of,  673 
Oleate  of,  670 
Oxide  of,  669 
Of  commerce,  669 
Phosphide  of,  673 
Sulphate  of,  671 
Valerianate  of,  673 
Zinc  chloride,  as  a  caustic,  344 
Zinc  salts,  as  antihidrotic,  441 ;  sources 
of  667  j  general  reactions  and  prepara- 


tion   of,  667;  impurities,  tests,  and 
general  action  of,  668 
Zinc  sulphate,  as  a  caustic,  344 ;  as  an 
astringent,  349 ;  as  a  local  emetic,  373 
Zinci  Acetas,  669 
JBromidum,  669 
Carbonas,  669 

Precipitatus,  669 
Chloridum,  669 
Iodidum,  557,  669,  673 
Oxidum,669 
Phosphidum,  669,  673 
Sulphas,  669 
Sulphocarbolas,  669 
Valerianas,  669,  952 
Zincum  granulatum,  669 
Zingiberace?e,  1036 
Zirconium,  symbol  and  atomic  weight  of  r 

11 
Zuelzer,  references  to,  101,  342 
Zuntz,  reference  to,  72 
Zygophylleas,  880 

Zymogens,  ferment-forming  substances, 
80 


INDEX  OF  DISEASES  AND  EEMEDIES. 


Note. — The  numbers  after  the  drugs  refer  to  the  works  quoted  as  authorities  for  the  treatment  :— 
Neale's  Medical  Digest,  1 ;  Bartholow's  Therapeutics,2  ;  Ringer's  Therapeutics,  3 ;  "Wood's  T7ierapeutics,  4. 


Abscess. 

Alcohol,  4.   As  a  pure  stimulant  where  a  large 

quantity  of  pus  is  being  poured  out,  draining 

the  system 
Belladonna,  2,  3.    Internally,  and  locally  as 

liniment  or  plaster,  to  abort  the  preliminary 

inflammation — e.g.   of  breast— afterwards  to 

ease  the  pain  in  addition 
Boric    Acid,    2.    A   powerful    non-irritating 

antiseptic  dressing 
Calcium  Phosphate.  Where  abscess  is  large  or 

chronic,  as  a  tonic 
Calcium  Sulphide,  3.     Small  doses  frequently 

repeated,  to  hasten  maturation  or  healing, 

especially  in  deep-seated  suppuration 
Carbolic  Acid,  1,  2,  4.     As  dressing,  and  as 

injection  after  evacuation 
Caustic  Potash,  3.    For  opening  abscess  in 

liver,  also  in  chronic  abscess  where  the  skin 

is    much   undermined,  also  used  to  prevent 

scarring  if  otherwise  opened 
Cod-Liver  Oil,  3.    In  scrofulous  cases  and  in 

hectic 
Counter-irritation.   To  surrounding  parts,  to 

check  formation  or  hasten  irritation 
Creasote.    Same  as  carbolic  acid 

EMPLA6TRUM  AMMONIAC!  C  HYDRARGYRO,  2.  As 

a  stimulant  to  indolent  inflammatory  swellings 

Ether,  3.  To  produce  local  anaesthesia,  used  as 
a  spray  for  opening  an  abscess. 

Ice,  1.    After  opening 

Iodine,  2.  As  injection  into  the  sac,  and  in- 
ternally to  cause  absorption  of  products  of 
inflammation 

Oakum,  1.     As  a.  stimulating   and  antiseptic 


Oleate  op  Morphine  and  Mercury,  3.  Be- 
lieves the  pain,  allays  the  inflammation,  and 
causes  the  absorption  of  the  products 

Permanganate  of  Potassium,  2,  3,  4.  As 
antiseptic 

Poultices,  3.  Advantageously  medicated,  e.g. 
with  belladonna  or  opium,  to  allay  pain  and 
inflammation 

Eesorcin,  2.  In  syphilitic  and  other  unhealthy 
sores  as  an  antiseptic 

Salicylic  Acid,  2.    As  antiseptic  dressing 

Sheet  Lead.  Is  useful  in  the  chronic  abscess 
of  the  leg  as  a  dressing 

Silver  Nitrate,  2.  A  strong  solution  in 
nitrous  ether,  painted  around  the  area  of  in- 
flammation, will  check  it  in  superficial  parts 

Sodium  Auro-terchloride,  1.  In  scrofulous 
abscesses  as  a  tonic 

Sulphides,  3.  Of  potassium,  sodium,  ammonium, 
and  calcium.  They  must  be  used  in  low  doses, 
and  are  indicated  in  scrofulous  abscess  and  in 
the  chronic  boils  of  children.  To  hasten  sup- 
puration 


Acidity. 

Acids,  2,  3.  Before  meals,  or  as  an  acid  wine 
duringmeals.  For  acid  eructations,  especially 
of  sulphuretted  hydrogen 

Alxawes,  3.  After  meals,  best  as  bicarbonates ; 
with  flatulence  give  magnesia,  if  there  is  con- 
stipation ;  lime  water,  if  there  is  diarrhcea 

Ammonia,  4.    In  headache  from  acidity 

Bismuth,  2,  3.  In  gastritis  due  to  chronic 
abscess  or  chronic  alcoholism.  Very  well  com- 
bined with  arsenic  in  very  chronic  cases,  with 
hydrocyanic  acid  in  more  acute  cases 

Careolic  Acid,  2.  To  stop  fermentation,  or  to 
relieve  an  irritable  condition  of  the  stomach. 

Charcoal.    As  biscuits 

Creasote.    Same  as  carbolic  acid 

Ipecacuanha,  3.  In  minim  doses  in  pregnancy 
where  flatulence  and  acidity  are  both  present 

Kino,  2.    Useful  along  with  opium  , 

Lead  Acetate,  2.  In  gastric  catarrh  and  py- 
rosis 

Manganese  Oxide,  2.  Sometimes  relieves,  pro- 
bably acting  like  charcoal 

Mercury,  3.  When  liver  deranged  and  stools 
pale 

Nux  Vomica.  In  small  doses  before  meals, 
especially  in  pregnancy,  or  in  chronic  alco- 
holism 

Pulsatilla,    ltlv.  every  four  hours  in  water 

Silver  Nitrate,  2.    Same  as  silver  oxide 

Silver  Oxide,  2.  Especially  useful  when 
acidity  is  accompanied  by  ueuralgic  pains  in 
stomach 

Sulphurous  Acid,  2.  If  associated  with  the 
vomiting  of  a  pasty  material,  presence  of 
sarcinee 

Tannic  Acid,  2.  In  acidity  associated  with 
chronic  catarrh  and  flatulence.  Glycerine  HI  h 
tannic  acid  gr.  iv,  as  pill 

Acne. 

Alkaline  Lotions,  2.    When  skin  is  greasy 

and  follicles  are  black  and  prominent 
Arsenic.    In  chronic  acne  ;  generally,  though 

not  always,  prevents  the  acne  from  bromide 

or  iodide  of  potassium 
Belladonna,  3.    As  local  application  to  check 

a  too  abundant  secretion 
Bismuth,  2.    As  ointment  or  powder.    In  acne 

rosacea  if  acute 
Borax.    Solution  very  useful 
Cajeput  Oil,  4.    As  stimulant  in  acne  rosacea 
Calcium  Sulphide,  3.    Same  as  sulphur.    For 
■    internal  use 
Cod-Liver  Oil 

Glycerine.    Both  locally  and  internally 
Iodide  of  Sulphur,  3.     In  all  stages  of  the 


1178 


INDEX  OF  DISEASES  AND  REMEDIES. 


Acne. 

Iodine,  4.    Is  of  doubtful  value 

Liquor  Htdrargyki  Perchloridi,  2.    In  very 

early  stages  as  a  wash 
Liquor  Hydrargyri  Pernitratis,  4.    A  single 

drop  on  an  indurated  pustule  will  destroy 

without  scar 
Phosphorus,  2.    In  chronic  cases  in  place  of 

arsenic.    The  phosphates  and  hypophosphltes 

are  aifer  and.  more  valuable.    The  latter  in 

acue  iudurata 
Potassium.  Bromide,  3.    Sometimes  useful  in 

moderate  doses  in  obstinate  cases.    This  salt 

and  the  iodide  very  often  cause  acne  when 

taken  continuously 
Sand,  1.    Friction  with,  useful 
Sulphur.  Internally,  and  externally  as  a  lotion 

or  ointment,  the  moat  valuable  agent 
Water.    Hot  sponging  several  times  a-day 

Addison's  Disease. 

Glycerine,  1.    In  full  doses 
Iron,    Anti-emetics  and  tonics 
Skimmed  Milk,  1.    As  diet 

After-pains. 

Act^sa  Bacemosa,  3.  It  restores  the  lochia  in 
cases  of  sudden  suppression  and  removes  the 
symptoms 

Belladonna.    As  ointment 

Camphor,  2.  Useful  when  combined  with  mor- 
phine, 10  gr.  with  £  gr.  of  morphine 

Chloral,  2.  In  large  doses  arrests  the  pains  ; 
contra-indicated  in  feeble  action  of  the  heart 

Chloroform.  Liniment  to  abdomen  along 
with  soap  liaiment 

Cimicifug-a,  2.    Same  as  ergot 

Ergot.  To  keep  the  uterus  constantly  con- 
tracted and  prevent  accumulation  of  clots  in 
its  cavity,  and  consequently  the  pains  which 
they  would  occasion 

Gelsemium,  2.  Stops  pains  in  doses  sufficient 
to  produce  its  physiological  effect 

Morphine  and  Atropine.  Hypodermically 
very  useful,  J-J  gr.  morphine  with  y^  gr.  of 
atropine 

Opium.    The  same  as  morphine 

Poultices.  Warm,  to  the  hypogastrium  re- 
lieve 

Quinine.  5-10  gr.  night  and  morning,  with 
neuralgic  after-pains  which  do  not  yield  to 
opiates 

Albuminuria. 

Aconite,  1,  2.    To  lower  a  high  temperature ; 

and  in  the  onset  of  acute  nephritis  in  scarlet 

fever 
Alcohol,  1.    Hurtful  in  acute  stage  ;   useful 

when  a  slight  trace  of  albumen  is  persistent 
Alkaline  Diuretics,  1.    To  prevent  formation 

of  fibrinous  plugs  in  the  renal  tubules 
Aqua  Calcis,  1.    In  large  doses  has  been  found 

to  increase  the  urine,  and  decrease  the  albu- 
men 
Arsenic,  1,  2.    Beneficial  in  very  chronic  cases. 

Albumen  will  return  if  the  use  of  the  drug  be 

stopped 
Baths,  I,  3.    Warm  water  and   hot   air  and 

Turkish,   to  increase    action   of   skin   after 

.  dropsy  or  uremic  symptoms  have  appeared    , 

Belladonna,  1.    Has  been  used  to  diminish  the 

chronic  inflammatory  condition   left  by  an 

acute  attack 
Broom.    As  diuretic  in  chronic  renal  disease 
Caffeine,  4.    To  increase  secretion  of  solids, 

especially   in   cases    dependent   on    cardiao 

disease.    Should  be  combined  with  digitalis. 


Albuminuria. 

Very  useful  in  chronic  Bright's  disease; 
should  be  used  with  great  caution  in  Jhe 
acute  stage 

Cannabis  Indica.    As  diuretic  in  hsematuria 

Cantharis,  1,  3.  in],  of  tincture  every  3  hours, 
when  acute  stage  has  passed  off,  to  stop  haana- 
turia 

Chimaphlla.    As  a  diuretic 

Cod-Liver  On,.    As  a  tonic 

Copaiba,  3.  To  remove  ascites  and  albuminu- 
ria dependent  on  cardiac  or  chronic  Bright's 
disease,  and  in  some  cases  of  hematuria 

Counter-irritation.  Dry  cupping  most  useful 
when  tendency  to  uraemia 

Croton  Oil,  1.  As  liniment  to  the  loins  in 
chronic  cases  is  sometimes  useful 

Digitalis,  2,  3.  The  infusion  is  the  most  valu- 
able in  acute  tubal  nephritis,  and  in  renal 
disease  attended  with  dropsy  due  to  cardiac 
disease.  Must  be  given  with  caution  in  granu- 
lar kidney 

Elaterium,  1,  3.  As  hydragogue  cathartic  for 
dropsy;  and  when  uraemic  symptoms  have 
come  on 

Eucalyptus,  2.  Cautiously  for  a  short  time  in 
chronic  disease 

Puchsin,  1.  In  gr.  j.  to  gr.  iij.  doses  in  the 
day,  in  albuminuria  of  children  of  renal  origin 

Gallic  Acid,  2,  4.  Lessens  albumen  and  he- 
maturia 

Gold,  Chloride  of,  2,  in  contracted  kidney,  in 
the  chronic  disease  in  doses  of  -fa  gr. 

Hydrastis.    Lessens  albumen 

Incisions,  3.  Over  the  malleoli,  to  relieve  the 
anasarca  of  the  lower  extremities 

Iron,  1,  2,  3.  To  diminish  aneemia  with  a  flabby 
tongue,  give  the  persalts.  In  dropsy,  asso- 
ciated with  high  tension,  iron  must  be  cau- 
tiously given,  and  withheld  unless  improve- 
ment is  quickly  shown.  It  always  does  harm 
if  allowed  to  constipate 

Jaborandi.  In  ursemia  and  dropsy  due  either 
to  renal  disease  or  occurring  in  pregnancy 

Juniper,  Oil  of.    Diuretic 

Lead,  3.  Lessens  albumen  and  increases  the 
urine 

Milk  Cure.  Pure  skim-milk  diet  sometimes 
very  useful  when  tendency  to  ursemia ;  it  also 
lessens  the  albumen 

Nitroglycerin,  1,  2.  In  acute  and  chronic 
albuminuria 

Nitrous  Ether,  2.    As  diuretic 

Oxygen.  Condensed,  will,  on  inhalation,  tem- 
porarily diminish  albumen 

Potassium  Salts.  Especially  the  iodide  and 
vegetable  salts  in  syphilitic  or  amyloid 
disease 

Potassium  Bitartr ate,  1, 3,  4.  As  hydragogue 
cathartic  and  diuretic 

Potassium  Bromide.    In  ursemic  convulsions 

Tartrates.    As  diuretics 

Turpentine.  As  diuretic,  HI  ss.-j.  dose  every 
2  to  4  hours 

Water.  Iu  large  draughts  as  diuretic  when 
excretion  of  solids  is  deficient ;  and  in  dropsy. 

Alcoholism. 

Act^ea  Racemosa,  2,  3.    In  irritative  dyspepsia 

Ammokia.  Aromatic  spirits  of,  as  substitute 
for  alcohol,  to  be  taken  when  the  craving 
comes  on. 

Arsenic,  3.  To  lessen  vomiting  in  drunkards, 
in  the  morning  before  food  is  taken ;  and  also 
in  the  irritable  stomach  of  drunkards 

Bismuth,  2,  3.  With  hydrocyanic  aoid,  to  re- 
lieve acidity  and  heartburn 

Bromides,  2,  3.  Useful  during  delirium  tre- 
mens, or  to  lessen  irritability,  in  5j.  doses,  in 
the  wakeful  condition  which  immediately  pre- 
cedes It 


INDEX  OF  DISEASES  AND  EEMEDIES. 


1179 


Alcoholism. 


Capsicum,  2,  3.    As  substitute  for  alcohol,  and 

also  to  relieve  the  restlessness  and  insomnia 
Chloral,  2.    To  quiet  nervous  system  and  in- 
duce sleep  in  an  acute  attack.    Must  be  used 
with  caution  in  old  drunkards 
Cocaine,  3.    To  remove  the  craving 
Faradization,  1 
Gelsemium,  2.    Same  as  bromides 
Lhpuline,  2,    Along  with  capsicum  as  substi- 
tute for  alcohol,  also  to  quiet  nervous  Bystem 
In  delirium  tremens 
Milk,  1.    At  night 

Kux  Vomica.    As  tonic  and  stimulant,  both  to 

nervous  system  and  generally  to  aid  digestion 

Opium,  2,  3.  May  be  necessary  to  produce  sleep  ; 

to  relieve  the  pain  of  the    chronic  gastritis 

and  the  want  of  appetite 

Orange.   Slowly'sucked,  a  substitute  for  alcohol 

Phosphorus,  3.     In  chronic  cases  as  nervine 

tonic 
Picrotoxine,  2.    For  tremors 
Quinine.    In  the  ;  horrors '  stage  it  acts  as  a 
sedative  to  the  brain  and  restores  the  digestive 
functions 
Sumeul.    In  the  headache  of  old  drinkers 
Water,  Cold.    A  glass  taken  in  small  sips  at  a 

time,  as  substitute  for  alcohol 
Water,  Hot.    1  pt.  drunk  as  hot  as  possible  an 

hour  before  meals  will  remove  craving 
Zinc  Oxide.    In  chronic  alcoholic   dyspepsia, 
and  nervous   debility.      It   aflso   allays  the 
craving. 


Amaurosis  and  Amblyopia. 

Seton.  In  temple,  or  bl  isters,  along  with  iodide 
of  potassium,  in  amaurosis  coming  on  sud- 
denly, and  associated  with  tenderness  of  the 
eyeball  on  pressure ;  the  disc  is  sometimes 
congested 

Strychnine,  1,  2,  3, 4.  Very  useful  in  cases  of 
tobacco  amaurosis,  alcoholic  excess,  nerve- 
atrophy  (without  cranial  disease),  aud  in 
traumatic  amaurosis 

Teratrine.  To  eyelids  and  temples.  Care 
must  be  taken  to  keep  out  of  the  eye 


Alopecia. 

Ammonia.  Very  useful— R  01.  amygd.  dul.,  Liq. 
ammonueaaf.  Sj.  Spt.  rosmarini,  Aquae,  Mellis 
aa  t.  3iij.  mm.  fl.  lotio  (B.  Wilson). 

Antimonium  Tartaratum,  1.  A3  lotion,  gr.  j., 
aquse  3j. 

Arsenic.    Internally 

Cantharidbs  Tincture,  1.  One  part  to  eight  of 
castor  oil  rubbed  in  roots  of  hair  morning  and 
night 

Carbolic  Aon),  1.    In  Alopecia  areata 

Glycerine,  883.  Very  useful  ;  either  alone  or 
in  combination  appears  greatly  to  assist 

Nitric  Acid.  With  olive  oil,  in  sufficient 
quantity  just  to  make  it  pungent 

Pilocarpine,  1, 4.  Subcutaneous  injection  has 
been  useful  . 

Sabine  Oleum,  1.  Prevents  loss  of  hair  In 
Alopecia  pityrodes 

Sapo  ViRrDia,  1.  Very  useful  as  a  shampoo 
night  and  morning-B  Saponis  virid.  (Ger- 
man), Alcoholis  aa  ij.,  01.  lavanduhe,  gutt» 

Shaving.    Sometimes  useful  after  illness 
Sodium  Bicarbonate,  1.  Asa  lotion  in  Alopecia 

'      SuiSVlomDE.    Useful  both  internally  and 
externally  .  .  ,„ 

Tannin,  1.  Watery  solution  or  made  up  into 
ointment 

Amaurosis  and  Amblyopia. 

Amyl  Kitritb,  1.    TTseful   in  many  cases  of 

disease  of  the  optic  nerve 
Arnica.    Sometimes  useful 

T?T  TEPTRICrTY    1 

Myotomy,  1.    In  asthenopia  and  hysterical  am- 
Piwc°ARPnra,  2.     In   tobacco    and    alcoholic 

RueUS  In  minute  doses  in  functional  dimness  of 

vision  e.g.  hysterical  amblyopia 
Ra^tonV  4.    Sometimes  useful  in  later  stages 

of  iritis  and  choroiditis,  and  in  loss  of  power 

of  optic  nerve 


Amenorrhea. 

Aconite,  3.  When  menses  are  suddenly  checked, 

as  by  cold,  &c. 
Act^ja  Eacemosa,  2,  3.    To  restore  the  secre- 
tion, and  remove  the  headaohe,  ovarian  neu- 
ralgia, &c.  produced  by  its  sudden  stoppage 
Alcohol,  4.    In  Budden  suppression  after  ex- 
posure 
Aloes,  2,  3.    Alone  or  with  iron.   In  torpor  and 
aneemia ;  best  administered  a  few  days  before 
the  expected  period 
Ammonium  Chloride,  3.    In  headache 
Apiol  (oil  of  parsley),  2,  4.    Gr.  iij.  twice  a  day 
for  some  days  before  the  expected  period ;  if 
there  is  a  molimen  gr.  xv.  in  a  few  hours. 
Useful  in  anaemia  and  torpor  only 
Arsenic,  2, 4.    Along  with  iron  in  ansemia  and   ■ 
functional    inactivity   of    the   ovaries    and 
uterus 
Asafcbtdda,  2.    Along  with  aloes  in  anaemia 

and  torpor  of  the  intestines 
Cantharides,  2,  4.    Along  with  iron  in  torpor 

of  the  uterus 
Cold  Sponging,  3.    To  brace  the  patient  up 
Colocykth.    lii  ansemia  with  constipation 
Electricity,  2.     Locally  applied,  sometimes 

useful 
Ergot,  2.  In  plethoric  subjects 
GJ-old  Salts,  2.    Like  Asafoetida 
G-uaiacum,  4.    Mild  stimulant  to  the  uterus 
Hydropiper,  2.    In  torpor;  with  iron  in  anae- 
mia, aloes  in  a  constipated  subject.    Contra- 
indicated  in  a  plethoric  condition.    Should 
be  given  a  few  days  before  menses  are  ex- 
pected 
Iron,  2,  3,  4.    In  anaemia,  q.  v. 
Manganese,  3.    Useful  in  the  amenorrhcea  of 
young  women ;  in  delayed  menstruation,  or 
when  a  period  has  been  missed  through  a 
chill.    Perseverance  is  required,  especially  in 
the  last  case 
Myrrh.    A  tonic  emmenagogue 
Nux  Vomica,  2.    In  combination  with  iron  in 

anjemia 
Potassium  Permanganate.    Like  Manganese 
Pulsatilla,  2.    Like  Aconite 
Eue,  2, 4.    In  atonic  condition  of  ovaries  or  of 

uterus.    Plethora  contra-indicates 
Saffron  Wine,  1.    Emmenagogue 
Salines,  4.    In  constipation  in  plethoric  cases 
Sanguinaria.    Like  Rue 
Santonin,  3.    In  two  doses  of  10  gr.  one  or  two 

days  before  the  expected  period 
Savin.    Like  Rue 

Senega,  4.    A   saturated   decoction   in   large 
doses  of  a  pint  daily  about  two  weeks  before 
period 
Serpentaria.    In  ansemia 
Silver  Nitrate.    Locally,  to  ps  uteri  at  period 
Sitz  Baths.    Hot,  alone,  or  with  mustard,  for 
some  days  before  the  period ;  with  mustard,  if 
suddenly  arrested 
Spinal  Ice-bag.    To  lumbar  vertebrae 


Anemia. 

Acids.    For  a  tonic  action  on  the  mucous  mem- 
branes in  the  anaemia  of  young  women 


1180 


INDEX  OF  DISEASES  AND  REMEDIES. 


Anaemia. 

Acidum  G-allicum,  1.  In  anasmia  due  to  a 
chronic  mucous  or  other  discharge 

alkalies,  1.  Potash,  and  Soda  as  gastric  and 
hepatic  tonics 

Aloes,  1.    As  tonic  and  slight  purgative 

Arsenic,  1,  2.  In  the  cases  where  iron  fails  of 
its  effect  or  does  not  agree  with  the  patient. 
Also  in  Pernicious  Anaemia 

Cold  Sponging. 

g  alvanis  ation . 

Hypoprosphites  of  Calcium  or  Sodium.  In 
cases  of  nervous  debility  care  must  be  taken 
that  they  do  not  derange  the  digestion 

Iron,  1,  2,  3,  4.  Very  useful.  When  stomach  is 
at  all  irritable  the  carbonate  is  often  best. 
"Weak  anaemic  girls  with  vomiting  after  food 
are  best  treated  with  the  Perchloride.  In 
coated  tongue  the  ammonio-citrate  is  often 
the  best  to  begin  with.  The  malate  has  been 
useful  in  pernicious  anaemia.  In  gastric  dis- 
turbance and  constipation  a  combination  with 
Bhubarb  is  often  very  effectual .  Where 
mucous  membrane  very  flabby  large  doses  of 
the  perchloride.  Chalybeate  Waters  more 
often  succeed  than  pharmaceutical  prepara- 
tions ;  one  drop  of  the  solution  of  perchloride 
in  a  tumbler  of  water  is  a  good  substitute  for 
them 

Lactophosphate  of  Calcium.  During  nurs- 
ing, or  after  exhausting  purulent  discharge 

Manganese.  May  be  given  along  with  iron — 
not  much  use  alone 

Nux  Vomica.  Useful  sometimes  along  with 
iron 

Oxygen,  2,  3.  In  anaemia  from  loss  of  blood  or 
suppuration 

Pancreatine    In  feeble  digestion 

Pepsin.    In  feeble  digestion 

Phosphate  of  Calcium.  During  growth,  or 
where  system  is  enfeebled  by  drain  of  any 
kind 

Quinine.    In  malnutrition 

Sea-bathing,  1.    Good,  but  not  in  chlorosis 

Wines.    Along  with  food  to  aid  digestion 

Aneurism. 

Aconite,  1,,2.  To  relieve  pain  and  slow  the 
circulation 

Aliment.    Low  diet ;  absolute  rest 

Barium  Chloride,  1,  2.  In  doses  of  J  gr. 
Perhaps  raises  the  arterial  tension.  It  has 
been  successfully  used 

Chloroform.    Inhaled  to  relieve  dyspnoea 

Electrolysis.  Sometimes  useful  in  causing 
coagulation  within  the  sao 

Ergotin,  1.  A  local  hypodermic  injection  has 
been  successful 

Eucalyptus,  1. 

Ferri  Pekchloridx  Liquor.  1.  To  cause  co- 
agulation on  injection  into  sac 

Lead  Acetate.    Useful,  combined  with  rest 

Potassium  Iodide,  Very  useful  in  doses  of 
gr.  xxx.  Should  be  combined  with  the  recum- 
bent position 

Veratrum  Viride.  Along  with  opium  In 
quieting  circulation 

Angina  Pectoris. 

Aconite. 

Arsenic,  1.    To  prevent  paroxysms 

Chamomile.    In  hysterical  symptoms 

Chloral.    In  full  doseB 

Chloroform,  1.   Cautiously  inhaled  to  ease  the 

pain 
Cold,  1.    Applied  to  forehead  gives  relief 
Ether,  To  diminish  pain,  combined  with  opium 

in  £  gr.  doses 
Morphine.    Hypodermically 


Angina  Pectoris. 

Nitrite  of  Amyl.  Gives  great  relief  during 
paroxysms ;  in  atheromatous  arteries  must  be 
used  with  care 

Nitrites  of  SoDruM  and  Potassium.  Less 
rapid  than  nitrite  of  amyl,  but  have  more  power 
to  prevent  return  of  symptoms 

Nitroglycerin.    Like  nitrite  of  sodium 

Phosphorus.  During  intervals  to  lessen  ten- 
dency 

PoTASsruM  Bromide.  In  full  doses  will  relieve 
the  spasm 

Quinine.    When  any  malarious  taint  is  present 

STRYCHNmE.  Sometimes  useful  in  mild  cases, 
in  very  small  doses 

Turpentine.  Locally  to  the  chest  during 
paroxysms 

Anus,  Fissure  of. 

Belladonna.    Locally  relieves  spasms 
Benzoic  Acid.    As  a  local  application 
Bismuth,  1.    With  glycerine,  as  a  local  appli- 
cation 
Calomel.    As  ointment 
Carron  Oil,  1.    As  a  dressing 
Castor  Oil.    To  keep  motions  soft 
Chloral.  Useful  in  dilute  solution  (2  per  cent.) 

as  a  dressing 
Chloroform,  1.    Diluted  with  half  its  bulk  of 

alcohol,  will  aid  healing 
Cocaine.    In  ointment 
Collodion.    Locally,  to  protect 
Dilatation,  Porcd3le.    Believes  spasm 
Hydrastis.    Local  application 
Ice,  3.    To  relieve  pain  after  operation 
Iodoform.    Locally,  to  heal  and  relieve  pain 
Iodo-tannin  (.solution    of   iodine  in   tannin). 

Useful  locally 
Opium  and  Gall  Oejtment.    Relieves  pain 
Potassium  Bromide.    With  five  parts  of  gly- 
cerine locally 
Bhatany,  1.    Injected  after  the  bowels  have 

been  opened  by  enema 
Sulphur.    To  keep  motions  soft 
Tannin.    Useful  as  a  local  application 


Aphonia. 


Aconite,  1.    In  the  painful  contraction  of  the 

throat  of  singers 
Alum.    As  spray  in  chronic  congestion  of  throat 

and  larynx,  with  hoarseness 
Ammonicm  Chloride.    As  vapour  in  laryngeal 

catarrh  • 

Argenti  Nitras,  1.    As  local  astringent 
Atropine.     In  hysterical    aphonia ;   must  be 

pushed  to  produce  physiological  symptoms 
Bexzoix,  Tincture  op.    Inhaled  in  laryngeal 

catarrh 
Borax.    A  piece  the  size  of  a  pea  slowly  sucked 

in  sudden  hoarseness 
Chloroform,    1.    In   hysterical   and   nervous 

cases 
Electricity.    Locally  applied 
Ether.    Like  chloroform 
GrLYCERLNE  of  Tannin.    Locally,  to  pharynx 
Ionatia.    Like  atropine  > 

Ipecacuanha.     Wine   as   spray  in  laryngeal 

catarrh 
Nitric  Acid.    In  hoarseness  from  fatigue  or 

indigestion 
Nux  Vomica,  1.    Locally  applied  in  impaired 

nervous  power 
Potassium  Nitrate.    Like  Borax 
Kue,  Oil  of.    As  inhalation  in  chronic  catarrh 
Sulphurous  Acm.    As  spray  or  inhalation,  in 

clergyman's  sore-throat 
Turkish  Bath.    In  acute  laryngeal  catarrh 
Uranium,   Nitrate  of.     As   spray   in   very 

ohronic  catarrh 
Zinc  Sulphate,  1.    Looul  astringent, 


INDEX  OF  DISEASES  AND  EEMEDIES. 


1181 


Aphtha. 

Alumen  Exsiccatum,  3.    To  aphthous  ulcers 

which  do  not  readily  heal 
Argenti  Nitras,  1.    Local  application 
Bismuth.    As  local  application 
Borax.    As  honey  or  as  glycerine,  either  alone 

or  with  chlorate  of  potassium 
Chlorine  Water.    Locally  applied 
Copper    Sulphate.     "Weak   solution  painted 

over  the  aphtbie 
Coptis  Tripolia.   Infusion  is  employed  in  New 

England 
G-lycerine. 
Hydrochloric  Acid,  2.    In  small  doses  and 

as  a  local  application 
Mercury.    In  the  form  of  hydrarg.  cum  creta  in 

children,  to  remove  the  indigestion  on  which 

aphthae  frequently  depends 
Mineral  Acids.    Dilute  solution  as  paint 
Nitric  Acid.    In  small  doses 
Potassium  Chlorate.    Exceedingly  useful  as 

wash,'  10  grs.  to  the  oz.,  alone  or  with  borax, 

also  given  internally 
Potassium  Iodide.    As  local  application,  solu- 
tion of  1-5  grs.  to  the  oz. 
Quinine.     1    gr.  every  two   or   three   hours, 

in  aphthaa  in  infants  consequent  on    diar- 
rhoea 
Rhubarb.  To  remove  indigestion,  as  compound 

rhubarb  powder 
Salicylic  Acdd.    As  local  application 
Sulphurous  Acid.    As  solution  or  spray,  well 

diluted 

Apoplexy. 

Aconite.  To  lower  blood-pressure  and  prevent 
further  haemorrhage,  where  pulse  is  strong 
and  arterial  tension  high 

Arsenic,  1.  In  cerebral  congestion  preceding 
apoplexy 

Cold  "Water.  To  the  head  when  face  con- 
gested 

Colocynth.    As  purgative 

Croton  Oil.  As  purgative,  one  drop  on  back 
of  tongue,  or  part  of  a  drop  every  hour 

Diet  and  Hygdsne,  Prophylactic.  Butcher's 
meat  and  stimulants  to  be  taken  very 
sparingly,  exposure  to  heat,  over-exertion, 
and  especially  anger,  to  be  avoided 

Elaterium.  In  suppository,  or  as  enema, 
during  attack 

Electricity.  To  promote  absorption,  after 
partial  recovery  has  taken  place 

Ice.    To  head 

Nitroglycerin.  To  lessen  cerebral  conges- 
tion . 

Potassium  Bromide.  In  combination  with 
aconite 

Potassium  Iodide.  To  cause  absorption  of 
effused  blood 

Stimulants.  Cautiously  exhibited  when  col- 
lapse is  present 

Venesection  or  Leeches,  1.  To  relieve^ar- 
terial  pressure  when  apoplexy  is  threaten- 
ing 


Appetite,  Impaired. 


Cannabis   Indica,  1.     Produces  an  enormous 

appetite 
Pood.    Savoury,  well-cooked 
Glycerine.     *  _ 

Ignatia.     Corrects    diseased     appetite     and 

hysteria 

Low  DIET.  _„ 

Nitric  Acid.    In  low  doses  with  a  bitter 

*P  EPTO  V  EH 

Strychnine.    Especially  in  Phthisis 


ASCARIS   LUMBEICOIDES 

(Round-worm). 

Camphor. 

Carbolic  Acid.    As  an  enema ;  unsafe 

Mucuna,  2.    As  an  electuary 

Quassia.    As  an  enema 

Santonin. 

Spigelia.    Like  Santonin ;  to  be  preceded  by 

a  purgative 
Turpentine. 
Valerian.    In  convulsions 

Ascites. 

Acidum  Nitricum,  1.    In  cirrhosis  of  the  liver 
Aconite.    In  scarlatinal  nephritis  at  the  onset 

of  the  attack 
Apocynum  Cannabtnum.    As  diuretic 
Arsenic.    In  old  persons  with  feeble  heart 
Asclepias.    In  dropsy  of  cardiac  origin 
Caffeine,  1.    In  cardiac  dropsy 
Calomel.    As  diuretic  in  cardiac  dropsy 
Cannabis  Indica,  1,  3.    As  diuretic  in  acute 

and  chronic  Bright's  disease  with  hsematuria 
Copaiba.     Especially  useful   in    hepatic  and 

cardiac  dropsy 
Croton  Oil.    In  dropsy,  in  -}  of  a  drop  doses 

every  morning 
Cytisus    Scoparius,    2.     In   cardiac    dropsy 

and  dropsy  with  chronic  Bright's  disease 
Digitalis.    Best  in  cardiac  dropsy;  its  action 

is  increased  by  combination  with  squill  and 

blue  pill 
Elaterium.    As  hydragogue  cathartic 
Gamboge.      Like     Elaterium.      Large     doses 

tolerated 
Jaborandi.    In  anasarca  and  unemia 
Jalap.    In  compound  powder  as  hydragogue 

cathartic 
Milk  Diet.    Sometimes  very  useful  when  kid- 
neys are  inadequate 
Podophyllin,  1.    In  hepatic  cirrhosis 
Potassii    Tartras   Acida.     In   combination 

with  Jalap  in  hepatic  cirrhosis 
Squills.  1.    As  diuretic  in  cardiac  dropsy. 
Stdllingia.    In  hepatic  dropsy 


Asthenopia. 


Atropine.    To  prevent  spasms 
Hydrocyanic  Acid,  1.   In  irritable  ophthalmia 
Hysteria,  1.    A  cause 
Masturbation,  1.    Often  a  cause 
Myotomy,  Intraocular,  1.    To  relieve  spasm 
Physostigma,  1.    In  the  paralysis  produced  by 
diphtheria,  and  in  senile  asthenopia 

Asthma. 

Aconite.    In  spasmodic  cases,  also  in  asthma 

consequent  on  nasal  catarrh  in  children 
Alcohol,  1.    In  combination  with  amyl  nitrite 

in  spasmodic  asthma 
Alkalies,  1.    In  chronic  bronchial  catarrh 
Alum,  3.    10  grs.  of  dry  powdered  alum  put  on 

the  tongue  will  arrest  a  spasm 
Ammonia  Vapour,  1. 
Ammoniacum.    Like  Asafcetida 
Amyl   Nitrite.    Sometimes  checks  paroxysm 

in  spasmodic  asthma   and   dyspnoea  due  to 

cardiac  hypertrophy.    Must  not  be  given  in 

chronic  bronchitis  and  emphysema 
Anesthetics,  4.    As  a  temporary  remedy  in 

severe  cases 
Antimony,  3.    In  asthmatic  conditions  in  chi'- 

dren,  -jfe  gr.  of  tartar  emetic  every  quarter  of 

an  hour 
Apomori'HINE,  1.    Emetic,  where  it  is  due  to  a 

peripheral  blocking  of  the  air-tubes 
Arsenic,  3.    In  small  doses  in  ca^es  associated 


1182 


INDEX  OF  DISEASES  AND  REMEDIES. 


Asthma. 


with  bronchitis  or  simulating  hay  fever,  or 

in  the  bronchitis  of  children,  or  in  dyspeptic 

asthma.    Inhaled  as  cigarettes  with  caution 

Asafcbtida.    As  an  expectorant  where  there  is 

profuse  discharge 
Belladonna.     Internally  in  large   doses  to 
relieve  paroxysm.     It   should   only    be   ad- 
ministered during  a  paroxysm  and  then  pushed 
Biiomides.    Only  available  in  true  spasmodic 

asthma  ;  soon  lose  their  efficacy 
Caffeine  Citrate,  1.    In  low  dose,  1-5  grs., 

which  varies  with  the  case 
Camphor,  1.    Gr.  ij.  combined  with  gr.  j.  of 

opium  in  spasmodic  asthma 
Cannabis  Indica.   Sometimes  useful  in  chronic 

cases 
Chamois-Leather  'Waistcoat,   3.    Beaching 
low  down  the  body  and  arms;  in  bronchial 
asthma 
Chloral.    During  paroxysm 
Chloroform.     Believes  when    inhaled    from 

tumbler  or  with  warm  water 
Coffee.    "Very  strong  during  paroxysm 
Colchicum.    In  gouty  cases 
Conium,  1.    Palliative  in  a  chronic  case 
Counter-irritation,  1.    Applied  for  a  short 

time  only  at  frequent  intervals 
Creasote.    Vapour  in  bronchitic  asthma 
Datura.    See  Stramonium. 
Ether.    In  full   doses   at   commencement  of 

attack,  or  administered  by  inhalation 
Ethyl  Iodide,  1.    16  to  20  drops  inhaled  will 

relieve  spasm 
^Eucalyptus.     Sometimes  along  with  stramo- 
nium, belladonna,  and  tobacco 
Galvanism  of  Pneumogastric  Begion.  Posi- 
tive pole  beneath  mastoid  process,  negative 
pole  to  epigastrium 
Gelsemium,  2.    Useful  in  some  cases,  but  after 

a  time  may  fail 
Grindelia.    To  prevent  or  cut  short  attack; 

used  as  cigarette 
Hyoscine,  2.    In  spasmodic  asthma 
Iodine,  1.    Painting  the  line  of  the  pneumo- 
gastric  nerves  with  liniment  or  tincture  in 
pure  spasmodic  asthma 
Ipecacuanha.  As  a  spray  in  bronchial  asthma, 
especially  in  children  ;  useless  in  true  asthma 
Lobelia.    To  prevent  and  cut  short  paroxysm. 

Cautiously  used  in  cardiac  weakness 
Mercury,    1.     In   spasmodic   and   bronchitic 

asthma  combined 
Morphine.     Combined  with  Belladonna  very 

useful 
Nitroglycerin,  1,  2,  3.     In  bronchitic,  ne- 
phritic, and  spasmodic  asthma 
Kux  Vomica  .    In  dyspeptic  asthma 
Opium.    Hypodermically,  during  paroxysm 
Oxygen.    As  inhalation  during  paroxysm 
Pepsin.      Exceedingly    useful    in   preventing 
attacks  in  dyspeptic  subjects 
■  Pilocarpine,  2.    In   spasmodic   asthma,  sub- 
cutaneously ;  also  in  humid  asthma  if  there  is 
no  cardiac  dilatation 
Potassium  Bromide. 
Potassium    Iodide.     In    large    doses,  when 

asthma  due  to  acute  bronchial  catarrh 
Potassium  Nithate.    Inhalation  of  fumes  of 
touch-paper  relieves  paroxysm.     Sometimes 
advisable  to  mix  a  little  chlorate  with  it 
Pyridine.     In  bronchial  asthma  vapour  to  be 

inhaled 
Quebracho,  2.    Good  in  nephritic  and  spasmodic 

asthma 
Quinine.    During  intervals  when  attacks  ire 

periodical 
Besohcix,  1.    Relieves  dyspnoea 
Silver    Nitrate.     Has   been    injected    into 

trachea 
Sodium  Arseniate,  1.    Tonic,  acts  prooably  on 
respiratory  centre 


Asthma. 

Sodium  Nitrite.    Like  Nitroglycerin 
Sodium  Phosphate,  1.    Sometimes  efficacious 
Stramonium.    Sometimes  very  useful.    May  be 
made  into  cigarettes,  or  20  grs.  of  dried  leaves 
may  be  mixed  with  nitrate  of  potassium,  and 
the  fumes  inhaled.    A  little  powdered  ipecac- 
uanha may  often  be  added 
Strychnine,  2.    In  weakness  of  the  respiratory 

centre 
Sulphur  Fumes,  1.    In  bronchitic  asthma 
Tobacco.    Smoking  is  sometimes  beneficial 
Turkish  Baths.    In  bronchial  asthma 


Astigmatism. 

Suitable  Glasses. 

Atheroma. 

Ammonium  Iodide.    To  promote  absorption 

Arsenic,  2.  Often  useful,  especially  where 
there  are  cerebral  symptoms 

Cod- Liver  Oil,  2. 

Digitalis,  4.  Bequires  caution  ;  useful  in 
general  capillary  atheroma 

Phosphorus.  In  minute  doses,  along  with  cod- 
liver  oil,  in  cases  with  cerebral  symptoms 

Quinine.    Like  Arsenic 

Atrophy. 

Arsenic.    In  muscular  atrophy 

Electricity. 

Massage. 

Olive  Oil.    Inunction  to  atrophied  parts 

Strychnine. 


Balanitis. 


Astringent  Lotions.    Alum ;  sulphate  of  zinc 
Lime  Water.    As  lotion 
Mercury.    Yellow  wash,  as  lotion 
Oil. 

Bed-sores. 

Alcohol.  As  wash  to  prevent;  afterwards 
dust  with  powdered  starch 

Alum.    With  white  of  egg,  as  local  application 

Balsam  of  Peru  and  Unguentum  Resixje, 
1.    Equal  parts  spread  on  cotton  wool 

Charcoal.    As  poultices,  to  stop  bed-sores 

Galvanic  Couplet.  Of  zinc  and  silver ;  one 
element  on  sore,  the  other  on  adjacent  part 

Glycerine.    Prophylactic  local  application 

Hydrargyri  Perchloridum,  1.  A  solution 
mixed  with  diluted  spirits  of  wine 

Iodoform. 

Medicated  Poultices,  1.  Patient  to  lie  with 
poultices  under  the  parts  likely  to  be  af- 
fected ;  if  fcetor,  cataplasma  carbonis  ;  if 
sloughing,  addition  of  Balsam  of  Peru 

Quinine,  1.    Local  dressing. 

Silver  Nitrate.    Dusted  over  open  bed-sores 

Styptic  Colloid. 

Tannate  of  Lead,  1.    At  an  early  stage 

Biliousness. 

Aconite.    As  adjunct  to  podophyllum 

Alkalies.  In  indigestion  due  to  obstruction  to 
the  flow  of  bile 

Alkaline  Mineral  Waters,  2.  In  catarrh  of 
the  bile-duct,  early  stage  of  cirrhosis,  and  ob- 
struction to  the  hepatic  circulation 

Aloes.  In  constipation,  and  in  deficient  secre- 
tion of  bile 

Ammonium  Chloride,  2.    In  jaundice  due  to 


INDEX  OF  DISEASES  AND  EEMEDIES. 


1183 


Biliousness. 

catarrh  of  the  bile-ducts  ;  early  stage  of 
cirrhosis ;  deficient  intestinal  secretion 

Ammonium  Iodide,  2.  In  catarrh  of  duodenum 
and  biliary  ducts,  in  the  early  stage  of  cirrhosis, 
m  the  malarial  cachexia;  efficacy  increased 
by  the  addition  of  arsenic 

Angostura.    In  bilious  fevers 

Argenti  Oxidum. 

Bryonia.    In  bilious  headache 

Calomel.  1.  In  excessive  production  with 
deficient  secretion ;  Calomel  or  Blue  Pill  at 
night  and  in  the  morning  a  Black  Draught 

Oalumea.    As  stomachic  tonic 

Carlsbad  Water.  A  tumbler  sipped  warm 
during  dressing  very  useful 

Euonymin,1.  At  night,  followed  in  the  morning 
by  a  saline  purge 

Eriedrichshall  Waters,  3.  A  wineglassful 
in  a  tumbler  of  hot  water  slowly  sipped  while 
dressing  in  the  morning 

Horse  Exercise. 

Hydrastis,  2.  When  chronic  gastric  catarrh 
is  present,  in  chronic  catarrh  of  the  duodenum 
and  bile-ducts,  with  inspissation  of  the  bile 
and  gall-stones 

Manganese.    In  malarial  jaundice 

Mercurial  Cathartics.  In  moderate  doses 
night  and  morning,  or  in  small  doses  more 
frequently  repeated.  Especially  useful,  when 
stools  are  pale,  is  the  bichloride 

Milk  Cure.    In  obstinate  cases 

Mineral  Acids.  Nitrobydrochloric  acid  es- 
pecially useful  in  chronio  hepatic  affections, 
dysentery  and  dropsy  of  hepatic  origin 

Podophyllum.  In  place  of  mercury  when 
stools  dark 

Rhubarb.    As  hepatic  stimulant 

Sodium  Phosphate,  2.  In  bilious  sick  head- 
ache ;  also  in  the  catarrh  of  the  gall-duct  in 
children,  dose,  10  gr. 

Stillingia,  2.  In  cirrhosis;  torpidity  and 
jaundice  following  intermittent  fever ;  ascites 
due  to  hepatic  changes ;  in  deficient  secretion 
to  be  combined  with  Nux  Vomica 

Bladder,  Irritable. 

Alkalies,  2.  Vegetable  salts,  especially  of 
potassium  when  the  urine  is  acid 

Aquapuncture,  2. 

Belladonna.  In  the  irritable  bladder  of 
children  more  especially  causing  nocturnal 
incontinence  of  urine 

Benzoate  op  Ammonium.    Like  Benzoic  Acid 

Benzoic  Acid.  In  large  prostate,  and  alkaline 
conditions  of  urine 

Buchu,  4.  In  combination  with  the  vegetable 
salts  of  potassium  in  a  very  acid  condition  of 
the  urine 

Cantharides.  In  women  without  acute  inflam- 
mation or  uterine  displacement ;  also  in  the 
irritable  bladder  produced  by  chronio  enlarge- 
ment of  the  prostate 

Copaiba.    In  chronic  irritability 

Cubebs.    Like  Copaiba 

Hops,  4.    Useful  in  a  few  cases  in  large  doses 

Indian  Corn  Silk  (Zea  Mays),  4.  A  mild 
stimulant  diuretic ;  infusion  ad  lib. 

Pareira.    In  chronic  irritable  bladder 

Bladder,  Paralysis  of. 

Cannabis  Indica.    In  retention,  from  spinal 


Bladder,  Paralysis  of. 

Nicotine,  1.  3j.  of  a  4  per  cent,  solution  of 
nicotine  injected  by  catheter  and  then  with- 
drawn in  a  few  minutes 

Strychnine. 

Blepharitis. 

Alkaltne  Lotions.    Warm,  to  remove  the  se- 
cretion 
Oupri  Sulphas.     Dropping  in  a  very  dilute 

solution 
Iron.    To  remove  the  anasmia  usually  present 
Mercury  (TJnguentum  Hydrarqyri  Nitra- 
tis).    Most  useful  application.    If  too  strong, 
dilute  with  vaseline  or  simple  ointment 
Pulsatilla.    Internally  and  locally 
Silver  Nitrate.    Pencilling  the  border  of  the 
lid  with  the  solid 

Boils. 

Acid  Nitrate  of  Mercury,  1.  To  abort  at  an 

early  stage 
Arnica,  1.    Locally  as  an  ointment,  and  also 

internally 
Arsenic.    To  lessen  tendency  to  recurrence 
Belladonna.    Internally,  or  as  local  applica- 
tion 
Boric  Acid,  I.    As  a  dressing 
Calcium  Sulphlde,  2, 3.  Occurring  in  strumous 

subjects  or  otherwise;  to  hasten  maturation 

or  abort 
Camphorated  Alcohol.    As  local  application 

in  early  stage 
Carbolic  Acid.    Injection 
Caustic,  1. 

Cocaine,  1.    To  allay  the  pain 
Collodion.     Painted   over  whole    surface   to , 

abort  in  papular  stage  ;  and  over  base,  leaving 

centre  free,  in  pustular  stage 
CouNTER-raRiTATiON.    By  plasters  surrounding 

the  boil 
Opium.    Lpcally  to  remove  pain 
Phosphates,  2.  4.    Especially  of  sodium  as  a 

constitutional  agent 
Potassium  Chlorate,  1.    As  an  alterative  ' 
Poultices.    To  relieve  pain  and  hasten  ma- 
turation 
Silver  Nitrate.    Strong  solution  painted  over 

the  skin  round  boil 
Strapping.    Properly  applied  gives  great  relief 
Subcutaneous  Incisions,  L 
Sulphides.    In  small  doses  to  abort  or  hasten 

maturation 
Sulphites,  1. 
Sulphur  Waters,  2. 
TJnguentum  Hydrargyri,  1.     Early  applied 

around  will  prevent  sloughing 
Yeast,  1.    Jss.  ter  die  for  an  adult  very  useful 

Bone,  Diseases  of. 

Calcium  Salts,  2,  4.  The  phosphate  in  rickets, 
in  delay  of  union  of  fractures ;  the  chloride 
in  strumous  subjects 
Cod-Liver  Oil.    In  scrofulous  conditions 
Iodine.    Alone,  or  with  cod-liver  oil 
Iodoform.    As  a  dressing  to  exposed  bone 


Breath,  Fetid. 


Cantharides.  In  atonic  bladder,  painting 
around  the  umbilicus  with  the  Acetum 

Ergot.  In  paralysis,  either  of  bladder  or 
sphincter,  when  bladder  so  that  urine  is  re- 
tained, and  incontinence  in  sphincter 

Galvanism.    In  lumbar  region 


Benzoic  Acid.    In  spray 

Camphor. 

Carbolic  Acid.     Dilute  solution  as  wash  to 

mouth 
Chlorixe.    Liq.  chlori  and  chloride  of  lime  as 

lotion 
Permanganate   of  Potassium.    As  wash  to 

mouth 


1184 


INDEX  OF  DISEASES  AND  REMEDIES. 


Bkight's  Disease. 

Vide  Albuminuria. 

Bronchiectasis. 

Chlorine.    As  inhalation  to  lessen  fcetor 

Creasote.    As  inhalation 

Iodine.    As  inhalation 

Pho&phates  and  Hypofhosphites 

Quinine 

Terebene.    As  inhalation 

Bronchitis,  Acute. 

Aconite,  2.    £-1  min.  every  hour  at  commence- 
ment of  an  acute  catarrhal  attack 
ACTiEA   Racemosa,  2.    In  acute  catarrh  and 
bronchitis  when  the  more  active  symptoms 
have  subsided 
Alkalies,  4.    To  render  mucus  less  viscid 
Amber  Oil,  4.    Counter-irritant  over  spine  in 

children 
Ammoniacum.    Very  useful  in  old  people 
Ammonium   Carbonate,  2.    "Where  much  ex- 
pectoration and  much  depression ;  or  where 
the  mucus  is  very  viscid  and  adherent 
Apomorphine,  4.    Causes  a  copious  expectora- 
tion in  the  early  stage 
Asaecetida.    Like  Ammoniacum 
Belladonna,  1.  In  acute  bronchitis  of  children, 

to  stimulate  respiratory  centre 
Benzoin  and  Benzoic  Acid,  3.    3].  inhaled 
from  hot  water  eases  cough  and  lessens  ex- 
pectoration 
Bleeding,  1-     From    the    superficial   jugular 

veins  in  severe  pulmonary  engorgement 
Chloral  Hydrate,  1,   4.    To  be   used  with 

caution  to  allay  pain 
Cod-Liver  Oil,  1.    Believes 
Colchicum.    In  gouty  cases 
Copaiba,  4.    In  advanced  stage  of  disease 
Counter-irritants,  3.    Dry-cupping  most  effi- 
cient in  acute  cases ;  mustard  leaves ;  mustard 
poultices 
Croton  Oil,  3.    As  liniment ;  vesication  must 

not  be  produced 
Cubebs.    When  secretion  copious 
Demulcents,  4.    Liquorice,  linseed 
Eucalyptus,  1,  4.    As  liniment  combined  with 
Belladonna  in  the  early  stage.    Internally  in 
the  late  stage 
Garlic,  Oil  op,  4.    In  the  acute  bronchitis  of 

children 
Ipecacuanha,  1,  2,  3, 4.    When  expectoration 
scanty,  dryness  in  chest,  ipecacuanha  in  large 
doses;  also  when  expectoration  has  become 
more  abundant,  but  difficult  to  expel 
Jalap,  3.   WithBitartrate  of  Potassium  instead 
of  bleeding  in  engorgement  of  the  right  side 
of  the  heart 
Lead,  3.    In  profuse  discharge 
Lobelia,  2,  3,  4.  "When  cough  is  paroxysmal  and 
there  is  much  expectoration  slightly  nauseant 
expectorants  are  good,  combined  with  opium 
Mercury,  1,    In  some  cases  useful  where  there 

is  much  congestion  and  little  secretion 
Morphine,    2.    £-gr.   combined   with   quinine 
(gr.  x.)  will  abort  the  attack  if  given  early 
enough 
Muscarine,  2.    In  doses  of  £  gr.  at  the  com- 
mencement of  the  attack ;  well  combined  with 
digitalis 
Mustard,  3.    Poultice  in  acute  bronchitis  of 

children  and  adults 
Nitric  Acid.    "When  expectoration  free  and  too 

copious 
Opium.    As  Dover's  powder  to  cut  short  attack, 

and  along  with  expectorants  to  lessen  cough 
Pilocarpine,  2.    With  abundant  exudation 
Potassium  Chlorate.  1.     First  increases  the 
fluidity  of  the  expectoration,  then  diminishes 
it  in  quantity,  increasing  the  feeling  of  relief 


Bronchitis,  Acute. 


Poultices,  3.  In  children  to  encircle  the  whola 
chest 

Quinine,  3.    To  reduce  temperature 

San&uinaria,  2,  4.  After  acute  symptoms  have 
subsided  ,     L  , 

Senega,  4.  In  the  advanced  stage  of  acute 
disorder  ,     ,     ...  _.     . 

Squills,  Sypup  of,  2,  4.  Combined  with  Tinct. 
Camphorse  Co.  after  acute  stage  is  over 

Tartah  Emetic,  2,  3,  4.  In  dry  stage  to  pro- 
mote secretion  ;  most  useful  in  the  first  stage 

Turpentine,  3,  4.  When  expectoration  very 
profuse ;  also  as  inhalation  or  stupes 

Bronchitis,  Capillary. 

Alum,  2.  As  a  nauseating  expectorant  and 
emetic 

Ammonium  Carbonate.  Much  fluid  or  viscid 
expectoration  and  lividity  commencing.  Also 
as  an  emetic 

Ammonium  Chlordde,  2,  3.  To  promote  se- 
cretion 

Ammonium  Iodide.  In  small  rapid  doses  re- 
lieves much 

Apomorphine,  2.  To  produce  a  plentiful  fluid 
secretion  ;  also  as  nauseant  expectorant 

Camphor,  2.    As  expectorant  and  stimulant 

Cupping.  Four  to  six  dry  cups  over  the  back 
often  give  very  great  relief,  and  if  the  pul- 
monary congestion  appears  very  great  wet 
cups  should  be  placed  instead,  and  8-10  oz.  of 
blood  withdrawn  from  adult 

Ethyl  Iodide,  2.    As  an  inhalation 

Iodides,  2.  Are  very  serviceable  to  diminish 
viscidity  of  expectoration  if  given  in  very  low 
doses 

Ipecacuanha.    As  expectorant  and  emetic 

Mustard.    As  poultices 

Pilocarpine,  2.  In  abundant  non-purulent 
exudation ;  not  to  be  used  in  dilatation  of 
veins  and  right  side  of  the  heart 

Poultices.    Over  whole  chest 

Serpentaria.  In  children  as  a  stimulant  ex- 
pectorant 

Subsulphate  of  Mercury,  2.  As  nauseant 
expectorant  and  emetic 

Turpentine,  2.  In  languid  circulation  in  the 
capillaries 


Bronchitis,  Chkonic. 


Acids,  3.    To  diminish  a  chronic  copious  ex- 
pectoration 
Actjea  Racemosa,  1.    Sometimes  relieves  the 

hacking  cough 
Alum,  1.    In  children  with  copious  expectora- 
tion in  doses  of  gr.  iij. 
Ammonia.    When  there  is  difficulty  in  bringing 

up  expectoration 
Ammoniacum.   Very  useful,  especially  in  elderly 

people 
Ammonium  Chloride,  2,  3,  4.    To  render  the 

secretion  less  viscid 
Antimony.    When  secretion  scanty 
Arsenic,  3,  4.    In  emphysema  and  asthmatic 
attack  as   cigarettes,  where   there  is  much 
wheezing  and  little  bronchitis  following  the 
sudden  disappearance  of  eczematous  rash 
Asafcetida.    Like  Ammoniacum 
Balsam   of   Peru,   3.     When    expectoration 

copious 
Balsam  of  Tolu,  3.    The  same 
Belladonna,  1.    To  children  choked  with  se- 
cretion  give  irij.  of  tincture  every  hour  to 
stimulate  respiratory  centre.    It  also  lessens 
the  secretion 
Benzoin,  3.    As  inhalation  or  as  spray 
Burgundy  Pitch.  4.    Emplastrum  in  chron^ 
bronchitis 


INDEX  OF  DISEASES  AND  EEMEDIES. 


J185 


Bronchitis,  Chronic. 

Camphor 

Cannabis  Indica,  1,    In  very  chronic  cases 
Carbolic  Acid.    As  inhalation  or  as  spray 
Carbonic  Acid  Gas,  1.    Inhaled 
Chamois-Leather  Waistcoat,  3. 
Cheken,  1.    The  fluid  extract  renders  expec- 
toration easier,  and  paroxysms  less  frequent 
Chloral  Hydrate,  1.  A  solution  of  gr.  x.  to 

Sj.  used  as,  a  spray  to  allay  cough 
Codeine.    In  place  of  opium  when  the  latter 

disagrees 
Cod-Liver  Oil.    One  of  the  most  useful  of  all 

remedies 
Colchicum.    In  acute  cases 
Conium,  1.    The  vapour  to  relieve  cough 
Copaiba.    Like  Balsam  of  Peru 
Creasote,  1.    Inhaled  to  allay  cough 
Crude  Petroleum,  1.    In  capsules  or  pills  in 

chronic  bronchitis 
Cubebs,  2,  4.    Like  Copaiba 
Digitalis.  Where  heart  is  feeble,  especially  in 

the  aged 
Emetics 

Eucalyptus.    Stimulant  expectorant 
Galbanum,  3.    Like  Ammoniacum 
Gallic  Acid.    With  profuse  discharge 
Grindelia,  2.    Expectorant  when  the  cough  is 

troublesome 
Hydrastis.    In  chronic  coryza 
Iodddes  2,  and  IODDfE,  3.     As  inhalation  or 

liniment  to  chest,  to  lessen  expectoration  in 

chronic    bronchitis ;   in   the   hoarse   hollow 

cough  of  infants  after  measles 
Ipecacuanha,  1,  3.    Wine  as  spray,  with  much 

expectoration ;  in  emetic  doses  in  children 

where  the  bronchioles  are  blocked  up  with 

mucus 
Iron.    When  expectoration  is  profuse 
Koumiss-Cure,  2.    Sometimes  very  useful 
Lobelia,  3.    When  there  is  spasmodic  dyspnoea 
Mercury,  1.    To  diminish  congestion 
Morphine,  lt  2.    To  quiet  cough,  in  small  doses 
Nitric  Acdd,  1.     In  mixtures  to  remedy  the 

effect  on  digestion  produced  by  sedatives  like 

opium 
Opium.    To  lessen  secretion  and  cough 
Phosphates,  3.    In  very  chronic  cases 
Physostigma,  4.    In  chronic  cases  with  great 

dyspnoea 
Plumbic  Acetate,  1.    In  profuse  secretion 
Potassium   Iodide,  1.    In  combination  with 

Antim.  Tart,  in  cases  of  great  dyspnoea.    The 

carbonate  in  viscid  secretion 
Sangutnaria,  2.    With  other  expectorants 
Senega,  3.    When  expulsive  efforts  are  feeble 
Serpentaria.    Like  Senega 
Spinal  Ice-bag,  3.    In  excessive  secretion 
Squill.    Where  expectoration  is  thick 
Stramonium,  1.    In  dry  cough 
Strychnine,  2.    As  respiratory  stimulant 
Sulphur,    3.      Where    expectoration   copious, 

bronchitis  severe,  and  constitutional  debility 
Sulphurous  Acid  Gas,  1,  2,  3.    As  inhalation 

or  spray 
Sumbul 
Tar.     To   lessen  secretion  and  allay  chronic 

winter  cough;  may  be  given  in  pill  or  as 

spray 
Terebene.    Internally,  or  as  inhalation 
Turkish  Bath,  3.    To  clear  up  a  slight  attack 

and  to  render  the  patient  less  susceptible  to 

taking  cold 
Turpentine,  1.    Liniment  to  chest  in  children 
Zinc    Oxide,   3.     To   control  too  profuse   a 

secretion 

BliONCHORRH(EA. 

Alcohol,  2.     Accordingly  as  it  agrees  or  dis- 
agrees with  the  patient 
Alum,  4.    A  remote  astringent 


BRONCHORRH(EA. 


Ammoniacum,  3.    In  old  people 

Ammonium  Carbonate,  2.  Stimulant  expec- 
torant 

Ammonium  Chlorldk,  2.  Stimulant  expec- 
torant 

Ammonium  Iodide,  3.  Small  doses  frequently 
repeated ;  value  increased  by  the  addition  of 
arsenic 

Asafcetida,  3.    Like  Ammoniacum 

Astringents,  4. 

Carbolic  Acid,  2.    As  spray 

Cod-Liver  Oll 

Copaiba,  2.  Stimulant  expectorant ;  to  be 
given  in  capsules 

Cubebs,  2.    Like  Copaiba 

Eucalyptus.    Sometimes  very  useful 

Gallic  Acid,  4.    Bemote  astringent 

Grindelia,  2.    Kespiratory  stimulant 

Iodlve.  As  counter-irritant  to  chest,  and  as 
inhalation 

Lead  Acetate,  3.   To  lessen  secretion 

Myrtol,  2.    In  profuse  fcetid  expectoration 

Oleum  Pini  Sylvestrjs.    As  inhalation 

Quinine,  2.    Tonic. 

Phosphates,  2.    Tonic. 

Spinal  Ice-bag,  3.    To  lessen  secretion 

Sulphurous  Acdd  Gas.  As  inhalation  or 
spray 

Terebene 

Turpentine,  2.  Stimulant  expectorant,  and 
also  as  inhalation 


Bruises. 


Aconite.    Liniment  locally,  to  relieve  pain 

Arnica.    As  local   application,  no   more   use 

than  alcohol,  and   sometimes    gives  rise  to 

much  inflammation ;  this  it  wilL  do  if  the 

skin  is  abraded 

'  Capsicum.    To  remove  discolouration  of  bruise 

Compressed  Sponge,  1. 

Convallaria  (Solomon's  Seal),  1.  The  juice 
from  the  fresh  root  will  take  away  a  '  black 
eye* 

Hamamelis,  3.    Locally 

Ice,  1 

Lead  Lotions.    To  allay  pain 

Oil  of  Bay.    Same  as  Capsicum 

Opium.    Local  application  to  relieve  pain 

Spirit  Lotion,  1. 

Sulphurous  Acid.  As  local  application  con- 
stantly applied 


Bubo. 


Argentic  Nitrate,  1.  A  saturated  solution, 
applied  over,  will  often  effect  absorption 

Bllsters,  1.  Followed,  up  by  application  of 
Tinct.  Iodi,  will  cause  absorption 

Chloral  Hydrate,  4.  25  per  cent,  solution, 
antiseptic  and  stimulant  application 

Copper  Sulphate,  1.    Gr.  iv.  to  3j. 

Hydrargyri  Perchlorddum.  1.  Epidermis  is 
first  removed  bya  blister  and  then  a  saturate*! 
solution  applied ;  a  poultice  is  then  applied  tv 
separate  the  eschar,  leaving  a  healthy  ulcer 

Ice.    To  relieve  pain  and  lessen  inflammation 

Iodine,  1,  3.  As  counter-irritant  applied  round 
the  bubo 

Iodoform,  1, 4.    As  local  application 

Lead  Lotions,  1.  Compresses  soaked  in  these 
will  abort,  or  assist  in  the  healing  process 

Mercury.  As  local  application  after  opening 
bubo,  when  syphilitic  affection  is  great 

Nitric  Acid,  1.  As  local  application  to  in- 
dolent bubo 

Peroxide  of  Hydrogen,  3.  Washed  and 
dressed  with  lint  soaked  in  it  . 

Potassa  Fusa,  1.    To  open,  instead  of  the  knife 

Potassio  -  Tartrate  of  Iron.  Local  and 
general- 

4g 


1186 


INDEX  OF  DISEASES  AND  EEMEDIES. 


Bubo. 


Potassium  Chlorate,  t.    Powdered  finely  and 

then  applied 
Silver  Nitrate.    Lightly  applied  to  surface 

in  indolent  bubo 
Sulphides,  3,    To  check  suppuration ;  not  so 

useful  as  in  an  ordinary  abscess 
Tartar  Emetic,  1.    When  inflammation  acute 

and  fever  considerable 


Bunion. 


Iodine.    Painted  on  in  indolent  forms 

Best.    "When  thickened  and  painful.    Pressure 

is  removed  by  thick  plaster.-,  with  a  hole  in 

the  centre 

Burns  and  Scalds. 

Alkalies,  1.    Soon  remove  the  pain  if  exposed 

to  the  air  after  application 
Alum,  1.    Finely  powdered  over  foul,  bleeding 

granulations 
Anhydrous  Dressings,  1. 
Argenti  Nitbas,  1.    Wash  with  a  solution  of 

gr.  iv.  to  gr.  viij.  to  5j.  and  wrap  in  cotton 

wool 
Bismuth  and  Glycerine,  I.    A  thick  paste 

of  the  subnitrate  protective 
Boric  Acid,  1,  2,  3.     Useful  as  ointment  or 

lint  dressings,  or  as  Boric  Oil 
Carbolic  Acid.   One  to  six  of  olive  oil,  locally ; 

1  per  cent,  solution  relieves  pain  and  prevents 

suppuration 
Carron  Oil,  1, 4.    In  recent  burns 
Chalk,  Oil,  and  Vinegar,  1,    Applied  as  a 

paste  of  a  creamy  consistence  relieves  pain  at 

once 
Chlorinated  Soda.    In  dilute  solution 
Chloroform,  Olive  Oil,  and  Lime-Water,  I, 

Soon  relieves  the  pain 
Cocaine,  3.    As  lotion  to  allay  the  pain 
Cod-Liver  Oil 
Cold,  1.    Instant  application 
Collodion,  2,  3.    Flexile,  to  protect  from  air 
Cotton  Wool.    To  protect  from  irritation  and 

so  lessen  pain 
Creasote,  1.    Like  Carbolic  Acid 
Gallje,  TJnguentum,  1.    To  prevent  cicatrix. 

Formula :  Ung.  gallse,  3]*«  Adipis  3j. 
Ice  to  Spine,  I. 

Iodoform,  1.    Local  anaesthetic  and  antiseptic 
Lead  Carbonate.    As  white  paint  for  small 

burns  ;  should  be  applied  instantly 
Lime,  3.     As  Lin.  Calcis,  or   lime-water  with 

linseed  oil 
Linimentum  Terebinthine,  (Kentish  Oint- 
ment, TT.S.P.),  2, 4.    To  be  applied  at  once  to 

the  injury 
Oakum,  1. 
Oil  and  Litharge,  1.    Applied  as  a  varnish 

containing  5  per  cent  Salicylic  Acid 
Ol.  Menthje  Piperita,  1.    Painted  on 
Phytolacca.    To  relieve  pain. 
Potassium  Chlorate,  1.    Solution  of  gr.  v.  to 

Sj.  locally 
Ehubarb  Ointment,  1.    One  part  of  root  to 

two  of  lard 
Salicylic  Acid,  2.    One  to  sixty,  olive  oil 
Soap  Suds,  1.    Instead  of  alkali,  if  it  is  not  at 

hand 
Sodium  Bicarbonate,  1.    Immediate  applica- 
tion of  a  saturated  solution 
Stimulants,  Local,  1.    Such  as  ITng.  Resinffl 

afterwards  followed  by  astringents 
Thymol,  1.     1  per   cent,  in  Olive  Oil,   local 

anaesthetic 
Treacle,    1.      A  useful    handy   remedy   for 

dressing 
Warm  Bath.    Keep  whole  body,  with  excep- 
tion of  head,  totally  immersed  for.  some  days 


Burns  and  Scalds. 

in  very  extensive  burns  or  scalds.  It  relieves 
pain,  although  it  may  not  save  life 

Whiting  and  Water,  1.  Mixed  to  the  thick- 
ness of  cream  and  smeared  over,  excluding 
the  air,  gives  instant  relief 

Zinc  Ointment  and  Vaseline.  In  equal  parts 
for  dressing 

Bursitis.  * 

Blisters.    Most  useful 

Carbolic  Acid,  4.    As  injection) 

Fomentations.    To  relieve  pain 

Iodine.    When  chronic,  Lin.  lodi  may  be  used 

as  a  blister,  or  the  liquor,  after  blistering  or 

aspiration 

Cachexia. 

Atr.    Fresh 

Aliment.    Nutritious 

Ammonium  Carbonate.  With  bark;  after 
acute  illness 

Arnica.    Internally,  in  bad  cases 

Arsenic,  1,  2.  In  malarial,  also  in  cancerous, 
cachexia ;  in  chronic  malaria,  combined  with 
iron 

Baths.    Turkish  bath  useful 

Chalybeate  Waters,  2 

Cholagogues.  Most  useful  before,  or  along 
with,  other  remedies,  and  especially  in  malarial 
cachexia  before  the  administration  of  quinine 

Electricity,  1 

Eucalyptus,  2.  In  general  cachectic  con- 
ditions 

Euonymin.    As  cholagogue 

Ferri  Succinas,  1,  2.  In  malarial  cachexia; 
iron  generally  in  all  ansemic  conditions 

Glycerine,  4.    As  a  food 

Grape  Cure 

Hydrastis.    In  malaria 

Manganese,  2.  Along  with  iron  and  as  syrup 
of  double  iodide 

Massage,  2.    Exceedingly  useful 

Mercury.   In  syphilitic  cases ;  see  Cholagogues 

Nitric  Acid.  In  debility  after  acute  disease ; 
in  combination  with  the  fresh  decoction  of 
bark 

Oil  and  Fats,  2.  Cod-liver  oil  very  useful. 
Cream  as  an  addition  to  food;  oil  as  in- 
unction 

Phosphates.  In  cachexise  attended  with  much 
discharge 

Phosphate  of  Calcium,  I.  In  scrofulous 
phthisis  and  malnutrition 

PoDophyllin.  As  cholagogue  ;  in  children  of  a 
few  months  old  improperly  fed  ;  in  alcoholic 
excess  ;  chronic  morning  .diarrhoea 

Potassium  Iodide.  In  syphilitic  and  resulting 
conditions 

Purgatives,  Saline.  As  adjuncts  to  chol» 
gogues 

Quinine,  2.    In  various  forms  of  cachexia 

Sarsaparilla.    In  syphilis 


Calculi,  Biltart. 


Aliment,  2.  Absence  of  starch  and  fat  recom- 
mended 

Anesthetics,  4.  During  the  passage  of  the 
calculus 

Belladonna,  4.    Relief  during  spasm 

Carlsbad  Waters,  1.    Prophylactic 

Chloral  Hydrate,  1.  To  relieve  pain  during 
paroxysm  ;  good  in  combination  with  morphine 

Chloroform.  Inhalation  from  tumbler,  most 
useful  to  relieve  paroxysm 

Counter-Irritation,  3.  To  relieve  pain  during 


INDEX  OF  DISEASES  AND  REMEDIES. 
Calculi,  Biliary.  Cancer. 


U87 


Creasote,  1.  "Where  the  mischief  arises  from 
the  intestinal  canal 

Emetics,  4.  Of  doubtful  value  in  aiding  the 
expulsion  of  the  calculus 

Ferri  Succinas,  1.  As  a  solvent  for  existing 
stou33,  and  prophylactic 

Ferri  Peruhlor.  Tlnctura,  1,  Like  Creasote, 
as  an  astringent.  Useful  if  renal  changes 
complicate 

Iridin,  l.  in  doses  of  gr.  j.  for  its  cholagogue 
properties 

Mercury,  1.  The  green  iodide,  with  manna  and 
soap  as  a  pill 

Morphine.  J  gr.  (repeated  if  necessary)  with 
r$3  gr.  atropine,  subcutaneoualy,  to  relieve 
pain  and  vomiting  in  paroxysm 

Nitric  Acid,  1.  Hepatic  stimulant  and  altera- 
tive 

Nitro-Hydrochloric  Acid,  1.  Same  as  Nitric 
Acid 

Nitro-Hydrochlorio  Bath.  To  cause  expul- 
sion of  calculus,  and  to  relieve  pain 

Oil,  1.  In  large  doses  has  been  followed  by  the 
expulsion  of  gall-stones 

Purton  Spa,  1 

Salicylate  op  Sodium.    As  prophylactic 

Sodium  Carbonate,  1.  In  large  quantity  of 
hot  water  during  passage  of  stone.  At  first 
there   is  usually   vomiting,    but    this    soon 


Sodium  Phosphate,  1,  2.  In  20  or  30  gr.  doses 
before  each  meal  as  prophylactic.  Should  be 
given  in  plenty  of  water 

Sprudel  Spa,  1 

Turpentine  and  Ether,  1,  2.  Durande's 
remedy.  Equal  parts  to  relieve  pain  during 
paroxysm  ;  also  occasionally  as  prophylactic 
along  with  a  course  of  Carlsbad  or  Yichy 
water 


Calculi,  Renal  and  Vesical. 

Alkalies,  2,  3.    To  resolve  calculi,  potash  and 

soda  to  be  used 
Alkaline  Mineral  Waters.  Especially  Vichy 

and  Bethesda 
Ammonium  Benzoate,  2.    To  resolve  phosphatic 

calculi 
An-esthetics.     To  relieve  pain  during  passage 

of  calculus 
Belladonna,  4.  Sometimes  relieves  the  pain  of 

the  passage  of  calculus 
Borocitrate  of  Magnesium,  1,  2.    To  dissolve 

uric  acid  calculus.    Formula  :  Magnesii  carb. 

