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Hit a AW ayecital nuit oe =—~ F ——_~ © - : : Pe a : — ao : 7 7 = 4 = : 7... @ ae a . > as a * 2 “ oe a 7 “ van . - ; _ i 7 + _" Se : : oe : 7 = - ' _ : ee a . ; > = i, — - - ; oo & ; —_ : : 7 a) - _ = if) 7 Y a} Ps wT 7 Ke * Oo i = 7 - . : 7 : : “i 7 = | “ _ eS = + : 7 7 | . : ie , oe 7 a . . : a ; 8 : a : a 7 7 7 a a - ; ; = - = : 5 ~~ ue nee ee ODOR A te ant Fe RNAP Ta aN Maan Shy Me wit RNY seen at ry bay UAL Th Wee) Shit i) POLAR NT HONS ARO TA NINO Alera Rt ENS Ohi} anit Byte AUPE i i wi Y Cathy oie Pomel nical yal Pay iy Uhh Tal i ieee i 10 Wie Ra | Pai Wayaen sy 4 i a ae he 4 aes e « > oe ra vee - _ a = og + i a 7 1 = - tp ‘U - 7 fr Ss dele 7 =) ~ - id - : ae a - on . ae 7 _ 4 vo 7) a] : ee . _ ee VETERINARY MATERIA MEDICA AND THERAPEUTICS BY KENELM WINSLOW, B.A.S., M.D.V., M.D. (Harv.) FORMERLY INSTRUCTOR IN ZOOLOGY, BUSSEY (AGRICULTURAL) INSTITUTE AND ASSISTANT PROFESSOR OF THERAPEUTICS, VETERINARY SCHOOL (BOTH) OF HARVARD UNIVERSITY AUTHOR OF “PRODUCTION AND HANDLING OF CLEAN MILK,” ‘“‘THE PREVENTION AND TREATMENT OF THE DISEASES OF THE DOMESTIC ANIMALS,” ETC. SEVENTH EDITION REVISED New York WILLIAM R. JENKINS COMPANY PUBLISHERS 851 & 853 SrxtH AVENUE (N.W. Cor. 48th St.) Copyright, 1901, 1905, by William R. Jenkins Copyright, 1907, 1908, 1913, 1916, by William R. Jenkins Company All Rights Reserved SEP {1 1916 PRINTED BY THE Press OF WILLIAM R. JENKINS COMPANY NEw YORK PREFACE TO SEVENTH EDITION in the seventh edition every line has been scanned in the course of the revision and the book has been entirely reset. Errors have been corrected, useless matter has been eliminated, and much new material has been inserted. Recent additions to our knowledge of the physiological actions of ergot and digitalis have required the entire re-writing of the sections treating of the actions of these drugs while, for the same reason, the sections on the actions of adrenalin and quinine have been changed in part. The therapeutic matter throughout the whole book has been especially revised and amplified to keep abreast of therapeutic prog- ress, including the entire section on Epitome of Modern Treatment. We would call particular attention to the large additions which have been made to the therapeutic sections under Iodine, Bismuth, _ Magnesium Sulphate, Lysol, Phenol, Cocaine, Sodium Chloride, Arsenic, Camphor, Antiseptics, Practical Disinfection, Bacterial Fil- trates and Vaccine Therapy. Among medicinal agents included for the first time in this book are :—Glycerophosphates, Picric Acid, Sodium, Cacodylate, Choretone, Cresol, Aspirin, Novocaine, Thiosinamine, Fibrolysin, Yohimbine and Phenolphthalein. A complete section on P»isons and Antidotes has been added for convenience in references. PREFACE TO: THE SEVENTH EDITION Spinal Anesthesia has been considered in detail for the first time. The matter on ‘‘Properties,’’ ‘‘Description,’’ and in many cases ‘‘Derivation’’ of drugs, is according to the U. S. Pharmacopeia, while the important preparations of both the U.S. and British Pharma- copeeias are included. KENELM WINSLOW. PREFACE TO SIXTH EDITION In this edition the chief change consists in the entire revision and almost complete rewriting of that part of the text treating of Physiological Action of Drugs. ‘This is required by the many elaborate investigations of the newer school of pharmacologists, 01 which Prof. Arthur R. Cushny is the foremost English exponent Our conception of the action of many of the inorganic agents— of the salts especially—has undergone a radical transformation owing to the fact that we now know that the salts are usually for the most part dissociated into electric positive and negative elements (ions), in the weak solutions present in the tissues, and that they thus form chemical combinations to which their pharmacological action is due. The action of a salt, then, is commonly that of its ions, and not that of its molecules or atoms. Among the revolutionary results of recent pharmacological ex- periments, to which we would call special attention in this revision, are those pertaining to the action of alcohol, ether and chloroform. Furthermore, readers will note the many additions to and changes in the physiological sections under iron, iodine, opium, caffeine, strychnine, pilocarpine, digitalis, veratrine, quinine and adrenalin Also in the articles on Feeding and Counter-Irritants. The wonderful experiments of Pawlow and others have upset the hitherto accepted teachings of the action of drugs on the digestive PREFACE TO THE SIXTH EDITION organs and have wiped out the class of drugs known ag cholagogues. Finally, many therapeutic additions (see p. 752 et seq.) have Leen made in the constant endeavor of author and publisher to keep the book up to date. KENELM WINsLow. August, 1908. . PREFACE TO FIFTH EDITION In accordance with the hitherto expressed desire of the author and publisher to keep this work at its highest point of efficiency, it has seemed necessary to again present a new and revised edition— the fourth edition of 1906 being exhausted. In the present revision the most notable feature is the substitution of a section on Condensed Treatment of Diseases of the Domestic Animals for the Index of Diseases and Remedial Measures, at the end of the book. In the preparation of this matter, very considerable time and pains have been taken to render this section a reflection and epitome of all that is most modern and_ progressive in veterinary therapeutics. Special indications for treatment, including drugs and thera- peutic agents other than drugs, in the different phases and stages of all the important diseases of the domestic animals, are to be found. These diseases embrace not only medical and surgical disorders, but those of the EYE, SKIN and Ear. If the attempt has been in any degree successful, this new edition to the book should prove one of its most valuable features both to practitioners and students. Moreover, many changes have been made in the text in consonance with recent advances in our knowledge of the action of drugs. KENELM WINSLOW. dre ayaa ie PREFACE TO FOURTH EDITION In the preparation of the fourth edition of this work, very con- siderable revision was made necessary on account of the many changes made in the eighth decennial revision of the United States Pharma- copeeia of September, 1905. To what an extent revision was required will be realized when it is known that there have been 123 additions, 106 changes in the strength of preparations, and 139 changes in the official title of drugs in the new Pharmacopeia. Thus the doses of many preparations have suffered the most radical change; e.g., the dose of tineture of aconite is three times what it formerly was, and that of the tincture of strophanthus is but half the former dose. Some of the most familiar of our old friends are scarcely recognizable by their new names, e. g., Acetphenetidum (phenacetin), Arseni Trioxidum (acidum arsenosum), Phenol (aci- dum ecarbolicum), Spiritus Glycerylis Nitratis (Spiritus Glonoini), ete. All Extracta Fluida have been changed. Thus no longer we write Extracti Nucis Vomiee Fluidi, but Fluidextracti Nucis Vomice. The official names of many salts are altered: hydrochlorate into hydrochloride; hydrobromate into hydro- bromide; and valerianate into valerate; with corresponding changes in the Latin terminations. While some of the changes in the new Pharmacopeia do not affect veterinarians, yet professional prudence and pride demand that the veterinary practitioner conform to many of them to avoid mistakes in dosage and nomenclature. PREFACE TO FOURTH EDITION In revising the General Index it was decided to make it a pro- nouncing vocabulary. That a professional knowledge of the proper pronunciation of drugs and terms of pharmacology is deplorably absent will be appreciated the moment attention is directed to the matter. So many teachers disregard the subject, it follows that every practitioner has a pronunciation of his own—each equally incorrect. Notwithstanding the short time which has elapsed since the last edition of this book, a number of additions have been made to keep it abreast of the times. Since the work has become the recognized authority in Veterinary Materia Medica and Therapeutics, and is the standard text-book on the subject in the veterinary colleges of the United States, the author and publisher feel it their duty to constantly revise its pages in order to hold the book up to that standard which it has hitherto attained. KENELM WINSLOW. PREFACE TO FIRST EDITION The writer wishes to acknowledge his indebtedness to the works of Brunton, Wood, Hare, Edes, Ringer, Bartholow, White and Mann, in human medicine; and to those of the following veterinary writers: Finlay Dun, Friedberger and Frohner, Ellenberger, Koch, Cagny, Miller; and to the leading veterinary periodicals. The matter on ‘‘properties,’’ ‘‘description,’’ and, in many cases, ‘“derivation,’’ is according to the U. S. Pharmacopeia, while the im- portant preparations of both the U. S. and British Pharmacopceias are included. The classification and arrangement of drugs employed in this book are modifications of those adopted by W. Hale White in his excellent treatise on Materia Medica, Pharmacology and Thera- peuties. KENELM WINSLOW. CONTENTS PAGE PRELIMINARY CONSIDERATIONS 1 Definitions . Rm Stihe yt hc eee ran uc oc mm Geen tre ecg ee SHR SAE 1 ModemotarACtion wor SD rugsie ca ee er ieee eee Ns fel Absorption of Drugs 3 MlinninationgotarDricsie 0.6 cine esis dee Rete ign babyy on 1d CIRCUMSTANCES MOopDIFYING THE ACTION OF DRUGS . . ..... . 6 ModelofieAdministration (is. 4 0 Ua) 8 Ye eM eats 6 Dosage poe Caras Anatomy and Phiyaislogy, ee oles Pe Mn oe eee eTO imesofeAdministrationy 9 - s es ee) 3 APE eel HEV iG eeeee sae lea ess he msl yp Ce) ANCHE BE a etal Se. Eero Suet Disease far is aise ead ame tee hoe ie oA ee SG ete ec cL HGWOSYNCLABVan LA utensil cs REE ond het ce ALO GENERAL ACTIONS OF DRUGS . . . SAE ale eae Wes es ek Drugs Acting on the Digestive Oia opr ee Ai ee ee ATS ge ze os Cinculationaeces Spee, artinee eee net yer, ee GOO ss (ee NET YOUS Sy SLCNI tue iter ts eee.) eto ee 2 Se RespinatonyaOneansiae neem: Wace, «corel ss ss a arinary<.Oreanse- a oie ake) feo ys ek ty AT a os Stone Orgeiey 5 s B* oo 6 Be a ee GY cemelniuencingm Metabolismy wit Wee unl yeiyen tie ya ule en fc ten tod se f BodilymrHeatw sec ee) sete ee: en een -h00 JSeeACtING HONE the SKINGe te Mil ciyalapie a, War «esse 2 coe OF «« Which destroy Micro-organistms and Parasites . . . . . 61 ERE NEA CYNE epg Wetec oll Ud es atid Mabry tah Moc N ee. MRO eka OW te OF ENC OMPENTUB TELTYSeUr sel ey eed ee ee, eas as sg wee) feces oh 8 A. EESCRIELIONMAVWIRELEN Gam mies lteter nth eh epee! ye ee (CUAGSTINIGATIONM Moore ike Go ke Rees, a ee we one ey 1. ENORGCANECMAGHNIT Sir 34 hiss ghar tenia Yenc eet wnt odes LLB VTGhDAG EMD RUGSH Mt ten Oe epee eee ee OS CONTENTS PAGE Dose TABLE . 589 POISONS AND ANTIDOTES . 606 GENERAL THERAPEUTIC MEASURES . 612 Food and Feeding . . 612 Counter-irritants . 626 Cold and Heat . ‘ . 632 Disinfectants, Antiseptics and Deodorants . 643 Venesection . . 653 Transfusion . 654 Intravenous Saline Infusions . 655 Hypodermoclysis . 657 Enteroclysis : . 657 Kunsel’s Treatment for Milk Fever in Cows . 659 Lavage . 661 Serum Therapy . 663 Bacterial Filtrates . . 670 Vaccines . 678 General Vaccine Therapy . . 680 EPITOME OF MoDERN TREATMENT OF DISEASES OF THE DOMESTIC ANIMALS GENERAL INDEX . 687 . 79 PRELIMINARY CONSIDERATIONS Definitions Pharmacology is derived from the Greek, Pharmakos, a drug, and is the sum of all exact knowledge pertaining to drugs, and there- fore embraces Materia Medica, Therapeutics, and Pharmacy. Materia Medica, derived from two Latin words signifying medical materials, treats of the derivation, natural history, physical and chemical properties, physiological actions, doses, and tests of purity of drugs. A special term sometimes used to describe the physical and chemical properties of drugs is Pharmacognosy, while Pharmacodynamics refers to the action of drugs on healthy animals. Therapeutics, derived from the Greek, Therapevo, meaning to serve or attend the sick, is that branch of knowledge which treats of the application of all means—medicinal or otherwise—to the cure of disease or relief of pain. The term has been further subdivided as follows: Rational Therapeutics, which treats of the application of drugs as founded on their physiological actions; Empirical Thera- peutics; the use of drugs as based on clinical evidence; and General Therapeutics, the use of remedial agents other than drugs, ¢.g., Heat, Cold, Electricity, Food, ete. Pharmacy is the art of preparing, compounding, dispensing and preserving drugs. - Toxicology, derived from the Greek Toxikon, a poison, is that branch of knowledge which treats of the nature, actions, detection and treatment of poisons. A medicine is an agent of animal, vegetable or mineral origin used for the cure of disease or relief of pain. The word cure, signi- fies literally to care for, from the Latin Cwro, and did not in its original sense mean to restore to health, although that is its present interpretation. A drug, derived from the Duten Droog, meaning dry. is now used synonymously with medicine, although orletally referring to an herb or dried medicinal plant. 1 é PRELIMINARY. CONSIDERATIONS MODE OF ACTION OF DRUGS. Drugs act locally when they influence a part with which they come in contact, and also when they affect one organ or apparatus after absorption. The first meaning is the usual one. Drugs act generally when they impress the body as a whole after absorption. Drugs applied to the unbroken skin usually act locally because they are commonly unabsorbed; also when drugs insoluble in the digestive tract (as charcoal and chalk), are given internally they act locally for the same reason. The local action of drugs after absorption is sometimes known as selective action, i.¢., the power that most drugs possess to influence one organ or appa- ratus rather than the whole system. Oftentimes this local action, in the case of secreting glands, is accomplished through stimulation of these parts during elimination of the drug. Occasionally a medicine acts both on the part with which it comes in contact and also through the circulation; e.g., tartar emetic causes emesis by local stimulation of the stomach and by stimulation of the vomiting centre after ab- sorption. Furthermore, remedies are said to exert a primary (or immediate) and secondary (or remote) action. The secondary effect is the result of the primary action; ¢.g., a saline cathartic primarily removes serous fluid from the bowels and secondarily or remotely leads to absorption of serous exudations; a counter-irritant primarily produces irritation of the skin and sen- sory nerve-endings, but secondarily relieves internal congestion by inducing reflex contraction of the subjacent blood vessels. Most drugs are absorbed into the blood after their ingestion and exert their action on various parts of the body through the medium of the nervous system. Some drugs, however, may directly influence muscular tissue, aS is seen in the supposed action of digitalis on the nerve-free heart’s apex; while others may immediately act on the cells of an organ, as pilocarpine on the sweat glands. As in the lat- ter instance, it is usually impossible to determine whether medicines affect the cells of an organ or nerve-endings in the organ. The action of most vegetable drugs is thought to arise from the chemical affinity of their active principles for the part or parts acted upon. Thus the selective action of strychnine depends upon its form- ing a chemical compound with the protoplasm of the cells of the spinal cord. The affinity of certain cells of the tissues and micro- organisms for specific substances is shown in the staining of the nervous system alone by intravenous injection of methylene blue. It is, in fact, the basis of all bacteriological stains of Frlich’s theory ABSORPTION OF DRUGS 3 of immunity and of his wonderful discovery of specifics for nagana, syphilis and relapsing fever. All substances are divided into electrolytes and non-electrolytes. Electrolytes are capable of decomposition into ions. The action of electrolytes, when used as medicines, is that of their ions. An ion is an electrified molecule or a molecule of a substance having a charge of positive or negative electricity. In case the ions of inorganic salts are inactive their medicinal effect may be due wholly to what is technically termed ‘‘salt action.’’ Salt action is dependent on osmosis. Any non-toxic salt (crystal- loid) in the blood increases its concentration and leads to a flow of water into it from the surrounding tissues, increases its mass and thus acts as a diuretic. The action of most salts, acids, and bases depends on their being in great part dissociated in the weak solutions found in the tissues into electrically positive (kation) and negative (anion) ions. Nor does the action of an ion represent the chemical action of the atom, as when KCl is dissociated into a positive K ion and a negative Cl ion. The action of the ion is a physical or electrical action. Sometimes one ion is inert, as the Cl ion in KCl. Sometimes one is inert and the other very toxic, as KCN, where the positive or K ion is practically without action (see action of ions under special salts). In organic drugs the action of one ion is usually so powerful that the other may be neglected, as morphine sulphate. No hypothesis can be formulated which will satisfactorily ac- count for the curative action of all medicines in all diseases and systems of medicine, as allopathy and homeopathy, founded on such hypotheses, are valueless. ABSORPTION OF DRUGS. Drugs are absorbed most rapidly in solution (especially in alco- hol) and when the circulation is active. Absorption from the diges- tive tract is poor when the circulation is depressed or in congested states; also from the subcutaneous tissues in similar conditions, more particularly in edema of these parts. Absorption from the stomach and bowels of healthy animals is chiefly influenced by the quantity of food in them. When these organs are empty, absorption is rapid; but when full, it is slow. For this reason absorption is markedly tardy and imperfect in ruminants. In these animals there is a com- paratively impervious skin-like mucous membrane and lack of vas- eularity in the first three gastric compartments; while a large amount of food is always to be found in the first and third stomachs; all of which tends to delay absorption and lessen the action of medicines given by the mouth. 4, PRELIMINARY CONSIDERATIONS. lf drugs are irritating, they should be given to animals on the food, or after feeding, in order that they be sufficiently diluted. ELIMINATION OF DRUGS. A drug is as much outside the body when within the digestive tube—so far as any action it may have on the body (unless an irri- tant)—as if it were on the skin. When absorbed, a medicine passes into the blood vessels or lymphatics and thence into the general cir- culation. That portion which enters the portal circulation reaches the liver and may be destroyed in part (some alkaloids) by this organ, After entering the blood the drug may form unknown com- binations with the tissues for which it has an affinity—thereby ex- erting its remedial effect—and is decomposed or rarely accumulates in the body, but usually is eliminated either unchanged or as decom- position-products in the breath, or by the excretions or secretions of the kidneys, bowels, liver, sudoriparous, salivary and mammary elands, and mucous membranes. The urine is the most frequent ehannel of elimination for soluble drugs. The bowels constitute the next more common pathway of elimination. Volatile drugs (chloro- form, ether) are eliminated very rapidly, usually, in the breath. If a drug is eliminated slowly the duration of its action is correspond- ingly long, and vice versa. This fact will guide us in the frequency of administration of medicines, since if a drug which is tardily elim- inated be given at frequent intervals it may be absorbed faster than it is excreted and so accumulate in the body and cause poisoning. The so-called Cumulative Action of a drug refers to the occurrence of a sudden and violent effect during its medicinal administration. This may be due (1) to delayed followed by rapid absorption; or (2) to slow—or sudden arrest of—elimination. The salts of the heavy metals, as lead, mereury, ete., and arsenical preparations are eliminated slowly. Digitalis and strychnine are said to be espe- cially prone to produce a cumulative action. Strychnine may, how- ever, be given subeutaneously in gradually increasing doses without the likelihood of poisoning. Digitalis may cause a cumulative effect in being slowly oxidized in the body or in leading to contraction of the renal vessels and suppression of urine-elimination. The drugs likely to cause a cumulative action must be administered infre- quently, once, twice, or thrice daily; whereas medicines which are ELIMINATION OF DRUGS 5 rapidly decomposed and eliminated (alcohol, nitrites, ete.) may be given at very frequent intervals if desirable. ‘The term excretion is often used synonymously with elimination, but, strictly speaking, a drug is not eliminated unless it has been first absorbed. On the other hand, an insoluble drug passing unabsorbed through the ali- mentary Canal is said properly to be excreted in the feces. CIRCUMSTANCES MODIFYING THE ACTION OF DRUGS. Mode of Administration. The following table gives the various methods of administering drugs in order of their rapidity of absorption, beginning with the method by which absorption is most rapid, and following with those by which absorption is less and finally least rapid: . Intravenous, by injection into the veins. . By inhalation (volatile drugs). . Subcutaneous, by injection into subcutaneous tissue. . Intratracheal, by injection into the trachea. . Oral, by the mouth. . Rectal, by the rectum. . Inunction, by the skin. . Intramammary injections. manana» WW Ee 1. Injection into the veins (usually into the jugular) is not so commonly practiced as the subcutaneous method, as there is a certain minute danger of inducing phlebitis, embolism and thrombosis. The danger is more theoretical than real, however, as we have fre- quently thrown from 53 (150 ec.) to 6143 (200 ce.) of fluidextract of cannabis indica into the jugular, and even chloral hydrate, a most irritating and caustic drug, in the dose of 15 (30. cc.) dissolved in 83 (240 ec.) of water, without producing any untoward symptoms. No method of administration can secure more rapid absorption, since intravenous injection 2s absorption. This has constituted one of the theoretical objections to the method, that the sudden entrance of a drug might create shock. Injection into the jugular is useful when very rapid and effective action is imperative, as in causing im- mediate catharsis in colic and intestinal obstruction of horses. In such cases barium chloride and eserine sulphate are employed in- travenously. The jugular is occluded with the hand and the injection is made with the same eare described below in reference to the subcutaneous method. The intravenous use of hot normal salt 6 —i MODE OF ADMINISTRATION 7 solution is frequently valuable in hemorrhage, shock and poisoning (see p. 655). 2. Volatile drugs are absorbed with great rapidity and effect owing to the enormous vascular surface of the lungs in contact with the inhaled vapor. Ether, chloroform, ammonia and amyl-nitrite are given by this method. Inhalation of medicated steam and sprays, used mainly for their local action on the respiratory tract, are also absorbed to some extent by the bronchial mucous membrane and lungs. This is a convenient and effective mode of applying local medication to horses in inflammatory troubles of the upper air passages, including the bronchial tubes, and in many cases may effect a cure without the use of internal remedies. 3. Subeutaneous or hypodermatic injection is suitable for solu- ble, non-irritating drugs of small bulk, when a sure and rapid action is desired. The medicinal solution should be free from solid particles and microérganisms. If the solution is not clean, or is irritating, abscess may occur. The syringe and needle must also be absolutely clean. Solutions made by dropping tablets in pure drinking water will rarely cause abscess, and the syringe may be made aseptic by filling it with aleohol (70 per cent.) and wiping the needle with the same, previous to their employment. Solutions may be preserved for hypodermatiec use with boric acid (1 per cent.), but soluble tablets are more convenient. In practising this method the hair should be removed from the seat of injection—preferably the thin skin underlaid by connective tissue behind the elbow or on the abdomen—and the part washed with water followed by aleohol; then a loose fold of skin is picked up and held firmly between the thumb and forefinger of the left hand, while the needle is thrust under the skin, but not into a vein. The syringe is slowly emptied and the needle withdrawn, keeping slight pressure over the point of injection with the thumb for a few seconds. The use of irritating drugs—permissible in emergen- cies—as fluidextract of ergot, tincture of digitalis, ether and ammo- nia, is less apt to be followed-by abscess if injected deeply into the muscular substance, but this method causes more pain than ordinary injections. To avoid getting air in the veins, all the air is removed from the syringe before using, by holding it, needle upwards, and pushing in the plunger till a few drops of the solution are forced out of the needle. The danger of introducing air into the blood stream is greatly exaggerated, however, as the writer has proved by forcing vast quantities of air into the jugular vein of a horse without pro- ducing any untoward symptoms. The proper quantity of a solution for subcutaneous use is 5-30 minims for dogs; 1-2 drachms for horses, although large amounts of salt solution may be injected into the sub- 8 CIRCUMSTANCES MODIFYING THE ACTION OF DRUGS cutaneous tissue or muscles (hypodermoclysis) with great benefit in hemorrhage, etc. (See p. 657.) The minimum doses of drugs should be employed by the sub- cutaneous method. : INDICATIONS FOR SUBCUTANEOUS INJECTION. (a) To secure a rapid action, as in relieving intense pain or motor excitement; and to support a failing heart, respiration and vascular tone in severe operations, anesthesia, or other poisoning. (b) When administration of drugs by the mouth is inadvisable or im- possible, as in unconsciousness, dysphagia, convulsions or vomiting. (c) When a local as well as general action is beneficial, e.g., the use of strychnine in roaring and other local paralyses; atropine in local muscular spasms; veratrine in muscular rheumatism: intraneural injections of alcohol for neuralgia. 4. Intratracheal injection is a_ strictly veterinary procedure. The skin is incised aseptically with a sharp scalpel midway in the neck, and a stout needle (attached to a syringe) is thrust between the rings into the trachea. Larger quantities [H., 5 i-t. (80.- 60.) ] and more irritating drugs are given in this way than by the subeutaneous method, and absorption is about as rapid; the dose is the same. There is undoubtedly danger, however, in giving irri- tant drugs by this method, especially chloral, and several cases of foreign-body pneumonia have come under our notice as the result of this mode of administration. It is the best method of benumbing or killing the parasites (S. filaria and micrurus) infesting the trachea and bronchi, and has been employed to influence the mucous membrane of the larynx and trachea in certain inflammatory condi- tions. 5. Drugs are usually given by the mouth and are absorbed from the stomach and intestines. Many non-irritating and not unpleas- ant drugs are taken voluntarily in the food, gruel, milk or drinking water by animals. Cats and dogs will often swallow medicine en- closed in a piece of meat. Absorption is more tardy than by the sub- cutaneous method, more rapid when given in solution into an empty stomach; slower when administered in powder, pill or ball, and on a full stomach. Some drugs are probably absorbed from the stomach, only to be destroyed or stored in the liver (alkaloids and heavy metals), and do not enter the general circulation at all. When drugs are administered for their local action on the stomach. in catarrh or ulcer, they should be given an half hour to an DOSAGE 9 hour before feeding; if given for their action in or on the intestines, they should be administered two or three hours after meals. 6. Rectal injections of medicines (enemata or clysters) are practised when the use of drugs by the mouth is inadvisable or impossible, as in unconsciousness, dysphagia, convulsions; also to destroy parasites (oxyurides) in the rectum, to influence an in- flamed or ulcerated rectal mucous membrane, and to remove intes- tinal contents (oil and glycerin). The dose of drugs by this method is generally twice that by the mouth, and absorption is slower and more imperfect. The drug should be xnon-irritating, soluble, and not too bulky, since a small amount is necessary (51-31. dogs; 3ii.-3viii. horses); to avoid tenesmus and expulsion. Warm starch solution (made by boiling) or linseed tea with a little laudanum is a good vehicle for medic- inal enemata, and retention of enemata is facilitated by pressure on the anus with a towel for some minutes after the injection is given. Solds are sometimes employed by rectum in suppositories. For general use of enemata see p. 26. 7. Drugs are absorbed very slightly by the skin, and then only when rubbed very vigorously into the epidermis (inunction) with lanolin, fat or oil of some kind. Mercury, silver and iodine are most commonly employed for absorption, but drugs are usually ap- plied externally for their local action only and not to influence the general system through the blood. Intramammary Injections.—These are useful in acute paren- chymatous mastitis. The injection is done with a Davidson syringe connected with a sterile milking tube. From one quarter to one pint is injected slowly into each teat and allowed to remain fifteen minutes and slowly withdrawn. ‘The treatment is given twice daily in contagious mastitis and but once in the simple form. Saturated boric acid solution is most often used, or 1/10 to 14 per cent. solution of sodium fluoride. Dosage. The study of dosage is known as Posology. The action of drugs is altered both in degree and in kind by the dose. Thus, in- creasing the dose would naturally lead to an increase in the intensity of a drug’s action, but it frequently changes the entire character of the action as well. Drugs, as strychnine, acting especially on the nervous system, often excite in therapeutic doses, but depress and paralyze in toxic 10 CIRCUMSTANCES MODIFYING THE ACTION OF DRUGS doses. Drugs, as digitalis, stimulating the heart in medicinal doses, usually depress and paralyze the organ in poisonous doses. Many drugs promoting urinary secretion, in ordinary doses, cause inflam- mation and urinary depression in large doses. The best way to determine the dose of a drug is to estimate the amount required for each pound of live weight. This only applies to the same species and to animals of ordinary build. Fat is a comparatively inert tissue as far as the action of drugs is concerned, so that a very fat horse, weighing, for example, 1,200 pounds, would be affected in a more pronounced manner by a dose of medicine than would a lean horse of the same weight and taking the same dose. In the case of young animals, and of those either above or under the ordinary size of the adult of any species, the dose should be proportioned—according to weight—to the average dose for the adult animal of that species. Thus, if the average weight of a horse is 1,000 pounds, the dose of any drug for a colt weighing 500 pounds would be half the usual dose for adult horses. In a general way the dose for all animals from birth to a few weeks old, is one-twentieth of that suitable for the mature animal of the same species; for yearlings, about one-third of the adult dose. The dose recommended for dogs is commonly the same as that given to man, but this rule does not apply in the case of some powerful drugs (strychnine), where the dose should be adjusted to the weight, 7.e., so much per pound, live weight. It is impossible to calculate the dose for all domestic animals as based on that for animals of one species, because the differences in anatomy and physiology modify the actions of drugs in degree and kind, but the dose for sheep is about one-fourth of that for the larger ruminants. The repetition of a dose is determined to a considerable extent by the duration and rapidity of a drug’s action. Agents used for their immediate effect, as those relieving pain and stimulating the circulation and respiration, are repeated frequently till the desired effect is attained. Medicines improving the condition of the diges- tion, blood and nutrition, as tonics of various kinds, require time for the accomplishment of their mission, and are usually given two or three times daily for a period of some weeks. Anatomy and Physiology. Certain differences in the action of medicines may be observed as occurring in the various species of animals, and in animals as contrasted in this respect with man. ANATOMY AND PHYSIOLOGY 11 ACTION OF DRUGS ON ANIMALS AS COMPARED WITH THAT ON MAN. From a comparative standpoint the action of drugs on the nervous system of animals differs from that on man. This follows according to the “law of dissolution,” which teaches that the more highly developed a part of the nervous system is in the evolutionary scale, the more sensitive is it to the influence of drugs. Since the cerebrum of man is relatively larger and more highly developed, in proportion to his weight, than is the case in animals, and since the spinal cord is larger and more highly developed in proportion to the brain in animals, it happens that drugs impressing the nervous system exert less effect on the brain, and more on the spinal cord, of animals than in man. Thus opium is more powerful in its influence on the brain of man, and strychnine is more potent in its action on the spinal cord of animals. Drugs are not absorbed so rapidly or perfectly in the enormous digestive apparatus of ruminants as in man; neither do emetics act in these animals, nor in horses; while in none of the lower animals are agents causing sweating so efficient as in man. ACTION OF DRUGS ON HORSES AS COMPARED WITH THAT ON OTHER ANIMALS. Differences exist relative to the action of drugs on the horse, as compared with other animals, chiefly in respect to the digestive apparatus. Emetics do not act on the horse, as this animal does not vomit unless the stomach is greatly distended with gas, which eauses dilatation of the cardiac outlet. Moreover, the stomach is too small to be successfully compressed by the abdominal walls, and the great length of the esophagus between the stomach and dia- phragm, together with the horseshoe-like band of fibres at its car- diae extremity, prevent the regurgitation of food. The intestines of the horse, on the other hand, are as voluminous as the stomach is small, and therefore are powerfully influenced by irritants (as purga- tives), although the action of cathartics is slow. The bowels: of horses excrete vastly more of the fluid ingested than is the case in man or dogs—whose kidneys chiefly assume this function—and the kidneys are said to eliminate about 15 per cent. of the fluid ingesta in horses, as against 50 per cent. in man and dogs. 12 CIRCUMSTANCES MODIFYING THE ACTION OF DRUGS ACTION OF DRUGS ON RUMINANTS AS COMPARED WITH THAT ON OTHER ANIMALS. The capacious four-fold stomach of ruminants always contains large amounts of food in the rumen and abomasum, while the im- pervious, poorly vascular and skin-like gastric mucous membrane renders absorption feeble and imperfect and enforces a compara- tively larger dosage than is proper for horses of greater weight. Ruminants are also generally insusceptible to emetics. The skin and kidneys of ruminants are still less active than is the case in horses. ACTION OF DRUGS ON DOGS AND PIGS AS COMPARED WITH THAT ON OTHER ANIMALS. The action of medicine on dogs and pigs is similar in kind to that observed in man, but the former animals are less sensitive to drugs as a rule, since the dose suitable for a man weighing 150 pounds is appropriate for a dog of 40 pounds weight. As exceptions to this rule, we find that dogs will not bear the human dose of ealo- mel, oil of turpentine, or strychnine. In fact, the ordinary tonic dose of strychnine (gr. 1/30) for man will throw a medium sized dog into convulsions, and may kill a small animal, notwithstanding that this amount is recommended as a suitable canine dose in veter- inary text books. Contrariwise, the dog is comparatively insensitive to many drugs powerfully influencing man,—notably morphine, aloes, colo- eynth and rhubarb. Most cathartics act more quickly on dogs than is the case with the other domestic animals, but saline purgatives are less appropriate in often causing vomiting, and because of their bulk. Time of Administration. This matter has been alluded to in speaking of the absorption of drugs. Medicines readily undergoing decomposition in the pres- ence of other substances, as iodine and hydriodie acid, should be given on an empty stomach; and likewise all drugs, when a speedy action is desired. IJrritants should be administered on a full stomach. TIME OF ADMINISTRATION 13 Habit.—This circumstance does not have the same importance in veterinary medicine which it possesses in human practice, since we control drug habits in animals. Animals usually become less susceptible to the action of drugs on their repetition, e.g., opium and cathartics. ‘This rule does not hold in the case of drugs having a cumulative action, nor in the repeated use of irritants on the skin, for then their action is strongly intensified. Disease—The action of drugs is profoundly influenced by disease. It is only possible to enumerate a few examples. Pain is almost an antidote to opium, and large repeated doses of the drug, previously innocuous, may, on the sudden cessation of pain, induce poisoning. Opium is also borne in enormous doses in peritonitis. Inflammation and congestion of the digestive organs hinders the ab- sorption of all medicines. A congested condition of the alimentary canal, and even of the respiratory tract in horses, contra-indicate the use of strong purgatives in these animals, since superpurgation may occur. A high temperature alters the action of many drugs. - Opium is not so efficient as an analgesic in fevers, while anti- pyretics will not lower the temperature in health. Stimulants are not nearly so potent in depressed bodily conditions, and counter-irri- tants will not produce their characteristic actions on the skin when the circulatory functions are at a low ebb. Idiosyncrasy.—Individual susceptibility to drugs is infrequent, but unfortunately cannot be anticipated. The writer has seen simple zine oxide (free from adulteration or impurities) cause a frenzy of irritation when rubbed on a dog’s skin, and a small dose of tartar emetic cause violent vomiting in a cow. Some animals are very susceptible to’ counter-irritants. Well-bred animals are com- monly more responsive to drugs than others. GENERAL ACTIONS OF DRUGS. Drugs Acting on the Digestive Organs. Sialagogues are agents increasing the secretion of saliva. An- tisialagogues are agents diminishing salivary secretion. Among the sources of saliva—the parotid, sublingual and submaxillary glands —the latter have received most study. The chorda tympani, with its centre in the medulla, is one of the two nerves supplying the submaxillary gland. It contains two sets of fibres, the secretory and vasodilator. Hence stimulation of this nerve, or its centre, whether immediately or reflexly, leads, by means of its vasodilator fibres, to dilatation of the blood vessels and enhanced vascularity of the gland, and so indirectiy to greater secretion; while, through ex- citation of the secretory fibres, the protoplasm of the glandular cells is influenced and secretion directly increased. Reflexly the gland is stimulated by drugs exciting the periph- eral terminations of the gustatory (lingual branch of the fifth nerve) and glossopharyngeal nerves in the mouth; the vagus endings in the stomach; by agencies sending pleasurable impressions to the brain through the medium of the eyes or nose; or by stimulation of other sensory nerves. The submaxillary gland is also supplied by a branch of the cervical sympathetic accompanying the submaxillary arteries. Stimulation of this nerve, or its centre, causes vascular constriction in the gland and inhibition of secretion. Sialagogues are often classed under three heads. Ist, Specific stalagogues, acting directly on the mechanism concerned with secre- tion, 2.e., the gland cells, or nervous apparatus. Pilocarpine is the best example of the specific class. It stimulates the gland cell or peripheral nerve endings. 2nd, Reflex sialagogues; exciting sen- sory nerve terminations and indirectly or reflexly stimulating the nervous mechanism controlling secretion. As examples of this class may be mentioned alkalies, acids, emetics, and other agents stimu- lating the mucous membrane of the mouth and stomach. 3rd, Mixed sialagogues, acting both specifically and reflexly. Phvso- 14 DRUGS ACTING ON THE DIGESTIVE ORGANS 15 stigmine, nicotine or tobacco and mercury preparations may be in- -cluded in this category. Antisialagogues.—These drugs may act in various ways to fessen salivary secretion, but atropine is most notable in this regard. It acts by depressing the peripheral endings of the secretory nerves. Uses.—Sialagogues are not of much therapeutic value. Some are added to the drinking water given to animals suffering from fever, to relieve dryness of the mouth and thirst. They are then ealled refrigerants; as, for example, potassium nitrate, diluted phos- phoric and other acids. The sialagogues are sometimes employed to stimulate the mucous membrane of the pharynx in sore throat and relaxed conditions; as, for example, potassium chlorate in electuary for horses. Excessive salivation produced by mercury salts or pilocarpine is relieved by an antisialagogue, 2. e., atropine. Stomachics are drugs which, in therapeutic doses, mildly stimu- late the mucous membrane of the mouth and stomach, thereby in- creasing the secretions and vascularity of these parts, the appetite, and, in a less degree, gastric peristalsis. These agents also influence the intestines, but this effect will be considered under carminatives. Stomachics may be divided into bitters, aromatics (drugs con- taining a volatile oil and often very pungent), and aromatic bitters (drugs containing a volatile oil and a bitter principle). While both the bitters and aromatics enhance the appetite, the action of the latter is more powerful and fleeting. Very large doses of stomachics are distinctly irritating, and cause anorexia, nausea, and vomiting in animals capable of the act. eo STOMACHICS. BITTERS AROMATICS Gentian Coriander Calumba Capsicum Quassia Pepper Hydrastis Ginger Peppermint Taraxacum Cardamon Alcohol Fennel Ether ’ AROMATIC BITTERS Fenugreek Chloroform Casearilla -Anise Alkalies (see Antacids) Chamomile Calamus Serpentaria Mustard Spearmint Uses.—Stomachics—particularly bitters—are serviceable in improving the appetite and gastric digestion ‘in atanie indigestion, 16 GENERAL: ACTION OF DRUGS and in enfeebled states of the digestive organs occurring in the course of chronic diseases or during convalescence from acute dis- orders. The aromatics are more frequently employed for their ac- tion on the intestines, when they are called carminatives. Bitters are contra-indicated in irritable or inflamed conditions of the ali- mentary tract. Antacids are drugs which are used to ecunteract acidity in the stomach and bowels resulting from indigestion and fermentation, or from excessive secretion of gastric Juice. Some (not ammonia com- pounds) are also occasionally employed to alkalize the blood and urine. Pawlow’s experiments, substantiated by many others, show that alkalies inhibit not only the secretion of acid gastric juice, but also all the other digestive secretions, 7.e., the secretions of the intestines, liver (bile), and pancreas (pancreatic juice). Antacids (as sodium bicarbonate and magnesia) are, however, indicated in gastrie hyper- secretion and hyperchitorhydria. If administered several hours after eating, antacids counter act acidity due to fermentation and relieve pain caused by this condi- tion. Since fermentation is frequently the cause of tympanites, the antacids are conjoined to advantage with carminatives (sodium bi- carbonate and ginger). The alkaline carbonates allay pain by means of the carbonie dioxide set free in their decomposition in the diges- tive tract, and the antacids are also beneficial in dissolving an ex- cessive secretion of mucus in catarrhal conditions of the alimen- tary canal. .The antacids are synonymous with alkalies, with the exception of the neutral vegetable salts—acetates, citrates and tartrates—of potassium and sodium, which are sometimes classed under this head. These do not alkalize the contents of the stomach, but nevertheless are broken up in the body and transformed into carbonates and thus render the urine more alkaline during their elimination. Among those included in the following list the sodium compounds are much less active in alkalizing the urine than the potassium salts. Sodium bicarbonate is in most frequent use in digestive disorders, but am- monium carbonate is particularly appropriate in flatulence, because it possesses more power in stimulating peristaltic action and ex- pelling flatus. ANTACIDS. Sodium carbonate Ammonium carbonate Sodium bicarbonate Magnesia Potassium carbonate Magnesium carbonate Potassium bicarbonate Calcium carbonate (chalk) DRUGS ACTING ON THE DIGESTIVE ORGANS. 1, Solution of potash Solution of lime (lime water) Ammonia Acids——Contrary to accepted ideas, Pawlow’s and Starling’s experiments show that mineral acids directly stimulate the secre- tion of acid in the stomach, and, indirectly, the secretions of the intestines, liver and pancreas. The first part of gastric secretion is caused by vagal stimulation through reflex action produced by the desire, sight, and smell of food, and is further increased by the tak- ing of food. In the latter part of gastric digestion, the acid product of the first part of digestion acts on the mucosa to cause the forma- tion of a chemical body, or hormone (Greek, to excite), known as gastrin. This is absorbed into the blood and stimulates the activity of the secretory glands of the fundus of the stomach. In the in- testines, acid chyme likewise leads to the formation of another hor- mone, secretin, which lkewise is absorbed and stimulates the secre- tion of the intestines, liver and pancreas. Carminatives include the same drugs which were mentioned as stomachics, namely, valerian, asafetida and the volatile oils; but the term as generally employed refers to their effect in exciting peristaltic action, and so expelling gas from the stomach and bowels. The aromatics are considerably more valuable. for this purpose than the bitters. Carminatives also prevent griping caused by many cathartics, aid digestion, and disguise the taste of dis- agreeable drugs. Capsicum and ginger are most frequently pre- seribed in veterinary practice. Digestives—Pepsin is occasionally of benefit in the treatment of dogs and young animals in case of enfeebled gastric digestion resulting from acute diseases or other general causes. It should be administered directly after eating, and is prescribed to advantage with hydrochloric acid. As a general proposition it is inadvisable to give agents which merely substitute an artificial for the natural digestion, except as a temporary expedient. A wiser course consists in removing the cause of indigestion by proper feeding or by en- forcing abstinence from food, and in the use of remedies calculated to strengthen the natural digestive functions. ; Panereatin may be given during, or immediately after, eating, and will assist gastric digestion for some time before sufficient acid is secreted to destroy it. In fact, some authors (Hare) insist that this substance is more valuable in any case than pepsin in aiding stomach digestion, although pancreatin is more commonly given several hours after eating, to promote intestinal digestion. Papain is another agent which is employed as an artificial digestive of vege- table origin. Its value is not yet definitely determined. 18 GENERAL ACTION OF DRUGS Antiseptics—These agents are sometimes used to prevent or arrest fermentation of food in the stomach and bowels. Since fer- mentation is primarily due to indigestion, it is essential to remove the cause by diet and other rational means rather than to combat the effects of indigestion. Large doses of antiseptics hinder the diges- tive processes and may endanger the life of the patient, so that it is impossible to attain perfect antisepsis in the alimentary canal. Among the drugs more commonly employed for their antiseptic action on the contents of the digestive tract may be mentioned: Carbolic acid Bismuth subcarbonate Creosote Bismuth salicylate Creolin Bismuth subgallate Naphtol Sodium sulphite, bisulphite Naphtalin and hyposulphite Bismuth subnitrate Hydrogen dioxide Emetics are drugs which cause vomiting. The act of vomiting proceeds from irritation of the vomiting centre in the medulla, which is in close proximity to the respiratory centre. This centre is either acted upon directly by drugs circulating in the blood, or reflexly by agents stimulating sensory nerves in various parts of the body. Thus, irritation of the sensory nerve-endings of the mouth, throat, gullet, lungs, heart, stomach, bowels, biliary passages, peritoneum, uterus and kidneys, may produce vomiticn. Vomiting is occasioned by simultaneous contraction of the abdominal walls and the dia- phragm. In this process the stomach is squeezed between the ab- dominal walls and diaphragm, and contraction of the longitudinal fibres, radiating from the lower end of the gullet, draws the stomach towards the diaphragm and so pulls open the cardiac orifice, while the pylorus is firmly contracted and closed. Some peculiarities may be noted in reference to vomition in the domestic animals. Dogs, pigs and eats vomit readily and may be placed in the same category as man in this respect. Horses rarely vomit and are not easily nauseated by emetics. Vomiting is prevented in these ani- mals by: 1. The small size of the stomach, which is not readily com- pressed between the abdominal walls and diaphragm. 2. The length of the gullet between the stomach and diaphragm, which form a valve-like obstruction when the tube is shortened by contraction of the longitudinal fibres at its lower extremity in attempts at vomi- tion. 3. A horseshoe-like band of fibres at the cardiac orifice, which hinders dilatation of this opening. Ruminants are likewise com- paratively insusceptible to emetics because of the large size of their digestive apparatus, which is not easily compressed between the Ce DRUGS ACTING ON THE DIGESTIVE ORGANS 19 parietes and diaphragm. Therefore the vomiting centre remains - probably in a state of non-development in the horse and ruminant, by reason of non-use. . Cattle and horses do, however, occasionally vomit. Cattle at sea frequently suffer from mal de mer, and the writer has observed actual vomition in them following the use of tartar emetic. Horses may vomit when the stomach is greatly distended with gas. Emetics may be classified as: 1. Specific, acting on the vomit- ing centre through the blood. 2. Local, by stimulation of the sen- sory nerve-endings in the mouth, throat, gullet and stomach. 3. Mixed, those acting in both ways. It is impossible, in our present state of knowledge, to apply this classification accurately to individual drugs, but the following statements may be made: If an emetic is injected into the carotid and vomiting instantly occurs, the drug has probably acted upon the vomiting centre; if some time elapses before the occurrence of vomition, it is probable that the drug has acted upon the stomach during its elimination by that organ. Contrariwise, if, after the ingestion of an emetic, a considerable period intervenes before vom- iting comes on, it is probable that the agent has acted on the vomit- ing centre. Again, if a larger quantity of a drug is required when injected into the blood than when swallowed, to cause emesis, it is fair to sup- pose that the agent acts on the stomach directly or during its elimi- nation. Finally, if an emetic is thrown into the blood after the removal of the stomach and substitution of a bladder in its place, and vomiting does not occur (Majendie’s experiment with tartar emetic), it shows that the agent only acts on the stomach; but if vomiting does occur, it indicates that the agent acts on the vomiting centre and causes emesis by contraction of the parietes and dia- phragm, with this reservation, that the drug may have been elimi- nated by the esophagus and intestines and have reflexly stimulated the vomiting centre through the medium of these parts. These re- marks demonstrate the complexity of the subject. EMETICS. Specific Mixed Local Apomorphine Tartar Emetic Tepid water Senega Ipecac Mustard Squills Copper Sulphate Salt Zine Sulphate Alum Ammonium Carbonate 20 GENERAL ACTION OF DRUGS Apomorphine is the only emetic given under the skin. It also acts well by the mouth, but causes more nausea an dallied effects than acting locally. Mustard and salt, 1 teaspoonful each, in a cup of lukewarm water, form a convenient emetic for dogs. Ipecac is useful in re- spiratory diseases as an expectorant as well as emetic, and zinc sul- phate is a prompt emetic in poisoning. The other emetics are prac- tically unimportant. Emeties cause, beside vomition, several other phenomena which are sometimes utilized therapeutically. Among these may be men- tioned nausea, salivation, violent respiratory efforts, compression of the abdominal glands and ducts and extrusion of their contents, passive congestion of the head, chest, and peripheral parts by reason of compression of the abdominal veins. Increased secretion of the mucous membranes of the nose, eyes, stomach, gullet and bronchial tubes follow passive congestion. Muscular relaxation always accom- panies nausea, and sweating ensues from relaxation of the skin and leaking out of the secretion. The flow of bile is increased on account of pressure on the liver and gall-bladder, while the secretion is also augmented. The pulse and respiration are more frequent during emesis, but are diminished in force and frequency afterwards. All these phe- nomena are more apparent after the use of specific emetics. Uses.—These apply particularly to dogs. 1. To empty the stomach in ease of poisoning, over-loading of the organ, and indigestion with convulsions in young animals :— Mustard, salt or zine sulphate. 2. To expel foreign bodies from the fauces and gullet (apo- morphine subcutaneously) ; or, by the forcible expiration attending vomition, to expel excessive secretion or exudation from the air passages in laryngitis or bronchitis :—Ipecac. 3. To empty the gall-bladder in eatarrhal jaundice and bilious. ness and to expel bile from the stomach. 4. To lower blood pressure and increase secretion in the first stage of bronchitis :—Ipecac. 5. To stop vomiting :—Ipecae in minute doses. Contra-indications.—Pregnaney; hernia; inflammation of the stomach, brain or abdominal viscera; bleeding from the stomach, bowels or lungs; aneurism and asthenia. Gastric sedatives and anti-emetics are agents used to relieve pain in the stomach and vomiting. These include: Ice Cocaine Hot water Cerium oxalate DRUGS ACTING ON THE DIGESTIVE ORGANS 21 Bismuth subcarbonate Lime water Bismuth subnitrate Minute doses of arsenic Carbon dioxide ss 7” 7 ipecac Hydrocyanie acid sg ~~” alcohol Morphine Ht ” ” iodine Menthol 2 7» silver nitrate Carbolie acid Chioroform Creosote Chloral Aconite Bromides Belladonna Nitrites Hyoscyamus Most of these agents act locally, but opium and morphine, chloral, the bromides, prussic acid and the nitrates act centrally. USES OF GASTRIC SEDATIVES AND ANTI-EMETICS IN CANINE PRACTICE. It must be recognized that vomiting is merely a symptom. It is, therefore, essential to remove the cause. This may sometimes be accomplished by starving, the use of an emetic, or tepid water. If vomiting is due to acute irritation of the stomach, as is frequently the case in dogs, ice and bismuth subnitrate (gr. x.-xx.), with tincture of aconite (M 1.-i1.), form suitable remedies. When vomiting arises from indigestion and fermentation, carbolic acid with bismuth often acts favorably. The vomiting following anes- thesia is probably of central origin. Here enemata of laudanum (mM x.-xxx.) and sodium bromide (gr. xx.-xxx.) are beneficial. Ipe- cac, iodine, silver nitrate and the like are useful in vomiting de- pendent upon an atonic or depressed state of the stomach. When vomiting is continuous, small quantities of milk and lime water, equal parts, or peptonized milk (3 i1.-iv.), or a drachm of cracked ice with a few drops of brandy, should be given at half-hour intervals. It may be rarely necessary to resort to rectal feeding. Purgatives or cathartics are agents which empty the bowels. They act: (1) By stimulating peristaltic action. (2) By increasing the secretions (succus entericus) of the intestinal glands and, per- haps, transudation of fluid from the blood vessels in the walls of the intestines. (3) By hindering absorptions of secretions and fluids which normally occurs in the lower bowels. (4) By a combination of two or more of these methods. Purgatives may be divided into: 1. Laxatives.—These include such agents as: Olive oil Nux vomica Cottonseed oil Linseed oil )} - : small dose Magnesia Castor oil $ Sulphur 29 GENERAL ACTION OF DRUGS These drugs slightly increase intestinal action, chiefly by stimu- lation of peristalsis. 2, Simple Purgatives.—These stimulate secretion and peris- taltic action. Among them may be mentioned: Aloes Rhubarb Calomel Senna Linseed oil Cascara sagrada Castor oil Phenolphthalein Frangula 3. Drastic Purgatives.—Drastics are essentially gastro-intes- tinal irritants, and in large doses cause mucous and bloody diarrhea, congestion of the mucous membrane of the alimentary canal and severe colic. They may produce death in poisonous doses with col- lapse by reason of gastro-enteritis. Drastics greatly increase both peristaltic action and secretion, and are contra-indicated in irritable and inflamed conditions of the digestive tract. They are, however, indicated for their revulsant or derivative effect (2.e., to dilate the blood vessels in the alimentary canal and to cause an outpouring of serum from the blood, thus relieving congestion in other parts) in some acute inflammations, as in brain diseases. Their medicinal action is often attended with considerable and irregular peristaltic contractions, so that griping oceurs. The latter is prevented by suitable combination with other purgatives; with hyoscyamus and belladonna; or with carminatives, as ginger. The drastics include: Croton oil Scammony Coloeynth Jalap Gamboge Elaterium 4. Hydragogue Purgatives—Hydragogues are agents which chiefly increase the fluidity of the intestinal contents. They in- clude: (a) SALINE PURGATIVES Magnesium sulphate Sodium phosphate Sodium sulphate. Potassium bitartrate (b) DRASTICS Jalap Scammony Elaterium The salines stimulate secretion by reason of their bitterness, and by their irritant and specific properties. They, moreover, hold on to the fluid thus secreted and hinder its absorption because of DRUGS ACTING ON THE DIGESTIVE ORGANS 23 their slow diffusibility. Purgation follows, owing to the mechanical effect of the increased fluidity of the bowels, and since the aug- mented bulk of the intestinal contents excites peristaltic action. When it is desirable to remove fluid from the blood the salt should be given in concentrated solution, but when a speedy purgative action only is required the saline should be administered in consid- erable dilution. This happens because salines continue to cause an outpouring of fluid (succus entericus) into the intestines until a 5 to 6 per cent. solution of the salt is reached. The nearer to this degree of dilution (5-6 per cent.), therefore, the dose is given, the more quickly will it purge. The drastics included in this class of purgatives have the power of markedly increasing intestinal secretion as well as peristaltic action. 5. Cholagogue Purgatwes.—Cholagogues are agents which as- sist in removing bile from the body. They are supposed to do this in two ways: 1. By directly stimulating the secretion of bile. These are called Direct Cholagogues, or Hepatic Stimulants. 2. By in- ereasing peristalsis in the upper portion of the small intestines, and thus hastening the expulsion of bile from the bowels. These are ealled Indirect Cholagogues. Some cholagogues are not generally considered purgatives, but it is proper to classify all of them thus, since bile stimulates peristalsis. SUPPOSEDLY DIRECT CHOLAGOGUES. *Sodium Salicylate *Sodium Phosphate *Podophyllum Ipecac Aloes Euonymus Rhubarb *Nitro-hydrochlorie Acid Colchicum : Corrosive Sublimate Sodium Sulphate INDIRECT CHOLAGOGUES. Calomel Mercury Most purgatives in a less degree. The drugs marked with an asterisk have been found by clinical evidence most valuable. The bile occurring at any time within the bowels is in part absorbed and then resecreted. This process may be repeated in- definitely, but is prevented by purgatives, especially those increas- ing peristalsis in the duodenum and upper part of the jejunum 24 GENERAL ACTION OF DRUGS (calomel), because they hurry along and expel the bile in the gut before it has time to be absorbed. In this way calomel and purgatives are indirect cholagogues in removing bile from the body; not by stimulating its secretion, but by hastening its excretion from the bowels. The experiments of Rutherford and Vignal have hitherto been chiefly responsible for the scientific basis of our belief in cholagogues. Their results have been swept aside by the more recent and thorough researches of Stadelmann, on animals, and of Pfaff, on men, with biliary fistulz. These researches show that there is no agent which has any marked influence in increasing the secretion of bile, except bile itself, Salicylic acid and its compounds do, however, have a feeble cholagogue action. Moreover, there is no morbid condition in which increasing the flow of bile would prove remedial. We must regard the existence of cholagogue action then as exceedingly problematical at present. Clinically so-called cholagogues are, nevertheless, of great value —as much so as they were ever thought to be. This happens, not because they increase the flow of bile, but because they act as pur- gatives (calomel), or as intestinal antiseptics (calomel, salicylic acid), expelling or inhibiting the formation of toxins or in some way improving digestion (nitrohydrochloric acid). The conditions in which they act most favorably are indigestion and constipation, with or without icterus and clay colored stools. Such conditions were formerly thought to be due primarily to disordered liver or “biliousness,”’ but the cases amenable to treatment really arise in the beginning from functional disorder of the stomach or intestines. The clinical value of so-called cholagogues is therefore not at all disturbed—only the theory accounting for their action. GENERAL USES OF PURGATIVES. 1. To empty the bowels.—In this way are removed fecal ac- cumulations and poisonous matters resulting from bacterial infec- tion, and from fermentative and putrefactive changes in the intes- tinal contents in indigestion. Foreign bodies, bile, pathological dis- charges and intestinal parasites are also expelled. Peristaltic action is quickened in chronic constipation, while spasmodie and painful conditions (colic) are relieved by ridding the bowels of the source of irritation causing the trouble. 2. To remove fluid from the body.—This effect is more marked after the use of concentrated solutions of saline purgatives and other GENERAL USES OF PURGATIVES 25 hydragogues. Concentration of the blood and resulting absorption of dropsies of renal and cardiac origin, or inflammatory effusions, may be accomplished by these agents. 3. To revulse.—That is, to cause dilatation of the blood vessels in the intestinal walls and so withdraw blood from remotely con- gested areas, as in cerebritis. The drastics are appropriate for this service. Pain and nervous phenomena in other regions are some times benefited by the counter-irritant action of drastic cathartics. 4. To deplete-——Cathartics, particularly concentrated saline solutions, deplete the body both locally and generally by withdrawal of serum from the blood vessels. Purgatives tend to combat inflam- mation (antiphlogistic action) in this way by lowering blood tension while they also favor reduction of a febrile temperature by removal of toxins. Local depletion by salines is especially indicated in diarrhea and dysentery, and in the first stages of acute inflammation of the digestive tract. Plethora and obesity are often treated by a depletive method with cathartics. 5. To eliminate.—Deleterious material in the blood resulting from renal insufficiency, and probably from infection in acute diseases, may be eliminated to a considerable extent by purgatives. So also may the hemic sources of rheumatism, lymphangitis and hemoglobinemia be excreted. Contra-ndications.—These refer rather to the special agent than to any disorder, for there is scarcely a condition in which some cathartic is not permissible. Drastics are inadmissible under the following circumstances: in catarrhal conditions of the respiratory and digestive tracts, in- testinal hemorrhage, collapse, anemia, hernia, prolapse of rectum, metritis, nephritis, pregnancy, general debility, and in wounds of and operations upon the pelvic or abdominal viscera. In well-defined enteritis and peritonitis cathartics are to be avoided. In mechanical obstruction of the intestines surgical inter- ference is indicated when practicable, but where this is impossible enemata and some purgatives may be employed. The intestines, developed to an extent disproportionate to the size of the stomach in the horse, are powerfully influenced by cathartics, so that in eatarrh of the respiratory organs and influenza, metastasis, or change in the site of fhe inflammation, may occur, and the intestines may become involved with the occurrence of excessive purging (super- purgation) after the ingestion of any but the mildest cathartics, as linseed oil. Aloes is the purgative given horses for ordinary pur- poses, while epsom and glauber salts are suitable for ruminants and pigs, and calomel and eastor oil for dogs. Water assists the action of purgatives, and its ingestion should be encouraged by supplying 26 GENERAL ACTION OF DRUGS a liberal quantity of common salt either with the purgative or on the food, and also by sweetening the drinking water with molasses in the case of cattle. If the action of cathartics is delayed, it is usually advisable to give enemata. Enemata, or Clysters.—These are fluid injections into the rec- tum and are used for the following purposes: 1. To empty the lower bowels when purgatives are inadmissible, as in intestinal obstruction, ulceration and inflammation, fecal ac- cumulations, debilitated conditions, obstinate vomiting, unconscious- ness, and in inability to swallow (sore throat and tetanus). 2. To relieve pain, spasm (ot intestines and bladder), and shock, when deep, hot enemata (105°—115° F.) are used. 3. To save life. After severe hemorrhage, deep injections of hot normal salt solutions, 110 F.° (Enteroclysis, see p. 657.) 4. To accelerate the action of purgatives, and as a preparation for abdominal and pelvic operations. | 5. To supply food. (See Artificial Feeding, p. 624.) 6. For their local effect upon inflammation of the mucous membrane of the rectum and colon. Opium and boiled starch solution; silver nitrate and tannic acid—in diarrhea, dysentery, colitis and proctitis. 7. To kill intestinal parasites (oxyurides),—solutions of quas- sia and common salt. 8. To administer medicines in dysphagia due to pharyngitis, tetanus, unconsciousness (apoplexy, coma and convulsions); to ob- stinate ‘vomiting and other causes. a 9. To reduce temperature,—cold enemata in fever. 10. To produce diuresis,—deep injections (110° F.) for re tention and absorption into the blood. 11. To improve muscular tone and intestinal peristalsis in chronic constipation,—cold enemata (55°—60° F.). 12. To overcome twist and intussusception. 13. To stimulate peristalsis, relieve congestion, and increase the flow of bile in catarrhal jaundice,—cold, deep irrigations (55°-60° F.) are here indicated. 14. The stomach of dogs may be washed out by hanging them in an inverted position with the head down and allowing water (often several gallons) to flow into the rectum from a height of 6 feet until vomiting begins. The anus should be compressed by the fingers while giving the injection to prevent escape of the water. This treatment is valuable in food or chemical poisoning, or after ingestion of for- eign bodies. Enemata are best given by allowing water to gravitate into the bowel from a height of 2 to 4 feet. The ordinary fountain syringe GENERAL USES OF PURGATIVES OME of human practice is suitable for the smaller animals, while for deep injections or irrigations a human rectal tube or soft catheter should be slipped over the hard rubber tube. In the case of horses or cattle, enemata may be siphoned through a rubber tube or piece of small hose. This is accomplished by filling the tube with water and compressing it at either end to prevent the escape of water, while one end is submerged in a pail or tub raised 2—4 feet above the patient, and the other end is then introduced directly within the bowel; or affixed to a rectal tube six feet long, when deep injections or irrigations are in order. A continuous flow is thus obtained. A still simpler method consists in pouring water into a funnel which has been fitted to one end of a rubber tube while the other end is passed into the rectum. That portion of the tube which is to be placed within the gut should always be lubricated with vase- line, oil or soap. Manual removal of hardened feces (scybala) must be practised in all animals before the use of enemata. The finger or blunt curette may be utilized for this purpose in small patients. The injection of linseed or cottonseed oil (H., O1.; D., 5 ii.) an hour before the use of larger enemata assists in softening the intestinal contents. When deep injections are indicated, the hind quarters of the animal should be raised—small animals may be partially inverted —and the fluid allowed to flow in slowly, pushing in the rectal tube as the gut distends. Such enemata are more effective whether the object be to simply unload the bowels, to cause retention and ab- sorption of the fluid, or to wash out the intestines. One to several gallons of warm water form a suitable quantity for unloading the bowels of large animals; one-half pint to a quart, in the case of small patients. The injections should be repeated until a good evacuation is secured. ‘To increase the purgative effect of enemata a cup each of soft soap, salt and molasses are added to a gallon of water; or a tablespoonful of each to a pint. Equal parts of milk and molasses form one of the most efficient enemata known for causing catharsis (H., Ci.; D., Oi). Linseed oil or cottonseed oil are also mixed with water. Epsom salts are still more efficacious (H., lbii. to gallon of water; D., 3 i.-iv. to pint); while oil of turpentine (H., 5 ii-iv.; D., 3 i.-iv.) is very active and especially useful in colic and flatulence, mixed with the enema. When clysters are given to be absorbed they should always be very slowly injected by only raising the water supply from 4 to 7 inches above the anus. From 10 to 20 gallons of normal salt solution may be given to horses within 24 hours and several quarts to dogs—if an attendant can devote time to the purpose (p. 65%). In chronic constipation and torpidity of the bowels plain cold water (55°—60° F.) injections are indicated. 28 GENERAL ACTION OF DRUGS Medicated irrigations are most serviceable in catarrhal dis- orders of the bowels (dysentery, etc.), 2.e., the fluid is allowed to flow in and out again till the solution returns clear. Drugs Acting on the Circulation. I.—Actine Upon tur Broop. (a) Blood Plasma.—tThe alkalinity of the blood plasma can be increased by the use of the salts of the alkaline and earth metals; i.€., potassium, sodium, lithium, ammonium, magnesium and cal- cium compounds. This effect is of value therapeutically in rheuma- tism, hemoglobinemia and uric-acidemia. In the former two dis- orders, increasing the alkalinity of the blood plasma appears to assist in the elimination of toxic material, while in the latter condi- tion the excretion of uric acid—existing in the blood as urates—is thought to be favored by potassium and lithium salts. These salts also alkalize the urine and increase its secretion. Drugs which re- move considerable fluid from the body, as purgatives, diaphoretics and diuretics, necessarily alter the composition of the blood plasma. By removing fluid from the plasma, these agents are useful in aid- ing absorption of inflammatory exudations, dropsies and edemas, since the mass of fluid removed is soon replaced from that contained in the food and tissues. In the various infectious and constitutional diseases treatment is largely directed to exciting the secretions and excretions with the purpose of eliminating products of tissue waste and bacterial action from the blood, which prove detrimental to the system. This line of treatment is pursued in uremia, hemoglobi- -nemia and lymphangitis. Venesection, saline infusions, hypoder- moclysis and enteroclysis alter the character of the plasma and often have a life-saving value. (See p. 652.) (b) The red Corpuscles——The so-called blood tonics, or hema- tinics, influence the red corpuscles, increasing their number and con- tent of hemoglobin when there is a deficiency of either. The effect upon the augmentation of hemoglobin is more marked. HEMATINICS Iron and its salts Corrosive sublimate Arsenic Potassium permanganate Copper salts Manganese dioxide The first two are immensely superior to the others in blood- making properties. Iron especially favors the formation of hemo- al DRUGS ACTING ON THE CIRCULATION 29 globin; arsenic increases the number of red corpuscles. Certain agents possess toxicological significance by destroying the composition of hemoglobin. Large doses of the coal tar products, as acetan- ilid, antipyrin and phenacetin, nitrites and potassium chlorate, con- vert hemoglobin into methemoglobin, a mixture, probably, of hema- tin and soluble albumin; while carbonic oxide, phosphorus, sulphur, arsenic, iodine, hydrogen sulphide and turpentine, in large doses, reduce oxyhemoglobin and prevent its combination with oxygen. Acetanilid, potassium chlorate and amyl-nitrite destroy the red blood cells, if absorbed in considerable amount. (ce) White Corpuscles.—It is possible experimentally to arrest purulent exudations caused by irritation and inflammation when quinine is introduced into the blood or applied locally to blood ves- sels. This happens because quinine and all cinchona salts, berberine sulphate and acetanilid—like other poisons to amebae—prevent the ameboid movement or migration (diapedesis) of leucocytes through the vessel walls. Unfortunately it is impossible to give large enough doses in practice to realize such favorable results in inflammatory disorders. An enormous increase of leucocytes (leucocytosis) occurs in acute diseases accompanied by a local exudation process, and also in leukemia, ete. Nucleic acid may induce lencocytosis and may be valuable in bacterial infections. Its therapeutic value is still doubtful after many years of trial. Arsenic, and in some cases quinine, appear to reduce leucocytosis, and in leukemia seem to thus aid recovery. Drugs altering the consistency of the blood are: Cal- cium chloride and (to a less extent) other calcium salts, gelatin and potassium iodide, which increase the rate and degree of coagulation ; eod-liver oil, which augments the solids in the blood; and toxic doses of mercury, which lessen the solids and coagulation and increase the fluidity of the blood. IJ.—Drues Acting on THE Heart. The following includes the mechanism controlling the heart, which may also be influenced by drugs: 1. The heart muscle. This contains the sinus node, which is a part of the heart muscle of the right auricle near the superior vena cava, and is called the pacemaker of the heart because the normal rhythmic impulses start here and:spread to the auricles and thence through the small muscle called the auriculoventricular bundle, situated in the septum, and by its two branches to both ventricles. This impulse normally causes the auricles to contract and then, a moment later, the ventricles. The heart muscle is itself capable of “rhythmically creating 30 GENERAL ACTION OF DRUGS a stimulus, of responding to a stimulus by contracting, of conveying the stimulus from muscle fibre to muscle fibre, and of maintaining its proper tone.” To bring the action of the heart into relation to the needs of the blood vessels a nervous mechanism is essential, as follows: 2. Inhibitory apparatus, including vagus roots in the medulla, vagus nerves with terminations in ganglia in the heart, and fibres passing from the ganglia to the sinus node and junctional tissue (between the auricles and ventricles) of the auriculoventricular bundle. 3. The accelerator apparatus consisting of the accelerator or sympathetic nerves with centres (presumably) in the brain, and in the inferior cornua of the anterior part of the spinal cord, with fibres connecting with the sympathetic thoracic ganglia whose cells send fibrils to the sinus node of the right auricle. The essential object of the circulation, in the last analysis, is to produce an adequate flow in the capillaries. This depends upon the heart’s output, the arterial resistance, and the amount and vis- cosity of the blood. The heart’s output is the resultant of the filling, the capacity, the rate and the strength of the ventricles. Powerful stimulation of the vagus may arrest the heart in diastole, or may impede the passage of impulses through the auriculoventricular bundle (heart block), so that the ventricles beat more slowly than the auricles. Stimulation of the vagus may cause loss of tone so that there is more relaxation in diastole and less force in systole. The coronary arteries are filled from the aorta in both systole and diastole and prolonging diastole may or may not increase the amount of blood entering them. In general, moderate slowing of the heart increases its blood supply and nutrition. The heart is influenced by drugs as follows: 1, Stimulation of the inhibitory apparatus leads to slowing or weakening of the heart-beats, or to both. 2. Depression of the inhibitory apparatus results in quickening or strengthening the heart-beats, or both. 3. Stimulation of the accelerator apparatus causes an increase in the rate or force of the heart-beats, or both. 4, Depression of the accelerator apparatus induces decrease in the rate or force of the heart-beats, or both. 5. Stimulation of the heart-muscle produces increase in the rate or force of the heart-beats, or both. 6. Depression of the heart-muscle lowers the rate or force of the heart- beats, or both. The vagus centre is stimulated by agencies increasing blood- pressure, or causing asphyxia. On the other hand, agencies reduc- DRUGS ACTING ON THE CIRCULATION 31 ing blood-pressure depress the vagus, or stimulate the accelerator nerve, or both. ‘Thus, the nitrites, as amyl nitrite, nitro-glycerin and spirit of nitrous ether, quicken the heart by lowering vascular tension. External stimuli to sensory nerves reflexly stimulate the heart, as also do many locally irritating agents taken internally; e.g., strong alcoholic or ammoniacal preparations. — Since drugs commonly influence more than one part of the mechanism controlling the heart, and since it is difficult to determine the exact physiological details in such complex actions, we shall con- tent ourselves with tabulating the actions of drugs ordinarily em- ployed for their influence on the heart, remembering that while moderate doses produce the effects enumerated below, poisonous doses often give rise to diametrically opposite actions. (a) Drugs increasing the force of the heart-beat. Digitalis Adrenalin Strophanthus Barium salts Do not alter rate a Slow the pulse } Sparteine Camphor particularly Squill Physostigmine (b) Drugs increasing the rate of heart-beats. Belladonna Stramonium Atropine Cocaine Hyoscyamus (ec) Drugs increasing the force and rate of heart-beats. Alcohol Strychnine ’ Chloroform Caffeine Ether Quinine Ammonia Arsenic Ammonium carbonate (d) Drugs decreasing the force and rate of the heart-beats. Aconite Prussie acid Veratrum viride Ergot Antimony salts Notr.—Aconite and veratrum do not depress the heart in medicinal doses; they only slow it by cardio-inhibitory stimulation. The drugs most frequently given to animals for their action on the heart are alcohol, ether, digitalis, strophanthus, ammonia, am- monium carbonate, camphor, caffeine, strychnine, atropine, aconite Og GENERAL ACTION OF DRUGS and yeratrum viride. The reader is referred to special articles on these drugs for therapeutical indications and other details. III.—Drvues Acting on tur Broop VusseEts. The following table includes the mechanism regulating vascular tension: Smooth muscular fibres 1. In the walls of the vessels......2 Terminations of vasodilators and vases constrictors 2. Nerve supply of vessels...... Vasodilators “"** L Vasoconstrictors Vasomotor centres in the medulla and subsidiary centres in the spinal Be GOnbres: oa. hdaesnieescoater ec win Meee ete cord and sympathetic system, con- trolling the vasodilating and _ con- stricting nerves Each vessel is governed by two sets of fibres,—the constricting and dilating,—but we cannot discriminate between the action of a drug on the muscular fibres and the peripheral nerve endings in the vessel walls; nor can we always tell whether a drug acts to stimu- late one set of peripheral fibres or depress the other. Vaseular tension is increased not only by contraction of vessels, but also by drugs which cause the heart to beat more quickly, and by those making its pulsations more forcible and complete, so that. all the blood is squeezed out of the ventricle at each contraction. Contrariwise, blood pressure is diminished, not only by those drugs inducing vasenlar dilatation, but by those reducing the rate or force of the heart, or both. We shall simply classify drugs influencing the vessels according as to whether they act after absorption into the blood, or only when applied locally to the vessel walls. (a) Drugs acting systemically to contract vessels. Adrenalin Digitalis Strychnine Cocaine Strophanthus Hamamelis Ergot Squill Hydrastis Atropine Sparteine Physostigmine ee 2. i A i de | DRUGS ACTING ON THE NERVOUS SYSTEM 33 (b) Drugs acting systemically to dilate vessels. Amyl nitrite Chloral Nitroglycerin Aconite Spirit of nitrous ether Opium Alcohol Belladonna (secondary action) Ether Hyoscyamus es Chloroform Stramonium ie (c) Agents acting locally to contract vessels. Cold Astringents (d) Agents acting locally to dilate vessels. Heat Counter-irritants Uses.—Drugs or agencies causing general dilatation of vessels are useful in overcoming internal congestions and colds by equaliz- ing the circulation; that is, by causing the blood to be distributed more equably about the body. They are also of benefit in morbid conditions attended with a high, vascular tension; and are service- able in dilating peripheral vessels and in causing perspiration and loss of heat in fevers (spirit of nitrous ether and alcohol). Drugs inducing general contraction of vessels are employed in disorders characterized by loss of tone, as in shock and collapse; and in heart weakness or disease (adrenalin, digitalis and strychnine) ; also in in- ternal hemorrhage and inflammations (ergot); and to aid the ab- sorption of dropsies and edemas. The uses of drugs locally contract- ing vessels will be described under Astringents (p. 57) and of agents locally dilating vessels under Counter-irritants (p. 56). Drugs Acting on the Nervous System. I.—Drves Inrivencine THE Brain. It is impossible to classify drugs according to their action on the various centres of the brain, because our knowledge is insuffi- cient. In a general way, drugs affecting the nervous system fall into two groups,—the excitant and depressant. But another diffi- culty arises in regard to classification from the fact that the same drug usually both excites and depresses. Many drugs influencing the nervous apparatus possess some exciting action, and most drugs 34 GENERAL ACTION OF DRUGS which excite in small doses cause depression and paralysis after poisonous quantities. It is probable that aleohol, ether and chloroform are cerebral depressants from the very beginning, contrary to accepted ideas. Belladonna and its congeners, on the other hand, only excite the brain in large amounts; while opium and cannabis indica may excite the brain in small doses, but are used for their more common depressant action. The condition of the patient has some bearing on the action of a drug influencing the brain. Thus moderate doses of alcohol depress and stupefy healthy animals while stimulating the enfeebled and ill-nourished. The brain of the lower animals is undeveloped compared to that of man, and, in accordance with the general fact that the more highly a portion of the nervous mechanism is organized the more powerfully is it influenced by drugs, it follows that drugs acting on che brain ana cord are more prone to affect the cord in veterinary patients while impressing the brain more potently in man. For this reason we notice in the horse that the primary period of excit- ability (sometimes seen in man) following the administration of morphine is much prolonged and not infrequently completely oblit- erates the somnifacient action of the drug in this animal. We shall be content to classify drugs acting on the nervous sys- tem according to their most pronounced action in moderate doses. l a) Cerebral Excitants. Camphor Quinine Caffeine Cocaine Uses.—These drugs are rarely used simply to excite the brain, but for other purposes. Camphor, caffeine and quinine are em- ployed to generally exzite the nervous system in depressed condi- tion. Camphor is perhaps the best agent we possess to stimulate the heart and vital nerve centres in emergencies. Caffeine is a valuable antidote to the depressing cerebral action of opium in poisoning and is a potent heart stimulant. (b) Cerebral Depressants.—It is fortunate that drugs pro- gressively paralyzing the functions of the brain follow the so-called law of dissolution—i.e., paralyze the various functions of the brain in the inverse order of their evolutionary development. The centres last to be acquired are the first to be paralyzed (cerebral centres) ; while those of earliest origin (the respiratory, vagus and vasomotor centres) are last to succumb to the action of cerebral depressants. DRUGS ACTING ON THE NERVOUS SYSTEM 35 The cerebral depressants are used mostly to relieve pain, when they are called anodynes or analgesics. Pain is due to irritation of any sensory nerve, or the sensory tract in the spinal cord, or of the sen- sory centres in the brain. Pain may be relieved by paralyzing any portion of this path and destroying connection with the perceptive centres in the brain. (1) Anodynes, by reason of their action on the brain. Codeine Alcohol Cannabis Indica Morphine Anesthetics Gelsemium Opium Chloral Bromides (2) Narcotics.—This term is a broad and somewhat inclusive one. Narcotics embrace drugs which depress the brain and cause sleep (hypnotics or soporifics) and stupor (some anodynes and anes- thetics), and finally paralyze the respiratory and circulatory func- tions. The following may be included in this group: Opium Anesthetics Cannabis Indica Stramonium Alcohol Chloral Belladonna Hyoscyamus (a) Hypnotics or Soporifics (drugs causing sleep) : Opium Bromides Paraldehyde Sulphonal Morphine Cannabis Indica Urethrane Trional Chloral (Of little importance in veterinary practice) Uses.—Hypnoties are not of much value in Veterinary medi- eine by simply promoting sleep. Their general sedative and ano- dyne actions are utilized in relieving motor excitement (spasms) or sensory excitement (pain). (b) General Anesthetics. Ether Nitrous oxide Methylene hichloride Chloroform Ethylene dichloride Schleich’s mixture (Of slight value in veterinary medicine) Anesthetics are agents which abolish sensation generally or 36 GENERAL ACTION OF DRUGS locally. It is thought that the general anesthetics act directly on the nerve cells. Anesthetics—like narcotics generally—first stimu- late and then depress the nerve centres, but depression is by far their most salient and useful effect. Anesthetics destroy the functions of nerve centres in the cere- brum and spinal cord, and so abolish pain, sensation and reflex ac- tion. The law of dissolution is exemplified in their action. Anes- thesia is commonly described in three stages. (1) The first or stimulant stage is exhibited by excitement and struggling, owing in part to fright and in part to irritation of the respiratory tract by concentrated vapor. There are also coughing and choking in this stage, following the local irritation of the vapor on the respiratory tract. There may be vomiting, and the circulation and respiration are reflexly stimulated. Stimulation now ceases, and depression of the cerebrum, together with the motor, sensor and reflex spinal centres, appears, and ushers in the (2) anesthetic stage, charac- terized by muscular relaxation and complete abolition of con- sciousness, sensation and motion. Between these two stages—the stimulant and anesthetic—there sometimes occurs a transient state in which sensation is lost before consciousness. This has been styled the anodyne stage. Finally, the (8) paralytic stage ensues, accompanied by de- pression and then paralysis of the three great vital medullary cen- tres controlling the circulation and respiration, together with that of the lowest reflex centres, so that involuntary micturition and def- ecation occurs. The animal dies of a combination of vasomotor, heart and respiratory failure. If recovery should follow the para- lytic stage, the bodily functions return in the reverse order of that in which they were lost; 7.¢., the lower vital functions first appear, followed finally by the higher cerebral functions. Uses.—Anesthetics are employed in surgical operations to pre- vent pain and struggling; in obstetrical operations and in the re- duction of fractures, dislocations and hernia, to secure complete muscular relaxation; to overcome spasms and convulsions resulting from disease or poisons; to arrest severe pain in colic; and finally to destroy aged or sick and useless animals. For fuller details see Anesthesia (p. 275). (ec) Drugs acting on the cortical motor centres of the brain. (1) DRUGS STIMULATING THE MOTOR CENTRES. Strychnine Physostigmine Atropine DRUGS ACTING ON THE NERVOUS SYSTEM 37 (2) DRUGS DEPRESSING THE MOTOR CENTRES. The Bromides Alcohol Chloral Anesthetics . The action of drugs on the cerebral cortical centres has been found by comparing the local effect of electrical stimulation before and after the internal use of drugs. Uses.—The drugs depressing the cortical motor area of the brain are valuable in convulsions and spasmodic disorders and in motor excitement, particularly in epileptiform convulsions of dogs. IIl.—Drues Acting on THE Sprnat Corp. The functions of the cord consist in the conduction of sen- sory impulses forward to the brain and of motor impulses backward to the muscles; in the origination of nervous force in centres con- trolling certain functions (sexual, sweating, etc.) ; and in reflex action by which the cord transmits impulses from sensory to motor tract of the same side of the body, or laterally, from sensory to motor col- umns on opposite sides. While drugs probably influence the various centres in the cord, our knowledge of their action is chiefly limited to that exerted on the motor cells of the inferior cornua. If a drug stimulating the motor cells of the cord is given ex- perimentally, slight peripheral irritation will reflexly cause con- vulsions, and, if the cord is severed from the brain, the same phe nomena appear. (A) Drugs stemulating the motor cells of the inferior cornua. Strychnine Ammonia Opium x d Le ct Brucine Anesthetics Ergot rimary action Thebaine Uses.—Strychnine is employed in paraplegia resulting from diseases of the spinal cord after irritation caused by the lesion has passed away. (B) Drugs depressing the motor cells of the inferior cornua. Physostigmine Emetine 2 C Antimony Bromides ‘ Turpentine 3 Silver Ergot Magnesium Zine Nitrites # j Sodium Saponin Gelsemium & | Potassium Lithium 38 GENERAL ACTION OF DRUGS Chloral Ether Nicotine Morphine Chloroform Veratrine Apomorphine Camphor Mercury Alcohol Carbolic acid Arsenic Uses.—Drugs depressing the motor cells of the cord are service- able as antidotes in the treatment of poisoning by those exciting the same (chloral and bromides in strychnine poisoning), and in convulsive and spasmodic disorders, as chorea and tetanus. Iil.—Drues Acting on THE NERVES The nerve terminations, rather than their trunks, are influ- enced by drugs. (A) Drugs influencing peripheral sensory nerve-endings. (1) Stimulating sensory nerve-terminations.—Counter-irritants. (See p. 56). General Uses.—They are applied externally (mustard and heat) to stimulate the heart and respiration in heart failure, shock and collapse. (2) Depressing sensory nerve-terminations.—These include local sedatives or anodynes, which lessen sensation; and _ local anesthetics, which abolish sensation. LOCAL ANODYNES Aconite © Morphine : Veratrine Menthol Chloral Heat Carbolie acid Prussic acid Cold Atropine Sodium bicarbonate LOCAL ANESTHETICS Cocaine Stovaine Holocaine saa Methyl-chloride Eucaine Novococaine Cold P { Ether Uses.—The local anodynes are employed to relieve pain of an inflammatory, rheumatic or neuralgic character, and itching. The local anesthetics are employed to prevent pain in surgical opera- tions. | DRUGS ACTING ON THE NERVOUS SYSTEM 39 (B) Drugs influencing peripheral motor nerve-endings. (1) STIMULATING MOTOR NERVE-TERMINATIONS Strychnine Aconite Pyridine Pilocarpine Nicotine = (2) DEPRESSING MOTOR NERVE-TERMINATIONS Curare Atropine Prussic acid Conium Cocaine Nicotine Amyl-nitrite Camphor and many others Uses.—Drugs influencing the peripheral motor nerve-endings are not of any practical therapeutical value. IV.—Drves Actine on true Nerves or Specrat SEnse. (A) Drugs acting on the eye. (1) Drugs influencing the pupil—The mechanism controlling pupil consists of the centres for the contraction of the pupil (in corpora quadrigemina ?), the centres for the dilatation of the pupil the medulla and acqueduct of Sylvius?), the third nerve, the cal sympathetic and the circular and radiating (latter some- s absent) muscular fibres of the iris. Drugs may act either rally or locally on these structures. The pupil is dilated by ; (1) depressing the contracting centre (oculomotor), (2) the minations of the third nerve or (3) the circular fibres of the iris; | contrariwise, by (4) stimulating the dilating centre, (5) the ter- nations of the sympathetic or (6) the radial fibres of the DERI d, finally, by a combination of these actions. _ Again, the pupil is contracted by drugs stimulating (1) the ce ae centre, (2) the terminations of the third nerve or (3) ) the terminations of the sympathetic or (6) the radial fibres of iris; and also by a combination of these actions. Drugs may act ally on the pupil through the medium of the circulation as well hen dropped into the eye. Furthermore, absorption and central mn may occur when drugs are dropped into the eye as well as entering the blood through the more ordinary channels. 40 GENERAL ACTION OF DRUGS only those acting locally. Drugs influencing the pupil are divided into two classes: (1) those that contract the pupil (myotics) and (2) those that dilate the pupil (mydriaties). (1) Mydriatics. (a) ACTING LOCALLY. Atropine Homatropine | Hyoscyamine Hyoscine Scopolamine | Gelsemine Cocaine Stimulates sympathetic endings. L Paralyse third nerve terminations (b) ACTING CENTRALLY. Anesthetics (late in their action) The dilating centre is stimulated by carbonic dioxide in the blood, and therefore dilatation of the pupil occurs in asphyxia; also after irritation of sensory nerves, the sexual organs and digestive apparatus. Uses.—Mydriatics are useful in dilating the pupil for ex- amination of the eye, and to prevent adhesions of the iris in central corneal ulcers; in keratitis, to overcome photophobia and blepharo- spasm ; and in iritis, to secure rest of the iris and ciliary muscles. (2) Myottes. (a) ACTING LOCALLY (b) ACTING CENTRALLY po ame cet third Anesthetics Pilocarpine nerve enaings Opium Usus.—Myotics are employed to prevent prolapse of the iris in wounds and ulcers of the cornea; to antagonize the effect of atropine; to prevent the entrance of light in Peaneal disorders of the eye; to lessen intra-ocular tension in glaucoma*; and, in alternation with * By opening up the filtration angle at the periphery of the anterior cham- ber and allowing drainage of lymph through the lymph spaces there into the canal of Schlemm, or to contraction of the intraocular vessels. so lessening secretion (Grénholm). DRUGS ACTING ON THE RESPIRATORY ORGANS 4] mydriatics, to break up adhesions to the iris. All the local mydriatics and myotics mentioned above act on the ciliary muscle to destroy the power of accommodation. Intra-ocular tension in glaucoma is usually increased by atropine and other mydriatics, but is diminished by eserine. V.—Drues AcTING on THE Ear. Strychnine makes the hearing (and sight) more acute; while salicylic acid, salicylates and quinine cause, in man, subjective symp- toms, including fulness, roaring and buzzing noises in the ears. Drugs Acting on the Respiratory Organs. It is impossible to describe under this head all the drugs in- fluencing the respiratory tract. Thus, agents affecting the circula- tion exert a powerful action on the blood supply and functions of the respiratory organs. The application of counter-irritants and heat and cold externally, reflexly produce notable alterations of pulmonary conditions. Emetics are indirectly serviceable in assist- ing the expulsion of exudations from the upper air passages in dogs. Furthermore, medicines having a depressing action on the nervous system are of importance in respiratory disorders in reliev- ing cough and spasm. We shall consider here those agents acting on the respiratory apparatus itself. Drues Acting on THE Resprratory Mucous MemBrRanr. (A) Drugs Acting Locally. 1. Stimulating the mucous membranes and causing vascular dilatation, increased secretion and muscular contraction of the walls. . Producing a sedative action. . Exerting an antiseptic influence. . Relaxing spasm. Causing a local astringent action. . Thinning exudations. D> Ot 09 dO 492 GENERAL ACTION OF DRUGS Errhines, or sternuatories, are drugs which are introduced intc the nostrils to cause irritation, coughing and sneezing and expul- sion of secretions, parasites and foreign bodies from the nasal - chambers and upper air passages. They are rarely of any value, and include tobacco, ipecac, euphorbium, ammonia, chlorine and sulphurous anhydride. By inhalation (in pint of water near the boiling point; unless otherwise stated ). (1) DRUGS EXERTING STIMULANT ACTION. CarbOlicwacrd 2. ss. 'si5< cvie sere omemonsivisrecreny cl estes gYr.xx WTCOSOLES tistien. ate cose ae ae aa enone xx OilP OF JEWDEDS : 7-20 che creremueje sie nonin erieea sae 388 Pincture-Of, Den ZO .\5 occ ass eis uses. nue 38s WANCCUTE LOE @1POCa Gis ntie 18 ciate su cuctevateiaten scons enete 38s. Oil “or tuTpentine: sa.)82 . ; 7 ie i PRESCRIPTION WRITING 83 RELATIVE VALUE OF UNITS IN TROY SYSTEM. tb E4 3 1) Gr. 1 = ole = 96 = 288 = 5,760 3 i. = 8 = 24 = 480 3 i. = 3 — 60 9 i. = 20 The abbreviation, Fl., is usually omitted in prescription writ- ing, as referring to fluids, the character of the preparation being sufficiently apparent. The Roman numerals are used to express the quantities employed. The Roman numerals are written under a horizontal line, the i’s or j’s are dotted (they are identical in Latin) and the dot serves to enforce and check the numbers used. Frac- tions are usually expressed in ordinary Arabic characters, except 14, which is often indicated by a double s (ss), standing for semis, the Latin for one-half. APPROXIMATE EQUIVALENTS OF WINE UNITS IN DOMESTIC MEASURES. Teaspoon =e 3 iii. = 5 Ce. Dessert spoon — 3 ii. = 10 Ce Table spoon — 3 ss. — 15 Ce. Cup = oo 18) 129 Ce. Tumbler = 3 viii. = 250 Ce. There are usually about six teaspoonfuls to the fluid ounce. It is a good plan to have some regard for the size of vials generally kept by druggists, and to write for a quantity to fill the bottle. The bottles commonly in use in human and canine practice are the 2 and 4 drachm; the 1, 2, 3, 4, 5, 6, 8, 12, and 16 ounce. The 2 drachm bottles are useful for measuring the dose of fluid extracts for horses; the 3 ounce bottle is convenient in writing pre- scriptions in the metric system for dogs, as it holds approximately 100 Ce. The 4 ounce bottle is the common size, employed in canine practice, containing 24 doses of one teaspoonful each. The 14 pt. and pt. bottles are more appropriate for larger animals. THE METRIC SYSTEM. The metric system will be described, because it is the universal system employed in scientific writings, and is now official. It is 84 PRESCRIPTION WRITING based on the fact that a uniform, unchangeable standard is em- ployed as the unit of all measures, whether of weight, capacity or area. ‘This standard is the ten-millionth part of the distance from either pole to the equator, and is denominated a meter (39.371 inches), and is the standard of length. The cube of 0.1 of a meter is taken as the unit of capacity and called a litre (2.1135 pints). The weight of water at its greatest density, 4° C. (39.2° F.), which this cube will contain, is termed a kilogram (2.2046 lbs. Avoirdu- pois), and is the unit of the measure of weight. METRIC DIAGRAM. The weight of water that the small cube will contain is one gramme. This is the unit of weight of the metric system. i: pe aenees oe Qnestenth Metre Long cen | wa VY fe + Y re a — nieie- 7 gr.ss. Strychnine sulphatis ................ 2T.Yoo Misce et fiat pilula 1; dispense pilulas tales numero xxx. (Abbreviated) M. et f. pil. 1. Dispense pil. tales No. xxx. Signa or S. (as before.) Translated: (Misce) mix (et) and (fiat) let there be made (pilula) pill 1; (dispense) dispense (pilulas) pills, (tales) such, (numero) in number, xxx. Abbreviated as above, (Signa) S.—= Label. The same prescription may be written in the metric system: Gr. 1=.06 gm. Fractions of a grain are converted into grams, therefore, by dividing .06 by the denominator of the fraction and multiplying the result by the numerator. The dose of aloes (gr. 14) is transformed into grams, then, as follows: 2).06(.03 X 1=.03 06 00 Gr. 1/120 is converted into grams thus: 120) .0600 (.0005 X 1=.0005 gm. 600 Solids in Gm. Liquids in Cec. RB He TEI TEM UICh age yee iteestoa sierra cian et oes~ oie | 12 PIGESSSOCOLEINES (cape siay-ieielo's so ise i102 000 | 03 Strychnine sulphatis ................. | 0005 M. et f. pil. 1; dispense pil. tales No. xxx. Sig. (as before). This prescription may be abbreviated in this manner: Orr FEQUCEIN s acsrcis\n clave > siete al «sta niall o) = fHeZ PAGES ISOC ota ale fol nln Talos ol o\clindel sin) ol teste otal) 0 | 03 Sty else sully ls cbs sjese rene) ta pole -awernie | 0005 M., ete. 102 PRESCRIPTION WRITING Prescriptions for balls are calculated and written in every re spect like those for pills. We may write the above prescription in another form, in case we prescribe a pill or ball mass to be made, or an official mass to be divided into pills. Suppose we write a pre- scription for a physic mass, suitable for horses. We conclude to write for a quantity of the mass sufficient to make eight balls. Each ball contains a single dose of aloes and sufficient excipient to make the mass of the proper consistency. The dose of aloes is one ounce, and we know by experience that it will take an equal amount of molasses and one drachm of powdered ginger to make a proper ball mass. Multiplying each of the ingredients, then, by 8, we find we need 8 ounces each of aloes and molasses, and 1 ounce of pulverized ginger, to make a mass which shall be divided into 8 balls. The Latin names and genitives of socotrine aloes we have al- ready described. Molasses is syrupus fuscus in Latin, or brown syrup. Syrupus, genitive syrup-t, of syrup. f'uscus, genitive fusc-, of brown. The Latin for powdered ginger is pulvis, powder, genitive pulver-is, of powder. Zingiber, ginger, genitive zingiber-is, of gin- ger. We will proceed to write the prescription thus: R Aloés socotrinz VTL PMMA CL watts scsoroueteruentven sh cieievetr erate misters aa 3 viii. Pulveris zimgiberts, i) ./.5 .. featic oes las elevators 31. Misce et fiat massa, in bolos viii., dividenda. (Abbreviated) M. et f. mass., in bolos viii., dividend. Sig. Give one ball at once. — JOHN SMITH The Latin directions to the pharmacist are translated: (Misce) mix (et) and (fiat) let there be made (massa) a mass (in bolos, ac- cusative pl. ), in balls viii. (dividenda) to be divided. This is also a stock phrase and should be memorized as applying to pills or balls made from a mass. The prescription is abbreviated: R Aloés soe. SY PA PUSCh->