3].;  Acid,  citric,  3i].;  Sodii  biborat.  3ij.;  Aquae, 

Jviij.  m.  sig. ;  3ij.  ter  die 
Calumba.    To  relieve  vomiting 
Castor  Oil.    As  purgative 
Chloroform.    As  in  biliary  calculi 
Cotton  Root.    As  decoction  to  relieve  gravel 

and  strangury 
Counter-Irritants,  3.    To  lessen  pain  during 

passage  of  calculus 
Cows'  Urine  (Hippuric  Acid),  1 
Mineral  Waters,  especially  Wildungen 
Morphine.    Hypodermically,  as  in  biliary  cal- 
culi 
Nitric  Acn>.     Dilute,  as  injection   into  the 

bladder  to  dissolve  phosphatic  calculi 
Potassium  Boro-Tartrate,  2.    More  efficient 

than  the  magnesium  salt ;  prepared  by  heating 

together  four  parts  of  cream  of  tartar,  one,  of 

boric  acid,  and  ten  of  water.    20  gr.  three 

times  a  day  well  diluted 
Potassium  Citrate.    In  hematuria  with  urio 

acid  crystals 
Water,  Distilled.    As  drink 


Acetic  Acn>.    As  injection  into  tumours 

Acid  Nitrate  of  Mercury 

Acids.    Internally  in  cancer  of  stomach 

Aluminium  Sulphate,  1.  A  caustic  and  disin- 
fectant application 

Argenti  Nitras,  1.  A  saturated  solution  in- 
jected in  several  places ;  to  be  followed  by  an 
injection  of  common  salt  of  a  strength  of  1  in 
1,000 

Arsenic,  1,  2,  3,  4.  As  local  application,  causes 
cancer  to  slough  out.  Sometimes  successful 
when  the  knife  fails,  but  is  dangerous.  In- 
ternally, in  cancer  in  stomach  lessens  vomiting. 
Supposed  to  retard  growth  of  cancer  in  stomach 
and  other  parts 

Belladonna.  Locally  relieves  pain.  Used  in- 
ternally also 

Bismuth,  2.  To  relieve  pain  and  vomiting  in 
cancer  of  stomach 

Bromine  CHLORroES,  1.  Alone  or  combined 
with  other  caustics.  To  be  followed  by  a 
poultice 

Bromine,  Pure,  2.  As  caustic  to  use  round 
cancer 

Carbolic  Acid,  1,  2,  3.  As  application  or  in- 
jection into  tumour  to  lessen  pain,  retard 
growth,  and  diminish  fcetor 

Carbonic  Acm,  1,  3.  To  relieve  pain  in  uterine 
cancer 

Caustic  Alkalies,  1.  In  strong  solution  dis- 
solve the  cells. 

Charcoal  Poultices.  To  relieve  pain  and 
fcetor 

Chian  Turpentine,  1.  Benefits  cases  according 
to  the  experience  of  some— of  others,  it  is  use- 
less 

Chloral  Hydrate,  3,  4.    To  lessen  pain 

Chloroform.  Vapour  as  local  application  to 
ulcerated  cancer 

Chromic  Acid,  2.    As  caustic 

Citric  Acid,    As  lotion  to  allay  pain,  1  in  60 

Codeine,  1.  As  a  sedative  in  cases  of  abdo- 
minal tumour 

Cod-Liver  Oil,  1.    In  cachexia 

Coffee,  1.    Disinfectant,  applied  as  fine  powder 

Conium,  2,  3,  4.  As  poultices  to  relieve  pain. 
Used  internally  also 

Gas  Cautery,  1.  A  form  of  actual  cau- 
tery 

Glycerine  of  Carbolic  Acid,  3.  Same  as  Car- 
bolic Acid 

Glycerine  of  Tannin,  3.  Mixed  withiodine,  to 
check  discharge  and  remove  smell  in  uterine 
cancer 

Hematoxylin  Extract,  1.  To  a  fungating 
growth 

Hydrastis,  1, 2.    Palliative  application 

Hyoscyamus.    Bruised  leaves  locally  applied 

Iodoform,  1, 2,  3.  Locally,  to  lessen  pain  and 
fcetor 

Iron  and  Manganese.    Internally  as  tonics 

Lime,'  1.    As  caustic 

Opium,  3.  Locally  and  generally,  to  relieve 
pain 

Papain.    As  local  application  or  injection 

Pepsin.    As  injection  into  tumour 

Potassium  Chlorate,  2.  Allays  the  pain  arte 
removes  the  fcetor 

Potassa  Fusa,  2.    As  escharotio 

Poultices.    To  relieve  pain 

Salicylic  Acu>.  Locally  applied  as  powder  or 
saturated  solution 

Sodium  Ethylate,  1.    A  powerful  caustic 

Stramonium,  1.    Ointment  to  relieve  pain 

Terebene,  1.    Disinfectant  dressing 

Vienna  Paste 

Warm  Enemata,  3.  To  lessen  pain  in  cancer  of 
rectum 

Zinc  Chloride,  2.    As  caustic 

Zinc  Sulphate,  2.    As  caustic- 


4  G  2 


1188 


INDEX  OF  DISEASES  AND  EEMEDIES. 


Cancrum  Obis. 


Cataract. 


Arsenic.    Internally 
Nitric  Acn>.    Undiluted  as  local  caustic 
Potassium  Chlorate,  1.    Internally  in  stoma- 
titis ;  useless  in  noma 
Quinine.    As  syrup  or  enema 


Carbuncle. 


Alcohol.    As  needed 

Ammonium  Carbonate.    Combined  with  bark, 

after  a  free  purge 
Arnica,  3.     Fresh  extract  spread  on  adhesive 

plaster  and  strapped ;  internal  administration 

is  also  beneficial 
Belladonna   Extract.     With  glycerine,   as 

local  anodyne 
Blister,  1.    To  cover  area,  with  a  hole  in  the 

centre  to  allow  discharge 
Boric  Acid,  1.  As  dressing 
Butyl-Chloral  Hydrate,  1.    To  lessen  the 

pain  of  facial  carbuncle 
Calcium  Sulphide,    -fa  gr.  hourly  useful 
Carbolic  Acid.    As  wash  and  injection  after 

spontaneous    discharge,    or    oa    lint    after 

opening 
Collodion.     Bound  base,  leaving  opening  in 

centre 
Ether,  1.  Sprayed  on  for  a  little  time  will  cause 
,  an  eschar  to  separate 
Hydrargyri,  TTnguentum,  1.  Early  application 

will  abort  sometimes 
Iodine.    Locally,  to  lessen  pain  and  inflamma- 
tion, should  be  applied  around  the  base 
Iodoform.    Useful  local  antiseptic  dressing 
Opium.    Locally,  mixed  with  glycerine 
Potassium  Chlorate  and  Mineral  Acids,  1. 

Internally  administered 
Potassium    Permanganate,    1.     Antiseptic 

lotion 
Poultices.    To  relieve  pain 
Strapping-.  Concentrically,  leaving  centre  free, 

lessens  pain 
Terebene,  or  Turpentine.    Antiseptic  appli- 
cation 


Caries. 


Calcium  Carbonate 

Calcium  Chloride 

Carbolic  Acid,  1.  As  a  disinfectant  lotion ; 
often  heals  under  this  treatment 

Cod-Liver  Oil 

G-old.    In  syphiloma  of  bone 

Iodine,  1.    Locally  and  internally ' 

Phosphates  of  Calcium  and  Iron.    Useful 

Phosphoric  Acid.  Diluted,  1  in  8  of  water, 
locally 

Phosphorus 

Potassium  Carbonate,  1.  Concentrated  solu- 
tion locally  applied 

Potassa  Pusa,  1.  To  carious  bone  to  remove 
disorganised  portion 

Potassium  Iodide.    In  syphilitic  cases 

Sarsaparilla 

Sulphuric  Acid,  1.  Injection  (one  of  strong  acid 
to  two  of  water)  into  carious  joints,  and  locally 
to  carious  or  necrosed  bone.  To  be  useful  the 
disease  must  be  superficial. 

Villate's  Solution— Cupri  sulph.,  Zinc,  sulph. 
aa  partes xv.,  Lig.  plumb,  subacetat.  part,  xxx., 
Acid  acet.  part,  cc,  as  injection  into  a  sinus 

Catalepsy. 

Chloroform,  1.    Inhaled 
Sternutatories 

Turpentine.  As  enemata  and  embrocations  to 
spine  during  paroxysms 


Codeine,    In  diabetic  cases 

Diet  and  Kegimen.    Nutritious  in  senile  cases. 

Sugar  and  starch,  to  be  avoided  in  diabetic 

cases 
Galvanism.    In  early  stage 
Mydriatics.    To  dilate  pupil  as  a  meaus  of 

diagnosis 
Phosphorated  Oil,  1.    Instilled  into  the   eye 

will  lead  to  absorption  if  borne 

Catarrh,  Acute  Nasal. 

Aconite,  3.  Internally  at  commencement, 
especially  in  children 

Aconite  and  Belladonna,  2.  In  sore-throat 
and  cold  with  profuse  watery  secretion,  one 
drop  of  tinct.  of  aconite  to  two  of  belladonna 
every  hour 

Aconite  Liniment.  To  outside  of  nose  in 
paroxysmal  sneezing  and  coryza 

Ammonia,  2.  Asinhalation  in  early  stage,  while 
discharge  is  serous 

Ammonium  Chloride,  4.  In  the  catarrh  of 
young  children 

Ammonium  Iodide,  2.    1  gr.  every  two  hours 

Argenti  Nitras,  1.  Injection  of  a  solution  of 
gr.  x.  to  3j. 

Arsenic.  Internally,  or  as  cigarettes  in  pa- 
roxysm and  chronic  cases ;  valuable  in  cases 
which  exactly  simulate  hay  fever 

Baths.  Hot  foot-bath.  Turkish,  at  com- 
mencement ;  cold  bath  is  prophylactic 

Belladonna,  2.  5  m.  of  tinct.,  and  afterwards 
one  or  two  doses  every  hour  until  the  throat 
is  dry  in  acute  nasal  catarrh,  with  profuse 
watery  secretion,  and  in  ordinary  sore-throat 

Benzoic  Acid,  1.  In  ordinary  catarrh,  for  its 
stimulant  effects 

Bismuth,  as  Ferrier's  Snuff— Bismuth  subnit. 
ij,  Acaciai  pulv.  3ij.,  Morph.  hydrochlor. 
gr.  ij. 

Camphor.    As  inhalation 

.Cabbolic  Acid.  As  inhalation,  or  much  diluted 
as  spray.  As  gargfe,  1  in  100,  when  catarrh 
tends  to  spread  from  nose  into  throat  and 
ohest,  or  to  ascend  from  throat  into  nose 

Cimicifuga,  2.  In  coryza  accompanied  by 
rheumatic  or  neuralgic  pains  in  head  and  face 

Cold  Powder—  Camph.  partes  v,  dissolved  in 
ether  to  consistence  of  cream,  add  Amnion, 
carbonat.  partes  iv.  and  Pulv.  opii  pari  j. 
Dose,  grs.  iij-x.  To  break  up  or  modify 
cold 

Cubebs.  Powder  as  insufflation  ;  also  smoked ; 
also  the  tincture  in  3ss.  doses  with  infusion 
of  linseed 

Ferrier's  Snuff,  vide  Bismuth 

Hot  Sponging,  3.    To  relieve  the  headache 

Iodine  and  Iodides.  As  inhalation  ;  like  am- 
monium iodide 

Iodoform  and  Tannin,  2.    As  insufflation 

Ipecacuanha,  2,  3.  In  moderate  doses  (gr.  x.) 
Dover's  powder  at  night  will  cut  short  an 
attack.    The  wine  as  spray  to  the  fauces 

Jaborandi,  1.  As  tincture  or  hypodermic 
injection  of  half  a  grain  of  pilocarpine 

Nux  Vomica.    In  dry  cold  in  the  head 

Oil.  Inunction  to  whole  body  to  lessen  sus- 
ceptibility. Locally  to  nose.  -  Sometimes 
ointment  may  be  used  instead 

Opium,  3.  As  Dover's  powder  at  commence- 
ment; but  not  with  obstruction  to  respiration 

Potassium  Bichromate.  Solution  locally,  1  to 
10  gr.  in  4  oz. 

Potassium  Chlorate.  Eight  or  ten  lozenges  a 
day  to  check 

Potassium  Iodide.  10  gr.  at  bedtime  to  avert 
acute  coryza 

Pulsatilla,  2.  Warm  lotion  applied  to  interior 
of  nares  ;  or  internally,  but  not  with  symptoms 
of  intestinal  irritation 


INDEX  OF  DISEASES  AND  EEMEDIES. 


1189 


Catarrh  ,  Acute  Nasal. 

,  Quinine.  10  gr.  of  quinine  with  £  gr.  morphine 
at  commencement  may  abort  it 

Salicylate  of  Sodium.  2fc  gr.  every  half-hour 
to  relieve  headache  and  neuralgia  associated 
with  coryza 

Sang-uinaria.    Internally,  and  powder  locally 

Ska-water  Gargle 

Spray.  Useful  means  of  applying  solutions 
such  as  ipecacuanha  wine,  already  men- 
tioned 

Sugar,  1.  Finely  powdered  and  snuffed  up  the 
nose  in  catarrh  due  to  potassium  iodide 

Sulphurous  Acid.  As  inhalation,  spray,  or 
fumigation 

Tannic  Acid,  1.  Injection  of  a  solution  in 
rectified  spirit 

Tartar  Emetic,  2,  3.  ^  to  ^  gr.  at  commence- 
ment, especially  in  children  with  thick  and 
abundant  secretion 

Turkish  Bath,  3 

Veratrum  Viride.    If  arsenic  fails 

"Warm  Foot-Bath,  3.    Before  going  to  bed 

Zinc  Sulphate,  1.  As  injection  to  nose,  gr.  j. 
to3j. 

Catarrh,  Chronic  Nasal. 

Alum.    In  powder  by  insufflation,  or  in  solution 

by  douche 
Ammonia.    Inhalation 
Ammonium  Chloride,  3.  In  thick  and  abundant 

secretion 
Asafcetida,  4.    Stimulant  expectorant 
Balsam  op  Peru,  4.    Stimulant  expectorant 
Benzoic  Acid,  4.    Inhaled  as  vapour 
Bromine.      As    vapour,    inhaled   with    great 

caution 
Carbolic  Acid.    1  to  100  as  spray,  or  1  to  200  as 

douche.    1  part  with  4  of  iodine  tincture  as 

inhalation  or  by  spray 
Cod-Liver  Oil,  2 
Cubebs,    2.      In   powder,   by   insufflation    or 

trochees 
Ethyl  Iodide,  2.    As  inhalation 
Eucalyptol,  3.  In  chronic  catarrh  with  profuse 

secretion 
Hamamelis,  3.     In  chronic  catarrh,  snuffed  up 

nose 
Hydrastis,  2.    In  chronic  catarrh 
Iodine,  2.    Vapour  inhaled 
Iodoform  and  Tannin,  2.    Insufflated 
Sangudcaria,  2.    In  very  chronic  cases 
Turpentine.    As  liniment  to  chest 


Cerebral  Anemia. 


Ammonia,   2.     Inhaled   is   useful   in   sudden 

attacks 
Amyl  Nitrite.    To  act  on  vessels 
Arsenic,  2.  In  hypochondriasis  of  aged  people ; 

best  combined  with  a  minute  dose  of  opium 
Aurum,  2.    Melancholic  state _ 
Caffeine.    In  hypochondriasis 
Camphor 

Chalybeate  Mineral  "Waters,  2 
Chloral  Hydrate.  In  small  doses,  withstimn- 

lants 
Digitalis 

EliECTRICITY 

Glycerine 

Guarana,  2.    Eestorative  after  acute  disease 
Iron  ,  , 

NiTEp-G-LYCERDm    To  dilate  cerebral  vessels. 

Like  Nitrite  of  Amyl 
Nux  Vomica 
Phosphorus  and  Phosphates,  2.   To  supply 

nutriment 
Quinine,  2 
Btrychnete,  2 


Cerebral  Concussion. 

Best.    Absolute  to  be  enjoined 
Stimulants.    To.be  avoided 
"Warmth.    To  extremities 

Cerebral  Congestion. 

Aconite,  2.    In  acute  cases  before  effusion  has 

taken  place 
Arsenic,  2.    In  commencing  atheroma  of  cere- 
bral vessels  and  tendency  to  drowsiness  and 

torpor 
Belladonna.    Very  useful 
Bromides.    Very  useful 
Cathartics.    To  lessen  blood-pressure 
Chloral  Hydrate.    When  temperature  high 
Colchicum.    In  plethoric  cases 
Colocynth.    As  purgative 
Diet.    Moderate,  animal  food   sparingly,  and 

stimulants  to  be  avoided 
Digitalis,  5.    In  alcoholic  congestion;   and 

simple  congestive  hemicrania 
Ergot,  2.    In  want  of  arterial  tone,  or  miliary 

aneurisms  causing  vertigo,  &o. 
Galvanism  of  head  and  cervical  sympathetic 
Gelsemium,  2.     In  great   motor  excitement, 

wakefulness,  horrors  after  alcoholic  excess 
Hydrocyanic  Acid 
Venesection,  2.    A  suitable  remedy  in  cases  of 

threatening  rupture  of  a  vessel 
Veratrum  Viride,  2.    In  acute  congestion,  the 

good  ceases  with  exudation 
"Water,    Cold  douche  to  head,  and  warm  to 

feet,  alternately  hot  and  cold  to  nape  of  neck 

Cerebritis. 

Ammonium  Chloride,    Locally 
Ice 

Chancre. 

Calomel,  1.    Applied  locally 

Camphor,  1.    Finely  powdered 

Canqoodt's  Paste,  4.     Zinc  chloride,  1  in  6, 

made  into  paste  and  applied 
Carbolic  Acuj.    Locally 
Caustics.    Chromic  acid,  bromine,  acid  nitrate- 

of  mercury,  zinc  chloride,  nitric  acid,  caustic 

Eucalyptol,   3.     Mixed  with  iodoform  and 

locally  applied 
Hydrogen  PEROxroE.    Constantly  applied  to 

destroy  specific  character 
Iodoform,    One  of  the  best  remedies 
Mercury.    Internally.    Black  wash  locally ;  or 

yellow  wash,  or  corrosive  sublimate  in  solution 


Chancroid. 


Camphor,  1.    Finely  powdered 

Carbolic  Acid.  As  injection  and  local  appli- 
cation 

Caustics.    Sometimes  necessary 

Eucalyptol,  3.    With  iodine 

Ferric  Iodide,  2,  3.  Internally  in  phageduenia 
cases,  or  debility 

Ferrum  Tartaratum.    Like  Ferric  Iodide 

Iodoform.    Very  useful 

Mercury.    Acid  nitrate  as  local  application 

Nitric  Acn>.    Locally  as  caustic 

Potassium  Chlorate,  1.    In  fine  powder 

Chapped  Hands  and  Lips. 

Benzoin,  4.    Compound  tincture,  1  part  to  4  of 

glycerine 
Collodion 
Glycerine.    Saturated  with  half  the  quantity 

of  eau  de  cologne ;  or  as  glycerinum  amyli 


1190 


INDEX  OF  DISEASES  AND  EEMEDIES. 


Chapped  Hands  and  Lips.         Cholera  Asiatica. 


Hydrastis.    As  lotion 

Lotio  Plumbi,  1' 

Solution  of  G-utta  Pbbcha,  1.    Protective 

Sulphurous  Acid.    As  lotion  or  as  fumigation 


Chest  Pains. 


Belladonna,  3.    In  pleurodynia,  as  plaster  or 

ointment 
Iodine,  3.    In  myalgia  as  ointment 


Chicken  Pox. 


Aconite 

Ammonium  Acetate 

Bath.   Cold  in  hyperpyrexia.   Warm  as  diapho- 
retic 
Compress,  Cold.    If  sore-throat. 
Laxatives 


Chilblains. 


Aconite,  1 

Arnica.    Useful 

Balsam  of  Pert;,  3.    As  ointment  when  "broken 

Basilicon.    Ointment. 

Cajeput  Oil 

Capsicum,  Tincture.  Locally,  -when  unbroken, 
a  strong  tincture  and  solution  oi  gum  arabio 
in  equal  parts  on  silk 

Carbolic  Acid,  2.  With  tincture  of  iodine  and 
tannic  acid  as  ointment 

Cod-Liver  Oil.   Internally 

Collodion 

Copper  Sulphate,  1.    Solution  of,  gr.  iv,  to  5j. 

Electricity 

Iodine,  1,  2,  3.  Ointment  or  tincture  to  un- 
broken chilblains 

Sulphurous  Aero,  1,  2,  3.  Diluted  with  equal 
part  of  glycerine,  as  spray,  or  as  fumes  of  burn- 
ing Bulphur 

Tincture  of  Opium,  1.    Locally  to  ease  itching 

Turpentine,  2 


Chlorosis. 


Arsenic.    In  place  of,  or  along  with,  iron 

Benzoin 

Berberine  Sulphate,  1.    Inferior  to  quinine 

Cocculus  Indicus.    In  amenorrhcea  and  leu- 

corrhcea 
Ergot.    In  chlorotic  amenorrhcea 
Eerri  Iodidum,  1. 

FERRO-MANGA  NATES,  1 

Galuc  Ach>,  1 

Hypophosphite  of  Calcium,  or  Sodium,  3 

Iron.  3.  Carbonate,  useful  form.  Sometimes 
best  as  chalybeate  waters.  In  irritable 
stomach  the  non-astringent  preparations ;  in 
weak  ansemic  girls,  with  pain  and  vomiting 
after  food,  the  persalts  are  best 

Manganese.    In  amenorrhcea 

Massage.  Useful,  combined  with  electricity 
and  forced  feeding 

Nux  Vomica,  2.    Useful,  combined  with  iron 

Oils  and  Pats.    As  inunction 

Pancreattn,  2.    To  improve  digestion 

Pepsm.    When  digestion  imperfect 

"Potassium  Iodide 

Purgatives.    Useful ;  often  indispensable 

Sea -Bathing 

Zinc  Phosphide 


Choking. 


Potassium  Bromide,  3.    In  children  who  choke 
over  drinking,  but  who  swallow  solids  readily 


.Alcohol,  2.  Iced  brandy,  to  stop  vomiting, 
and  stimulate  the  heart 

Ammonia,  1,  4.    Intravenous  injection 

Amyl  Nitrite 

Antimony,  1  ,  ,  , 

Arsenic.  In  small  doses,  has  been  used  to 
stop  vomiting.  . 

Atropine,  2.    Hypodermically  in  collapse 

Boric  Acid,  1 

Cajeput  Oil  „  ... 

Calomel,  2.    In  minute  doses  to  allay  vomiting 

Camphor,  2,  3, 4.  mv.  of  strong  tincture,  along 
with  tincture  of  opium,  every  ten  minutes, 
while  the  symptoms  are  violent,  and  then  every 
hour 

Cannabis  Indica,  1 

Cantharides 

Capsicum,  1 

Carbolic  Acid,  2.  Gr.  ss.  along  with  mi],  °* 
iodine  every  hour 

Chloral  Hydrate.  Subcutaneously,  alone,  or 
with  morphine  in  the  stage  of  collapse 

Chloroform,  2  or  3  min.,  either  alone  or  with 
opium,  every  few  minutes  to  allay  the  vomiting 

Cinnamon 

Copper  Salts.  Sometimes  used  to  stop  vomit- 
ing 

Corrosive  Sublimate 

Counter-irritation  over  Epigastrium 

Greasote,  1.  Alone  or  with  opium  to  allay 
vomiting 

Dry  Paceing,  1 

Guaco,  1 

Hydrocyanic  Acid 

Ice  to  Spine,  3.    For  cramps 

Ipecacuanha,  1 

j  a  bora  n  dc,  1 

Lead  Acetate.  Has  been  used  as  an  astringent 
in  early  stages  along  with  camphor  and  opium 

Morphdje,  3.  One-eighth  to  one-fourth  of  a 
grain  subcutaneously  to  relieve  cramps 

NaphthalIn.    May  be  useful 

Nitric  Aero 

Opium,  2.  In  subcutaneous  injection  ^Vi  Sr- to 
check  the  preliminary  diarrhoea,  and  arrest  the 
collapse 

Permanganates 

Phosphoric  Acid,  1 

Physostigma,  1 

Podophylun,  1 

Potassium  Bromtoe,  1 

Qudsixe,  1 

Ricinl.  Oleum 

Saline  Injections,  2.  Into  the  veins  have  a 
marvellous  effect  during  col  lapse,  in  apparently 
restoring  the  patient,  but  their  benefit  is  gene- 
rally merely  temporary 

Strychnine.  Has  been  used  during  the  prelimi- 
nary diarrhoea,  and  also  as  a  stimulant  to 
prevent  collapse 

SULPHO-CARBOLATES,  1 

Sulphuric  Acid.  Alone,  or  with  opium,,  is 
very  effective  in  checking  the  preliminary 
diarrhoea 

Transfusion  of  Melk.  Has  been  used  in  col. 
lapse 

Turpentine.  Has  sometimes  appeared  service- 
able in  doses  of  10-20  m.  every  two  hours 

Cholera  Infantum. 

Aliment.    Milk 

Arsenic.    For  vomiting  in  collapse 

Bismuth  Sub-Nitrate,  1, 2.    In  emulsion 

Biiandy,  2.    In  full  doses 

Caffeine 

Calomel,  2.  In  minute  doses  to  arrest  the 
vomiting 

C.\  mphor,  2.  Where  there  is  very  great  depres- 
sion, 


INDEX  OP  DISEASES  AND  EEMEDIES. 


1191 


Cholera  Infantum. 

Carbolic  Acid,  2.    With  bismuth  or  alone  very 

effective 
Cold.  4.    Bath  at  75°  F.  every  three  or  four 

hours,  or  cold  affusions 

CREA80TE,  I 

Cupri  Sulphas,  2.    In  very  minute  doses  up  to 

the  one  thirty-secondth  of  a  grain 
Ferri  et  Ammonii  Oiteas,  1 
Ice  to  Spine,  1 

Ipecacuanha.  When  stools  greenish  or  dysen- 
teric 

Lead  Acetate.    Very  useful 

Liquor  Calcis,  1 

Mercury,  2,  3.  J  gr.  of  grey  powder,  hourly. 
In  urgent  cases  a  starch  enema  should  be 
given,  containing  a  minute  quantity  of  lauda- 
num 

Nux  Vomica,  1 

Oleum  Ricini 

Peptonized  Milk,  1 

Potassium  Bromide,  2.  In  nervous  irrita- 
bility and  feverishness 

Potassium  Chlorate,  4.    In  enemata 

Keborcin 

Rhubarb,  1 

Silver  Nitrate.  After  acute  symptoms  are 
past 

Sodium  Phosphate 

Tannin  and  Glycerin 

Zinc  Oxide,  2.    With  bismuth  and  pepsin 


Cholera  Simplex. 


Alcohol.    Dilute  and  iced. 

Arsenic.    To  stop  vomiting 

Atropine,  2.  Hypodermically,  an  efficient 
remedy 

Cajeput  On..    Used  in  India 

Calumba.    As  anti-emetic 

Camphor.    Very  useful 

Carbolic  Acid,  2.    With  bismuth 

Chloral  Hydrate.  Subcutaneously,  very  use- 
ful 

Copper  Salts.    As  astringent 

Ipecacuanha.    Very  useful 

Lead  Acetate,  2.  At  commencement  and  be- 
fore administering  opium,  in  order  to  deplete 
the  vessels 

Mustard.  Internally,  as  emetic ;  poultice  over 
chest 

Opium.    Hypodermically 

Salines,  2.    To  precede  the  use  of  Lead  Acetate 

Sumbul 

Veratrum  Album 


Chordee. 

Aconite.    1  m.  every  hour 

Amyl  Nitrite,  1 

Atropine,  2.  Subcutaneously  along  with  mor- 
phine 

Belladonna.  With  camphor  and  opium,  in- 
ternally, very  useful 

Bromh>es.    Especially  of  Potassium 

Brominated  Camphor,  4  ,,..,,. 

Camphob,  2,3,4.    Internally,  useful  in  full  doses 

Cannabis  Indica 

Cantharis,  2,  3.  One  drop  of  tincture  three 
times  a  day  as  prophylactio  _ 

Colchicum,  2.    3ss.  of  tincture  at  night 

Cubebs 

Digitalis,  1  , 

Lupulin,  2,  4.    As  prophylaotic 

Morphine.  Hypodermically,  in  penmnum  at 
night,  most  useful  -,....         L     «.  „» 

Tartar  Emetic,  2.  If  earned  to  the  extent  of 
producing  nausea 

TobIoco  Wine,  2.  Just  short  of  nauseating  at 
bedtime 


Chorea. 

ANttlN,  1 

Amyl  Nitrite,  1 

Antimony,  1,  3.    In  gradually  increasing  doses 

twice  a  day,  to  maintain  nauseating  effect 
Apomorphine,  3 

Arsenic.    Useful  sometimes ;  must  be  pushed 
till  eyes  red  or  sickness  induced,  then  discon- 
tinued, and  then  used  again 
Belladonna,  1 
Bromide  of  Iron,  4 
Bromide  of  SoDruM,  4 

Calcium  Chloride,  1,  2.    In  strumous  subjects 
Cannabis  Indica,  2.    May  do  good;  often  in- 
creases the  choreic  movements 
Chloral  Hydrate,  2, 3,4.  Sometimes  very  use- 
ful in  large  doses,  carefully  watched,  also  where 
sleep  is  prevented  by  the  violence  of  the  move- 
ments 
Chloroform,  3.    As  inhalation  in  severe  cases 
Cimictfuga,  3.    Often  useful,  especially  when 
menstrual  derangement,  and  in  rheumatic 
history 
Cocculus,  Picrotoxine,  2.   In  large  doses 
Cod-Liver  Oil 

Cold,  1,  3.    To  spine  or  sponging,  but  not  with 
rheumatism,  pain  in  joints,  fever ;  best  to 
begin  with  tepid  water 
Conium,  2,3,4.    The  succus  is  sometimes  useful, 

must  be  given  in  large  doses 
Copper.    The  ammonio-sulphate  in  increasing 

doses  till  sickness  produced 
Curare,  1 

Electricity,  1,  2.    Static  electricity 
Ether  Spray,  1.    Instead  of  cold  to  spine 
Hyoscyamus,  1 
Iron,  1, 2, 3.    Chalybeate  waters  in  ansemia  and 

amenorrhoea 
Lobelia,  4.    Only  in  nauseating  doses 
Mineral  Water  Baths,  1 
Morphine,  2,  3.  Subcutaneously  in  severe  cases, 
until  effect  is  manifested ;  by  mouth  in  com- 
bination with  chloral  best 
Muss,  3 
Physostigma,  3.    Three  to  six  grains  of  powder 

a  day  for  children,  ten  to  twenty  for  adult 
Potassium  Bromide 
Quinine,  1 
Silver,  3.    The  oxide  and  nitrate  sometimes  do 

good 
Strychnine,  2.  Useful  at  puberty,  or  in  chorea 

from  fright 
Valerian,  3.    To  control  the  movements 
Veratrum  Vdjide,  3.    Has  been  employed 
Water.    Cold  affusion  to  spine  useful 
Zntc  Sulphate,  1,  3.    In  small  but  very  fre- 
quent doses,  and  when  the  nausea  produced  is 
unbearable  another  emetic  to  be  used 


Choroiditis. 


Mercury 
Opiates 

Climacteric  Disorders. 

Aconite,  mj  hourly  for  nervous  palpitations 
and  fidgets 

Ammonia,  2,  3.  As  inhalation.  Raspail  s  Em 
sedative  locally  with  headache.  R  Sodii 
chloridum,  iij. ;  Liq.  ammoniaB,  Sij.;  Spiritus 
camphoree,  3iij.  J  Aquam  ad  Sxxxij. 

Ammonium  Chloride.    Locally  in  headache 

Calabar  Bean,  2.    In  flatulence,  verti?o,  &c. 

Camphor,  3.    For  drowsiness  and  headache 

Change  of  air  and  scene  useful  adjunct 

Cimicipuga.    For  headache 

Eucalyptol,  3.    Flushings,  flatulenoe,  &o. 

Hot  Spongdjgs,  3 

Iron.  For  vertical  headache,  giddiness,  and 
feeling  of  heat,  fluttering  of  the  heart 


1192 


INDEX  OP  DISEASES  AND  EEMEDIES. 


Climacteric  Disorders. 

Nitrite  of  Amyl.    Where  much  flushed 
■    Nux  Vomica,  3.    Useful  where  symptoms  are 
limited  to  the  head 
Potassium  Bromide.    Very  useful 
Warm  Bath 
Zinc  Valerianate 

CoCCYGODYNIA. 

Belladonna.    Plaster  useful 

Chloroform.    Locally  injected 

Counter-irritation 

Electricity 

Surgical  Treatment.  In  obstinate  cases 

Coldness. 

Cold  Water,  3.    As  prophylactic  with  friction 

and  wrapping  up 
Spinal  Ice-bag,  3.    Por  cold  feet 
Strychnine 

Colic,  Intestinal. 

Ammonia,  3.    In  intestinal  colic,  and  in  colic  of 

children 
Antacids,  4.    In  acidity 

Arsenic.    When  pain  is  neuralgic  in  character 
A9af<etida,    2,    4.      To    remore     flatulence, 

especially  in  children  and  hysterical  patients 
Atropine,  4.    In  simple  spasmodic  colic 
Belladonna,  3,  4.    Especially  in  children  and 

intestinal  spasm 
Chamomile  Oil.    In  hysterical  women 
Chloral  Hydrate,  3.    Sometimes  relieves 
Chloroform.     By  inhalation,  to  remove  pain 

and  flatulence 
Cocculus.    During  pregnancy 
Essential  Oils.    Aniseed,  2,  3,  4.    Cajeput, 

Camphor,  Cardamoms,  Cinnamon,  Cloves, 

Peppermint,  Rue,  Spearmint.    All  useful 
Ether,  2, 4.    Internally  and  by  inhalation 

POMENTATIONS 

Ginger,  4.    Stimulant  carminative 

Lime  Water.  In  children,  where  due  to  curd- 
ling of  milk 

Milk  Cure.    In  enteral gia 

Morphine.    Very  useful 

Nux  Vomica.    Useful 

Opidm,  3.  In  intestinal  colic;  If  constipated, 
a  purgative.  With  spirits  of  chloroform  in 
renal  and  hepatic  colic 

Phosphate  op  Sodium.  In  hepatic  colic,  to 
prevent  gall-stones  forming 

Potassium  Bhomlde,  3.  In  local  spasm  in 
children,  which  can  be  felt  through  hard  ab- 
dominal walls 

Poultices.    Large  and  warm,  of  great  service 

Tobacco.    Dangerous 


Colic,  Lead. 


Colic,  Lead. 


Alum,  2, 4.    Believes  the  pain  and  constipation 
Belladonna,  1 

Bromides,  2.    As  solvents  alone  or  with  iodides 
Castor  Oil.    Given  twice  a  day  to  eliminate 
Chloroform,  1.    Internally  and  externally  as 

liniment 
Eggs,  1. 

Electro-chemical  Baths,  1 
Iodide  of  Potassium,  2.    Most  useful  in  elimi 

nating  lead  from  the  system,  and  combined 

with  magnesium  sulphate  to  evacuate  it 
Magnesium  Sulphate.    Most  useful  along  with 

iodide  of  potassium 
Milk,  1 

Morphine,  2.    Subcutaneously  to  relieve  pain 
Opium 
Sodium  Chloride,  1 


Sulphur,  1.    To  aid  elimination 
Sulphur  Baths 

Sulphuric  Acid,  1,  2.  Dilute  in  lemonade  as 
a  prophylactic  and  curative 

Colic,  Eenal  and   Hepatic, 
vide  also  Calculi. 

Aliment.    Abstain  from  starches  and  fats 
Alkalies.    Alkaline  waters  very  useful 
Baths.    Warm,  to  remove  pain 
Chloroform.    Inhalation  from  tumbler  during 

fit 
CouNTER-mRiTATioN.    See  Irritants,  &c. 
Ether.    Like  chloroform 
Opium.    In  small  doses  frequently  repeated,  or 

hypodermically  as  morphine 
Turpentine 

Coma. 

Blisters,  3.  On  various  parts  of  the  body  in 
succession  in  the  critical  conditibn,  especially 
at  the  end  of  a  long  illness 

Cold  Douche.  In  the  drunkenness  of  opium 
care  must  be  taken  not  to  chill,  and  it  is  best 
to  alternate  the  cold  with  warm  water 

Croton  Oil.  As  a  purgative  in  cerebral  con- 
cussion, &c. 

Mustard.    To  stimulate 

Potassium  Bitartbate,  3.  Purgative  where  the 
blood  is  poisoned 

Turpentine.    Enema  as  stimulant 


Condylomata. 


Argentio  Nitrate,  1.    As  caustio 

Arsenic,  3.    As  caustic 

Carbolic  Acid,  2, 4.    Locally 

Chromic  Acid,  1,  2,  4.  1-4  of  water,  locally, 
as  caustic 

Iodoform,  2.    Locally  applied 

Mercury.  Wash  with  chlorine  water,  or  chlori- 
nated soda,  and  dust  with  calomel  and  oxide 
of  zinc  in  equal  quantities 

Nitric  Acid.  As  caustic,  or  dilute  solution  as  a 
wash 

Thuja.  Strong  tincture,  locally,  small  doses 
internally,  useful 

Zinc  Chloride  or  Nitrate,  3.  Locally,  as  a 
caustic  or  astringent 

CoNJUNOriVITIS. 

Alum.  After  acute  symptoms  have  subsided, 
but  not  if  the  epithelium  is  denuded,  since 
perforation  may  then  take  place 

Argenti  Nitras,  1.  Solution  of  gr.  iv.-5j.  in 
purulent  ophthalmia.  The  solid  iu  gonorrhceal 
ophthalmia,  to  be  afterwards  washed  with 
sodium  chloride  solution,  gr.  iv.-3j. 

Belladonna.    Locally  and  internally 

Bismuth,  1, 2.    Locally,  in  chronic  cases 

Blisters.    Behind  ear 

Cadmium.  As  a  wash  instead  of  copperor  zinc; 
the  sulphate,  gr.  j.-$j. 

Castor  Oil.  A  drop  in  eye  to  lessen  irritation 
from  foreign  body 

Copper  Sulphate.    As  oollyrium 

Ergot,  1,  2.  The  fluid  extract,  undiluted, 
locally  applied  in  engorgement  of  the  con- 
junctival vessels 

Euphrasia.    As  a  mild  astringent 

Mercury,  3.  As  citrine  ointment,  very  useful 
outside  the  lids  in  palpebral  conjunctivitis 

Opium.    Liquid  extract  in  eye  relieves  pain 

Pulsatilla.    As  wash  and  internally 

Tannin.    As  Collyrium 

Zinc  Sulphate,  3.    As  Collyrium 


INDEX  OF  DISEASES  AND  EEMEDIES. 


1193 


Constipation. 


Aloes,  vide  Dinner  Pill 

Alum 

Ammonium  Chloride.    In  bilious  disorders 

Apples.    Stewed  or  roast 

Arsenic.    In  small  doses 

Belladonna  Extract,  2,  3,  4.  ,L-£  gr.  in 
spasmodic  contraction  of  the  intestine  leading 
to  habitual  constipation;  best  administered 

•    along  with  nux  vomica  as  a  pill  at  bedtime 

Bismuth,  3.  Formula  :  R  Aluminii  Sulphas, 
gr.  jss. ;  Bismuth!  Subnitratis,  gr.  j. ;  Extracti 
Gentians,  q.s.;  fiat  pilula 

Cahlsbad  Waters.  Tumblerful  sipped  hot 
while  dressing 

Cascara  Sagrada,  4.  In  habitual  constipation, 
Hlx.-xx.  of  fluid  extract  an  hour  or  two  after 
meals 

Castor  Oil.  ntx.-xx.  in  a  teaspoonful  of  brandy 
and  peppermint  water  before  breakfast 

Cocculus.  When  motions  hard  and  lumpy,  and 
much  flatus 

Cod-Liver  Oil,  3.  In  obstinate  cases  in  children 

Coffee,  3.    Sometimes  purges 

Colocynth,  3.  Compound  pill.  Colocynth  pill 
at  night,  or  a  few  drops  of  Prussian  tincture 

Croton  Oil.  When  no  inflammation  is  present, 
very  active 

Dinner  Pills.  Aloes  and  myrrh ;  aloes  and 
iron ;  with  nux  vomica  and  belladonna  or 
hyoscyamus,  taken  just  before  dinner 

Enemata,  2,  3, 4.  Soap  and  water,  or  castor  oil ; 
habitual  use  tends  to  increase  intestinal  tor- 
por ;  should  only  be  used  to  unload 

Ergot.    To  give  tone 

Euonymin,  4.  Cholagogue  purgative  in  hepati  c 
torpor. 

Fig,    One  before  breakfast 

G-AMBOGE,  4.    In  habitual  constipation 

Guaiacum,  3.  Especially  when  powerful  purga- 
tives fail 

Honey.    With  breakfast 

Hydrastis.    Useful  in  biliousness 

Ipecacuanha,  3.  One  grain  in  the  morning 
before  breakfast 

Jalap,  3.    Along  with  scammony 

Lime,  3.    Saccharated  solution  alter  meals 

Liquorice  Powder,  Compound.  A  teaspoon- 
ful at  night  or  in  the  morning 

Magnesia,  3.  Solution  of  bicarbonate,  useful 
for  children  and  pregnant  women 

Mercury,  3.    In  bilious  disorders,  stools  light 

Muscarine,  2.    To  increase  peristalsis 

Nux  Vomica.  Ttiv.-x.  in  a  glass  of  cold  water 
before  breakfast  or  before  dinner 

Opium,  1.    When  rectum  is  irritable 

Physostigma.  TRx.  of  tincture  along  with 
belladonna  and  nux  vomica  in  atony  of  the 
walls 

Podophyllum.  Very  useful,  especially  in 
biliousness  ;  ten  drops  of  the  tincture  at 
night  alone,  or  the  resin  along  with  other 
purgatives  in  pill,  especially  when  stools  are 
dark 

Prunes,  3.  Stewed,  often  efficient.  If  stewed 
in  infusion  of  senna  they  are  still  more  active 

Bhubarb  Compound  Pill,  3.  At  night ;  also 
for  children,  mixed  with  bicarbonate  of  sodium 

Saline  Waters.  In  morning,  before  breakfast } 
Friedrichshall,  Hunyadi  Janos,  or  Pullna 

Sknna.    As  confection,  &c. 

Soap,  3.    Suppository  in  children 

S tillingia.    »lx.  of  fluid  extract 

Strychnine,  4.    In  atony  of  the  walls 

Sulphates,  3.  In  purgative  natural  waters,  in 
small  doses  ;  sulphate  of  potassium,  has  been 
used  in  poisonous  doses 

Sulphur,  3.  Sometimes  very  useful  as  a  good 
addition  to  compound,  liquorice  powder,  as  in 
that  of  the  Prussian  Pharmacopoeia 

Tobacco,  2.  lUv.  of  wine  at  bed-time,  or 
cigarette  after  breakfast 


Constipation. 

Treacle.    With  porridge  useful  for  children 

Turpentine.  In  atonic  constipation  with  much 
gaseous  distension  of  colon 

Water.  Draught  in  the  morning  before  break- 
fast 

Whole-Meal  Bread 

Convalescence. 

Alcohol,  2.    With  meals 

Bitteiis.    The  simple 

Coca,  2.    Either  extract,  or  as  coca  wine  for 

a  nervine  tonic 
Cod-Liver  Oll 
Cueam 

Eucalyptus.    A  tonic  after  malarial  disease 
Guarana,  2.    Same  as  coca 
Hydrastis,  2.    As  a  substitute  for  quinine 
Iron,  2.    As  chalybeate  waters 
Koumiss 

Lime.    As  lime-water  or  carbonate  of  calcium- 
Opium.    As  enema  for  insomnia 
Pancreatin,  2.    To  aid  digestion 
Pepsin,  2.    The  same 
Phosphates,  2 
Phosphites,  2 
Sea-Bathing,  3 
Sumbul.    Where  great  nervous  excitability 

Convulsions,  Infantile. 

Aconite 

Alcohol.  A  small  dose  of  wine  or  brandy 
arrests  convulsions  from  teething 

Asafostdja.  A  small  dose  in  an  enema  arrests 
convulsions  from  teething 

Baths.  Warm,  with  cold  affusions  to  the 
head 

Belladonna.    Very  useful 

Bromide  op  Potassium,  2,  3,  4.  Exceedingly 
useful ;  children  hear  it  in  large  doses ;  gr.  v. 
three  times  a  day  or  oftener  for  a  child  a 
year  old  in  convulsions  from  teething 

Chloral  Hydrate.  In  large  doses— gr.  v.  by 
mouth  or  rectum 

Chloroform.    To  arrest  fit 

Garlic  Poultices,  4.  To  spine  and  lower  ex- 
tremities in  infantile  convulsions 

Ignatia.    When  intestinal  irritation 

Spinal  Ice-bag 

Valerian.    When  due  to  worms 

Teratrum 

Corneal  Opacities. 

Cadmium 

HYDRARGYRI  BtCHLORDOUM,  1.     £  gT.  to  5j. 

Iodine.    Internally  and  locally 

Mercury.    Internally  and  locally 

Silver  Nitrate.    Locally 

Sodium  Chloride.  Injected  under  conjunctiva 


Corns. 


Acetic  Acid 

Chromic  Acid 

Iodine 

Poultices.  And  plaster  with  hole  in  centre  to 
relieve  pressure 

Salicylic  Acid,  3.  Saturated  solution  in  collo- 
dion with  extract  of  cannabis  indioa,  3ss-3j. 

Silver  Nitrate 

Cough. 

Aconite.    In  throat-cough  and  emphysema 
Alcohol,   3.     Believed  by  brandy  or  wine; 

aggravated  by  beer  or  stout 
Alum,  3.    As  spray  or  gargle 


1194 


INDEX  OF  DISEASES  AND  REMEDIES. 


Cough. 

Argenti  Nitras,  1.  In  throat-cough,  a  solution 

of  gr.  vitj.-Jj.  applied  to  fauces 
Apomorphine.    In  bronchitis,   with   deficient 

secretion;  and  as  emetic  in  ohiidren  where 

there  is  excess  of  bronchial  secretion 
Asaf(Etida,  2.    In  the  alter -cough  from  habit, 

and  in  the  sympathetic  whooping-cough  of 

mothers 
Belladonna,  3,  4.     Tn  nervous  cough  and  un- 
complicated whooping-cough 
Blue  Pill.     In  gouty  or  bilious  pharyngeal 

irritation 
Butyl-Chloral  Hydrate,  3.    In  night  coughs 

of  phthisis 
Camphor.    Internally,  or  locally,  painted  over 

the  larynx  with  equal  parts  of  alcohol 
Carbonic  Acid  Gas,  3.    Inhalation  in  nervous 

cough 
Cerium,  2.    In  cough  associated  with  vomiting 
Chloral  Hydrate,  2.    In  respiratory  neurosis 
Chloroform,  3.    With  a  low  dose  of  opium  and 

glycerine  in  violent  paroxysmal  cough ;    if 

very  violent  to  be  painted  over  the  throat 
Cod-Liver  Oil.    One  of  the  most  useful  of  all 

remedies  in  cough 
Conium,  3.    In  whooping-cough 
Creasote,  3.    In  winter  cough 
Cubebs,  2,  3.     Along  with  linseed  in  acute 

catarrh 
Gelsemium,  2,  3.    In  convulsive  and  spasmodic 

coughr  with  irritation  of  the  respiratory  centre 
Grindelia,  2.  In  habitual  or  spasmodic  cough 
Glycerine,  3.    Along  with  lemon-juice,  as  an 

emollient 
Hydrocyanic  Aero,  2, 4.    For  irritable  cough, 

and  in  phthisis,  ana  in  reflex  cough  arising 

from  gastric  irritation 
Hyoscyamus,    In  tickling  night-coughs 
Iodine,  3.  As  inhalation  in  cough  after  measles, 

or  exposure  to  cold,  associated  with  much 

hoarseness  and  wheezing  of  the  chest 
Iodoform,  3.  In  the  cough  of  phthisis 
Ipecacuanha.  Internally,  and  as  spray  locally; 

in   obstinate   winter   cough  and    bronchial 

asthma 
Ipecacuanha  and  Squill  Pill.    In  chronic 

bronchitis  at  night 
IjACtucarium.    To  relieve 
Laurocerasus,  Substitute  for  hydrocyanic  acid 
Linseed.    In  throat-cough 
Liquorice.    In  throat-cough 
Lobelia,  2.    In  whooping-cough  and  dry  bron- 

chitic  cough 
Nasal  Douche.    In  nasal  cough 
Opium,  2,  3.    Morphine  locally  to  the  throat  and 

larynx,  and  generally 
Plasters.    Calefaciens  and  picis  to  the  chest 
Potassium  Bromide.    In  reflex  coughs 
Potassium  Carbonate,  1.    In  dry  cough  with 

little  expectoration 

PRUNUS  YlRGHflANA 

Pulsatilla.  Anemonine,  gr.  ss-j.  dose,,  in  asthma 

and  whooping-cough 
Sangudsaria.    In  nervous  cough 
Tannin.    As  glycerine  to  the  fauces  in  chronic 

inflammation,  especially  in  children 
Iar    Water.      In    winter-cough,    especially 

paroxysmal,  bronchitis  and  phthisis 
Valerian.    In  hysterical  cough 
Zinc  Sulphate,  1.  In  nervous  hysterical  cough 

Croup. 

Aconite,  3.    In  catarrhal  croup 

Alum,  2,  3,  4.     Teaspoonful,  with  honey  or 

syrup,  every  £  or  £  hour  until  vomiting  is 

induced ;  most  useful  emetic 
APOMORPHrNE,  2.     As  an  emetic;  may  cause 

severe  depression 
Calomel,  2.    Large  doses,  to  allay  spasm  and 

check  formation  of  false  membrane 


Croup. 

Carbolic  Acid,  2.    Spray 

Copper  Sulphate,  2,  3.    gr.  j-v.,  according  to 

age  of  child,  until  vomiting  is  induced 
Ipecacuanha,  2,  4.    Must  be  fresh;  if  it  does- 

not  succeed,  other  emetics  must  be  taken 
Jaborandi,  4.    Beneficial  in  a  few  cases 
Lactic  Acid.    To  dissolve  membrane  (1  in  20); 

applied  as  spray  or  painted  over 
Lime  Water,  4.      Spray,  most  useful  in  adults 
Lobelia,  3.    Has  been  used 
Mercury    Subsulphatk.     One    of  the  best 

emetics ;  gr.  iij-v.  given  early 
Quindje,   2.      In   spasmodio   croup,   in   large 


Sanguinaria.    A  good  emetic.    R  Syr.  ipecac. 

3ij.;  Pulv.  sanguin.  gr.  xx. ;  Pulv.  ipecac. 

gr.  v. ;  give  a  teaspoonful  every  quarter-hour 

till  emesis,  then  half  a  teaspoonful  every  hour 
Senega.    As  an  auxiliary 
Sulphurous  Acid,  3.    As  spray 
Tannin,  3.    As  spray,  or  glycerin  of  tannin 
Tartar  Emetic,  2.    Too  depressant  in  young 

children 
Zinc  Sulphate,  2,  3.    Sometimes  used  as  an 

emetio 

Cystitis. 

Aconite.    When  fever  present 

Alkalies.    When  urine  is  acid  and  the  bladder 

irritable  and  inflamed 
Ammonium  Citrate,  1.    In  chronic  cystitis 
Arbuttn,  4.    Diuretic  in  chronic  cystitis 
Belladonna.     Most   useful  to    allay  irrita- 
bility 
Benzoic  Acid,  1.    In  catarrh  with  an  alkaline 

state  of  the  urine 
Boric  Acid,  4.    As  Boroglyceride  as  injection 

in  cystitis,  with   an   alkaline  urine  due  to 

fermentation 
Buchu.    Especially  useful  in  chronic  cases 
Canthaedoes,  3.  In  small  doses  long  continued, 

where  there  is  a  constant  desire  to  micturate 

associated  with  much  straining  and  pain  in 

the  act. 
Carbolic  Acid,  3.    And  sulpho-carbolates  as 

antiseptics 
Chimaphila.    In  chronio  cases 
Copaiba.    Useful 
Cubebs 
Eucalyptus.     Extremely  useful   in  chronic 

cases 
Hot  Enbmata,  3.    To  relieve  the  pain 
Hut  Sitz-Bath,  3 

Hyoscyamus.    To  relieve  pain  and  irritability 
Iodine  ajjd  Iodides,  4 
Iodoform.    As  suppository 
Milk  Dibit,  1 
Opium.    As  enema,  or  suppository,  to  relieve 

pain 
Parkira.    In  chronic  cases 
Potassium  BnoMroE.    To  relieve  the  paim 
Potassium  Chlorate 
Quinine.    In  acute  cases 
Sauoylic  Acid,  4.    In'  chronic  cystitis  with 

ammoniacal  urine 
Sulphites.    To  prevent  putrefaction  of  urine 
Trtiicum  Repens,  1 
Turpentine,  3,  4.    In  chronic  cases 
Uva  Ursi,  4.    In  chronio  cases 
Zea  Mays,  4.    A  mild  stimulant  diuretic 

Cysts. 

AcupusrcTiraB,  2 

Chloride  of  Gold,  2,    In  ovarian  dropsy 

Galvano-punctuke 

Iodine,  2,    As  an  injection  after  tapping 

Silver  Nitrate,  2.    As  an  injection 


INDEX  OF  DISEASES  AND  REMEDIES. 


1195 


Deafness. 


AMMONIUM  CHLORIDE 

Oakthariiies.    As  ointment  behind  the  ear 
Colchicum.    In  gouty  persons 
Gargles.    In  throat-deafness 
Glycerin,  3.    Locally 
Quinine.    In  Meniere's  disease 
Tannin,  3.    In  throat-deafness 

Debility. 

Alcohol,  3.  Along  with  food  often  very  useful. 
Liable  to  abuse— not  to  be  continued  too 
long ;  effect  watched  in  aged  people  with  drv 
tongue  ' 

Arsenic,  3.  In  young  anaemic  persons,  alone 
or  with  iron,  and  in  elderly  with  feeble  cir- 
culation. 

Bitters.    Useful  as  tonic 

Calcidm  Salts,  3.  Phosphates  if  from  over- 
work or  town  life ;  hypophosphites  in  nervous 
debility 

CHOLAQoauE  Purgatives.  When  debility  is 
due  to  defective  elimination  of  waste 

Cinchona.  A  fresh  infusion  along  with  carbon- 
ate of  ammonium 

Cod-Liver  Oil 

Digitalis.    When  circulation  is  feeble 

Eucalyptus.    In  place  of  quinine 

Hydrastis.    The  same 

Iron.    In  ansemic  subjects 

Manganese,  2.    Alone  or  with  iron 

Morphine,  3.  Subcutaneously,  if  due  to  onan- 
ism or  hysteria 

Nux  Vomica.    Most  powerful  general  tonic 

Quinine,  3.    General  tonic 

Sanguinaria.  When  gastric  digestion  is  feeble 

Sarsaparilla.    If  syphilitic  taint  is  present 

Sea-Bathing,  3.  In  chronic  illnesses  with 
debility 

Turkish  Baths,  3.  If  due  to  tropical  climate, 
with  caution ;  in  townspeople,  when  they  be- 
come stout  and  flabby 


Delirium. 


Alcohol.    When  delirium  is  due  to  exhaustion 
Antimony.    Along  with  opium  in  fever,  such 

as  typhus 
Baths,  Cold.    In  fever 
.Belladonna,    In  the  delirium  of  typhus 
Blisters,  4.     In  delirium  due  to  an  irritant 

poison,  and  not  to  exhaustion 
Bromidk  op  Potassium.    In  fevers 
Camphor.    In  20-gr.  doses  every  two  or  three 

hours  in  low-muttering  delirium 
Cannabis    Indica.      In    nocturnal    delirium 

occurring  in  softening  of  the  brain 
■Chloral  Hydrate, '3,  4.  In  violent  delirium  of 

fevers 
Cold  Douche,  3.    Place  patient  in  warm  bath 

while  administered 
Hyoscyamus,  1 
Morphine.    Hypodermically 
Musk,  4.    In  the  delirium  of  low  fever,  and  in 

ataxic  pneumonia  of  drunkards  with  severe 

nervous  symptoms 
Opium.    With  tartar  emetic 
Quinine,  1 
Valerian,  4.     In  the  delirium  of  adynamic 

fevers 


Delirium  Tremens. 


Alcohol,  2.    Necessary  when  the  attack  is  due 
to  a  failure  of  digestion ;  not  when  it  is  the 
result  of  a  sudden  large  excess 
Ammonium  Carbonate.    In  debility 
Antimony,  4.     Along  with    opium,   to   quiet 
maniacal  excitement  and -give  sleep 


Delirium  Tremens. 


Arnica,  2.    The  tincture  where  there  is  great 


Beef-tea.    Most  useful 
Belladonna.    In  insomnia  when  coma-vigil 
Bromide  of  Potassium.    In  large  doses,  especi- 
ally when  an  attack  is  threatening 
Brominated  Camphor,  4.     Nervine,  sedative, 

and  antispasmodic 
Butyl-Chloral  Hydrate,  1 
Cannabis  Indica.    Useful,  and  not  dangerous 
Capsicum,  2.     20-30-gr.  doses,  repeated  after 

three  hours,  to  induce  sleep 
Chloral  Hydrate,  2.    If  the  delirium  follow  a 

debauch ;  with  caution  in  old  topers  and  cases 

of  weak  heart ;  instead  of  sleep,  sometimes 

produces  violent  delirium 
Chloroform,  2.    Internally  by  stomach 
Cimicdjuga.    As  a  tonic 
Coffee 

Cold  Douche  or  Pack,  1,  3.    For  insomnia 
Conium.    As-  an  adjunct  to  opium 
Croton  Oil,  4.    Purgative 
Digitalis,  2,  3,  4.    In  large  doses  has  had  some 

success 
Enemata.    Nutritive,  when  stomach  does  not 

retain  food 
Foodj  nutritious,  more  to  be  depended  upon 

than  anything  else 
Gamboge,  4 
Hyoscyamus.  Useful,  like  belladonna,  probably, 

in  very  violent  delirium 
Ice  to  Head,  3.    To  check  vomiting    , 
Lupulin,  4.    As  an  adjunct  to  more  powerful 

remedies 
Opium.    To  be  given  with  caution 
Potassium  Bromide 
Quinine.    To  aid  digestion 
Stramonium.    More  powerful  than  belladonna 
Sumbul.    In  insomnia  and  nervous  depression 

preceding  an  attack 
Veratrum  Viride,  4.    Very  dangerous 

Dentition. 

Belladonna.    In  convulsions 

Bromide  of  Potassium.    To  lessen  Irritability 

and  to  stop  convulsions 
Calumba.    In  vomiting  and  diarrhoea 
Hypophosphites.    As  tonic 
Phosphate  of   Calcium.    When   delayed  or 

defective 

Diabetes  Insipidus. 

Alum 

Atropine 

Okeasote 

Dry  Diet,  2 

Eroot,  2.    Carried  to  Its  fall  extent 

Gallic  Acid.    Combined  with  opium 

Gold  Chloride,  2.    In  a  few  cases 

J aborandi,  2.    In  some  cases 

Krameria.    To  lessen  the  quantity  of  urine 

Muscarine,  2.    In  some  cases 

Nitric  Acm 

Opium.    Most  useful ;  large  doses,  if  necessary 

Potassium  Iodide,  2.    In  syphilitic  taint 

Valerian.    In  large  doses 

Diabetes  Mellitus. 

CA  UflON.—The  urine  of  patients  taking  salicylic 

acid  gives  Tromme?''s  test  for  sugar. 

Alkalies,  2.  Alkaline  waters  are  useful,  when 
of  hepatic  origin,  in  obese  subjects;  and  in 
delirium 

Almond  Bread 

Ammonium  Carbonate 

Ammonium  Citrate    - 


1196 


INDEX  OF  DISEASES  AND  REMEDIES. 


Diabetes  Mellitus. 


Ammonium  Phosphate 

Arsenic,  3.    In  thin  subjects 

Belladonna.    Full  doses 

Calcium  Sulphide 

Codeine.    A  most  efficient  remedy.   Sometimes 

requires  to  be  pushed  to  the  extent  of  18  gra. 

or  more  per  diem 
Creasote 
Glycerin.    As  remedy,  and  as  food  in  place  of 

sugar 
Gold  Chloride,  2 
Hydrogen  Peroxide 
Ikon.    Most  useful  along  with  morphine 
Jabosandi 
Kramerta 
Lactic  Aero 
Opium,  3, 4.    Most  useful 
Phosphoric  Acid.    To  lessen  thirst 
Potassium  Bromide 
Quinine 

Quinine  Bromide,  with  morphine 
Quinine  Sulphate 
Rhubarb 

Salicylate  of  Sodium 
Skim-Milk  Duet 
Sodium  Citrate 
Sodium  Phosphate.    As  purgative 


Diarrhoea. 


Aconite.  In  high  fever  and  cutting  abdominal 
pains 

Alkalies,  3, 4.  In  small  doses  in  diarrhoea  of 
children,  if  due  to  excess  of  acid  in  the  intes- 
tine, causing  colic  and  a  green  stool 

Alum,  4 

Ammonium  Carbonate,  3.  In  the  after-stage 
if  there  is  a  continuous  watery  secretion 

Ammonium  Chloride,  3.    In  intestinal  catarrh 

Argentic  Nitrate,  3.  In  acute  and  chronic 
diarrhoea  as  astringent 

Arnica 

Aromatics,  4.  In  nervous  irritability  or  relaxa- 
tion without  inflammation 

Arsenic,  2,  3.  A  few  drops  of  Powler's  solution 
iu  diarrhoea  excited  by  taking  food ;  in  diar- 
rhoea with  passage  of  membranous  shreds 
associated  with  uterine  derangement ;  and 
along  with  opium  in  chronic  diarrhoea  of 
malarial  origin. 

Bael.    Infusion  to  children 

Belladonna,  4.    In  colliquative  diarrhoea 

Bismuth,  2,  3,  4.  In  large  doses  in  chronic 
diarrhoea  ;  with  grey  powder  in  the  diarrhoea 
of  children 

Cajeput  Oil,  4.  Along  with  oamphor,  chloro- 
form and  opium  in  serous  diarrhoea 

Calcium  Carbonate,  2.  The  aromatio  chalk 
mixture  in  the  diarrhoea  of  children,  and  in 
the  diarrhoea  of  phthisis  and  typhus 

Calcium  Caebolate 

CALcruM  Chloride.  In  the  colliquative  diar- 
rhoea of  strumous  children,  and  in  chronio 
diarrhoea  with  weak  digestion 

Calcium  Phosphate,  3.  In  chronic  diarrhoea, 
especially  of  children 

Calomel,  2.  In  minute  doses  in  chronio  diar- 
rhoea of  children,  with  pasty  white  stools 

Calx  Saccharata,  1,  3.  In  the  chronic  diar- 
rhoea and  vomiting  of  young  children 

Camphor,  2, 3, 4.  In  the  early  stage  of  Asiatic 
cholera,  at  the  commencement  of  summer 
diarrhoea,  acute  diarrhoea  of  children,  and 
diarrhcea  brought  on  by  effluvia 

Cannabis  Indica,  1 

Capsicum,  3.  From  eating  fish ;  and  in  summer 
diarrhoea,  and  diarrhoea  after  expulsion  of 
irritant 

Carbolic  Aero 

Cascarilla 

Castor  Oil  and  Opium,  3, 4.    To  carry  away 


DlARRH(EA. 

any  irritant ;  also  alone  in  the  diarrhoea  of 
children 

Catechu,  4.    Astringent 

Charcoal,  4.    In  foul  evacuations 

Chloral  Hydrate,  1 

Chloroform,  3.  As  spirits  with  opium  after  a 
purgative 

Cocaine,  4.    In  serous  diarrhoea 

Cod-Liver  Oil,  3.  To  children  with  pale  stink- 
ing stools 

Cold  or  Tepid  Pack,  3.  In  summer  diarrhcea 
of  children 

Copaiba,  4.  Prom  its  local  action  in  chronic 
cases 

Copper  Sulphate,  2,  3.  ^  gr.  along  with  opium 
in  acute  and  chronic  diarrhoea,  associated  with 
colicky  pains  and  catarrh 

Corrosive  Sublimate,  3.  In  small  doses  in 
acute  and  chronic  watery  diarrhoea,  marked 
by  slimy  or  bloody  stools,  of  children  and 
adults ;  and  diarrhcea  of  phthisis  and  typhoid 

Coto  Bark.    In  catarrhal  diarrhoea 

Creasote 

Dulcamara.  In  diarrhoea  of  children  from 
teething  and  exposure 

Ergot,  2,  4.  In  a  very  chronic  diarrhoea  suc- 
ceeding to  an  acute  attack 

Erigeron  Canadense 

Eucalyptus,  4.    In  catarrh 

Plannel  Binder.    Adjunct  in  children 

Galls.    In  chronic  diarrhoea 

G-uarana.    In  convalescence 

Hjematoxylon.  Mild  astringent,  suitable  to 
children  from  its  sweetish  taste 

Ice  to  Spine,  3 

Injection,  3.  Of  starch  water,  at  100°  P.,  with 
tinct.  opia  and  acetate  of  lead,  or  sulphate  of 
copper  in  the  choleraic  diarrhoea  of  children 

Ipecacuanha,  3.  Drop  doses  of  the  wine  every 
hour  in  the  dysenteric  diarrhcea  of  children, 
marked  by  green  slimy  stools 

Iron  Pebnitrate,  3.    Simple  astringent 

Kino.    Astringent 

Krameria.    Astringent 

Lead  Acetate,  2,  3,  4.  In  suppository  or  by 
mouth ;  in  the  summer  diarrhoea  of  children ;' 
with  morphine  of  adults :  with  opium  in  purg- 
ing due  to  typhoid  or  tubercular  disease,  in  pro- 
fuse serous  discharge,  and  in  purging  attended 
with  inflammation 

Magnesia.    Antacid  in  children 

Mercury,  3.  The  grey  powder  in  diarrhoea  of 
children,  marked  by  derangement  of  intestinal 
secretion  and  stinking  stools ;  to  be  withheld 
where  masses  of  undigested  milk  are  passed ; 
in  adults,  vide  Corrosive  Sublimate 

Mjneral  Acids,  2,  4.  In  profuse  serous  dis- 
charges, and  in  cholera  infantum 

Nitric  Aero.  With  nux  vomica,  to  assist  mer- 
cury, when  due  to  hepatic  derangement ; 
combined  with  pepsin  when  this  is  the  ease 
with  children 

Nitro-hydrochloric  Aero,  4.  When  it  is  an 
intestinal  dyspepsia 

Nitrous  Aero,  4.  In  profuse  serous  diarrhcea, 
and  the  sudden  diarrhoea  of  hot  climates 

Nux  Vomica.    In  chronic  cases 

Oak  Bark.    Infusion  astringent 

Opium,  3,  4.  In  tubercular  and  typhoid  diar- 
rhoea  ;  in  acute,  after  expulsion  of  offending 
matter;  as  an  enema,  with  starch,  in  tho 
acute  fatal  diarrhoea  of  children 

Pepsin.  Along  with  nitro-hydrochloric  acid  in 
infantile  diarrhoea 

Podophyllum,  3.  In  chronic  diarrhcea,  with. 
high-coloured,  pale  or  frothy  stools 

PoTASsruM  Chlorate.  In  chronio  oases  with 
mucilaginous  stools 

Pulsatilla.    In  catarrhal 

QumrNE 

Rhubarb,  3, 4.    To  evacuate  intestine 


ESTDEX  OF  DISEASES  AND  KEMEDIES. 


1197 


DlARRTKEA. 

Rumex  Crispus,  3.    In  morning  diarrhcea 
Salicin,  2.    In  catarrh,  and  chronic  diarrhcea  of 
.  children 
Salicylic  Acid,  3.    In  summer  diarrhcea  and 

diarrhcea  of  phthisis 
Sulphuric  Acid.    Diarrhcea  of  phthisis 
Tannin  with  Opium,  2,  3,  4.    In  acute  and 

chronic  internally,  or  as  enema 
Veratrum  Album,  3.    In  summer  diarrhcea 
Zinc  Sulphate  and  Oxide,  3,  4.    A  stimulant 

astringent ;  of  the  oxide  gr,  iij.  or  gr,  iv.  for 

children 


Diphtheria. 

■Alcohol.    Freely  given,  very  useful 

Ammonium  Chloride 

Apomorphtne.    As  an  emetic 

Argentic  Nitrate,  2,  3.    Of  doubtful  value 

Arsenic.    Internally 

Belladonna,  2.  At  commencement,  especially 
useful  when  tonsils  much  swollen  and  there 
is  little  exudation ;  later  on,  to  support  the 
heart 

Benzoic  Aero,  4.    In  large  doses 

Boric  Acdd  or  Borax,  3,  4.  Glycerine  solu- 
tion locally 

Bromine,  1.    As  inhalation 

Carbolic  Aceo,  2, 4.  As  spray  or  painted  on 
throat,  internally  with  iron 

Chloral  Hydrate 

Chlorenated  Lime.  Locally,  as  gargle  or 
wash 

Chlorbse  Water.  Internally,  locally  in  slough- 
ing of  the  throat 

Cold,  3,  4.    Externally 

Copper  Sulphate.    As  emetic 

Glycerine  op  Carbolic  Acid,  3.  Painted  over 
twice  a  day 

Guaiacum,  2,  3,  4.    Internally. 

Hydrochloric  Acdd,  2.  Dilute  as  gargle,  or 
strong  as  caustic 

Iodine,  3.    As  inhalation 
i  Iron,  2,  3, 4.    The  perchloride  in  full  doses  by 
the    mouth,  and   locally   painted    over   the 
throat 

Lactic  Acdd,  2,  3.  A  spray  or  local  application 
of  a  solution  of  3J.-3J.  of  water,  to  dissolve  the 
false  membrane 

Lemon  Juice,  1.    Gargle 

Lime  Water,  4.  Most  serviceable  in  adults,  as 
a  spray 

Mercury.  Internally  as  calomel  or  cyanide, 
^-^  of  a  grain 

Papain.    As  solvent  of  false  membrane 

Pilocarpine,  2,  3,  4.  Sometimes  aids  in  loosen- 
ing the  false  membrane 

Potass^e,  Liquor.    Internally. 

Potassium  Bichromate.    As  emetic 

Potassium  Chlorate,  2, 4.  Internally  in  large 
doses  frequently  repeated,  and  locally  as  a 
gargle       * 

Potassium  Permanganate,  3.    As  gargle 

Quinine,  3.    Strong  solution  or  spray 

Resorcin,  2.    Spray  to  the  throat 

Salicylic  Acid.  Locally  as  gargle,  or  in- 
ternally 

Sanguinaria.    As  emetic.    Vide  Croup 

Sassafras,  Oil  of.    As  local  application 

Soda  Chlorinata,  3.    In  a  solution  as  gargle 

Sodium  Hyposulphite  and  Sulphites.  In- 
ternally and  locally 

Sodium  Benzoate,  2.  In  large  doses  and 
powder  unsufflated 

Strychnine,  3.    Subcutaneously  for  paralysis 

sulpho-carbolates,  2 

Sulphurous  Acdd 

Tannin,  3.    5  per  cent,  solution  as  a  spray 

Tolu,  Balsam  of 


Dropsy. 

Aconite,  1,  3.    At  once  in  scarlet  fever  if  tem- 
perature should  rise 
Acupuncture,  3.    In  oedema  about  the  ankles, 
to  be  followed  up  by  hot  bathing ;  not  much 
use  in  tricuspid  disease 
'Ammonium  Benzoate.    In  hepatic  dropsy 
Ammonium  Chloride.    In  hepatic  dropsy 
Antihydropin,  1,  4.    A  crystalline  principle 
extracted  from  cockroaches ;    is  a  powerful 
diuretic  in  scarlatinal  dropsy ;   gr.  xv.  as  a 
dose  for  an  adult ;  the  insect  used  in  Russia 
Arsenic,  3.    In  dropsy  of  feet  from  fatty  heart, 
debility,  and  old  age 

ASCLEPIAS  SyRIACA 

ASCLEPIAS  SYRIACA  AND  APOCYNUM 

Broom.  One  of  the  most  useful  diuretics, 
especially  in  scarlatinal,  renal,  and  hepatic 
dropsy 

Bryonia.    As  drastic,  purgative,  and  diuretic 

Caffeine,  4.  In  cardiac  and  chronic  renal 
dropsy 

Cannabis  Indica.    As  diuretic 

Chenopodium  Anthelminticum.  In  scarlatinal 
dropsy 

Chimaphila,  2.    In  renal  dropsy 

Colchicum.  In  hepatic,  cardiac;  and  scarlatinal 
dropsy 

CoNVALLARlA,  3,  4.  Used  by  the  Russian 
peasantry 

Copaiba,  2,  3,  4.  Especially  in  hepatic  dropsy 
and  cardiac  dropsies,  not  certain  in  renal 

Digitalis,  2,  3,  4.  In  all  dropsies,  but  es- 
pecially in  cardiac  dropsy ;  Infusion  is  the 
best  form 

Dry  Diet,  2 

Elaterium,  3, 4.  Useful  hydragogue  cathartic, 
especially  in  chronic  renal  disease ;  should  not 
be  given  in  exhaustion 

Erythrophlceum.  In  cardiac  dropsy  instead  of 
digitalis 

■  Gamboge,  4.    Never  to  be  used 

Hellebore.    In  post-scarlatinal  dropsy 

Iron,  2.  To  correct  ansemia ;  along  with  saline 
purgatives 

Jaborandl.  2,  4.  In  renal  dropsy  with  sup- 
pression of  the  renal  function 

Jalap,  3,  4.    In  some  cases 

Juniper,  2,  3.  Exceedingly  useful  in  cardiac, 
and  chronic,  not  acute  renal  mischief 

Milk  Diet,  2 

Nitrous  Ether.  Useful  alone,  or  with  other 
diuretics 

Parsley,  2.    A  stimulant  diuretic 

Potassium  Bitartrate  and  Acetate,  2,  3,  4. 
With  compound  jalap  powder,  most  useful  of 
the  hydragogue  cathartics 

Potassium  Iodede,  3.  In  large  doses,  some- 
times a  diuretic  in  renal  dropsy 

Potassium  Nitrate.    As  diuretic 

Saline  Purgatives,  2 

Senega,  4.    In  renal  dropsy 

Squill,  2,  3,  4.    In  cardiac  dropsy 

Strophanthus.    In  cardiac  dropsy. 

Sulphate  of  Magnesium,  3.  A  concentrated 
solution  before  food  is  taken 

Taraxacum 
'  Turpentine.    In  albuminuria 

Duodenal  Catarrh. 

Arsenic,  2.  In  catarrh  of  the  bile-ducts  as  a 
sequela 

Bismuth 

Gold,  2.    The  chloride 

Hydrastis,  2.  In  catarrh  associated  with  gall- 
stones 

Ipecacuanha 

Nitro-Hydrochloric  Acid 

Podophyllum 

Rhubarb 


L198 


INDEX  OF  DISEASES  AND  EEMEDIES. 


Dysentery. 


Aconite.    With  much  fever 

Alum,  3.    To  control  the  diarrhoea 

Ammonium  Chloride,  1 

Argentic  Nitrate,  1.    As  injection 

Arnica.    With  much  depression 

Arsenic,  2,  3.    Fowler's  solution,  along  with 

opium,  if  due  to  malarial  infection 
Belladonna 

Benzoin.   In  chronic  cases 
Bismuth,  1 

Calomel,  4.    In  acute  sthenic  type 
Carbolic  Acid 

Castor  Odl.  In  small  doses,  with  opium 
Cathartics,  4.  To  cause  local  depletion 
Cold,  4.    Enemata  of  ice-cold  water  to  relieve 

pain  and  tenesmus 
COPAD3A,  4.    In  some  cases 
Corrosive  Sublimate,  1,  3.    In  small  doses  in 

acute  or  chronic  cases  when  stoolB  are  slimy 

and  bloody 
Creasote 
Cupric  Sulphate,  2.    In  acute,  with  sulphate 

of  magnesium,  and  in  later  stage  with,  opium ; 

with  opium  in  chronic 
Ergotin,  2,  4.    In  very  chronic  type 
Glycerine,  4.      "With  linseed   tea  to  lessen 

tenesmus 
Grape  Diet,  2 

Hamamelis.    Where  much  blood  in  motions 
Injections,  3.    In  early  stages,  emollient ;  in 

later,  astringent 
Iodine 
Ipecacuanha,  2,  3,  4.  In  30-gr.  doses  on  empty 

stomach,  with  complete  rest ;  or  as  enema, 

with  small  quantity  of  fluid ;  milk  is  a  good 

vehicle 
Iron,  2.    Internally,  or  as  enemata 
Lead  Acetate,  2,  3,  4.    By  mouth,  or  as  ene- 
ma or  suppository,  along  with  opium 
Lemon  Juice 
Magnesium  Sulphate,  2.     In  acute  cases,  in 

early  stage 
Nitrous  Acm,  4.    In  the  chronic  dysentery  of 

hot  climates 
Nux  Vomica,  2.    In  epidemic  cases ;  and  where 

prune  juice  stools  and  much  depression 
Opium,  2,  3, 4.    To  check  the  diarrhoea,  given 

after  the  action  of  a  saline  purge 
Potassium  Bitartrate.    In  advanced  stages 

where  much  mucus 
Potassium  Chlorate,  4.    As  enema 
Quindte  Sulphate.  In  large  doses  in  malarious 

cases,  followed  by  ipecacuanha 
Soda  Chloeinata.    As  enema 
Sulphur.    In  chronic  cases 
Tannin,  2.  Conjoined  with  milk  diet  in  chronic 

disease 
Turpentine,  2,    Along  with  opium  when  the 

acute   symptoms   have   passed  off ;   also  in 

epidemic  of  a  low  type 
Zd\tc  Oxdoe 
Zinc  Sulphate,  2.    By  mouth  or  enema 


Dysmenorrhea. 


Aconite,  2.    In  congestive  form  in  plethorics ; 

or  sequent  to  sudden  arrest 
Ammonium  Acetate,  4 
Amyl  Nitrite,  2,  3,  4.    In  neuralgic  form 
Apiol  (Oil  of  Parsley),  4.    As  emmenagogue  in 

neuralgic  form ;  to  be  given  just  before  the 

expected  period 
Arsenic,  3.   When  membranous  discharge  from 

uterus 
Belladonna,  4.  In  neuralgio  form ;  along  with 

synergists 
Borax.    In  membranous  form 
Butyl-Chloral  Hydrate,  3.  In  neuralgic  form 
Cajeput  Oil,  3 
Camphor,  2,  4.  Frequently  repeated  in  nervous 

subjects 


Dysmenorrhea. 

Cannabis  Indica,  2.    Tery  useful 

Chloral  Hydrate,  2 

Chloroform,  2.    Vapour  locally 

Cimicifuga,  2.  In  congestive  cases  at  com- 
mencement 

Electricity.  The  galvanic  current  in  neu- 
ralgic ;  an  inverse  current  in  congestive 

Ergot,  2.  In  congestive  cases  at  commence- 
ment, especially  if  following  sudden  arrest 

Gelsemium,  2,  3 

Gotger,  4.    If  menses  are  suddenly  suppressed 

Guaiacum,  4.    In  rheumatic  cases 

Hamamelis,  3.    Often  relieves 

Hot  Sitz  Bath,  3 

Ipecacuanha.    As  an  emetic 

Iron,  2.    In  anaemia 

Morphine,  2.    Like  opium 

Nux  Vomica.    In  neuralgic  form 

Opium.  Exceedingly  useful  in  small  doses  of 
3  to  6  ms.  of  tincture  alone,  or  along  with  3 
or  4  gr.  of  chloral 

Pulsatilla,  2.    Like  aconite 

Rue 

Sumbul 

Dyspepsia. 

Acids.    Before  or  after  meals,  especially  nitro- 

hydrochloric  acid 
Alcohol,  2, 4.   Along  with  food  when  digestion 

is  impaired  by  fatigue,  &c. 
Alkalies,  1,  2,  3,  4.    Very  useful  before  meals 

in  atonic  dyspepsia  or  two  hours  after 
Alkamne  Mineral  Waters 
Aloes.    As  dinner  pill,  along  with  nux  vomica, 

in  habitual  constipation 
Arsenic,  2,  3.     nij.  of  liquor  before  meals  in 

neuralgia  of  the  stomach,  or  diarrhoea  excited 

by  food 

A8AFCETDDA 

Belladonna,  3.  To  lessen  pain  and  constipa- 
tion 

Berberine 

Bismuth,  3.  When  stomach  irritable ;  and  in 
flatulence 

Bitters,  2.  Given  with  acids  or  alkalies  to 
stimulate  digestion 

Bryonia.    In  bilious  headache 

Calabar  Bean,  4.  In  the  phantom  tumour 
sometimes  accompanying 

Calumba.    Very  useful 

Capsicum.    In  atonic  dyspepsia 

Cardamoms 

Castor  Oil 

Cerium  Oxalate 

CHAMOMUiE 

Charcoal.    For  flatulence 

Cholagogues.    Often  very  useful 

Cinchona 

Cocadse,  3.  In  nervous  dyspepsia,  J  gr.  twice 
or  three  times  a  day 

Cod-Liver  Oil,  3.  In  the  sinking  at  the  epi- 
gastrium in  the  aged  without  intestinal  irri- 
tation 

Colchicum,  3.    In  gouty  subjects 

Cold  Water,  3.  Half  a  tumbler  half  an  hour 
before  breakfast 

Creasote,  3.    If  due  to  fermentative  changes 

Eucalyptus,  2,  3.  In  atonic  dyspepsia  due  to 
the  presence  of  sarcinaB 

Gallic  Acno.    In  pyrosis 

Gentian,  1.    In  atony  and  flatulence 

Ginger,  4.    An  adjunct 

Glycerine 

Gold,  2.    The  chloride  in  nervous  indigestion 

Hops,  2.    A  substitute  for  alcohol 

Hot  Water,  3.  A  tumbler  twice  or  three  times 
between  meals,  in  acid  dyspepsia,  flatulence, 
and  to  repress  the  craving  for  alcohol 

Hydrastis.  In  chronic  dyspepsia  or  chronic 
alcoholism 


INDEX  OF  DISEASES  AND  EEMEDIES. 


1199 


DrsPEPSIA. 

Htdkochlomo  Acid,  3,  4.  Dilate  after  a  meal, 
especially  if  there  is  diarrhoea 

Hydbocyanic  Acid.    In  irritable  cases 

Ipecacuanha,  3.  Useful  adjunct  to  dinner-pill, 
in  chronic  irritable  dyspepsia 

Kino.    In  pyrosis 

Lactic  Acid.    In  imperfect  digestion 

Lime  Wateb 

Maonesia,  4.    In  acid  dyspepsia 

Maonesium  Sulphate 

Manganese.    Iu  gastrodynia  and  pyrosis 

MEltcUKY.    As  cholagogue 

Morphine,  3.  Subcutaneously  in  irritable  dys- 
pepsia of  irritable  subjects 

Mux  Vomica.  Exceedingly  useful  in  most 
forms  along  with  mineral  acids 

Opium,  3.  In  sinking  at  the  stomach  partially 
relieved  by  food  which,  at  the  same  time, 
produces  diarrhoea,  a  few  drops  of  tincture 
before  meals;  with  nux  vomica  In  palpitation, 
&c. 

Pancreatdj.  1J  or  2  hours  after  meals,  very 
useful 

Pepper,  4.    In  atonic  indigestion 

Pepsin,  2.  Sometimes  very  useful  with  meals ; 
and  in  apepsia  of  infants 

Podophtllin,  3.  A  cholagogue,  used  instead 
,of  mercury;  useful  along  with  nux  vomica 
and  mineral  acids 

Potassium  Iodide 

Potassium  Permanoanate,  4.  Like  manganese 

Potassium  Sulphide 

Quassia 

Quinine,  3.  In  elderly  people,  and  to  check 
flatulence 

Rhubarb 

Sanguinaria.    In  atonic  dyspepsia 

Silver  Nitrate,  4.    In  neuralgic  cases 

Silver  Oxide 

Sulpho-carbolate  op  Sodium,  3.  In  flatulence 
and  spasm  after  a  meal ;  in  the  latter,  phos  - 
phorus  is  better 

Sulphurous  Acid.  In  acid  pyrosis  and  vomit- 
ing 

Tannic  Acid.  3.    In  irritable  dyspepsia 

Taraxacum 

Turkish  Bath,  3.    In  malaise  after  dining  out 

Wahoo  (Euonymin),  4.    As  a  cholagogue 

Xanthoxylum.    As  stomachic  tonic 

Dysphagia. 

Bromide  of  Potassium.  In  hysterical  dys- 
phagia ;  or  dysphagia  of  liquids  in  children 

Cajeput  Oil.    In  nervous  dysphagia 

Cocaine,  3.  In  tonsillitis,  &c.  as  cause,  4  per 
cent,  solution  painted  oyer 

Hydrocyanic  Acid,  1.    As  gargle 

Iced  Fluids.  Slowly  swallowed  in  spasmodic 
dysphagia 

Dtspngea. 

Vide  Asthma,  Bronchitis,  Cboup,  Emphysema, 
Phthisis 


Ear-ache. 


Dysuria. 


Alkalies.    When  urine  very  acid 
Belladonna 
Camphor.    In  strangury 
Cannabis  Indica.    In  hematuria 
Oantharldes  Tincture 
Ohimaphila 

Ergot.    In  paralysis,  when  bladder  feels  imper- 
fectly emptied 
Gelsemium 
Nitrous  Ether 
Opium 


Almond  Oil 

Atropine,  2.    Along  with  opium 

Blisters,  3.    Behind  the  ear 

Cocaine,  3.    As  spray 

Ether  Vapour,  1.    To  tympanum 

Glycerine,  3 

Hop  Poultice,  2 

Lead  Acetate,  and  Opium.   As  wash 

Opium 

Pulsatilla 

ECCHYMOSES. 

Alcohol.    Externally 
Arnica.    Internally  and  externally 
Compressed  Sponge,  1.    Bound  over 
Ice,  1 

Solomon's  Seal  (Convallaria),  1.  The  juice 
of  the  root,  especially  in  a '  black  eye ' 

Ecthyma. 

Cod-Liver  OrL,  2.    Internally  and  locUly 

Grape  Cure.    Useful 

Lead.    Locally 

Quinine,  2,  3.    For  the  malnutrition 

Zinc  Oxide.    Locally 

ECTROPIUM  AND  EnTROPIUM. 

Collodion 
Silver  Nitrate 

Eczema. 

Alkalies,  Weak  solutions  as  a  constant  dress- 
ing 

Alum,  3.  To  check  a  profuse  discharge,  not 
curative 

Ammonium  Carbonate,  1.  Along  with  fresh 
infusion  of  cinchona 

Axacardium  Orientals 

Argentic  Nitrate,  2,  3.  Simple  solution,  or 
solution  in  nitric  ether  painted  over  in  chronic 
form 

Arsenic,  2.  Applicable  only  in  squamous  and 
chronic  form,  not  in  acute 

Belladonna,  2.  Internally,  or  atropine  subcu- 
taneously, in  acute  stage 

Benzoin,  3.  Compound  tincture  painted  on  to 
relieve  itching 

Bismuth,  2, 3.  Where  there  is  much  exudation,, 
the  powder,  or  ointment  either  of  subnitrate 
or  carbonate 

Blisters,  3.  In  chronic  cases,  especially  of 
hand 

Borax,  3.  The  glycerine  in  eczema  of  the  scalp 
and  ears 

Boric  Acn>  Ointment,  2,  3.  Topically,  espe- 
cially in  eczema  of  the  vulva 

Camphor,  3.    Powder  to  ally  heat  and  itching 

Carbolic  Acid,  2, 3.    Internally  and  locally 

Cashew  Nut  Oil.    Ointment  in  chronic  cases 

Chloral,  1.  As  ointment  3ss.r3j.  of  petroleum ; 
or  as  lotion 

Cinchona,  3.  Powdered  bark  locally  as  an 
astringent 

Citrine  Ointment,  2,  3.  Locally,  alone  or  with 
tar  ointment  in  eczema  of  the  eyelids 

Cocaine,  3.    To  allay  itching  in  scrotal  eczema 

Cocoa  Nut  Oil,  1.    In  eczema  narium 

Cod-Liter  Oil,  3.  In  eczema  of  children  due 
to  malnutrition,  and  locally  to  skin  to  prevent 
cracking 

Collodion,  1 

Coxium,  1 

Copper  Sulphate,  2.    Astringent 

Crotox  Seels.    Tincture  of,  as  ointment 


1200. 


INDEX  OF  DISEASES  AND  EEMEDIES. 


Eczema. 


Emphysema. 


Electricity,  2.    Central  galvanisation  in  very 

obstinate  cases 
Eucalyptol,  3.    "With  iodoform  and  vaseline  in 

dry  eczema 
Glycerin,  3,  4.    As  local  emollient  after  an 

attack 
Glycerols  of  Aloes,  1.    In  eczema  aurium 
Hamamelis.    Locally  to  allay  itching 
Iris  Versicolor.    In  chronic  gouty  cases 
Jaborandi,  1 

Lead  Salts,  2,  3.    "Where  there  is  much  inflam- 
mation and  weeping,  a  lotion  containing  a 
glycerine  preparation ;  if  ■  dry  and  itching,  a 
strong  solution  or  an  ointment 
Lime  Water,  3.    A  sedative  and  astringent,  in 

later  stages  with  glycerine 
Lithia,  1.    In  gouty  subjects 
Mercury 
'  Oil  of  Cade,  3.    With  vaseline 
Phytolacca.    In  obstinate  cases 
Plumbago,  1.  Ointment  in  eczema  aurium 
Potassium  Salts,  1.    Internally 
Potassium  Cyanide,  3.    To  allay  itching 
Potato  Poultice,  3.    Cold,  sprinkled  with  zinc 

oxide,  to  allay  itching 
Rhus  Toxicodendron.    Internally  and  exter- 
nally ;  with  much  burning  and  itching,  and  in 
chronic'  eczema  of  rheumatism  worse  at  night 
time 
Salicylic  Acid,  2,  3.    Locally,  if  there  is  much 

weeping  .  , 

Soap,  3.    A  glycerine  soap  to  wash  with  night 

and  morning  will  allay  itching 
Sulphides  )  3.    Internally,  and  as  baths ;  but 
Sulphur    j  not  in  acute  stage 

Tannin,  2,  3;'  After  removal  of  the  scales  the 
glycerine  of  tannin,  tar,  or  other  ointment 
may  be  required  to  complete  the  cure 
Tar,  3.    Ointment;  and  internally  as  pill  or 

capsule  in  very  chronic  form 
Turkish  Bath 
Viola  Tricolor.    Infusion  along  with  senna ; 

externally  as  ointment 
Warm  Baths,  3.    In  acute  stages 
Yolk  of  Egg,  2.    With  water  locally 
2inc,  1,  3.    The  oxide  and  carbonate  as  dusting 
powders ;  the  oxide  as  ointment,  if  the  raw 
surface  is  indolent   after   inflammation  has 
subsided 


Elephantiasis. 


Anacardium  Orientals 

Arsenic.    Along  with  five  or  six  times  as  much 

black  pepper 
Cashew  Nut  Oil 
Gctrjitn  Oil 

Iodine,  1.    Internally  and  externally 
Saksaparilla 


Emaciation. 


Especially   valuable   if   following  on  retro- 
cession of  a  rash 

Belladonna,  3.    E  bronchitis  and  dyspnoea  are 
severe 

Bleeding.    When  right  side  of  heart  engorged 

Chloral,  3.    In  acute  if  sudden,  a  single  large 
dose  ;  if  long  continued,  small  doses 

Cod-Liver  Oil.    One  of  the  best  remedies 

Compressed  Ant,  2.    Inhaled 

Cubebs,  3.    The  tincture  sometimesrebeveslike 
a  charm 

Ether.    Internally,  as  inhalation 

Grindelia,  2.    In  most  respiratory  neuroses 

Hypo  phosphites 

Iodide  of  Ethyl.    As  inhalation 

Iron 

Lobelia,  3.      Where  there  is  severe  dyspnoea, 
or  capillary  bronchitis 

Oxygen.    In  paroxysmal  dyspno3» 

Purging,  3.    Instead  of  bleeding 
'  Senega 

Stramonium 

Strychx(NE,  2,  4.    As  a  respiratory  stimulant 

Turpentine,  Oil  of 


Empyema. 


All  used  as  injections 
to  wash  out  cavity 


Arsenic 

Calcium  Chloride,  1.    In  scrofulous  diathesis 

Cinchona 

Cod-Liver  Oil 

Iodine 

Iron 

Pancreatin 

Pepsin 

Phosphate  of  Calcium 

Potassium  Chlorate,  1 

Potassium  Iodide,  1.    In  syphilitic  taint 

Emphysema. 

Apomorphine.    When  secretion  is  scanty 
Arsenic,  2,  3,     In  subjects  who  are  affected 
with  dyspnoea  on  catching  a  very  slight  cold. 


Aspiration,  or  free  incisions 
Carbolate  of  Iodine,  2. ' 
Carbolic  Acn>,  2,  3, 
Chlorine  Water,  3, 
Iodine,  2,  3,  4. 
Quinine,  3. 
.  Salicylic  Acid, 

Endocarditis. 

Aconite.    In  small  doses  frequently  at  com- 
mencement 
Blisters 
Bryonia 

Chloral  Hydrate,  2.    In  moderate  doses 
Mercury,  4.    To  prevent  fibrinous  deposits; 
conjointly  with  alkalies ;    if   of  rheumatic 
origin 
Opium.    In  full  doses 
Potassium  Salts.    To  liquefy  exudation 
Quinine,  2.  In  full  doses  at  the  commencement 
Salicylic  Acid,  2.    In  the  rheumatic  form 

Endometritis. 

Carbolic  Acid,  2.  Locally  applied,  undiluted, 
on  cotton  wool  probe  in  chronic  form 

Chromic  Acid,  2.  Strong  solution,  15  gr.-3j.  of 
hot  water  in  catarrh 

Ergot.    Subcutaneously 

Glycerin.    Locally 

Hot  Water  Injections 

Hydrargyri  BiCHLOfiiDUM,  1.  Antiseptic  in- 
jection 

Iodine 

Iodoform 

Iodo-tannin.  Solution  of  iodine  in  tannic  acid 
applied  on  cotton  wool 

Nitric  Acid 

TTstilago  M&YDIB 


Enteritis. 


Aconite.    In  acute  oagea 
Argentic  Nitrate,  1, 4.    In  chronic  form 
Arsenic,  3. '  In  small  doses  along  with  opium 
Calomel,  4.      In  obstructive   enteritis   with 

constipation,  pushed  to  salivate 
Castor  Oil.    Especially  in  the  chronic  enteritis 

of  children.    Very  useful  along  with,  opium 
Copper  Sulphate,  2.    In  minute  doses 
Iron 


INDEX  OF  DISEASES  AND  EEMEDIES. 


1201 


Enteritis. 

Lead  Acetate,  2.    Sedative  astringent 

Linseed,  4.    Infusion  as  drink 

Magnesium  Sulphate,  4.    The  most  valuable 

purgative 
Opium 

Podophyllum 
Poultice  Hot 

Skim  Milk.    As  diet,  alone  or  with  lime-water 
TJlmus.    Infusion  as  drink,  or  leaves  as  poultice 

Enuresis. 

Atropine 

Belladonna.    Very  useful  for  children,  but  the 

dose  must  be  large 
Buchu.    In  chronic  cases 
Oantharides,   3.     Internally   very  useful   in 

middle-aged  women  or  the  aged 
Chlobal  Hydrate.    In  children 
Collodion.    To  form  a  cap  over  prepuoe 
Ergot.    In  paralytic  cases 
Iodide  of  Iron.    In  some  cases 

LUPULINE 

Potassium  Nitrate,  3.    In  children 

Rhus  Toxicodendron 

Rn  us  Aromatica 

SANTONrN.    When  worms  present 

Strychnine,  3.    Yery  useful  in  the  paralysis  of 

the  aged,  and  incontinence  of  children 
Turpentine 

Epididymitis.     Vide  Testicle, 
Diseases  of. 

Aconite.    In  small  doses  frequently  repeated 
Mercury  and  Morphine.    Locally  as  oleate  if 

persistent 
Pulsatilla.    In  very  small  doses  along  with 

aconite 
Silver  Nitrate.       Strong    solution    locally 

applied  to  abort 


Epilepsy. 


APOMORPHrNB.    To  prevent ;  in  emetic  doses 
Argentic  Nitrate,  1,  2,  3,  4.    Sometimes  use- 
ful, but  objectionable  from  risk  of  staining 
Arsenic.    In  epileptiform  vertigo 

ASAFOSTIDA 

Anesthetics,  4.    Barely  called  for 

Belladonna.  In  petit  Tnal,  in  nocturnal  epi- 
lepsy and  in  ansemic  subjects ;  perseverance 
in  its  use  is  required 

Blisters.    Over  seat  of  aura. 

Bromd3es  op  Potassium,  Sodium,  Lithium, 
and  Iron.  Most  generally  useful ;  dose  should 
be  large  ;  in  cases  occurring  in  the  day-time, 
in  grand  mat,  reflex  epilepsy,  and  cerebral 
hypereemia 

BROMINATED  CAMPHOR,  4 

Bryonia 

Calabar  Bean,  4.  Doubtful  value  ;  may  pro- 
duce a  succession  of  fits 

Camphor,  4.  Has  been,  but  is  not  now,  muoh 
used 

Cannabis  Indica,  2 

Cautery,  3.    Frequently  and  lightly  repeated 

Cerium  Oxalate,  1 

Chloral  Hydrate,  2.  Full  dose  at  bed-time  in 
nocturnal  attacks 

Chloroform.    Inhalation  in  hystero-epilepsy 

Cod-Liver  Oil 

1  CONIUM  „,  .  i    i.   +„ 

Copper  Salts,  2,  3,  4.   The  ammomo-sulpnate 

is  sometimes  .useful 
Electricity,  1  «.m*i- 

Hydrargyri   BiNiODrouM,    L      In   syphilitic 

history 
Hydrobromic  Acid 
Ignatia 


Epilepsy. 

Iron,  2,  3.  In  uterine  obstruction,  in  cerebral 
and  general  anosmia ;  alone,  or  the  bromide 
along  with  the  bromide  of  potassium 

Lobelia,  4.  Has  been  used  as  a  nauseant  to 
relieve  the  spasms 

Musk,  3.    Has  been  tried 

Nitrite  op  Amyl,  2,  3,  4.  Inhaled  will  cut 
short  a  fit ;  if  there  is  appreciable  time  be- 
tween aura  and  fit  will  prevent  it,  and  cut 
short  status  epilepticus 

Nitrite  op  Sodd  m,  3.  In  petit  mat  in  gr.  j.  dose 
thrice  daily 

Nitro-glycerin,  2,  3.  Like  nitrite  of  amyl, 
but  slightly  lont  er  in  acting 

Paraldehyde.    Instead  of  bromides 

Phosphorus 

Picrotoxin,  1,  2.  Weak  and  ansemic  type;  or 
nocturnal  attacks ;  must  be  persisted  in 

Potassium  Iodlde.  With  bromide  ;  alone  in 
syphilitic  history 

QUTNINE 

Rue.    When  seminal  emissions  also  are  present 

Santonin,  4.    Has  been  tried 

Seton,    In  the  back  of  the  neck 

Strychnine,  2.  In  idiopathic  epilepsy  and  espe- 
cially in  pale  anaemic  subjects ;  not  if  there 
is  any  organic  lesion 

Sumbul,  1 

Turpentine.    If  due  to  jrorms 

Valerian,  3.  Sometime3  does  good,  especially 
if  due  to  worms 

Zino  Salts,  2,  3,  4.  The  oxide,  or  sulphate ; 
epileptiform  vertigo  due  to  gastric  disturb- 
ance is  often  relieved  by  the  oxide 

Epistaxis. 

Aconite,  3.  In  small  and  frequent  doses  to 
children,  and  in  plethora 

Alum,  2.  Powder  snuffed  or  blown  up  the 
nostrils 

Arnica.    In  traumatic  cases 

Barium  Chloride,  2.    To  lower  arterial  tension 

Belladonna 

Blister  over  Liver,  1 

Cocaine,  3.  Locally  in  haemorrhage  from  the 
nasal  mucous  membrane 

Compression  op  Facial  Artery,  3 

Digitalis,  2,  3.    The  infusion  is  the  best 

Ergot,  2,  3, 4.    Subcutaneously,  or  by  stomach 

Gallic  Acid.    Along  with  ergot  and  digitalis 

Hamamelis 

Ice.    Over  nose  and  head 

Ipecacuanha,  2,  3.  Until  it  nauseates  or  pro- 
duces actual  vomiting 

Iron,  2.  As  spray  the  subsulphate  or  per- 
chloride 

Pluggdsg  anterior  and  posterior  nares  neces- 
sary, if  epistaxis  obstinate 

Tannin,  2.    Locally  applied 

Transfusion,  2.    If  death  threatens  from  loss 

Turpentine,  2.  Internally  in  passive  haemor- 
rhage 

Warm  Bath,  3.  To  feet  and  hands,  with  or 
without  mustard 

Warm  Water  Bag.    To  spine 

Erysipelas. 

Aconite,  3.  At  commencement  maj  cut  it 
short ;  valuable  when  skin  is  hot  and  pungent 
and  pu!se  firm;  also  in  erysipelatous  inflam- 
mation following  vaccination   . 

AMMONruM  Carbonate,  2,  3.  When  tendency  to 
collapse,  and  in  typhoid  condition ;  internally 
and  locally ;  more  adapted  to  idiopathic, 
especially  facial  erysipelas  than  to  traumatic ; 
with  fever,  digitalis  or  aconite 

Belladonna,  2, 3, 4 

4e 


1202 


INDEX  OF  DISEASES  AND  REMEDIES. 


Erysipelas. 

Benzoic  Acid,  4.  The  soda  salt  313.— 3iij-  in  the 

twenty-four  hours 
Boric  Acid,  4.     Lotion  in  phlegmonous  ery- 


Carbolic  Acid,  2,  3.  Lint  soaked  in  2  per  cent, 
solution  relieves  pain ;  subcutaneously  3ss., 
alcohol  3ss.,  water  Sij. 

Collodion,  3.  Locally  in  superficial  erysipelas, 
useless  when  cracked 

Digitalis.    Infusion  locally 

Hot  Fomentations,  3 

Iodine,  3,  4.  Solution  not  too  strong  painted 
over 

Iron.  Large  doses  frequently,  and  local  appli- 
cation    . 

Potassium  Permanganate,  3.  Solution,  locally 
and  internally 

Quinine,  2.    In  large  doses 

Eesorcin,  2.    Antipyretic  and  antiseptic 

Rhus  Toxicodendron 

Silver  Nitrate.  Strong  solution  locally  ap- 
plied for  an  inch  or  two  beyond  inflamed  area 

Sodium  Salicylate,  2.    Antipyretic 

Sulphurous  Aero,  3.  Equal  parts  with  gly- 
cerine locally 

Tartar  Emetic,  1.    Small  doses  frequently 


Erythema. 


Acids.    In  cases  of  indigestion 
Alum,  2.    Lotion 

Belladonna,  2.    In  simple  erythema 
Bismuth.    Locally 

Hydrochloric  Acid,  2.    If  reflex  from  gastro- 
intestinal disturbance 
Lead,  2.    The  glycerine  of  the  carbonate 
Nitric  Aero,  2.    Like  hydrochloric  acid 
Quinine.    In  erythema  nodosum 
Bhus  Toxicodendron 
Zinc,  2.    Locally,  as  ointments  or  lotions 

Exophthalmos. 

Barium  Chloride,  2.    To  raise  arterial  tension 
Belladonna,  2,  3 

Chalybeate  "Waters,  2.    For  the  anasmia 
Digitalis,  2.    If  functional  in  young  subjects ; 

often  relieves  in  other  cases 
Galvanism  of  the  cervical  sympathetic,  and 

pneumogastrio  nerves 
Iron.    For  the  anasmia 

Favus. 

Boric  Acid,  2.    Locally  in  ethereal  solution 
Carbolic  Acn>,  2.    As  a  local  parasiticide 
Cod-Liver  Oil,  2.    In  a  debilitated  subject 
Mercury,  Oleate,  3.    Parasiticide  ;  also  lotion 

of  bichloride  gr.  ij.~3j.  of  water 
Myrtol,  2.    Parasiticide 

Oils,  3.    To  get  rid  of  scabs,  and  prevent  spread 
Kesorcin,  2.  ) 

Salicylic  Acid,  2.       \  Like  myrtol 
Sulphurous  Acid,  3.  J 


"Fever. 


Acids  or  Acid  Drinks,  3.  To  allay  thirst  and 
aid  digestion 

Aconite,  2,  3,  4.  Small  doses  frequently  in  all 
sympathetic  fevers 

Alcohol,  2,  3.  Often  useful,  but  effect  watched 
carefully  and  quickly  discontinued  if  it  does 
not  relieve  symptoms 

Alkalies,  3.  Febrifuges,  and  increase  urinary 
solids 

Ammonia,  4.    In  a  sudden  collapse 

Ammonium  Acetate,  2,  3.  Very  useful  as  dia- 
phoretic, more  so  in  milder  forma 


Fever. 

Ammonium  Carbonate,  3.    In  scarlet  fever  and 

measles,  and  in  any  typhoid  condition 
Antipyrin,  3, 4.    To  reduce  temperature ;  has 

caused  collapse  and  death 
Arnica,  2.  Full  doses  of  the  infusion  in  sthenic 
reaction;    low  doses  of  the  tincture  in  as- 
thenia 
Arsenic,  3.    In  malarious  fevers ;  and  in  pros- 
trating acute  fevers  to  raise  the  patient's  tone 
Belladonna,  3.    In  eruptive  fevers  and  de- 
lirium 
Benzoate  of  Sodium,  4.    In  infectious  and 

eruptive  fevers,  antiseptic  and  antipyretic 
Bitters,  3.    "With  acid  drinks  to  quell  thirst, 

e.g.  cascarilla,  orange  peel,  &e. 
Blisters,  3.    Flying  blisters  in  various  parts  of 

the  body  in  the  semi-comatose  state 
Bromide  of  Potassium,  3 
Calomel,  2.    In  the  early  stages  of  typhoid 
Camphor,  3.    In  adynamic  fevers,  and  in  de- 
lirium, in  gr.  xx.  doses  every  two  or  three 
hours,  and  effects  watched 
Carbolate  of  Iodine,  2.  In  the  later  stages  of 

typhoid ;  and  in  chronic  malarial  poisoning 
Carbolic  Aero,  2,  3.    An  antiperiodic  and  anti- 
pyretic 
Castor  Oil,  3.    As  purgative 
Chloral,  3.    In  the  violent  delirium  and  wake- 
fulness of  typhus,  &c,  and  to  reduce  fever 
Cimicipug  a  ,  2.    When  cardiac  action  is  quick 

and  tension  low 
Cocculus.    In  typhoid,  to  lessen  tympanitis 
Coffee.    In  place  of  alcohol 
Cold  Bath  and  Affusion,  1,  2,  3, 4.    To  lessen 
hyperpyrexia,   and    a    first-class   stimulant, 
tonic,  and  sedative 
Cold  Packing,  3.  In  acute  fevers,  especially  on 

retrocession  of  a  rash 
Digitalis,  1,  2,  3,  4.     In  inflammatory  eruptive 
fevers,  especially  scarlet  fever,  as  an  anti- 
pyretic ;  much  used  in  typhoid  on  the  Con- 
tinent 
Elatekium,  1.    Hydragogue  cathartic 
Eucalyptus,  3.    In  intermittent  fevers 
Gelsemium,  2,  4.  In  malarial  and  sthenic  fevers, 

especially  in  pneumonia  and  pleurisy 
Glycerine,  3.    Demulcent  drink 
Hot  Affusions,  3.    For  headache  sometimes 

better  than  cold 
Hydrastis,  2.    Inferior  to  quinine  in  inter- 
mittent fever 
Ice.    To  suck ;  bag  to  forehead 
KAntn*,  4.    Not  a  safe  antipyretic 
Lemon   Juice,  4.     An  agreeable  refrigerant 

drink 
Mercury.    Small  doses  at  the  commencement 

of  typhoid  or  scarlet  fever 
Musk,  3.    A  stimulant  in  collapse ;  along  with 

opium  in  an  acute  specific  fever 
Opium,  3.     In  typhoid  delirium;  with  tartar 
emetic  if  furious ;  at  the  crisis  aids  action  of 
alcohol 
Phosphate  of  Calcium,  3.    In  hectic 
Quinine,  2,  3,  4.    In   malarial,   typhoid,   and 
septic  fevers ;  the  most  generally  applicable 
antipyretio 
Eesorcin,  2.    Antipyretic  and  antiseptic 
Bhus  Toxicodendron.  In  rheumatic  fever,  and 

scarlet  fever  with  typhoid  symptoms 
Salicin.  \  -    _  ..   . 

Salicylate  of  Sodium,  3. 1  In  rheumatic  fevers, 
Salicylic  Acid,  2,  3.  J  or  m  hyperpyrexia 
Strychnlxe,  3.    Subcutaneously  for  muscular 

paralysis  as  a  sequela 
Sulphate  of  Magnesium,  3.    As  a  depletive 

and  purgative 
Tartar  Emetic,  3,  4.  In  small  doses,  with 
opium,  if  delirium  is  not  greater  than  wake- 
fulness ;  if  greater,  in  full  doses,  with  small 
doses  of  opium :  diaphoretic ;  in  ague  aids 
quinine,  also  in  acute 


INDEX  OF  DISEASES  AND  EEMEDIES. 


1208 


Fever. 

Turpentine,  2.    As  Btimulant  in  typhoid,  puer- 
peral, and  yellow,  and  to  Btop  hemorrhage  in 
typhoid 
Veratrum  VrRTDE.    In  delirium  ferox 
Warm  Sponging,  3.    In  the  simple  fevers  of 
children 

Fistula. 

Capsicum.  As  weak  Infusion  locally 
Pepper.  The  confection  as  laxative 
Sangubjaria.    As  injection 

Flatulence. 

Abstention  from  sugar,  starchy  food,  tea,  3 

Alkalies.    Before  meals 

Ammonia,  3.    In  alkaline  mixture  a  palliative 

Asafostida,  2,  3.  In  ohildren ;  simple  hys- 
terical, or  hypochondriacal 

Belladonna,  2.  If  due  to  paresis  of  intestinal 
walls 

Bismuth,  3.  With  charcoal,  in  flatulent  dys- 
pepsia 

Calumba,  2.    With  aromatics 

Camphor,  2.  In  hysterical  flatulence,  especially 
at  climacteric 

Carbolic  Acid,  3.    If  without  acidity,  &o. 

Carlsbad  Waters.  If  due  to  hepatio  derange- 
ment 

Carminatives 

Charcoal 

Chloroform,  3.  Pure,  in  drop  doses  in  gastric 
flatulence 

Creasote 

Essential  Oils,  3 

Ether,  2.    In  nervousness  and  hypochondriasis 

Eucalyptol,  3.  At  climacteric,  if  associated 
with  heat  flushings,  &o. 

Galvanism,  1 

Hot  Water,  3.    Between  meals 

Ipecacuanha,  3.  In  constipation,  oppression 
at  epigastrium,  and  in  pregnancy 

Mercury,  3.    When  liver  sluggish 

Muscarine,  2.    In  intestinal  paresis 

Nux  Vomica,  2,  3.  In  constipation,  pain  at  top 
of  head 

Physostigma,  2.    In  women  at  change  of  life 

Potassium  Permanganate.    In  fat  people 

Bus,  1.    Most  efficient 

Sulpho-Carbolates,  3.  When  no  acidity,  and 
simple  spasms 

Sulphurous  Acid,  3.    If  due  to  fermentation 

Turpentine.  Pew  drops  internally,  or  as 
enema  in  fevers,  peritonitis,  &c. 

Flushing  and  Heat. 

Eucalyptol,  3.   At  climacterio 

Iron.    Most  useful 

Nitrite  of  Amyl,  3.  If  associated  with  men- 
strual irregularity ;  accompanying  symptoms, 
cold  in  the  extremities,  giddiness,  fluttering  of 
the  heart ;  inhalation,  or  internally  in  one- 
third  of  a  drop  doses ;  effects  sometimes  dis- 
agreeable 

Nux  Vomica,  3.  With  tinct.  opii  in  the  hysteria 
of  middle-aged  women 

Potassium  Bromide,  3.   If  at  climacteric 

Valerian 

Valerianate  of  Zinc,  3.   At  climacterio 

Fractures  and  Dislocations. 

Aconite.    If  febrile  symptoms  are  present 
Arnica.    Internally  and  locally 
Iodine.    Antiseptic  dressing 

Opium  „  „  .  , 

Phosphate  of  Calcium.    Quickens  union 


Freckles. 


Alkaline  Lotions,  2 

Benzoin 

Borax 

Iodine 

Lime-Water 

Mercuric  Chloride,  1.  Locally,  with  gly- 
cerine, alcohol,  and  rose  water,  j  of  gr.  to 
the  oz. 

Olive  On. 

Potassium  Carbonate 

Gangrene. 

Ammonium  Chloride,  1 

Balsam  of  Peru 

Bromine,  2.    Escharotic  in  hospital  gangrene 

Carbolic  Aero,  2,  3, 4.  Locally  in  strong  solu- 
tion to  act  as  a  caustic  ;  as  a  dressing  to  pro- 
mote healthy  action 

Charcoal.    As  poultice 

Chlorine  Water.    To  destroy  fetor 

Chromic  Acid,  2.    Local  escharotic 

Cinchona 

Creasote 

Eucalyptol,  2.  Along  with  camphor  in  gan- 
grene of  lungs  to  prevent  spread  and  lessen 
the  fetor 

Lime  Juice  and  Chlorine  Water  in  hospital 
gangrene 

Myrtol,  2.  To  destroy  fetor  and  promote 
healthy  action 

Nitric  Acid,  2,  4.  Next  to  bromine  the  most 
useful  escharotic 

Oakum,  1.    Dressing 

Opium 

Oxygen.   As  a  bath 

Potassium  Chlorate 

Potabsa  Pusa,  2.    Wide  canstic 

Besorctn,  2.    Antiseptic,  antipyretic 

Salicylic  Aero,  2.    Locally 

Sanguinahia 

Turpentine,  2.  Internally,  and  inhalation  of 
vapour 


Gastralgia. 


Acupuncture.    Sometimes  gives  great  relief 

Alum,  2.    If  pyrosis 

Arsenic,  2,  3,  4.    In  small  doses 

Atropine,  2.    In  gastric  ulcer 

Bismuth,  2,  3, 4.    In  irritable  gastralgia 

Charcoal,  3.    In  neuralgia 

Chloral,  3.    To  relieve  pain 

Chloroform.    Two  or  three  drops  on  sugar 

Creasote,  3 

Ergot 

Ether,  2.    A  few  drops 

G-ALVANISM.  Of  pneumogastric  and  sympathetic 

Hydrocyanic  Acid,  2,  4.    If  purely  nervous 

Manganese,  2,  3,  4.    The  black  oxide  purified 

Milk  Cure 

Morphine.     Subcutaneously,  in   epigastrium, 

very  useful,  or  with  bismuth  and  milk  before 

each  meal 
Nitro-glyoerin,  2.    Quickly  eases 
Nux  Vomica,  3.    To  remove  morbid  condition 

on  which  it  depends 
Pancreatin 
Pepsin 

Quinine,  2.    If  periodic  in  character 
Besorctn,  2 

Salicylic  Acid,  2.    Like  quinine 
Silver  Nitrate,  2, 3, 4.    Nervine  tonic 
Silver  Oxide,  2 
Zinc  Oxide,  2 

Gastric  Ulcek. 

Arsenic,  2.    In  chronic  ulcer  it  eases  pain  and 
vomiting,  and  improves  the  appetite 

4  H  2 


1204 


INDEX  OF  DISEASES  AND  REMEDIES. 


Gastric  Ulcer. 


Atropine,  2.    Arrests  pain  and  vomiting 

Bismuth,  2.    Like  arsenic 

Cannabis  Indica 

Carlsbad  Salts.    Before  meals 

Castor  Oil 

Charcoal,  3.    In  chronic  ulcer  to  allay  pain 

Ice-bag,  3.    To  epigastrium 

Lead  Acetate,  2.    To  check  hasmatemesis 

Limb  "Water  with  Milk,  3.    Diet 

Mercuric  Chloride.    Small  dose  before  meals 

Milk 

Morphine;,  2.   Like  atropine 

Nutritive  Enemata,  2, 3, 4 

Opium 

Pepsin 

Peptonised  Mtt.tt,  l 

Potassium  Iodide.  With  bicarbonate,  to  lessen 

flatulent  dyspepsia 
Silver  Nitrate,  2,  3,  4.    To  relieve  pain  and 

vomiting 
Silver  Oxide,  2 
Tannin 
Turpentine,    3,  4.     Frequently  repeated   to 

check  haemorrhage 

Gastritis. 

Alum.    "When  vomiting  of  glairy  mucus 

Ammonium  Chloride,  4.    In  gastric  catarrh 

Arsenic,  3.    In  drunkards 

Atropine,  2.    In  chronic  cases 

Bismuth,  4.    In  catarrh 

Caffeine,  3.    Especially  when  associated  with 

migraine 
Calumba 
Cinchona 

Eucalyptus,  3.    In  chronic  catarrh 
Hydrastis,  2 

Hydrocyanic  Acid,  2,  3.    To  allay  pain- 
Ice,  2,  3.    To  suck ;  and  to  epigastrium 
Ipecacuanha,  2.    In  catarrh 
Lead  Acetate,  3.    Along  with  opium 
Nutrient  Enemata 
Nux  Vomica 
Opium 

Silver  Nitrate,  4.    In  chronic  gastritis 
Silver  Oxide 
Tannic  Acid 
Veratrum  Tiride,  4.    Should  never  be  used 

Glanders. 

Ammonium  Carbonate.    Every  hour  in   con- 
centrated solution,  followed  by  opiate 
Arseniate  of  Strychnine 
Carbolic  Acid.    Locally 
Chlorinated  Soda.    Locally 
Creasote 

Iodide  of  Sulphur 
Iodine 

Potassium  Bichromate 
Sulphites 

Glandular  Enlargements. 

Ammoniacum,  4.    Plaster   counter-irritant  on 

scrofulous  glands 
Ammonium  Chlorlde 
Arsenic 

Barium  Chloride 
Belladonna 

Blisters,  3.    To  scrofulous  glands 
Cadmium  Chloride 
Calctum  Chloride.    In  enlarged  and  breaking 

down  scrofulous  glands 
Calcium  Sulpbjde,  3.    For  glands  behind  jaw 

with  deep-seated  suppuration 
Carbolio  Acld,  4,    Injeotions  of  a  2  per  cent. 

solution 
Cod -Liver  Oll, 


Glandular  Enlargements 

Conium,  2,  4.    In  chronic  enlargements 

Gold  Chloride.    In  scrofula 

Guaiacum 

Iodlne.    Internally ;  and  painted  around*  not 

over  the  gland 
Iodoform.    As  a  dressing  to  breaking  down 

glands 
Lead  Iodide,  2.    Ointment 
Mercury,  2,  4.     Internally,  and   locally  the 

oleate  of  mercury  and  morphine 
Pilocarpine,  2.    In  acute  affections  of  parotid 

and  submaxillary 
Potassium   Iodide.    Ointment  over  enlarged 

thyroid,  and  chronically  inflamed  glands 
Sulphddes,  2 
Valerian 

Glaucoma. 

Atropine.    Has  caused  this  disease 
Dubosine.    Like  Atropine 
Eserlne.    Lowers  intraocular  tension 
Iridectomy.    The  only  cure 

Gleet. 

Aloes 

Bismuth,  3.    Along  with  glycerine  or  mucilage 

Blisters,  2,  3.  To  perinseum  useful  in  obsti- 
nate gleet 

Cantharldes,  2,  3,  4.  Minim  doses  of  tincture 
frequently  repeated 

Copaiba.  Internally,  and  locally  smeared  on  a 
bougie  and  introduced ;  best  used  in  chronic 
form 

Copper  Sulphate.    As  injection 

Eucalyptol,  3.    In  very  chronic  gleet 

Iron,  2,  3,  4.  Along  with  opium,  either  per- 
"  chloride  or  sulphate  as  injection 

Juniper  Oil.    Like  Copaiba 

Kino 

Lead  Acetate,  3.    Injection  is  sometimes  used 

Lime  "Water,  3 

Mercury,  3.  Half  a  grain  of  bichloride  in  six 
ounces  of  water 

Peru,  Balsam  of 

Piper  Methysticum 

Sandal  Wood  On*.  "Useful  both  locally  and 
generally 

Tannin,  Glycerine  of,  3.    As  injection 

Toxu,  Balsam  of 

Turpentine,  2, 8,  4.  In  a  condition  of  relaxa- 
tion 

Zinc  Sulphate,  3.    As  injection 

Glossitis. 

Bismuth.    Locally 

Electrolysis,  2.    In  simple  hypertrophy,  and 

cystic 
Leeches,  1 
Purgatives 

Glottis,  (Edema  op. 

Ammonium  Carbonate.    As  emetic 

Inhalations 

Scarification.    Especially  useful 

Tracheotomy 


GolTRE. 


Iodine,  2,  3,  4.  Internally,  and  locally  as  oint- 
ment or  tincture,  and  as  injection 

Mercuric  Biniodide,  2,  3.  As  ointment,  to  be 
used  in  front  of  hot  fire  or  hot  sun 

Potassium  Iodide,1  3 


INDEX  OF  DISEASES  AND  REMEDIES. 


1205 


Gonorrhoea. 


Aconite,  2,  3.    In  acute  stage 

Alcohol,  3.    Not  to  be  touched 

Alkaline,  3.  Salts  or  waters,  as  citrates  oi  bi- 
carbonates  to  make  urine  alkaline 

Alum,  2.    As  an  Injection 

Antimony,  4.    If  acute  stage  is  severe 

Benzoic  Acid,  4.    Internally 

Bismuth,  2,  3,  4.  Alone,  or  with  hydrastis  in- 
jected 

Buchu,  2.    More  useful  after  acute  stage 

Cadmium  Sulphate,  2.    Astringent  injection 

Cannabis  Lndica,    To  relieve  pain  and  lessen 


Canthartdes,  3.  In  small  doses  where  there  is 
pain  along  urethra  and  constant  desire  to 
micturate.  The  tincture  in  min.  doses  three 
times  daily  in  chordee 

Cocaine,  3.    Injection  to  relieve  the  pain 

Colchicum,  2.    In  acute  stage 

Copaiba.    After  acute  stage 

Cubebs.    Either  alone  or  mixed  with  copaiba 

Erigebon,  Oil  op,  4 

Eucalyptus,  Oil  of,  4 

Glycerin  of  Tannin,  2, 3.  In  later  stage  in- 
jection 

Hydrastis,  2.    As  injection 

Iron,  2,  3.    Astringent  injection  in  later  stage 

Kaolin 

Lead  Salts.    As  injection 

1£erourio  Chloride.    Weak  solution,  locally 

Pulsatilla 

Quinine,  4.    Stimulant  in  later  stage 

Sandal  "Wood  Oil.    Internally  and  locally 

Stlver  Nitrate.  As  injection,  said  to  out 
short  at  commencement 

Turpentine  _ 

Veratrum  Vhude,  2.    In  early  stage  of  acute 

feTer  ,      ^  ,.14. 

Zino   Salts.     As   injection,   sulpho-carbolate, 

acetate,  &c. 

Gout. 

Aconite,  3 

ATiTf  AT.TTKR,    2 

Alkaline  Mineral  Waters,  2 

Alkaline  Poultice,  3 

Ammonium  Phosphate,  1 

Ammonium  Tartrate,  1 

Argentic  Nitrate,  1 

Arnica,  2 

Arsenic,  2, 4 

Belladonna,  1 

Blisters,  3 

Carbonate  of  Lithium,  3, 4 

Carbonic  Acid,  1 

Carlsbad  Waters,  3 

Chicory,  1 

Chloral,  1 

Citrate  of  Lithium,  3, 4 

Cod-Liver  Oil,  3, 4 

Colchicum,  1,  2,  3, 4 

Cold  Water,  1 

Collodion,  3 

Ether,  4 

Fraxinus,  1 

Guaco,  1, 2  „      , 

Horse  Chestnut  Oil,  1 

Iodide  of  Potassium,  4 

Iodine,  1,  3 

Iodoform, 3 

Lithium,  1, 4 

Magnesia,  4 

Manganese,  2 

Morphine,  1 

Oil  of  Peppermint,  3 

Pine  Leaves  Bath,  1 

Piper  Methtsticum,  1 

PoTABSiE  Liquor,  4 

PRUNUS  TIBGINIANA,  1 
QUINDW,! 


Gout. 

Rubefacients,  4 
Salicylic  Acid,  1 
Sodium  Chloride,  1 
Sodium  Salicylate,  1 
Strawberries,  1 
Strychnine,  3 

Sulphides,  3.    In  chronic  cases 
Sulphur  Baths,  2, 3 
Trimethylamme,  1 
Turkish  Baths,  3 
Yeratrtnb,  1,  3.    As  ointment 
Vichy  Waters,  1 

Gums,  Spongy. 

Alum,  2 

Areca 

Iodine  Tincture.    Locu.ii j 

Krameria,  1 

Myrrh 

Pomegranate  Bark 

Potassium  Chlorate,  1 

Tannin,  2 

ELematemesis. 

Alum,  2,  3 

Ammonium  Chloride,  2, 3 
Ergot,  2,  3.    Hypodermically 
Gallic  Acid,  3,  4 

PTlMAMTBT.TH,  2,  3 

Ice,  3.    Exceedingly  useful 

Ipecacuanha 

Iron  Perchlortde,  or  Pbrnitrate,  3 

Iron  Subsulphate,  4 

T.irjm  Acetate,  2,  3 

Logwood,  2 

Magnesium  Sulphate 

Ehatany,  2 

Sulphuric  Acid,  3 

Tannin,  2, 3, 4 

Turpentine,  2,  3, 4 


HEMATURIA. 


Alum,  1.    Internally,  or  as  injection  into  tlie 

bladder 
brtartrate  of  potassium 
Camphor,  3 
Cannabis  Indica,  3 
Ohtmafhila 
Copaiba 
Ckeasote 
Digitalis 
Ergot,  2 

Gallic  Acid,  2,  3,  4 

Hamamelis,  3 

Ipecacuanha 

Iron  Perchloride,  or  Pebnitbate,  1 

Krameria.    Extract  in  large  dose 

Lead  Acetate 

Matico 

Quinine,  2, 3 

Bhatany,  2 

Tannic  Acid,  3 

Turpentine  OrL,  1,  2, 3, 4 


HEMOPTYSIS. 


Acetic  Acn> 

Aconite 

Alum,  4 

Ammonium  Chloride 

Arnica 

Astringent  Inhalations,  4 

Barium  Chloride,  2 

Chlobodyne,  1  ' 

Chloroform.   To  outside  of  onest 

Copaiba 


1206 


INDEX  OF  DISEASES  AND  KEMEDD3S. 


HAEMOPTYSIS. 

Copper  Sulphate,  1 

Digitalis,  1,2,  3 

Dry  Cups.    To  chest 

Eksot  akd  Ergotlnin,  2,  3, 4 

Ferric  Acetate.    Added  to   water,  bo  as  to 

take    away  the  taste ;   a  little   constantly 

sipped 
Ferri  Persulphas,  1 
Gallic  Acn>,  1,  2,  3,  4.    Very  useful 
Hamamelis,  3.    Very  useful 
Hot  Water  Bag,  3.    To  spine 
Ice,  3 

Ipecacuanha,  1, 2, 3, 4 
Iron,  2,  3.    And  absolute  rest 
Lead  Acetate,  1, 2,  i.    Very  useful 
Matico 
Morphine,  3 
Opium,  4 

Phosphoric  Acid 
Potassium  Bromide,  1 
Potassium  Chlorate,  1 
Potassium  Nitrate.  When  fever  present,  along 

with  digitalis  or  antimony 
Pyrogallic  Aero,  1 
Silver  Oxide 

Sodium  Chloride.    In  drachm  doses 
suesulphate  op  iron,  4 
Sulphuric  Acid,  3 
Tannin,  1, 3 
Th.  Laricis,  1 
Turpentine,  1, 3, 4 
Yeratrum  Viride,  1,  2 

HAEMORRHAGE,  INTESTINAL. 

,    Belladonna.    For  rectal  ulcers 
Castor  Oil 
Ergotin,  2,  3 
Ferric  Chloride,  1 
Hamamelis.    Very  useful 
Ice,  2,  3 
Iodine 
Iron,  2,  3 
Lead  Acetate,  2 
Opium,  2, 3 

Potassium  Bitartbatb,  1 
Sulphuric  Acid,  2,  3 
Tannic  Acid,  2, 3,  4 
Turpentine,  1,  2,  3,  4.    Very  useful 

Hemorrhage,  Postpartum. 

Acetic  Acid 

Achillea 

Capsicum 

Cimicdjuga 

Compression  of  Aorta,  3 

Digitalis 

Enemata,  Hot 

Ergot,  4.    Most  efficient 

Ether  Sprat 

Gallic  Acid 

TTamamfi.th.    For  persistent  oozing 

Hot  Water.    Injection  into  uterus 

Hydrastis 

Ice,  3.    To  abdomen,  uterus,  or  rectum 

Iodine 

Ipecacuanha,  3,  4.    An  emetic  dose ;  good 

Iron,  Perchloridb  Diluted,  3.    1-4  injected 

into  uterus 
Mechanical  Excitation  of  VoMrrrsa,  3 
Mux  Vomica.    Along  with  ergot 
Opium,  2.    3j.  dose  of  tincture,  with  brandy, 

in  profuse  bleeding 
Pressure  over  Uterus 
Quinine,  4 


Hemorrhoids. 

Alum,  2.  In  bleeding]  piles,  powder  crystal  or 
ointment 

Argentic  Nitrate,  1 

Belladonna,  1 

Bismuth,  1       a 

Bromide  of  Potassium,  3 

Calomel,  1, 3 

Carbolic  Acid,  1,  2.    Injection  into  piles 

Castor  On,,  3 

Chalybeate  Waters,  2 

Chlorate  of  Potassium,  3 

Chromic  Acid,  1 

Cooaine,  4 

Cold  Injection,  3 

Oubebs,  4 

Ergot,  1,  2, 4 

Ferri  Perchlortdum,  1 

Ferri  Protosulphas.    As  lotion 

Galls  Ointment,  2,  3.  With  opium  very  use- 
ful 

Grapes,  2 

Glycerine,  1, 4 

Hamamelib,  1,  3.  Internally,  and  locally  as 
lotion,  injection,  enema,  or  suppository 

Hydrastis.    As  lotion  and  internally 

Hyoscyamus.  Bruised  leaves  or  ointment 
locally 

Ice,  3 

Iodoform,  1, 4.    As  ointment  or  suppository 

Leeches,  2 

Lead,  3 

LlQ.  POTASSiB,  1 

Magnesia,  1 

Malt,  1 

Nitric  Aero,  1,  2,  3.  As  caustic ;  dilute  as 
lotion 

Nux  Vomica,  1.    Very  useful 

Ol.  Ijni,  1 

Ol.  Terebinths,  1 

Opium,  3 

Pitch  Ointment,  1 

Potassium  Bitartrate,  1 

Bheum,  1, 3 

Saline  Purgatives,  2 

Senna,  2.  As  confection,  or,  better  compound 
liquorice  powder  of  Prussian  Pharmacopoeia 

Stilllngia.  In  constipation  and  hepatic  dis- 
ease 

Stramonium,  4 

Sulphur,  1, 2,  3,  4.    As  confection 

Sulphurous  Waters,  2 

Tannic  Acid,  4 

Tobacco,  4 


Hat  Fever. 


Hemorrhoids. 


Alkaline  Mineral  Waters  useful 
Aloes,  1,  2, 3,  4.    As  purgative 


Aconite,  3 

Ammonia,  3 

Argentic  Nitrate,  1 

Arsenic,  1,  2,  3.    As  cigarette 

Atropine,  2 

Boric  Acid,  1 

Brandy  Vapour 

Bromine,  2 

Camphor,  3 

Carbolic  Acid,  1, 2 

Chlorate  of  Potassium,  3 

Cocaine,  3,  4 

Coffee,  Strong,  1 

Grindelia,  2 

Hamamelis,  3 

Iodide  of  Potassium,  L,  3.     Internally  and 

locally 
Iodides,  2 
Ipecacuanha,  3 
Lobelia,  1 
Morphine,  1,  2 
Muscarine,  2 
Opium,  3 
Pilocarpine,  2- 


INDEX  OF  DISEASES  AND  REMEDIES. 


1207 


Hay  Fever. 


Headache. 


Locally,  as  injection  or 


-,    1,  2,  3,  4 
douche 
Salicylic  Acid,  1 
Strychnine,  1 
Sugar  Snuff,  1 
Sulphurous  Acid,  3 
Sulphurous  Spbay,  1 
Tetrachloride  op  Carbon,  1 
Tobacco,  1 

TR.  CANTHARDDES,  1 

Turkish  Bath,  1,  3 
Veratrum  Viride,  3 

Headache. 

Aconite,  1.    When  circulation  excited. 

AcTiEA  Racemosa,  3 

Ammonia,  1,  2,  3,  4.    Aromatic  spirits  in  $-2  dr. 
doses.     Easpail'a  lotion  very  useful ;   often 
relieves  nervous  headache 
AMMONruM    Chloride,    3.    10-15  gr.  doses  in 
hemicrania 

Antacids,  4 

Arsenic.    In  brow  ague 

Atropine,  2,  3.    Locally  to  eye  in  migraine 

Belladonna,  3.  Frequently  given  in  frontal 
headache,  especially  at  menstrual  period,  or 
from  fatigue 

Bicarbonate  op  Sodium.  With  bitters  before 
meals  in  frontal  headache  at  the  junction  of 
hairy  scalp  and  forehead,  or  pain  in  upper  part 
of  forehead  without  constipation.  As  wash  to 
the  mouth  when  headache  depends  on  decayed 
teeth 

Bleeding,  1 

Bromides,  2 

Bromide  of  Potassium,  3.    In  large  doses 

Bryonia.    In  bilious  headache 

Butyl-Chloral  Hydrate,  1 

Caffeine,  4 

Caffeine  Citrate,  1 

Cajeput  Oil.    Locally 

Camphor,  3.  Internally,  andsaturated  solution 
externally 

Cannabis  Lndica.    In  neuralgic  headache 

Carbon  Disulphdje,  1 

Chamomile 

Chloroform,  Spirits  of.    In  nervous  headache 

Cimicifuga.  In  nervous  and  rheumatic  head- 
ache, especially  at  menstrual  period 

Coffee  and  Morphine,  1 

Cold  Affusion,  3 

Croton  Oil 

Digitalis,  2.  ^  of  a  grain  twice  a  day  for  con- 
gestive hemicrania 

Electricity,  1 

Ergot,  2, 4 

Ether  Spray,  3.  Locally,  for  frontal  headache 
after  illness  or  fatigue 

Friedrichshall  Water,  3 

Galvanism,  2 

Guarana  , 

Heat.  As  hot  water-bag  or  poultice  to  nape  ot 
neck 

Hot  Sponobto,  3 

Hot  Water,  3 

Hydrastis.  In  oongestive  headache  with  con- 
stipation 

Ice-bag,  3 

Ignatia.    In  hysterical  headache 

Iodide  of  Potassium,  1.  In  rheumatio  head- 
ache, with  tenderness  of  scalp 

Iris.    In  supra-orbital  headache,  with  nausea 

Magnesium  Sulphate,  4.  For  frontal  headache, 
with  constipation 

Menthol.    As  local  application 

Mercury,  3.    In  bilious  headache 


Morphine,  1 

Mustard,  3. 

of  neck 


As  foot-bath,  or  poultice  to  nape 


Nitrite  of  Amyl,  1,  2.    As  inhalation  when 
face  pale 

NlTRO-GLYCERIN,  2 

Nitro-Hydrochloric   Acn>.     For  pain    just 

above  eyeballs  without  constipation,  also  for 

pain  at  back  of  neck 
Nux  Vomica.    Frequently  repeated  in  nervous 

or  bilious  headache 
Paraldehyde,  3 
Phosphoric  Acid,  1 

Picrotoxine,  2.    In  periodical  headaohe 
Podophyllum,  3.    When  constipation 
Potassium  Cyanide,  2.   As  local  application 
Pulsatilla,  1 
Quinine 
Salicylate  of  Sodium.    3-gr.  dose  every  half 

hour  exceedingly  useful 
Sangubsarla.    In  gastric  derangement 
Sitz-bath,  3 

Skull-cap  as  prophylactic 
Sodium  Chlortde,  1 
Sodium  Phobphate,  2.    As  laxative  in  bilious 

headache 
Spectacles.    Where  the  headache  depends  on 

inequality  of  focal  length  or  astigmatism 
Strychndje,  1,  2 
Tea,  3.    Strong  black  or  green,  often  relieves 

nervous  headache  quickly 
Valerian.    In  nervous  and  hysterical  cases 
Vehatrum  Viride,  3 
Zinc  Oxide,  3 

Heartburn. 

Acids,  3 

Alkalies,  3 

Almonds.    Six  or  eight  blanched. 

Ammonia,  3 

Antacids,  4 

Bismuth,  3 

Capsicum 

Cod-Liver  Oil,  1 

Morphine,  3 

Mux  Vomica,  3.    Very  useful 

Opium,  3 

Podophyllum 

Pulsatilla 

Heart,  Dilated. 

COCAINE,  3 

Digitalis,  1, 2, 3 
Ergot,  2 
Iron,  2 

Morphine,  2,  3 
Nitrite  of  Amyl,  2,  3 
Nitrite  of  Sodium 

NlTRO-GLYCERIN,  2 

Heart,  Fatty. 

Arsenic,  1, 3 

Belladonna 

Cimicdtuga 

Cod-Liver  On,  1,  3 

Ergot 

Iron 

Nitrite  of  Amyl,  4 

Strychnine,  3 

Heart,  Hypertrophied. 

Aconite,  2,  3,  4.    To  be  used  with  care  when 

valvular  disease  is  present 
Bromides,  2 

Camphor.    In  palpitation  and  dyspnoea 
Cimicdtuga,  2 

Digitalis,  2,  3, 4.    In  small  doses 
Ergot,  2 


1208 


INDEX  OF  DISEASES  AND  EEMEDLES. 


Heart,  Hypertrophied. 

Galvanism,  1 

T.hati  Acetate,  1.    In  palpitation 
Nitrite  op  Amyl,  2, 3 
Veratrum  Virede,  2,  3 

Heart,  Palpitation  of. 

Aconite,  1, 2,  3.    Internally 

Amyl  Nitrite 

Belladonna,  1, 4.    Internally  useful  in  cardiac 

strain 
Bromide  of  Potassium,  1,  2.    In  fluttering 

heart 
Camphor 

.   ClMICIFUGA,  2 

Cocaine,  3 

Digitalis,  2, 3 

Eucalyptus 

Hot  Bath 

Hyoscyamus.    In  nervous  palpitation 

Lead,  1 

Milk.  Curb.    In  gouty  persons 

Posture,  1.    Head  hung  forward,  body  bent, 

arms  by  the  sides,  and  breath  held  for  a  few 

seconds 
Potassium  Iodide,  1 
Senega 

Valerian.    In  nervous  cases  with  dyspnoea 
Veratrtne,  2,  3.   As  ointment  to  chest 

Heart,  Valvular  Disease  of. 

Aconite,  3,  4.    To  quiet  action.    To  be  used 

with  caution 
Arsenic,  1, 3 
Cdmicdjuoa,  2 
Comp.  Sp.  of  Ether,  4 
Digitalis,  1,  2,  8,  4.    In  mitral  disease,  to  be 

avoided  in  purely  aortic  disease,  but  useful 

when  this  is  complicated  with  mitral 
Iron,  1 

Morphine,  2,  3.    To  relieve  pain  and  dyspnoea 
Nitrites.    To  lessen  vascular  tension 
Purgatives,  3.    To  lessen  tension  and  remove 

fluid 
Salicin,  1 

Strychnine,  3.    As  cardiac  tonic 
Veratrum  YrRLDE,  4 

Hectic. 

Anttpyrin 

Calcium  Phosphate 

Calumba 

Cold,  4 

Digitalis,  1 

G-elsemium 

Ipecacuanha 

Iron.    Especially  Mistura  ferri  composita 

Prunus  Virginiana,  4.    To  lessen  cough 

Salicin.    To  lessen  perspiration 

Salicylate  of  Sodium,  1 

Strychnine.    To  lessen  night  sweats 


Hepatitis. 


Hemeralopia. 

Amyl  Nitrite,  1 

Blisters.    Small,  to  external  oanthns  of  the 

eye 
Electricity 
Mercury.    Locally 
Quinine.    In  large  doses  internally 
Strychnine,  1 

Hepatitis. 

Aconite,  2 

Alkaline  Mineral  Waters,  J 

Ammonium  Chloride,  1, 4 


Bryonia 

Chelidonium 

Colchicum,  2 

Iodine,  1.    As  enema 

Leeches 

Mercury,  4 

Nitre  and  Antimony,  1 

Nitro-Hydrochloric  Acid,  2, 4 

Rhubarb,  2 

Sulphurous  Waters,  2 

Tartar  Emetic.    With  opium 

Hernia. 

Chloral,  1.  As  enema 
Chloroform,  1,  3 
Ether  and  Belladonna,  1 
Ether  Spray,  1 
Forced  Enemata,  4 
On.,  1 
Opium,  1 

Herpes  Zoster. 

Aconite  and  Opium.    Locally 

Alcohol.    Locally 

Atropine,  2 

Belladonna,  2 

Calomel,  2 

Carbolic  Aclo,  1 

Celandine 

Chloroform,  1 

Collodion,  1 

Copper  Acetate,  2 

Dulcamara 

Ferri  Perchlor.,  1 

Galvanism,  1,  2 

Morphine,  3 

Myrtol,  2 

Phosphorus,  1 

Bhus  Toxicodendron 

Sllver  Nitrate,  3.    Strong  solution  locally 

Spouts  of  Wine,  1 

Tar,  1 

Veratrtne,  3.    As  ointment 

Zinc  Ointment,  2 


Hiccough. 


Amber,  Oil  of,  4 

Apomorphine,  3 

Belladonna,  4 

Bismuth,  1 

Camphor,  3 

Cannabis  Indica,  1 

Chloral,  1, 4 

Chloroform,  3 

Ether,  4 

Iodoform,  1 

Jarorandi,  1 

Laurel  Water 

Morphine,  1,  3.    Hypodermlcally 

Muse,  4 

Mustard  and  Hot  Water,  S 

NrTRO-GLYCERIN,  3 

Nux  Vomica 
Pepper 

Potassium  Bromide 

Pressure  over  Phrenic,  Hyold,  or  Epigas- 
trium, 1 
Quinine.    In  full  doses 
Sugar  and  Vdsegab,  1 
Tobacco  -smoking,  1 

Hydrocephalus,  Acute. 

Blisters.    To  the  nape  of  the  neck  useful 
Bromlde  of  Potassium 
Ouoton  Oil,  3.    Liciirent 


INDEX  OF  DISEASES  AND  EEMEDIES. 


1209 


Hydrocephalus,  Acute. 

Elateriuh.I 

Ergot 

Iodide  op  Potassium,  1,  4 

Iodoform,  1,  4.  Dissolved  in  collodion,  or  as 
ointment  to  neck  and  head ;  along  with  small 
doses  of  calomel,  as  enemata 

Leeches 

Mercuric  Chloride.    Small  doses  internally 

Tartar  Emetic.    Ointment 

Turpentine.  By  mouth  or  as  enema,  at  com- 
mencement 

Hydrocephalus,  Chronic. 

Blisters 
Cod-Liver  Oil 
Iodide  of  Iron 
Iodide  of  Potassium,  1 
Iodine 
Mercury 
Potassium  Bromide,  1 


Hydrophobia. 

Acid,  Acetic  and  Hydrochloric,  1 

Actual  Cautery 

Acupuncture.    To  wound  immediately 

ALISMA,  1 

Amyl  Nitrite.  2 

Arsenic,  1 

Asparagus,  1 

Atropine,  1 

Belladonna 

Bromide  op  Potassium,  1 

Calabar  Bean,  1 

Cannabis  Indica,  1 

Carbolic  Acid,  1 

Chloral,  1 

Chloride  of  Potassium,  4 

Chloroform,  1,  2.    To  control  spasms 

Curare,  1, 2 

Eboharotics,  4 

Ether,  2 

Euphorbia,  1 

Excision  op  Bitten  Part,  1 

hoang-nan,  1 

Hyoscyaminb,  1 

IODINE,  1 

jabobandi,  1 
Mercury,  1 
Morphine,  1, 2 

NlTRO-GLYCERIN,  2 

Permanganate  op  Potassium.    As  lotion  to 

wound 
Potassium  Iodide,  1 
Quinine 

Silv^Sitrate.  To  wound,  no  use,  even  though 

applied  immediately 
Stramonium,  1 


Hydrothorax. 

Blisters,  1 

Broom  _      .. 

Digitalis.    As  dinretio 

Dey  Diet,  2 

Elaterium     m    it        B.     .      .^ 

Iodine,  2.    Injections  alter  tapping 

JABOBANDI,  1 
MERCURY,  1 
MORPHINE,  1 

pilocarpine,  1,  z,  • 
besin  op  copaiba,  2 
Sanguinaria 
Tr.  FerrlI 
Vbratbum  Viride,  1 


Hypochondriasis. 


Alcohol,  4.   As  temporary  stimulant 
Arsenic,  2.    In  the  aged 
Asapcetida,  2 
Bromide  op  Potassium,  3 
Oappeine,  2 

Oimicipuga.    In  puerperal,  and  spermatorrhoea 
Colohicum,  2 
Oreasote 
Electricity,  4 

Gold  Chloride,  2.    When  giddiness  and  cere- 
bral anaemia 
Hyoscyamus.    In  syphiliphobia 
Ignatia 
Musk,  1 

Opium,  2.   In  small  doses 
Ox-Gall 
Sumbul 


Hysteria. 

Aconite,  3 

Act^a  Bacbmosa,  3 

Alcohol,  3 

Aloes.    In  constipation 

Ammonia,  Aromatic  Spirits  op,  2 

Amyl  Nitrite,  1 

Anesthetics,  4 

Antispasmodics,  4 

Apomorphtne,  1, 3 

Arsenic 

Asapcetida,  2,  3, 4 

Atropine.    In  hysterical  aphonia 

Belladonna,  1 

Bromide  op  Camphor,  1, 4 

Bromide  op  Potassium,  3,4 

Bromide  op  Sodium,  4 

Camphor,  2, 4.    In  hysterical  excitement 

Cannabis  Indioa,  3 

Chloroform,  1, 3 

Oimicipuga.    In  hysterical  chorea 

COCAINH,  2,  4 

Cod-Liver  Oh,  2, 3 

Cold  Water  poured  over  mouth  to  cut  short 

attack 
C0NIUM.4  _        ^    .      .     ,.     , 

ELECTRicrrY,  4.   To  cut  short  attack 
Ether,  2, 4 
Eucalyptus,  2 
Faradism,  2 
Galbanum.     Internally,   and    as   plaster   to 

sacrum 
Galvanism,  1 

Garlic.   To  smell  during  the  paroxysm 
Hyoscyamus,  1 
Ignatia 

Ipecacuanha,  1.   As  emetic 
Iron,  2,  3 

Lupulin.    When  Bleepless 
Massage,  1, 2 
Morphine,  3 
Musk,  3, 4 
Nux  Vomica,  3 
Oil  op  Amber,  4 
Oil  op  Wormseed,  4        i 
Opium,  1, 3.    In  sma11  doa8" 
Paraldehyde,  3 
Pellitory.    Por  Globus 
Phosphates,  2 

Phosphorus,  1, 3.   In  hysterical  paralysis 
Santonin.    If  worms  present 
Spdutus  Etherib  Nitrosi.    To  relieve  spasm 
Tartar  Emetic 
Valerian,  2, 4 

Valerianate  op  Ammonium,  4 
Valerianic  Aero,  4 
Volatile  Oils,  3 
Zinc  Oxide,  1 
Zinc  Sulphate,  1 
Zinc  Valerianate,  3 


1210 


INDEX  OF  DISEASES  AND  EEMEDIES. 


Ichthyosis. 


Inflammation. 


Baths,  3 
Ood-Ltvee  Oil,  1 
Elm  Bark  Decoction. 
Glycerine,  1 
Zinc  Oxide 


Useful 


Impetigo. 


Acetate  of  Lead,  2 

Arsenic 

Some  Acid,  1 

Calcium  Chloride 

Chrysophanio  Acid.    Locally 

Cod-Liver  On,,  1 

Glycerine  of  Tannin,  2, 3 

Grape  Coke 

gutta-pebcha 

Hydrocyanic  Acid.   To  relieve  itching 

Laurel  "Water.    To  relieve  itching 

Mercury.    Locally 

Mineral  Acids,  2 

Nitric  Acid,  1.   Internally 

Oil  of  Cade,  1 

Oils,  3 

Potassium  Chloride,  1 

Poultices,  3 

Quinine,  2,  3 

Sulphate  of  Copper,  3 

Sulphur,  3.    Internally 

Tannin.    Locally 

Tab,  1 

Zinc  Ointment 

Zino  Oxide,  2, 3 

Impotence. 

Arseniate  of  Ikon,  2 
Cannabis  Indioa,  2 

CanTHARIDES,  3 
CUBEBS 

Ergotin,  2.  Hypodermically  about  dorsal  vein 
of  penia,  -when  it  empties  too  rapidly 

Gold  Chloride,  2.  To  prevent  decline  of 
sexual  power 

Ntrx  Vomica,  2.    Very  useful 

Phosphoric  Acid 

Phosphorus,  2 

SANGUTNABIA,  2 

Serpentaria 

Strychnbje,  3 

Turpentine,  4 

Zmc  Phosphate,  3.    Very  useful 

Inflammation. 

Aconite,  1, 2,  3.  At  the  commencement  of  all 
inflammations,  superficial  or  deep-seated; 
best  given  in  small  doses  frequently  repeated 
until  pulse  and  temperature  are  reduced 

Alcohol,  2.  As  antipyretic  and  stimulant, 
especially  useful  in  blood-poisoning 

Alkalies,  2 

Ammonium  Chloride,  1 

Antimonium  Tart.,  1,  2, 4 

Antimony,  3.  10-15  m.  of  vinum  antimonii  fre- 
quently repeated  at  commencement 

Arnica,  2 

Arsenic,  1 

Atropine,  3 

Barium  Chloride,  2 

Belladonna,  1, 2, 3.  In  gouty  and  rheumatic 
inflammation  and  cystitis 

Blisters,  4 

Borax,  4 

Bryonia.  In  serous  inflammations  after  heart 
or  pulse  lowered  by  aconite 

Chloral.  When  temperature  is  high  and 
muoh  delirium 

OoD-LlVER  Oil,  3.    In  chronic  inflammations 


Cold,  4 

Copaiba,  4 

Digitalis,  2,  3 

electricity,  1 

Ergot,  2 

Fomentations,  3 

Gelsemium,  2 

Ice,  3.    Locally  applied 

Iodine,  3.    Locally 

Lead,  4 

Leeches,  2 

Mercuby,  1, 3, 4.  In  deep-seated  inflammations, 
especially  those  of  serous  membranes  and 
iritis,  and  syphilitic  cases 

Mercuby  Frictions,  1 

Nitrates,  3 

Opium,  1,  2,  3.  Exceedingly  useful  to  check 
It  at  commencement,  and  relieve  pain  after- 
wards 

Phosphorus,  1 

FrLOCARPIN,  2 

Poultices,  3 

Pulsatilla.  In  inflammation,  when  purulent 
discharge  from  eyes,  ears,  and  nose  ;  and  in 
epididymitis 

Purgatives 

Quinine,  1,  2.  In  peritonitis  and  in  acute  in- 
flammations along  with  morphine 

Salicin 

Salicylate  of  Sodium.  Most  useful,  especially 
in  rheumatic  affections 

Salicylic  Acid.    Most  valuable 

Saline  Cathartics,  2 

Stramonium,  4 

Sulphides,  3.    To  abort  or  to  hasten  maturation 

Vbratrum  Viride,  L,  2 

Water,  2 


Influenza. 


Aconite,  1 

AC'IVEA  Bacemosa,  3 

Ammonium  Acetate,  with  Nitrous  or  Chloric 
Ether 

Carbolic  Acid.   As  spray  and  gargle 

Oimicifuoa 

Cubebs,  3 

Hot  Sponging,  3 

Opium.    With  Ipecacuanha,  useful  for  cough 

Potassium  Nitrate.  Freely  diluted,  as  lemon- 
ade 

Qutntne.    Useful,  especially  in  later  stages 

Sangutnaria.    Sometimes  very  useful 

Spirttus  Etheris  Nitrosi 

Sulphurous  Acid,  3.  By  fumigation  or  inha- 
lation 

Turkish  Baths.    Useful 

Insomnia. 