.-30.) > She Sw. Seieotie. (42-6. se) omev.-xx, (23-183). : 150 INORGANIC AGENTS Syrupus Carcir LactopnospHatis. Syrup of Calcium Lacto- phosphate. (U.S. & B. P.) Precipitated calcium carbonate, 25; lactic acid, 60; phosphoric acid, 36; orange flower water, 50; sugar, 725; water, a sufficient quantity to make 1,000. Dose.—Foals and calves, 3% ss.-i. (15.-30.); D., 3 i-iv. (4.-15.). CaLcium PHOSPHATE. Action and Uses.—Calcium salts are most important con- stituents of the body, being essential for the contractibility of mus- cles, the activity of nerves, the coagulability of blood and, as calcium phosphate, forming 50 per cent. of bones. Calcium salts mostly pass unchanged through the bowels. A small amount is absorbed and eliminated by the large bowel and by the kidneys. The food or- dinarily contains an amount of lime in excess of the needs of the body. By withholding lime from the food animals may develop con- ditions similar to rickets. Rickets, however, is not usually due to lack of lime salts, but to an abnormal condition in which the lime ingested cannot be deposited in the bones, although abounding in the blood. Lime being deficient in the bones in rickets and osteomalacia, it has been given in these conditions and also in caries and fragilitas ossium. Unless the food has been deficient in calcium salts their use will probably be of little benefit. The same comment applies to the administration of calcium salts | in delayed union in fractures and in anemia, malnutrition, and weak- ness of young animals. In the latter conditions the calcium salt should be given with iron. Calcium phosphate should be given on food with iron to improperly nourished pregnant animals and pre- vents loss of the young through marasmus and rickets. Administration.—Precipitated calcium phosphate may be given on the food, but is more readily absorbed if it is administered in the syrup of calcium lactophosphate. A glycerophosphate of lime has recently come into vogue and preparations are made containing the elycerophosphates of lime, potassium, magnesium, iron, sodium and quinine. They are used in anemia and malnutrition and conva- lescence. Dose, of the glycerophosphate of calcium and iron—H., 35 i.- ot Pee DY es vale. es CALCIUM CHLORIDE 151 Catcir Cutoripum. Calcium Chloride. CaCl,. (U. S. &B. P.) Derivation.—Neutralize hydrochloric acid with caleium ear- bonate and evaporate: 2HCl + CaCO, = CaCl, + CO, + H,O. Fusion at the lowest possible temperature renders the salt an- hydrous. Properties.—White, translucent, hard fragments; odorless; hav- ing a sharp, saline taste, and very deliquescent. Soluble in 1.3 part of water, in 8 parts of alcohol. : Dose.—H. & C., 5 ss.-i. (15.-30.) ; D., gr.5-20 (.8-1.3). Gelatinum. Purified Gelatin. (U.S. P.) Derivation.—The purified air-dried product of the hydrolysis of certain animal tissues, as skin, ligaments, and bones, by treatment with boiling water. Properties.—An amorphous, more or less transparent solid, usu- ally shredded or in thin sheets; colorless or with a slight yellowish tint, Imodorous, and having a slight, characteristic, almost insipid taste. Insoluble in cold water, but swells and softens when im- mersed in it, gradually absorbing 5-to 10 times its weight of water. Soluble in boiling water and glycerin, insoluble in alcohol, ether and chloroform, fixed and volatile oils. Actions and Uses.—Calcium chioride has been used of late ex- tensively both to prevent and arrest hemorrhage. Outside of the body, calcium chloride causes blood te coagulate more quickly and firmly than usual, and the same kind of action appears to obtain— 2.e., rendering blood more coagulable—when the salt is given inter- nally. Calcium chloride is an efficient hemostatic in hematemesis, hemoptysis, purpura hemorrhagica and in all conditions giving rise to hemorrhage. When administered by the mouth several days before surgical operations in maximum doses it may lessen hemor- rhage in cases likely to be attended by much bleeding. Two per cent. solutions of gelatin in normal salt solution have been given by the mouth, rectum and subcutaneously for the same purposes, and it is thought that the gelatin owes its power in arresting hemorrhage to — the calcium (0.6 per cent.) contained in it. Unless gelatin is steril- ized fractionally for half an hour on three to five successive days, tetanus may ensue when it is injected under the skin, and numerous eases have been reported following such use in human surgery. Merck sells a perfectly sterilized gelatin. The simplest manner of employ- ing gelatin to arrest hemorrhage internally is by injection per rec 152 INORGANIC AGENTS tum; 114 ounces for small animals and 10 ounces to a pint for larger animals of the following aqueous solution, given at body temperature after the bowel has received a cleansing enema of boiled water. The solution is made of gelatin to the amount of 6 per cent. and calcium chloride to the amount of 1 per cent., to which a little laundanum may be added to prevent expulsion. It should be re- peated every five hours as long as there is danger of hemorrhage. Experiments by H. C. Wood, Jr., appear to show that gelatin may be given ad libitum by the mouth and retain its hemostatic action; therefore gelatin should be given freely in this way as well. Aqueous solutions of gelatin 10 per cent. with calcium chloride 1 per cent., have been used locally to arrest bleeding in wounds and cavities of the body, but considering the danger of tetanus and the fact that adrenalin chloride is a better local hemostatic, such a use of gelatin is inadvisable. Catx Cuxtorata. (See Chlorine, p. 219.) Catci SutpHas Exsicoatus. (U. S. P.) Dried Calcium Sul- phate, or Plaster of Paris, used for bandages. Barium. (Baruim is not used in the metallic state.) “Bartt Cutormum. Barium Chloride. BaCl,. (Non-official.) Derivation.—Native barium sulphate is fused with charcoal. The resulting sulphide is treated with hydrochloric acid. BaSO,+ . 29C=BaS+2 CO,. BaS+2 HCl=BaCl,-+-+-H,8. Properties.—Ocecurs in colorless, glistening, rhombic plates; taste bitter and disagreeable; permanent in dry air; soluble in 2.5 parts of cold water; reaction neutral. Dose.—H., 3 i-11 by mouth; intravenously, gr. xv. Action Internal.—Barium chloride is an intense irritant if swallowed in considerable amount and in insufficient dilution. Large medicinal doses stimulate the muscular coat of the bowels and cause increased peristalsis and purging. Evacuations from the bowels follow in horses one-half to one hour after the salt is given in drench; in one to two hours after administration to these animals in ball; in a few minutes after intravenous injection. Subcutaneous injection will occasion abscess. The drug resembles physostigmine in its action on the intestines. or BARIUM al Heart and Blood lar contractions of the heart stronger and slower. ‘The salt acts en- tirely on the heart muscle and does not influence the vagi. Lethal doses are followed by slower and slower ventricular contractions, succeeded by peristalsis of the cardiac muscle, and, finally, by stop- page of the heart in systole. Barium chloride also directly excites the muscular walls of the capillaries, and, like physostigmine, increases vascular tension in small doses. Muscles.—Barium chloride stimulates muscular contraction when it is applied locally. The potassium salts antagonize the action of barium chloride on the circulation and muscles. Toxic doses, given intravenously, cause convulsions owing to stimulation of the spinal cord and medulla. This is succeeded by paralysis of the cen- tral nervous system. Summary.—Cireulatory stimulant, and purgative in large medicinal doses. Uses.—Many practitioners are afraid to use barium chloride, but repeated use of the drug has convinced us that it is absolutely safe when given in the dose of 1 gram or 15 grains, intravenously, or 4 to 8 grams (1 to 2 drachms) by the mouth in solution for the horse. Barium chloride is of the ereatest value in colic and obstinate con- stipation of horses. It may for the time cause some increase of “pain but not nearly as much as follows the use of eserine or arecoline, and it quickly passes off when the bowels are moved. Great care should be exercised to avoid introduction of the barium solution into the connective tissue while injecting it into the vein. The needle of the hypodermic syringe should be introduced into the jugular about midway of the neck, and after some drops of blood have exuded from the vein, the syringe is attached and slowly emptied, when the plunger is withdrawn eral some blood enters the syringe. Then the needle may be removed with safety. It is rarely necessary to repeat the dose of barium chloride, and small doses of fluidextract of cannabis indica may be given to lessen colic while barium is acting, when it is given by the mouth.* Extensive experiments of Muiry with barium chloride lead him to conclude that the salt may be administered intravenously in the amount of 1.0 to 2.0 gm. (15 to 30 gr.) in 1 to 2 drachms of sterile water; that 2 gm. is a safe dose by the intrajugular method for a horse of ordinary weight and fair condition; that the drug acts *Lockhart reports two deaths in horses from 214 and 3 drachms of barium chloride by the mouth and he warns that the efficient cathartic dose approaches the lethal limit with this drug. (Amer. Vet. Review, Apr., 1914). +Jour. of Comp. Med. and Vet. Archives, Jan. and Feb., 1899. 154 INORGANIC AGENTS promptly when given in this way, catharsis being produced within one to nine minutes, and that even volvulus may be relieved; that there are no unpleasant symptoms following the smaller dose (1 gm.), and that even after the 2 gm. dose there are only slight signs of pain and sweating; that while the passages from the bowels are few in number the total amount of feces is large; finally, that the drug has the advantage of being cheap. That the toxic line is closely approached in giving barium chloride in the dose of 2 gm. intravenously, is shown by experiment 31,* in which a gelding weighing 900 pounds received two 2 gm. ate intrajugularly at about 294 hours apart, when death occurred from heart failure in nine minutes after the second dose. Barium chloride is also useful in relieving tympanites of cattle. Four to five drams are given to cattle and one and one-quarter drams to calves in drench. Magnesium. (The metal is not used in medicine.) Maenesir Sutpuas. Magnesium Sulphate. MgSO, + 7 H.O. CUE. S175; Ps) Synonym.—Epsom salts, sal amarum, sal Epsomense, sal anglicum, sulfas magnesicus, ete., E.; magnesia sulfuria, P.G.; sulfate de magnésie, sel d’Epsom, sel de seidlitz, sel amer, F'r. ; bitter- salz, schwefelsaure magnesia, G. Derivation.—lt is obtained from native dolomite, a double carbonate of magnesium and calcium, or magnesite (MgCO,). MgCO, + H,SO, = MgSO, + H,O + COQ,. Properties.—Small, colorless, rhombic prisms, or acicular erystals, without color, and having a cooling, saline and bitter taste; slowly efflorescent in dry air; soluble in .85 part of water; insoluble in alcohol; reaction neutral. Incompatibles.—Lime water, alkaline garbonates, phosphoric acid, phosphates, silver nitrate and lead acetate. Dose.—H., laxative, 5 i1.-iv. (60.-120.); C., purgative, Tbi.-ii. (500.-1,000.); laxative, 3 iii-iv. (90.-120.); Calves, 3 ii.-iii. (60.-90.) ; Sh., 3 iv.-vi. (120.-180.) ; D., 3 i.-iv. (4. 15.). Action Internal.—Epsom and Glauber’s salts are the best pur- gatives for general purposes in the treatment of cattle and sheep. The mode of action of Epsom salts is similar to that described under * Jour. of Comp. Med. and Vet. Archives, Jan. and Feb. 1899. MAGNESIUM SULPHATE 155 sodium sulphate. Briefly, magnesium sulphate causes purgation by increasing intestinal secretion, retarding absorption of fluid from the bowels, and probably by stimulating peristalsis. The salt moves the bowels, in the case of the larger animals, usually within twelve or fifteen hours. Epsom salt is absorbed to some extent, and is eliminated by the kidneys and sweat glands, increasing the secretions of these organs, especially when the dose is small. Summary.—Hydragogue cathartic. Feeble diuretic and diaphoretic. Uses.—For uses the reader is referred to Sodium Sulphate (p. 131), as they are almost identical. Epsom salt is useful in febrile diseases of horses, as in influenza and pneumonia, given in solution, in doses of two to four ounces daily. Solutions of mag- nesium sulphate produce local anesthesia when injected under the skin or intraspinally. Tucker has shown that magnesium sulphate is useful in acute sprains and rheumatism, dermatitis, erysipelas, neuralgia and orchitis applied to the affected parts in saturated solution on gauze compresses wrung out in the fluid and covered by a waterproof ma- terial. Its beneficial action is partly to be ascribed to its local anes- thetic influence. The intravenous injection of magnesium sulphate causes gen- eral anesthesia and death by paralysis of the respiratory centre. It acts locally and intradurally much like cocaine as a local anesthetic. lee. of a 25 per cent. solution for each 25 lbs. body weight is in- jected intradurally to cause spinal anesthesia. Loss of sensation and motion may last for 14 hours. Recently several deaths have been reported in humans by Boos owing to swallowing concentrated solutions of an ounce or more with absorption. He warns against using solutions containing more than 6 per cent. to avoid absorption and poisoning. Therefore there may be some danger in using concentrated solu- tions of Epsom salts, which are often used to withdraw water from the blood in dropsies. The subcutaneous injection of 20 c.c. of a saturated solution of magnesium sulphate (Squibb’s) in each side of the neck of a horse, twice daily, will relieve the spasms of tetanus. Mohler and EHichorn in a severe acute case gave this treatment with complete recovery. The spasms began to relax on the fifth day and on the twelfth day the injection was given once daily for another 10 days. Antitoxin should be used also to neutralize the toxins.. Ten drams of a 25 per cent. solution have been injected intraspinally with good effect in equine tetanus, but such treat- ment is not without danger. 156 INORGANIC AGENTS Maenesir Carponas. Magnesium Carbonate. (MgCo,), Mg(OH),-+5H,0. (U.S. P.) Synonym.—Magnesii carbonas ponderosa, or magnesii carbonas levis, B. P.; magnesia alba, magnesia hydricocarbonica, carbonas magnesicus, carbonate of magnesia, E.; magnesia carbonica, P.G. ; carbonate de magnésié, magnésie blanche, Fr.; weisse magnesia, G. Derivation.—Mix concentrated, boiling, aqueous solutions of magnesium sulphate and sodium carbonate, and evaporate. 5MeSO, + 5Na,CO, + H,O = (MgCO,),Me,(OH), + NA,SO, + CO. Purified by digestion with water, filtration a drying. Properties.—Slight, white, friable masses (heavy magnesium), or a bulky, white powder (light magnesium), without odor, and having a slightly earthy taste; permanent in the air; almost in- soluble in water, to which, however, it imparts a slightly alkaline reaction ; insoluble in alcohol. Dose.—Foals and calves, 3 i.-ii. (4.-8.); D., gr.v.-3 1. (.3-4.). Maenestt Oxtpum. Magnesium Oxide or Magnesia. MgO. (U.S. & B. P.) Synonym.—Magnesia levis, light magnesia, B. P.; calcined mag- nesia, magnesia calcinata, E.; magnesia usta, P. G.; magnésie caleinée, Fr.; gebrannte magnesia, G. Derivation—Heat magnesium carborate. 4 (MgCO,) Mg (OH),.+ 5 H,O=5 MgO+6 H,O+4CO,. Water and carbon dioxide are driven off and magnesia (MgO) is left. Properties—A white, very bulky, very fine powder, without odor, and having an earthy, but not a saline taste. On exposure to the air it absorbs moisture and carbon dioxide; almost insoluble in water; insoluble in alcohol. Dose.—Foals and calves, 5 1-11. (4.-8.); D., gr.v. Bi, (.3-4.). Maenesit Oxipum Ponprrosum. Heavy Magnesium Oxide, or Heavy Magnesia. MgO. (U.S. P.) Derwation.—Made from light magnesia by trituration with alcohol, drying and pulverizing. Properties.—A white, dense, very fine powder. Only differs in tests from hght magnesia in that it does not readily unite with water to form a gelatinous hydroxide. ALUMINUM 157 Dose.—Foals and calves, 5 1.-11. (4.-8.); D., gr.v.-3 1. (.8-4). ACTION OF MAGNESIUM CARBONATES AND OXIDES. Internal.—Alimentary Canal.—These salts are antacid and counteract abnormal acidity when exhibited after a meal. The car- bonate also exerts a sedative action in liberating carbon dioxide in the stomach, and both the carbonate and oxide unite with the gastric juice to form chlorides, lactates and bicarbonates. These compounds are mild, saline purgatives. Blood and Urine-——The oxide and carbonate of magnesium alkalize the blood and urine, and are slight diuretics. They resemble potassium and sodium bicarbonates, as antacids, but are milder be- cause feebly absorbed. Uses.—Philhip’s milk of magnesia is a good laxative and ant- acid preparation for puppies. One or more teaspoonfuls may be added to milk, which will be taken voluntarily. Magnesia is a use- ful remedy for foals and calves affected with intestinal indigestion, tympanites and acid diarrhea. It may be given to advantage in powder: magnesia and rhubarb, 2 drachms each; with ginger, one drachm. This dose should be administered in milk or flour gruel. Magnesia may give rise to intestinal concretions if its use is persisted in for a considerable period. Maenesium carbonate and oxide are antidotes to mineral acids, oxalic acid, salts of mercury, arsenic and copper, and alkaloids, by alkalizing the gastric contents and rendering these bodies insoluble. Arsenic antidote is kept on hand at drug stores and is made by add- ing solution of ferric sulphate to an aqueous mixture of magnesia (see Ferri Oxidum Hydratum cum Magnesia, p. 186). Heavy Metats: Inctuping ALuMiInuM, CrRIum, PLumsum, Ar- GENTUM, Zincum, Cuprum, BismurHuM, Frrrum, Maneanum anp HyprarcyRum. Aluminum. (The metal is not used as medicine. ) Anumun. Alum. Alk (SO,); —-12 H,0 (U.S. & B. P.) Synonym.—Potassium alum, aluminum and potassium sul- phate, sulphate of aluminum and potassium, E.; alun, sulphate Valumine et de potasse, Fr.; alaun, kalialaun, G. 158 INORGANIC AGENTS Derivation.—From alum slate, clay, shale, or schist, a native mixture of aluminum silicate and iron sulphide. This is roasted and exposed to the air, when the sulphur is oxidized into sulphuric acid and combines in part with aluminum and iron to form sul- phates. The mass is lixiviated with water, and aluminum and iron sulphates together with sulphuric acid are recovered in solution. The solution is concentrated and to it is added potassium chloride. The double sulphate of potassium and aluminum (alum) is formed, which erystallizes out on cooling, while potassium sulphate and ferric chloride remain as bye-products. Alum is purified by recrystalliza- tion. Properties.—Large, colorless, octohedral crystals, sometimes modified by cubes, or crystalline fragments; without odor, but having a sweetish and strongly astringent taste. On exposure to the air the crystals are liable to absorb ammonia and acquire a whitish coat- ing. Soluble in 9 parts of water. It is also soluble in waim glycerin; insoluble in alcohol; reaction acid. Incompatibles.—Iron, lead and mercury salts, alkalies, lime, tartrates and tannic acid. Dose.—H. & C., 3 ii.-iv. (8.-15.) ; Sh. & Sw., gr.xx.-3 i (1.3-4.); 5 gr.v.-x. (.8-.6); emetic, D., 31. (4.). D ALUMEN Exsiccatum. Dried Alum. AIK. (SO,), (U. S. P.) Synonym.—Alumen ustum, B. P.; burnt alum, E.; alum calcine (desseché brulé), Fr.; gebrannter alaum, G. Derivation.—Heat 100 em. of alum moderately until aqueous vapor ceases to be disengaged, and the product is reduced to 55 gm. Axtumint Hyproxipum. Aluminum Hydroxide. Al,(OH), (ies, 2 Synonym.—Aluminum hydrate, hydrated alumina, E. ; alumine, Fr.; thonerdehydrat, reine thonerde, G. Deriwation.— Alum, 100 gm.; monohydrated sodium carbonate, 43 9m.; water, a sufficient quantity. Mix hot, boiling solutions of alum and sodium carbonate. Precipitate strained, washed and dried. Properties.—A white, light, amorphous powder; odorless and tasteless; permanent in dry air; insoluble in water or alcohol. Dose.—Same as alum. ALUMINUM SULPHATE ; 159 | Atumini Sutpuas. Aluminum Sulphate. Al,(SO,), +16 H,O. Synonym.—Sulphate of aluminum, E.; sulphate d’alumine, Fr. ; schwefelsiure thonerde, G. Derwation.—Aluminum hydroxide [Al (OH),] is dissolved in diluted sulphuric acid, and the solution is filtered and evaporated to dryness. Properties.—A white, crystalline powder, without odor, having a sweetish and afterwards astringent taste; permanent in the air; soluble in one part of water; insoluble in alcohol; reaction acid. Dose.—Same as alum. AtumMiInuM SAtts. Action Hxternal.—Dried alum is a superficial caustic, in con- tact with raw surfaces, on account of its affinity for water. It is only used externally. Alum has no action on unbroken skin, but applied to mucous membranes or denuded parts it is antiseptic and astrin- gent; coagulates albumin of discharges; precipitates or coagulates albumin of the tissues; squeezes blood out of the vessels; reduces in- flammation and makes the part whiter, tougher and denser. Alum is an hemostatic, stopping bleeding by compression of the structures surrounding the vessels, and by causing blood to clot. Alum coagu- lates casein and gelatine in the presence of an alkali. Action Internal.—Stomach and Intestines ——Enormous doses of alum produce gastro-enteritis, while large doses cause vomiting in earnivora. All the secretions are diminished in the alimentary canal, and constipation ensues, unless the dose is excessive. Traces of alum aie said to appear in the urine, but little is absorbed from the diges- tive tract and systemic poisoning is not caused by the ingestion of alum. Intravenous injection of salts of aluminum produce vomiting, weakness, tremors, convulsions, paraplegia, diarrhea, and nephritis. Aluminum induces degeneration of the brain and cord, and inflam- mation of the bowel and kidneys in its elimination by these parts— hke the other heavy metals. Alum does not, therefore, occasion any astringent action in the body outside of the digestive tract, and is ex- ereted by the bowels. Uses External.—Alum is employed mainly for local surgical purposes. In arresting slight hemorrhages it may be applied in saturated solution on absorbent cotton pledgets, or in the form of burnt alum dusted upon the bleeding surface. Epistaxis may be controlled by the injection of a strong solution into the nostrils, or 160 INORGANIC AGENTS by insufflation of burnt alum, Alum is sometimes used on granulat- ing surfaces of indolent ulcers, or wounds, as a slight caustic, stimu- lant and antiseptic. It can be employed alone, or as a dusting pow- der, containing: alum, 1 part; charcoal, 4 parts; and salicylic acid, 2 parts. Alumen exsiccatum will often prevent the escape of synovia from small punctured wounds when applied to their apertures. So- lutions (gr.iii.-v. to 5 i.) are occasionally instilled into the eye in conjunctivitis, but alum is not generally so satisfactory as boric acid, zine sulphate, or silver nitrate, in this disease. Alum crystals may be applied with profit to granular lids. Alum is used more fre- quently in the treatment of stomatitis, or apthous sore mouth. It | is also beneficial in ptyalism. A 5 per cent. solution may be utilized to touch the inflamed oral parts by means of a swab. A spray of the same strength is serviceable for the cure of laryngitis and bron- chitis in dogs. A 2 per cent. solution is appropriate as an injection for otor- rhea, or canker of the ear, attacking dogs. A similar solution will relics leucorrhea, pruritus vulvee, and prolapsus ani. The following combination, containing dried alum, forms an excellent preparation for application to dead tissue. It causes sloughing of the necrotic mass and is indicated when the use of the knife is inadmissible. R TAINS? CSIC CA lca trusts aieeren: hence ear nae 25.0 ACIGIS ATSENOSIT a icteure ise Shere see cas ene meee oe 15:0 Acidi anboliciviseca ois skiateoete an cen oes 10.0 COT ERGL Ass ced aleurone netuc eed abe on cementite ch oe 25.0 M. et fiat unguentum. Uses Internal—Alum is a prompt, safe and non-depressing emetic for dogs. It is suitable in poisoning, or when the secretions are excessive in laryngitis or bronchitis. Teaspoonful doses should be given in solution in syrup every 15 minutes in these latter diseases, until vomiting occurs. Alum in the proportion of 1 dram to the pint of warm water makes an excellent enema for emptying the bowels. Aluminum hydroxide is an antacid and astringent. It combines with acid in the stomach (antacid) and goes into a soluble form when it acts as an astringent in the bowels. It is, therefore, more applicable for internal use in the treatment of diarrhea and dysentery. Other astringents, such as tannic acid in some form, lead acetate, or copper sulphate, are, however, usually more valuable in diarrheal disorders. Aluminum sulphate may be used inter- changeably with alum, externally or internally. wail CERIUM OXALATE 161 Cerium. (Cerium is not employed medicinally.) Crrit Oxaras. Cerium Oxalate. Ce, (C,0,), +9 H,O. (UG TS ts 18 es) Synonym.—Cerous oxalate. Derivation.—Precipitate a solution of ammonium oxalate with a soluble salt of cerium. Properties.—A white, granular powder, without odor or taste, and permanent in the air; insoluble in water, aicohol or ether. Dose.—D., gy.iii.-v. (.18-.3). a Action and Uses.—The physiological details concerning the action of cerium are unknown. It is useful in relieving vomiting of a retlex or nervous character, and is often combined with bismuth salts. Cerium is absorbed with difficulty from the digestive tract. Given intravenously, it produces poisoning resembling that of bis- muth. SECTION IV. Prumsum, ArcentuM, Zincum, Cuprrm anp BismutTuvum. Plumbum. (Lead is not used in the metallic state in veterinary medicine, except as a last resort.) Prumer Oxtpum. Lead Oxide. PbO. (U.S. & B. P.) - Synonym.—Litharge, E.; lithargyrum, P.G.; bleiglatte, G. Derivation.—Made by roasting lead in the air. Properties—A heavy, yellowish or reddish-yellow powder, or minute scales, without odor or taste. On exposure to the air it slowly absorbs moisture and carbon dioxide. Almost insoluble in water; insoluble in aleohol. Reaction faintly alkaline. ead oxide is only valuable for its preparations. 162 1NORGANIC AGENTS PREPARATION. Emplastrum Plumbi. Lead Plaster. (U.S. & B. P.) (Diachyion Plaster.) Lead acetate, 60; soap, 150; water, a sufficient quantity. Basis of other preparations. Prumsi Acwras. Lead acetate. Pb(C,H,0,), + 3 H,O. (U. S. & B. P.) Synonym.—Sugar of lead, E.; sel, (suecre) de saturne, Fr.; essigsaures bleioxyd, bleizucker, G. Derivation.—FHeat lead oxide in acetic acid and water. Poo + 2 HC.H,0O, + H,O = Pb(C,H;,0.). + 3 H,O. Lead acetate crystallizes on cooling. Properties.—Colorless, shining, trausparent, monoclinic prisms or plates, or heavy, white crystalline masses, or granular crystals, having a faintly acetous odor and a sweetish, astringent, afterwards mctallic taste. Efflorescent and absorbing carbon dioxide on exposure to the air. Soluble in 2 parts of water and in 30 parts of alcohol. Reaction slightly acid. Incompatibles—Hard water, alkalies, mineral acids and salts, potassium iodide, opium, vegetable astringents and albuminous liquids. Dose.—H. & C., 31.(4.); Sh. & Sw., gr.xv.-xx.(1.-1.3); D., grill. (.06-.12). PREPARATIONS. Made from lead acetate in which lead exists as the subacetate, PbO (CH,COO)>.. Liquor Plumbi Subacetatis. Solution of Lead Subacetate. (U. S. P.) Liquor Plumbi Subacetatis Fortis. (B. P.) Synonym.—Goulard’s extract, acetum plumbi; cum acetum saturni, plumbum hydrico-aceticum solutum, subacetas plumbicus liquidus, E.; liquor plumbici subacetici, P. G.; sous-acetate de plomb liquide, extract de Goulard de vinaigre, plomb, Fr.; bleiessig, G. Composition—An aqueous liquid, containing in solution about 25 per cent. of lead subacetate (approximately), Pb,O (CH;COO),. LEAD CARBONATE 163 Liquor Piumdi Subacetatis Dilutus. Diluted Solution of Lead Subacetate. (U. S. & B. P.) Synonym.—Lead Water. Lead subacetate, 40; water to make 1000. Ceratum Plumbi Subacetatis. Cerate of Lead Subacetate. (U.S. P.) Solution of lead subacetate, 20: camphor, 2; wool fat, 20; paraffin, 20; white petrolatum, 38. Prumsgi Carponas. Lead Carbonate. (PbCO;). Pb(OH).. (Non-official. ) Synonym.—White lead, E.; céruse, Fr.; bleiweiss, G. Derivation.—Expose lead to the action of acetic acid vapor and air with carbonic dioxide. 4 Pb + 2 HC,H,0, + 2 O, + 2 CO, = (PbkCo,)2 Pb (OH), + Pb(C,H;0.)>. Properties—-A heavy, white, opaque powder, or a pulverulent mass, without odor or taste. Permanent in air. Insoluble in water or alcohol. Used only externally. Prumst Nirras. Lead Nitrate. Ph (NO;).. (U. 8. & B. P.) Synonym.—Salpetersaures bleioxyd, bleisalpeter, G. Derwation.—Dissolve lead in nitric acid. Properties.—Colorless, transparent, octohedral crystals, or white, nearly opaque crystals; without odor, and having a sweetish, astringent, and afterwards metallic taste; permanent in the air; reaction acid; soluble in 1.85 parts of water; almost insoluble in aicohecl. Only used externally in 1 per cent. solution as an astringent and deodorant in gangrenous surfaces. ete. Prumer loprpum. Lead Iodide. Pb I,. (U.S. & B. P.) Derwwation.—Treat solution of lead nitrate with that of potas- sium iodide. Pb (NO,). + 2 KI = Pb], + 2 KNO;. Dry the precipitate. Properties.—A heavy, bright, yellow powder, without odor or taste; permanent in the air; soluble in about 1,300 parts of water; very slightly soluble in aleohol; used only externally. 164 INORGANIC AGENTS PREPARATION. Unguentum Plumbi Iodidi. Ointment of Lead Iodide. (B. P.) Employed externally to absorb glandular swellings. ACTION OF LEAD SALTS. Eaternal.—Soluble lead salts differ somewhat from salts of the other heavy metals in being more astringent and less irritant. This happens because they form a denser precipitate with albumin of the tissues and of secretions. The acetate which is generally used is dissociated slowly in solution in contact with the tissues. The metallic ion coagulates albumin by forming a lead albuminate, so producing a protective pellicle over raw surfaces; while the acid - constituent has little effect (lack of irritation). The acetate thus makes the tissues drier, denser and harder—and contracts vessels— but has no action on the unbroken skin. Internal.—Soluble salts of: lead in concentrated solution—and at times insoluble salts—cause gastro-enteritis in large doses. Lead salts are absorbed in medicinal doses whether taken in a soluble or insoluble state. The chemical form of the lead compound at the time of absorption is unknown. Lead is deposited in the tissues, es- pecially in the liver and kidney, and is very slowly eliminated in the urine and intestinal mucus, bile, milk and saliva. ‘Lead salts have a marked astringent action on the entire digestive canal and diminish secretions accordingly. After absorption lead salts have no remote astringent action. Toxicology.—Poisoning not infrequently occurs in animals at pasture, from eating paint, sheet lead, or products of lead or smelt- ing works. The drinking water may be contaminated with lead, especially from new pipes, or lead receptacles in which water has been standing. Hard water is not affected by lead pipes, since an insoluble crust of lead phosphate and sulphate is deposited upon the interior of the pipes. There is an acute and chronic form of poison- ing. The first is caused by single large doses of soluble lead salts, and is characterized by gastro-enteritis and colic; rarely there are symptoms of absorption, as convulsions, coma, paralysis and death. The feces are sometimes colored black with lead sulphide; the vomitus is white from lead chloride. Three groups of symptoms may be briefly tabulated, which occur to a greater or less degree in chronic lead poisoning: ACTION OF LEAD SALTS 165 DIGESTIVE SYMPTOMS. Lead line on gums. Thirst. Colic. Abdomen retracted, or “tucked Constipation. up.” Anorexia. NERVOUS SYMPTOMS. Paralysis of tendons—extensors— Anesthesia. of extremities. Arthralgia. Animals stand on knees before. Dizziness. Animals stand on toes behind. Tremors. Convulsions. Delirium. General paralysis. Coma. Wasting of muscles. Amblyopia. The nervous symptoms are due to peripheral neuritis and to influence on the brain and cord. GENERAL SYMPTOMS. Dyspnea. Edema. Pulse accelerated. General debility. Emaciation. Interstitial nephritis. Anemia. Animals die in chronic poisoning from paralysis of the respira- tory muscles, or in convulsions. ‘The lead line (gray or black dotted appearance) on the margin of the gums, at their junction with the teeth on the lower jaw, is due to sulphuretted hydrogen in the mouth, acting upon the lead deposited in the gums, and forming lead sulphide. The treatment consists in removing the cause, relieving the symptoms and in hastening elimination. Potassium iodide eliminates lead in a soluble form into the bowels and kidneys. Magnesium sulphate converts lead into an insoluble sulphate in the intestines and then sweeps out the salt. The stomach pump or emetics should be employed in acute poisoning. Alum is the best emetic. This treatment should be followed by the administration of opium and Epsom salts. Administration.—Lead acetate is given to the larger animals in solution or ball; to the smaller patients in pill; to young animals in solution in milk. Uses External.—Lead acetate is useful in the treatment of skin diseases, as weeping eczema and erythema, and in excoriations, 166 INORGANIC AGENTS blistered surfaces, bruises, strains, and burns. An efficient loticn having an astringent and sedative action in such conditions. con- tains: laudanum, 1 part; Goulard’s extract, 4 parts; and oil, glycerin or water, 16 parts. The “white lotion” of veterinary medicine is made by adding 3 drachms each of lead acetate and zine sulphate to a pint of water. It is a favorite astringent, sedative and antiseptic application for strains, bruises, scratches, bursitis and tenosynovitis in horses. Compresses soaked in it are bandaged to the part. Also it is of value as an injection in urethritis, and ex- ternally in balanitis of dogs. The stronger solution of lead subacetate., should not be employed extensively on raw surfaces or muccus mem- branes undiluted. The diluted solution of lead subacetate may be used as an injection for leucorrhea. Lead acetate should be diluted with 20 to 40 parts of vinegar or water. Lead acetate is not suitable for collyria, if there is any ulceration of tlie cornea, because a perma- nent tilm may be deposited and obscure the sight. Lead iodide, in 10 to 20 per cent. ointment with petrolatum, has proven of service in aiding resolution of induration or caked condition of the udder in acute mammitis, if applied twice daily with thorough massage, before suppuration has set in. Uses Internal.—Lead acetate is serviceable in the treatment of diarrhex, dysentery, and hemorrhage from the stomach and bowels. It is frequently prescribed in these diseases with opium, but should not be used over a long period. \ Argentum. Arcentr Nrrras. Silver Nitrate. AgNo,. CU. S.:&:B.-P2) Derwation.—Dissolve silver in nitric acid with heat. 3 Ago + 6 HNO, = 6 AgNO, +3 H,. Evaporate and erys- tailize Properties.—-Colorless, transparent, tabular, rhombic crystals, becoming gray, or grayish-black on exposure to light in the presence of organic matter; without odor, but having a bitter, caustic and strongly metallic taste; reaction neutral; soluble in 0.54 part of water and 24 parts of alcohol. Incompatibles.—Alkalies and their carbonates, acids except (nitric and acetic), chlorides, potassium iodide, astringent infusions and solutions of arsenic. Dose.—H. & ©., gr.v.-x. (.8-.6); Sh. & Sw., grit. (.06-:12) ; D., gr. +4 (.008-.03). MITIGATED SILVER NITRATE 167 Areenti Nirras Mrricatus. Mitigated Silver Nitrate. (U.S. P.) Synonym.—Argenti et potassi nitras, B. P.; mitigated caustic, E.; argentum nitricum erystallizatum, P. G.; azotas (nitras) argen- ticus, azotate d’argent, nitre lunaire, Fr.; salpetersaures silveroxyd, silbersalpeter, G. Derwation.—Melt silver nitrate, 30, with potassium nitrate, 60, in a crucible at as low a temperature as possible. Mix and cast into suitable moulds. Properties.—A white, hard solid, generally in the form of pen- cils or cones of a finely granular fracture; becoming gray or grayish- black on exposure to light in presence of organic matter; odorless, having a caustic, metallic taste, and neutral reaction. Each of its constituents soluble in water and alcohol to the extent mentioned under. Argenti Nitras and Potassii Nitras. Used only externally. Arernti Nirras Fusus. Moulded Silver Nitrate. (U.S. P.) Synonym.—Lunar caustic, lapis infernalis, azotas (nitias) argenticus fusus E.; argentum nitricum fusum, P. G.; azotate d’ar- gent fondu pierre infernale, F.; héllenstein, geschmolzenes salpeter- saures silberoxyd, G. Derivation.—Melt silver nitrate, 100, with hydrochloric acid, 4, at as low a temperature as possible. Mix and pour into suitable moulds. Properties.—Practically same as above. Used only externally. Silver oxide, cyanide, and iodide are official, but unimportant in veterinary medicine. ACTION OF SILVER NITRATE. External.—Silver nitrate is more caustic in action than any of the lead, copper or zinc salts (except zine chloride). When applied externally in the pure state to a mucous membrane, or a raw surface, it forms a white coating of coagulated protein, or silver albuminate. This coating limits the further action of the salt, so that lunar caustic is always superficial and localized in its effect. Silver nitrate is the caustic in most common use, since it produces a more healthy condition in a granulating wound after its application and separation of the eschar. Silver compounds are powerfully anti- septic because silver itself is actively antiseptic and because the nitrate destroys germs in coagulating their proteid protoplasm. In 168 INORGANIC AGENTS dilution, silver nitrate is stimulant, astringent, antiseptic and caus- tic, according to its strength. Internal. Silver nitrate is probably precipitated to a con- siderable extent by the hydrochloric acid of the gastric juice, as the chloride. Some of it is possibly converted into the albuminate, and absorbed as such. When ingested for a long period silver is deposited in the tissues in the form of the oxide, causing dark stain- ing of the skin in man. These stains, occurring when silver nitrate comes in direct contact with the skin, can be removed by a solution containing potassium cyanide, 214 drachms; iodine, 15 grains; and water, 3 ounces. Large doses of silver nitrate cause gastro-enteritis with nervous symptoms—paralysis and convulsions—and death from depression of the respiratory centres. Common galt is the antidote, both externally and internally, forming the insoluble chloride. In addition to salt, opium and demulcents should be ex- hibited in acute poisoning. Silver nitrate in medicinal doses has probably a local stimulating, astringent and alterative action on the mucous membrane of the stomach; to a less degree on the bowels. Elimination may not take place at all—inert organic compounds being deposited in various parts of the body—or may occur slightly from the epithelium of the digestive tract. A chronic form of poisoning by silver nitrate (argyrism) is seen in man, following its continued use, and is accompanied by pigmentation of the skin, marasmus, chronic indigestion, with wasting of the testes and mam- mary glands. A similar condition has been produced in animals, associated with anorexia, weakness, anemia and emaciation. _ Uses External. An aqueous solution (grill. to 4 1.) is most valuable in treatment of catarrhal conjunctivitis, while a stronger preparation (gr.x. to 5 i.) is employed for purulent conjunctivitis, as a stimulant, astringent and antiseptic collyrium. When strong solutions, like the latter, are used, the eye should immediately be flooded with a solution of common salt and water to precipitate the excess of silver nitrate as the insoluble chloride and thus prevent further irritation. Lunar caustic is applied in pencil form to ulcerated surfaces. When these surfaces are touched lightly the caustic stimulates sluggish granulations; when more heavily, it destroys exuberant granulations. In 2 to 4 per cent. solution, silver nitrate is caustic to mucous membranes; in 14 per cent. solution it is stimulant and astringent to mucous membranes. Boils may be aborted by painting them with a saturated solu- tion of silver nitrate. Pruritus ani, or vulve, is relieved by paint- ing the parts several times daily with a 4 per cent. solution. A solution (gr.ili. to 5 i.) may be used in the form of spray in the treatment of pharyngitis and laryngitis in the dog. In catarrh of Se Le PROTARGOL 169 the external ear, so common in dogs, the canal should be swabbed with a 5 per cent. watery solution of silver nitrate after thorough cleansing with ether, or alcohol and naphtha, to remove dirt and ‘sebaceous matter. In 2 to 6 per cent. solutions silver nitrate is curative in moist patches of eczema in dogs. Fissures in the skin occurring in sore teats of cows are cured by the application of fused silver nitrate. Uses Internal.—The erystals should only be employed inter- nally, to insure purity. Silver nitrate is not of much value for in- ternal use except in the digestive tract. Pills containing the silver salt are sometimes given to dogs with diarrhea and ulcer of the stomach. Dysentery may be treated by enemata containing 12 grains of silver nitrate to the ounce of water. If this treatment is followed by much irritation, injections of sait and water should be used afterwards. Protareor. (WNon-official.) Protargol was first introduced into medicine by Prof. Neisser, in 1897, as a local remedy for gonorrhea in man. It is a fine, yellowish-brown, soluble powder, a combination of a protein sub- stance with silver; odorless, and possessing a strong metallic taste. Protargol has recently superseded silver nitrate (which con- tains 64 per cent. of silver) to a considerable extent in medicine because, containing less silver (8.3 per cent.), protargol is decidedly less irritating, is not precipitated by albumin or solutions of sodium chloride, does not discolor the skin and more than equals silver nitrate in certainty and efficiency of action. Protargol is particularly applicable in veterinary medicine as a bland but powerfully penetrating antiseptic and mild astringent in the treatment of inflammatory conditions of the conjunctival membranes. The drug does not cause the pain, redness, swelling and lachrymation which follow the use of silver nitrate; nor does it lead to the formation of fibrinous coagula and the production of false membranes and opacities of the cornea seen after the applica- tion of silver nitrate. A 10-per-cent. solution of protargol induces less flushing of the eye and discomfort than a 1-per-cent solution of silver nitrate, and the irritation of a 2 or 4 per cent. solution is not, as a rule, more than would be produced by one-half grain to the ounce solution of zine sulphate (Cheney). Protargol is indicated in acute catarrhal and purulent con- junctivitis in from one-half to 10 per cent. aqueous solutions; 170 INORGANIC AGENTS usually in one-half per cent. solution in the catarrhal form, two or three times daily, appled with a camel’s hair brush or by instilla- tion; and in the purulent variety, in 2 or 4 per cent. solution with a pledget of absorbent cotton on a probe, or with a camel’s hair brush, in conjunction with frequent boric acid irrigations. This new silver combination has also been used with reported success (and the use might apply to canine practice) in human medicine as a non- irritating astringent and antiseptic agent internally in .5 gm. doses, twice or thrice daily, in pills, for the relief of hemorrhages and ulcer- ations of the alimentary canal, in diarrhea and in purulent inflam- mation of the genito-urinary tract. Kingston reports favorable results in purpura hemorrhagica in horses from the intravenous in- jection of one ounce of a 5 per cent. solution of protargol twice daily. ARGYROL. Argyrol represents one of the latest of the numerous organic silver compounds, this preparation containing as much as 20 to 25 per cent. of the metal combined with a proteid substance obtained from wheat. It occurs as a brownish powder, soluble in less than its own weight of water, forming dark-brown solutions which stain clothing black, but the stains may be removed by solutions of corrosive sublimate. Like protargol, it is not precipitated by the salts of the tissues, nor does it coagulate albumin, so that its action is not neu- tralized by the tissues—as is the case with silver nitrate; and thus, unlike the latter, it possesses a penetrating puwer when applied locally. Argyrol is used in from 5 to 50 per cent. aqueous solution for the same purposes to which protargol is adapted. Solutions of argyrol should be freshly made. Argyrol is the most valuable silver substitute we have and so far from being irritating is actuallv seda- tive in 10 per cent. solution. In inflammatory diseases of the mucous membranes of the eye, urethra and bladder it has no equal. SoLuBLE SILVER. Soluble silver, known also as Colloidal Silver, or more com- monly as Collargol, is an allotropic form of metallic silver (87 per cent. silver) wholly soluble in water, and discovered by Lea about 1890. It may be used intravenously, subcutaneously, by inunction (as Credé’s ointment, see below), and by the mouth, if first dissolved in the proportion of five parts of collargol with one part of white of egg in one hundred parts of water; or it may be given in pill with SOLUBLE SILVER 171 sugar of milk.* When given intravenously—which is the most effective mode of administration—one injection may suffice, but if it does not cause immediate improvement in the symptoms, several doses may thus be given at six-hour intervals. Soluble silver has recently preven successful in many cases of general infection, where it appears to either kill or inhibit the growth of staphylococci and streptococci. It is certainly worthy of trial in veterinary medicine in this field, where it has accomplished noteworthy results.+ Puerperal septicemia, mastitis, extensive cellulitis, fetid bronchitis, pneumonia, influenza, endo and pericarditis, deep sup- purations, phlebitis, suppurating nasal sinusitis, empyema and other bacterial infections have yielded to the systemic and local influence of soluble silver in human medicine. Its expense is the only ob- jection to its free emplovment in animal practice, and this applies to all the new organic silver compounds. A rigor often occurs froin one to four hours after the injection of collargol, but no other ill effects have been noted. When the silver can be used locally (in local infections) it is also effective and may or may not be at the same time given intravenously, its desirability by the latter mode depending on the degree of general infection. The dose intra- venously is 314-1 (2.-4.) for horses; dogs, gr. 1-2 (.06-0.12), given in 2 to 5 per cent. aqueous solution. It is injected into the tissues as in abscess, in 1 per cent. solutions. It is soluble in 20 parts of water, which should be distilled or boiled, and solutions in water may be kept for months in brown bottles. Solutions, from having a clear, brown color, become gray and turbid when decomposed. 1-3000 aqueous solutions are appropriate for use on mucous mem- branes or cavities of the body. Credé’s Ointment, made by incorporating collargol with lard and wax to the extent of 15 per cent., has given good results when rubbed for thirty minutes into the skin (which has previously been scrubbed with soap, water and alcohol) in the treatment of local and even general infections. It often arrests the formation of boils, threatened suppuration of glands, lymphangitis, phlebitis, cellulitis and mastitis. The dose by inunction is 4% to 1 ounce for horses, 1% to 1 drachm for dogs. Collargol appears to be non-toxic wi:en given intravenously or by inunction, if used with reasonable care. * Collargol has been also given with benefit by the rectum (Mal. a eens yi in foals and calves. 172 INORGANIC AGENTS Zincum. (Zine is not used in Medicine in the metallic state.) Zinct CuLoripum. Zine Chloride. ZnCl, (U.S. & B. P.) Derivation.—Dissolve zine in hydrochloric acid by boiling. The solution contains the zine chloride with chlorides of iron and lead as impurities. These are precipitated by adding first nitric acid then zine carbonate. Filter and finally evaporate. Zm, + 2 HCl 27a Cl, 4-2 its Properties—A white, granular powder, or porcelain-like masses, irregular or moulded into pencils; odorless; of such in- tensely caustic properties as to make tasting dangerous unless the salt be dissolved in much water, when it has an astringent, metallic taste; very deliquescent; reaction acid; soluble in about 0.4 part of water; very soluble in alcohol. Liquor Zinct Cutorip:. Solution of Zine Chloride. (U.S. & BP.) Derivation.—Made as above with the addition of water. It contains about 50 per cent., by weight, of zine chloride. Properties.—A clear, colorless liquid, odorless, having a very astringent, metallic taste and an acid reaction. Spec. gr. about pa shatwo. CAC! ey, Toxicology.—Zine chloride is a powerful irritant if swallowed in any degree of concentration, and will, therefore, produce gastro- enteritis. Emétics or the stomach tube should be used, followed by demulcents and sodium bicarbonate. Uses.—Zine chloride is employed in a paste made into small pieces with flour; or on lint soaked in a saturated solution, dried, and introduced under the skin about the base of tumors to cause their destruction by sloughing. It is employed in the form of pen- ceils on unhealthy, granulating surfaces, as in “foot rot,” and in- jected in strong solution into fistulous tracts to destroy their walls. It is not used internally. Zinct Sutpuas. Zine Sulphate. ZnSo,-+ 7 H,O. (Uz S..8 BPs) Derivation.—Prepared by dissolving zine in sulphuric acid. Zn, + 2 H,SO, = 2 ZnSO, + 2 Ha. PRECIPITATED ZINC CARBONATE 173 Iron and tin exist as impurities, and are removed by chlorine solution and zine carbonate. Properties.—Colorless, transparent, rhombic crystals, without odor, and having an astringent, metallic taste. Efflorescent in dry air; reaction acid; soluble in 0.53 part of water, in 3 parts of glycerin ; insoluble in alcohol. Incompatibles.—Lead acetate, silver nitrate, lime water, al- kalies and carbonates, vegetable decoctions or infusions, and milk. Dose.—H. & C., 3 i-ii. (4.-8.); Sh. & Sw., gr.x.-xx. (.6-1.3) ; ) Zinct CarBonas Prazcipiratus. Precipitated Zine Carbonate. (U. S. P.) Synonym.—Zinci carbonas, B. P.; precipitated zine carbonate, kohlensaures zinkoxyd, G. Derwation.—Solutions of nearly equal ‘weight of sodium car- bonate and zine sulphate are boiled together; dry precipitate. 8 ZnSO, + 8 Na,CO, + 2 H,O = 2 (ZnCO;), Zn (OH).? (hy- drated basic zine carbonate) + 8 Na,SO,-+ 2 CO,. This salt is in reality a mixture of zine carbonate and oxide, in varying propor- tions, with water of crystallization. Properties.—An impalpable white powder, of somewhat vari- able chemical composition, without odor or taste; insoluble in water or alcohol. Zinct Oxipum. Zine Oxide. Zn O. (U.S. & B. P.) Derivation.—Heat the carbonate to redness. 2 (Zn CO;), Zn(OH), = 8 ZO + 2 HO + 6 CO,. Properties—An amorphous, white powder, without odor or taste. It gradually absorbs carbon dioxide from the air. Insoluble in water or alcohol. Dose.—H. & C., 3 iii. (4.-8.); D., gr.v.-x. (.3.6). PREPARATION. Unguentum Zinci Oxidi. Ointment of Zine Oxide. (U. 8. P.) Zine oxide, 200: benzoinated lard, 800. (U.S. P.) Unguentum Zinci. 15 per cent. of zine ointment. (B. P.) 174 INORGANIC AGENTS Zinct Acretas. Zine Acetate. Zn (C,.H;0,.), +2 H.O. (U.S. &*B. P.) Derwation.—Dissolve zine oxide in diluted acetic acid and boil. ZnO + 2 HC,H,0, = Zn(C,H,0,).-+ H,O. Evaporate and crystallize. Properties.—Soft, white, six-sided monoclinic plates, of a pearly lustre, having a faintly acetous odor, and an astringent metal- lic taste. Exposed to the air the salt gradually effloresces and loses some of its acid; reaction acid; soluble i in 2.5 parts of water and in 36 parts of alcohol. Incompatibles.—Same as sulphate. Dose.—Same as sulphate. ACTION OF THE ZINC SALTS. EHaternal.—The salts of zine (except the chloride) have an astringent action on raw surfaces and mucous membranes in pre- cipitating solutions of proteids, as zinc albuminate, notably the sul- phate and acetate. Absorption is not followed by poisoning, as most of the zine is stored in the liver. They resemble other astringents, especially copper salts, and are more irritating than lead acetate or subacetate. Internal.—In the alimentary tract very large doses of the sul- phate or acetate may induce gastro-enteritis, which is to be treated with demulcents and alkaline carbonates in order to form insoluble compounds. Vomiting will relieve carnivora; otherwise the stomach tube must be resorted to. Zine salts apparently produce no remote effects upon the bodv when ingested. Given intravenously (double salts) to mammals, zine causes vomiting, diarrhea, muscular weakness and_ paralysis. It is eliminated chiefly by the alimentary tract and slightly in the bile and urine. In therapeutic doses the zine salts are astringent, dimin- ishing secretion in the digestive tract. USES OF ZINC SALTS. External.—Zine sulphate is in common use as an astringent collvrium for subacute conjunctivitis (gr.ss.-ii. to 3 i.). It is also emploved in the treatment of canker of the ear in dogs (gr.x to % i.), or as “white lotion” (see Plumbi Acetas), in this affection. USES OF ZINC SALTS 175 In diseases of the feet, as in canker of the horse, equal parts of zine, copper and iron sulphates with 5 per cent. carbolic acid and vaseline q. s. to make a paste, are of value. The salt is likewise serviceable as a stimulant and astringent solution (gr.li.-v. to 3 i.) in moist eczema, ulcers, atonic inflamma- tions of mucous membranes, balanitis and urethritis in dogs, and leucorrhea. Zine carbonate is a much milder astringent than zine sulphate or acetate. The impure carbonate (calamine) is an ingredient of the popular astringent and antiseptic “pink ointment” of veterinary medicine used for the cure of “scratches” in horses. Zinci carbonatis (impure).............56- 3 ii. INUTOGME” Gaeeodabo 600s Jolasitdcdcouc co oas 3 iss. Calciigearbrsprecipirassre \-jaioicrer-is ios) ole 3 X. Creosoti Germ havi pent ieaer comics lereeiote stolen? aa 3 iss. Adipis PRIA Ts TA Trias pe Te ae cee eS RV M. S. External use. ee _ The lard and wax are first melted together and then the other ingredients are stirred in. Calamine in the form of a lotion is a more cleanly application for house dogs and pets than ointment or paste. The following is useful in dermatitis, erythema and moist eczema attended with itching. The carbolic acid may be omitted when the lotion is applied over a large surface to avoid pois- oning by absorption or from the acid being licked off by the patient. BR Ex Acidis, carbolici.. acc; 5.03240 fesse 1.0 gr.xv. VALI Oxsthes oa ooddbancacobndooo0d 15.0 33s. OMENMNMED Go decudanbosodducoodEs 5.3 gr. 80 (Cliyeomtye Vgdias on dodo socadnocacGo 30.0 § i. Liquoris- calcis ad..........-...+- 240.0 § viii. M. et fiat lotio (shake). Sig. External use. Zine is used externally in the form of a dusting powder, ointment or paste. In eczema, erythema and scratches, the zinc oxide ointment is valuable and can be combined with carbolic acid (gr.x to 3,1.) or creolin (5 per cent.) to great advantage, when itching is a prominent symptom. Still better than zinc ointment is a paste containing zinc“oxide, 2 parts; starch and vaseline, each 3 parts. Zinc acetate can be used in all cases as a substitute for zinc sulphate. 176 INORGANIC AGENTS Internal.—Zine sulphate is the best and most prompt emetic for dogs in many conditions, as poisoning. It should be given in tepid water. Zinc oxide is occasionally prescribed in diarrhea, and empirically as a tonic and antispasmodic in chorea and epilepsy. Zine oxide may be given in powder, pill, or dissolved in alkaline solutions. Zinc VALERATE. See p. 484. Zinc PHospuipe. ‘See p. 219. Cuprum. (Copper is not used in the metallic state in Medicine.) Cuprt SurpHas. Copper Sulphate. Cu So, +5 H.O. : (U8, & Bs P2) Synonym.—Cupric sulphate, blue vitriol, blue stone, sulfas supricus, suprum vitriolatum, E.; cuprum sulfuricum purum, P. G.; vitriol bleu, sulfate de Cuivre, Fr.; kupfervitriol, blauer-vitriol, schwefelsaures kupfer (kupferoxyd), G. Derwation.—Boil metallic copper and sulphuric acid together. 2 Cu+2 H, SO,=2 CuSO,+ 2 H,. Dissolve product in hot water and crystallize. Properties.—Large, transparent, deep blue, triclinic crystals; odorless, of a nauseous, metallic taste; slowly efflorescent in dry air; soluble in 2.2 parts of water; almost insoluble in alcohol; reaction acid. Incompatibles.—Mineral salts (except sulphates), alkalies and their carbonates, iodides, lime water and vegetable astringents. Dose.—H. & C., 3i.-ii. (4.-8.); Sh. & Sw., gr.xx.-xl (1.3-2.6) ; D., gr.i.-il, (.06-.12) ; Emetic—D., gr.vi.-xx. (.36-1.3). ACTION OF COPPER SULPHATE. External.—Copper sulphate precipitates protein in solution and is stimulant, astringent or caustic to mucous membranes or raw surfaces, according to the strength applied. Internal.—In poisonous doses copper sulphate causes salivation, vomiting, gastro-enteritis, and nervous symptoms (convulsions, ACTION OF COPPER SULPHATE EC paralysis and delirium), and finally death from collapse. When in- jected intravenously copper salts lead to destruction of the blood, and fatty degeneration of the liver, kidneys and heart. Rarely does absorption from the digestive tract cause poisoning, since the salt is either vomited, or absorbed too slowly, or stored in the liver. The treatment consists in emptying the stomach in animals which cannot, or do not, vomit, and the use of magnesia, tannin or yellow prussiate of potash, as antidotes; and demulcents, as milk and white of egg, together with opium. Large doses are emetic to the dog, but should not be used except in phosphorus poisoning. Smaller doses are astringent in the digestive tract. The copper absorbed from the ali- mentary tract lodges in the liver, kidneys, and thyroid gland. It is eliminated slowly in the urine, bile, intestinal secretions, saliva and milk. Copper is a normal constituent of the tissues and has a strong affinity for hemoglobin attaching itself, on absorption, to the corpus- cles as cuprohemol. Uses Eaternal.—Copper sulphate is employed in the solid, crys- talline form in granular conjunctivitis, by rubbing the stick over the affected surfaces of the lids. A solution (gr.-ii. to 5 i.) is dropped into the eye for simple conjunctivitis. Copper sulphate is similar in action to zinc sulphate, but more powerful. On ulcerated and granular surfaces it is used as a stimulant and astringent, as in the following mixture, a combination of cupric sulphate and zine sulphate, of each 244 drachms (10gm..), with solution of lead subacetate, 5 drachms (20gm.), which is of value in thrush and canker of the feet in horses, and as an application for chronic sores and unhealthy indolent granulating surfaces. It may also be applied locally with an equal part of dried alum in the form of powder for the treatment of thrush. The disappearance of the moisture and foul odor will soon herald recovery. . In foot root of sheep one part each of copper sulphate and lard, with two of tar, may be prepared by melting and then mixing the ingredients. Two ounces each of zine and copper sulphate in one pint of vinegar are curative when injected into sinuses. Uses Internal.—Copper sulphate is prescribed for its local effect with opium in diarrhea, and injected into the bowel in 2 per cent. solution in ulcerated conditions of the rectum. The sulphate of copper in small doses is believed to be a tonic remedy in anemia and nervous conditions, although without sufficient experimental proof. It is thought to resemble arsenic and to increase the number of cor- puseles, firmness of flesh and amount of fat. Copper sulphate is often used as a vermicide in the treatment of lumbricoid worms and ozena, combined with iron. Copper sulphate in 1 drachm doses (4.0 gm.), with powdered charcoal and fenugreek, of each 1-144 178 INORGANIC AGENTS drachms (6. gm.), given to the horse night and morning for eight to ten days and followed by a brisk cathartic of aloes and linseed oil, will cause the expulsion of ascarides. It is recommended in purpura, and is given to dogs in the form of arsenite of copper for chorea and epilepsy. Copper sulphate, added to reservoirs of drinking water in the proportion of 1 part to 5 to 50 millions of water, destroys algae but is innocuous to animals. Copper sulphate forms an inert com- pound with phosphorus. Hydrogen dioxide or potassium perman- ganate are safer and more effective antidotes in phosphorus poisoning, as too large doses of copper sulphate are required for this purpose. Cupri Acrras. Copper Acetate. (Non-official.) Synonyms.—Verdigris, cupric subacetate, E.; acetate de cuivre, vert-de-gris, F.; grunspau, G. Derwation.—Exposure of copper plates to pomace or residue resulting from expression of juice from grapes in wine making, or to immersion in pyroligneous acid. Propertves.—Pale-green masses of minute, acicular crystals, sometimes of bright blue hue. Verdigris is the impure article; the pure salt is known as Crystals of Venus. The taste is coppery and odor vinegar-like. Soluble in water. Dose.—H. & C., gr.15-30 (1.-2.); Sh. & Sw., gr.5-10 (.8-.6). Action Haternal.—lt is astringent, stimulant and escharotic according to the strength whether applied to the unbroken skin or to mucous membranes or raw surfaces. Action Internal.—This salt is an efficient vermifuge for the expulsion of ascarides from the horse. It should be given in doses of gr.15-30 (1.-2. gm.) twice daily with powdered gentian and char- coal, 1 drachm of each (4.0 gm.), for a week and then be followed by a cathartic dose of aloes. It is a poison in large doses, causing gastro- enteritis, convulsions and death. The antidotes are milk, raw eggs and soap. Bismuthum. (Bismuth is not employed medicinally in the metallic state.) Bismutur Suscarsonas. Bismuth Subearbonate. (BiO),CO, + Ot CUS) be) Synonym.—Bismuthi carbonas, B. P. Derivation Made by dissolving pure metallic bismuth in BISMUTH SUBNITRATE 179 diluted nitric acid, precipitating with ammonia water, and redissolv- ing in nitric acid. ‘This solution is treated with ammonium carbon- ate, or a solution of sodium carbonate. 2Bi (NO;), +38 Na,CO, + H,O = (BiO), CO, + H,O + 2 CO, +6 NaNO,. The precipitated bismuth subcarbonate is fil- tered and washed. Properties—A white, or pale yellowish-white powder, of some- what varying chemical composition; odorless and tasteless, and per- manent in the air. Insoluble in water or alcohol, but completely soluble in nitric or hydrochloric acid, with copious efflorescence. Dose.—-., 3 ii.-iv.(8.-15.))\; D., gr.x.xxx. (.6-2.)). Bismutrur Susnirras. Bismuth Subnitrate. BiO NO, + H.O? GUESS éB4 Ps) Synonym.—Bismuthum subnitricum, P.G.; bismuthum hydri- conitricum, magisterium bismuthi, subazotas (s, subnitras) bismuthi- cus, sous-azotate de bismuth, Fr.; basisches salpetersaures bismuth- oxyd, G. Derwation.—Dissolve pure metallic bismuth in diluted nitric acid. First’ reaction—Bi, + 6 HNO, = 2 Bi (NO,); + 3 Ho. Final reaction—Bi (NO,), + H,O = BiONO,+ 2 HNO,. Evaporate; add water; wash and dry precipitated bismuth subni- trate. Properties—A heavy, white powder of somewhat varying chemical composition; odorless and almost tasteless, and permanent in the air. Almost insoluble in water and insoluble in alcohol, but readily soluble in nitric or hydrochloric acid. Dose.—Same as subcarbonate. Bismutur Supsaricyias. Bismuth Subsalicylate. (U. S. P.} Dose.—D., gr.iv (0.24). Bismutui Supeartas. Bismuth Subgallate. (U. S. P.) Synonym.—Dermatol. Properties.—A fine, amcrphous, yellow powder; permanent in the air and odorless; insoluble in water, ether, alcohol or chloroform ; soluble in acids; used externally as a substitute for iodoform; it is antiseptic and astringent; occasionally given internally. Dose.—D.., gr. v.-x. (.3-.6). 180 INORGANIC AGENTS ACTION OF BISMUTH SUBNITRATE AND SUBCARBONATE. Eaternal.—The insoluble salts of bismuth have a protecting, sedative, astringent and antiseptic action on raw surfaces. If applied over very extensive areas for a considerable length of time, they may cause absorption and poisoning. Bismuth has no action on the un- broken skin. Internal.—The salts of bismuth are absorbed and eliminated to some extent. When administered continuously in enormous doses, or when absorbed from the skin or given intravenously, bismuth has caused stomatitis, vomiting, diarrhea, weakness, convulsions, black- ness of the mucous membranes of the digestive tract, and death. Probably, as ordinarily used, all the bismuth absorbed from the ali- mentary canal is stored in the liver. In poisoning, however, it irri- tates the parts which eliminate it—7.e., the kidneys, mouth and the bowels (chiefly the cecum). An odor of garlic appears in the breath after the continuous exhibition of bismuth, owing to traces of tellu- rium contained in the bismuth. Recently several ounces of bismuth subnitrate have been given at one dose to the human to secure a skiagram of the digestive organs and also have been injected as Beck’s paste to cure suppurating cavities. Poisoning has sometimes occurred following the use of such enormous doses due to the bismuth and also to the transformation of the nitrate into a nitrite. Nausea, vomiting, cyanosis, rapid pulse and respiration, and prostration have been observed in such cases. It is safer to use the subcarbonate or oxychloride when massive doses are given. Two ounces of either may be given internally to man with perfect safety. As ordinarily used, the salts of bismuth are absolutely harmless, although formerly poisoning was not infrequent from their contam- ination with arsenic. The tongue and feces are stained black by bismuth salts, which are transformed into the sulphide. Bismuth, locally and mechanically, by reason of its weight and insolubility, protects and coats the mucous membrane of the digestive tract, and thus exerts a sedative, astringent and antiseptic action throughout the canal. Bismuth must, therefore, be given, to be effective, in large and frequent doses, and when the stomach is empty. For this reason the drug is not of much value in the treatment of the horse and ruminant, as a sufficient quantity cannot be used economically. USES OF BISMUTH SUBNITRATE AND SUBCARBONATE 181 USES OF BISMUTH SUBNITRATE AND SUBCARBONATE. External.—Bismuth subnitrate is a very good dusting powder on sores, and for moist skin diseases and ulcerated surfaces. It may be combined with zine oxide and salol, or used in the form of an ointment in the proportion of 1 to 4. The following is an effective combination to apply to superficial wounds and raw surfaces at- tended with much secretion: Re - Bismuthi subnitratis......... 50.0 3i.3v. AGidie tannicitems teste ae se ete 25.0 3 vi. TOGMOROTMT Hz) seiae ects ees eee eee 15.0 3 iv. Carbos ligmit eee ce ere cee 100.0 3 iii. 3 ii. M. et fiat pulvis Sig. Dust on surface. It may be employed to advantage in coryza and ozena, by insuffla- tion into the nostrils. A paste made by boiling vaseline in an enameled jar and stirring in bismuth subnitrate, in the strength of 33 per cent., is of ‘great value for curing fistule and chronic sup- purating cavities when injected warm so as to completely fill them. If one injection does not cure, repeat in a week and then every 4 days fora month. The paste, while warm, is drawn up into a metal or glass syringe. In small fistule, as about the rectum, long flexible tips may be used to insert in the sinus. More than 100 grams should not be retained in the body (in the human) lest poisoning occur. In old or thick-walled sinuses or abscesses there is little danger of absorption. In thin-walled and recent abscesses a ten per cent. ointment may be used. When there is indigestion and diarrhea with a marked, blue line about the gums, following injection of a large amount of bismuth, poisoning may occur. This is stopped by injecting warm oil into the cavity and aspi- rating the contents some 12 hours later. This new method of Beck’s has completely revolutionized the treatment of sinuses, especially those connected with bone. Various other suppurating cavities are cured by bismuth injec- tions. Thus empyema, cold and tuberculous abscesses, and sinuses following operations. The paste should cause a suppurating sinus to discharge a serous fluid. Causes of failure are due to the presence of a foreign body or 182 INORGANIC AGENTS sequestrum of bone. Or the paste has not been soft enough to enter all pockets. When large amounts of the paste are required substi- tute chalk for bismuth. Dermatol (bismuth subgallate) is even more efficient than the subnitrate alone as an antiseptic and as- tringent dusting powder. Internal.—Bismuth is one of the best agents to relieve vomiting in dogs, owing to the soothing and sedative effect upon inflamed mucous membranes. It may be given alone or in combination with oxalate of cerium upon the tongue or in the food. It is also a very efficient agent in diarrhea in the dog, being astringent, sedative and antiseptic. Its use should be preceded by the administration of oil or calomel, in diarrhea. Bismuth is given for diarrhea in powder with salol; or in suspension with gum arabic and water, with one drop of carbolic acid to each dose of bismuth; or better, in capsules, dispensing one grain of carbolic acid and five grains of bismuth. The sedative effect upon the stomach is increased by giving the sub- carbonate of bismuth with bicarbonate of sodium, while the sedative effect, upon the bowels is enhanced by combining morphine with bis- muth subnitrate. It is generally immaterial whether the subnitrate or subearbonate of bismuth be selected in any given case. Bismuth salicylate is more powerful as an antiseptic than the other salts. It is useful in diarrhea, intestinal fermentation and indigestion of dogs. The drug should be given in capsules. fF. | SECTION Y. Ferrum. Metallic iron is official in the form of fine, bright and non-elastic wire, from which are made iron preparations and reduced iron. Frerrum Repuctum. Reduced Iron. (U. S. P.) Synonym.—Ferrum redactum, B. P.; iron by hydrogen, Quevenne’s iron, ferrum hydrogenio reductum, ferrum ope hydro- genii paratum, E.; ferrum redactum, P. G.; fer réduit par ’hydro- géne, Fr.; reducirtes eisen, G. Derivation.—Hydrogen gas is passed over freshly made and carefully washed ferric oxide in a hot and closed tube. Fe.O, + 3 H, = Fe, + 3 H.O. Properties.—A very fine grayish-black, lustreless powder, with- out odor or taste; permanent in dry air; insoluble in water or alcohol. FERROUS SULPHATE 183 Dose.—H., 3 1-11. (4.8.); C., 3 ii-iv. (8.-15.); Sh. & Sw., Grox xxx (Cl3-2.)) 3) Da eri.-ve (06-3 ): Ferri Surpuas. Ferrous Sulphate. Fe So, +7 H,.O. QUarSG BB: Bs) Synonym.—Copperas, green vitriol, vitriolum martis purum, sulfas ferrosus, ferrum vitriolatum purum, E.; ferrum sulphuricum purum, P. G.; sulfate de fer, sulfate ferreux, Fr.; schwefelsaures eisenoxydul, G. Derwvation.—Iron wire is dissolved by boiling in diluted sul- phuric acid. Fe, + 2 H.SO,=2 Fe SO,+ 2 Hag. Properties.—Large, pale, bluish-green, monoclinic prisms, with- out odor, and having a saline styptic taste; efflorescent in dry air. On exposure to moist air the crystals rapidly absorb oxygen and be- come coated with brownish-yellow, basic ferric sulphate; soluble in 0.9 part of water; insoluble in alcohol. eDose——H 5 iis (4-8); C., 3 i-iv. (8.-15.))> Sh, & Sw., gr.xx.-xxx. (1.3-2.); D., gr.i-v. (.06-.3). Ferri SurpHas Exsiccarvus, Exsiccated or Dried Ferrous Sulphate. Kesso, - 3)to@: = CU. S: & B: PR.) Synonym.—Ferrum sulfuricum siccum, P. G.; sulfate de fer desséché, Fr.; entwisserte schwefelsaures eisenoxydul, G. Derivation.—Allow ferrous sulphate, 100, to effloresce at a temperature of 104° F. Then heat on a water bath till the product weighs 65. Properties.—A_ grayish-white powder, soluble in water. Dose.—Same as sulphate. Ferrt SurpHas Granuratus. Granulated Ferrous Sulphate. HecO 7 ELOn ines Bor) Deriwation.—Dissolve ferrous sulphate, 100, in distilled water, 100, and add sulphuric acid, 5. Evaporate till the product weighs 150. Pour alcohol, 25, upon it and dry. Properties.—Pale, bluish-green, crystalline powder. Dose.—Same as sulphate. Frerrt Carponas Saccuaratus. Saccharated Ferrous Carbon- atey ne (Us. wr bs) Synonym.—Ferrum carbonicum saccharatum, P. G.: carbonas 184 INORGANIC AGENTS ferrosus saccharatus, saccharure de proto-carbonate de fer, Fr.: ziickerhaltiges kohlensaures eisen, G. Derwation.—Ferrous sulphate, 50; sodium bicarbonate, 35; Properties.—-Greenish-brown powder, without odor; sweetish sugar and distilled water. Made by solution, precipitation and washing. Contains 5 per cent., by weight, of ferrous iodide (Fel,). taste; becomes oxidized on exposure to the air. Dose.—Twice that of iron sulphate. Massa Ferri Carsponatis. Mass of Ferrous Carbonate. (U.S. P.) Dose.—D., gr.i.-v. (.06-.3) in pill. Syrupus Ferri loprp1. Syrup of Ferrous Iodide. (U.S. & B. P.) Properties.—Transparent, pale green liquid; sweet, ferruginous taste. Dose.—H., 3 ss.-i. (15.-30. ec.); D., M v.-xxx. (.3-2.). Ferri Curtoripum. Ferric Chloride. Fe,Cl,-+H,O. (U.S. P.) Synonym.—Ferrum sesquichloratum, P. G.; ferruin muriatum oxydatum, chloridum seu chloruretum ferricum, ferri perchloridum, sesquichloride (perchloride) of iron, E.; perchlorure de fer, chlorure ferrique, Fr. ; eisenchlorid, G. Derivation.—Solution of ferric chloride, 100 Gm., evaporate to 40 Gm. on water bath. Set aside to crystallize; break into pieces and keep in glass-stoppered bottles in dark. Properties.—Orange yellow, crystalline pieces, odorless, or hav- ing a faint odor of hydrochloric acid, and a strong styptic taste; deliquescent; soluble in water and alcohol; reaction acid; not used internally. Liquor Frrrt Cuioripr. Solution of Ferric Chloride. (U. 8. P.) Synonym.—Liq.: ferri perchloridi, B. P. An aqueous solution of ferric chloride (Fe, Cl,) containing not less than 29 per cent. of the anhydrous salt, or about 10 per cent. of metallic iron. Derivation.—Dissolve iron wire, 125, in hydrochloric acid, 680, nitrie acid and water to make 1,000. (U.S. P.) SOLUTION OF FERRIC SUBSULPHATE 185 First reaction.—Fe, + 4 HCl = 2 Fe Cl, + 2H.. Second reaction.—6 FeCl, + 6 HCl]+ 2 HNO, = 38 Fe, Cl, +2 NO-+ 4 H,O. Properties.—A_ reddish-brown liquid, having a faint odor of hydrochloric acid; an acid, strongly styptic taste and an acid re- action. Dose.—H. & C., 3 ii.-iv. (8.-15.) ; Sh. & Sw., M x.-xx. (6.-1.3) ; DE im) ii.-x: G12-.6):. PREPARATIONS. Tinctura Ferri Chloridi. ‘Tincture of Ferric Chloride. (U.S. P.) . Solution of ferric chloride, 350; alcohol to make 1,000. Dose.—H. & C., 3 i.-ii. (30.-60.) ; Sh. & Sw., Mxx.-xxx. (1.3-2.); D., Mv.3i. (.3-4.) Contains 13.28 per cent. of the anhydrous salt, or 4.58 per cent. of metallic iron. Tinctura Ferri Perchloridi. Tincture of Iron Perchloride. (B. P.) Dose.—Same as Tinctura Ferri Chloridi (U. S. P.) Liquor Frrrt Sussurpuatis. Solution of Ferric Subsulphate. (U.S. B.) Synonym.—Solution of basic ferric sulphate FeO (SO,);, Monsel’s solution, solution of persulphate of iron, E.; liquor hémos- tatique de Monsel, Fr.; basischschewefelsaures eisenoxydlésung, Monsel’s eisenlésung, G. Contains about 13.6 per cent. of metallic iron. Derwwation.—Ferrous sulphate, 675; Sulphuric acid, 65; nitric acid and distilled water, of each a sufficient quantity to make 1,000. Properties—A dark reddish-brown liquid, odorless or nearly so; of an acid, strongly styptic taste and an acid reaction; miscible with water and alcohol. Dose— He ©. 5. ss. (15.); Sh. & Swat) xxx, (6-1.3); Doom, ti-x. (.12-.6). Tt has no value for internal use. 186 INORGANIC AGENTS Frrrt Hyproxipum Cum Maenestt Oxrpo. Ferric Hydroxide with Magnesium Oxide. (U.S. P.) (Arsenic Antidote.) Solution of ferric sulphate, 40 cc.; water, 125cc. Magnesium oxide, 10 gm.; water, q.s. Keep solutions separate till ready for use; then mix. Uses.—This preparation is used as a chemical antidote to arsenic, whereby the arsenic mass is mechanically enwrapped and converted into the insoluble arsenite. The administration of the arsenic antidote should be followed by emetics, or the stomach tube. Dose.—Large quantities should be repeated frequently ad libitum. Ferri pt Porasstr Tarrras. Iron and Potassium Tartrate. GDS Sree (Potassio-Ferric Tartrate. ) Synonym.—Ferrum tartaratum, B. P.; tartarus ferratus, P. G.; ferri potassio-tartras, ferrum tartarizatum, tartras ferrico- kalicus, ete., E.; tartrate de fer et de potasse, tartre martial, Fr.; Welnsaures elsenoxyd-kali, eisenweinstein, G. Properties.—Thin, transparent scales, varying in color from garnet-red to reddish-brown; without odor, and having a sweetish, slightly ferruginous taste; slightly deliquescent in the air; very soluble in water; insoluble in alcohol. Iron and potassium tartrate contains 15 per cent. of metallic iron. Dose—D., gr.v.-x. (.8-.6). Ferri er Ammonit Cirras. Iron and Ammonium Citrate. (U. 8. & BP.) Synonym.—Ferrum citricum ammoniatum, P. G.; ferri am- monio-citras, ferro-ammonium citricum, ammonio citrate of iron, E.; citrate de fer et d’ammoniaque (de fer ammoniacal), Fr. ; citron- ensaures eisenoxyd-ammonium (ammoniak), G. Properties.—Thin, transparent, garnet-red_ scales, without odor, and having a saline, mildly ferruginous taste; deliquescent in moist air; soluble in water; insoluble in alcohol. Iron and ammonium citrate contains 16 per cent. of metallic iron. Dose.—D.., gr.v.-x. (.3-.6). IRON AND QUININE CITRATE 187 Ferri eT Quintin Cirras. Iron and Quinine Citrate. (U.S. &B.P.) Synonym.—Chininum ferro-citricum, P. G.; citras ferrico- quinicus, citrate de fer et de quinine, Fr.; citronensaures eisen chinin, G. Propertves.—Thin, transparent scales, of .a reddish-brown color, without odor, and having a bitter, mildly ferruginous taste; slowly deliquescent in damp air; slowly but completely soluble in cold water and but partially soluble in alcohol. Iron and quinine citrate contains 11.5 per cent. of quinine and 13.5 per cent. of metallic iron. Dose.—As below. Frrri ET Quinine Crrras Soxvsitis. Soluble Iron and Quinine Citrate. “CUS. Es) Occurs in thin, greenish-yellow, transparent scales. Very rapidly and completely soluble in cold water. Soluble quinine and iron contains 11.5 per cent. of quinine and 13.5 per cent. of metallic iron. Dose.—D., gr.v.x. (.3-.6.) GENERAL ACTION OF IRON AND ITS SALTS. External.—The local action of iron salts—like those of the other heavy metals—depends upon coagulation of the proteids of the tis- sues through the formation of albuminate compounds with the metal and the setting free of the acid ions of the salt. Certain salts of iron, depending upon their acid constituent, are strongly astringent and more-or less irritant—as the chloride, perchloride, sulphate, persulphate, and nitrate. They contract tissue by coagulating albumin, when applied to raw surfaces or mucous membranes, and through this means, by compressing the blood-vessels from without and plugging them from within with clotted blood, arrest hemorrhage. The astringent salts may also induce some contraction of the vessels besides. Iron—in the form of liquor ferri chloridi or liquor ferri subsulphatis—is the most powerful of the metallic hemostatic agents we possess. Internal.—Alimentary Canal.—Iron is a food rather than a medicine. It exists as a natural constituent of vegetable foods and of the body, and is found particularly in the hemoglobin of the blood— to the extent of about half an ounce in that of the horse. There is a 188 INORGANIC AGENTS sufficient quantity in the food to support healthy animals. If iron is ingested by a normal animal in ordinary doses, it has little effect uniess continued for a long time in considerable quantity, when it may produce indigestion and constipation. Large doses of irritant and astringent salts, as the perchloride, may induce gastroenteritis by local irritation. Internally in the stomach the iron salts behave as they do ex- ternally. Acid ions are set free from the iron salt and the metal combines with albumin. The liberation of the acid ion leads to an astringent action and, if large doses are ingested, actual irritation. The degree of astringency is due to the preparation also. Thus ferric chloride is especially astringent because of the ease of dissociation and corrosive action of the HCl ion. Ferrous sulphate is only a little less so; while reduced iron, the oxide, carbonate, double salts and salts of the vegetable acids (citrates, acetates and tartrates), and albuminates, are very slightly or not at all astringent. In the case of the salts of the organic acids and double salts the acid ions are but slowly dissociated, and in that of the albuminate there is no acid to be freed. Acid salts, as the sulphate, are more suitable for the horse than the dog. Iron may blacken the tongue from formation of the sulphide. In the stomach all forms of iron are converted into chlorides, by the HCl] of the gastric juice, and then probably into albuiminates. Iron is naturally absorbed from the organic compounds of the inetal existing in the nucleoalbumins of food, and, either existing in this form or when given in medicine in the inorganic state, it is probably absorbed chiefly from the duodenum as the albuminate. But in any event the greater portion escapes from the bowel un- absorbed. The route which iron follows, after absorption, has been quite accurately ascertained by many experiments. It is taken up from the duodenum by the epithelial cells and leucocytes and carried by the blood into the spleen, in which it is first deposited. From thence, through the blood, it is conveyed to the liver and bone marrow. If it is needed for blood-making it is transformed by many steps into hemoglobin in the liver. But if it is not so needed it is eliminated by the large intestine and escapes from the bowel in the form of the sulphide and albuminate—the feces turning dark on exposure to air. Constitutional Action.—This is not observed unless iron is given intravenously. A salt which will not coagulate blood and which will free its iron ion must be employed—as the tartrate of iron and sodium. Large doses thus given cause vomiting, purging, convulsions, dyspnea and failure of respiration. Albumin and casts may appear in the urine. In other words, gastrointestinal and renal GENERAL ACTION OF IRON AND ITS SALTS 189 irritation succeeded by stimulation and final depression of the central nervous system. The numerous compounds of iron now manufactured by phar- maceutical concerns under the name of albuminates and peptonates, and supposed to imitate the natural organic forms of iron found in the blood and liver, are not superior to the inorganic salts in many eases and are worthless in others. Some—as ferratin and carniferrin —are more readily absorbed and less irritating than many of the inorganic preparations and might be of some value in canine practice. Blood.—In anemia iron is mainly of worth by furnishing build- ing material for blood. It may also stimulate the blood-making organs and in this way perhaps increase the number of red corpus- cles. The leucocytes are also somewhat augmented. Iron increases the power of the red corpuscles to hold and carry oxygen from the lungs to the tissues, and to transform it into ozone. Iron is then indirectly an oxidizing agent, stimulating tissue change and vital activity. Elimination.—Iron is chiefly excreted by the intestinal mucous membrane, however administered, yet it is also found in minute amounts in the urine, bile, saliva, sweat and tears. Summary.—tIron is essentially a blood tonic and restorative, increasing the number of red blood corpuscles, the amount of hemo- globin, and aiding nutrition. Externally it is an astringent, styptic and stimulant. Uses EHaternal.