Aconite,  1.  1  m.  every  quarter  of  an  hour 
when  skin  dry  and  harsh 

Alcohol,  2,  3.    Sometimes  very  useful 

Atropine.  With  opium,  tio-iio  gr.  atropine, 
to  x  or  4  gr.  morphine 

Belladonna,  2 

Bleeding,  1 

Butyl-Chloral,  1,  3.    If  heart  weak 

Camphor,  1 

Cannabis  Indica,  3.  Alone  or  with  hyoscyamus 

Chloral,  1,  2,  3.  Most  useful,  alone  or  with 
bromide  of  potassium  :  the  addition  of  a  small 
quantity  of  opium  to  the  chloral  and  bromide 
assists  their  action 

Chloroform 

Codeine,  1,  3 

Coffee,  Causes  insomnia,  but  has  been  recom- 
mended in  insomnia  from  deficient  nervous 
power,  or  ohronic  alcoholism 

Cold  Douche,  3 


INDEX  OF  DISEASES  AND  KEMEDIES. 


1211 


Insomnia. 


Digitalis,  1.  When  deftoient  tone  of  vaso-motor 

system 
Duhoisine,  2 
Ether,  3.    In  full  dose 
Galvanisation,  2 

Gelsemium,  3.    In  simple  wakefulness 
Humulus,  2.    A  hop-pillow  sometimes  useful  In 

the  aged 
Hyoscese,  2 
Hyosuyamus,  2,  3, 4.    Alone,  or  with  oannabis 

indica,  useful  to  combine  with  Quinine 
Hypnone 

Ignatia.    In  nervous  Irritability 
Morphine,  2,  3 

Musk.    In  irritable  and  nervous  oases 
Opium,  1, 3, 4.    Most  powerful  hypnotic,  given 

alone  or  in  combination 
Paraldehyde,  2,  3 
Phosphorus,  1, 2, 3.    In  the  aged 
Potassium  Bromide,  1,  2,  3,  4.    In  full  doses, 

alone  or  with  other  hypnotics 
Removal  Island,  3 
Srrz  Bath,  3 
Sodium  Lactate,  1 
Sumbul,  1.   In  nervous  irritability  and  ohronio 

alcoholism 
Tannate  of  Oannabcj,  3 
Tartar  Emetic,  3.     Along  with  opium  when 

there  is  a  tendency  to  congestion  of  brain, 

which  opium  alone  would  increase 
TTrbthane 
Warm  Bath,  3 

Warmth.    Internally  and  externally 
Water,  2 
Wet  Compress 
Wet  Pack,  1 

INTERCOSTAL.   NEURALGIA 

Is  very  commonly  connected  with 
Leucobrhcza,  q.  v.    (  Vide  also  Neuralgia.) 

Intermittent  Fevee 

Aconite,  1 

Alcohol,  1 

Ammonium  Carbazotate.    J-l  gr.  in  pill 

Ammonium  Chloride,  4 

Apiol,  2,  4.  In  mild  cases,  15  gr.  during  an 
hour,  in  divided  doses  four  hours  before  the 
paroxysm 

Arsenic,  3, 4.  Exceedingly  useful,  especially  in 
irregular  malaria 

Atropine,  1.  Subcutaneous!;,  to  arrest  or  cut 
short  cold  stage 

Berberine.    In  chronic  cases 

Bleeding,  1 

Bruclne 

Camphor,  1.  Taken  before  the  fit  to  prevent 
it 

Capsicum,  2.    Along  with  quinine  as  adjuvant 

Carbolic  Acid,  1, 2 

Chamomile,  3 

Chinolin,  2 

Chloral  Hydrate,  1.  As  antipyretic  when 
fever  high ;  and  to  check  vomiting  or  con- 
vulsions in  adults  and  children  during  mala- 
rious fever 

Chloroform,  1, 2,  4.  To  prevent  or  cut  short 
cold  stage 

Cimicifuga.    In  brow  ague 

OrNCHONIDLNE,  2.      Like  ClNCHONINE 

Cinchonine,  2.    Useful  and  cheap 

Coffee,  1 

Cold  Compress,  1 

Cornus  Florida.    A  substitute  for  quinine 

Digitalis,  1 

Elatertom,  1 

Emetics,  3 

Eucalyptus  Globulus,  2,  3, 4.    During  cenva- 


Inteemittent  Fever. 

Ferric  Sulphate 

Ferrous  Iodide 

Gelsemium,  4.  Pushed  until  it  produces  dilated 
pupils  or  double  vision 

Grlvdelia  Squarrosa.  In  hypertrophied 
spleen 

Hot  Bath,  4 

Hydrargyrum  Sublimatum,  1 

Hydrastis,  2.    In  obstinate  cases 

Hydroqutnoxe,  2 

Hyoscyamine,  1 

Iodine  Tincture.  To  prevent  recurrence  of 
ague 

Ipecacuanha,  2,  4.    Most  useful  as  emetic 

Eauiin,  2 

Leptandra  Virginica.  After  disease  is  les- 
sened by  quinine 

Morphine.    Along  with  quinine  as  an  adjuvant 

Mustard  to  Soles  of  Feet,  1 

Narcotin,  3.  2-6  gr.  three  times  a  day  some- 
times very  useful 

Nitric  Acid,  z.    In  obstinate  cases 

Nitrite  of  Amyl,  2, 4.  By  inhalation  to  relieve 
or  shorten  cold  stage 

Nitrite  of  Sodium,  3 

NlTRO-GLY0ERL\,2,  3 

Nux  Vomica,  2 

Ol.  Terebinthin^!,  1 

Opium,  1.    In  full  doses,  to  prevent  chill 

Pepper.    Along  with  quinine 

Phosphorus,  1 

PrLOCARPIN,  2 

PrPERTHE,  4 

Potassium  Bromide,  1 

Potassium  Chlortde,  1 

Potassium  Nitrate.     10  gr.  in  brandy  and 

water,  or  dry  on  the  tongue  to  prevent  fit 
Quassia,  3 
qutnetum,  1 
Qutnine,  1,  3,  4.    As  prophylactic  to  abort  fit 

and  to  prevent  recurrence  ;  its  action  is  aided 

by  purgatives,  emetics,  and  aromatics 
Quinine  Bromohydrate.    Like  quinine,  and 

less  liable  to  produce  cinchonism 
Besorcln,  2 
Sacoharated  Lime,  1 
Salicin,  1, 2 

Salicylic  Acid,  1, 2,  3, 4 
Sodium  Chloride.    Tablespoonfnl  In  glass  of 

hot  water  at  a  draught  on  empty  stomach 
Sodium  Hyposulphate,  3.    In  mild  cases 
Spider  Web.    As  pill 
Stramonium,  1 
Strychnine 

Inteeteigo. 

Bismuth,  2,  3.    Locally. 

Camphor,  3.     Added  to  dusting   powders  to 

allay  heat  and  itching 
Carbolic  Acid,  1 
Carbonate  of  Calcium,  3, 4 
Fullers'  Earth 
Glycerine  of  Tannin,  2, 3 
Lead  Lotion,  1 
Ltme  Water,  3 
Soap,  3 
Tannin,  1 
Zinc  Ointment,  2 

Iritis. 

Acidum  Hydrooyanicum,  1 

Atropine,  2, 3, 4 

Belladonna,  1, 3.    Internally  and  locally 

Bleeding,  1 

Copaiba,  1 

Duboisine,  2.    Substitute  for  atropia 

ESERLNE,  2 
HOMATKOPLNE,  2 


.212 


INDEX  OF  DISEASES  AND  EEMEDIES. 


.RITIS. 

Iodide  of  Potassium,  1 

Mercury,  1,  2,  3, 4.    Most  serviceable 

Morphine,  1,  3 

Opium.    To  lessen  pain 

Pilocarpi*!,  2 

Salicylic  Acid,  1 

Santonin,  1 

Sodium  Salicylate,  1 

Turpentine,  1.    In  rheumatic  iritis 

[mutability. 

Alkaline  Waters 

Bromide  op  Potassium 

Chloral,  3 

Oolchicum.    With  potash  in  large  quantity  of 

water  when  gouty 
Ignatia.    In  small  doses 
Laxatives.    In  constipation 
Srrz-BATH,  3 
Strychnine,    In  small  doses 


Jaundice. 

Alkaline  mineral  waters  in  catarrh  of  duode- 
num or  bile-ducts,  2 
Aloes,  2 
Ammonium  Chloride,  2.    In  scruple  doses  m 

jaundice  from  mental  emotion 
Ammonium  Iopide,  2.    When  catarrh  of  bile- 
ducts 
Arsenic  In  malarious  cases 
Benzoic  Acid,  1 
Calomel  Purgative,  4.   Followed  by  saline, 

often  very  useful 
Carlsbad  Salts.   Very  useful 
Carlsbad  Waters,  1 
Celandine 
Chloroform,  1 
Oolchicum 
Dulcamara 
Eggs,1 
Emetics,  4 
Bnemata,  4.    Cold  water,  one  or  two  litres  once 

a  day 
Ether.    When  due  to  gall-stones 
Euonymfn,  1, 2,  3 
Bel  Bovdjum,  1 

Hydrastis,    In  cases  of  catarrh  of  ducts 
Ipecacuanha,  1, 4 
iRrsrs 
Iris,  2 

Lemon  Juice,  4 
Magnesia,  1 
Magnesium  Sulphate 

Manganese,  2.  In  malarious  or  catarrhal 
cases 

Mercurials,  2,  3   < 
Mineral  Acres,  1 

Kitro-hydrochlorio  Aero,  2,  4.  Internally, 
and  as  local  application  over  liver,  or  as  bath 
in  catarrhal  cases 

Podophyllum,  2.  In  oatarrhal  conditions  very 
useful 

Potassium  Chloride,  1 

Potassium  Salts,  4 

Potassium  Sulphate.   As  laxative 

Quinine,  1.    In  malarious  cases 

Bhubarb,  2.    Jaundice  in  children 

Sanguis  aria 

Sodium  Phobfhate,  2,  3.  Very  useful  in 
catarrh  of  bile-ducts 

StHjLingia.    After  ague 

Turpentine,  1 

Lactation,  Defective. 

Calabar  Bean 
Castor  Oh.  Leaves 
Jaborandi,  2 


Lactation,  Defective. 

Mustard  Poultice 
Vanilla 

Lactation,  Excessive. 

Alcohol,  3  . ,      ,, 

Belladonna,  1, 2, 3.    Internally  and  loonlly 

Camphor  and  Glycerine,  1 

Chloral,  1 

Coffee,  1 

Electricity,  1 

Hempseed  Oil,  1 

Iodide  of  Potassium,  1 

Msrcury,  1 

Parsley,  1 

Quinine,  3 

Bicinus  Leaves,  1.    As  poultice 

Tobacco,  3 

Laryngismus  Stridulus. 

Aconite 
Belladonna 

Bromtdes.    Very  useful  in  large  doses 
Chloral  Hydrate 

Chloroform.    As  inhalation  to  stop  spasm 
Cod-Ltver  Oil,  3 
Cold  Sponging 

Cold  Water  dashed  in  Face,  3 
Conhne.    Pushed  until  physiological  action  ob- 
served 
Emetics 
Ether,  2 

Ipecacuanha.-  As  emetic 
Lancing  Gums,  3 
Lobelia,  3 

Morphine.    Hypodermically 
NTtro-glycertn,  2 
Potassium  Bromide,  1,  3 
Quran™ 

Spinal  Ice-bag,  3 
Sub-sulphate  of  Mercury,  2 
Tartar  Emetic,  2 
Worms,  Bemoval  of,  3 


Laryngitis,  Acute. 


Acetic  Acid,  1.    As  inhalation 
Aconite,  1,  2 
Antpmon.  Pot.  Tart.,  1 
Benzoin,  1.    As  inhalation 

GELSEMrUM,4 
GLYCERrNE,  4 

Inhalations,  4 

Iodine.     As  inhalation   and  counter-irritant 

over  neck 
Leeches.    To  larynx,  or  nape  of  neck 
Mercury,  4 
Morphine 

QUINCE,  1 

Scarification  of  Larynx - 

Silver  Nitrate,  1,  4.    As  spray 

Sulphurous  Acid.    As  inhalation  or  spray 

Tracheotomy,  1 

veratrum  vtride,  1 

Ztec  Chloride,  1 

Zinc  Sulphate.   As  emebio 


Laryngitis,  Chronic. 


Alum.    As  garle 

Ammonium  Chloride.    As  spray 

Bismuth.    Locally  by  insufflation. 

Carbolic  Aoid.    As  spray. 

Ferric  Chloride.     As  spray,   or  brushed  on 

interior  of  larynx 
Gelsemium,  4 
Glycerine,  4 
Guaiacum.    As  lozenges  or  mixture 


INDEX  OF  DISEASES  AND  REMEDIES. 


121 


Laryngitis,  Chronic. 


Inhalation,  4 

Iodine.    As  counter-irritant 

Mercury,  4 

Morphine.  Mixed  with  bismuth  or  starch  as 
insufflation,  most  useful  when  much  irrita- 
tion, as  in  laryngeal  phthisis 

Silver  Nitrate,  1,  4.  As  solution  to  interior 
of  larynx 

Sulphurous  Aon).  As  fumigation,  inhalation, 
or  spray 

Tannin.    As  gargle  or  spray 

Uranium  Nitrate.   As  spray 


LeUCORRH(EA. 


Acid  Nitric  and  Cinchona,  1 

Alkalies,  3 

Aloes,  1 

Alum,  2,  3.    As  Injection 

Ammonio-Ferric  Alum,  4 

Argenti  Oxidum,  1 

Arsenic,  1 

Eael  Fruit,  1 

Balsam  of  Peru.    Internally 

Balsam  of  Tolu.    Internally 

Belladonna,  3.    As  pessary,  for  over-secretion 

and  pain 
Bismuth,  1,  2, 4.    As  injection  or  pessary 
Borax.    As  injection 


As  injection 


As  injection 


Locally 

As  local  application,  alone   or 


Boric  Aero,  3 
Carbolic  Acid,  1,  2,  3. 
Clmicifuga 
cocculus  indicus 
Cold  Sponging,  3 
Common  Bed  Wine,  2 
Copaiba 

Copper  Sulphate,  3. 
Creasote,  1 
Ergot,  1,  3 
Glycerine 
Hydrastis,  2. 
Iodine,  4 
Iodoform, 

mixed  with  tannic  acid 
Iodo-Tannin,  2 
Iron,  3.    Internally 
Lead,  2,  3 
Lime  Water,  3 
Monsel's  Solution,  2 
Myrrh.    Internally 
Phosphate  of  Calcium,  3.    Internally 
Potassium  Bicarbonate,  3.     Dilute  solution 

as  injection 
Potassium  Bromide,  1 
PoTAssitM  Chloride,  1 
Potassium,  Permanganate  of,  1, 4 
Saffron,  1 
Sptnal  Ice-Bas,  3 

Sumbul  . 

Tannin,  1, 2. 3, 4    As  injection  or  suppository 
Zinc  Sulphate,  3 


Lichen. 


Alkalies,  3 

Arsenic,  1, 3, 4 

Cantharidbs,  3 

Chloroform,  3 

Cod-Liver  Oil,  1 

Glycerols  of  Aloes,  1 

Mercury,  3.    Locally 

Potassium  Cyanide,  3 

Silver  Nitrate,  3.    Solution  locally 

sulphides,  3 

Sulphur,  1 

Tar  Ointment 

Thymol,  1 

Warm  Baths,  3 


Locomotor  Ataxy. 

Amyl  Nitrite,  1 

Argentic  Phosphate,  1 

Belladonna 

Calabar  Bean,  3 

Cannabis  Indica 

C  hloridk  of  Gold,  2 

Damiana,  1 

Electricity,  1, 2 

Ergot 

Hyoscyamus,  2 

Morphine,  1 

Nitro-Hydrocbxorio  Acm 

Phosphorus,  2 

Physostigma,  1 

Potassium  Iodide,  1.    For  syphilitic  taint 

Silver  Nitrate,  1, 2, 4 

Sodium  Salicylate,  1 

Strychnine,  1 

Lumbago. 

Aconite.    Small  doses  internally,  and  linimc 

locally 
Actma  Bacemosa,  1,  3 
Acupuncture,  2, 3 

Aquapuncture,  2.    Sometimes  very  useful 
Atroplne,  1 
Belladonna,  3 
Capsicum,  3.    Locally 
Carbolic  Acid,  1.    Hypodcnrdcally 
Cautery 

Chloroform,  2.    Liniment 
Cimicdtuga,  2.    Sometimes  very  useful  int 

nally 
Cod-Liver  On,  4 
Electricity,  1 
Emflastra,  2 
Ether  Spray,  1, 3 
Eucalyptus  OrL,  1.    As  liniment 
Faradization,  3 
Galvanism,  2 
Guaco,  1 

Guarana.    In  large  doses 
Hot  Douche,  2.    Or  hot  poultice 
Hot  Flat  Iron,  3 
Ice,  rubbed  over  back,  1,  3 
Iodide  of  Potassium,  3,  4 
Iodides,  2 
Lead  Plaster,  3 
Massage,  2 

Morphine,  1,  2,  3.    Hypodermically 
Nitrate  of  Potassium,  3 
Pitch  Plaster,  3 
Poultices,  3 
Quinine,  1 

Bhus  Toxicodendron 
Salicylic  Aero,  2 
Sulphur,  4 
Thermic  Hammer,  3 
Turkish  Bath,  3 
Turpentine,  3.    Internally  and  locally 

TERATRUM  VlfiTDE,  3 


Lupus. 


Arsenic 

Blisters,  3 

Carbolic  Acid 

Cautery 

Ohaulmugra  Oil 

Chromic  Aero 

Cod-Liver  Oil,  1,  2 

Creasote 

Galvano-Cautkry,  2 

Hydrargyri  Blniodidum,  1 

Hytrargyri  Nitratis  Acidum,  1 

Iodide  of  Potassium 

Iodide  of  Starch 

Iodide  of  Sulphur.    Externally 

Iodine.    In  glycerine 


1214 


INDEX  OF  DISEASES  AND  REMEDIES. 


Lupus. 


Iodoform 

Lead  Lotion 

Mercury.    Internally  and  locally 

Phosphorus 

Plumbic  Nitrate,  1 

Potassium  Chlorate,  2 

Pyrogallic  Acid 

Salicylate  or  Sodium 

Salicylic  Acid,  1 

Silver  Nitrate 

Sodium  Acetate 

Sodium  Ethylate 

Zinc  Chloride 

Zinc  Sulphate,  2 


Mania. 


ACTiEA  RACEMOSA,  3 

Alcohol,  1 

.Anesthetics,  2 

Atropine,  2 

Belladonna.    Useful 

Blisters,  4 

Bromh)e  op  Potassium,  3, 

Bromides,  2 

Camphor 

Cannabis  Indica,  1,  3 

Chloral  Hydrate,  1,  2,  3, 4.    As  narcotic  and 

carminative 
Chloral' and  Camphor,  4 
Cold  Douche,  3 

CoNflNE,l,  2, 2,4.    Alone,  or  with  morphine 
Croton  Oil,  3, 4.    As  purgative 
Daturine 

Digitalis,  1,  2.  In  acute  and  chronic  mania, 
especially  when  complicated  with  general 
paralysis  and  epilepsy 

DuBOisrNE,  2.    As  calmative 

Ergot,  2.    In  recurrent  mania 

Ether.    In  maniacal  paroxysms 

Galvanism,  to  head  and  cervical  sympathetic 

Gamboge,  4 

Gelsemium,  1,  2,  3,  4.  With  much  motor  ex- 
citement and  wakefulness 

Hyoscyamtne,  2 

Hyoscyamus,  1,  2,  3.  In  hallucinations  and  hy- 
pochondriasis 

Iron,  2 

Morphine,  2,  3 

Opium,  3.    Alone  or  with  tartar  emetic 

Paraldehyde,  2, 3 

Physostigma,  2 

Stramonium 

Veratrum  "Virdde,  2 

Wet  Pack,  1,  2 


Mastitis. 


Mastitis. 

Potassium  Bromide,  1 
Stramonium.    Fresh  leaves  as  poultice 
Tartar  Emetic.    In  small  doses  frequently  re- 
peated at  commencement 
Tobacco  Leaves.   Ab  poultice 

Measles. 

Aconite,  3 

Ammonium  Acetate 

Ammonium  Carbonate,  1, 3 

Antimony 

Camphor 

Carbolic  Acid.    Internally,  at  commencement 

Cold  Affusion,  3 

Digitalis,  1 

Fat,  3 

Iodine,  3 

Ipecacuanha 

Mustard  Bath,  3.    When  retrocession  of  rash 

Packing,  3 


Aconite,  1 

Ammonium  Chloride,  1.    As  lotion,  locally 

Arnica,  1 

Belladonna,  1,  2,  4.    Locally  as  liniment  or 

.    ointment 

Calcium  Sulphide.  Internally,  if  ahscess  is 
forming 

Chloral  Poultice,  1 

Conium,  1 

Digitalis  Infusion.    Locally  as  fomentation 

Friction,  with  oil 

Galvanism,  1 

Hyoscyamus.  As  plaster  to  relieve  painful  dis- 
tension from  milk 

Ice,  1 

Iodine,  1 

Jaborandi,  1,  2 

Mercury  and  Morphine  Oleate,  1.  Locally, 
in  mammary  abscess 

Phytolacca,  1,  2.  To  arrest  inflammation, 
local  application 

Plaster,  1.    To  support  and  compress  mamma) 


When  sleeplessness 
In  adynamic  cases 


Potassium  Bromide. 
Potassium  Chlorate, 
Pulsatilla 
Purgatives,  3 
Qudstne 

Veratrum  Yiride,  3 
Zinc  Sulphate,  1 

Melancholia. 


Alcohol,  4 

Arsenic,  2.    In  aged  persons,  along  with  opium 
Belladonna,  1 

Bromide  of  Potassium,  1,  3.  Often  very  useful 
Bromides,  2 
Caffeine,  2 
Camphor,  3 
Cannabis  Indica,  2 
Chloral  Hydrate,  1.   As  hypnotic 
Cimioifuga.    In  puerperal  or  uterine  despon- 
dency 
Cocaine,  4 
Colchicum,  2 
colocynth,  2 
Galvanism 
Gold,  2 
Ignatxa. 
Iron 

Morphine,  1,  3 
Musk,  3 

Nitrous  Oxide,  1 

Opium,  2.    In  small  doses  especially  useful 
Phosphorus,  3 
Turkish  Bath,  1 
Valerian.    In  hysterical  and  suicidal  cases 

Meniere's  Disease. 

G  KLBEMIUM,  3 
QUINIKE,  1 

Meningitis,  Cerebral. 

Aconite 

Ammonium  Carbonate,  2 

Belladonna 

Blisters.    To  nape  of  neck 

Bromide  op  Potassium,  1,  3.    In  convulsions 

consequent  on  meningitis 
Bryonia.    When  effusion 
Cold,  4.    To  head 
Cold  Baths,  2 
Digitalis,  2 
Ergot,  2 
q-elsemium,  2 
Hyoscyamus 
Iodide  oe  Potassium,  I 
Mercury.    As  ointment,  or  internally 


INDEX  OF  DISEASES  AND  REMEDIES. 


121 


Meningitis,  Cerebral. 

Opium,  2.    In  small  doses,  alone  or  with  tartar 

emetic 
Pilocarpine,  2 
Pulsatilla*  2.    In  acute  cases 
Purgatives.    At  commencement ;  calomel  and 

jalap  most  useful 
Quinine,  2 
turpentine,  2 
■Venesection.    When  mnch  excitement 

Meningitis,  Cerebro-Spinal. 

Aconite,  1, 2.    Along  with  opium 

Antimony,  3.    Alone,  or  with  opium 

Atropine,  1 

Belladonna,  1 

Bromide  op  Potassium,  1,  3 

Cautery,  1.    Freely  to  back 

Cold,  to  spine,  4 

Cold  Baths,  2 

Digitalis.    In  early  stage 

Era  ot,  2.    Useful 

Gelsemium,  2.    Useful 

Opium,  2.    Very  useful  in  large  doses 

Quinine,  2.    At  commencement,  large  doses 

Turpentine.    As  enema 

Venesection 

Menorrhagia. 

ACTiEA  BACEMOSA,  3 

Aloes,  2, 4.    As  adjuvant  to  iron 

Ammonium  Acetate,  4 

Ammonium  Chloride,  3.    For  headaches 

Argentic  Oxide,  1 

Arsenic,  1.    With  iron 

Berberine,  1 

Bromide  of  Potassium,  1, 2, 3 

Calcium  Phosphate,  3.    In  ansemia 

Cannabis  Indica,  2,  3.    Sometimes  very  useful 

Cimicipuga 

Cinnamon,  Oil  op,  1,  3 

Conhne,  1 

Creasote,  1 

Digitalis,  1, 2, 3.    Sometimes  useful 

Ergot,  1,  2,  3, 4.    Most  useful 

Ferri  Perchloridum,  1 

Gallic  Acid,  1, 2,  3.    Very  useful 

Guaiacum,  1 

Hamamelis,  3.    Useful 

Hot  Water  Bag  to  dorsal  and  lumbar  verte-  ■ 

brae,  1,  3 
Hydrargyri  Perchlobidum,  1 
Hydrastis,  1 
Ice,  1.   To  spine 
Iodine,  1 
iodoporm,  1 
Ipecacuanha,  2.    In  emetic  doses  in  evening, 

followed  by  acidulated  draught  in  morning 
Iron 

Lemons,  3 

Magnesium  Sulphate.    Sometimes  useful 
Phosphates,  4 
Potassium  Chlorate,  1 
Pyrogallic  Aero,  1 
Quinine,  1,  3 
Bue,  4 
Savtne,  3,  i 
Senega 
Sulphuric  Aero,  1.    When  due  to  fibroid  or 

polypus 
Tannin,  1,  3 
Urtica  Urens,  1 
Vlnca  Major,  I 

Mentagra. 

Arsenic 

Canada  Balsam,  1 
Carbolic  Acn>,  1 


Mentagra. 

Cod-Liver  Oil, 

Copper.    Locally,  as  lotion 

Epilation,  1 

Goa  Powder,  1 

Iodide  of  Sulphur,  1 

Mercury 

On.  op  Turpentine,  1 

Oleate,  Bichloride,  or  Nitrate  of  Mercui 

As  ointment  or  lotion 
Petroleum 
Silver  Nitrate,  2 
Sulphurous  Acid.    With  glycerine 
Tr.  Iodine  (compound) 
Zinc  and  Copper  Sulphate 
Zinc  Chloride 

Metritis,  Acute. 

Aconite 

Aloes,  1.    Enema 

Aurum,  2 

Carbolic  Acid,  2 

Ekgotln,  2,  4 

Hydrargyri  Bichloridum,  1 

Iodine,  2 

Iodoform,  2 

Nitrate  of  Silver,  2 

Nitric  Acid,  2 

Opium.    As  suppository  or  enema 

Potassa  Fusa,  2 

Poultices 

Saline  Laxatives,  2 

Saline  Mineral  Waters,  2 

Turpentine  Stupes 

Milk  Deficiency. 

Gossypium.    Decoction  or  seeds,  two  or  th 

times  every  hour 
Ricmus.    Poultices  or  infusion  of  leaves  to 


Muscle  Volitantes. 

Blue  Pill.    In  biliousness 

Iodide  of  Potassium 

Iron.    Perchloride  in  anosmia  and  climacter 

Valerian 


Myalgia. 


Acupuncture,  1, 2 

Aquapuncture,  2 

Ammonium  Chloride,  1,  2,  3 

Arnica.    Internally  and  locally 

Belladonna  Liniment,  1,  3.    Locally 

Belladonna  Plaster 

Chloroform  Liniment,  1.    With  friction 

Clmicifuga,  2 

Electricity,  1 

Ether,  3 

Friction 

Gelsemium.    Large  doses 

Iodide  of  Potassium.    In  rheumatic  cases 

Iodides,  2 

Iodine 

Massage,  2 

Opium 

Packing 

Poultices,  3 

Salicylate  of  Sodium 

Salicylates,  2 

Veratrlve.    Externally 

Xanthoxylum.    Internally  and  externally 


Myelitis. 


Barium  Chloride,  S 
Belladonna 


1216 


INDEX  OF  DISEASES  AND  REMEDIES. 


Myelitis. 

Electricity,  1,  4.  In  chronic  cases 
Ergot,  1,  2 
Galvanism,  2 
Hydrotherapy,  2 
Iodides,  2 

Iodide  of  Potassium,  1 
Massage,  2 
Mercury,  2 

Phosphorus,  4.  In  paraplegia  from  excessive 
venery 

PlCROTOXDJ,  2 

SILVER  NITRATE,  4.     Useful 

STRYCHNINE,  .1,  2 

NlEVUS. 

Antimonium  Tartaeatum,  1 

Careoijc  Acid,  1 

Chloral,  1 

Chromic  Acid,  2 

Collodion,  1, 2 

Creasote,  1 

Croton  On.,  1 

Electrolysis,  1 

Persic  Chloride,  1 

Galvano-Cautery,  2 

Hydrargyri  Bichloredum,  1 

Liquor  Plumbi,  1 

Nitrate  of  Mercury  (Acw),  1 

Nitric  Acid,  1,  2 

Potassium  Nitrate,  1 

Sodium  Ethylate,  1 

Tannlv,  1 

vaccination,  1 

Ztkc  Chloride,  3 

Nails,  Ingrowing. 

Altoi.I 

Ferri  Perchloridum,  1 

FERRI  l'ERSULPHAS,  1 

Glycerine 

Iodoform, 1 

Lead  Carbonate.    Locally 

Liquor  Potassje 

Plumbi  Nitras,  1 

Silver  Nitrate 

Tannlv,  1 

Nausea. 

Aconite,  1 

Ammonio-Citrate  of  Iron,  1 
Belladonna,  1 
Bismuth,  1 
Calomel,  1 
Calumba,  1 
Carbolio  Acid,  1 
Certum  Oxalate,  1 
Chloral,  1 
Cinnamon 
Cloves 

Cocculus  Indicus.    In  vio'ent  retelling  with- 
out vomiting 
Coffee,  1 
Creasote,  1 
Electricity,  1 
Hydrocyanic  Acid,  1 
Ice 
lngluvin,  1 

lODrNE,  1 

Ipecacuanha.  In  sickness  of  pregnancy  and 
chronic  alcoholism ;  very  small  dose,  1  til  of 
wine 

Koumiss,  1 

Lead  Acetate,  1 

Leeches,  1 

Liquor  Potasses,  1 

Morphine 

Nutmeg 


Nausea. 


vide 


Pepper 

Peppermint 

Pepsin,  1 

Pimento 

Pulsatilla.    In  gastric  catarrh 

Salicin 

Spt.  Nucis  Juglandis,  1 

Strychnine,  1 

Sulphuric  Acid,  1 

Nephritis       Acute. 
Bright's  Disease. 

Aconite,  1,  3.    At  commencement 

Alkalies,  3 

Aqua  C  amis,  1 

Arsenic,  1  * 

Belladonna,  1, 4 

Bromide  of  Potassium,  3 

Camphor,  1 

Cannabis  Indica,  3.    As  diuretic,  especially  in 

hematuria 
Canthartdes,  3.     I  in.  of  tincture  every  three 

hours  to  stop  hematuria  after  acute  symptoms 

have  subsided  9 

Cod-Liver  Oil,  3 
Copaiba,  3 
Croton  Liniment,  1 
Cytisus  Scoparius,  1 
Digitalis,  3.    As  diuretic 
Elaterium,  1,  3 
Eucalyptus.    Given  cautiously 
Fuchsin,  1 
Gallic  Acid,  1 
Glonoine,  1 
Hyoscyamus 
Incisions,  3 
Iron,  3 

Jaborandi,  1,  3, 4 
Juniper 
Lead, 3 

Liquor  Ammonii  Acetatis,  1 
Liq.  POTASSai,  1 
pilocarpus,  1 

Potassium  Bttartrate,  3,4 
Potassium  Iodide,  1, 3 
Potassium  Sulphate,  1 
Poultices.   Over  loins,  very  useful 
Senega, 3 
Tannin,  1,3 
Tartrate,  3 

Tincture  Ferri  Perchlortdi,  1 
Turkish  Baths,  3 
Turpentine.    1  m.  doses,  every  two  to  four 

hours 
Warm  Baths,  3 

Nervousness. 

Aconite.    1  HI  of  tincture  at  bed-time  for  rest- 
lessness and  fidgets 

Ammonium  Chloride,  1 

Argenti  Phosphas,  1 

BROMrDE  of  Potassium,  3,  4.    Over-work  and 
worry 

Caffeine,  4.    Where  much  debility 

Camphor,  4 

Chamomile 

Chloral  Hydrate,  1, 3 

Chloroform, 3 

Cod-Liver  On. 

Cold  Sponging,  3 

Electricity,  1 

Ergot,  1 

Ether,  4 

Hops.    Internally,  and  as  pillow 

Hydrargyri  Perchloridum,  1 

Ignatia 

e,  1 


INDEX  OP  DISEASES  AND  REMEDIES. 


1217 


Nervousness. 


MUSK.    In  uterine  derangement 

OPIUM,  1 

Phosphorus,  1 
Strychnine,  1 

issbsp^fr1107' ana  ■*■ aoute  *»■• 

Neuralgia. 

Aconite,  2 

AcoNrrrNE,  1,  2,  3,  4    As  ointment 

'acupuncture1,  1,  3 

Alcohol,  2, 3,  4 

Ammonium  Chloride,  1,  3,  4.    I  ax  doses 

Ammonium  Valerianate,  1, 4 

Amyl  Nitrite,  1,  2,  3 

Anesthetics,  2 

Antiseptic  Oils,  2 

Aquapuncture,  2 

Arsenic,  1,  2,  3, 4 

Atropine,  1, 3.  As  liniment,  or  hypodermlcally 

near  the  nerve 
Auro-Terchlor.  Iod.,  1 
Belladonna,  1,  2,  3, 4 
Bebeeru  Bark 

BLISTER3, 1,  4 

Bromide  of  Potassium,  1, 3. 4    • 
Bromides,  2, 

Butyl-Chloral,  2,  3,  4.    Por  neuralgia  of  fifth 
nerve 

Caffeine 

Cannabis  Indica,  1,  3,  4 

Capsicum,  3.    Locally 

Carbonic  Aero   3.    Locally  for  uterine  neu- 
ralgia 

Cautery,  1 

Chamomile,  3 

Chaulmooqra  Oil,  1 

Chelldonium 

Chloral  and  Camphor,  2,  3,  4.    Equal  parts 
locally  applied 

Chloral  and  Morphine,  1 

Chlorate  of  Potassium,  3.    In  facial  neu- 
ralgia 

Chloroform,  1,  2, 3, 4.    Locally,  and  by  inhala- 
tion, when  pain  very  severe 

Cimicdjuga?  2.    In  neuralgia  of  fifth  nerve,  and 
ovarian  neuralgia 

Cocaine,  3 

Codeine,  1 

C6d-Ltver  Oil,  2, 4 

Colchicum,  I 

Conium,  1,  3,  4 

counter-ibrrtation,  3 

creasote,  1 

Cupri-Ammonii-Sulphas,  1, 

Digitalis,  1 

Dogwood,  Jamaica,  1 

Electricity,  1, 4 

Epispastics,4 

Ergot,  3, 4.    In  visceral  neuralgia 

Ether,  1,  3, 4 

Ferric  Perchlordde,  1 

Ferro-Manganates,  1 

Galvanism,  2     . 

Gelsemium,  2,  3,  4 

Gloxoixe,  1 

Hydrocyanic  Acid,  3 

Hyoscyamus,  3 

Ignatia.    In  hysterical  cases  and  in  intercostal 
neuralgia 

Iodides,  1.    Especially  when  nocturnal 

Iodide  of  Potassium,  4 

Iodoform,  1,  3,  4 

Iron,  2,  3 

Massage,  2 

Menthol,  1 

Morphine,  1,  2,  3.    Hypodcrmically 
iMustaiu)  Poultice 

Narceine,  1 

Nickel,  I 


Neuralgia. 

Nitro-glycehin,  2, 4 

Nux  Vomica.    In  visceral  neuralgia 

On,  of  Cloves.    Locally 

Optom,  3 

Peppermint,  3.    Locally 

Phosphorus,  1,  2,  3,  4 

Potassium  Bichromate,  1 

Pulsatilla 

Pyrethrum.    As  masticatory 

Quinine,  3,  4.    In  periodical  cases 

Qulvlne  Salicylate,  1 

Saliclv,  1 

Salicylic  Acid 

Sodium  Salicylate,  1, 3 

Spinal  Ice-bag,  3 

Stavesacre 

Stramonium,  1,  3 

Strychnine,  1, 2 

Sumbul.    Sometimes  very  useful 

Thermocautery 

Tonga,  1 

Turkish  Bath,  1 

Turpentine,  1, 2 

Valerian 

Valerianated  Zinc,  3 

Valerianic  Acid,  4 

Veratrine,  2,  3,  4 

Vibration 

Wet  Pack,  2 

Neuralgic  Pains. 

Cold  Sponging 

Priotion.    Along  back  or  on  limbi 

Rubefacients.   Useful 

Valerian 

Warm  Sponging 

Nightmare. 

Bromide  of  Potassium,  3 
Camphor  Water 

Nipples,  Sore, 

Alcohol.    Locally 
Arnica,  3 
Balsam  of  Peru 
Balsam  of  Tout 
Benzoin,  1 

-Borax.    Saturated  solution  locally 
Brandy  and  Water,  3 
Carbolic  Aero,  1 
Catechu,  1 
Chloral  Poultice,  1 
Collodion,  1,  3 

Ferrous  Subsulphate.    Locally 
India  Rubber,  1 
Lead  Nitrate,  1 
Lead  Salts 
Lime  Water,  3 
Potassium  Chlorate,  1 
It  h  ataxy,  1.    1  part  extract  to  IS  of 

Butter 
Shdjld,  1 
Silver  Nitrate 
Sulphurous  Acid,  3" 
Tannic  Acid,  4 
Tannin,  Glycerine  of,  1 
Zixc  Shield,  3 


Nodes. 

Mercury  Oleate,  3.    With  morphine,  Ioca'ly 
Potassium  Iodloe,  3.     Internally  and' exter- 
nally 
Stramonium  Leaves.   As  poultice 

•  4  i 


1218: 


INDEX  OF  DISEASES  AND  REMEDIES. 


Nyctalopia. 


Amyl  Nitrite,  1 

Blisters.    Small  to  external  canthua 

Quinine 

Strychnine,  1 


Nymphomania. 


Anaphrodisiacs,  1 

Bromide  op  Potassium,  1,  2, 


4.    In  large 


Camphor,  2,  3.    In  large  doses 
Camphor  Honobromate,  2 
Digitalis,  1 
Lupuline 
Opium,  1 
Stramonium,  1 

Sulphur.    "When  due  to  njemorrhoida 
Sulphuric  Acu>.    Internally 
Tobacco,  2.    So  as  to  cause  nausea,  effectual 
but  depressing 

Obesity. 

Alkalies,  2,  3 

Alkaline  Waters,  2.    Especially   those    of 

Marienbad,  2 
Ammonium  Bromide,  1,  2 
Banting's  System — living  on  meat  and  green 

vegetables,  and  avoiding  starch,  sugars,  and 

fats,  1, 2 
Fucus  Vesiculosus,  1 

LlQ.  POTASSJB,  1 

Potassium  Permanganate,  2 
Salines,  1 
Sodium  Chloride,  1 
Sulphurous  Waters 
Vegetable  Acids,  2 
Vinegar,  3.    Very  injurious 

Onychia. 

Alum,  1 

Aluminium  Sulphate,  1 

Arsenic,  1 

Carbolic  Acid.    As  local  anestbetio 

Chloral,  2.    Locally 

Corrosive  Sublimate,  4 

Ferri  Perchloridum,  1 

Ferri  Persulphas,  1 

Iodoform,  1,  2.    Locally 

Lead  Nitrate,  1,  2,  3, 4 

Mercury,  3.    As  ointment,  alternately  with 

poultices 
Silver  Nitrate,  L,    At  commencement 
Tannin,  1 
Tar  Ointment 
Tartar  Emetic 

Ophthalmia,  vide  Conjunctiv- 
itis. 

Orchitis,  vide  Epididymitis. 

Otitis,  vide  Earache. 

Otorrhcea. 

Aconite,  3 
Alcohol 

Alum,  1,  3.    Insufflation 
Arsenic,  1 
Boric  Acid,  1 
Cadmium,  2.    Locally 
Carbolic  Acid,  1 
Caustic,  1 


OtOEEH(EA. 

Chloral,  1 

Cod-Liver  Oil,  3 

Cotton  Wool,  1 

Iodide.    2  grs.  to  an  ounce  locally 

Iodoform,  1 

Lead  Acetate,  3 

Lead  Lotions,  2 

Lime  Water,  3 

Liquor  Soda     Locally,   when   discharge  Is 

fetid 
Mercury,  Brown  Citrine  Odjtment,  2  _ 
Permanganate  of  Potassium,  4.   As  injection 

or  spray 
Quinine 

Silver  Nitrate,  2.    Locally 
Spt.  Vini  Bect.,  1 
Sulpho-Carbolates,  2 
Tannin,  Glycerine  of,  2,  3.    Very  useful 
Zinc  Sulphate,  2 

Ovaritis  and  Neuralgia. 

Gold 

OXALURIA. 

Mineral  Acids,  3 
Nitric  Acid,  2 
Nitbo-Hydboohlobic  Acid,  S 

OZuENA. 

Acetate  of  Ammonium,  3 

Acid,  Sulphurous,  1 

Alum,  3.    As  powder  or  wash 

Bichromate  of  Potassium,  2 

Bismuth,  3 

Boro-glyceride,  3    . 

Bromine,  2.    As  inhalation 

Calcium  Chloride,  1 

Calomel  Snuff,  1 

Carbolate  of  Iodine,  2 

Carbolic  Acid,  2,  3 

.Chlorinated  Lime.  Injections  of  Tihe  solutions 
of 

Ethyl  Ioddde,  2 

Glycerlne  and  Iodine,  1 

Gold  Salts 

Hydrastis.    Internally  and  locally 

Insufflation,  2 

Iodine,  2,  3,  4.  As  inhalation.  Much  benefit 
derived  from  washing  out  the  nose  with  a 
solution  of  common  salt,  to  which  a  few 
drops  of  the  tincture  of  iodine  have  been 
added 

Iodoform,  1,  2 

Iron,  3 

Medicated  GOtton,  1 

Mercuric  Oxdoe,  or  Ammoxiated  Mercury,  3 

Potassium  Chlorate,  1 

Potassium  Iodeoe,  1 

Potassium  Permanganate,  4 

Sodium  Arseniate,  1 

Sodium  Chloride,  1 

Sodium  Etiitlate,  1 

Spray,  1 

Tannin,  Glycerine  of,  3 

TlSCT.  THU.LE,  1 


Parotitis. 


Aconite 

Emetics,  1 

Jaborandi,  1 

Mercury.    J  gr.  of  grey  powder  three  or  four 

times  a  day 
Poultice 


INDEX  OP  DISEASES  AND  EEMEDIES. 


121< 


Pediculi. 


Peritonitis. 


Anise 

Bake  Clothes  to  destroy  ova 
Chloroform,  1 
Coccuxus  iKDIOtTS 
Dalmatian  Flowers,  1 
Essential  Oils,  3 
LaureliLbaves,  Decoct.  1 
Mercury,  3.    As  ointment  or  wash 
Petroleum,  1 
Pyrethrum,  1 
Quassia,  1 
Stavesacre,  3 


Pemphigus. 


Arsenic,  1,  2,  3,  4 

Belladonna,  2 

Chlorate  of  Potassium,  1 

Cod-Liver  Oil 

Hqt  Bath,  1 

Iodide  of  Potassium,  1 

Mercury 

Phosphorus,  1 

Silver  Nitrate 

Sulphides,  1 

Tae.1 

Pericarditis. 

Aconite,  3 

Alcohol,  3.    Sometimes  very  useful 
Bleed  ins,  1 

.Blisters,  1,  3.    Near  heart  very  useful 
Bryonia.    Useful  in  exudation 
Calomel  and  Opium.    Formerly  much  used 
Digitalis,  1,  3.    When  heart  is  rapid  and  feeble 

with  cyanosis  and  dropsy 
Iodide  op  Potassium,  4 
Iodine,  1 
Iodoform,  4 
Mercury,  1,  4 
Opium,  1.    In  grain  doses  every  three  to  six 

hours,  very  useful 
Poultice,  3 
Quinine,  1 
Veratrum  Vieide,  3 

Periostitis. 

Iodide  of  Potassium,  or  Ammonium,  3 

Iodine.    Locally 

Mercury,  1.    Internally 

Mercury  and  Morphine  Oleate,  3.  Externally 

Mezereon.    In  rheumatic  and  scrofulous  cases 

Phosphates,  4 

"POTTT  TICES 

Stavesacre.    When  long  bones  affected 

Peritonitis. 

Aconite,  2, 4.   At  commencement 

Ammonia,  1 

Antimony,  3 

Blisters,  4 

Bryonia.    When  exudation 

Chloral,  2 

Chlorine  Solution,  3 

Cocculus  Indicus.    For  tympanites 

Cold,  4 

Ice,  1 

Iodine,  1 

Ipecacuanha,  4 

Leecheb,  2  

Mercury,  1,  4.    When  there  is  a  tendency  to 

fibrous  exudation 
Opium,  1,  2,  3,  4.    Freely,  most  useful 
Plumbic  Acetate,  1 
Potassium  Salts,  2 
Poultices,  2,  3, 4 


Quinine,  1,2 

Rubefacients,  2 

Steam,  2.  Applied  to  the  abdomen  under  a  clotl 

when  poultices  cannot  be  borne 
Turpentine,  2.  For  tympanites 
Vebatrum  Yiride,  4 


Perspiration. 


Agaric.    In  phthisis 

Aromatic  Sulphuric  Acm,  2.    In  phthisis 

Atropine,  2,  3.    In  sweating  of  phthisis,  in 

tcrnally 
Belladonna,  3.    As  liniment  for  local  sweats 
Betula,  1 
Carbolic  Acm.  With  glycerine  locally  for  fetii 

sweat 
Ergot,  3 

Gallic  Acid,  2,  3.    In  phthisis 
Glycerine,  1 
Iodoform,  3 
Jaborandl  1 
Lead,  2 
Muscarine,  2 

Neat's  Foot  Oil  rubbed  over  the  surface 
Oils,  3 

Opium,  3.    As  Dover's  powder  in  phthisis 
Permanganate  of  Potassium,  2.    Locally  fo 

fetid  perspiration 
Picrotoxtn,  2.  3 
Pilocarpine,  3 
Quinine,  3 
Saliod*.    In  phthisis 
Salicylic  Acid,  2.     With  borax  in  fetid  pei 

spiration 
Spinal  Ice-Bag,  3 
Sponging,  3.    Very  hot 
Strychnine.    In  phthisis 
Tannin,  3 
Vinegar.    Locally 
Zinc  Oxide,  2,  3.    In  phthisis 

Pertussis. 

Aconite,  1 

Alum,  1 

Ammonium  Chloride,  1 

Amyl  Nitrite,  1 

Argenti  Oxidum,  1 

Arnica,  1 

Arsenic,  1 

Atropine,  1 

Belladonna,  1 

Bexzin,  1 

Blister,  1.    To  nape  of  neck 

Bromide  of  Ammonium,  1 

Bromide  of  Potassium,  1 

Butyl-Ohlohal,  1 

Canthartdes,  1 

Carbolic  Acid,  1.    As  spray 

Castanea  Tesca,  1 

Cerium  Oxalate,  1 

Cheken,  1 

Chloral,  1.    In  spasmodic  stage 

Chloroform,  1.  Asinhalation  during  paroxysi 

Clover  Tea,  1 

Cochineal,  1 

Cod-Liver  Oil,  1 

Coffee,  1 

Decoction  of  Chestnut  Leaves,  ad  lib,  Som 

times  useful 
Drosera,  1 
Ergot,  1 
Ether  Spray,  1 
Gas  Lime,  1.    Exhalation 
Gelsemium,  1.    In  spasmodic  stage 
Hydrobromic  Ach>,  1 
Hydrocyanic  Aero,  1..  In  habitual  cough  whe 

the  true  whooping  cough  has  ceased 
Hydrogen,  Peroxide  of,  1 

4  i  2 


1220 


INDEX  OF  DISEASES  AND  EEMEDIES. 


Pertussis, 


Inhalation  op  Atomised  Fluids,  1 
Ipecacuanha,  1.    Sometimes  very  useful  alone, 

or  combined  with,  bromide  of  ammonium 
Leeches,  1.    To  nape  of  neck 
Lobelia,  1.    In  spasmodic  stage 
Milk  Diet,  1 

monobromate  of  camphor 
Morphine,  1 
Nitric  Acid,  1 

Opium.    In  convulsive  conditions 
potassa  sulphurata,  1 
Quinine,  1 

Salicylic  Acid,  1.    As  spray 
Silver  Nitrate 
Sodium  Carbolatum,  1 
Sodium  Salicylate,  1 
Tannin,  1 

Tar,  1.    For  inhalation 
Tartar  Emetic 

TEREBINTHIN-fli  OLEUM,  1 

Urtica,  1 

Vaccination,  1 

Valerian 

Valerianate  of  Atropine,  1 

Wild  Thyme,  1 

Zinc  Sulphate,  1 


Pharyngitis. 


Phlegmasia  Alba  Dglews. 

Belladonna  Extract.  "With  mercurial  oint- 
ment locally 

Blisters.    In  early  Btage 

Creasote.    As  enemafca 

Hamamelis  .        . . 

Hydrochloric  Acid.  With  potassium  chlorate, 
in  barley  water 

Leeches.    During  active  inflammation 

Opium.    Internally  and  locally  to  allay  pain 

Photophobia. 

Ammonium  Chloride,  1 

Atropine,  1,  3 

Belladonna,  3.    To  eye 

Bromtdeof  Potassium,  1 

Butyl-Chloral,  1 

Calabar  Bean,  1 

Chloroform  Vapour,  1,  3 

Cold,  1 

Coniine.    In  scrofulous  photophobia  locally 

Galvanism,  1 

Iodine  Tr.,  1 

Mercuric  Chloride.    By  insufflation 

Nitrate  op  Selter,  1 

Opium,  L  3 

Potassium  Chlorate,  1.    In  large  doses 

Seton,  1 

Tonga,  1 


Aconite,  1,  2,  3 

Acid,  Sulphurous,  1,  3 

ACTiEA  RACEM09A,  3 

Alcohol,  3.    Dilute  as  gargle 

Alum,  2,  3.    As  gargle 

Ammonii  Acetatis,  Liq.,  1 

Belladonna,  1,  2,  3 

Capsicum,  3.    As  gargle 

Cimicifuga.    Internally  when  pharynx  dry 

Copper  Sulphate.      Locally 

Cubebs  Powder,  2.    Locally  applied 

Electric  Cautery,  1 

Ferric  Chloride.  Looally.  as  astringent,  in- 
ternally as  tonic 

Glycerine,  3.  Locally,  alone  or  as  glycerine  and 
tannin 

Guaiacum,  1 

Hydrastis,  2.    Internally  and  locally 

Ice,  1,  3 

Iodine,  I,  3 

Iodoform, 2 

Ipecacuanha,  3.    As  spray 

Nitric  Acid,  1,  3 

Pomegranate  Bark.    As  garg'e 

Potassium  Chlorate,  1.    Locally 

Quinine.    A3  tonic 

Silver  Nitrate,  2,  3.    In  solution  locally 

Sodium  Borate,  1 

Strychnine.    As  tonic 

Tannin,  2,  3.    As  powder  or  glycerine  looally 

Zinc  Sulphate,  1,  3.    As  gargle 


Phimosis. 


Belladonna.    Locally 
Elastic  Ligament,  1 
Lupulin.    After  operation 
"Warm  Baths,  1 


Phlebitis. 


Blisters,  3 

Hamamelis 

Hot  Foment ationb 

Opium.    To  allay  pain 

Rest,  absolute 


Phlegmasia  Alba  Dolens. 

Ammonium  Carbonate;     In  full  doses  wheD 
much  prostration 


Phthisis. 


Act^a  Racemosa,  3 

Alcohol.    Along  with  food  or  cod-liver  oil 

Ammonium  Carbonate,  1 

Ammonium  Chlordde,  1 

Ammonium  Urate,  1 

Antimonium  Tartaratum,  1 

Antipyrin.    To  reduce  temperature 

Arsenic.    To  remove  commencing  consolida- 

tion,  and  also  when  tongue  is  red  and  irritable 
Atropine.    To  check  perspiration 
.  Belladonna,    Locally  for  pain  in  muscles 
Benzoic  Acid,  3 
Benzoin.    As  inhalation  to  lessen  cough  and 

expectoration 
Blisters 
Bromides,  2 

Butyl-Chloral,  3.    To  check  cough 
Calcium  Chloride,  1, 2,  3     - 
Camphor,  1 
Cannabis  Ixdica,  4- 
Carbo  Ligxi,  1 
Carbolic  Acid,  1,  2 
Chaulmoogra  Oil,  1 
Chloral,  3.    As  hypnotic 
Chlorine,  1 
Chlorodyne,  1 

Chloroform,  3.    As  linctus  to  check  cough 
Cocaine,  2.    A  solution  locally  to  tnroat  and 

mouth  tends  to  relieve  irritable  condition  and 

aphthae,  especially  in  later  stages 
Cod-Hver  Oil,  2, 3, 4.    Most  useful  as  nutrient 
Conium,  1, 4 
Coto  Bark,  3 
Counter-irritation,  3 
Creasote,  1,  2,  3.    As  inhalation 
Croton  Oil,  3.    To  chest  as  counter-irritant 
Digitalis,  1 
Enemata,  3.    Of  starch  and  opium  to  control 

diarrhoea 
Ether,  1 

Eucalyptus  Ol.,  1, 4 
Ferri  Iodidum,  1 
Eekri  Sulphas,  1 
Fluoric  Acid,  1 
Gallic  Acid,  4 
Gelsemium,  3 
Glycerine.  3.    Asnutrientin  place  of  cod-liver 

oil,  locally  to  mouth  in  the  last  stages  to  re- 
lieve dryness  and  pain 


INDEX  OF  DISEASES  AND  EEMEDIES. 


1221 


Phthisis. 

GUAIACUM,  1 

Hypophosphttes,  1,  2,  3.    Very  useful  in  early 


Inulin.    Possibly  useful 
Iodine  Liniment,  1,  3,  4.    As  a  counter-irritant, 
to  remove  consolidation  in  early  stage,  and  to 
remove  pain  and  cough  later ;  as  inhalation 
to  lessen  cough  and  expectoration 
Iodoform,  3.    As  inhalation 
Ipecacuanha,  3.    As  spray  to  the  throat  to 
relieve   bronchial   asthma   and  emphysema, 
combined  with  fibroid  phthisis 
Koumiss,  1 
Li  n seed,  1 
Mercuric  Chloride,  3.    In  minute  doses  for 

diarrhoea 
Mineral  Ac  ros,  1 
Mineral  Waters,  1 

Morphine,  with  Starch  or  Bismuth.  Locally 
to  larynx,  and  in  laryngeal  phthisis   most 
useful 
Mustard    Leaves.     Most  useful   to    lessen 
pain  and  prevent  spread  of  subacute  inter- 
current inflammation 
Ol.  Plni  Sylvestris,  1 
Ol.  Lini  and  Whisky,  1 

Opium,  3.    To  relieve  cough,  and,  with  ipeca- 
cuanha and  Dover's  powder,  to  check  sweating 
Oxalic  Acid,  1 
Oxyoen,  2,  3 
Ozone,  1 

Pancreatic  Emulsion,  1 
Peroxide  of  Hydrogen,  1 
Phallandrium,  1 
Phosphates,  2, 4 
Phosphate  op  Calcium,  3.    As  nutrient,  and 

to  check  diarrhoea 
Phosphoric  Acid,  1 

Picrotoxds,  2,  3.    To  check  perspiration 
Pilocarpine,  2,  3.    To  check  sweats 
Plumbi  Acetas,  1 
Plumbi  Caebonas,  1 
Podophyllum, 1 
Potass*,  Liquor,' 1 
Potassium  Chloride,  1 
Potassium  Iodide,  1 
Prunus  Virginiana,  2,  i 
Prunus,'Tincture,  1 
Quinine,  1,  3.    As  tonic  to  leBsen  temperature, 

to  check  sweat 
Eaw  Meat  and  Phosphates,  1 
Salicylic  Acid,  3.    When  breath  foul   and 

expectoration  offensive 
Sangulnaria,  1 
Sea  Bathing,  3 
Sea  "Voyage,  1 
Skcale,  1 

Silver  Nitrate,  1, 3 
Snuff,  1 

Sodium  Benzoate,  1, 2 
Sodium  Chloride,  1 
Sodium  Phosphate,  1         | 
Sponging,  very  hot,  3 
Strychnine,  2,  i 
Sugar,  1 
Sulphur,  1 
Sulphuric  Aero,  3 

Sulphurous  acid,  1, 3.   As  fumigation 
Terebene,  1 
Thymol,  1, 4 
Tb.  Iodl.  1 
Transfusion,  1 
Turkish  Bath,  1, 3 
Turpentine,  1 
Vinegar,  3 


Pityriasis. 

Borax,  2,  3.    Saturated  solution  or  glycerin* 

locally 
Cajeput  Oil,  4 
Carbolic  Acid,  2.    With  glycerine  and  wate: 

locally 
Chrysarobinum, 
Citrine  Ointment,  1 
Glycerine,  1 
Lead,  3.    Locally 
Mercuric  Ointment,  3.    Locally 
Myrtol,  2 

Oleate  of  Mercury,  2 
Safo  Laricis,  1 
Sulphides,  2.    Locally 
Sulphurous  Acid,  3 


Pityriasis. 


Pleurisy. 


Aconite,  2,  3.    In  early  stage 

Antimony,  3 

Belladonna  Plaster.    Most  useful  to  reliev 

pain  in  old  adhesions 
Blisters,  2,  3, 4 

BLOOD-LETTrNG,  2 

Bryonia.    After  aconite 

Chloral,  2 

Cod-Liver  Oil,  3 

Digitalis,  2.    When  much  effusion 

Gelsemium,  4 

Iodide  of  Potassium,  2,  3, 4.    To  aid  absor 

tion 
Iodine,  3, 4.    As  a  liniment  externally  to  assi 

absorption,    or   as  a  wash  or  injection  ' 

cavity  after  tapping 
Jaborandi,  1, 4 

Local  Wet  Pack.   To  chest 
Mercury,  1, 4 
Morphine,  1, 2,  3 
Packing,  3 
Pilocarpine,  1, 2 
Poultices,  3, 4 
Purgative  Salts,  3 
Quinine,  2 
Sinapisms,  3 
Sodium  Chloride 
Veratrum  Viride,  1,  3 

Pleurodynia. 

Act-ba  Bacemosa,  3 

Acupuncture,  3 

Belladonna,  3.  Plaster  or  liniment  very  usel 

Blistering,  3 

Chloral,  3.    With  camphor,  locally 

Ckoton  Oil,  3.    Locally  in  obstinate  cases 

Ether,  3.    As  spray,  locally 

Iodine,  3.    Locally 

Iron.      When    pleurodynia   associated    wi 

leucorrhcea 
Morphine,  1 
Mustard  Leaves,  3 
Nerve-stretching,  1  . 

Opium,  3.    Liniment  rubbed  in  after  wa: 

fomentations  or  hypodermic  injections.    . 

ternally,  mo6t  useful  to  cut  short  attack  a 

relieve  pain  . 

Plasters.    To  relieve  pain  and  give  suppor 
Poultices,  3 
Quinine 
Strapping,  1 
Veratrum  Viride 
Wet-cupping.     When  pain  severe  and  fe' 

high 


Pleuro-Pneumonia. 


Acetic  Acid,  2 

Arsenic  and  Mercury.   Internally 

Bichloride  of  Mebcuby,  2 


Bryonia 

Carbolic  Acid.    2  per  cent,  solution  injec 
locally 


1222 


INDEX  OP  DISEASES  AND  KEMEDIES. 


Pleuropneumonia.. 

Sanguinaria 
Turpentine.    Locally 

Pneumonia. 

Acid,  Phosphoric,  1 

Aconite.      Very   useful,  especially    at    com- 
mencement 
Alcohol,  4 
Ammonia,  4 

Ammonium  Carbonate,  2.    As  stimulant 
Arnica,  1 

Belladonna.    At  commencement 
Bleeding,  1 

Blisters.    At  beginning  to  lessen  pain 
Bryonia.    "When  pleurisy  present 
Carbonate  of  Sodium,  1 
Chloral,  1, 4 
Chloroform,  1 
Cold,  4 
Cold  Bath,  1 

Cold  Compress  to  Chest,  1 
Copper  Acetate 
Copper  Sulphate,  2 
Bigitalis,  1, 2, 4.    To  reduoe  temperature 


Prolapsus  Ani. 


Expectorants,  4 

Gelsemium,  4 

Iodide  of  Ammonium,  3 

Mercury,  4 

morphine,  2,  3 

Muscarine,  2 

Packing,  3 

Phosphorus,  3, 4 

Pilocarpine,  1 

Plumbi  Acetas,  1 

Potassium  Chlorate,  1 

Potassium  Nitrate,  1 

Poultices,  1,  3, 4.    To  lessen  pain 

Quinine,  1, 2,  3,  4.    To  lower  temperature 

Salicylate  of  Sodium.    As  antipyretic 

Secale,  1 

Senega.    As  expectorant 

Serpentaria,  2.    With  carbonate  of  ammonia 

as  stimulant 
Sinapisms,  3 

STmULANTS,  1 

Strychnine,  1 

Tartar  Emetic,  1,  3, 4 

Turpentine,  2, 4.    As  stimulant  at  crisis 

Teratrine,  1 

Veratrum  VrpjDE,  1,  2, 3, 4 

Wet  Pack,  2 


Polypus. 


Alcoholic  Spray,  1 
Alum.    As  insufflation 
Carbolic  Acid  and  Glycerine,  i 
Sbsquichloride  of  Iron,  1 
Sodium  Ethylate,  1 
Tannin,  1.    As  insufflation 
Tr.  Oph  cum  Croco,  1 
Zinc  Sulphate,  1 


Prolapsus  Ani. 


Aloes,  1 

Alum,  3.    In  solution  locally 

Bismuth,  1 

Electricity,  1 

Ergotin,  1 

Hydrastis.    As  enema  or  lotion 

Ice.    When  prolapsed  parts  inflamed 

Nitric  Acid,  1 

Opium,  1 

Pepper.    Confection 

Podophyllum.    In  small  doses 

Silver  Nitrate,  1 


Strychnine,  1,  3.    As  adjunct  to  laxatives 
Tannin,  3.    As  enema 


Prolapsus  Uteri. 


Alum,  3.    As  hip-bath  and  vaginal  douche 

Bromide  of  Potassium,  1 

Cimicifuga.  To  prevent  miscarriage  and  pro- 
lapsus 

Electricity,  1 

Galls.    Decoction  of,  as  injection 

Glycerine  Tampon,  1 

Ice,  3.  Locally  when  part  inflamed,  and  to 
spine 

Oak  Bark.    As  injection 

Secale,  1 

Tannin,  3 


Prostate,  Enlarged. 


Alkalies,  2.    When  irritation  of  the  bladder 

with  acid  urine 
Ammonium  Benzoate,  2.    For  cystitis   with 

alkaline  urine 
Ammonium  Chloride,  1 
Conium,  1 
Ergot,  1,  2 

Iodine,  1,  2.   Apply  to  rectum 
Iodoform,  2.    As  suppository  very  useful 
Sulphides,  2 


Prostatitis. 


Blisters.    To  perineum  in  chronic  cases 

Buchu 

Cantharides,  3.    Small  doses  of  tincture 


Hot  Injections,  3 

Hydrastis.    Internally  and  locally 

Iron 

Silver  Nitrate.    Locally 

Turpentine 

Prurigo  and  Pruritus. 

Aconite,  1.    Externally 

Alkaline  Lotions,  1 

Alkaline  Warm  Baths,  2 

Alum.    A  strong  solution  for  pruritus  vulva 

Aluminium  Nitrate,  1 

Arsenic,  1.    Internally 

Atropine,  1 

Balsam  of  Peru,  1 

Belladonna,  2 

Boric  Acid,  1 

Borax,  1,  3.    Saturated  solution 

Bromide  of  Potassium,  1 

Calomel.  Ointment  very  useful  in  pruritus 
ani 

Cantharides,  3 

Carbolic  Acm,  1,  2,  3.  Internally  and  locally, 
especially  in  prurigo  senilis 

Chloral  and  Camphor,  1 

Chloroform  Ointment,  3 

Cod-Liver  Oll.    As  inunction 

Corrosive  Sublimate.    For  pruritus  vulvae 

Cyanide  of  Potassium,  2,  3.  As  lotion  or  oint- 
ment, to  he  used  with  care 

Electricity,  1 

Gelsbmium 

Glycerine 

Glycerols  of  Tab 

Hot  Water,  1 

Hydrargyrum  Bichloridum,  1 

Hydrargyrum  Oleatum  cum  Morphea,  1. 2 

Hydrocyanic  Acld,  2.    Locally 

Ice,  3  ^^ 

Iodoform,    As  ointment 


Index  of  diseases  and  eemedies. 


1223 


Prurigo  and  Pruritus. 

Liquor  Carbonis  Detergens 
Maiune  Lint,  1 
Mercury.    Locally 
Opium,  1 
Oil  of  Cade,  1 

PETROLEUM  OlL,  1 

Pilocarpine,  1 
potassium  oarbonatb 
Salicylic  Acid,  1 
Sapo  Viridis,  1 
Silver  Nitrate,  1,  2 
Sodium  Carbonate 
Stavesacrb,  1 
Strychnine,  1 
Sulphate  of  Zinc,  1 
Sulphides 
Sulphites,  1,  2 

Sulphur  and  Compounds,  1,  3 
\  Tar  Ointment 
Tobacco,  1.    Useful  but  dangerous 
Turkish  Baths,  1, 3 
Warm  Baths,  3 

Psoriasis. 

Aconite 

Alkaline  Baths,  1 

Ammonium  Carbonate,  1 

Ammonium  Chloride 

Arsenic,  1, 2,  3,  i 

Baths.   Alkaline,  to  remove  scales 

Berberine 

bleeding,  1 

Cajeput  Oil,  4 

Calomel,  1,  3.    Locally  as  ointment 

CaNTH ABIDES,  3 

Carbolic  Acid,  1,  3 

Carbonic  Acid 

Chlordde  op  Lime,  1 

Chromic  Aero.    10  grs.  to  the  ounce  in  psoriasis 
of  tongue 

Chrysophanic  Actd,  1, 4 

Cod-Ltver  On,  1,  2 

Copaiba,  1 

Copper  Sulphate,  3 

Corrosive  Sublimate, Bath,  1 

Creasote  Baths,  1 

Electricity,    1.     Constant    current    rapidly 
applied 

Pats  and  Oils,  3 

Galium,  1 

Glycerine,  4     , 

Glycerols  of  Lead,  1 

Guano,  Urate  of  Ammonium  Baths,  1 

Hepar  Sulphuris 

Hydrochloric  Acid,  1 

India-rubber  S.olution,  1 

Iodine,  4 

Iris 

Lead  Iodide,  I.    Locally 

Liq.  Potass-s:,  1 

Mercury,  1,  3.    Locally  as  ointment 

Mezereon 

Nitric    and    Nitro-Hydrochloric     Acids. 
When  eruption  is  symptomatic  of  indigestion 
Phosphorus,  1,  2, 4.    As  substitute  for  arsenic 
Pitch,  1 

Potassium  Acetate,  1 
Potassium  Iodide,  I 
Pyrogallic  Actd,  1 
Salicylic  Aero,  1 
Sapo  Laricis,  1 

Silver  Nitrate,  1,  2,  3.    In  psoriasis  of  tongue 
Soap,  3 

Sodium  Arseniatb,  1 
Sulphides,  3 

Sulphur,  1,  3.    Internally 
Sulphur  Baths,  2 

Sulphur  Iodtoe.    Internally  and  externally 
Tar,  3.    As  ointment 

TEREBINTHmS  OL.,  I 


Psoriasis. 

Thymol,! 
Turkish  Baths,  3 
Ulmus,  1 
Vaseline 
Warm  Baths,  3 

Ptosis. 

Arseniate  of  Sodium 

Ergot 

Salicylic  Aero 

Tr.  Iodl  1 

Veratbine.    Locally  to  the  eyelids  and  temples 

Zinc  Chloride 

Pttalism. 

Acids.    In  small  doses  Internally  and  as  gargles 

Alcohol.    Dilute  as  gargle  ' 

Atropine.    Hypodermically 

Belladonna,  1, 2, 4.   Very  useful 

Brandy,2 

Calabar  Bean,  1 

Chlorate  of  Potassium,  1.   As  gargle 

Chlorhje  of  Zinc,  1 

Iodide  of  Potassium 

looms.    As  gargle,  1  of  tincture  to  30  of  water 

Opium,  4 

Purgatives,  1 

Sulphur,  1 

Tannin,  2 

Vegetable  Astringents,  2 

Puerperal  Convulsions. 

Aconite.    In  small  doses  frequently 

Anesthetics,  4 

Belladonna.    Useful 

Benzoic  Acid,  1 

Bleeding,  2 

Bromide  of  Potassium,  1, 3 


Camphor,  4 

Chloral,  1,  2,  3,  4.    In  full  doses 

Chloroform,  1,  2,  3,  4.    By  inhalation 

Cold  to  Abdomen,  1 

Dry  Cupping  over  Loins 

Ether,  1 

Ice.    To  head 

Morphine,  2,  3.    Hypodermically  very  useful 

Mustard.    To  feet 

Nitrite  of  Amyl,  2, 4.    Of  doubtful  utility 

NlTRO-GLYCERIN,  4 

Ol.  Crotonis,  1 
Pilocarpine,  1 

Veratrum  Vuude,  1.    Pushed  to  nausea  very 
useful 

Puerperal  Fever. 

ACID,  SALICYLIC)  2 

Aconite,  1.    Useful  at  commencement 

Alkaline  Sulphates.    In  early  stages 

Ammonia  Liq.,  1 

Amyl  Sol.  of  Iodine,  1 

Blisters,  1 

Borax,  4 

Calumba.    As  tincture 

Camphor,  1 

Carbolic  Aero,  1, 2 

Chloroform,  1 

Creasote  Oil,  I 

Digitalis,  4 

Emetics,  1 

Ergot,  1 

Hydrargyrum,  1.  The  snbchloride  or  bichloride 

Ice,  1 

Iodine,  1 

Ipecacuanha,  1 


1224 


INDEX  OF  DISEASES  AND  EEMEDIE3. 


Puerperal  Fever. 


PURPIJRA. 


Opium,  1,  2.     For  wakefulness   and  delirium 

very  useful 
Permanganate  of  Potassium,  2 
Plumbi  Acetas,  1 
Potassium  Oxalate,  1 
Purgatives,  1 
Quincne,  1,  2.    In  large  doseB 
Hesorcin,  2 
Sodium  Benzoate,  1 
Sodium  Sulphite,  1 
Stimulants,  1 

Stramonium.    "With  cerebral  excitement 
Tr.  Ferri  Perchloridi,  1 
Turpentine,  1,  2,  3,  4.    With  much  vascular 

depression  and  tympanites 
Venesection,  1 
Veratrum  Viride,  1 
"Warburg's  Drops,  I 

Puerperal  Mania. 

Aconite.    "With  much  fever 

Anaesthetics,  2.    During  paroxysm 

Bromide  of  Potassium,  2,  S 

Bromides,  2 

Camphor,  1 

Chalybeates,  2 

Chloral,  1,  2,  3 

Chloroform,  1 

Cimicifuga.    "Useful  in  hypochondriasis 

Duboisine,  2 

Hyoscyamus,  2.    In  mild  cases 

Iron.    In  anemia 

Morphine,  2, 3 

Opium,  I 

Poultices 

Quinine,  2.    "When  much  siclmess 

Stramonium.     When    delirium    furious    hut 

intermittent,  or   suicidal,  or  when  impulse 

to  destroy  child 
Tartar  Emetic,  1,  2, 3.    Frequently  repeated 

Puerperal  Peritonitis. 

Aconite.    At  commencement 

Antimony,  3 

Chlorine  Solution,  3 

Cimicifuga.    In  rheumatic  cases 

Heat  to  Abdomen,  2 

Ice  to  Abdomen,  2 

Laxatives.'    Useful  combined  with  Dover's 

powder  and  hyoscyamus 
Mercury,.  4 
Opium,  2.    Very  useful 
Quinine,  2.    In  large  doses 
Turpentine,  2.    As  stimulant,  10  m.  frequently 

repeated 


Purpura. 


Agrimonia,  1 

Alum.    Locally  with  brandy 

Arsenoc,.3 

Digitals,  2 

Electricity,  1 

Ergot.    Very  useful 

Gallic  Acid 

Iron.    Internally 

Lead  Acetate,  2 

Lime  Juice,  1 

Malt,  1 

Milk,  1 

Molasses,  1 

Nitrate'  of  Potassium 

Nux  Vomica 

Phosphates,  1 

Potassium  Binoxalate,  1 

Potassium  Chlorate,  X 

Potassium  Citrate,  1 

Quinine 


Sulphuric  Acid,  2 
Tannic  Acid 
Tr.  Laricis,  1 
Turpentine,  1, 2,  3,  4 


Pyaemia. 


Alcohol,  4 

Alkalies,  1 

Ammonium  Carbonate,  3 

Bleeding,  1 

Boric  Acid 

Ergotin,  1 

Eerri  Perchloridum,  1, 4 

Iodine,  1 

Jaborandl.  I 

Malt  Liquor,  2 

Oil  of  Cloves.    Locally 

Permanganate  of  Potassium,  3.   Internally 

Quinine,  1,  2,  3, 4.    In  large  doses 

Kesorcin,  2 

Salicln,  3 

Salicylic  Acid,  2 

Tannin,  1 

Turpentine.    As  stimulant 

Pyelonephritis. 

Canthabtdes,  2 

Erigeron,  2 

Eucalyptus,  2 

Gallic  Acid,  2 

Hydrastis 

Pipsissewa  (Ciiimaphila),  2 

Turpentine,  2 


Pyrosis. 


Bismuth,  3, 4 
Camphor,  1 
Carbolic  Acid 
Creasote 
Gallic  Acid,  1 
Glycerine,  1 
Lead,  3 

Manganese  Oxide,  3,  4 
Mineral  Acids 
Nitrate  of  Sllver,  4 
Nitric  Acid,  3 
Nux  Vomica 
Oxide  of  Silver,  4 
Pulvis  Kino  Composites,  1 
Strychnine,  1 
Sulphuric  Acid,  1,  3 

Relapsing  Fever. 

Laxatives 


Leeches. 
Quinine 


As  cupping  for  headache 


Remittent  Fever. 


Aconite 

Arsenic,  4 

Eenzoates,  3 

Cold  Affusion,  1 

Emetics 

Qelsbmium.    In  bilious  remittents 

Hyposulphites,  1 

Ipecacuanha,  4 

IrtvnrasTom's  Pills,  1 

Morphine.    Hypodermicajly 

Myrrh,  1 

Nitric  Acid,  1 

Packing.    Useful 

Quinine.    20-30  gr.  for  a  dose,  once  or  twice 

daily 
Besorcin,  2 


INDEX  OF  DISEASES  AND  EEMEDIES. 


1225 


Remittent  Fevee. 

Salicylic  Acid,  2 
Silvek  Nitrate,  1 
Sodium  Chloride,  1 
Turpentine,  1 
Warburg's  Tincture,  4 

Renal  Calculi,  vide  Calculi. 
Rheumatic  Aetheitis. 

Aconite.    Locally 

Actaa  Eacemosa,  3 

Arnica.    Internally  and  externally 

Arsenic,  1,2,3,4 

Buckeye,  1 

Chaulmoogra  Oil,  1 

Cimicifuga.    When  pains  are  nocturnal 

Cod-Liver  Oil,  2,  3 

Colchicum,  2 

Cold  Douche,  3 

Electricity,  1 

Guaiacum 

Iodide  of  Potassium,  3, 4 

Iodides,  2 

Iodine,  1,  3.    Internally  as  tonio 

Iodoform,  1 

Lithium,  2.    Internally  and  locally 

Morphine,  1 

Potassium  Bromide,  3.     Sometimes  relieves 

pain 
Quinine,  1 

Quinine  Salicylate,  I 
Sodium  Salicylate,  u. 
Stimulants,  1 
Strychnine,  1 
Sulphides,  3 
Sulphur 
Turkish  Bath,  1,  3  ' 

Rheumatism,  Acute. 

Acid  Steam  Bath,  3 

Aconite,  1, 2,  3,  4 

ACTiEA  Racemosa,  1, 3 

Acupuncture,  3 

Alcohol,  4 

Alkalies,  1, 2 

Amber,  Oil  of,  4 

Ammonium  Bromide,  2, 4 

Antimony,  1 

Aquapuncture,  1 

Arnica,  2 

Arsenic,  4 

Belladonna,  1 

Benzoates,  2 

Benzoic  Aero,  3      '    ■ 

Bicarbonate  and  Citrate  of  Potassium,  3 

Blisters,  1,  2,  3.    Yery  efficient  around  joints, 

near  to  cardiac  region 
Bryonia 

Burgundy  Pitch,  4 
Cajeput  Oil,  4 
Carbolic  Acid,  1, 4 
Chloroform,  4 
cimicifuga,  4 
Citric  Acid,  1 
Cod-Liver  Oil,  4 
,    Colchicum,  1,  4 
Cold  Baths,  1, 2,  3 
Conium,  3, 4 
Cikasote,  1 
Digitalis 

Donovan's  Solution,  4 
Dover's  Powder,  4 

Dulcamara.   In  persons  liable  to  catarrh 
Faradisation,  1 
Fraxbtus  Polygamia,  1 
Guaiacum,  i 
h  orse  Chestnut  Oil,  1 


Rheumatism,  Acute. 


Hot  Pack,  1 

Iodine,  4 

Iodoform,  4 

Iron, 2 

Jaborandl,  4 

Leeches,  1 

Lemon  Juice,  1, 2 

Lime  Juice,  3 

Lithium  Bromide,  2.  Especially  when  Insomnia 

and  delirium  present 
Magnesia,  4 
Manaca,  1 
Mercury,  1, 4 
Mineral  Acids,  1,  2 
Mineral  Baths,  1 
Mustard  Plasters,  1 
Opium,  1, 3, 4.  1  gr.  every  2  or  3  hours,  especially 

when  cardiac  inflammation 
Packing,  3 
Pellttory,  4 

Permanganate  of  Potassium,  1 
Potassium  Acetate,  1 
Potassium  Ioddde  and  Opium,  1 
Potassium  Nitrate,  1,  3, 4 
Poultices,  3 
Propylamine,  1 

Quinine,  1,  3, 4.    As  antipyretio 

Rhus  Toxicodendron.    Exceedingly  useful  in 
after-stage  and  subacute  forms 

Salicin,  1, 2,  3 

Salicylate  of  Sodium,  1,  3.     Relieves  pain 
most  quickly 

Salicylates,  1, 2 

Scudamore's  Mixture,  4.    Contains  colchicum 
wine,  magnesia,  and  sulphate  of  magnesium 

Sodium  Bbnzoate,  1 

Spigelia  Anthelmintica.    In  pericarditis  and 
shifting  inflammation  of  joints 

Spiraea  TJlmaria,  1 

Steam  Bath,  1 

Stimulants,  1 

Sulphur,  4 

Sulphurated  Potash,  4 

Sulphurous  Acid,  1, 3.    Eumigative 

Tr.  Ferri,  1 

Trimethylamlne,  1, 2 

Turkish  Bath,  3 

Veratrine,  1,  3, 4 

Teratrum  Viride,  1,  3 

Zinc  Cyanide,  1 

Zinc  Oxide,  1 

Rheumatism,  Cheonic. 

Aconite,  1 
Act^a  Eacemosa,  3 
Acupuncture,  1 
Alkaline  Baths,  1 
Alkaline  Mineral  Waters,  2 
Ammonium  Chloride,  1 
Ammonium  Phosphate,  1 
Arnica 
Arsenic,  1 
Atropine,  1 
Belladonna 
Blistering,  3 
Bryonia 

Burgundy  Pitch.    As  plaster  locally 
Cajjsput  Oil.    Internally  and  externally 
Capsicum,  3 
Carbonic  Aero,  3 
,    Chaulmoogra  Ori,  1 
Chimaphila 
Chloral,  3 
Cimicifuga,  2 

Cod-Liver  Oil,  2,  3,    Internally  and  locally 
Colchicine,  1 
Colchicum,  2 
Cold  Douche,  3 
Dulcamara 
Faradisation^  1 


1226 


INDEX  OF  D.'SEASES  AND  EEMEDIES. 


Eheumatism,  Chkojstic. 


Galvanism,  3 
guaiacum,  1,  2 

GUARANA,  1 

Ice  and  Salt,  3 

Iodide  of  Potassium,  1,  3.     Especially  when 

pain  worst  at  night 
Iodides,  2 

Iodine,  1,  3.    Locally 
Lamp  Black,  3 
Lithium   Bromide,  2.     When   smaller   joints 

affected 
Lupulin 

Manganese  Sulphate,  2 
Massage,  1 

Mercury  and  Morphine,  3,    Oleate  locally 
Mezereon,  3 
Packing,  3 
Phytolacca 
Pdse  Leaf  Baths,  1 
Potassio-Tartrate  of  Ikon,  X 
Potassium  Niteate,  3 
Poultices,  3 
Propylamine,  1 
QumiNa.     When    ranch   debility    and  night 


Quinine  Salicylate,  1 

Rhus  Toxicodendron,   Internally  and  locally 

Salicylic  Acid,  2 

Sodium  Salicylate,  1 

Stramonium,  1 

Sulphur,  1,  2,  3.    Locally,  and  as  sulphides  or 

sulphur  waters  internally 
Thuja  Occidentalis, 
Turkish  Baths,  2,  3 
Veratrine,  3 
Xanthoxylum,  2 

ElCKETS. 

Calcium  Phosphate,  3.    If  child  is  suckling  it 

may  be  given  to  nurse 
Cod-Liver  Oil,  2,  3, 4 
Cold  Sponging, 3 
Ferric  Iodide 
Gallic  Aero,  1 
Iron,  2, 3 
Lime,  1,  3 

Nitro-Hydrochlork!  Acid  Baths,  1 
Phosphates,  2 
Phosphorus,  2,  4 
Quran™, 
Sarsafarilla,  1 
Sugar,! 


Sakcin^:. 


Calcium  Chloride,  1 

Carbolic  Aero,  I 

Creasote,  1 

Gastric  Syphon.    To  wash  out  stomach 

Sulphites,  1,  3 

Sulphuric  Acid 

Wood  Spirit,  I 


Scabies. 


Alkalies,  3 

Anise.    As  ointment 

Arsenic,  1 

Baking  of  clothes  to  destroy  ova 

Balsam  of  Peru,  1.    Locally,  agreeable  and 

effective 
Benzoic  Acid.    As  ointment  or  lotion 
Cajeput  Oil,  2 

Carbolic  Aero,  1, 2.    Dangerous 
Chloroform,  1 
Chrisma,  1 

Coal  Tar  Naphtha,  1 
Cocculus  iNDicns.    As  ointment 
Copaiba,  1 


Scabies. 

Copper  Sulphate,  2 

Corrosive  Sublimate,  2 

Glycerine,  1, 4 

Iodine,  1 

fftwu.i,  1.    As  ointment 

Liq.  Potass^,  1 

Manganese,  2  . 

Mercury.    White  precipitate  ointment 

Oil.    Inunction 

Petroleum,  1 

Phosphoretted  Oil,  1 

Potassium  Ioddde,  3 

Soft  Soaf 

Stavesacbe,  1.    As  ointment 

Storax,  1,  3.    With  almond  oil,  when  skin 

cannot  bear  sulphur 
Sulphide  of  Calcium 
Sulphides,  2 
Sulphites,  2 

Sulphur,  1,  3.    As  ointment 
Sulphur  and  Lime,  3 
Sulphur  Baths,  2 

Sulphuric  Acid,  3.    Internally  as  adjuvant 
Sulphurous  Acid,  3 
Tar.    Ointment 
Yaseltne 


Scaelej  -Fever. 


Aero,  Acetic,  1 

Aero,  Nitric,  1, 3 

Aconite,  2, 3, 4 

Ammonium  Benzoatb,  1 

AImyl  Hydride,  1 

Arsenic,  3.  If  tongue  remains  red  and  irritable 
during  convalescence 

Belladonna,  1, 2,  3, 4 

Benzoate  of  Sodium,  2 

Bromine,  1 

Carbolic  Acid,  1, 2.    As  gargle 

Carbonate  of  Ammonium,  1,  2, 3.  Greatly  re- 
commended in  frequent  doses  given  in  milk 
or  cinnamon  water 

Chloral,  1 

Chlorine  Water,  1, 2,  3.    As  gargle 

Cold  Compress,  3.    To  throat 

Cold  Affusion,  1, 3,  i 

Copaiba,  I 

Digitalis,  1, 2 

Fat,  2, 3.  As  inunction  to  hands  and  feet  during 
the  rash,  and  over  the  whole  body  during 
desquamation 

Ferric  Perchlortde.  In  advanced  stage  with 
albuminuria  and  hematuria,  very  useful 

Hot  Bath,  1 

Hot  Packtng,  1 

Hydrochloric  Aero,  1, 2 

Ice,  3.    To  suck,  especially  at  commencement 

Ice  Poultice,  3 

Iodine,  I 

Juniper  Oil,  3.    As  diuretic  when  dropsy  occurs 

Mercury,  1,  3.  £  of  a  gr.  of  grey  powder  every 
hour  to  lessen  inflammation  of  tonsils 

Mineral  Acrns.    Internally,  and  as  gargle 

Mustard  Bath,  i.    When  rash  recedes 

Packing,  3.    Useful  and  comforting 

Potassium  Chlorate,  1, 4 

Potassium  Ioddde,  1 

Potassium  Permanganate,  3.  As  gargle  to 
throat 

Purgatives.  Most  useful  to  prevent  albu- 
minuria 4 

QUTNTNE,  1,  2,  i 
BESORCrN,  2 

Rhus  Toxicodendron- 
Salicylate  of  Sodium.    As  antipyretic 
Salicylic  Acid,  1 , 2, 3 
Strychnine,  3.    Hypodermically  in  paralysis 
Sulphate  of  Magnesium,  3 
Sulphur,  1 


INDEX  OF  DISEASES  AND  REMEDIES. 


1227 


Scarlet  Fever. 

Sulphurous  Aero,  1, 3.    Inhalation  when  throat 

much  affected 
Tb.  Ferri,  1 
Vkratrum  YmiDE,  3 
Water,  2 

Sciatica. 

Acid,  Sulphuric,  1 

Aconite,  3.    As  ointment  or  liniment 

act.ba  hacemosa,  3 

Acupuncture,  2, 3 

Aquapuncture,  1, 2 

Atropine,  1, 2,  3 

Belladonna,  3 

Blisters 

Cautery,  1.  Exceedingly  useful,  slight  appli- 
cation of  Paquelin's  theraio-cautery 

Chloride  of  Ammonium,  1, 3 

Chloral,  1 

Chloroform,  1,  2,  3.  Locally  as  liniment, 
inhalation  when  pain  excessive 

Cod-Liver  Oil,  4 

Conium,  4 

Copaiba  Resin,  1 

Counter-irritation,  3 

Oroton  Oil,  1,  3.    Internally  as  purgative 

Electricity,  4 

Ether,  1,  3.    As  spray 

Galvanism 

Gelsemium,  1 

Guaiacum,  1, 2 

Iod  cde  of  Potassium,  1, 3, 4 

Iodides,  2 

Menthol,  1 

Morphine,  1, 2,  3.    Hypodermically  most  useful 

Phosphorus,  1 

Plasters,  1 

Poultices,  3 

Salicylic  Acid,  2 

Salicylate  of  Sodium,  1, 3 

Sand  Bath 

Skcale,  1 

SH.VER  Nitrate,  1, 2 

Stramonium.  Internally,  pushed  until  phy- 
siological action'  appears 

Sulphur,  1,  3,  4.  Tied  on  witn  flannel  over 
painful  spot 

Turkish  Bath,  3 

Turpentine,  1,  2, 3.  In  ^  oz.  doses  internally  for 
three  or  four  nights  successively 

Vebatrine,  3.    As  ointment 

Scrofula. 

Acacia  Charcoal,  I 

Acid,  Phosphoric,  4 

Alcohol,  4 

Arsenic,  1 

Barium  Chloride,  1 

Blisters,  3.    To  enlarged  glands 

Calcium  Phosphate,  3 

Calomel,  3 

Chalybeate  Waters,  2 

Chloride  of  Calcium,  3 

Cod-Liver  On,,  2,  3, 4.    Exceedingly  serviceable 

Fats,  1.    Inunction 

Galium  Apardxum,  1 

Gold  Salts,  1 

Iodides,  2 

Iodide  of  Iron,  3, 4 

Iodine,  3, 4.    Locally  to'  glands,  and  internally 

Iron,  2,  3 

Milk  and  Lime  Water,  1 

Peroxide  of  Hydrogen,  1 

Pipsissewa,  4 

Phosphates,  2, 4 

Potassium  Chlorate,  I 

SANQUUfARIA,  2 

Sarsaparilla,  2  4 


Scrofula. 


Soft  Soap,  3 
still1xgi a,  2 
Sulphides,  1, 3 
Walnut  Leaves,  1 


Scurvy. 


Acids.  As  preventive  in.  the  absence  of  lime- 
juice 

Aconite.  In  acute  stomatitis  with  salivation 
in  scorbutic  conditions 

Agrihonia,  1,  Useful  in  the  absence  of  other 
remedies 

Alcohol.    Diluted  as  gargle 

Alum.    Locally  with  myrrh  for  ulcerated  gums 

Ammonium  Carbonate.   In  scorbutic  diathesis 

Arsenic.    In  some  scorbutic  symptoms 

Atropine.    Hypodermically  when  salivation 

Cinchona.  As  decoction,  alone  or  diluted  with 
myrrh  as  gargle 

Citric  Acid.   As  substitute  for  lime-juice 

Ergot,  1 

Ergotln,  Hypodermic  Injection  of,  or  Ergot 
by  mouth  to  restrain  the  haemorrhage 

Ff.rri  Arsenias,  1.  As  a  tonic  where  other 
remedies  have  failed 

Ferri  Perchloridi,  Tlnctura,  1.  To  restrain 
haemorrhage 

Laricis,  Tlnctura,  1.  Like  Ferri  Perchlor., 
Tinct. 

Lemon  Juice,  4.  Exceedingly  useful  as  preven- 
tive and  curative 

Liberal  Diet  often  sufficient 

Liquor  SoD.fi  Chlorinate.    Locally  to  gums 

Malt,  1.    An  antiscorbutic 

Oranges.    Useful 

Phosphates,  1.    Non-assimilation  a  cause 

Potassium  Binoxalate.  In  doses  of  4  grains 
three  times  a  day ;  if  not  obtainable  sorrel  is 
useful  instead 

Potassium  Citrate,  1.  Substitute  for  lime- 
juice 

Quinine.    With  mineral  acids  internally 

Silver  Nitrate 

Tartar  Emetic 

Vegetable  Charcoal.  As  tooth-powder  to 
remove  fetid  odour 

Vinegar.  Very  inferior  substitute  for  lime- 
juice 


Sea-Sickness. 


Asm.  Nitrite,  1.  A  few  drops  on  handkerchief 
inhaled ;  the  handkerchief  must  be  held  close 
to  the  mouth 

Atropine,  3.    t&5  gr.  hypodermioally 

Belladonna,  l.    Like  Atropine 

Bitters,  2.    Calumba,  &c. 

Caffeine  Citrate,  1.    For  the  headache 

Cannabis  Indica,  1.  J-i  gr.  of  the  extract  to 
relieve  headache 

Capsicum,  1. 

Champagne,  Iced,  1.  Small  doses  frequently 
repeated 

Chloral,  2,  3.  15  to  30  grs.  every  four  hours 
most  useful ;  should  be  given  before  nausea 
sets  in ;  the  combination  with  Potassium 
Bromide  taken  with  effervescing  Citrate  o£ 
Magnesia  is  very  good 

Chloroform,  2,  3.    Pure,  2-5  min.  on  sugar 

Chloric  Ether.    Stomachic  tonic 

Cocaine,  1.  Infusion  of  Coca  leaves  quickly 
relieves 

Counter-irritation.  Mustard  plaster  or  leaf 
to  epigastrium 

Creasote,  1 

Hydrocyanic  Aero,  1 

Hyoscyamtne,  1,  3.  fa  gr.  with  the  same  quan- 
tity of  strychnine 

Ice,  1.   To  spine 


1228 


INDEX  OF  DISEASES  AND  REMEDIES. 


Sea-Sickness. 


Sneezing. 


Magnetic  Belt,  1. 

Morphine,  2.    Hypodermically 

Nitro-glycerin,  2.  Same  action  as  Nitrite  of 
Amyl 

Nitro-Hydrochloric  Acid,  1.  Formula :  Acidi 
nitro-hj  drochlorici,  3iij-,  Acidi  hydrocyanici 
dil.,  *ss.,  Magnesii  sulphatis,  3ij.,  Aq„  Sviij. 
'ij.  ter  die  sumenda 

Nux  Vomica,  2.  When  indigestion  with  con- 
stipation 

Potassium  Bromide,  1.  Should  be  given  several 
days  before  voyage  is  begun 

St.  Etienne  Arsenical  Waters,  1. 

Salt  and  Warm  Water,  1. 

Sodium  Bromide.    Like  Potassium  Salt 


Seborrhea. 


Borax,  4.  With  glycerine  and  lead  acetate,  as  a 

local  application 
Glycerine 
Iodine 
Lead  Acetate.    With  borax  and  .glycerine,  as 

above 
Liquor  Potass.^:,  2.  Locally  applied  to  hardened 

secretion 
Sodium  Chloride 
Zinc  Oxide,  2.    In  inflammation  the  following 

formula  is  useful  :  R,  Zinci  oxidi,  -  j. ;  Piumbi 

carbonat.  3j. ;  Cetacei,  Sj. ;  01.  olivas,  q..s,;  ft. 

ung. 

Sexual  Excitement. 

Camphor,  3, 4.    Will  often  control 

Digitalis,  1.    Anaphrodisiac ;  also  diminishes 

quantity  of  seminal  fluid 
Lupulus"Humulus,  4.    In  large  doses 
Opium,  1.    Anaphrodisiac 
Potassium  Bromide,  4.    The  most  generally 

useful 
Stramonium,  1.   3n.  nymphomania,  or  epilepsy 

due  to  sexual  excitement 


Sleeplessness. 


Alcohol,  3.    With  care  in  febrile  disorders 

Butyl-Chloral.    Like  Chloral 

Cannabis  Indica.  Instead,  of  opium,  when  the 
latter  does  not  agree 

Chloral  Hydrate,  3.  In  the  high  tension  of 
Bright's  disease  ;  in  delirium  tremens,  acute 
mania,  and  puerperal  -convulsions ;  contra- 
indicated  by  weak  heart 

Codeine,  3,.    A  pure  narcotic 

Digitalis,  3.  In  want  of  arterial  tone,  marked 
by  blood  rushing  to  the  head  when  the  person 
lies  down 

Ether,  4.    In  full  dose 

G.KL8EMIUM,  2.  Jn  mania  with  motor  excite- 
ment 

Cold  Sponging  either  of  the  whole  body  or 
feet  only,  followed  by  brisk  rubbing 

Hyoscyamine,  3.    Sleeplessness  of  acute  mania 

Hop  Pillow 

Hypnone 

Lettuce.    A  supper  of  lettuce  and  ale 

Opium,  3, 4.    In  acute  disease 

Potassium  Bromide,  3, 4.  In  over-work  of  any 
description ;  in  alcoholic  mania 

Phosphorus,  2.  Well  combined  with  chloral 
in  cerebral  anaemia  and  in  the  aged 

TXrethane.    Like  Chloral 

Warm  Bath,  3.    Or  warm  sponging 

Wet  Pack.    Like  the-preceding  in  fever 


Sneezing. 


Camphor,  3.  As  powder,  or  strong  tincture  in- 
haled in  commencing  catarrh 

Chamomile  Flowers,  1.    In  nares 

Cotton  Plug.    In  nares 

G-ELSEMniM.  In  excessive  morning  sneezings 
with  discharge 

Iodine.    Inhalation 

Mercury.  Heaviness  of  head  and.  pain  in  limbs 

Potassium  Iodide,  3.  10-gr.  doses  frequently 
repeated 

Pressure  beneath  Nose,  over  the  termination 
of  the  nasal  branch  of  the  ophthalmic  division 
of  the  fifth 


Somnambulism. 


rARSENic,  3.    In  .paroxysmal  sneezing,  such  as 

usually  ushers  in  hay  fever 
Belladonna,  1 


Optum 

Potassium  Bromide.    In  all  cases  of  children 
and  adults 

Spasmodic  Affections. 

Aconite,  3,  4.    Externally  and  internally ;  it 

subdues  motor  spasm,  and  the  spasms  of  dys- 

pncea  in  spasmodic  asthma  of  children 
Alcohol.     In   the  dyspnoea  of    fever    with 

caution,  and  in  flatulent  distension 
Ammonia,  3.    In  syncope,  and  in  the  intestinal 

colic  of  children 
Ammoniacum.    In  hysteria 
Amyl  Nitrite.    In  spasm  of  the  arterioles 
Anesthetics.    To  reduce  muscular  spasm 
Arsenic.    Nervine  tonic  in  hysteria,  epilepsy, 

(Sec. 
Asafostida,  4.     Carminative,  and  to  relieve 

functional  spasm 
Atropdte,  3, 4.    Internally,  to  relieve  spasm  of 

involuntary  muscular  fibre ;  hypodermically, 

local  spasm 
Cajeput,  Oil  of,  4.    In  intestinal  colic 
Camphor,     Nervine,   vaso-motor,  respiratory 

stimulant 
Cardamoms.    Carminative 
Chamomile,  Oil  of.    Migraine 
Chloroform,  In  small  doses  to  co-ordinate ;  in 

large  doses  it  paralyses  muscular  movements 
Cimicifuga.     Congestive  dysmenorrhcea ;  and 

in  acute  bronchitis 
Cocalne,  4.    Cerebral  stimulant 
Conium,  1.    To  relieve  clonic  muscular  spasm 
Copper.    Nervine  tonic  in  chorea,  &c. 
Electricity 

Ether.    Like  alcohol  and  chloroform 
Gelsemium,  2.    In  hypereesthesia   and  motor 

excitement 
Grindelia,  2.    In   spasm   due  to  respiratory 

neurosis 
Hot  Sand,  3.    Locally,  in  painful  spasm,  such 

as  intestinal  colic 
Hyoscyamus,  1.    In  pain  about  the  bladder 
Ice,  1.    To  spine 
Ipecacuanha,  2.    In  laryngismus  stridulus,  in 

an  emetic  dose 
Lactucarium,  4.    Cerebral  sedative 
Lead  Salts  probably  have  an  action  on  the 

spinal  cord 
Leeches.    By  counter-irritation 
Lobelia.    In  spasm  of  the  respiratory  organs 
Local  Pressure,  1.    On  a  particular  point,  to 

be  found  for  each  case 
Lupuline,  2.    Cerebral  sedative 
Musk,  4.    A  mild  nervine -stimulant 
Nitroglycerin,  1.    Like  Amyl  nitrite 
Nux  Vomica.    Nervine  tonic 
Opium,  2,  3, 4.    Central  sedative,  both  for  motor 

and  sensory  nerves 
Oxygen,  1.    Heated  and  mixed  with  nitrite  of 

amyl  in  spasmodic  asthma 
Physostigmink.    To  paralyse  muscular  fibre 
Potassium  Bromide,  1.    Sedative  to  the  cen- 
tral nervous  system 


INDEX  OF  DISEASES  AND  EEMEDIES. 


1229 


Spasmodic  Affections. 


Poultices,  Mustard;    Counter-irritant 

Silver  Nitrate.  Tonic  in  epilepsy  and  chorea, 
laryngismus  stridulus,  &o. 

Strychnine.    Nervine  tonic 

Sulpho-carbolates,  3.    In  flatulent '  spasms ' 

Sumbul.  In  nervousness  and  hysterical  sym- 
ptoms, both  in  men  and  women 

Tobacco,  3.  Believes  spasm  by  its  prostrating 
effect 

"Valerian,  4,    In  hysteria 

Veratrine.  Prolongs  the  systole  of  the  heart 
and  muscular  fibre 

Veratrum  Viride.  Controls  and  depresses  the 
vaso-motor  system 

"Warmth  to  abdomen  to  allay  cramp  and  con- 
vert into  peristalsis 

Zinc  Salts.    Like  copper  and  silver 


Spermatorrhoea. 

Arsenic,  2.  In  functional  impotence;  best 
combined  with  iron  as  the  arseniate,  and  with 
ergot 

Belladonna,  2,  3.  In  relaxation  of  the  genital 
organs  where  there  is  no  dream  nor  orgasm ; 
one-fourth  grain  of  extract,  and  a  grain  and  a 
half  of  zinc  sulphate 

Bladder  to  be  emptied  as  soon  as  patient 
awakes 

Bromide  of  Potassium,  2.  When  it  is  physio- 
logical in  a  plethoric  patient,  not  when  geni- 
talia are  relaxed 

Calomel,  1.    Ointment  applied"  to  urethra 

Camphor  Bromede,  2,  4.  ,  Or  camphor  alone  ; 
diminishes  venereal  excitement 

Canthabides,  2,  3.  In  cases  of  deficient  tone 
either  from  old  age,  excess,  or  abuse ;  should 
be  combined  with  iron 

Chloral,  4.    To  arrest  nocturnal  emissions 

&M1CD7UGA,  2.  Where  emission  takes  place  on 
the  least  excitement 

Cold  Douching  and  Sponging,  2 

Digitalis,  2,  3.  In  frequent  emissions  with 
languid  circulation;  with  bromide  in  ple- 
thoric subjects 

Electricity 

Ergot,  2.    Deficient  tone  in  the  genital  organs 

Gold  Chloride,  2.    To  increase  venereal  desire 

Hydrastis,  2.    Local  application  to  urethra 

Hypo  phosphites,  3.    Nervine  tonic 

Iron.    Where  there  is  anaemia  only 

Lupulin,  2.  Oleoresin,  to  diminish  nocturnal 
emissions 

Nitrate  of  Silver,  2.  Vesication  by  it  of  the 
perineum ;  and  local  application  to  the  pro- 
static portion  of  the  urethra 

Nux  Vomica,  2.    Nervine  tonic  and  stimulant 

Phosphorus,  3.  In  physical  and  mental  de- 
bility 

Quinlve.    As  a  general  tonic 

Spinal  Ice-bag,  3 

Sulphur.  As  a  laxative,  especially  if  sequent 
to  rectal  or  anal  trouble 

Turpentine,  4.  In  spermatorrhoea  with  im- 
potence 

Zinc  Oxide,  1 


Spina  Bifida 


Calcium  Phosphate 

Collodion.    As  means  of  compression 

Cotton  Wool  over  tumour 

Glycerine.    Injection  after  tapping 

Iodine,  Injections ;  formula  for  injection  : 
Iodine,  gr.x. ;  Potassium  Iodide,  gr.xxx. ;  Gly- 
cerin, ?j. 

Potassium  Iodide 

Tappixg,  followed  by  compression. 


Spinal  Concussion. 

Arnica 

Bleeding.    To  relieve  heart 

Lead  Water  and  Opium.    As  lotion 

Leeches 

Vinegar.    To  restore  consciousness 

Spinal  Congestion. 

Aconite 

Antiphlogistic  treatment 

Cold  Affusions.    To  spine 

Ergot,  4.    In  large  doses 

Gelsemhtm 

Nux  Vomica 

Turpentine 

Wet  Cupping 

Spinal  Irritation. 

Aconite  Ointment,  3.   Locally 

Arsenic 

Atropine 

Belladonna,  3.   Gives  way  to  this  more  readily 

than  to  aconite 
Blisters.    To  spine 

ClMICBJUGA 

Cocculus  Indicus.    Like  strychnine 

Conium  "• 

Counter-irritation 
.  Digitalis 

Electricity,  2,  4.    Combined  with  massage  and 
rest 

Ergot,  4.    In  spinal  congestion 

Ignatia 

Leeches 

Nux  Vomica 
'  Opium.    In  small  doses 

Phosphoric  Acdd 

Phosphorus 

Picrotoxin 

Potassium  Bromdje,  2.    To  lessen  activity 

Sinapis,  Ltnimentum.    Counter-irritant 

Sodium  Hypophosphite 

Strychnine.    To  stimulate  the  depressed  nerve- 
centres 

Veratrum  Viride 

Spinal  Paralysis  and 

Softening. 

Argentic  Nitrate,  4.  In  chronic  inflammation 

of  the  cord  or  meninges 
Belladonna,  3.    In  chronic  inflammatory  con- 
ditions 
Cod-Liver  Oil,  2.    As  a  general  nutrient 
Electricity,  2,  3.  -Combined  withmassage  and 

rest 
Ergot,  4,    In  hypersemia  of  the  cord 
Hyoscyamus,  2,  3.    In  paralysis  agitans  to  con- ' 

trol  tremors 
Iodide  of  Potassium,  2.    In  syphilitic  history 
Mercury.    Temporarily  cures  in  chronic  in- 
flammation of  the  cord  and  meninges 
Phosphorus,  2.    As  a  nervine  tonic 
Physostigma,  2,  3.    In    a   few"  cases  of  pro- 
1     gressiveparalysisof  the  insane,  in  old-standing 
hemiplegia,  in  paraplegia  due  to  myelitis,  and 
in  progressive  muscular  atrophy  it  has  done 
good  service 
Picrotoxin,  2.    Spinal  stimulant  after  febrile 

symptoms  have  passed  off 
Strychnine,  2,  3, 4.    Like  picrotoxin 


Spinal  Affections. 


Arsenic,  2.    With  quinine  in  malarial  enlarge- 
ment ;  alone  in  simple  eugorged  spleen ;  in 
-  ■  t y pho-malarial    fever ;-  and-  prophylactic   in 
malaria 


1230 


INDEX  OF  DISEASES  AND  KEMEDIES. 


Spinal  Affections. 


Gold  Affusion,  2.  To  reduce  the  engorged 
spleen 

Ergot,  1.  In  relapsing  intermittent  fever  as- 
sociated with  permanently  enlarged  spleen 

Gelsemium,  2.  Beneficial  in  cases  in  which, 
arsenic  is,  but  not  specific 

Graph  Curb 

Hydrastis,  2.    Less  powerful  than  quinine 

Iodine  and  Iodides,  2.  To  promote  absorption 
of  the  enlarged  spleen  in  simple  hypertrophy 

Manganese,  2.    To  remedy  anemia  if  present 

Mercuric  Biniodeoe.  The  ointment  applied 
over  the  splenic  area  rapidly  produces  absorp- 
tion in  simple  enlargement 

Muscarine,  2.    In  vascular  dilatation 

Nitric  Acid,  1.  Long  course  in  syphilitic  and 
cachexia  with  enlargement  of  the  spleen 

Plumbic  Iodide,  2.    Like  mercuric  iodide 
Quinine,  2,  3,  4.    Almost  a  specific  in  the  ma- 
larial enlargement  of  the  spleen 
Resorcin,  2.    Like  and  equal  to  quinine 


Splenic  Affections. 


Aconite 
Ammonium  Iodide 


Sprains. 


Aconite  Lintment.    Well  rubbed  in 
Alcohol.    Methylated  spirit  in  four  of  water 

applied  to  sprain  continuously  and  allowed  to 

evaporate 
Ammonium  Chloride,  1.  Prolonged  application 

of  cold  saturated  lotion 
Arnica.,  3.    Much  vaunted,  little  use 
Bandaging,  1.     To  give  rest  to  the  injured 

ligaments 
Calendula.   As  a  lotion 
Camphor,  4.    A  stimulating  liniment 
Cold  Douche,  1, 3. 
Collodion,  1.    A  thick  coating  to  exert  a  firm 

even  pressure  as  it  dries 
Hot  Fomentations,  1.    Early  applied 
Inunction  of  Olive  Oil,  1.  With  free  rubbing 
Iodine.     To  a  chronic   inflammation  after  a 

sprain 
Lead  Lotions.    Applied  at  once  to  a  sprained 

joint 
On-  of  Bay 
Best 

Ehus  Toxicodendron.    Lotion 
Shampooing.      After  the    inflammation    has 

ceased,  to  break  down  adhesions 
Strapping,  1.    To  give  rest 
Turpentdsb  Liniment.    A  stimulant  applica- 
tion to  be  well  rubbed  in 
Vinegar,  4.    Cooling  lotion 


Sterility. 

Gosstpii  Radix,  4.    In   dysmenorrhea   with 

GujScum,  1.    In  dysmenorrhea  with  sterility 
Intra-uteeine   Stems,   1.    To   stimulate  the 

lining  membrane  of  the  uterus 
Ket-tsI-Ching,  1.     A  Japanese    remedy  for 

female  sterility  .     .  .....      .      .._ 

Phosphorus,  2.     Functional   debility  in  tne 

male 
Potassium  Iodide.    An  emmenagogue 

Stings  and  Bites. 

Aconite 

Alum,  1.    For  scorpion  sting  

Ammonia  and  Alkalies,  3.  In  stings  pf 
insects,  to  neutralise  the  formic  acid ;  and  in 
snake-bite  , 

Aqua  Calcis,  1.    In  stings  of  bees  and  wasps 
Arsenic.    As  a  caustic 
Camphor 

Carbolic  Acdd.    Mosquito-bites  and  scorpion- 
stings 
Chloroform,  1.    On  lint 
Essence  of  Pennyroyal,  1.  Against  mosquitos 
Eucalyptus,  1.    Plant  in  room  to  keep  away 

mosquitos 
Ipecacuanha,  1.    Leaves  as  poultice  for  mos- 
quito and  scorpion  bites 
Mint  Leaves 

Oil  of  Cinnamon.  3j.to  3j.  spermaceti  ointment 
spread  over  hands  and  face  against  mosquitos 
Oil  of  Cloves.    The  same 
Potassa  Fusa.     In  dog-bites  a  most  efficient 

caustic 
Removal  of  Sting 
Rosemary 
Sage 
Silver  Nitrate.  A  caustic,  but  not  sufficiently 

strong  in  dog-bites 
Soap,  1.    To  relieve  itching  of  mosquito-bites 
Stdiulants 
Sugar.    Founded,  in  wasp-stings 


Stammering. 


Hyoscyamus 

Stramonium 

Vocal  Training  the  most  useful 

Sterility. 

Alkaline  Injections,  I.    In  excessively  acid 

secretions  from  the  vagina 
Aurum,  2.     "Where  due  to  chronic   metritis, 

ovarian  torpor  or  coldness  ;  also  in  decline  in 

the  sexual  power  of  the  male 
Borax.    Vaginal  injection  in  acid  secretion 
Cantharideb.    As  a  stimulant  where  there  Is 

impotence  in  either  sex 
Cimicifuga,  2.    In  congestive  dysmenorrhea 
Dilatation  of  Cervix  in  dysmenorrhcea,  in 

pinhole  os  uteri,  and  in  plugging  of  the  cervix 

with  mucus 
Electrical  Stimulation  of  Uterus,  1.    In 

torpor 


Stomatitis. 

Acros,  Mineral,  3.    Nitro-hydrochlorie  acid  as 

gargle  or  internally  ulcerative  stomatitis 
Alcohol,  2.    Brandy  and  water,  a  gargle  in 

mercurial  and  ulcerative  stomatitis 
Alum,  3.    Burnt  alum  applied  locally  in  ulcer- 
ative stomatitis 
Argentic  Nitrate,  1.    In  thrush  locally 
Bismuth,  2.    In  aphthae  of  nursing  children, 
sore  mouth,  dyspeptic  ulcers,  mercurial  sali- 
vation, locally  applied 
Borax,  1.    In  thrush  and  chronic  stomatitis 
Boric  Acid,  3.    Lotion  of  1  in  50 
Carbolic  Acid,  4.    Strong  solution  locally  to 

aphthsB 
Copper  Sulphate,  3.     Locally  in  ulcerative 

stomatitis,  and  to  indolent  ulcers  and  sores 
Cornus.    Astringent 
Eucalyptus,  2.    In  all  forms 
Glycerine  of  Tannin,  3.    In  ulcerative  stoma- 
titis 
Hydrochloric  Acid,  2.    Concentrated  in  gan- 
grenous   stomatitis ;    dilute    in    mercurial, 
aphthous,  &o. 
Hydrastis,  2.    Fluid  extract  locally 
Iris.    In  dyspeptic  ulcer 
Krameria,  2.    Local  astringent 
Lime  Water,  3.    In  ulcerative  stomatitis 
Mercury.    In  dyspeptic  ulcers,  grey  powder 
Potassium  Chlorate,  1,  2,  3,  4.    The  chief 

remedy  locally  and  internally 
Potassium  Iodide,  1.    In  syphilitic  ulceration 
Bubus,  2.    Astringent 

Salicylic  Aero,  3.  One  part  in  sufficient  al- 
cohol to  dissolve,  to  50  of  water,  in  catarrhal 
inflammation  to  ease  the  pain 


INDEX  OF  DISEASES  AND  REMEDIES. 


1231 


Strabismus. 

Atropine.  To  lessen  converging  squint  when 
periodic  in  hypermetropia 

Eserine.  To  stimulate  the  ciliary  muscles  in 
deficient  contraction 

Electricity 

Hyoscyamus 

Mercury.    Lite  Iodide  of  Potassium 

Operation 

Potassium  Iodide.  In  syphilitic  history  if 
one  nerve  only  is  paralysed 

Shade  over  One  Eye.  In  children  to  main- 
tain acuity  of  vision 

SrnTi  bi  e  Glasses.  To  remedy  defective  vision 

Strophulus. 

Anttmonium  Crudum 

Borax  and  Bran  Bath.    If  skin  is  irritable 
Carbonate  of  Calcium 
Chamomile 
Glycerine 
Lancdto  the  Gums 
Lead  Lotions.    To  act  as  astringents 
Mercury.    Grey  powder  if  stools  are  pale 
Milk  Diet 
Pulsatilla 

SpnuTUS  .Stheris  Nitrosl  In  S.  confertus 
where  there  is  deficient  secretion  of  urine 


Sunstroke. 

Aconite,  1.    Not  to  be  used  with  a  weak  heart 
Alcohol,  1.    Is  afterwards  always  a  poison 
Ammonia,  1.    3?or  its  diaphoretic  action 
Apomorphese,  1.    tk  grain  at  once  counteracts 

symptoms 
Artificial  Respiration 
Belladonna 

Bleeding,  1.    In  extreme  venous  congestion 
Brandy.    In  small  doses  in  collapse 
Camphor 

Chloroform.    In  convulsions 
Digitalis,  1.    To  stimulate  heart 
Ergot,  1.    By  the  mouth  or  subcutaneously 
Gelsemtum 

Hot  Bath.    In  collapse 
Ice;  1.    To  reduce  temperature.    Ice  drinks  as 

well 
Leeches 
Nitrite  of  Amyl 

NlTRO-GLYCEIHN 

Potassium  Bromide,  1.  To  relieve  the  delirium 

Quinine.    In  thermic  fever 

Scutellaria 

Tea.     Cold,  as  beverage  instead  of  alcoholic 

drinks 
Yeratrum  VTRIDE 
Water,  Cold.    Affusion 
Wet  Sheet.     Where  the  breathing  is  steady, 

otherwise  cold  douche 

Suppuration". 

Alcohol,  2.    To  be  watched 

Ammonium  Carbonate.  In  combination  with 
bark 

Calcium  Salts,  2.    To  repair  waste 

Carbolic  Acid,  2.    Lotion  and  dressing 

Cinchona.    As  tonic,  fresh  infusion  is  best 

Hypophosfhites,  1.    Tonic 

I0DD3E  of  Iron.    Tonic 

Ioddje  of  Manganese.   Tonio 

Mercury 

Phosphates.    Like  the  hypophosphites 

Quinine.    Tonic 

Saiisapartlla.    Tonic 

Sulphujes,  3.  When  a  thin  watery  pus  is  se- 
creted, to  abort,  or  hasten  suppuration 


Surgical  Fever. 


Aconite 
Chloral 

QUININE 

Salicylic  Acid 

Tinctura  Ferri  Perchloridi,  1.  As  a  pro- 
phylactic 

Veratrum  Viiudi.  To  reduce  the  circulation 
and  fever 


Sycosis. 


ARSENICI '  BT    HYDRARGYRI     IoDEOI,     LIQUOR. 

Where  there  is  much  chronic  thickening 
Canada  Balsam  and  Carbolic  Acid,  1.    In 
equal  parts,  to  be  applied  after  epilation  in 
tinea  sycosis 
Chloride  op  Zinc,  1.    Solution  in  tinea  sycosis 
Chrysarobini,  TJng.    In  parasitic  sycosis 
Cod-Liver  Oil.    In  chronic  non-parasitic 
Hydrargyri  Acmi  Nitratis,  TJng. 
Hydrargyri  Ammoniatum,  TJng.   In  parasitic 
Hydrargyri  Oxddi  Rubri,  TJng. 
Iodide  op  Sulphur  Ointment,  1.     In  non- 
parasitic 
Oleate  of  Mercury,  2,  3.    In  parasitic 
Oleum  Terebinthin2B,  1.    Like  the  preceding 
Shaving 
Sulphurous  Acid.    Like  preceding 

Eincj  et  Cupri  Sulphas,  1 


Syncope. 


Aconite 

Alcohol,  3,  4.  Sudden,  from  fright  or  weak 
heart 

Ammonia,  3,  4.  Inhaled  cautiously  ;  the  car- 
bonate internally 

Arsenic.  ■  Nervine  tonic,  prophylactic 

Belladonna,  1.    In  cardiac  syncope 

Camphor.    Cardiac  stimulant 

Chloroform,  3.  Transient  cardiac  stimulant. 
Mostly  in  hysteria 

Cold  Douche 

Counter-irritation  to  Epigastrium,  1.  In 
collapse 

Digitalis,  4.  In  sudden  collapse  after  haemor- 
rhage ;  the  tincture  by  the  mouth,  digitalin 
hypodermically 

Ether,  4.    In  collapse  from  intestinal  colic 

Galvanism 

Heat  to  Epigastrium,  1 

Lavandula 

Musk 

Nitrite  op  Amyl,  1, 4.  In  sudden  emergency, 
in  fatty  heart,  in  syncope  during  anaesthesia, 
and  in  haemorrhage 

Position.    Head  lowest  and  feet  raised 

Stimulants,  1.    Undiluted 

Teratrum  Album.    An  errhine 


Synovitis. 


Aconite 

Alcohol  and  Water.    Equal  parts 

Antuiony.    Combined  with  saline  purgatives 

Arnica 

Bandage  or  Strapping.  Martin's  elastic 
bandage  in  chronic 

Blisters.  Flying  blisters  at  night  in  chronio 
synovitis ;  if  not  useful,  strong  counter-irrita- 
tion 

Calctum  SuLPHrDE.    As  a  general  tonic 

Carbolic  Acid,  2.  Injections  of  3j.  of  a  2  per 
cent,  solution  into  the  joint 

Carbonate  op  Calcium 

Cod-Liver  Oil.    Tonic 

Conium,  1.    In  sorofulous  join'* 

Heat 


1232 


INDEX  OF  DISEASES  AND  EEMEDIES, 


Synovitis. 


Iodine.  Injection  in  hydrarthrosis  after  tapping, 

or  painted  over 
Iodoform,  1.    Solution  in  ether,  1  in  5,  injected 

into  tuberculous  joints;  as  a  dressing  after 

opening 
Mercury.  Scott's  dressing  in  chronic  strumous 

disease.    Internally  in  syphilitic  origin 
Oleate  of  Mercury.    To  remove  induration 

left  behind 
Potassium  Iodoje 
Pressure,  combined  with  rest 
Shampooutg  and  Aspiration,  1 
Silver  Nitrate,  2.    Ethereal  solution  painted 

over 
Spldjts 
Sulphur 

Syphilis. 

Acid,  Acetic,  1.    Caustic  to  sore 

Acn>,  Carbolic,  2.  To  destroy  sore,  mucous 
patches,  condylomata,  &c. ;  as  bath  in  second 
stage 

Aero,  Nitric,  1,  3,  4.  In  primary  syphilis,  to 
destroy  the  chancre,  especially  when  phage- 
denic. The  nitro-hydrochloric  acid  in  consti- 
tutional syphilis 

Ammonium  Iodide,  1.  Prescribed  with  excess 
of  the  carbonate  in  tertiary  symptoms;  as 
ointment  to  nodes,  &c,  in  nocturnal  pains 

Aurum,  2.  In  recurring  syphilitic  affections 
where  mercury  and  iodide  of  potassium  fail 

Bamberger's  Peptone,  1.    Mercurialised 

Benzoin,  2.    Antiseptic  dressing  for  ulcers 

Bicyanide  of  Mercury,  1.  To  destroy  mucous 
tubercles,  condylomata,  and  to  apply  to  syphi- 
litic ulceration  of  the  tonsils  and  tongue 

Boric  Acid.    Like  Benzoin 

Calcium  Sulphide 

Calomel,  1,  2,  3,  4.  For  vapour  bath  in  se- 
condary ;  dusted  in  a  mixture  with  starch 
or  oxide  of  zino  over  condylomata  will  quickly 
remove  them 

Camphor,  1.    Dressing  in  phagedenic  chancres 

Cauterisation,  1 

Cod-Liver  Oil.    Tonic  in  all  stages  , 

Creasote.  Internally  in  strumous  subjects, 
and  where  mercury  is  not  borne 

Denutrition,  2.    Hunger-cure  of  Arabia 

G-uaiacum,  2,  4.  Alterative  in  constitutional 
syphilis 

Iodide  of  Iron,  3.  In  sloughing  phagedena ;  in 
tertiary  with  anawnia 

Iodide  of  Starch 

Iodoform,  1,  2,  4.  Dressing  for  chancre  and 
ulcers 

Iron,  1,  2,  3, 4.  In  anaemia,  the  stearate  per- 
chloride  and  iodide  are  useful 

Lotio  Plava.    Dressing  for  syphilitic  ulcers 

Lotio  Nigra.  Dressing  for  syphilitic  ulcers, 
and  gargle  in  sore  throat  and  stomatitis 

Manganese,  2.    In  cachexia 

Mercury,  1, 2,  3, 4,  The  specific  remedy  in  one 
or  other  of  its  forms  in  congenital  and  ac- 
quired syphilis  in  primary  or  secondary  stage 

Oil  of  Mezereon.    In  constitutional  syphilis 

Oil  of  Sassafras.    In  constitutional  syphilis 

Phosphates,  4.    In  syphilic  periostitis,  &c. 

Podophyllum,  1.  Has  been  tried  in  secondary, 
with  success  after  a  mercurial  course 

Potassium  Chlorate,  1,  2,  4.  Local  applica- 
tion of  powder  to  all  kinds  of  syphilitlo  ulcers, 
gargle  in  mercurial  and  specific  stomatitis 

Potassium  Iodide,  1,  2,  3,  4.  The  specific  for 
all  forms  of  tertiary  syphilis  where  there  has 
been  a  mercurial  course  ;  also  in  combination 
with  mercury 

Salicylic  Acid,  2.    Antiseptic  application 

Sarsaparilla,  1,  2, 4.    Alterative  in  tertiary 

Soft  Soap,  3.  h  To  syphilitic  glandular  swell- 
ings 


Syphilis. 

Stdilingua,  2*  Most  successful  in  cases  broken 
down  by  a  long  mercurial  and  iodide  course 
which  has  failed  to  cure  ;  improves  sloughing 
phagedenic  ulcers 

Suppositories  of  Mercury,  1 

Turkish  and  Vapour  Baths,  2.  To  maintain 
a  free  action  of  the  skin 

Wet  Pack 

Zixc  Chloride,  1,  3.  Locally  to  ulcers  as 
caustic 

Tabes  Mesenterica. 

Alcohol 

Arsenic.    In  commencing  consolidation  of  the 

lung 
Barium  Chlortoe,  L    In  scrofula 
Calcium  Chloride.     In  enlarged  scrofulous 

glands 
Cod-Liver  Oil 
Diet,  plain  and  nourishing 
Fatty  Inunction,  1 
Ferri  Pernitratis,  Liquor,  1.  Hsematinic  and 

astringent 
Gallic  Acid,  1.    Astringent  in  the  diarrhoea  of 
Gelsemium,  2.    In  the  reflex  cough  of 
Iodine 

Olive  Oil.    Inunction 
Phosphates,  2.    As  tonic 
Phosphoric  Acid 

Tape-Wokm. 

Agrimonia,  1.    Caffre  remedy 

Alanthus  Glandulosa,  2.    The  oleoresin  or 

decoction 
Alum,  3.    As  injection 
Areca  Nut 

Balsam  of  Copaiba,  1.    In  half-ounce  doses 
Carbolic  Acid,  2 

Chenopodium  Oil,  4.    10  drops  on  sugar 
Cocoa  Nut,  1.    A  native  remedy 
Cod-Liver  Oil.    Tonic 
Creasote,  1 

Ether,  1, 4.  An  ounce  and  a  half  at  a  dose,  fol- 
lowed by  a  dose  of  castor  oil  in  two  hours 
Fdoix  Mas,  Oil  of.    Followed  by  purgative 
Iron.    Tonio 
Kamala 
Kousso 
Mucuna,  4.  Night  and  morning  for  three  days, 

then  brisk  purgative 
Myrzina  Africana,  1.    Used  in  Upper  Egypt, 

to  which  it  is  native 
Papaya,  1 

"Pelletdsrine,  3.    The  tannate 
Pumpkin  Seeds,  4.    Pounded  into  an  electuary, 

£ij.  at  dose 
Bunica  Granatum,  L  4.   The  same  as  its  chief 
J  ■  alkaloid,  pelletierine 
Quinine.    As  tonic 
Resorcin,  2 
Salicylic  Actd,  2.    This  and,  the  preceding  to 

be  followed  by  a  purgative 
Sulphuric  Acid,  1.    The  aromatic  acid 
Turpentine,  2 
Valerian,   3.      In    convulsions   due  to    the 

worms 

Testicle,  Diseases  of. 

Aconite.    In  small  doses  frequently  repeated  in 

acute  epididymitis 
Ammonium  Chloride,  2.    Solution  in  alcohol 

and  water,  topical  remedy 
Antimony,  3.    In  gonorrhoeal  epididymitis 
Belladonna.    In  neuralgia  of  the  testis.    As 

an  ointment  with  glycerine  in  epididymitis  or 

orchitis 


INDEX  OP  DISEASES  AND  EEMEDIES. 


1233 


Testicle,  Diseases  of. 


Tetanus. 


Collodion.  By  Its  contraction  to  ezert  pressure 
on,  in  gonorrheal  epididymitis 

Compression,  1.  At  the  end  of  an  acute  and 
beginning  of  a  subacute  attack,  as  well  as 
chronic  inflammation 

Conium,    Poultice  of  leaves  in  cancer 

Copaiba,  1.    In  orchitis 

Digitalis,  1.    In  epididymitis 

Gold  Salts.    In  acute  and  chronic  orchitis 

Hamamelis.  In  some  patients  gives  rise  to 
seminal  emissions 

Hot  Lotions.    In  acute  inflammation 

Ice  Bag,  2, 3.    In  acute  orchitis 

Iodine,  1,  2.  Injection  into  an  encysted  hydro- 
cele ;  local  application  in  orchitis  after  the 
acute  symptoms  have  passed  off 

Iodoform,  1,  2.    Dressing  in  ulceration 

Magnesium  Sulphate.  With  antimony  in  epi- 
didymitis 

Mercury  and  Morphine  Oleate,  1,  2,  3.  In 
syphilitic  enlargement  and  chronic  inflamma- 
tion 

Nitrate  op  Silver,  2,  4.  Ethereal  solution 
painted  around  an  enlarged  testis  better  than 
over 

Nux  Vomica.    In  debility    . 

Phosphoric  Acid  and  Phosphates.  In  the 
same  condition 

Potassium  Bromide 

PoTASsruM  Iodide.    In  syphilitic  testicle 

Pulsatilla.  In  very  small  doses  along  with 
aconite 

Suspension.    In  orchitis  and  epididymitis 

Tetanus. 

Aconite,  1.  In  large  doses  to  control  muscular 
spasm 

Acupuncture,  1.  On  each  side  of  the  spines  of 
the  vertebrae 

Alcohol,  1.  Will  relax  muscular  action,  also 
support  strength 

Anesthetics,  1.    To  relax  muscular  spasm 

Antimonium  Tartaratum,  1.  In  large  doses, 
along  with  chlorate  of  potassium 

Apomorphine.    As  a  motor  paralyser 

Arsenic 

Atropine,  1,  2.  Local  injection  into  the  stif- 
fened muscles  to  produce  mild  poisoning. 
Useful  both  in  traumatic  and  hysterical 
tetanus 

Bromide  of  Potassium,  1,  2, 4.  In  very  large 
doses  frequently  repeated  does  good 

Cannabis  Indica.  1,  4.  Serviceable  in  many 
cases ;  best  combined  with  chloral 

Chloral,  1,  2,  3,  4.  In  large  doses ;  best  com- 
bined with  bromide  or  cannabis  indica 

Conium,  1,  3.  Injection  of  mxv.  every  two 
hours  of  the  following  formula,  increasing  the 
dose,  has  done  good.     R  Coniiue,  ttlij.;  Acidi 

.    sulphurici  dil.  Utf.;  Mme.  3j. 

Curare,  2.    An  uncertain  drug 

Duboisine,  2.    Like  atropine 

Preezing  the  Nehve,  1.  In  traumatic  tetanus 
has  been  proposed 

Gelsemium,  2,  3.  In  a  few  cases  it  has  done 
good  ,  . 

Heat  to  Spine,  1.    "Will  arrest  convulsions 

Hyosctamus.    In  traumatic 

Ice-bag  to  Spine,  1 

Lobelia,  4.    A  dangerous  remedy 

Morphine,  2.  Injected  into  the  muscles  gives 
relief  .     . 

Nerve-stretching,  1.  Where  a  nerve  is  im- 
plicated in  the  cicatrix  has  done  good 

Neurotomy,  1.    In  the  same  cases 

Nicotine,  1,  2.  Cautiously  administered  re- 
lieves the  spasm ;  best  given  by  rectum  or 
hypodermically ;  by  the  mouth  it  causes  spasm 
which  may  suffocate 


Nitrite  of  Amyl,  1,  2,  3,  4.  In  some  cases  it 
cures 

Nitro-glycerln,  2.    Like  the  preceding 

Opium,  1.    Alone  or  with  chloral 

Physostigma,  2,  3, 4.  The  liquid  extract  pushed 
to  the  full.  G-iven  by  the  mouth,  or  rectum,  or 
hypodermically 

Quinine,  1.  In  both  idiopathic  and  traumatic 
tetanus 

Strychnine,  1,  2.  The  evidence,  which  is  doubt- 
ful, seems  to  show  that  it  is  beneficial  in 
chronic  and  idiopathic  tetanus;  should  only  be 
given  in  a  full  medicinal  dose 

Vapour  Baths 

Warm  Baths 

Thread-Worm  [Oxyuris  Ver- 
micularis). 

Aconite,  2.    In  the  fever  produced 

Alum,  3.    Injections 

Asafcetida  with  Aloes,  1 

Carbolic  Acld,  1.     Solution,  gr.  ij.  to  3j.  in 

doses  of  3j.;  or  as  enema 
Castor  Oil 

Chloride  op  Ammonium,  3.  To  prevent  accu- 
mulation of  intestinal  mucus,  which  serves  as 

nidus 
Common  Salt,  3.    Along  with  antimony  to  re 

move  catarrhal  state  of  intestine,  or  alone  as 

enema 
Enema.  Aloes 
Enema   Quassia,  1,  2,   3.      Or   infusion    by 

mouth 
Ether  (Sulphuric),  1.  Injection  of  solution  of 

li|  xv.  in  water 
Eucalyptol,  2,  3.    Injection 
Ferri  Perchloiudi,  Tinct.,  1,  3.    Enema 
Lime  Water.    Enema 
Mercurial  Ointment,  1.    Introduced  into  the 

rectum  relieves  itching  and  U  anthelmintic 
Oleum  Cajuputi,  4 
<JL.  Oliv^e,  1 

OL.  TeREBINTHM-SI 

Santonica,  3 
Santonin,  3 

Scammony,  3.    Por  thread-worms  in  rectum 
Tannin.    Enema 
Tonics 

Vlnegar.  Enema,  diluted  with  twice  its  bulk 
of  water 


Throat,  Sore. 


Aconite.  In  acute  tonsillitis  with  high  tem- 
perature ;  in  the  sore-throat  of  children  before 
running  on  to  capillary  bronchitis ;  be3t 
given  frequently  in  small  doses 

Alcohol,  3.    Gargle  in  relaxed  throat 

Alum,  3,  4.  Gargle  in  chronic  relaxed  throat, 
simple  scarlatinal  and  diphtheritic  sore-throat 

Arsenic,  3.  In  coryza  and  sore-throat  simu- 
lating hay  fever  ;  in  sloughing  of  the  throat 

Balsam  of  Peru 

Balsam  of  Tolu 

Belladonna,  1,  3,  4.  Believes  spasm  of  the 
pharyngeal  muscles ;  also  when  the  tonsils  are 
much  inflamed  and  swollen 

Capsicum,  3.    As  gargle  in  relaxed  sore-throat 

Carbolic  Acid,  4.  As  a  spray  in  relaxed  sore- 
throat  and  in  coryza 

Catechu.    Astringent  gargle 

Chlorine  Water,  4.  Gargle  in  malignant 
sore-throat 

CimICJFUGa,  2,    In  combination  with  opiumand 

-    syrup  of  tolu  in  acute  catarrh 

Cold  Compresses,  3.    In  tendency  to  catarrh 

Electric  Cautery,  1.  In  chronic  sore-throat, 
to  get  rid  of  thickened  patches  '  *    '  * 

4   K 


1234 


INDEX  OF  DISEASES  AND  EEMEDIES. 


Throat,  Sore. 


Tic  Douloureux. 


Ferri  Perchloridum.  Gargle  in  relaxed  sore- 
throat 

Glycerine  op  Tannin,  3.  To  swab  the  throat 
with  in  the  same  condition 

Guaiacum,1.  Sucking  the  resin  will  abort  or  cut 
short  the  commencing  quinsy 

Hydrastis,  2.  Gargle  in  follicular  pharyngitis 
and  chronic  sore-throat 

Ice,  1,  3.    Sucked,  gives  relief 

Iodine,  1,  3.  Locally  to  sores  and  enlarged 
tonsil 

Ipecacuanha,  3.'  As  spray  in  congestion  of 
upper  pharynx 

Liq.  Ammonti  Acetatis.    In  full  doses 

Magnesium,  Sulphate-  To  be  given  freely  in 
acute  tonsillitis 

Mercury,.  3,  In  very  acute  tonsillitis  grey 
powder  or  calomel  in  small  doses 

Mercury  and  Morphine  Oleate.  In  obstinate 
and  painful  sore-throat 

Myrrh.    Gargle  in  ulcerated  sore-throat 

Nitric  Aero.  As  alterative  with  infusion  of 
cinchona 

Phytolacca.    Internally,  and  as  gargle 

Podophyllum.    Cholagogue  purgative 

Potassium  Chlorate.    Chief  gargle 

Potassium  Nitrate.  A  ball  of  nitre  slowly 
sucked 

Pulsatilla,  2.  In  acute  coryza  without  gastric 
irritation 

Sangumaria,  2.  The  tincture  sprayed  in  ex- 
tended chronic  nasal  catarrh 

Silver  Nitrate,  3,  4.  Solution  in  sloughing  of 
the  throat  or  chronic  relaxation ;  saturated 
solution  an  anaesthetic  and  cuts  short  in- 
flammation 

Sodium  Borate,  1.    In  clergyman's  sore-throat 

Sodium  Salicylate,  3.    In  quinsy 

Steam.  Of  boiling  water,  and  vapour  of  hot 
vinegar 

Sulphurous  Acid,  3.    Spray 

Sumach,  4.  The  berries  infused  and  addition  of 
potassium  chlorate  a  most  efficient  gargle 

Tracheotomy 

Veratrum  Virlde.  To  control  any  febrile 
change 

Zinc  Chloride 

Zlnc  Sulphate,  1.    A  gargle 

Tic  Douloureux. 

Aconitine,2.  Formaila:AconitinBe(Duquesnel's), 
gr-  tV  !  Glycerini,  Alcouolis,  aa.  j.;  Aq.  menth. 
pip.,  ad  3ij.;  dose  3j.  cautiously  increased  to 
3ij. 

Ammondjm  Chlorite,  3.    In  large  dose 

Amyl  Nitrite,  1.    In  pale  anaemic  patients 

Anaesthetics  quickly  relieve,  2 

Arsenic,  3.    Occasionally  useful 

Atropine,  3.    Hypoderniically,  and  ointment 

Butyl-Chloral  Hydrate 

Caffeine 

Cannabis  Ixdica 

Cautery  in   Dental  Canal,  1.    Where  pain 

C  radiated  from  mental  foramen 

Chamomile 

Chloroform,  3.    Inhalation,  hypodermically 

Counter-irritation 

Cupric  Ammonio-Sulphate,  1.  Believes  the 
insomnia 

Delphinine.    Externally 

Electricity 

Gelsemium,  3, 4.    Valuable 

G-lonoixe,  1.    In  obstinate  casea 

Heat 

Hyoscyamus 

Iron,  1.  In  combination  with  strychnia  j  tho 
following  formula  is  good :  Ferri  potassio- 
tartratis,  9iv.;  Vin.  opii,  3jss. ;  Aq.  ciimam. 
ad  Jviij.  3j.  terdie  suraenda 

Caurocerasi,  Aqua 


Ligature  of  the  Carotids,  1.  In  obstinate 
cases  a  last  resort.     Has  done  good 

Morphine,  3.    Hypodermically 

Ol.  Crotonis,  1.  Sometimes  cures ;  will  re- 
lieve 

Phosphorus,  3.    In  obstinate  cases 

Physosistigma 

Potassium  Iodtde.  The  following  formu'a 
relieves:  R  Chloral,  gr.  v.;  Potassii  lodidi, 
gr.  iij.  ;  Sp.  ammonias  co,,  3i. ;  Infusum 
gentianas,  ad  3].    Alone  in  syphilitic  history 

Pulsatilla,  1.    Relieves 

Salicin,  1.  Instead  of  quinine,  where  pain  is 
periodic 

Stramonium 

Veratrdse,  3.    Ointment 

Valerian,  1.  R  Zinci  valerianatis,  Quininse 
valerianatis,  aa.  gr.  xii. ;  Extraoti  Hyoscyami, 
gr.  xxiv.,  fiat  pilulse  duodecim.,  una  ter  die 
.sumenda 

Tinea  Circinata. 

Boric  Aero,    1,    2.     In    simple    or    ethereal 

solution 
Carbolic  Acid,  2.     Solution,  or  glycerine  of 

carbolic  acid 
Chromic  Acid 
Cod-Liver  Oil 
Copper,  Carbonate 
G-oa  Powder.    As  ointment,  or  moistened  with 

vinegar 
Kamala,  1 
Oil  op  Cade 

Sulphites,  2.    Or  sulphurous  acid 
Sulphur  Baths,  2.    Faithfully  carried  out 

Tinea  Decalvans,  vide  Alo- 
pecia. 


Tinea  Favosa. 


Calcium  Sulphide 

Carbolic  Acid,  L    Lotion 

Cleanliness 

Epilation,  1.  Followed  up  bv  usinga  parasiticide 

Hyposulphites 

Mercury,  3.    A  lotion  of  the  bichloride,  gr.  ij. 

ad  3]'. ;  or  the  oleate  of  mercury  ointment 
Nitric  Acid,  1.     Caustio  after  the  crust  has 

been  removed 
Oil.    To  soften  and  remove  scabs 
Oleander 
Petroleum,  1.    One  part  to  two  of  lard  after 

crusts  are  gone 
Sulphides 
Sulphurous  Aero,  3.     The  glycerine  of  the 

B.P.  preparation  assisted  by  epilation 
Turkish  Bath,  1.    Followed  by  the  use  of  car- 

bolic  soap,  instead  of  ordinary 
"Viola  Tricolor 
Zinc  Chloride,  1.    Dilute  watery  solution 

Tinea  Tarsi. 

Blisters  to  Temple,  3 

Epilation,  1,  3.  Removal  of  soabs  and  appH- 
cation  of  stick  of  lunar  caustic 

Mercury,  1, 3.  Afterremoval  of  scabs,  TJng.  hy- 
drargyri  nitratis  diluted  to  half  its  strength  ; 
also  R  Plumbi  acetatis,  3j. ;  IJng.  hydrargyri 
oxidi  rubri,  3j.;  Zinci  oxidi,  si.;  Calo- 
melanos,  3ss.;  Adepis,  5ij. ;  Olei  palmat. 
3v. ;  ft.  ung. ;  also  Oleate 

Tixct.  Iodi,  1.  After  removal  of  scabs  fol- 
lowed by  application  of  glycerine 

Uxo  Picis,  1.    Touched  aloug  edge  of  tarsi 


INDEX  OP  DISEASES  AND  EEMEDIES. 


1235 


Tinea  Tonsurans. 


Tonsils,  Enlarged. 


Acetic  Acid,  3.    Strong  locally 

Acetum  Cantharidis,  1 

Arsenic,  1.    Tonio 

Boric  Acm,  1.  Ethereal  solution  after  head 
is  thoroughly  cleansed 

Carbolic  Acm,  1,  3.    In  early  stages 

Chbisma,  1.  A  derivative  from  petroleum.  A 
parasiticide 

Chrysophanic  Acid,  1.  Gr.  xxx.  to  5j.  as  oint- 
ment 

Coccoxus  Indicus 

Cod-Liver  Oil 

Coster's  Paste.   Iodine  3ij.,  Oleum  cadini,  3ij. 

Creasote 

Croton  Oil,  1,  3.  Liniment  followed  by  a 
poultice 

Epilation 

Iodine,  1,  3.    The  tincture  in  children 

Menthol,  1.    Parasiticide  and  analgesic 

Mercury,  1,  3.  White  precipitate  lightly 
smeared  over,  the  oleate,  perr-itrate  and  oxide 
as  ointments.  The  bichloride  as  a  lotion 
gr.  ij.  ad  5j. 

Oil  of  Naphtha 

Salicylic  Acid,  1.  Strong  solution  in  alcohol, 
gr.  xl.  ad  ,5j .,  or  gr.  xl.  to  vaseline  3  j. 

Sodium  Bthylatk 

Sulphurous  Acid,  1,  3 

sulpho-cyanide  op  potassium 

Thymol.    Like  menthol 

Tongue,  Diseases  of. 

Bicyanide  of  Mercury,  1.  In  mucous  tuber- 
cles 

Borax.  In  chronic  superficial  glossitis ;  and  in 
fissured  tongue 

Cinnamon.    To  flavour 

Cloves.    As  gargle 

Cochlearia  Armoracia,  1.    As  gargle 

Conium 

Frenulum.    Should  be  divided  in  tongue-tie 

Ginger.    Masticatory 

Hydrastis.    In  stomatitis 

Iodine 

Iodoform.    To  ulcers 

Mercury.    In  syphilitic  disease 

Mezereon,  Oil  of.    Sialagogue 

Nitric  Acid.  In  dyspeptic  ulcers ;  the  strong 
acid  as  caustic 

Nux  Vomica 

Pepper.    Condiment 

Phytolacca 

potasstum  bromide 

Potassium  Chlorate.  In  aphthous  ulceration, 
chronic  superficial  glossitis,  stomatitis 

Potassium  Iodide.  In  tertiary  specific  ulcera- 
tion, and  in  macroglossia 

Pyrethrum.    Masticatory 

Bhus  Toxicodendron 

Silver  Nitrate.    Caustic  to  ulcers 

Xanthoxylum,  2.    In  lingual  paralysis 

Zinc  Chloride.    Caustic 

Tonsillitis,      vide     Throat, 
Sore. 

Tonsils,  Enlarged. 

Aluminium  Sulphate.    Locally  applied 

Ammonium  Iodide 

Catechu.    Astringent  gargle 

Excision 

Fel  Bovinum,  1.    Inspissated,  rubbed  up  with 

conium  and  olive  oil  as  an  ointment  to  be 

painted  over 
Ferri  Perchloridl  Tinctura.    Astringent  in 

chronically  enlarged  tonsils 
Iodine  Tincture.    To  cause  absorption 


Massage,  1.    Of  the  tonsils 

Silver  Nitrate.    Caustic 

Tannin,  1.    Saturated  solution  of  fresh  tannin 


Tonsils,  Ulcerated. 


Cantharides.    As  vesicant 

Coptis.    Gargle 

Iron.    Gargle 

Lycopodium.    To  dust  over 

Magnesium  Sulphate.    Free  purgation  with 

Mercuric  Iodide.    In  scrofulous  and  syphilitic 

ulceration 
Potassium  Chlorate.    Gargle 
Potassium  Iodide.    In  tertiary  syphilis 
Sulphurous  Acid.    Pure  or  B.P.  mixed  with 

equal  quantity  of  glycerine  and  painted  over 


Toothache. 


Aconite,  3.    Liniment  or  ointment  In  facial 

neuralgia  if  due  to  decayed  teeth 
Alum,  2.    A  solution  in   nitrous  ether  locally 

applied 
Argenti  Nitras.     The  solid  applied  to  the 

clean  cavity  and  the  mouth  then  gargled 
Arsenic,  1,  3.    Caustic  to  destroy  the  dental 

nerve 
Belladonna 

Butyl-Chloral,  1,  3.    In  neuralgic  toothache 
Calcium  Salts 
Camphor.    Bubbed  on   gum,  or   dropped    on 

cotton  wool  and  placed  in  tooth 
Camphor  and  Chloral.    Liniment  to  relieve 

facial  neuralgia 
Capsicum,  3.    A  strong  infusion  on  lint 
Carbolic  Acm,  2.    A  single  drop  of  strong,  on 

cotton  wool  placed  in  cavity  of  tooth 
Chamomile 
Chloral,  1.    Solution  in  glycerine  one  in  four, 

or  solid  in  cotton  wool  to  be  applied  to  the 

hollow  tooth 
Chloroform,  1,  3.    Into  ear  or  tooth  on  lint ;  a 

good  liniment  with  creasote  ;  or  injected  into 

the  gum 
Cocaine,  3.    The  nydrochlorate  into  a  painful 

cavity 
Colchicum.    Along  with  opium  in  rheumatic 

odontalgia 
Collodion,  3.    Mixed  with  melted  crystallised 

carbolic  acid,  and  put  into  cavity  on  cotton 

wool ;  first  increases  and  then  diminishes  pnin 
Conilve,  3.    Solution  in  alcohol  on  cotton  wool 

and  put  into  tooth 
Creasote.    Like  carbolic  acid 
Croton  Oil 
Electricity 
Gelsemium,  1, 3.    To  relieve  the  pain  of  a  carious 

tooth  unconnected  with  any  local  inflamma- 
tion 
Ginger 
G-lonoinb 
Iodine,  3.    Painted  on  to  remove  tartar  on  teeth, 

and  in  exposure  of  fang  due  to  atrophy  of  gum 
Mercury.    As  alterative  and  purgative 
Morphine.    Subcutaneously  injected 
Nitric  Acid.    To  destroy  exposed  nerve 
Nux  Vomica 
Oil  of  Cloves,  2, 4.    Dropped  into  the  cavity 

of  a  hollow  tooth 
Opium,  2.    Dropped  into  cavity 
Pellitory,  4.    Chewed 
Potassium  Bromide 
Pulsatilla,  1.    In  rheumatic  odontalgia 
Quinine.    In  full  dose 
Besorcin,  2.    Like  creasote 
Sodium  Bicarbonate,  1,  2.    Saturated  solution 

to  rinse  mouth  with 
Tannin,  1,  2.    Ethereal  solution  dropped  into 
'     carious  tooth 
Zinc  Chloride,  1,  3.    To  destroy  exposed  pulp 

4  K  2 


1236 


INDEX  OF  DISEASES  AND  EEMEDIES. 


Torticollis. 


Aconite.    Liniment  externally ;  and  tincture 

internally 
Arsenic,   1.    Controls  and   finally   abolishes 


Belladonna.    Liniment 
Capsicum,  3.    Strong  infusion  applied  on  lint 
and  covered  with  oiled  silk 

ClMICIFUGA 

Conium,  1.    Due  to  spasmodic  action  of   the 

muscles 
Electricity,  2.    Galvanism  to  the  muscles  in 

spasm  ;  faradic  to  their  paretic  antagonists 
Local  Pressure,  1 
Massage,  1 
Nerve-stretching,  1 
Nux  Vomica 
"Water,  2.    Hot  douche 


Trismus. 


ACONITE 

Anesthetics.    To  allay  spasm 

Bklladonna,  1.    Extract  in  large  doses 

Cannabis  Indica 

Chloral,  4.  In  T.  neonatorum,  one  grain  dose 
by  mouth  or  two  by  rectum  when  spasms  pre- 
vent swallowing 

Conium.  The  Succus  is  the  most  reliable  pre- 
paration 

Ether 

Gelsemtum 

Opium 

Physostigma 

Tumours. 

Anaesthetics.  To  detect  the  presence  of 
phantom  tumours;  also  to  rela-i  r.bdomiual 
walls  to  permit  deep  palpation  of  abdomen 


Tympanites. 


Acids,  1.    After  meals 

Alkalies,  1.    Before  meals  with  a  simple  bitter 

Arsenic 

Asafostida,  4«    As  an  enema 

Aspiration,  1.    To  relieve  an  over-distended 

gut 
Bismuth,  1 
Capsicum 
Carbolic  Aero,  1.    Or  creasote  in  tympanites 

due  to  fermentation 
Chamomile,  1.    Enema 
Chloral,  1.    As  an  antiseptic  to  fermentation 

in  the  intestinal  canal 

COCCtTLUS  INDICUS 
COLCHICUM 

Cubebs,  1.    Powdered  in  T.  after  strangulated 

hernia 
Galvanism,  1.    In  old  cases,  especially  of  lax 

fibre 
Ginger 

"  Glycerine.    Associated  with  acidity 
Hyoscyamus 
Ice  Poultice,  1.    Prepared  by  mixing  linseed 

meal  and  small  pieces  of  ice  ;  in  tympanites 

of  typhoid  fever 
Iris 

Nux  Vomica 
Ol.  Terebinth  iNiE,  1.   Very  efficient  as  enema, 

not  for  external  application 
Plumbi  Acetas.    "When  due  to  want  of  tone  of 

intestinal  muscular  walls 
Rue,  1.    Very  effectual 
Sumbul,  1 

Vegetable  Charcoal,  1.    In  gruel,  in  flatu- 
t     (lent  distension  of  the  colon  associated  with 

catarrh ;  dry,  in  flatulent  distension  of  the 
'  stomach  > 


Typhlitis. 

Arsenic 

Belladonna 

Ice  Bag,  2,  3.    Or  poultice  over  the  caecum    • 

Leeches,  2.    At  once  as  soon  as  tenderness  is 

complained  of,  unless  subject  is  too  feehle 
Magnesium  Sulphate,  2.  Only  when  disease  is 

due  to  impaction  of  caecum 
Metallic  Mercury 

Opium,  2.    Better  as  morphine  subcutaneously 
Veratbum  Virlde 

Typhoid  Fever,  vide  Fevers. 