—Liquor ferri chloridi and liquor ferri subsul- phatis are sometimes used to stop bleeding from wounds or natural cavities of the body. They may be injected, applied by swab, or on absorbent material, which is packed into the wound or cavity. Asa loeal application in pharyngitis, we use 1 part of the solution of ferric chloride with 4 parts of glycerin. In the same strength, diluted with water, the chloride may be injected into the uterus to stop hemorrhage. Again, a solution, in the strength of 2 drachms to the pint of water, is employed as an enema to destroy ascarides. The objection to these solutions of iron is that they form heavy, nasty, tenacious clots, when employed to arrest hemorrhage, and the clots are apt to decompose and favor sepsis. Therefore they should not be used if other means, as ligature, pressure, heat or cold, or adrenalin chloride can be utilized. Internal.—Reduced iron is one of the best preparations for dogs. Tt is commonly administered in pill, and often with other tonics, as strychnine, quinine, and arsenic. Reduced iron is non-irritating, 190 INORGANIC AGENTS which can be prescribed to the larger animals. The other form is the tincture of ferric chloride. The sulphate is more astringent and irritating than some of the other iron salts, but does not usually cause constipation in the horse. Indeed, when constipation is due to loss of tone in the lower bowel, small doses, by their local stimulant ac- tion, may actually assist peristalsis. The dried ferrous sulphate is prescribed to horses in anemia, and is the most common constituent of tonic powders. It is frequently combined with powdered gentian, nux vomica, arsenic, and bicarbonate of sodium. Sodium bicarbonate is useful in indigestion and lessens the astringent action of sulphate of iron in neutralizing the acid set free from the salt. Nux vomica relieves constipation. A common and useful preparation for the horse is as follows: Sodii bicarbonatis. Pulvemucis' VOmrCata scr pa ascct oeieeie les cleus aa 3 ii. Herri isulphatis) @xsices = ss aeeeiaie!sieiel== o1slois 3 i. M. ct f. pulv. 1. Dispense pulv. tales no. xxx. S. Give one powder on the feed three times daily. Ferrous sulphate is given in anemia secondary to chronic indi- gestion, intestinal parasites, leucorrhea, ozena, albuminuria, and in convalescence from acute diseases. Ferrous sulphate is in itself an anthelmintic, but, to get its full effect when used for this purpose in the treatment of round worms in the horse (ascarides), it should be given twice daily on the food for ten days, and then a pint of linseed oil containing three ounces of oil of turpentine is to be administered to complete the cure. In convalescence, iron may well be preceded by alcohol and bitters. Large doses of iron sulphate are indicated in hemorrhage from the’ bowels, if unassociated with acute inflam- mation, as in purpura. In the latter disease, sulphuric acid is a synergistic remedy. The saccharated ferrous carbonate may be given horses if they will not voluntarily take the sulphate of iron on their food. It is a useful, mild, non-astringent preparation for dogs, and may be given in powder, or the mass may be dispensed in pills. The iodide of iron is thought to be of benefit in man in scrofu- lous conditions, but as these states do not commonly occur in horses and dogs, the drug is chiefly of value, in the form of the syrup, in rickets, and acts almost as a specific in that form of polyuria afflicting horses during hot weather, and also in mild cases of anasarca and dropsy. The syrup should be prescribed undiluted and water should be added just before administering the preparation. If prescribed GENERAL ACTION OF IRON AND ITS SALTS 191 with water, the syrup will undergo decomposition if allowed to stand for any length of time. The syrup must be a fresh preparation, else free iodine is formed in it, which will blacken the buccal mucous membrane. When the action of iodine and iron is desirable, it is often better to prescribe them separately. The tincture of ferric chloride is a very powerful preparation. It contains free hydrochloric acid. Alcohol constitutes three-quarters of its bulk, and there are also some traces of ether. It was formerly thought to be hydrochloric ether, arising from the action of the con- tained muriatic acid on the alcohol of the preparation; but Weir Mitchell has shown it to be nitrous ether. Ferric chloride is of itself diuretic, apart from any action of nitrous ether in the tincture. The free acid aids digestion in the stomach. The tincture of ferric chloride is locally stimulant and astringent, and generally aids digestion ; is diuretic, and in large doses, owing to the alcohol which it contains, ts somewhat stimulating. The tincture is, accordingly, particularly valuable in anemia, dependent upon chronic indigestion in horses and cattle, and in that occurring in convalescence from acute diseases. In such conditions, the preparation stimulates appetite, digestion and renal activity. When given by the mouth, the tincture of the chloride of iron is of local benefit in pharyngitis, combined with chlorate of potash, glycerin and water. Also in membranous croup of fowl (roup) in 10 m. doses; and of foals, calves and pigs (5 ss.), with an equal amount of potassium chlorate. It is prescribed in intestinal hemorrhage (dried ferric subsulphate or Monsel’s salt given in 1 to 2 drachm doses in gelatine capsules is more effective for this purpose in the larger animals), but there is no remote astringent or styptic effect exerted upon the vessels or tissues. Small doses of the tincture of ferric chloride may be safely dropped, undiluted, upon the tongue of horses or cattle from a small bottle used as a measure. It is frequently conjoined with alcohol and mineral acids. The fluidextract of quassia or calumba are often combined with the tincture of ferric chloride without imcom- patibility. iron and ammonium citrate and iron and potassium tartrate are mild, non-astringent preparations, suitable for dogs and given in pill. The soluble citrate of iron is sometimes given subcutaneously every other day: H., 3 ss.; D., gr.l. in aqueous soiution. Iron and quinine citrate is a useful combination for dogs, dispensed in pill. It is often employed in canine distemper and chorea. No drug is given more indiscriminately than iron: Pallor is a poor indication. Blood examination is the only safe guide. 192 INORGANIC AGENTS . Manganum. (Manganese is not used in Medicine in the metallic state.) Porassit PerMANGANAS. Potassium Permanganate. KMnO, (U.S. & B. P.) Synonym.—Kali hypermanganicum crystallisatum, P. G.; hypermanganas potassicus S. kalicus, permanganate of potash, E.; permanganate de potasse, Fr.; uebermangansaures kali, G. Derivation.—Caustie potash, chlorate of potassium and black oxide of manganese are fused together. 6 KHO + KCIO,; + MnO, = 3 K,MnO, + KC1+ 3 HO. The manganate of potassium is boiled with water till the color changes to purple and the perman- ganate is formed. 38 K,MnO, + 2 H,O = 2 KMnO, + 4KHO + MnO,. The liquid is neutralized with carbonic dioxide gas and evaporated. Properties.—Slender, monoclinic prisms, of a dark purple color, odorless, and having a taste at first sweet, but afterwards disagreeable and astringent; permanent in dry air; soluble in 15 parts of water; undergoes decomposition with alcohol; reaction neutral. Tncompatibles.—It is very readily deoxidized in the presence of organic matter. Dose.—H., gy.xv.-xx. (1.-1.8) in one pint of water; D., gr.i.-i1. (.06-.12) ; in pill, or tablet, with kaolin. ACTION OF POTASSIUM PERMANGANATE. External.—Potassium permanganate, like hydrogen dioxide, is a powerful oxidizing agent. It quickly parts with its oxygen in contact with organic matter, largely in the form of ozone, and is broken up into black oxide of manganese and potassa. Solutions, which are of a purple hue, change into a dark brown color when this transformation occurs, and are no longer of any medicinal value. This action is exceedingly rapid and transient, and its cffects cor- respondingly so on the tissues. . For this reason, and because bacteria are so combined with organic matter in the tissues, its action is largely exerted on the latter, and potassium permanganate is, there- fore, a better antiseptic than disinfectant. The antiseptic action of potassium permanganate is, moreover, quite superficial, since it parts with its oxygen so soon as it comes in contact with the albumin POTASSIUM PERMANGANATE 193 of the tissues. Outside of the body, permanganate of potash is a disinfectant, but it is too expensive for general purposes. In powder it is slightly caustic, owing to the potassa set free in its decomposi- tion; and in solution is stimulant to the tissues. A solution of per- manganate of potash is a deodorizer when in contact with putrid and decomposing matter, but is not of the slightest value as a deodorizer and disinfectant to premises when simply standing in vessels, as frequently advised. There is no danger from absorption of potas- sium permanganate when applied to the body. Uses ‘Internal.—Potassium permanganate is occasionally used in human medicine in dyspepsia and flatulence, for its antiseptic action, and in obesity. It is supposed to resemble iron in its effects, and has been used in ammenorrhea associated with anemia. Moor, of New York, has shown that potassium permanganate is the best chemical antidote for morphine or opium, chemically destroying them by oxidation; 10 to 15 grains may be given to dogs in 8 ounces of water immediately after poisoning. Horses may be given 2 drachms of permanganate of potash in 5 pints of water. In case morphine has been swallowed, solutions of potassium permanganate should be acidulated with vinegar, or diluted sulphuric acid, in order to form soluble compounds in the digestive tract. After mor- phine or opium have been absorbed into the blood, it is said that potassium permanganate is also antidotal when injected subeutane- ously. It is difficult to see, theoretically, how this can be the case, and practically has been proven not to be so. Uses External—Potassium permanganate is a valuable anti- septic and deodorizer in solutions varying in strength from one- tenth of 1 per cent. to 4 per cent., and is used in the treatment of sores, wounds, ulcers, abscess, caries, gangrene, fetid ozena, otor- rhea, and leucorrhea. In the stronger solution it is stimulant, as well as antiseptic. It is a useful agent in stomatitis and sore threat, when applied locally by means of a swab. The powder is employed as a caustic upon ulcers. Potassium permanganate is one of the best agents with which to sterilize the hands before operating. A satu- rated solution is to be recommended for this purpose, and the stains may be removed from the hands by washing them in a saturated solution of oxalic acid, or in a dilute solution of hydrochloric acid. Potassium permanganate is a test for impure water in changing color in the presence of organic matter. ‘Two ounces of a 1 per cent. solution will clarify-and deodorize 100 gallons of stale and putres- cent rain water. 194 INORGANIC AGENTS SECTION VI. Hydrargyrum. Mercury. Quicksilver. Synonym.—Mercurius vivas, argentum vivum, E.; mercure, vif-argent, Fr.; quecksilber, G. Derivation. —Cinnabar, the native sulphate, is roasted or dis- stilled with lime, and condensed. Properties.—A. shining, silver-white metal, without odor or taste; liquid at ordinary temperatures, and divisible into spherical globules; insoluble in the ordinary solvents; boils at 675° F., and is completely volatilized; spec. gr., 13.5584. When cooled to 38.88° F., it forms a ductile, malleable mass. I PREPARATIONS CONTAINING METALLIC MERCURY. I.—Hydrargyrum cum Creta. Mercury with Chalk. (U. S. & B. P.) Synonym.—Gray powder. Mercury, 38 gm.; honey, 10 gm.; prepared chalk, 57 gm.; water, sufficient quantity to make 100 gm. (U.S. P.) Mercuric oxide becomes developed by keeping, making the powder more active. Properties.—A light gray, rather damp powder, free from grittiness, without odor, and having a slightly sweetish taste. Contains mercury in fine division by shaking the ingredients together. Dose.—Foals and calves, gr.x.-xv. (.6-1.); D., gr.i-x. (.06-.6). 11.—Massa Hydrargyri. Mass of Mercury. (U. 8. P.) Synonym.—Pilula hydrargyri, B. P.; blue mass, blue pill, pilule cerulea, E.; pilule de mercure, Fr,; mercurial pillen, G. Mercury, 33 gm.; glycyrrhiza, 10 gm.; althea, 15 gm.; glycerin, 9 gm.; honey of roses, 33 gm. Contains 33 per cent. of mercury in a state oi fine division. (U.S. P.) Dose.—D., gr.i.-x. (.06-.6). III1.—Unguentum Hydrargyri. Mercurial Ointment. (U. S. & B. P.) (Blue Ointment.) Synonym.—Pommade mercurielle, pommade Napolitaine, Fr.; graue queck- silbersalbe, G. RED MERCURIC OXIDE 195 Mercury, 500 gm.; lard, 250 gm.; suet, 230 gm.; oleate of mercury, 20 gm. Contains 50 per cent. of mercury. (U.S. P.) Hyprareyri Oxipum Rusrum. Red Mercurie Oxide. Hg0O. (U. 8. & B. P.) Synonym.—Hydrargyrum oxydatum rubrum, P. G.; hydrar- eyri-nitrico-oxydum, mercurius corrosivus (precipitatus) ruber, oxydum hydrargyricum, peroxide of mercury, red precipitate, mer- curic oxide, E.; deuto-oxyde (peroxyde) de mercure, oxyde mer- curique, précipite rouge, poudre de Jean de Vigo, Fr.; rothes queck- silberoxyde, rother pricipitat (quecksilber-pracipitat), G. 3 Hg, +16 HNO, = 6 Hg (NO3;)o. (Mercurie nitrate) + 4NO+ 8 H,O. : Rub mercuric nitrate with metallic mercury and heat. 2 Hg (NO). + Hg, = 4 HgO + 2 N30, Derivation.—Dissolve mercury in diluted nitric acid. Properties.—Heavy, orange-red, crystalline scales, or a crys talline powder; odorless, and having a somewhat metallic taste; permanent in the air; almost insoluble in water; insoluble in alcohol. PREPARATION. Unguentum Hydrargyri Oxidi Rubri. Ointment of Red Mercurie Oxide. (U. S. & B. P.) Synonym.—Red precipitate ointment. Red murcuric oxide, 10; water, 10; hydrous wool-fat, 40; petrolatum, 40. (U. S2 PB) Hyprarcyrt Oxipum Fravum. Yellow Mercuric Oxide. HgO (U. 8. & B. P.) Synonym.—Hydrargyrum oxydatum via humida paratum, P. G.; hydrargyrum oxydatum precipitatum (vel flavum) precipi- tated oxide of mercury, E.; oxyde de mereure jaune (précipité), Fr.; pracipitirtes (Gelbes) quecksilberoxyde, G. Derivation.—Precipitate an aqueous solution of mercuric chloride, 100, with caustic soda, 40: HgCl, +2 NaOH = HgO + 2 NaCl + H.O. Properties.—A light orange yellow, amorphous, heavy, im- palpable powder; odorless, and having a somewhat metallic taste; permanent in the air, but turning darker on exposure to the light ; almost insoluble in water; insoluble in alcohol. 196 INORGANIC AGENTS PREPARATIONS. Unguentum Hydrargyri Oxidi Flavi. Ointment of Yellow Mercuric Oxide. (U.:S., BP.) -.B. Ps. 2 per cent. Yellow mercuric oxide, 10; water, 10; hydrous wool-fat, 40; petrolatum, 40. Oleatum Hydrargyri. Oleate of Mercury. (U. 8S. P.) Hydrargyri Oleas. (B. P.) Yellow mercuric oxide, 25; water, 25; oleic acid to make 100. (U.S. P.) HyprarGayrt Cuiortipum Corrosivum. Corrosive Mercuric Chloride, Fo Ol”: CU Sy Py) (Corrosive Chloride of Mercury, Corroswe Sublimate.) Synonym.—Hydrargyri perchloridum, B. P.; hydrargyrum bichloratum corrosivum, P. G.; hydrargyrum muriaticum corro- sivum, hydrargyri bichloridum, sublimatus corrosivus, sublimnatum corrosivum, mercurius sublimatus corrosivus, chloruretum (chlore- tum) hydrargyricum, perchloride of mercury, bichloride of mercury, E.; Deutochlorure de mercure, sublimé ecorrosif, chlorure mercu- rique, Fr.; stzendes quecksilberchlorid, stzender quecksilbersub- limat, G. ~ . Deriwation.—Heat a mixture of mercuric sulphate, 20; sodium chloride, 16; manganese dioxide, 1. Hg SO,-+ 2 NaCl-+ MnO, = HgCl, + Na,SO,-+ MnO,. The bichloride sublimes and is con- densed. | Properties.—Heavy, colorless, rhombic crystals, or crystalline masses; odorless, and having an acrid and persistent metallic taste: permanent in the air; soluble in 13 parts of water and in 8 parts of alcohol. Incompatibles.—It is incompatible with most substances. Dose.—H. & C., gr.v.-vii. (.8-.5); Sh. & Sw., gril. (.12); D., or.t$o-4 (.002-.008). Hyprareyrt Curortpum Mrrr. Mild Mercurous Chloride. HgCl (We SiSes) (Calomel, Mild Chloride of Mercury.) Synonym.—Hydrargyri subchloridum, B. P.; hydrargyrum chloratum mite, P. G.; hydrargyri chloridum, hydrargyrum _ RED MERCURIC IODIDE 197 chloratum mite, P. G.; hydrargyri chloridum, hydrargyrum chloratum (muriaticum) dulce, mercurius dulcis, calomelas chloru- retum (chloretum) hydrargyrosum, subchloride (protochloride) of mercury, E.; protochlorure (sous-muriate) de mercure, caloméle, Fr. ; quecksilberchloriir, calomel, G. Derivation.—Heat mercurous sulphate and sodium chloride. Calomel sublimes. Hg, SO,-+ 2 Na Cl =2 HgCl + Na,SOQ,. Properties.—A white, impalpable powder; odorless and taste- less; permanent in the air; insoluble in water or alcohol. When strongly heated it is wholly volatilized without melting. Dose.—H., 3 ss.-i. (2.-4.); C., 5 v.-vi. (20.-24.); D., gr.ss. (.03), in divided doses; D., gr.ili.-v. (.2-.3) in single doses. PREPARATION, Pilule Cathartice Composite. Compound Cathartic Pills. (U. S. P.) Compound extract of colocynth, 80; calomel, 60; resin of jalap, 20; gamboge, 15; diluted alcohol, Q. S. to make 1.000 pills. Dose.—D., pill 1 to 3. Hyprareyvrt Ioprpum Rusrum. Red Mercuric Iodide. Hegl.. CUS. o7 5..2.) (Biniodide of Mercury, Red Iodide of Mercury.) Synonym.—Hydrargyri biiodatum rubrum, P. G.; deutoio- duretum (biniodidum) hydrargyri, mercurius iodatus ruber, idure- tum hydrargyricum, E.; deut-iodure (bi-iodure) de mercure, iodure mercurique, Fr.; rothes jodquecksilber, quecksilberjolid, G. Derivation.—Mix aqueous solutions of corrosive mercuric chloride, 40gm., and potassium iodide, 50gm. The red iodide is precipitated. Filter, wash and dry. HgCl, +2 KI = Hel, + 2 me Cl Properties.—A scarlet-red, amorphous powder; odorless and tasteless; permanent in the air; almost insoluble in water; soluble in 116 parts of alcohol. Unauentum Hyprarcyrt Nirratis. Ointment of Mercuric Nitrate (Citrine Ointment). (U.S. & B. P.) Mercury, 70 gm.; nitric acid, 175 gm.; lard, 760 gm. (U. S.) Properties.—A lemon-yellow ointment. 198 INORGANIC AGENTS Hyprarcyrum AmmoniAtum. Ammoniated Mercury. HgNH,Cl. (U8, &:B.:P3) (White Precipitate, Mercurie Ammonium Chloride. } Synonym.—Hydrargyrum precipitatum album, P. G.; hy- drargyrum amidato-bichloratum (ammoniato-muriaticum), hydrar- gyri ammonio-chloridum, mercurius precipitatus albus, E.; oxy- chlorure ammoniacal de mercure, mercure précipite blanc, Fr.; weisse quecksilber-pracipat, quecksilberchloridamidid, G. Derivation.—Mix an aqueous solution (1 to 20) of corrosive mercuric chloride, 2000, with ammonia water, 150. Properties.—White, pulverent pieces, or a white, amorphous powder, without odor, and having an earthy, afterwards styptic and metallic taste; permanent in the air; almost insoluble in water or in ,alcohol. PREPARATION. Unguentum Hydrargyri Ammoniati, Ointment of Ammoniated Mercury. (W582 &.B-P2) Synonym.—White precipitate ointment. Ammoniated mercury, 10; White petrolatum, 50; hydrous wool-fat, 40. (U. S. P.) GENERAL ACTION OF MERCURY AND ITS SALTS. ExternalThe salts of mercury are antiseptic, germicidal, irritant and—in the case of the soluble salts—caustic, when applied to raw surfaces or mucous membranes. Corrosive sublimate is one of the slowest acting, most powerful and frequently used anti- septics. The germicidal action of mercury salts is due to their habit of combining with albumin wherever it exists and forming the albu- minate of mercury. Thus they act on bacteria and in so doing destroy germ life. The caustic action of the soluble salts of mercury may be explained by the fact that when the salts are dissociated by contact with the tissues the metallic and acid ions are corrosive. Moreover, like the other salts of the heavy metals, they precipitate the proteids of the tissues with which they come in contact, but, un- like them, the mercury albuminate thus formed is soluble to some extent in the fluids of the body and therefore does not protect the surface from the further action of the salt. The antiseptic effect of corrosive sublimate is lessened by this action since the salt is decom- posed in contact with albumin and the coagulated proteid prevents GENERAL ACTION OF MERCURY AND ITS SALTS 199 it from reaching germs. By the addition of salt, hydrochloric or tartaric acid to solutions of corrosive sublimate the union of mercury with albumin is materially prevented and such combination (with tartaric acid) is provided in the tablets sold for surgical purposes. Corrosive sublimate is more irritant to the tissues than carbolic acid, creolin or lysol, and cannot penetrate raw surfaces so well to reach germs (on account of its coagulating proteids), and cannot be used in contact with metallic instruments since mercury is deposited upon them through decomposition of this salt. The salts of mercury kill the lower forms of animal as well as vegetable life, and are valuable in the treatment of parasitic skin diseases. As a rule, anti- septics relieve itching, and the mercury salts are often used to combat this condition. Mercury and its salts are absorbed when rubbed into the unbroken skin, particularly when in combination with oil or grease. Metallic mercury and its salts (notably the iodide), when rubbed well into the skin with fat, are thought to aid the absorption of in- flammatory exudates in underlying parts. Internal_—The irritant salts of mercury, as the bichloride, iodide, nitrate, and some of the oxides, in large doses, produce gastro- enteritis, vomiting, colic, bloody diarrhea, anuria, or urine holding albumin and casts, collapse and death. The white of egg is an anti- dote to corrosive sublimate, forming an insoluble albuminate. Emetics, or the stomach tube, should be used in case vomiting is not spontaneous. The use of mercury, or any of its compounds, if continued for any considerable time, either internally or externally, in such a way as to lead to absorption, may cause a chronic form of poisoning or mercurialism. This condition is characterized by fetor of the breath and soreness of the gums, making mastication painful. The gums are swollen and bleed easily; the tongue swells and salivation ensues. The teeth become loosened, the salivary and parotid glands enlarge, the temperature is elevated, and if the condition continues, there are: ulceration of the mouth (due to irritation produced by mercury eliminated in the saliva), necrosis of the jaw, general weakness, a watery condition of the blood, edema, anemia and cachexia, prostra- tion and death. Local poisoning, as exhibited by paralysis of the hand and forearm, has occurred in a man who applied the ointment of red iodide of merenry to cattle. There is a tendency for mercury to accumulate in the liver and kidneys, chiefly, and also in the tissues generally, when given in large doses, or in smaller doses when con- tinued for a considerable period. The prevailing fashion of administering calomel] in small and repeated doses may lead to mercurialism if purgation does not occur. 200 INORGANIC AGENTS Stomach and Intestines.—Calomel and preparations of metallic mercury are most commonly used for their action on the digestive tract. Exactly what chemical changes they undergo is uncertain. Calomel was thought to be converted into mercuric chloride in the stomach, but this appears to be improbable. It is also surmised that the alkaline juices in the duodenum convert calomel into the gray ox- ide. Sufficient evidence of this is lacking. It is more probable that these insoluble preparations do not remain long enough in the stomach to be irritating (though vomiting is occasionally caused by calomel), but exert an irritating and therefore purgative effect in the bowels owing to some of the mereury combining with proteids-of the intes- tinal mucous membrane. Some of the preparation is thus absorbed, as an albuminate of mercury, while the larger portion is swept out with the feces. Calomel and mercuric chloride are also intestinal antiseptics. The mercurial purges have always enjoyed a great reputation in the treatment of so-called biliousness and torpid liver, the sup- position being that they stimulated the liver and flow of bile. But experiments on man and animals show that they exert no apparent effect on the liver or biliary secretion. Their indubitable efficacy is due to their cathartic and intestinal antiseptic action, as such con- ditions (biliousness, ete.) are not owing to liver disorder but to in- digestion. The purgative action of calomel and mercury is assisted by salines, which increase the amount of fluid in the bowels, and aid in the expulsion and prevent the absorption of mercury. The saline should be given four hours after the administration of calomel to eattle. Blood and Metabolism.—lIt is stated that calomel may be ab- sorbed unchanged from the intestines by leucocytes to some extent. It is probable, however, that mercury preparations are chiefly ab- sorbed as albuminates and even metallic mercury is oxidized, when in contact with the tissues, and absorbed. Small doses of mercury apparently increase the nutrition and weight of healthy animals and also the hemoglobin and red corpuscles. Mercury is sometimes called an antiphlogistic, as it has been supposed to combat the effect of inflammations. A part of this result may be attributed to the anti- septic action of the salts of mercury in the intestines by preventing fermentation and absorption of toxic material. For want of a better term to explain the beneficial actions of mercury on the tissues, that vague term “alterative’ is frequently applied. Mercury (and calomel in particular) is diuretic, stimulating the secreting cells of the kidneys, and increasing the amount of urine. SUMMARY OF ACTIONS OF MERCURY AND ITS SALTS 201 Elumimation.—Mercury is eliminated very slowly, mainly by the cecum and colon (after its absorption), but also by the kidneys, liver, salivary glands, and, in fact, by every conceivable channel. In thus stimulating the eliminative activities of the various glands, mercury has been termed a deobstruent. It has been surmised that its alterative effect depends, in part, upon this action in stimulating —to use the old term—the emunctories. . SUMMARY OF ACTIONS OF MERCURY AND ITS SALTS. EHxternal.—Antiseptic, germicide, irritant, caustic, parasiticide, antipruitic and sorbefacient. Internal.—Antiseptic, purgative, antiphlogistic, alterative and diuretic (calomel). USES OF MERCURY AND ITS SALTS. Hydrargyrum cum creta is similar to calomel in its effects, but very much milder, unless it contains the black oxide of mercury, when its action is much intensified. The same may be said of massa hydrargyri. Either preparation may be given dogs as a laxative in indigestion with vomiting and diarrhea; or to foals and calves (in milk or gruel) with intestinal indigestion and diarrhea, particularly if accompanied with jaundice. The oleatum or unguentum hydrar- gyri are rubbed into the skin to cause resolution of chronic inflam- matory swellings, and also to kill anima! and vegetable parasites. As the former action is due to absorption, large quantities will lead to poisoning when applied over an extensive surface. We can use other and safer remedies, as creolin, tar or sulphur ointment, for parasiticides. One should not employ an amount of blue ointment greater than 1 ounce for the larger animals; 3 drams for sheep; and 20 to 40 grains for dogs. Blue ointment is commonly diluted with 3 or 4 parts of lard. It is to be remembered in this connection that grease alone will kill lice and other parasites on the skin. On account of their sorbefacient properties, the oleate and blue ointment of mercury are applied over chronically enlarged glands, swollen joints, and thickened tendons. In view of their parasitic action, these preparations are employed to kill the fungus of favus and ringworm, and to destroy lice and the acari of mange, when in- habiting circumscribed areas. Itching in skin diseases, as chronic eczema and psoriasis, is relieved by either blue ointment or the oleate of mercury. 202 INORGANIC AGENTS HYDRARGYRI. OXIDUM RUBRUM ET FLAVUM. The official ointments of the red and yellow mercuric oxides are prescribed, as stimulant and antiseptic preparations, in chronic conjunctivitis, corneal ulcers (gr. i.-ii. of the yellow oxide to 3 i. of vaseline), granular lids and sealy skin diseases. They are also em- ployed on indolent ulcers, swollen glands and old granulating sur- faces. When used on mucous membranes, or raw surfaces, the offi- cial ointments should be diluted with equal parts of lard. HYDRARGYRI CHLORIDUM CORROSIVUM. _ Hxternal.—Corrosive sublimate is of value mainly as an anti- septic on the unbroken skin. It is germicide in solutions containing 1 part to 500, or 1000, of water. Applied to mucous membranes, or raw surfaces, it is antiseptic in solutions varying in strength from 1-10,000 to 1-1,000. In the larger cavities of the body, as the vagina, solutions should not be used in strength greater than 1-5000 or 1-3000. Experi- ments by Harrington and Walker go to show that corrosive sub- limate is much less active than commonly believed. A 1-1000 solu- tion requires more than ten minutes’ contact to kill common forms of pus cocci, so that dipping the hands for a few seconds in such solu- tions does more harm than good in inducing a false security which does not exist. They conclude bv saying that, as the result of their experiments, “corrosive sublimate in any of the strengths commonly employed is a much overrated disinfectant, and under the best of conditions is so uncertain in its action that it would be of advantage to abandon its use altogether in surgery.” Post & Nicoll wholly endorse this result. They find tine. iodine, aleohol (over 50 per cent.), tine. green soap, and 5 per cent. carbolic acid kill all bacteria in less than 1 minute. 1.5 per cent. sol. of lysol kills most germs within one minute, while 1-500 corrosive requires more than 10 min- utes toe kill almost any pathogenic microdrganisms. These men are known to be careful and trustworthy investigators and their findings agree with the results obtained by many great surgeons. In view of the ease with which corrosive sublimate combines with albumin, it is best not to rely upon this agent for wound disinfection, but to employ normal salt solution for cleansing, followed by the hydro- gen dioxide. It is only fair to state, however, that corrosive subli- mate is still regarded as the antiseptic sheet anchor by many good surgeons for the irrigation of infected wounds and cavities, and for skin disinfection. HYDRARGYRI CHLORIDUM CORROSIVUM 2038 For hand and skin disinfection Harrington’s solution * of corro- sive sublimate is perhaps the most effective of any in existence. Mercurie bichloride, even in the weaker solution, is too damag- ing to the serous membrane of the peritoneal cavity, and there is too much danger of absorption to warrant us in using it in intra-abdom- inal operations. As a caustic, saturated solutions are injected into fistulous tracts: e.g., fistulee of the withers, “quittor’ and ‘‘poll evil,” to destroy their so-called pyogenic membranes, and hasten repair. There is not much danger of absorption when used in this way. Corrosive sublimate is very useful as a parasiticide, in destroy- ing lice, ringworm and the fungus of favus, in solution (1-500 on the unbroken skin). It also relieves itching in pruritus, prurigo and ur- ticaria, but is generally inferior to carbolic acid in this respect. Apart from the body, corrosive sublimate in solution 1-500 or 1-1000 is one of the cheapest and most effective disinfectants for premises infected with the contagion of glanders, anthrax, etc. The walls and floors of stables (after thorough cleansing and washing with soft soap and boiling water), clothing and all paraphernalia, not metallic, ean be disinfected by washing or soaking in solutions of bichloride. Before operations, the operative field should be sterilized by serub- bing with green soap and then with Harrington’s solution, after the hair has been shaved from the part. During an operation, irriga- tion with corrosive (1-3000) solution or boiled normal solution is commonly practised. In epizodtie abortion, in addition to quar- antining the diseased animals, their discharges and the premises should be disinfected, and both the well and sick female animals should be washed twice daily about the genital regions with a solu- tion of corrosive sublimate. Yellow wash, made by the addition of 30 gr. of mercuric bichloride to 1 pint of lime water, is sometimes employed as a stimulant application in chronic eczema, and to re- lieve itching. It contains the yellow oxide of mercury. In puru- lent conjunctivitis, frequent irrigation with-a 1-1000 solution of corrosive sublimate is of the greatest service. Internal.—Corrosive sublimate is of value in minute doses as a blood tonic, and is recommended as an antiphlogistie agent in in- flammatory diseases of serous membranes, as pleuritis, meningitis, and arthritis. It is probably inferior to calomel for this purpose. We at least know that the calomel is an efficient cathartic in inflam- matory diseases. *Harrington’s solution consists of: Commercial alcohol (94 per cent.), 640 c.c.; commercial hydrochloric acid, 60 c.c.; corrosive sublimate, 0.8 gm. It is the most powerful preparation for skin disinfection known (except tine. of iodine), rendering the skin sterile in most cases after application for two minutes. 204 INORGANIC AGENTS Mercuric bichloride is employed as an intestinal antiseptic in the treatment of dysentery and diarrhea with mucous or vile smelling discharges. In these conditions, irrigation of the rectum with a 1-5000 solution is of advantage. This solution should be drained off through the rectal tube and followed by an injection of plain boiled water. Admainistration.—Corrosive sublimate is given in the form of a pill or ball. If exhibited in solution to the large animals, it must be diluted with 2 quarts of water. HYDRARGYRI CHLORIDUM MITE. External.—Calomel is of use in chronic eczema when applied over small patches in its pure state, or as “black wash.” The latter consists of one drachm of calomel in one pint of lime water, forming the black oxide of mercury, and is a very efficient preparation to relieve itching and promote recovery in chronic eczema, by mild stimulation. Calomel is of benefit when blown into the eye once or twice a week, stimulating and hastening absorption of opacities of the cornea following keratitis. It is a good agent to arrest thrush when worked up into the commisure of the hoof, between the frog and the bars, and retained in place by oakum packing. Internal.—Calomel is a purgative, intestinal antiseptic, diu- retic and alterative. It is also used for its remote antiphlogistic effects. It is particularly adapted to dogs, and is given in a single dose, or often, to better advantage, in half-grain doses, repeated every two hours till purgation occurs. For diarrhea or vomiting in dogs, calomel is useful in removing the source of irritation, in being antiseptic and easily borne by an irritable stomach. In accordance with the theory that calomel is transformed by the alkaline intes- tinal secretions into the grey mercurous oxide. it has been the custom to combine sodium bicarbonate with it in order to facilitate this transformation. Sufficient evidence to substantiate the occurrence of the transformation is wanting and the clinical value of the combi- nation is doubtful. The administration of calomel should be fol- lowed by oil, salines or other cathartics, if purgation does not occur within twenty-four hours after its ingestion, otherwise mercurialism may occur. In jaundice, with light-colored feces, gastro-duodenitis or con- stipation, calomel is a valuable remedy for dogs. In the jaundice occurring as a form of influenza in horses, nitro-muriatic acid is more effective. Calomel is one of the best remedies for the treat- ment of dysentery unless there is great weakness. It should be HYDRARGYRI IODIDUM RUBRUM 205 continued in repeated small doses till the character of the discharge changes. Foals and calves, with indigestion and diarrhea, may be given calomel to advantage to remove the source of irritation in the digestive tract. Calomel must be combined with a smal! dose of aloes, or with linseed oil, to form an effective cathartic for the horse. As aloes acts on the large, and calomel on the small intestines, the above combination secures a general purgative influence. Cattle are given calomel, followed by the administration of salines, to produce free catharsis. As a remedy for round worms, YY, tc Y4 grain each of santonin and calomel, with 5 grains of sugar of milk, are administered to dogs four times, at half hour intervals, and followed by castor oil. Lumbricoid worms in the horse may be treated by conjoining 2 drachms of santonin with 1 drachm of calomel, given to the fasting animal, and followed by a pint of lin- seed oil. One dram each of calomel, extract of male fern and aloes with one half ounce of ginger make a good anthelmintic ball for the horse. Calomel was formerly very frequently used, and is ocea- sionally prescribed to this day in the treatment of enteritis, pleuritis, meningitis, peritonitis, pericarditis, and iritis, for its antiphlo- gistic and alterative action in supposedly diminishing inflammatory exudations. At the present time these actions are very much questioned, and any beneficial effects accruing from the use of calomel in inflammatory diseases are now ascribed to its action as a purgative and intestinal antiseptic in destroying and eliminating toxins from the bowels. Calomel is of value in inflammatory diseases when given at the onset of the attack. In dropsy (ascites of dogs), calomel sometimes acts as a useful diuretic, when combined with digitalis and squill (gr.i. each) in pill form. Administration.—Calomel is given to catile on the tongue or in gruel; to horses in ball, on the food, or on the tongue, to dogs in pill, tablet or on the tongue; to fowl on the food (gr.i.). The compound eathartic pill is a good purgative preparation for occasional use. Two or three pills for large dogs; one to two pills for small animals. HYDRARGYRI IODIDUM RUBRUM. The red mercuric iodide is a favorite remedy in veterinary practice. It causes absorption of morbid exudations through its counter-irritant, local absorbent and alterative effect, in combining the action of iodine end mercury. It is employed with 8 to 10 or 12 parts of lard or vaseline, and is of value in the treatment of peri- 206 INORGANIC AGENTS ostitis with osseous deposits, especially for splints. Spavin and ringbone are treated with red iodide of mercury alone, but are gen- erally cured more effectively by rest, firing, and blistering. The red iodide of mereury ointment is also of use for enlarged glands, chronic swelling about tendons, joints or burse; and applied about the throat in chronic laryngitis and “roaring.” The ointment is rubbed on splints every third day, or until vesication is produced, and the hair begins to drop out, when its use is stopped for a time. It is useful in chronic rheumatic joints and in induration of the udder in bovines. Like other mercury preparations, the red iodide must not be employed in large quantities over an extensive surface. It is much more irritant locally than blue ointment. UNGUENTUM HYDRARGYRI NITRATIS. Citrine ointment is similar to unguentum hydrargyri ammoni- ati (white precipitate ointment), but more powerful, and should be diluted with equal parts of lard. These preparations are used for their stimulant action in granular lids, chronic eczema, pityriasis, and for their anti-parasitic effect in ring-worm. SECTION VII. Arsenum. Arsenic is not used in the metallic state as medicine. Arsent Trioxtipum. Arsenic Trioxide. (U. S. P.) Actpum Arsrenosum. Arsenous Acid. As,O3;. (U.S. P., 1890.) Synonym.—Acidum arseniosum, B. P.; acidum arsenicosum, P. G.; arsenic trioxide, white arsenic, arsenicum album, arsenic, arsenious anhyrid, E.; acid arsenieux, arsenic blanc, fleurs d’arsenic, Fr. ; arsenicsiure, weisser arsenic, G. Derivation.—Arsenical ores are roasted and purified by sublimation. Properties—A heavy solid, occurring either as an opaque, white powder, or in irregular masses of two varieties; the one SOLUTION OF POTASSIUM ARSENITE 207 amorphous, transparent and colorless, like glass; the other crystal- line, opaque, or white, resembling porcelain. Both are odorless and tasteless. The glassy variety dissolves slowly in 30 parts of water; the porcelain-like in 80 parts of water. Arsenous acid is sparingly soluble in alcohol, but soluble in glycerin, hydrochloric acid and solutions of the alkali hydrates and carbonates. When heated to 424° F., arsenous acid is completely volatilized without melting. Incompatibles.—Lime water, salts of iron and magnesia. Dose.—H., gr.i.-v. (.06-.3) ; Sh. & Sw., gr.i-ii. (.06-.12); D., gr. 70-710 (.002-. ae Lievor Porastr Arsenitis. Solution of Potassium Arsenite. (USE) (Fowler’s Solution.) Synonym.—laiquor arsenicalis, B. P.; liquor kali arsenicosi, P. G.; solutio arsenicalis Fowleri, kali arsenicosum solutum, arsenical solution, E.; liqueur arsenicale de Fowler, Fr.; Fowlers’- che tropfen, G. Arsenous acid, 10 Gm.; potassium bicarbonate, 20 gm.; compound tincture of lavender, 30 Ce.; distilled water to make 1000 Ce. Strength, 1 part of arsenous acid in 100. Dose.—H. & C., 3 ii.-3 i. (8.-30.); Sh. & Sw., 3 i--ii. (4.-8.) ; D., Mii-x. (.12-.6). Usual dose for H., 3 ss. (15. ). Liquor Actp1 Arsrenost. Solution of Arsenous Acid. (U. 8. P.) Synonym.—Liquor arsenici hydrochloricus, B. P.; hydrochloric solution of arsenic, E.; liqueur arsenicale hydrochlorique, Es chlorarsenik-lésung, G. Arsenous acid, 10 Gm.; diluted hydrochloric acid, 50 Ce.; distilled water, a sufficient quantity to make 1000 Ce. Strength, 1 part of arsenous acid in 100. Dose.—Same as Fowler’s solution. Aroxyt. Sodium Arsanilate (C,H, NAs O, Na+ 3 H,O). A combination of anilin and arsenic, a white, soluble, crystalline powder containing 26 per cent. of metal arsenic. Hare states that atoxyl is 140 as toxic as Fowler’s solution. Atoxyl is given subeutane- 208 INORGANIC AGENTS ously in ten per cent. freshly prepared solution in trypanosomiases (dourine, surra, nagana), piroplasmes, anemias and leukemia. Dose.—Gr. iv., gradually increased to gr. xv., once daily. Over- dosage has caused blindness. A reduction-product of atoxyl, arseno-phenyl-glycin, a yellow, soluble powder, bids fair to supersede atoxyl in trypanosomiases, as it cures apparently by one injection. It is too recent to judge its true value as yet. . Sodium cacodylate is a white soluble powder identical in action with arsenic. . Dose.—H., gr. x.-xl.; D., gr. %4-% subcutaneously. It has been used successfully in the treatment of dourine, and other trypanosomiases, given in the dose of 8 grs. twice daily under the skin to horses for 5 days, followed by an intermission cf a week and the same repeated. ACTION OF ARSENICAL COMPOUNDS. External.—Arsenous acid acts as a caustic on raw surfaces and mucous membranes. It produces considerable pain, and may lead to poisoning. In frogs poisoned by arsenic the epidermis peels off very rapidly, owing to degeneration of its lower layers. Internal.—Digestive Tract.—Arsenic, when given in minute doses, improves the appetite, and inereases both the motion and secretions of the stomach and duodenum. In larger amounts, ar- senic is an irritant, causing loss of appetite, nausea and digestive disturbance. In toxic doses arsenic produces gastro-enteritis. Blood.—Arsenic is absorbed into the blood, and in some forms of anemia increases notably the number of red corpuscles, and to some extent the hemoglobin. Circulation.—It is said that arsenic stimulates the pulse rate when given in minute doses. In large doses it has a local depressing action on the heart—and probably on the vasomotor centre—lowering the force and frequency of the heart and reducing blood pressure. The nerve endings, ganglia, and muscle of the heart are alike para- lyzed, and this action takes place when the heart is removed from the body. Respiration.—In small doses arsenic quickens the breathing and stimulates the respiratory centre; whereas in lethal amounts the respiration fails through lowered blood pressure and exhaustion. Nervous System.—The nervous apparatus is powerfully in- fluenced by arsenic. Toxic doses cause paralysis of the spinal tracts, in frogs, with loss of sensation, motion, and reflex action, and the ACTION OF ARSENICAL COMPOUNDS 209 brain and nerves are also depressed. ‘The nerve trunks are chiefly affected in the higher animals. There is peripheral neuritis and trophic changes occur. Medicinal doses of arsenic are stimulant to the nervous system generally. Metabolism.—Therapeutic doses probably diminish tissue. change and the elimination of urea and carbonic dioxide. Large doses, on the other hand, increase metabolic processes and the escape of nitrogenous waste. Elimination.—Arsenic is eliminated slowly by most channels, but mainly by the urine and to a less extent by the mucous membrane of the respiratory and digestive tracts. Traces are found in the milk, sweat, tears and saliva. It exists in, and can be recovered from, the bodies of animals years after their death from toxic amounts of arsenic. Summary.—Arsenic is unfortunately one of die drugs whose physiological action—so far as we know it—does not apo any light, in many instances, upon its therapeutic effects. In altering the condition of the patient for the better, in some diseases, it is described by that vague and otherwise indefinable term, “alterative.” Toxicology.—The lower animals, as the horse and cow, are ‘proportionately not nearly so susceptible to the poisonous effects of arsenic as the human subject; 114 grains is the smallest fatal dose reported in man. An amount as large as one drachm of arsenous acid in solution is required to cause death in a horse or cow, although much smaller quantities have produced death when repeated a num- ber of times (two daily doses of 45 gr., four daily doses of 30 gr. have proved fatal to horses). One half ounce to an ounce and a half of white arsenic is the toxie single dose for the horse and cow, and from one to two drams for sheep—with considerable variations. Dogs have been killed by 3 grains. Mild toxic action is seen follow- ing therapeutic doses of arsenic when the physiological limit is reached. This condition is characterized by loss of appetite (nausea. and vomiting in dogs), watery discharge from the nose and eyes, puffiness of the eyelids, indigestion with mild colic, and diarrhea. The pulse may be accelerated and harder than normal. The ap- pearance of albumin in the urine is the surest sign that arsenic has been pushed past the safe physiological limit. Acute Poisoning begins with bilious, mucous, or bloody purging and colic. There is vomiting in dogs. Thirst is excessive; the urine is high-colored and Hilscminmo i the pulse is feeble, small and frequent ; the respiration is rapid and difficult from abdominal pain; the extremities are cold, and there is great weakness of the limbs. Collapse, with eoremal ore and coma, often close the scene in from five to twenty hours to three days. 210 INORGANIC AGENTS A sub-acute form of poisoning occasionally occurs after a remission from the acute attack, only to be followed by death in from two to five days. In the interim, cutaneous eruptions may appear. Rarely, death takes place within an hour or two, in coma, collapse or convulsions. Chronic Poisoning, such as is seen in the human subject living in apartments furnished with arsenical wall paper or fabrics, or in those working in arsenic, is rarely observed in animals and only occurs in those living in the immediate vicinity of smelters and chemical works. In this condition there are symptoms similar to those noted above as occurring in the milder form of arsenic poison- ing, together with gradual loss of strength and flesh, suppression of milk, nasal ulcers, local paralysis or paraplegia, and anesthesia. © (WU: S: P.) Synonym.—Spiritus rectificatus, B. P.*; spiritus vini rectifi- eatus, alcohol vini, rectified spirit, E.; alcool, Fr.; weingeist, G. ; spiritus, P. G. Aleohol is derived directly from fruit sugar, and indirectly from starch. The grains, as wheat, rye, corn; and potatoes, supply starch most economically. The starch in these substances is con- verted into glucose by heating with very dilute sulphuric acid, or by fermentation with malt. Glucose is further acted upon by yeast con- taining the Torula cerevisie, which converts 15 per cent. of glucose * Rectified spirit (B. P.) contains 90 per cent. of pure alcohol by volume (85.65 per cent. by weight). There are four official dilutions in the B. P. containing 70, 60, 45 and 20 per cent. of alcohol by volume respectively. 258 INORGANIC AGENTS into alcohol and carbonic dioxide. OC,H,,0O,=2 C,H; O H + 2 CO.. The weak alcohol resulting is subjected to repeated distillation until sufficiently pure and concentrated. In the natural fermenta- tion of fruit sugar in grape juice, during the formation of wine, the amount of alcohol is self-limited to 15, rarely 20 per cent., since the ferment is killed by an amount of alcohol greater than this. Deriwation.—The official aleohol is derived from rectified spirit, by maceration, first with anhydrous potassium carbonate, then freshly fused calcium chloride, and finally by distillation. Properties:—A liquid composed of about 92.3 per cent., by weight, or 94.9 per cent., by volume, of ethyl aleohol (C,.H;O H), and about 7.7 per cent., by weight, of water (U. S. P.). A trans- parent, colorless, mobile and volatile liquid, of a characteristic, rather agreeable odor, and a burning taste. Spec. gr. about .816 at 15.6 C. (60° F.). Miscible with water in all proportions and with- out any trace of cloudiness. Also miscible with ether or chloroform. It is readily volatile at low temperatures, and boils at 78° C. (172.4° F.). It is inflammable and burns with a blue flame. Dose.—H. & C., 3 i.-iii. (30.-90.) ; Sh. & Sw., 3 ii-iv. (8.-15.) ; D., 3 iii. (4.-8.). PREPARATION. Alcohol Dilutum. Diluted Alcohol. (U.S. P.) A liquid composed of about 41.5 per cent., by weight, or about 48.9 per cent., by volume, of absolute ethyl alcohol (C,H; O H), and about 58.5 per cent. of water. (U.S. P.) Derivation.—Alcohol, 500; distilled water, 500. Autconot Azssotutum. Absolute Aleohol. C,H;O H. (U. §.-& BP.) Ethyl aleohol, containing not more than 1 per cent., by weight, of water. Deriwvation.—Percolation of the purest alcohol through quick- lime, out of contact with the air, and redistillation in vacuo. Properties.—Transparent, colorless, mobile and volatile liquid, of a characteristic, rather agreeable odor, and a burning taste. Very hydroseopic. Spee. gr. not higher than 0.797 at 15.6° C. (60° F.) DEODORIZED ALCOHOL 259 AtcouoLt Droporatum. Deodorized Aleohol. ( Non-official. ) A liquid composed of about 92.5 per cent., by weight, or 95.1 per cent. by volume, of ethyl alcohol (C. H; O H), and about 7.5 per cent., by weight, of water. Derwation.—Distillation of alcohol with about 2 per cent. of pure fused sodium acetate. Properties.—Similar to alcohol, except as regards odor. Sriritus Frumenti. Whisky. (U.S. P.) Synonym.—Eau-de-vie de grains, Fr.; kornbranntwein, G. Derwation.—An alcoholic liquid obtained by the distillation of the mash of fermented grain (usually of mixtures of corn, wheat and rye), and at least four years old. Properties.—An amber-colored liquid, having a distinctive odor and taste, and a slightly acid reaction. Its specific gravity should not be more than 0.945, nor less than 0.924, corresponding, ap- proximately, to an alcoholic strength of 37 to 47.5 per cent. by weight, or 44 to 55 per cent. by volume. Contains no more than traces of fusel oil. The alcoholic liquors owe their flavor or bouquet to ethers which are only developed in course of time. The amylic alcohol, or fusel oil in whisky is therefore converted into ethers, which give the characteristic flavor to whisky. Dose.—H. and C., 3 ii.-iv. (60.-120.); Sh. & Sw., 3% i-il. (30.-60.) ; D., 3 i-iv. (4.-15.). Sprrirus Vint Gartiict. Brandy. (U.S. & B. P.) Synonym.—Spirit of French wine, E.; eau-de-vie, cognac, Fr. ; Frantzbranntwein, G. Deriwwation.—An alcoholic liquid obtained by the distillation of the fermented unmodified juice of fresh grapes, and at least four years old. Brandy is somewhat astringent and is often not made from the distillation of wine, but is a factitious preparation. Native brandy is said to be purer, but is usually inferior in flavor to that of foreign manufacture. Brandy contains 39-47 per cent. of absolute alcohol by weight; 46-55 per cent. by volume. Dose.—Same as that for whisky. 260 INORGANIC AGENTS Spiritus Juniper1 Composirus. Compound Spirit of Juniper. (U. 8. P.) Derivation.—Oil of Juniper, 8; oil of caraway, 1; oil of fennel, 1; alcohol, 1,400; water to make 2,000. Compound spirit of juniper is similar to gin in its therapeutic action. Contains about 15 per cent. more alcohol. Gin is made by distillation of fermented malt and juniper berries. Gin differs from the other alcoholic preparations therapeutically in being more diuretic. Dose.—Same as that for whisky. Rum. (Not official.) Rum is made from a fermented solution of molasses by distilla- tion. It contains, by weight, from 40 to 50 per cent. of absolute alcohol. Rum does not differ physiologically from alcohol. There is no authoritative Latin name for rum. Dose.—Same as that for whisky. Vinum Atsum. White Wine. (U.S. P.) Derwation.—An alcoholic liquid made by fermenting the juice of fresh grapes, the fruit of Vitis vinifera (nat. ord. vitacez), free from seeds, stems, and skins. Properties.—A pale amber or straw-colored liquid, having a pleasant odor, free from yeastiness, and a fruity, agreeable, slightly spirituous taste, without excessive sweetness or-acidity. The Phar- macopeia (1890) directs that the wine should contain from 7 to 12 per cent., by weight, of absolute alcohol. California Hock and Reis- ling, Ohio Catawba, Sherry, Muscatel, Madeira and the stronger wines of the Rhine, Mediterranean, and Hungary, come within the pharmacopeeial limits. Wines containing more than 14 per cent. of alcohol, are usually fortified, i.¢e., have alcohol or brandy added to them, and much imported Sherry and Madeira contain 15 to 20 per cent., by weight, of absolute alcohol. Vinum Rusrum. Red Wine. (U.S. P.) Derivation.—An alcoholic liquid made by fermenting the juice of fresh colored grapes, the fruit of Vitis vinifera (nat. ord. vitacez) . in presence of their skins. — 7 ALCOHOL 261 Properties—A deep-red liquid, having a pleasant odor, free from yeastiness, and a fruity, moderately astringent, pleasant and slightly acidulous taste, without excessive sweetness or acidity. Should contain not less than 7, nor more than 12 per cent., by weight, of alcohol. Native Claret, Burgundy, Bordeaux, and Hun- garian wines may be included within the pharmacopeial limits of vinum rubrum. Port (vinum portense) is fortified with brandy during fermentation, and contains 15 to 25 per cent. by weight, of absolute alcohol. Port is astringent from tannic acid in the grapes, skins and stalks, or the astringency may be due to logwood. Red wines are said to be rough, contain tannic acid and there- fore are astringent. Dry wines are those which contain little sugar. The wines develop ethers with age, and these improve their flavor and action. Champagne contains about 10 per cent. of absolute alcohol and carbonic acid gas, which acts as a local sedative upon the stomach. Ale, stout and beers contain from 4 to 8 per cent. of alcohol, together with bitters and malt extracts. Cider contains 5 to 9 per cent. of absolute alcohol. Imported Sherry (vinum xericum, B. P.), 15 to 20 per cent. of absolute alcohol. Alcohol is the solvent most com- monly employed in pharmacy, dissolving alkaloids, resins, volatile oils, balsams, oleo-resins, tannin, sugar, some fats and fixed oils. Action External.—When applied in dilution to mucous mem- branes, raw surfaces or wounds, alcohol is a stimulant and local anesthetic; while in concentration, it is irritant and even caustic, coagulating mucus and albumin. [If alcohol is allowed to evaporate from the unbroken skin, cooling of the surface and contraction of the superficial blood-vessels ensue, with diminished secretion of sweat; but when alcohol is rubbed into the skin, it is absorbed, takes up water, hardens the integument and causes temporary vascular dilatation. Alcoholic aqueous dilutions containing 60 to 70 per cent. of absolute alcohol are among the most valuable skin disinfectants. Absolute alcohol, or the undiluted commercial alcohol, have no germicidal action on dry bacteria, and alcohol in less than 40 per cent. strength is too weak. Alcohol is equal in germicidal action to 3 per cent. carbolic acid solution. Action Internal.—Alcohol acts locally upon the mucous mem-’ brane of the alimentary canal, as described above, and if swallowed in concentration it produces congestion and white patches in the mouth by coagulating albumin upon the mucous membrane. The secretion of saliva is increased. In small doses the more poweriul alcoholic liquors, as whisky and brandy, aid digestion by stimulat- ing locally the gastric circulation, secretion, movement and appetite. Aleohol, except in great dilution, tends to inhibit the action of 962 INORGANIC AGENTS the digestive ferments—gastric and pancreatic—and in so far antagonizes its beneficial influence on gastric digestion just noted. So, while often aiding digestion, alcohol may fail on this account in some cases. | In large amounts, alcohol destroys the action of the peptic and pancreatic ferments, causes inflammation of the walls of the stomach and perverts the normal secretion into a mucous discharge. Aleohol is slightly astringent in the digestive tract, and may relieve pain by its local anesthetic action upon the stomach, and spasm, by stimulating the nervous mechanism controlling the stomach and bowels, and so co-ordinating the peristaltic movements. Circulation.—The reputation of alcohol as a circulatory stimu- lant has been much dimmed by the results of many experimenters who have found it has no stimulating action on the heart whatever. Still more recent work shows that alcohol has a mild stimulating action on the heart—especially when nutrition is low—probably by providing the heart muscle with assimilable nutriment. The reason for the supposition that alcohol is a heart stimulant was based on its action in increasing the pulse rate in man. In animals diluted alcohol does not affect either the rate or force of the heart, except in poisonous doses, when the pulse is slowed and weak- ened, owing to weakening of the cardiac systole and dilatation of the heart cavities. In man the increased pulse rate is attributable to muscular and mental activity produced by alcohol. The blood pressure is not materially altered by medicinal doses of alcohol. Alcohol raises blood pressure, however, after section of the cord cuts off vasomotor action. More delicate apparatus also shows that the output of the isolated heart is greater under alcohol. Marked dilatation of peripheral vessels following the use of alcohol, is seen in the flushing of the face in man. Redistribution of blood occasioned by alcohol appears to be of signal value in certain morbid conditions, as chills. In fever the slowing of the pulse, sometimes produced by alcohol, is thought to be due to its quieting effect on the central nervous system. There is a transient stimulation of the heart induced by the ingestion of strong alcoholic solutions in acting reflexly on the cir- culatory centres through irritation of the upper alimentary mucous membrane. Large doses of alcohol depress and paralyze the vaso-constrictor centres and heart muscle. Respiration.—The respiration is not appreciably influenced by medicinal doses of alcohol in animals. In man slight reflex stimula- tion occurs, with increase in rate, owing to peripheral excitation ALCOHOL 263 of the alimentary tract. Enormous doses paralyze the respiratory centres. Temperature.—The temperature, both in health and fever, may be lowered by alcohol, because alcohol causes relaxation of the peripheral blood-vessels and loss of heat by radiation from the skin. The larger the quantity of alcohol ingested, the greater the fall of temperature.—lIn alcoholic narcosis, vasomotor paralysis and lessened movements lead to great loss of heat, particularly if the animal be at the same time exposed to cold. In small doses, aleohol may some- times increase the temperature in man by leading to excitement and muscular movements, but the sensation of warmth perceived in man following the use of alcohol is generally fallacious, and is simply due to flushing of the vessels of the skin and stomach. Some of the lowest temperatures ever observed have been in drunken persons exposed to cold. Tissue Change.—Metabolic activity is not altered to any degree by the action of alcohol in ordinary amounts. In serving as a non- nitrogenous food, of course, aleohol may influence carbonic dioxide exhalation as do other foods of its kind. But the drug does not exert a specific depressing action on the blood corpuscles or cell protoplasm to hinder oxidation, as it was formerly thought. Deductions drawn from the action .of alcohol on tissue change as shown by carbonic dioxide and urea elimination are faulty. Aleohol increases or diminishes tissue change and oxidation only in proportion as it stimulates or interferes with muscular movement. Under the influence of alcohol more nitrogen escapes as uric acid and less in the form of urea. Nervous System.—Moderate doses of alcohol stimulate, while excessive quantities depress and paralyze the nervous system. This action is similar to that exerted upon the circulatory organs. The ~ local effects of alcohol upon the peripheral nerves resembles the action after absorption upon the system generally. The nervous system is affected in nearly the same order and manner as by anesthetics, and the same stages may be observed. The stages include the stimulant, depressant and paralytic. The law of dissolution is demonstrated by alcohol, as the more highly organized centres, and those more recently developed in the process of evolution are the first to suc- eumb, and following out this order the medulla, the first of the higher centres to be developed, is the last to be influenced by the drug. In accordance with this law the cerebrum is first acted upon. The period of excitement is brief and is due in a considerable degree to the increased cerebral circulation and flushing of the brain. It is essential to emphasize the fact that by far the most apparent and 964 INORGANIC AGENTS decided action of alcohol is one of depression upon the nervous system as a whole. Many experimenters—as Schmiedeberg and Bunge— affirm that alcohol acts only as a depressant to the nervous system from the very outset. An increasing mass of evidence corroborates this view. The apparent enhanced mental activity in man is, ac- cording to this theory, simply due to lack of inhibitory control over the higher cerebral centres. Hence the freedom of speech and lack of modesty. Similarly the activity of the spinal reflex centres is thought to follow failure of inhibition. The mental excitement in man is chiefly due to exciting surroundings and does not occur in many persons nor in animals. While the fact that alcohol is no more a nervous than a cir- culatory stimulant is now being generally accepted, the author has not yet seen fit to change his original statements in this book. Alcohol has certainly an apparent primary stimulating effect on nerve centres and it is yet to be positively proven that alcohol has no real, actual stimulating effect on the nervous system. The stimu- lating influence of alcohol upon the spinal centres is more marked in the lower animals than in man, because the brain is proportion- ately small and poorly developed in the former. The primary stimu- lating effect of alcohol is shown in man by increased mental activity and apparent brilliancy, but acute reasoning and judgment are not enhanced, and in many cases there is almost immediate mental con- fusion and drowsiness induced. In man there is emotional excite- ment and the functions of speech and imagination are stimulated in the primary stage, but depression is soon noted in the loss of judgment and reasoning power, emotional control, decent restraint and speech. The patient cries, shouts, sings or laughs and talks incoherently. In the lower animals the stimulation of the higher and sensory psychical cerebral centres, with exhilaration, is rarely observed, but depression is seen in stupor and muscular incodrdina- tion. Stimulation of the cerebral motor centres is shown by motor excitement. In man, following the symptoms described above, there is incodrdination of muscular movements, first of those more highly and recently organized, such as are employed in writing, and then the muscular movements more remotely developed are affected, and the person is unable to walk, and finally there is complete paralysis of the motor centres and muscles. The staggering and uncertain gait of drunken people occurs not only because the cerebral motor and cerebellar centres are depressed by alcohol, but also because of loss of sensation and touch, or muscular sense, which is essential in main- taining the equilibrium. In relation to the spinal cord, primary stimulation of the reflex centres is more marked in animals than in ALCOHOL 265 man, as has been pointed out. In animals this stimulation causes motor excitement, so that the patient trembles, jumps about, or strikes out with the feet. Depression of the reflex centres occurs in the latter stage of poisoning, and is exhibited by involuntary defeca- tion and micturition; sensation and voluntary motion are lost. The motor nerves and muscles are not generally paralyzed, except by the local action of alcohol. The medulla finally becomes depressed and paralyzed, so that respiration, which is first stimulated, now fails, and the heart muscle becomes paralyzed and its action ceases. The action of alcohol upon the nervous system may be sum- marized with a fair degree of accuracy, as stimulation and then depression of the parts enumerated below, and in the following order: Cerebral psychical centres. Spinal centres. Cerebral sensory centres. Sensory, reflex and motor. Cerebral motor centres. Medullary centres. , Cerebellum. Vasomotor (early depression). Respiratory. Horses and dogs are comparatively susceptible to alcohol, ruminants slightly so. An amount of alcohol equivalent to a pint of whisky has killed a sound horse, while four ounces of whisky will | cause death in dogs if vomition be prevented by ligature of the esophagus. Primary motor excitement is followed by unsteady, staggering gait, and coma in fatal cases. Skin.—Aleohol dilates the peripheral vessels, and therefore brings more blood to the sudoriparous glands, and excites their func- tional activity. It is thus a diaphoretie. Kidneys.—Aleohol acts as a diuretic. The exact mode of this action is unknown. Nutrition.—Aleohol is a food, and, like other non-nitrogenous foods, supplies force and energy in its oxidation, takes the place of fats and carbohydrates, and may form fat in the body. It also protects food and tissue proteids from combustion. We are ignorant of the fate of alcohol after absorption, but we do know that the greater portion is decomposed and is not eliminated. Alcohol is most advantageous as a food in fever, or in conditions associated with weak digestion, since it is readily absorbed and assimilated. Alcohol causes dulness and lessened power for mental or physical work in man, and in normal conditions is not a desirable food unless there is a deficiency in the ordinary diet. In acting as a substitute for fat and carbohydrates, alcohol assists the accumulation of fat. 266 INORGANIC AGENTS Elimination.—When alcohol is ingested in ordinary doses it is practically all consumed, and none but the most trivial amount is eliminated, i.e., five to ten per cent. The greater the quantity absorbed the larger the amount eliminated by the urine, breath, sweat and feces, both relatively and absolutely; but under no cir- cumstances after the most enormous doses does the elimination exceed 25 per cent. of the quantity ingested. Milk is not affected in quality or quantity through the ingestion of alcohol by the animal secreting it. Summary.—Alcohol is externally refrigerant, astringent, anhidrotic and antiseptic, and if applied so that absorption occurs, it is rubefacient. On raw surfaces it is slightly anesthetic. Alcohol is internally a stomachic, carminative and slight local anesthetic in the digestive tract. Alcohol is reflexly a heart stimulant through its irritant action on the alimentary tract before absorption. It also is a direct, mild stimulant to the heart. Alcohol is a narcotic and its chief action is in progressively depressing and paralyzing nerve cen- tres. It supplies force and is a food. Alcohol is a diuretic, diaphoretic, and antipyretic in dilating peripheral vessels and in causing sweating. Acute Poisoning.—In coma and muscular relaxation, the treat- ment consists in emptying the stomach by the tube, in the external application of heat and counter-irritants; while strychnine, digi- talone and atropine should be given subcutaneously and followed up with ammonia by the mouth. Uses External—Alcohol is applied to the unbroken skin to bruises, for its local refrigerant and astringent action in relieving pain and congestion. Diluted to 70 per cent. strength, aleohol forms an antiseptic and local anesthetic application to wounds, and like most antiseptics, relieves itching, particularly when combined with 1 to 2 per cent. of carbolic acid. Alcohol diluted with one-third part of water makes one of the best known agents for disinfection of the hands and operative field. It is relied upon entirely in some of the best hospitals in the country, in addition to thorough serub- bing in soap and water. Uses Internal.—Digestive Tract.—Alcohol is a useful remedy to promote appetite and assist digestion. The drug should be given immediately before eating or with the food, properly diluted, and often advantageously with egg and milk during fever or convalescence from acute diseases. Alcohol is frequently combined with bitters, as compound tincture of gentian, when employed as a stomachic. Acute Diseases.—Alcohol finds its greatest field of usefulness in the treatment of febrile diseases, notably influenza and strangles, bronchitis and pneumonia in horses. In such conditions it flushes ALCOHOL 267 the vessels of the skin and distributes the blood more equally, allowing the heart to receive more blood and thus overcoming internal con- gestion. It is impossible to reconcile the clinical remedial effects of aleohol with its action on healthy animals. The results of recent researches—especially as showing an absence of stimulation of the circulation and respiration by aleohol—has led to its lessened use as a therapeutic remedy. Nevertheless the enormous practical ex- perience of some of the most acute clinicians of the past and present, that aleohol renders service in the diseases named herein, does not permit one to hastily sweep it aside as a therapeutic agent. We may summarize its worth in acute diseases as follows. It is a food and one which is not only digestible but which in itself may aid digestion. It has more food value than sugar. It dilates peripheral vessels and equalizes the circulation. In man one of its most potent effects is probably in acting as a narcotic and quieting the nervous system. A high temperature does not contra-indicate its use, but it is not desirable in the early stages of acute inflammatory disorders. Alco- hol is particularly serviceable in asthenic diseases—as purpura —and in continued fevers associated with much depression—as in puerperal and other forms of septicemia. In fevers alcohol sometimes causes the heart to beat more slowly. Whether this be due to stimulation of the inhibitory apparatus or invigoration, directly or indirectly, of the weakened organ, we do not know. The pulse, respiration and nervous system are our guides, and the object is to bring the functions into a more normal condition. Aleohol should therefore reduce the frequency of the pulse and respiration, when they are too rapid, and should cause the animal to become quieter. If these results are obtained, the use of the drug should be persisted in; if otherwise, administration should be stopped. Small and repeated doses are more appropriate in fever. Alcohol is one of the most rapidly effective agents at our com- mand in syncope and cardiac failure from various causes—as sur- gical shock, severe hemorrhage, collapse, exhaustion, snake bite, and following exposure to cold. In these conditions it should be given in the form of spirits diluted with only an equal part of very hot water. It may act in these cases by stimulating reflexly the medullary, cardiac and respiratory centres by its irritant action on the ali- mentary tract. From our physiological data alcohol should not be of service in such conditions as a stimulant. Its narcotic action in serving as a nervous sedative in lessening anxiety and pain and so offsetting the effects of shock—may account in some measure for its 268 INORGANIC AGENTS worth. Thus morphine is one of the best drugs to use in surgical shock—even better than alcohol. After exposure to cold it is easy to explain the benefit derived from alcohol in its action in dilating the peripheral vessels and directly antagonizing the results of cold. Experiments on healthy animals regularly receiving moderate doses of alcohol have proved that they are more susceptible to inoculation with bacteria and toxins than controls. In disease, however, clini- cians greatly differ on this point, Hare even going so far as to claim his experiments show that alcohol increases the power of the blood to overcome germs in disease. Here again the results of the effects of alcohol in health and disease clash. Administration.—Veterinary practitioners are fortunately ex- empt from any moral considerations in relation to their medicinal use of alcohol. Rum, gin and whisky are more eommonly employed than the other alcoholic preparations, although diluted alcohol is practically as valuable. Gin is indicated when a diuretic action is important. Brandy, being more astringent, is given to dogs with diarrhea, and, combined with cracked ice in tial quantities, relieves vomiting. Sherry may also be administered to dogs with advantage. The dose of the various alcoholic liquids depends upon the quantity of alcohol contained in them. Animals will usually take aleoholic preparations voluntarily if largely diluted with water, milk or gruel. Whisky should be diluted with about 4 parts of water when given in drench, unless the reflex action is desired, when it is administered in considerable doses with an equal amount of hot water. Diluted aleohol, undiluted whisky or brandy are injected sub- cutaneously when a rapid action is imperative. firHrr. Ether. (C, ‘H;)3,0. (U.S. P.) Synonym.—Atther purus, B. P.; ether fortior, pure ether, E.; éther hydrique pur, Fr.; reiner ether, G. A liquid composed of about 96 per cent., by weight, of absolute ether or ethyl oxide [(C;H,;).0], and about 4 per cent. of alcohol containing a little water. Derivation.—Obtained by distillation of alcohol with sulphuric acid. There are two steps in the production of ether; sulphovinic acid and water are formed in the first step. H,SO,-+ C, H;O H = C, H;, H S 0,-+H,0. Sulphovinie acid is then further acted upon by alcohol. C3H,, H'S 0, + C,H, O 2 =(G38:)5 O4F= Hes 07a he distillate is freed from water by agitation with calcium oxide and chloride, and subjected to redistillation. ETHER 269 Properties.—A transparent, colorless, mobile liquid, having a characteristic odor and a burning and sweetish-taste. Spec. gr. .716 to .717 at 77° F. Soluble in about 10 times its volume of at 77° EF. Miscible in all proportions with alcohol, chloroform, ben- zine, benzol, fixed and volatile oils. Ether boils at about 35.5° C. (96° F.), and it should therefore boil when a test tube, containing some broken glass and half filled with it, is held for some time in the hand. Ether is highly volatile and inflammable; its vapor, when mixed with air and ignited, explodes violently. The color of light blue litmus paper moistened with water should not be changed when the paper is immersed in ether for 10 minutes. Upon evaporation ether should leave no residue. ther is a solvent for fats, oils, alkaloids, resins, gutta percha and gun cotton. Ether vapor is heavier than air, and, consequently, etherization should never be done above a light or fire. Dose.—H. & C., 3 i.-ii. (80.-60.) ; Sh. & Sw., 3 ii.-iv. (8.-15.) ; D., x.-3i. (.6-4.). PREPARATIONS. Aither Purificatus. (B. P.) (Ether freed from most of its alcohol and water.) Spiritus Aitheris. Spirit of Ether. (U. S. & B. P.) Ether, 325; alcohol, 675. (U.S. P.) Dose.—Same as for ether. Spiritus Aitheris Compositus. Compound Spirit of Ether. (U.S) & BP.) Synonym.—Hoffman’s anodyne. Ether, 325; alcohol, 650; ethereal oil, 25. (WeNS:) P:) Dose.—Same as for ether. Action External.—Ether evaporates rapidly from the skin, and abstracts so much heat in the process that the superficial parts are cooled, benumbed, and even frozen. This action is taken advantage of in spraying ether from an atomizer upon the skin (with or without cocaine injected) to cause local anesthesia in minor surgical opera- tions, as opening abcesses. The spray should not be applied more than a few minutes, or freezing, damage to the tissues, and retard- ation of the healing process will ensue. If ether is applied with friction, or if evaporation from the skin is prevented by bandaging, it will act as a rubefacient. Action Internal.—Digestive Organs.—Ether is an irritant to 270 INORGANIC AGENTS the mucous membrane of the digestive tract, and should be given only when considerably diluted with water. Ether stimulates secre- tion, motion, and increases local blood supply of the stomach. Ether, in concentration, resembles alcohol and ammonia in stimulating the heart reflexly, by its irritant action upon the alimentary canal, before it has time to be absorbed. It relieves pain and spasm in the di- gestive tract by codrdinating or restoring nervous control over the stomach and bowels. Circulation.—K ther is reflexly a stimulant to the heart and vasomotor centres through peripheral irritation of its vapor, as in the ease of alcohol. Some authorities allow no direct stimulating action (Oushny). In poisonous doses, or after prolonged inhalation, the circulation becomes depressed and weak. Nervous System.—Kther is chiefly depressant to nerve centres. Its apparent primary stimulation of the central nervous system is somewhat doubtful and many experimenters deny that it directly stimulates the nerve centres at all. Ether depresses and abolishes The functions of all the great nerve centres in the following order, and with the following results : 1. The cerebrum (with loss of consciousness). 2. Sensory spinal tract (loss of sensation). 3. Motor spinal area (loss of motion and partial loss of reflex action). 4. Sensory medullary centres. 5. Motor medullary centres (failure of respiration). Ether does not affect. the nerves or muscles when inhaled or ingested. Ether depresses the action of the nerves, however, when applied locally. Respiration.—The respiratory centre is stimulated by inhala- tion or ingestion of therapeutic quantities of ether. Paralysis of the respiratory centre occurs in the last stage of ether poisoning. Ether vapor is irritant to the respiratory mucous membrane, and causes coughing and choking during inhalation. It is not an appropriate anesthetic, therefore, in inflammatory conditions of the respiratory tract, because its vapor is given in greater concentration than in chloroform. In giving ether by the drop method undue irritation of the lungs is avoided and such conditions as bronchitis, pulmonary edema and pneumonia. Ether vapor excites the peripheral ends of the trifacial nerve in the face, and the vagus nerve in the lungs, so the temporary arrest of respiration often occurs when a fresh supply of ether is added during inhalation. Temperature.—The temperature of the body may be raised during the stage of excitement and struggling, but prolonged etheriza- ETHER O71 tion leads to loss of heat, owing to evaporation of ether from the lungs, and general depression of the nervous system. Hlimination.—Ether is eliminated principally from the lungs. Recent experiments indicate that ether causes contraction of the renal arteries, with diminution in the size of the kidneys, suppression of urine and albuminuria. Ether damages the kidneys, however, less than chloroform, which sometimes leads to fatty degeneration. Acetone has been found in the urine of 90% of patients in human practice within 18 hours of etherization (through a closed cone). Death may sometimes occur in coma, following ether anes- thesia, with rapid pulse and breathing and the odor of acetone in the breath. This oceurs less often than with chloroform (which see, under Metabolism). Uses.—Apart from its value as an anesthetic, ether is mainly of service for two purposes. J irst: in collapse, syncope, or “sinking spells,” due to poisoning, or natural causes. Ether may be given by the mouth, or subcutaneously into the muscular tissue, to avoid abscess. It should not be given as a stimulant when such an agent is required during or following anesthesia. Second: In spasmodic colic or tympanites, ether relieves pain, spasm and flatulence. The following prescription will be found useful for the horse: R VAC CNIS ee ery ae cro hea eerste ieclaioncitica a elena euerenavaine 5 i. Chlorofonmige aces iets ere ace orate eles z ii. IMME, @pilosbodaoubogoonodooocod¢oo00ODO doe 3 ii. M. et f. haustus. S. Give at once in a pint of cold water. Ether is a good antispasmodic remedy for asthma, hiccough or “thumps,” in the horse, and has a narcotic action upon tape and lumbricoid worms. When used for the latter purpose, ether should be followed by a purge. Ether may be employed in an enema to nareotize and remove the Oxyuris curvula of the horse. Ether should never be given internally or by inhalation to animals whose flesh is to be eaten soon after as it imparts a strong flavor to the meat and is also said to “spot? it. Administration.—Ether should be given in gelatine capsules; mixed with two parts of cracked ice and water; or with equal parts of brandy or whisky, to avoid undue irritation by ether and its vapor upon the mucous membranes during deglutition. 272 INORGANIC AGENTS Curorororm. Chloroform. CHCl. (U.S. &B. P.) Synonym.—Chloroformum purificatum, purified chloroform, E.; chloroformium, P. G.; formylum trichloratum, chloroforme pur, Fr.; reines chloroformum, G. A liquid consisting of 99 to 99.4 per cent., by weight, of abso- lute chloroform, and 0.6 to 1 per cent. of alcohol. : _ Derwation.—Aleohol and water are heated in a still to 37.7° C. (100° F.), when chlorinated lime is added and chloroform is evolved. The chemical action is very complicated. Chloroform, free from chlorinated compounds, is also made from acetone and chlorinated lime by distillation. Calcium acetate, hydrate and chloride result as bye products. ao 2 C;H,0 + 6 Ca O Cl, =2 C H Cl, + Ca (C.H;0,), + 2 Ca O.H, + 3 Ca Cl. For tests and purification, vid. U. S. P. Properties—A heavy, clear, colorless, mobile and diffusible liquid, of a characteristic, ethereal odor, and a burning, sweet taste. Spec. gr. not below 1.476 at 25° C. (77° F.). Soluble in about 200 times its volume of cold water, and in all proportions in alcohol, ether, benzol, benzine and the fixed and volatile oils. Chloro- form is volatile even at a low temperature, and boils at 60° to 61° C. (140° to 141.8° F.). It is not inflammable, but its vapor in the presence of a naked flame undergoes decomposition with the forma- tion of noxious gases, chiefly chlorine. This has caused death during chloroform inhalations. Chloroform is a solvent for fats, resins, oils, balsams, gutta percha, wax and many alkaloids. Dose.-—H. & C., 3 i-ii. (4.-8.); Sh. and Sw., M xx.-xxx. (1.3-2.); D., ™m ii-xx. (.12-1.3). PREPARATIONS, Aqua Chloroformi. (U. 8. & B. P.) (Saturated Solution. ) Used as vehicle in cough and diarrhea mixtures for dogs. 2 Linimentum Chloroformi. (U. 8. & B. P.) Chloroform, 300; soap liniment, 700. (U.S. P.) Spiritus Chloroformi. (U. 8. & B. P.) Chloroform, 60; alcohol, 940. (U. 8. P.) Dose.—H. & C., 3 iii. (30.-60.); Sh. & Sw., 3 ii.-iv. (8.-15.); D., 3 ss.i. (2-4.). CHLOROFORM 273 Action External.—Chloroform acts as a rubefacient if rubbed into the skin, or prevented from evaporation by bandaging. In evaporating from the surface it produces mild refrigeration. Chloro- form penetrates the skin more easily than many other agents, and is employed for this reason to aid the absorption of belladonna and other drugs used in liniments. Chloroform possesses some local anesthetic action upon mucous membranes, raw surfaces, or when rubbed into the skin. Action Internal.—Digestive Tract.—Chloroform is an irritant in concentration, but, properly diluted, stimulates the flow of saliva and increases the secretions, motion, and blood supply of the stomach. Chloroform has a local anesthetic and antiseptic action in -the alli- mentary canal, and by its stimulant effect in restoring the normal state of nervous and-muscular tissue, relieves spasm, pain and flatulence in the stomach and small intestines. Circulation—Chloroform exerts an ever increasing depressing influence upon the heart muscle, its ganglia, and the vasomotor centres. | Vasomotor depression leads to dilatation of the arterioles and leaking of blood into the veins, with consequent venous engorgement (particularly of the abdomen), and arterial anemia. Failure of respiration in chloroformization is secondary to cerebral anemia, and chloroform kills, primarily by vasomotor depression. (Leonard Hill and Hare.) The ventricles dilate and all cardiac muscular contractility is lost in fatal poisoning. Death, however, occurs almost invariably in healthy animals during chloroform inhalation from respiratory failure associated with circulatory depression. The heart usually continues to beat after cessation of breathing. Death from syncope occurs occasionally, and circulatory depression is greater and occurs more suddenly than with ether. Rarely sudden death occurs in the beginning of anesthesia from reflex inhibitory arrest of the heart produced by the inhalation of concentrated chloroform vapor. The degree of concentration is of the utmost importance. arses 3 ii Chloroform tray vesereis ekctetescsveleyat atest ete) stelacets 3 ss M. Sig. Give at one injection intratracheally. Phenol, 1 part; with camphor, 3 parts; forms a liquid which is without the toxic and caustic properties of phenol alone. It makes a serviceable application for small burns, wounds and ulcers, as in broken knees and in necrosis of the coronary band in horses. Phenol is useful as a spray in the form of Dobell’s solution which is indicated in coryza, in influenza and distemper. 304 INORGANIC AGENTS Sodii bicarb. Sodii boratis aay sor Phenol Sat pas Tes ae ees tb: SS Glycerin a on 5-2 ees eens rao & Aquae. Bark es On Sig—Dobell’s solution. Apply with atomizer or syringe. Crude carbolic acid may be used in 5 per cent. solution to disinfect infected buildings and their contents, and, with whitewash, can be applied to walls after cleaning. To be more precise, the strength of crude carbolic acid for dis- infection depends upon the amount of cresylic acid it contains, which may be ascertained from the dealer. The disinfectant solution of crude carbolic acid should be such that it will contain 2 per cent. of cresylic acid. Commercial cresol (containing over 90 per cent. of pure cresol) is more effective and cheaper than crude carbolic acid as a disin- fectant. It should be dissolved in hot water and used in 2 per cent. solution. A 5 per cent. cresol solution is useful in the form of a foot bath in a shallow trough for foot rot in sheep, which are driven through it thrice weekly. : Uses Internal.—The systemic action of carbolic acid after ab- sorption is of value in some general bacterial diseases. This is most notable in the case of tetanus, as has been seen. Moreover, .the subcutaneous injection of 2 drachms (8 ee.) of a 3 per cent. aqueous solution of carbolic acid every ten days into all pregnant cows during the prevalence of epizootic abortion has been extensively employed as a prophylactic measure. Recent reports discredit the value of this treatment, however. In the carbuncle form of anthrax in man, the injection of carbolic acid has yielded successful results and it may be tried in cattle. But speedy destruc- tion of anthrax patients in veterinary practice is usually the only wise procedure. Locally, carbolic acid may exert an antiseptic and anesthetic action in the stomach. Carbolic acid is sometimes of service in relieving vomiting and gastric pain caused by flatulence m dogs, and in counteracting intestinal fermentation and diarrhea in all animals. In diarrhea of dogs, grain doses are combined to advantage with bismuth subnitrate in powder, capsule, or pill. Crrosotum. Creosote. (U.S. & B. P.) Synonym.—Kreosotum, P. G.; kréosote, Fr.; kreosot, G. Derwation.—A mixture of phenols and phenol derivatives, ne eee 4 CRESOL 305 chiefly guaiacol and creosol, obtained during the distillation of wood tar, preferably of that derived from the beech, Fagus sylvatica Linné. (Nat. ord. cupuliferz. ) Properties.—An almost colorless, yellowish or pinkish, highly refractive, oily liquid, having a penetrating, smoky odor, and a burning, caustic taste. Usually becoming darker in tint on exposure to the ight. Spee. gr. not below 1.070 at 59° F. Soluble in about 140 parts of water, but without forming a perfectly clear solution. Freely soluble in alcohol, ether, chloroform, acetic acid, fixed and volatile oils. | Dose.—H., ™Mv.xv. (.3-1.); D., Mss. (.03-.12). Action and Uses.—The action of creosote upon animals is prac- tically the same as that of ecarbolic acid in kind, but is much less toxic. The antidotes and treatment of poisoning are also similar. Externally, creosote is as effective a germicide as carbolic acid, but the latter is usually preferred, being much cheaper. Creosote may be applied in the same strength for its local antiseptic, parasiticide, and local anesthetic action. It is employed in skin diseases and especially those of parasitic origin. In scab 1 part is dissolved in 65 parts of 50 per cent. alcohol, and in follicular mange of dogs it may be applied with olive oil (1 to 14) to which is added two parts of potassium hydroxide. Internally, creosote is administered, as is carbolic acid, to check vomiting and to act as an intestinal antisep- tic in indigestion with fermentation and diarrhea. Creosote is of much service as an inhalation (Mmxx. to Oi. of boiling water) in sub-acute bronchitis, in fetid nasal discharge and in gangrene of the lung in horses. It is occasionally given by intratracheal injection (creosote, Tx. in 5 ss. of 50 per cent. alcohol) in gangrenous pneu- monia of horses and to sheep and calves in the same manner in parasitic bronchitis (Mv. in 3 i. 50 per cent. alcohol). It may also pe given by the mouth in verminous bronchitis so as to kill the filaria in its elimination by the bronchial mucous membrane. Neu- mann advises creosote (3 ii.), benzine (3 x.), and water (2 qts.); of the mixture for sheep, 1 teaspoonful daily, by the mouth, for 8 days for verminous bronchitis. Cresot. Trikresol. C,H,OH. A mixture [C,H, (CH,;) O H] of the three isomeric cresols obtained from coal tar, freed from phenol, hydrocarbons and water. It should be preserved in amber-colored bottles from the light. A colorless, or straw-colored refractive fluid, having a phenol-like odor, and turning yellowish-brown on prolonged exposure to light. Spee. gr. 1.032. Cresol is soluble in 60 parts of water at 77° F.; miscible 306 INORGANIC AGENTS in all proportions with petroleum benzine, benzene, alcohol, ether and glycerin; miscible with alkali hydroxide solutions. The three cresols are meta-, ortho- and para-cresol. They are constituents of tars and are related to carbolie acid chemically and therapeutically. To increase their solubility as antiseptics they are suspended with soap (lysol), used in emulsion (creolin), or dissolved by salts (solveol). Cresol ranks favorably with phenol as an antiseptic but is used more commonly in the form of creolin and lysol. The dose of eresol is the same as that of phenol. Creotinum. Creolin. (Non-official.) Derivation.—Obtained from soft coal by dry distillation. Com- position very complex. It is said to contain cresol and higher homo- logues of phenol. Properties.—Dark-brown, syrupy, alkaline liquid, of a tarry taste and odor. Nearly soluble in alcohol; soluble in chloroform and ether. When added to water, creolin forms a white emulsion containing in suspension as much as 12 per cent. of the drug. Dose.—H. and C., 3, ss.-i. (15.-30.), in single dose. For con- tinuous use—H. and C., 3 i-ii. (4.-8.); D., mi-v. (.06-.3). Action External.—Creolin is a powerful and useful disinfectant, antiseptic, and parasiticide. It forms a slippery coating upon the skin. Strong solutions are not caustic, but may cause a dermatitis when continuously applied. Creolin generally represents carbolic . acid, but is much more efficient as a germicide, less irritating, and does not endanger animal life from absorption.* Aqueous solutions (emulsions), containing from 14 to 1 per cent., are employed for antiseptic purposes. Action Internal.—Creolin is eliminated by all channels, giving the secretions a tarry odor, and coloring the urine brown. One or two drachms of creolin (a lethal dose of carbolic acid), when given daily to dogs for weeks at a time, produce no bad effects. It is a good intestinal antiseptic, and better than carbolie acid. Uses.—Oreolin is employed mainly outside of the body, and is a useful general antiseptic for surgical purposes in 1 per cent. solu- tion. Antiseptic poultices, so valuable upon septic sloughing parts, are best made by soaking clean gauze in a 1 per cent. aqueous solu- tion of creolin, and applying the same, covered by a waterproof protective. Creolin solutions are not to be recommended for instru- ments during operations, as the fluid is so turbid that they cannot be seen by the operator. A 2 per cent. solution is useful for a *Creolin, to avoid toxic effects, should be pure. That made by Merck is a reliable article. LYSOL 307 vaginal or uterine injection; a 1 per cent. soiution for irrigation of the bladder in cystitis, or eye in keratitis and conjunctivitis; and a 14 per cent. solution for intestinal irrigation in dysentery. As a parasiticide, 2 per cent. solutions, or 10 per cent. ointments or soaps, may be used to kill lice, fleas, and acari of scab and mange. Froh- ner advises equal parts of creolin and alcohol, with 8 parts of green soap, in mange and scab with occasional use of a 2 per cent. bath. The same treatment is useful in chronic mange and grease. With alcohol (1-10-20) creolin is remedial in alopecia areata. Sheep are dipped to advantage in 2 per cent. solutions, to destroy ticks, instead of the more dangerous arsenical liquids. Creolin (of Merck) may be used internally, as an intestinal antisep- tie and anthelmintic. One ounce given on an empty stomach, in a quart of water, is one of the most effective vermifuges for the horse. Lysorum. Lysol. A preparation, Liquor Cresolis Compositus (U. S. P.), is now official and represents lysol. It bas the advantage of being cheaper than lysol. Derivation—From that part of tar oil which boils between 190° and 200° ©., by dissolving in fat and saponifying in alcohol. Properties.