Aconite,  1,  2,  3.    To  reduce  the  pyrexia 
Alcohol,  2, 4.    Valuable,  especially  in  the  later 

stages 
Alum,  3.    To  check  the  diarrhoea 
Antipyrin,  4.    To  lower  the  temperature 
Argenti  Nitras,  1,  2.     To  check  diarrhoea ;  in 

obstinate  cases  along  with  opium ;  should  not 

he  given  until  the  abdominal  pain  and  diar- 
rhoea have  begun 
Arnica,  2.    Antipyretic 
Arsenic,  1, 2.    Liquor  arsenicaliswith  opium  to 

restrain  the  diarrhoea 
Baths,  1, 2,  3.    Agreeable  to  patient,  andreduce 

hyperpyrexia 
Belladonna,  1.    During  the  pyrexial  stage  it 

lowers  the  temperature,  cleans  the  tongue, 

and  steadies  the  pulse  ;  afterwards  it  brings 

on  irritability  of  heart 
Bismuth,  2.    To  check  diarrhoea 
Calomel,  2.    Gr.  x.  first  day,  and  eight  each  day 

after,  the  German  specific  treatment.    3.  In 

small   continuous  doses   without  producing 

stomatitis 
Calx  Saccharata,  1.    "With  milk  when  the 

tongue  is  black  and  parched 
Cabbo&ate  of  Iodine,  2.    One  drop  of  tincture 

of  iodine  and  of  liquefied  carbolic  acid,  out  of 

infusion  of  digitalis,  every  two  or  three  hours 
Carbolic  Aodd,  1,  2.    Cuts  short  the  attack 
Carbonate  of  Ammonium,  3    - 
Charcoal,  1.    To  prevent  fetor  of  stools,  accu- 
mulation of  fetid  gas,  and  to  disinfect  stools 

after  passage 
Conchinin,  1.    Synonym,  Quinidine ;  equal  to 

quinine 
Creasote,  1.    Like  carbolic  acid 
Digitalis,  1,  3..    To  lower  temperature   and 

pulse-rate  ;   death    during  its  use  has  been 

known  to  occur  suddenly 
Ergot,  1,  3-    For  intestinal  haemorrhage 
Eucalyptus,  1.    Thought  to  shorten  disease 
Perri  Perchloridi,  Tinctura 
Hydrochloric  Acid,  1,  2.    To  diminish  fever 

and  diarrhoea 
Hyoscyamus 
Iodine,  1,  2.    Specific  German  treatment;  use 

either  liquor  or  tincture 
Lead  Acetate,  3.    To  check  diarrhoea 
Mercury,  3.    The  perchloride,  tn.x.  of  the  liquor 

every  two  or  three  hours 
Opium,  3.    To  check  delirium  and  wakefulness 

at  night,  and  to  relieve  the  diarrhoea 
Phosphoric  Acid.    Cooling  drink 
Potassium  Iodide,  1.    Alone  or  with  iodine 
Quinine,  1,  2,  3,  4.    In  large  doses  to  reduce 

the  temperature 
Resorcix,  2.    Antipyretic 
Sajlicylic  Acid,  1,  2,  3, 4.    Some  hold  that  it  is 

good  in  the  typhoid  of  children,  many  that  it 

does  great  harm 
Sodium  Bexzoate,  2.    Antipyretic 
Sulpho-careolates.      Proposed    as-   internal 

antiseptics 
Tartar  Emetic.    In  pulmonary  congestion 
Turpentine,  1,  2,  3, 4.    In  the  bad  symptoms  at 

the  end  of  the  second  week,  nix.  every  two 

hours,  and  every  three  hours  in  the  night ; 

specific  if  the  diarrhoea  continue  during  con- 

Talescence 


INDEX  OP  DISEASES  AND  KEMEDIES. 


1237 


Typhus  Fever. 


Vomiting. 


Aconite 

Alcohol,  4.  Where  failure  of  the  vital  powers 
threatens 

Antimony,  3.  Combined  with  opium,  in  pul- 
monary congestion,  wakefulness,  and  delirium 

Arnica,  2.    Antipyretic 

Baths,  1,  2,  3,  4.  To  reduce  temperature ; 
instead  of  baths,  oold  compresses,  &c,  may  be 
used 

Belladonna,  3,  4.  Cleans  the  tongue,  steadies 
and  improves  the  pulse;  too  long  usage 
makes  the  heart  irritable 

Calx  Sacchabata.  "With  milk  in  the  black  and 
coated  tongue 

Camphor 

Chloral,  3,  4.  In  wild  delirium  in  the  earlier 
stages  of  the  fever,  but  not  in  the  later 

Chlorine  Water,  4.    Not  much  used  now 

Cod- Liver  Oll 

Co  unter-lrretation 

Cuca,  1.    Tentative 

Ddjt.    Nutritious 

Digitalis,  1, 4.  To  increase  the  tension  of  the 
pulse  and  prevent  delirium  ;  if  a  sudden  fall 
of  pulse  and  temperature  should  occur  during 
its  administration  it  must  be  withheld 

Expectant  Treatment 

Hyoscyamus 

Musk 

Opium 

Phosphoric  Acid.    Agreeable  drink 

Potassium  Chlorate.    In'  moderate  doses 

Potassium  Nitrate.  Mild  diuretic  and  diapho- 
retic 

Quinine.  In  full  doses  to  pull  down  tempera- 
ture 

Salicylic  Acdd,  4,    Antipyretic 

Strychnine,  1.  Where  the  circulatory  system 
is  deeply  involved 

Turpentine,  1.    In  the  stupor 

Yeast,  1,    Accelerates  the  course  of  the  disease 

Vomiting. 

Acros,  3.  In  acid  eructations,  given  imme- 
diately after  food 

Alcohol,  2.  Iced  champagne,  in  sea-sickness, 
&c.    Hot  brandy  is  also  useful 

Alkalies,  2.    Especially  effervescing  drinks 

Alum,  3.  In  doses  of  five  to  ten  grains  in  phthi- 
sis, when  vomiting  is  brought  on  by  cough 

Ammonium  Carbonate 

Ammonio-Citbate  of  Iron,  1.  In  the  vomiting 
of  anasmia,  especially  of  young  women 

Apomorfhinb.  To  empty  the  stomach  of  its 
contents 

Arsenic,  2,  3.  In  the  vomiting  of  cholera ;  in 
chronic  gastric  catarrh,  especially  of  drunk- 
ards ;  chronic,  not  acute  gastric  ulcer,  and 
chronic  painless  vomiting 

Bicarbonate  of  Sodium,  3.  In  children  3ss. 
to  ij.  to  the  pint  of  milk.  If  this  fails,  stop 
milk.  In  acute  indigestion  with  acid  vomit- 
ing 

Bismuth,  2,  3,  4.  In  acute  and  chronic  catarrh 
of  the  stomach  or  intestine 

Blisters.  In  vomiting  due  to  renal  and 
hepatic  colic 

Bromides,  2,  In  cerebral  vomiting  and  cholera 
infantum 

Calcium  Phosfeatb 

Calomel,  2.  In  minute  doses  in  cholera  infan- 
tum and  similar  intestinal  troubles 

Calumba.    A  simple  bitter  and  gastric  sedative 

Carbolic  Acid,  2,  4.  In  irritable  stomach, 
along  with  bismuth ;  alone  if  due  to  sarcinse 
or  other  ferments ;  in  Asiatic  cholera  and 
cholera  infantum 

Carbonic  Aero  Waters,  3.    With  milk 

Cerium  Oxalate,  3,  4.  In  doses  of  gr.  j.  in 
sympathetic  vomiting 


Chloral,  2.  In  sea-sickness  and  reflex  vomiting 
Chloroform,  2,  3.  In  drop  doses  in  sea-sickness, 

and  in  reflex  vomiting  such  as  passage  of 

calculi 
Cocaine 

Cueasote.    Like  carbolic  acid 
Electricity,  1.    In  nervous  vomiting  the  con- 
stant current  positive  pole  on  last  cervical 

vertebra,  and  negative  over  stomach 
Emetics.    If  due  to  irritating  substances 
Ether,  2.    Like  chloroform 
Eucalyptus,  3.    In  vomiting  due  to  sarcinae 
Gelatin,  3.    To  the  food  of  babies  who  suffer 

from  chronic  vomiting  of  lumps  of  curded 

milk 
Horseradish 
Hydrocyanic    Acdd.     In   cerebral  vomiting, 

vomiting  of  phthisis,  and  of  acute  disease  of 

stomach 
Ice.    Sucked 

Ice  Bag,  1.    To  spine  or  epigastrium 
Iodine.    The  liquor  in  3-5HI  doses 
Ipecacuanha,  1,  2, 3,4.  In  sympathetic  nervous 

vomiting,  in  minute  doses;  in  the  vomiting  of 

children  from  catarrh,  and  the  vomiting  of 

drunkards 
Iris 

Koumiss,  1.    Diet  and  food  in  obstinate  cases 
Leeches,  1.  To  epigastrium  if  tender,  especially 

in  malarial  vomiting 
Lime  Wateh,  3,  4.    In  chronic  vomiting  with 

milk,  especially  in  the  case  of  children.    The 

saccharated  is  laxative 
Magnesia,  3.    In  sympathetic  vomiting 
Mercury,  3.    In  vomiting  with  clayey  stools ; 

vide  Calomel 
Morphlne,   1,  3.     Hypodermically  injected  in 

the  epigastrium  in  persistent  sea-sickness 
Nitrite  of  Amyl,  2.    In  concentrated  form  in 

sea-sickness 
NrrRO-GLYCERDf,  2,  3.    Like  nitrite  of  amyl 
Nutrient  Enemata,  2,  3.    In  persistent  vomit- 
ing 
Nux  Vomica,  2,  3.    In  atonic  dyspepsia 
Opium,  4.     As  a  suppository  in  severe  acute 

vomiting,  especially  associated  with  obstinate 

constipation,  which  is  relieved  at  the  same 

time 
Pepsin,  2.    In  the  vomiting  of  dyspepsia 
Potassium  Iodide.    In  very  small  doses 
Pulsatilla.    In  catarrh 
Qulvlne,  3.    In  sympathetic  vomiting 
Silver  Nitrate.    In  nervous  derangement 
Spiritus  Nucis  Juglandis,  1.      Believes  or 

cures  in  sympathetic  vomiting  and  gastric 

irritability 
Sulphurous  Acid,  1.    If  due  to  saremje 
Tartar  Emetic.  If  due  to  irritating  substances 

or  poisons 
Teratrum.    In  vomiting  of  summer  diarrhoea 
Zdjc  Sulphate.    Emetic 

Vomiting  of  Pregnancy. 

Aconite,  1, 4.  In  full  doses,  so  long  as  physio- 
logical effect  is  maintained 

Arsenic,  2.  Where  the  vomit  is  blood,  or  streaked 
with  blood,  drop  doses  of  Fowler's  solution 

Belladonna,  1.  Either  internally,  or  plaster 
over  the  hypogastrium 

Bismuth,  1.    Along  with  pepsin 

Bromide  of  Potassium,  1, 4.  Controls  in  some 
cases  in  large  doses 

Calcium  Phosphate,  1 

Calomel,  1.  In  small  doses  to  salivate,  or  one 
large  dose  of  10  gr. 

Calumba,  1.    Occasionally  successful 

Carbolic  Acid,  1,  2.    An  uncertain  remedy 

Caustics,  Xi    To  the  cervix  if  abraded 

Cerium  Oxalate,  1.    The  chief  remedy 

Champagne 


1238 


INDEX  OF  DISEASES  AND  EEMEDIES. 


Vomiting  of  Pregnancy. 

Chloral,  1,  3 

Cocaine,  1,  3.  10  m.  of  a  3  per  cent,  solution 
will  relieve  and  cure  in  a  few  doses 

Coffee,  1.    Before  rising 

Creasote,  3 

Dilatation  of  the  Os  "Uteri 

Electricity,  1.    Same  as  in  nervous  vomiting 

Hydrocyanic  Acid,  2.  Sometimes  useful,  often 
fails 

Ingluyet 

Iodine,  2.  A  drop  of  tincture  or  liquor  as  a 
last  resort 

Ipecacuanha,  3,  4.    In  minim  doses  relieves 

Koumiss.    As  diet 

Morphine,  1,  3.  Suppository  introduced  into 
the  vagina ;  no  abrasion  should  be  present  or 
there  may  be  symptoms  of  poisoning 

Naphtha,  1.    1  or  2  drops 

Nux  Vomica,"  2.  1  and  1-2  drop  doses  of  tinc- 
ture 

Pepsin,  1,  2.  Like  ingluviu  but  not  so  suc- 
cessful 

Plumbic  Acetate,  1.    In  extreme  cases 

Potassium  Iodide,  1.    Like  iodine 

Quinine,  3.    Sometimes  useful 

Salicin 

Spinal  Ice-bag,  2 

Warts. 

Acetic  Acid,  1.  Touched  with  the  glacial 
acid 

Alum,  1.    Saturated  solution  in  ether 

Anttmonic  Chloride 

Arsenious  Acid 

Caustic  Alkalies 

Carbolic  Acid 

Chloral 

Chromic  Acid 

Corrosive  Sublimate 

Creasote 

Mercuric  Nitrate,  3 

Nitric  Acid 

Permanganate  of  Potassium,  1 

Phosphoric  Acid 

Potass.*:,  Liquor,  3 

Poultice 

Salicylic  Acid,  3.  Saturated  solution  in  collo- 
dion, with  extract  of  Indian  hemp 

Rue 

Savin 

Silver  Nitrate,  1.  In  venereal  warts  along 
with  savin 

Sodium  Ethylate,  1 

Stavesacre 

Sulphur 

Wen. 

Extirpation 


Wounds. 


Wounds. 


Aconite 

Alcohol,  2.  In  pyrexia ;  antiseptic  and  astrin- 
gent dressing 
,.  Aloes,  3.    Topical  stimulants 

Aluminium  Acetate 

Anhydrous  Dressings 

Balsam  of  Peru 

Benzoin 

Blotting  Paper,  1.    As  lint,  saturated  with 
an  antiseptic 


Boric  Acid 

Calamine,  1 

Calendula 

Carbolated  Camphor,  1 

Carbolic  Acid,  2,  3,  4 

Charcoal 

Chloral,  1.    Antiseptic  and  analgesic 

Collodion,  1,  3.    To  exclude  air 

Conium 

Eucalyptus 

Glycerine,  1 

Hamamelis,  3.    On  lint  to  restrain  oozing 

Heat 

Iodine 

Iodoform,  3 

Lead  Dressings,  1 

Nitrate  of  Silver.     To  destroy  unhealthy 

granulations 
Nitric  Acid 
Oakum 
Opium 
Petroleum 

Permanganate  op  Potassium 
Potassium  Chlorate,  1 
Poultices 
Salicylic  Acuj 

Sodium  Chloride.    J  per  cent,  solution 
Styptic  Collold,  1.    To  prevent  bedsores,  &c 
Sugar 

Sulphurous  Acid,  ],  3 
Tannin 

Turkish  Baths 
Turpentine 

Yeast  in  hospital  phagedena 
Zinc  Sulphate  and  Chloride: 


Yellow  Fever. 


ACONITE 

Arsenic 

Belladonna 

Camphor 

canthabede3 

Capsicum 

Carbolic  Acid,  1, 2.  Snbcutaneously  and  bj 
the  stomach 

Champagne,  2.    Iced 

Chlorate  of  Potassium 

Chlorodyne 

Cimicdtuga 

Ergot,  1.    To  restrain  the  haemorrhage 

0elsemium 

Iodide  of  Potassium 

Ipecacuanha 

Lead  Acetate 

Liquor  Calcis 

Mercury 

Nitrate  op  Silver 

Nitro-hydrochloric  Actd 

Mux  Vomica 

Quinine,  1.  In  some  cases  good,  in  others  harmful 

Salicylic  Acid 

Sodium  Bexzoate,  1.  By  subcutaneous  injec- 
tion 

Sodium  Salicylate 

Stimulants 

Sulphur  Baths 

Sulphurous  Baths 

Tannic  Acid 

Tartar  Emetic 

Turpentine,  2.   Por  vomiting 

Vegetable  Charcoal 

Vsratbum  Vikidb 


BIBLIOGRAPHICAL   INDEX. 


Acids. 

Bertram,  Z.  f.  Biol.,  xiv.  p.  558 

Bobrik,  KBnigsberger  Diss.,  1863 

Brunton  and  Cash,  Phil.  Trans.,  pt.  1.    1884, 

p.  231 
Buchheim,  Arch.  f.  phvsiol.  Heilk.,  1857,  p.  122 ; 

Pflilger's  Arch.,  Bd.  xii,  1876 
Cook,  Praot.,  vol.  xxvii..  p.  328 
Oyon,  Arch.  f.  Anat.  u.  Physiol.,  1866,  p.  416 
Edelfsen,  Centralbl.  f.  d.  med.  Wiss.,  1878,  p.  513 

(Phosphoric  acid) 
Elsasser,  Die  Magenerweichung   d.  Sauglinge, 

1846 
Feitelberg,  Dorpat.  Diss.,  1883 
GShtgens,  Centralbl.  t .  d.  med.  Wiss.,  1872,  vol.  a. 

p.  833 
Garogee,  Centralbl.  f.  d.  med.  Wiss.,  1879,  p.  253 

(different  kinds  of  Phosphoric  acid) 
Gaskell,  Journ.  of  Physiol.,  vol.  iv.  p.  48 
Goltz,  Virch.  Arch.,  Bd.  xxvi.  p.  1 
Guttmann,  Arch,  f .  path.  Anat.,  lxix.  p.  534 
Heiss,  Zeitschr.  f.  Eiologie,  1876,  Bd.  xiL  p.  151 
Hermann,  Toxicolog.,  1874,  p.  160 
Hertwig,  Thierheilkunde 
Hofbauer,  Bossbach's  Pharmacol.  Unters.,  Bd. 

iii. 
Hofmann,  Zeitschr.  f.  Biologie,  1871,  Bd.  vii. 

p.  338 
H'oppener,  Dorpat.  Diss.,  1863 
Kobert,  Schmidt's  Jahrb.,  Bd.  clxxix.  p.  225 
Koch,  Zeitschr.  f.  rat.  Medicin,  3.  B.  Bd.  xxiv. 

p.  264 
Kiihne,  Unters.  lib.  d.  Protoplasma,    Leipzig, 

1864 
Kurtz,  Job,.,  Alkalientzieh.  a.  d.  Thierk.,  Dorpat. 

Diss.,  1874  ;  u.  Centralbl.  f.  d  medicin.  Wiss., 

1874,  vol.  xii.  p.  569 
Lassar,  0,  PflUger's  Arch,  1874,  vol.  ix.  p.  44 
Leyden  u.  Munk,  Virch.  Arch.,  Bd.  xxii.  p.  237 
Maly,  Liebig's  Annal,  Bd.  clxxiii.  p.  227, 1874 
Meissener,  G.,  Zeitschr.  f .  rat.  Med.,  3.  B.  Bd. 

xxiv.  p.  97 
Miquel,  Arch.  f.  physiol.  Heilk.,  1851,  p.  479 
Onsum,  Arch.  f.  path.  Anat,  Bd.  xxviii. 
Piotrowski,  Dorpat.  Diss,  1856 
Quincke,  Corr.-Blatt.   f.  Schweizer  Aertze,  iv. 

No.  1,  1874 
Salkowski,  Tirch.  Arch,  Bd.  lviii.  p.  460 
Sieber,  N,  Journ.  f .  pract.  Chemie,  N .  P,  Bd.  xix. 

1879,  p.  433  (Antiseptic  action  J 
Strassburg,  Pnliger's  Arch,  Bd.  iv.  p.  454 
StrUbing.  A.  f .  exp.  Path.  u.  Pharm,  Bd.  vL  266 

(Phosphoric  acid) 
Szabd,  Z.  f.  physiol.  Chem,  1.  p.  140  (complete 

literature  of  the  acids  in  gastric  juice) 
Trachtenberg,  Dorp.  Diss,  1861 
Walter,  Arch.  f.  exp.  Path.  u.  Pharm,  1877,  p. 

148 
ZUlzer,  Virch.  Arch,  Bd.  lxvi,  pp.  223  and  282 

(Phosphoric  acid) 


ACONITINE. 


Achscharumoff,  Eeichert  u.  Du  Bois's  Archiv, 

1866,  p.  255 ;  Schmidt's  Jahrb,  cxxxvi.  p.  157, 

1867 
Anrep,  V,  Arch.  f.  Anat.  u.  Phys,  1880,  p.  161 
Berthemot,  Pharmaz.  Centralbl,  1837,  p.  733 
Bbhm  a.  Ewers,  Arch,  f .  exp.  Path.  u.  Pharm, 

Bd.  iii.  p.  385 
Bbhm  und  Wartmann,  Verh.  d.  physik.  med. 

Ges.  in  Wttrtzburg,  N.F,  Bd.  iii. 
Brodie,  Phil.  Trans.  1811,  p.  178 
Coulson,  Schmidt's  Jahrb,  xix.  285 
Cramoisy,  E.  P,  Paris,  J.  B.  Sailliere  &  flls,  p.  30, 

1865 
Debout  &  Gnbler,  Schmidt's  Jahrb,  cxxv.  19, 

1864 
Dyce  Duckworth,  Brit.  Med.  Journ,  vol.  i.  p.  224, 

1861 ;  Schmidt's  Jahrb.,  cxi.  p,  23, 1861 
Ewers,  C,  Dissert,  liber  Aconitine,  Dorpat,  1873 
Perrand,  De  l'Aconit,  Lyon,  Chauvine,  1861 
Fleming,  An  Inquiry  into  the  Phys.tfc  Medicinal 

Properties  of  the  Aconitum  napetlus,  Edinb. 

1845 
Fothergill,  Digitalis,  London,  1871,  p.  6 
Fristedt,  Nord.  Med.  Ark,  iii.  3,  No.  18,  p.  38, 

1871 
Geiger,  Hesse,  Brandes   Pharmaz.   Centralbl, 

1835,  p.  85 
Grehant  &  Duquesnel,  Bull.  g6n.  de  Therap, 

Aug.  1871,  p.  492 
Gubler,  Bull.  gen.  de  Therap,  lxvi.  p.  385,  May, 

1864 
Guillaud,  Arch,  de  Phys.  norm,  et  path.,  1875, 

p.  766 
Hahn,  Essai  sur  l'Aconit,  Strasbourg,  1863 
Hariey,  St.  Thomas's  Hosp.  Reports,  v.  p.  149 
Hottot  et  Debout,  Bull.  Ther,  lxvi.  p.  360,  Apr. 

1864 
Janus,  Corn,  de  Man.  Spec.  Medic,  inaug.  de 

Aconito,  Lugd.  Batav,  1841,  8vo.  p.  68 
Lewin,  Priiger  Vierteljahrs.,  Bd.  cxxxi.  p  20; 

Cent,  'f.  d.  med.  Wiss,  1875,  p.  401 
Liegeois  &  Hottot,  Journ.  de  Phvsiol.,  iv.  p.  520, 

Oct  1861 ;  Schmidt's  Jahrb,  cxiv.  p.  291, 1862; 

Bull,  de  Therap,  Paris,  lxv.  p.  208, 1863 
Mackenzie  &  A.  Guillaud,  Arch.  d.  Physiol,  1875, 

p.  766 
Mackenzie,  G.  H,  London  Practitioner,  xx.  p. 

100 
Mammi,  Dell' Aconito  Napello,  Beggio,  1866,  p.  30 
Nunneley,  F.  B,  Proceed,  of  the  Boyal  Societv, 

vol.  xviii.  p.  46, 1870 
Orfila  on  Poisons  (translated  by  Waller),  7th  ed. 

vol.  ii.  p.  46 
Pereira,  Elements  of  Mat.  Med,  4th  ed.  ii.  pt.  ii. 

p.  684 
Praag,  L.  von,  Virchow's  Archiv,  Bd.  vii.  438-478, 

1854 
Ringer,  8,  and  W.  Murrell.  Journ.  of  Phys,  i. 
p.  232,  Nos.  4, 5 


1240 


BIBLIOGEAPHICAL  INDEX. 


AcONITLNE. 

Rosenthal,  J.,  Sitzungsber.  d.  phys.  med.  Ges.  zn 
Erlangen,  1876,  6.  Juni 

Schroff,  Yon,  sen.,  Priiger  Vierte'jahrs.,  xlii.  p. 
129, 1854  ;  Oest.  med.  Jahrb.,  xvii.  p.  57, 1861; 
Scum.  Jahrb.,  cxii.  15, 1861 

Schulz,  Marburger  Diss.,  1846 

Simon  u.  Sobernheim,  Handb.  d.  Tox.,  p.  60 

Skey,  Froriep's  Not.,  ii.  80,  1837,  Schmidt's 
Jahrb.,  xvii.  p.  306 

Soubeiran,  Schmidt's  Jahrb.,  xix.  285 

Turnbull,  On  the  Preparations  and  Medical  Pro- 
perties of  the  Natural  Order  Ranunculacea?, 
London,  1836  ;  Froriep's  Not.,  i.  302,  U.  252, 
1837  ;  Schmidt's  Jahrbuch,  xix.  285 

Weyland,  Eckhard's  Beitr.,  v.  1,  p.  29 

Wibmer,  Wirkungen,  i.  p.  33 

Alcohol. 

Anstie,   Stimulants'   and    Narcotics,    London, 

1864 ;  Lond.  Practitioner,  viii.  p.  148,  Mkr, 

1872,  July,  1874;   Lond.  Med.  Review,  1862; 

Reurint,  Lancet,  ii.  Sep.  13,  1865,  p.  343 
Baudot,  E.,  17  Union  Medicale,  1863 
Bechamp,  London  Lancet,  1873,  vol.  i.  p.  846 
Bernard,  01.,   Lecons  sur  les  Effets  des  Sub- 
stances toxiques,  Paris,  p.  397;  Gaz.  Med.  de 

Paris,  1856,  p.  295 
Binz,  Virchow's  Archiv,  1871,  iv.  p.  529,  Bd.  liii.; 

Berl.  klin.  Woch.,  xi.  11,  p.  129. 1874-1876,  p. 

54 ;  Archiv.  f  Ur  exp.  P.  u.  Ph.,  vi.  287 
Blair,  Glasgow  Med.  Journ.,  Feb.  1870,  p.  204 
Boeck,  V.,  Unters.  tib.  d.  Zer.-etz.  d.  Eiweiss. 

Miinchen,  1871 
Boeck,  V.,  u.  Bauer,  Zeitschrift  f.  Biol.,  Bd.  x. 

p.  361 
Boeker,  Beitr.  z.  Heilkde.,  i.  p.  247, 1849 
Bonwetsch,  Dorpat  Diss.,  1869,  p.  39 
Bouvier,  Cuuy,  PnUger's  Arch.,  Bd.  ii.  p.  370 ; 

Wirk.  der  Alcohol  aui  d.  Kbrpertemperatur, 

Bonn,  1869 ;  Centraibl.  i .  d.  med.  W.,  Bd.  ix. 

p.  807, 1871 
Brodie,  Phil.  Trans.,  Lond.,  1811,  p.  178 
Bruntou,  Lauder,  Book  of  Health,  Cassell  &  Co., 

p.  183;  Practitioner,  xri.  p.  56;  Contemporary 

Review,  xxxiii.  p.  691 
Carpenter,  Alcohol  in  Health  and  Disease,  Lond., 

1851,  2d  ed. 
C  emens,  Theodor,  of  Frankfort,  Deutsche  Klinik, 

1874, 1875 
Daub,  P.,  Centraibl.  f.  d.  med.  Wiss.,  1873,  p.  466 
Davies,  N.  S.,  Trans,  of   the   American   Med. 

Assoc,  1855 ;  Diction,  encycloped.,  ii.  Alcohol, 

p.  582 
Dogiel,  J.,  PnUger's  Arch.,  1874,  Bd.  viii.' 
Du]ardin-Beaumetz  et  Audige,  Compt.  Rendus, 

lxxxi.  192-194 
Dupre,  The  Doctor,  Feb.  1, 1873  ;  Lond.  Practi- 
tioner, vol.  viii.  148,  vol.  ix.  1872,  p.  28,  vol. 

xiii.  p.  15 
Edes,  R.  D.,  Bost.  Med.  &  Surg.  Journ.,  1872, 

vol.  lxxxvi. 
Flourens,  Systeme  Nerveux,  Paris,  1842,  p.  400 
Fokker,  Nederlandsoh  Tijdschrift  vor  Genees- 

kunde,  1871 
Fori  tana,  Berlin,  1787,  p.  439 
Ford,  N.Y.  Med.  Jou.  n.,  Jan.  1872 
Giacomini,  Traite  Philos.de  Mat.Med.etTherap., 

Paris,  1842 
Hammond,  Phys.  Memoirs,  Philadelphia,  1863; 

Amer.  Journ.  Med.  Sci„  Oct,  1856,  p.  305 
Hermann,  Archiv  f .  Anat.  u.  Phys.,  1867,  p.  64 
Horwath,  Gaz.  des  HOpitaux,  Sep.  1878 
Huss,  Magnus,  Ohron.  Alkoholkrankh.,  Stock- 
holm, 1852 
Leudet,  Arch.  Gen.  de  MM.,  Jan.  1867,  vol.  ix. 

pp.  5-39 
Leuret  et  Lassaigne,  Paris,  1826,  p.  200 
Lichtenfels  u.'  Frbhlich,  Denkschr.  d.  k.  k.  Acad.  ' 

d.  w.  in  Wien,  1852.  Math.  Nat,  C1..LU  lit. 

113  ^        '' 


Alcohol. 

Lieben,  A.,  Ann.  d.  Chemie  u.  Pharm.,  1870,  vii, 

Suppl.  Bd.  p.  236  . 

Ludger,  Lallemand,  Perrin,  Duroy,  Paris,.  1860, 

p.  424,  Cbameret  edit. 
Magendie,  Precis  Elem.  de  Phys.,  Paris,  1825 
Magnan,  De  l'Alcnolisme.  Paris,  1874  ;  Gaz.  Med. 

de  Paris,  No.  xl.  p.  444, 1871 
Manassein,  Centraibl.  f.  d.  med.  Wiss.,  ix.  p.  689, 

1871 
Marvaud,  Paris,  Bailliere  et  fils,  Ire  ed.  1871, 

pp.  89,  169 
Meihuizen,  Arch.  d.  Ges.  Phys.,  vii.  4  u.  5,  p. 

201, 1873 
Obernier,  PnUger's  Archiv,  Bd.  ii.  p.  494 
Orflla,  Tox.  Gen.,  1818 

Parkes  and  Wollowicz,  Proceedings  of  the  Royal 
.  Society,  1870 
Percy,  Exp.  Inquiry  on  Alcohol  in  Ventricles  of 

Brain,  Lond.  1839 
Perrin,  Arch.  Generales,  6th  series,  tome  ix. 
Rabow,  Berl.  klin.  Wochenschrif  t,  1871,  p.  257 
Rabuteau,  l'TTnion  Med.,  1870,  pp.  154  and  165  ; 

Compt.  Rend.,  lxxxi.  631 
Rajewsky,  TJeber  das  Vorkoramen  von.  Alcohol 

im  Organismus,  PnUger's  Archiv,  Bd.  xi.  p. 

122 
Riegel,  F.,  Deutscb.  Arch,  f  Ur  klin.  Med„  1873 
,     Ringer  and   Rickards,   London   Lancet,   1866, 

vol.  i.  p.  208 
Ruge,  P.,  Virch.  Arch„  Bd.  xlix.,  p.  252 
Schmidt,  A.,  Cent,  f .  d.  med.  Wissen.,  1875,  371-4 
Schulinus,   Unters.   Uber   d.    Vertheilung   des 

Weingeistes    im    tbier.    Organismus,    Diss. 

Dorpat,  1865 ;  Arch.  Heilk.,  1866,  p.  97 
Smith,  E.,  Brit.  Med.  Journ.,  March,  1859, 255 
Strauch,  Dor|  ater  Diss.,  1852 
,     Subbotin,  Phvs.  Bedeutung  des  Alcohols,  Z.  f. 

Biol.,  vii.  361 ;   Schmidt's  Jahrb.,  1872,  Bd. 
.  oliv.  p.  261 

Suessarott,  Phila.  Med.  Times,  vol.  iv.  p.  774 
Sulzynski,  Dorpat.  Disser.,  1865 
Thudichum  and  Dupre,  Tenth  Rep.  of  Med.  Officer 

of  the  Privy  Council,  London,  1868 
Voit,  Zeitschr.  f .  Biologie,  Bd.  vii.  p.  841 
Wibmer,  Wirk.  d.  Arztn.  n.  Gifte,  i.  90 
Complete  list  of  Literature  on  Alcohol,  given  in 

tbe  Index  Catalogue  of  the  Surgeon-General's 

Library,  U.S.  Army,  vol.  i. 

Alkalies. 

Aubert,  Z.  t  rat.  Med.,  1852,  p.  225 

Aubert  u.  Dehn,  PnUger's  Arch.,  1874,  Bd.  ix. 

p  115 
Bence  Jones,  Lect.  on  Application  of  Chem.  & 

Mechan.to  Path.,  and Therap.,  Lond.,  Churchiil 

and  Sons,  1867,  pp.  41,  70,  107,  125;  Pflug. 

Arch.,  iv.  p.  235, 1871 
Bernard,  C,  Lecons  de  Physiol,  experiment.,  torn. 

ii.  p.  404 
Bernard,  CI.,  etGrandeau,  Journal  de  l'Anatomie 

et  de  Physiol.,  t.  i.  p.  378 
Bischoff,  Zeitschr.  f .  Biologie,  Bd.  ili.  p.  309 
Blake,  Edinburgh  Med.  &  Surg.  Journal,  1838 
B  jhm,  A.  f .  exp.  P.  u.  Ph.,  viii.  p.  68 
Bouchardat,  Du  Diabete  Sucre,  Paris,  1852 
Boussingault,  Ann.  de  Ch.  et  Phys.,  t.  xix.  p.  117, 

xx.  p.  113,  xxii.  p.  116 
Brunton,  Lauder,   The   Practitioner,   London, 

1874,  Nos.  71  &  72,  pp.  342  and  4U3,  vol.  xii. 
Brunton  and  Cash,  Phil.  Trans.,  1884,  p.  197 
Buchheim,  Arohivf.  exp.  Path.  u.  Fharmak.,  iii. 

252-259 ;  Vierordt's   Arch.   f.    Phys.  Heiik., 

1853,  liv.,  Iv.,    lvii. ;  Archiv  f.  exp.  P.   & 

Pharm.,  Bd.  Iii,  p.  262 
Bunge,  Z.  f.  Biologie,  1873,  p.  104,  and  1874, 

p.  Ill,  Bd.  ix.  &  * 
Durand-Fardel,  Lettres'Med.  sur  Vichy.  Paris. 

1855  "  ' 

Faluk,  Aroh.  f .  path.  Anat,  Bd.  lvi. 


BIBLIOGRAPHICAL  INDEX. 


1241 


Alkalies. 

FlBel,  Pfluger's  Archiv,  Bd.  xxxv.  p.  160  foil 

Intestine) 
Fbrster,  Z.  t  Biologie,  Bd.  ix.  p.  207 
Fbrster,  E.,  Arch.  d.  Heilk.,  v.  521, 1884 
Grandeau  et  Bernard,  L'Institnt,  1863,  No.  1555 
Gnttmann,  Berl.   klin.    Wochenschrift,    1865 

Nos.  34-6;  Virch.  Arch.,  xxxv. 
Heubel,  Wirk.  wasseranziehender  Stoffe  aui  die 

Linsd.,  Pfluger's  Archiv,  Bd.  xx.  p.  114 
Hirtz,  Nou.  Die.  de  Med.,  torn.  i.  A.  p.  594 
Hoffmann,  F,  Zeits.  (.  Biol.,  vii.  p.  338 
Hoppe-Seyler,   Med.   Ohem.    Unters.;   and  his 

pupils,  Sertoli,  Kaupp ;  Arch.  £.  Phys.  Heilk., 

1855 
Jaoobi,  Med.  Times  and  Gaz.,  1876,  vol.  i.  p.  177 
Kemmerieh,  Pfliiger's  Archiv,  1869,  p.  49 
Kiein  u.  Verson,  Sitzungsber.  d.  Wien.  Akad., 

Bd.  lv.  p.  627 
Kbhler,  H.,  Centralbl.  f.  d.  med.  Wiss.,  1877 ; 

vol.  XV.  No.  38,  p.  673 
Xiiebig,  V.,  Ann.  d.  Chem.  n.  Pharm.,  lxxvii.  p.  25 
Lbffler  (.Saltpeter),  Schmidt's  Jahrb,,  1848,  Bd. 

lx.  p.  18 
Lomikowsky,  Berl.  klin.  Woch.,  1873,  p.  475 
Lowit,  Pfliiger's  Archiv,  xxv.  p.  466 
Magendie,  Union  Med.,  1852,  p.  498 
Marchand,  Virchow's  Archiv,  Bd.  lxxvii.  1879 
Mauricet,  Schmidt's  Jahrb.,  cxviii.  18,  1863 
Merandon,  Act.  phys.  des  Sels  de  Potasse,  These 

de  Paris,  1868 
Mialhe,   Chimie  appliquee,  Paris,  1856,  p.  58; 

Bull.  Therap,  lxxxiv.  p.  154,  28  Feb.  1873 
Munk,  Cent.  f.  d.  med.  Wissen,  No.  27, 1886 

(Saline  Diuretics) 
Masse,  H.,  Wagner's  Handworterbuch  der  Phys., 

i.  p.  167  (Blut) 
Nothnagel,  Virchow's  Archiv,  Bd.  Ixxxviii,  p.  1 

(On  Intestine) 
Podcopaw,  Virch.  Arch.,  xxxiii.  505 
Eabuteau,  Gaz.  Hubdom,  1871,  43,  46,  48 
Banke,   P.,    Beichert   u.     Du   Bois-Reymond's 

Arch.,  1864.  p.  320 
Bichet,  Ch.,  Compt.  Bend.,  xciii.  p.  649 ;  Arch. 

d.  Phys.  norm,  et  path.,  1882,  ii.  pp.  145  and 

366 
Billiet,  Arch.  Gen.  de  Med.,  iv.  35, 1848 
Binger,  Journ.  of  Phys.,  vol.  iii.  p.  193 
R'dhrig,  Arch.f.  wissensch.  Heilk.,  vi.  3,  4,  p.  396, 

1863 
Bossbach,  >  Pestschr.  der   Julius-Maximil.  V ni- 

versitiit  zu  Wiirzburg,  Leipzig 
Salkowski,   Archiv   f.   path.  Anat.,  Bd.    liii.  J 

Centralbl.  med.  Wiss.,  xi.  1873.  p.  774 
Schmidt,  Al.,  u.  Aronstein,  Pfliiger's  Archiv, 

Bd.  viii.  p.  75 
Serturnex,  Ann.  f.  d.  Universal-System  d.  Ele- 
ments, Jahrg.  1826 
Setschenow,  Centralbl.  1.  d.  med.  W.,  1873,  p. 

355 
Tilt,  Lancet,  i.  1861,  p.  656,  June 
Traube,  Berl.  klin.  Wochenschrift,  1864,  p.  18 
Trousseau,  Clin.  Med.  de   I'Hdtel-Dieu,  Paris, 

1861 
Trousseau  et  Pidoux,  Traite  de  Therap.,  Pans, 

Asselin,  1868,  8e  cd.  p.  420 
Toit,  Unters.  ttb.  d.  Binfluss.  d.  Kochs.  auf  d. 

Stoffwechsel,  Milnchen,  1860;    und  Ber.  d. 

Miinchen.  Acad.,  1869 
Yoit,   Z.   t.  Bio!.,  Bd.  i.  p.  195  (Glaubersalz, 

Stoffwechsel) 
Voit  und  Bauer,  Zeitsohrift  f.  Biol.,  1869,  Bd.  V. 

p.  536 
Zuntz,  Pfltig.  Arch.,  i.  p.  361 

Alkaline  Earths. 

Bence-Jones,  Chem.  Soc.  Quart.  Journ.,  xv. 
Beneke,  Pathologie  des  Stoft'wechsels,  1876 
Boussingault,  Ann.  d.  Chem.  u.  Pharm.,  lix. 

(Phosphors,  alk.  Erden) 
Chossat,  Gaz.  Med.  de  Paris,  1842  (Phosphates) 


Alkaline  Earths. 

Diakonow,  Centralbl.  t.  d,  med.  W.,  1867,  Bd.  v. 

p.  673 
Dussart,  Beneke  et  Peissier,  Arch.  Gen.,  6e  ser. 

tome  xiv.  p.  670,  xv.  pp.  66  and  198 
Neubauer,  u.  Yogel,  On  Urine,  etc.  1863 
Piorry,  Journal  de  Chfm.  Med.,  tome  ix.  1863 
Boloff,  Virchow's  Archiv,  Bd.  xlvi.  p.  305 
Weiske,  Zeitsohrift  f.  Biol.,  Bd.  vii.  p.  333 
Zalesky  in  Hoppe-Seyler's  Med.-chem.  Unters. 

Alkaloids. 

Heger,  Journ.  d.  Med.  Chir.  et  Pharm.  de 
Bruxelles,  1879  (sur  l'Absorption  des  Alca- 
lolfdes  dans  la  Poie,  les  Poumons  et  "les 
Muscles) 

Rossbach,  Verh.  d.  Wiirzb.  physiol.  medic.  Ges., 
N.P.,  Bd.  v.  1,  vi.  162  u.  190,  vii.  20 ;  Pfluger's 
Archiv,  x.  438,  xxi.  1  (Antagonism^ ;  Ver- 
handlung  d.  Wiirzb.  physiol.  medic.  Ges., 
N.P,  Bd.  iii.  346,  1872,  Bd.  vi.  p.  162,  1874 ; 
Pfluger's  Arch.,  xxi.  213,  1880 

Aloes,  see  Purgatives. 

Buchheim,  Die  scharf en  Stoffe,  p.  27 
Barker,  Pordyce,  American  Practitioner,  1872 
Gerhard,  North  American  Med.  and  Surg.  Journ. 
Groves,  Pharm.  Journ.,  xvi.     - 
Husemann,  Pflanzenstoffe,  p.  1047 
Lienan,  Oldenb.  Corresp.-Blatt,  9,  10,  1861 
Miirset,  A.,  Arch.  f.  exp.  Path.  u.  Pharmak.,  Bd. 

xix.  p.  310 
Smith,  T.  and  H.,  Chem.  Gaz.,  1851, 107 
Stille,  Therapeutics,  vol.  ii.  p.  444 
Trousseau  and  Pidoux 

Althaea. 

Bury,  Pract.,  xxxi.  p.  346 


Alum. 


Barthez,  Prank's  Magiizin,  iii. 

Blanc,  L'Union,  1 17,  120, 1873 

Gamgee,  Schmidt's  Jahrb.,  cli.  p.  23, 1871 

Homolle,  Paris,  Malteste,  1861,  p.  125  ;  l'Union, 

15,  17,  1861 
Mitscherlich,  Lehrb.  d.  Artzneimittellehre,  1847 
Paulier,  Gaz.  Hebd.  (2),  x.  p.  717,  1873 
Eosenstirn  in  Rossbaoh's  Pharmakoiog.  Unters. 

1874,  Bd.  ii.  p.  78 
Schreber,  Jahrb.  f.  Kinderheilk.,  iii.  2,  p.  138, 

1860 
Smith,  Curtis,  Philad.  Med.  and  Surg.  Beport, 

xxiv.  p.  409 

Ammonia     and     Ammonium 
Salts. 

Barclay,  Med.  Times  &  Gaz„  Nov.  1853,  p.  553 
Bellini,  Lo  Sperimentale,  1872,  Giugno,  561 
Bence-Jones,  Philas.  Trans.,  London,  1851,  p. 

399 
Bichlmayr,  Z.  fiir  Biol.,  1867,  381  ' 
Billroth,  Arch,  f  ..klin.  Chirurg.,  Bd.  vi.  p.  421 
Blake,  St.  George's  Hosp.  Rep,  v.  p.  73,  1870 
Bohm  u.  Lange,  A.  f.  exp.  P.  u.  Pharm.,  ii.  p. 

b64 ;  und  Dorpater  Diss.,  1874    • 
Brunton  and  Cash,  Proc.  Roy.  Soc,  1883 
Cazenave,  Bull.  gen.  de  Therap.,  xxxi.  70 
Choimeley,   St.  Andrew's  Med.   Grad.  Assoc 

Trans.,  iii.  102, 1870 
Crum-Brown  and  Fraser, Trans.  Roy.  Soc.  Edinb. 
Payrer,  Indian  Annals  of  Med.  Science,  1872 
Delioux,  Bull,  de  l'Acad.,  xxxv.  No.  23,  15  Dec. 

1870,  p.  883 
Feder,  Z.  i.  Biol.,  xiii.  p.  286 


1242 


BIBLIOGRAPHICAL  INDEX. 


Ammonia     and     Ammonium 
Salts — (  con  tinyed  ) . 

Feltz,  V,  et  B.  Bitter,  Journ.  d'Anatomie  et 

de  la  Physiol.,  1874,  p.  326 
Punke    u.   Deahna,    Pnllg.   Arch,    1874,    is. 

p.  416 
Gmelin,  Apparatus  Medicamin,  ii.  1,  48 
Halford,  G.  B.,  Melbourne  Argus,  1872 
Hallervorden,  A.  I.  exp.  P.  u.  Pharm,  x.  p.  125 
Husemann  u.  Selige,  Arch.  f.  exp.  Path.,  vi. 

552-77 
Huxham,  On  Fevers,  p.  299 
Knieriem,  von,  Zeitsohr.  f.  Biol.,  1874,  Bd.  a.. 

p.  263 
Knoll,  Wien.  Acad.  Sitzber.,  1874,  Bd.  lxviii. 
Kiihne  u.  Strauch,  Centralbl.  med.  Wiss,  1864, 

No.  36,  pp.  561,  677 
Lnoge,  P.,  Arch.  f .  exp.  Path.  u.  Pharm.,  Bd.  ii 

p.  368 
Maurecet,  Schmidt's  Jahrb.,  clxviii.  p.  18,  1863 
Mitscherlich,  Zeits.  des  Preuss.  Vereins  f .  Hei  k., 

Nos.  43, 44,  46,  46,  1841 ;  Lehrb.  der  Arztn., 

ii.  228 
Munk,  Zeitschr.  f.  physiol.  Obem.,.ii.  p.  29 
Priestley,  On  Air,  ii.  p.  369,  1790 
Babuteau,  Gaz.  Hebd.,  43,  46,  48, 1871 ;  Comptea 

Bend,  lxx.  25,  p.  1356,  1870 ;  Traite  element. 

de  Therapeut,  4th  ed.  p.  536 
Richet  et  Montard-Martin,  Compt.  Kend.,  xcii. 

p.  465 
Rohmann,  Centr.  f.  klin.  Med.,  No.  36,  1884 
Salkowski,  Zeitschr.  f.  phys.  Ohem,  Bd.  i.  pp. 

iv.,  1,  374 
SohifEer,  Berl.  klin.  Woehenschr,  1872 
Schmiedeberg,  A.  f .  exp.  P.  u.  Pharm.,  viii.  p.  1 
Stevenson,  Guy's  Hosp.  Eep.,  3rd  ser.  xvii.  225, 

1872 
Thiry,  Henle  u.  Pfeufer's  Zeits.  (3),  xvii.  p.  166, 

1864 
Trousseau  et  Pidoux,  Traite,  9th  ed.  1,  p.  453 
Walter,  A.  f.  exp.  P.  u.  Pharm.,. vii.  p.  148,  u. 

Wibmer,  Wirk.  d.  Arzneim.  u.  Gifte,  Munich, 

1831,  pp.  123,  127,  139,  144 

Amtl  Compounds. 

Richardson,  Brit.  Ass.  Rep.,  1865,  p.  280 

Amtl  Nitrite, 
of  Amyl. 

Anilin. 

Bergmann,  PrKger  Vierterjahrsschr,Bd.lxxxviii. 

p.  109, 1865 
Feltz  et  Bitter,  Compt.  Bend.,  lxxxii.  p.  1512, 

1876 
Jolyet  et  Cahours,  Compt.  Eend..  lxvi.  p.  1181 

(Methyl-  and  other  Compounds) 
Schuchhardt,  Virch.  Arch.,  Bd.  xx.  p.  446 

Antifebrin. 

Cahn  &  Hepp,  Centr.  £.  klin.  Med.,  Aug.  14, 1886 

Antimony. 

Ackermann,  Virch.  Arch.,  Bd.  xxv.  1862,  p.  531; 

Rostock,  1856  (Ader),  iv.  p.  44 ;   Henle  u. 

Pfeufer's  Zeits.  f .  ration.  Med.,  3.  R.  ii.  Heft, 

3, 1858 
Balfour,  Tartar  Emetio  in  Pever,   Inflamm, 

Asthma,  etc.,  Loud.,  1818 
Booker,  Beitr.  z.  Heilk,  ii.  p.  234, 1849 
Brinton,  Todd's  Cyclop,  of  Anat.  and  Physiol., 

Suppl.  p.  319 
Buchheim  u.  Eisenmenger,  Eckhardt's  Beirt., 

Bd.  y.  ...... 


see    Nitrite 


Antimony. 

Corput,  van  den,  Journ.  Med.  de  Brux.,  xxxv. 

p.  491,  Nov.  1863 
Denny,  Brit.  Med.  Journ.,  Jan.  28,  1871,  p.  69 
Duffln,  Edin.  Med.  &  Surg.  Journ.,  xix.  3,  p.  354, 

1823 
Eisenmenger,  TT.  d.  Einfl.  Gifte  a.  d.  Zuckungs- 

curve  d.  Froschesmuskels,  iv.  p.  7,  Giessen, 

1869 
Porget,  Bull.  gen.  de  Therap,  lviii.,  June,  1860, 

p.  481 
Ponssagrives,  Bull.  gen.  de  Therap.,  lvii.,  Aug. 

1859,  p.  145 
Gianuzzi,  Centralbl.  med.  Wise.,  1865,  p.  129 
Grimm,  Pflttg.  Arch.,  iv.  p.  205 
Jankowich,  Oesterr.  Jahrb.,  N.P.,  xxxviii.  p.  53, 

1842 
Jones,  Handfield,  Med.  Times  &  Gaz.,  Dec.  1852, 

p.  362 
Koschlafcoff    u.   Bogomoloff,   Centralbl.   med. 

Wiss.,  1868,  p.  628 ;  Pflttger's  Arch,  v.  p.  280, 

1872 
Kleiman  u.  Simonowitsch,  Arch.  f.   d.   ges. 

Physiol.,  Bd.,  v.  p.  280 
Lange,  D.,  Klinik,  28,  80,  31,  1863 ;  Schmidt's 

Jahrb,  cxxiii.  283,  1864 
Lepelletier,  Paris,  1835,  p.  171 
Long,  BulL  gen.   de   Therap,  lis.  Oct.  1860, 

p.  317 
Magendie,  Paris,  1813 

Mayerhofer,  Heller's  Arch.,  iii.  3-5,  p.  356,  1846 
Mosso,  Schmidt's  Jahrb,  Bd.  clxix.  p.  236 
Ndbiling,  Zeits.  f.  Biol.,  Bd.  iv.  p.  40,  1868; 

Schmidt's  Jahrb.,  cxl.  24 
Orfila,  Memoires  de  l'Acad.  roy.  de  Med,  viii. 

1840,  p.  509 
Papillaud,  Schmidt's  Jahrb..  clvi.  p.  267,  1872 
Pecholier,  Comptes  Eend.,  lvi.  1863,  p.  718;  Gaz. 

Hebd,  Apr.  17,  1863,  p.  275 
Badziejewski,  Arch.  f.  Anat.  u.   Phys,   1871, 

p.  472 
Easori,  Milano,  1830 ;  Arch.  gen.  de  Med,  1824, 

iv.  pp.  300,  415 
Eayer  et  Bonnet,  Diet,  de  Med.  et  de  Chir,  iii. 

69,  Paris,  1829 
Richardson,  Med.  Times  and  Gaz,  May,  1856, 

p.  473 
Salkowski,  Virch.  Arch,  xxxiv.  p.  73 
Solon,  Martin,  Memoires  de  l'Acad.  roy.  de  Med, 

viii.  1840,  p.  518 
Stedmann,  Med.  Times  &  Gaz,  Dec.  1852,  641 
Taylor,  Guy's  Hosp.  Rep,  1860,  p.  397 
Traube,  Centralbl.  med.  Wiss,  1864,  p.  490 
Trousseau  et  Pidoux,  Traite  de  Therap.  et  de 

Mat.  Med,  9e  ed.  1870,  ii.  p.  954 
Viborg  and  Hert wig,  quoted  by  Wibmer,  Wirk. 

d.  Arzneim.  u.  Gifte,  v.  187, 194 
Witt,  J.  H.  D.  de,  Groningae  apud  Wilkens,  8, 

1847,  p.  32 
Wood,  Philad.  Med.  Times,  vol.  iii. 

Antipyrin. 

Bettelheim,  Wien.  med.  JahrbUoher,  1885 

Apiol. 

Galileo  u.  Poggesohi,  Bull.  Gen.  Therap.,  1861,  ii. 

p.  279 
Joret,  Bull.  Therap,  Peb.  1860,  lix.  p.  97 
Joret  et  Homolle,  Journ.  de  Pharm.  et  de  Chim., 

8e  ser.  xxviii.  212 
Marotti,  Bull.  Therap,  lxv.  pp.  295  and  341, 1863 ; 

Gaz.  Hebd.,  45 

Apomorphine. 

Bourgeois,  These  de  Paris,  1874,  No.  19 ;  Bull. 

gen.  de  Therap,  lxxxvi.  p.  236, 1874 
Ohouppe,  Soo.  de  Biol,  July  18, 1874  ;  Arch,  de 

Physiol,  1875,  p.  101 
David,  G.,  Gaz.  Med,  1874,  p  465 


BIBLIOGEAPHICAL  INDEX. 


1243 


Apomoephine. 


Aesenic. 


Dujardin-Beaumetz,    Bull.  Gen.    de    Therap, 

lxxxvii.  Oct.  8,  1874,  p.  345 
Eichberg,  Wurtemberg.  Corr.-Bl.,  89,  pp.  1819- 

1873 
Fronmttller,  Memorabil,  xviii.  9,  1873 
Ganghofner,  B»hn.  Corr.-Bl.,  i.  3,  p.  65,  1873 
Gee,  St.  Barth.  Hosp.  Reports,  vol.  v.  p.  215 ; 

Trans.  Clin.  Soc,  ii.  p.  166,  1870 
Gellhorn,  AUgem.  Zeitschr.  f.  Psych,  xxx.  46, 

1873 
Greve,  Berl.  klin.  Wochens,  xi.  28,  29,  1874 
Harnack,  Arch.  £.  exp.  Patli.  u.  Pharm,  Bd.  ii. 

p.  291,  1874      . 
Huchard,  H„  Union  Med.,  Oct.  1874,  p.  493 
Juratsz's  Centralbl.  f.  d.  med.  Wiss.,  p.  499, 

1874 
Lob,  Berlin,  klin.  Woollens.,  1872,  p.  400 
Mattbeissen,  R,  &  C.  R.  A.  Wright,  Proceedings 

Roy.  Soc,  xvii.  455 
Mayer,  E.  L„  Berichte  Deutsch.  Chem.  Gesell., 

Berlin,  1871,  iv.  121 
Meyer,  De,  Bull,  de  la  Soo.  roy.  de  Pharm.  de 

Bruxelles,  1872 
Moerz,  A.,  Priiger  Vierteljahrs,  1872,  Bd.  civ. 

p.  82 
Holler,  Bull,  de  l'Acad.  de  Med.  de  Belgique, 

viii.  3, 1873,  p.  749 
Oberlin,  Revue  Med.  de  l'Est,  Aug.  1874,  ii. 

p.  98 
Onsum,  Norsk  Mag.,  3.  E.  iii.  155, 1872 
Quebl,  Hallenser  Diss.,  1872 
Pierce,  British  Med.  Journ.,  1870,  rol.  i.  p.  204 
Riegel  u.  Boehm,  Deutsch.  Arch.  f.  klin.  Medi- 
•    cin,  Bd.  ix.  211,  239,  1871 
Routy,  These  de  Paris,  1874,  No.  437 
Biebert  u.  Boehm,  Arch.  d.  Heilk.,  Bd.  xii.  6. 

Heft,  1871,  p.  522 
Wertner,  M.,  Wien.  med.  Presse,  1876,  269 
Ziolkowski,  Apomorphin,  Inaug.  Diss,  Greifs- 

wald,  1872 

Aeaeoba  oe  Oheysaeoba. 

Fayrer,  Med.  Times,  ii.  1874,  pp.  470,  547 ;  1876, 

ii.  p.  711 
Thompson,  I.  Ashburton,   Brit.   Med.  Journ., 

May,  p.  607, 1877 

Aenica. 

Balding,  C.  C,  Lancet,  vol.  ii.  p.  885,  Dec.  1870 
Fayrer,  Practitioner,  xvi.  p.  52 
White,  Boston  Med.  and  Surg.  Journ.,  Jan.  1875, 
p.  61 

Aeomatic  Compounds. 

Baumann  u.  Herter,  Z.  f .  physiol.  Chem,  L  244, 

ii.  336 
Brieger,  A.  f.  Anat.  n.  Phys.,  1879,  Physiol. 

Abth.,  Suppl.  Bd.  p.  61  (Pyrocatechin,  Hydro- 

chinon,  Resorcin) 


Aesenic. 


Binz  u.  Schulz,  Arch.  1.  exp.  Path.  n.  Pharm., 

Bd.xi.  p.  200  ,       . 

Bergeron  and  Lemaltre,  Brit,  and  For.  Med.-Chir. 

Review,  vol.  xlviii.  p.  226, 1871 
Blake,  Edin.  Med.  and  Surg.  Journ.,  1839 
Boeck,  Ton,  Zeitscbr.  f.  Biol,  Bd.  vii.  p.  418, 

u   xii.  p.  sl2;  u-  Centralbl.  d.  med.  Wiss., 

1876,  lib.  d.  Zersetzungdes  Eiweisses,  Munohen, 

G.  Himmer,  1871,  p.  41 
BShm  u.  Schafer,  Ueb.  aeu  Einfluss  des  Arserf. 

auf    ungetorm.   Permente,    Wurzburg.   Ver- 

handlungen,  N.P.,  Bd.  iii.  1872 
•Brodie,  Phil.  Trans.,  1811,  1812 
Cunze,  Henle  u.  Heufer's  Zeitschr.  {,  rat.  Med., 


3,  xxviii.  p.  33, 1866;  Schmidt's  Jahrb.,  cxxxi. 
19 
Dogiel,  Pfliiger's  Archiv,  xxiT.  p.  328 
Downie,  K.  M.,  Indian  Medical  Journ.,  1872 
D'Etiolles,  Leroy,  Gaz.  Hebd.,  1857,  vol.  iv. 
Peitelberg,  Inaug.  Dissert.,  Dorpat,  1883 
Pilehne,  Virchow's  Archiv,  lxxxiii.,  p.  1 
Plandin  u.  Danger,  Husemann,  Toxicologie,  p. 

823 
Fleck,  Arch.  {.  Biologic,  Bd.  viii.  p.  444 
Fokker,  Schmidt's  Jahrb.,  clviii.  15 
Fowler,  Med.  Rep.on  Arsenic  in  Ague,  etc.,  Lond. 

1786 
Gaethgens,  Arch.  f.  exp.  P.  u.  Pharm.,  Bd.  r. 

p.  128,  u.  Centralbl.  t  med.  Wiss.,  1876 
Gies,  Arch.  f.  exp.  Path.  u.  Pharm.,  Bd.  viii. 

p.  175 
Grohe,  Fr.,  u.  Fr.  Mosler,  Virch.  Arch.,  Bd. 

xxxiv.  p.  213 
Herapath,  Philosophical  Mag.,  1851,  p.  345 
Heisch,  Chas.,  Pharmaceutical  Journ.  and  Trans., 

vol.  i.  2nd  series,  1859, 1860,  p.  556 
Hoffman,  Virch.  Arch.,  Bd.  i.  (50),  p.  456 
Imbert-Gourbeyre,  Histoire  lies  Eruptions  arse- 

nicales,  Monit.  des  Hdpit.,  1857 
Jackson,   W.    C,    Amer.  Journ.  of  the   Med. 

Sciences,  July  1858,  p.  57 
Jiiger,  Wirk.  d.  Arseniks  auf  PfLanzen,  Stutt- 
gart, Schweizerbart,  1864,  p.  113 
Johannsohn,  Arch.  L  exp.  P.  u.  Pharm,  Bd.  ii. 

p.  106 
Karajau,  Tardieu,  Sur  Tempoisonnement,  p.  335 
Kendall  and  Edwards,  London  Pharmaceutical 

Journal,  ix.  1850 
KShler,  H,  of  Hal  le,  Brit,  and  Foreign  Med.-Chir. 

Rev,  1870,  vol.  xlv.  p.  538 
Kossell    u.   Gaethgens,  Arch.  f.  exp.  Path.  u. 
Pharm,  Bd.  v.  133,  and  Centralbl.  med.  Wiss, 
1875,  530  ;  1876,  833 
Lachese,  Ann.  d'Hyg.  et  de  Med.  legale,  1837, 

le  serie,  tome  xvii.  p.  334 
Lesser,  A,  Virch.  Arch,  Bd.  lxxiii.  p.  398,  and 

lxxiv.  125,  1878 
Leube,  Deutsch.  Arch.  f.  klin.  Medicin,  Bd.  v. 

372, 1869 
Loew,  O,  Pfliiger's  Archiv,  xxxii.  p.  Ill 
llaaa,  Verhandl.  d.  Leipziger  Nacurforsch.  Vers, 

1872 
Mackenzie,  Ind.  Med.  Gazette,  1872 
Maclagan,  C,  Edin.  Med.  Journal,  vol.  i.  1864, 

p.  203 
Nunn,  Emily  A,  Journ.  of  Physiology,  i.  p.  247 
Pinkham,  Boston  Med.  and  Surg.  Journ,  1878, 

vol.  xcix.  358 
Popow,  N.  (with  lead  and  mercury),  Virchow's 

Archiv,  xciii.  p.  351 
Renner,  Wttrtzburger  Diss,  1876 
Ringer  and  Murrell,  Journal  of  Physiol,  1.  p. 

'213 
Saikovski,  Virch.  Arch,  Bd.  xxxiv.  p.  77 
Saikowsky,  Mosler  u.  Grohe,  Virch.  Arch,  1865, 

Sept.  u.  Oct,  p.  208 
Salomon,  Alex.,  Wirk.  kleiner  Dosen  Arsenik, 

Diss.  Berl,  1873,  p.  35 
Sawitsch,  Dorpater  Dissert,  1854 
Schmidt  u.  Sturzwage,  Moleschott's  TTnters, 

vi.  3,  p.  283,  1859 
Schroff  (senior),  V,  Zeitschr.  d.  Wiener  Aerzte, 
N.F.  ii.  44;  Schmidt's  Jahrb,  1860,  cv.  176, 
1860 
Schulz,  Arch.  1  exp.  P.  a.  Pharm,  Bd.  xi.  p. 

131 
Sklarek,  W„  of  Berlin,  Reiohert's  Archiv,  1866, 
p.  481 ;  Schmidt's  Jahrb,  cxxxii.  290 
-  Sturtzwage,  Dorpater  Dissert,  1859 
Taylor,  Guy's  Hosp.  Reports,  vol.  x.  3rd  series, 

1864,  p.  227 
'  TJnterberger,  S„  n.  Bohm,  Arch,  f .  exp.  Path.  n. 
Pharm,,  Bd.  ii.  pp.  89,  99, 1874  ;  ibid.  Bd.  xi. 
p.  89 
Virchow,  Virchow's  Arohiv,  Bd.  xlvii.  p.  524 


12-14 


BIBLIOGRAPHICAL  INDEX. 


Arsenic. 

Vogt,  Lehxbucli  d.  Pharmacodynamic,  3te  Aufl, 

Bd.  i. 
Vulpian,  Arch,  de  Phys.,  1868  (Compounds) 
Weir-Mitchell,  New  York  Med.  Journ,  vol.  i. 
Wyss,  Arch.  d.  Heilkunde,  1873,  p.  16 

ASPIDOSPERMINE,     Vide      Q,UE- 
BRACHO. 

Atropine. 

Anrep,  PflUger's  Arch,  Ed.  xxi.  1880  (chron. 

Atropinvergiftung ) 
Arlt,  Arch.  l.  Ophthalmologic,  1869,  p.  294 
Bennett,  Hughes,  Brit.  Med.  Journ,  1874,  vol. 

ii.  647;  London  Med.  Beoord,  1877,  p.  341 
Bernard,    CI,   Physiol,   u.  Path,   du   Systeme- 

Nerveux,  Paris,  vol.  ii.  p.  112 
Bezold,  V,  u.  Blobaum,  Unters.  a.  d.  physiol. 

Labor,  in  Wurtzburg,  Bd.  i,  1867 
Boehm,    Studien   iiber   Herzgifte,   WUrzburg, 

1871 
Borelli,  Ed.  Med.  Journ,  Nov.  1871,  vol.  xvii. 

p.  480 
Botkin,  Virchow's  Arch.,  Bd.  xxiv.  p.  83 
Braun,  Arch.  i.  Ophthalmologic,  Band  v.  Abth.  ii. 

p.  112 
Buchheim,  Arch.  f.  exp.  Path,  v.  p.  463 
Budge,  Ueb.  d.  Bewegung  der  Iris,  1855 
Chambers,  Lancet,  1864,  vol.  i.  p.  8 
Da  Costa,  Amer.  Journ.  Med.  Sciences,  July, 

1865,  p.  71 ;  Pennsylvania  Hosp.  Rep,  1858  J 

Philad.  Med.  Times,  Feb.  15, 1871 
Dogiel,  J,  Max.  Schultze's  Arch.  f.  microscop. 

Anat,  Bd.  vi.  Heft  i.  1870,  p.  85 
Bonders,  The  Accommodation  and  Refraction  of 

the  Bye,  Syd.  Soc.  ed,  pp.  584,  588 
Eckhard,  Eckhard's  Beitriige  zu  Anat.  u.  Phys., 

viii.  p.  1 
Fraser,  Transactions  of  the  Royal  Society  of 

Edinburgh,  May,    1869,  vol.  xxv.  450,  vol. 

xxvi.  1872,  with  complete  rtmml  of  older 

literature 
Fraser,  T.  R„  Bartholow,  Oglesby,  Nunnely,  The 

Practitioner,  iv.  pp.  27,  65,  and  217 
Gnauck,  Arch,  f .  Anat.  u.  Phys.,  1881,  p.  466 
Graefe,  Von,  Deutsche  Klinik,  1851 
Graser,  Arch,  t  exp.  Path.  u.  Pharmak,  Bd. 

xvii.  p.  5 
Harley,  The  Old  Veg.  Neurotics,  London,  1869, 

p.  220 
Hayden,  Dublin  Quarterly,  Aug.  1863,  p.  51 
Heidenhain,  Pfllig.  Arch,  Bd.  v.  p.  309 
Hirschmann,  L,  Zur  Lehre  v.  d.  durch  Arzneim. 

u.s.w,  Reichert's  Arch.,  1863,  p.  309 
Iwanoff,   Alex,    u.    Alex.    Bollett,    Arch.  f. 

Ophthalm,  Bd.  xv.  p.  17 
Jones,  Wharton,  Med.  Times  and  Gazette,  p.  28, 

vol.  i.  1857 
Ladenburg,  Ber.  d.  deutsch.  chem.  Ges,  Jg.  xii. 

1879,  p.  941 ;  Compt.  Rend,  xc.  p.  874 
Langendorff,  Arohiv  f.  Anat.  u.  Phys.  (Phys. 

Abth.),  1886,  p.  267 
Lautenbach,  Phil.  Med.  Times,  May  26, 1877 
Lemattre,  Arch;  Generates,  Aug.  1865,  p.  173 
Lichteufels   u.  Frbhiich,   Denkschr.  d.  Wien. 

Acad.  Math,  Naturw.  CI,  1852,  p.  113 
Luchsinger,  Arch,  f .  d.  ges.  Phys.,  xv.  p.  482 
Meuriot,   De  la  Methode  physiol.   en   Thera- 

peutique  et  de  ses  Applications  a  l'Etude  de 

la  Belladonne,  Paris,  1868,  p.  73 
Korris,  Wm.  P.,  Amer.  Journ.  of  Med.  Sci,  Oct. 

1862,  p.  396 
Putnam,  Miss  Mary,  New  York  Med.  Record, 

1873 
Bossbach,   Pharmakol.  TJnters,  Bd.  1.  ii.  iii, 

Wurtzburg,  1873  (vide  also  Alkaloids) 
Eossbach  u.  FrBhlich,  Pharin.  "Outers.  Wilrzburg, 

Lp.6,N.F,v.  1874 


Atropine. 

Roy  and  Brown,  Journ.  pf  Phys,  vol.  vi. 
'     Schapiro,  Cent,  f .  d.  med.  Wiss,  1884,  No.  33 
Schtff.LaNazione,  1872,  No.  23o  _     , 

Schmiedeberg,  Arb.  des  Phys.  Instit.  z.  Leipzig, 

V  p.  41, 1870 
Schroff,  Zeitschr.  d.  Wien.  Aertze,  1852 
Stellwag  v.  Carion,  Der  intraoculare  Drucku.  d. 

Innervations-Terhaltn.  der  Iris,  Wien,  1868 
Szpilman  u.  Luchsinger,  PflUger's  Archiv,  Bd. 

xxvi.  p.  459  .      .,„,.,     . 

Valentin,  Y,  Versuch  einer  physiol.  Pathologie 

der  Nerven,  Leipzig,  1864,  2e  Abth.  p.  368 
Weir-Mitchell,  Injuries  of  Nerves,  Philadelphia, 

1872,  p.  258 
Wood,  Amer.  Journ.  Med.  Sci,  Apr.  1873,  p.  332  ; 

N.S.  p.  258,  Jan.   1871;  Philadelphia  Med. 

Times,  vol.  i.  p.  290 
Zeller,  Virchow's  Arohiv,  Ixvi.  p.  384 

Barium. 

Bbhm  u.  Mickwitz,   Arch.  f.   exp.   Path.  u. 

Pharm,  1875,  Bd.  iii.  p.  216 
Brunton  and  Cash,  Roy.  Soc.  Proc,  No.  226, 

1883  ;  Phil.  Trans,  1884 ;  Cent.  d.  med.  Wiss, 

1884,  p.  545 
Hermann,  Toxicologic,  1191 
Lisfranc,  quoted  by  Lewin,  Nebenwirkungen 

der  Arzneien,  p.  74 
Onsum,  Arch.  f.  path.  Anat,  Bd.  xxviii.  p.  233 

Bebeeru  Bark. 

Albers,Virch.  Arch,  Bd.  xxiv.  p.  304 

Binz,  Virchow's  Aroh,  Bd.  xlvi.  p.  130 

Fliickiger,  N,  Jahrb.  Pharm,  1869 

Gamgee  and  Maclagan,  Edin.  Boy.  Soc.  Trans, 

1869,  p.  867 
Walz,  N.  Jahrb.  Pharm,  xii.  1861,  p.  302 

Benzoic  Acid. 

Bird,  Golding,  Urinal  Deposits,  Philad.,  1859, 

p.  160 
'  Brown,  Zur  Therapie  der  Diphtheritis,  Arch.  f. 

exp.  Path.  u.  Pharm,  Bd.  viii.  p,  140 
Bryant,  Lancet,  ii.  1876,  747 
Bucholtz,  Arch,  f .  exp.  Path.  u.  Pharm,  Bd.  iv. 

p.l 
Delcours,  Gaz  des  Hop.,  Deo.  1844 
Dougall,  Med.  Times  and  Gazette,  i.  p.  495, 1873 
Fleck,  Benzoesaure,  Carbolsaure,  Zimmtsaure, 

MUnohen,  8vo.  Oldenburg,  1875 
Garrod,  Memoirs  of  the  Chem    Soc,  i.  1842  ; 

London  Lancet,  ii.  p.  239, 1844 
Griibe  W,  Centralbl.  f.  Chem,  1876,  pp.  777,  778 
Hallwachs  u.  KUhne,  Gbtting.  Nachr,  8, 1857 
Jaarsveld,  A.  f .  exp.  P.  u.  Pharm,  x.  268 
JafEe,  Ber.  d.  deutsch.  chem.  Ges,  1877,  p.  1925 
Keller,  Ann.  der  Chem.  und  Pharm,  xliii.  108 ; 

Lancet,  ii.  Nov.  1844,  p.  2E9 
Lamaire,  Phil.  Med.  Times,  iv.  638 
Meissener  u.  Shepard,  Unters.  lib.  d.  Enstehen 

des  Hippurs.  im  thier.  Organismus,  Hannover, 

1866 
Morri,  Trans.  Phil.  Coll.  of  Med,  March  7, 1855 
Rohde,  Berl.  klin.  Wooh,  1871, 10 
Salkowski,  E,  Berl.  klin.  Wochens.  1876,  297 
Seligsohn,  Chem.  Centralbl,  1861 
Shepard,  V,  C,  Der  Hippursaure  im    thier. 

Organismus,  Hannover,  1866 
TJre,  Medico-Chir.  Trans,  xxiv.  p.  30, 1841 
Ure  and  Wood,  Phil.  Trans,  March  7, 1B& 

Benzol. 

Hoffmann,  P.  A,  quoted  bj  B'dhm,  Ziemssen's 

Cyclopaedia,  vol.  xvii.  p.  51  i 
Perrin,  L'TJnion  Med,  1861,  No.  6,  p.  92 


BIBLIOGEAPHICAL  INDEX. 


1245 


Bichloride  of  Methylene. 

Richardson,  B.  W.,  Med.  Times  and  Gaz.,  1867,  p. 
479 ;  ibid.,  1869,  ii.  524  ;  Brit.  Med.  Journ., 
vol.  t.  p.  332,  1871 ;  vol.  ii.  p.  249,  1872 ; 
London  Lancet,  1877,  ii.  26 

Bismuth. 

Becker  u.  Jansen,  Arch,  der  Pharm.,   lv.  31, 

lxviii.  129,  lxxvii.  231,  lxxviii.  18 
Bergeret  et  Mayencon,  Journ.  de  l'Anatomie. 

1873,  p.  242 
Ferler-Meyer,  Wurzburg  Diss.,  1879 
Langhans,  Zeits.  £.  Chirurgie,  xxii.,  p.  575 
Luohsinger  u.  Mory,  Mitth.  d.  Bern.  Naturf.- 

Ges.,  1883,  p.  23 
Stefanowitsch-Lebedeff,    Viroh.'s    u.    Hirsoh'a 

Jahresb.,  1869,  p.  335 
Wiggers,  Canstatt's  Jahresb.  Pharm.,  1848,  p. 

104 ;  1851,  p.  105  ;  1854,  p.  109 

Bitters. 

Buchheim  u.  Engel,  in  Buchheim's  Beitr.  z. 

Arzneimittellehre,  Leipzig,  1849 
Koehler,   H.,  Tageblatt  d.  46.   Naturforscher- 

Versamml.  zu  Wiesbaden,  1873,  p.  70 

Blatta  Orientalis. 

Bogomolow,  Lond.  Record,  1877,  p.  502 
Buttenwieser,  Der  practische  Arzt,  Feb.  1882 
Unterberger,  Petersburg,  med.  Woohensch,,  1876 

Blood  Eoot. 

Smith,  R.M,  Amer.  Jonrn.  Med.  Sci.,  Oot.  1876, 
p.  346 

Borax. 

Binswanger,  Pharm.  WUrdigung  der  Borsaure 

des  Borax  u.s.w.,  1846 
Buchholz,  Arch.  exp.  Path.  u.  Pharm.,  Bd.  iv. 

p.  1 
Copland,  Diet,  of  Pr.  Med.  (art.  Abortion) 
Dumas  and  Schnatzles,  Pharmac.  Journ.,  April 

1874 
G  melin,  App.  Medicaminnm,  i.  p.  104 
Guiboart,  Histoires  des  Drogues  simples,  i.  p. 

191 
Homberg,  Mem.  de  l'Acad.  des  Sci.  de  Paris, 

1702,  33 
IUchter,  Ausflihrl.  Arzneiml.,  iii.  p.  558 
Vogt,  Pharmakol.,  ii.  587 
Wibmer,  Wirk.  d.  Arzneim.  u.  G  if  te,  t.  51 

Bratera. 

Bedall,  Sydenh.  Tear  Book,  1868,  p. 476 ;  l'Union, 

116,  p.  596,  1863 
Leidesdorf,  Wien.  med.  Woch.,  xii.  26, 1871 
Viale,  Journ.  de  Ohimie  med.,  5,  ii.  p.  207, 1866 


Bromal  Hydrate. 


McKendrick,  J.  O-.,  Bd.  Med.  Journ.,  July  1874, 

P.  1 
Rabuteau,  Gaz.  Hebdom.,  xiiii.  p.  681 
Steinauer,  B,  Virch.  ArchiT,  1870,  Bd.  I.  p.  235, 

lix.  p.  65 

Bromides,  Mixed. 

Erlenmeyer,  Centralbl.  f.  Nervenheilk.,  No.  14, 
1884 

Bromine  and  Bromide  of  Po- 
tassium. 

Anstie,  Practitioner,  xii.  p.  19, 1874 


Bartholow,  The  Bromides,  1871 
Binz,  Practitioner,  xii.  p.  6,  Jan.  1874 
Blake,  Journ.  of  Anat.,  iv.  1, 1870 

Bromine  and  Bromide  of  Po- 
tassium. 

Clark  and  Amory,  Bromide  of  Potass.,  Boston, 

1S72 
Ciouston,  Journ.  Mental  Sci.,  Oct.  1868,  vol.  xiv. 

p.  305 
Complete  Literature,  see  Krosz,  Arch.  f.  exp.  P. 

u.  Pharm.,  1876,  Brl.  vi.  p.  46 
'  Eulenburg    u.    Guttmann,    Schmidt's   Jahrb., 

exxxvii,  p.  158,  1868 
Hammond,  Quart.  Journ.  of  Psycholog.  Med., 

vol.  iii.  p.  46,  1869 
Laborde,  Paris,  B.  Delahave,  p.  30, 1870 
Marchand,  B.,  These  de  Paris,  1868,  p.  32 
Namias,  Compt.  Rendus,  lxx.  16,  p.  882, 1870 
Ozanam,  Gaz.  des  Hop.,  No.  66, 1856 
Paul,  C,  Gaz.  des  H6p.,  91, 1866 
Podcopiiw,  Virch.  Arch.,  xxxiii.  p.  505, 1865 
Purser,  J.  M.,  Dub.  Quart.  Journ.,  xlii,  94,  May 

1869 
Ringer,  Sydney,  Lancet,  i.  p.  392, 1869  I 

Teissier,  Gaz.  Med.  de  Lyon,  p.  501,  Not.  16, 

1868 
Williams,  Obstet.  Trans.,  xii.  249, 1871 

Brominated  Camphor. 

Sesnier,  Gaz.  des  Hdp.,  35, 1865 
Bourneville,  Le  Progres  Med.,  1874 ;  The  Prac- 
titioner, Aug.  1874,  p.  119 ;  Comptes  Eend. 

Aug.  1875 
Crichton-Browne,  Edinb.  Med.  Journ.,  June,  1865, 

p.  1085 
Deneffe,  Presse  Med.  Beige,  1871,  p.  405 
Hamilton,  McLean,    N.Y.  Med.    Journ.,  July 

1872,  p.  72 
Hammond,  Wm„  N.T.  Med.  Journ.,  Dec.  1871, 

p.  594 
Lawson,  Practitioner,  vol.  xiii.  p.  324,  1874,  vol. 

xiv.  p.  262,  1875 
Mussy,  Guenau  de,  Union  Med.,  83-6, 1866 
'Pathault,  Bromure  de  Camphor,  Paris,'  1875 
Ricard,  Union  Med.,  cxi.  p.  417,  1869 
Soulez,  Amer.  Journ.  Med.  Sci.,  July,  1877,  p.  237 ; 

Lond.  Med.  Bee,  1877,  p.  196. 

Broom. 

Pick,  Arch,  f .  exp.  Path.  u.  Therap.,  i.  397, 1873 
Husemann,  Die  Pflanzenstoff  e,  p.  64 

Brucine. 

Buchheim  u.  Loos,  Eckhard's  Beitrage,  Bd.  v. 
(MetUylbrucine) 

Cacodyl  Compounds. 

Lebahn,  Rostocker  Inaug.  Diss.,  1868 

Renz,  Deutsch.  Arch.  f.  klin.  Med.,  1865,  i.  2, 

235 
Schmidt  u.  Chomse,  in  Moleschott's  Unters.,  vi. 

122 

Cadmium. 

Marme,  Zeitschr.  f.  rat.  Med.,  1867,  Bd.  xxix. 
p.  113 

Caffeine. 

.Albers,  Deutsche  Klinik,  1853,  p.  370 

Amory,  Boston  Med.  Journ.,  May  28, 1868,  p.  261 


1246 


BIBLIOGRAPHICAL  INDEX. 


Caffeine. 


Aubert,  Pfliiger's  Arch.,  ▼.  p.  589, 1872 
Bennett,  Alex:.,  Brit.  Med.  Journal,  1874,  vol.  ii. 

p.    510;   Edin.   Med.   Journ.,   ccxx.   p.  328, 

1873 
Bennett,  J.  Hughes,  Brit.  Med.  Journ.,  1874, 

vol.  ii.  p.  697 
Binz,  Arch.  f.  exp.  Path.  n.  Ph.,  1878,  ix.  p.  31 ; 

Berl.  klin.  Wochenschr,  xlv.  p.  545, 1872 
B'doker,  BeitrSge  z.  Heilk.,  Bd.  i.  1849 ;  Arch.  d. 

Vereins.  f.  Gemeins.    Arb.  z.  Ford.  d.  wiss. 

Heilkunde,  Bd.  i.  p.  213 
Brill,  Marburger  Dissert.,  Blwert,  1862 
Brown-Sequard,  Arch,  de  Phys.  Norm,  et  Path., 

1868 
Eggerth,  Diss,  de  CofEea,  Pesth,  1833,  p.  31 
Eisenmenger,  Ueb.  d.  Einfluss  v.  Giften  a.  d. 

Zuokungscurve,  etc.,  G-iessen,  Pietsch,  1869, 

p.  49 
Falck  und  Stuhlmann,  Tirchow's  Archiv,  Bd.  xi. 

p.  325 
Garrison,  J.  B.,  Phila.  Med.  and  Surg.  Beporter, 

xxx.  Feb.  6,  p.  Ill,  1874 
Gubler,  Bull.Ther,  xciii.  523 
Hoppe,   F,   l'Echo  Medical,    1858;    Deutsche 

Klinik,  1857,  p.  181 
Johannsen,  0.,  Dorpater  Diss.,  1869 
Langgard,  Centr.  t .  d.  med.  Wiss.,  1886,  p.  513 
Leven,  Arch,  de  Phys.,  1868,  t.  i.  p.  178 
Marvaud,  Angel,  Eflets  physiol.  et  therap.  dea 

Aliments  d'Epargne,  Paris,  1869-71,  p.  118 
Meihuizen,  Pfliig.  Arch.,  vii.  4-5,  p.  201, 1873 
Mitscherlich,  Der  Cacao  und  Chocolade,  Berl. 

1859 
Payen,  Compt.  Bend.,  xxii.  p.  724,  xxiii.  pp.  8 

and  244, 1846 
Biegel,  Verhandl.  d.  III.  Cong.  f.  inner.  Med., 

1884 
Roques,  Schmidt's  Jahrb.,  x.  p.  18 
Bunge,  Schweigg.  Journ.  Chem.  Phys.,  xxxi. 

1820 
Schmiedeberg,  Arch,  t  exp.  P.  u.  Ph.,  Bd.  ii. 

p.  62,  1874 
Schroeder,  V.,  Cent.  f.  d.  med.  Wissen,  1886, 

p.  465 
Smith,  H.  M.,  Journ.  of  Applied  Sciences,  Sept. 

1874 
Stuhlmann  n.  Falk,  Yirch.  Arch.,  Bd.  xi.  p. 

481 
Thompson,  Med.  Times  and  Gaz.,  Feb.  12,  p.  185, 

1871 
TIspensky,  Eeichert's  Arch.,  1868,  p.  522 ;  Cen- 

tralbl.,  1868,  p.  677 
Voit,  Ueber  d.  Wirk.  d.  Kochsalzes  u.  Kaffees 

auf  d.  Stoffwechsel,  MUnchen,  1860,  p.  135 

Calcium  Chloride. 

Warburton  Begbie  Works,  New  Syden.  Soo. 

Camphor. 

Baum,  Centralbl.   f.   d.  med.   Wiss.,  1870,  p. 

467 
FlUckiger,  Neues  Bepertor.  f .  Phann.,  xvii.  28, 

1868 
Grisar,  Bonnar  Diss.,  1873,  u.  Centralbl.  f.  d. 

med.  Wiss.,  1874,  p.  77 
Gubler,  Bull,  de  Therap.,  Dec.  30, 1871,  p.  629 
Harley,  Practitioner,  ix.  210,  1872 
Heubner,  Arch.  £.  exp.  Path.  u.  Phann.,  v.  p. 

427 
Hoffmann,  Beitrag   z.  Keuntn.  d.  Physiolog. 

W.    d.   Carbolsfture   u.    d.    Camphors,   Diss. 

Dorpat,  1866 
Pellacani,  Archiv  f.  exper.  Path.  u.  Pharmak., 

xvii.  p.  369 
Sohmiedeberg  u.  Meyer,  Z.  f .  phys.  Chem.,  iii.  < 

422, 1879 
Wiedemann,  Arch.  f.  exp.  Path.  u.  Pharm.,  Bd. 

Ti.  p.  216  (with  complete  list  of  Literature;  . 


Cannabis  Indica. 

Christison,  Edinb.  Monthly  Journ.  of  Med.  SoL, 

July,  1851,  p.  26 
Fronmilller,  Klinische  Studien  iib.  d.  schlaf- 

machende  Wirkung,  etc.,  Erlangen,  bei  Enke, 

1869 
Lawrie,  Stille's  Therap.,  vol.  i.  p.  772 
O'Shaughnessy,  On  the  Preparations  of  Indian 

Hemp,  Calcutta,  1830 
Preobraschensky,  Dragendorf's  Jahresb,  1877, 

p.  98 
Boemer,  St.  Louis  Med.  and  Surg.  Journ.,  p.  363, 

1873 
Schroff,  V.,  Zeitschrift  d.  Wien.  Aerate,  1857, 

u.  Lehrbuch  d.  Pharmakologie,  Aug.  3,  1868, 

p.  499 
Wood,  Proceed.  Amer.  Philos.  Society,  1869,  vol. 

xi.  p.  226 

Cantharidin. 

Cautieri,  Schmidt's  Jahrb.,  Bd.  clxv.  p.  237 
Cornil,  Practitioner,  xxvii.  p.  110 
Galippe,  Gaz.  Hebdom.,  1874,  p.  439 
Husemann,  Hanb.  d.  Toxicol.,  1862,  p.  264 
Palle,  Journ.  de.  Pharm.  et  de  Chimie,   June 

1871 
Badecki,  Dorpater  Diss.,  1866 
Schwakowa,  Berner  Diss.,  1876 
StUler,  Deutsche  Z.  f .  Chir,  1872,  xii.  377 

Carbazotic  Acid. 

Binz,  Virch.  Arch.,  Bd.  xlvi.  p.  130 

Erb,  W.,  Die  Pikrinsaure,  Wurzburg,  1865 

Carbolated  Camphor. 

Soulez,  Amer.  Journ.  Med.  Sci.,  July,  1877,  p. 
237,  and  London  Med.  Becord,  May,  1877 

Carbolic  Acid. 

Almen,  Zeitschr.  f .  Anal.  Chimie,  Bd.  x.  p.  125, 

Heft  7 
Aufrecht,  Centralbl.  med.  Wiss.,  1874,  p.  129 
Baumann,  Pfliiger's    Archiv,  Bd.  xiii.  .p.  285  ; 

Zeits.  f.  phys.  Chimie,  v.  Hoppe-Seyler,  i.  p. 

244 ;  Du  Bois'  Arch.,  physiol.  Abth.,  1879,  iii. 

245 
Baumann  u.  Sonnenburg,  Med.  Times  and  Gaz., 

ii.  1878 
Bill,  J.  H.,  Amer.  Journ.  Med.  Sci.,  Oct.  1870, 

p.  673 
Brieger,  Zeitschr.  f.  physiol.  Chemie,  iii.  p.  134 
Buchholtz-Waldemar,  Dorp.  Diss.,  1866 
Buchholtz,  Einwirk.  a.  Gahrungs-Processe,  Dor- 
pat,  1866,  p.  50 
Buliginski,  Hoppe-Sejler's  Med.  chem.  TJnters., 

Berlin,  1867,  p.  234 
Dougall,  John,  Lancet,  1870,  vol.  ii.  p.  176 
Eames,  J.  H.,  Brit.  .Med.  Journ.,  May,  p.  490, 

1873 
Erb,  E„  Schmidt's  Jahrb,  Bd.  clxiv.  p.  148 
Hagen,  Sohmidt's  Jahrb.,  Bd.  clxiv.  p.  147 
Hoffmann,  W„  Dorpat.  Diss,  1866 
Hoppe-Seyler,  Pfliiger's  Arch,  1872,  Bd.  v.  pp. 

470,  475,  476,  479 
Hueter,  C,  Deutsch.  Zeits.  f.  Chir,  iv.  p.  508, 

1874 ;  Sohmidt's  Jahrb,  clxiv.  p.  144 
Husemann,  Schmidt's  Jahrb.,  Bd.  civ.  p.  274 
Husemann  u.  TJmmethun,  Deutsch.  Klinik,  1870 

and  1871 
Eempster,  W,  Amer.  Journ.  Med.  Sci,  July, 

1868,  p.  31 
Knuze,  Centralbl.  med.  Wiss,  1874,  p.  479 
LaWe,  E,  Arch.  Gen.  do  Scien,  t.  xviii.  p.  451, 

1871 
Lemaire,  J.,  De  l'Acide  phenique,  2e  ed,  Paris, 

1865 


BIBLIOGRAPHICAL  INDEX. 


1247 


Carbolic  Acid. 

Lister,  J.,  Lancet,  vol.  ii.  1867,  p.  353 
Mader,  Centralbl.  f.  Chir.,  1877,  p.  376 
Neumann,  I.,  Aroh.  1  Dennat.  u.  Syphil,  Jahrg. 

i.  1869,  p.  425 
Oberst,  Berl.  klin.  Wooh.,  1878,  p.  157,  No.  xil. 

(Acute  Poisoning) 
Fatrouillard,  Journ.  de  Pharm.  et  de  Chimie, 

Dec.  1871,  p.  459 
Plugge,  P.  0.,  PflUgert  Arch,  1872,  Bd.  v.  p. 

540 
Reuder,  Journ.  de  Pharm.  et  de  Chimie,  p.  456, 

Deo.  1871 
Rosenbach,  "Deb.  d.  Einfluss  Carbolsaure,  u.s.w, 

Gottingen,  1873 
Salkowski,  PflUger's  Arch.,  Bd.  T.  p.  210,  335, 

1872  ;  Centralbl.  med.  Wiss.,  1876,  p.  818 
SchafEer,  Journ.  f.  praot.  Chimie,  N.F.  xviii. 

p.  282 
Schmidt,  T„  Centralbl.  i .  Chir.,  1876,  552 
Senator,  Berl.  klin.  Wochenschr.,  1876,  p.  69 
Sonnenburg,  Deut.  Zeits.  f.  Chir.,  Bd.  ix.  p. 

356 
Stadeler,  Ann.  d.  Chem.  u.  Pharm.,  Bd.  lxxxvii. 

p.  17 
Stevenson,  Brit.  Med.  Journ.,  vol.  i.  p.  442, 1870 ; 

and  Guy's  Hosp.  Rep.,  1868,  p.  407 
Tauber,  Z.  f.  phys.  Chem.,  ii.  366 
Ummethun,  Gottingen.  Diss.,  1873 
Tolkmann,  Volkmann's   Samml.   klin.  Yortr., 

1875,  No.  xcvi.  in  Beit.  z.  Chir.,  p.  42 
Waldenstrom,  Zeitschr.  d.  Allgemein.  Apothek.- 

Tereins,  Jan.  10,  1872 
Wilson,  Erasmus,  Journ.  Cutaneous  Med.,  June, 

1870 

Carbon. 

Liebermann,  Sitzber.  d.  k.  k.  Acad.  d.  Wiss. 

Wien.,  1877,  p.  331 
Stenhouse.  Economical  Applications  of  Charcoal, 

3rd  ed.  Loud.  1855 


Carbonic  Acid. 

Basch,  Ton,  u.  Dietl,   Wien.  m.  Jahrb,  1870, 

xxvi.  3 
Beddoes,  on  the  Med.  Effects  of  Factitious  Airs, 

pp.  iv.  p.  42 
Bernard,  CI.,  Subst.  toxiques,  etc.,  p..  135 
Bert,  Comptes  Bend.,  t.  lxxxvii.  p.  628 
Buchheim,    A.  t.  exp.  P.  u.  Ph.,  Bd.  iv.  p. 

137 
Christison,  on  Poisons,  3rd  ed.  p.  745 
Donders,  PflUger's  Arch,  Bd.  v.  p.  20 
Friedlander  u.  Herter,   Z.  f.  physiol.  Chem., 
•    1878,  ii.  99,  and  1879,  iii.  19 
Heidenhain  u.  L.  Meyer,  Stud.  d.  physiolog. 

Instit,  zu  Breslau,  Bd.  ii.         ■  - 
Hermann,  L,  Exper.  Toxikolpgie,  1874,  p.  118 
Hickmann,  Seance  de  l'Acad.  Boy,  Sept.  24, 

Humboldt,  Von,  TJ.  Ub.  d.  gereizte  Nerven  u. 

Muskelfaser,  ii.  p.  321 
Kiihne,   Protopl&sma  u.  Contractilit'at,  pp.  28, 

Liebig,  G,  Arch.  f.  Anat.   u.  Physiol.,  1850, 

p.  401 
Pflilger,  PflUger's  Arch,  Bd.  i. 
Preyer,  Wiener  Acad.  Sitzber.  Math.-nat.  CI., 

Bd.  xlix. ;  PflUger's  Arch.,  Bd.  i.  p.  395 
Priestley,  on  Airs,  vol.  i.  p.  302 
Quincke,  A.  f .  exp.  P.  u.  Ph.,  vii.  p.  101, 1877 
Schott,  Aug,  Berl.  klin.  Woollens.,  No.  33,  1885 
Setschenow,  Wiener  Acad.  Sitzungsber.  Math.- 
nat   CI.,  Bd.  xxxvi. ;  Z.  f.  rat.  Med.,  Bd.  x.  p. 
101  •  Centralbl.  f .  d.  med.  Wiss,  1873,  p.  355, 
1877,  625,  u.  1879,  p.  369 
Znntz,  Centralbl.  1.  d.  med.  Wiss,  Bonner  Diss, 
'    1868 ;  Berl.  klin.  Wochenschr,  186, 1870     , 


Carbonic  Oxide. 

Priedberg,   Die  Vergift.   durch  Kohlendunst, 

Berlin,  1866 
Hoppe-Seyler,  Tirch.  Arch.,  1857,  Bd.  xii. 
Kiihne,  Centralbl.  t.  d.  med.  Wiss,  1864,  p.  134 
Lothar  Meyer,  Breslauer  Diss,  1858 
Pokrowsky,  Arch,  f .  Anat.  u.  Phys.,'  1866,  p.  59 
Senff,  Dorpater  Diss,  1862 
Traube,  Gesammelte  Beitriige,  Berlin,  1878,  iii. 

Chinoline. 

McKendrick  and  Dewar,  Proc.  Boy.  Soc,  1874, 
p.  432 

Chloral  Hydrate. 

Adams,  Lancet,  i.  pp.  212  and  667, 1870 

Adrian,  New  York  Med.  Journ,  1870 

Andrews  and  Da  Costa,  Amer.  Journ,  Med.  Sci, 

April  1870,  p.  359 
Anstie  and  Andrews,  Amer.  Journ.  of  Insan, 

July  1871 
Beck,  Jos.  R,  St.  Louis  Med.  and  Surg.  Journ, 

June  1872 
Bouchut,  N.T.  Med.  Gaz.,  Dec.  1870 
Bradbury,  J.  B,  Brit.  Med.  Journ,  vol.  i.  p.  363, 

1871 
Brunton,  Lauder,  Journ.  Anat.,  viii.  p.  332, 1874 
Clarke,  Lancet,  May  2, 1874,  p.  643 
Clemens,  Schmidt's  Jahrb,  Bd.  cli.  p.  105 
Demarquay,  Bull.  Therap,  t.  lxxvii.  p.  307 
Dieulafoy  and  Krishaber,  Amer.  Journ.  Med.  Sci, 
.    Jan.  1870,  p.  234 

Djurberg,  Schm.  Jahrb.,  Bd.  cli.  p.  84 
Dujardin-Beaumetz    et   Hirne,  Bull.  Therap, 

lxxxvi.  p.  224, 1872 
Elliott,  G.  F,  Lancet,  1873,  i.  754 
Fuller,  H.  W,  Lancet,  March,  1871,  p.  403 
Gascoyen,  Brit.  Med.  Journ,t  vol.  i.  p.  91, 1872 
Giovanni  u.  Bauzoli,  Schmidt's  Jahrb.,  Bd.  cli. 

p.  91 
Hammarsten,  Deutsche  Klinik,  1870 ;  Schmidt's 

Jahrb,  Bd.  cli.  p.  90 
Harnack,  Arch.  f.  exp.  Path.  u.  Pharmak,  Bd. 

xvil.  p.  185  (Chloral  group) 
Harnack  u.  Witowski,  ibid.,  Bd.  xi.  p.  1 
Keen  and  Personne,  Phil.  Med.  Times,  vol.  iv. 

p.  385 
Keen,  Schmidt's  Jahrbucher,  clxxvii.  p.  139 ; 

Am.  Journ.  Med.  Sci,  July  1875,  pp.  76  and 

150 
Kirn,  Ludwig,   Allgem.   Zeits.   f.  Psychiatrie, 

xxix.  1872 ;  Practitioner,  vol.  x.  p.  361 
Leavitt,  Amer.  Journ.  Med.  Sci,  Apr.  1871,  p. 

363 
Levinstein,  Lancet,  i.  p.  279, 1874 
Lewisson,  Reichert's  Arb.  f.  Anat.  u.  Phys,  1870, 

p.  348 
Liebreich,   Chloralhydrat,  enr  neues  Hypnoti- 

cum,  Berlin,  1869;   Wiener  med.  Wochens, 

Aug.  1869,  p.  1087 
Macnamara,  Pract,  vol.  ix.  257 
Mering,  T,  Arch,  f .  exp.  Path,  iii.  18S-203;  Zeits. 
.  f .  phys.  Chemie,  vi.  p.  480 
Morgenstern,  Wien.  med.  Presse,  Nov.  1871,  p. 

1212 
Mosso,  Schmidt's  Jahrb,  clxxvii.  p.  138 
Murchison,  Lancet,  ii.  p.  596, 1870 
Owsjannikow,  Leipz.  Acad.  d.  W,  1871 
Pellogio,  Schmidt's  Jahrb,  Bd.  cli.  p.  89 
Personne,  Journ.  de  Pharm.  et  de  Chimie,  1870, 

p.  1 
Playfair,  Lyon,  Lancet,  1874,  vol.  i.  p.  263 
Bajewski,  Centralbl.  f.  d.  med.  Wiss,  1870,  p. 

'211 ;  Schmidt's  Jahrb,  Bd.  cli.  p.  90 
Rehn,  Jahrb.  f.  Kinderkrankb,  1871,  p.  430 
Reynolds,  Practitioner,  1870,  iv.  p.  188 
Richardson,  Med.  Times  and  Gaz,  vol.  ii.  p.  374, 

1870 
Rigden,  Practitioner,  vol.  v.  p.  151, 1870, 


1248 


BIBLIOGEAPHICAL  INDEX. 


Chloral  Hydrate. 

Eussell,  Glasgow  Med.  Journ.,  Feb.  1870,  p.  209 
Schmidt1  s  Jahrb.,  Bd.  cli. ;   Kbhler's  Abstracts 

of  papers 
Schule,  AUgem.  Zeits.  f.  Psych.,  xxviii.  p.  1 
Schulz,  Arch.  i.  exp.  Path.  u.  Ph.,  xvi.  p.  305 
Smith,  N.  R.,  Bost.  Med.  aud  Surg.  Journ.,  vol. 

Tiii.  p.  33,  1871 
Tomasczewitz,  Pfliiger's  Arch.,  Bd.  ix.  p.  35 
Waterhouse,  Practitioner,  Dec.  1870,  vol.  v.  p. 

244 
"Watson,  Med.  and  Surg.  Reporter,  Jan.  37, 1871 
Widenhofer,  Boston  Med.  and  Surg.  Journ.,  1874 

Chloride  op  Sodium. 

Becquerel  et  Rodier,  G-az.  de  Paris,  xlriii.  1844 

Bert,  P.,  Comp.  Bend.,  lxxiii.  p.  382 

Berzelius,  Lehrbuch,  ix.  n.  98 

Guttmann,  Klin.  Woch.,  1865,  xxxiv.-xxxvi. 

Hoppe,  Deutsche  Klinik,  xxxii.  1863 

Klein  u.  Yerson,  Centralbl.  f.  med.  Wiss.,  1867, 

p.  788 
Lehmann,  Physiol.  Chem.,  i.  p.  440,  ii.  171,  241, 

iii.  141,  255 
Miiller,  Inaug.  Diss.,  Greifswald  (on  Pleurisy) 
Nasse,  H.,  R.  Wagner's  Handworterbuch  (art. 

Blut),  p.  167 
Panum,  Yirch.  Arch.,  iv.  1852 
Poggiale  et  Plouviez,  Comp.  Bend.,  xxv.  p.  110 
Prussak,  Wien.  Acad.    Sitzungsber.,  M.  1876, 

(Abth.  ii.),  p.  13 
Babuteau,  Bull,  de  Therap,  lxxxi.  1871,  p.  562 
Bobinson,  Brit.  Med.  Journ.,  1883  (on  Pleurisy) 
Voit,  "Cnters.  Ub.  d.  Einfluss  d.  Kochsalzes,  u.s.w., 

MUnchen,  1860 
Wiscknewsky,  Canstatt's  Chemie,  p.  116, 1867 


Chloroform. 


Anstie,  Stimulants  and  Narcotics,  p.  321 

Baudin,  Le  Progres  M6d,  Sept.  1874 

Bernard,  CI.,   Lecons  sur  les  Anesthesiques, 

Paris,  1875 
Bernstein,  Centralbl.  1.  d.  med.  "Wiss.,  1867,  Bd. 

v.  p.  38 ;  Schmidt's  Jahrb.,  Bd.  clxii.  p.  218 
Bert,  Comp.   Bend.,  t.  lxiv.  ,1867 ;    Journ.  of 

Anat.  and  Phys.,  May,  1870,  p.  312  ;  Compt. 

Bend.,  cxiii.  p.  768 
Bonwetsch,  Dorpater  Dissert.,  1869 
Bbttcher,  Virch.  Arch..  Bd.  xxxii.  p.  126 
Bowditcb,  H.  P.,  and  0.  S.  Minot,  Boston  Med. 

and  Surg.  Journ.,  May  1874 
Bndin  et  Coyne,  Arch,  de  Phys.  norm,  et  path., 

1875.  61-100 
Bufalini,   Giorn.  di  Clin,  e  Therap.,  iii.  1884 

(Chloroform  water  in  chronic  gastritis) 
Carter,  Brit.  Med.  Journ.,  vol.  i.  p.  208,  1867 
Chloroform  Committee,  Med.-Chir.  Trans.,  vol. 

xlvii.  p.  326 
Dogiel,  Arch.  f.  Anat.  u.  Phys.,  1866 
English  Chloroform  Committee,   Medico-Chir. 

Trans.,  1864,  vol.  xlvii. 
Eulenburg  (Anaesthetics),  Cent.  Id. med.  Wiss., 

1881,  No.  6 
Glover,  Ed.  Med.  Journ.,  1842,  pp.  709  and  1009 
Gosselin,  Arch.  Gen.,  1848,  vol.  xviii.  p.  385 
Harley,  Phil.  Trans.,  London,  1865 
Hartmann,  Giessener  Dissert.,  1855 
Hermann,  Arch,  f .  Anat.  u.  Phys.,  1866,  p.  27 
Holmes,  E.  L,  Chicago  Med.  Examiner,  Sept. 

1868 
Husemann's    Abstracts     in    Yirchow-Hirsch's 

Jabresber. ;  Schmidt's  Jahrb.,  Bd.  cli.  p.  80 
Knoll,  Wien.  Acad.  Sitzber.,  1874,  1876, 1877 
Krnkenberg,  Yergleioh.  phys.  Studien,  Abth.  1, 

p.  77 
Lallemand,  Perrin,  Duroy,  Du  R61e  de  l'Alcohol 

et  des  Anesthesiques,  Paris,  1860 
Leute,  T.  D.,  Psyohol.  and  Med.  Legal  Journ., 

Feb.  1875 
Luchsinger;  Pfliiger's  Arohiv,  xxviii.  p.  61 


Chloroform. 

McKendriek,  Coats,  and  Newman,  Brit.  Med. 

Journ.,  Deo.  18, 1880 
Noel,  Lond.  Med.  Record,  1877,  p.  457 
Nothnagel,     Berl.    klin.    Wochenschr.,     1806, 

Bd.  iii. 
Prevost,  Pract.,  July,  1881 
Eanke,  H.,  Centralbl.  f.  med.  W,  1867,  p.  209,  u. 

1877,  No.  34,  p.  608 
Richardson,  Med.  Times  and  Gazette,  1860-70 
Sabarth,  Das  Chloroform,  Wtirzburg;  1866 
Sansom,  Chloroform,  p.  55,  Philadelphia,  1866 
Scheinesson,  Dorpater  Diss.,  1868,  ii.  Arch.  d. 

Heilk.,  Bd.  x.  p.  36 
Sohenk,  Sitz-berichte  d.  Wien.  Acad.,  M.N.  CI., 

1R68,  Bd.  lxviii. 
Schmidt's  Jahrb.,  Bd.  cxiii.  cxlv.cli,  H.  Kbhler's 

Abstracts 
Schmidt,   A.,  u.  F.  Schweiger-Seidel,  Ber.  d. 

KBnig.   Sachs.  Gesell.  d.  Wiss.   Math.  Phys. 

Klin.,  1867,  p.  190 
Schmiedeberg,  Dorpater  Diss.,  1867 
Simpson,  Edin.  Month.  Journ.  of  Med.  SeL,  1847, 

p.  33,  and  1848,  p.  315 
Simonin,  Centralbl.  Chir.,  1876,  p.  234 
Snow,  On  Chloroform  and  other  Anaesthetics, 

London,  1858 
Yulpian,  Compt.  Bend.,  lxxxvi.  p.  1303 
Westphal,  Yirch.  Arch.,  Bd.  xxvii.  p.  409 
Winslow,  W.  H.,  Phil.  Med.  Times,  vi.  p.  275 

Chrysophanic  Acid. 

Gehe's  Handelsberichte,  1878-79 
Squire,  Centralbl.  f .  d.  med.  Wiss,  1877,  p.  384, 
u.  1878,  p.  699 

ClMICIFUGA.- 

Chapman,  N.,  Elements  of  Therap,  6th  ed.  vol .  i. 
Davies,  N.  S,  Trans.  Amer.  Med.  Assoc,  1848, 

vol.  i.  p.  351 
Young,  Amer.  Journ.  Med.  Sci,  vol.  ix.  1831, 

p.  310 

ClNCHONINE. 

Buotaheim  u.  Loos,  Eckhard's  Beitrage, 
(Methyl  compounds.) 


Cocaine. 


Anrep,  Pfliiger's  Arch.  Bd.  xxi.  3,  38  (with  com- 
plete list  of  literature) 

Bennett,  A.  Hughes,  Edin.  Med.  Journ.,  Oct. 
1873 

Jessop,  Practitioner,  xxxiv.  p.  1 ;  Proc.  Roy. 
Soc,  1S35. 

Koller,  Cent.  f.  d.  med.  Wiss.,  1874,  p.  870 

Codeine,  vide  Opium  Alka- 
loids. 

Barbier,  Gaz.  Med,  ii.  p.  147, 1834 
Barnay,  De  la  Codeine,  Paris,  1877 
Baxt,  W,  Reiohert's  Arch,  1869,  p.  125 
Berthe,  Compt.  Bend.,  lix.  p.  914, 1865 ' 
Crum-Brown  and  Fraser,  Proceed.  Roy.  Soc.  of 

Edin,  xxv.  Jan.  6, 1868 
Des  Brulais,  Mon.  des  H6p,  xcvi.  p.  767, 1856 
Dumont,  Mon.  des  H6p,  xxviii.  p.  221, 1858 
Falck,  Deutsche  Klin,  1870 
Guibert,  Nouveaux  Med,  p.  397 
Harley,  Old  Yeg.  Neurotics,  p.  179 
Husemann,  Pflanzenstoffe,  p.  155 
Krebel,  Med.  Ztg.  Ensslands,  1856,  p.  69 
Kunkel,  Journ.  de  Chimie  Med,  xi.  223, 1833 
Mitchell,  Weir,  Amer.  Journ.  Med.  Soi..  Jan. 

1870,  p.  26  ' 


BIBLIOGRAPHICAL  INDEX. 


1249 


Codeine,  vide  Opium  Alka- 
loids. 

Myrtle,  Brit.  Med.  Journ.,  1874,  i.  478 

Ott,  Opium  Alkaloids 

Pavy,  Guy's  Hosp.  Reports 

Schroff,  Von,  Pbannakologie,  3.  Aufl.  p.  483 

Wachs,  L,  Das  Codein,  Diss.  Marburg,  1858 

COLCHIOTM. 

Albers,  Deutsche  Klinik,  1856 
Bacmeister,  Arch.  d.  Pharmacie,  1857 
Bird,  Urinary  Deposits,  Phila.,  1859,  p.  354 
Garrod,  A.  B.,  Med.-Chir.  Trans.,  1858,  xii.  348 
Geiger,  Annal.  Chem.  Pharm.,  vii.  274 
Hammond,  Proc.  Phila.  Acad.  Nat.  Sci.,  Dec. 

1858 
Hoppe  u.  Aschofc,  Vierteljahrs.  f.  prakt,  Pharm., 

vi. 
Krahmer,  Journ.  f .  Pharmacodynamic  ii.  561 
Lewins,  R,  Ed.  Med.  and  Surg.  Journ.,  1841, 

vol.  lvi.  p.  200 
Ludwig  and  Pfeiffer,  Arch,  der  Pharm.,  cxi.  3 
Maclagan,  Ed.  Monthly  Journ.  of  Med.  Sci.,  3rd 

series,  vol.  xiv.  p.  24 
Major,  G.  W,  Canada  Med.  Surg.  Journ.,  Dec. 

1873 
Percy,  S.  E.,  Amer.  Med.  Times,  Apr.  1862,  p. 

173 
Rossbach,  Pharm.  TJnters.,  Bd.  ii.  1876,  pp.  1-58 ; 

Arch,  t .  d.  ges.  Phys.,  xii.  p.  308 
Schroff,  V.,  Zeitschr.  d.  Ges.  d.  Aerzte,  1851,  u. 

Oesterr.  Zeitschr.  i.  pract.  Heilk.,  1856 
Scudamore,  On  Gout,  Lond.  1835 
Taylor,  Med.  Juris.,  2nd  ed.  vol.  i. 
Wood,  Geo.  B.,  U.S.  Dispensatory,  13th  ed.  p. 

1504 

Colocynth,  vide  Purgatives. 


Buchheim,  Die  scharfen  Stoffe,  etc. 
Husemann,  Handbuch.  d.  Toxicol.,  p.  525 
Marine,  W,  Zeits.  I.  rat.  Mediz,  xxvi.  61 
Schroff,  Yon,  Pharmacologic,  4.  Aufl.,  p. 
1873 


CONDURANGO. 

Brunton,  Lauder,  Journ.  of  Phys.,  v.  17 

Ernst,  Vjhrschr.  f.  ger.  Med.,  xvi,  2,  p.  321,  u. 

Schmidt'B  Jahrb.,  clvii.  p.  121 
Friedreich,  Berliner   klin.  Wochenschr.,  1874, 

No.  1 
Gianuzzi,  Cent.  f.  d.  med.  Wiss.,  1873,  p.  824 
Hulke,  Oentralbl.  f.  d.  med.  Wiss.,  1872,  p.  Ill 
Obalinski,  Oentralbl.  f.  Chir.,  1874,  No.  12,  p. 

177 
Biegel,  Berl.  klin.  Wochenschr.,  1874,  No.  35  u. 

36 
Sanctis,  De,  Schmidt's  Jahrb.,  clvii.  p.  121 
Sandahl,  Hygiea,  1872,  p.  14,   and   Schmidt's 

Jahrb.,  clviii.  p.  121 
Schroff,  Ton,  Schmidt's  Jahrb.,  clviii.  p.  211 

Copaiba. 

Bernatzik,  Prager  Vierteljahrs.,  Bd.  o.  1868,  p. 

239 
Blanchard,  Gaz.  des  Hop.,  xl.  1852 
Gubler,  Comment,  therap.  du  Code,  p.  88  ;  Bull. 

de  la  Soc.  de  Therapeut,  le  serie,  xvi. 
Mitscherlik,  Preuss.  Yereinsz.,  xix.  22, 1848 
Bees,  Guy's  Hosp.  Rep.,  vol.  xvii. 
Schweitzer,  Poggend.  Ann,  Bd.  xvii.  pp.487  and 

1095 
Valentine,  Grundriss  der  Phys. 
Weikart,  H.,  Arch.  d.  Heilk.,  1860,  p.  176 
Wilks,  Lancet,  i.  12,  Mar.  1873,  p.  410 


COPPER. 

Bailly,  L'Union,  6, 1874 ;  Schmidt's  Jahrb.,  clxiii. 

1874,  iii.  Bd.  p.  61 
Bergerefc  u.   Mayencon,   Journ.  de  l'Anat.  et 

Phys,  1873 
Blake,  Prank's  Magaz.,  ii.  405 
Blasius,  Zeitschr.  f.  rat.  Med,  3.  Reihe,  Bd.xxvi. 

p.  240 
Buchner,  Toxikol,  2.  Aufl,  p.  525 
Burq,    Ducom,    Schmidt's    Jahrb,    1878,    Bd. 

clxxviii.  14 ;  Arch,  de  Phys.  Norm,  et  Path, 

1877,  t.  iv.  183 
Clapton,  Med.  Times  and  Gaz,  vol.  i.  p.  658, 

June,  1868 
Clemens,  Schmidt's  Jahrb,  cxxxi.  p.  82, 1866 
Palck,  Deutsche  Klinik,  xi.  1859 
Paulk,  Deutsch.  Klin,  x.  430 
Peltz  et  Hitter,  Compt.  Rend.,  lxxxiv.  p.  606  ;  #. 

lxxxv.  p.  87 
Galippe,  Etude  toxicol.  sur  le   Cuivre,   Paris, 

1875  ;  Comptes  Rendus,  t.  ixxxiv.  pp.  404  and 

718 
Harnack,  Arch,  f .  exp.  P.  u.  Pharm,  Bd.  iii.  p. 

46,  u.  Bd.  ix.  p.  164,  1874 
Honerkopff,  Ueb.  d.  An  wend.  d.  schwef  elsauren 

Kupferoxydes  gegen  Croup,  Leipzig,  1852,  p, 

60 
Lieberk1ihn,Poggendorff'sAnn,1852,Bd.lxxxvi. 
London  Clinical  Soc.  Transactions,  1870,  p.  13 
Merat  et  de  Lens,  Diet.  univ.  de  Mat.  Med,  ii 

p.  67 
Mitscherlich,  Miiller's  Arch,  1837,  p.  91 
Neebe,  Marburger  Diss,  1857 
Pierre,  St,  u.  Pecholier,  Med.  Oentralbl,  1854 

p.  270 
Wibmer,  Wirk.  der  Arzneim.  u.  Giffce,  ii.  260, 

1838 

COTO. 

Albertoni,  Arch.  f.  Path.  u.  Pharm,  xvii.  291 
Burkhart,  Berl.  klin.  Woch,  1877,  p.  276 
Jobst,  Ber.  d.  deutsch.  chem.  Ges,  1876,  No.  17 


368,    Ckoton  Oil,  vide  Purgatives. 

Adams,  Husemann,  Toxicol.,  Bd.  ii.  p.  443 
Brunton,  Lauder,  Practitioner,  xii.  346 
Buchheim,  Yirehow's  Arch.,  xii.  1 
G-iacomini,  Stille's  Therapeutics,  vol.  ii.  p.  451 
Hertwig,  Stille's  Therapeutics,  2nd.  ed.  vol.  ii. 

p.  449 
Joret,  Bull,  de  Therap.,  lxi.  p.  385, 1861 
Radziejewsky,  Casuistik  der  Yergift.  bei  Huse- 
mann, Handbuch,  p.  442,  u.  Pnanzenstoffe,  p. 
1113 
"Wibmer,  Wirkungen,  etc.,  ii.  222 


CuBEBA. 

Adams,  Edinb.  Med.  Surg.  Journ.,  xv.  61 
Bernatzik,  Prag.  Yierteljahrs.,  1864,  Bd.  Ixxxi. 

p.  9 
Clarus,  Arzneiml,  p.  728 
Crane,  Edin.  Med.  Surg.  Journ.,  xxi.  302 
Crawford,  Edin.  Med.  Surg.  Journ.,  xiv.  32 
G'odecke,  Preuss.  Yereinsz.,  34,  35, 1850 

CUEAEE. 

Buchheim   u.   Loos,   TTeber    d.    pharmakolog.  • 

Gruppe  des  Curarius,  Giessener  Dissert.,  1870 
Bernard,  CI.,  Lecons  sur  les  Substances  toxiques, 

Paris,  1857,  p.  338 ;  Revue  des  Sciences,  1865 
Bezold,  Reicherfc  u.  du  Bois'  Arch.,  1859 
Colasanti,  Pfliiger's  Arch.,  Bd.  xvi.  p.  157 
Conty  et  de  Lacerda,  Compt,  Rend.,  lxxxix.,  p. 

582 
Eckhardt,  Beltr.  z.  An.  u.  Physiol.,  Bd.  vi.  p.  19, 

Gieaaen,  1871  (Historical)  ;  Ibid.  Bd.  vii.  p.  67 

4l 


1250 


BIBLIOGBAPHICAL   INDEX. 


CUEAEE. 

Prey,  Ludwig  3  Arbeiten,  1870,  p.  98 
Eunice,  Ber.  d.  k.  sachs.  Acad.,  1869 
Hermann,  Pfliiger's  Arch.,  Bd.  xviii.,  p.  458, 

1878  ;  Arch.  1.  Anat.  u.  Phys.,  1807,  64,  p.  650 
Kblltker,  Virch.  Arch.,  Bd.  x.  p.  1 
Ktihne,  Beichert  u.  du  Bois'  Arch.,  1860,  p.  477 
Lautenbach,  Phil.  Med.  Times,  May  26,  1877 
Preyer,  Gbttinger  Zeitsch.  f.  Chemie,  i.  p.  381 

(Curarine) 
EHhrig  u.  Zuntz,  Pfliiger'3  Arch..  Bd.  iv.  p.  57, 

1871 
Schulz,  Zeitsehr.  f .  klin.  Med.,  iii.  p.  10 
Steiner,  J.,  Reichert  u.  Du  Bois'  Arch.,  1875, 

u.  eigene  Schrift.,  Leipzig,  1877 
TarchanofO,  J.,  Arch,  de  Phys.  norm,  et  path., 

1875,  33-60 
Zuntz,  Pfliiger's  Arch.,  Bd.  xii.  p.  522, 1876 

Cyanogen,  vide  Peussic  Acid. 


Datueia. 

Laurent,  Oh.,  These,  Paris,  1870,  p.  2? 


Digitalis. 


Ackermann,  Deutsch.   Arch.  f.  klin.  Medicin, 

Bd.  xi.  9,  p.  136;    Tolkmann'3  Samml.  klin. 

Vortrage,  No.  48,  Leipzig,  1872 
Bert,  P.,  Gaz.  Med.  de  Paris,  xi.  1873 
Boldt,  Inaug.  Diss.,  Schmidt's  Jahrb.,  March, 

1872 
Bbhm,  Pfliiger's  Arch.,  Bd.  v.  4  u.  5,  p.  153, 

1872 
Bordier,  Bull.  Therap.,  1868,  yol.  lxxiv.  p.  110 
Brunton,  Lauder,  On  Digitalis,  London,  1868 
Brunton  and  Meyer,  Journ.  of  Anat.  and  Phys., 

vii.  1872,  p.  134 
Brunton  and  Power,  Proc.  Boy.  Soc,  1874,  No. 

153 
Christison,  Edin.  Med.  Journ.,  vii.  p.  149 
Coblentz,  Z.  B.,  Strasburg,  Thesis,  1862 
Costa,  Da,  Amer.  Journ.  Med.  Sci.,  Jan.  1871,  p.  1 
Dickinson,  Med.-Chir.  Trans.,  vol.  xxxi  v.  p.  1 
Donaldson  and  Stevens,  Journ.  oil  Phys.,  vol.  iv. 

p.  165 
Dybkowsky,  W.,  and  E.  Pelikan,  Zeitsehr.  f. 

wiss.  Zool,,  Bd.  xi.  1852 
Eulenbnrg     u.     Ehrenkaus,    Med.    Central-Z., 

xxviii.  777,  1859 
Fagge  and  Stevenson,  Proceed,  of  the  Royal  Soc. 

London,  vol.  xiv.  p.  270 
Fotbergill,  Digitalis,  London,  1871 ;  Brit.  Med. 

Journ.,  pp.  5,  27,  57,  90,  115,  and  146.  1871 
G'brtz,  Schmidt's  Jahrb.,  Bd.  clv'ii.  ;  Unters.  iib. 

Digitalis-Priiparationen,  Dorpat,  1873 
Gourvat,  Gaz.  Med.  de  Paris.  1871 
Gaunot,  Phila.  Med.  Times,  iv.  30 
Hammond,   Proc.  Biol.   Dep.  Acad.  Nat.  Sci. 

Phila.,  Dec.  1858  ;  Am.  Med.  Journ.,  Jan.  1859, 

p.  275 
Homolle,  Arch.  Gener.  de  Med.,  July,  1861,  p.  5  ; 

Journ.  de  Pharm.  et  de  Ghimie  (3),  vii.  p.  57 
Kiihler,  H.,  Arch.  i.  exp.  Path.  u.  Pharm.,  i.  2,  p. 

138,  1873 
Kbhnhorn,  Lancet,  1876, 1  p.  682 
Koppe,  Arch.  f.  exp.  Path.  n.  Pharm.,  Bd.  iii.  p. 

274 
Kosmann,  Bull,  de  Therap.  lix.  p.  60,  July,  1860 
Lorain.  Paul,  Journ.  de  l'Anat.  et  Phys.,  1870,  p. 

128 
Meiliuizen,  Arch.  t.  Phys.,  vii.  p.  201, 1873 
Meusnier,  Aug.,  De  l'Aotion  de  la  Digitale  sur 

la  Ponction  glycogenique,  Paris,  Thesis,  1868 
Meyer,  A.    B.,  Arb.    u.    d.    Phys.    Instit.  zu 

ZUrich,  Centralbl.  f.  med.  Wiss.,  xvii.  p.  270, 

1869 
Onimus,  Journ.  de  l'Anat.  et  Phys.,  ii,  337,  July, 

1865 


Digitalis. 

Otto,  Deutsch.  Arehiv  f.  klin.  Med.,  xvi.  140 
Paul,  C,  Bull.  Therap,  1868,  lxxiv.  p.  193 
Perrier,  Arch.  f.  exp.  Path.  u.  Pharm.,  Bd. 

p.  191 
Quevenne  et  Homolle,  Arch,  de  Phys,  deTherap, 

etc.,  par  Bouchardat,  i.  1854 
Ranvier,  Comptes  Bendus,  1869,  vol.  lxix.  p. 

1327 
Boucher,  Practit.,  ix.  p.  304, 1872 
Sanders,  Edin.  Med.  Journ.,  iv.  369 
Schmiedeberg,  Arch,  i .  exp.  Path.  u.  Pharm.,  Bd. 

iii.  p.  16 ;  Hid.  xvi.  p.  149  ;  Ludwig's  Festgabe, 

1.222 
Schroff,  V.,  Wien.  W.  S.,  xxiv. ;  Wochenhlatt  d. 

k.k.  G.  der  Aerzte  z.  Wien,  xx.  xxii.  1868 
Skoda,  Wien.  m.  Presse,  xiii.  Jahrb.,  142,  p.  21, 

1864 
Stadion,  Prager  Tierteljahrs.  f .  d.  prakt.  Heilk., 

1862,  Bd.  lxxiv.  p.  97,  1872;  Sydenham  Soc. 

Year-book,  1862,  p.  451 
Stannius,  Arch.  f.  Phys.  Heilk.,  Bd.  i.  1851,  p. 

177 
Tardiau,  Clinique,  p.  685,  Obs.  viii.,  Pari3,  1807 
Thomas,  Arehiv  f .  Heilk.,  Bd.  iv.  p.  329,  1865 
Trauhe,  Annalen  d.  Oharitekrankenh.  in  Berlin, 

1851,  Bd.  ii.  p.  1 ;  Gesammelte  Beitrage  z.  Path. 

u.  Physiol.,  Bd.  i.  Berlin,  1871 ;  Med.  Central- 

Z.,  xxx.  94,  1863  ;  Berl.  klin.  Woch,  vii.  201, 

213,  1870,  xxxi.  xxxiii.  1871 
Vulpian,  Comptes  Bendus  de  la  Soc.  de  Biol., 

1855,  p.  70 
Weil,  A.,  Eeich.  Arch.  f.  Anat.,  1871,  p.  252 
Winkel,  Phila.  Med.  Times,  1874,  iv.  p.  0,  p.  554, 

1861 
Winogradoff,  Virch.  Arch.  f.  Anat.,  Bd.  xxii.  p. 

457 
Wood,  Amer.  Journ.  Med.  Sci..  July,  1871 
Wunderlich,  Manual  Med.  Therm.,  Sydenham 

Soc.  Transl.,  p.  325 

DlTAINE. 

Harnack,  Arehiv  t.  exp.  Path.  n.  Pharmak.,  vii. 
p.  120 

DUBOISINE. 

Marme,  Nachr.  v.  d.  k.  G-es.  d.  Wiss.  u.  d.  G.  A. 
Universit.  zu  Gbttingen,  1878,  No.  xii.  p.  413 

Elateeium. 

Gibson,  Brit.  Med.  Journ.,  Nov.  1861 

KShler,  Virch.  Arch.,  Bd.  xlix.  p.  408,  L.  2,  p. 

273,  3,  p.  375,  1870 
Morries,  Repertor.  f.  Pharm.,  xxxix.  p.  134 
Setoff,  Von,  Pharmakologie,  4.  Aufl.,  371, 1873 
Stille,  Therap.,  vol.  ii.  p.  459 

Emetine. 

Ackermann,  Rostocker  Diss.,  1856 

Carriger,  J.  H.,  New  York  Med.  Journ.,  491, 1878 

Chouppe,  Le  Progres  Med.,  1874,  p.  425  ;  Bull,  de 

Therap.,  June,  1874,  86,  p.  481 
D'Ornellas,  Gaz.  M6d.,  1873,  p.  537 
Duckworth,  Dyce,  Bartholomew  Hosp.  Reports, 

vol.  v.  p.  218,  1869,  vol.  vii.  p.  91, 1871 
Poulkrod,  Phila.  Med.  Times,  viii.  p.  554 
Harnaok,  E„  Arch,  f .  exp.  Path.  u.  Pharm.,  Bd. 

ii.  p.  299,  iii.  44 
Magendie  et  Pelletier,  Journ.  de  Pharmaoie,  lix. 

p.  223,  1817 
Orfl'.a,  Toxicol.,  i.  651 
Pecholier,  Comptes  Bendus,  Bd.  Iv.  1862,  p.  771 : 

Gaz.  Med.,  1862 
Podwyssotski,  A.  f.  exp.  Path.  u.  Pharra„  Bd.xL 

p.  231,  1879 


BIBLIOGRAPHICAL  INDEX. 


1251 


Emetine. 

PolUohronie,  L'Ipecacuanha,  Paris,  1874 
Weylandt,   Eckhardt's    BeitrSge   z.   Anat.   n. 
_Physiol.,  Giessen,  1869,  v.  i.,  n.  Inaug.  Dissert. 
Woodhull,  A.  A.,  Atlanta  Med.  and  Surg.  Journ., 
1876  ' 

Ergot,  vide  Secale  cornutum. 

Bailly  et    See,  Bull.    Therap„    t.   lxxviii.   p. 

435 
Barlau-Pontayral,  Journ.  des  Sci.  med.  pratiques 

de  Montpellier,  tomes  vi.  vii. 
Bodin,  Journ.  des  Connaissances  Med.,  1842 
Boldt,  Schmidt's  Jahrb.,  March,  1872 
Bonjean,  Traite  de  l'Ergot  de  Seigle,  Paris,  1845 
Boreischa,  Arbeit.  Pharm.  Lab.  Moskau,  i.  55 
Brown-Sequard,  Arch,  de  Phys.,  1870,  t.  iii.  p. 

434 
Buchheim,  Berl.  klin.  Wochenschr.,  1876,  p.  309, 

So.  xxii. ;  Arch.  J.  exp.  Path.  u.  Pharm.,  Bd. 

iii.  p.  1 
Christmann,  Central bl.  £  d.  med.  Wiss.,  p.  800, 

Nov.  1869 
Clemens,  Deutsche  Klinik,  1865,  267 
Costa,  Da,  Amer.  Med.  Journ.  Sci.,  Jan.  p.  117, 

1875 
Diez,  Stille's  Therapeutics,  2nd  ed.  vol.  ii.  p.  585 
Dragendorff  u.  Podwissotzky,  Arch,  f .  exp.  Path. 

u.  Pharmak.,  Bd.  vi.  pp.  153, 192 
Duboue,  Becherches  sur  les  Proprietes  therap. 

de  Seigle  ergote,  Paris,  1873 
Eberty,  Hallenser  Diss.,  1873 ;  Schmidt's  Jahrb., 

Bd.  clviii.  p.  127 
Goodal),  Proceed.  Med.  Soc.  Pennsylvania,  1873 
Hampel,  Practitioner,  vol.  i.  p.  263 
Haudelin,  Dorp.  Diss.,  1871 ;  Schmidt's  Jahrb., 

Bd.  civ.  p.  143 
Hensinger,  Journ.  f.  Pharmacodyn.,  Bd.  i.  p. 

405 
Hermann,  Buchner's  Eepertor.  f.  Pharm.,  1871 
Hildebrandt,  Berl.  klin.  Woch.,  p.  297,  1872 
Holmes,  Ch.  L.,  Arch,  de  Physiol.,  t.  iii.  p.  384, 

1870 
Kerscb,  Betz's  Memorabilien,  vol.  xviii. 
Kitchen,  Amer.  Journ.  Insan.,  July  1873 
Kobert,  Practitioner,  xxxiii.,  409 
Kbhler,  H.,  Tirch.  Arch.,  Bd.  lx.  p.  384 
Langenbeck,  Berl.  klin.  Woch.,  p.  117, 1869 
Le  Gendre,  Bull.  Therap.,  t.  lxxvii.  p.  282 
Levi,  Lo  Sperimentale,  Aug.  1875 
Luton,  A.,  Gaz.  Hebdom.,  Oct.  1871,  p.  610 
Meadows,  Practitioner,  vol.  i.  166 
Nicitin,  Eossbaoh's  Pharm.  Unters.,   Bd.  iii. 

1878 
Mcoll,  P.,  and  Mossop,  Brit,  and  For.  Med.-Chir. 

Bev.,  vol.  i.  1872,  p.  252 
Oldwright,  Canada  Med.  Journ.,  1870,  320,  321, 

404 
Ostere,  Stille's  Therap.,  2nd  ed.  vol.  ii. 
Poyet  et  Commarmond,  Annal.  de  la  Soc.  de 

Med.  de  St.  Btienne  et  de  la  Loire,  1863 
Bamsbotham,  Principles  and  Practice  of  Obste- 
tric Med.  and  Surg.,  Phila.  I860,  p.  318 
Kossbach,  Pharm.  Unters.,  Bd.  i. 
Salkowski,  Berl.  klin.  Wochenschr.,  1876,  p.  228 
Schilling,  Aerztl.  Intelligenzbl.,  1883 
SchUller,  Berl.  klin.  Wochenschr.,  1874,  p.  305 
Tanret,  Bull.  Therap.,  xciii.  p.  231 
Tulasne,  Ann.  Scien.  Natur.  Botan.,  3e  serie,  t.  xx. 

1853 
Vogt,  P.,  Berl.  klin.  Wochenschr.,  1869,  No.  xii. 

p.  117 ;  March,  1872,  p.  115 
Wernich,  Tirch.  Arch.,  Bd.  lvi.  p.  505,  1872 ;  u. 

Beitr.  z.  Geburtsh,  Bd.  iii.  Berlin,  1874 
Winckler,  Amer.  Journ.  Pharm.,  May,  1864 
Woakes,  Practitioner,  vol.  i.  p.  257 
Wood,  Phila.  Med.  Times,  vol.  iv. 
Wright,  S.  A.,  Bd.  Med.  and  Surg.  Journ.,  Oct. 

1839,  vol.  Hi.  p.  293 
Zweifel,  Arch.  I.  exp.  Path.  u.  Pharm.,  Bd.  iv. 

p.  387 


Erigeron. 

Starke,  Lond.  Med.  Eec,  1876,  p.  267 

Erythrophlceum. 

Brunton  and  Pye,  Phil.  Trans.,  1877,  p.  627 
Gallois  et  Hardy,  Arch,  de  Phys.  norm,  et  path., 

1876,  p.  197 
Harnack  u.  Zabrooki,  Arch,  f .  exp.  Path.  u.  Ph., 

xv.  p.  403 
See  etBochefontaine,Compt.Eend.,  xc.  p.  1366 
Zabrooki,  Inaug.  Diss.,  Halle,  1882 

Ether. 

Bowditch  and  Mimol,  Boston  Med.  and  Surg. 

Journ.,  May  21, 1874 
Kronecker,  Arch,  f .  Anat.  u.  Phys.,  1881,  p.  354 
McKendrick,  Coats,  and  Newman,  Brit.  Med. 

Journ.,  Dec.  18, 1880 

Ether  Oil. 

Binz,  Arch.  texp.  Path.  u.  Pharm.,  Bd.  v.  p.  109, 

Bd.  viii.  p.  50 
Bbhm  u.  Kobert,  O.  I.  d.  med.  Wiss.,  1879,  p.  689 
Grisar,  Bonner  Dissertation,  1873 
H'dgyes,  Centralblatt  f.  d.  med.  Wissen.,  1879, 

p.  32 
Kbhler  and  his  pupils,  Schmidt's  Jahrb.,  Bd. 

clxxiv.  pp.  19,  80, 121 

Eucalyptus  Oil. 

Aron,  Schmidt's  Jahrb.,  Bd.  civil,  p.  239 
Binz,  Brit.  Med.  Journ.,  i.  1874,  p.  15 
Bohn,  Berl.  klin.  Wochens.,  p.  110, 1872 
Brudell,  Bull.  Therap.,  May,  1875,  vol.  lxxxix. 

p.  108 
Cortau,  Montpellier  Med.,  May,  1872 
Gimbert,  Arch.  Gen.,  1873,  xxi.  p.  141 
Haller,  Wien.  med.  Wochens.,  xxvi. 
Keller,   Wien.   med.    Wochens.,   xxii.    p.  227, 

1872 
Kdhler,  H.,  Arch.  d.  Pharm.,  3.  Eeihe,  Bd.  iii. 

Heft  2 
Lorrinser,  Wien.  med.  Wochens.,  xix.  xx. 
Martin,  S.,  Bull.  Therap.,  Ixxxiii.  p.  453 
Mosler,  Deutsch.  Arch.  klin.  Med.,  1872,  x.  160 
Pappillon,  Gaz.  Hebdom.,  1872,  p.  501 
Babuteau,  Bull.  Therap.,  lxxxiii.  549 
Sehlager,  Inaug.  Diss.  G'dttingen,  1874 
Seitz,  Bayer.  Aerztl.  Intell.-Blatt,  1870,  p.  310 
Siegen,  Bonner  Diss.,  1873 
Tristany,  Buchner's  Repertor.,  xix.  1870 

Fat. 

Lassar,  Berl.  klin.  Wochenschr.,  1879,  No.  xviii 

p.  261 
Munk,  J.,  Yerh.  d.  physiol.   Ges.   in   Berlin, 

Jahrg.  1877-79,  No.  13 

FUCHSIN. 
Paris,  Diss.,  Bern,  1878 

Gelsemium. 

Bartholow,  Lond.  Practitioner,  ▼.  p.  203 
Centralbl.  f.  d.  med.  Wiss.,  1876,  pp.  128,  320, 

384,  608,  927 ;  1877,  p.  783  j  1878,  p.  652  ;  1S80, 

p.  74 
Courtwright,  Cincinnati  Lancet  and  Obs.,  1876, 

963 
Ott,  Phila.  Med.  Times,  v.  p.  691,  vii.  p.  289 
Binger  and  Murrell,  Lancet,  ii.  1875,  p.  908  ;  i.  p. 

83,  vol.  ii.  pp.  78  and  569,  1876 
Tweedy,  J.,  Lond.  lancet,  1877,  i.  p.  833 
Wormlcy,  Amer.  Journ.  Pharm.,  1870 

4  L  2 


1252 


BIBLIOGBAPHICAL  INDEX. 


Glycerine. 

Dujardin-Beaumetz  et  Audige,  Bull.  Therap, 

xci.  p.  62 
Eckhard,  Centralbl.  med.  Wiss.,  1876,  p.  273 
Lewin,  L,  Z.  f .  Blologie,  1879,  Bd.  XV.  p.  243 
Luchsinger,  PfLiig.  Arch.,  Bd.  xi.p.  502;  Centralbl. 

med.  Wiss.,  1877 
Munk,  J.,  Verh.  d.  physiol.    Ges.  zu  Berlin, 

Dec.  13,  1878,  u.  Virch.  Arch.,  Bd.  lxxvi.  Heft 

1,  p.  119 
Schultzen,  Berliner  klin.  Wochenschr.,  1 872,  No. 

xxxv.  p.  417 
Schwann,  Eckhart's  Beitrage  z.  Anat.  u.  Physiol., 

Tiii.  p.  159 
Ziemssen's  Encyclop,  vol.  xvi.  for  Literature 

GUAIAC. 

Bell,  Lond.  Med.  Gaz,  Oct.  1840,  p.  202 
Bryden,  Brit.  Med.  Journ.,  No.  47, 1857,  p.  9G7; 

No.  97,  p.  927, 1858 
Husemann,  Die  Pflanzenstoffe,  p.  1106 
Sandras,  Bull,  de  Th6r.,  v.  371 
Walker,  Brit.  Med.  Journ.,  vol.  i.  pp.  628  and  660, 

1864 
Wood,  IT.S.  Dispensatory,  p.  1233 


Hellebore. 


Helm,  Wlirzburger  m.  Zeitschr,  ii.  5,  6,  p.  448, 

1861 
Marine,  Z.  f.  rat.  Med.,  3.  Beihe,  Bd.  xxvi.  p. 

1098 
Scattergood,    H.,  Journ.  de   Bruxelles,  xxxix. 

p.  550,  1864 
Schroff,  Von,  Prager  Vierteljahrss.,  Ixii.  1859, 

p.  49,  95, 106,  lxiii.  p.  95 

Hydrastis. 

Pellner,  Wien.  med.  Jabrbiicher,  1885 

Hyoscyamine. 

Harley,  Old  Yeg.  Neurotics 

Hellmann,  Beitr.  d.  phys.  Wirk.  des  Hyoscya- 

mins,  Diss.  Jena,  1873 
Hellmann,  Beitr.  z.  Kenntniss  d.  phys.  Wirk.  des 

Hyoscyamins,  Jen.  1873. 
Hbhn,  Arch.  d.  Pharm.,  1868,  p.  216 
Laurent,  De  l'Hyoscyamine  et  de  la  Daturine, 

p.  15,  Paris,  1870 
Lemaitre,  Arch.  Gen.,  1865,  vol.  vi. 
Oulmont,  Bull.  Gen.  de  Therap.,  lxxxiii.  p.  4S1, 

1872  ;  Practitioner,  vol.  x.  p.  1,  1873 
Schroff,   V.,  Woch.    d.  Zeits.  d.  Gescllsch.  d. 

Aerzte  z.  Wien,  1865 

Iodine  and  Iodide  of  Potas- 
sium. 

Annuschat,   A.   f.   exp.  P.  u.  Pharm.,  x.  261 

(Action  in  Lead  Poisoning) 
Bachrach,  Berl.  Diss.,  1878 
Balfour,  Ed.  Med.  Journ.,  xiii.  p.  776,  xiv.  p.  33, 

xv.  p.  47,  xvi.  p.  704 ;  Brit.  Med.  Journ.,  1874, 

i.  112 
Behier,  Nerven-Centralorg.,  Schmidt's  Jahrb., 

cxxvi.  162,  1865 
Benedikt,  M.,  Wien.  Jahrb.,  xviii.  ii.  94, 1862 
Bernard,  01.,  Arch.  Gener,  1853,  Bd.  i.  p.  5 
Binz,  Virch.  Arch.,  Bd.  Ixii.  p.  124,  u.  Arch.  f. 

exp.  P.  u.  Ph.,  Bd.  viii.  p.  309  ;  ibid.  xiii.  p.  1 13 
Bock,  V,  Z.  f.  Biol.,  1869  ;  Bd.  iii.  126 ;  Bd.  v. 

393  ;  Schmidt's  Jahrb.,  Bd.  cxlv.  p.  142 
Bbhm  u.  Berg,  A.  f.  exp.  P.  u.  Ph.,  v.  337,  1876 
Brarme,  Diss.,  Leipzig,  1856 
Buehheim,  Arch.  f.  exp.  Path.  u.  Pharm.,  Bd. 

iii.  104 


Iodine  and  Iodide  of  Potas- 
sium. 

Chuckerbutty,  Brit.  Med.  Journ,  vol.  ii.  pp.  61 

and  85.  1862  (In  Aneurysm) 
Cogswell',  Edinburgh,  1837 
Coindet,  Proriep's  Notizen,  i.  55,  89, 1822 
Devergie,  Arch.  gen.  de  Med.,  x.  2,  p.  255, 1826 ; 

Frank's  Mag,  iii.  i.  p.  201 
Dorpater  Diss.  v.  Arroneet,  1852  ;  Strauch,  1852  ; 

Heubel,  1865  ;  Sartisson,  1866 
Eulenburg,  Berlin,  klin.  Wochenschr,  xvi.  1870 
Fournier,  Centralbl.  f .  d.  med.  Wiss,  1878,  p.  55 
Issersohn,  Berl.  Diss,  1877 
Greenhalgh,  Brit.  Med.  Journ,  vol.  i.  p.  52, 1868 
Handfield,  Jones,  Beale's  Arch,  i. 
Heubel,  E,  Dorpat.  DiBS,  1865,  p.  70 
Kiimmerer,  Tirch.  Arch,  Bd.  lix.p.  459 ;  Bd.  lx. 

p.  527 
Keith,  Edin.  Med.  Journ,  xviii.  p.  1077, 1873 
Kochler,  Deutsche  Zeitschr.  f .  pract.  Med.,  1877, 

No.  xi. 
Melsens,  Schmidt's  Jahrb,  Bd.  cxxxiv.  19, 1867; 

Memoire  sur  l'Emploi  de  l'lodure  de  Potas- 
sium pour  combattre  les  Affections  Saturnines 

mercurielles   et    les   allid.   consecut.   de   la 

Syphilis.    Bruxelles,  1868 
Pellikan.    V.,   Beitrage    zur   Pharm.    u.    Tox., 

Wlirzb,  1858,  p.  118 
Rabuteau,  Gaz.  Med.  de  Paris,  xix.  p.  190,  xxii 

p.  302,  xxiii.  p.  313, 1869 
Rilliet,  Bull,  de  l'Acad.  Boy,  xxv. 
Einger,  Practit,  March,  1872,  vol.  viii.  p.  129 
Rose,  Arch,  i.path.  Anat.,  1866  ;  Bd.  xxxv. 
Rosier,  Prank's  Mag,  ii.  p.  120, 136 
See,  Lond.  Med.  Rec,  i.  pp.  757,  777 
Sharpe,  T.  S,  Amer.  Journ.  Med.  Sci,  Jan.  1876, 

p.  124 
Taylor,  R.  W,  Amer.  Journ.  Syphil.  and  Derma, 

April,  1873 
Wallace,  I,  Liverpool  Med.  and  Surg.  Rep.,  1871 

Iodoform. 

Behring,  Wien.  med.  Blatter,  1884,  No.  9 

Binz,  Arch.  f.  exp.  P.  u.  Ph,  viii.  309 

Elsberg,  Phila.  Med.  Times,  Oct.  4,  1873,  vol.  iv. 

p.  4 
Pereol,  Bull.  Therap,  t.  lxxiv.  p.  400,  May,  1868 
Hogyes,  Arch.  f.  exp.  P.  u.  Ph,  x.  228 
Izard,  A.  A,  New  Treat,  of   Vener.  Diseases, 

Boston,  1872 
Kennedy,  S,  Med.  and  Surg.  Rep,  Jan.  1870, 

p.  50 
Lazansky,  Centra'bl.  Chir,  1876,  219 
Moleschott,    Wien.    med.    Wochenschr,   1878; 

Lond.  Med.  Reo,  Nov.  1878,  pp.  350  and  464 
Oberliinder,  Centralbl.  f.  d.  med.  W,  1879,  p.  336 
Pelletan,  Phila.  Med.  Times,  iv.  6!)5 
Volker,  G,  Bull.  Therap,  t.  lxxiii.  p.  493,  Deo. 

1867 

Ipecacuanha,  vide  Emetine. 

Ackermann,  Beobachtungen  Ub.  physiol.  "Wirk. 

d.  Emetica,  Rostock,  1856,  4.  Diss. 
Cunningham,  Edin.    Med.  J.,  vii.  p.  25,  July, 

1861 
Duckworth,  Dyce,  St.  Barth.  Hosp.  Rep.,  v.  p. 

230, 1869,  vii.  p.  98, 1871 
Higginbottom,  Brit.  Med.  Journ.,  vol.  i.  p.  143, 

1869 
Pecholier,  Comp.  Rend.,  vol.  Ivi.  p.  718, 1863 
Sehuchard,  Arzneim.,  p.  586 
Wibmer,  Wirk.  d.  Arzneim.  u.  Gifte,  ii.  77 

Iron. 

Becquerel,  Simon's  Chemistry,  vol.  ii.  p.  254 
Bernard,  CI.,  L'Union  M6d.,  1854 


BIBLIOGKAPHICAL  INDEX. 


1253 


Iron. 

Blake,  Journ.  of  Anat.  and  Phys.,  p.  280,  Not. 

1868 
Complete  list  of  Literature  (228  Nos.)  by  Scherpf 

in  Rossbach'sPharmakolog.  TJnters.,  187T,  Bd. 

ii. ;  later  works,  Hamburger  Z.  f.  phys.  Chem ', 

v.  1 ;  Hoppe-Seyler,  Ii.  p.  191 
Cutler  &  Bradford,  Amer.  Journ.  Med.  S.  1 1878. 

p.  78 
Mialhe,  Cbim.  Appliquee,  Paris,  1856 
Mitscherlich,  0.  g.  Preuss.  Vereins-Z.,  1846,  xxi. 
Nasse,  Lond.  Med.  Rec,  1877,  p.  498  ;  Wagner's 

Handwbrterb.,  Bd.  i.  (art.  Blut) 
Podrowsky,  W.,  Virob.  Arch.,  Bd.  xxii.  5  and  6. 

p.  476, 1861  ' 

Quevenne,  Memoire  sur  1'Aotion  phys.  et  therap. 

des  Perrugineux,  Arob.  de  Phys.,  de  Therap. 

et  d'Hygiene,  Oct.  1854,  p.  93 
Quincke,  TTeb.  Siderosis,  Festschr.  z.  Haller's 

Jubelf .  Bern ;  Reiohert  u.  Du  Bois'  Arob.,  vi. 

p.  757, 1868 
Sasse,  A.,Vierteljahrs.  f .  prakt.  Heilk.,  1866, 2.  Bd. 
Soherpf,  Resorpt.  u.  Assim.  d.  Eisens,  Wiirzb. 

1878 
Simon,  Animal  Chem.,  Lond.,  1846,  Syd.  Soo.  ed. 
Tiedemann  u.  Gmelin,  Heidelberg,  1820. 

Irritants,  vide  Oil  of  Mus- 
tard. 

Jaborandi,  vide  Pilocarpine. 

Carville,  Journ.  de  Therap.,  1875,  p.  81 
FereoL  Journ.  de  Therap.,  Jan.  1876,  p.  45 
Galezowski,  Med.  Times  and  Gaz.,  1877,  ii.  558 
Greene,  Phila,  Med.  Times,  vi.  p.  56 
Hardy,  Journ.  d.  Therap.,  88,  p.  469, 1875 
Harnack    u.    Mayer,  Arch.   f.  exp.   Path.    u. 

Phar.,  xii.  p.  366 
Langley,  J.  N.,  Brit.  Med.  Journ.,  1875,  vol.  i. 

p.  241 ;  Journ.  d.  Phys.,  1878,  p.  339  ;  Journ. 

Anat.,  x.  188, 194 
Luchsinger,  Pfliiger's  Arch.,  xv.  482 
Pillicier,  Inaug.  Diss.,  Bern.,  1875 ;  Med.  Cen- 

tralbl.,  1876,  p.  430 
Purjesz,Deutsch.  Arch.  klin.  Med.,  xvii.  p.  533 
Ringer,  Lancet,  i.  1875,  p.  159 ;  Lond.  Pract., 

xvii.  p.  401 
Schwann,  Med.  Centralbl.,  1874,  p.  440 
Scotti,Berl.  klin.  Wochensch.,1877,  p.  141 
Stumpf,  Deutscb.  Arch.  f.  klin.  Med. ,  xvi.  p.  255 
Tweedy,  Lancet,  i.  1875,  p.  159 
Weber,  Med.  Centralbl.,  1874,  p.  770 

Jalap,  vide  Purgatives. 
Jequirity. 

Warden  and  Waddell,  The  Non-bacillar  Nature 
of  Abrus-Poison,  Calcutta,  1884 

Kawa-Kawa. 

Lewin,  TJeber  Piper  Methysticum,  Berlin,  1886 

Lactic  Acid. 

Auerbach,   A.,    Deutscb.    Zeitschr.    f.    praot. 

Medicin,  1877,  No.  xlvii. 
Bbtticher,  Berl.  klin.  Woohens.,  1877,  p.  537 
Erler,  Centralbl.  med.  Wiss.,  1876,  p.  658 
Fischer,  Lond.  Med.  Rec,  1877,  p.  193 
Lothar,  Meyer,  Virch.  Arch.,  Bd.  lxvi.  p.  120 
Mendel,  Deutsch.  med.  Woohens.,  1876,  No.  17 
Preyer,  Centralbl.  med.  Wiss.,  1875,  p.  677 

Lanolin. 

Liebreich,  O.,  Berl.  klin.  Wochens.,  1885,  No.  47 ; 
Deutsch.  med.  Wbchens.,  1886,  No.  28 


Lead. 

Annuschat,  A.  f.  exp.  Path.  u.  Pharm.,  Bd.  vii. 

p.  45,  and  Bd.  x.  p.  261 
Bardenhewer,  E,  Berl.  klin.  Wochensoh.,  1877 

126 
Blake,  Edln.  Med.  and  Surg.  Journ.,  lvi.  1,  p.  110 

1841 
Chatin,  Comptes  Rendus,  Soc.  Biolog.,    t.  iv. 

1862,  p.  84 
Cours,  A.  de,  De  l'Hemianesthesie  saturnine, 

Paris,  1875 
Debove  et  Renaut,  Le  Progres  M6d.,  1876, 151 
Eulenburg,  A.,  Deustch.  Aroh.  fur  klin.  Med., 

Bd.  iii.  p.  506 
Falck,  Virch.  Handbuchd.  spec.  Path.  undTher., 

ii.  1,  1855 
Prank,  A.,  Deutsch.  Arch.  klin.  Med.,  xvi.  423 
Friedlander,  Virch.  Arch.,  Bd.  lxxv.  p.  24, 1879 
Gusserow,  Arch.  f.  path.  An.,  Bd.  xxi. 
Harnack,  A.  f.  exp.  P.  u.  Pharm.,  Bd.  iii.  54, 

1874,  Bd.  ix.  152 
Henle,  Zeitsohrift  f.  rat.  Med.,  3.  R.  Bd.  iv.,  u. 