—A clear, brown, oily liquid, of a feeble, creosote- like odor. Soluble in water, forming a clear, frothy, soapy fluid, and in alcohol, chloroform, and glycerin. Lysol contains 50 per cent. of cresol. | Lysol is used as a substitute for creolin, in 14 to 2 per cent. aqueous solution. It is a powerful antiseptic, and is stated to be half as poisonous as creolin, and only 1% as toxic as carbolic acid. A 1 per cent. solution of lysol is more effectively antiseptic than similar solutions of either phenol, creolin or a 1 to 1000 solution of mercuric bichloride. The latter requires over one half hour to kill most pathogenic micro-organisms. One per cent. lysol destroys streptococci within one minute. Two per cent. solutions are useful in irrigating wounds and for making wet dressings and vaginal in- jections. Lysol should be bought under its official name (liq. cresolis co.), as it is then much cheaper. Solutions do not roughen the surgeon’s hands, and instruments submerged in them are not injured or obscured. The drug Liquor Cresolis Compositus is perhaps the most widely used and valuable surgical antiseptic and disinfectant at our disposal at the present time. 308 INORGANIC AGENTS BeranapuTnor. C1oH70 H. (U.S: 2} Synonym.—N aphtol. A phenol occurring in wood tar, but usually prepared artificially from naphthalin. Derivation.—Naphthalin is treated with strong sulphuric acid. B-naphthalin sulphonic acid is formed C,)H, H SO;). The latter acid is dissolved in water with milk of lime, and the resulting cal- cium salt is recovered by crystallization. The crystals are then dissolved in water and treated with sodium carbonate, when sodium naphthalin-sulphonate (Cy) H; SO; Na) results. The latter is mixed with fused sodium hydroxide, when sodium naphtol C,,H, O Na) and sodium sulphite are obtained. Hydrochloric acid is added to the former, and naphtol results, which is further purified by sublimation and recrystallization. Properties.—Colorless, or pale buff-colored, shining, crystalline lamine, or a white, or yellowish-white, crystalline powder; having a faint phenol-like odor, and a sharp and pungent but not persistent taste. Permanent in the air. Soluble in about 950 parts of water, and in 0.61 parts of alcohol; also very soluble in ether, chloroform, or solutions of caustic alkalies. septic and parasiticide. It is said to be several times more germi- cidal than phenol. B-naphtol somewhat resembles carbolic acid in its toxic effect. It irritates the mucous membranes, causing sneez- ing and coughing in the respiratory tract, nausea and diarrhea when swallowed, and acute nephritis, with inflammation of the urinary tract and strangury in its elimination. It is a useful application externally in 10 per cent. ointment, for mange and ringworm. Internally it is employed to kill round and tape worms, and as an antiseptic in intestinal fermentation. It should be given in keratin coated pill (to avoid irritating the stomach), or capsules, to dogs, and in ball to horses. Naputruarenum. Naphthalene. C,, Hs. (U. S. P.) Synonym.—N aphtalin. Derivation.—A. hydrocarbon obtained from coal tar by distilla- tion between 856° F. and 482° F. The impure naphtalin resulting is treated with sulphuric acid and sodium hydroxide, and is further purified by distillation with steam, and then by mixture with strong sulphuric acid, and finally by redistillation. RESORCINOL 309 Properties.—Colorless, shining, transparent lamine, having a strong characteristic odor resembling that of coal tar, and a burning aromatic taste ; slowly volatilized on exposure to the air. Insoluble in water; soluble in 13 parts of alcohol; very soluble in ether, chloro- form, carbon disulphide, and fixed and roletle oils. Dose. —H., 3 i-iv. (8.-15.); D., gr.i-xx. (.06-1.3). Actions and Uses—Naphthalene produces in poisonous doses diarrhea and emaciation, nephritis and retinal degeneration with cataract. It is oxidized in the body and eliminated in the urine as beta- and alpha-naphtol, but while thus sterilizing the urine neither naphthalene nor naphtol should be employed when there is irritation of the urinary tract. Naphthalene, like other coal tar products, is an antiseptic and parasiticide. It may be used as an antiseptic dressing powder upon wounds, or in 10 per cent. ointment for parasitic skin diseases. Naphthalene is almost insoluble in the digestive tract, and acts as an antiseptic, therefore, throughout this canal. It is of service in intestinal fermentation, diarrhea, dissentery, and as a vermicide in combination with castor oil. Naphthalene is administered to dogs in starch wafers or gelatine capsules ; and to horses in ball or electuary. Resorcivor. C,H,0,. (U. 8. P-) Synonym:—Resorcinum. Resorein. Metadioxybenzol. Derwative.—A diatomic phenol formed by the action of fuming sulphuric acid upon benzine, whereby benzine metadisulphonie acid [C,H, (H S O,).] results. The latter is neutralized by milk of lime; calcium sulphate is expressed, and sodium carbonate is added. The process is continued by filtration, and the filtrate evaporated to dryness. The residue is heated with sodium By este with the formation of sodium resorein [C,H, (O Na)s]. Sulphurous acid is driven off fant sodium resorein by boiling, and the result is extracted with ether; impure resorcin is recovered by distillation, and is purified by sublimation or by recrystallization from water. Properties.—Colorless, or faintly reddish, needle-shaped crys- tals, or rhombic plates; having a faint, peculiar odor, and a disa- greeable, sweetish, and afterward pungent taste. Resorcin acquires a reddish or brownish tint on exposure to light and air. Soluble in 0.5 part of water, and slightly more soluble in alcohol; readily soluble in ether or glycerin, and very slightly soluble in chloroform. Dose.—H., 3 iv.-vi. (15.-24.) ; Foals and Calves, 3 ss.-i. (2.-4) ; D., gr.ii.-v. (.12-. 3).. Action and Uses.—Resorcin was originally employed as an antipyretic, but is not now used for this action, being ie ‘depressing to the heart. It is an efficient antiseptic, externaliy and internally; 3 310 INORGANIC AGENTS possesses a slight local anesthetic effect, and is not nearly so irritating topically as oher iol. Resoreinol is chiefly used in skin diseases to cure itching, scaling and induration in subacute and cluonice eezema. It may be combined with zine ointment (1 to 8), or is used in solu- tion with glycerin and lime water, gr.xv. to xx. to the ounce. In- ternally, resorcin is of worth in diarrhea and fermentation. Formauprinypr. CH O FH. (Non-official. ) Synonym.—Formic aldehyde. Derivation.—Obtained by partial combustion of wood alcohol, without ignition, by evaporation of the spirit in contact with a hot, platinized, asbestos plate. 2 CH, OH+0,=2CHOH bs 2 H,O. Propertwes.—Formaldechyde is a pungent gas, having a spec. gr. of 1.6; soluble in water, forming a clear, colorless, stable solution when kept in glass-stoppered bottles, but volatilizing on exposure to the air. formalin was the commercial name for an aqueous solution containing 40 per cent. of formaldehyde gas, but is now official. PREPARATION. Liquor Vormaldehydi. (U.S. P.) Formalin. Containing not less than 37 per cent. of formaldehyde gas. Action and Uses.—Formaldehyde and formalin are powerful microbicides. A 1 per cent. solution of formalin will kill Staphy- lococeus pyogenes aureus in about an hour; B. typhosus in 40 to 50 minutes; B. coli communis in 30 to 40 minutes; B. anthracis and S. cholerz in less than 15 minutes. Clothes soaked in cultures of B. typhosus, S. choleree and Staphylococcus pyogenes aureus, and then for 24 hours in a 1 per cent. solution of formalin, were found to be completely sterile (Slater). Trillat and Robinson have apparently shown that formaldehyde gas has wonderful disinfectant and pene- trating properties, destroying all pathogenic bacteria in ordinary rooms containing the microorganisms buried under mattresses, be- tween blankets, in clothing and other articles, in the air, dust, and morbid seeretions. Harrington has prov ed, however, that the pene- trating power of form: dehyde is nil in the case of moist substances, and that sterilization is not always complete when microorganisms are imbedded in, or covered by, dry pervious material. Still, for- maldehyde is the best gaseous disinfectant now known for the sterilization of infected premises. It does not kill insect pests, animal | | TORMALDEHYDE oul parasites or rats, but burning sulphur is effective for this purpose. The gas is most effective between 60 degrees and 70 degrees F. It should not be used if air temperature is below 50 degrees F’. The premises containing tae gas should be sealed from 4 to 24 hours. Formaldehyde vapor is extremely pungent and irritating to the mucous mémbranes, causing running of the nose and eyes in those exposed to its influence ; but some experimenters have subjected ani- mals to formaldehyde vapor (of disinfectant strength ) for hours without causing their death. In Harrington’s experiments two rab- bits were killed by formaldehyde in the disinfection of a room, and exhibited the following post-mortem appearances: Congestion and hemorrhage of the buccal mucous membrane; intense bronchitis with hyperemia, and consolidation of the lung with a purulent and slightly fibrinous exudate. There was also congestion of the abdominal or- gans, including the liver, kidneys and spleen. As death may occur, it is certainly unwise to attempt the disinfection of premises with formaldehyde, when inhabited by men or animals. The injection of 2 per cent. formalin in glycerin into badly infected and suppurating joints has proved unusually successful in human surgery. lrom 2 to 4 drachms are used, after aspiration, and the injection may be repeated 3 times, a week apart. The joints are immobilized meanwhile. The solution should never be used until it is 24 hours old. Internal Action.—Solutions of formaldehyde are intensely irri- tant. Nausea, vomiting, coma with slow pulse, and death have fol- lowed its ingestion. The red blood cells are altered in form, and destructive changes have been noted in the liver and kidneys. For- maldehyde escapes unchanged in the urine. Uses.—Formic aldehyde vapor is not injurious to clothing, met- als, or other like articles, as are sulphurous anhydride or chlorine gas, and it bids fair to supersede all other agents for the gaseous disin- fection of premises infected with pathogenic bacteria. Formalde- hyde gas may be generated by evaporating formalin in a vessel over a lamp, or other form of heating apparatus. Harrington states that the evaporation of 110 ce. of formalin is sufficient to kill all pathogenic micro-organisms within 21% hours, in 1,000 cubic feet air space. Formaldehyde gas may be liberated most economically by mixing 8 oz. of potassium permanganate with 1 pint of formalin in a galvanized iron pail 12 inches deep and 10 inches in diameter at the bottom and 18 inches at the top. The pail should be placed on sand or in water as much heat is generated and great frothing occurs. This should be only done in deep tin vessels to avoid the effects of great frothing. This quan- tity of formalin and potassium permanganate is suitable for the 5 bY INORGANIC AGENTS disinfection of 1000 cu. ft. of space, if the air is moist and warm, but if cold and dry this amount will disinfect only half as much space. A solidified formaldehyde is also on the market to which one need only add hot water, to free the gas. In veterinary disinfec- tion one may spray formalin in five per cent. solution with a force pump all over the floors, walls, fixtures, ete. Rubber gloves should be used to protect the hands. Formalin, in 14 to 2 per cent. solution, is perhaps the most powerful antiseptic that has been used for surgical purposes, but, when used in such strength upon raw surfaces and mucous mem- branes it produces pain and irritation and coagulates albumin so as to shut off the underlying parts from participating in the antiseptic action. These stronger solutions, although formerly employed for surgical uses, should be confined to skin disinfection or where an escharotic action is desired on sloughing tissues. Ordinarily the strength of an aqueous solution should not exceed 1-2000, or at most 1-1000, for application to raw surfaces or mucous membranes, and even in this dilution applications sometimes produce considera- ble pain and irritation, and, for this reason, are contraindicted for ordinary surgical use. | Success is reported from the use of formalin on sloughing sur- faces of malignant growths and foul ulcers. A 4 per cent. solution is increased to 10 per cent. and finally to pure formalin, the solu- tions being applied on cotton saturated with the drug and retained on the part for thirty minutes each day. A 5 per cent. solution of formalin is serviceable for sterilizing catheters, instruments and sutures, for the preservation of pathological specimens, for the dis- infection of stables, and in the treatment of canker of the feet in horses. PREPARATIONS. Hexamethylenamina. Hexamethylenamine. C, H,, Ny (U.S. P.) (Urotropin.) Urotropin occurs in colorless, transparent crystals, soluble in 1.2 parts of water and in 14 parts of alcéhol; odorless, cf a sweet, afterward bitter taste, and slight alkaline reaction. It is made by combining solutions of ammonia and formaldehyde, and was first introduced into medicine by Nicolaier in 1895. Urotrepin appears to be decomposed in the kidneys with the liberation of formaldehyde, and thus disinfects the urinary tract. It is, in fact, considered the best urinary antiseptic in human medicine and has been used with the greatest success in the treatment of all infectious diseases of the urinary pas- sages, especially acute and chronic pyelitis and cystitis. It tends to render normal a putrid urine containing pus or mucus, is a solvent for uric acid and is slightly diuretic. These actions are of value in similar diseases of animals, especially of dogs. The liberation of formaldehyde is favored by an. acid urine and with an alkaline urine some agent, as benzoic acid, should also be given. \ DILUTED HYDROCYANIC ACID 313 Very recently it has been shown that urotropin is also eliminated in the bile, pancreatic juice, synovia, cerebro-spinal fluid, and in the saliva and milk of dogs. Also in middle ear mucus. For this reason the drug is now employed to disinfect these parts. After head and spine injuries and in middle ear abscess, septic arthritis and cholecystitis the drug is indicated. The drug may be given in from 5 to 10 grain doses thrice daily in solution, in canine practice. H. & C. 3 ii.-iv. (8.-15.). It can now be bought more cheaply under its official name than by its trade name, urotropin. In diabetes mellitus of the human urotropin is often beneficial in reducing the loss of glucose in the urine; it should be tried in this disease in dogs. Glutol (Formalin-Gelatin). Glutol is a coarse, white powder, without odor or irritating properties, and is prepared by dissolving gelatin in water and drying the solution in formalin vapor. It is a most valuable antiseptic powder in liberating formalde- hyde gas in contact with living cells. Glutol forms a scab when dusted over fresh wounds, preventing infection, and is serviceable in the treatment of in- fected wounds, abscesses, boils (after paracentesis), sinuses and other surgical conditions. It was first brought into use by Dr. C. L. Schleich, in 1896. Class 7.—Miscellaneous Carbon Compounds. Actpum Hyprocyantcum Ditutrum. Diluted Hydrocyanic Acid. HCN. (U.S. &B. P.) Synonym.—Prussie acid, acidum hydrocyanatum, s. borussicum, E.;* acide cyanhydrique, s. hydrocyanique, Fr.; cyanwasserstoff- sdure, blausdure, G. Derivation.—A liquid composed of 2 per cent., by weight, of absolute hydrocyanic acid, and 98 per cent. of water. Obtained by distillation of potassium ferrocyanide, 20; sulphuric acid, 8; and water, 65; into distilled water. The following reaction first occurs: K, Fe C, N,+2H,S 0,=2K,8S0,+ H, Fe C, N,; then on the application of heat, the hydroferrocyanic acid resulting in the first reaction reacts with the remaining potassium ferrocyanide and sulphurie acid, as follows: H, Fe C, Ng + K, Fe C, Ng + H.S Og —6§ HCN-+K,S 0,-+ K, Fe C, N,). Diluted hydrocyanie acid can also be made by mixing hydro- ehloric acid, 5; with distilled water, 55; silver cyanide, 6. Shake together in a glass-stoppered bottle. AgCON-+HClI=>HON-+ Ag Cl. When the precipitate of silver chloride falls, pour off the clear, supernatant fluid. * Scheele’s prussic acid contains 4 to 5 per cent. of the pure hydrocyanic acid. 314 XNORGANIC AGENTS Properties.— clear, coloriess liquid, of a characteristic taste and odor, resembling those of sitter almond. It is very unstable and is apt to be inert as obtained from ordinary drug stores. It should be kept in inverted glass-stoppered dark bottles. Incompatibles—Salts of iron, copper and silver; sulphides and red mercuric oxide. Dose.—H. & C., M.xxi-xl. (1.3-2.6) ; Sh., 1 x.-xv. (.6-1.); Sw., Mil-v. (.12-.8); D., mi.-iti. (.06-.2). Action Eaternal—Prussic acid is absorbed to some extent through the unbroken skin; paralyzes the peripheral sensory nerves, and acts as a local anesthetic. If the finger is held over a bottle containing the acid, it soon becomes anesthetized. Upon mucous membranes, or raw surfaces, prussic acid is rapidly absorbed and exhibits its usual constitutional action. Action Internal.—Alimentary Canal.—Hydrocyanie acid exerts a sedative effect upon the mucous membrane of the stomach and upper portion of the digestive tract. It is absorbed into the blood, but we are ignorant of its fate or mode of elimination. Blood.—In poisoning, the blood becomes first of a bright ar- - terial hue, and later assumes a dark, venous color. The first con- dition is due to the fact that the tissues do not absorb oxygen owing to changes in the protoplasm which interfere with cell respiration ; probably also in part because the blood is hurried so rapidly through the dilated peripheral vessels that it does not have time to yield up its oxygen. The dark color of the blood is probably owing to asphyxia and accumulation of carbonic dioxide, following the para- lytic action of prussic acid upon the respiratory centre. A sub- stance called cyanohemoglobin is formed outside the body by hydro- cyanic acid when shaken with blood. The acid appears to deoxydize the normal oxyhemoglobin, and blood thus treated has no ozonizing property. Cyanchemoglobin was thought to account for the action of prussic acid, but it does not exist within the body in the blood of poisoned animals. The red blood corpuscles are altered in shape by the action of prussic acid upon blood withdrawn from the vessels. They generally become rounder, then granular, and finally disin- tegrate and liquefy. But these changes do not occur in the blood during life. The general action of prussic acid is altogether inde- pendent of any influence upon the blood, since the same toxic effect is produced upon the bloodless, or “salt frog” (vessels containing normal salt solution), as upon the normal batrachian. Nervous System and Muscles.—Prussic acid first stimulates the hind-brain—as shown by convulsions, and excitation of the vagus, respiratory and vasomotor centres—and then paralyzes the whole nervous system. The brain, cord and nerves become paralyzed by DILUTED HYDROCYANIC ACID 315 targe doses. The convulsions occurring in poisoning are shown by experiments to be da2 probably to stimulation of the hind-brain, although they have been attributed to altered cerebral circulation and to asphyxia. They are, however, present during that period of poisoning when the blood is of a bright arterial hue. The spinal cord is paralyzed at a period after coma and convulsions have ap- peared. The peripheral nerves and muscles are paralyzed directly by toxic doses, and not through the mediation of the central nervous apparatus. This is proved by shutting off the blood supply con- taining the drug, from a frog’s leg, and leaving the nervous con- men intact, when no effect of prussic acid is observed upon the imb. Heart and Blood Vessels.—Death sometimes occurs instantane- ously from large lethal doses of prussic acid, owing to diastolic arrest of the heart. This action is due probably to paralysis of the heart: and also to irritation of the vagus centre. Moderate non-toxic doses stimulate the vagus centre of the medulla, without diminish- ing the force of the heart. When the vagi are previously di- vided, this action does not occur, but after large doses slowing of the heart is observed whether the vagi are cut or not; thus showing that the heart muscle is directly influenced. Moderate doses of prussic acid first stimulate, and then depress the vasomotor centre. Arterial pressure is therefore primarily raised considerably, but this is followed by a fall to, or below, the normal. Toxic doses stimulate the vasomotor centre very briefly, and this action is succeeded by profound depression and paralysis of the centre, accompanied by a great diminution of blood tension. Respiration.—Inhalation of the pure acid will cause death in a confined atmosphere, and even inhalation of the medicinal solution will induce the physiological symptoms of the drug. The respira- tory centre is usually depressed from the beginning, by prussic acid, and the respiratory movements are therefore lessened in frequency throughout the period of its action. Rarely, there is a primary tran- sient stimulation of the centre, so that the breathing is increased in frequency. In the latter stage of poisoning, the breathing is feeble and shallow, and only occur at long intervals. If death does not su- pervene immediately from diastolic arrest of the heart, it comes on more slowly by asphyxia. The respiratory movements become less frequent and forcible, the animal giving an occasional gasp, until finally the breathing ceases altogether, while the heart continues to beat for a time. Summary.—Prussic acid in any considerable dose exerts a transient stimulation upon the hind-brain, followed by depression of the brain, spinal cord, nerves, muscles, and the three great medullary 316 INORGANIC AGENTS centres controlling the heart, respiration and vessels. ‘Lopicaily ap- phed, hydrocyanie acid also paralyzes nerves and muscles, end acts therapeutically as a local sedative and anesthetic. Toatcology.—Prussic acid is one of the most powerful poisons in existence. Death may be instantaneous, or life may be prolonged for over an hour after a lethal dose. More commonly the animai survives for a few minutes, and we observe the following symptoms in dogs: The animal falls, froths at the mouth, the respiration is of a gasping character and occurs at infrequent intervals. There is unconsciousness, the pupils become dilated, there are muscular tremblings and clonie or tonic spasms. Defecation and micturition occur, and erections often ensue in the male. Respiration ceases before the cardiac pulsations. Three stages may be distinguished in fatal poisoning. First: a very short period elapses before the symptoms appear. There are giddiness, difficult breathing, and slow pulse in this stage. See- ond: the pupils dilate, vomiting may occur, and the animal utters loud cries. Spasmodie defecation, micturition and erections may be present, with convulsions and unconsciousness. Third: the last stage is characterized by collapse, spasms, general paralysis and death. The subacute form of poisoning may ensue and prove fatal, or, owing to the volatile character of the drug, complete recovery may take place within one-half or three-quarters of an hour. Oc- casionally dogs continue to be paralyzed for several days and get well. The minimum fatal dose recorded in man is %o of a grain of pure acid, or about 50 drops of the medicinal solution. Four to five drachms of the diluted acid frequently, but not invariably, cause suvacute poisoning and death, in horses, within an hour. One to two drachms of the pharmacopeial preparation usually kills dogs within ten minutes. Prussie acid is commonly used to destroy the domestic animals, but the subcutaneous injection of strychnine is preferable for the destruction of the smaller animals (p. 3871). Two to four drachms of the medicinal acid are to be given to dogs and eats of the ordi- nary size, and certain, painless, and rapid death will occur if a fresh preparation of the drug can be obtained. The unopened, half-ounce vial, kept by druggists, is recommended. Big dogs, horses, and the other larger animals are not killed rapidly, nor sometimes at all, by great quantities of the diluted acid. Hence, shooting is a more humane and preferable mode of death for them. In the experience of the writer, one to two drachms of prussic acid saturated with potassium cyanide, failed to kill a horse, when injected directly into the jugular vein. The odor of the acid lingers about the animal for a few hours after death; the eyes are fixed and staring; the POTASSIUM CYANIDE oily pupils dilated; the teeth are clinched tight and covered with froth, while the blood 1s of a very dark color. The treatment embraces empty- ing the stomach by large doses of promptly acting emetics, or by the stomach tube, vr pump; atropine, ether and brandy subcutaneously, and inhalations of ammonia, together with artificial respiration, and hot and cold douches upon the chest. Uses.—Prussic acid is indicated for three therapeutic purposes: 1. To relieve gastric pain and vomiting, by its paralyzing action upon the peripheral sensory nerves of the stomach. 2. To stop coughing. 3. To allay itching by means of its local, sedative action upon the cutaneous sensory nerve-endings. As a medicine it is not of much value, but is used in veterinary practice as a cough remedy, when the symptom is of reflex origin, or is caused by chronic or verminous bronchitis; and the acid is often conjoined with chloroform, or opium, in some form. In ver- minous bronchitis the medicinal acid may be given by inhalation (3 ss. in 3 1. of water) to calves, or internally (Mxv.) to assuage coughing and to kill the strongyles. Prussic acid is a dangerous remedy for use in relieving itching unless the dose is carefully regu- lated. Ten minims of the acid, with gr. %4 of corrosive sublimate to the ounce of water, is efficient in pruritus in the larger animals in amounts not larger than this for single applications, and not larger than half this for the smaller patients. Porassir Cyantipum. Potassium Cyanide. K ON. (U.S. & BP.) Synonym.—Cyanure de potassium, Fr.; cyankalium, G. Derivation.—Made by heating together potassium ferrocyanide ard carbonaie. Properties.—White, opaque, amorphous pieces; or a white, granular powder, odorless when perfectly dry, but in moist air exhal- tng the odor of hydrocyanie acid. Taste sharp and alkaline, and in moist air the salt deliquesces. Reaction very strongly alkaline. Solutions stain and destroy clothing. Soluble in about 2 parts of water; sparingly soluble in alcohol. Dose.—H., gr.i-ti. (.06-.12) ; D., gr. “Ao (.006). Action and Uses.—Potassium cyanide is transformed, in the stomach and blood, into prussic acid, and resembles the latter in its action, but is much slower. Death has been caused in man by 5 grains of the salt. 318 INORGANIC AGENTS _ Arcentr Cyanipum. Silver Cyanide. Ag ON. (U.S. ES) A white, insoluble, tasteless, odorless powder, used for making vrussic acid. Prunus Vireiniana. Wild Cherry. (U.S. P.) Synonym.—Keorce de cerisier de Virginie, Fr.; wildkirschen- inde, G. The bark of the wild cherry, indigenous in the United States, contains a ferment (emulsin) which, in. the presence of water, acts on a glucoside (amygdalin, C,, H,, N O,,) contained in the bark, with the formation of hydrocyanic acid, glucose and a volatile oil. A fluidextract, infusion and syrup of prunus virginiana are official. The latter preparation is sometimes employed in cough mixtures for dogs, on account of its sedative action. The entire value of the drug depends upon the minute amount of prussic acid formed in it. The official hydrocyanie acid is more reliable, but syrupus pruni virginiane (U. S. P.) may be used as a vehicle for more efficient remedies. Perrotarum. (U.S. P.) (Three varieties. ) 1.—Prrrotatum Liquipum. Liquid Petrolatum. (U.S. P.) Derwation.—A mixture of hydrocarbons, chiefly: of the marsh- gas series, obtained by distilling off the lighter and more volatile por- tions from petroleum, and purifying the residue when it has the desired consistence. Properties.—A colorless, or more or less yellowish, oily, trans- parent liquid, without odor or taste; or giving off, when heated, a faint odor of petroleum. Spec. gr. about 0.875—0.945. Insoluble in water; scarcely soluble in cold or hot alcohol, or cold absolute alcohol; but soluble in boiling absolute alcohol, and readily soluble in ether, chloroform, carbon disulphide, oil of turpentine, benzin, benzol, and fixed and volatile oils. 2.—Prrrotatum.* Petrolatum. (U. S. P.) Synonym.—Vaseline, cosmoline. Derivation —A mixture of hydrocarbons, chiefly of the marsh- * The 1905 edition of the U. S. P. does not now recognize, as formerly, the varieties Petrolatum Molle and Spissum. PETROLATUM ALBUM 319 gas series, obtained by distilling off the lighter and more volatile portions from petroleum, and purifying the residue when it has reached the desired melting point. Properties.—A fat-like mass of about the consistence of an oint- ment, varying in color from yellowish to light amber, having not 1aore than a slight fluorescence, even after being melted; transparent in thin layers, completely amorphous, and without odor or taste; or giving off, when heated, a faint odor of petroleum. The melting point of petrolatum ranges between 45° and 48° C. (118° and 118.4° F.). In other respects soft petrolatum has the solubility of liquid petrolatum. 3.—PETROLATUM ALBUM. White Petrolatum. . A colorless mixture of hydrocarbons, chiefly of the methane series, obtained by distilling off the lighter and more volatile por- tions from petroleum, and purifying the residue. A white, unctuous mass, of about the consistency of an ointment, transparent in thin layers, completely amorphous; without odor or taste. Otherwise it resembles, in solubility, petrolatum. Action and Uses.—Petrolatum is a valuable emollient. It soothes, protects and softens parts to which it is applied, and is su- perior to animal and vegetable fats and oils in not becoming rancid, and therefore irritant and malodorous. Petrolatum may be used . alone, or as an excipient in the preparation of ointments, but does not aid the absorption of drugs (as do alcohol, glycerin, chloroform, and animal oils and fats), for it is not itself absorbed even when administered internally. Petrolatum exerts a demulcent action upon the mucous membrane of the alimentary tract, and may be prescribed in electuary or capsule in inflammation thereof. Liquid petrolatum is useful given internally in piles (D. 3 ss. twice daily) to soften the feces. It is also very seviceable with menthol and camphor (aa gr. xv. to 3 i.) dropped in the nostrils (with a medicine dropper) for dogs with coryza. Petrolatum is sold universally under the pro- prietary names of vaseline and cosmoline, and is often combined with antiseptics for medicinal and surgical purposes in skin diseases and upon inflamed mucous membranes, blistered and abraded sur- faces and sores. It is one of the most useful agents in lubricating instruments, protecting metal from rust, preserving leather, and is sometimes employed as a vehicle for electuaries. RuicoLene. (Non-official.) Rhigolene is a petroleum product prepared by repeated distilla- 320 INORGANIC AGENTS tion until the liquid boils at 64.4° F. It evaporates at a lower temperature than any other substance, except cymogene, and is em- ployed as a spray to induce numbness and local anesthesia of a part in minor surgical operations, such as paracentesis of an abscess or the use of the actual cautery. Azntuytis Cotormpum. (U.S. P.) C, H; Cl. Ethyl chloride is in more common use for the same purposes. It is a colorless, mobile, very volatile liquid; slightly soluble in water but readily soluble in alcohol. It is made by the action of HCl gas upon absolute ethyl alcohol. It is usually sold in glass tubes with a serew or lever-spring metal top enabling the fluid to be sprayed upon the surface of the body in any desired amount. . On account of its great volatility and rapid evaporation it abstracts) heat and freezes a part, and so acts as a local anesthetic. It is convenient for minor surgical operations, as opening abscess or boil, or for aspiration. The vapor is very inflammable. Ethyl chloride is also used to produce transient, general anesthesia. 1 or 2 drachms may be used for dogs. It is exceedingly rapid in its effects and a safe anesthetic for short periods. It is sprayed into the neck of a funnel, the large end being partly filled with absorbent cotton and held tightly over the nose. Recovery is also extremely rapid. Ethyl chloride is often sold under the name of ‘“‘kelene.” It is used fre- quently as a preliminary to ether in human practice and is more agreeable to inhale. Plenty of air should be allowed, except at the outset. Jevadacte ANE, VEGETABLE DRUGS. SECTION I.—DRUGS ACTING UPON THE BRAIN. Opium. Opium. (U.S. & B. P.) Derwation.—The concrete, milky exudation. obtained by incis- ing the unripe capsules of Papaver somniferum Linné (Nat. ord. Papaveracex), and yielding in its normal, moist condition, not less than 9 per cent. of crystallized morphine, when assayed by the official: process (U. S. P.) Opium is procured from Turkey, Asia Minor, Persia, India and Egypt. The Smyrna, or Turkey opium is the more common variety used in the United States. It occurs in ir- regular, globular masses, covered with poppy leaves and capsules of a species of dock, weighing from 14 to 1 pound. Properties.—In irregular, flattened, more or less rounded masses of variable size, externally grayish-brown, covered with remnants of poppy leaves and with occasional fruits of a species of Rumez ; more or less plastic when fresh, but becoming hard on keeping; internally dark brown, somewhat lustrous; odor strong, narcotic; taste bitter and characteristic. It yields its medicinal properties to water, al- cohol, and diluted acids, forming dark brown solutions. Ether ex- tracts its principles in part. Constituents.—There are nineteen or more alkaloids; the three first are used in human medicine, but narceine .is of no value in veterinary medicine. Morphine. 2.5—22 8 per cent. Thebaine. .15— 1. per cent. Codeine. a Bh weal Narcotine. L310 Narceine. ae ey ano neon Papaverine. IE cease Tn addition to these, the following exist in minute quantity, but some are merely “pharmaceutical curiosities” :— 7 39] DA 329 VEGETABLE DRUGS Protopine. Organic Acids. Cryptopine. Meconie Acid. Oxynarcotine. Lactic Acid. Hydronarcotine. Pectin. Laudanosine. Gum. 50. per cent. Laudaine. Resin. Pheadine. Glucose. Codamine. Fixed Oils. Meconodine. A Volatile Oil. Gnoscopine. Odorous Bodies. Lanthopine. Caoutchouc. Water. 15.—25. per cent. Ammonium Salts. Neutral Bodies. Meconin. - Meconoisin. Calcium Salts. Magnesium Salts. Impurities.—Starch, molasses, leaves, fruit, stones and water. Incompatibility.—Solutions of lead acetate and subacetate, and of copper and arsenic salts, precipitate meconates, sulphates and coloring matters, but the opium remains physiologically active. Ferric chloride produces a deep red color with opium, by its union with meconic acid. Tannin compounds precipitate codeine tannate. Alkalies, their carbonates and ammonia precipitate morphine and narcotine. : Dose.—H., 3 i.-ii. (4.-8.); C., 3 ii-iv. (8.-15.); Sh., gr.x.-xxx. (.6-2.); Sw., gr.v.-xx. (.3-1.3);-D., gr.ss.-iii. (.03.2). Orr Purvis. Powdered Opium. (U.S. P.) Opium dried at a temperature not exceeding 85° C. (185° F.), and reduced to a fine powder. Powdered opium, for pharmaceu- tical or medicinal purposes, when assayed should yield not less than twelve (12) nor more than twelve and a half (12.5) per cent. of crystallized morphine. Any powdered opium of a higher percentage may be brought within these limits by admixture with powdered opium of a lower percentage in proper proportions. Onlv those are mentioned here which are applicable to veterinary practice. Dose.—Same as for opium, but preferable to the crude drug. PREPARATIONS. Extractum Opti. Extract of Opium. (U.S. & B. P.) Powdered opium, 100; distilled water, 1000; sugar of milk, a sufficient quantity. Made by trituration, filtration, and evaporation. Assayed to con- tain 20 per cent. of morphine. (U. S. P.) OPIUM PREPARATIONS 523 Dose.—Avout one-half that of powdered opium. H., 3as.-i. (2.-4.); C., Si-ii. (4.-8.); Sh. gr.v.-xv. (.3-1.); Sw., gr.iiss.-x. (.15-.6); D., gr.4-i.ss. (.015-.09). Pulvis Ipecachuanhe et Opw. Powder of Ipecac and Opium. (U. S. P.) Synonym.—Dover’s powder, E.; pulvis ipecacuanhe opiatus, s. pulvis Doweri, P. G.; poudre de Dower, Fr.; Dower’sches pulver, G. Ipecac, 10; powdered opium, 10; sugar of milk, 80. The most diarphoretic compound of opium. Dose.—H., 3.ss.-i. (15.-30.); D.; gr.ili-xv. (.2-1.). Tinctura Ipecacuanhe et Opvi. Tincture of Ipecac and Opium. (UeeS3"25) Synonym.—Liquid Dover’s powder. Tincture of deodorized opium, 1000; fluid extract of ipecac, 100; diluted alcohol, a sufficient quantity to make 1000. Made by evaporation and filtration. Dose.—Same as Dover’s powder. Tinctura Opiit. Tincture of Opium. (U.S. & B. P.) Synonym.—Laudanum, tinctura meconii, tinctura thebaice, E.; tinctura opii simplex, P. G.; teinture d’opium, teinture thébaique, Fr.; einfache opium- tinktur, G. Granulated opium, 100; alcohol, 400; water, 400; diluted alcohol to make 1000. Made by trituration, maceration with precipitated calcium phosphate, and percolation. Assayed and standardized to contain between 1.2 and 1.25 gm. of morphine in 100 ec. (U.S. P.) D., Miii-xx. (2-1.3.). Tinctura Opii Camphorata. Camphorated Tincture of Opium. 2 (WS; B:) Synonym.—Tinctura camphore composita, B. P.; paregoric, elixir pare- goricum, paregoric elixir, E.; tinctura opii benzoica, P. G.; élixir parégorique, Fr.; benzéesaurehaltige opiumtinktur, G. Powdered opium, 4; benzoic acid, 4; camphor, 4; oil of anise, 4; glycerin, 40; diluted alcohol to make 1000. Made by maceration and filtration. (U. S. P.) Dose.—D., 3i.-iv. (4.-15.). Opium Deodoratum. Deodorized Opium. (U. S. P.) Synonym.—Opium denarcotizatum. Powdered opium (containing 12-12.5 per cent. of morphine), 500; purified petroleum benzin, q. s. Made by repeated maceration, agitation and percolation 324 VEGETABLE DRUGS with purified petroleum benzin. ‘the petroleum benzin removes narcotic and odorous principles, which cause nausea and disagreeable after-effects in opium. Contains 12—12.5 per cent. of morphine. Dose—Same as powdered opium. The eighth (last) edition of the U. S. P. has introduced Opium Granulatum (granulated opium); made by drying opium at a temperature not exceeding 85° ©. (185° F.) and reducing it to a coarse (No. 20) powder. It should not yield less than 12 nor more than 12.5 per cent. of crystallized morphine. Dose, same as deodorized opium. Tinctura Opi Deodorata. Tincture of Deodorized Opium. (U. S. P.) Granulated opium, 100; purified petroleum benzin, 75; alcohol, 200; water to make 1000. Made by percolation with water, agitation with purified pe- troleum benzin, and evaporation. Assayed and standardized to contain between 1.2 and 1.25 gm. of morphine in 100 c.ec. Dose.—Same as tincture of opium, but less nauseating. Extractum Opti Liquidum. (B. P.) (Contains % per cent. of morphine.) Dose.—Same as laudanum. Vinum Opi. (U.S. P.) Dose.—Same as laudanum. Morrutna. Morphine. C,, H,, N O, + H, O. (Ue Ss & BP) Derwation.—An alkaloid obtained from opium. 1. Macerate opium in cold water, forming a solution of mor- phine meconate. 2. Add calcium chloride to precipitate calcium meconate and resins. 3. Evaporate solution remaining, which con- tains morphine hydrochlorate, till it crystallizes; press in flannel to remove narcotine and coloring matter; redissolve; filter; evaporate and erystallize repeatedly. 4. Decolorize by digestion with char- coal. 5. Precipitate with ammonia and wash, when pure morphine is separated from codeine. Properties.—Colorless or white, shining prismatic crystals, or fine needles, or erystalline powder; odorless and having a bitter taste ; permanent in the air; soluble in 3330 parts of water. Dose.—Same as salts of morphine, but the latter are preferable on account of their solubility. Morpuinz Hyprocnormum. Morphine Hydrochloride. C,,HiaN O,H Cl +3. BOF CU SG Bee) Derivation. —Morphine is stirred with hot distilled water, to fr See eS MORPHINE SALTS 325 which hydrochloric acid is gradually added. Morphine hydrochlorate erystallizes out on cooling. Properties.—White, silky, glistening needles or microcrystalline cubes, or a white, crystalline powder, odorless, and having a bitter taste; permanent in the air. It loses its water of crystallization at 100° C. (212° F.). Soluble in in 17.2 parts of water, and in 42 parts of alcohol at 25° C. (77° F.); soluble in 0.5 part of water at 80° C. (176° F.), and in 35.5 parts of alcohol at 60° C. (140° F-.) ; insoluble in ether and in chloroform. Incompatibility.—Ineompatible with all agents containing tan- nin, alkaline carbonates, lime water, salts of copper, mercury, zinc and lead; and with Fowler’s solution of arsenic. Dose.—H. & C., gr.ili.-x. (.2-.6) ; Sh., gr.ss.-i1. (.03-.12) ; Sw., or, Yo-% (.006-.03) ; D., gr. 14-14 (.008-.08). Subcutaneously.—H., gr.iii-iv. (.2-.24); D, gr Wye (.008-.03). 124 parts of morphine hydrochloride correspond to 100 parts of morphine. Morruina Acreras. Morphine Acetate. Crea Ni O.c HO 5 LO, CUS. & BP.) Derivation.—Morphine is dissolved in acetic acid and water, and the solution evaporated and crystallized. Properties.—A white, or faintly yellowish-white, crystalline, amorphous powder, having a faint, acetous odor and bitter taste. It slowly loses acetic acid on exposure to the air, and should be kept in dark, amber-colored, well-stoppered vials. Soluble, when freshly prepared, in 2.25 parts of water, and in 21.6 parts of alcohol. Dose.—Same as morphine hydrochloride. Morruin# Surpuas. Morphine Sulphate. (CEE, NO} 2 clos Op-p 5 HOx “(U. S.-& Bb: P.) Derivation.—Morphine is stirred into boiling distilled water; diluted sulphuric acid is added until neutralization is attained, and the sulphate crystallizes out on cooling. Properties.—White, feathery, acicular, silky crystals, or in cubical masses, odorless, permanent in the air, and having a bitter taste. It loses three molecules of water of crystallization at 100° C. (212° F.), and the remaining two at 130° C. (266° F.). Solu- ble in 15.3 parts of water, and in 465 parts of alcohol at 25° C. (77° F.); soluble in 0.6 part of water at 80° C. (176° F.), and in 326 VEGETABLE DRUGS 187 parts of alcohol at 60° C. (140° F.}; insoluble in ether and chloroform. Dose-—Same as hydrochloride. 125 parts of morphine sul- phate correspond to 100 parts of the pure alkaloid. The official salts of morphine may be used interchangeably. The acetate is more soluble, but less stable, than the sulphate, which is sufficiently soluble for practical purposes, and is in more common use. Liquor Morpeuinez Hyprocuioripr. (B. P.) One per cent. Dose.—H., 3 vi.-% ii. (24.-60.); D., mx-3 i. (.6-4). Liquor Morpuinaz Acetatis. (B. P.) Same strength and dose as above. Insectio Morruin® Hypovrrmica. (B. P.) One per cent. Dose.—Same as liquor morphini hydrochloridi. SuppostrortA Morpuinz. (B. P.) (Gr. 14 morphine. ) Dose.—Dog, 1 per rectum. Copmrma: Codeine.” Cy,H.; NO, 4-.H,0..°\(U8..& Be P.) Derwwation.—An alkaloid obtained from opium by evaporation of the ammoniacal liquid, after the precipitation of morphine. The residue is added to water, precipitated by potassium hydrate, and redissolved in ether, from which codeine crystallizes out on evapora- tion. Properties—White, or nearly translucent, orthorhombic prisms, octahedral crystals, or a crystalline powder; odorless, and having a faintly bitter taste; slightly efflorescent in warm air. Soluble in 88 parts of water, 1.6 parts of alcohol, 12.5 parts of ether, and 0.66 part of chloroform at 25° C. (77° F.); soluble in 59 parts of water at 80° CO. (176° F.), and in 0.92 part of alcohol at 60° C. (140° F.). Dose.—D., gr. 14-11. (.015-.12). . OPIUM AND MORPHINE Bo Heroin. (Diacetylmorphine. ) This remedy, derived from morphine, was first introduced by Dreser, in 1898, and is now used extensively in human medicine as a substitute for morphine and codeine. Heroin occurs as a white, odorless, crystalline powder, possessing a slightly bitter taste and alkaline reaction. Practically insoluble in water, but readily solu- ble in weak acidulous solutions. Heroin hydrochloride is a white, crystalline, odorless powder, soluble in 2 parts of water. Heroin surpasses both morphine and codein therapeutically in many ways. It increases markedly the inspiratory and expiratory force, while lessening the number of the respiratory movements, and exerts a special sedative influence on the respiratory mucous membranes. The drug acts also as a general motor depressant, hypnotic and analgesic, but is not comparable to morphine in these respects. Heroin is said to be five times more toxic for dogs than morphine. The after-effects of small medicinal doses (nausea, constipation, ete.) are slight. Heroin is particularly valuable in the treatment of all varieties of cough affecting the hu- man subject, and should prove useful in canine practice. Heroin may be administered in powder, pill or tablet, the hydrochloride in solution, every few hours. The dose of either is, for the dog, gr. 44-% (.0025- 01). Opium AND MorpHINe. The action of morphine and opium is practically the same, with some exceptions to be noted. Action External.—Opium may be absorbed to a slight extent from the unbroken skin, and causes a mild, anodyne action. Ab- sorption readily occurs from mucous membranes and raw surfaces, with resulting characteristic effects. Action Internal.—Digestive Tract—Opium diminishes the two principal activities of the digestive organs, namely, secretion and motion. Secretions all over the body are decreased, except that of sweat. The action upon the alimentary tract in lessening secretion, is partly a local one and partly constitutional, following the ab- sorption of the drug. The mouth is made dry, thirst is increased and appetite impaired. Opium is absorbed rather slowly from the stomach and bowels, and stimulates the splanchnic nerve centre of — the sympathetic system, which inhibits the movements of the stomach and intestines, and thus lessens peristaltic action of these organs. 3828 VEGETABLE DRUGS Opium is directly opposed to belladonna in this respect, as the latter drug paralyzes the intestinal inhibitory apparatus (splanchnic end- ings), and so increases peristalsis. In diminishing both secretion and motion, opium causes con- stipation in health, but is most useful in relieving vomiting and diarrhea. In toxic doses, opium may induce diarrhea from paraly- sis of the splanchnic inhibitory centre. Blood and Elumination.—Morphine circulates in the blood as such. The greater part of opium is decomposed in the body, a por- tion being destroyed by the liver, while some is probably burned up in the blood. The smaller part is eliminated, chiefly by the kidneys, but also in the other secretions. It is found in the gastric juice after hypodermic injection, and therefore washing out the stomach assists elimination and recovery in opium poisoning. Nervous System.—The most important action of opium is ex- erted upon the nervous system. It is necessary to study the drug from the comparative standpoint in order to obtain a full under- standing of its effects. The brain of man, being more highly de- veloped and sensitive, in comparison with other parts of the nervous system, than the brain of the lower animals, it follows that this organ is more powerfully influenced in man, while the spinal cord is often mainly impressed in the lower animals. We may take the action of opium on the frog, at one end of the scale, as exhibiting the most active spinal symptoms; while in man, at the other end of the scale, cerebral phenomena predominate. The other animals occupy an intermediate position; the action upon the horse and ruminants is something between that exerted upon the frog and man, and the influence upon dogs approaches more nearly that seen in human beings, only that a relatively greater dose is re- quired to produce the same result, as the brain is not so highly organized or sensitive to the action of medicines. The brain of the horse is only one-twelfth as large as that of man, in proportion to their respective body weights, and it follows that the spinal cord of the horse is more readily affected by opium, in accordance with the general law that the more highly developed a part is, the more easily is it influenced by therapeutic agents. Opium exerts first a stimulating, and then a depressing action upon the brain and spinal cord, and in studying the action compara- tively it will be noted that the influence upon the cord in the frog, horse, ruminant, and to some extent in the dog, preponderates fre- quently over the effect of the drug upon the brain, for the reasons stated above. Action on the Froy.—In non-poisonous doses, sleep is pro- duced and diminished spinal reflex activity, followed by a period of OPIUM AND MORPHINE 329 reflex excitement. Toxic doses of 1 or 2 grains of morphine, in- jected under the skin, causes at first a condition where convulsions occur, if the animal is artificially irritated; later they come on spontaneously. This state is followed by general paralysis, respira- tory failure and death. The convulsions are shown to be due mainly to stimulation of the receptive and transmitting cells of the spinal cord, as in strychnine poisoning. - Action on Horses.—Three grains of morphine, injected sub- cutaneously, occdsion sometimes drowsiness, and at other times pro- duce no visible effect. Four to six grains, given in the same way, cause restlessness, a rapid pulse, and moisture of the skin. The animal paws the ground and walks in a rhythmical manner about the stall. The pupils are dilated. Large doses (12 grains) are fol- lowed by increased excitement aggravated by noises, sweating, ptyalism, muscular rigidity, staggering gait, trembling and delirium; while still larger doses (four drachms of the extract of opium) cause violent trembling, convulsions, insensibility to pain and external irri- tation, without coma; or (morphine, gr. 36 under the skin), rarely, stupor for several hours (3 hours), dilated pupils and blindness, followed by delirium and restlessness, continuing for a longer time (7 hours) and ending in recovery. Horses have recovered from an ounce of opium, but 214 ounces of the drug, and 100 grains of morphine have proved fatal. The action of opium upon the horse differs from that upon man and dogs in the more frequent occurrence of restlessness and motor excitement due to stimulation of the cere- bral and spinal motor centres; and in dilatation instead of con- traction of the pupil. The rationale of the latter phenomenon has not been discovered. Action on Ruminants.—These animals are comparatively insusceptible to opium. Ounce doses of the drug cause, in cattle, restlessness, excitement, hoarse bellowing, dry mouth, nausea, indi- gestion and tympanites. Sheep are affected in much the same man- ner, One to two drachms of morphine have led to fatality in cattle. Fifteen to thirty grains of the alkaloid comprise a lethal dose for sheep. Swine are variously influenced; sometimes excited, some- times dull and drowsy. . Action on Birds.—Birds, as represented by chickens, ducks and pigeons, are exceclingly insusceptible to opium. This is chiefly due to the slow absorption from the crop. Pigeons cannot be given enough opium by the mouth to cause death, but 8 to 10 grs. of morphine per orem, or 2 or 3 grs. hypodermatically, will prove fatal. The toxic symptoms in birds are exhibited by unsteadiness, difficult breathing and failure of respiration, convulsions and death. The pupils are unaffected, and sleep does not ensue. 330 VEGETABLE DRUGS Action on Dogs.—When 8 or 10 grains of morphine are given to a moderate sized dog, coma comes on, from which the animal may recover. One half a grain injected under the skin of a dog weighing 25 lbs., causes nausea, vomiting and perhaps purging, sleep deepening into coma, contracted pupils, and shallow breathing; the condition lasting for several hours and followed by recovery. Opium rarely exerts an hypnotic action upon cats, but rather motor excite- ment. Lethal doses (average, 4 grain of morphine sulphate sub- cutaneously to the 2.2 pounds, live weight, for dogs; 2 to 3 grains sometimes kill small dogs), increase the frequency of the pulse, cause vomiting, unsteadiness, contracted pupils, motor excitement, as twitching of the limbs, followed by coma, respiratory failure and death. Recovery from full doses of opium is accompanied in dogs by general physical and mental depression and lassitude, as in man. There are muscular weakness, loss of natural spirit, timidity, and nausea, lasting for several hours. The action of opium on dogs differs from that on man only in degree. The dose required is proportionately larger. There is often more preliminary excitement and symptoms of reflex irritation, as muscular twitching. These animals do not sweat, and the pupils are not so continuously con- tracted in poisoning. Failure of the drug to produce sleep, and the presence of nausea, retching, dreams, delirium, hallucinations, occasionally observed in dogs, are common to man. Convulsions rarely occur in either men or dogs. Action on Man.—In man, a small dose of morphine (14 gr.) causes usually a sense of well-being, together with itching of the nose, and later, of the skin generally, dryness of the mouth (oc casionally there may be nausea, vomiting and faintness), followed by sleep, or a pleasant, dreamy state. After-effects may be absent, or consist of nausea, headache, coated tongue and constipation. If the dose is larger, sleep comes on quickly, the pupils are contracted, the respiratory movements and pulse become slow, and the skin is moist. With lethal doses, sleep deepens into coma, from which the patient can at first be aroused; the coma becomes profound, the pulse feeble and rapid, the respiration stertorous, slow and imperfect. The mucous membranes are cyanotic, the face livid, the pupils dilate, and the surface is covered with clammy sweat. Death occurs from respiratory failure, occasionally preceded by convulsions. One- eighth of one grain of morphine subcutaneously is the smallest fatal human dose recorded. (Average dose for man, gr. 14.) The action of opium upon man, as compared with that upon the horse and rumi- nants, is characterized by its predominant depressing effect upon the higher mental functions. The motor centres of the brain and cord are only slightly influenced. ACTION OF OPIUM 331 General Action of Opium Upon the Nervous System.—The action of opium on the nervous system may be summarized as fol- lows: 1. On the Cerebrum.—The predominant action of opium on man and the dog consists in depression of the higher brain centres with the production of nervous sedation and sleep. In the hind- brain depression of the perceptive centres gives relief from pain. In the fore-brain depression of the centres for intellect—especially of will and attention—causes sleep. The middle or motor area of the brain is commonly not affected until paralyzed in fatal poisoning. In horses and cats, however, toxic doses do stimulate the cerebral motor centres. A primary stimulant stage in the action of opium on the brain of man is sometimes evident. In this there is a feeling of well-being and enhanced mental powers. But the stimulation is brief and rarely uniform, imagina- tion being increased at the expense of reason and judgment. This stage is often wholly absent. In the lower animals—other than dogs —the sedative and hypnotic effect of opium is less certain and may be completely wanting. In a general way small and moderate doses cause cerebral de- pression, while large doses give rise to spinal reflex excitability in the lower animals—especially in the horse, ass, cattle and cats. 2. On the Spinal Oord—Small medicinal doses depress the motor cells, but large and toxic amounts stimulate the motor cells indirectly and cause convulsions—probably—as in strychnine poison- ing—by increasing the activity of the receptive and transmitting cells of the cord. Convulsions, caused by spinal and cerebral motor stimulation, rarely occur in man or dogs but are common after toxic amounts in horses, cattle and cats. The result of a fatal dose is paralysis of the central nervous system, including the respiratory and, to much less degree, the vagus and inhibitory centres. The unique and inestimable value of opium depends upon its anodyne action. Relief from suffering is often induced without the production of sleep. Muscular weakness is present in man and dogs, but even this evidence of depression may be absent in horses and ruminants, yet pain be effectually relieved. Tnitial stimulation of the vomiting centre may cause emesis; but, as depression of the centre rapidly ersues, the act becomes later improbable. The excitability of the motor and sensory nerves is slightly increased, but otherwise the nerves are not affected except in poisoning, when the sensory, and later tae motor nerves are para- lyzed. The muscles remain uninfluenced. Sa2 VEGETABLE DRUGS Respiration.—Opium does not influence the respiratory func- tions in small therapeutic doses, but large doses make the respiratory movements slower and feebler, and death occurs from the direct depressing and paralyzing action of the drug upon the respiratory centres in the medulla. Circulation.—Small doses commonly produce little effect upon the heart. Large doses first increase the force and then slow the heart’s action, while toxic quantities depress the organ. The cardiac muscle is primarily stimulated, with acceleration of the pulse, but depression soon follows more or less synchronously with stimulation of the vagus centre and endings, so that the pulse becomes infre- quent. Finally, before death, depression of the inhibitory apparatus oceurs, and this, coexisting with depression of the heart itself, pro- duces a feeble, rapid pulse, characteristic of the last stage of opium poisoning. Death occurs with diastolic arrest of the heart owing to failure of the cardiac muscle, although fatality is mainly due to the more powerful effect of the drug upon the respiratory centre. The action of opium upon the vasomotor system is unimpor- tant. Immediately after the administration of large doses there is a slight primary stimulation, followed in the toxic stage by some depression of the vasomotor centres in the spinal cord and medulla. Pupil._—The pupil of the horse is widely dilated by large doses of opium. The pupil in the dog occasionally remains unchanged, and often dilated before undergoing contraction. Oontraction of the pupil is a characteristic physiological effect of large doses of opium in man and the dog. Jn birds the pupil is unaffected. These various contradictory phenomena are at present inexplicable. In man, contraction of the pupil is brought about by stimula- tion of the pupillary centre in the floor of the aqueduct of Sylvius and, through it, the oculomotor nerves. Dilatation, preceding death, occurs from depression of the centre. Kidneys and Metabolism.—The excretion of urea appears to be diminished by opium in man, but varies greatly in animals. Tem- porary retention of urine may follow the administration of a con- siderable dose of opium, owing to diminished sensibility of the bladder. The amount of urine voided may be greater or less than normal; more commonly the latter. Opium lessens the secretion of bile. The elimination of carbonic dioxide is diminished by the hyp- notice action of opium, but is increased if there is general excitement and muscular activity following the use of the drug. Skin.—Opium induces mild diarphoresis in man; occasionally sweating occurs in horses, but not at all in dogs. Temperature—The bodily temperature may be slightly in- MORPHINE CONTRASTED WITH OPIUM 300 creased by large medicinal doses of opium, but is diminished by toxic quantities. Toxicology.— The: symptoms of poisoning have already been sufficiently described in previous sections. The treatment embraces irrigation of the stomach, or the use of emetics, as apomorphine hydrochlorate under the skin, and the subcutaneous injection of strychnine, enemata of hot, strong, black coffee; leading the animal about, slapping him, or using the faradic current. Dr. Moor, of New York, has apparently found in potassium permanganate the most efficient antidote for opium and morphine. Ten to fifteen grains, dissolved in eight ounces of water, should be given by the mouth, to large dogs. One to two drachms of potassium perman- ganate may be administered to horses in two or three pints of water. Permanganate solution oxidizes and destroys morphine, and should be acidulated with a little vinegar or diluted sulphuric acid, after the ingestion of morphine salts. The antidote has been recom- mended to be given subcutaneously after absorption, or hypodermic injection of morphine, but this is not of the slightest use. Morphine Contrasted with Opvm.—Opium is more constipat- ing, more sudorific, and more apt to disturb the digestion than mor- phine. Morphine is more anodyne and soporific; more readily ab- sorbed and more suitable for use under the skin. Synergists.—Belladonna aids the action of opium and yet is antagonistic to it. It assists opium in its anodyne action and lessens nausea, indigestion, and constipation following the action of the latter drug. Belladonna and atropine are antagonistic to opium in stimulating the brain and respiration, and increasing peristalsis. Small doses of belladonna combined with opium do not interfere with the soporific action of the latter, notwithstanding the exciting influence of the former upon the brain. The bromides also promote the sedative and hypnotic action of opium, and lessen the depression . and nausea following its administration. Opium often acts pro- foundly when combined with chloral, and this combination is oc- easionally used to induce anesthesia (p. 292). Chloroform and ether are frequently prescribed with opium to secure an additional antispasmodic and anodyne action in colic. The astringents and mineral acids enhance the effect of opium in diarrheal disorders. Codeine.—Codeine in large doses causes motor excitement and convulsions in dogs and cats, but physiological experiments con- ducted by various observers have otherwise yielded diverse results. This is explicable, since so-called codeine is frequently in part mor- phine. Codeine is inferior to morphine as an anodyne and hyp- notice, but is a useful sedative in relieving bronchial irritation and eough, and in the doses commonly employed does not induce indi- 304 VEGETABLE RUGS gestion, nausea or constipation. Ihe writer wou.a particularly recommend it for dogs suffering witk bronchitis, combined with phenacetin in powder or tablet. The other alkaloids of opium are not of sufficient therapeutic vzlue to warrant their consideration in this work. Admimistration.—Morphine sulphate is employed under the skin where an immediate effect is required. The preparations more frequently used in veterinary practice include laudanum and the deodorized tincture, powdered opium, extract of opium, and the salts of morphine. One-quarter grain of the latter is equivalent to one grain of opium. Paregoric is useful in canine practice for cough mixtures. Dover’s powder combines the expectorant and dia- phoretic action of ipecac with the sedative, antiphlogistic and sudo- rifie influence of. opium, but the former drug has little effect upon the horse. The preparation may be serviceable, however, in the first stage of catarrhal affections of the respiratory tract in dogs. Fluid preparations are generally desirable in securing more rapid absorption, but opium produces the best result in diarrhea, when given in pill or ball. Enemata composed of thin, boiled starch solution and laudanum at the body temperature are to be recom- mended in diarrhea of the young, dysentery and pain arising from strangury or disease of the genito-urinary organs. Opium sup- positories are of value in canine practice for the same purposes, and will relieve irritation and pain caused by piles. Uses External.—Opium is applied externally in various ways. In the form of laudanum it is sprinkled on poultices and prescribed in liniment (laudanum and soap liniment, equal parts) for its ano- dyne action, but has probably little medicinal virtue upon the un- broken skin. On raw surfaces, sores and ulcers, opium does relieve pain, and for this purpose laudanum may be conjoined advantage- ously with lead water (1-25). INDICATIONS FOR THE INTERNAL USE OF OPIUM. 1. To relieve pain and spasm. 2. To lessen secretions. 3. To allay motor excitement, diminish muscular action, and prevent hemorrhage. 4. To abort inflammatior.. 5. To act as a stimulating and supporting agent. The sudorific action of the drug upon the tower animals is slight and comparatively unimportant. Among the preceding indications the first three naturally follow from the physiological action of INDICATIONS FOR THE INTERNAL USE OF OPIUM 335 opium, while the latter two are deduced solely from clinical experi- ence. 1. Although the anodyne and sedative action of opium is not so marked in its influence upon veterinary patients as in human subjects, yet it is by far the most valuable agent we possess for relieving pain of any description, particularly when combined with atropine. In spasmodic colic of horses, opium arrests pain by pre- venting irregular and violent peristaltic action. It may be given as morphine (with atropine), subcutaneously; or as laudanum, with ether and chloroform in a drench, simultaneously with an aloes ball. In this affection opium actually assists the action of the purgative by overcoming spasm. Pain directly antagonizes the effect of opium, and repetition of the dose is both justifiable and necessary until relief is obtained. Hypodermic medication is therefore safer when the dose has to be repeated, in enabling the practitioner to decide that failure to relieve pain is due to insufficient dosage rather than to delayed absorption from the digestive canal. Opium is indicated in all forms of pain and in motor excite- ment in cerebritis and meningitis. The pains and spasmodic con- tractions resulting from acute or traumatic meningitis are benefited by opium; also neuralgic and rheumatic pains. The spasms of eclampsia and tetanus are eased when opium is combined with chloral in enema, or when morphine is injected under the skin. The in- jection of morphine under the skin may prove antidotal in strych- nine poisoning. Five grains saved a collie dog which had supposedly received a fatal dose of strychnine. Clonic spasm of the diaphragm in horses (““Thumps”) is also treated successfully with opium. Morphine under the skin is useful in asthma in dogs. The subcutaneous use of morphine sulphate (gr.ss-i) in dogs 30 minutes before operation is of the greatest service in causing easy ether anesthesia and permitting the use of the minimum amount of ether. After the animal has once been etherized the author has fre- quently done gastro-jejunostomy and even partial gastrectomy without any further ether being required. 2 and 3. Opium is invaluable in lessening secretion, motion and pain in various digestive disorders. Gastric digestion is in- hibited by the action upon secretion and motion, and opium should not be administered immediately after the ingestion of food, unless the demand for it at that time is impezative. Laudanum or mor- phine are also valuable in preventing threatened abortion, and in the treatment of after-pains and post-pavs1m hemorrhage in mares, cows and bitches. Excessive vomiting in dogs may be combated with opium and bismuth, or with morphine hypodermatically. Opium quiets peris- ome) BON 6) VEGETABLE DRUGS talsis and secures rest of the canal in gastritis and gastro-enteritis. In superpurgation and in all forms of diarrhea and dysentery, opium is the remedy par excellence. (Laudanum in dose of 5-10 drops for large birds is an efficient remedy for diarrhea in poultry.) Its administration in these disorders should be accompanied, or preceded, by an oleaginous (horse), saline (herbivora) or mercurial (horse and dog) purgative; and its action may be assisted by astringents, alkalies, mineral acids, and intestinal antiseptics in various com- binations suited to the particular case. The following formule are useful in diarrhea of horses and cattle. Jaudanum and spirit of camphor, each 5 i, with tine. capsicum, 3 i. in drench thrice daily; or 3 1. each of pulv. opium and eatechu, with 3 i. each of chalk, ginger and sodium bicarbonate in flour gruel twice daily. One third of this prescription is suitable for calves. For dogs 5 to 10 minims of laudanum may be added to a tablespoonful of mistura cretae; or to half a dram of bismuth suspended in water. Peritonitis, enteritis, and acute obstruction of the bowels are treated most successfully with opium, which quiets the bowels, re- lieves pain and facilitates the vis medatrix nature, besides acting as an antiphlogistic in the first-mentioned diseases. By preventing muscular activity and allaying general excitability, opium is the most effective hemostatic in all internal hemorrhages, and it quiets the heart most effectively in acute endocarditis. Cough, as a symptom of irritation within the respiratory tract, is more commonly treated by some form of opium than by any other drug. When cough is irritative or excessive, and is not remedial in removing secretion, then it is very properly controlled by opium. If, on the other hand, respiratory movements are weak, or cyanosis threatens from retained secretions, opium is distinctly contraindi- cated, since it depresses the respiratory centres and lessens the irri- tation produced by the secretions in the bronchial tubes, which would otherwise cause coughing and expulsion of the exudate. Morphine sulphate (gr. 4o to gr. %) may be given in chloroform water every 3 hours in troublesome cough in house dogs. Opium, especially when combined with belladonna, notably di- minishes secretions, so that this combination is peculiarly appropri- ate in the treatment of cough and exudation, and it is only when increasing moist rales are found to exist during this medication that it should be stopped. Pleuritic cough causes intense pain and ac- complishes nothing, so that opiug here affords great relief without inducing bad results. 4, ‘Opium possesses dre onlogitte action in aborting and com- bating inflammation. Reflex excitability is lessened by opium, and therefore irritation of nerve centres, which would otherwise cause APOMORPHINE HYDROCHLORIDE pol vascular dilatation, stasis, and inflammation, is prevented by the drug. This is at least the theory. Opium and quinine are the two remedies having the most popular clinical reputation for aborting colds and inflammation, and the latter agent also diminishes reflex excitability. Inflammation of serous membranes is thought to be that form most favorably influenced by opium, as peritonitis, en- teritis and meningitis, for which purpose the drug is frequently com- bined with calomel. But opium is also an extremely useful anti- phlogistic remedy in coryza, bronchitis, pneumonia and pleurisy, and in inflammations of the mucous coat of the digestive canal, as gastritis and dysentery. A single full dose should be given at the earliest possible stage of these disorders, and the patient should be kept as quiet as possible to secure the best result. 5. Opium stimulates and supports the system in a manner not explicable on physiological grounds. It often conserves life in a remarkable way in patients weakened by long continued disease and in those suffering from shock, loss of blood following surgical opera- tion, parturition, or other natural causes. Opium in some form (often as codeine) is the most useful remedy in diabetes mellitus, in dogs, in reducing the loss of glucose in the urine. Contra-indications—In respiratory diseases associated with cyanosis or excessive exudation, in very high fever and obstinate constipation. The drug must be used with caution in the treatment of the aged and very young. Apomorruine Hyprocutoripum. Apomorphine Hydrochloride. Gy IN. ODE Cle +(Ua8i &-B: P-) Deriwation.—The hydrochloride of an artificial alkaloid, ob- tained by heating morphine (or codeine) in hermetically closed tubes, with an excess of pure hydrochloric acid. The morphine thus loses one molecule of water; C,;,H,,N O; =C,,;H,;N O,. + H,0. Properties.—Minute, grayish-white, shining, monoclinic prisms, without odor, having a faintly bitter taste, and acquiring a greenish tint upon exposure to light and air. Soluble in about 39.5 parts of water, and about 38.2 parts of alcohol; very little soluble in ether or chloroform. It should be kept in small, dark, amber-colored vials. ES. 2B: Ee connie H., gr. 34 (0.045). Foals, gr. Y% (.03). Sh. & Calves, gr. 14 (.03). Cows, gr. 114 (.09). D., gr. V4o-¥% (.006.012). By the mouth, D., gr. %40-%5 (.0015-.0024) as expectorant. 338 VEGETABLE DRUGS PREPARATION. Injectio Apomorphine Hypodermica. (B. P.) One per cent. Dose.—H. m. 75. Sh. & Calves, m. xl. D. m. x.-xx. Action Internal.—Small doses (gr. %o-%0) cause vomiting in dogs, while larger doses produce salivation and trembling in addi- tion to vomition. Very large quantities (gr. 4-5) occasion first great excitement; the dog howls, runs and jumps about, the pupils are dilated and the slightest noise excites great alarm. Then the animal weakens in the hind legs, becomes paraplegic, falls and goes into convulsions. The breathing, at the beginning rapid, becomes weak and slow. Death ensues from respiratory failure. Nervous System.—The drug primarily stimulates the brain and induces delirium and excitement, but secondarily causes cerebral paralysis. The origin of the convulsions is not ascertained. Apo- morphine is a direct local paralyzant to the muscles, acting upon their substance or upon the motor nerve endings. Curculation.—Medicinal doses do not alter the force, but may increase the rate and tension of the pulse by stimulation of the cardiac accelerator nerves and vasomotor centres. Toxic doses paralyze the heart muscle and lower blood pressure. Respiration.—The respiratory movements are at first markedly increased by large doses of apomorphine. The reason for this is uncertain. Lethal doses depress and paralyze the respiratory centre. The breathing then becomes feeble and infrequent. The agent causes a copious outpouring of a watery fluid from the blood vessels of the respiratory mucous membrane, and is, therefore, an expec- torant. Vomiting Centre.—This is stimulated by therapeutic doses of apomorphine, but paralyzed by toxie doses, so that vomiting may not occur in poisoning. Apomorphine does not act locally upon the stomach. Uses.—Apomorphine is a reliable, prompt and powerful emetic. The alkaloid is generally given under the skin and can be adminis- tered along with zine sulphate or other emetic in poisoning. In narcotic poisoning, as with chloral or opium, apomorphine—like other emetics—may fail to act efficiently. In the first stage of acute bronchitis, apomorphine is useful in canine practice, and again in the later stage, when the animal becomes choked with exudation. The drug, in a mild emetic dose, will aid recovery by causing vio- lent expiratory efforts during vomition, and these tend to expel se- BELLADONNA LEAVES 339 eretions, which is furthermore assisted by the action of the alkaloid in rendering the secretions less viscid. Chronic dry bronchitis of dogs is likewise benefited by apomorphine. In pica in cattle, 114 gr. may be given on three consecutive days or in recent cases, gr. ill. are given subcutaneously in the same way. In pica in foals, sheep and calves the drug is equally effective in smaller doses. Even in parrots and other birds gr. 114 in water by the mouth may cure the habit of plucking out the plumage. Apomorphine must be used with some caution in foals and horses since F. Smith has reported an alarming condition in the horse produced by the giving of two grains under the skin attended with delirium, great restlessness, constant movement of the limbs, excitement and sweating. Apomorphine hydrochloride sometimes relieves choking in animals by its relaxing spasm and increasing secretion of the gullet. Three-quarters of a grain may be injected under the skin in horses. It should be tried before using a probang, as, if suc- cessful, it will act within fifteen or twenty minutes. The alkaloid decomposes in erystal, and rapidly in solution, becoming toxic and of a green hue. Solutions should be freshly prepared. Class 2.—Stimulating the Brain. Berraponn® Forza. Belladonna Leaves. (U.S. Aid Big te) Synonym.—Deadly nightshade, E.; folia S. herba belladonne, feuilles de belladonne, Fr.; tollkraut, tollkirschen blitter, wolf- kirschen-blatter, G. Derivation.—The dried leaves of Atropa Belladonna Linné (Fam. Solanacee), yielding, when assayed by the U. S. P. process, not less than 0.35 per cent. of mydriatic alkaloids. Usually of a dull brownish-green color, the leaves much wrinkled and matted together, frequently with the flowering tops intermixed ; leaves from 6 to 20 Om. long, 4 to 12 Cm. broad, broadly ovate, apex acute, margin entire, narrowed into the petiole, upper surface brown- ish-green, lower surface grayish-green, epidermis more or less papil- lose, particularly on the under surface; odor distinctly narcotic, espe- cially on moistening; taste somewhat bitter and acrid. The powder is characterized by few hairs and numerous, small, arrow-shaped crystals of calcium oxalate. Constituents.—Two alkaloids; 1, atropine, the chief one, rep- resenting the action of belladonna; and, 2, hyoseyamine. 340 VEGETABLE DRUGS Atropine is now considered to be an artificial product of hyoscyamine, and therefore the latter to be the natural alkaloid. Belladonna leaves should contain not less than 0.35 per cent. atropine. Dose.—H. & C., 5, s8.-1. (15.-30.) ; D., gr.i.-v. (.06-.3). PREPARATIONS. Eztractum Belladonne Foliorum. Extract of Belladonna Leaves. (U. S. & B. P.) Made by percolation with diluted alcohol, and evaporation to pilular consist- ence. Used in preparing the unguentum belladonne. Contains 1.4 per cent. of mydriatic alkaloids. Dose.—H. & C., gy.x.-xx. (.6-1.3); Sh. & Sw., gr.ii-iv. (.12-.24.); D., gr.4-3 (.008-.03) . Tinctura Belladonne Foliorum. Tincture of Belladonna Leaves. (U8: & Bs P:) Belladonna leaves, 100, diluted alcohol to make 1,000. Made by maceration and percolation. (U.S. P.) Dose.—D., Mv.-xxx. (.3-2.). Unguentum Belladonne. Belladonna Ointment. (U. S. & B. P.) Extract of belladonna leaves, 10; diluted alcohol, 5; hydrous wool fat, 20; benzoinated lard, 65. (U.S. P.) BreLLaponn Raprx. Belladonna Root. Synonym.—Racine de Belladonne, Fr.; wolfskirschenwurzel, tollkirschen-wurzel, G. Derivation—The dried root of Atropa Belladonna Linné (Fam. Solanaceoe), yielding, when assayed not less than 0.5 per cent. of mydriatic alkaloids. In cylindrical or somewhat tapering, longitudinally wrinkled pieces, 1 to 2.5 Cm. thick, the bark somewhat incurved at the edges of roots which have been split before drying; externally pale brown- ish-gray, dusty or mealy, outer layers of the periderm rather soft, frequently abraded, and thus showing lighter patches; fracture nearly smooth, mealy, and emitting a characteristic puff of dust; internally whitish, the older roots showing medullary rays near the bark; nearly inodorous; taste sweetish, afterwards bitterish and strongly acrid. Constituents—Same as leaves. Contains not less than 0.5 per cent. atropine. ATROPINE 341 PREPARATIONS, Fluidextractum Belladonne Radicis. Fluidextract of Belladonna Root. (USB) Made by percolation with alcohol and water, and evaporation. One ce. of the extract —one gm. of belladonna root. Standarized so that 100 ce. of the fluidextract contain 0.5 gm. of mydriatic alkaloids. The most reliable prepara- tion. D., Mi-iii. (.06-.2). Linimentum Belladonne. Belladonna Liniment. (U. S. & B. P.) Camphor, 50; fluidextract of belladonna to make 1,000. (U.S. P.) Atropina. Atropine. C,;H2, NOs. CUSS2Gp BES) An alkaloid obtained from belladonna. As it occurs in com- merce, it is always accompanied by a small proportion of hyoscya- mine extracted along with it, from which it cannot readily be sepa- rated. Derivation.—Atropine is obtained from a strong tincture of the root. Slaked lime is added, which splits up atropine malate and precipitates lime malate. The excess of lime is precipitated by sul- phurie acid, and coloring matters by potassium carbonate, which also sets free atropine. The atropine is dissolved in chloroform, recov- ered on evaporation, and purified by digestion with warm alcohol and charcoal. Properties.—White, acicular crystals, or a more or less‘ amor- phous white powder; without odor, having a bitter, acrid taste, and gradually assuming a yellowish tint on exposure to air. Soluble in 450 parts of water, 1.46 parts of alcohol, 16.6 parts of ether, 1.56 parts of chloroform, and about 50 parts of glycerin. At about 113.8° C. (237° F.) it melts, forming a colorless liquid. At about 140° C. (284° F.) it begins to give off white, acrid fumes, and when ignited, it is consumed without leaving a residue. It has a mark- edly alkaline reaction; its saturated aqueous solution acquires a pink color upon the addition of a drop of phenolphtalein. Incompatibles—Decomposed by sodium or potassium hydrate. Dose.—H., gr.ss.-iss. (.03-.09) ; average dose, gr.i. (.06); C., eri-ii. (06-12); Sh. & Sw., gr. Yo-%e (.003-.005); D., gr. Voo-%o (.0005-.001). 342 VEGETABLE DRUGS AtTropin& SutpHas. Atropine Sulphate. (C,,H,;NO;). H,SO,. (US. @B2 2.) Derwation.— Atropine is dissolved in sulphuric acid and treated with ether, when the insoluble sulphate settles out. Properties.—A white crystalline powder or microscopical needles and prisms (the form of the latter being probably due to the hyoseyamine present); odorless, having a very bitter, nauseating taste, and permanent in the air. Jt should be tasted with the utmost caution, and only in dilute solution. Soluble in 0.38 part of water, 3.7 parts of alcohol, 2140 parts of ether, and in 620 parts of chloro- form at 25°C... (77° E,)... At about 189:9°9C..(3'%3.0° faire pine Sulphate melts; when free from hyoscyamine it melts at about 118° C. (370.4° F.). When ignited it chars, emits acrid vapors, and is rapidly and completely consumed. Dose.—H., gr.i.-iss. (.06-.09) ; C., gr.i.-ii. (.06-.12) ; Sh. & Sw., gr. Use (.004-.005) ; D., gr. “20-%0 (.0005-.0008), average dose, er. Yoo (.0006). ACTION OF BELLADONNA AND ATROPINE. External.—Belladonna is ordinarily not absorbed from the un- broken skin, but when applied to raw surfaces and mucous mem- branes, or, to a less extent, when rubbed into the skin with camphor (linimentum belladonne), chloroform, alcohol, ete., it depresses the sensory nerve endings and produces a local anodyne action. Thus applied it also depresses the peripheral motor nerve fibres, and is sometimes injected into spasmodically contracted muscles for relief of spasm. The vessels are said to be first contracted and then dilated by the local action of the drug, and the secretions of the skin are diminished. | Internal.—Digestive Tract.—Belladonna (atropine) apparently diminishes the gastric secretion and is largely used to lessen gastric hyperacidity. In the intestines atropine prevents undue griping produced by drastic cathartics by some unknown action, since the inhibitory sphlanchnic endings are not depressed as has hitherto been taught. Large doses of atropine excite peristalsis through stimula- tion of Auerbach’s plexus (Magnus). Circulation.—Belladonna is readily absorbed into the blood, but has no particular action upon this fluid within the body. Dilute solutions of atropine paralyze and stop corpuscular movement in the blood withdrawn from the vessels. The characteristic action of bella- donna upon the circulation consists in depression of the peripheral pneumogastric fibres in the heart, with greater frequency of the ACTION OF BELLADONNA AND ATROPINE 343 pulsations. There is also, probably, a slight stimulation of the car- diac muscle. Belladonna is therefore a heart stimulant, by increas- ing the number of its beats without diminishing their force. Large doses sometimes give rise to primary slowing of the pulse, owing to stimulation of the inhibitory apparatus. Blood pressure is exalted synchronously with the increased frequency of the heart, and is due to cardiac stimulation and also to stimulation of the spinal and medullary vasomotor centres, with constriction of blood vessels of the abdomen.+ In poisoning, vascular tension is considerably lowered because of paralysis of the vasomotor centres, smooth muscles (or ganglia), of the vessel walls (with vascular dilation), and the heart muscle itself. Nervous System.—Cerebrum.—Belladonna is classed as a de- lirifacient by some authorities,—notably Wood. It stimulates the brain incodrdinately, and large doses produce restlessness, nervous excitement and delirium in man, and occasionally delirium in the lower animals. Stimulation is succeeded by exhaustion and some depression, with stupor rather than coma. Spinal Cord.—Belladonna appears to exert a double action (stimulant and depressant) upon the spinal cord. The spinal vasomotor and respiratory centres are stimulated. Large doses cause complete loss of motion and reflex action in the frog, lasting for sev- eral days, and followed by reflex excitability and convulsions. Poi- soning in mammals is exhibited by less paralyzant action accompanied by more convulsive movements. Various explanations have been offered to reconcile these phenomena. ‘The prevalent theory is, that, following complete paralysis of the spinal cord, the motor and sensory tracts recover before the inhibitory centres, so that normal stimuli pass through the latter unrestrained and result in convulsions, Nerves.—The action of belladonna upon the nerve endings is extremely important, and represents, to a considerable degree, the therapeutic value of the drug. The peripheral motor nerve ter- minations, and, to a less extent, their trunks, are depressed and para- lyzed. This is never so complete, however, but that there is some voluntary power left in an animal fatally poisoned. Depression and loss of function of the afferent nerves come on more slowly, and exist to a less degree. Belladonna, then, when applied locally or given internally, is an anodyne, but is far inferior in this respect to opium; and, whereas opium acts centrally, belladonna acts periph- + Dilatation of the vessels of the skin occurs at the same time but this is insufficient to reduce blood pressure. In man this is shown by flushing of the skin and a bright rash on the face and neck after large doses. 344 VEGETABLE DRUGS erally. The terminations of all secretory nerves are also depressed and paralyzed by belladonna, and secretions are therefore diminished. Secretions.—Dryness of the mouth is one of the first physiolog- ical symptoms following the administration of belladonna. This is due to paralysis of the peripheral terminations of the secretory nerve (chorda tympani) of the submaxillary gland, and of the secretory nerve endings of the other salivary and mucous glands in connection with the mouth. Another characteristic effect of belladonna consists in the production of dryness of the skin, which follows the action of the drug in paralyzing the peripheral nervous filaments supplying the secretory cells of the sudoriparous glands. In the same manner the tracheal and bronchial secretions are diminished, and also the secretion of milk (anti-galactagogue action), by depression of the terminations of the secretory nerves. The drug does not exert any decided influence upon the secretions of the intestinal tract, but the secretion of gastric juice is diminished or arrested and, to a less de- gree, that of the pancreatic juice and bile. The HCl in the gastric juice is much. more reduced than the pepsin or fluid as a whole. The amount of urine is sometimes increased after the ingestion of small doses of belladonna, but is considerably lessened, or suppressed, in poisoning by the drug. Experiments upon man show that the uri- nary solids are increased: urea and uric acid to a slight extent; sul- phates and phosphates to a considerable degree. Muscles and their Nerves.—Atropine is antispasmodic in its effect upon involuntary muscle. It depresses both the unstriped fibres and their motor nerve endings. Toxic doses cause paralysis of the smooth muscles. Voluntary muscles are not affected by any doses of atropine, although the motor nerves controlling them are depressed by toxic amounts of the alkaloid. Small doses of atropine, given experimentally to animals, do not appear to affect peristalsis at all and do not alter the normal influence of the vagus or splanchnic nerves. Its action in preventing griping and the violent peristaltic movements of pilocarpine can not be explained except by its effect on some unknown mechanism. After large doses, as has been noted above, intestinal action is stimulated and vomiting and purging occur in poisoning by the drug. . Atropine has been used successfully to produce three diverse actions on the bowel: (1) to quiet intestinal movement in inflamma- tion of the bowels; (2) to relieve spasm in colic and spastic condi- tions generally; (3) very commonly to aid catharsis in sluggish states of the intestines. In practice, small doses will often move the bowels effectively, while, on the other hand, enormous doses (gr. %e, in- stead of the usual dose of gr. 400) have recently proved success- + ACTION OF.BELLADONNA 345 ful in moving the bowels in obstinate constipation (in human pa- tients) due to obstruction,* when all other means failed. Con- versely, it is, and has been, the common practice to give atropine with morphine to prevent peristalsis in peritonitis and with appar- ently satisfactory results. The cathartic action of atropine in small doses is not explicable by its known physiologic effect, but its sedative influence is noted in experimental work in preventing griping of drugs. The predominant action of belladonna in paralyzing the peripheral vagi in the heart has been described. The pneumogastric terminations are depressed in the heart by moderate doses, while the heart muscle is paralyzed by large quanti- ties of belladonna. A like depressing influence is believed to be exerted upon the efferent nerve endings of the unstriped muscles of the bladder, urethra, uterus and vagina, as well as upon the muscles of these organs. Belladonna acts medicinally as an antispasmodic in relation to the muscles. Resmration.—Small doses of atropine do not affect the respira- tion. Large therapeutic doses make the respiratory movements quicker and deeper, by stimulation of the medullary and spinal respiratory centres. Fatal doses produce respiratory failure and asphyxia, owing to paralysis of the respiratory centre and the peripheral vagus filaments concerned with the respiratory move- ments. Belladonna also paralyzes the peripheral fibres of the pneu- mogastric nerve in the bronchial tubes and acts therapeutically as follows: 1. As a respiratory stimulant; the drug is generally in- ferior to strychnine in this respect. 2. As an antispasmodic, by depressing the efferent vagus endings in the bronchial tubes and re- laxing spasm of the smooth muscle of their walls. 3. As a seda- tive, by depressing the afferent vagus fibres and diminishing the irritation produced by secretion, so that:cough is allayed. 4. As an agent lessening secretion. Temperature.—Moderate doses of belladonna cause a rise of temperature, while fatal doses lessen bodily heat. The first phe- nomenon is produced by stimulation of the spinal thermogenic cen- tres, while the latter effect follows the vasomotor paralysis which occurs after lethal doses. An elevation of 2\ to 5.4° F. has been noted in dogs after full doses of atropine, while a greater fall of temperature has been observed in the same animal in fatal poisoning. Elevation of tem- perature is accompanied by increased heat loss, caused by radiation from the dilated cutaneous vessels. *It is probable in these cases that the obstruction was due to spasm, and not mechanical. 346 VEGETABLE DRUGS Eye.—The action of belladonna upon the eye affords another illustration of the depressing action of the drug upon the nerve ter- minations. The myoneural junctions of the third (oculomotor) nerve in the circular muscle are paralyzed, which leaves the radi- . ating fibres free to act and they therefore draw back the edges of the iris and dilate the pupil. The nerve terminations in the radiating fibres do not seem to be influenced by atropine. The mydriatic action is exhibited, whether the drug be given by the mouth or dropped directly into the eye. In the former case, the drug does not act through the nervous system, but locally upon the peripheral filaments of the third nerve through the medium of the blood. The muscular fibres of the iris are unaffected by belladonna. The ter- minations of the sympathetic and the trigeminus may be stimulated, which would also produce dilation of the pupil. These latter actions are not definitely determined, while it is known that the dominant effect consists in depression of the oculomotor nerve endings, as before stated. Paralysis of accommodation follows paralysis of the terminations of the third nerve in the ciliary muscle, and therefore vision is disturbed. Intraocular tension is increased by large and continuous dosage of belladonna, and an artificial glaucoma may be thus produced. Elimination.—Belladonna is eliminated by the kidneys and bowels; traces have been found in the milk. It is, however, chiefly oxidized in the body. Summary.