Handb.  d.  rat.  Path.,  1847,  Bd.  ii.  179 
Hermann,  Arch.  f.  Anat.  u.  Phys.,  1867,  64 
Heubel,  Pathogen,  u.  Sympt.  d.  chron.  Bleiver- 

gift.,  1871 ;  Virch.  u.  Hirsch's  Jahrbtlcher,  1871 , 

Bd.  i.  p.  316 
Hitzig,  Studien  ii.  Bleivergift.,  1868 
Kussmaul  u.  Meyer,  Arch.  f.  klin.  Med.,  Bd.  ix. 

283 
Lancereaux,  E.,  Comptes  Rendus  de  la  Soc.  Biol., 

liv.  3rd  ser.  1862,  p.  84 
Lewald,  TJnters.  tib.  d.  Ausscheid.  von  Arzneim. 

aus  dem  Organismus,  Breslau,  1861 
Lewy,  B.,  Schmidt's  Jahrb.,  Bd.  clii.  p.  250 
Malassez,  Arch,  de  Phys.,  1874,  p.  50 
Manouvriez,  Arch.  d.  Phys.  normal e  et  Pathol., 

1870,  411,  1876,  762 ;  Reoherohes  cliniques  sur 

l'Intox.  Saturnine  locale  et  directe,  Paris,  1874 
Mason,  New  York  Med.  Journ.,  1877 
Paul,  0.,  Aroh.  Gen.,  5th  series,  vol.  xv.  1860. 

p.  513 
Remak,  Arch.  f.  Psychiatr.  u.  Nervenkr.,  Bd.  ix. 

Heft  3,  p.  510 
Renaut,  Gazette  Med.,  1878,  No.  32,  u.  Centralbl. 

f.  d.  med.  W.,  1879,  p.  159. 
Rosenstein,  Arch,  f .  path.  Anat.,  Bd.  xxxiv.  1867, 

P.* 
Rosenstirn,  Rossbach's  pharmak.  TTnters.,  Wiirz- 

burg,  1874 
Tanquerel  des  Planches,  Die  gesammten  Blcl- 

krankh.,  iibers.  v.  Frankenberg,  1842 
Trousseau,  Froriep's  Notiz.,  xviii.  No.  13,  p.  207, 

1827 
Wood,  Geo.  B.,  Therapeutics,  vol.  i.  p.  158 

Lithium,  vide  Alkalies. 

Gibb,  Report  of  Brit.  Assoc,  for  Advancement  of 

Science,  1864 
Mitchell,  Weir,  Amer.  Journ.  Medical  Science, 

Oct.  1870,  p.  443 

Lobelia. 

Ott,  I.,  Bost.  Med.  and  Surg.  Journ.,  1875,  vol. 
xcii.  p.  124  ;  Phila.  Med.  Times,  vi.  p.  121 

Magnesium, 
Earths. 

Manganese. 

Charvet,  Bull,  de  Therap.,  lxxviii.  p.  80,  1870, 

Lungengangran. 
Garrod,  Med.  Times  and  Gaz. 
Gmelin,  U.S.  Dispensatory 
Laschkewitz,  Journ.  de  Bruxelles,  t.  xliv.  p. 

534,  June  1867 


vide    Alkaline 


1254 


BIBLIOGBAPHICAL  INDEX. 


Manganese. 

Leared,  Glasgow  Med.  Journ.,  Jan.  1865,  p.  488 
Petrequin,  Nouvelles  Recherches  du  Manganese, 

2e  6d.  Paris,  1852  ;  Bull.  Therap.,  Mar.  1852, 

p.  193 
"Williams,  American  Journ.,  N.S.  cxvii.  p.  ,74, 

Jan.  1870 

Massage. 

Zabludowski,  Cent.  i.  d.  med.  Wiss.,  14,  1883, 
p.  241 

Mercury. 

Baerensprung,  Ann.  d.  Charite,  1856,  Bd.  yii. 

P.  2 
Bamberger,  Wien.  med.  Wochenschr.,  1876,  Nos. 

xi.  u.  xiv. 
Boeck,  V.,  Z.  £  Biologie,  v.  3, 1869  ;  Schmidt's 

Jahrb.,  Bd.  cxlv.  p.  142 
Cash,  Proc.  Phys.  Soc,  Dec.  12,  1885  ;  Joum. 

Phys.,  vol.  vii.  (Perchloride) 
Foot,  A.  W.,  Dub.  Journ.  Med.  Sci.,  1873 
Fiirbringer,  Berl.  klin.  Wochenschr.,  1878,  No. 

xxiii.  p.  832 
Hassenstein,  Kbnigsberger  Diss.,  1879 
Heilborn,   Arch.  f.  exp.  Path.  u.  Pharm.,  Bd. 

yiii.  p.  361 
Jendrassik,  Deutsch.  Arch,  f.klin.  Med.,  xxxviii. 

p.  499  (Calomel) 
Reyes,  E.  L.,  Amer.  Journal  Med.  Sci.,  Jan.  1876, 

p.  17 
Kblliker,  Th.,  Verh.  d.  WUrzburger  phys.  med. 

Ges.,  N.F.,  Bd.  x.  1877 
Kussmaul,  Unters.  lib.  d.  constit.  Mercurial., 

1861,  p.  17 
Lewin,  Charite-Ann.,  Bd.  xiv. 
Locke,  Pract.,  xxxvii,  p.  170 
Mussy,  N.  G.  de,  Gaz.  des  Hopitaux,  1868 
Oetlingen,  V.,  Dorp.  Diss.,  1848 
Overbeck,  Mercur.  u.  Syphil.,  Berlin,  1861 
Eindfleisch,  Arch.  f.  Dermatol.,  1870 
Saikowski,  Virch.  Arch.,  Bd.  xxxvii.  p.  346 
Schlesinger,  Arch.  f.  exp.  Path.  u.  Pharra.,  xiii. 

p.  317 
Sigmond,   Mercury,    Blue   Pill,   and  Calomel, 

Lond.,  1840 
Sigmund,  Wien.  med.  "Wochenschr.,  1859 
Stern,  Berl.  klin.  Wochenschr.,  1878,  p.  59 
Toit,  XJeb.  d.  Aufnahme  des  Q.  u.  seiner  Verb. 

und  Kbrpor,  in  hiS-Phys.  chem.  Unters.,  1857 
Wilbouchewitcz,  Arch,  de  Physiol.,  Sept.  1874, 

p.  509 
Zeitsch.  f .  Therapie,  2, 1884  (Tannate) 

Methylene-Blue. 

Ehrlich,  Deutsch.  med.  "Woch.,  1885,  No.  4, 1886 ; 
Centralbl.  f.  d.  med.  "Wiss.,  No.  8, 1885 

Morphine,  vide  Opium  Alka- 
loids. 

Muscarine. 

Bauerlein,  Zur  Accommodat,  des  menschl.  Auges, 

Wtirtzburg,  1876 
Boehm,  Arch,  f .  exp.  Path.  u.  Ph.,  xix.  p.  87 
Bogoslowsky,  Centralbl.  t  d.  med.  Wiss.,  1870, 

p.  97 
Harnack,  Arch.  f.  exp.  Path.  u.  Pharm.,  Bd.  iv. 

p.  168,  1876 
HBgyes,  Arch.  J.  Anat.  it  Phys.,  1882,  p.  37 
Jordan,  Arch.  f.  exp.  Path.,  viii.  p.  15 
Krenchel,  Arch.  f.  Ophthalm.,  xx.  ii.  p.  134 
Ott  and  Woodfield,  Journ.  of  Phys.,  i.  p.  193 


Muscarine. 


Sohmiedeherg  u.  Koppe,  Das  Muscarfn,  Leipzig, 

1869 
Schmiedebergu.  Harnack,  Arch.  f.  exp.  Path.  u. 

Pharm.,  Bd.  vi.  p.  101, 1876 
Weinzweig,  Archiv  f.  Anat.   u.  Phys.  (P hys. 

Abth.),  1882,  p.  527 

Musk. 

Barbier,  Mat.  MM.,  ii.  p.  217 

Filehne,  Sitzungsher.  der  Erlanger  phys.  med. 

Ges.,  1876 ;  u.  Centralbl.  1  d.  med.  Wiss.,  1876, 

p.  880 
Jbrg,  Materialien  z.  e.  a.  Axzneimittellehre,  p. 

285,  Leipzig,  1825 
Tralles,  Com.  de  rebus  in  Sc.  Natur.  et  Med. 

gestis,  xxvi.  p.  434 
Trousseau  et  Pidoux,  Traite,  etc.,  8e  ed.il.  p.  187 

Naphthalin. 

Rossbach,  Berl.  klin.  Wochenschr.,  1884,  Nos.  24, 
42,  46,  p.  279 

Narceine,  vide  Opium  Com- 
pounds. 

Albers,  Virch.  Arch.,  rol,  xxvi.  p.  225 

Baxt,  Beichert's  Arch.,  1869,  p.  112 

Belner  et  Debout,  Bull.  Therap.,  t.  lxvii.  p.  145 

Bernard,  CI.,  Arch.  Generates,  1874.  6e  s6r.  t.  iv. 

p.  459 
Eulenburg,  Schmidt's  Jahrb.,  Aug.  and  Oct.  1866, 

cxxxi.  p.  22 
Fronmiiller,  Schmidt's  Jahrb.,  Bd.  cxli.  p.  15 
Harley,  The  Old  Veg.  Narcotics,  p.  143  ;  PennsyL 

Hosp.  Reports,  1868 
Husemann,  PflanzenstofLe,  p.  184 
Kersoh,  S,,  Schmidt's  Jahrb.,  Bd.  cxli.  p.  15 
Line,  Journ.  de  Pharm.  et  de  Chimie,  4c  ser. 

t.  iii.  p.  386 
Mitchell,  Weir,  Amer.  Journ.  Med.  Sci.,  Jan. 

1870,  p.  17 
Oetlinger,  Inaug.  Diss.,  Tubingen,  1866 
Sohroeder,  V.,  Arch.  f.  exp.  Path.  u.  Pharmak., 

Bd.  xvii.  p.  96 

Narcotics,  vide  Opium  Alka- 
loids. 

Bumpf,  Centralbl.  d.  med.  Wiss.,  1884,  p.  366 

Nicotine. 

Albers,  Deutsche  Kllnik,  1851,  No.  32 

Anrep,  V.,  Du  Bois'    A.  f.  An.  u.  Phys.,  Phys. 

Abth.,  Jg.  1879;   Suppl.  Bd.  p.  167;   u.  Jg. 

1880,  p.  209 
Basch,  "V.,  u.  Oser,  Wien.  med.  Jahrb.,  1872,  p. 

367 
Benham,  W.  T.,  West  Biding  Lunatie  Asylum 

Bep.,  vol.  iv.,  p.  307,  1874 
Bernard,  CI.,  Substances  Tox.,  pp.  399,  410 
Bernstein  u.  Dogiel,   Verhandl.  des  nat.-med.- 

Vereins  zu  Heidelberg,  iv.  28 
Bibra,  T.,  Die  Narkot.  Genussmittel,  1855,  p.  297 
Blatin,  Recherch.es  phys.  et  clin.  sur  la  Nico- 
tine et  le  Tabao,  Paris,  1870 
Bohm,  Herzgifte,  WUrzburg,  1871,  p.  12 
Bon,  Le,  Med.  Centralzeit.,  xli.  1,  June,  1872 
Bbttger,  Buchner's  Neue  Repert.  der  Pharm, 

xvi.  579 
Brodie,  Phil.  Trans.,  1811,  p.  178 
Buchheim  u.  Loos,  Ueb.  d.  Gruppe  d.  Curarins, 

Diss.,  Giesen,  p.  48 
Eulenburg  u.  Vohl,  Vierteljahrssohr.  i.  Gerichtl. 

Medioin,  Bd,  xiv.,  No.  6,  p.  249 


BIBLIOGEAPHICAL  INDEX. 


1255 


Nicotine. 


Grilnhagen,  Centralbl.  f  iir  med.  Wiss,  1863,  p. 

Hammond,  Amer.  Journ.  Med.  Sal.,  p.  282, 1857 

Haughton,  p.  55 

Hirschmann,  L.,  Eeich.  Arch.,  1863,  p.  309 

Husemanu,  Handb.  d.  Toxicol.,  vol.  ii.  483 

KBUiker,  Virch.  Arch.,  x.  p.  253,  1856 

Krocker,  Berl.  Diss.,  1855 

Namias,  Comp.  Eend.,  lis:,  p.  90,  1864 

Nasse,  V.,  Beitr.  z.  Darmbewegung,    Leipzig, 

1866 
Orflla,  Memoire  sur  la  Nicotine  et  sur  la  Coni- 

cine,  Bruxelles,  Youker  freres,  1851 
Praag,  L.  t.,  Viroh.  Arch.,  Bd.  viii.  p.  56 
Eeil,  Journ.  f.  Pharmacodyn..  Bd.  ii.  p.  203 
Eogow,  Zeitschr.  t.  rat.  Med.,  xxix.  p.  1 
Eosenthal,  Centralbl.  1.  d.  med.  Wiss.,  1863,  p.  737 
Boy  and  Graham  Brown,  Journ.  of  Phys.,  vol.  vi. 
Savory,  The  Lancet,  1863,  vol.  i.  p.  549 
SchmieiHoerg,  Sitzber.  d.  K.  Sachs.  Acad.,  1870  ' 
See,  Nouveau  Diet,  de  Med.  V.,  art.  Asthma,  p. 

715, 1865  ;  Journ.  of  Anat.,  May  1870,  p.  315 
Snrminsky,  Zeitschr.  I.  rat.  Med.  (3),  xxxvi.p.  205 
Traube,  Allgemeine  med.  Central-Zeit.,  1862  ; 

Centralbl.  1.  d.  med.  Wissens,  1863,  pp.  Ill,  159 
Truhart,  Dorpater  Diss.,  1869 
'   Tsohesohichin.  Eeich.  n.  DuBois'  Arch.,  1868,  p. 

151  '  * 

Uspensky,  Eeich.  u.  Du  Bois'  Arch.,  1868,  p.  522 
Vulpian,  Comptes  Eend.  de  la  Soc.  de  Biol.,  1851 

p.  151 
Wertheim,  Zeitschr.  d.  k.  k.  Gesellsch.  d.  Aerzte 

z.  Wien,  1851,  8. 

Niteic  Oxide. 

Podolinsky,  Arch.  f.  ges.  Physiol.,  1872,  Bd.  vi. 
p.  553 

Nitrite  op  Amyl. 

Aldridge,  Ch.,  West  Biding  Lunatic  Eeports, 

vol.  i.  p.  71 
Amez-Droz,  Arch,  de   Phys.   Norm,  et  Path., 

Sept.  1873,  p.  467 
Arb,  a.  d.  physiol.  Inst.  z.  Leipzig,  1869 ;  Journ. 

of  Anat.  and  Phys.,  vol.  t.  p.  93  ;  Lond.  Clin. 

Soc.  Beports,  vol.  iii. 
Balard,  Ann.  de  Chimie  et  de  Phys.,  xii.  1844,  p. 
'    294 
Berger,   O.,  Allgem.    med.    Central-Zeit.,  May 

1871 
Brunton,  Lauder,  Lancet,  vol.  ii.  p.  97, 1867 
Brim  ton  and  Gresswell,  St.  Barth.  Hosp.  Rep., 

1876,  p.  143  (other  nitrites) 
Filehne,  Pfluger's  Archiv,,  Bd.  ix.  p.  470 ;  and 

Arch.  f.  Anat.  u.  Physiol.,  1879,  p.  385 ;  Berl. 

klin.  Wochensch.,  Nov.  4, 1875 
Fothergill,  Brit.  Med.  Journ.,  1874,  i.  77 
Gamgee,  A.,  Philos.  Trans.,  1868,  p.  589 
Giacosa,  Z.  f.  physiol.  Chemie,  iii.  p.  54 
Gray,  St.  Clair,  Glasg.  Med.  Journ.,  1871,  p.  188 
Guthrie,  Ann.  d.  Chem.  u.  Pharm.,  Bd.  iii. 
Hoffmann,  F.  A.,  Beichert's  Arch.,  1872,  747 
Jolyet  n.  Eegnard,  Centralbl.  f.  d.  med.  Wiss., 

1876,  p.  860 ;  Gaz.  MM.  de  Paris,  1876,  No.  29 
Kraepelin  (abst.)  in  Bivista  sperim.  di  Frenia- 

tria,  anno  ix.,  1883,  p.  124 
Ladendorf,  Berl.  klin.  Wochensch.,  No.43, 1874, 537 
Mayer,  S.,  A.  f .  exp.  P.  u.  Pharm.,  v.  55,  63 
Mitchell,  Weir,  Phila.  Med.  Times,  1872,  vol.  i. 

p.  353 
Pick,  Tiber  d.  Amylnitrit,  26.  Aufl.  bei  Hii'sch- 

wald,  Berlin,  1877  ;  mit  ausfiihrlicher  Slterer 

Literaturangabe,  Centralbl.  med.  Wiss.,  No.  55, 

p.  865, 1873 ;  Deutsch.  Arch.  klin.  Med,  xvii. 

143 
Putnam,  Mary,  Jacobi's  New  York  Med.  Bee, 

Jan.  1875,  p.  11 
Bichardson,  B.  W.,  Trans.  Brit.  Med.  Assoc,  for 

Adv.  of  Science,  1864-1872 ;  Brit,  and  For. 

Med.-Chir.  Bev,  July  1867 


Nitrite  of  Amyl. 

Schuller,  Berl.  klin.  Wochensch.,  No.  25, 1874, 294 
Sebold,  L.  Th.,  Inaug.  Diss.  Marburg,  1874 
TJrbantscliItsch,  Wien.  med.  Presse,  1877 
Wood,  Amer.  Journ.  Med.  Soi,  July,  1871,  p.  39 

NlTEOBENZOL. 

Bahrdt,  Arch.  f.  physiol.  Heilk,  1871,  p.  320 
Filehne,  A.  f.  exp.  P.  u.  Ph.,  'x.  p.  339 
Guttmann,  Arch.  f.  Anat.  u.  Phys.,  1866 
Helbig,  Deutsche  mil.-arztl.  Zeitschr.,  Bd.  ii. 

1873 
Letheby,  Med.-Chirurg.  Beview 
Lewin,  Virchow's  Arch.,  Ixxviii.  p.  193, 1879 
Mering,  V,  Centr.  f .  d.  med.  Wiss,  1875,  945 
Poincare,  Centralbl.  f.  d.  med.  Wiss,  1879,  p.  937 

NlTEOGEN. 

Chevreul,  Nouv.  Bullet.  d.I.  Soc.  Philomet,  1816 
Meyer,  L,  Zeitschr.  f.  r.  Med,  N.F,  t.  viii.  n 

256 
Eegnault  et  Beiset,  Compt.  Eend,  t.  xxvi. 

NlTEOGLYCEEIN.  ,  „;  . 

Bruel,  These,  Paris,  1876 

Brunton,  Lauder,  and  Tait,  St.  Bartholomew's 

Hosp.  Eep,  1876,  p.  140 
Green,Practitioner,  xxviii.  102, 
Murrell,  Lanoet,  1879,  pp.  80, 113,  225 
Pelikan,  Beitriige 

Niteous  Oxide. 

Amory,  N.T.  Med.  Journ,  Aug.  1870,  p.  1 
Bert,  Gaz.  d.  H6p,  1879,  Nos.  xxxvii.  et  xli. ; 

Compt.  Eend,  lxxxvii.  p.  728 ;  ibid,  lxxxix. 

p.  245 
Cotton,  Phys.  Action   of   Nitrous  Oxide  Gas, 

Phila.  1871 
Goldstein,  Pfliiger's  Arch,  1878,  Bd.  xvii.  331 
Hermann,  L,  Arch.  f.  Anat.  u.  Physiol.,  1864,  p. 

521 
Jolyet  et  Blanche,  Arch,  de  Phys,  July  1873, 

p.  364 
Thomson,  B,  Phil.  Med.  Times,  Nov.  15,  1873, 

p.  97,  vol.  iv. 
White,  T.  W,  Dental  Mat.  Med,  Phila.  1868 
Zuntz,  Pfliiger's  Arch,  xvii.  135 

Oil  op  Cajdput. 

Claiborne,  Gaillard'sMed.  Journ.,  Virginia,  TT.S.A 

Oil  op  Mustaed. 

Heidenhain,  Pfliiger's  Arch,  Bd.  iii.  p.  504  ;  Bd. 

V.  p.  309  ;  Bd.  vi.  p.  20 
K'dhler,  Centralbl.  f.  d.  med.  W,  1878,  pp.  4o3, 

450 
Naumann,  Frag.  Vierteljahrsschr,  Bd.  lxxvii. 

P.1 
Paalzow,  Pfluger's  Arch,  1871,  vol  iv.  p.  492 

Oil  op  Tuepentine. 

Crucis,  Leon,  De  la  Ter6benthine  Paris,  thesis, 

1874 
Fleischmann  in  Bossbach's  Pharm.  Unters,  Bd. 

ii.  Vgl.  ittherische  Oele         ■ 
Hcppe,  Journ.  f.  Pharmacodyn,  Bd.  i.  p.  105 
Kobert,  E,  Centralbl.  f.  med.  Wiss,  1877,  p.  129 

Opium  Alkaloids. 

Albers,  Arch.  f.  path.  Anat,  Bd.  xxvi.  p.  229 

Baker,  Morrant,  St.  Bartb.  Hosp.  Bep. 

Baxt  (Thebaine),  Wien.  Acad.  Sitzber,  2.  Abth, 

Bd.  lvi.  p.  189 ;  u.  Arch.  f.  Anat.  u.  Phys., 

1869,  p.  128,  Lud  wig's  Arbeiten 


1256 


BIBLIOGRAPHICAL  INDEX. 


Opium  Alkaloids. 

Bernard,  Cl.,Lecons  sur  l'Anesth.  et  s.  l'Asphyxie, 

Paris,  1875 ;  Arch.  Gen.  p.  455,  yol.  iv.  6th 

ser.  1864 
Boeck,  V.,  TTnters.  lib.  d.  Zersetz.  d.  Eiweiss. 

Munchen,  1871 
Bouchardat,  Schmidt's  Jahrb.,  Bd.  cxx.  p.  280 
Brunton  u.  Cash,  Cent.  f.  d.  med  Wiss.,  p.  241, 

1886  (Morphine) 
Buskirk,  Washington  Post,  Jan.  3o ,  1878 
Chalkius,  Quart.   Journ.  Psychol,   Med.,  1868, 

Tol.  ii.  739 
Charvet,  Pereira's  Mat.  Med.,  vol.  ii.  p.  1035. 

Phila.  1854 
Chastaing,  Compt.  Rend.,  xciv.  44  (Morphine) 
Dain,  Amer.  Med.  Journ.,  July  1874 
Dietl  and  Vintschgau,  PflUg.  Arch.,  Bd.  xvi. 

p.  316 
Dragendorff,  Pharm.  Zeitschr.  f .  Russland,  1866 
Eckhard,  C.  u.  P.,  Eckhard's  Beitrage  z.  An.  u. 

Phys.,  Bd.  viii.  p.  79, 138, 1878  (Morphine) 
Eulenburg  (Narcein),  Deutsch.  Arch.  f.  klin. 

Med.,  Bd.  i.  p.  65 
Kset,    Morrison,  N.Y.  Med.   Eec,  July  1874, 

p.  342 
Gscheidlen  (Morphin),  TTnters.  a.  d.  physiol.  Lab. 

in  WUrzburg,  Bd.  ii,  1869 
Hall,  Marshall,  Memoirs  on  the  Nervous  System,  ■ 

London,  1837,  p.  7 
Harley,  Old.  Teg.  Neurotics,  107,  London,  1869 
Kauzmann,  Dorpater  Diss.,  1868 
Knllik er,  Arch.  f .  path.  Anat.,  Bd.  x. ;  Tirch. 

Arch.,  Bd.  x.  p.  248 
Literature,  complete,  Arch,  f .  Path.  u.  Pharm. 

vii.  24 
Loomis,  A.,  New  York.  Med.  Eec,  1873 
Meihuizen,  PflUger's  Arch.,  Bd.  vii.  1873,  p.  201 
Mitchell,  Weir,  Amer.  Journ.  Med.  Sci.,  Jan. 

1869,  p.  37,  Jan.  1870,  p.  17 
Miiller  (Thebaia),  Marburger  Dissert.,  1868 
Nasse,  Beitr.  z.  Physiol,  d.  Darmbew.,  Leipzig, 

1866 
Nothnagel,  Handb.  d.  Arzneim.,  Berlin,  1870,  p.  8; 

(on  Intestine)  Yirchow's  Archiv,  lxxxix.  p.  1 
Oetinger  (Narcein),  TUbinger  Diss.,  1866 
Paby,  Med.  Times  and  Gaz.,  June  1869,  p.  641 
Beese,  Amer.  Journ.  Med.  Sci..  Jan.  1871,  pp.  133, 

373 
Salvioli,  Ludwig's  Arbeiten 
Schroder,  V.,  Arch.  L  exp.  Path.  u.  Pharm.,  xvii. 

p.  96 
Smith,  E.,  Lancet,  vol.  i.  p.  419, 1854 
Stolnikow,  Zeitsch.  f.  phys.  Chemie,  viii.  p.  236 
Wachs,  tib.  Codein,  Marburger  Diss.,  1868 
Witkowski  (Morphine),  Arch,  f .  exp.  Pathol,  u. 

Pharm.,  Bd.  vii.  p.  247.   Complete  Literature 
Wood,  Bost.  Med.  Surg.  Journ.,  vol.  lix.  p.  268, 

1858 

Organic  Acids,  vide  Acids. 

OXYDIMORPHIN. 

Diedrich,  Inaug.  Diss.  Gbttingen,  1883 

Oxygen. 

Afanassiev,  Ber.  d.  k.  sachs.  Ges.  d.  "Wiss.,  1873 

Assmuth,  Dorp.  Diss.,  1864 

Bert,  Lecons  sar  la  Respiration 

Binz  (Ozone),  Berl.  klin.  Wochensch.,  1884, 
No.  20 

Buchheim,  Arch.  f.  exp.  P.  u.  Ph.,  Bd.  iv.  p.  137 

Donders,  PflUger's  Arch.,  Bd.  v.  p.  20 

Dybkowski  in  Hoppe-Seyler's  Med.-Chem.  TTn- 
ters., Bd.  i. 

Estor  et  St.  Pierre,  Journ.  de  l'Anatomie  et  de 
la  Phys.,  t.  ii.  106 

Fernet,  Ann.  d.  Sciences  nat.,  vi.  t.  viii. 

Priedlander  u.  Herter,  Z.  £.  physiol.  Ohem,,  ill.  19 


Oxygen. 


Gorup-Besanez,  Anna!,  d.  Chem.  n.  Pharm.,  Bd. 

ex.  u.  exxv. 
Hacker,  Dissert.  Dorpat,  Riga,  1863 
Herter,  TJeber  d.  Spannung  des  O.  im  arterielleu 

Blut,  Z.  1.  physiol.  Chem.,  iii.  98, 1879 
Hoppe-Seyler,  Med.  Chem.TJnters.,Bd.  i.,  in  Arch. 

f.  Physiol.,  Bd.  vii.  9  ;  Physiol.  Chimie,  i,  pp. 

7,39 
Httfner,  Zeitsch.  f .  phys.  Chemie,  i.  pp.  317,  386, 

u.  Centralbl.,  1878,  p.  710 
Llebig,  G.,  Aerztl.  Intelligenzbl.,  1879,  No.  xix. 
Magnus,  Poggendorf 's  Ann.,  Bd.  xl.  p.      3,  u. 

lxvi.  p.  177 
Manassein,  Centralbl.  1.  m.  Wiss.,  1871,  xliv. 

p.  688 
Meyer,  Lothar,  Zeitschr.  f .  rat.  Med.,  No.  1,  Bd. 

viii.  p.  256 
Miiller,  W-,  Wien.  Acad.  Sitzber.,  Bd.  xxxiii,  99 
#     Pfliiger  in  seinem  Arch.,  Bd.  1,  p.  274 

Eegnault  et  Reiset,  Compt.  Rend.,  t.  xxvi.  pp.  3. 

4, 17 
Schmidt,  Al.,   Ozon   im   Blut,   Dorpat,  1872; 

Hiimatol.  Studien,  Dorpat,  1865 ;  Centralbl.  f. 

d.  med.  Wiss.,  1867;  Ber.  d.  k.  sachs.  Ges.  d. 

Wiss.,  M.  phys.  CI.,  Bd.  six. ;  Arch,  f .  path. 

Anat.  u.  Phys.,  Bd.  xlii. 
Schbnbein,  Boy.  Soc.  Proc.  1840 

Pellitoey. 

Browne,  London  Practitioner,  svii.  p.  86 

Peppermint. 

Marcusson,  Hallenser  Diss.,  1877 

Pepsin. 

Albertoni,  Centralbl.  f.  d.  med.    Wissensch., 

1878,  p.  641 
Bea'e,  Arch.  f.  1850,  i.  iv. 

Davidson,  Practit.,  March  1872,  vol.  viii.  p.  131 
Dowdeswell,  Pract.,  Papain,  vol.  xxx.  p.  485 
Ewald,  Prerichs  u.  Leyden's  Z.  i .  klin.  Med.,  L 

p.  231 
Gray,  Jas.,  Edinb.  Med.  Journ.,  Jan.  1853,  p.  31 
Joynes,    L.    S.,  Richm.    and   Louisville   Med. 

Journ.,  1869 
Leube,  W.  O.,  Deutaches  Arch.  f.  klin.  Med.  ix. 

532  ;  x.  1,  1872 
Manassein,  Virch.  Arch.,  1872,  vol.  Iv.  p.  413 
Roberts,  Sir  W.,  Digestive  Perments 
Tuson,  Med.  Times  and  Gaz.,  vol.  ii.  1882 
Wayne,  Amer.  Jouru.  Pharm.,  1868 

Pepton. 

Chandelon,  Ber.  d.  deutsch.  Chem.  Gesell.,  xvil. 

p.  2143  (1885) 
Penzoldt,  Deut.  med.  Wochensohr.,  Bd.  iv.  pp. 

413, 425 
Bchmidt-Muhlheim,  Ludwig's  Arb. 
Seegen,  PflUger's  Arch.,  vol.  xxv.  p.  165  ;  ibid. 

vol.  xxviii.  p.  990 
Tanret,  Comptes  Rendus,  xcii.  1163 

Permanganate  op  Potassium. 

Kronecker,  Ludwig's  Arbeiten,  1871,  p.  183 

Peroxide  of  Hydrogen. 

Assmuth,  Dorp.  Diss.,  1864 

Guttmann,  Virch.  Arch.,  Bd.  Ixxiii.  p.  23,  a. 

lxxv.  p.  255 
Richardson,  Lancet,  vol.  i.  p.  383, 1862 
Schwerin,  Arch.  i.  path.  Anat.,  Ixxiii.  p.  23 
Stohr,  Arch,  f .  klin.  Med„  1867,  Bd.  iii.  p.  421 


BIBLIOGRAPHICAL  INDEX. 


1257 


Petroleum. 


Physostigma. 


Lassar,  Berl.  klin.  Wochenschr.,  1879,  No.  xviii. 
p.  261 

Phosphorus. 

Abstract  of  the   Literature   up   to   1867,   la 

Schmidt's  Jahrb.,  Bd.  cxxxvi.  p.  209 
Andant,  Joum.  de  Med.  de  Bruxelles,  1868-79 
Anatie,  Pract.,  1873,  Tol.  xi.  103 
Aufreoht,  Deut.  Arch.  f.  klin.  Med.  xxiii.  331 
Bauer,  Zeitschr.  f.  Biologie,  Bd.  vii.-xiv. 
Bollinger,  Deutsoh.  Arch.  klin.  Med.,   Bd.  v. 

p.  149,  1869 ;  Bd.  vi.  p.  94,  1870 
Demarbaix  and  Wilmart  Presse  Med.  beige,  xxi. 

p.  197,  xxv.  1869 ;  Schmidt's  Jahrb.,  Bd.  oxliv., 

cxlv.  p.  152 
Dybkowsky,  Hoppe-Se  yler's  Med.-Chem.  Unters., 

Heft  i.  p.  64 
Eamcs,  II.,  Dub.  Journ.  Med.  Sci.,  Jan.  1872,  p.  1 
Eulenburg  u.  G-uttmann,  Aertz.  Literaturblatt, 

1868,  No.  12  ;  Syd.  Year  Book,  1868,  p.  460 
Falk,  jun.,  Arch.  f.  exp.  Path.  u.  Pharm.,Bd.  vii. 

1877 
Friese,  Berl.  klin.  Wochens.,  1877,  p.  437 
Gamgee,  Priestley,  and  Larmuth,  Journ.  Anat. 

and  Phys.,  xi. 
Hartmann,  Dorp.  Diss.,  1866 
Hermann  u.  Brunner,  PfiUger's  Arch.,  Bd.  i  ii.  p.  1 ; 

Deut.  Arch.  klin.  Med.,  p.  198 
KBhler,  Berl.  klin.  Wochens.,  1870 
Kohts,  0.,  Pfllig.  Arch.,  Bd.  xiii.  p.  84 ;  Deutsoh. 

Arch,  f .  klin.  Med.,  Bd.  v.  p.  168 
Lebert  and  Wyss,  Arch.  Gen.,  1868 
Mayer,  Canstatt's  Jahresb.,  Bd.  v.  1862,  p.  123 
Meyer,  Arch,  f .  exp.  Path.  u.  Ph.,  xiv.  p.  313 
Munk    u.  Leyden,  Die  acute   Phosphorrerg, 

Berl.  1865 
Ossikowsky,  Wien.  med.  Presse,  1872  * 
Percy,  S.  B.,  Prize  Essay,  Trans.  Amer.  Med. 

Assoc,  1872,  p.  659 
Poulet,  Gaz.  Med.  de  Paris,  Aug.  1872 
Schiff,  Arch.  f.  exp.  Path.  u.  Pharm,  Bd.  ii.  p. 

347 
Schuchardt,  Henle  und  Pfeufer's  Arch.,  N.F, 

Bd.  Tiii.  p.  235 
Schulzen  et  Biess,  Ann.  de  Charite,  t.  XT. 
Botnitschewsky,  Z.  f .  physiol.  Ohemie,  iii.  p.  391, 

1879 
Thompson,  J.  A.,  Lond.  Pract.,  vol.  xi.  pp.  13  and 

27,  July  1873 
Vetter,  Virch.  Arch.,  Bd.  liii.  p.  186,  p.  21 
Vigier,  Bull.  Therap.,  xc.  Jan.  1876 
Virchow,  sein  Archiv,  Bd.  xxxi.  p.  399, 1864 
Tulpian,  Arch,  de  Phys.,  1868  (Compounds) 
Wegner,  Virch.  Arch.,  Bd.  It.  p.  11,  June  22, 

1872 ;  Wien.  med.  Presse,  Jan.  1872 
Weyl,  Arch.  d.  Heilk,  1878,  p.  163 

Physostigma. 

Amagat,  Journ.  de  Therap.,  1876 

Arnstein,  C  u.  Sustschinsky,   Unters.  Phys. 

Lab.  Wttrzburg,  2.  Th.  p.  86 
Bezold,  V.,  u.  Gbtz,  Central,  f .  d.  med.  Wissens., 

April  6, 1867,  p.  234 
Complete  Literature  by  Harnack,  Arch,  f .  exp. 

Path.  u.  Pharm.,  Bd.  v.  p.  401 
Edwards,  J.  B.,  Med.  Times  and  Gaz.,  vol.  ii.  p. 

212, 1864 
Engelhardt,  Unters.  a.  d.  Phys.  Lab.  Wurzburg, 

2.  Th.  526 
Fraser,  Ed.  Med.  Journ.,  ix.,  Aug.  and  Sept., 

pp    123   and  235,  1863 ;    Trans.   Boy.   Soc, 

Edinb.,  xxiv.  73, 1867,  xxvi.  1872 
Frdlich,  Pharm.  Unters.,  i.  56 
Fronnmller,  Deutsch.  Klinik,  32,  35,  1864 
Grafe,  A.  von,  Deut.  Klinik,  No.  xxiv.  1863 
Graser,  Arch.f.  exp.  Path.  u.  PhannaK,  Bd.  xviu 

Heft  5 
Grunhagen,  Virch.  Arch.,  Bd.  xxt.  p.  621 


Barley,  Journ.  de  l'Anat.  et  de  la  Phys.,  1864, 

pp.  140-152 
Harnack  u.  Witkowski,  Arch.  f.  exp.  Path.  u. 

Pharm.,  t.  142 
Hirschler,  Wien.  med.  Woch.,  13,  xlii.  1863 
Hbring,  Wtirteniberg.  Corresp.-Blatt,  xti.  1863 
Jones,  W.,  Pract.,  1869,  toI.  iii.  p.  163 
Key  worth,  Glas.  Med.  Journ.,  N.S.  1869,  i.  p.  54 
Kleiawachter,  Berue  Fhotogr.  des   Hdpitaux, 

1870 
KBhler,  Arch,  f.exp.  Path.  u.  Pharm.,  Bd.  i.  280, 

1873 
Laschkewitsch,  Virch.  Arch.,  1866,  Bd.  xxxr.  294, 

1866 
Laurence,  Ophthal.  Hosp.  Eeports,  iT.  1,  129, 

1863 
LeTen  u.  Laborde,  Schmidt's  Jahrb.,  Bd.  cxlvi. 

p.  136 
Lewisson,  Beich.  Arch.,  1870,  p.  346 
Maynard,  Virchow's  Archir,  toI.  lxxxix.  p.  258 
Merson,  Journ.  of  Mental  Sci.,  Jan.  1875,  vol.  xx. 

p.  602 
Ogle,  Brit.  Med.  Journ.,  vol.  i.  p.  673, 1863 
Papi,  C.  Schmidt's  Jahrb,,   cxlii.    287 ;    Gaz. 

Lomb.,  1858 
R'dber,  Berlin.  Diss.,  1868 
Bobertson,  Argyll,  Edinb.  Med.  Journ.,  1863 
Boemer,  St.  Louis  Med.  and  Surg.  Journ.,  1873, 

367 
Bosenthal,  Beich.  Arch. 
Bossbach,  Pharmak.  Unters.,  Heft  i.  1873 
Schiff,  Centralbl.  f .  d.  med.  Wiss.,  1873,  p.  37 
Subbotin,  Arch.  f.  klin.  Med.,  Bd.  vi.  285, 1869 
Tachau,  Arch.  d.  Heilk.,  1865,  p.  70 
Tweedy,  J.,  Pract.,  1883,  vol.  xxxi.  p.  321 
Vee  et  LeTen,  Comptes  Bend,  de  la  Soc.  de 

Biol.,  1865,  p.  161 
Vintschgau,  Moleschott's  Unters.,  ix.  800, 1865 
Watson,  E.,  Ed.  Med.  Surg.  Journ.,  xii.  p.  11, 
May,  1867 ;  Centralbl.  f.  d.  med.  Wiss.,  1868, 
p.  143 
Weber,  Klin.  Monatsschr.  f .  Augenheilk,  Aug. 

1863 
Westermann,  Schmidt's  Jahrb.,  Bd.  exxxriii.  p. 
290 

PlCROTOXINE. 

Luchsinger,  Physiol.  Stud.,  Leipzig,  1882 
BoTighi  e  Santini,  Pubblicaz.  del  B.  Instit.  di 
Stud.  sup.  in  Firenze,  1882,  p.  1 

Pilocarpine. 

Complete  List  of  Literature  (117  Authors),  by 
Lewin,  Berl.  Charite  Annal.,  v.  Jahrg.  1878, 
p.  559 

Prussic  Acid. 

Bernard,  01.,  Lecons  sur  les  Subst.  toxiques, 

p.  193,  laris,  1857 
Bischoff,  Ueb.  Vergift.,  Wien,  1844 
Bbhm,  Arch.  f.  exp.  P.  u.  Pharm.,  Bd.  ii. 
Bbhm  u.  Knie,  Arch.  f.  exp.  Path.  u.  Therap., 

Bd.  ii.  pp.  135, 137 
Bunge,  A.  f.  exp.  P.  u.  Pharm.,  xii.  1  (Gangas). 
Coze,  Gaz.  Med.  de  Paris,  1849  ;  Comptes  Bend., 

t.  XXTiii.  1849,  p.  780 
Fagge,  Hilton,  Guy's  Hosp.  Rep.,  1868,  p.  259 
Funke,  Ber.  d.  k.  sachs.   Gesell.   d.   Wiss.  z. 

Leipzig,  Bd.  xl.  1859,  p.  28 
Gahtgens  in  Hoppe-Seyler's  Med.  Chem.  Unters., 

Berl.,  1866,  pp.  324,  346 
Geinitz,  E.,  PfiUger's  Arch.,  Bd.  iii.  1870,  p.  46 
Harley,  Lond.  Phil.  Trans,  1865,  p.  706 
Hiller,  Centralbl.  f .  d.  med.  W.,  1877,  577 
Hiller  and  Wagner,  Lancet,  1877,  ii.  933 
HoppeSeyler,  Med.  Chem.  Unters.,  Berl.  1867, 

140 ;  Virch,  Arch.,  Bd.  xxxTiii.  p.  475 


1258 


BIBLIOGRAPHICAL  INDEX. 


Prussic  Acid. 

Httnefeld,  der  Chemismus  In  d.  thierischen  Or- 
ganisation, Leipzig,  1840 
Jones,  J.,  N.Y.  Med.  Rec,  vol.  ii.  p.  459 
Keen,  Proc.  Phil.  Acad.  Nat.  Soi.,  1869 
Kiedrowski,  Viroh.  Jahresb.,  1858,  vol.  i.  p.  48 
Kblliker,  Yirch.  Arch.,  Bd.  x.  p.  272 
Lankester,  Bay,  Pfliiger's  Arch.,  vol.  ii.  1869, 

p.  492 
Laschkewitsoh,  Eeieh.  Aroh.  f .  Anat.,  1868,  p.  653 
Lautenbaoh,  Phil.  Med.  Times,  May  26, 1877 
Lecorch6  and  Meuriot,  Arch.  Gen.    t.xi.  6e  serie, 

pp.  539,  543 
Lewisson,  Reich.  Arch.,  1873,  p.  352 
Preyer,  Die  Blausaure,  physiol.  TJnters.,  2  Thl. 

Bonn,  1808  u.  1870,  contains  a  lull  rismnA  of 

the  literature  of  the  subject  up  to  1870 
.     Preyer,  Arch.  f.  exp.  Path.  u.  Ph.,  Bd.  iii.  p.  381 
Rossbach   u.  Papilsky  in   Rossbach's   Pharm. 

Unters.,  Bd.  iii.  1877 
Schbnbein,   Schmidt's  Jahrb.,  Bd.    cxl.    1868, 

p.  161 
Schubarth,   Horn's   Arch.  f.  med,  Ert,   Berl. 

1824 
Sobernheim,  J.  P.,  Handb.  d.  prakt.  Toxicol., 

Berlin,  1838 
Stannius,  Arch.  f.  Anat.,  1858,  p.  95 
Vietz,  P.  B.,  Med.  Jahrb.   d.  k.  k.  bsterreich. 

Btaates,  Bd.  ii.  1814 
Wahl,    De  Yi  et  Effectu  Acidi  Hydrocyanati, 

Bonn,  1865 
Wallach,  Ber.  d.  deutsch.  chem.  Ges.,  x.  2120 

Ptomaines  and  Leucomaines. 

Brieger,  tjb.  Ptomaine 

Gautier,  Sur  les  Alcaloldes  derives  de  la  destruc- 
tion bacterienne,  etc.,  Paris  (Masson),  1886 

Guareschi  u.  Mosso,  Les  Ptomaines,  Turin, 
1883 

Nicati  et  Rietsch,  Oompt.  Rend.,  xc.  p.  928 

Selmi,  Sulla  Ptomaine,  etc.,  Bologna,  1878  ;  ibid. 


Purgatives. 

Asp,  Ludwig's  Arbeiten,  1868 

Brieger,  Aroh.  f.  exp.  Path.,  Bd.  viii.  p.  355 

Brunton,    Lauder,   Med.  Press    and   Circular, 

Dec.  31, 1873,  p.  590  ;  Pract.,  vol.  xii.  pp.  342 

and  403 
Buchheim,  Arch.  f.  physiol.  Heilk.,  Bd.  xiii.  u. 

xiv, ;  Yirchow's  Archiv,  Bd.  xii.  p.  1 
Palck,  Virchow's  Archiv,  Bd.  liv.  p.  173 
Hay,  Matthew,  Journ.  of   Anat.  and  Physiol., 

vol.  xiv. ;  Lancet,  April  21, 1883 
Headland,  Action  of  Medicines,  London,  1867, 

P.  443 
Kbhler,  H.,  Yirchow's  Archiv,  Bd.  xlix.  p.  408 
Moreau,  P.  A.,  Memoires  de  Physiologie,  Paris, 

1877;    Oomp.    Kend.,   t.    lxvi.    1868;    Arch. 

Generates,  6e  ser.  t.  xvi.  p.  234 
Mosler.  Berl.  klin.  Wochensch.,  No.  xJv.  1873, 

p.  533 
Nasse,  O.,  Beitr.  z.  Physiol,  der  Darmbewegung, 

Leipzig,  1866 
Radziejewski,  Reichert  und  Du  Bois-Reymond's 

Arch.,  1870,  p.  37 
Rbhrig,  A.,  Strieker's  Med.  Jahrb.,  1873,  p.  240  ; 

Exp.  Unters.  U.  d.  Phys.  d.  GalleDabsonderung, 

Wien,  1873 
Rutherford,  British  Med.  Journ.,  vol.  i.  p.  362, 

1877;    Schmidt's   Jahxb.,  1878,  Bd.    clxxvii. 

p.  11  S. 
SchiflE,  II  Morgagni,  1867 
Simon,  Gus.,  Arch.  d.  klin.  Ohir.,  xv.  p.  99 
Thiry,    Sitzungsber.    d.    Wiener  Acad.,   Math. 

Naturw.  CI.,  1864,  Bd.  i.  p.  95  :  Gaz.  Med., 

1871 
Vulpian,  Gaz.  Med.,  1873,  p.  300 
'  Wood,  Amer.  Journ.  Med.  Sci.,  vol.  lix.  p.  395 

1870 


Pyridine. 

'  McKendrick  and  Dewar,  Proc.  Roy.  Soc,  1874, 
p.  432 
Seej  Germain,  Comptes  Rend.  Ac.  Scien.,  1886 

PntOGALLOL. 

Bullet,  de  Th6rap..  Jan.  30, 1883 ;  Cent.  f.  d.  med. 
Wissensch.,  No.  42, 1883 

Quebracho  Bark. 

Gutmann,  Arch.  f.  exp.  Path.  u.  Pharm.,  xiv. 

p.  451 
Harnack  u.  Hofmann,  Zeits.  f.  klin.  Med.,  Bd. 

viii.  Apr.  6, 1884 

Quinine. 

Albertoni  et  Ciotto,  Bull.  Therap.,  xc.  p.  403 
Appert,  Yirch.  Arch.,  Bd.  lxxi.  p.  364 
Baldwin,  W.  O.,  Amer.  Journ.  Med.  Sci.,  Apr. 

1847,  p.  292 
Bauer  u.  Kiinstle,  Deutsch.  Arch.  f.  klin.  Med., 

Bd.  xxiv.  p.  53 
Baxter,  Buchanan,  Practitioner,  vol.  viii.  pp. 

325-330 
Binz,  Zur  Salicylsaure-  u.  Chininwirkung,  Arch. 

f.  exp.  Path.  u.  Pharm.,  Bd.  i.  p.  18, 1873,  Bd. 

v.  p.  39,  Bd.  vii.  p.  275 ;  Lond.  Pract.,  p.  4, 

vol.  v.  1870 ;  Virch.  Arch.,  Bd.  xlvi.  1864,  p. 

138 
Bochefontaine,  Recherches  exp.  a  la  Contracti- 

lite  de  la  Rate,  Paris,  1873  ;  Arch,  de  Physiol, 

July  1873 
Boeck,    Yon,   Unters.   U.    d.    Zersetzung    des 

Eiweisses  im  Thierkbrper,  Munich,  1871 
Briquet,  Traite  Therap.  de  Quinquina,  Paris, 

1855 
Brunton,  Lauder,  and  Pardington,  St.  Bartholo- 
mew's Hosp.  Rep.,  1876,  p.  150 
Burt,  Med.  and  Surg.  Reporter,  1870 
Chalvet,  Schmidt's  Jahrb.,  Bd.  cxli.  p.  152 ;  Gaz. 

Hcbdom.,  2e  ser.  t.  v.  1868 
Chaperon,  Pfttig.  Arch.  f.  Phys.,  1869,  vol.  ii. 

p.  295 
Chiara,  L'Un.  Med.,  Nov.  20, 1873,  p.  795 
Clapton,  Med.  Times  and  Gaz.,  vol.  i.  p.  462, 

1864 
Complete  Collection  of  Literature  up  to  1875 

(82  Nos.)  in   Binz,  Das  Chinin,   Berlin,  bei 

Hirschwald,  1875 
Cutler,  J.  R.,  Psych,  and  Med.  Legal  Journ., 

1875 
Dietl,  Wien.  med.  Wochensch.,  1852 
Dupuis,  L' Action  Phys.  de  Quinine,  Paris,  1877 
Eulenburg,  A.,  Reich.  Arch.  f.  Anat.,  1865,  p. 

423 
Geltowsky,  Lond.  Pract.,  vol.  viii.  p.  321 
Hallier,  Das  Cholera-Contagium,  Leipzig,  1867 
Hamilton,  J.  B.,  Ind.  Med.  Gaz.,  1873 
Henbach,  Arch.  f.  exp.  Path.  u.  Pharm.,  Bd.  v. 

p.  233  ;  Centralbl.  med.  Wiss.  1874,  p.  673 
Henke,  Deutsch.  Arch.  f.  klin.  Med.,  Bd.  xii, 

p.  630 
Hesse,  Ber.  d.  deutsch.  Chem.  Ges.,  x.  2152 
Jacobowitch,  Magnan,  Revue  des  Sci.  Med.,  1873 
Jerusalimsky,  Ueb.  d.  phys.  Wirk.  d.  Chinin, 

Berl.,  bei  Hirschwald,  1875  ;  Centralbl.  med. 

Wiss.,  1876,  p.  476 
Jones,  Bence.  Leotures  on  Path,  and  Therap., 

London,  1867 
Kerner,  Lond.  Pract.,  vol.  x.  169 ;  Pfliig.  Arch. 

f.  Phys.,  1870,  p.  93 
Kbhler,  ZeitsohriJt  f.  d.  ges.  Naturwiss.  f.  Saoh- 

sen  in  Thilringen,  Bd.  xlix.,  u.  Sitzber.  der 

Naturforscher-Gcscllsch.  zu  Halle,  1876 
Lauderer,  Repertorium  f .  Pharm.,  Bd.  xxv.  1836, 

1839,  1842 
Liebermeister,  Deutsch.  Arch.  f.  klin.  Med.,  Bd. 

iii.  1-867 


BIBLIOGRAPHICAL  INDEX. 


1259 


Quinine. 

Magendie,  Gaz.  Med.,  1847 
Martin,  A.,  Inaug.  Diss.,  Giessen,  1868 
Meher,  Memoires  de  l'Aoad.,  t.  xii.  p.  722, 1843 
Monteverdi,  Ann.  et  Bull,  de  la  Societe  de  Med. 

de  Gand,  May  1871 
Mosler,  Path.  d.  Leukamie,  Berl.,  1872,  p.  451 
Naunyn  n.  Quincke,  Belch.  Arch,   f.  Anat.. 

1869  ' 

Pages,  Gaz.  Med.,  1846 
Personne,  Centralbl.   f.   d.   med.  Wiss.,  1879. 

p.  110 
Plorry,  Arch.  Gen.  de  Med.,  1847 
Pringle,  Abs.  on  Diseases  of  the  Army,  Lond- 

1765  ^ 

Babuteau,  BulL  Therap.,  t.  lxxv.  p.  475 
Bapmund,  Deutsoh.  Klin.,  1874,  p.  51 
Baucillia,  L'TJnion  Med.,  1873 
Rausone,  Inaug.  Diss.  Bonn,  1871 
Benzl,  D.,  Bull.  Therap.,  xcL  p.  45 
Bhoads,  B.,  and  W.  Pepper,  inn.,  Pennsyl.  Hosp. 

Bep.,  TOl.  i.  1868 
Rich,  Charleston  Med.  Journ.  and  Beview 
Bossbach,  Pharm.  TJnters.,  Bd.  i.  Heft  iii. 
Bovighi  e  Santini,  Pubblicaz.  del  R.  Instit.  di 

Stud.  sup.  in  Firenze,  1882,  p.  1 
Sayre,  Amer.  Praot.,  1871,  p.  260 
Soharrenbroich,  Inaug.  Diss.  Bonn,  1867 
Schlockow,  De  Chini  sulfurici  Vi  physi.  nonnulla 

Exp.  Vratisl.,  1860 
Schroff,  Strieker's  Med.  Jahrb.,  1875,  p.  176 
Sohulte,  A.,  CentralM.  t  d.  med.  Wiss,  p.  727, 

Nov.  1871 
Walranen,  Boston  Med.  and  Surg.  Journ.,  1873 
West,  Jos.  J.,  Savannah  Journ.  Med.,  vol.  i.  p.  19. 

1858 
Wilson,  J.  S.,  South.  Med.  and  Surg.  Journ., 

p.  341, 1855,  Sept.  1860 
Zunst,  Beit.  z.  Phys.  des  Slates,  Inaug.  Diss. 

Bonn,  1868;   Arch,   t   exp.   Path.,   Bd.    ii. 

p.  343 

Eesorcin. 

Kaegler,  Pratt.  Arzt.,  xxv.  p.  260  (cuts  short 
facial  erysipelas) 

Ehubarb,  vide  Purgatives. 

Eicin,  vide  Purgatives. 
Eue. 

Cahours  et  Gerhard,  Annates  de  Cliim.  et  de 

Physique,  xxiv.   p.    227,  2e  aer.;  Pharmaz. 

Jahresb.  v.  Wiggers,  viii.  50 
Cooper,  G.  T.,  Med.  Exam.,  N.S.  ix.  720 
Gorup-Besanez,  Neues  Repert.   fur  Pharmaz., 

xix.  385 
Helie,  Bull,    de   Therap.,   xv.   55 ;   Schmidt's 

Jahrb.,  xxi.  p.  275 

Saccharine. 

Boscoe,  Becent  Progress  in  Coal-tar  Industry, 
Boy.  Inst.  Proc,  1886 

Salicylates    and     Salicylic 
Acid. 

Biilz,  Arch.  d.  Heilk.,  xviii.  p.  60 
Bochefontaine  and  Chabret 
Boohef  ontaine,  Le  Progres  Med.,  1877,  p.  630 
Buohholtz,  Arch,  fcexp.  Path.  u.  Pharm.,  Bd.  iv.; 

Dorpat.  Diss.,  1866 
Byasson,  Centralbl.  t  Chlr.,  1877,  p.  809 
Callender,  Trans.  Lond.  Clin.  Soc,  ix.  p.  9 


and     Salicylic 


Salicylates 
Acid. 

Danewsky,  Arbeit,  im  Pharm.  Lab.  Moskau.  i. 

p.  190 
Drasohe,  Centralbl.  f.  Chir.,  1876,  777 
Farsky,  Sitzber.  d. k.  Akad.  d.  Wiss.,  Bd.  ii.  lxxiv. 

p.  49 
Jacoud,  Le  Progres  Med.,  1877,  pp.  528,  745 
Laborde,  Bull,  de  Therap.,  xoiii.  p.  276 
Marme,  Gbttinger   Nachrioht.,  1878,  No.  vii. 

p.  229 
Martenson,  Petersb.  med.  Zeits.,  1875,  p.  343 
Meyer  u.  Kolbe,  Journ.  f.  prakt.Chem.,  Bd.  xii. 

P.9 
Musey,  Bull.  Therap.,  xiii.  p.  318 
Eiess,  Berl.  klin.  Wochens.,  xii.  1875,  pp.  674, 

675 
Eobin,  Lond.  Med.  Rec,  1877,  p.  161 
Soheflfer,  Marburger  Diss.,  1860 
Schroeder,  Deutsch.  Arch,  t  kiln.  Med.,  xviii. 

516 
See,  Bull,  de  l'Acad.  Med.,  1877,  p.  697 
Senator,  Berl.  klin.  Wochens.,  1875,  p.  461 
Strieker,  A.  E.,  Berl.  klin.  Wochens.,  xiii.  p.  I. 

1876  ' 

Weber,  Bull,  de  Therap.,  xciii.  p.  328 
WolfEberg,  Deutsch.  Arch.  klin.  Med.,  xv.  p.  403 
Wolfsohn,  Konigsberg.  Diss.,  1876  ;  Centralbl.  f. 

med.  Wiss.,  1877,  p.  30 
Zeits.  f.  phys.  Chemie,  tL  2 

Salicylic  Acid. 

Bertagnini,  Annal.  d.  Chemie  u.  Pharm.,  Heft 

xcvii.  p.  248, 1856 
Binz,  Niederrh.  Ges.  f .  Nat.  u.  Heilk.  Sitz.,  v.  6,, 

Dec.  1875  u.  20.  Miirz  1876 ;  u.  Berl.  klin. 

Wochenschr.,  1876,  No.  xxvii. ;  Arch.  f.  exp. 

Path.,  vii.  p.  275 
Butt,  Centralbl.  f.  d.  med.  Wiss.,  1875,  No.  xviii. 

p.  276  ;  u.  Zur  antipyret.  Bedeutung  d.  Salioyl- 

siiure  u.  d.  salicyls.  Natrons,  Stuttgart,  1876 
Ebstein,  Berl.  klin.  Wochenschr.,  1873,    1875, 

1876 
Feser  u.  Friedberger,  Arch.   f.  wiss.  u.  pract. 

Thierheilk.,  1875,  Heft  ii.  iii.  u.  vi. ;  1876, 

Heft  ii.  u.  iii. 
Fleok,  Benzoesaure,  Carbolsaure,  Salicylsiiure, 

Zimmetsaure,    Vergl.     Versuche,   Miiuchen, 

1875 
Fliescher,  Centralbl.  f.  d.  med.  Wiss.,  p.  628, 

1876,  No.  xxxvi. ;  u.  Arch.  f.  klin.  Med.  1877, 

Bd.  xix. 
FUrbringer,  Centralbl.  f.  d.  med.  Wiss.,  p.  273, 

1875,  No.  xviii. 
Gedl,  M.,  Med.  Centralbl.,  1876,  p.  403 
Goltdammer,    Berl.   klin.   Wochenschr.,    1876, 

No.  iv. 
KBhler,  H.,  Centralbl.  f.  d.  med.  Wiss,  1876, 161, 

195 ;  Deutsch.  Zeitschr.  f.  pract.  Med.  v.  Kuiize, 

1877 
Kolbe,  Journ.  f.  pract.  Chem.,  N.F.  Bd.  xii.  1875, 

Bd.  xi.  p.  9 
MSli,  Berl.  klin.  Wochenschr.,  1875,  No.  xxviii. 
Salkowski,  Berl.  klin.  Wochenschr.,  1875,  No. 

xxii. 
Thiersch,    Klin.   Ergebnisse   der   Lister'schen 

Wundbehandl.  in  Volkmann's  Samml.  klin. 

Vortrage,  Nos.  lxxxiv.and  lxxxv. 
Wolfsohn,  Dissert.  Konigsberg,  1876 

Sanguinaria. 

Smith,  B.  M.,  Amer.  Jours.  Med.  Sci,  Oct,  1876. 
p.  346 

Santonin. 

Andaul,  Brit.  Med.  Journ.,  vol.  i.  p.  186, 1872 
Berg,  Wurttemberg.  Medio.  Correspond.,  1862 


1260 


BIBLIOGEAPHICAL   INDEX. 


Santonin. 

Binz,  Arch.  f.  exp.  P.  u.  Ph.,  Bd.  vi.  p.  300 
Brown,  Dyce,  Brit,  and  For.  Med.-Chir.  Rev., 

AprU  1871,  p.  472 
Falck,  Deutsche  Klinik,  1860 
Frohnstein,  Diss.,  Bern.,  1877 
Guepin  et  Martin,  Ann.  de  Therap.,  1862 
Kranss,  Inaug.  Diss.,  Tubingen,  1869 
Manns,  Marburger  Diss.,  1858 
Rose,  Virch.  Arch.,  Bd.  xvi.  p.  233,  Bd.  xviii. 

p.  15,  Bd.  xix.  p.  522,  Bd.  XX.  p.  245,  Bd.  xxviii. 

p.  30,  Bd.  xxx.  p.  442 
Walz,  Jahresber.  f.  pract.  Pharm.,  Bd.  it. 
Whitehead  (in  amenorrhcea),  Lancet,  Sept.  5, 

1885 

Saponin. 

Buchheim  u.  Eisenmenger,  Kckhanlt's  Beitriige, 

v.  3,  Giessen,  1869 
Harnack,  Arch.  f.  exp.  Pharm.,  ii.  1874 
Keppler,  Berl.  klin.  Wochenschr,  1878,  p.  475 
Kbhler,  H.,  Die  totale  Anasth.  durch  Saponin, 

Halle,  1873 
Lautenbach,  Phila.  Med.  Times 
Pelikan,  Berl.  klin.  Wochenschr.,  xxxvi.  1867, 
p.  375  ;  u.  Bulletin  d.  k.  Acad,  zu  St.  Peters- 
burg, xii.  1867,  p.  253 
PrzybyszcwsM,  Arch.  f.  exp.  Path.,  v.  137 
Schmiedeberg,  Ludwig's  Festgabe,  p.  127 

Savin. 

Letheby,  London  Lancet,  vol.  i.  p.  677, 1845 

Silver  Nitrate,  etc. 

Bogolowski,  Arch.  f.    path.   Anat.,   Bd.    xlvi. 

p.  413 
Charcot  et  Ball,  Gaz.  Med.,  1864 
Ourci,  Lond.  Med.  Rec,  1877,  p.  72 
Eichmann,  Husemann's  Toxicologie,  871 
Fragstein,  Berl.  klin.  Wochens.,  3877,  294 
Frommann,  Virch.  Arch.,  Bd.  xvii.  p.  135 
Jacobi  u.  Gissmann,  A.  f .  exp.  P.  u.  Pharm.,  Bd. 

viii.  p.  217, 1878 
Higginbottom,  Lond.  Pract.,  vol.  ii.  p.  34, 1869 
Kramer,  Das  Silber  als  Arzneim.,  Halle,  1845 
Neumann,  Med.  Jahrb.,  1877,  p.  369 
Pepper,  Trans.  Phila.  Coll.  Phys,  1877 
Reimer,  Arch,  t  Heilk.,  Bd.  xvi.  p.  296 
Rosenstirn  in    Rossbach's   pharmak.    Unters. 

Bd.  i. 
Rouget,  Arch,  de  PAnatom.  et  de  Physiol.,  July 

1873,  p.  356,  u.  Jahresber.  d.  ges.  Med.,  1870, 

Bd.  i.  p.  363 
Roszahegzi,  A.  f .  exp.  P.  u.  Pharm.,  Bd.  ix.  p. 

289,  1878 
Weichselbaum,  Centralbl.  f.  d.  med.  Wiss,  1878, 

p.  954 
Yandell,  Amer.  Pract.,  June  1872 

Sodium  Salts,  vide  Alkalies. 

Barnard,  Phys.  Exp.,  t.  ii.  p.  393  ;  Phila.  Med. 

Times,  vol.  v. 
Bidder  and  Schmidt,  Canstatt'B  Jahresb.,  1852 
Gaule,  Arch.  i.  Anat.  u.  Phys.,  1878,  p.  296 
Grandeau,  Robin's  Journ.  de  l'Anat.,  1864,  p. 

378 
Guttmann,  Virch.  Arch.,  Bd.  xxxv.  p.  450 
Longet,  Physiologie,  Paris,  1861,  t.  i.  p.  196 
Munich,  Arch.  Vereins  Gemeinsch.  Arb.,  Bd.  vi. 

p.  369,  1863 
Nothnagel,  Virchow's  Archiv 
Plouviez,  Com.  Rend.,  t.  xxv.  1847,  p.  113 
Podkaepow,  Virch.  Arch.,  Bd.  xxxiii.  p.  507 
Rabuteau,  L'TJnion  Med,  t.  xii.  p.  186, 1871 
Roberts,  Urinary  and  Renal  Diseases,  Am.  ed., 

1866,  pi  240 


Spigelia. 

Eberle,  Materia  Med.  and  Therap.,  vol.  i. 
Spalsbury,  Bost.  Med.  and  Surg.  Journ.,  vol.  Iii. 
p.  72, 1855 

Squill. 

Dassen,  Groninger  Diss.,  1834 

Husemann,  Arch.  d.  Pharmacie,  Bd.  vi.  Heft  iv. 
1876 ;  Deutsch.  med.  Wochens.,  xiii.  p.  149, 
1875  ;  Lond.  Med.  Rec,  1876,  p.  120  ;  Toxico- 
logie, Bd.  i.  413 

Jarraersted,  A.  f.  exp.  P.  u.  Pharm.,  1879,  Bd. 
ii.  p.  22  (Scillain) 

SchrofT,  Wien.  Wochenschr.,  1864,  43,  p.  673 

Wolfring,  Bayer,  arztl.  Intelligenzbl.,  1843 

Staphysagria. 

Boehm  u.  Serek,  Arch.  f.  exp.  Path.,  v.  p.  311 

Strychnine. 

Amagat,  Journ.  d.  Therap.,  1875,  p.  467 
Ambrosoli,  Gaz.  Med.,  1857,  p.  525 
Bennett,  Brit.  Med.  Journ.,  vol,  ii.  p.  436, 1874 
Bernard,  CI.,  Lecons  sur  les  Substances  Toxiques, 

Paris 
Bochefontaine,  Arch,  de  Phys.  norm,  et  path., 

1873,  p.  664 
Brown-Sequard,  Comptes  Rendus,  1849,  29,  p.  672 
Buchheim,  R.,  Arch.  f.  d.  ges.  Phys.,  xi.  177-181 
Buchheim  u.  Engel,  Beitr.  z.  Arzneim.,  Leipzig, 

1849,  i.  p.  92 
Cohn,  Wien.  med.  Wochensch,  Nos.  xlii,  xlvii. 

1873 
Deen,  Van,  Phys.  de  la  Moelle  epiniere 
Eckhard,  Hermann's    Handb.  d.  Phys.,  Bd.  ii. 

Th.  2,  p.  40,  etc. 
Falck,  F.  A.,  jun.,  Vierteljaarsschr.  f.  gerichtl. 

Med.,  N.F.   Bd.  xx.  2,  193,  xxi.  12,  u.  xxiii. 

1874 
Falck,  senior,  Virch.  Arch.,  xlix.  1870,  p.  458 
Freusherg,  Arch.  f.  exp.  Path.  u.  Pharm.,  Bd. 

iii.  pp.  204  and  348, 1875 
Gartner,  Sep.-Abdruck  a.  d.  Ixxx.  Bd.  d.  k.k. 

Acad.  d.  Wiss.,  iii.  Abt.  Dec.  Hf  t.  Jahrg.  1879 
GrUtzner,  Pfluger's  Archiv,  1876,  Bd.  xi.  p.  601 
Harley,  Lancet,  July  1856,  p.  40 
Heinemann,  C,  Virch.  Arch.,  Bd.  xxxiii.  p.  394 
Hippel,  V.,  Wirk.  des  Strych.  auf  d.  Augen, 

Berlin,  1873,  p.  77 
Husemann,  Arch.  d.  Pharm.,  Bd.  viii.  Heft  3, 

1877 
Jacoud,  Pathol.  Interne,  i.  441 
Jochelsohn,  Rossbach's  pharm.  TJnters.,  Bd.  i. 
Jolyet,    Gaz.  Med.  de   Paris,  1877  (Iodide  of 

ethyl  compound  and  cicutine). 
Klapp,  Journ.  Mental  Diseases,  Oct.  1878 
Kolliker,  Virch.  Arch.,  Bd.  x.  p.  239, 1856 
Lange,  F.,  Kbnigsberger  Diss.,  1874 
Leube,  Arch.  f.  Anat.  u.  Phys.,  1867,  p.  629 
Ludwig  and  Walton,  Ludwig's  Arbeiten,  1882 
Magendie,  Paris  Soc.  Philom.,  N.  Bull,  i.  368, 

1880 
Mager,  S.,  Wiener  Acad.  Sitzungsber.,  Math. 

Nat.  Wiss.  CI.,  3.  Abth.  1871 
Martin-Magron    et   Buisson,   Brown-S6quard's 

Journ.  de  la  Phys.,  1860,  t.  iii.  pp.  130,  342 
Matteuoci,  Traite  des  Phenoin.  electro-physiol., 

Paris,  1844 
Meschede,  Berl.  klin.  W.,  1878,  No.  xxiv. 
Moller,  TJgeskr.  f.  Liiger,  3.  R.  Bd.  xix.  161 
Moreau,  Comptes  Rend.  Soc.  de  Biol.,  1855,  p.  173 
Nagel,  Die  Behandl.  d.  Amaurosen  u.  Amblyo- 

pien  m.  Stryoh.,  Tubingen,  1871 
Nasse,  O,  Centralbl.  f.  med.  Wiss,  1865,  p.  787 
O'Farrell,  L.,  Phila.  Med.  Times,  vol.  iii.  p.  311 
Orr,  Gaz.  Med,  July  6,  1872 
Polikan,  B,  Beitr.  z.  ger.  Med,  p.  92, 1858 
Ranke,  Virch.  Arch,  Jxxv.  p.  1, 1878 


BIBLIOGEAPHICAL  INDEX. 


1261 


Strychnine. 

Richter,  Zeitschr.  f.rat.  Med.,  Ul.  Bd.  xviii.  p.  76 
Rosenthal  u.  Leube,  Arch,  fur  Anat.  u.  Phys., 

1867,  p.  629 
Rossbach,  Centralbl.  f .  med.  Wiss.,  xxiv.  p.  369, 

1873  . 
Rossbach  u.  Jochelsten,  WUrtzburg.    Abhandl., 

1873,  p.  92 
Savory,  Lancet,  May  1863;  Schmidt's  Jahrb., 

cxix.  p.  286, 1863 
Schifi,  Schmidt's  Jahrb.,  Bd.  exli.  p.  25 
Schlesinger,  Wien.  med.  Jahrb.,  1874 
Schrofl,  T.,  jun.,  Wien.  med.  Jahrb.,  1872,  p. 

420 ;    Wochenbl.  d.  Zeitsohr.    d,   Aerzte  zu 

Wien,  No.  14, 1866 
Schultzen,  Arch.  f.  Anat.  u.  Phys.  (Dubois), 

p.  491, 1864 
Spence,  A.  T.,  Edinb.  Med.  Journ.,  July  1866, 

xii.  i.  p.  44 
Tschepke,  Deut.  Klinik,  xiii.  1861 
Uspensky,  Arch.  f.  Anat.  u.  Phys.,  1868,  iv.  p. 

522 
Valentin,  Path,    der  Nerven,    p.    327,    pt.   ii. 

Leipzig,  1864  ;  Arch,  de  Physiol.,  Not.  1870,  p. 

125,  t.  111.  p.  120 
Wittich,  Bericht  Fortschritte  Anat.,  1857,  p.  434 
Wundt,  Unt.  d.  Med.  d.  Nerven,  Stuttgart,  1871 

Sugar.    . 

Mering  u.  Musculus,  Hoppe*Seyler's  Z.  1  phys. 
Ch,  i.  p.  395  and  ii.  177 

Sulphide  of  Calcium. 

Ringer,  Sydney,  Lancet,  Feb.  1874,  vol.  i.  p.  264 

Sulphur  and   Sulphuretted 
Hydrogen. 

Dorpater  Diss.  Krause,  1853 ;  Trachtenberg,  1861; 

H'oppener,  1863 
Hermann,  Toxicologic 
Hoppe  Seyler,  Centralbl.  f.  d.  med.  Wiss.,  1863, 

p.  433  ;  Med.  chem.  Unters.,  1867,  Bd.  ii. 
Kunkel ,  Pfliiger's  Arch.,  Bd.  xiv.  p.  344 
Poleck,  Die  chem.  Natur  der  Minengase,  etc., 

Berl.  1867 
Eegensburger  Centralbl.  med.  Wiss.,  1877,  p.  328 
Rosenthal  u.  Kaufmann,  Reichert's  Arch.,  1866, 

p.  647 
Schmiedeberg,  Arch.  d.  Heilk.,  1867,  Bd.  vui. 

p.  422 
Sertoli,  Institute  flsiol.  di  Pavia,  1869 

Tannic  Acid.    Tannin. 

Hennig,  Arch.  d.  Pharm.,  Bd.  cxxxiii. 
Lewin,  Arch.  f.  exp.  Path.  u.  Ph.,  xxxi.  p.  74 
Rosenstirn,  Hossbach's  pharmak.  Unters.,  Bd.  i. 
Schroff,  Die  Pflanzenstoffe,  Lehrb.  d.  Pharm.,  1. 
Auflage 

Thuja. 

Kbhne,  Gbttingen.  Diss.,  1883 


Thymol. 


Husemann,  Arch,  f .  exp.  Path.  u.  Pharm.,  Bd. 

~iv.  1875,  p.  288 
KUssner,  Habil.-Schr.,  Halle,  1878 
Lewin,  Centralbl.  f.  d.  med.  Wiss.,  1875,  p.  324 


Tobacco,  vide  Nicotine. 

Benham,  W.  T.,  West  Riding  Lun.  Reports,  vol. 

iv.  p.  305, 1874 
Bernard,  Cl„  Substances  Toxiques,  p.  410 
Copeland,  Diet,  of  Pract.  Med.,  art.  Colic 
Hirschmann,  Reich.  Arch.,  1863,  p.  309 
Husemann,  Handb.  d.  Toxicol.,  vol.  ii.  483 
Nasse,  Beitrage  z.  Phys.  der  Darmbewegung, 

Leipzig,  1866 
Reil,  Journ.  f.  Pharmacodyn.,  Bd.  ii.  p.  203 
Rosenthal,  Centralbl.  f.  med.  Wiss.,  1863,  p.  738 
Traube,  Allgem.  med.  Central-Zeit.,  1862 
TJspensky,  Reich.  Arch.,  1868,  p.  525 
Vohl  u.  Eulenburg,  Arch.  Pharm.  (2),  1873,  Bd. 

cxlvii.  130-6 
Yulpian,  Comptes  Rendus  de  la  Soc.  de  Biol., 

1859,  p.  151 


Trimethylamine 
lamin). 


(or  Propy- 


Tin 


IN. 

White,  Archiv  f.  exp.  Path.  a.  Pharmak.,  1880, 
viii.  p.  33 


Husemann,  Selige,  Arch.  f.  exp.  Path.  u.  Pharm., 
Bd.  vi.  p.  56 

Valerianate  of  Amyl. 

Wade,  W.  P.,  Brit.  Med.  Journ.,  i.  1874,  p.  741 

Veratrine. 

Bezold,  V.,  u.  Hirst,  Unters.  a.  d.  WUrzburger 

physiol.  Laborator.,  Bd.  i.  1869  (contains  the 

entire  older  Literature) 
Brunton  and  Cash,  Cent.  I.  d."mod.  Wiss.,  1883, 

p.  81 ;  Journ.  of  Physiol,  iv.  1 
Claus,  Journ.  of  Anat.,  viii.  p.  228 
Eisenmenger,  Ueb.  d.  Einfluss   d.  Gifte  u.  d. 

Zuckungscurve     des    Froschmuskels,     Diss. 

Giessen,  1862,  p.  40 
Fick  u.  B'dhm,  Verhandl.  d.  phys.  med.  Ges.  in 

Wiirzburg.,  N.F.  Bd.  iii.  pp.  198,  229 
Guttmann,  Reich.  Arch,  f .  Anat.,  1'866,  p.  498 
Jones,  Phila.  Med.  and  Surg.  Reporter,  xvii.  p. 

361,  1872 
Kblliker,  Virch.  Arch.,  Bd.  x.  p.  257,  exp.  ix. 
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Nos.  xvii.  u.  xviii.  pp.  208  and  221  ^ 


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