—It will be observed that belladonna, generally speaking, first stimulates and then depresses the nerve centres, while it chiefly paralyzes the motor nerve terminations, including the in- hibitory (vagus), the secretory (chorda tympani, etc.), and, to a less extent, the sensory nerves. Secondary depression of the cerebrum is not so profound as that of the great medullary centres, especially the respiratory centre, and there is sometimes a slight and brief stimulation of the motor nerves of the smooth muscles, viz., vagus, splanchnic, and possibly vasomotor nerves. Full medicinal doses depress the peripheral filaments of the inhibitory and secretory nerves and the motor nerves of the unstriped muscles, as well as the muscles themselves, lessen the functional activity of the voluntary motor system, and, to a less degree, that of the afferent nerves. The pulse becomes quickened because of paraly- sis of the peripheral vagus endings and stimulation of the heart; the blood tension is augmented because of the increased cardiac action and stimulation of the vasomotor centres; and the respiration is accelerated because of excitation of the respiratory centres. The temperature is elevated owing to the circulatory exaltation and stimulation of the heat-producing centres. Slight delirium may be ACTION OF BELLADONNA AN present from the exciting action of the drug upon the cerebral motor centres. The spinal cord is unaffected by therapeutic doses. Locally applied, belladonna is a direct paralyzant to nerves, muscles, vessels and cells. « PHYSIOLOGICAL RELATIONS OF BELLADONNA TO OTHER DRUGS. A medicinal dose of atropine stimulates, while morphine de- presses, the brain, respiratory functions, and intestinal peristalsis. This antagonism ceases when poisonous doses of the two drugs are combined, and therefore atropine should be given with caution in the treatment of opium narcosis, so as not to aggravate the already existing central nervous depression, particularly of the respiration. Morphine relieves pain, causes sweating, and contracts the pupil centrally. Atropine dilates the pupil, produces dryness of the skin, and depresses the functions of sensory nerves through its periphera! action. Atropine antagonizes physostigma in so far as the latter stimulates the peripheral oculomotor nerve fibres, the vagi, diminishes blood pressure, depresses the respiratory centres, and stimulates the unstriated muscle of the intestines, and the secretions of the stomach, bowels and bronchial tubes. Atropine-is antagonistic—in part—to pilocarpine, which stimu- lates secretory nerve terminations in the sweat and salivary glands, the peripheral oculomotor filaments, and the nerve endings in the involuntary muscle of the heart, stomach, intestines and uterus. Atropine counteracts the influence of aconite and muscarin (the poison of fungi) upon the heart, and the action of the latter prin- ciple in producing spasm of the pulmonary vessels. Tovicology.—Toxic doses of belladonna cause in animals dryness of the mouth, increased frequency of the pulse and respiration, ele- vation of temperature, dilation of the pupil and partial blindness, restlessness, nervousness, delirium, twitching of the muscles (oc- casionally erythema), and frequent micturition. These symptoms are succeeded, in fatal poisoning, by fall of temperature, retention of urine, muscular weakness, staggering gait, partial anzsthesia, con- vulsions and paralysis (one preponderating over the other), weak, slow, irregular respiration, feeble, rapid pulse, paralysis of the sphincters, stupor and death. Death oceurs mainly from asphyxia, but is due in part to cardiac failure. The physiological test consists in placing a drop of the urine (secreted by the poisoned animal) into the eye of a healthy animal, when mydriasis should follow if the case be one of belladonna poisoning. Three-quarters of a grain otf atropine under the skin has proved fatal to dogs. Two grains of 348 =e VEGETABLE DRUGS atropine produce mild toxic symptoms in the horse. Small dogs are slightly poisoned by gr. %o of atropine; medium sized dogs by gr. %o given hypodermatically. Cattle are as susceptible as horses, al- though herbivora are not so easily influenced as carnivora. The pulse in dogs is greatly accelerated, sometimes as high as 400, while the pulse rate of the horse is not generally more than doubled. Rodents, as guinea pigs and rabbits, and pigeons, are particularly insuscepti- ble to belladonna, in regard to its effect upon the pupil, circulation, etc. The treatment of poisoning includes the use of the stomach tube, emetics, pilocarpine, chloroform or ether in the stage of excite- ment; and cardiac stimulants, as caffeine, and artificial respiration in the later depression. Also external heat and general faradism. Post-Mortem Appearances.—These are not generally character- istic, except of asphyxia. The blood is dark and poorly coagulable. There is congestion of the lungs, general passive hyperemia, and sometimes ecchymoses in the brain, cord, and their membranes. Congestion of the retina is said, however, to be pathognomonic of belladonna poisoning. Administration.—The fluidextract of belladonna root is the official preparation more commonly used for horses. The alcoholic extract of the leaves is given in pill or suppository to dogs, and in electuary to horses. Atropine sulphate is employed under the skin when a rapid effect is desired. Uses Hxternal.—Local application of belladonna is more ef- fective when combined with internal medication of the same drug. Belladonna is used for mammitis, applied by massage in the form of liniment, and given by the mouth. It relaxes spasm, contracts the blood vessels, and lessens inflammation and congestion; para- lyzes the secretory nerves and so diminishes the amount of milk, vascular tension, pain and glandular activity. In fissure of the rectum, and in hemorrhoids, belladonna (with opium) in ointment or suppository, allays spasm and pain. Liniment of belladonna is useful in rheumatic or neuralgic pain, and rubbed upon the throat, in cases of pharyngitis and laryngitis, affords a serviceable appli- cation, when combined with the internal administration of the drug. Uses in Connection With the Hye.—In examination of the fundus of the eye, the media, or lens, for cataract, the pupil may be dilated to advantage with a weak solution (gr. %o-3 i.) of atropine sulphate. A drop will suffice, and no trace of its effect will remain after the second day. A strong solution (gr.iv.-4 1.) is essential to completely paralyze the iris and ciliary muscle. In the normal ani- mal, accommodation is paralyzed and vision disturbed for 8 or 12 days after the use of this solution. Atropine is particularly useful USES OF BELLADONNA 349 in keratitis and iritis. In the former disease, photophobia and blepharospasm are diminished by the paralyzing action of atropine upon the trigeminus, and pain, congestion and inflammation are diminished by contraction of the peripheral blood vessels. In central perforating ulcer of the cornea, with protrusion of the iris, atropine, by dilating the pupil, draws the iris away and prevents its perma- nent adhesion (anterior synechia) to the cornea, while the perfora- tion is becoming filled with lymph and the anterior chamber is being restored. Strong solutions of atropine instilled at frequent intervals, are useful in iritis by (1) paralyzing and securing rest of the iris and ciliary muscles; (2) in lessening local blood supply, congestion and inflammation, and in preventing adhesions of the posterior sur- faces of the iris to the anterior capsule of the lens (posterior synechiz), which both limits the normal variation in the pupillary diameter and interferes with the nutrition of the lens, and so pre- disposes to cataract. Atropine is contraindicated in glaucoma. Uses Internal.—The general indications follow directly from our knowledge of the physiological action of the drug. They are as follows:—1. To stimulate the respiration and circulation. 2. To diminish secretion. 3. To relieve spasm and pain. 1. Acute diseases, as pneumonia, bronchitis, influenza, cerebro- - spinal meningitis, etc., are frequently treated at the outset with bella- donna, with the intent of cutting short the inflammatory process by pro- ducing general vascular contraction. This applies more particularly to pharyngitis, laryngitis and coryza where there seems good evidence to prove that sometimes a full dose of belladonna at the outset of these disorders may actually abort them. Besides there are the beneficial effects of the drug in relieving cough, spasm and obstructed breathing noted below. In the second stage of acute diseases, as pneu- monia, belladonna is a valuable agent in combination with strych- nine, to stimulate respiration, prevent effusion and vasomotor and cardiac depression. Belladonna is of service also as a respiratory, cardiac and vasomotor stimulant in poisoning by various drugs, in- eluding opium, chloroform, ether, aconite, prussic acid, physostigma and pilocarpine. Experiments by Reichert (Therapeutic Monthly, May, 1901) and others show that atropine, while stimulating the respiratory centre exerts a powerful depressing action on the pul- monic motor fibres of the vagi, and that in opium poisoning atro- pine, instead of strengthening, actually lessens respiratory power. Strychnine and caffeine are undoubtedly much better antidotes in this condition. Belladonna is an antidote in poisoning by antimony. In surgical shock, with low temperature, owing to vasomotor paral- ysis and vascular dilatation, and in collapse from injury and disease atropine is a most potent remedy, combined with camphor subcu- 350 VEGETABLE DRUGS taneously. In pneumonia, especially, belladonna is of great value following the crisis. 2. Belladonna is employed therapeutically to diminish exces- sive sweating and salivation, mercurial or otherwise. It is recom- mended in serous, or watery diarrhea. Edema of the lungs is com- bated most successfully with atropine (combined with strychnine) subcutaneously. In the second stage of acute respiratory diseases, as bronchitis, influenza, canine distemper, and pneumonia, belladonna di- minishes secretion, irritability and cough, and stimulates the heart and respiration. It may be associated with opium to increase the sedative effect. Atropine is the best remedy, apart from antacids, to counteract gastric hyperacidity. 3. Belladonna does not have much influence over spasm of the voluntary muscles, unless injected (atropine) into their substance. Rheumatic lameness, neuralgia, and cramps and spasm due to in- jury of nerves, may be treated in this manner. Belladonna Jiniment or a local injection of atropine are indicated in that condition of the tender skin and muscles seen in horses and dogs after severe exercise. Spasm of involuntary muscle is, however, more easily overcome, and this action is of exceeding therapeutic importance. Intestinal spas- modie colic of horses suceumbs most readily when atropine is given with morphine under the skin. In peritonitis and enteritis, full and repeated doses of atropine, with morphine, assist in paralyzing the smooth muscular fibres of the intestines, and in quieting peris- taltic movement. Large doses of atropine have been recently used in human medicine, and with remarkably good results, in the treat- ment of intestinal obstruction from impacted feces, and even in in- vagination and twist. Cough, stridulus breathing, and spasm, associated with acute pharyngitis and laryngitis, are influenced favorably by belladonna, in the first stage. The drug acts locally to paralyze the ends of the motor nerves in the throat, relieves spasm, and also contracts the peripheral vessels and overcomes congestion and inflammation. It may be given to horses in electuary, and also applied in liniment or ointment externally. The following prescription is suitable for horses suffering from pharyngitis or laryngitis. R Fluidextr. Belladonne Rad.............00. 51, Pulv. Potassii Chloratis...........2..008. 3 ii. Pauly’ Glycyrrhnizie ccs c corere eree cre eesti 5 Vv. SyTUp! USGI. ses ae tare a ca eee Q. S. M. et f. electuarium. Sig. Give 4 ounce every two hours. (Furnish 4 ounce for sample dose.) HYOSCYAMUS aya In bronchitis and asthma, belladonna also allays spasm and lessens secretion, irritation and cough. Other spasmodic conditions benefited by belladonna are, “thumps,” lead colic, convulsions (with bromides), spasm of the rectum owing to fissure or other causes, and incontinence of urine due to spasm of the neck of the bladder. Pal- pitation of the heart is relieved by the sedative action of the mydriatic upon the unstriated cardiac muscle. Tetanus is favorably influenced by extract of belladonna given in electuary. In this section may he included the effect of small doses of belladonna in acting as a laxa- tive in constipation, and thus assisting the action of peristaltic stimulants, as aloes and strychnine. Pills containing aloin (gr. 4), extractum belladonne alcoholicum foliorum (gr. 1), and extractum cascare sagrade (gr. 4%), form a useful laxative combination in chronic constipation of dogs. Hyoscyamus. Hyoscyamus. (U.S. P.) Synonym.—Hyoscyami folia, B. P.; henbane, herba hyoseyami, E.; feuilles de jusquiame noire, Fr.; bilsenkrant, G. The dried leaves and flowering tops of Hyoscyamus mger Linné (Fam. Solanacee), collected from plants of the second year’s growth, and yielding, when assayed, not less than 0.08 per cent. of mydriatic alkaloids. Habitat.—Indigenous to England, the Continent, and Asia, and naturalized in the northern part of the United States. Description.—Leaves ovate or ovate-oblong, the lower with a short petiole, the upper sessile, 5 to 25 Cm. long, 2 to 10 Cm. broad, acute, coarsely and angularly toothed or lobed, grayish-green, glandu- lar-hairy, particularly on the lower surface; flowers nearly sessile, with an urn-shaped, unequally 5-toothed calyx and a campanulate, purple-veined corolla, which in the fresh state is yellowish; fruit capsular, 2-celled, and enclosed in the calyx; odor, heavy, narcotic; taste somewhat bitter and nauseous. The powder is grayish-green and contains calcium oxalate in single or twin monoclinic prisms about 0.010 Mm. in diameter. — Constituents.—Two alkaloids: hyoseyamine C,;H.,,N O;, and hyoscine. The first resembles atropine is composition and action. Impure, amorphous, commercial hyoseyamine is a dark-brown fluid and contains as its active principle mainly hyoscine. Incompatibility.—Incompatible with caustic alkalies and vege- table acids, lead acetate and silver nitrate. Hyoscyamus may be given in pill with the two latter mineral salts. Dose.—H. & C., % ss.-i. (15.-30.) ; D., gr.v.-xv. (.3-1.). ob! VEGETABLE DRUGS PREPARATIONS. Hetractum Hyoscyami. Extract of Hyoscyamus. (U. 8. & B. P.) Made by evaporation of the fluidextract to pilular consistency. The extract should contain 0.3 per cent. of mydriatic alkaloids. Dose—H. & C., gr.xx.-3 i. (1.3-4.); D., gr.ss.-ii. ‘(.03-.12). Fluidextractum Hyoscyama. Fluidextract of Hyoseyamus. ° ! (U.:8: Bs) Made by maceration, percolation with alcohol and water, and evaporation, so that 1 ce.—1 gm. of hyoseyamus. Each 100 ce. of fluidextract contains 0.075 gm. of alkaloids from hyoscyamus. Dose.—H. & C., 38s.-i. (15.-30.); D., Mv.-xv. (.3-1.). Tinctura Hyoscyami. Tincture of Hyoscyamus. (U. 8. & B. P.) Hyoscyamus, 100; diluted alcohol to make 1000. Made by maceration and percolation. Standardized to contain 0.007 gm. of mydriatic alkaloids in each 100 ec. of the tincture. (U.S. P.) Dose.—D., 3 i.-iv. (4.-15.). The dose of hyoscyamus preparations is generally two to four times that of similar belladonna preparations. Succus Hyoscyami. Juice of Hyoscyamus. (B. P.) Dose.—Same as tincture. Hyoscyamine Sutpuas. Hyoscyamine Sulphate. (C,;Hy; N O53). HoS Og. The neutral sulphate of an alkaloid obtained from Hyoscyamus and other plants of the Solanacew. It should be kept in amber- colored, well-stoppered vials. Derwation.—Hyoseyamine is derived from hyuseyamus seed. The latter are treated with ether to extract fat, and then distilled with alcohol and sulphuric acid. The liquid residue is neutralized with caustic soda and precipitated with tannic acid. The precipitate is mixed with lime and extracted with aleohol. The resulting al- coholie solution is first treated with sulphuric acid, then with caustic soda, and finally with ether, which dissolves the alkaloid. The lat- ter is recovered by distillation. Properties.—White, indistinct erystals, or a white powder; odorless, having a bitter, acrid taste; deliquescent when exposed to the air. Very soluble in water, and in 6.4 parts of alcohol; very slightly soluble in ether or chloroform. Dose.—H., gr.i.-ti. (.06-.12) ; D., gr. %o-%o (.001-.002). ILYOSCINE LYDROBROMIDE oe ee Hyoscyaminaz Hypropromipum. Iyoscyamine Hydrobromide. ©,,H,,N O,H Br. (U.S. P.) The hydrobromide of an alkaloid obtained from Hyoscyamus and other plants of the Solanacew. It should be kept in amber- colored, well-stoppered vials. Properties. —White, prismatic crystals, or a yellowish, amor- phous, resin-like mass, having, particularly when damp, a tobacco- like odor, and an acrid, nauseous, and bitter taste; deliquescent on exposure to the air. Very soluble in water; soluble in 2 parts of alcohol, 1600 parts of ether, and in 2.5 parts of chloroform at 25° Cai: B.), Dose.—H.., gr.i.-ii. (.06-.12) ; D., gr. Y%o-%o (.001-.002). Hyosctynz Hyprosromipum. Hyoscine Hydrobromide. Cap NO, Br. (UU; S. PB: & B.-P.) The hydrobromide of an alkaloid obtained from hyoscyamus. Propertics.—Colorless, transparent, rhombic erystals; odorless and having an acrid, slightly bitter taste. Permanent in the air. Soluble in 1.5 parts of water, and in 16 parts of alcohol; very slightly soluble in ether or chloroform. Dose.—H., gr. %-% (.001-.015) ; D., gr. Yoo-Yso (.0006-.002). Action Internal—The action of hyoseyamus is a resultant of that of its two alkaloids, hyoscine and hyoscyamine. The latter is practically atropine, except that its mydriatic action is shorter. Hyoscine, in poisonous doses, is a powerful depressant to the cerebrum, respiratory centre, s spinal reflex centres, and motor tract. Tt differs from atropine in being a cerebral sedative, and in its greater paralyzant action upon the spinal cord. The tetanic stage succeed- ing spinal paralysis, observed in atropine poisoning, does not ensue with hyoscine. The latter alkaloid slightly depresses and slows the heart, and does not paralyze the vagus terminations, nor depress the motor and sensory nerves or muscles. The circulation is but slightly influenced, and vasomotor depression only occurs in the latter stage of lethal poisoning. Death occurs from paralysis of the respiratory centres. Poisoning in animals is exhibited by loss of muscular power, slowing and failure of respiration, dryness of the mouth, stupor and asphyxia. The pulse may be infrequent, the pupils are dilated and the skin is moist rather than dry. Delirinm and con- vulsions sometimes occur in man. The effect of the combined action of hyoscyamine and hyoscine in hyoscyamus is shown when we com- pare the drug with belladonna. Hyoscyamus is more of a cerebral 354 VEGETABLE DRUGS sedative and hypnotic, and less of a heart and respiratory stimulant. It is said to possess more power in overcoming spasm, and griping of cathartics, and in aiding intestinal movement. Hyoseyamus is also thought to exert a more pronounced antispasmodic action than belladonna upon the smooth muscles of the bladder and urethra. Uses.—Hyoseyamus is generally applicable in the same dis- orders for which belladonna is indicated. In relieving some sorts of spasm, hyoscyamus is more efficient than belladonna, as in spasmodic colic, spasm of the bladder, and griping caused by cathartics. ‘Tetanus, chorea, and epileptic convulsions in dogs, are benefited by henbane, but the drug does not possess a curative action. Hyoscyamine may be combined to advantage with strych- nine, subcutaneously, in impaction of the bowels in horses. The former drug relaxes intestinal spasms, and assists the stimulant action of strychnine upon the intestinal muscle. Repeated small doses of oil will facilitate peristalsis in this condition. Hyoscine hydrobromide is indicated in spasmodic affections and in nervous and sexual excitement. It is a powerful drug and should be employed at the outset in small doses. To avoid contamination with hyos- camine is difficult, and the preparation of Merck is to be recom- mended. Hyoscine has not been employed to any extent in vet- erinary practice. It is used in human medicine as a hypnotic and sedative in mania and delirium of the insane. It causes no un- pleasant after-effects. Scopolamine is identical with hyoscine and is so named because obtained from Scopola atropoides. Scopolamine, or hyoscine, with morphine under the skin (after Korff) have been employed to some extent as general anesthetics in human surgery to replace ether or chloroform. To aid in obstetric operations in cows, as in replacing an inverted uterus, scopolamine hydrobromide (gr. %) with morphine sulphate (ori) may be injected subcutaneously, and the dose repeated in twenty minutes. Hyoscine (or scopola- mine) is sometimes given to horses to aid the action of chloroform and prevent its excitement, One hour before operation gr. %-%4 may be injected under the skin for this purpose. To produce gen- eral anesthesia in dogs, morphine is given with hyoscine in 2 doses— one 2 hours, and the other 15 minutes, before operation. Thus (for each dose) morphine, gr. ss., with hyoscine, gr. “400, are injected sub- cutaneously and will generally suffi¢e for the performance of ordinary operations—although a few whiffs of ether may be required in addition. Dogs are comparatively insusceptible to scopolamine. It has been estimated by Bernardini that morphine may be given to the extent of gr. % to each 2.2 lbs. of live weight; and hyoscine from gr. Yeo to gr. Ys to each 2.2 lbs. live weight for dogs. CANNABIS INDICA 355 Cannasis Inpica. Indian Cannabis. (U.S. & B. P.) The dried flowering tops of the pistillate plants of Cannabis sativa Linné (Fam. Moracew), grown in the East Indies and gathered while the fruits are yet undeveloped, and carrying the whole of their natural resin. Synonym.—Indian hemp, E.; chanvre indien, Fr.; indischer hanf, G.; herba cannabis indice, P. G. Haschisch is a confection of the drug. Arabian habitués of this preparation are frequently impelled by as influence to deeds of violence. They are called “‘haschaschins”; hence the English, assassins. Gunjab, or ganga, is the dried plant used in India for smoking. Churrus is the resin and epidermis scraped off the leaves. Bhang consists of the young leaves, flowering and fruiting tops and resin ‘resulting from the first season’s growth. Habitat.—The official cannabis is indigenous to ‘Asia, but the common hemp plant (Cannabis sativa) grows in America and many other parts of the world. Description.—In dark green or more or less brownish com- pressed masses, consisting of the densely paniculate branchlets, about 5 Cm. or more in length, and the inflorescence more or less ag- glutinated with a resinous exudation; commonly with a few unde- veloped digitate leaves of one or more linear-lanceolate leaflets ; clothed with numerous sheathing, pointed bracts, each containing two small mature but unfertilized pistillate flowers; odor agreeably narcotic; taste characteristic. In the powder few or no pollen grains or stone-cells should be present. Incompatibility.—W ater precipitates the active resinous prin- ciples. Lemon juice and other vegetable acids are the most efficient antidotes. Constituents—The active principle of cannabis indica is Can- nabinol (O H C.) H.,C O H), a red oil or resin boiling at a high temperature, which apparently exerts the characteristic action (Mar- shall) of cannabis indica on man and animals. But the therapeutic value of the principle has not been sufficiently studied to enable it to be used as a substitute for the crude drug or its preparations. The drug yields various other bodies such as: 2. Cannabene, C,,Hoo. or oil of Indian hemp, which is very toxic. 8. Cannabin, a resinoid. 4. Cannabindon, C,H,.0, a dark, red syrup. 5. Cannabine, an alkaloid. 6. Cannabinone, a resin. The last three are given medicinally but have no advantage over the crude drug. 7. Can- nabitetanine, a convulsant alkaloid. 356 VEGETABLE DRUGS PREPARATIONS. Eztractum Cannabis Indice. Extract of Indian Cannabis. (U. S. & B. P.) Made by maceration and percolation with alcohol, and by evaporation to a pilular consistence. Dose.—H., 3 i.-ii. (4.-8.); D., gr.4-i. (.015-.06). Fluidextractum Cannabis Indice. Fluidextract of Indian Cannabis. (U. 8S. P.) Made by maceration and percolation. The alcohol is distilled oi from the last part of the percolate, and the residue is dissolved in the first part (700 Ce.), and enough alcohol is added to make 1 Cc. of the fluid extract equal 1 em. of the crude drug. Dose.—H., 3 iv.-vi. (16.-24.); D., Mii-x. (.12-.6). Administration.—The extract is given in ball, pill, electuary or suppository; or the fluid preparations may be used. Tinctura Cannabis Indice. Tincture of Indian Cannabis. (U. S. & B. P.) Indian cannabis, 100; alcohol to make 1,000 Cc. Made by maceration and percolation. (U. 8. P.) Dose.—D., Txx.-xxx. (1.3-2.). Action External—Cannabis indica exerts a considerable irri- tant action when applied to mucous membranes. This is followed by local anesthesia. Action Internal.—Indian hemp is a distinct depressant to the functions of the brain and cord in poisonous doses, although thera- peutically stimulating these organs in small quantities, and produc- ing in man a kind of intoxication and mild delirium. The reflex activity of the spinal cord is primarily increased, but this is succeeded by diminution of reflex movement, and, after large doses, by anes- thesia and loss of voluntary motion. The sensory tract (centres and nerves) is depressed by considerable therapeutic doses. Polyuria is seen after the ingestion of cannabis indica in dogs. The pulse is sometimes slowed by the drug through stimulation of the vagus and depression of the heart muscle and death is said to occur from the latter cause. Death is extremely rare after the largest doses, however. Our knowledge of the detailed physiological action of the drug is imperfect. The action of cannabis comes on slowly and continues for a long time. A horse receiving, under the direction of the writer, at the Harvard Veterinary Hospitai, 14 ounce of the solid extract, became drowsy. Sleen after a few hours deepened into stupor, and stupor —— CANNABIS INDICA 357 into coma. ‘The respiration became slow, the pulse slightly accel- erated, and the animal so anesthetic that amputation of the penis was done on the following day without producing the slightest pain or struggling. The animal had to be supported in slings, and only recovered after three days. Frequently neither constipation, anorexia, or other deleterious after-effects follow the action of this drug. The following are extracts from experiments of Muir* with cannabis indica: Gelding, 8 years old; condition poor. Gave two doses of fluidextract (Park Davis & Co. normal fluid) undiluted of 12.5 cc. each (about 3 drachms) intra- jugularly, twenty minutes apart. Became rapidly nervous and excitable, in- creased by sounds or touch. In half an hour from first dose he became sleepy and stupid. A third dose of 15 ce. (% ounce) was injected into the jugular about an hour after the first and caused sweating and a sleepy condition, in which the animal jerked and twitched his head as if dreaming. The tem- perature dropped to 96° F., and the sleepy state, alternating with excitement when annoyed lasted three hours, when delirium supervened and continued for six hours, at which time al) the symptoms disappeared. Pony, 575 pounds; condition fair. Received 15 ec. (1% ounce) of the fluid- extract intravenously. In two minutes became delirious: in ten minutes was asleep against stall. In half an hour fell to floor and slept there for eighteen hours and could not be aroused. Temperature fell to 92.5° F. Respiration reg- ular; pulse from 42 to 30 during experiment. Gelding, 1050 pounds; in good condition. Given 45 cc. of fluidextract in- travenously. In three minutes rearing, kicking, snorting and going on like one mad. He ran back and forth along one side of his stall like a caged tiger with sweat rolling off him and cutting and bruising himself, being apparently anesthetic. He endeavored to bite or strike anyone approaching and remained delirious and excitable for twelve to twenty-four hours. Gelding, 650 pounds, 30 ce. of fluidextract injected into jugular. In four minutes became unsteady; in twelve minutes he was asleep; in half an hour he fell and so slept for eighteen hours. Temperature dropped to 91.° F. from normal; the pulse was accelerated and the respiration slightly so. Muir deduces from his experiments that as much as 50 ce. (3 iss.) of the fluidextract may be given with safety intravenously. In the human being, cannabis induces very peculiar mental phenomena, including hallucinations, a sense of double consciousness, and great prolongation of time, so that minutes are drawn out into hours, and hours into days. Sometimes sexual excitement. exalta-— tion, and hilariousness are exhibited; at other times a dreadful premonition of impending death seizes the human subject. The drug is not fatal, except ix. colessal doses, but the effects may appear * Jour. Comp Med. and Vet. Archives, April and May, 1900. 358 VEGETABLE DRUGS alarming. Intrajugular injection into a small dog, of five drachms of the fluidextract (10 minims of which proved active in man) only caused death after several hours (Hare). Preparations of Indian hemp vary greatly in strength, many being entirely inert, and this fact constitutes one of the principal objections to its use. The practitioner is recommended to experiment until he secures a reliable preparation, and use no other thereafter. Uses.—Cannabis is indicated for the relief of: 1, pain; 2, spasm; 3, nervous irritability. It is not comparable to morphine as an analgesic, on account of the uncertainty and slowness of its action. It is only superior to opium in not causing constipation, anorexia and indigestion. It has been used therefore in single doses of an ounce of the extract in enteritis and colic and in laminitis, and often combined with chloral. The permanency of the action of Indian hemp suggests its use in conditions of long continued pain or spasm. In thirty-five cases of tetanus in the human being, treated with cannabis, twenty-one recovered and fourteen died. The results reported in veterinary practice have been almost as favorable; over half the cases have recovered when subjected to this medication. No drug, however, approaches phenol in its success in the cure of tetanus. Cannabis Indica is occasionally employed as a sedative for irritable cough, and to relieve the spasms of chorea and quiet the delirium of parturient apoplexy. It is also very serviceable in blad- der irritation and cystitis Im overcoming spasm. The intrajugular injection of 10 to 15 ce. of a filtered reliable fluidextract of cannabis indica (Park, Davis) in horses will pro- duce a rapid and safe general anesthesia for surgical operations. The animal will often lie down and is both relaxed and uncon- scious for a considerable period. Palmer affirms, however, that intra- venous injections of cannabis sometimes cause thrombus and lame- ness in horses months afterwards owing to its insolubility in the blood (Vet. Review, Dec., 1913). CarreIna. Caffeine. C.yH,,.N,0O, + H,O. (USS: & BP.) Synonym.—Theine, guaranine, E.; coffein, G.; caféine, Fr. A feebly basic, proximate principle, obtained from the dried leaves of Thea sinensis Linné (nat. ord. ternstreemiacee), or from the dried seeds of Coffea arabica Linné (nat. ord. rubiacex), and found also in other plants. Habitat.—Indigenous to Africa, and cultivated in other tropical countries. Derivation.—Crushed coffee is treated with successive portions of boiled water, and the resulting solution is precipitated with lead — CAFFEINE 359 acetate and filtered. Hydrogen sulphide decomposes the excess of lead acetate remaining in the filtrate. The latter is then concen- trated by evaporation and neutralized with ammonia water. Caf- feine crystallizes on cooling. The alkaloid is purified by charcoal and: recrystallization. Properties.—White, flexible, silky, glistening needles, usually matted together in fleecy masses, permanent in the air; odorless, and having a bitter taste. If crystallized from water, it contains one molecule of water of crystallization, but if crystallized from alcohol, chloroform, or ether, it contains none. Soluble in 45.6 parts of water, 53.2 parts of alcohol, 375 parts of ether, and 8 parts of chloro- form at 25° C. (77° F.); soluble in 5.2 parts of water at 80° C. (176° F.), and in 17.1 parts of alcohol at 60° C. (140° F.). Its solubility in water is increased by the presence of certain salts,—e.g., potassium bromide, sodium benzoate, sodium salicylate, and others. Caffeine is neutral to litmus paper.. Caffeine exists, curiously enough, as the active principle of the national non-alcoholic bever- ages in use all over the world. Coffee contains .6 to 2.2 per cent. of caffeine, together with glucose, fat, vegetable casein, tannic acid, and an empyreumatic oil developed by roasting, 7.e., caffeone. Tea contains 1.36 to 3. per cent. of caffeine, or theine, and also a volatile oil and tannic acid. Guarana (the seeds of Paullinia eupana) con- tains 4 to 5 per cent. of caffeine; maté, or Paraguay tea (the leaves - of Ilex paraguayensis), contains .45 to 1.2 per cent. Caffeine is found in kola nut (the fruit of Sterculia acuminata), used as a bev- erage in Africa, and now as a nervous stimulant in human medicine, and is allied to theobromine, occurring in chocolate beans, and to cocaine, existing in coca leaves. Incompatibility—_Caffeine is incompatible with mercury salts, potassium iodide and tannic acid. Dose.—H. and C., 3 ss.-ii. (2.-8.); D., gr.-ss.-ili. (.03-.2), ac- cording to size. H., gr. xxx. subcut. Carremna Crrrata. Citrated Caffeine. (U. S. P.) Derivation.—Dissolve citric acid (50) in hot, distilled water (100) ; add caffeine (50) and evaporate the resulting solution, on a water bath, to dryness, constantly stirring towards the end of the operation. Reduce the product to a fine powder and transfer it to well-closed bottles. Properties—A white powder, odorless, having a slightly bitter, acid taste and an acid reaction. One part of Citrated Caffeine forms a clear, syrupy solution, with about 4 parts of hot water. Upon 3860 VEGETABLE DRUGS dilution with 5 parts of water, a white, crystalline precipitate (caf- feine) separates, which redissolves when about 25 parts of water have been added. It is also soluble in a mixture of equal volumes of chloroform and alcohol. Dose.—H. & C., 3 ii.-iv. (8.-15.); D., gr. i-vi. (.06-.36). Action Internal.—Caffeine has no particular action upon the digestive tract, except in large quantities, when it may cause gastro- intestinal irritation. The effect of caffeine and raw coffee is identi- cal, but when the latter is roasted, aromatic oils, or an empyreumatic oil, are developed (caffeone). It is impossible to separate completely the action of caffeine from caffeone in boiled coffee. Recent inves- tigations appear to show that the oil (eaffeone), of which there is from one to one-half drachm in a cup of the beverage, has no physiological action except to disturb digestion and cause bilious- ness. This result is not in accord with the general belief, and it is probable that caffvone possesses a transient action in stimulating intestinal peristalsis, the cerebral functions, and in lessening vas- cular tension. Circulation.—Caffeine stimulates the heart muscle and vasomo- tor centres. The action of the heart is strengthened and accelerated after moderate doses in most cases. Sometimes the stimulating action on the vagus centre overcomes that on the heart and the pulse is somewhat slowed. Blood tension is enhanced. In poisoning the pulse becomes weak and irregular and the heart stops in diastole. Nervous System.—Caffeine is a certain and direct stimulant to the higher nervous centres. In moderate doses it produces wake- fulness and restlessness (action of tea and coffee at night on man), and increases the capacity for mental and physical work (see mus- cles). In the lower animals caffeine often causes the most intense cerebral excitement and mania in large doses. The alkaloid affects the spinal cord like strychnine, and toxic quantities produce rest- lessness, increased reflex excitability and convulsions in the lower animals. It is undetermined whether the convulsions are of cerebral or spinal origin. The motor and sensory nerves are unaffected by medicinal doses. Caffeine opposes the depressant action of opium and alcohol. It antagonizes aleohol in stimulating the highest or controlling functions of the brain, the reasoning faculties, perception of sensory impressions and association of ideas, and greater accuracy of touch and capacity for physical exertion. Muscles.—The injection of caffeine solution into a frog’s leg causes a stiffness and hardness of the muscles like that seen in rigor mortis. On muscle fibres, removed from the body, it acts in the same way by coagulating the muscle proteids. In small quantities in the body it stimulates the muscle to contract and increases CAFFEINE 361 its capacity and endurance for work. The action of tea and coffee, in enabling men to perform more physical work, has hitherto been ascribed to the action of caffeine on the nervous system, but is now attributed to its effect on the muscles themselves. Kidneys.—The kidneys primarily contract for two or three minutes with corresponding diminution in the flow of urine, after the subcutaneous injection of small doses of caffeine. This effect is independent of the general vascular condition, and is followed by an increase in the volume of the kidneys, with accompanying augmen- tation of the urinary secretion, as shown by experiments with Roy’s oncometer. The renal cells are directly stimulated, and it is thought that caffeime also increases the blood supply of the malpighian bod- ies. The drug is therefore a local diuretic and (with theobromine) is the most efficient and powerful. No other drug can produce such a flow of urine. Respiration.—The respiratory centres are stimulated (along with the vagus and vasomotor) by caffeine in moderate doses, and depressed by toxic amounts. Metabolism.—Caffeine increases tissue change and therefore the elimination of urea and carbonic dioxide—contrary to the time hon- ored teaching. Toxtcology.—Cafteine is a spinal and muscle poison to the frog. Tetanic convulsions occur in the batrachian similar to those pro- duced by strychnine, but there is also muscular rigidity. These phenomena follow the direct stimulation of the spinal motor tract and muscles, and are succeeded by paresis. In man, stimulation of the cerebral cortex occurs, while both stimulation of the brain and cord are observed in the domestic animals. The symptoms of poisoning in dogs, cats and mammals generally, are restlessness, oceasionally vomiting in dogs, rapid breathing, primary reduction followed by rise in temperature, clonic or tonic convulsions, mus- cular weakness, and general paresis. Death occurs from respiratory failure. The minimum fatal dose is about 1 gr. to 1 Ib. of live weight in the cat. Administration.—Caffeine and its ordinary salts are decomposed by water and therefore should not be given subcutaneously. The alkaloid is best administered in solution with sodium salicylate, or benzoate, for use under the skin as follows :— R Caffeine cise ei cdgnoogoudcdocUGDNND Sodii@salicylatis! <3...0. e+ ce «l- Ai QY.XXX. INGURD ‘So ocacoodeUsogdoodeoLdobUDOUeuNL 3 il. M. S. Give at one dose hypodermically to horse. Ten drops to dog. 362 VEGETABLE DRUGS B Caffeine ....... salle wisi iatele iei= levers aver suareiote Sodii benzoinatis .........0.02cceeees Aa gr.xxx PA GUUDR ace ane eh ecalterelot lee at ere rouse custome en Least ens 3 il. M. S. Give at one dose under the skin, to horse. The soluble citrate may be given internally, but it is not a definite or reliable preparation, and inferior to caffeine, which may be administered in solution with a little citric acid, or as above. Uses.—Three indications for the use of caffeine may be deduced from our knowledge of its physiological action. 1. To stimulate the brain. 2. To stimulate the heart. 3. To cause diuresis. ° 1. Its application as a cerebral stimulant is very limited in veterinary medicine. It acts thus as an antidote to opium poisoning. One and a half grains of caffeine will save cats poisoned by the mini- mum fatal dose (gr. 17) of morphine. 2. Caffeine possesses particular value in the treatment of dropsy of cardiac origin in dogs, because of its diuretic action, as well as stimulant effect upon the heart. The therapeutic indications are much the same as for digitalis, but caffeine differs from digitalis in the following particulars: Does not slow the heart. Is not cumulative. Nor regulate the heart. More transient in its effect. Caffeine, in combination with acetanilid and other modern coal tar products, is useful in preventing their depressing action upon the heart. Furthermore, caffeine, tea and coffee are serviceable in the treatment of acute asthenic diseases in the horse (influenza), dog (distemper), and in foals and calves, acting as nervous and cardiac stimulants and perhaps restraining tissue waste. Caffeine is valua- ble in emergencies demanding immediate stimulation of the heart, respiration and vaso-motor centres as in belladonna, opium and co- caine poisoning. 3. The diuretic property of caffein renders it appropriate in aiding the absorption of pleuritic effusion, ascites, and dropsies, particularly of cardiac and renal origin, and in the hepatic form as well. . NUX VOMICA 363 SECTION Il—DRUGS ACTING ON THE SPINAL OORD. Class 1.—Stimulating the Inferior Cornua. Nux Vomica. Nux Vomica. (U.S. & B. P.) Synonym.—Semen nucis vomice, poison nut, Quaker button, E.; noix vomique, Fr.; krahen-augen, brechnuss, G. The dried, ripe seed of Strychnos Nuax-vomica Linné (Fam. Loganiaceae), yielding, when assayed; not less than 1.25 per cent. of strychnine. Description.—Orbieular, nearly flat, sometimes irregularly bent, 15 to 30 Mm. in diameter, 3 to § Mm. thick; externally grayisb or greenish-gray, the surface covered with short, closely appressed, satiny hairs; rounded or somewhat acute at the margin, with a slight ridge extending from the centre of oue side to the edge; internally whitish-gray, horny, very tough, the endosperm in two more or less regular coneavo-convex halves, between which, at one end, lie the heart-shaped, palmately nerved cotyledons; inodorous; taste intensely and persistently bitter. Constituents—Two alkaloids. 1. Strychnine, 0.2-0.6 per cent. 9. Brucine (C,;H.,N.O,), 0.5-1.0 per cent. Similar in action to strychnine, but weaker and slower. Both alkaloids exist in com- bination with igasuric acid. Brucine occurs in rectangular octo- hedral crystals; is soluble in alcohol, in 7 parts of chloroform, and possesses a bitter taste. With sulphuric and nitric acids a beautiful blood-red color is developed. There are also, 4. Igasuric acid with which strychnine and brucine are combined. 5. Loganin, O,;H3,0,4, an inert glucoside occurring in colorless prisms. Dose.—H. & C., 3 i.-ii. (4.-8.); Sh., gr.xx.-xl. (1.3-2.6); Sw., er.x.-xx. (.6-1.8); D., gri-ti. (.06-.12). PREPARATIONS. Extractum Nucis Vomice. Extract of Nux Vomica. (U. S. & B. P.) Made by maceration with aicohol, water and acetic acid; percolation with aleohol and water, and evaporation. Standardized to contain 5 per cent. of (.06-.12); D., gr.4-4 (.008-.016). Dose.—H. & C., gr.vii-xv. (.5-1.); Sh., gr-iiss.-v. (.15-.3) ; Sw., gr.i.-ii. strychnine. (U.S. P.) 364 VEGETABLE DRUGS Fluidestractum Nucis Vomice. Fluidextract of Nux Vomica. (U.5.2P:) Made by digestion and percolation with alcohol, water and acetic acid. The alcohol is distilled off and the solution evaporated. Alcohol and water are added so that the fluidextract shall contain 1 per cent. of strychnine. Dose—H. & C., Si-ii. (4.-8.); Sh. Mxx.-xxx. (1.8-2.); Sw., x.-xx. (0-1.3); D., Mi--ii. (.06-.12). Tinctura Nucis Vomice. Tincture of Nux Vomica. (U. S. & B. P.) Made by solution of the extract of nux vomica, 20, in alcohol, and water to make 1,000. (U.S. P.) Contains 0.1 per cent. strychnine. Dose.—D., Mv.-x. (.3-.6). Strycuynina. Strychnine. C., Hy. N, 0, (U.S. & B. P.) An alkaloid obtained from nux vomiea, ae also obtainable fr ont other plants ot the natural order Loganiacee. Derivation—Nux vomica seeds are powdered and strychnine is extracted with water acidulated with hydrochloric acid. The solu- tion is concentrated and strychnine precipitated with lime. It is then redissolved in boiling aleohol and the crystals are deposited upon concentration of the solution. ~ Properties.—Colorless, transparent, prismatic crystals, or a white crystalline powder; odorless, and having an intensely bitter taste, perceptible even in solutions of 1 in 700,000. Strychnine should be tasted with eatreme caution. Permanent in the air. Soluble in 6400 parts of water, 110 parts of alcohol, 5500 parts of ether, 6 parts of chloroform, 150 parts of benzene, and in 180 parts of amyl alcohol at 25° C. (77° F.); soluble in 3000 parts of water at 80° ©. (176° F.), and in 28 parts of alcohol at 60° C. (140° F.). Upon ignition, it is consumed, leaving no residue. No coloration is produced with nitric or sulphuric acid, but a drop of the latter and a grain of potassium bichromate, added to a crystal of strych- nine upon a porcelain plate, yields a beautiful violet, changing into purplish-red and cherry-red, and finally to orange or yellow. Dose.—Same as strychnine sulphate or nitrate (minimum quan- tities), which are preferable on account of their greater solubility. Srrycunin® Sunpuas. Strychnine Sulphate. (C,H, (N.0;)s 5.80," 5:0. (U: See BES Derivation.—Made by the action of sulphuric acid on. strych- nine, Properties.—Colorless, or white, prismatic crystals, odorless, and having an intensely bitter taste, perceptible in highly dilute (1 in " ao STRYCHNINE SULPHATE 365 700,000) solution. Efflorescent in dry air. Soluble in 31 parts of water and in 65 parts of alcohol; 2 parts of boiling water and in 8.5 parts of boiling alcohol. Almost insoluble in ether. Upon ignition, it is consumed, leaving no residue. Sulphuric acid should produce no color with strychnine sulphate, but on adding a fragment of potassium dichromate, a blue color should be formed, changing to deep violet, then to purplish-red, cherry-red, and finally to orange or yellow. Sulphuric acid containing 1 per cent. of ammonium vanadate produces a deep violet-blue color, changing to deep purple, and finally to cherry-red. Dose.—H., gr.ss.-i.ss. (.03-.09); C., gr.i-il. (.06-.18); Sh., er. Y-4%4 (.015-.08); D., gr. 420-40 (.0005-.0015). The smaller doses are to be used when strychnine is given subcutaneously. Strychnine Nitras.—Strychnine Nitrate, occurring in colorless, odorless, glistening needles, is now official. Has very bitter taste; soluble in 42 parts of water. Dose same as Strychnine Sulphate. Strychnine Hydrochloridum (B. P.). Dose same as Strychnine Sulphate. The dose of strychnine should be proportioned to the weight in the case of all animals, but more particularly dogs. Otherwise, convulsive attacks or a fatal result may occur. The dose can be accurately determined, according to Feser, by the following data: Dose per kilo (2lbs. 30z. 119.9gr. avoirdupois) live weight: Horse, sheep and cattle....... .0001-.0002 (gr.1499-1400) SIME? Geb cao sooeUOOodD Oooo D Ode .0002-.0003 (gr.t499-M400) IDOE SceonedoocesuonpdsGeDDGS .0001 (gr.Véoo) In accordance with the foregoing figures, the dose for the Horse weighing 1,000 Ibs. is .045-.09 (gr.3-13) Dog “ 100 “ “ .0045 (gr.143) ee e 50 “ 00225 (greg) as a3 25 “ “ 00112 (grtéo) és as 10 “ “ .00045 (gra) Moreover, these doses may be given every three hours without producing poison by their cumulative action. Notwithstanding the foregoing figures, caution should be exercised in prescribing strych- nine to dogs, as these animals appear sometimes extremely sus- ceptible to strychnine, and it is therefore advisable to begin with a minimum dose (gr. 420) in small animals. The dose of one grain should not be ordinarily exceeded in the ease of horses, as one and one-half grains proved fatal in an excep- tional ease. If animals are depressed by disease, poison, or shock, 366 VEGETABLE DRUGS they will often bear much larger doses than could ordinarily be ad- ministered with safety. Action Haternal_—Strychnine is a powerful antiseptic, but is of no practical value on account of its poisonous properties. Brucine is a local ansesthetic. Action Internal.—Digestive Tract.—Strychnine and nux vomica act. as bitter stomachics in increasing vascularity, appetite, gastric secretion and motion. In addition to this they improve the local tone of the alimentary canal; probably by exciting the various spinal centres. Strychnine also stimulates the intestinal muscular tunic and therefore increases peristaltic action. Circulation.—Experiments on animals show that the chief action of strychnine on the circulation consists in stimulation of the vasomo- ter centres with slight increase of blood pressure. Clinically, how- ever, strychnine appears to accelerate and strengthen the heart-beat and this is thought to result from excitation of the cardiac muscle. There is, however, no experimental evidence to show that medici- nal doses of strychnine’ influences directly the mammalian heart (Cushny). The heart is accelerated by muscular activity in con- vulsions. Very large doses slow and weaken the heart. In poison- ing, blood tension is still further enhanced through asphyxia and muscular movements occasioned. by convulsions forcing the blood out of the abdomen. Nervous System and Muscles.—The effect of strychnine, which stands preéminent before all others, consists in the production of greatly exaggerated reflex action. Under its influence slight sensory stimuli result in the most marked and uncontrollable motor impulses (convulsions). It is proved also that afferent impulses must reach the cord through the sensory tract for convulsions to oceur. Section of the spinal cord from the brain in animals shows conclusively that strychnine convulsions are of spinal origin. Ingenious experiments furthermore indicate that the tract in the spinal cord—which is acted upon to cause increased motor re- sponses to sensory stimuli—is situated between the entrance of the sensory roots into the cord and the motor cells of the inferior cornua. Or, more precisely, the seat of strychnine action appears to be im- mediately adjoining the afferent side of the inferior cornual cells. Increased reflex excitability produced by strychnine has been heretofore attributed to the direct stimulating action of the drug on the motor tract of the cord. This is apparently not the case, for, when a solution of strychnine is applied to the cord at the level of the cells controlling the forelegs, and the forelegs are irritated, there is increased contraction of the hind as well as the fore limbs. The motor cells of the hind limbs, in this experiment, are not directly STRYCHNINE POISONING 367 acted upon by strychnine at all. The action of -strychnine on the cord is thought to be indirect. That in some way it removes the natural resistance to the pas- sage of afferent impulses to the motor cells and therefore a greater force remains to be expended on the motor cells (Cushny). To put it more briefly, strychnine increases the conductivity of the cord for sensory impulses. In fatal strychnine poisoning general paralysis ensues through depression of the spinal sensory and motor centres. This may be immediate after enormous doses, with absence of convulsions; or appear at the end of fatal poisoning. ‘The motor nerve endings are also paralyzed but this is secondary in mammals to the more impor- tant paralysis of the motor and sensory spinal centres. The volun- tary muscles and afferent nerves are unaffected by strychnine. Respiration.—It is probable that strychnine is the most power- ful and effective respiratory stimulant we possess. Through its in- fluence the respiratory movements are quickened and strengthened by therapeutic doses. It is likely the action, as upon other spinal centres, is indirect, 7.¢., the respiratory centres are made to respond more forcibly to sensory stimuli. Organs of Special Sense.—The sense of sight, smell, hearing and touch is rendered more acute by strychnine. Elimination.—Strychnine escapes to some extent unchanged, and also as strychnic acid, in the urine. It appears within half an hour of ingestion and may be discovered in the urine from 3 to 8 days thereafter. The greater part of strychnine is probably oxidized in, the body. While the drug is not cumulative, in the sense of producing sudden and violent action following its continual use in gradually increasing doses, yet a tolerance for it can not be acquired. Administration._-For tonic purposes, strychnine may be given to dogs in pills or tablets, and to horses in solution dropped on the tongue. Nux vomica is given to horses upon the food in the form of powder, or in fluidextract upon the tongue; while the tincture is more appropriate for dogs. When large doses of strychnine are used, or an immediate action is desired in acute diseases and emer- gencies, the alkaloid should be given under the skin. Toxicology.—One-twentieth of a grain of strychnine nitrate, in- jected subcutaneously by the writer into a dog weighing 25 lbs., caused imeasiness and excitement, with protrusion of the eye-balls, and in the space of ten minutes, tetanic convulsions. The breathing was shallow and almost imperceptible, the pulse rapid and irregular, the lips were covered with foam, the tail was stiff and extended, the ears laid back, and there was general muscular rigidity, the animal lying on his side in a state of opisthotonos. This condition lasted \ 368 VEGETABLE DRUGS about three minutes, and was followed by a period of relaxation. But the slightest noise or irritation of the skin brought on convulsions. The convulsions became less frequent and violent, and ceased alto- gether within half an hour. The same animal was given gr. Yo of the alkaloid on the following day, but without producing any ap- preciable result. One-tenth of a grain, given on another day and in the same manner, caused immediate uneasiness and restlessness, and in ten minutes induced a severe convulsion, lasting for three min- utes, in which the animal was so rigid that he could be lifted bodily without bending. The ears were drawn back, the limbs were extended and stiff, the tail was straight and rigid, and there was twitching of the muscles of the jaw and limbs. The corners of the mouth were drawn back (risus sardonicus), the mouth was covered with foam, and there was some trismus. The breathing was nearly suppressed, owing to te- tanic spasm of the respiratory muscles. Following this convulsion, the jaw dropped, the muscles relaxed and another attack could not be produced by noises or external irritation. Some twitching of the temporal muscles persisted. Evidently the second stage of poisoning had ensued, and the motor nerves and cells of the inferior cornua had become paralyzed. Death occurred in general paralysis within half an hour, and without any recurrence of convulsions or tetanic condition. Death takes place more commonly in strychnine poison- ing from asphyxia, during a convulsion, and is caused by spasm of the respiratory muscles, or, more rarely, by spasm of the glottis. Sometimes death ensues, after enormous doses, in general paralysis from depression of the spinal nerve centres—without the occurrence of convulsions. Rarely death occurs from exhaustion between the paroxysms. When strychnine is given medicinally in large doses the appearance of restlessness, excitement, and muscular twitchings, should warn one of the danger of approaching poisoning. The lethal dose for dogs has been set at gr. %-gr. % (Kauf- mann). This is much too large, as evidenced by the experiment mentioned above. The fatal amount varies greatly in accordance with the weight of an animal; probably less than gr. %o by the mouth would kill toy terriers, and cases are reported where they have been destroyed by gr. %o9 of the alkaloid. The therapeutic dose should therefore be proportioned as advised, to the weight of the animal. Five to eight grains of nux vomica will kill dogs. The minimum fatal dose of strychnine for man is one-half a grain. Usuaily four to seven grains constitute a lethal quantity, but recovery has ensued following the ingestion of 22 grains, after a full meal. Horses.—The toxic symptoms in horses resemble those already described in the dog. They do not appear for some time (20 min- TREATMENT OF STRYCHNINE POISONING 369 utes to 6 hours), depending on the rapidity of absorption when the drug is swallowed, and include excitement, muscular spasm and con- vulsions, increased frequency of the pulse, and difficult respiration. Death oceurs in convulsions or in the interim between them. The minimum fatal dose of strychnine, when given under the skin, is about 114 to 3 grains, and when swallowed, 3 to 5 grains of the alka- loid, or 1 to 2 ounces of nux vomica. Cattle are similarly affected with horses and dogs. There are exhibited muscular spasms, frequent pulse, difficult respiration, sensi- tiveness to light, sounds and external stimuli, protrusion of the eye- balls and convulsions. The fatal dose, by the mouth, varies greatly owing to difficulty of absorption in the complicated and capacious digestive apparatus of these ruminants. This is true of all medi- eines. When given under the skin, the lethal dose is a little larger than that for horses. The fatal dose for swine is said to be from er. %-gr. %4. Chickens are comparatively insusceptible; also guinea pigs and some monkeys. Strychnine poisoning differs from tetanus in the fact that mus- cular rigidity is continuous in the latter, but disappears to a consid- erable degree, if not completely, in the periods between the con- vulsions, in the case of strychnine poisoning. Moreover, in tetanus the body and limbs are less, and the jaw more affected; while in strychnine poisoning the condition is reversed. Treatment.—The treatment embraces the use of chemical anti- dotes, as iodine or its salts, or tannic acid; animal charcoal and emetics or the stomach tube, before absorption has occurred. The best physiological. antidote is chloral in large doses per rectum. Chloroform and nitrite of amyl may also be given by inhalation, and quiet and rest enforced. Artificial respiration is of service in paraly- © sis, but not in convulsions, unless air be forcibly driven into the trachea through a canula. Calabar bean and gelsemium both depress the inferior cornua, but neither are of much value in strychnine poisoning. Post-Mortem Appearances.—These are simply those of as- phyxia, with the usual congestive lesions and dark fluid blood, except that spinal hyperemia is observed. Uses Internal.—The indications for the employment of strych- nine may be directly deduced from its physiological actions. The indications are as follows: 1. To stimulate the respiratory and vasomotor centres and nervous system. 2. To stimulate the spinal cord; more particularly the motor eells of the inferior cornua. 370 VEGETABLE DRUGS 3. To stimulate appetite, digestion, and intestinal peristalsis in atonic conditions. 4, To destroy dogs and other small animals. 1. Strychnine is a good remedy to stimulate the heart, respi- ration, vasomotor centres and nervous system, and to promote appetite and digestion in acute diseases. It is commonly em- ployed in the treatment of pneumonia and influenza and in all acute diseases when the necessity arises. Strychnine should not be used continuously, but only to bridge over a period of weakness or collapse, and it is not indicated in pneumonia until evidence of heart weakness arises. It should be realized, however, that strychnine is not in any way comparable to digitalis as a heart stimulant and in heart weak- ness in pneumonia, or other diseases, digitalis is infinitely preferable. Strychnine is useful in influenza by counteracting nervous depres- sion and improving the appetite and digestion. In collapse and shock, following surgical operations, or in ether, chloroform and opium poisoning, strychnine is usually prescribed as a cardiac and respiratory stimulant, given in large doses subcutaneously. In surgi- cal shock Crile finds strychnine of no value and it is undoubtedly true that adrenalin is much more effective. Strychnine has been popularly regarded as the heart stimulant, but the fashion of so regarding and using it is departing since physiological experiments do not substantiate this view. While Cabot does not find it useful in raising blood pressure in disease yet strychnine is undoubtedly of service in some cases of chronic cardiac trouble. The alkaloid has proved extremely serviceable in chronic bronchitis, emphysema, and in that combination of these disorders, often associated with asthma and known as “broken wind” or “heaves,” in horses. It is also use- ful in asthma and chronic bronchitis of dogs. The beneficial effect in these diseases is explained by the stimu- lating action of the drug on the respiratory centres, and the favor- able influence exerted on digestion. Strychnine is also appropriate in convalescence from acute diseases for the same reason. 2. In mild eases of chorea in dogs, strychnine is prescribed to advantage with Fowler’s solution. In accordance with its physio- logical action, strychnine is indicated in various paralyses of spinal origin, but. should not be used where there is irritation or inflamma- tion of the spinal motor tract. Jt is employed in hemiplegia and paraplegia, resulting from hemorrhage, after the lapse of several weeks, when irritation produced by the clot has passed away. Strychnine is said to be efficacious in the after-treatment of cerebro- spinal meningitis of horses, and also in the paraplegia of cattle (from parturient fever, and in the paraplegia coming on before parturition in weak cows and not disappearing after labor) and that USES OF STRYCHNINE By all of dogs resulting from various and often undiscovered causes. Strychnine is serviceable in the paralysis of lead poisoning, and in that form caused by traumatism or toxemia following influenza, dis- temper in dogs, and rheumatism. When injected into the muscular tissue, the alkaloid is believed to stimulate the peripheral nerves and muscular fibres, and is employed with benefit in localized paralyses affecting groups of muscles before atrophy has occurred, as in “roar- ing” in horses. Either retention or incontinence of urine, resulting from atony or paralysis of the bladder, may be relieved by strychnine; also pro- lapse of the rectum induced by similar causes. Strychnine has proved curative in some cases of amaurosis, when injected in the region of the temple. 3. Strychnine or nux vomica, associated with iron and arsenic, form the most generally satisfactory tonic combination for the horse and dog, particularly with reference to the digestion. Atonic forms of indigestion and constipation, the accompaniments of anemia, are those amenable to the influence of the drug, which stimulates peris- talsis, and therefore hinders fermentation, prevents relaxation, and so over-secretion from loss of vascular tone. Strychnine is a valuable remedy in overloaded rumen and omasum, and chronic tympanitis of cattle; or in overloaded and impacted large intestines of the horse. It should be given sub- cutaneously in these conditions, and frequently in combination with pilocarpine and eserine or arecoline. Constipation, and, on the other hand, diarrhea, are benefited by strychnine when they are due to atony of the intestinal muscular coat. It is more commonly in the former disorder that the drug finds its usefulness. The aloin, strychnine and belladonna pills, with cascara sagrada, are useful in habitual constipation in dogs, but the weaker formula, containing gr. 420 of strychnine, should be employed. The value and application of strychnine in anorexia and atonic digestive disorders has been sufficiently treated above. 4. There is no more convenient, certain or humane agent for destroying dogs and cats and other small animals than strychnine injected into the gluteal muscles (gr. ss. to gr. 1.). Death occurs instantaneously without struggling, pain or con- vulsions, and in less than a minute in most cases. 372 VEGETABLE DRUGS Class 2.—Depressing the Inferior Cornua. Puysostiema. Physostigma. (U. S. P.) Synonym.—Physostigmatis semen, B. P.; Calabar or ordeal bean, faba physostigmatis, S. faba Calabarica, E. The ripe seed of Physostigma venenosum Balfour (Fam. Leguminose), yielding, when assayed by the process given below, not less than 0.15 per cent. of alkaloids soluble in ether. Habitat.—Calabar and the region of the mouth of the Niger, in Western Africa. : Description.—Oblong, somewhat reniform, 15 to 30 Mm. long, 10 to 15 Mm. thick; externally reddish- or chocolate-brown, smooth, somewhat roughened near the brownish-black groove which extends almost the entire length of the convex edge, its reddish, rounded margins elevated and somewhat thickened; embryo whitish, with a short, curved hypocotyl and two large, concavo-convex cotyledons; having a bean-like and heavy odor when crushed; taste at first starchy, afterwards acrid. Constituents.—The principal constituent is the alkaloid physos- tigmine, or eserine. There are also the alkaloids calabarine, a product resulting from the decomposition of eserine, and eseridine, similar to action in eserine, but weaker; and a neutral principle, physosterin, resembling cholesterine. Calabar Bean Dose.—H., gr.xv.-xxx. (1.-2.); (.015-.06). The official preparations are the extract and tincture of physostigma, but physostigmine is solely used in veterinary medicine, since it is more certain and generally free from calabarine, which produces, in toxic doses, a tetanic condition followed by paralysis. Dy ot el Puysostieminz Saricyias. Physostigmine Saliclyate. .N,,.N,0.0,H,0;, -(U. SP.) Synonym.—Eserine salicylate. The salicylate of an alkaloid obtained from physostigma. Deriwation.—Physostigmine is obtained from the alcoholic ex- tract of Calabar bean by “dissolving the extract in water, adding sodium bicarbonate, shaking the mixture with ether, and evaporating the ethereal liquid. The salicylate of the alkaloid—the most stable salt—is made by adding physostigmine to a solution of salicylic acid in boiling distilled water, when the salt crystallizes on cooling. PHYSOSTIGMINE 373 Properties.—Colorless, or faintly-yellowish, shining, acicular, or short, columnar crystals; odorless, and having a bitter taste. Soluble in 72.5 parts of water, and in 12.7 parts of alcohol; in 30 parts of boiling water, and very soluble in boiling alcohol. (iras. .P:) Tae & C., gr.iss.-iii (.09-.18); D., gr. Yoo-%o (.0006- 002). Given usually subcutaneously, intravenously or intratracheally to horses. Puysostieminz Sutpuas. Physostigmine Sulphate. (U. 8. & B. BP.) Synonym.—Kserine sulphate. The sulphate of an alkaloid obtained from physostigma. Properties—A white, or yellowish-white, micro-crystalline powder, odorless, and having a bitter taste. It is very deliquescent when exposed to moist air, and gradually turns reddish by exposure to air and light. Very soluble in water, chloroform and in alcohol. Dose.—H. & C., by the mouth, gr. 114-8 (.09-.18) ; D., gr. %o- Ho (.001-.006); H., subeut., gr. 1-114 (.06-.09) ; intratracheally, gr. % (.03); foals and calves, subcut., gr. %42-% (.005-.002); D., subeut., gr. Yoo-%o (.0006-.002). Given usually subcutaneously, intravenously or intratracheally to horses. PHYSOSTIGMINE. Action Internal.Alimentary Tract.—The flow of saliva is at first stimulated, whether by direct excitation of the salivary cells or not, is undetermined. Salivation ceases when the gland is de- prived of blood by general vascular contraction. The peristaltic action of the stomach and bowels is increased by the direct local action of the alkaloid on the muscles or ganglia of their walls. There are three stages, in reference to this action, observed in poisoning. First, there is stimulation of peristaltic action, then tetanic con- traction and diminution of the intestinal calibre, and finally relaxa- tion and dilatation of the bowels. The secretions in the digestive tract are augmented by the expulsion of considerable mucus per rectum. When the alkaloid is given to horses, under the skin, within the trachea or intravenously, defecation and expulsion of gas commonly occurs in the space of half an hour, occasionally in a few minutes, and is often considerable in amount (11-20 lbs. of feeces). Circulation.—Eserine is readily absorbed, but exerts no influ- ence on the blood. Moderate doses render the cardiac pulsations B74 | VEGETABLE DRUGS slower and more forcible, and increase vascular tension. Large toxic doses cause the heart to beat more rapidly and less forcibly. The first effect is due probably to stimulation of the peripheral vagi and heart muscle, and possibly the involuntary muscular fibres in the vessel walls. The second phenomenon follows depression of the heart and peripheral vagi, and terminates in cardiac paralysis and diastolic arrest. The action on the cireulation is entirely subordi- nate to the influence of the drug upon the nervous system, and is unimportant from a therapeutical standpoint. Nervous System and Muscles—The essential physiological ac- tion of physostigmine consists in depressing the cells of the inferior cornua. This has been abundantly and directly proved by applica- tion of the alkaloid to the spinal cord. The superior columns are finally depressed; perception of pain is wanting, but that of touch persists. The sensory nerves are not affected, and the motor nerve trunks but slightly. The muscular tremors are due to stimulation of the voluntary muscles themselves, or to the motor nerve endings. These are characteristic of physostigma poisoning in animals, but are not so frequently observed in man. Calabarine may be present in old preparations of physostigma, from decomposition of physos- tigmine, and acts like strychnine on the spinal cord. In poisoning by such, calabarine may induce convulsions. The involuntary mus- cles throughout the body are stimulated, including those of the stom- ach, intestines, bronchial tubes, heart, blood vessels(?), spleen, uterus, bladder and iris. In the case of some of these organs, it has not been decided whether the muscles themselves, or the motor nerve terminations, are affected. Respiration.—The respiration is not disturbed by medicinal doses. Toxic quantities at first quicken, and then retard the res- piratory movements, and death occurs from asphyxia, before cessa- tion of the heart, owing to paralysis of the medullary and spinal respiratory centres. The acceleration of breathing is due to the stimulation of the pulmonary vagal endings, and possibly to the constriction of the unstriped muscle of the bronchial tubes. Secretions.—Secretion is generally inereased, including that of the salivary, gastric, intestinal, sudoriparous and lachrymal glands. In this respect eserine is antagonistic to atropine. Eye.—Physostigmine is a myotic, applied locally or adminis- tered internally. Intraocular tension is diminished and there is spasm of accommodation (see footnote, p. 40). In all probability contraction of the pupil is brought about by stimulation of the cir- cular muscular fibres of the iris or of the oculomotor nerve endings. Eserine is thus directly antagonistic to atropine in its effect upon the eye, but they resemble each other in that they both exert a local PHYSOSTIGMINE 375 action and do not affect the irides of birds. Enormous doses of physostigmine paralyze the oculomotor nerves and dilate the pupil. Hlimination.—Eserine is rapidly absorbed and _ eliminated, mainly by the urine, but also in the other secretions. Toxicology.—Physostigma has been called ‘ordeal bean,” be- cause native Africans suspected of crime are given the crude drug. Vomiting it, they are proved innocent and survive the ordeal. Re- taining it, they die, and so are properly and primitively punished. Animals poisoned by Calabar bean exhibit muscular tremors which continue throughout the toxic period, and are often so violent as to sunulate convulsions. Soon there is loss of muscular power and the animal falls or lies down. The respiration becomes rapid, labored, and sterterous; the pulse is increased in frequency by large toxic doses, and the temperature slightly elevated. There are salivation and sweating. The pupil is sometimes contracted and, when enormous lethal doses have been injected, dilated. Vomiting oceurs in animals capable of the act, and loud peristaltic noises are heard, followed by the expulsion of feces, mucus and flatus, with colicky pains and tenesmus. Reflex action is diminished or abol- ished, but sensation is preserved until late in the toxic period. The muscles are completely relaxed and powerless, notwithstanding the tremors which afflict them. The breathing becomes weak and irregu lar, and death occurs from respiratory failure. In experiments of Winslow and Muir conducted independently and at different times the following cases may be of interest: A healthy gelding, weighing 1,050 lbs., was strapped upon the dissecting table and given three grains of eserine sulphate intrajugularly. Within a few minutes slight muscular tremors appeared in the neck; the pulse rose to 120, the respiration was 24, and the temperature normal. There was slight sweating. The pulse soon fell to 60, and was strong and hard, while the respiration be came rapid and labored. No other symptoms developing within twenty-five minutes after the first dose, three grains of the alkaloid were administered in the same manner as before. The pulse became more frequent (78), the respira- tion (48) was difficult, and the muscular tremors increased in violence till they resembled convulsions. Sweating was profuse, while saliva dropped freely from the mouth. The respiration and pulse were now reduced in frequency and became weaker. The pupils were unaffected, but the eyes were staring. Half an hour after the second dose increased peristaltic action was evidenced by loud noises and the expulsion of gas and dung. Recovery began in two hours from the exhibition of the second dose. It is possible that the severe muscular tremors were caused by contamination of the eserine with calabarine, as the former was not a fresh preparation. An aged express horse, suffering for a week from impaction of the colon, was given twelve minims of a com- mercial extract of calabar bean. He fell down almost immediately, perspired freely, exhibited muscular tremors, and expired within a few minutes, The 376 VEGETABLE DRUGS writer is unable to state the minimum fatal dose for horses, but eserine should be used with caution in weak subjects.—WINSLOwW. A gelding, 800 lbs., poorly nourished, temperature normal, pulse 60, was given physostigmine sulphate gr. 144 (0.1) in 4% drachm of water intrajugularly. Muscular tremors and colic came on in seven minutes; in eleven minutes de- feeation occurred, the heart became more rapid and colic increased. Passages from the bowels were frequent for two hours—about fifteen in all—the feces weighing twenty pounds in the aggregate. All symptoms abated after three hours from the time of receiving the drug.—MuiR.* A gelding, thirteen years old, in good condition and weighing 1,205 Ibs., temperature and pulse normal, was given 3 grains (0.18) of eserine sulphate under the skin. After thirty-two minutes elapsed, defecation began and con- tinued with the expulsion of considerable mucus and flatus until six passages had occurred within one hour and twenty minutes. During this time the pulse had increased in frequency and the animal was restless and pawing the ground. An hour and a half after the first dose, a second dose of 3 grains (0.18) was given in the same way. In twenty minutes muscular tremors and weakness became marked, for the first time, and great distress was evident, the patient appearing to be in much pain; the respiration short, jerky and labored, and nostrils distended and working. The evacuations continued until twenty-three had been passed from the time of receiving the first dose and until one and one-half hours after the second dose. The feces were quite liquid and con- tained much mucus and during passage were attended with considerable strain- ing. The weight of feces aggregated 17 lbs. Four hours after the last dose all symptoms disappeared.—MUIR.* Summary.—Full medicinal doses of physostigmine (gr. 114-3), given subcutaneously or intravenously, produce slight to considerable colic, increased peristalsis and mucus secretion, muscular tremors and weakness, and frequent defecation—beginning in ten to twelve minutes after intravenous use, about thirty minutes or more after . injection under the skin—and being twice as copious when the former mode of administration is employed than after the latter. Moreover, the disagreeable accompaniments of purging last twice as long (five hours) after the hypodermic method than after the intravenous injection (two and a half hours). Muir deduces from his experiments that physostigmine is a safe and active cathartic for the horse and is free from evil after-effects; that along with increased peristalsis and mucous evacuation from the bowels there are colic and more rapid pulse-rate with muscular tremors and weakness; that eserine acts more quickly and effectively when in- jected into the external jugular vein, and that it may be safely given in this manner in a dose of 3 grains dissolved in 30 minims of water, to horses in fair condition and of average weight. * Jour. of Comp. Med. and Vet. Archives, Jan. and Feb., 1899. PHYSOSTIGMINE BH Er The toxic line is closely approached, however, when physostig- mine is used in this way, and we should be careful not to cross it by exceeding the dose. Barium chloride acts as rapidly and without the unpleasant accompaniments of purgation caused by eserine, so that the former is generally preferable as a cathartic for use by the intravenous method. The minimum fatal dose is stated to be from gr. “5-42 for dogs, and gr. 40-40 for cats. The treatment should be pursued with emetics, or the stomach tube, and the antidote, atropine. The latter will prevent death in rabbits when given five minutes after the administration of three times a minimum fatal dose. Atropine should be given under the skin, together with alcoholic stimulants, digitalis, and ammonia by the mouth. Artificial res- piration should be practised and external heat applied. The es- sential action of atropine in antagonizing eserine, consists in stimu- lation of the respiratory centres, while it depresses the peripheral eardiae vagi, and so, to a certain extent, counteracts the primary influence of eserine on the heart. Large doses of atropine may only exaggerate the secondary depression of eserine upon the peripheral vagi in the heart, and so hasten a fatal result. Strychnine is an- tagonistic to eserine in stimulating the respiratory centres and in- ferior cornua. Uses External.—Physostigmine has been injected empirically, but it is asserted with good results, into chronic dropsical effusions of joints and burs of tendons in horses, after removal of the fluid ‘by aspiration. From .05-.1 gm. is used, dissolved in 5.-10. gm. of sterile water; and this treatment is followed by cold applications for several days afterwards. Uses Internal.—Three physiological actions of eserine are put to therapeutical uses. 1. The myotie action on the eye. 2. Stimulation of the involuntary muscles. 3. Depression of the inferior cornua. 1. *Eserine is useful, in alternation with atropine, to break up adhesions to the iris; to lessen intraocular tension in glaucoma; and to prevent prolapse of the iris and staphyloma, after wounds and ulcers of the cornea. It is also employed to contract the pupil and shut out the light in photophobia, and to antagonize the influence of atropine on the eye. The action of eserine is, however, not nearly so powerful or persistent as that of atropine on the eye, and is somewhat painful. It is employed in 1 per cent. solution. 9. Physostigmine is mainly of value for its action in rapidly stimulating the unstriated muscles of the alimentary canal. In *See page 40. 378 VEGETABLE DRUGS obstinate constipation of horses it is particularly useful; 1 gr. of eserine sulphate being given subcutaneously or intravenously with 38 grs. of pilocarpine sulphate; the latter to increase the intestinal se- cretions. Strychnine sulphate (gr. 1) may be added to counteract the depressing action of eserine on the respiratory centres and in- ferior cornua. Physostigmine, in combination with pilocarpine, is serviceable for its speedy action in flatulent colic and impaction of the cecum, colon, and rectum in horses, and has been employed to expel caleuli and foreign bodies from the intestines. Physostigmine is contraindicated in spasmodic colic, when it may increase the trouble by exciting intense peristaltic contractions. Its employment is also attended with some danger in overloaded or greatly distended stomach or bowels, in view of possible rupture of these organs. The drug, like other purgatives, may aggravate the damage produced by twist or intussusception. In twist of the pelvic flexure of the colon in the horse, commonly mistaken for enteritis, eserine is often life-saving and the remedy at our command. In atonic conditions of the stomach and bowels, and in indi- gestion due to chronic intestinal catarrh, small and repeated doses of eserine are sometimes of benefit. In cattle, eserine (gr.-i.) and pilcocarpine (gr.-iii.) subcutaneously are of great value in impaction of the rumen and omasum, in acute gastritis, and in parturient apoplexy, to quickly empty the digestive canal. serine is some- times given subcutaneously to foals (gr. %42-%) for retention of me- conium. It is effective in obstinate constipation of dogs given by the mouth (gr. %o-%2 ) in pill, twice daily. Eserine has been employed in chronic bronchitis, asthma and emphysema, to improve the tone of the bronchial mucous membranes and expel secretions. 3. Eserine is one of the drugs commonly used in the treatment of tetanus in human and veterinary practice, with only a moderate degree of success. It must be employed early, given every three or four hours, and pushed to the physiological limit. Chorea and epilepsy have been treated with eserine without any pathological basis, as far as epilepsy is concerned, and with little therapeutic ad- vantage in either instance. In some cases of paraplegia, resulting from myelitis, a favorable effect has been obtained in man. Eserine is an appropriate purgative (hypodermatically) in acute encepha- litis. Eserine has been used in strychnine poisoning, but is inferior to chloral bromides and anesthetics, and while it is antagonistic to a certain extent, and alters the character of strychnine convulsions, yet animals die more quickly when poisoned by both strychnine and eserine, than by strychnine alone. GELSEMIUM 379 GrtseMium. Gelsemium. (U.S. & B. P.) Synonym.—Radix gelsemii, yellow jessamine, E.; racine de jasmin jaune, Fr.; gelber jasmin-wurzel, G. The dried rhizome and roots of Gelsemiwm sempervirens (Linné) Aiton filius (Fam. Loganiacee). Habitat.—Southern United States. Description.—Cylindrical, usually in cut pieces of variable length, from 5 to 20, or even 30, Mm. in diameter; externally light yellowish-brown, with purplish-brown longitudinal lines; fracture of the rhizome splintery, the roots breaking with one-half the fracture transverse, the other half oblique or short-splintery; bark about 1 Mm. thick; wood pale yellow, porous, but tough, with numerous dis- tinct medullary rays, in the rhizome excentric, and with four groups of internal phloem; odor pronounced, characteristic; taste slightly aromatic, bitter. Constituents.—The most important is the first alkaloid. 1. Gelsemine, C;,HggN4,O,2. renal vessels are not dilated, and the oncometer shows that the size of the kidney is not increased. The drug stimulates the secretory cells of the renal tubules and causes diuresis directly as well as indi- rectly by increasing general blood pressure. The active principle is eliminated in the urine. H,,0,), a glucoside readily de- composed into glucose and kinovie acid. (8) Cincho-tannie acid, or kino-tannic and kinovi-tannic acid (2-4 per cent.). The astringent principle of cinchona. Distin- guished from tannic acid in yielding green color with ferric salts. (9) Cinchona red, the coloring matter of cinchona bark. Nearly insoluble in water. (10) A volatile oil existing in minute amount. (11) Starch, gum, resin and salts common to other vegetable matters. Incompatibility. —Cinchona is incompatible with lime water, ammonia, metallic salts or gelatin. Dose.—H., 3 ii.-iv. (8.-15.); C., 3 i-ii, (30.-60.); Sh. & Sw., 3 i.-iv. (4.-15.) ; De C, gr. x.-3 1. (6-4 ip PREPARATIONS. 9 Fluidextractum Cinchone. Fluidextract of Cinchona. (U5 5S..Ra) Made by maceration and percolation with glycerin, alcohol and water; evaporation of the last portion of the percolate, and addition of the residue te first portion, with enough water and alcohol so that it shall contain 4 per cent. of alkaloids. (U.S. P.) Dose.—Same as cinchona. Extractum Cinchone Liquidum. (B. P.) Contains 5 per cent. of alkaloids. Dose.—Same as cinchona. Infusum Cinchone Acidum. (B. P.) Dose.—H., Oi. (500.); D., 3ii.-iv. (8.-15.). Tinctura Cinchone. Tincture of Cinchona. (U. S. & B. P.) Made by maceration and percolation of cinchona, 200, with glycerin, 75; and alcohol and water a sufficient quantity to make 1000. 0.75 gm. alkaloids in 100 ec. of tincture. (U. S. P.) Dose.—H.. 3 i.-ii. (30.-60.); D., 3ss.-ii. (2.-8.). QUININE SULPHATE 435 Cincuona Rusra. Red Cinchona. Cinchone rubre cortex, B. P. The bark of Cinchona succi- rubra Pavon (nat. ord. Rubiacexw), containing not less than 5 per cent. of anhydrous cinchona alkaloids. Habitat.—Ecuador, west of Chimborazo. Description.—In quills or incurved pieces, varying in length, and from 2 to 4 or 5 Mm. thick; the outer surface covered with a grayish-brown cork, more or less rough from warts and longitudinal, watery ridges, and from few, mostly short, transverse fissures; inner surface more or less deep reddish-brown and distinctly striate; frac- ture short-fibrous in the inner layer; powder reddish-brown; odor slight; taste bitter and astringent. Constituents.—Same as cinchona. Dose.—Same as cinchona. PREPARATION. Tinctura Cinchone Compositus. Compound Tincture of Cinchona. (U. S. & B. P.) Made by maceration and percolation of red cinchona, 100; bitter orange peel, 80; serpentaria, 20; with glycerin, 75; and alcohol and water to make 1000. (U.S. P.) Dose.—H., 5 ii.-iv. (60.-120.); D., 3ss.-iv. (2.-15.). *Quininz SurpHas. Quinine Sulphate. (Ci, Eo.N.05).-HsO,- 7.H,0: (U.S. & BP.) Synonym.—Chininum sulfuricum, P. G.; sulfas quinicus, disul- phate or basic sulphate of quinia, E.; sulphate de quinine, Fr.; schwefelsaures chinin, G. Derivation.—Prepared by boiling cinchona bark with hydro- chloric acid and adding lime to the filtered decoction to precipitate alkaloids and coloring matter. The precipitate is washed and di- gested in boiling alcohol to dissolve quinine and cinchonine. The alcohol is distilled off and the residue dissolved in diluted sulphuric acid, boiled with animal charcoal, filtered, and quinine sulphate crys- tallizes, leaving cinchonine sulphate in solution. Properties.—White, silky, light and fine needle-shaped crystals ; fragile and somewhat flexible, making a very light and easily com- pressible mass; lustreless from superficial efflorescence after being for some time exposed to the air; odorless, and having a persistent and very bitter taste. The salt is liable to lose water on exposure to * Tine. Quinine Ammoniata (B. P.), from the sulphate. Dose—H., 3 8s.-1. D., 3 ss.-i. eye 406 VEGETABLE DRUGS warm air, to absorb moisture in damp air, and to become colored by exposure to light. Soluble at 25° C. (77° F.), in 720 parts of water, and in 86 parts of alcohol; also in 36 parts of glycerin; in about 400 parts of chloroform; in 30 parts of boiling water; and freely in dilute acids. Incompatibles.—Alkalies and their carbonates, iodine, and tan- nie acid. Dose.—H. (ionic), gr. xv.-5 i. (1-4); C., 5 ss-iss. (2.-6.); Sh. & Sw., gr. vx. (.3-.6); D. & Cats, gr. i-ii. (.06-.12). Anti- pyretic Dose—H. & C., 3 ti-iv. (8-15. SL Sh., gr. xxx.-xl. (2.-2.6); Sw., gr. xy.-xxy. (1. 1.8); D. & Cats, gr. v.-x. (.3-.6) Quinty= BisutpHas. Quinine Bisulphate. C.,H..N.2O5 H.S0,+7H,O. (U.S. & B. P.) Derivation.—Made by the action of sulphuric acid on quinine sulphate suspended in water; filtration and crystallization. _ Properties.—Colorless, transparent or whitish, orthorhombic crystals or small needles; odorless, and having a very bitter taste; elfiorescing on exposure to the air; soluble in 8.5 paris of water and in 18 parts of alcohol: very soluble in boiling water and in boiling alcohol. Dose.—Practically same as quinine sulphate, but theoretically it should be slightly larger. The salt is very soluble, but is commonly made extemporaneously by adding diluted sulphuric acid (Q. S.) to quinine sulphate in preparing solutions for medicinal use. The salt is serviceable for administration in pill; or for hypodermic injection, when it should be given in about onethird smaller dose than that of quinine sulphate by the mouth. Quixtyn= Hypropromiptm. Quinine Hydrobromide. C,.H,.N,O, H Br+ 4.0. (U0: S-P.) Derivation.—Made by the action of barium bromide, in solu- tion, on quinine sulphate suspended in water: filtration, evaporation, and crystallization. Properties.—White, light, silky needles: odorless, and having a very bitter taste. The salt is likely to lose water on exposure to warm or dry air. Soluble in 40 parts of cold water, and in 0.67 part of alcohol ; very soluble in boiling water and boiling alcohol ; also ae in 16 parts of ether and very soluble in chloroform (77° B), Dose.—Same as quinine sulphate. QUININE HYDROCHLORIDE 437 *Quininz Hyprocuioripum. Quinine Hydrochloride. 6; HNO, HCl = 2.0. (U.S & BP.) Deriwvation.—Made by the action of hydrochloric acid on quinine, and by crystallization. Properties.—White, silky, light and fine, needle-shaped crystals ; odorless, and having a very bitter taste. The salt is lable to lose water when exposed to warm air. Soluble in 18 parts of water, and in 0.6 part of aleohol; in 1 part of boiling water, and very soluble in boiling alcohol; also soluble in 0.8 part of chloroform (77° F.). Dose.—Same as quinine sulphate.+ QuIninz VALPRAS. Quinine Valerate. CooHa4N2020;Hi 02 + H,0. (B. P.) Derwation.—Made by decomposition of quinine sulphate with ammonia, followed by the immediate action of valerianic acid, and erystallization from a cold solution. Properties.—White, or nearly white, pearly, lustrous, triclinic erystals, having a slight odor of valerianic acid, and a bitter taste. Permanent in the air. Soluble in 100 parts of cold water, and in 5 parts of alcohol; in 40 parts of boiling water, and in 1 part of alcohol. Dose.—D., gr. i.-ii. (.06-.12). Three times daily as tonic. Quisixz ET Urpar Hyprocuiorimpum. Quinine and Urea Hydrochloride. (Non-Official.) Synonym.—Quinine Bimuriatis carbamas. Quinine and urea bimuriate. Prepared by dissolving quinine hydrochloride, 400, in dilute HCl, 300; mixing with 60 to 61 parts of urea CO(NH,).; warming, filtering and allowing to crystallize. Occurs in large, transparent prisms, or in hard, white, interlaced, four-sided prisms. Soluble at ordinary temperatures in its own weight of water, and in alcohol. CuInoiiInum or QuinomInum. Chinoidine or Quinoidine. Brown, resinous mass, containing mixture of quinidine, cin- chonine and cinchonidine. A cheap substitute for quinine sulphate. Dose.—Three or four times that of quinine sulphate. * Tinctura Quinine (B. P.), from the hydrochloride. Dose—H., Espey 1D) 3 ss.-i. + Quinine Salicylas, Quinine Salicylate (U. S. P.). Soluble in 77 parts of water. Occurs in colorless needles. Dose as for sulphate. 438 VEGETABLE DRUGS QuinipInaz Sutpuas. Quinidine Sulphate. (Cy 9H2,N.0.)>. H.SO, + 2 H,O. (Non-Official. ) The neutral sulphate of an alkaloid obtained from the bark of several species of cinchona (nat. ord. Rubiacex). Synonym.—Sulfate de quinidine, Fr.; schwefelsaures chinidin (cinchinin), G. | Derwation.—Recovered from quinoidine, or from the mother liquors after the crystallization of quinine sulphate, by the same method as for quinine. Properties.—White, silky needles, odorless, and having a very bitter taste; permanent in the air. Soluble in 100 parts of cold water, and in 8 parts of alcohol; in 7 parts of boiling water, and very soluble in boiling alcohol; also in 14 parts of chloroform and in acidulated water; almost insoluble in ether. Dose.—One-third larger than quinine sulphate. Cincnoninm Sutpuas. Cinchonine Sulphate. - (Ci ;Hj5N.0).:- HO, HO. eS BP) Derivation.—Obtained from the mother liquors after the crys- tallization of the sulphates of quinine, quinidine and cinchonidine, by precipitation with caustic soda, washing with alcohol to free it from other alkaloids, solution in sulphuric acid, and by purification with animal charcoal, and crystallization. Properties—Hard, white, lustrous, prismatic crystals, without odor, and having a very bitter taste. Permanent in the air. Solu- ble in 58 parts of cold water, and in 10 parts of alcohol; in 18.59 parts of boiling water, and in 3.25 parts of boiling alcohol. Also soluble in 78 parts of chloroform, but almost insoluble in ether. Dose.—One third larger than that of quinine sulphate. CrncHonipIn” Sutpuas. Cinchonidine Sulphate.* (OH. N,0)5-2,80, + 3 B02" (U8) Pe) Derwation.—Procured from the mother liquors, after the erys- tallization of quinine sulphate, by further concentration. Purified by erystallization from alcohol, and finally from hot water. Properties.—White, silky, acicular crystals, without odor, and having a very bitter taste; slightly efflorescent on exposure to air. Soluble in 63 parts of water, and in 72 parts of alcohol; in 1.42 * Bliwir Ferri, Quinine et Strychnine Phosphatum (U.S. P.), and Syrupus Ferri Phosphatis cum Quinina et Strychnina (B. P.), (dose—D., 3i.), are good tonic preparations for dogs. ACTION AND USES OF QUININE 439 parts of boiling water, and in 8 parts of boiling alcohol; also soluble in 900 parts of chloroform, and almost insoluble in ether. Dose.—One-third larger than that of quinine sulphate. CINCHONA AND ITS ALKALOIDS AS REPRESENTED BY QUININE. Action External.—The action of quinine on all forms of proto- plasm is to stimulate in small doses, or in much dilution, and to depress and paralyze in large doses, or in strong solutions. It has the same action on unorganized living matter (ferments) in many eases but does not affect some. It is still more destructive to pro- tozoa, especially to the organisms of malaria and Texas fever. Qui- nine is a powerful antiseptic and microbicide. A solution (1 to 250) of the alkaloid or its salts are poisonous to the microbes of fermenta- tion and putrefaction. A one per cent. solution quickly destroys bacteria and vibrios, but spores may live in it for some days. Qui- nine and its salts cause irritation of the denuded skin, or mtcous membranes, but exert no effect upon the unbroken skin. Action Internal.—Digestive Tract.—Quinine, in therapeutic doses, acts as a simple bitter (stomachic), and therefore promotes appetite and gastric digestion. It stimulates the gustatory nerves in the mouth and gastric nerves in the stomach, thus reflexly increas- ing the flow of saliva and gastric juice, and the vascularity and peristaltic motion of the stomach together with the appetite. Ex- perimentally, quinine increases the activity of the ferments of the gastric and pancreatic juices (pepsin, rennin, trypsin) in great dilu- tion while destroying them in larger amounts. Large doses, particu- larly if the stomach be irritable, may cause vomiting. Quinine be- comes dissolved in the gastric juice and is converted into the chloride. A portion unabsorbed finds its way into the bowels and is there pre- cipitated by the alkaline juices and bile, whose acids form insoluble salts with quinine, unless the bile is in great. excess. ~ Blood.—Quinine is absorbed into the blood, and would naturally be precipitated in this alkaline fluid; but this is not the case, and it has been shown that quinine is probably held in solution by the loosely combined carbonic dioxide gas in the blood. Quinine pos- sesses several well-defined and important actions in relation to the blood. 1. White Blood Corpuscles.—Quinine in great dilution lessens the ameboid movements of the white corpuscles in blood removed from the body. When a frog receives large doses of quinine and its mesentery is irritated, the white corpuscles do not collect in the ar- terioles or migrate through their walls (diapedesis). Again, when inflammation has already begun in the mesentery, quinine stops the ¢ 440 VEGETABLE DRUGS transmigration of leucocytes, and yet does not stop those in the tissues from. wandering away. Moreover, large doses markedly lessen the number of white corpuscles in the blood. While medicinal doses of quinine given by the mouth unquestionably produce leukopenia, yet it is generally considered highly improbable that the effect of quinine in inhibiting the movement of leucocytes observed in the frog, when large doses are introduced into the blood, occurs after the therapeutic use of the drug in mammals. Yet it has recently been shown that a solution of quinine in blood, equal to that when a full dose (gr. x., man) is ingested, increases markedly phagocytosis in the case of all the common pathogenic organisms. Very large doses (gr. xxx.-xl., man) diminish phagocytosis. It is hard to explain this action when we consider leucocytosis is hindered by quinine, but it may show why benefit should be expected from the drug in septic conditions. 2. Red Blood Corpuscles.—Therapeutic doses increase the num- ber of red corpuscles. The latter diminish in size in febrile con- ditions, but, under the action of quinine (and other antipyretic agencies), regain their normal condition. This follows the effect of quinine in lowering temperature, and is not due to any specific power of quinine exerted on the corpuscles themselves. Heart and Blood Vessels.—Quinine in moderate doses does not affect the heart or vessels appreciably. Large doses at first stimulate the muscle of the heart and blood vessels and cause the pulse to be accelerated and vascular tension to be raised. In poisoning this effect is temporary and is followed by depression of the muscle of the vessel walls and heart and the cardiac pulsations become slow and weak and the blood tension falls. Death occurs immediately from failure of respiration. Although the heart is much weakened it com- monly continues to beat for some time after breathing ceases. The action on the heart is like that on all forms of living tissues—pri- mary stimulation followed by depression and paralysis. Nervous System.—Here again the general action consists in primary stimulation followed by depression and paralysis of the cerebrospinal system. The breathing is first accelerated and then weakened and death occurs from paralysis of the respiratory centre. Fatal poisoning is very rare after ingestion of quinine. Ounce doses have been swallowed by man without serious result. Occasionally convulsions have occurred but perhaps due to an admixture of the other alkaloids, as cinchonidine and cinchonine are convulsive agents in toxic doses. Toxic doses of quinine injected into the carotid artery cause meningitis by direct irritation. In man, ringing in the ears, fulness in the head, and slight deafness commonly follow a large medicinal dose (cinchonism). Blindness also very rarely oc- curs in man after large doses. Vomiting, diarrhea, albuminuria and ACTION AND USES OF QUININE 441 skin eruptions sometimes occur in poisoning by the drug due to local irritation. There are contraction of the retinal vessels and degen- erative changes in the retina and spiral ganglia of the cochlea, which account for the loss of sight and hearing. There is some clinical evidence that quinine in medicinal doses is a cerebral stimulant, but there is no experimental proof of the fact. Spmal Cord and Nerves.—Quinine, as shown by experiments conducted on the frog, lessens reflex activity after small doses. This condition disappears on section of the medulla. Toxic doses, how- ever, cause permanent loss of reflex excitability. The same alkaloid first excites and then paralyzes the peripheral sensory nerve endings. These effects on the nervous system are not observed in mammals. Muscular contractility is stimulated by small and paralyzed bv poisonous doses of quinine. Uterus.—In experiments with the intravenous or subcutaneous injection of quinine into animals normal uterine contractions are augmented or rhythmical contractions are originated by the drug. The production of labor pains or abortion has been observed in woman following the use of large doses for the cure of malaria. The alkaloid stimulates uterine contractions in inertia of parturition but there is considerable testimony affirming that it increases at the same time the tendency to flowing. Kidneys, Metabolism and Elumination.—Quinine lessens the elimination of both urea and uric acid. It is therefore evident that there is some alteration or inhibition of metabolism whereby nitrog- enous decomposition is decreased and nitrogen is stored in the body. There is no diminished oxidation of carbohydrates in the tissues, which is the chief source of animal heat, for the excretion of CO, and absorption of O by the lungs is unaltered by quinine. This ~ accords with the known fact that the oxidizing ferment of the tissues is inhibited by the drug. About three-fourths of the quinine ab- sorbed is destroyed in the tissues. The remaining fourth escapes unchanged in the urine in man but much altered in dogs. While its excretion in the urine begins soon after its ingestion, and lasts for some days, the greater amount escapes within twenty-four hours. None is found in the other excretions. Antipyretic Action.—Quinine does not alter the normal tem- perature of a healthy animal, but does reduce temperature in fever. The amount of reduction depends upon the cause of the fever. An explanation of the antipyretic power of the alkaloid may include: 1. The antiseptic property of quinine. This is most marked in the case of the plasmodium malarie, which is destroyed by the alkaloid, and the malarial fever is therefore overcome. 449 VEGETABLE DRUGS 2. By retarding nitrogenous decomposition or metabolism and thus lessening the production of heat in the tissues. 3. By dilating the vessels of the skin and therefore inducing loss of heat. Administration.—Quinine sulphate is usually given to horses in aqueous solution with sufficient diluted sulphuric acid to dissolve the salt. It may also be administered to these animals in ball, gela- tine capsule, enema or subcutaneously. Quinine is exhibited to dogs in pills, solution or suppositories. The alkaloid is not commonly injected under the skin, because local irritation and abscess may fol- low; but this does not frequently happen in the horse. The bisul- phate, hydrobromide and hydrochloride are most suitable for hypo- dermic use. The first salt is more soluble, but the latter two are less irritating. , At a temperature of 45° C. (113° F.) Quinine bisulphate is soluble in................. 8.8 parts of water. Quinine hydrobromide is soluble in............. 45,02 “8 ae Quinine hydrochloride is soluble in.............. ral We, Sac oP This temperature may be used for subcutaneous injection, but the salts should be thoroughly dissolved and one grain of tartaric acid should be added to each five grains of quinine bisulphate, in order that precipitation may not occur in the tissues. The dose by the subcutaneous method is one-third less than by the mouth. The sulphates of quinidine, cinchonine and cinchonidine are similar in action to quinine, and their relative antipyretic effect is said to be: quinine, 100; quinidine, 90; cinchonidine, 70; cin- chonine, 40. The cinchona compounds are indicated for tonic and stomachic purposes. Uses External—Quinine and urea hydrochloride has recently come into extensive use as a local anesthetic. In 1 per cent. solution it forms a satisfactory substitute for cocaine and its allies and it has three advantages over cocaine. It is non-toxic, it may be boiled in solution, and its anesthetic effect is often prolonged for hours or days, lessening pain and spasm after operation and aiding dressing of wounds. Anesthesia comes on within 5 to 30 minutes after injec- tion into the tissues. In 25 per cent. solution it is used to anes- thetize mucous membrane, but is not so satisfactory as cocaine for this purpose. It has been used in a great variety of operations, in- cluding those within the belly. The line of incision on the belly wall is anesthetized and after the belly is opened the parietal peritoneum must be injected. Not much pain is caused by handling the viscera unless the mesenteric attachments are pulled upon. ACTION AND USES OF QUININE 443 Uses Internal.—lIt is impossible to draw definite deductions as to the therapeutic indications for quinine founded on physiological experiments, since these are only suggestive and not conclusive. For the sake of convenience, we may classify the uses of quinine under the following heads: 1. Tonic Action.—Quinine is of unquestionable value as a tonic, more particularly in relation to digestion, but probably also by increasing the number of red corpuscles and stimulating the nervous system generally. It is in those cases of anorexia and atonic dyspepsia secondary to exhaustion, overwork, anemia, or fol- . lowing acute diseases, that the drug is indicated. Here, combination with iron is often of service, and the tincture of the chloride is a good preparation because it contains sufficient free muriatic acid to dissolve any of the salts of quinine. The compound tincture of einchona is a prime, bitter tonic for dogs; or quinine may be given in a pill with reduced iron and arsenic as a tonic. Chorea in the human patient has been treated successfully with quinine, but this remedy has failed in dogs. Nevertheless, the alkaloid is an excellent tonic in canine distemper with its accompanying anemia, but it should be combined with iron and arsenic. Quinine is a good tonic for purpura in horses. 9. Antiseptic and Antiphlogistic Hffect.—Quinine possesses much less antipyretic power than phenacetin, antipyrin and acetanilid. It acts more favorably with a falling than a rising temperature, and should be given two or three hours before the probable time of maxi- mum temperature. Quinine is employed in many acute diseases, such as influenza, bronchitis and pneumonia of horses. In full doses, at the outset of colds or inflammatory diseases of the respira- tory tract, quinine may prove abortifacient. Later in these diseases the drug may be given as an antipyretic and antiphlogistic (without much benefit probably), but in the convalescent stages quinine, in small doses, becomes of great worth as a tonic. Some experiments involving the injection of putrid material into the blood of dogs, appeared to indicate that quinine had a restraining influence on the resulting septic state, and, in some cases, saved life. Puerperal fever and erysipelatous inflammation yield somewhat to quinine, and the drug should be tried in these infections. The alkaloid does not lower the temperature or prove destructive to the micrococci of pyemia. A vast number of cases of rheumatic fever have been treated with quinine in human practice, but the results are inferior to those obtained by salicylates. In subacute and chronic muscular rheumatism quinine is sometimes useful. It has been in- jected into the affected muscles in this disorder, in horses, with favorable results. 444 VEGETABLE DRUGS The alkaloids of cinchona may be used as antipyretics in all acute diseases with the exception of meningitis, cerebritis, gastritis, nephritis and cystitis, where they produce too much irritation. They are also contra-indicated in epilepsy and middle-ear disease. 3. Specific Properties.—One c.c. of a 1 per cent. solution of bimuriate of quininé and urea to the pound, live weight, has recently been found by Mark Francis (Texas Exper. Sta., 1911) to prove curative in 98 per cent. of cases of Texas fever in cattle when not seen too late. The warm sterile solution is injected within the abdominal cavity in the standing animal. The point of injection is in the right flank low down in front of the anterior border of the - internal oblique muscle. It is done by allowing the fluid to run in by gravity from a 1000 ec. wash flask of the laboratory connected with 3 ft. of sterile tubing and needle. The fluid should flow freely or else the needle is not in the abdominal cavity. The skin should be first shaved and scrubbed and sterilized with alcohol or, better, iodine or Harrington’s solution. One injection is usually sufficient, but it may be repeated in 48 hours if necessary. Quinine stands preéminent in the treat- ment of malaria, as it is the only drug which can be relied upon to kill malarial organisms. While periodicity in the febrile attacks is characteristic of malaria, an absolute diagnosis can only be made by the discovery of Laveran’s plasmodium in the red blood corpus- cles. Malaria but rarely affects the lower animals in this country, although exceedingly common among human beings. Cases are said to occur not infrequently among horses and cattle in India. A single full antipyretic dose of quinine, if given from twelve to six hours before a promised malarial attack, will usually prevent it. A single large dose should be given once daily for several days thereafter. When the disease is severe, treatment may also be pursued by the rectal and hypodermic methods at the same time that quinine is given by the mouth. A purge of aloes and calomel should be exhibited prior to the administration of quinine in the treatment of malaria. Class 2.—Salicylic Acid, Salicin, Salol, Oil of Gaultheria and Methyl Salicylate. Actpum Sattcyzticum. Salicylic Acid. HC,H,0O3. (Ue S&B. ee.) Synonym.—Acid salicylique, Fr.; salicylsaiire, G. An organic acid, existing naturally in combination in various plants, but chiefly prepared synthetically from carbolic acid. SALICYLIC ACID 445 Derivation.—Made by passing carbonic dioxide through sodium earbolate at a temperature of 428° F. (220° C.). 2 NaC,H,O (sodium carbolate) + CO, = Na,C,;H,O, (sodium salicylate) + C,H,O (phenol). Sodium salicylate is treated with hydrochloric acid, when salicylic acid is precipitated. Na,C,;H,O, +2 H Cl= HC,H,O; + 2 Na CL. Properties.—Light, fine, white, prismatic needles, or a light, white, crystalline powder; odorless, having a sweetish, afterward acrid taste, and permanent in the air. Soluble in about 308 parts of water, and in 2 parts of alcohol; in 14 parts of boiling water, and very soluble in boiling alcohol. Also soluble in ether, absolute alco- hol, and chloroform. Incompatible.—Spirit of nitrous ether. Impurities.—In artificial salicylic acid, metacreosotie and orthocreosotic acids. Dose.—H. & C., 3 i1.-5 i. (8.-80.); Sh., 3 1-iv. (4.-15.); Sw., 5 ss.-l. (2.4.); D., gr. v.-xxx. (3.-2.). PREPABRATION.—Unguentum Acidi Salicylicit (2 per cent.), B. P. SAnrcinum.- Salicm-: ~C,,H,.07. (WU. Si:&-B. P:) A neutral principle (glucoside) obtained from several species of Salix and Populus (nat. ord. Salicacez). Habitat.—Europe, but cultivated in North America. Derwation.—Obtained from a decoction of willow bark. Salicin crystallizes on evaporation, after removal of tannin by agi- tation with lead oxide. It is purified by repeated solution and erys- tallization. Properties.—Colorless, or white, silky, shining crystalline needles, or a crystalline powder; odorless, and having a very bitter taste. Permanent in the air. Soluble in 21 parts of water, and in 71 parts of alcohol; insoluble in ether or chloroform. Dose.—H. & C., 3 ii.-3 i. (8.-30.); Sh., 3 i-iv. (4.-15.); Sw., 3 ss.-i (2.-4.); D., gr. v.-xxx. (.3-2.). *Sopm Sarroyias. Sodium Salicylas. NaC,H,;O3. (UES: & Bi-P:) Synonym.—Silicylate de soude, Fr.; natrium salicylicum, G. Derivation—Made by the action of salicylic acid on sodium * Strontii salicylas and lithii salicylas are now official. Strontium salicylate is less irritating to the stomach and lithium salicylate combines action of lithium salts. Doses same for both as for the sodium salt. 446 VEGETABLE DRUGS carbonate. 2 HC,H,0O,-+ Na,CO,=2% NaC,H,O, + H,O + CO,. The solution is filtered, and heated to expel carbon dioxide. Properties.—A white, amorphous, microcrystalline powder or scales; odorless, and having a sweetish, saline taste. Permanent in cool air. Soluble in 0.8 part of water, and in 5.5 parts of alcohol; very soluble in boiling water or aleohol; also soluble in glycerin. Dose.—Same as salicin. Puenyiis Saricyras. Phenyl Salicylate, C,H, 03. (U. 8. P.) Synonym.—Salol, B. P.; salicylic ether of phenol. Derivation.—Made by heating salicylic and earbolic acids with phosphorous pentachloride. Properties.—A_ white, crystalline powder; odorless, or having a faintly aromatic odor, and almost tasteless. Permanent in the air. Almost insoluble in water; soluble in 5 parts of alcohol; also soluble in 0.3 part of ether, and readily in chloroform, and in fixed or volatile oils. Dose.—H., 3 iii.-vi. (12.-24.); D., gr. v.-x. (0.3-0.6). SALICYLIC ACID, SALICIN, SODIUM SALICYLATE AND PHENYL SALICYLATE OR SALOL. Action Hxternal.—Salicylic acid, sodium salicylate, salicin and salol are powerful antiseptics resembling carbolic acid in action but less toxic and irritant. A solution of salicylic acid (1-60) is equivalent to a solution of carbolic acid (1-22) in destroying some bacteria, but is not generally as useful, being less penetrating in its action on the tissues. In solution salicylic acid softens and removes the horny layer of the skin without causing any soreness. Salicylic acid, sodium salicylate and salicin, in their pure state, are irritating to the unbroken skin or raw surfaces. Salol is not. Action Internal.—Salicylic acid is an irritant in the digestive tract and in large doses causes nausea and vomiting in dogs. It slightly increases the flow of bile. Salicylic acid is converted into salicylates by the alkaline intestinal juices, and is absorbed in this form, chiefly as sodium salicylate.: For this reason, and because the latter salt is less irritating than salicylic acid, sodium salicylate is preferred to the acid when a constitutional action is desired. Salicin splits up in the bowels into salicylic acid, salicylous acid (HC;H;0,), salicyluric acid (HO,H,NO,), and glucose. Salol is decomposed by the pancreatic juice into salicylic acid (64 per cent.) and carbolic acid (36 per cent.) After large doses the urine takes on the char-. SALICYLIC ACID, SALICIN, SALICYLATES AND SALOL 447 acteristic smoky color produced in poisoning by phenol. Salol is an intestinal antiseptic. The salicylic group are slight cholagogues. Circulation.—Moderate doses of sodium salicylic, or salicylic acid increase blood pressure by stimulation of the heart muscle and vaso-constrictor centre, but large doses depress the heart force, blood pressure and nervous system. The artificial acid is said to be more depressant than natural salicylic acid obtained from plants, because of orthocreosotic and metacreosotic acids existing as impurities in the former. Natural salicylates cost 5 to 10 times as much as the arti- ficial, and Eggleston, from an exhaustive recent study, states that there is no material difference in the action of the two. Nervous System.—The only known action of salicylic acid on the central nervous system is that on the medullary, respiratory and vasomotor centres which are first stimulated, then depressed, and finally paralyzed by lethal doses. Therapeutic quantities often cause, in man (salicylism), ringing in the ears and headache. Besides, some deafness, dimness of vision and excessive perspiration are not uncommon after large doses. Respiration.—The respiratory movements are primarily quick- ened by the stimulation of the peripheral vagi and respiratory centres produced by sodium salicylate and salicylic acid; but after large doses the respiratory centres are depressed and paralyzed and death takes place by asphyxia. Temperature.—Medicinal doses do not influence the normal temperature of healthy animals, but do often lower bodily heat in fever, and frequently induce sweating. The largest therapeutic doses must be given to secure an antipyretic action. Antipyresis oceurs from heat loss due to dilation of cutaneous blood vessels. Kidneys and Elimanation.—Salicylic acid, salicin and sodium salicylate circulate in the blood as sodium salicylate and are elim- inated in the urine as salicyluric and salicylic acids. This happens in this wise: Some of the salicylic acid of sodium salicylate com- bines with glycocoll in the body and forms salicyluric acid. HC,H.O, + O,H;NO, (glyeocoll) = HC,H,NO, (salicylurie acid) +_ HO; while some of the sodium salt is decomposed by phos- phorie acid in an acid urine into salicylic acid. Like quinine, the excretion of salicylic acid begins soon, in one hour, and is all excreted within 48 hours. Therefore large doses given continuously aceumu- late in the body, and it is said the salicylates thus accumulate chiefly in the synovial fluid in the various joint cavities which accounts for their action in rheumatism. The quantity of urea and uric acid in the urine is increased very considerably by salicylic acid, and usually the amount of urine itself. It is made aseptic by the escaping salicylic acid, or in the case of salol, by both carbolic and salicylic 448 VEGETABLE DRUGS acids. Sometimes salicylates irritate the kidneys in large doses ‘and blood and albumin appear in the urine. The urine of animals tak- ing salicylic acid may be rendered green by indican and pyrocatechin, formed through the action of pancreatic juice, and takes on a purple color with ferric chloride. Salicylic acid is also eliminated in the milk, sweat and bile. Toatcology.—In man, continued large doses give rise to delir- ium, vomiting, depression of the circulation, epistaxis, hematuria, and retinal hemorrhages. The herbivora are not easily affected by large doses of salicylic acid or salicylates, but dogs exhibit nausea and vomiting, accelerated respiration, irregular pulse, loss of mus- cular strength, staggering gait, stupor, and, if death occurs, it is preceded by slow breathing, dilated pupils, dyspnea, and convulsions due to asphyxia. The minimum fatal dose for a small dog is about one drachm of sodium salicylate, subcutaneously. Administration.—Sodium salicylate contains 48 grains of the acid to the drachm. Sodium salicylate is used in preference to the acid because it is soluble and unirritating. It is given in solution, or to dogs in pills or tablets. Salicylic acid may be exhibited in solution by warming it with glycerin (gr. iv.-3 i.); or with syrup (1-5), and aqua ammoniae in sufficient quantity to dissolve it, thus forming ammonium salicylate. It may also be administered in pill or ball. Salol is given in pill, powder or mixture with water. The larger doses of salicylic acid and salicylates should not be repeated, and are used for their antipyretic action. A maximum daily dose of one ounce of salicylic acid or sodium salicylate, for horses, or one drachm of either for large dogs, should rarely be exceeded. Uses External.—Salicylic acid is employed in various forms as an antiseptic. Aqueous solutions (1-300) may be applied to wounds. Stronger solutions are prepared with alcohol, borax, sodium bicar- bonate, and ammonium acetate solution. Salicylic acid may be ap- plied as a dusting powder with zine oxide (1-8), or in ointment (1-20 or 80), for its stimulant and antiseptic effect on wounds. It is used in the treatment of burns with cottonseed oil (1-8). Salicylic acid is useful in powder or ointment in acute moist eczema (1-50), and in the following formula: Salicylic acid, one part; zine oxide, starch and vaseline, each 16 parts. Ringer recommends in pruritus ani and vulvee—salicylic acid, 3 ii.; ol. theobrom., 3 v.; cetac., 3 iii.; ol. myrist, 3 i-ss. Sal- icylie acid is of value in skin diseases with induration, and for removing horny growths as warts and corns. For the latter it is mixed with collodion (3 ii. in 3 1.) and applied twice daily for a week or so when the growth comes away without any irritation. Salol is used as an antiseptic dusting powder of uncertain value. ASPIRIN 449 Uses Internal.—The salicylic acid group are specifies in rheu- matie fever. They lower temperature, lessen pain, and by shortening the attack lessen the danger of cardiac complications. Sodinm salicylate should be given every three hours- in doses of 3 il. to horses, and gr. x.-xx. to dogs. But this form of rheumatism is rare in veterinary practice, and salicylic acid is unfortunately not nearly so valuable in the treatment of other varieties. _Salicylates are prob- ably worthless in chronic rheumatic arthritis where the local appli- eation of heat, stimulating liniments and blisters are serviceable; but they may be used with benefit in acute muscular rheumatism, sciatica, and rheumatic complications of influenza in horses. Salicylic acid, salicin, and salicylates are not comparable with the cold tar products as general antipyretics, and are useless in hyperpyrexia. Sodium salicylate is sometimes prescribed in gastric fermentative dyspepsia when the salicylic acid, set free by the hydrochloric acid of the gastric Juice, acts as an antiseptic. Salol is a good intestinal anti- septic in diarrhea and intestinal indigestion, particularly when com- bined with bismuth subnitrate in powder or aqueous mixture for dogs. Salol is undissolved in the stomach, is less irritating ‘than either salicylic acid or sodium salicylate, and is prescribed to lessen pain and fever. It may be advantageously given in doses of gr. v. to dogs, with phenacetin gr. y., and codeine gr. 14, for painful rheu- matism. It is probably inferior to sodium salicylate, but can be conveniently administered in powder as just noted. Salol is also a local anzsthetic and antiseptic in the urinary tract .(carbolie acid from decomposition), and is useful in cystitis and urethritis, to alleviate pain, to prevent frequent micturition, and to render the urine asceptic. It may be combined advantageously for this purpose with hexamethylenamine. Salicin acts more slowly than salicylic acid or sodium salicylate, and is not in general use. Salicylates are used in indigestion with slight icterus in acting as cholagogues. ASPIRIN. ACBTYLSALICYLICUM. ACETYISALICYLIC ACID. @,H,0, Aspirin is made by heating fifty parts of salicylic acid with seventy-five parts of acetic anhydride at a temperature of 302° F., and by purification and crystallization. It occurs in small colorless, erystalline needles, odorless and having an acidulous taste. It is soluble in 100 parts of water and freely soluble in alcohol and ether. With alkalies it is decomposed into salicylic acid and salicylates with the liberation of acetic acid. It passes through the stomach un- changed and is slowly dissolved in the alkaline juices of the intes- 450 VEGETABLE DRUGS tines, with less systemic symptoms (tinnitus in man) than follows the use of salicylic acid. It is merely a substitute for the latter and is supposed to be less irritating to the stomach but this is not always the case. Fashion has at present endowed it with much wider scope than has been given to salicylates and salicylic acid. It is suitable in the same cases in which the latter are indicated, as in rheumatic affections and as an intestinal antiseptic. It is often combined with other antipyretics and ‘analgesics, as acetphenetidin. It is incom- patible with alkalies, their carbonates or bicarbonates. Dose.—H., 3 ii.-iv. (8.-15.) ; D., gr. v.-xx. (0.3-1.3). Given in capsules or tablets to dogs; with syrup to horses. Oteum GavuttuEerim. Oil of Gaultheria. (U.S. P.) Synonym.—Oil of checkerberry, oil of wintergreen, oil of box- berry. A volatile oil distilled from the leaves of Gaultheria procumbens Linné (nat. ord. Ericacee), consisting almost entirely of methyl salicylate (CH;0,H;O;), and nearly identical with volatile oil of betula. Habitat.—North America; west as far as Minnesota, and south to Georgia. Properties.—A colorless or yellow, or occasionally reddish liquid, having a characteristic, strongly aromatic odor, and a sweetish, warm and aromatic taste. Spec. gr. 1.172 to 1.180 at 77° F. Solubility same as methyl salicylate. Dose.—H., 6 ii.-3 1. (8.-30.); D., Mv.-xv. (.3-1.). Oxteum Berurar. Oil of Betula. (U.S. P.) Synonym.—Oil of sweet birch. It is practically identical in properties and action with oil of gaultheria. Merny. Saticyrats. CH,C,H,O,. ° (U..S.'P.) Synonym.—Artificial or synthetic oii of wintergreen. Derivation—Prepared by distillation of salicylic acid. or sal- icylates, with methyl] alcohol and sulphuric acid. Properties.—A colorless or slightly yellowish liquid, having the characteristic, strongly aromatic odor and the sweetish, warm and aromatic taste of oil of gaultheria, with the essential composition of which it is identical. It is wholly identical with oil of betula (birch). OIL OF GAULTHERIA 451 Spec. gr. 1.180-1.185 at 77° F. Soluble in all proportions in aleo- hol, glacial acetic acid, or carbon disulphide. Dose.—H., 5 i1.-3 i. (8.-80.); D., mv.-xv. (.3-1.) ACTION AND USES OF OIL OF GAULTHERIA, OIL OF BETULA AND METHYL SALICYLATE. Oil of wintergreen contains about 90 per cent. of methyl sal- icylate. Eleven parts of methyl salicylate are equivalent to nearly ten parts of salicylic acid. The oil and methyl salicylate are free from the impurities ‘of artificial salicylic acid, while methyl salicylate is of more certain composition than the oil. Both behave similarly to salicylic acid therapeutically, although the oil is more of a local irritant, and they are used for the same purposes as salicylic acid. Hither may be given in emulsion, or to dogs in capsules, and in com- bination with salicylic acid or salicylates. Methyl salicylate is serviceable in the following liniment for rheumatism : 13 Tine. opii. Methyl Salicylatis. Chloroform. sa ccs susie ho sole see sre gene aa 3i ifn, SAMI WG Sdededacugon babeOoODOND ad. 3 viii. M. S. External use. The external application of methyl salicylate to acutely inflamed rheumatic joints is one of the most efficient forms of treatment, and, since some is absorbed, will take the place of the internal adminis- tration of salicylates to a slight extent. It is usually best to combine this treatment with internal medication, however. Plain gauze, or other absorbent material, is saturated with methyl salicylate, applied to the affected joint, and then covered with oil silk, or rubber pro- tective and bandage. SECTION IX.—VOLATILE OILS, OR DRUGS CONTAINING THEM. GENERAL ACTION OF VOLATILE OILS. Synonym.—Essential, ethereal, aromatic or distilled oils. Externally, volatile oils cause reddening of the skin (rube- facients), sometimes blistering (vesicants), and often local anes- thesia, notably oil of cloves and peppermint. They are also 452 VEGETABLE DRUGS parasiticide, antiseptic and disinfectant, penetrating into the proto- plasm of bacteria. Internally, these agents stimulate the flow of gastric, salivary and intestinal secretions and increase the vascularity and movements of the stomach and bowels, and are antiseptic and anthelmintic. They therefore temporarily improve digestion, over- come flatulence by expelling gas from the intestines, prevent griping produced by cathartics, and disguise and offset disagreeable effects and tastes of medicines. In the digestive tract, volatile oils excite reflexly the nervous system and heart, and augment the pulse rate and vascular tension. In large doses, volatile oils are gastro-intestinal ir- ritants. Volatile oils may be absorbed from the skin, bronchial mucous membrane, and stomach. ‘They are eliminated by the skin, bronchial mucous membrane and kidneys, and act as antiseptics and parasiticides in the kidneys and lungs. In the process of excretion the parts are stimulated; vascularity, secretion, and contractility of the unstriated muscle of the bronchial tubes are increased, and volatile oils thus assist expectoration and coughing. In irritating the kidneys and mucous membrane of the genito-urinary tract, the volatile oils are stimulant and diuretic; while © in poisonous doses they produce acute nephritis, strangury, and hema- turia. Toxic doses, injected into the circulation, lower the force of the heart and the blood pressure, and occasion a sort of intoxication, and sometimes convulsions. To summarize: volatile oils possess the following actions in a greater or less degree: parasiticide, antiseptic, disinfectant, rubefacient, vesicant, local anesthetic, sialagogue, sto- machic, carminative, antispasmodic, stimulant, expectorant, emmena- gogue, and diuretic actions. Class 1—Used Mainly for their Action on the Skin. TEREBINTHINA. Turpentine. (U.S. & B. P.) A concrete oleoresin obtained from Pinus palustris Miller, and from other species of Pinus (nat. ord. Conifers). Habitat.—Southeastern United States; from Virginia to the Gulf of Mexico. Description.—In yellowish, opaque, tough masses, brittle in the cold; crumbly, crystalline in the interior, of a terebinthinate odor and taste. Oxeum Trresintoine. Oil of Turpentine. (U.S. & B. P.) A volatile oil distilled from turpentine. TURPENTINE 453 Synonym.—Spirit of turpentine, E.; essence de térébinthine, Fr. ; terpentinél, G. Properties.—A thin, colorless liquid, having a characteristic odor and taste, both of which become stronger and less pleasant by age and exposure to the air. Spec. gr. 0.860 to 0.870 at 77° F. Soluble in three times its volume of alcohol; also soluble in an equal volume of glacial acetic acid. Solvent for resins (varnish), fats, wax, gutta percha, india rub- ber, sulphur, phosphorus, iodine, and many alkaloids. It is dextro- rotatory, but the French variety is leavo-rotatory. Old oil of tur- pentine and French oil of turpentine (Pinus maratima) are oxidizing agents. Constituents.—Turpentine contains 20 to 25 per cent. of oil of turpentine. Oil of turpentine is composed of several isomeric hydro- carbons, called terpenes, and having the formula C,)H,,. The chief ones in the oil are pinene, phellandrene, limonene, and dipentene. The oil of juniper, savin, cubeb, caraway, cloves, thyme, ete., contain various terpenes. They differ from each other in their boil- ing points and direction in which they rotate the plane of polarization. The terpenes are oxidized into camphors. Dose.—Carminative—H. & C., 3 i.-ii. (80.-60.); Sh. & Sw., 5 i-iv. (4.-15.); D., ™x.-xxx. (.6-2.). Anthelmintic—H. & C., 3 ii.-iv. (60.-120.); D., 3 ss.-iv. (2.- 15.). Diuretic—H. & C., 3 ii.-vi. (8.-24.). PREPARATIONS. Linimentum Terbinthine. Turpentine Liniment. (U.S. & B. P.) Resin cerate, 650; oil of turpentine, 350; melt the resin cerate and add the oil of turpentine. (U. S. P.) Oleum Terebinthine Rectificatum. Rectified Oil of Turpentine. (Us SPs) Derivation.—Made by shaking oil of turpentine with an equal volume of Solution of Sodium Hydroxide, and distillation. Properties—A thin, colorless liquid, having the same properties as oil of turpentine. : (unamenune 9 Tercbene. Ciba. (Uanss&. Becks): A liquid consisting of dipentene and other hydrocarbons, ob- tained by the action of concentrated sulphuric acid on oil of turpen- tine and subsequent rectification with steam. Properties.—A colorless, or slightly yellowish, thin liquid, hav- ing a rather agreeable, thyme-like odor, and an aromatic, somewhat 454. VEGETABLE DRUGS terebinthinate taste. Spec. gr. about 0.850 at 77° F. Only slightly soluble in water, but soluble in 3 times its volume of alcohol, and in glacial acetic, or carbon disulphide. Dose.—H. & C., 3 ii.-vi. (8.-24.) 5 Mv.-xv. (.3-1.). Terpini Hypras. Terpin Hydrate. C©,,H,,O0, + H.O. (U.-8.°2.) The hydrate of the diatomic alcohol, Terpin. Derwation.—Reetified oil of turpentine, aleohol and nitrie acid are mixed together in shallow, porcelain dishes, and after three or four days terpin hydrate crystallizes out. The crystals are collected, drained, dried on absorbent paper, and purified by recrystallization in alcohol. Properties.—Colorless, odorless crystals, having an aromatic, somewhat bitter taste. Soluble in 200 parts of water and in 10 parts of alcohol. Dose.—H., 3 ss.-ii. (2.-8.); D., gr. v.-xx. (.3-1.3). OIL OF TURPENTINE. Action External.—Oil of turpentine is an irritant to the skin, causing itching, pain and redness, or even vesication, followed by local anesthesia. It produces intense irritability and restlessness when applied externally to some horses. The oil is antiseptic, dis- infectant and parasiticide, being more penetrating to the skin than mustard or cantharides. Action Internal.—Alimentary Canal.—The oil induces a sense of warmth in the stomach (man), and increases gastric secretion, motion and vascularity, but is too disagreeable to be used as a sto- machic. In acting similarly in the bowels, particularly in stimulat- ing the muscular coat, oil of turpentine is a useful carminative by exciting peristalsis and expelling gas in tympanites. Its antiseptic properties also antagonize intestinal fermentation. Large doses occasion purging and are anthelmintic. Toxic doses create gastro-enteritis and sometimes intestinal ulceration. The ir- ritation of the nerve endings in the digestive tract caused by turpen- tine, leads to reflex stimulation of the nervous system and heart. Circulation.—Turpentine is readily absorbed into the blood. Experimental evidence is at variance with regard to the action of the oil on the circulation. Small doses apparently increase the force and frequency of the heart-beat, and slightly raise blood pressure. The vessels are somewhat contracted and the drug is employed to arrest hemorrhage in the digestive tract and in remote organs. It USES OF OIL OF TURPENTINE, ETC 45% is inferior to ergot as an hemostatic. Large doses of turpentine lower the cardiac force and frequency, and cause vascular dilatation and fall of blood pressure. _ Respiration.—Oil of turpentine enhances the strength and rapid- ity of the respiratory movements, in small doses, but large quantities depress the respiration. The oil is easily absorbed by inhalation and is also eliminated in the breath. Inhalation of the oil stimulates the bronchial mucous membrane, acts as an antiseptic, and excites muscular contraction of the bronchial tubes and cough. Authorities differ as to the influence of turpentine on bronchial secretion. Rossbach found that the inhalation of air saturated with turpentine diminished secretion, while the topical application of a watery solution increased secretion. The oil is essentially a local stimulating expectorant. Nervous System.—Medicinal doses occasion mental exhilaration in man. Large doses cause dulness, languor, and unsteady gait in animals; while distinctly toxic doses produce coma, sensory paralysis, loss of reflex activity, and, at times, convulsions. Kidneys and Genito-Urinary Tract—The kidneys are very prone to irritation during its elimination. Small doses induce fre- quent micturition. Large quantities lead to albuminuria, pain in the lumbar region, hematuria, and constant painful passage of high- colored urine, owing to irritation of the urinary mucous membrane and muscular spasm of the urethra (strangury). Menorrhagia and dysmenorrhea occur in females under the influence of the oil. Acute nephritis and complete suppression of urine follow great toxic doses. The urine has sometimes the odor of violets. Elimination.—Turpentine is eliminated in the urine, breath, and, to some extent, in the bile and intestinal mucus; slightly by the skin. Toxtcology.—Turpentine poisoning is not an uncommon occur- ~ rence from the administration of large doses (undiluted) by empirics. Post-mortem appearances reveal gastro-enteritis, sometimes conges- tion and inflammation of the lungs, and fatty degeneration of the liver, kidney and muscles, following prolonged use of the oil. The action of terebene and terpin hydrate is very similar to oil of turpentine. Administration.—Oil of turpentine is given with eight or more times its volume of cottonseed or linseed oil, gruel, or milk; and in emulsion with acacia or white of egg. An emulsion is made by shaking a single dose with powdered acacia, and adding water or oil. Teerebene is administered in a similar manner. Terpin hydrate may be exhibited in pill, ball or alcoholic solution. 456 VEGETABLE DRUGS USES OF OIL OF TURPENTINE, TEREBENE AND TERPIN IIYDRATE. External.—oOil of turpentine is employed as a stimulant and counter-irritant with two or three parts of cottonseed oil and soap liniment, or as the official liniment in rheumatism, myalgia, sprains, shoulder lameness, swollen joints, gangrene, frost bites, burns and ulcers. Oil of turpentine is a very efficient disinfectant with which to sterilize the skin or accidental wounds when more appropriate agents are not at hand. It is serviceable in the same form and for the same actions applied to “sitfasts’ and obstinate ulceration about the heels in horses, and in footrot of sheep. As a parasiticide, the oil, diluted two or three times with sweet oil, is painted on the skin to kill ringworm and lice. Oil of turpentine is a valuable counter-irritant in relieving pain and inflammation of deep-seated parts. It is particularly useful in tympanitis, flatulent and spasmodic colic and peritonitis. In the first two named disorders, external application is combined with the internal and rectal exhibition of the drug. Oil of turpentine is less frequently employed over the chest in pleurisy and bronchitis. The turpentine stupe is the favorite method of applying the oil in abdominal troubles. . CUiaSi-Ps) Synonym.—Ammonium valerianate. Made by the action of ammonia gas upon valerianic acid, and erystallization. Properties.—Colorless, or white, quadrangular plates, emitting the odor of valeric acid, of a sharp and sweetish taste, and deliques- cent in moist air. Very soluble in water and in aleohol; also soluble in ether. Dose.—D., gr. il.-v. (.12-.3). Frerrt Varpras. Ferric Valerate. (Non-official.) Made by precipitating a solution of ferric sulphate with a so- lution of sodium valerianate, and washing and drying the precipitate. 484 VEGETABLE DRUGS Properties.—A dark, brick-red, amorphous powder of somewhat varying chemical composition; having the odor of valerianic acid and a mildly styptic taste; permanent in dry air. Insoluble in cold water, but readily soluble in alcohol. Dose.—D., gr. i.-iii. (.06-.18). Zinct Vatpras. Zine Valerate. Zn(C;H,O.). + 2 HO. CUsSeG. ae.) Synonym.—Zine valerianate. Made by crystallization from a mixture of hot solutions of zine sulphate and sodium valerate. Properties.—White, pearly scales, having the odor of valeric acid, and a sweetish, astringent and metallic taste. On exposure to the air it slowly loses valeric acid. Soluble in 50 parts of water, and in 35 parts of alcohol. Incompatibility—Incompatible with acids, metallic salts and soluble carbonates; also vegetable astringents. Dose.—D., gr. 1.-ii1. (.06-.18). Admunistration.—V alerian should be given in the form of the fiuidextract to horses, and this preparation or the tinctures may be exhibited to dogs in dilution. Valeric acid is not used in medicine except to make valerianates. Of the salts, the zine valerate is the most popular, and is administered in pills to canine practice. ACTION AND USES OF VALERIAN AND VALERATES. The physiological action of valeric acid and the valerates is an unknown quantity, but clinical evidence supports their value. The volatile oil in valerian has much the same properties as other volatile oils in stimulating secretion, motion, vascularity and appetite, in relation to the digestive organs; and, in its elimination, the oil ex- cites the mucous membranes of the bronchial tubes and genito-urinary tract. The oil also stimulates the circulation reflexly. Toxic doses of the oil paralyze the brain and cord and depress the circulation; while lethal quantities of ammonium valerate are said to first excite the spinal motor tract and cause convulsions, and to finally occasion spinal depression and paralysis. Valerian and the valerates are called antispasmodics in stimulating and strengthening an enfeebled nervous system and thus combating disorders which are created by an increased susceptibility to impulses originating within the brain, ASAFETIDA 485 or outside of the body. Valerian is both recommended and used in the treatment of polyuria and diabetes insipidus of the horse; in chorea of dogs resulting from distemper, and occasionally in hysteria, epilepsy, convalescence from acute diseases, and nervous restlessness. Although the drug is of secondary importance, it finds a much larger field of usefulness in human medicine. ; Zine valerate is more commonly employed in canine practice for chorea. Ferric valerate is supposed to combine the tonic and antispasmodic action of the two constituents in one preparation. The oil of valerian is a useful remedy (in emulsion) as a carminative in flatulence. It may be given to horses in doses of 3 ss.-i.; and to dogs in quantities of Mii.-v. AsaFretipa. Asafetida. (U.S. P.) Synonym.—Asafetida, B. P.; Gummi-resina asafcetida, ase fétide, asafcetida, Fr.; stinkasant, teufelsdreck, G. A gum-resin obtained from the root of Ferula foetida (Bunge) Regel (nat. ord. Umbelliferee) and probably other species of Ferula. Habitat.—Persia, Afghanistan and Turkestan. Properties.—In roundish tears, from 2 to 6 Mm. or more in diameter; externally pale yellowish-brown, internally milk-white; brittle when cold, and breaking with a flat, conchoidal, and waxy fracture; or the tears are superficially united into irregular masses without any intervening dark-colored substance. It has a peculiar odor, and a bitter, acrid, nauseous taste. When triturated it readily yields a milk-white emulsion. . Constituents.—1, a volatile oil (5 per cent.), containing as its most important ingredient, allyl sulphide, which gives asafcetida its disagreeable odor; 2, gum, about 25 per cent.; 3, bassorin resin, 65 per cent., containing ferulaic acid (C,)H,,)0,). Dose.—H. & C., 3 ss.-i. (15.-30.); Sh. & Sw., 3 i-ii. (4.-8.) ; Dy ers inicxit. (.18=8)): Administration.—Asafeetida is given in ball to the larger ani- mals or in an extemporaneous emulsion which is readily made— owing to the gum in the drug—by trituration with water. Asafetida is administered to dogs in pill. The drug may also be injected in aqueous mixture per rectum. Preparations.—Pilule asafcetide (gr. iii. each) ; dose—D., 1-4. Tinctura asafcetidee (1-5) ; dose—H., 3 ii.-iv. (60.-120.) ; D., 3 ss.-i. (2.-4.). Emulsum (mistura) asafotide, milk of asafetida (1-25) ; dose—D., 3 ss.-i. (15.-30.). 486 VEGETABLE DRUGS Action and Uses.—Asafetida is of value by reason of its volatile oil, and therefore possesses much the same action as other agents of this class. In experiments on man asafetida caused “‘stomachache,” activity of the bowels, increased pulse rate and respiratory move- ments, headache, dizziness, and sexual desire. Asafetida is chiefly used as a carminative, stimulating expec- torant, and nerve stimulant or antispasmodic. Liquid preparations may cause nausea and vomiting in dogs owing to the nauseous taste. The drug is of most service in flatulent colic of horses, when it is combined with ammonium carbonate in ball, or is given in this form simultaneously with linseed oil and oil of turpentine. In atonic constipation of horses, asafetida is prescribed with aloes in ball. Asafetida is occasionally employed as a stimulating expectorant in chronic bronchitis, and in the later stages of bronchial eatarrh, but it is probably inferior to ammoniacum for this purpose. As an antispasmodic agent, asafetida is useful in functional spas- modie affections, including hysteria, chorea and convulsions. The emulsion may be given in enema to dogs, in the two latter disorders. Finally, tincture of asafetida is recommended to be added to alcoholic liquors in veterinary practice to prevent their “misappro- priation”’ by stable attendants. Class 4.—Used Mainly for their Stimulant and Diuretic Actions on the Kidneys and Genito-Urinary Tract. Buon... Buchu. 2(U. S.;P.) Synonym.—Buchu folia, B. P.; feuilles de bucco, Fr.; buckublatter, buccoblatter, G. The dried leaves of Barosma betulina (Thunberg) Bartling et Wendland (nat. ord. Rutacee). Habitat.—South Africa. Description.—About 15 Mm. long, roundish, obovate, with a rather wedge-shaped base, or varying between oval and obovate, ob- tuse, crenate or serrate, with a gland at the base of each tooth; dull yellowish-green; thickish, pellucid-punctate; odor and taste strongly aromatic, somewhat mintlike, pungent and bitterish. Constituents.—1, a volatile oil, having an odor somewhat like peppermint, 114 per cent.; 2, a stearopten (Buchu camphor or dios- phenol, O,)H,,0.), possessing an odor like peppermint and in solu- tion in a liquid hydrocarbon, but crystallizing on exposure to the air; 3, barosmin, a glucoside, soluble in ether, volatile oils, diluted acids and alkalies; 4, gum; 5, rutin, a bitter substance. Dose.—-H. & C., % iti. (30;-60:) 3D... cor? xv.-xxxaGk-2),. ACTION AND USES OF BUCHU 487 PREPARATIONS. Fluidextractum Buchu. Fluidextract of Buchu. (U. S. P.) Made by maceration, percolation and evaporation, so that 1 Ce.=1 Gm. of Buchu. Dose.—H. & C., 3 1.-11. (30.-60.); D., Mxv.-xxx. (1.-2.). An infusion (1-20) by steeping leaves in boiling water for half an hour in a closed vessel, is sometimes preferred, and will be taken voluntarily by the larger aningils in linseed tea. Tinctura Buchu. Tincture of Buchu. (B. P.) Dose.—Same as that of the fluidextract. ACTION AND USES. The volatile oil and bitter principle act upon the digestive or- gans as an aromatic bitter, promoting appetite and digestion in small doses, while large doses cause nausea and vomiting in dogs. The volatile oil is absorbed and eliminated by the mucous membranes, particularly of the bronchial tubes and genito-urinary tract. It thus stimulates and disinfects the mucous membranes, slightly increases the secretion of urine, and imparts its peculiar odor to the latter. The drug is of considerable value in the treatment of chronic or subacute pyelitis, cystitis and urethritis. It is stimulating, but only slightly irritatmg. Buchu has been recommended in chronic ne- phritis, and is useful in irritation of the urinary bladder, with fre- quent micturition, combined with spirit of nitrous ether. Buchu is occasionally prescribed in the later stages of bronchitis or in the chronic form of this disease, and is employed in its native country as a remedy for chronic diarrhea and dysentery. Oxrum Juniper. Oil of Juniper. (U.S. & B. P.) Synonym.—Oleum fructus (Vel Baccee) juniperi, oil of juniper berries, E.; essence de geniévre, Fr. ; wachholderbeersl, G. A yolatile oil distilled from the fruit of Juniperus Communis Tinné (nat. ord. Conifere.) Habitat.—Canada and United States; Rocky Mountains, south to New Mexico. Properties.—A colorless, or faintly greenish-yellow liquid, be- coming darker and thicker by age and exposure to air; having the characteristic odor of juniper, and a warm, aromatic, somewhat terebinthinate and bitterish taste. Spec. gr. 0.860 to 0.880. Solu- ble in 10 volumes of 90 per cent. alcohol. 488 VEGETABLE DRUGS Composition.—Oil of juniper is a terpene (C,)H,,), and is isomeric with oil of turpentine. Dose.—H. & C., 3 i-ii. (4.-8.); D., Mii.-x. (.12-.6). PREPARATIONS. Spiritus Juniperi. Spirit of Juniper. (U. S. & B. P.) Oil of Juniper, 50; alcohol, 950. (U.S. P.) Dose.—H. & C., J i.-ii. (30.-60.); D., 3ss.-i. (2.-4.). Spiritus Junipert Compositus. Compound Spirit of Juniper. Oil of juniper, 8; oil of caraway, 1; oil of fennel, 1; alcohol, 1400; water o make 2000. Dose.—H. & C., J ii.-iv. (60.-120.): D., 3i.-iv. (4.-15.). ACTIONS AND USES. Oil of juniper resembles oil of turpentine physiologically as well as chemically. It is a stomachic and carminative, particularly when combined with alcohol and other aromatic oils (sp’r. juniper. co.), but is used in medicine chiefly for its stimulant and diuretic action upon the kidneys and genito-urinary tract during its elimina- tion. Oil of juniper is capable of irritating the kidneys in large doses, and causing congestion, strangury, and even suppression of urine. It is less likely, however, to disturb digestion than oil of turpentine, and does not so readily occasion hematuria and albu- minuria. Oil of juniper is indicated in chronic nephritis, pyelitis and cystitis; also in dropsy of cardiac, renal, or hepatic origin. It is efficient in assisting absorption of effusions into serous cavities, through its diuretic properties. The compound spirit of juniper approximates gin in composition, although it is not the official name for that liquor. This preparation is useful in the convalescent per- iod of acute bronchitis and influenza, stimulating the bronchial mucous membrane by virtue of the volatile oil, and acting as a cir- culatory stimulant and diuretic. The oil of juniper is an efficient renal stimulant in passive congestion of the kidneys, and following the active stage of acute nephritis. Juniper berries are sometimes given to the larger animals on their food (3i.-ii.), or are exhibited in infusion. SAVIN 489 Class 5.—Used Mainly for its Emmenagogue Action on the Female Generative Organs. Sapina. Savin. (U.S. P.) Synonym.—Sabine cacumina, B, P.; savin tops, E.; sabine, Fr.; sadebaumspitzen, sevenkraut, G.; summitates (herba) sabine, eG. | The tops of juniperus Sabina Linné (nat. ord. Conifers). - Habitat.—Canada, Northern United States, Europe and Siberia. Description.—Short, thin, sub-quadrangular branchlets; leaves rather dark green, in four rows, opposite, scale-like, ovate-lanceolate, more or less acute, appressed, imbricated on the back with a shallow groove containing an oblong or roundish gland; odor peculiar, tere- binthinate; taste nauseous, resinous and bitter. The chief constitu- ent is the volatile oil, about 2 per cent. Dose.—H., 3 i.-ii. (30.-60.) ; D., gr. v.-xv. (.3-1.). PREPARATION. Fluidextractum Sabine. TFluidextract of Savin. (U. S. P.) Made by maceration and percolation with alcohol, and evaporation, so that 1 Ce.=1 Gm. of the crude drug. Dose.—H. & C., 5i-ii. (30.-60.); D., Mv.-xv. (.3-1.).. Oxzum Sazinz. Oil of Savin. (U.S. & B. P.) Synonym.—Kssence de sabine, Fr.; sadebaumdl, G. A volatile oil distilled from the fresh tops of savine. Properties.—A_ colorless, yellowish liquid, having a peculiar terebinthinate odor, and a pungent, bitterish and camphoraceous taste. It becomes darker and thicker by age and exposure to the air. Spec. gr. 0.855-0.865. Soluble in one-half volume of 90 per cent. alcohol and glacial acetic acid. It is composed of several terpenes. Dose.—H. & C., 3 ii.-iv. (8.-15.) ; D., Mi.-v. (.06-.3). Administration.—The oil is given in capsules or pills to small animals; in emulsion with gum, or in bland oil, to the larger animals. Action External.—The oil is a powerful irritant to the skin, pro- ducing redness, vesication and even pustulation. Action Internal.—The oil resembles oil of turpentine, but is more irritating. Full doses cause gastric stimulation, reflex circu- latory excitement, and frequent micturition. Toxic quantities oc- easion gastro-enteritis with vomiting (in dogs), purging, colic, pain- 490 VEGETABLE DRUGS ful micturition, and the passage of bloody, albuminous urine. There are also unconsciousness, stertor, rapid breathing and pulse, con- vulsions and collapse. Lesions of gastro-enteritis are observable after death, except in rare cases, when only congestion of the brain and lungs oceur. The oil is eliminated by the skin and bronchial mucous membrane, but chiefly by the kidneys, with consequent stimulation of the genito-urinary organs. The uterus and ovaries are irritated and congestion of them follows with acceleration of ovulation. The oil also excites uterine contractions in the pregnant state. The drug is therefore an emmenagogue and ecbolic. Uses.—The Unguentum (B. P.) may be applied externally as a counter-irritant. The oil is occasionally employed as an anthelmin- tic, but is inferior to other agents for this purpose. It may be given in atonic ammenorrhea, or in metrorrhagia due to uterine relaxation, with benefit, but it should be used cautiously. The oil is not to be used as an abortifacient, since sufficient doses to cause abortion will usually endanger the life of the mother or fetus, or both. So-called Solid Volatile Oils or Stearoptens. Campurora.. ::Camphor: °-C,5H,,0: °° (CU: S: & B. P:) Synonym.—Gum camphor, laurel camphor, E.; camphre, Fr. ; kampfer, G. A stearopten (having the nature of a ketone) obtained from Cinnamomum Camphora (Linné) Nees et Ebermaier (nat. ord Laurinee), and purified by sublimation. Habitat.—China, Japan, Cochin China and Sunda Islands. Properties.—White, translucent. masses, of a tough consistence and a crystalline structure, readily pulverizable in the presence of a little aleohol, ether, or chloroform; having a penetrating, charac- teristic odor, and a pungently aromatic taste. Spec. gr. 0.990. Very sparingly soluble in water, but readily soluble in alcohol, ether, chloroform, carbon disulphide, benzin, and in fixed and volatile oils, and milk. When camphor is triturated, in about molecular propor- tions, with menthol, thymol, phenol, or chloral hydrate, liquefaction ensues. On exposure to the air it evaporates, and when moderately heated, it sublimes without leaving a residue. Composition.—“A stearopten is a solid erystalline substance separated from any volatile oil on long standing or at low tempera- ture.” Camphor is a stearopten and is chemically an oxidation product of a terpene (Pinene or Cymene),—the principal constituent of ali volatile oils. A terpene is a hydrocarbon containing 10 atoms CAMPHOR 491 of carbon, and the terpene (C,)H,,) from which camphor is derived is isomeric with that of oil of turpentine and many other volatile oils. Dose.—H., 3 1.-ili. (4.-12.); C., 3 ii.-iv. (8.-15.); Sh. & Sw.,. gr. xv.-5 1. (1.-4.); D., gr. ii.-xx. (.18-1.3). PREPARATIONS. Aqua Camphore. Camphor Water. (U.S. & B. P.) Triturate camphor, 8, with alcohol, 8, and purified tale, 15; then with water to make 1000. Filter. (U.S. P.) Dose.—Ad lib. Spiritus Camphore. Spirit of Camphor. (U. S. & B. P.) Dissolve camphor, 100, in alcohol, 800; filter, and add alcohol to make 1000. (U. S.) Dose.—H. & C., 3 i.-ii. (30.-60.); D., 3s.-i. (2.-4.). Linimentum Camphore. Camphor Liniment. (U. S. & B. P.) Synonym.—Camphorated oil. Camphor, 200; cottonseed oil, 800. (U.S. P.) Dose.—H. & C., 3 ss.-i. (15.-30.); D., Tx.-xv. (0.6-1.) Ceratum Camphore. Camphor Cerate. (U.S. P.) Camphor liniment, 100; white petrolatum, 150; white wax, 356; lard, 400. Tinctura Camphore Composita. (B. P.) (Paregoric.) Contains 1 part of morphine in 2000 = gr.} opium in 3i. paregoric. Dose.—D., 3 38.-i. Camphora Monobromata. Monobromated Camphor. C,,H,;BrO. (U=:S: B:) Derivation—Made by heating camphor and bromine together at a tem- perature of 172°F. (77.7°C.) and solution in benzin. C,H, O+2 Br=CyH,; Br O+H Br. Reerystallized from hot alcohol. Properties.—Colorless, prismatic needles or scales, having a mild, cam- phoraceous odor and taste; permanent in the air, unaffected by light, and neutral to litmus paper. Almost insoluble in water; freely soluble in alcohol, ether, and chloroform, hot benzin and fixed and volatile oils; slightly soluble in glycerin. Dose.—D., gr.ii.-x. (.12-.6). Action External—Camphor resembles the volatile oils chemi- eally and physiologically. It is a slight antiseptic externally, and parasiticide. The vapor of camphor kills moths, fleas, bugs, ete. Camphor is a mild irritant, producing a rubefacient action followed 499 VEGETABLE DRUGS by partial anesthesia. It is eliminated in part by the skin and oc casions some diaphoresis. Action Internal.—Alimentary Canal.—Camphor stimulates the stomach, increasing the secretion, motion and vascularity of the organ. In the bowels camphor is supposed to overcome pain, spasm, and check secretion in diarrhea, but has little effect in norntal con- - ditions and in therapeutic doses. Circulation.—The frog’s heart is stimulated by camphor, and the pulse is slowed and increased in force by moderate doses. The drug acts in part directly on the heart muscle and in part reflexly from irritation of the stomach. While animal experiments do not show that camphor has any material effect on the heart in ordinary doses yet clinical experience has proved that it does stimulate the circulation in conditions of general depression of the circulation from acute illness, in poisoning and after surgical operations. Moreover, when ingested, camphor stimulates the heart reflexly by irritation of the stomach, as in the case of alcohol. Animal experiments do show that it sometimes first stimulates and then depresses the vasomotor centres in large doses, producing a corresponding effect on blood pressure. Poisonous quantities of camphor depress the heart and the pulse becomes feeble and rapid. Leucocytosis is favored by camphor. Respiration.—Camphor does not influence the respiration ma- terially in therapeutic doses. Occasionally the respiration is made slower and deeper. Camphor, like volatile oils, stimulates the bron- chial mucous membranes in its elimination by the lungs, and in- creases the blood supply and secretion of these parts. The charac- teristic odor is imparted to the breath after the ingestion of camphor. The drug is believed to relieve spasm and cough in bronchitis. Nervous System.—Camphor is often classed as an antispas- modic. It stimulates the nerve centres in the brain, medulla, and spinal cord, and thus overcomes spasm due to nervous weakness and incodrdination. Poisonous doses depress and paralyze the higher nervous centres. Kidneys and Sexual Organs.—Camphor is oxidized in the body into camphorol (C;)9H,,0.) and eliminated in the breath and sweat, but mainly in the urine, as camphoglycuronic acid. The drug in- fluences the sexual organs, in some cases, but in most instances does not affect them. Full medicinal doses sometimes stimulate the sex- ual functions (aphrodisiac action). Very large doses are said to depress sexual desire (anaphrodisiac action), but these quantities may irritate the genito-urinary tract and produce erotic excitement. Temperature.—Camphor is a slight antipyretic. Toxicology.—Two to four ounces of camphor given to horses CAMPHOR 493 or cattle induce delirium and convulsions (cerebral stimulation) with rapid pulse and breathing, but usually recovery ensues. Two to four drachms cause, in dogs, vomiting, unsteady movements, asphyxia, coma (cerebral depression) and death from respiratory failure. Administration.—Camphor is exhibited internally in the form of the spirit, in pill or ball; and in solution in oil or milk. Uses Hxternal.—Camphor is applied in powder as a stimulant and antiseptic on indolent sores; mixed with chalk or zine oxide, as a dusting powder, in chafing or erythema, for its anesthetic proper- ties. It is employed in liniments (Lin. Saponis, Lin. Camphore), in strains, bruises, rheumatism and myalgia, as a rubefacient and local anodyne. Uses Internal.—Camphor is a valuable agent in stimulating the vital nerve centres in depression, collapse and shock and also, in less degree, the circulation. In poisoning by alcohol, opium, belladonna, etc., and post- operative shock and collapse it has the highest reputation with leading surgeons and clinicians. It should be given subcutaneously dissolved in almond, olive or cottonseed oil in the proportion of the linimentum camphorae (U. S. P.), that is 1 to 4. The oil should be first sterilized by boiling. R CHnnNNChES SG ooqs "= “Sidvcoapoo0poouOoDedO oD 3 i. Olei olive...... Hag eeGalie fy sitabeteciageval Si sle ye SoH eCos 3 iv. M. Sig. Inject as one dose subcutaneously (Horses). Inject m. xv for dogs. Repeat hourly. The effect of these injections is to produce some induration and not more than 114 drams should be injected at one point. Camphor is of benefit in exhausting acute diseases (influenza, pneumonia and canine distemper), for the same reason, and because it possesses diaphoretic and antipyretic properties. It may be combined with alcohol, spirit of nitrous ether, and ammonia com- pounds, in these affections. Respiratory disorders are improved by camphor, since it is an expectorant, diaphoretic, stimulant and antiseptic. It is prescribed in spasmodic cough, bronchitis and pharyngitis. For the latter, in electuary with belladonna. Camphor is a valuable drug in diarrhea, particularly in the serous variety, and in that form following exposure to cold. It is not useful in inflammatory conditions, but checks secretion and pain. Camphor is prescribed alone in diarrhea, or with brandy and lauda- num. 494 VEGETABLE DRUGS Camphor is sometimes given as an antispasmodic in hysteria and “thumps” (spasm of diaphragm) of horses; and in nervous pal- pitation of the heart, and chorea (monobromated camphor) of dogs. Spirit of camphor and nitrous ether are efficient in relieving irritation of the genito-urinary tract. Camphor has proven of serv- ice in purpura hemorrhagica of horses given thrice daily in pills (gr. 75). Taymor. Thymol. C,,H,,0. (U.S. & B. P.) A phenol (or stearopten, B. P.) occurring in the volatile oils of Thymus Vulgaris Linné, and in other volatile oils. Habitat.—Thymus vulgaris, Southern Europe, cultivated. Derivation.—Thymol is made from the terpenes of the volatile oils mentioned above, by fractional distillation and saponifying the result with caustic soda to remove more terpenes, and by cooling. The resulting soap, or soda-thymol compound is decomposed with hydrochloric acid, and thymol is crystallized from an alcoholic solu- tion. Properties.—Large, colorless, translucent crystals of the hexag- onal system, having an aromatic, thyme-like odor, and a pungent, aromatic taste, with a very slight caustic effect upon the lips. Its specific gravity, as a solid, is 1.030, but when liquefied by fusion it is lighter than water. It melts at 50° to 51° C. (122° to 123.8° F.), remaining liquid at considerably lower temperatures. When tri- turated with about equal quantities of camphor, menthol, or chloral, it liquefies. Soluble in about 1100 parts of water, and in less than its own weight of alcohol, ether or chloroform; also readily soluble in carbon disulphide, glacial acetic acid, and in fixed or volatile oils. Dose.—H., 3 ss.-ii. (2.-8.); Sh. (single dose), 3 ss.-ii.ss.; D., gr. i.-xv. (.06-1.). Action and Uses——Thymol resembles carbolic acid chemically and physiologically. It is less poisonous and irritant, more costly, and possesses greater antiseptic powers. It is much less valuable, however, medicinally, on account of its expense, and odor which strongly attracts flies. Poisoning is not produced readily, as absorption from the diges- tive tract is slow; but after considerable doses by the mouth, or when injected into the blood, toxic symptoms occur. One drachm given intravenously to a dog caused prostration, coma and respiratory fail- ure. Recovery ensued after the use of artificial respiration. Often no lesions are discoverable after death. At other times there is hyperemia of the lungs and kidneys caused by elimination of the GENTIAN 495 drug. The urine is colored greenish or yellowish-brown by trans- mitted light. Thymol is used externally for general antiseptic purposes, for application to ulcers, and as an injection in cystitis in aqueous satu- rated solution. It is employed in ointment with vaseline (1-15) to destroy ringworm and to relieve itching in pruritus, eczema, lichen, psoriasis, ete. It may be applied as follows for the same purposes: R UU Coo Gebooddoodoe Se deoUdsooDo OOO gr.xv. INNO Sogssonoododsob Sedo UNO oOo LON oO OK 3 il. 88 (CUMGERIN “Se oocecucansHoaboueeosoooN DONS 3 Vv ANG EtloWoln Uo Goo UG DO OBoeUOOu OD aROe OOD Oi M. An efficient antiseptic mouth wash consists of borax, gr. 40; thymol, gr. 20; water, 3 iv. It is indicated in stomatitis. Thymol internally is a powerful anthelmintic and parasiticide. It is em- ployed as an intestinal antiseptic; as a remedy for tape and round worm (uncinariasis in dogs), in goitre, and as a urinary antiseptic in cystitis. It is given in diluted alcoholic solutions; better in oil or capsules. As a vermifuge full doses (D., gr. x.-xxx.) should be preceded and followed by a purge, but not oil which acts as a solvent. SECTION X.—VEGETABLE BITTERS. Gentiana. Gentian. (U.S. P.) Synonym.—Gentiane radix, B. P.; radix gentiane rubre (vel lute vel majoris), gentian root, E.; radix gentiane, P. G.; racine de gentiane (de gentiane jaune), Fr. ; enzianwurzel, bitterwurzel, rother (gelber) enzian, G.- The root of Gentiana lutea Linné (nat. ord. Gentianez). Habitat.—The yellow gentian is indigenous in the Alps and mountains of southern and central Europe. Description.—In nearly cylindrical pieces or longitudinal slices, of variable length and from 5 to 35 Mm. thick; externally yellowish- brown, the rhizome annulate, the roots longitudinally wrinkled ; fracture short but uneven, the bark rather thick, separated from the somewhat spongy, reddish-yellow or brownish inner portion by a dark brown cambium zone; odor strong, characteristic; taste slightly sweetish, strongly and persistently bitter. 496 VEGETABLE DRUGS Constituents.—The chief one is (1) gentiopicrin (may be split into gentigenin and glucose), a bitter crystalline glucoside, soluble in aleohol and water. There is also (2) gentisic acid (C,4H190;), combined with gentiopicrin and gum, and (3) a trace of volatile oil; (4) gentigenin, a sugar. Contains no tannin. Incompatibles——lIron in solution forms a black compound with the coloring matter in gentian. Silver nitrate and lead salts are incompatible with gentian. Dose.—H., 3, ss.-i. (15.-80.); C., 5 i.-ti. (30.-60.); Sh. & Sw., 3 iii. .(4.-8.); D., gr. v.-xxx. (.3-2.). PREPARATIONS. Extractum Gentiane. Extract of Gentian. (U.S. & B. P.) Made by maceration and percolation with water, and evaporation to a pilular consistence. Dose.—About one-third that of gentian. Fluidextractum Gentiane. Fluidextract of Gentian. (U. S. P.) Made by maceration and percolation with diluted alcohol, and evaporation, so that 1 Cc.=1 Gm. of the crude drug. Dose.—Same as gentian. Tinctura Gentiane Composita. Compound Tincture of Gentian. (Us: Si &.B.-P) Gentian, 100; bitter orange peel, 40: cardamon, 10; made by maceration and percolation with alcohol and water, to 1000. (U.S. P.) Dose.—H. & C., 3i.-iv. (30.-120.); D., 3i.-iv. (4.-15.). Admunistration.—Gentian is usually given to horses, cattle and sheep in powder, or to the former in the form of the compound tincture. The extract is suitable for dogs when exhibited in pills. Gentian is often employed as an excipient in the preparation of balls. Action.—The simple bitters, as gentian, act as stomachic and bitter tonics. They are stomachics in promoting gastric digestion by stimulation of the gustatory nerves, thus improving the appetite and reflexly causing dilatation of the blood vessels in the stomach and increasing salivary and gastric secretions. Furthermore, the bitters excite gastric and intestinal peristalsis to a slight extent. The bitters only act as tonics by their local effect in facilitating the diges- tion and assimilation, and by increasing the appetite. Externally the bitters are mildly antiseptic; while internally they are inimical to intestinal parasites. Uses.—Gentian is serviceable in simple loss of appetite. It is especially indicated in feeble gastric digestion caused by acute dis- QUASSIA = 497 ease, overwork, insufficient and poor food, and in that form associ- ated with general debility and anemia. In the latter state, char- acterized by a pasty tongue, anorexia, rough coat and pallid mucous membranes, which may often be co-existent with the presence of intestinal worms, powdered gentian is most efficient when given to horses on the food three times daily with dried ferrous sulphate. Again, loss of appetite, general weakness, and feeble digestion occurring in horses during convalescence from acute diseases, as in- fluenza and pneumonia, is favorably met by a combination of com- pound tincture of gentian and whisky (1 ounce each), or by diluted hydrochloric acid and the compound tincture. The drug is useful in atonic indigestion, or mild chronic gastric or intestinal catarrh of young animals, when conjoined with sodium bicarbonate, which acts as a sedative and solvent of mucus. The simple bitters, including gentian, are contra-indicated in any acute inflammation of the digestive tract, since they are mild irritants. Gentian is a valuable bitter for cattle and sheep, but quinine is more commonly given to dogs. Quassta. Quassia. (U.S. P.) Synonym.—Quassie lignum, B. P.; quassia wood, bitter wood, bitter ash, E.; quassie, bois amer, Fr.; quaissienholz, G. Habitat.—Jamaica and West Indies. Description.—The wood of Picrasma excelsa (Swartz) Planchon (Fam. Stmarubacee), known commercially as Jamaica Quassia, or of Quassia amara Linné (Fam. Simarubacee), known commercially as Surinam Quassia. Jamaica Quassia.—Oceurring in various forms, usually in chips, raspings, or billets; yellowish-white or pale yellow, and of rather coarse texture; odor slight; taste intensely bitter; medullary rays containing tetragonal prisms or small, arrow-shaped crystals of cal- cium oxalate. Billets of Jamaica Quassia are usually 12.5 Cm. or more in diameter; in tangential section, the medullary rays are mostly 3 to 5 rows of cells in width. Surinam Quassia.—Occurring usually in billets not exceeding 7.5 Cm. in diameter; the wood is heavier, harder, and more deeply colored than that of Jamaica Quassia, and the medullary rays in tangential section are mostly 1 or 2 rows of cells in width. Constituents.—Chiefly, quassiin (Ci 9H,,0;), a bitter, neutral principle occurring in crystalline rectangular plates. There is also a volatile oil, but no tannin. Dose.—Quassiin, D., gr. %-1%3 (.008-.02). 498 VEGETABLE DRUGS PREPARATIONS. Extractum Quassie. Extract of Quassia. (U.S. & B. P.) Made by percolation with water, boiling and evaporation to pilular con- sistence. Dose.—H., 3i.-ii. (4.-8.); D., gr.ss.-iii. (.03-.18). Fluideatractum Quassie. Fluidextract of Quassia. (U.S. P.) Made by maceration and percolation with alcohol and water, and evapora- tion, so that 1 Ce.=1 Gm. of quassia. Dose.—H. & C., J i.-ii. (30.-60.); Sh. & Sw., Sii-iv. (8.-15.); D., Mxv.-51. (1.-4.). Tinctura Quassie. Tincture of Quassia. (U.S. & B. P.) Made by maceration and percolation of quassia, 200, with alcohol and water to make 1000. (U.S. P.) Dose.—Twice that of fluidextract. ° Liquor Quassie Concentratus. (B. P.) Dose.—Same as for fluidextract. Administration. Quassia may be given to horses in the official preparations,—preferably the fluidextract,—or in infusion (1-80, in cold water for half an hour, B. P.). The dose of the infusion is 3, iv. for horses, 3 ii.-iv. for dogs. Actions.—Quassia is the most active and bitter stomachic we possess. Large doses irritate the digestive tract. The drug is poi- sonous to the lower forms of animal life. One grain will kill a frog with the production of convulsions and respiratory and heart failure. A sweetened infusion is often employed to destroy flies. Consid- erable doses of quassia increase the secretion of urine, and stimulate peristaltic action and contraction of the urinary bladder. It is an antiseptic and prevents fermentation in the digestive canal. Quassia acts generally in the same manner as gentian, by sharpening the appetite, and increasing salivary and gastric secretions, together with vascularity and peristalsis of the stomach. The volatile oil assists the stomachic action. Uses.—Quassia, like gentian, is very serviceable in promoting appetite and digestion in atonic dyspepsia. It has this advantage, however, that it may be combined with liquid preparations of iron without incompatibility. Quassia is the most efficient vermicide in our possession for the destruction of Oxvuris curvula, horse; and O. vermicularis, dog, in the lower bowel. An infusion is employed for this purpose, made by soaking quassia chips in cold water (3 ii.-Oi.) for half an hour. The rectum should be first thoroughly washed CALUMBA 499 out with soap and water, and one-half pint of this infusion is given in enema to dogs; two quarts to horses. CatumBa. Calumba. (U. S. P.) Synonym.—Calumbe radix, B. P.; columbo, E.; columbo, Fr. ; kolumbowurzel, G. The root of Jateorhiza palmata (Lamarck) Miers (nat. ord. Menispermacez). Habitat—Mozambique, East Africa. Cultivated in the East Indies. Description.—In transverse, tircular or oval, biconcave sections, 2.5 to 5 Cm. in diameter and 2 to 12 Mm. thick; externally greenish- brown and roughly wrinkled; internally yellowish or grayish-yellow, with a few interrupted circles of fibrovascular bundles, distinctly radiate in the outer portion, with a dark cambium; fracture short, mealy ; odor slight; taste slightly aromatic, very bitter. Constituents.—1, calumbin (C.,H..0,), a neutral bitter, erys- talline substance; 2, an alkaloid, berberine (C.)H,;NO,), found in berberis, hydrastis, etc.; 3, calumbie acid (Cz,H,.0,); 4, starch, 33 per cent. Dose.—H. & ©., 3 ss.-i. (30.-60.); Sh. & Sw., 3 i-ii. (4.-8.) ; . QT. V.-Xxx. (.3-2.). D PREPARATIONS. Fluidextractum Calumbe. Fluidextract of Calumba. (U. S. P.) Made by maceration and percolation with alcohol and water, and evapora- tion, so that 1 Ce.—1 Gm. of the crude drug. (U. S. P.) Dose—Same as Calumba. Tinctura Calumbe@. Tincture of Calumba. (U.S. & B. P.) Made by maceration and percolation of calumba, 200, in alcohol, and water to make 1000. (U.S. P.) Dose. —H. & C., Jii.-iv. (60.-120.); D., 3i-iv. (4.-15.). Dose of tincture (B. P.) half that of U. S. P. tincture. Administration.—Calumba is given in powder on the food, or in the official preparations to the larger animals. The infusion (1-16, B. P.) may be used in the same doses as that of cascarilla. The tincture, and extract (gr. ii.-x., B. P.) are the best preparations for dogs. Actions and Uses.—Calumba is a mild but pure hitter. Ber- berine, calumbin and ealumbic acid are all bitter, but none of them 500 VEGETABLE DRUGS possess any powerful physiological action. Calumba is indicated in the same cases as gentian, but, being free from tannin, may be com- bined with iron preparations without producing an unsightly, inky mixture. It is less irritating than other bitters, and may be pre- scribed in more irritable conditions of the stomach. Calumba is frequently used during convalescence from the acute diseases and diarrhea. Taraxacum. Taraxacum. (U. 8. P.) Synonym.—Taraxici radix, B. P.; dandelion, E.; pissenlit, dent de lion, Fr.; léwenzahn, G. The dried root of Taraxacum officinale Weber (nat. ord. Com- posite), gathered in autumn. Habitat.—Naturalized in the United States and growing com- monly in waste places. Indigenous in Europe. Description.—Cylindraceous and tapering very gradually, of variable length, and 1 to 2 Cm. thick above, crowned with several short, thickish heads, usually simple or somewhat branched, the branches closely parallel; externally blackish-brown, longitudinally wrinkled; fracture short, showing a yellowish, porous central axis, surrounded by a thick, whitish bark, containing numerous milk ves- sels arranged in concentric circles ; inodorous: bitter. Constituents.—1, taraxacin, a bitter, soluble, crystalline sub- stance; 2, inulin; 3, firaxacerin (CsH,,0) ; 4, resin, causing the milky juice; 5, asparagin, of no medicinal value. Dose. ee 3i.-ii. (30.-60.); Sh. & Sw., 3 ii-iv. (8.-15.); D., 3 i-ii. (4.-8.). PREPARATIONS. Ectractum Taraxaci. Extract of Taraxacum. (U. 8S. & B. P.) Made by percolation of powdered taraxacum, 1000; with alcohol and water, 1000; and evaporation to pilular consistence. Dose.—H. & C., 3i.-iv. (4.-15.); D., gr.v.-xx. (.3-1.3.). Fluidextractum Taraxaci. Fluidextract of Taraxacum. (U.S. P.) Made by maceration and percolation with diluted alcohol, and evaporation, so that 1 cc.=1 gm. of taraxacum. Dose.—Same as taraxacum. Extractum Taraxici Liquidum. (B. P.) Dose-—Same as taraxacum. Administration.—The fresh juice squeezed from the root (sue- cus, B. P.) may be given to horses; or the official preparations may be used. HYDRASTIS 501 Action and Uses.—Taraxacum is a simple stomachiec and bitter and may be employed in place of gentian or calumba. It has been generally taught that taraxacum is an hepatic stimulant and increases the secretion of bile. This has been proved fallacious. The extract is often used as an excipient in preparing masses. Hyprastis. Hydrastis. (U.S. P.) Synonym.—Hydrastis rhizoma, B. P.; golden zeal, yellow root, yellow puccoon, orange root, Indian dye, Indian tumeric, E.; racine @hydrastis de Canada, Fr.; Canadische gelbwurzel, G. The rhizome and roots of Hydrastis canadensis Linné (nat. ord. Ranunculacez), yielding not less than 2.5 per cent. of hydrastine. Habitat.—North America in woods, west to Missouri and Ar- kansas. Description—Rhizome of oblique growth, subcylindrical, straight or somewhat tortuous, 2 to 5 Cm. long, and 3 to 6 Mm. in diameter, with short stem remnants, or stem scars, and slightly an- nulate; externally brownish-gray to yellowish-brown; fracture short, waxy, deep yellow; bark about 0.5 Mm. thick, wood wedges bright vellow, pith large, light yellow; the roots thin, brittle, with a thick vellow bark and a somewhat quadrangular wood; odor distinct; taste bitter. Constituents.—1, berberine (C2)H,;NO,), an alkaloid occurring in yellow crystals and found in many plants of the families Ber- beracess, Ranunculacese, and Menispermacer; 2, hydrastine (Co, H,,NO,), a colorless, crystalline alkaloid, soluble in alcohol and ether; 3, canadine (C.,H.,NO,), occurring in white, acicular crys- tals. ; Dose.—H. & C., 3 ii.-3 i. (8.-80.); Sh. & Sw., 3 i-ii. (4.-8.) ; D., gr. v.-3 i. (.3-4.). PREPARATIONS. Fluidectractum Hydrastis. Fluidextract of Hydrastis. (U. S. P.) Made by maceration and percolation with alcohol, glycerin and water, and evaporation. Assayed and enough menstruum added so that it will contain 2 per cent. of hydrastine. ; Dose—H..& C., 3ii.-3i. (8.-30.); Sh. & Sw., 3i-ii. (4.-8.); D., Myv.-3i. (3-4.). Extractum Hydrastis Liquidum. (B. P.) Dose.—E. & C., 3i.-iii. (4.-12.); D., Mv.-xv. (.3-1.). 502 VEGETABLE. DRUGS Tinctura Hydrastis. Tincture of Hydrastis. (U. S. & B. P.) Made by maceration and percolation of hydrastis, 200; with diluted alcohol, to 1000. Dose.—H., 5 i.-ii. (30.-60.); D., 3ss.-ii. (2.-8.). Glyceritum Hydrastis. Glycerite of Hydrastis. (U. S. P.) Made by maceration and percolation of hydrastis, 1000; add water to the percolate and evaporate. Add water to the residue, set aside 24 hours and filter; add enough water to the filtrate to make 500; then add glycerin, 500. Dose.—Same as fluid extract. Hyprastinz Hyprocuioripum. Hydrastine Hydrochloride. C.F, NO-H Cl. (0 8. P.) The hydrochloride of an artificial alkaloid derived from hydras- tine. Properties.—Light, yellow, amorphous granules, or a pale yel- low crystalline powder; odorless, and having a bitter, saline taste; deliquescent on exposure to damp air. Very soluble in cold and hot water, and in alcohol. Dose.—H., gr. i.-ti. (.06-.12) ; D., gr. Yo-% (.005-.01). Hyprastin. (Non-official). The commercial name for a mixture of variable composition, consisting chiefly of berberine, together with hydrastine, and a resin. A greenish-yellow powder, having a bitter taste. Wrongly termed hydrastine. Dose.—H., gr. xv.-xxx. (1.-2.); D., gr. iii-v. (.18-.3). Actions.—Hydrastis and its alkaloids, berberine and hydrastine, act. as simple bitters and stomachics, in small doses, by improving the appetite and stimulating the secretion, motion and vascularity of the stomach. Hydrastis causes contraction of the non-pregnant uterus, and may induce abortion in pregnant animals. It also in- creases the flow of urine. The drug is a mild anti-periodic, but is decidedly inferior to quinine in this respect. Hydrastine and berberine resemble each other in actions, uses and doses. Berberine sulphate and hydrastine hydrochloride are to be found in the market, and are used in the same doses as the pure alkaloids. Poisonous doses of hydrastine and berberine are followed by convulsions and paralysis; the former is more convulsant. Hydrastine is said pri- marily to markedly increase vascular tension. It is uncertain whether this action is due to vascular contraction or cardiac stimula- CALAMUS 5038 tion. In poisoning by. either alkaloid there is great cardiac and vasomotor depression. Uses.—Hydrastis, berberine, and hydrastine are employed in anorexia and atonic indigestion. The fluidextract of hydrastis and hydrastine (both, however, are very expensive) are especially efficient for horses in combination with other bitters and iron, as follows: BR Hiuidextry | Capsicus facvsderycr aicccisnc)teyete siete 3 ii. Fluidextr. Hydrastis. Fluidextr: INucis Vomice..........:......aa 5 Ul. M. (Furnish 3 ii. bottle) Sig. Small bottleful tid. on tongue. OR R Hydrastinz Pulv. Gentian Pulv. Nucis Vomice Merri Subphe Hxsicenirenacietsctonncpeis ere o)tt> aa 5 il. M. et div. in ch’t, no. xii. Sig. One powder on food tid. Hydrastis is exhibited empirically (probably as a local stimu- lant and antiseptic) in atonic and inflammatory conditions of the digestive organs, with great benefit, as in chronic gastro-intestinal eatarrh or catarrhal jaundice. Hydrastis is used most frequently in human medicine to stop uterine hemorrhage of all descriptions, and is often conjoined with the fluid extract of ergot for this purpose. Hydrastinine hydrochloride has been employed with great success as a hemostatic in metrorrhagia. Hydrastine is given to horses as a bitter tonic in doses of gr. ili.-v.; and to dogs in quantities of gr. 14-14. Externally, the fluidextract of hydrastis (1-8 to 1-2), or hydrastine (gr. v.-5 i.), in aqueous solution, are most serviceable as local stimulants in the treatment of the subacute stages in inflam- matory diseases of mucous membranes, and in relaxed or atonic conditions of these tissues. The solutions are applied as injections, or lotions, in leucorrhea, endometritis, balanitis, otorrhea, stomatitis, ete., and upon indolent ulcers. Catamus. Calamus. (U.S. P.) Synonym.—Sweet flag, radix acori, E.; rhizoma calami, P. G.; acore vrai, acore odorant, Fr. ; kalmuswurzel, G. The unpeeled, dried rhizome of Acorus Calamus Linné (nat. ord. Aroidez. ) ~ 504 VEGETABLE DRUGS Description.—Rhizome 1 to 2 Cm. thick, usually in longitudi- nally split pieces of various lengths; when entire, cylindraceous and somewhat vertically flattened, externally reddish-brown, somewhat annulate from remnants of leaf-sheaths; upper surface with triangu- lar leaf-sears, the lower surface with circular pitted scars of roots; fracture short, showing numerous oil-cells and scattered fibrovascular bundles, the latter crowded within the endodermis; odor aromatic; taste pungent and bitter. Constituents.—1, acorin (C3g,H,¢ O,), a liquid, yellow glucoside having a bitter taste; 2, a volatile oil, 1-2 per cent.; 3, calamine; 4, choline. Dose.—H. & C., 3 i.-ii. (30.-60.); Sh. & Sw., 3 i-iii. (4.-12.) ; D., gr. xv.-3 i. (1.-4.). PREPARATION. Fluidertractum Calami. Fluidextract of Calamus. (U. S. P.) Made by maceration, percolation and evaporation, so that 1 Ce.=1 Gm. of the crude drug. Dose.—H. & C., 5i.-ii. (30.-60.); Sh. & Sw., 3i-iii, (4.-12.); D., Mxv.-3i. (1.-4.). The powdered root may be given on the food to the larger animals; the fluidextract, or an infusion (1-16), may be exhibited to any patients. Action and Uses.—Calamus is a mild aromatic bitter. and is therefore useful in anorexia and indigestion associated with mild forms of flatulence. The powdered root is employed as an excipient in powders, balls and electuaries. It is innocuous, and the dose is therefore unimportant. SECTION XI.—VEGETABLE CATHARTICS. Class 1—Simple Purgatives. Ator. Aloes. (U.S. P.) (ALor Barsapensis, ALor Socotrina, PHarm. 1890.) The inspissated juice of the leaves of Aloe vera (Linné) Webb, Aloe Chinensis Baker, Aloe Perryi Baker, or other species of Aloe (Fam. Ltliacee). . Properties.—In yellowish-brown or orange-brown to blackish- BARBADOES ALOES 505 brown opaque masses; translucent in thin fragments; fracture un- even, dull and waxy, somewhat resinous, or smooth and glassy, some- what conchoidal; occasionally exhibiting microscopic crystals of aloin; odor characteristic; taste nauseous, bitter. Atop Barpapensis. Barbadoes Aloes. (B. P.) Synonym.—Curacoa aloes, E.; aloés des Barbades, Fr.; Barba- dos-aloe, G. The inspissated juice of the leaves of Aloe vera (Linné) Webb (nat. ord. Liliacez). Habitat.—The island of Barbadoes. Properties.—In hard masses, orange-brown, opaque, translucent on the edges; fracture waxy or resinous, somewhat conchoidal; odor saffron-like ; taste strongly bitter. Almost entirely soluble in alcohol. Aztor Socorrina. Socotrine Aloes. (B. P.) Synonym.—Aloe succotrina, aloés sucotrin, s. socotrin, F'.; socotora s. socotrinische aloe, G. The inspissated juice of the leaves of Aloe Perryi Baker (nat. ord. Liliacez). Habitat.—Eastern Africa. Properties.—In hard masses, occasionally soft in the interior; opaque, yellowish-brown, orange-brown, or dark ruby-red, not green- ish, translucent on the edges; fracture resinous, somewhat conchoidal. When breathed upon, it emits a fragrant saffron-like odor; taste pe- culiar, strongly bitter. Almost entirely soluble in alcohol and in 4 parts of boiling water. The aqueous solution becomes turbid on cooling and yields a deposit. The color of socotrine aloes is lighter, and it is less opaque than Barbadoes aloes. The powdered socotrine aloes is brighter and red- der, and the odor less disagreeable than that of Barbados aloes. Ator Caprmnsis. Cape Aloes. (Non-official.) Synonym.—Aloés der Cap, Fr. Habitat.—Afriea. Properties.—Occurs in dark-brown or olive-green resinous _ masses; fracture conchoidal; odor strong, sour and disagreeable. Yields a gamoge-yellow powder. Solubility same as socotrine aloes. Product of several varieties of aloes obtained from Cape Town and Natal. 506 VEGETABLE DRUGS Dose of Aloes.—H., 3 ss.-i. (15.-30.) ; C., 3 i.-ii. (30.-60.) ; Sh., 3, ss.-i. (15.-30.) ; Sw., 3 it-iv. (8.-15.); D., gr. xx.-3 i. (1.3-4.). Constituents.—1, aloin; 2, a resin; 3, a volatile oil, giving the odor; 4, a trace of gallic acid. Atomum. Aloin. (U.S. &B.P.) Synonym.—Aloine, Fr. A neutral principle obtained from several varieties of aloes, chiefly from Curacoa aloes and Barbadoes aloes (yielding Barbaloin), and Socotra or Zanzibar aloes (yielding Socaloin), differing more or less in chemical composition and physical properties according to the source from which it is derived. Derivation.—Obtained by pulverizing and macerating Barba- does aloes in cold water, and evaporating the resulting solution in vacuo. Aloin crystallizes out and is dried between folds of bibulous paper. It is purified by repeated solution in hot water, filtration, recrystallization, and finally by solution in hot alcohol and erystalliza- tion. Nataloin is derived from Cape aloes. Properties.—A micro-crystalline powder or minute acicular crystals, lemon yellow to dark yellow in color, possessing a slight odor of aloes and an intensely bitter taste. It is slightly hygyro- scopic. Aloes from Curagoa aloes is soluble in about 65 parts of water and 10.75 parts of alcohol. Barbaloin and socaloin are soluble in about 60 parts of cold water. Barbaloin is soluble in 20 parts of aleohol. Socaloin in 30 parts of absolute alcohol. Dose. & ©.,:3 tie-ttiv (8--12:).3: D., greiiiacx: (12-13); in combination with other purgatives. PREPARATIONS OF ALOES. The official preparations are numerous, but most are not applicable to veterinary practice. Tinctura Aloés et Myrrhe. Tincture of Aloes and Myrrh. (Ui:8.;P:) Synonym.—“Elixis pro,” elixir proprietas Paracelsi, E. Made by maceration and percolation of purified aloes, 100; myrrh, 100; and liquorice root, 109; with alcohol and water to make 1000. Pilule Laxative Composite, U. S. P. Aloin 1.3 gm.; strychnine, 0.05 gm.; _extr. belladonna leaves, 0.8 gm.; ipecac, 0.4 gm.; glycyrrhiza. 4.6 gm.: syrup q. s. to make 100 pills. Dogs. Dose, 1 to 2 pills. Action External.—Aloes is a slight stimulant to raw surfaces. Tt is absorbed from the denuded skin and thus may occasion purging. ALOIN 507 Action Internal.—Alimentary Canal.—Aloes is first of all a purgative. In addition to this it is a bitter, and therefore small doses excite salivary and gastric secretion, together with the move- ments and vascularity of the stomach, and appetite. The activity of aloes in the bowels is due largely to the solvent action of bile upon it. Aloes is absorbed from the digestive tract and is eliminated by the bowels, kidneys and mammary glands. It may be excreted in sufficient quantity in the milk to create looseness of the bowels in nursing animals. Aloes stimulates peristalsis of the large intestines, but does not notably increase the secretions of the bowels. Moreover, its action is very slow (12-24 hours). This probably happens because the drug does not act till it reaches the large intestines, locally, or through elimination. Aloes is preéminently the best purgative for horses, but does not operate so well on the other domestic animals. Epsom salts, glauber salts or linseed oil are preferable for cattle; linseed oil or earron oil for foals and calves; and castor oil or calomel for dogs. In chronic constipation in dogs cascara sagrada, phenolph- thalein and aloes are, however, effective (see below). A full dose of aloes often creates some general disturbances in horses, including nausea, slight colic, diuresis, elevation of temperature (1°-2° F.) and pulse, with purging lasting from 2 or 3 to 24 hours. Aloes also pos- sesses anthelmintic properties because of its bitter qualities and pur- gative action. Socotrine aloes may be used in the official prepara- tions, but Barbadoes aloes finds most favor in veterinary medicine, and is probably the stronger of the two. Cape aloes is a little in- ferior to the other varieties and is more apt to produce diuresis. Aloes and aloin lead to catharsis, whether injected under the skin, into the blood, or applied on raw surfaces. Administration by the mouth is more effective. Aloin appears to contain the active princi- ples of aloes, and is usually as operative, but some manufactures are ineffective. Kidneys and Sexual Organs.—Aloes causes reflex, or sympa- thetic irritation of the female pelvic organs in its operation on the lower bowel; is an emmenagogue, and may prove abortifacient. The drug sometimes excites diuresis. Administration.—Aloes is given to horses in semi-solution after being rubbed up with hot (115°-120° F.) water; or in ball. The patient should, if possible, be previously prepared by a diet of bran mashes and salt only, for 2 or 8 feedings before exhibition of the purge. An effective aloes ball is made by melting and mixing Bar- badoes aloes (1 lb.) with glycerin and molasses (each 3 ii.), and powdered ginger root (3 i.), on a water bath. When the mass is properly mixed it is removed from the fire and aleohol (3 v.) is 508 VEGETABLE DRUGS added. The mass is poured on a layer of flaxseed meal to cool, and then is weighed into portions of 3 1014 each. These are rolled into balls, covered with tissue paper, and preserved in tight tin or glass vessels. Horses should not be worked after receiving aloes balls, but should be given a little walking exercise 12 hours after the adminis- tration of the dose. Colic and superpurgation may follow if the dose is repeated within 48 hours, or if large quantities of cold water are allowed during the action of the cathartic. If aloes does not operate satisfactorily, it is safer to give linseed oil by the mouth and rectal injections, than to administer a second dose of aloes. Uses External.—The tincture of aloes and myrrh is sometimes applied as a stimulant to wounds, and powdered aloes is mixed with plaster of Paris in making splints for dogs, to prevent these animals from biting and tearing them off. Uses Internal.—Aloes is employed in the treatment of the horse, whenever an active purge is desirable, with the following exceptions: It must not be used in acute diseases of the respiratory tract lest metastasis occur, and the inflammation attack the bowels. Neither in acute inflammation of the alimentary canal nor the kidneys is it desirable; nor in intestinal obstruction or impaction of the colon. In the first two named conditions, aloes is too irritating to the organs implicated; in the two last, the drug may aggravate the trouble by the production of impotent peristaltic movements. Pregnancy con- tra-indicates the use of aloes, lest abortion ensue. The therapeutic scope of aloes being large, it is impossible to enumerate all the dis- eases in which it is useful. Perhaps this cathartic is more com- monly serviceable in indigestion and spasmodic or flatulent colic. In acute inflammatory diseases of the brain and cord aloes is often combined with calomel (3 i.) in ball to enhance the effect. The administration of an aloes ball is followed by that of small doses of Epsom salts (3 iv.) in the drinking water in the treatment of hemo- globinemia of horses, or in conditions when we wish to assist the depleting action of aloes. Turpentine is followed by aloes, or aloes is given prior to a course of iron sulphate and gentian, for the de- struction of round-worms in horses. A laxative ball may be com- posed of aloes (3 ii-iv.), ginger and powdered nux vomica (each 4 ii.), mixed with glycerin or molasses. It is often taught that aloes is contraindicated in hemorrhoids, but this teaching does not obtain unless the piles are inflamed. In piles, associated with an atonic condition, aloes may be beneficial by improving the tone of the bowels. The U. S. P. compound laxative pills is one of the best laxatives in chronic constipation of dogs and cats. Each pill contains “420 gr. of strychnine. Aloes may be use- ful in jaundice due to constipation, but in general it is inferior to LINSEED OIL 509 salines, calomel and podophyllin in the treatment of this disorder. According to Brunton, the presence of bile in the intestines is es- sential for the action of aloes. Therefore the absence of bile in the bowels would forbid the use of aloes as a purgative. Laxative doses of aloes are valuable in amenorrhea, or absence of estrum, about the time that “heat” should occur, in combination with iron. Quxum Linz. Linseed Oil. (U.S. & B. P.) Synonym.—Oil of flaxseed, E.; huile de lin, Fr.; leinél, leinsa- mendol, G. . A fixed oil expressed from linsced without the use of heat. Properties.—A_ yellowish or yellow, oily liquid, having a slight, peculiar odor and bland taste. When exposed to the air it gradually thickens and acquires a strong odor and taste; and if spread in a thin layer on a glass plate and allowed to stand in a warm place, it is gradually converted into a hard, transparent, resin-like mass (absence of non-drying oils). Spec. gr. 0.925 to 0.935 at 77° F. Soluble in about 10 parts of absolute alcohol, and in all proportions in ether, chloroform, ben- zin, carbon disulphide, or oil of turpentine. Constituents.—1, linolein; 2, myristin; 3, palmitin; 4, albumin, which gives the oil its drying qualities. Dose.—H., Oss.-i. (250.-500.). Mild laxative, on bran mash. C., Oi.-ii. (500.-1000.) ; Sh. & Sw., 3 vi.-xii. (180.-360.); D. & C., % ss.-li. (15.-60.) Action and Uses.—Linseed oil exerts a laxative, or mild purga- tive effect by its mechanical action in lubricating the bowels and their contents. It is suitable for horses when a derivative or de- pleting action is not desirable, as in fecal impaction or overloaded bowels in weak animals, and. in those suffering from inflammatory diseases of the respiratory tract or digestive organs; diarrhea, dys- entery, and in pregnancy. Aloes, on the other hand, would be con- traindicated in these conditions. Carron oil (linseed oil and lime water, equal parts), is particularly appropriate as a remedy for “heaves” in horses (3 il.-iv.), and is one of the best cathartics for foals, lambs and calves (3 ii-iv.). The laxative and antacid properties of this preparation tend to combat intestinal fermentation which is so common in young animals with digestive disorders and diarrhea. The same qualities of carron oil prevent flatulence and interference with the already impeded breathing in “heaves” of horses. Linseed oil is frequently given to ruminants, although Epsom salts is generally the best purge for them. It is indicated for these div VEGETABLE DRUGS animals when.a milder operation than that obtained by a full dose of salts is required, and for its demulcent action in irritable states of the digestive organs. J.inseed oil, combined with salts, is useful in impaction of the rumen and omasum in cattle. By combining linseed oil with croton oil we procure a potent purge for cattle. Castor oil or sweet oil are usually preferable to linseed oil in the treatment of dogs. Soap suds enemata are made more effective by the addition of 1 or 2 pints of linseed oi] (for horses), and 1 or 2 ounces (for dogs). The oil may be given in its pure state, but more uncommonly is prescribed with gruel, glycerin, mucilage, or molasses. One ounce each of linseed oil and molasses may be given to the larger animals; or one drachm of either to the smaller animals, as an expectorant in bronchitis. The mixture is often a most serviceable one and prob- ably acts by improving the nutrition of the bronchial mucous mem- brane. Linseed oi] and sweet oil resemble cod liver oil in this respect, and while both are probably inferior to the latter, as expec- torants, they are more palatable and cheaper. Oteum Ricinr. Castor Oil. (U.S. & B. P.) Synonym.—Oleum palme christi, huile de ricin, Fr.; ricinu- sol, G. A fixed oil expressed from the seed of Ricinus communis Linné (nat. ord. Euphorbiacee). Habitat.—India. Cultivated in many countries. Properties.—A pale, yellowish and almost odorless, transparent, viscid fluid, having a bland, afterwards slightly acrid, and generally offensive taste. Spec. gr. 0.945 to 0.965 at 77° F. Soluble in equal volumes of alcohol, and in all proportions in absolute alcohol, or in glacial acetic acid; also soluble in three times its volume of 92.5 per cent. aleohol (absence of more than about 5 per cent. of most other fixed oils). Constituents.—1, ricinolein, or ricinoleie acid glyceride, C,H; (C,sH3,03)33 2, an acrid principle; 3, palmitin, stearin and myris- tin; 4, possibly a non-purgative alkaloid, ricinine. Dose.—H. & C., Oi. (500.); Sh. & Sw., 3 ii.-iv. (60.-120.) ; D. & Cats, 3 i.-i1. (30.-60.) ; poultry, 3 1. (4.). Castor Oil Seeds.—These are not official. The name Ricinus is applied to the plant because of the resemblance of the seed to a ricinus, or tick. The seeds are of a shiny, gray color, marked with brownish spots and streaks. They are about the size of small beans (17 Mm. & 8 Mm.), ovoid, flattened, and white inside. They con- tain 50 per cent. of oil, and an acrid, poisonous substance, a toxalbu- CASCARA SAGRADA alot min, ricin. ‘Three seeds have caused death in man, and they are ten times more purgative. than the oil. Action and Uses.—Castor oil closely resembles olive oil save that when saponified ricinoleic, instead of oleic, acid is formed. In the intestines the ricinoleic acid is further changed to ricinoleates which are irritant and therefore cause purgation. Much of the castor oil is absorbed like other oils and in China castor oil is even used for _food. Castor oil is mild, but has a more decided purgative action than linseed oil and often occasions griping. It acts within 4 or 5 hours and will purge when absorbed from the skin or rectum. Castor oil is specially applicable in canine practice, to unload the bowels, and in irritated conditions of the digestive tract. It is useful in con- stipation only as an occasional remedy, since it is followed by greater tendency to this condition. It is generally used as an occasional remedy in constipation but small doses are sometimes given daily in chronic constipation. It is also indicated in overloaded bowels, in- digestion, diarrhea, and pregnancy; after the ingestion of foreign or putrid matters; and to assist the action of anthelmintics. Castor oil is inferior to linseed oil for horses, as a simple laxative, because it is more prone to cause colicky pains, and because it is more expensive. Castor oil is thought to be notably useful in irritation and inflam- mation of the intestines in these animals, however, as in diarrhea, dysentery, and enteritis; and can be combined with anodynes and antispasmodies to prevent griping. Two or three ounces of castor oil are suitable for calves or foals with gastro-intestinal disorders. One or two teaspoonfuls are suitable for poultry. Administration.—Castor oil is given to dogs with syrupus rhamni cathartici in the proportion of 1 ounce of the former to 1 drachm of the latter; or with glycerin (equal parts) and a few drops of oil of wintergreen. It is administered to puppies (3 1.-11.) with an equal volume of sweet oil. Castor oil may be exhibited to horses with oil of peppermint (Mxx.); or in digestive irritation, in warm cooked flour gruel with laudanum (3 ss.) and fluidextract bella- donna (3 i.) ; to foals and calves with mucilage or gruel and 5 drops of oil of peppermint. Ruamnus Pursuiana. (U.S. P.) Cascara Sagrada. (B. P.) Synonym.—California buckthorn, sacred bark, chittem bark. The bark of Rhamnus Purshiana de Candolle (nat. ord. Rham- nace). Collected at least one year before being used. Habitat.—United States from northern Idaho west to Pacific Ocean. Description.—In quills or curved pieces, of variable length and 512 VEGETABLE DRUGS “1 to 5 Mm. thick; outer surface reddish-brown, frequently more or less covered with grayish or whitish lichens, several of which are peculiar to this bark, and with small groups of their brownish fruit- heads; inner surface yellowish to light brownish, becoming dark brown with age and reddened by alkalies, longitudinally striate; fracture short, with projections of bast fibres in the inner bark, and the medullary rays forming converging groups; odor distinct; taste bitter and slightly acrid. Constituents.—1, three resins; 2, a neutral body; 3, a volatile oil; 4, malic and tannic acids. Dose.—D., gr. v.-xxx. (.3-2.). PREPARATIONS. Fluidextractum Rhamni Purshiane. Fluidextract of Rhamnus Purshiana. Made by maceration and percolation with diluted alcohol, and evaporation, so that 1 cc.—1 gm. of the crude drug. (U. S. P.) Dose.—D., Mv.-xxx. (.3-2.). Fluidestractum Rhamni Purshiane Aromaticum. (U. S. P.) ' Dose.—TV.-xxx. Extractum Cascare Sagrade Liquidum. (B. P.) Dose.—D., Tiv.-xxx. (.3-2.). Extractum Cascare Sagrade. (B. P.) Dose.—D., gY.ii.-viiil. (.12-.5). Syrupus Cascare Sagrade Aromaticus. (B. P.) Dose.—D., 3ss.-ii. (2.-8.). Franeuta. Frangula. (U.S. P.) Synonym.—Rhamni frangule cortex, B. P.; buckthorn, alder buckthorn, black alder, E.; bourdaine, bourgéne, Fr. ; faulbaumrinde, G.; cortex frangule, P. G. The dried bark of Rhamnus Frangula Linné (nat. ord. Rham- nee), collected at least one year before being used. Habitat.—Europe and northern Asia. Description.—In quills of variable length, frequently flattened or crushed; bark 0.3 to 1 Mm. thick, externally grayish-brown to purplish-black, with numerous lenticels and occasional patches of foliaceous lichens; inner surface smooth, minutely striated, brown- ish-yellow to deep brown; fracture short and of a purplish tint in the outer layer, fibrous and pale yellow in the inner layer; odor PHENOLPHTHALIEN 513 distinct ; taste somewhat aromatic, sweetish, and bitter; when chewed, imparting to the saliva a yellow color. Constituents.—1, a glucoside, frangulin (Cy9H. 9019), converted in time into (2) emodin (C,;H,,)O;), a glucoside, to which the drug owes its purgative action. Frangulin also yields emodin, a constitu- ent of rhubarb as well, and rhamnose (C,H,,0;), by hydrolysis. Dose.—D., 3 ss.-i. (2.-4.). PREPARATIONS. Fluidextractum Frangule. Fluid extract of Frangula. (U. S. P.) Made by maceration and percolation with alcohol and water, and evapora- tion, so that lce. of the preparation—1 gm. of the crude drug. Dose.—D., 3ss.-i. (2.-4.). Actions and Uses.—The buckthorns are laxatives in the doses employed in medicine. The fresh bark of R. frangula produces vio- lent gastroenteritis (frangulin), and the same effect is produced by the bark of caseara sagrada, so that both should be kept a year before using. Frangula is rarely employed, but Cascara sagrada is one of the best purgatives for chronic constipation in dogs. The dose does not require to be increased on repetition. On the contrary, the tone of the bowels is improved by the drug. It has a very bitter taste and is apt to cause griping so that cascara is commonly given with aromatics. Fluidextractum Rhamni Purshianze Aromaticum (U. 8. P.), Syrupus Cascaree Sagradz Aromaticus, are the best prepara- tions. A solid and fluidextract are also official (U. S. & B. P.). The aromatic syrup of cascara sagrada may be prescribed to advan- tage with an ounce or two of castor oil, as an occasional purgative for dogs. A syrup of purging buckthorn (Rhamnus catharticus) is also occasionally given dogs and eats with castor oil. D., 3 1.-11.; Cats, 3 ss.-1. PHENOLPHTHALIEN, Cy 9H, 404. Is made from phenol, phthalic anhydride and sulphuric acid by the action of heat. It occurs in white, yellowish or grayish-white amorphous or crystalline powder. It is tasteless and odorless, and soluble in 600 parts of water, in 10 parts of alcohol, and in solutions of hydroxides and carbonates. Its solutions in acids are colorless but with alkalies turn red. It is used in chemistry as an indicator of acidity or alkalinity. It does not apparently have any other physiological effect than that of a purgative and is especially indi- 514 VEGETABLE DRUGS cated in habitual constipation. It does not cause griping, and pro- duces no bad effect on the system even when used over long periods of time. It is sometimes prescribed with aloes. Phenolphthalein is eliminated chiefly by the intestines. Dose.—H.., 3 1.-3 iss. (4.-6.) ; dogs, gr. ii.-x. (0.12-0.6) ; puppies and eats, gr. ss.-il. (0.03-0.12). Phenolphthalein may be given to horses with food. To dogs and cats it is given in capsule, or tablets with chocolate (Thaletts, Mul- ford), or in pill with aloes, strychnine, belladonna and cascara (Phenalos, Mulford). Rurvum. Rhubarb. (U.S. P.) Synonym.—Rhei radix, B. P.; rhubarbe, Fr.; rhubarber, G. The dried rhizome of Rheum officinale Baillon, Rheum pal- matum Linné, and the var. tanguticwum Maximowicz (Fam. Poly- gonaceew), or probably other species of Rhewm, grown in China and Thibet, and deprived of most of the bark and carefully dried. Description.—Subcylindrical, barrel-shaped, conical, plano-con- vex or irregularly formed pieces, frequently with a large perforation ; hard and moderately heavy; 5 to 15 Cm. long, 4 to 8 Cm. in diam- eter; externally mottled with alternating strie of light brown paren- chyma cells and dark brown medullary rays, occasionally with red- dish-brown cork patches and small, radiate scars of fibrovascular tissue, smooth and sometimes covered with a bright brownish-yellow powder; fracture somewhat granular, presenting a peculiar marbled appearance ; odor characteristic; taste bitter, astringent; gritty when chewed. Powder bright orange-yellow, becoming red with alkalies, con- taining rosette-shaped crystals of calcium oxalate which are from 0.050 to 0.100 Mm. in diameter, and spherical starch grains from 0.005 to 0.020 Mm. in diameter, either single or 2- to 4- compound. Constituents —1, the purgative principle which gives the yellow color, a glucoside, chrysarobin (Cz;H2 01,4), yields 2-3 per cent. of chrysophanic acid (C,;H,)0,), also called rhein or chrysophan; 2, rheotannic acid (C.,H»,0,), which gives astringency to rhubarb; 3, calcium oxalate (35 per cent.), causing grittiness; 4, resinous bod- ies: pheoretin, emodin, aporetin and erythroretin. Chrysophanic acid and the resins are somewhat purgative, but the exact purgative principles have yet to be discovered. ; Dose.—Stomachic—H. & C., 3 i-ii. (80.-60.); Sh., 3 i. (4); D. & Cats, gr. v.-x. (.3-.6). Mild Purgative-—Foals and calves, 3 i.-ti. (4.-8.); D., 3 1.-11. (4.-8.). Fowl, gr. v.-vii. in pill. RHUBARB 515 PREPARATIONS. Fluidextractum Rhei. Fluidextract of Rhubarb. (UsS2-2:) Made by maceration and percolation with alcohol and water, and evapora- tion, so that 1 Cc.—=1 Gm. of the crude drug. Dose.—Same as that of rhubarb. Pulvis Rhei Compositus. Compound Powder of Rhubarb. (US: &7 BP.) Synonym.—Gregory’s powder. Rhubarb, 25; magnesia, 65; ginger, 10. Dose.—Foals and Calves, 3ss.-i. (15.-30.). Extractum Rhei. Extract of Rhubarb. (U.S. & B. P.) Dose.—D., gr.v.-x. (.3-.6). There are many other official preparations, but they possess no value in veterinary medicine. Action Internal.—Alimentary Canal.—Rhubarb is a bitter, and therefore in small doses improves digestion in all animals by increas- ing the flow of salivary and gastric juices, and by stimulating the appetite, vascularity, and movements of the stomach. It is called a stomachic and bitter tonic. Larger doses cause mild purgation in the ease of dogs and eats, but horses and cattle are but slightly affected in this way. The activity of rhubarb is partly due to the solvent action of bile. It is commonly described as an agent which stimu- lates peristaltic action, but it is not certainly known how purging is brought about. Secondary constipation is more apt to follow the use of rhubarb than other drugs, because of rheotannic acid. This substance may be absorbed and eliminated into the bowels after the occurrence of purgation. Rhubarb, by virtue of chrysophanic acid, stains the feces, urine, milk and sweat yellow in its excretion. Uses.—Rhubarb is an efficient laxative remedy for the treat- ment of indigestion in young animals associated with diarrhea. In this condition it sweeps out the source of irritation and then exerts an astringent effect. The drug often acts most favorably with an antacid in the disorders noted. Gregory’s powder is useful in the eare of foals, calves and lambs with diarrhea. The fluidextract may be given to dogs, but rhubarb is not so generally useful a purga- tive for these animals as castor oil, calomel, cascara sagrada, phenolph- thalein, or compound laxative pills. Rhubarb has been recommended when a laxative is desirable, in cases of hemorrhoids, to improve local tone, and also as a purgative in diarrhea of young animals due to worms. 516 VEGETABLE DRUGS One or two drops of the tincture of rhubarb in the drinking water form a serviceable laxative for small birds. Curysaropinum. Chrysarobin. (U. S. & B. P.) Synonym.—Goa powder, araroba powder. A neutral principle, extracted from Goa Powder, a substance found deposited in the wood of Vouacapoua Araroba (Aguiar) Druce (nat. ord. Leguminose). Habitat.—Brazil. Properties—A pale orange-yellow, microcrystalline powder, odorless and tasteless; turning brownish-yellow on exposure to the air. Very slightly soluble in cold water or alcohol. Soluble in so- lutions of alkalies. Constituents.—Chiefly chrysarobin (Cy;H390,4)—also called rhein and chrysophan,—an orange-yellow, crystalline glucoside, some- what soluble in alcohol and ether; freely soluble in chloroform and benzol. It is oxidized into chrysophanic acid (C,,H,,)0,), and glu- cose. PREPARATION. Unguentum Chrysarobini. Chrysarobin Ointment. (U.S. & B. P.) Chrysarobin, 6; benzoinated lard, 95. (U. 8.) Action and Uses.—Chrysarobin is a powerful irritant to the skin and destroys parasites. It stains the skin and other materials dark brown. This may be removed, unless. fixed by an alkali, with a weak solution of chlorinated lime or caustic soda. Chrysarobin is also a strong irritant in the gastro-intestinal tract, causing vomiting and purging in carnivora. It is eliminated by the kidneys, coloring the urine yellow. Chrysarobin is used as a parasiticide in the treatment of ring- worm, and as a stimulant to the skin in chronic cutaneous disorders, as eczema (with much itching and scaling), and in alopecia areata. The official 5 per cent. ointment should be diluted 2 or 3 times for delicate skins. It should be applied over a large area with care, but is one of the most efficient remedies in obstinate diseases of the skin. Senwa. Senna. Synonym.—Senna Alexandrina, senna Indica, B. P.; senna leaves, folia senne, E.; feuilles de séné, Fr.; sennesblatter, G. The dried leaflets of Cassia acutifolia Delile (Alexandria Sen- SENNA 517 na), and of Cassia augustifolia Vahl (India Senna) ; nat. ord. Legu- minose ). Description.—Alexandria Senna.—Leaflets about 25 m. long and 10 Mm. broad, having extremely short, stout petioles; inequilater- ally lanceolate or lance-ovate, acutely cuspidate, entire, subcoriaceous, brittle, pale green or grayish-green, sparsely and obscurely hairy, es- pecially beneath, the hairs appressed, 1-celled, and thick-walled; odor characteristic; taste somewhat mucilaginous and bitterish. India Senna.—Leaflets 25 to 50 Mm. long, 10 to 15 Mm. broad, inequilaterally lanceolate, entire, thin, more abruptly pointed than those of Alexandria Senna, yellowish-green, and smooth above, paler beneath ; in odor and taste closely resembling Alexandria Senna. Senna should be free from stalks, and from Argel leaves, which are sometimes present in Alexandria Senna, and- which are equi- lateral, 1-veined, thick, wrinkled, glaucous, and possess 3-celled hairs. Habitat.—Alexandria Senna.—Upper Egypt, Nubia, and Cen- tral Africa. . Indian Senna, or Tinnivelly Senna.—Eastern Africa to India. Constituents.—1, the purgative properties are chiefly due to magnesium and calcium cathartates; salts of cathartic acid (Cis TH 52Ng2SO.), a black, amorphous sulphurated glucoside; 2, two glu- cosides, sennacrol and sennapicrin, insoluble in water ; 3, chrysophanic acid; 4, cathartomannit (C.,H,4,0,,), an unfermentable sugar. Dose.—H. & C., 3 iv.-v. (120.-150.); Sh. & Sw., 3 i-ii. (30.- 60.); D. & C., 3 i.-iv. (4.-15.) ; fowl, gr. xv.-xx. in pills. PREPARATIONS. Fluidectractum Senne. Fluidextract of Senna. (U. S. P.) Made by maceration and percolation with diluted alcohol, and evaporation, so that 1 Ce. =1 Gm. of the crude drug. Dose.—Same as senna. Pulvis Glycyrrhize Compositus. Compound Powder of Glycyrrhiza. (U.-S:& B.-P:) Synonym.—Compound liquorice -powder. Senna, 180; glycyrrhiza, 236; washed sulphur, 80; oil of fennel, 4; sugar, _ 500. Dose.—D., 3ss.-ii. (2.-8.). Syrupus Senne. (U.S. & B. P.) Dose.—D., 3i.-iv. (4.-15.). Action Internal.—Senna stimulates and increases the vascularity of the intestinal mucous membrane, and causes increased peristalsis 518 VEGETABLE DRUGS of the large intestines, particularly of the colon. It produces copious pale-yellow and watery evacuations. .The drug has a nauseous taste and purging is accompanied by some griping and flatulence. Senna acts more satisfactorily when combined with other purgative agents. It is absorbed and will occasion catharsis in sucklings after admin- istration to their mothers, and after intravenous injection. The urine may be colored red or yellow by its elimination. It is ex- tremely doubtful if senna exerts any influence on biliary secretion. Uses.—Senna is but rarely employed in veterinary medicine. It may be used where a simple, vigorous cathartic is indicated in constipation, or in cases of slight fecal accumulation. The drug acts more effectively when given in conjunction with salts. The fluidextract, or an infusion made by pouring boiling water over the leaves and allowing them to macerate until the water becomes cold, are added to solutions of magnesium sulphate. This combination is more suitable for cattle or sheep. The syrup or com- pound liquorice powder may be given to dogs as simple purgatives in occasional or habitual constipation. Class 2.—Drastic Purgatives. Otzeum Tier. Croton Oil. (U.S. P.) Synonym.—Oleum crotonis, B. P.; huile de croton, huile de graines de tilly, Fr.; crotondél, G. A fixed oil expressed from the seed of Croton Tiglinm Linné (nat. ord. Euphorbiacez). Habitat.—India, Indian Archipelago, and Philippine Islands. Also cultivated. Properties.—A pale yellow or brownish-yellow, somewhat viscid, and somewhat fluorescent liquid, having a slight fatty odor, and a mild, oily, afterwards burning and acrid taste (great caution is necessary in tasting). Spec. gr. 0.935 to 0.950 at 77° F. When fresh it is soluble in about 60 parts of alcohol, the solubility increas- ing by age. It is freely soluble in ether, chloroform, carbon disul-_ phide, and in fixed and volatile oils. Constituents.—1, crotonoleic acid, the purgative principle. A slight amount is free in the oil but it is mostly formed in the bowels. Tt resembles ricinoleie acid in its chemistry; 2, erotonol (C;,H.,0,), a non-purgative body causing irritation of the skin; 3, tiglinic acid (C,;H,O,), and many volatile acids existing as glycerides and ac- counting for the odor of croton oil; 4, free and combined fatty acids. CROTON OIL 519 Dose.—H., xv.-xxx.(1.-2.); C., 3 ssi. (2.-4.); Sh. & Sw., iMsv-2x.) (3-46); DD. Mss... (08-18) .0 5 Croton seeds resemble castor seeds in size, but are not mottled or shiny. They are 13 Mm. long by 8 Mm. wide; oval in shape; white within, and possessing a mild, mucilaginous taste at first, but soon becoming hot and sharp. They contain from 50 to 60 per cent. of croton oil and a toxalbumin, crotin, which is, however, less poison- ous than the toxalbumin of castor oil seeds, Ricin. Action External.—Croton oil is a most powerful irritant, caus- ing pain, redness and swelling of the skin, soon followed by vesicles and pustules. Permanent destruction of the hair follicles succeeds with loss of hair and cicatrices. When applied to the skin, injected into the blood or under the skin, it is eliminated to some extent by the bowels, producing purging; and sometimes by the kidneys, creat- ing diuresis, irritation of these organs and strangury. Action Internal.—The acrid, irritant, purgative principle of croton oil is crotonoleic acid. Some already exists free in the oil _while more is formed by saponification or decomposition of the oil in the bile and alkaline juices of the bowels into crotonoleic acid and glycerin. Croton oil is an intense internal irritant. It increases the vascularity of the stomach and bowels and in Jarge doses creates gastro-enteritis. Medicinal doses notably augment the intestinal se- cretions—but not that of bile—and to a degree peristalsis. The drug may act in half an hour, but usually within a few hours, and pur- gation is attended with colicky pain and griping. The movements are very fluid and sometimes contain blood. Croton oil is therefore a drastic hydragogue cathartic. The purgative action is probably due in part to direct irritation of the intestinal mucous membrane ; in part to absorption and elimination of the purgative principle by the bowels. Toxicology.—Ten drops of croton oil will kill a dog unless vom- iting occurs. Eight to thirty drops prove fatal to a horse, intra- venously. The treatment of poisoning includes the use of emetics or stomach tube, demulcents and opium. Administration.—Croton oil may be placed on the tongue of an unconscious animal, in a small quantity of linseed oil, olive oil, or lard. The oil can also be given in enema with a pint of linseed oil. Tt may be exhibited to dogs in pill, castor oil, or rubbed up with a little butter and smeared on the back of the tongue. Croton oil (in a pint of linseed oil) is valuable in assisting the action of salts in obstinate constipation of cattle. It may be administered to horses (mx.), when a powerful derivative and purgative action is indi- eated, as in acute inflammation of the brain and cord, with calome!] and aloes in ball. 520 VEGETABLE DRUGS Uses External.—Croton oil is ordinarily superseded by milder counter-irritants, as turpentine, mustard, or stimulating liniments; but it may be employed so as to secure any degree of irritation ac- cording to its strength. It is occasionally used for horses in acute diseases of the brain, applied around the poll and on the back of the neck; 1 part (20-301), with 30 parts each of oil of turpentine and linseed oil; in acute disorders of the chest (10-15m on either side) and abdomen (401), similarly diluted. Absorption, purging and revulsant action may be secured by the external application of croton oil. Croton oil is more often employed in cattle (1-6 or 10, with cod liver oil) for its counter- irritant effect when rubbed into the skin, as in laryngitis, glandular enlargement, and rheumatic joints. It is less likely to cause severe inflammation and blemishing than in horses. For swine, croton oil is diluted with 2 volumes of linseed or cod liver oil. Uses Internal.—Croton oil is more suitable as a drastic cathartic for cattle, than for horses. It is prescribed in obstinate constipation (not of organic origin) when other remedies fail. Also in uncon- scious conditions where its small bulk will allow of its exhibition. Again, for its derivative and rapid effect in cerebral congestion, par- turient apoplexy, ete. Croton oil may be given to dogs and pigs in similar conditions. The oil is too irritant for horses to justify its use save In exceptional cases. Scammonium. Scammony. (U.S. & B. P.) Synonym.—Scammonée, Fr.; seammonium, G. A gum resin obtained by excising the living root of Convolvu- lus Scammonia Linné (nat. ord. Convolvulacee). - Habitat.—Syria. | Description.—In circular cakes or irregular, angular pieces of various sizes, greenish-gray or brownish-black, often covered with a grayish-white powder; very brittle, breaking with an angular frac- ture, porous and of a resinous lustre; internally of a uniform brown- ish-black color, more or less translucent in thin fragments; odor pe- culiar, somewhat cheese-like; taste slightly acrid. Seammony is easily reduced to an ash-gray powder, which when triturated with water yields a greenish emulsion; ether dissolves at least 75 per cent. of it. Constituents.—1, a resin (80-95 per cent.) ; 2, gum; 3, starch. Dose.—D., 3 iii. (4.-8.); Cats, 3 ss-i. (2.-4.); Sw, 3 ii.-iv. (8.-15.). JALAP 521 PREPARATION. Resina Scammonti. Resin of Scammony. (U. S. P.) Scammonie Resina. (B. P.) Derwation.—Made by solution in boiling alcohol, and precipitation with water. Properties.—Yellowish-brown or brownish-yellow masses or fragments, breaking with a glossy, resinous fracture; translucent at the edges; or a yellowish-white or grayish-white powder, having a faint, peculiar odor, and a slight, peculiar taste. Soluble in alcohol, ether, and oil of turpentine. Constituents.— Mainly scammonin (C,gH1.0.2.), idemtical with jalapin. Dose.—One-half that of scammony. Jatapa. Jalap. (U.S. & B. P.) Synonym.—Tuber jalape, P. G.; jalap, radix jalapz, Fr. ; jalape, jalapenknollen, G. The dried tuberous root of Hxogonium Purga (Wenderoth) Bentham (Fam. Convolvulacew), yielding not less than 8 per cent. of total resin, but not more than 1.5 per cent. of resin soluble in ether. Habitat.—Mexico. Description.—Napiform, pyriform or oblong, 3 to 8 Cm. long and 1 to 5 Cm. in diameter, the large roots often incised, more or less wrinkled, dark brown, with lighter colored spots, and short transverse ridges; hard, compact, internally dark brown, with nu- merous concentric circles composed of small resin cells; fracture resin- ous, lustrous, not fibrous; odor slight, but peculiar, smoky and sweetish ; taste sweetish and acrid. Constituents.—1, a hard resin, chiefly the glucoside jalapurgin ; 2, a soft resin. Dose.—D.., 3 i.-ii. (4.-8.) ; Cats, 3 ss.-i. (2.-4.); Sw., 3 ii-iv. (8.-15.) PREPARATIONS, Pulvis Jalape Compositus. (U.S. & B. P.) Jalap, 35; potassium bitartrate, 65. Dose—D., gr.xv.-lx. Resina Jalape. Resin of Jalap. (U.S. & B. P.) Derivation—Made by maceration and percolation with alcohol, partial distillation; precipitation with water; washing and drying. Properties —Yellowish-brown or brown masses or fragments, breaking with a resinous, glossy fracture, translucent at the edges, or a yellowish-gray or yellowish-brown powder, having a slight, peculiar odor, and a somewhat acrid taste. Permanent in the air. Soluble in alcohol; insoluble in carbon disulphide, 522 VEGETABLE DRUGS benzol, and fixed and volatile oils. Not more than 10 per cent. of it is soluble in ether. Constituents —1, jalapurgin or convolvulin (CgHiO2), the most active principle; insoluble in ether; 2, jalapin, identical with scammonin; 3, starch or gum. Dose.—One-quarter that of jalap. ACTION OF SCAMMONY AND JALAP. Scammony and jalap are powerful hydragogue cathartics in their action on swine, dogs and cats. Horses and cattle are but slightly affected by them in ordinary doses. Their resins are dis- solved by the bile in the duodenum, and a purgative substance is formed which chiefly stimulates the intestinal glands and causes a copious outpouring of secretion. Both drugs excite peristaltic action and increase the vascularity of the intestinal mucous membrane, particularly seammony, so that griping may occur. They produce gastrointestinal irritation, with vomiting and purging, in animals capable of the act, after large doses. While jalap and scammony are active purgatives, they are not always certain, and are therefore more frequently employed in combination with other cathartics. They are indirectly cholagogue—like calomel —in sweeping out bile from the small intestines and preventing its reabsorption, and are said to be anthelmintics as well. The active principles of both drugs are absorbed, as death has taken place in an infant after exhibition of seammony to its nurse, and purging has followed the rubbing of jalap into the shaven skin of dogs. Uses.—Jalap is in more common use than scammony because it is somewhat more of a hydragogue and less prone to cause griping. It is particularly indicated in dropsy or ascites of dogs, made into pills with 3 grains of calomel. Jalap may also be given to expel round or thread worms; in torpidity of the liver; and in obstinate constipation in dogs. The latter is treated more satisfactorily by massage, rectal enemata, manual evacuation and repeated doses of sweet oil. Campoeta. Gamboge. (U.S. & B. P.) Synonym.—Gutti, P. G.; gummi resina gutte s. gutti, gutta gamba, cambodia, gutte, gomme-gutti, Fr.; gummigutt, eutti, G. A gum-resin obtained from Garcinia Hanburii Hooker filius (nat. ord. Guttifere). Habitat—Siam, Anam, and Camboja. Properttes.—In cylindrical pieces, usually hollow in the centre, COLOCYNTH 523 of variable length, 2 to 5 Cm. in diameter, externally grayish orange brown, longitudinally striate; fracture conchoidal, orange-red, waxy, and somewhat porous; inodorous; taste very acrid. Powder bright yellow, sternutatory, containing few or no starch grains. Not more than 25 per cent. should be insoluble in alcohol; ash not more than 3 per cent. Oonstituents.—1, gambogic acid, a bright yellow or orange-red resin, to the extent of about 75 per cent. of the crude drug; it is not so active as the crude drug; 2, a soluble gum. Dose.—H., 3 ss.-i. (15.-80.) ; C., 5 i-iss. (80.-45.); Sh. & Sw., Gre xx oie (1e3-4.) 5) De ore v.-x. (.3-.6). Action and Uses.—Gamboge is a drastic, hydragogue purgative, and slightly diuretic. Its action is uncertain and often violent, with production of griping pains. Large doses cause vomiting in carniv- ora and omnivora, and gastro-enteritis in all animals. Gamboge is dissolved by the bile and alkaline intestinal juices and some of it is absorbed, since it colors the urine yellow in its elimination and occasions diuresis. Attempts to create catharsis by injection of gamboge into the blood, have proved futile. Gamboge should never be prescribed alone and is rarely used in veterinary medicine. It has been recommended in obstinate constipation, in- digestion, impaction of the third stomach, and cerebral diseases. of eattle, combined with salts, or rubbed up with water and an equal amount of aloes (aa%i). The gum forms an emulsion when the drug is triturated with water. Cotocyntuis. Colocynth. (U.S. P.) Synonym.—Colocynthidis pulpa, B. P.; coloquintida, bitter ap- ple, E.; coloquinte, Fr.; koloquinten, G. The peeled and dried fruit of Citrullus colocynthis Schrader (nat. ord. Cucurbitaceze). Habitat.—A vine growing in North and South Africa, South and West Asia, and Japan, ete. Description—From 5 to 10 Om. in diameter; globular, white or yellowish-white; light, spongy, readily breaking into three wedge- shaped pieces, each containing, near the rounded surface, many flat, ovate, brown seeds; inodorous; taste intensely bitter. The pulp only should be used; the seeds separated and rejected. Constituents.—1, the chief purgative principle is colocynthin (C;,H,,023), 1-2 per cent. An amorphous or erystalline bitter glucoside. Soluble in water and alcohol. There is also (2) an insoluble, resinous body called colocynthitin, colocynthein or citrullin. 524 VEGETABLE DRUGS Dose.—Colocynthin.—H.., 3 ss.-i. (2.-4.); D., gr. 4-1. (.015- .06) Evatrrinum. Elaterin. C©.,H,,0;. (U.S. & B. P.) Synonym.—Cucumis asininus, cucumis agrestis, wild or squirt- ing cucumber, E.; concombre sauvage (purgatif d’ane), Fr.; spring- gurke essels-kiirbis, spritzgurke, G. A neutral principle obtained from elaterium, a substance de- posited by the juice of the fruit of Ecballium Elaterium (Linné) _A. Richard (nat. ord. Cucurbitacez). Habitat.—Elaterium grows in North Africa, West Asia and Southern Europe. It is also cultivated. Derwation.—Elaterium is exhausted with chloroform. Ether is added and elaterin is precipitated and is purified by redissolving in chloroform and crystallizing. Properties.—Minute, white, hexagonal scales, or prismatic crys- tals, without odor, and having a slight, acrid, bitter taste. Insoluble in water, and in 262 parts of alcohol; also soluble in 318 parts of ether, or in 22 parts of chloroform. Permanent in the air. . Dose.—D., gr. ¥40-“42 (.008-.005). ACTIONS AND USES OF COLOCYNTH AND ELATERIN. The action of colocynth and elaterin is similar in man, but the latter is more powerful. Both greatly increase secretions while they stimulate peristalsis in some degree. Large doses cause painful eriping, gastro-intestinal inflammation, excessive watery purging. and collapse. Elaterin frequently fails to purge horses and dogs, although death may follow large doses. Colocynth acts more cer- tainly in the lower animals and is recommended by P. Cagny in dropsy and cerebral disease. Neither drug, however, is of any im- portance in veterinary medicine. Colocynth is contained in the compound eathartic pill given to dogs in doses of from one to three pills. Popopuyrtium. Podophyllum. Synonym.—Podophylli rhizoma, B. P.; May apple, mandrake root, E., podophylle, Fr.; fussblatwurzel, G. The dried rhizome of Podophyllum pellatum Linné (nat. ord. Berberidez). Habitat.—North America. PODOPHYLLUM 525 Description.—Of horizontal growth and variable length, sub- eylindrical, flattened above, sometimes branched, consisting of joints 5 to 10 Cm. long, the internodes 2 to 8 Mm. thick; externally pale yellowish-brown to dark brown, nearly smooth; nodes annulate, the upper surface being marked by large cup-shaped scars, the lower surface with numerous root-scars or remains of roots; fracture short, the fractured surface mealy or horny, whitish to pale brown, with a circle of small wood-bundles, and a large pith; odor slight, more pronounced and characteristic in the powder; taste sweetish and disa- greeably bitter and acrid. Constituents—1, a resin, podophyllin (4-5 per cent.); 2, a coloring matter, podophyllic acid. PREPARATION. Resina Podophylli. Resin of Podophyllum. (U. 8. & B. P.)* Synonym.—Podophyllin. Derivation—Made by maceration and percolation of podophyllum with alcohol; partial evaporation, and precipitation of the resin with diluted hy- drochlorie acid; washing with water, drying. Properties—An amorphous powder, varying in color from grayish-white to pale greenish-yellow or yellowish-green; having a slight, peculiar odor, and a peculiar, faintly bitter taste. Permanent in the air. Soluble in alcohol and in solutions of potassium and sodium hydrate. Constituents.—Chiefly podophyllotoxin (C.,;H,,0,-+2 H,O), stated to be a mixture of a purgative principle, picropodophyllin, and an inert body, podo- phyllinie acid, associated with a coloring matter, podophylloquercitin, and other resins. Dose.—H. & C., 3i.-ii. (4.-8.); D., gr.i-ii. (.06-.12). Pilule Podophylli, Belladonne et Capsici. Pills of Podophyllin, Belladonna and Capsicum. (U. S. P.) Dose.—D., 1 pill. Actton.—Podophyllin is a powerful though slow acting ca- thartic. Podophyllotoxin when given in large doses under the skin or into a vein causes glomerular nephritis and hemorrhages into vari- ous organs. Large doses cause purging and vomiting in animals, and lethal quantities occasion gastro-enteritis, colic, super-purgation, with bloody fecal evacuations, convulsions and death. It acts in — the same way whether it is applied externally, injected into the blood, or given internally. Podophyllin must therefore exert its effect after absorption, during excretion from the bowel, and about ten hours are required to produce purgation. The action is exerted mainly on the duodenum, which is intensely inflamed and even ulcerated in poisoning. Podophyllin owes its activity partly to the presence of 526 VEGETABLE DRUGS bile, which seems to be a solvent for it. It is probable that the in- testinal secretions are somewhat augmented. The fecal movements, after medicinal doses of podophyllin, are liquid, often stained with bile, and may be accompanied by some nausea and griping. Since podophyllin is an uncertain purgative, affecting different patients unequally, it should be combined with other agents when a purgative action is desired; preferably calomel and aloes. The time required for the action of these drugs is nearly the same as that necessary for podophyllin. Podophyllin has heretofore been regarded as es- sentially a cholagogue, but there is no sufficient evidence to warrant this assumption. . Administration.—Podophyllin should be given to dogs in pills; to horses in ball with calomel and aloes, if purgation is desired; or dissolved in liquor potassee and diluted with water. Uses.—Podophyllin, clinically, appears to be particularly use- ful in chronic constipation associated with jaundice and hepatic dis- orders. The result of its action is said to be more favorable when the fecal discharges are dark colored, whereas calomel is more suc- cessful if the evacuations are of a light hue. SECTION XII.—TANNIC ACID, AND DRUGS CONTAINING IT. Gatza. Nutgall. (U.S. & B. P.) Synonym.—Galls, E.; galle, P. G.; noix de galle, galle de chéne, Fr.; gallafel, G. An excrescence on Quercus lusitanica Lamarck (nat. ord. Cupuli- fers), caused by the punctures and deposited ova of Cynips tinctoria Olivier. Habitat.— Levant. Description.—Subglobular, 1 to 2 Cm. in diameter, externally blackish olive-green or blackish-gray, more or less tuberculated above, the basal portion nearly smooth and contracted into a short stalk, sometimes with a perforation on one side; heavy; fracture horny, yellowish or grayish; in the centre a cavity containing either the partly developed insect, or pulverulent remains left by it; nearly inodorous; taste strongly astringent. Constituents—1, (gallo) tannic acid, 60 per cent.; 2, gallic acid, 2-3 per cent.; 3, sugar; 4, resin. 1 NUTGALL 52 PREPARATIONS. Unguentum Galle. Nutgall Ointment. (U.S. & B. P.) Nutgall, 20; Ointment, 80. (U.S. P.) Unguentum Galle Cum Opio. (B. P.) Acipum Tannicum. Tannic Acid. HC,,H Oy. GUEST Be Ps) Synonym.—Acidum gallo-tannicum, tanninum, tannin, digallic acid, E.; acid tannique, tannin, Fr.; gerbsaéure, tannin, G. An organic acid obtained from nutgall. Derivation.—Powdered nutgall is exposed to damp air for 48 hours. It is then treated with water and ether. The water dis- solves tannic acid; the ether removes gallic acid, coloring matters and impurities. The mixture is filtered and allowed to stand, when the lower aqueous layer yields tannic acid on evaporation. Properties. —A light yellowish, amorphous powder, gradually turning darker when exposed to air and light, usually cohering in the form of glistening scales or spongy masses, odorless, or having a faint, characteristic odor, and a strongly astringent taste. Soluble in about 0.34 part of water and in about 0.23 part of aleohol at 25° C. (77° F.); very soluble in boiling water, and in boiling alcohol; also in about 1 part of glycerin, with the application of a moderate heat; freely soluble in diluted alcohol, sparingly in absolute alcohol; almost insoluble in absolute ether, chloroform, ben- zene, or petroleum benzin. Incompatibles— Alkaloids, alkalies, mineral acids, silver, ferric, lead and antimony salts, gelatin and emulsions. Dose.—H. & ©., 3 ss.-5 38. (2.-15.); Sh. & Sw., 3 ss.-1. (2.-4.) ; Diver. tex: (06-1.). PREPARATIONS. Collodium Stypticum. Styptic Collodion. (U. S. P.) Tannic acid, 20; alcohol, 5; ether, 25; collodion, to 100. Made by solution. Unguentum Acidi Tannici. Ointment of Tannic Acid. (U.S. P.) Tannic acid, 20; glycerin, 20; ointment, 60. Glyceritum Acidi Tannici. Glycerite of Tannic Acid. (U. S. & B. P.) Tannic acid, 20; glycerin, 80. (U.S. P.) 528 VEGETABLE DRUGS Adminisiration.—Tannic acid is given in solution in aromatic waters, alcohol, syrup, wine, glycerin, and water; also it is exhibited in powder. The drug is used externally in powder, ointment, glycer- ite, and lotion. Suppositories containing tannic acid are sometimes introduced into the rectum. Action External.—Tannic acid coagulates albumin, gelatin, and fibrin. It has little effect upon the unbroken skin, but when applied to a raw surface or mucous membrane, it coagulates and dries secre- tion, and so fills up the mouths of glands, making the tissues harder, denser, and drier. Tannic acid causes a species of “tanning” com- patible with life, by occasioning coagulation of the interstitial fluid in the tissues, abstraction of moisture, and contraction of the cells of the part—through the formation of protein tannate. It is the most important astringent principle contained in vegetable drugs. Tannic acid is, moreover, a local styptic or hemostatic in arresting hemorrhage by contraction of the smooth muscles of the vessel walls, by coagulation of the blood, and constriction of the tissues surround- ing the blood vessels. Tannic acid causes arrest of leucocyte move- ments, and diapedesis of. the same, at the point of its application. Tannie acid, although a slight local irritant to raw surfaces, exerts a depressing action upon the sensory nerve endings, and is essentially a sedative in inflammatory conditions by causing ischemia. There are several kinds of tannic acid, possessing slightly different chemical and phvsiological properties. The official tannie acid—gallotannic acid—is contained in nutgall and oak bark, while another variety— eatechutannic acid—is found in kino, ecatechu, ete. Action Internal—Tannie acid dries the mouth by closure of glandular (mucous) ducts with coagulated secretion, and by con- striction of the surrounding parts. It lessens the flow of mucus and of the digestive juices in the stomach and intestines by the same process. In the stomach tannic acid precipitates protein but as di- gestion proceeds and peptones are formed, with which tannic acid does not combine, the acid is set free again and acts as an astringent. © Large doses irritate the alimentary canal and may create vomiting and diarrhea. Tannic acid is converted into gallic acid in the bow- els. Traces appear in the blood and urine as sodium tannate or gallate which has no astringent action. Of the tannic acid swal- lowed not more than 1 per cent. is excreted in the feces and urine as tannic or gallic acid. All the rest is oxidized in the body. Gallic acid does not coagulate albumin or gelatin and has a very feeble astringent action—like that of any weak acid—so that tannic acid’ should always be used for a local effect. The remote astringent in- fluence of tannic or gallic acid on the tissues, after absorption in the form of sodium gallate or tannate, is nil. Catechu and kino are TANNIGEN, TANNYL ACETATE 529 often chosen in place of tannic acid in the treatment of diarrhea, because they are less soluble (than tannic acid) and the contained catechutannic acid comes in contact with the intestinal mucous mem- brane for a longer time. The salts of tannic acid (tannates) are not astringent. Uses Hxternal._—Tannic acid is a valuable astringent in a great variety of local inflammatory lesions. In the form of the elycerite, tannic acid may be applied advantageously to the skin in moist ec- zema, and as a remedy for frost bites. It is a useful application for sore and cracked teats. The mouth is painted with the glycerite for the cure of ulcerative or apthous stomatitis. The same preparation is injected into the ear in otorrhea of dogs, and into the vagina to arrest vaginitis and leucorrhea. Pure tannic acid is an excellent agent when dusted upon raw surfaces, ulcers, and sores; and to stop bleeding in slight wounds. An aqueous solution is useful in leu- corrhea (2-5 per cent.), in eczema (5-10 per cent.), as a high enema in dysentery (1 per cent.), and to kill ascarides (1-2 per cent.) in the rectum. A one per cent. aqueous solution is sometimes utilized as an inhalation in subacute laryngitis, tracheitis, and brouchitis. Powdered opium and nutgall ointment (1-14), or glycerite of tannin, are serviceable in hemorrhoids and rectal fissures, ulcers, or prolapse of the rectum. Uses Internal—Tannic acid is exhibited in powder or solution to arrest bleeding in the stomach. It is a good astringent in diar- rhea and an hemostatic in intestinal hemorrhage, given in ball or pill, and often with opium. ‘Tannic acid is an antidote to alkaloids, metallic salts, and tartar emetic, forming comparatively insoluble tan- nates, which should be removed if possible by evacuation of the stom- ach, Tannalbin is a tasteless, odorless, non-irritating, brown powder of tannic acid (50 per cent.), combined with albumin by heat, and only soluble in the pancreatic juice in the bowel. It is more suitable for young animals in diarrhea than is tannic acid. Dose & OC) Sr vv. (4.-15.) > foals & ‘calves, gr. xx.-x!: (1.3-2.6); D. & C., gr. x.-xx. on food. Tannicen, Tannyt Acerars, C,,H,,0;;. Made by heating tannin and acetic anhydride in the presence of elacial acetic acid. Occurs as a light gray, odorless, tasteless powder. Insoluble in water but soluble in alcohol and alkalies. It passes un- changed through the stomach into the bowels where it acts as an astringent in the presence of the solvent action of the alkaline juices. It is useful in diarrhea and dysentery in young animals. Foals and 530 VEGETABLE DRUGS calves take gr. xxx. (2.) with food. The advantage of both of these preparations over tannic acid depends upon the fact that they do not irritate the stomach, passing through it unchanged, and being only dissolved by the alkaline intestinal juices. Acipum Gatiicum. Gallic Acid. HC,H,;0, + H,.O. CU... GB. Ps) Synonym.—Acide gallique, Fr.; gallussiiure, G. An organic acid, usually prepared from tannic acid. Derivation.—Made by exposure of paste of nutgall and water to the air for a month, when tannic acid undergoes hydration (tannic acid) HC,,H)0, + ae 50.2 CEO: (gallic acid). The liquid is then expressed from the paste and te residue is boiled with dis- tilled water and filtered, when hot, through animal charcoal. Gallic acid erystallizes out from the filtrate. Properties——White, or pale fawn-colored, silky, interlaced needles or triclinic prisms; odorless; having an astringent or slightly acidulous taste; permanent in the air. Soluble in 83.7 parts of water, and in 4.14 parts of alcohol; in 40 parts of ether, and in 12 parts of glycerin. Very slightly soluble in chloroform, benzol, or benzin. Incompatibles.—Metallic salts and spirit of nitrous ether. Dose.—H. & C., 3 ii.-3 ss. (8.-15.); Sh. & Sw., 3 ss.-1. (2.-4.) 5 D., gr. v.-xx. (.3-1.3). Action and Uses.—Experiments show that gallic acid has a very feeble astringent action when locally applied and tannic acid should always be preferred. It is absorbed and transformed into sodium gallate and exists in this form in the tissues. Since sodium gallate has no remote astringent action its use by the mouth for such a purpose is without scientific basis, although successful results are alleged to have followed its administration in the treatment of hemorrhage from the lungs, uterus and kidneys, and in polyuria, albuminuria, bronchorrhea, leucorrhea, and excessive sweating. Pyrocarnor. ~ Pyrogallol:- -C.1, (OH), (Us...) Synonym.—P yrogallic acid. Derwation.—A triatomic phenol obtained chiefly by the dry distillation of gallic acid, HC;H,O,; = C,H;(OH); +-COs,. Properties.—Light, white, shining lamin, or fine needles; odorless, and having a bitter taste; acquiring a gray or darker tint _ WHITE OAK 5S cx exposure to the air and light. Soluble in 1.6 parts of water, and in 1 part of alcohol; also soluble in 1.1 parts of ether. Action and Uses.—Pyrogallol is an excellent agent for the treat- ment of chronic psoriasis and for ringworm. An ointment contain- ing an amount of pyrogallol, varying from gr. x.-3 1. to the ounce of lard, is commonly employed. Toxic symptoms may follow its ex- tensive application. Quercus. White Oak. (U.S. P.) [Quercus Apa, Pharm. 1890.] The dried bark of Quercus alba Linné (Fam. Cupulifere), col- lected from trunks or branches ten to twenty-five years of age, and deprived of the periderm. Synonym.—Quercus cortex, B. P.; cortex quercus, écorce de chéne, Fr. ; eichenrinde, G. ; Habitat.—North America, in woods. Description.—In nearly flat pieces, 2 to 10 Mm. thick; exter- nally light brown, becoming darker with age, rough-fibrous; fracture uneven, coarsely fibrous; odor distinct; taste strongly astringent; not tingeing the saliva yellow when chewed. Constituents.—1, quercitannic acid, 6 to 11 per cent.; 2, a bitter principle, quercin; 3, resin; 4, a sugar, quercite. Dose.—H., 3 ss.i. (15.-30.); C., 5 i-ii. (30.-60.) ; Sh. & Sw., 5 i-ii. (4.-8.); D., gr. x.-xxx. (.6-2.). Preparation.—F luidextractum Quercus (U. S. P.)—H. 3 ss. (is. De. Mase): Action and Uses.—White oak bark is identical in action with tannic acid, but the latter is preferable for internal use. Oak bark is a cheap substitute for tannic acid applied externally in poultices, infusions, and decoctions, as an astringent. It is administered in- ternally in infusion, or decoction (1-8), in diarrhea and dysentery. The infusion may be given in gruel and combined with ginger, opium and alcohol in the treatment of “scouring” in foals and calves. Catecuu. Catechu. (B. P.). Synonym.—Catechu pallidum, catechu nigrum, terra japonica, cutch, E.; cachou, Fr. ; katechu, pegueatechu, G. 532 VEGETABLE DRUGS GampBir. Gambir. (U.S. P.) [To replace Carzcuu, PHarm. 1890]. An extract prepared from the leaves and twigs of Ourvuparia Gambir (Hunter) Baillon (Fam. Rubiacoe). Description.—Irregular masses, or cubes about 25 Mm. in diam- eter; externally reddish-brown, pale brownish-gray, or light brown; fracture dull-earthy, friable, crystalline; inodorous, bitterish, very astringent, with a sweetish after-taste; free from starch. Not less than 70 per cent. should be soluble in ‘alcohol. Constituents.—1, catechutannic acid (about 45 per cent. ) is the active principle; it is converted into the isomeric inactive catechuic acid, or catechin (Cy,H»)90, + 5 H,O), by the saliva and by boiling, a red color being developed. There is also (2) pyrocatechin or catechol. Incompatibles.—Metallic salts, alkalies, and gelatin. Dose.—H., 3, ss.-i. (15.-80.) ; C., 3 i-ii. (80.-60.) ; Sh. & Sw., 5 tats (458) sD cor vox 3-22) PREPARATIONS. Tinctura Catechu. (B. P.) Dose,—H. & C., 3i.-ii. (30.-60.) ; Foals, Calves and Sheep, 3ss.-i. (15.-30.) ; D., 3ss.-ii. (2.-8.). Pulvis Catechu Compositus. Kino, Rhatany and Catechu. (B. P.) Dose.—Same as tatechu. Tinctura Gambir Composita. Compound Tincture of Gambir. Gambir (a species of catechu), 50; cinnamon, 25; alcohol to make 1000. (U2:5:22:) Now replaces the compound tincture of catechu and possesses the same action and is given in the same doses as the tincture. Administration.—The compound tincture, or an infusion (made by pouring boiling water over catechu, digesting for an hour, and straining), and the powder, are employed internally. The powder is given in flour gruel. The powder, or an infusion of any strength may be applied externally. Catechu is represented in the B. P. by catechu pallidum, an extract of the leaves and young shoots of Uncaria gambier, Indian Archipelago. It occurs in brown cubes, about an mies square, and possesses a bitter, astringent taste. It is employed in the same doses and for the same purposes as catechn. KINO 533 Action and Uses.—The action of catechu is exactly like that of tannic acid. ‘The latter is preferable for external use on account of its greater solubility and astringency. Catechu acts more slowly and persistently in the digestive tract, by virtue of its tardy solu- bility, and is a useful remedy in diarrhea, particularly in that of a watery or serous nature. It is frequently prescribed in this dis- order with other synergistic agents, as opium, ginger and chalk. Finlay Dun recommends the following combination: Catechu, pre- pared chalk, and ginger, each three ounces; powdered opium, six drachms. Divide into eight balls, for horses; into six doses sus- pended in starch gruel for cattle; and into eight or ten doses (given in gruel) for calves or sheep. The compound tincture of gambir with laudanum is an equally suitable combination for all animals with diarrhea, given in drench. If there is much mucus in the fecal discharges, showing a catarrhal state of the intestinal mucous mem- brane, it is advisable to order oil, salts, or calomel before locking up the bowels with an astringent. Catechu has been given internally in dysentery, and to stop uterine and other hemorrhages. Kino. Kino. (U. 8S. & B. P.) The inspissated juice of Pterocarpus Marsupium Roxburgh (nat. ord. Leguminosee). Habitat.—Kast Indies. Kino, indigenous in the West Indies, is occasionally imported here. Properties—Small, angular, dark brownish-red, shining pieces ; brittle, in thin layers, ruby-red and transparent; inodorous, very astr ingent and sweetish, tingeing the saliva deep red. Soluble in nical: nearly insoluble in ether, and only slightly soluble in cold water. Constituents.—The most important is (1) kinotannic acid (©; H,.Ox, 75 per cent.), resembling catechu-tannic acid, but not identi- eal with it. There are also: 2, kinoin, a crystalline, neutral sub- - stance; 8, pyrocatechin, C,H, (OH).; 4, eum; 5, Beet, 6, kino- red, formed by oxidation from imotannie acid. Incompatibles.—Mineral acids, metallic salts, ce solutions of alkaloids, alkalies, and gelatin. Dose.—H., 5 SS.-1. “(15.-30.) ; C., 3 iii. (30.-60.); Sh. & Sw., Seeli (Ae Ss )\g Ds org viexxX. | (3-2.). PREPARATIONS. | Tinctura Kino. Tincture of Kino. (U.S. & B. P.) Prepared by maceration and filtration of kino, 150, and purified tale, 10; with glycerin, 150; water and alcohol to make 1000. (U.S. P.) 534 VEGETABLE DRUGS Dose.—H. & C., 3i.-ii. (30.-60.) ; Foals, Calves and Sheep, 3ss.-i. (15.-30.) ; D., 3ss.-ii. (2.-8.). Pulvis Kino Compositus. Compound Powder of Kine. (B. P.) (Pulv. cinnamon, 4 grs.; kino, i5 grs.; opium, 1 gr.) Dose.—Dog, 1 powder; Foals and Calves, 4 powders. Administration—Kino may be given in ball, powder, infusion (1-32), or tincture. Action and Uses.—The physiological actions and therapeutics of kino are nearly similar to those of catechu. The gum and pectin contained in kino renders its effect milder and more soothing to mucous membranes. Aqueous solutions gelatinize on standing, on account of the gum in them. The drug is prescribed chiefly in serous diarrhea, and also is occasionally exhibited in dysentery and internal hemorrhages. Kkramerta. Krameria. (U.S. P.) Synonym.—Kramerie radix, B. P.; radix rhatanhie, rhatany root, E.; radix ratanhe, P. G.; ratanhia, Fr.; ratanhawurzel, G. The dried root of Krameria triandra Ruiz and Pavon (Peruvian Krameria), Kramerta Ixina Linné (Savanilla Krameria) or of Kra- merua argentea Martius (Para or Brazilian Krameria) (Fam. Krameriacee). Habitat—Peru and Brazil. Description.—Perurvian Krameria.—Root-branches several or many, usually attached to a short, hard, and woody tap-root, which is 1.5 to 4 Cm. thick, roughly fissured, and supporting a knotty, sev- eral- to many-headed crown; roots of variable length, rarely exceed- ing 50 Cm. and usually less than 1 Om. thick, cylindrical, flexuous or wavy, very flexible; externally light red-brown, more or less marked with dark, scaly patches, especially upward, otherwise smooth- ish, devoid of transverse fissures; fracture tough and splintery, the pinkish-brown bark occupying less than one-third of the radius, the wood yellowish or pinkish-white, finely radiate; modorous and of a very astringent taste. Savanilla and Brazslian Kramerias.—Branches usually oceur- ring detached from the tap-root and crown, less flexuous than those last. described, externally of a purple-brown or chocolate brown, and with numerous transverse cracks or fissures; fracture less tough than that of Peruvian Krameria, the bark and wood both darker, the bark occupying two-fifths or more of the radius, the taste more astringent than that of Peruvian Krameria. HEMATOXYLON bab Constituents.—The chief principle is (1) kramero-tannie acid, O54t12402,, about 20 per cent. There are also: 2, rhatanin; 3, rhatanic-red (Cygl1,,0,,), the coloring matter. Incompatibles.— Metallic salts, alkalies, gelatin, and lime water. Dose.—H., 3% s8.-1. (15.-20.); C., 3 i.-11, (80.-60.); Sh. & Sw., 4 i-li, (4.-8.); D., gr. v.-xxx. (.3-2.). PREPARATIONS, Plwideatractum Krameria. Vluidextract of Krameria. (WAS: 2,) Made by maceration and percolation of krameria with glycerin and diluted alcohol, and evaporation, so that 1 Ce.=-1 Gm, of the crude drug. Dose.—Same as krameria. Latractum Kromeria. Vixtvact of Krameria. (U. 8. & B. P.) Made by filtration, and evaporation of a cold, aqueous infusion to dryness. *s ses (.3-.6), Vinctura Krameria. TVinetwre of Krameria. (U. 8. & B. P.) Made by maceration and percolation of krameria, 200; with diluted alcohol to 1000. (U.S. P.) Dose.—Hi. & C., Hi.-ii. (80.-60.) Voals, Calves and Sheep, % as.-i. (16.-30.) ; D., 3 86.-ii. (2.-8.). Action ond Uses.—Krameria and its preparations nearly resem- ble catechu and kino in all respects as astringents. The fluid extract is a serviceable preparation in watery diarrhea, and in arresting hemorrhage from the stomach and howels. An infusion (1-20, B. P.) is an efficient remedy for leucorrhea when injected into the vagina. he powdered extract is blown into the nostrils, or applied to the rectum to stop bleeding in these parts. Hamwarozxyiton. WHematoxylon. Synonym.—Hematoxyli lignum, B. P.; logwood, E.; lignum campechianum, P. G.; lignum ceruleum—hois de campéche, hois dinde, bois de sang, Fr.; blauholz, campecheholz, G. The heart wood of Hematoxylon Caimpechianum Linné (nat. ord, Leguminose. ) Habitot.—Central America; naturalized in the West Indies. Description.—Usually in small chips, reddish-brown, the freshly cut surface dark yellowish-red; on transverse section the wood show- ing medullary rays which are four cells wide; odor faint, agreeable; taste swectish, astringent. 536 VEGETABLE DRUGS Hematoxylon imparts to water containing a little acid a yellow- ish color, which is changed to purple or violet-red by alkalies. When the surface has a greenish metallic lustre, the wood has undergone fermentation and should be rejected. Constituents.—The most important is (1) tannic acid. There are also; 2, hematoxylin, C,,H,,O, (12 per cent.), a coloring matter, but in nearly colorless crystals when pure. It turns red on exposure to light, and solutions are used to stain pathological specimens; 3, hematein, O,,H,.0,, formed hematoxylin by oxidation, and posses- sing a green, metallic lustre. Incompatibles.—Lime water, and tartar emetic, with metallic salts, form a blue compound. PREPARATION. Eaxtractum Hematoxyli. Extract of Hematoxylon. (U.S. & B. P.) Made by boiling in water, straining, and evaporating to dryness. Dose.—H. & C., 338.-iv. (2.-15.); Sh. & Sw., 3ss.-i. (2.-4.); D., gr.v.-xv. (.3-1.). A non-official fluidextract is often found in commerce. Dose.—Three times that of extract. Action and Uses.—Hematoxylon is a mild astringent, coloring the feces and urine red during its elimination. The extract is given in diarrhea of young animals, and may be combined for this purpose with aromatic sulphuric acid, ginger, chalk and opium. It is also employed internally in dysentery, atonic indigestion, and in leucor- rhea. The decoction (1-16, B. P.) may be exhibited in Oss.-i. doses to the larger animals; in 5 i1.-11. doses to’smaller patients. Hamametipts Fora. Hamamelis Leaves. (U2 4:5.-22) Synonym.—Witch-hazel. The leaves of Hamamelis virginiana Linné (nat. ord. Hama- melidacez), collected in autumn. Description.—Short, petiolate, about 10 Om. long, obovate or oval, slightly heart-shaped and oblique at the base, sinuate-toothed, thickish, nearly smooth; inodorous; taste astringent and bitter. HAMAMELIDAS Contes Hamamelis Bark. (US2P)) The bark and twigs of Hamamelis virginiana Linné (Fam. Hamamelidacee). Constituents.—The most important principle is (1) tannic acid, 8 per cent.; there are also: (2) a bitter substance, and (3) a resin. OLIVE OIL FO PREPARATIONS. Fluidextractum Hamamelidis Foliorum. Fluidextract of Hamamelis Leaves. (U.S. P.) Made by maceration and percolation with alcohol, glycerin and water, and evaporation, so that 1 cc.—1 gm. of the crude drug. Dose.—H. & C., 3i.-ii. (30.-60.); D., 38s.-ii. (2.-8.). Eaztractum Hamamelidis Liquidum. (B. P.) Dose.—Same as fluidextract. Aqua Hamamelidis. (U.S. P.) Takes place of the proprietary extracts and consists of the bark macerated in water and distilled, alcohol being added to the distillate. Dose.—Double that of fluidextract. Unguentum Hamamelidis. (B. P.) Action and Uses.—Hamamelis is apparently physiologically inert, as shown by experiments on healthy animals. It nevertheless possesses considerable medicinal virtue as an astringent and styptic. Witch-hazel is a valuable agent, applied externally, to stop venous oozing in wounds, and to reduce swelling and pain of bruises and sores. The fluidextract may be diluted with 8, or less, parts of water, for these purposes; or the B. P. ointment (1-10) may be employed. Internally hamamelis is useful in diarrhea and mucous discharges. It arrests hemorrhage from the uterus, kidneys, lings and digestive tract; sometimes in a surprising manner. The fluidextract is a successful hemostatic in bleeding from the bladder or rectum (piles) when injected (1-8) into these parts. It lessens soreness and swelling of blind piles—with an equal part of glycerin and a little starch— and the same preparation is beneficial in eczema, pruritus, and cutaneous irritations. The clear, colorless proprietary extracts— now the aqua (U.S. P.) takes their place—are often more efficient externally and internally (in the same doses) than the official flnid- extract. SECTION XITI.—VEGETABLE DEMULCENTS. Oxeum Ontva. Olive Oil. (U.S. & B. P.) Synonym.—Sweet oil, E.; oleum olivarum, P. G.; huile @olive, Fr. ; oilyvenol, G. A fixed oil expressed from the ripe fruit of Olea europea Linné 538 VEGETABLE DRUGS (nat. ord. Oleacez). It should be kept in well stoppered bottles in a cool place. Habitat.—Southern Europe and Asia. Properttes.—A pale yellow, or light greenish-yellow, oily liquid, having a slightly peculiar odor, and a nutty oleaginous taste, with a faintly acrid after-taste. Spec. gr. 0.910 to 0.915. Very sparingly soluble in alcohol, but readily soluble in ether, chloroform, or carbon disulphide. Very frequently adulterated with cotton seed, or other seed oils, which probably are of equal medicinal value, however. Constituents.—1, olein, C,H; (C13H3;0.)s3, 72 per cent., a fluid oil, a combination of oleic acid (HC,.H;,0,) and glyceryl; 2, pal- mitin, C,H, (C,g¢H3,0.)3, about 28 per cent., a combination of palmitic acid (HC,,H,,0,.) and glyceryl; and (38) arachin, Coo H49O2. Dose.—Laxative.—H. & C., Oi.-ii (500.-1000.); D., 3 ii-iv. (60.-120.). OxLeum Gossypir Seminis. Cotton Seed Oil. (U.S. P.) A fixed oil expressed from the seed of Gossypium herbaceum Linné and of other species of Gossypium (nat. ord. Malvacee), and subsequently purified. Habitat.—S. United States and other semi-tropical countries; cultivated. Properties.—A pale yellow, oily liquid, without odor, and hav- ing a bland, nut-like taste. Spec. gr. 0.915 to 0.921. Very spar- ingly soluble in alcohol but readily soluble in ether, chloroform, or earbon disulphide. Constituents.—1, olein; 2, palmitin; 3, coloring matter. Dose.—Same as that of olive oil. Action and Uses.—Olive oil is in common use as an emollient in burns and skin irritation. It assists in the performance of mas- sage for sprains and bruises. Cotton seed oil has superseded it in liniments, as a matter of economy. Administered internally, sweet oil (with an.equal part of castor oil) is a useful laxative for dogs. Linseed oil is more frequently given to the larger animals. An enema of 14 pint, or more, of olive oil is serviceable in softening hard fecal masses in dogs, and should be followed by the use of warm soap suds. Sweet oil is a food, but is rarely used as such. Like other bland oils, it improves the nutrition of the bronchial mucous mem- brane in subacute or chronic bronchitis, and is of considerable benefit in these disorders, but inferior to cod liver oil or linseed oil. Olive oil is an efficient demulcent in inflamed conditions of the alimentary SOAP 539 tract, and in poisoning by irritants. Large quantities form soap-like masses,—with the alkaline intestinal juices,—which have been mis- taken for gall stones. Cotton seed oil is of equal therapeutic value with sweet oil. Sapo. Soap. Synonym.—Sapo duras, B. P.; hard soap, white castile soap, E.; savon, Fr.; seife, G. Derwation.—Soap is made by boiling olive oil with a solution of caustic soda, C;H;(C,,H3,0.), (olein) + 8 NaOH = 3 NaCj, H,;,;0, (sodium oleate or soap) -+ C;H;(OH); (glycerin). Properties.—A white, or whitish solid, hard, yet easily cut when fresh; having a faint, peculiar odor free from rancidity; a disagreeable alkaline taste, and an alkaline reaction. Soluble in water and in alcohol; more readily with the aid of heat. PREPARATIONS. Linimentum Saponis. Soap Liniment. (U. S. & B. P.) ‘Synonym.—Opodeldoc. Lin. sapo. camph. Soap, 60; camphor, 45; oil of rosemary, 10; alcohol, 725; water to make 1000. Made by solution, agitation and filtration. (U.S. P.) Emplastrum Saponis. Soap Plaster. (U.S. & B. P.) Soap, 10; lead plaster, 90; made by solution in water, 100; and evapora- tion. Sapo Morais. Soft Soap. (U.S. & B. P.) Synonym.—Potassium oleate, sapo viridis, green soap. A soap prepared from potassa and a fixed oil. Derivation.—Heat linseed oil, 400, to 140° F. Dissolve potas- sium hydroxide, 95, in water, 450; add alcohol, 40; and stir the mix- ture into the oil at the same temperature until it is soluble in boiling water without the separation of oily drops. Properties.—A soft, yellowish-brown, unctuous mass, having a characteristic odor and an alkaline taste. Soluble in about 5 parts of hot water; also in 2 parts of alcohol without leaving more than 3 per cent. of insoluble residue. PREPARATION. Linimentum Saponis Mollis. Liniment of Soft Soap. (U. 8. P.) Synonym.—Tinctura saponis viridis. 540 VEGETABLE DRUGS Soft soap, 650; oil of lavender flowers, 20; alcohol to make 1000. Made by solution and filtration. Castile soap is the best example of a pure soap. Mottled castile soap contains iron as the coloring matter. The household “soft soap” is not sapo mollis, but is made of all kinds of rancid fats and is generally unfit for medicinal use. Yellow laundry soap owes its eolor to rosin. Super-fatted soaps are of neutral reaction and un- irritating. They are used as a basis for medicinal soaps containing tar, carbolic acid, ete. Action and Uses.—Most soaps are alkaline. Soap is a detergent or cleansing agent. The lather mechanically removes dirt, while the alkalinity assists in the removal of grease, dead epidermis, and sebaceous matter from the skin. The caustic alkali contained in soap relieves itching and is stimulating to the skin; so much so, that cheap soaps are harmful in normal conditions of the integument. Liniment of soft soap is frequently employed in chronic eczema and psoriasis, to remove scales and crusts; to stimulate the parts; and to quiet itching. It should be rubbed smartly into the skin, washed off, and followed by the application of a suitable ointment. Gauze saturated with soap suds (soap suds poultice) is an excellent agency to cause the exfoliation of the epidermis in patches of old scaly eczema or psoriasis, when applied for several hours. Soft soap, oil of cade, and alcohol, equal parts, are recommended as a useful preparation for the treatment of chronic eczema and pruritus. The application of soap and water is a necessary preliminary to the employment of a vesicating ointment, or parasiticide, since it cleanses the skin, and, by removing epidermis, exposes the burrows of acari in mange and scab. Soap liniment is a favorite remedy for sprains and bruises. If a more stimulating action is desirable, it is advisa- ble to combine oil of turpentine or water of ammonia with it. Jf an anodyne effect is indicated, tincture of aconite or opium is added. Chafing of the skin produced by harness, should be treated by washing the skin with soap and water, and then by dusting with zine oxide and starch, equal parts. Sapo mollis, together with an equal amount of flour of mustard, forms a most satisfactory cleansing and disinfectant mixture for the hands of the operating surgeon when emploved in the same manner as ordinary soap. Soap may also be used as a lubricating agent for the hands or instruments in making examinations. Soap is a useful excipient for balls, pills, and plas- ters, and it is a constituent of liniments. Soap is employed both as a qualitative and quantitive ‘test for hard water. This contains salts of the alkaline earth metals, as sulphates and carbonates of magnesium and calcium. Soap is de GLYCERIN : 541 composed by these salts, and insoluble soaps, 7.e., calcium and mag- nesium stearate, are precipitated. The free alkali of the soap is then converted into insoluble sulphates and carbonates. ‘These reactions produce a milky precipitate when a solution of soap is added to hard water. Internally soap is an antacid and somewhat irritating, and may occasion vomiting and stimulation of intestinal peristalsis. These actions are taken advantage of in emergencies, when it may be given to dogs as an emetic, or to all animals in poisoning by acids, ) Made by maceration of colchicum seed, 100; alcohol, 150; and white wine to make 1000. Dose.—H. & C., 3iii.-5 i. (12.-30.) ; D., Mx.-xxx. (.6-2.). Tinctura Colchici Seminis. Tincture of Colchicum Seed. (U. S. & B. P.) Made by maceration and percolation of colchicum seed, 100; with alcohol and water to make 1000. (U.S. P.) Dose.—H. & C., 3 iii.-3 i. (12.-30.); D., Mx.-xxx. (.6-2.). Action Eaternal.—Colchicum is an irritant to the skin and mu- cous membranes. Action Internal.—Digestive Organs.—Colchicum and colchicine are identical in action without regard to their method of introduction into the system. Colchicum is essentially a gastro-intestinal irritant in large doses. This irritant action may explain all its effects on other organs. Full medicinal doses occasion anorexia, nausea, colicky pains, loud intestinal rumblings (borborygmi), and purging. Col- chiceine appears to closely resemble colchicine physiologically. Neither the circulation, nervous system, respiration, nor tempera- ture are affected by colchicum save in poisonous doses. Circulation.—Toxic doses reflexly influence the circulation, but colchicum does not appear to affect it directly until late in poisoning, when the vagus endings become depressed and paralyzed and the pulse is weak and rapid. Nervous System.—Toxie quantities depress and paralyze the motor cells of the inferior cornua in the spinal cord, and also depress the sensory nerves. Death occurs from paralysis of the respiratory centres. Kidneys and Elimination.—It is doubtful whether colchicum exerts any decided or uniform action on the kidneys. Experiments relating to this matter are perplexingly conflicting. Sometimes the urinary solids are increased—urea more than uric acid—and some- times not. In poisoning, nephritis and hematuria occasionally re- sult from the elimination of colchicum. COLCHICUM 565 Toxicology.—Colchicum is a very poisonous drug. Accidental lethal poisoning occasionally occurs among herbivora from eating meadow saffron at pasture, or in hay. In such cases it is naturally im- possible to estimate the quantity of the plant ingested. Two and one- half drachms of the wine of the root, and one-half grain of the alka- loid, have proved fatal to man. Two drachms of the corm have killed a dog, and one-tenth of a grain of colchicine has destroyed a eat. The symptoms of poisoning occur only after some hours when elimination begins and comprise: anorexia, nausea, dulness, saliva- tion, violent vomiting (in carnivora), purging, at first watery, then mucous and often bloody, and accompanied by great tenesmus, tym- panites, and cclic, owing to elimination by the alimentary canal, as _ well as by the kidneys. There are often such nervous symptoms as tremors, stupor, coma, and paralysis beginning in the hind limbs and progressing to involve the fore limbs and respiratory muscles. Death occurs from respiratory failure as the breathing ceases before the heart beat. The effect on the nervous system is due to general collapse. The animal becomes very weak, its movements slow and difficult, the respiration is infrequent and feeble, the pulse rapid and imperceptible, the skin is cold and covered with a clammy sweat, and death occurs in collapse following severe gastro-enteritis. After the injection of large doses of colchicine, increasing the amount does not aggravate the symptoms. Post-Mortem Appearances.—The mucous membrane of the stomach and intestines is swollen, congested, and eroded. Some- times free blood is found within their lumen. There is also acute hyperemia of the kidneys. Treatment.—This consists in the use of the stomach tube, emetics, and cathartics, unless there has been free purging and vomit- ing. Tannic acid is the best chemical antidote, but is not wholly satisfactory. It should be used, however. Demulcents (oil and egg albumin) and opium relieve the local irritation, pain and purg- ing. Stimulants, as camphor, digitalone, atropine, strychnine, and alcohol, together with external heat, combat collapse. Summary.—Medicinal doses produce no physiological effect. Large amounts cause renal and gastro-intestinal irritation and in- flammation during the elimination of the drug. Administration.—The crude drug is not suitable for use. The wine of the root is the best preparation. Uses.—It is difficult to estimate the therapeutic value of col- chicum. It is called an alterative by many authorities, for want of a better term to describe a drug whose physiological actions do not explain its medicinal virtues. Colchicum is the most successful single remedy for gout in human medicine, but does not possess 566 VEGETABLE DRUGS much value in veterinary practice. It is sometimes used with con- siderable advantage in the treatment of subacute and chronic rheu- matism, and in that form complicating influenza in horses. Potassium iodide is generally prescribed with colchicum in these disorders, and also in pericarditis and pleurisy of rheumatic origin. Colchicum is commonly believed to be a serviceable diuretic in various diseases (although this hypothesis is not physiologically substantiated). It is therefore recommended in hemoglobinuria and swelling of the legs in horses; in cerebral congestion ; ascites; pleural and pericardial effusions, and dropsies, as an eliminative. . Col- chicine, subeutaneously, is especially lauded in rheumatism. SECTION XVIIL—VEGETABLE DRUGS ACTING MECHANICALLY. Amytum. Starch. ©,H,,0;.. (U. 8S. & B. P.) Synonym.—Corn starch, E.; fecule (amidon) de froment, de blé, Fr.; kraftmehl, weizenstarke, G. The starch grains obtained from the fruit of Zea Mays Linné (nat. ord. Graminez). Habitat.—Tropical Asia and Africa, but cultivated in tropical, sub-tropical and temperate countries. Description.—In fine powder or irregular, angular white masses, consisting of somewhat spherical, but usually polygonal grains, about 0.010 to 0.025 Mm. in diameter, with a lenticular, circular, or tri- angular central fissure; inodorous and tasteless; insoluble in cold water or alcohol; forming a whitish jelly when boiled with water, which when cool gives a deep blue color with iodine T. S. ; triturated. Constituents.—1, starch-granulose ; 2, starch-cellulose. PREPARATION. Glyceritum Amyli. (U.S. P.) (See p. 541.) Glycerinum Amyli. (B. P.) Action and Uses.—Starch is a mechanical protective externally, used as a dusting powder, alone or with zinc oxide (1-4), in chafing, erythema, and moist eczema. The glycerite of starch is a serviceable demulcent. Boiled starch paste, mixed with glue, is used to stiffen bandages by painting the mixture on in layers with a brush. Boiled OIL OF THEOBROMA 567 starch gruel (2 tablespoons of starch to a pint of water) is a suitable diet for diarrhea, and is frequently injected into the rectum as a _demulcent in diarrhea and dysentery, and as a vehicle for enemata. Starch is an antidote to iodine. It is utilized in pharmacy as a vehicle to suspend insoluble powders or oils, and in mucilage (1-40, B. P.), as a basis for ointments. Zine oxide, one part; starch and vaseline, each 3 parts, form a very satisfactory preparation for acute eczema in dogs, which does not rub off so readily as zine ointment. Oteum Turosromatis. Oil of Theobroma. (U.S. & B. P.) Synonym.—Butter of cacao, E.; beurre de cacao, Er. ; ; cacaobut- ter, G.; oleum (butyrum) cacao, P. € A fixed oil expressed from the roasted seed of TeheoR eat Cacao Linné (nat. ord. Sterculiacez). Properties.—A_yellowish-white solid, having a faint, agreeable odor, and a bland, chocolate-like taste. Readily soluble in ether or chloroform. Constituents.—1, olein; 2, stearin; 3, theobromine, C;H,N,O,, an alkaloid; 4, glycerides of formic, butyric, and acetic acids. Uses.—Cacao butter melts at the temperature of the body, and is chiefly used as an excipient for suppositories and electuaries. It also has a demulcent action and may be employed on raw surfaces or in inflammation of the throat and digestive tract. Gossypium Pouriricatum. Purified Cotton. (U.S. P.) Synonym.—Absorbent cotton, E.; bombyx, lana gossypii,— coton, Fr. ; baumwolle, G. The hairs of the seed of Gossypium herbaceum Linné, and of other cultivated species of Gossypium (nat. ord. Malvaces), freed from adhering impurities and deprived of fatty matter. Habitat.—Tropical Asia and Africa; cultivated in subtropical and tropical countries, mostly in the Southern United States. Description.—White, soft, fine filaments, appearing under the microscope as hollow, flattened and twisted bands, spirally striate and slightly thickened at the edges; inodorous and tasteless; insoluble in ordinary solvents, but soluble in copper ammonium sulphate solu- tion. Uses.—Absorbent cotton is used as a cheap, convenient and cleanly substitute for ordinary sponges; to make poultices by soaking it in antiseptic solutions (as lysol or creolin, 1-2 per cent.) and plae- ing it between layers of gauze; and for surgical dressings. 568 VEGETABLE DRUGS Oakum, consisting of the fibres of old rope, is often employed as a cheap absorbent material, saturated with tar, in packing horses’ feet. Tow,—The coarser unbleached fibres of flax; and lint,—the scrapings of soft, loosely woven linen,—are also utilized as absorbent substances for surgical purposes. Pyroxyrinum. Pyroxylin. (U.S. & B. P.) Synonym.—Gun cotton, soluble gun cotton, colloxylin. Derivation.—Made by maceration of purified cotton, 100; in a mixture of nitric acid, 1400; and sulphuric acid, 2200; at a tem- perature of 32° C. (90° F.), until a sample is soluble in a mixture of 1 volume of alcohol and 8 volumes of ether; washing with cold and boiling water, draining, and drying in small pellets. PREPARATIONS. Collodium. Collodion. (U.S. & B. P.) Pyroxylin, 40; ether, 750; alcohol, 250. Made by solution, agitation, and decantation of clear portion. Collodium Cantharidatum. Cantharidal Collodion. (U.S. P.) Synonym.—Blistering collodion. Made by percolation of cantharides, 60; with chloroform, distillation of the chloroform and evaporation of the residue until it weighs 15 (Gm.), and solution in flexible collodion, 85. Collodium Flexile. Flexible Collodion. (U. S. & B. P.) Mix collodion, 920; Canada turpentine, 50; and castor oil, 30. (U.S. P.) Collodium Stypticum. Styptie Collodion. (U. S. P.) Mix tannic acid, 20; alcohol, 5; ether, 25; add collodion to make 100. Action and Uses.—Collodion, when painted on dry skin, rapidly dries and leaves a thin, protective coating. It is a useful agent to seal and secure coaptation of small wounds and to keep them aseptic. Also to protect abraded surfaces, as fissures of teats. Flexible col- lodion is less apt to crack. Collodion contracts the superficial tissues and will often abort boils when applied directly over them. Col- lodion is employed as a vehicle for the application of many other agents, as salicylic acid (p. 444), corrosive sublimate, carbolic acid, iodoform, ete. EUPHORBIUM 569 Evupuorsium. Euphorbium. (Non-official.) The dried juice of a cactus-like plant, Euphorbium resinifera, growing in Morocco and regions contiguous to the Atlas Mountains. Obtained by incising the stems and branches. Description.—In dull yellowish tears, of the size of peas; odor- less; taste acrid; powder of a grayish color; insoluble in water, but soluble in alcohol, ether and oil of turpentine. Constituents.—1, an amorphous, bitter, acrid resin (C,)>H,,02), 40 per cent., the active principle; 2, euphorbon (C,3;H».0), a erys- talline resin, soluble in chloroform and ether (20 per cent. of drug). Action and Uses.—Euphorbium is an intense irritant, both ex- ternally and internally. It is sometimes employed in veterinary medicine as a constituent of vesicating preparations to enhance their effect, but if applied alone it is liable to cause extensive irritation, sloughing, and destruction of tissue. Euphorbium may, however, be safely applied in tincture (1-16), or in ointment with cantharides, as a vesicant for horses. The following combination is recommended as a powerful blister for the latter animals. Euphorbium and can- tharides, each two parts; corrosive sublimate, one part; vaseline, eight parts; cerate, twelve parts. There is no danger of absorption and genito-urinary inflammation from the use of euphorbium, as with cantharides. SECTION XVIII.—MEDICINAL AGENTS OF ANIMAL ORIGIN. - GranpuLm SuprrEenates Stcom. Dessicated Suprarenal Glands. (U.S. P.) The suprarenal glands of the sheep (Ovis aries Linné) or ox (Bostaurus Linné), freed from fat, and cleaned, dried, and pow- dered. A light yellowish-brown, amorphous powder, having a slight, characteristic odor; partially soluble in water. Doso— Ties 4.) Dr or. Ive, (25). ADRENALIN or Eprnepurin, C,H,(OH), CHOH CH, NHCH,. Adrenalin (epinephrin) is the active principle of the supraren al glands, first isolated by Abel (although the discovery 1s commonly 570 VEGETABLE DRUGS credited to Takamine), and introduced into medicine at the beginning of this century. It is a light, white, microcrystalline substance, slightly soluble in cold water, especially when slightly acidulated with HCl. It has a somewhat bitter taste and produces a benumbing of the tongue. Adrenalin is permanent in powder, but changes color and is oxidized in aqueous solution. It is said to be the active prin- ciple of the suprarenals, but non-toxic, which can not be said of the glands or their extracts (and not of adrenalin). Adrenalin is from 825 to 1,000 times more powerful than the glands in its physiological effect. Solutions may be boiled without impairing their therapeutic activity. Action.—Circulation.—The action of adrenalin on the circula- tion is only seen:to advantage when the drug is given intravenously. Then there is a great rise of blood pressure and the heart beats first more rapidly and strongly, then more slowly, and again it is acceler- ated. The cause of the high blood pressure is stimulation of the sympathetic nerve endings (vasoconstrictors) of the thoracico-lumbar cord, and also it is in part due to the stronger contractions and more complete evacuation of the heart cavities, thus increasing its output. The vessels in the abdominal cavity are more particularly contracted while the blood vessels of the lungs, brain and heart are not supplied with sympathetic fibres and are not constricted. The result is that the blood is forced out of the abdominal organs, and the heart, lungs and brain are correspondingly congested. The peculiar effect of adrenalin on the heart is due to primary stimulation of the accelerator nerve endings of the heart muscle, making the organ beat faster and more strongly, while the slowing is due to stimulation of the vagus centre by the increased blood pres- sure. Acceleration again occurs when the blood pressure falls away, and the vagus ceases to be stimulated, and accelerator stimulation resumes its sway. The action on the circulation is very transient, lasting not more than ten minutes, and being repeated with each new dose. But the predominant and most valuable effect of adrenalin con- sists in the complete blanching of mucous membranes and raw sur- faces after the local application of these substances. Adrenalin is undoubtedly the most powerful astringent and hemostatic known, owing to its stimulation of the involuntary muscles of the blood vessels. Subcutaneous injection of a 1 to 1000 solution causes blanching over an area about two inches in diameter within a minute and lasts for six to twelve hours. Solutions containing adrenalin to the amount of 1 to 5000, 1 to 10,000, or even 1 to 20,000, will produce an ischemia after their hypodermic use within a few minutes and ADRENALIN 571 lasting for three to six hours. Neither ecchymoses nor sloughing occurs after the proper injection of the drug. Secondary hemorrhage does not ordinarily appear after the use of adrenalin, but it will pre- vent the secondary relaxation, congestion and pain sometimes seen following the use of cocaine. The local constricting action is undoubtedly due to direct stimu- lation of the vasoconstrictor nerve endings as it does not occur when adrenalin is painted on the lung or brain since their vessels are not supplied with sympathetic fibres. The local contraction of blood vessels by adrenalin prevents its ready absorption when it is applied externally, taken by the mouth or injected subcutaneously. For this reason the intramuscular, or better, intravenous injection are indicated for its systemic effect. Abdominal Organs.—Here stimulation of the sympathetic nerve endings gives rise to different actions according to the special functions of the fibres stimulated. Thus movements of the bowels and stomach are inhibited, and lost in poisoning, through stimulation of the splanchnics. The same action is exerted on the gall bladder whose movements are inhibited. The pyloric, anal and ileo-colie sphincters, .on the other hand, receive motor fibres from the sympathetic and are thus contracted by the stimulation of the sym- pathetic. Action on the uterus (contraction or relaxation from pre- ponderance of inhibitory or motor fibres) varies with the species of animal and whether pregnant or non-pregnant, according to the particular effect of the sympathetic stimulation. The same remark applies to the action of adrenalin on the urinary bladder. Toxicology.—Poisoning may be produced in animals by the intravenous and subcutaneous injection of adrenalin. In smaller poisonous doses there are glycosuria, diuresis and nephritis, while fatal amounts cause vomiting, restlessness, tremors, paraplegia, pros- tration, dyspnea from edema of the lungs, respiratory failure and death. There is increase in the secretion of saliva, tears, bile and esophageal and bronchial mucus. The secretions are increased by sympathetic stimulation but not greatly, on account of the vascular constriction. Summary.—Study of the evolutionary development of the su- prarenals shows that the secreting portion of the glands is derived from the sympathetic system. Suprarenal secretion (adrenalin) acts in the body to always and everywhere stimulate sympathetic nerve endings. Thus it stimulates the heart (accelerator stimulation), constricts blood vessels (vasoconstrictor stimulation), inhibits the action of the stomach and bowels (splanchnic stimulation), dilates the pupil (sympathetic nerve stimulation), and contracts or relaxes the uterus 572 VEGETABLE DRUGS according as to whether the motor or inhibitory fibres. predominate in the hypogastic nerve. Many authors teach that adrenalin acts by direct stimulation of unstriated muscle. But it affects unstriated muscle differently (relaxation or contraction) and its action corresponds precisely to sympathetic stimulation. Furthermore it fails to constrict the vessels of parts (lungs and brain) not supplied by sympathetic fibres. Uses.—Eaternal.—Adrenalin chloride is commonly sold in a 1 to 1000 aqueous solution in the shops. It has proven of most value when combined with cocaine for subcutaneous use in operative work. One part of the 1-1000 solution may be added to nine parts of normal salt solution (one heaping teaspoonful of sodium chloride to the quart of sterile water), to which is added 1 per cent. of cocaine, or more if desired. A stronger solution of adrenalin chloride than this (1 to 10,000) is not usually desirable in operative work, because it is irri- tating, and in some instances when stronger solutions were used so much ischemia was produced that the blood vessels could not be found and ligated and secondary hemorrhage ensued. It is usually suffi- cient to add Mx.-xx. adrenalin solution (1-1000) to 3ss. of cocaine solution. The combination of cocaine with adrenalin is coming into gen- eral favor and marks a distinct progress in local anexsthesia. Four advantages are claimed for this combination; 1, that the operation is made comparatively bloodless; 2, that the cocaine is retained in the operative field a longer time, owing to the contracted state of the vessels, and does not escape into the general circulation; this is a double advantage—in prolonging anesthesia and in preventing sys- temic effect of cocaine; 3, that adrenalin is a circulatory stimulant and will offset the toxic action of cocaine; 4, that adrenalin counter- acts the vascular relaxation seen sometimes after the use of cocaine. Adrenalin has also proven of great service in arresting hemor- rhages from wounds, mucous membranes and cavities of the body. A solution equivalent to a 1 to 5000 of adrenalin in sterile salt solu- tion may be applied for this purpose directly to the bleeding surface, or gauze saturated with it may be packed into wounds and cavities, as the nose, uterus and vagina. Adrenalin chloride is useful also in many inflammatory diseases of the eye and nose in the same strength. Catarrhal conjunctivitis, keratitis, episcleritis and iritis yield to its influence, particularly when it is combined with other astringents on account of its transient action. It is instilled with atropine in iritis. Adrenalin chloride in a 1:to 5,000 solution containing 2 per cent. of boric acid forms a useful preparation for general applications in inflammations of mucous membranes. Two to four Ce. of adrenalin solution are injected on either side of the fetlock in acute laminitis ADRENALIN 573 to lessen the blood supply in the foot. The treatment is too recent to determine its value and the reports have been somewhat conflict- ing. Internal.—Adrenalin has been given empirically in azoturia with the most favorable results according to the reports of many re- liable practitioners. Two drams of the 1-1000 solution in a little water are to be administered every two hours, combined with arecoline under the skin. Adrenalin is employed internally to arrest bleeding from the stomach, intestines and uterus. Its local application in hemorrhage from the bladder, rectum, nose, vagina and uterus is, however, much more effective. The drug is said to have yielded good results in human practice in the treatment of diabetes insipidus and purpura hemorrhagica. It is not of benefit for the arrest of internal hemorrhage other than in the digestive tract. This follows because it does not contract the vessels of the brain and lungs and because its effect in increasing general blood tension is inimical to its local effects in constricting vessels. Reichert, as the result of his experiments on morphinized dogs, be- lieves that adrenalin is a valuable and rapidly acting stimulant to the heart, vasomotor system and respiration in poisoning by opium and anesthetics. The latest experimental and clinical studies show adrenalin is of chief value for internal use in conditions of greatly reduced blood pressure, as in poisoning by ether and chloroform inhalation, by chloral, and in surgical shock. Here it is now considered the most efficient remedy, although its action is very transient. Bossi has artificially produced osteomalacia in sheep by removal of one adrenal gland. Treatment has likewise been successful in osteomalacia in the human, and in rickets in puppies by intramuscular injection of 1-1,000 adrenalin solution (m.v.-xv. t.1.d.). Administration.—Adrenalin is preferable to the so-called supra- renal extracts, the dried and powdered suprarenal capsules of sheep and oxen. When the drug is given by the mouth or rectum, its action on the system at large is slow and uncertain, owing to the tardiness of absorption, presumably due to the vascular constriction it occasions and to its rapid decomposition. Intravenous injection is most effective in solutions of 1 to 10,000, or more dilute, in normal salt solution. Subcutaneous injection is somewhat uncertain owing to slow absorption, through vascular constriction. But the 1-1,000 solution (H., 3 i.; D., mx.) may be injected deep into the muscle with certain effect and without irritation. A stronger solution than 1 to 10,000 may cause an abscess if the drug be given hypodermically. The doses of adrenalin chloride in 1 to 1000 solution are: Dogs, MN 10.-60. (0.6-4.0) ; horses, 5 1-4 (4.-15.) Adrenalin should be 574 VEGETABLE DRUGS repeated once in two hours when given internally as an hemostatic. It is an expensive drug. Cantuaris. Cantharides. (U.S. & B. P.) Synonym.—Spanish flies, blister beetles, muses hispanic, E. ; oe Fr.; spanische fliegen, canthariden, G.; cantharides, G. Cantharis is the beetle, Cantharis vesicatoria De Geer (class _ Insecta; order Coleoptera) thoroughly dried at a temperature not exceeding 104° F. Habitat.—Southern Europe, Germany and Russia; living chiefly on Oleacez and Caprifoliaces. Description.—About 25 Mm. long and 6 Mm. broad; flattish eylindrical, with filiform antenne, black in the upper part, and with long wing-cases, and ample, membranous, transparent, brownish wings, elsewhere of a shining, coppery-green color. The powder is grayish-brown, and contains green shining particles. Odor strong and disagreeable; taste slight, afterwards acrid. Constituents.—1, the active principle is cantharidin, C,,H,.0, (2 per cent.), in colorless scales, insoluble in water, soluble in alcohol, ether, chloroform, oils, acetic acid and acetic ether; it is found chiefly in the generative organs, eggs, and blood of the beetles; 9 2, a volatile oil; 3, a bland, green oil; 4, acetic and uric acids, extractives and salts; cantharides deteriorates with age and should be kept unpow- dered in tightly stoppered bottles. Dose.—Hi. & C., gr. v.-xx. (.3-1.3); Sh. & Sw., gr. iv.-viii. (.25- oi er eli. (.06- 12), PREPARATIONS, Tinctura Cantharidis. Tincture of cantharides. (U. S. & B. P.) Made by percolation of cantharides, 100; with alcohol to make 1000. (U. 8. P.) Dose.—H. & C., 3ii-iv. (8.-15.); D., Mii-xv. (.12-1.). Ceratum Cantharidis. (U.S. P.) Cantharidis powdered, 320; petrolatum, wax, rosin and lard to make 1000. Unguentum Oantharidis. (B. P.) Action Haternal.—Cantharides, by virtue of cantharidin, is an intense irritant. When applied to the skin in ointment it produces no effect for several hours, but after that time causes dilatation of the cutaneous vessels, hyperemia, and blisters, which appear in from CANTHARIDES 575 3 to 12 hours. The blisters soon break, discharge their serous con- tents, and then dry and crust the surface. If the action of can- tharides is maintained continuously; if the application is repeated, or covered with a bandage; or if the skin was previously inflamed, then inflammation of the deeper-seated parts ensues, followed by suppuration, sloughing, loss of tissue, destruction of hair follicles, and scars. The drug is therapeutically a rubefacient and vesicant, and counter-irritant, in occasioning dilatation of the superficial ves- sels, and reflexly, contraction of those in the remote underlying parts. Cantharides acts more powerfully on the skin of horses and dogs, than on that of cattle and swine. If applied over an extensive sur- face, absorption and poisoning may occur. Action Internal.—Cantharides affects mainly the digestive and genito-urinary tracts. It is a violent gastro-intestinal irritant. Toxie doses cause vomiting, in animals capable of the act, at first bilious (and containing greenish specks of the wings and wing cases), then mucous, and finally bloody. There is purging in all, associated with great pain and straining, of a mucous, fibrinous, and often hemorrhagic character. There are salivation, swelling and pain in the salivary glands. The gastro-enteritis is accompanied by general prostration, and feeble, rapid pulse. A few hours after the occur- rence of the preceding symptoms there is enough absorption of can- tharidin to induce lumbar pain, followed by frequent, scanty and painful micturition (strangury). The urine is albuminous and often bloody. Cantharides is eliminated chiefly by the kidneys, but also to some extent by the other excretory organs, including the skin. Sexual excitement may be present in poisoning. It is more common with small than large toxic doses. There are erections and great heat in the penis, and even inflammation and sloughing of the organ. Abortion is precipitated in the pregnant, and “heat” is has- tened in the non-pregnant female. Stupor, coma, and collapse close the scene after lethal doses. Twenty grains of cantharides have killed a man; forty, a dog; and one drachm has destroyed a horse. The treatment includes the use of emetics or the stomach tube; opium, to relieve pain and strangury; albuminous, mucilaginous drinks; and, in collapse, external heat, alcoholic stimulants, cam- phor, digitalone, strychnine and atropine under the skin. Oils and fats dissolve cantharidin and must not be given in poisoning as de- mulcents. Post-Mortem Appearances.—Swelling, congestion, ecchymoses, and erosion of the gastro-intestinal mucous membrane are observed after death by cantharides. There are, moreover, lesions of acute nephritis and cystitis, with inflammation of the whole genito-urinary 576 VEGETABLE DRUGS mucous membrane. Hyperemia of the brain and spinal cord have also been reported. Uses Haternal.—Cantharides is employed more frequently than any other counter-irritant, to cause blistering, in veterinary practice. The reader is referred to the section on counter-irritants (p. 626) for an account of their actions. The action of cantharides is too tardy and irritating, and there is too much danger of absorption and poison- ing to recommend it for the production of counter-irritation over an extensive area (chest and abdomen) in acute pulmonary congestion, pneumonia, bronchitis, colic, enteritis and peritonitis. Mustard, tur- pentine, and external heat are generally preferable in these disorders. A blister of cantharides is serviceable in pericarditis and pleuritis with effusion, and, applied over the throat in severe, acute laryngitis, may obviate the necessity of tracheotomy. Again, blisters are useful on the poll in inflammation of the brain and its membranes; and over the spine in myelitis and meningitis; over the lumbar region in para- plegia. A eantharidal application is often efficacious in muscular or joint rheumatism when placed over the affected area, or near by, in acute conditions. Furthermore, a cantharides blister is of advantage in acute diseases of the ear, when rubbed in above and behind this organ; and will relieve pain in the stomach, and vomiting when applied to the epigastrium. Cantharides is the remedy usually employed in the treatment of diseases of the bones, joints, burse, ligaments, and tendons. In exostoses, as spavin and ringbone, the ointment is used most effectively after the actual cautery, to secure absorption and resolution, or anchylosis. Cantharidal ointment is often sufficient, together with complete rest, in the treatment of synovitis, and strains of tendons and ligaments. A cantharides blister is, sometimes, beneficial in hastening the formation of abscesses (“strangles”’); or to aid their resolution after paracentesis; also to stimulate indolent ulcers or wounds; and to assist absorption of traumatic indurations, when ap- plied around these lesions. The actual cautery, followed by a can- tharides blister, will cause swelling and close the opening in the abdominal parietes of small umbilical hernias of foals and calves. Likewise, blisters are valuable in closing and sealing punctured wounds into joints and synovial cavities.* Cantharides is commonly employed in ointment (1 to 4 to 8) made by melting and mixing the excipients in a double boiler; 7.e., over a water bath, and stirring in thoroughly the powdered drug. The following is a good prepara- tion: *The U. S. P. cerate may be used, as it is a powerful preparation. Its strength is 32 per cent. cantharides. LARD BTL Pulv. Cantharidis. COPS GET eet ee ero Ca EO ety CR SET ENON aa 3 ii. AGO: gnodod0d0dccc0U5 ono OUND ODD OOOO 3 Xiv. S. External use. More powerful ointments are made with powdered euphorbium and cantharides, each 2 parts; corrosive sublimate, 1 part; vaseline, 8 parts; cerate, 12 parts; or, Tar and resin, each + parts; yellow wax, 3 parts; cottonseed oil, 10 parts; powdered euphorbium, 2 parts; cantharides, 6 parts. The technique of blistering consists in cutting the hair and wash- ing the part to be blistered, and rubbing the blister long and thor- oughly into the skin. The animal should be controlled by tying up the head, or using a cradle, or side-bar attached to the halter and surcingle, to prevent horses from biting the blistered area. The tail should be tied up if the blister is applied within its reach. Dogs should be muzzled, but are apt to rub the sore spot. The serum discharged from the blister must be continually sponged off with soap suds and water, to prevent excoriation of the subadjacent skin, or the latter may be covered with rosin cerate, or, better, a solution of rosin in alcohol, by means of a brush. The blister is washed off in 36 or 48 hours after its application, and vaseline should thereafter be kept on the part. The use of cantharidal blisters is contraindicated in weak or young animals; on the flexures of joints; or delicate skin on the inner aspect of the upper part of the limbs; on acutely inflamed areas; and in renal disease. Uses Internal.—Cantharides is rarely administered internally. It is sometimes successful in stopping incontinence of urine, when due to relaxation of the neck of the bladder, and it may be used as a stimulant in chronic cystitis and pyelitis. Cantharides is recom- mended to inerease sexual desire in cows and mares, but it has usually to be given in toxic doses to produce an aphrodisiac action. The tincture should be employed when the drug is exhibited internally. Apres. Lard. (U. 8S. & B. P.) Synonym.—Adeps preeparatus, B. P.; axungia, axungia porci s. poreina, prepared lard, hog’s lard, E.; axonge, graisse de pore, Fr.; schweineschmalz, G.; adeps suillus, P. G. The prepared internal fat of the abdomen of the hog (Sus Serofa Var. domesticus Gray.) (class Mammalia; order Pachyder- mata), purified by washing with water, melting, and straining. 578 VEGETABLE DRUGS Properties.—A soft, white, unctuous solid, having a faint odor free from rancidity, and a bland taste; insoluble in water; slightly soluble in alcohol; readily soluble in ether, chloroform, carbon disul- phide, or benzin. Spec. gr. about 0.917 at 77° F PBEPARATIONS. Ceratum. Cerate. (U.S. P.) Synonym.—Cerat simple, Fr.; einfaches cerat, wachssalbe, G. White wax, 300; white petrolatum, 200; benzoinated lard, 500. Unguentum. Ointment. (U.S. P.) Synonym.—Unguentum simplex, B.P.; simple ointment, E.; pommade sim- ple. Fr.; wachssalbe, G. Lard, 800; white wax, 200. (U.S. P.) Ceratum Resinoe. (See p. 459.) Adeps Benzoinatus. (See p. 464.) Srvum Preparatum. Prepared Suet. (U.S. & B. P.) Synonym.—Sevum preparatum, B. P.; mutton suet, E.; suif, Fr.; talg, hammeltalg, G.; sebum, P. G. The internal fat of the abdomen of the sheep Ovis aries Linné (class Mammalia; order Ruminantia), purified by melting and strain- ing. Properties.—A. white, solid fat, nearly inodorous, and having a bland taste when fresh, but becoming rancid on prolonged exposure to the air. Insoluble in water or cold alcohol; soluble in about 60 parts of ether, and slowly in 2 parts of benzin. Constituents.—1, olein; 2, stearin; 8, palmitin; 4, hircin. Aprps Lan Hyprosus. Hydrous Wool Fat. (U.S. & B. P.) Synonym.—Lanolin, cesypum. The purified fat of the wool of sheep (Ovis aries, Linné; class Mammalia; order Ruminantia), mixed with not more than 30 per cent. of water. Properties.—A yellowish-white, or nearly white ointment-like mass, having a faint, peculiar odor. Insoluble in water, but miscible with twice its weight of the latter, without losing its ointment-like character. Constituents.—1, cholesterin, C.,H,, (OH); 2, ethers of oleic, stearic, palmitic and other acids. ACTION AND USE OF LARD, SUET, ETC. 579 Avers Lanz. (U.S. &B. P.) (Wool fat withcut water. ) ACTION AND USE OF LARD, SUET, AND HYDROUS WOOL FAT. Lard is used mainly as a basis of ointments and cerates. Ben- zoin is commonly added to it to prevent or retard rancidity. Lard is inferior to petrolatum as a lubricant. It is rarely given internally as an antidote to caustic alkalies, and as a demulcent. Suet is contained in certain ointments and plasters. It is harder than lard and becomes rancid on prolonged exposure. lLanolin is not subject to rancidity, but possesses no particular medicinal action. It is indicated where absorption of some drug is desired (mercury, potassium iodide) by inunction, as it is believed to be more readily absorbed from the skin than any other fat. Lanolin is used as a basis of ointments. It may be mixed with twice its weight of water without losing its ointment consistency. Crea Frava. Yellow Wax. (U.S. & B. P.) Synonym.—Cera citrina, beeswax, B. P.; cire jaune, Fr.; gelbes wachs, G. A solid substance prepared from the honey comb of the bee, Apis mellifica Linné (class Insecta; order Hymenoptera). Properties.—A yellowish to brownish-yellow solid, having an agreeable, honey-like odor, and faint, balsamic taste. Spec. gr. 0.951-0.960. It is brittle when cold; by the heat of the hand it becomes plastic. Insoluble in alcohol; sparingly soluble in cold al- cohol, but completely soluble in ether, chloroform, fixed and volatile oils. Constituents—1, myricin or myrical palmitate (Cz )H¢,, C,,H;,0.), a spermaceti-like substance; 2, cerin or cerotic acid (C,,H,;,02), an imperfectly saponifiable waxy body; 3, hydrocarbons (C,,H;, and Cz4H,,); 4, an alcohol (C.;H5.0); 5, ceryl alcohol (C,,H;,0) ; 6, hydrocarbons, 12 per cent. Cera Atpa. White Wax. (U.S. & B. P.) Synonym.—Cire blanche, Fr.; weisses wachs, G. Yellow wax, bleached by exposure to air, light and moisture. Properties.—A yellowish-white solid, somewhat translucent in thin layers, having a slightly rancid odor, and an insipid taste. Spec. er. 0.950-0.960. Solubility and composition the same as those of yellow wax. 580 VEGETABLE DRUGS Uses.—Y ellow and white wax are used as bases for plasters, oint- ments and cerates, since they do not decompose nor melt at the tem- perature of the body. Cyraczum. Spermaceti. (U.S. & B. P.) A peculiar, concrete, fatty substance, obtained from (the head of the sperm whale) Physeter macrocephalus Linné (class Mam- malia; order Cetacea). Habitat.—Indian and Pacific Oceans. Properties.—White, somewhat translucent, slightly unctuous masses of a scaly-crystalline fracture and a pearly lustre; odorless, and having a bland, mild taste. It becomes yellow and rancid by exposure to the air. Spec. gr. 0.938 to 0.944. Insoluble in water, nearly so in cold alcohol; soluble in ether, chloroform, carbon disul- phide, fixed and volatile oils. Constituents.—1, chiefly a fat, cetin or cetyl palmitate (C1, H,3C,gH3;,0.2), composed of cetylic aleohol (C,,H;,0H) and pal- mitic acid (HC,,H,,0.) ; 2, sperm oil, a small quantity. PREPARATION. Unguentum Cetacei. (B. P.) Spermaceti, white wax, and olive oil. Made by melting and mixing. Action and Uses.—Spermaceti resembles wax. It is used as an emollient and as a basis for plasters, ointments, and cerates. It is rarely used alone. Mert. Honey. (U.S. & B. P.) Synonym.—Miel, Fr.; honig, G. A saccharine secretion deposited in the honeycomb by the bee, Apis mellifiea Linné (class Insecta; order Hymenoptera). Properties—A_ syrupy liquid of a bright yellowish to a pale- yellowish-brown color; translucent when fresh, but gradually becom- ing opaque and crystalline; having a characteristic, aromatic odor, and a sweet, faintly acrid taste. Nearly soluble in water. Constituents.—1, grape sugar (dextrose); 2, fruit sugar (glu- cose) ; 3, a volatile oil; 4, wax; 5, formic acid, a trace. Fresh honey contains sucrose or cane sugar, which is changed into grape and fruit: sugars. SUGAR OF MILK 581 PREPARATION, Mel Depuratum. Clarified Honey. (U.S. & B. P.) Synonym.—Mel depuratum, P. G.; miel despumé, mellite simple, Fr.; gereinigter honig, G. Derwation.—Melt honey with two per cent. of its weight of paper-pulp in water bath; skim, strain, and add five per cent. of its weight of glycerin. Dose.—Ad lib. Honey is employed as an excipient in electuaries and confec- tions. It is.a demuleent and mild laxative for young animals. Oxymel (clarified honey, 8 parts; water and acetic acid, each 1 part) is a soothing preparation for the throat. Saccnarum Lactis. Sugar of Milk. (C,,H,.0,, + H,0.) (QUle IS we 1B en) Synonym.— Lactose, lactin, milk sugar, E.; suere de lait, Fr. ; milehzucker, G. A peculiar, crystalline sugar obtained from the whey of cows’ milk, by evaporation, and. purified by recrystallization. Properties.—White, hard, crystalline masses, yielding a white powder, feeling gritty on the tongue; odorless, and having a faintly sweet taste. Permanent in the air. Soluble in about 4.79 parts of water; insoluble in alcohol, ether, or chloroform. Dose.—Ad lib. Uses.—Sugar of milk is less soluble and therefore less sweet than cane sugar. It is harder, and thus assists in the subdivision of drugs, and serves as a vehicle in the making of powders and trit- urates. It also forms the basis of homeopathic preparations. Sugar of milk is a considerable diuretic and may be given to dogs in 2 to 4 drachm doses daily, in solution in the drinking water, for dropsy of renal or cardiac origin. Pspstnum. Pepsin. (U.S. & B. P.) A proteolytic ferment or enzyme obtained from the glandular layer of fresh stomachs from healthy pigs, and capable of digesting not less than 3000 times its own weight of freshly coagulated and disintegrated ege albumen. ; Derivation.—The chopped mucous membrane of a pig’s stomach is macerated for several days in a weak, aqueous solution of hydro- chlorie acid, with frequent stirring. The pepsin is precipitated from this solution by the addition of sodium chloride and rises to the a 582 VEGETABLE DRUGS surface. The floating mixture is skimmed off, drained, pressed and dried. Sometimes the surface of the clean mucous membranes of the stomach of pigs, calves, or sheep is simply scraped off and dried. Properties.—Lustrous white, pale yellow or yellowish, trans- parent or translucent scales or grains, or a fine white or cream-colored amorphous powder, free from any offensive odor, and having a slightlv acid or saline taste. It should be not more than slightly hygroscopic. Soluble, or almost entirely soluble, in about 50 parts of water, the solution having more or less opalescence; more soluble in water acidulated with hydrochloric acid; insoluble in alcohol, ether or chloroform. Pepsin, when in solution, is incompatible with alkalies, alkaline earths, or alkali carbonates. Dose.—D., Calves and Foals, gr. x.-3 i. (.6-4.). PREPARATIONS. Glycerinum Pepsini. (B. P.) (Contains hydrochloric acid, 3i.=gr.v. pepsin.) Dose.—D., 3 i.-ii. Action and Uses.—Pepsin is of some value in the treatment of dogs and young animals.” It assists the digestion of proteids in the stomach, but has no aetion on fat or carbohydrates of the food. The drug should usually be given along with hydrochloric acid, which converts any pepsinogen, in the gastric tubules, into pepsin. Pepsin contains the unorganized digestive ferment of the gastric juice, but is not by any means the pure ferment, which has never been isolated. Much of the commercial pepsin is inert, or is composed largely of mucus, albumin and peptone, which later gives the preparation a musty odor and causes it to absorb moisture when exposed to the air, and to become sticky. Pepsin is serviceable in gastric indigestion of young animals, which is sometimes accompanied by diarrhea, and in dyspepsia and feeble digestion caused by acute illness. Its use must not be long persisted in, as the normal functions of the stomach will fail from lack of use. Pepsin is administered in pill, or solution with hydro- chloric acid. PanorEatinum. Pancreatin. (U.S. P.) Synonym.—Zymine, B. P. A mixture of the enzymes naturally existing in the pancreas of warm-blooded animals, usually obtained from the fresh pancreas of PANCREATIN 583 the hog (Sus scrofa, var. domesticus Gray), or the ox (Bos taurus Linné), and consisting principally of amylopsin, myopsin, trypsin, and steapsin, and proved to be capable, when assayed, of converting not less than 25 times its own weight of starch into substances soluble in water. Derwvation.—Chopped hog’s pancreas is macerated in a dilute aqueous solution of hydrochloric acid for 48 hours, and pancreatin, which is separated by adding a saturated solution of sodium chloride, rises to the surface and is skimmed off, drained, washed, and when nearly dry, is diluted with sugar of milk until 10 grains will exactly emulsify 2 drachms of cod-liver oil. Properties.—A yellowish, yellowish-white or grayish, amorphous powder; odorless, or having a faint, peculiar, not unpleasant odor, and a somewhat meat-like taste. Slowly and almost completely solu- ble in water; insoluble in alcohol. Dose.—D., gr. v.-xv. (.8-1.). Action and Uses.—Pancreatin fulfils a fourfold function by vir- tue of the four ferments contained in it. It digests proteids by means of the ferments, trypsin and myopsin; it decomposes and emulsifies fat owing to the ferment, steapsin; it converts starch into sugar by reason of the ferment, amylopsin; it coagulates milk through the action of a milk-curdling ferment. Pancreatin is thus more useful than pepsin on account of its more extended actions. Tt does not digest food in an acid medium, but may aid digestion in the stomach, before much gastric juice has been secreted, during the first half hour after the ingestion of food. Pancreatin acts more efficiently in intestinal indigestion because of the presence of an al- kaline secretion. For this reason pancreatin is commonly prescribed with sodium bicarbonate, and, if given for intestinal indigestion, it is administered in pill or tablet to dogs one or two hours after feeding. It is indicated in diarrhea, when the fecal movements contain particles of undigested food, and in other forms of deficient digestion due to general disease. Pancreatin is more especially valuable to digest food previous to its administration by the mouth or rectum (see Artificial Feeding, p. 624). For this purpose a good preparation can be made extemporaneously by washing and cutting up a fresh pig’s pancreas, soaking it in absolute alcohol for 24 hours, pressing out the alcohol, macerating it in ten times its weight of glycerin for 48 hours, and filtering. The filtered glycerin extract is added in the proportion of 3 i. to the pint of warm milk, with a little sodium bicarbonate, to artificially digest it. 584 VEGETABLE DRUGS Fret Bovis. Oxgall. (U.S. P.) Synonym.—F el tauri, inspissated oxgall, E. The fresh bile of Bos Taurus Linné (class Mammalia; order Ruminantia). Properties.—A_ brownish-green or dark green, somewhat viscid liquid, having a peculiar, unpleasant odor, and a disagreeable, bitter taste. Spec. gr. 1.015 to 1.025. It is neutral, or has a slightly al- kaline reaction. PREPARATION, Fel Bovis Purificatum. Purified Oxgall. (U.S. P.) Synonym.—Fel bovinum purificatum, B.P.; fiel de boeuf purifie, Fr.; gereinigte ochsengalle (rindsgalle), G. Evaporate oxgall, 300, to 100; add alcohol, 100. The alcohol is distilled off from the decanted and filtered solution, and the remainder evaporated to pilular consistence. Properties —A_ yellowish-green, soft solid, having a peculiar odor and a partly sweet and partly bitter taste. Very soluble in water and alcohol. Dose.—Same as for oxgall. Dose.—D., gr. v.-xv. (.3-1.). Actions and Uses.—Purified oxgall contains all the active ele- ments of bile,—biliary acids, coloring matter and cholesterin. One part of oxgall represents about fifteen parts of bile. Most of the bile ingested is absorbed from the stomach (where it may act as a simple bitter), and small intestines, and is carried to the liver. From the liver it is not only excreted again into the bowel but it also stimulates the secreting cells of the liver (by means of bile acids) and increases the secretion of bile. Bile is in fact the only certain cholagogue known. Bile has but a feeble antiseptic action, yet it excites the secretion of the pancreatic fat-splitting ferment and aids the absorption of fat in the food. In thus aiding digestion it prevents the fetid feces seen in biliary obstruction. Bile, moreover, assists the solubility and action of certain cathartics, viz., podophyllum, rhubarb, scammony, aloes and jalap—and has a laxative action itself, probably through the irritation of bile acids on the large intestines. Bile is indicated medicinally in obstruction to the normal flow of bile—to aid in- testinal digestion—and also to facilitate the action of the cathartics noted above. It may be used also to advantage in enema for dogs with chronic constipation and impacted feces (2 drams to 2 ounces of water). Internally it is given to dogs in pills 2 hours after meals. PAPAIN 58 pe | Papatn. (Non-official. ) Synonym.—Papayotine, papaya, papayine, papoid. A digestive ferment obtained from the juice of the unripe fruit of Carica papaya (Papaw), an herbaceous tree growing in the East and West Indies. Papain or papayotine are often used to describe the dried juice itself, which exists in the form of a powder similar to that of gum arabic. Papain occurs in the form of a white, or greyish-white, nearly tasteless powder, soluble in glycerin and water. Papain is said to digest both proteids and carbohydrates, in either an acid or alkaline medium, and is recommended in gastric or in- testinal indigestion in pill or powder. It has also been used to destroy pyogenic membrane of fistule and abscess, in 5 per cent. solution; or tumors and malignant growths, injected into the tissues in 10 per cent. solution. This latter use is accompanied by pain and febrile temperature, although the substance is said to merely dissolve diseased tissues without caustic effect. Papain may be given to dogs, foals, or calves in doses of gr. ii.-x. (.12-.6). Oreum Morruvam. Cod liver oil. (U.S. & B. P.) Synonym.—Oleum jecoris ascelli, P. G.; oleum hapatis mor- rhuz, cod oil, E.; huile de morue, huile de foie de morue, Fr. ; leberthran, stockfischleberthran, G. A fixed oil obtained from fresh livers of Gadus morrhua Linné and other species of Gadus (class Pisces; order Teleostei; family Gadide). Hatbitat.—North Atlantic Ocean. Properties.—A pale-yellow, thin, oily liquid, having a peculiar, slightly fishy, but not rancid odor, and a bland, slightly fishy taste. Spec. gr. 0.918 to 0.922. Scarcely soluble in alcohol, but readily soluble in ether, chloroform or carbon disulphide; also in 2.5 parts of acetic ether. Brown oils are not desirable therapeutically. Constituents.—1, glycerin oleate, 70 per cent.; 2, palmitin and stearin, 25 per cent.; 3, oleic, margaric, palmitic, stearic, butyric and acetic acids, in small quantities; 4, biliary matter, as cholic, fellinic and bilifellinic acids; 5, gaduin (C,,H,,0,) ; 6, morrhuol, a erystalline substance containing iodine, phosphorus and bromine; 7, traces of iron, lime, and magnesia; 8, decomposition products or cadaveric alkaloids, in brown oils. Dose.—H. & ©., 3 ii.-v. (60.-120.); Sh. & Sw., J ss.-i. (15.- 30.); D. & C., 3 1-1. (4.-12.). Action Internal.—Cod liver oil resembles other oils in aiding nutrition, the accumulation of fat, and the maintenance of bodily 586 VEGETABLE DRUGS heat, but surpasses them in three particulars: 1, cod liver oil is more easily absorbed; this has been proven comparatively by in- jecting various oils into separate ligated portions of the living animal bowel; 2, cod liver oil is more readily oxidized after absorption; this is shown by the fact that it reduces and therefore changes the color of potassium permanganate solutions more quickly than other oils; 8, cod liver oil increases the number of red blood corpuscles in anemia; this has been demonstrated by blood-counts, but not by comparison with the effect of other oils. The ease of absorption is thought by some to be due to biliary principles which aid the dif- fusion of substances through a mucous membrane (osmosis) when the latter is moistened by bile; by others it is attributed to the pres- ence of free acids in the oil which would tend to saponify and emul- sify the drug. The medicinal superiority of cod liver oil has led many writers to classify it as an alterative, and special properties have been referred to the minute traces of iodine, phosphorus, and bromine in the oil. These agents exist in too infinitesimal an amount to exert much therapeutic action. It is probable that no one constituent, or group of constituents, yet separated from the oil truly represent its medicinal effect. Cod liver oil is inferior to other oils in one respect, however, and this consists in its liability to cause nausea, indigestion, diarrhea and vomiting, in large doses and in some patients. Administration.—Cod liver oil may be given pure, or if this does not agree, it may be exhibited in various ways: 1, with an equal quantity of lime water and a little syrup; 2, with ether (M-x.), small animals; 3 i. to large animals; or with whisky; 3, shaken with white of an egg, or mucilage of tragacanth, and a few drops of oil of peppermint; 4, to dogs, in one of the proprietary emulsions, or with malt extract. The oil should be given after feeding and ad- ministration begun with the smaller doses as recommended above. Uses.—Cod liver oil is indicated generally in conditions of malnutrition occurring primarily; in the course of chronic diseases ; or following acute diseases. It is especially indicated in diseases of the respiratory tract, when it improves the nutrition of the mucous membranes, as well as the general nutrition. Thus cod liver oil is one of the best remedies in tardy convalescence from canine asthma and distemper; from influenza, bronchitis, pneumonia and strangles in horses; also in “heaves,” emphysema, or broken wind in horses. Carron oil is cheaper and very efficient in the latter disorder, given on the food. Cod liver oil is valuable in the treatment of chronic bronchitis, chronic eczema, and chorea of dogs; and in rickets, anemia, weak- ness, and emaciation in all young animals. It often proves curative ICHTHYOL 587 in various forms of muscular and chronic articular rheumatism, and facilitates the absorption of chronically enlarged glands. The use of cod liver oil is contra-indicated in hot weather, and in animals suffering from indigestion or acute diarrhea. It is often beneficial, however, in chronic diarrhea. Linseed oil, oil cake, and cottonseed meal may often be conven- iently and properly substituted for cod liver oil, in the case of the large patients; while morrhuol (gr. iii. =1 teaspoonful cod liver oil?) given in pills, or lipanin (oleic acid, 6; olive oil, 100) may be exhibited in drachm doses to dogs when cod liver oil does not agree. Icutuyotum. Ichthyol. (Non-official.) Synonym.—Ammonium ichthyol sulphonate. Derivation.—A bituminous quartz occurring in the Tyrol Moun- tains, containing the fossil remains of fish, is distilled with strong sulphuric acid, and sulphurous acids are removed from the distillate by sodium chloride, while sulphonic acid separates out. The latter is usually saturated with ammonia, forming ichthyol; but similar preparations are made by the combination of sulnhoniec acid with sodium, lithium and zine. Properties.—A thick, dark, reddish-brown liquid, of a tarry consistency, and possessing a peculiar, disagreeable odor and hot, bituminous taste. It is soluble in water, glycerin, alcohol, benzol, fats and fixed oils. Constituents.—Ichthyol contains about 15 per cent. of sulphur; also an inseparable volatile oil, to which its disagreeable odor is due. Action and Uses.—Ichthyol is one of the most widely used drugs recently introduced into medicine. It is employed.in the treatment of acute and chronic diseases of the skin and subadjacent tissues, accompanied with inflammation, pain, swelling, and induration; also in epidermal proliferation. Ichthyol is supposed to readily permeate the skin, and there act to relieve inflammation and pain, and aid resolution. It is one of the most commonly prescribed remedies in chronic eczema and urticaria; in erysipelas, muscular and articular rheumatic disorders; and in bruised and strained muscles, tendons and ligaments. The drug is commonly used in the treatment of frost bites, burns, and in causing absorption of lymphatic enlarge- ments. Ichthyol is recommended as a cure for sarcoptic mange and scab. The drug is somewhat antiseptic, and is a stimulant, anodyne and resolvent to the skin, locally. Ichthyol is most satisfactorily ap- plied to the unbroken skin in 25 to 50 per cent. ointment, with lanolin or lard. Solutions in water, glycerin, oils or alcohol, are sometimes 588 VEGETABLE DRUGS employed of various strengths. Ichthyol is rarely given internally for chronic rheumatism. While the drug has had the widest use and commendation, and in the most diverse lesions, yet its reputation is waning and was not founded on any solid basis—unless that of its unusually vile odor. Thiol is a substitute for ichthyol, lacking the unpleasant odor of the latter medicament. Thiol is derived from brown-colored paraffin or gas-oils, by a complicated process, and consists of a mix- ture of sulphureted hydrocarbons. The drug exists in two forms: 1, thiolum liquidum, a thin, brownish-black liquid, soluble in water and glycerin; 2, thiolum siccum, occurring in lustrous scales. Thiol is cheaper than ichthyol and is said to be as efficacious as the latter. This remains to be proved. Liquid thiol is employed in 10 per cent. aqueous solution or in ointment; and thiolum siceum in powder, dusted on inflamed parts, as in acute moist eczema. DOSES OF DRUGS. In the following table three doses are usually given for each drug. The first dose is for horses and cattle, in both the apothecaries’ and metric systems of weights and measures. The second dose is for sheep and swine, in both the apothecaries’ and metric systems of weights and measures. The third dose is for dogs (and also eats) in both the apothecaries’ and metric systems of weights and meas- ures. Letters are used to signify the name of the animal for which the dose is intended. Thus: H., Horses; C., Cattle; Sh., Sheep; Sw., Swine; D., Dogs (which also includes cats in most cases). The followng abbreviations are also employed: lb., pound; pt., pint; 0z., ounce; dr., drachm; m., minim; gr., grain; gm., gram; cc., cubic centimeter. These doses are suitable for animals of average weight. Dose Table. ACETANILID.—H. & C., dr. 1-2 (gm. 4.-8.). Sh. & Sw., dr. 3-1 (gm. 2.-4.). D., gr. 3-7 (gm. .2-.5). Acetum Optit.—H., oz. 1-2 (cc. 30.-60.). C., oz. 2-3 (cc. 60.-90.). Sh. & Sw., dr. 2-6 (ce. 8.-24.). D., m. 3-20 (ce. .2-1.3). Acip, ARSENoUS.—H. & C., gr. 2-3 (gm. .12-.2); single dose, gr. 5-10 (gm. .3-.6). Sh. & Sw., gr. 1-2 (gm. .06-.12). D., gr. Yo-Yo (gm. .002-.006). Acip, Benzoic.—H., dr. 2-4 (gm. 8.-15.). D., gr. 5.-15 (gm. .3-1.). Acip, Boric.—H., dr. 2-4. (gm. 8.15.). D., gr. 5-15 (gm. .3-1.). Actp, Carpotic.—H. & C., gr. 15-30 (gm. 1.-2.). Sh. & Sw., gr. 5-10 (gm. .3-.6). D., gr. 3-1 (gm. .03-.06). Actp, Cirric.—H., dr. 2-4 (gm. 8.-15.). D., gr. 10-20 (gm. .6-1.3). Acip, Gattic.—H. & C., dr. 2-4. (gm. 8.-15.). Sh. & Sw., dr. 3-1 (gm. 2.-4.). D., gr. 5-20 (gm. .3-1.3). Actp, Hypriopic (syrup of).—D. dr. 1 (ce. 4.). Acip, HyprocHtoric (dilute).—H., dr. 1-2 (ce. 4.-8.). C., dr. 2-4 (ce. 8.-15.). Sh. & Sw., m. 15-20 (ce. 1-1.3). Sw. & D., m. 5-20 (ce. .3-1.3). 589 590 DOSE TABLE Acip, HypRrocyANic (dilute).—H. & C., m. 20-40 (cc. 1.3-2.6). Sh., m. 10-15 (ce. .6-1.). Sw., m. 2-5 (ce. .12-.3). D., m. 1-3 (ce. .06-.2). Acip, Lactic.—H. & C., dr. 2-4 (ec. §.-15.). D., dr. 4-1 (ce. 2.-4.). Actp, Nitric (dilute).—H., dr. 1-2 (ce. 4.-8.). C., dr. 2-4 (8.-15.). Sh., dr 4-1 (cc. 2.-4.). Sw. & D., m. 5-30 (ce. .3-2.). AcID, NITROHYDROCHLORIC.—H., m. 20-40 (cc. 1.3-2.6). D., m. 3-5 (ce. .2-.3). Acip, NITROHYDROCHLORIC (dilute).—H., dr. 1-2 (cc. 4.-8.). C., dr. 2-4 (ce. 8+ 15.). Sh., dr. 3-1 (cc. 2.-4.). Sw. & D., m. 5-30 (.3-2.). AcID, PHOSPHORIC (dilute).—H., dr. 1-2 (ce 4.-8.). C., dr. 2-4 (ec. 8.-15.). Sh. & Sw., dr. 3-1 (ce. 2.-4.). D., m. 5-30 (.3-2.). Acip, SALIcYLic.—H. & C., dr. 2-8 (gm. 8-30). Sh., dr. 1-4 (gm. 4.-15.). Sw., dr. 3-1 (gm. 2.-4.). D., gr. 5-30 (gm. .3-2.). Acip, SutPHuRiIc (dilute).—H., dr. 1-2 (cc. 4.-8.). C., dr. 2-4 (ec. 8.-15.). Sh, dr. 3-1 (ce. 2.-4.). Sw. & D., m. 10-30 (ce. .6-2.). Acip, SULPHURIC, AROMATIC.—H., dr. 3-1 (ce. 2.-4.). C., dr. 2.-4. (ce. 8.-15.). Sh., m. 15-30 (cc. 1.-2.). Sw. & D., m. 5-15 (ee. .3-1.). Acip, SULPHUROUS.—H. & C., oz. 1-2 (cc. 30.-60.). Sh. & Sw., dr. 1-2 (ce. 4.-8.). D., dr. 4-2 (ce. 2.-8.). Acip, Tannic.—H. & C., dr. 3-4 (gm. 2.-15.). Sh. & Sw., dr. 3-1 (gm. 2.-4.). D., gr. 1-15 (gm. .06-1.). Acip, TarTaric.—H. & C., dr. 2-4 (gm. 8.-15.). D., gr. 10-30 (gm. .6-2.). ACONITE.—H., gr. 3-20 (gm. .2-1.3). D., gr. 49-2 (gm. .006-.12). ACONITE, Ratract of Leaves.—H., gr. 3-6 (gm. .2-.4). D., gr. 4-1 (gm. .03-.06). AconITE, Extract of.—H., gr. 1-3 (gm. .06-.2). D., gr. Y%o-14 (gm. .006-.015). AconitTE, Fluidextract of.—H., m. 3-20 (cc. .2-1.3). D., m. %49-2 (ce. .006-.12). ACONITE, Tincture of.—H., m. xx.-3i. (1.3-4.). C., 3ss.-iss. (2.-6.); Sh. & Sw., m. x.-xx. (.6-1.3). D., m. ii-x. (.12-.6). ACONITINE NITRATE (Squibb).—H., gr. 14, (gm. .002). D., gr. Uoo-oo (gm. .00015.-0003). ADRENALIN SOLUTION.—(By mouth), H., dr. 2-4 (ce. 8.-15.). D., ™10-60 (ce. 0.6-4.). ALOES.—H., oz. 3-1 (gm. 15.-30.). C., oz. 1-2 (gm. 30.-60.). Sh., oz. 3-1 (gm. 15.-30.). Sw., dr. 2-4 (gm. 8.-15.). D., gr. 20-60 (gm. 1.3-4.). Atoin.—H. & C., dr. 2-3 (gm. 8.-12.). D., gr. 2-20 (gm. .12-1.3). AtuM.—H. & C., dr. 2-4 (gm. 8.-15.). Sh. & Sw., gr. 20.-60. (gm. 1.3-4.). D., gr. 5-10 (gm. .3-.6). Emetic, dr. 1 (gm. 4). ' Ammonia, Aromatic Spirit of.—H. & C., oz. 1-2 (cc. 30.-60.). Sh. & Sw., dr. 2-4 (cc, 8.-15.). D., dr. $-1 (ee. 2.-4.) DOSE TABLE 591 AMMONIA, Spirit of. —H. & C., oz. 3-1 (cc. 15.30.). Sh. & Sw., dr. 1-2 (ce. 4.-8.). D., m. 10-20 (ce. .6-1.3). AmmoniA, Water of —H. & C., oz. 4-1 (ce. 15.-30.). Sh. & Sw., dr. 1-2 (ce. 4.-8.). D., m. 10-20 (ce. .6-1.3). Ammonia, Stronger Water of.—H. & C., dr. 2-6 (cc. 8.-24.). Sh. & Sw., dr. 1 (ce. 4.). D., m. 5-10 (ce. .3-.6). AMMONIUM, Solution of Acetate-—H. & C., oz. 2-4 (cc. 60.-120.). D., dr. 2-8 (ee. 8.-30.). AMMONIUM BENZOATE.—H., dr. 2-4 (gm. 8.-15.). D., gr. 5-15 (gm. .3-1.). AMMONIUM CARBONATE.—H., dr. 2 (gm. 8.). C., dr. 3-6 (gm. 12.-24). Sh. & Sw., gr. 15.-40. (gm. 1.-2.6). D., gr. 3-10 (gm. .2-.6). Emetic,-D., gr. Gy (av, Ye AMMONIUM CHLORIDE.—H., dr. 2 (gm. 8.). C., dr. 3-6 (gm. 12.-24.) Sh. & Sw., gr. 15-40 (gm. 1.-2.6). D., gr. 3-10 (gm. .2-.6). AMMONIUM VALERATE.—D., gr. 2-5 (gm. .12-.3). AmyYL Nirritr.—H., dr. 3-1 (ce. 2.-4.). D., m. 2-5 (ce. .12-.3), by inhalation. ANISE.—H. & C., oz. 1-2 (gm. 30.-60.). Sh. & Sw., dr. 2-3 (gm. 8.-12.). D., gr. 10-30 (gm. .6-2.). ANISE, Oil of. —H., m. 20-30 (ce. 1.3-2.). D., m. 1-5 (cc. .06-.3). Anis, Spirit of —D., dr. 1-2 (ce. 4.-8.). ANTIMONY AND PoTASsIuM TARTRATE.—H., dr. 2-4 (gm. 8.-15.). Sw., emetic, er. 4-10 (gm. .24-.6). D., gr. %o-% (gm. .006-.03). Emetic, D., gr. 1-2 (gm. .06-.12). Antimony, Wine of.—D., m. 5-60 (ce. .3-4.) ANTIPYRIN.—H. & C., dr. 3-4 (gm. 12.-15.). Sh. & Sw., dr. 1 (gm. 4). D., 5-20 (gm. .3-1.3). ANTI-STRANGLES ANTITOXIN.—H., 30 ¢c.c. (see p. 667). ANTISTREPTOCOCCUS SERUM.—H., 20-50 cc. ANTITOXIN ANTI-STRANGLES.—H., 30 c.c. (see p. 667). Influenza—H., 30 to 90 e.c. (see p. 661). Tetanus—H., 10 c.c. as prophylactic (see p. 658). APOMORPHINE HypROCHLORIDE.—Subcutaneously—H., gr. 3% (0.045). Foals, gr 14 (0.03). Calves & Sheep, gr. 4% (0.03). Cows, gr. 11% (0.09). D., Yo to 16 (0.006-0.012) as emetic. By the mouth, as expectorant —D., Yq to %5 (0.0015-0.0024). Areca Nut.—H., oz. 4-1 (gm. 15.-30.). Lamb, dr. 1 (gm. 4.). D., gr. 15-60 (gm. 1.-4.) Fowl, gr. 10-40. ARECA, Fluidextract of——Dose same as nut. ber} . fey 5 o Oe ARECOLINE HypropromMipE.—H. & C., gr. 3-14 (0.04-0.09) ; average dose subcutan., er. i. (gm. 0.06). ARSENIC.—See Acid, Arsenous. 592 DOSE TABLE ARSENIC, Fowler’s Solution of.—H. & C., dr. 2-8 (ce. 8.-30.). Sh. & Sw., dr. 1-2 (ce. 4.-8.). D., m. 2-10 (ce. .12-.6). ASAFETIDA.—H. & C., oz. 3-1 (gm. 15.-30.). Sh. & Sw., dr. 1-2 (gm. 4.-8.). D., gr. 3-10 (gm. .2-.6). ASAFETIDA, Emulsion of.—D., oz. 4-1 (cc. 15.-30.). ASAFETIDA, Pill.—D., (1.-4.). ASAFETIDA, Tincture of. —H. & C., oz. 2-4 (ce. 60.-120.). D., dr. 4-1 (ce. 2.-4.). ASPIDIUM, Fluidextract of (B. P.).—H. & C., dr. 3-6 (cc. 12.-24.). Sh. & Sw., dr. 1-2 (ec. 4.-8.). D., m. 15-60 (ce. 1.-4.). ASPIDIUM, Oleoresin of.—H. & C., dr. 3-6 (cc. 12.-24.). Sh. & Sw., dr. 1-2 (ce. 4.-8.). D., m. 15-60 (ee. 1.-4.). ASPIRIN.—H. & C., dr. 2-4 (gm. 8.-15.). D., gr. 5-20 (gm. 0.3-1.3). AToxyL.—H., gr. 5-15 subcut. (gm. 0.3-1.). ATROPINE SULPIATE.—H., gr. 1-14 (gm. .06-.09). C., gr. 1-2 (gm. .06-.12). Sh. & Sw., gr. 5-45 (gm. .004-.005). D., gr. Yyoo-Qq (0.0005-.0008). Average dose, D., gr. Y%o9 (gm. .0006). BALSAM OF PERU.—H. & C., oz. 1-2 (ce. 30.-60.). Sh. & Sw., dr. 1-2 (ce. 4.-8.). D., m. 10-30 (ce. .6-2.) Bartum CHLoRIDE.—By mouth, H., dr. 1-2 (gm. 4.-8.). Intravenously, H., gr. 15 (gm. 1.). By mouth, Cows, dr. 4 (gm. 15.). Calves, dr. 1 (gm. 4.). BeLLADONNA, Alcoholic Extract of Leaves—H. & C., gr. 10-20 (gm. .6-1.3). Sh. & Sw., gr. 2-4 (gm. .12-.24). D., gr. 3-4 (gm. .008-.03). BELLADONNA, Tincture of Leaves.—D., m. 15-30 (ce. 1.-2.). BELLADONNA Root, Fluidextract of.—H., dr. 1-2 (ce. 4.-8.). C., dr. 2-3 (ee. 8.-12.). Sh. & Sw., m. 10-15 (cc. .6-1.). D., m. 1-3 (ce. .06-.2). BENZOIN, Tincture of.—H., oz. 1 (ec. 30.). D., dr. 3-1 (cc. 2.-4.) BetruLa, Oil of.—See Gaultheria. BIsMUTH SALICYLATE.—D., gr. 5-10 (gm. .3-.6). BISMUTH SUBCARBONATE.—H., dr. 2-4 (gm. 8.-15.). D., gr. 10-30 (gm. .6-2). BISMUTH SUBNITRATE.—Dose same as subcarbonate. Branpy.—H. & C., oz. 2-4 (ec. 60.-120.). Sh. & Sw., oz. 1-2 (ec. 30.-60.). D., dr. 1-4 (ce. 4.-15.). BucuHu, Fluidextract of.—H., oz. 1-2 (cc. 30.-60.). D., m. 5-30 (cc. .3-2.). BucxTuorn (Rhamnus Catharticus), Syrup of.—D., oz. 1-2 (ce. 30.-60.). Cats, oz. 3-1 (ec. 15.-30.). CAFFEINE.—H., 3 ss.-ii. (gm. 2.-8.). D., gr. 3-3 (gm. .038-.2). CAFFEINE, Citrated.—H., 3 ii.-iv. (gm. 8.-15.). D., gr. 1-6 (gm. .06-.36). DOSE TABLE 593 CaLamMus.—H. & C., oz. 1-2 (gm. 30.-60.). Sh. & Sw., dr. 2.3 (gm. 8.-12.). D., gr. 15-60 (gm. 1.-4.). CALAMUS, Fluidextract of.—-Dose same as Calamus. CaLcrum, Precipitated Carbonate of.—H., oz. 1-2 (gm. 30.-60.). C.. oz. 2-4 (gm. 60.-120). Sh. & Sw., dr. 2-4 (gm. 8.-15.). D., gr. 10-60 (gm. 6-4). CaLcrum CHLoRIDE.—H. & C., oz. 4-1 (gm. 15-30). D., gr. 5-20 (gm. .3-1.3). CaLcIuM, LACTOPHOSPHATE, Syrup of.—Foals and Calves, oz. 3-1 (cc. 15.-30.). D., dr. 1-4 (ce. 4.-15.). CatcruM, Precipitated Phosphate of —H., dr. 2-4 (gm. 8.-15.). C., oz. 3-1 (gm. 15.-30.). Sh. & Sw., dr. 1-2 (gm. 4.-8.). D., gr. 5-20 (gm. .3-1.3). CALOMEL.—See Mercury. CatumBa.—H. & C., oz. 4-1 (gm. 15.-30.). Sh. & Sw., dr. 1-2 (gm. 4.-8.). D., gr. 5-30 (gm. .3-2.). CALUMBA, Fluidextract of.—Dose same as Calumba. CALUMBA, Tincture of.—H. & C., oz. 2-4 (ce. 60.-120.). D., dr. 1-4 (ce. 4.-15.). Campuor.—H., dr. 1-3 (gm. 4.-12.). C., dr. 2-4 (gm. 8.-15.). Sh. & Sw., gr. 15-60 (gm. 1.-4.). D., gr. 3-20 (gm. .2-1.3.). CAMPHOR, Monobromated.—D., gr. 2-10 (gm. .12-.6). CAMPHOR, Liniment of—H., subcut., oz. 4-i. (c.c. 15.-30.), not more than dr. 14% injected at one point. D., m. 15-30 (cc. 1.-2.). CaMPHOR, Spirit of.—H., oz. 1-2 (cc. 30.-60.). D., dr. 3-1 (ce. 2.-4.). CannaBis Inpica, Extract of.—H., dr. 1-2 (gm. 4.-8.). D., gr. 3-1 (gm. .015- .06). CANNABIS INDICA, Fluidextract of.—H., dr. 4-6 (cc. 15.-24.). D., m. 3-10 (ce. .2-.6). CANNABIS INDICA, Tincture of.—D., m. 15-30 (cc. 1.-2.). CANTHARIDES.—H. & C., gr. 5-20 (gm. .3-1.3). Sh. & Sw., gr. 4-8 (gm. .24-.5} D., gr. 1-2 (gm. .06-.12). CANTHARIDES, Tincture of.—H., dr. 2-4 (ce. 8.-15.). D., m. 2-15 (ce. .12-1.). CapsicuM.—H., gr. 20-60 (gm. 1.3-4.). C., dr. 1-2 (gm. 4.-8.). D., gr. 1-8 (gm. .06-.48). Capsicum, Fluidextract of.—Dose same as Capsicum. Capsicum, Oleoresin of.—H., m. 10-30 (cc. .6-2.). C., dr. 4-1 (ce. 2.-4.). D., m. 4-1 (ce. .015-.06). Capsicum, Tincture of.—H., dr. 2-4 (cc. 8.-15.). C., oz. 4-1 (ee. 15.-30.). D., m. 5-60 (cc. .3-4.). CARBON BISULPHIDE.—H., dr. 2-4 (ce. 8.-15.). CarpamMon.—H. & C., oz. 1-2 (gm. 30.-60.). Sh. & Sw., dr. 2-3 (gm. 8.-12.). D., gr. 10-30 (gm. .6-2.). 594 DOSE TABLE CARDAMON, Fluidextract of—Dose same. (Non-official.) CARDAMON, Compound Tincture of.—D., dr. 1-2 (ce. 4.-8.). CARDAMON, Tincture of.—D., dr. 1-2 (cc. 4.-8.). CASCARA SAGRADA.—D., gr. 5-30 (gm. .3-2.). CASCABA SAGRADA, Fluidextract of —D., m. 5-30 (ee. .3-2.). CascaRA SaGRADA (Solid) Extract of.—D., gr. 2-8 (gm. .12-.5). CASCARILLA.—H. & C., oz. 4-1 (gm. 15.-30.). Sh. & Sw., dr. 1-2 (gm. 4.-8.). D., gr. 10-30 (gm. .6-2.). Castor O1L.—H. & C., pt. 1 (ec. 500.). Sh. & Sw., oz. 2-4 (ce. 60.-120.). D., dr. 1-2 (ce. 4.-8.). Fowl, dr. 1 (cc. 4.). CaTECHU.—H., oz. 3-1 (gm. 15.-30.). C., oz. 1-2 (gm. 30.-60.). Sh. & Sw., dr. 1-2 (gm. 4.-8.). D., gr. 5-30 (gm. .3-2.). CATECHU, Fluidextract of (non-official). —Dose same as Catechu. CATECHU, Tincture of. —H. & C., oz. 1-2 (cc. 30.-60.). Foals, Calves and Sheep, oz. 4-1 (ec. 15.-30.). D., dr. 3-2 (ec. 2.-8.). CreRIuM OXALATE.—D., gr. 3-5 (gm. .2-.3). CHALK, Compound Powder of.—D., gr. 10-60 (gm. .6-4.). CHALK MrxtTuRE.—D., oz. 1-2 (ec. 30.-60.). CHALK, PREPABED.—H., oz. 1-2 (gm. 30.-60.). C., oz. 2-4 (gm. 60.-120.). Sh. & Sw., dr. 2-4 (gm. 8.-15.). D., gr. 10-60 (gm. .6-4.). CuaRcoAL (Wood, and animal, purified).—H. & C., oz. 1-2 (gm. 30.-60.). Sh. & Sw., dr. 2-4 (gm. 8.-15.). D., gr. 20-60 (gm. 1.3-4.). CHLORAL.—H. & C., oz. 1-2 (gm. 30.-60.). Sh. & Sw., dr. 1-2 (gm. 4.-8.). D., gr. 5-20 (gm. .3-1.3). CHLOBETONE.—D., gr. 5-10 (gm. 0.3-0.6.). CuLororoRM.—H. & C., dr. 1-2 (ec. 4.-8.). Sh. & Sw., m. 20-30 (ce. 1.3-2.). D., m. 2-20 (ce. .12-1.3). CHLOROFORM, Spirit of —H. & C., oz. 1-2 (30.-60.). Sh. & Sw., dr. 2-4 (ec. 8.- 15.). D., dr. $-1 (ee. 2.-4.). CINCHONA BARK.—H., dr. 2-4 (gm. 8.-15.). C., oz. 1-2 (gm. 30.-60.). Sh. & Sw., dr. 1-4 (gm. 4.-15.). D., gr. 10-60 (gm. .6-4.). CINCHONA, Compound: Tincture of.—H., oz. 2-4 (cc. 60.-120.). D., dr. 3-4 (ce. 2.-15.). CINCHONA, Extract of.—H., dr. 1-2 (gm. 4.-8.). D., gr. 5-30 (gm. .3-2.). CrincHONA, Fluidextract of.—H., dr. 2-4 (ec. 8.-15.). C., oz. 1-2 (cee. 30.-60.). Sh. & Sw., dr. 1-4 (cc. 4-15.). D., gr. 10-60 (ce. .6-4.). CINCHONINE SULPHATE, Tonic Dose.—H., gr. 20-60 (gm. 1.3-4.). C., dr. 3-14 (gm. 3.-6.). Sh. & Sw., gr. 6-15 (gm. .36-1.). D., gr. 14-2$ (.1-.15). DOSE TABLE 595 CINCHONINE SULPHATE, Antipyretic Dose.—H., dr. 23-5 (gm. 10.-20.). Sh. & Sw., gr. 40-50 (gm. 2.6-3.3). D., gr. 7-15 (gm. .5-1.). CINCHONIDINE SULPHATE.—Dose same as Cinchonine Sulphate. Cocaine HypROCHLOBIDE.—H., gr. 5-10 (gm. .3-.6). D., gr. 4-2 (gm. .008-.045). Cop LIvEB OIL.—H., oz. 2-4 (cc. 60.-120.). Sh. & Sw., oz. 4-1 (ce. 15.-80.). D., dr. 1-3 (ee. 4.-12.). CODEINE.—D., gr. 4-2 (gm. .015-.12). CoLcHICINE.—H. & C., gr. 3-3 (gm. .01-.03). D., gr. Yoo Ko (gm. .0005-.0012). CotcHicum CormM.—H. & C., dr. 3-2 (gm. 2.-8.). Sh. gr. 10-20 (gm. .6-1.3). Sw. & D., gr. 2-8 (gm. .12-.5). CoLcHiIcuM CorM, Fluidextract of.—Dose same as Colchicum. CoLcHicumM CorM, Tincture of.—H. & C., dr. 3-8 (ce. 12.-30.). D., m. 10-30 (CCR6-25)% CoLcHicuM CorM, Wine of.—H. & C., dr. 3-8 (cc. 12.-30.). D., m. 10-30 (ce. .6-2.). CoLLARGOL (Colloidal Silver).—See p. 170. CoLocyNTH.—D., gr. 3-8 (gm. .2-.5). CoLocyNTHIN.—H., dr. 3-1 (gm. 2.-4.). D., gr. 3-1 (gm. .015-.06). CoNIINE HYDROBROMIDE.—H. & C., gr. 3-14 (gm. .045-.1). Sh. & Sw., gr. 3-2 (gm. .012-.024). D., gr. 149-45 (gm. .002-.005). Conrum.—-H. & C., dr. 1-2 (gm.-4.-8.). Sh. & Sw., gr. 10-20 (gm. .6-1.3). D., gr. 2-5 (gm. .12-.3). ConIuM, Fluidextract of.—Dose same as Conium. ConrtumM, Extract of —H. & C., gr. 12-24 (gm. .72-1.5). Sh. & Sw., gr. 2-4 (gm. .12-.24). D., gr. 4-1 (gm. .015-.06). CONVALLARIA, Fluidextract of.—H. & C., dr. 1-2 (ce. 4.-8.). D., m. 5-10 (ce. .3-.6). CopPpER SULPHATE.—H. & C., dr. 2-4 (gm. 8.-15.). Sh. & Sw., gr. 20-40 (gm. 1.3-2.6). D., gr. 1-2 (gm. .06-.12). Emetic—D., gr. 6-20 (gm. .36-1.3). CORROSIVE SUBLIMATE.—(See Mercury.) Cotton Root BaRK.—(See Gossypium.) CrEosoTE.—H., m. 15-30 (cc. 1.-2.). C., dr. $-1 (ce. 2.-4.). Sh. & Sw., m. 5.-15 (ee. .38-1.). D., m. 3-2 (ce. .03-.12). CrreoLtin.—H. & C., dr. 1-2 (cc. 4.-8.). D., m. 1-5 (cc. .06-.3). Single dose as anthelmintic. H., oz. 4-1 (cc. 15.-30.). Croron O1.—H., m. 15-30 (ce. 1.-2.). C., dr. $-1 (cc. 2.-4.). Sh. & Sw., m. 5-10 (ce. .38-.6). D., m. $-3 (ce. .03-.2). DIGITALEIN.—H., gr. §-3 (gm. .008-.015). D., gr. Yoo (gm. .0006). 596 DOSE TABLE DigiTALIN.—H., gr. 4-4 (.008-.015). D., gr. WYoo-Yo9 (.0003-.0006). DiGITALINUM PuRUM, German.—H., gr. ss.-i. (.03-.06). D., gr. Yo-149 (.001-.002). DieiTaLis.—H., gr. 10-60 (gm. .6-4.). C., dr. 3-14 (gm. 2.-6.). Sh. & Sw., gr. 5-15 (gm. .3-1.). D., gr. 3-3 (gm. .03-.2). DIGITALIS, Fluidextract of.—Dose same as Digitalis. DigITaLis, Extract of.—H., gr. 5-10 (gm. .3-.6). D., gr. §-4 (gm. .008-.03). DiciTauis, Infusion of. —H. & C., oz. 2-6 (cc. 60.-150.). Sh. & Sw., oz. $-1 (ce. 15.-30.). D., dr. 1-4 (ee. 4.-15.). DIGITALIS, Tincture of.—H. & C., dr. 2-4 (ec. 8.-15.). Sh. & Sw., dr. 4-14 (ce. 2.-6.). D., m. 5-30 (cc. .3-2.). DIGITALONE, subcut.—H., dr. 2-4 (ec. 8.-15.). D., m. 5-20 (cc. 0.3-1.3). DigiTox1In.—H., gr. 34-4 (.008-.015). D., gr. UYs5o-q (.00025-.00125). Dover’s Powper.—H., oz. 3-1 (gm. 15.-30.). D., gr. 5-10 (gm. .3-.6). Dover’s PownbeR, Liquid.—H., oz. 4-1 (cc. 15.-30.). D., m. 5-10 (ce. .3-.6). ELATERIN.—D., gr. Yo-Yo (gm. .003-.005). Ercot.—H. & C., oz. 3-1 (gm. 15.-30.). Sh. & Sw., dr. 1-2 (gm. 4.-8.). D., dr. 4-1 (gm. 2.-4.). Ereort, Fluidextract of.—Dose same as Ergot. Ercot, Extract of (Ergotin)—H. & C., gr. 20-60 (gm. 1.3-4.). D., gr. 2-10 (gm. .12-.6). Ercot, Tincture of —H. & C., oz. 4-2 (ce. 15.-60.). Sh. & Sw., dr. 1-4 (cc. 4,-15.). D., dr. 4-2 (ec. 2.-8.). ESERINE.— (See Physostigmine. ) ErHer.—H. & C., oz. 1-2 (cc. 30.-60.). Sh. & Sw., dr. 2-4 (ec. 8.-15.). D., m. 10-60 (ce. .6-4.). Erner, Spirit of, and Compound Spirit of —H. & C., oz. 1-2 (cc. 30.-60.). Sh. & Sw., dr. 2-4 (ec. 8.-15.). D., m. 10-60 (cc. .6-4.). Eruer, Nitrous, Spirit of (Sweet Spirit of Nitre)—H. & C., oz. 1-4 (ce. 30.- 120.). Sh. & Sw., dr. 2-4 (ce. 8.-15.). D., m. 10-60 (cc. .6-4.). EUCALYPTUS, Fluidextract of.—H., oz. 2-3 (cc. 60.-90.). D., dr. 3-2 (ce. 2.-8.). EvcatyPtvus, Oil of.—H., dr. 2-4 (ce. 8.-15.). D., m. 5-20 (ce. .3-1.3). EUCALYPTOL.—Dose same as Oil of Eucalyptus. FENNEL.—H. & C., oz. 1-2 (gm. 30.-60.). Sh. & Sw., dr. 2-3 (gm. 8.-12.). D gr. 10-20 (gm. .6-1.3). a, Fret Bovis.—(See Oxgall.) FENUGREEK.—H. & C., oz. 1-2 (gm. 30.-60.). Sh. & Sw., dr. 2-3 (gm. 8.-12.). D., gr. 10-30 (gm. .6-2.). FIBROLYSIN.—H., 11.5 ¢.c. subcut. DOSE TABLE 597 FRANGULA, Fluidextract of. —D., dr. 4-1 (cc. 2.-4.). GaMBoGE.—H., oz. 4-1 (gm. 15.-30.). C., oz. 1-14 (gm. 30.-45.). Sh. & Sw., gr. 20-60 (gm. 1.3-4.). D., gr. 5-10 (gm. .3-.6). GAULTHERIA, Oil of —H. & C., dr. 2-0z. 1 (ec. 8.-30.). Sh. & Sw., dr. 3-2 (ce. Peis) 5) IDay aii, alley (eres Belloc GELSEMINE.—H., gr. 4-4 (gm. .015-.03). D., gr. 1éo-%o (gm. .001-.003). GEI SEMIUM.—H., dr. 1-2 (gm. 4.-8.). D., gr. 5-10 (gm. .3-.6). GELSEMIUM, Fluidextract of—Dose same as Gelsemium. GELSEMIUM, Tincture of.—H., oz. 4-2 (ce. 15.-60.). D., m. 15-60 (ce. 1.-4.). GENTIAN.—H., oz. 3-1 (gm. 15.-30.). C., oz. 1-2 (gm. 30.-60.). Sh. & Sw., dr. 1-2 (gm. 4.-8.). D., gr. 5-30 (gm. .3-2.). GENTIAN, Fluidextract of —Dose same as Gentian. GENTIAN, Compound Tincture of —H. & C., oz. 1-4 (ce. 30.-120.). D., dr. 1-4 (ee. 4.-15.). Gineger.—H., dr. 2-oz. 1 (gm. 8.-30.). C., oz. 1-4 (gm. 30.-120.). Sh. & Sw., dr. 1-2 (gm. 4-8). D., gr. 5-15 (gm. .3-1.). GINGER, Fluidextract of—Dose same as Ginger. GINGER, Oleoresin of.—One-fifth dose of Ginger. GLycrRiIn.—H. & C., oz. 1 (ee. 30.). D., dr. 3-1 (ce. 2.-4.). GLYCEROPHOSPHATES, Lime and Iron.—H., dr. 3 (gm. 12.). D., gr. 5-15 (gm. 0.3-1.). GLYCYBRHIZA.—See licorice. Gossypium Root, Fluidextract of Bark of —H. & C., oz. 4-1 (ce. 15.-30.). Sh. & Sw., dr. 1-2 (ce. 4.-8.). D., dr. 3-1 (ce. 2.-4.). GRANATUM (Pomegranate).—D., dr. 3-14 (gm. 2.-6.). GRANATUM, Fluidextract of.—Dose same as granatum. GRANATI RApIctis CorTEX, Fluidextract of.—D., dr. 3-2 (cc. 2.-8.). HEMATOXYLON, Extract of —H. & C., dr. 3-4 (gm. 2.-15.). Sh. & Sw., dr. 3-1 (gm. 2.-4.). D., gr. 5-15 (gm. .3-1.). [a:MATOXYLON, Fluidextract of.—H. & C., oz. 3-13 (ec. 15.-45.). Sh. & Sw., dr. 14-3 (ce. 6.-12.). D., m. 15-45 (ce. 1.-3.). HAMAMELIS, Fluidextract of —H. & C., oz. 1-2 (ce. 30.-60.). D., dr. 3-2 (ce. 2.-8.). HAMAMELIS, Water of.—Same doses as fluidextract. Hyprastin.—H., gr. 15-30 (gm. 1.-2:).. D., gr. 3-5 (gm. .2-.3). HypRASTINE HypROCHLORATE.—H., gr. 1-2 (gm. .06-.12). D., gr. Yole (gm. .005-.01). 598 DOSE TABLE HypRASTIS, Fluidextract of —H. & C., dr. 2-0z. 1 (cc. 8.-30.). Sh. & Sw., dr. 1-2 (ce. 4.-8.). D., m. 5-60 (cc. .3-4.). HyYDRASTIS, Glycerite of. —-Dose same as Fluid Extract. HyprastTis, Tincture of.—H., oz. 1-2 (ce. 30.-60.). D., dr. 3-2 (ce. 2.-8.). HyoscinE HyYDROBROMIDE.—H., gr. 3-4 (gm. .01-.015). D., gr. WYsoYoo (gm. -0004-.0006) . HyOSCYAMINE HYDROBROMIDE AND SuLpPHAtTeE.—H., gr. 1-2 (gm. .06-.12). D., er. go-go (gm. .001-.002). Hyoscramus.—H. & C., oz. 4-1 (gm. 15.-30.). D., gr. 5-15 (gm. .3-1.). HyoscyaMus, Fluidextract of.—Dose same as Hyoscyamus. HyoscyaMus, Extract of —H. & ©., gr. 20-60 (gm. 1.3-4.). D., gr. 3-2 (gm. .03-.12). Hyoscyamus, Tincture of.—D., dr. 1-2 (cc. 4.-8.). Hyoscyamus, Sueccus of.—D., dr. 1-2 (ec. 4.-8.). HYPOPHOSPHITES, Compound Syrup of.—D., dr. 1 (ce. 4.). INFLUENZA ANTITOXIN.—H., 30 to 90 cc. Iopinge.—H. & C., dr. $-1 (gm. 2.-4.). Sh. & Sw., gr. 10-20 (gm. .6-1.3). D., gr. 2-5 (gm. .12-.3). IopInE, Compound Solution of.—H., dr. 2-4 (cc. 8.-15.). D., m. 2-10 (cc. .12-.6). IopINE, Tincture of.—H., dr. 2-4 (ce. 8.-15.). D., m. 2-10 (ce. .12-.6). Ipecac.—H., dr. 1-2 (gm. 4.-8.). C., dr. 2-4 (gm. .8-15.). Sh. dr. 3-1 (gm. 2.-4.). D., gr. 3-2 (gm. .03-.12). Emetic—D. & Sw., gr. 15-30 (gm. 1.-2.). Cats, gr. 5-12 (gm. .13-.72). Iprcac, Fluidextract of.—Dose same as Ipecac. Ipecac, Syrup of. —D., Expectorant, m. 15-60 (cc. 1.-4.). Ipecac, Wine of.—D., Expectorant, m. 15-60 (cc. 1.-4.). Tron AND AMMONIUM CITRATE.—D., gr. 5-10 (gm. .3-.6). Iron, Carbonate, Saccharated.—H., dr. 1-2 (gm. 4.-8.). C., dr. 2-4 (gm. 8.-15.). Sh. & Sw., gr. 20-30 (gm. 1.3-2.). D., gr. 1-5 (gm. .06-.3). Iron, Chloride, Solution of.—H. & C., dr. 2-4 (ce. 8.-15.). Sh. & Sw., m. 10-20 (ee. .6-1.3). D., m. 2-10 (.12-.6). Iron, Chloride, Tincture of —H. & C., oz. 1-2 (ce. 30.-60.). Sh. & Sw., m. 20- 30 (cc. 1.8-2.). D., m. 5-60 (cc. .3-4.). Iron, Iodide, Syrup of.—D., m. 5-10 (cc. .3-6.). Tron, (and) Quinine Citrate—D., gr. 5-10 (gm. .3-.6). Iron, Reduced.—H., dr. 1-2 (gm. 4.-8.). C., dr. 2-4 (gm. 8-15). Sh. & Sw., er. 20-80 (gm. 1.3-2.). D., gr. 1-5 (gm. .06-.3). Iron, (and) Strychnine Citrate—D., gr. 1-2 (gm. .06-.12). DOSE TABLE 599 Iron, Sulphate and Dried Sulphate——H. & C., dr. 1-2 (gm. 4.-8.). Sh. & Sw., gr. 20-30 (gm. 1.3-2.). D., gr. 1-5 (gm. .06-.3). JABORANDI.—H. & C., dr. 2-4 (gm. 8.-15.). Sh. & Sw., dr. 3-1 (gm. 2.-4.). D., gr. 5-60 (gm. .3-4.). JABORANDI, Fluidextract of.—Dose same as Jaborandi. JALAP.—Sw., dr. 2-4 (gm. 8.-15.). D., dr. 1-2 (gm. 4.-8.), Cats, dr. 4-1 (gm. 2.-4.). JaLaP, Fluidextract of.—Dose same as Jalap. JALAP, Resin of.—Sw., dr. 3-1 (gm. 2.-4.). D., gr. 15-30 (gm. 1.-2.). Cats, gr. 7-15 (gm. .5-1.). JUNIPER, Compound Spirit of —H. & C., oz. 2-4 (cc. 60.-120.). D., dr. 1-4 (ce. 4.-15.). ; JUNIPER, Oil of. —H. & C., dr. 1-2 (ce. 4.-8.). D., m. 2-10 (ec. .12-.6). KaMALA.—H., oz. 1 (gm. 30.). D., dr. $-2 (gm. 2.-8.). Kino.—H., oz. 3-1 (gm. 15.-30.). ©C., oz. 1-2 (gm. 30.-60.). Sh. & Sw., dr. 1-2 (gm. 4.-8.). D., gr. 5-30 (gm. .3-2.). Kino, Fluidextract of—Dose same as Kino. Kino, Tincture of. —H. & C., oz. 1-2 (ec. 30.-80.). Foals, Calves and Sheep, oz. 4-1 (ec. 15.-30.). D., dr. $-2 (cc. 2.-8.). Koussin.—D., gr. 5-40 (gm. .3-2.6). Kousso.—Small dogs, dr. 3-1 (gm. 2.-4). Large dogs, dr. 2-4 (gm. 8.-15.). Kousso, Fluidextract of —Dose same as Kousso. KRAMERIA.—H., oz. 3-1 (gm. 15.-30.). C., oz. 1-2 (gm. 30.-60.). Sh. & Sw., dr. 1-2 (gm. 4.-8.). D., gr. 5-30 (gm. .3-2.). KRAMERIA, Fluidextract of.—Dose same as Krameria. KRAMERIA, Extract of. —H. & C., dr. 2-3 (gm. 8.-12.). Sh. & Sw., gr. 20-40 (gm. 1.3-2.6). D., gr. 5-10 (gm. .3-.6). KRAMERIA, Tincture of.—H. & C., oz. 1-2 (cc. 30.-60.). Foals, Calves and Sheep, oz. 4-1 (cc. 15.-30.). D., dr. 3-2 (ce. 2.-8.). Leap AcetTate.—H. & C., dr. 1 (gm. 4.). Sh. & Sw., gr. 15-20 (gm. 1.-1.3). D., gr. 1-2 (gm. .06-.12). Licortce.—Ad lib. LicoRice, Fluidextract of.—Ad lib. Licorice, Extract of.—Ad lib. Licorice, Compound Powder of.—D., dr. 1-2 (gm. 4.-8.). Lime, Solution of (Lime Water).—H. & C., oz. 4-6 (cc. 120.-180.). Calves and Foals, oz. 2 (cc. 60.). D., dr. 1-8 (ce. 4.-30.). LINSEED Om.—H., pt. 4-1 (cc. 250.-500). C., pt. 1-2 (cc. 500.-1000.). Sh. & Sw., oz. 6-12 (cc. 180.-360.). Dogs and Cats, oz. 4-2 (ce. 15.-60.). 600 DOSE TABLE LITHIUM CARBONATE.—D., gr. 3-10 (gm. .2-.6). LirHtum CriTRAtTe.—D., gr. 5-20 (gm. .3-1.3). MAGNESIA.—Foals and Calves, dr. 1-2 (gm. 4.-8.). D., gr. 5-60 (gm. .3-4.). MAGNESIUM CARBONATE.—Dose same as Magnesia. MAGNESIUM SULPHATE.—H. (laxative), oz. 2-4 (gm. 60.-120.). C. (purgative), Ib. 1-2 (gm. 500.-1000.) ; (laxative), oz. 3-4 (gm. 90.-120.). Calves, dr. 2-3 (gm. 8.-12.). Sh., oz. 4-6 (gm. 120.-180.). D., dr. 1-4 (gm. 4.-15.). Mate FERN, Oleoresin and Fluid Extract of. —H. & C©., dr. 3-6 (cc. 12.-24.). Sh. & Sw., dr. 1-2 (ce. 4.-8.). D., m. 15-60 (cc. 1.-4.). MeENTHOL.—D., gr. 2 (gm. .12). MERCURY WITH CHALK.—Foals and Calves, gr. 10-15 (gm. .6-1.). D., gr. 1-10 (gm. .06-.6). Mercury, Corrosive Chloride of —H. & C., gr. 5-8 (gm. .3-.5). Sh. & Sw., gr. 2 (gm. .12). D., gr. %o-¥g (gm. .002-.008). Mercury, Iodide of (red).—Dose same as Corrosive Chloride. Mercury, Mass of (Blue Pill).—D., gr. 1-10 (gm. .06-.6). Mercury, Mild Chloride of.—H., dr. 4-1 (gm. 2.-4.). ©., dr. 5-6 (gm. 20.-24.). D., gr. Yo (gm. .006-.03), in divided doses; gr. 3-5 (gm. .2-.3), in single doses. MetTHyL SALICYLATE.—H., dr. 2-8 (cc. 8.-30). D., m. 5-15 (ce. .3-1.). MorPHINE AND ITS SALTS.—H. & C., gr. 3-10 (gm. .2-.6). Sh., gr. 3-2 (gm. .03- 12). Sw., gr. Yo (gm. .006-.03). D., gr. $-3 (gm. .008-.03). Sub- cutaneously—H., gr. 3-4 (gm. .2-.24). D., gr. §-3 (gm. .008-.03). MorrRHvoL.—D., gr. 1-5 (gm. .06-.3). Mustarp.—H. & C., oz. 3-1 (gm. 15.-30.). Sh. & Sw., dr. 3-2 (gm. 2.-8.). D., gr. 10-15 (gm. .6-1.). Emetic—D., oz. 3 (gm. 15.). Myrru, Tincture of —H. & C., Zi-ii. (30.-60.). Sh. & Sw., Siii-vi. (12.-24.).. D., 3ss.-i. (2.-4.). NAPHTHALIN.—H., dr. 2-4 (gm. 8.-15.). D., gr. 1-20 (gm. .06-1.3). Napurou.—H., dr. 2-3 (gm. 8.-12.). D., gr. 1-10 (gm. .06-.6). * Nicotine.—H. & C., gr. 19-49 (gm. .001-.003). NITROGLYCERIN (1 per cent. solution).—H. & C., dr. 3-1 (cc. 2.-4.). D., m. 1-2 (ec. .06-.12). Nux Vomica.—H. & C., dr. 1-2 (gm. 4.-8.). Sh., gr. 20-40 (gm. 1.3-2.6). Sw., gr. 10-20 (gm. .6-1.3). D., gr. 1-2 (gm. .06-.12). Nux Vomica, Extract of. —H. & C., gr. 2-15 (gm. .12-1.) Sh., gr. 23-5 (gm. .15-.3). Sw., gr. 1-2 (gm. .06-.12). D., gr. $-4 (gm. .008-.015). Nux Vomic4, Fluidextract of —Dose same as Nux Vomica. Nvux Vomica, Tincture of.—D., m. 5-10 (ec. .3-.6). DOSE TABLE 601 OLIvE O1t.—H. & C., pt. 1-2 (cc. 500.-1000.). D., oz. 2-4 (cc. 60.-120.). Oprium, Camphorated Tincture of (Paregoric).—D., dr. 1-4 (ce. 4.-15.). OpiuM, Extract of.—H., dr. 3-1 (gm. 2.-4.). C., dr. 1-2 (gm. 4.-8.). Sh., gr. 5-10 (gm. .3-.6). Sw., gr. 2-10 (gm. .12-.6). D., gr. 3-3 (gm. .01-.03). OpiuM, Powder.—H., dr. 1-2 (gm. 4.-8.). ©., dr. 2-4 (gm. 8.-15.). Sh., gr. 10-20 (gm. .6-1.3). Sw., gr. 5-20 (gm. .3-1.3). D., gr. 3-3 (gm. .03-.2). Oprum, Tincture of.—H., oz. 1-2 (cc. 30.-60.). C., oz. 2-3 (cc. 60.-90.). Sh. & Sw., dr. 2-6 (ce. 8.-24.). D., m. 3-30 (ce. .2-2.). Opium, Wine of.—Dose same as Tincture. OxGALL.—D., gr. 5-15 (gm. .3-1.). PANCREATIN.—D., gr. 5-15 (gm. .3-1.). PApPAIN.—Foals, Calves and Dogs, gr. 2-10 (gm. .12-.6). PELLETIERINE TANNATE.—D., gr. 2-5 (gm. .12-.3). PEPPERMINT, Oil of. —H. & C., m. 15-30 (ce. 1.-2.). D., m. 1-5 (ce. .06-.3). PEPPERMINT, Spirit of —H. & C., dr. 2-4 (ce. 8.-15.). D., m. 15-30 (ce. 1.-2.). Prepsin.—Dogs, Foals and Calves, gr. 10-60 (gm. .6-4.). PHENACETIN.—H., dr. 2-3 (gm. 8.-12.). D., gr. 5-10 (gm. .3-.6). PHENOLPHTHALEIN.—H., dr. 1-14 (gm. 4.-6.). D., gr. 2-10 (0.12-0.6). Cats & Puppies, gr. 3-2 (gm. 0.03-0.12). PHENOL.—See Acid Carbolic. PHOSPHORATED OIL.—H., dr. 2-3 (ce. 8.-12.). D., m. 1-5 (ce. .06-.3). PuHospHorus.—H., gr. 1-2 (gm. .06-.12). C., gr. 2-3 (gm. .12-.2). Sh. Sw. & 1D), gr. Vo0-40 (gm. .0006-.003) . PHOSPHORUS, Spirit of.—D., m. 7-20 (ce. .5-1.3). PuysostTigMA.—H., gr. 15-30 (gm. 1.-2.). D., gr. 3-1 (gm. .015-.06). PHYSOSTIGMA, Fluidextract of—Dose same as Physostigma. PHYSOSTIGMINE SULPHATE AND SALICYLATE.—H. & C. By the mouth, gr. Iss.-ili. (.09-.18). D., gr. %o-%o (.001-.006). H. Subcut., gr. 1.-Iss: (.06-.09). In- tratracheally, gr. ss. (.03). Foals and Calves, subcut., gr. 40-16 (.005-.01). D. subeut., gr. Yoo-149 (.0006-.002). PILOCARPINE AND ITS SALTS.—(Subcut.) H. (purgative), gr. 2-5 (gm. .12-.3). C. (purgative), gr. 5-10 (gm. .3-.6). H. (diaphoretic; dangerous), gr. 6-12 (gm. .36-.72). Sh., gr. 1 (gm. .06). D., gr. Y%o-14 (gm. .006-.02). Pmocarpus.—H. & C., dr. 2-4 (gm. 8.-15.). Sh. & Sw., dr. 3-1 (gm. 2.-4.). D., gr. 5-60 (gm. .3-4.). PrrocaRPus, Fluidextract of.—Dose same as Pilocarpus. Poporpnyrtin.—H. & C., dr. 1-2 (gm. 4.-8.). D., gr. 1-2 (gm. .06-.12). PoMEGRANATE.—See Granatum. 602 DOSE TABLE POTASSIUM ACETATE.—H, & C., oz. 3-1 (gm. 15.-30.). Sh. & Sw., dr. 3-1 (gm. 2.-4.). D., gr. 5-20 (gm. .3-1.3). PoTASsiuM BICABBONATE.—Dose same as Acetate. PoTASsSIuM BITARTRATE.—H. & C., oz. 4-1 (gm. 15.-30.). Sh. & Sw., oz. 4 (gm. 15.). D., dr. 3-1 (gm. 2.-4.). PoTassIuM BroMipE.—H. & C., oz. 1-2 (gm. 30.-60.). Sh. & Sw., dr. 2-4 (gm. 8.-15. D., gr. 5-60 (gm. .3-4.). POTASSIUM CARBBONATE.—H. & C., oz. $-1 (gm. 15.-30.). Sh. & Sw., dr. 4-1 (gm. 2.-4.). D., gr. 5-20 (gm. .3-1.3). PoTASSIUM CHLORATE.—Dose same as Carbonate. POTASSIUM CITRATE.—Dose same as Carbonate. PorassiuM HypROXxIbE, Solution of. —H. & C., oz. 4-1 (cc. 15.-30.). Sh. & Sw., dr. 3-1 (ec. 2.-4.). D., m. 5-20 (ee. .3-1.3). Potassium lIopipE.—H., 3ii.-iv. (8-15). ©. 3vi. (24). Sh. & Sw., gr. xv.-xxx. (1.-2.).. D., gr. ii. x. (.12-.6.). Porasstum NitRatTe.—Dose same as Carbonate. Quassia, Extract of —H., dr. 1-2 (gm. 4.-8.). D., gr. 3-3 (gm. .03-.2). QuASSIA, Fluidextract of. —H. & C., oz. 1-2 (cc. 30.-60.). Sh. & Sw., dr. 2-4 (ec. 8.-15.). D., m. 15-60 (ce. 1.-4.). Quassta, Tincture of.—H. & C. oz. 2-4 (cc. 60.-120.). D., “dr. 3-2 (ce. 2.-8.). Quasstn.—D., gr. 4-3 (gm. .008-.02). QUERCUS ALBA.—H., oz. 3-1 (gm. 15.-30.). C., oz. 1-2 (gm. 30.-60.). Sh. and Sw., dr. 1-2 (gm. 4.-8.). D., gr. 10-30 (gm. .6-2.). QurERcus ALBA, Fluidextract of —Dose same as Quercus Alba. QUINIDINE.—Tonic dose—H. gr. 20-60 (gm. 1.3-4.). C., dr. 3-14 (gm. 3.-6.). Sh. & Sw., gr. 6-15 (gm. .36-1.). D., gr. 14-23 (gm. .1-.15). Antipyretic dose—H., dr. 23-5 (gm. 10.-20.). Sh. & Sw., gr. 20-40 (gm. 1.3-2.6). D., gr. 7-15 (gm. .5-1.). QUININE AND ITs Satts.—Tonic dose—H., gr. 15-60 (gm. 1.-4.) C., dr. 4-14 (gm. 2.-6.). Sh. & Sw., gr. 5-10 (gm. .3-.6). Dogs and Cats, gr. 1-2 (gm. .06-.12). Antipyretic dose—H. & C., dr. 2-4 (gm. 8.-15.). Sh. & Sw., gr. 20-40 (gm. 1.3-2.6). Dogs and Cats, gr. 5-10 (gm. .3-.6). QUINOIDIN.—Dose three or four times that of Quinine. REsoRCIN.—H., dr. 4-6 (gm. 15.-24.). Foals and Calves, dr. 3-1 (gm. 2.-4.). D., gr. 2-5 (gm. .12-.3). RHAMNUS CATHARTICUS, Syrup of.—D., oz. 1-2 (cc. 30.-60.). Cats, oz. 4-1 (ce. 15.-30.). RHAMNUS CATHARTICUS, Fluidextract of —D., dr. 4-1 (cee. 2.-4.). DOSE TABLE 603 RHUBARB.—Stomachic—H. & C., oz. 1-2 (gm. 30.-60.). Sh. & Sw., dr. 1 (gm. 4.). D., gr. 5-10 (gm. .3-.6). Purgative—Foals, Calves and Dogs, dr. 1-2 (gm. 4.-8.). Fowl, gr. v.-vil. in pill. RHUBARB, Fluidextract of.—Dose same as Rhubarb. RHUBARB, Compound Powder of.—Foals and Calves, oz. 3-1 (gm. 15.-30.). SABINA, Fluidextract of.—H., oz. 1-2 (ce. 30.-60.). D., m. 5-15 (ce. .3-1.). SaBiIna, Oil of —H. & C., dr. 2-4 (cee. 8.-15.). D., m. 1-5 (cc. .06-.3). Saricin.—H. & C., dr. 2-8 (gm. 8.-30.). Sh., dr. 1-4 (gm. 4.-15.). Sw., dr. 4-1 (gm. 2.-4.). D., gr. 5-30 (gm. .3-2.). SaLoLt.—H., dr. 3-6 (gm. 12.-24.). D., gr. 5-10 (gm. 0.3-0.6). SANTONIN.—H., dr. 3-4 (1.-15.). D., gr. 1-3 (.06-.18). Puppies, gr. 4-4 (.015- 03). Savin.—See Sabina. ScamMmMony.—D., dr. 1-2 (gm. 4.-8.). Cats, dr. 3-1 (gm. 2.-4.). Scammony, Resin of.—D., dr. 4-1 (gm. 2.-4.). Cats, gr. 15-30 (gm. 1.-2.). SenNNA.—H. & C., oz. 4-5 (gm. 120.-150.). Sh. & Sw., oz. 1-2 (gm. 30.-60.). D., dr. 1-4 (gm. 4.-15.). Fowl, gr. xv.-xx. in pill. SENNA, Fluidextract of. —Dose same as Senna. Senna, Syrup of.—D., dr. 1-4 (4.-15.). Serum, Antistreptococcus.—See p. 661. Sinver Nirratse.—H. & C., gr. 5-10 (gm. .3-.6). Sh. & Sw., gr. 1-2 (gm. .06-.12). D., gr. $-4 (gm. .008-.03). Soprum BicaRBonATEe.—H. & C., oz. 3-2 (gm. 15.-60.). Sh. & Sw., dr. 3-1 (gm. 2.-4.). D., gr. 5-30 (gm. .3-2.). Soprum CaAcopyLATE.—H., gr. 8-30 (gm. 0.5-2.). D., gr. 2-14 (gm. 0.05-0.1) subcut. Soprum CARBONATE.—H. & C., dr. 2-6 (gm. 8.-24.). Sh. & Sw., gr. 20-40 (gm. 1.3-2.6). D., gr. 5-20 (gm. .3-1.3). Soprum CHLORIDE.—Purgative—Cattle, lb. 3-1 (gm. 250.-500.). Sh., oz. 1-2 (gm. 30.-80.). Soprum BroMipe.—H. & C., oz. 1-2 (gm. 30.-60.). Sh. & Sw., dr. 2-4 (gm. 8.-15.). D., gr. 5-60 (.3-4.). Soprum HyproxipE, Solution of. —H. & C., oz. 3-1 (ce. 15.-30.). Sh. & Sw., dr. 4-1 (ce. 2.-4.). D., m. 5-20 (cc. .3-1-3). Soprum PxrospHaTe.—C., Ib. 1-14 (gm. 500.-750.). H. & Sh., oz. 2-4 (gm. 60.- 120.). D., dr. 1-2 (gm. 4,-8.). Soprum SALicyLaTe.—H. & C., dr. 2-8 (gm. 8.-30.). Sh., dr. 1-4 (4.-15.). Sw., dr. 3-1 (gm. 2.-4.). D., gr. 5-30 (gm. .3-2.). Soprum SuLpHAaTr.—C., Ib. 1-14 (gm. 500.-750.). H., oz. 2-4 (gm. 60.-120.). Sh., oz. 2-4 (g. 60.-120.). D., dr. 1-4 (gm. 4.-15.). 604 DOSE TABLE SopruM SULPHITE, BISULPHITE AND THIOSULPHATE.—H. & C., oz. 1 (gm. 30.). Sh. & Sw., dr. 3-1 (gm. 2.-4.). D., gr. 5-30 (gm. .3-2.). SQUILL.—H., dr. 1-2 (gm. 4.-8.). C., dr. 2-4 (gm. 8.-15.). Sh., gr. 15-30 (gm. 1,-2.). D., gr. 1-5 (gm. .06-.3). SQUILL, Fluidextract of.—Dose same as Squill. SQuILL, Tincture of.—H., dr. 6-12 (cc. 24.-48.). C., oz. 14-3 (ee. 45.-90.). Sh., dr. 13-3 (cc. 6.-12.). D., m. 5-30 (ce. .3-2.). SQuiLL, Syrup of.—H., oz. 4 (ec. 15.). D., dr. 4-1 (ce. 2.-4.). SQuUILL, Compound Syrup of.—D., m. 5-30 (cc. .3-2.). STROPHANTHUS, Tincture of —H. & C., dr. 1-4 (ce. 4.-15.). D., m. 2-10 (ce. .12- 6). STROPHANTHIN.—H., gr. 3-4 (gm. .012-.03). D., gr. og (0.0003). STRYCHNINE AND ITS SALTS.—H., gr. 4-2 (gm. .03-.12). C., gr. 2-3 (gm. .12-.2). Subcutaneously. H. & C., gr. $ to 1. Sh., gr. 3-1 (gm. .015-.06). D., gr. YooYo (gm. .0005-.001). SutpHur.—H. & C., oz. 2-4 (gm. 60.-120.). Sh. & Sw., oz. 1-2 (gm. 30.-60.). D., dr. 4-4 (gm. 2.-15.). TANNALBIN.—H. & C., dr. 1-4 (gm. 4.-15.). Foals and Calves, gr. 20-40 (gm 1.3-2.6). - TANNIGEN.—Foals and Calves, gr. 30 (gm. 2.). TaRAxacuM.—H. & C., oz. 1-2 (gm. 30.-60.). Sh. & Sw., dr. 2-4 (gm. §.-15.). D., dr. 1-2 (gm. 4.-8.). TARAXACUM, Fluidextract of.—Dose same as Taraxacum. TARAXACUM, Extract of —H. & C., dr. 1-4 (gm. 4.-15.).. D., gr. 5-30 (gm. .3-2.). TEREBENE.—H. & C., dr. 2-6 (cc. 8.-24.). D., m. 5-15 (ec. .3-1.). TERPIN HypRATE.—H., dr. 4-2 (gm. 2.-8.). D., gr. 5-20 (gm. .3-1.3). TETANUS ANTITOXIN.—H., 10 ¢.c. prophylactic dose, see p. 664. TuyMoL.—H., dr. 4-2 (gm. 2.-8.).. Sh. (single dose), 3ss.-iiss. D., (gm. .06-1.). TURPENTINE, Oil of —Carminative—H. & C., oz. 1-2 (cc. 30.-60.). Sh. and Sw., dr. 1-4 (ce. 4.-15.). D., m. 10-30 (ec. .6-2.). Anthelmintic—H. & C., oz. 2-4 (ec. 60.-120.). D., dr. 4-4 (ec. 2.-15.). Diuretic—H. & C., dr. 2-6 (cc. 8.-24.). er. 1-15 5 VALERATE OF AMMONIUM.—D., gr. 2-5 (gm. .12-.3). VALERATE OF JRoN.—D., gr. 1-3 (gm. .06-.2). VALERATE OF ZINC.—D., gr. 1-3 (gm. .06-.2). VALERIAN.—H. & C., oz. 1-2 (gm. 30.-60.). D., gr. 10-60 (gm. .6-4.). VALERIAN, Fluidextract of—Dose same as Valerian. 5 DOSE TABLE 605 VALERIAN, Tincture of.—D., dr. 3-2 (ce. 2.-8.). VALERIAN, Ammoniated Tincture of.—D., dr. 4-2 (ce. 2.-8.). VALERIAN, Oil of.—H., dr. 3-1 (ce. 2.-4.). D., m. 2-5 (ce. 12-.3). VERATRINE.—H., gr. 3-2 (gm. .03-.12). C., gr. 2-5 (gm. .12-.3). D., gr. oo (gm. .0012-.006). VERATRUM.—H. & C., dr. 4-1 (gm. 2.-4.). Sh. & Sw, gr. 20-30 (gm. 1.3-2.). D., gr. Yo-1 (gm. .006-.06). VEBATRUM, Fluidextract of —Dose same as Veratrum. VERATRUM, Tincture of.—H. & C., oz. 3-1 (cc. 15.-30.). Sh. & Sw., dr. 2-4 (ee. 8.-15.). D., m. 5-10 (ee. .3-1.) WHIsKEY.—H. & C., oz. 2-4 (cc. 60.-120.). Sh. & Sw., oz. 1-2 (ce. 30.-60.). D., dr. 1-4 (ce. 4.-15.). WILp CHERRY, Syrup of.—D., dr. 1-4 (ce. 4.-15.). WINTERGREEN, Oil of.—See Gaultheria. YOHIMBINE HYDROCHLOBIDE.—H. & C., gr. 2-14 (gm. 0.045-0.1). Sh. & Sw., gr. 4 (gm. 0.03). D., gr. 45-16 (gm. 0.005-0.01). Zinc ACETATE.—H. & C., dr. 1-2 (gm. 4.-8.). Sh. & Sw., gr. 10-20 (gm. .6-1.3). D., gr. 2-3 (gm. .12-.2). Zinc Oxipe.—H. & C., dr. 1-2 (gm. 4.-8.). D., gr. 5-10 (gm. .3-.6). ZINC PHOSPHIDE.—D., gr. 4 (gm. .006). ZINC SULPHATE.—H. & C., dr. 1-2 (gm. 4.-8.). Sh. & Sw., gr. 10-20 (gm. .6-1.3). D., gr. 2-3 (gm. .12-.2). Emetic—D., gr. 10-15 (gm. .6-1.). POISONS AND ANTIDOTES. Note.—In poisoning, the chemical antidote should be given first—if it is at hand. The next thing is to evacuate the stomach. Washing out the stomach is practically always done in human medicine, except in convulsions of strychnine poisoning and in poisoning by acids and caustic alkalies. This is readily per- formed in the case of the dog with assistance and may be accomplished in the horse. Where facilities for lavage are not at hand, an emetic should be given the dog, cat and pig. Mustard is the emetic usually at hand. The dog and cat take 1 tablespoonful, and the pig two, in water. Zinc sulphate is more effective; D. & C. gr. v; Sw. gr. xv, in two ounces of water. Apomorphine hydrochloride, under the skin, is the most certain of all; D. gr. Yo to gr. $; cats, gr. Yo. ACETANILID, ANTIPYRIN, PHENACETIN. Caffeine subcut., with an equal amount of sodium salicylate, H. gr. xxx; D. gr. ii. Strychnine sulph. H. gr. ii; D. gr. Yo to gr. Yo. Atropine sulph. gr. 13; D. gr. Y%49 subcut. Acetic Actp, See Acids. ACIDS. ACETIC, HypRocHLogic, Nitric, OxXALIc, PHOSPHORIC, SULPHURIC, TARTARIC. Antidotes.—Magnesia, chalk, plaster scraped off the walls, soap—one of these, with demulcents as eggs, milk, and oil. Large quantities of water by the mouth. ACONITE. Empty stomach with tube: emetics put too much strain on the heart. Atropine under the skin is most valuable. Also digitalis, strychnine, alcohol, ammonia and ether are useful. Tannic acid is partial antidote. Keep the patient quiet and do artificial respiration if necessary. ALCOHOL. Emetic or stomach lavage. Strong coffee by the mouth. Give subcuta- neously, Caffeine with equal amount of sodium salicylate, H. gr. xxx; D. gr. ii. Strychnine nitrate under the skin, H. gr. i, D. gr. Yoo to gr. 149. Inhalation of ammonia. Camphorated oil subcut. H.5i; D. m. xv. ALKALIES, CAUSTIC. AMMONIA WATER, QUICK LIME, PoTASSIUM and SopituM HYDRATE and CARBONATE. Antidotes.—Vinegar or lemon juice in water, or weak solutions of citric or tartaric acids. Do not evacute the stomach. Demulcents as ege white, milk. External heat and mustard paste. Camphorated oil subcut. H. 31; D. m. xv. AMMONIA WATER, See Alkalies. 606 POISONS AND ANTIDOTES 607 ANESTHETICS, ETHER, CHLOROFORM. Hold small animals upside down. Do artificial respiration. Try rhythmic traction of the tongue. Pour ether from a height of several feet on epigastrium. Adrenalin solution (1 to 1,000) injected into vein, H. §ss; D. m. xxx. Atropine sulph. subeut. H. gr. 13; D. gr. %o. Strychnine subcut. H. gr. 1; D. gr. 499 to er. Yo. “Digitalone” subcut. H. §ss; D. m. xx to m. xxx. . ANTIMONY, TARTARIC EMETIC. Antidote.—Strong tea or tannic acid. Magnesia, slacked lime. Emetic or lavage if vomiting has not occurred. Give cathartic of salts or oil. Inject subcut. “digitalone,” H. 3ss; D. m. xx to xl. Give under the skin strychnine sulph. H. gr. i; D. gr. Yo9 to gr. Yo. Heat and mustard paste externally. ANTIPYRIN, See Acetanilid. ARSENIC. Antidote.—Freshly prepared “arsenic antidote” or hydrated sesquioxide of iron in large amount by the mouth. Perform lavage if possible or give emetic. The antidote is of little value. Caffeine, with equal amount of sodium benzoate, H. gr. xxx; D. gr. ii. subcut. “Digitalone” subcut., H. §ss; D. m. xx to m. xl. Morphine subcut., H. gr. iii, D. gr. ss. Heat and mustard paste externally. AMYL NITRITE. NITROGLYCERIN. Inhalation of Ammonia. Alcohol subcut. H. Ji; D. 3i to ii. Atropine sulph. subeut. H. gr. 14; D. gr. 9. Strychnine sulph. subcut. H. gr. i; D. gr. Yoo to gr. 149. Injectio ergotin. hypoderm. H. 3ii; D. m. x. ATROPINE. BELLADONNA. Emetics or lavage. Chloroform inhalation for convulsions. Caffeine, with equal amount sodium benzoate, subcut. H. gr. xxx; D. gr. i. Strychnine sulph. subeut. H. gr. ii; D. gr. Yoo to gr. 149. Pilocarpine. Artificial respiration. BARIUM CHLORIDE. Antidote. Magnesium or sodium sulphate. Lavage with same. BELLADONNA, See Atropine. CANTHARIDES. Egg white, gruel, linseed tea, barley water; avoid oils. Lavage or emetic. Tine. opium for pain. H. 3ii; D. m. x to xv. Give large amount of sodium bicarbonate in drinking water. High enemata of 5% sodium bicarbonate solu- tion. CarpoLtic Acrp, See Phenol. CaRBON MonoxipE, See Gas Poisoning. Carponic Actp, See Gas Poisoning. CHLORAL. Lavage or emetics. Strychnine sulph. subcut. H. gr. ii; D. gr. Yoo to Yo. Caffeine subcut., with equal amount sodium salicylate, H. gr. xxx; D. gr. il Artificial respiration. Heat and mustard paste externally. CutorororM, See Anesthetics. 605 POISONS AND ANTIDOTES CoaL GAS, See Gas Poisoning. COCAINE. If swallowed give emetic or lavage. Ether inhalation if convulsions present. Morphine sulph. subcut. H. gr. v; D. gr. ss. Alcohol by mouth. H. jii; D. 3ii. Strychnine sulph. for collapse, H. gr. i; D. gr. Yoo to gr. 1%» subcut. CoLCHICUM. Antidotes——Tannic acid, oil, milk, linseed tea, barley water. Give emetic or lavage. ‘Tine. opium. H. 3iii; D. m. x to xv. Atropine sulph. subcut. H. gr. 14; D. gr. Yo. Caffeine subcut., with equal amount sodium salicylate, H. gr. xxx; D. gr. ii. Camphorated oil, subcut. H. 3i; D. m. xv. Heat and mustard paste externally. CONIUM. Emetic or lavage. Strychnine sulph. subcut. H. gr. ii; D. gr. Yoo to gr. Yo. “Digitalone,” subcut. H. 3ss; D. m. xx to xl. Camphorated oil subcut. H. 3i; D. m. xv. Heat and mustard paste externally. CoPpPER SULPHATE and other soluble salts. Antidotes.—Potassium ferrocyanide, magnesia, egg white, milk. Emetic or lavage. Morphine subcut. H. gr. iii; D. gr. ss. Mustard paste rubbed on belly. CROTON OIL. Egg white, milk, linseed tea. Emetic or lavage. Tinc. opium H. 3iii; D. m. x to xv. Alcohol, H. Jii; D. 3i. Heat and mustard paste externally. CREOSOTE, See Phenol. DIGITALIS. Antidote——Tamnic acid. Give emetic or lavage. Keep the patient quiet. Tine. aconite, H. 3i; D. m. x, subcut. Camphorated oil, subcut., H. 3i; D. m. xv. Caffeine, subcut. with an equal amount of sodium salicylate, H. gr. xxx, D. gr. ii. Heat and mustard paste externally. ESERINE, See Physostigmine. ETHER, See Anesthetics. GAS POISONING, CARBON MONOXIDE, CoaAL GAS, MARSH GAS, CARBONIC ACID. Artificial respiration, direct transfusion of blood. Cold douches on the head. Apply mustard paste to body. GELSEMIUM. Give emetic or lavage. “Digitalone” subcut., H. 3ss; D. m. xx to m. xl. Strychnine sulph. subcut., H. gr. i; D. gr. 1499 to gr. 149. Mustard paste and heat externally. Artificial respiration. . Hyprocuioric Actip, See Acids. HyprocyAnic Acrp, See Prussic acid. HyoscyAmus, See Atropine. IODINE. Flour or starchy substance mixed with water. Give emetic or lavage. “Digitalone” subcut., H. 3ss; D. m. xx to m. xxx. Strychnine sulph. subcut., H. gr. i; D. gr. Yoo to gr. 4. Heat and mustard paste externally. POISONS AND ANTIDOTES 609 IODOFORM. Absorption from skin or internally. Give sodium bicarbonate internally in large doses. Saline intravenous infusion. Alcohol subeut., H. 3ii; D. 3i. Hot blankets to cause sweating. JABORANDI, See Pilocarpine. LEAD ACETATE AND SOLUBLE LEAD SALTS. Antidotes.—Magnesium or sodium sulphate, or milk and eggs. Give emetic or lavage. Morphine sulph. subcut., H. gr. iii; D. gr. ss. Chronic Poisoning. Potassium iodide, H. & C. 3ii to 3iv thrice daily. Linseed oil. Lime, See Alkalies. LOBELIA. Give emetic or lavage. Morphine sulph. subcut. to allay pain and vomiting, H. gr. v; D. gr. ss. Caffeine, with an equal amount of sodium salicylate, H. gr. xxx; D. gr. ii. subeut. Strychnine sulph. subcut. H. gr. i; D. gr. og to gr. MYo- Mustard paste and heat externally. MERCURIC BICHLORIDE AND OTHER SOLUBLE SALTS OF MERCURY. Antidotes.—Egg white, tannic acid. Give emetic or lavage. “Digitalone” subeut. H. 38s; D. m. xx to m. xl. Atropine sulph. subcut., H. gr. 14; D. gr. 1%. Mustard paste and heat externally. Mercurial salivation. Use saturated potassium chlorate solution to swab mouth thrice daily and stop ingestion of mercury. MORPHINE AND OPIUM. Antidote.—Potassium permanganate, H. 3ii to 2 qts. of water. D. gr. xv in half a pint of water. Give emetic. Lavage most important whether drug swal- lowed or injected. Caffeine subcut., with an equal amount of sodium salicylate, H. gr. xxx; D. gr. ii. Strychnine sulph. subcut., H. gr. i; D. gr. Yoo to gr. Mo. General faradic stimulation of the skin, or whipping of the animal. Artificial respiration. j NITRATE OF SILVER, See Silver nitrate. Nitric Acip, See Acids. NITROGLYCERIN, See Amy] nitrite. NITROHYDROCHLORIC AcIp, See Acids. Nux Vomica, See Strychnine. Opium, See Morphine. Oxatic Actp, See Acids. PHENACETIN, See Acetanilid. PHENOL, CARBOLIC ACID, CREOSOTE. Antidote—Magnesium or sodium sulphate; benefit doubtful. Give emetic or better lavage with 10 per cent. solution of alcohol. Strychnine sulph. subcut., H. gr. i; D. gr. Yop to gr. Y%. Atropine sulph. subeut. H. gr. 13. D. gr. 1%). Camphorated oil subcut., H. 3i; D. m. xv. Artificial respiration. Saline intravenous infusion. Mustard paste and heat externally. PnHospHoRuS Acip, See Acids. 610 POISONS AND ANTIDOTES TARTARIC AcID, See Acids. Topacco. Antidote—Tannic acid. Give emetic or lavage. Strychnine sulph. subcut., H. gr. ii; D. gr. Yoo to gr. 1%. Camphorated oil subcut. H. Zi; D. m. xv. Mustard, paste and heat externally. PHOSPHORUS. Antidotes.—Potassium permanganate, H. 3ii in 2 qts. of water; D. gr. xv in half pint of water, or hydrogen dioxide, or copper sulphate, H. 3ii; D. gr. x. in solution. Give emetic or lavage. Avoid oil and fats. Give large doses of sodium bicarbonate for secondary symptoms. PHYSOSTIGMINE, ESERINE, CALABAR BEAN, _ Atropine sulph. subcut. H. gr. 14; D. gr. Yo. “Digitalone,” subeut., H. 35ss; D. m. xx to m. xl. Alcohol subeut. H. JZiv; D. 3ii. Strychnine sulph. subcut., H. gr. i; D. gr. og to gr. Mp. Artificial respiration. PILOCARPINE. JABORANDI. Atropine sulph. subcut. H. gr. 13; D. gr. Mp. PoTassiIuM CARBONATE, See Alkalies. PoTASSIUM CYANIDE, See Prussic acid. Potassium HypratTeE, See Alkalies. Prussic Actip. Hyprocyanic Acip. PoTAsSstuM CYANIDE. Artificial respiration. Lavage. Atropine sulph. subcut., H. gr. i; D. gr. Vo, every half hour. Camphorated oil subcut., H. 31; D. m. xv. Intravenous injection sodium hyposulphite, H. 3i; D. gr. xxx in solution. Mustard paste and external heat. SAVIN. Give lavage or an emetic. Cathartics, as epsom salts, or castor, or linseed oil. Morphine sulph. subcut., H. gr. v; D. gr. ss. SILVER NITRATE. Give emetic or lavage with salt and water. Salt is the antidote and must be given freely. Demulcents, egg white, sweet oil, milk, soap and water. Morphine sulph. subeut., H. gr. iii; D. gr. ss. Mustard paste and heat externally. SNAKE BITE. Ligature about limb between wound and heart. Excise wound or cauterize it with a hot iron. Inject about bite 1% solution chlorinated lime, or 1 to 1000 solution potassium permanganate. Calmette’s antivenin. Strychnine sulph. subcut., H. gr. i; D. gr. Yoo to gr. Yo. Soprlum CARBONATE, See Alkalies. Sopium Hyprats, See Alkalies. POISONS AND ANTIDOTES 611 STRYCHNINE. Nvux Vomica. Lavage with tannic acid solution under influence of amyl nitrite or chloro- form inhalation. If convulsions are already present give amyl nitrite subcut. H. 31; D. m. v and follow with chloroform inhalation. Chloral and potassium bromide per rectum in starch water. H. of each Jii; D. gr. xxx each. SULPHATE OF COPPER, See Copper. SuLpHuRiIc Acip, See Acids. TARTARIC EMETIC, See Antimony. TURPENTINE, OIL OF. Give emetic or lavage. Give demulcents:—Kgg white, gum arabic solution, linseed tea. Epsom salts, Linseed oil. Intravenous saline infusion. ZINC SALTS, SOLUBLE. Lavage if emesis is not copious. Cathartics, as linseed or castor oil, or epsom salts. Morphine sulph. subcut., H. gr. v; D. gr. ss. Stimulants. Mus- tard paste and heat externally. GENERAL THERAPEUTIC MEASURES. Food and Feeding. In order to comprehend the rationale of feeding in disease it is essential to know something of the principles of feeding in health. A food has been defined as “that which, being innocuous in relation to the tissues, is a digestible, absorbable substance that can be oxi- dized in the body and decomposed in such a way as to give up to the body the forces it contains.” A complete food is composed of organic and inorganic constitu- ents. The inorganic matters, with the exception of common salt, and rarely phosphate of lime and sodium, are usually present in sufficient quantity in ordinary food. The organic components of vegetable food stuffs are divided into nitrogenous and non-nitrogenous classes. These are analogous to the constituent parts of the animal body into which they are transformed. The greater portion of animal tissue is made up of nitrogenous elements, while the larger part of plants is composed of non-nitrogenous material. Among the nitrogenous elements the most important are the proteids. Gluten of flour is an example of a vegetable proteid; while white of egg, casein of milk, and fibrin of blood represent animal proteids. Fat exists as such in both plants and animals. A single, chemical com- pound, as protein, is known as a nutrient in relation to feeding. The nutrients of importance -are proteids, fat, and carbohydrates. The first two are common to animal and plant structure; the latter to plants alone. A complete food contains the three nutrients just mentioned and inorganic substances. Carbohydrates include such bodies as sugar, starch, and cellulose, or woody matter of plants. Proteids consist of carbon, hydrogen, oxygen, nitrogen, and sulphur, united in different proportions. Carbohydrates are composed of car- bon, hydrogen and oxygen. Fat is similar in composition to car- bohydrates, but in its combustion outside the body yields two and a quarter times as much heat as that produced by an equal weight of carbohydrate. Fat as a nutrient is therefore empirically regarded as equivalent to two and a quarter times the same weight of carbo- hydrate material. Hitherto computation of the food requirements has been based simply on the pounds of digestible nutrients and the proportion of 612 FOOD AND FEEDING 613 proteids to carbohydrates, this proportion being known as the nu- tritive ratio. Now scientific feeding is founded on the fuel value or energy value of food. The fuel value means the amount of heat that is given out by food in its combustion in the body. There is much less heat formed by the combustion of food within the body— on account of losses in food undigested and fermented in the bowels and escaping incompletely burned in the urine—than would occur in food burned outside the body. The heat or energy value of food is measured in calories or therms. A calorie is the quantity of heat necessary to raise 1 gram of water 1° C. A therm is the amount of heat required to raise 1 kilo. of water 1° CO. Tables based on the most elaborate experiments showing the actual amount of fuel or energy value of foods, together with the amount of digestible protein and dry matter contained in them, must be consulted in cal- culating daily rations. Thus, for maintenance of animals of 1,000 lbs. live weight per diem, it has been found that eattle require 0.5 lb. of digestible protein and food of the energy value of 6.0 therms. Horses require 1.0 lb. digestible protein and food of a fuel value equal to 7.0 therms. The daily food requirements of grown eattle are such that for each pound of digestible protein there should be 8 to 10 lbs. of carbo- hydrates and 20 to 80 lbs. of total dry matter. More important still, it has been found that there are necessarv—in addition to the mainte- nance requirements of cows—O.05 Ih. of digestible protein and 0.3 therm in energy value in the daily ration for each pound of milk produced. As a practical application of the foregoing, suppose that we compute a ration for cows giving 25 lbs. of milk daily and weighing 850 lbs. Consulting a table showing maintenance requirements, we find that 0.45 lb. of digestible protein and food of energy value of 5.6 therms are necessary. Multiplying the additional require- ments for each pound of milk produced (as above) by 25, we find that 1.25 lbs. of protein and 7.5 therms are necessary for this milk yield—beside the maintenance requirement. Adding the require- ments for maintenance to those for milk yield we get the total daily requirements for cows weighing 850 lbs. and yielding 25 Ibs. of milk as follows: Digestible protein. Energy value. Lbs. Therms. HomemMaintenance were eiacise eer oie 0.45 5.6 Horse bel bswotemiliee ey icine reicienciion 5 1145) 7.5 1.70 13.10 614 GENERAL THERAPEUTIC MEASURES We shall now have to consult a table* showing the energy value, proteid content, and dry matter in all ordinary fodders, and com- bine them so that they shall possess in the daily ration 1.7 lbs. of digestible protein, energy value of 13.10 therms, and dry matter equal to 20 to 380 lbs. The particular food stuffs must be selected so that they shall be the cheapest in the locality in which the feeding is done. The mechanism of the animal body is always “running,” and an animal at rest is like a motor car at a stand-still with the engine moving. ‘Therefore no more protein is required by a horse at light- work than at rest, for repair of the machine. More fuel for work- ing* the machine is, however, needed. The requirements for work- ing horses are: For light work, digestible protein, 1.0 lb.; therms, 9.8. For moderate work, digestible protein, 1.4 lb.; therms, 12.40. For heavy work, digestible protein, 2.0 lbs. ; therms, 16.00. Horses doing hard work, growing and pregnant animals, and all animals supplying nitrogenous products, as wool and milk, de- mand more nitrogen in their food. The proteids, as we have seen, constitute a large proportion of the solids and fluids of the body. The protein absorbed into the blood is utilized in two ways. One part is Energy-forming, the circulatory protein of Voit. The other is Tissue-building, or the Organic Protein of Voit. That part which is devoted to energy-producing is not trans- formed into tissue but is split up (katabolized) by the cells, or en- zymes within the cells (chiefly of muscles), and thus produces heat or energy. | The other part is directly built into living protoplasm. If the amount of circulatory protein is deficient, then the organized protein is called upon, the tissues are robbed of their substance, and the body | emaciates. When a larger amount of protein is contained in the blood, we have a proportionately larger elimination of nitrogenous matter in the urine, as equilibrium is soon established in the adult animal of constant weight, so that the amount of nitrogen eliminated equals that ingested. In young and growing animals a portion of the nitrogen does not reappear in the urine, but is utilized in tissue formation. This also applies to previously starving animals on be- ing well fed. An excess of circulating protein, besides being waste- ful economically, is harmful in causing various disordered conditions, resulting in the formation of products of imperfect oxidation. The vegetable proteids are transformed into bodies of simpler chemical composition in the stomach and are there converted in part * Armsby, Bull. 346, U. S. Dep’t. Agric. FOOD AND FBEDING 615 by the gastric juice, but chiefly by pancreatic (trypsin), biliary and intestinal ferments in the intestines, into peptone, proteoses, and possibly acid and alkali and native albumin. The epithelial cells of the intestines possess the power not only to absorb the peptone, but to transmute it into more complex isomeric compounds, as serum albumin, serum globulin and fibrinogen; spe- cial cells being employed in the formation of particular compounds. Any peptone not so converted by the intestinal epithelium be- comes a poison when absorbed into the entero-hepatic circulation, but its toxicity is destroyed by the liver cells. In regard to the metabolism and fate of proteids, energy is not only directly liberated by the decomposition of the energy-producing protein in the muscle cell but is also formed by the functional activity of cell protoplasm in which katabolic changes occur. So that the tissue-building pro- tein is eventually an energy-producer as well. Elimination of nitrogenous matter is not increased by muscular activity, nor proteid metabolism, as carbohydrates furnish the fuel for the mechanical work—with increase of CO, and H,O elimination. The katabolism of protein in muscles then goes on independently of, and is not aug- mented by, muscular contractions. In the course of the metabolic processes in the muscles there are intermediate products set free—as kreatin, leucin, glycocoll, sarco- lactic acid, etc. These products are finally split up (katabolized) or synthetized (anabolized) in the liver with the formation of urea, uric acid, phosphates, sulphates, ete., as end-products, with the liberation of heat. From its absorption to the final urea stage each gram of protein liberates energy or heat equal to 4.1 calories. This heat formation is of extreme importance in stimulating and sustaining nervous action. The following réle is played by protein as a nutritive :— 1. It is the building material for cell protoplasm of tissues of all kinds. . 2. It forms energy directly by undergoing destruction without tissue-building. 8. It may be so transformed (through its H and C) that it is deposited as fat. A dog can live on lean meat (pure protein) for months and gain in weight. Carbohydrates of the food, as starch and sugar, are converted by the enzymes of the intestinal mucosa into sugars—as dextrose, levulose and galactose, which pass into the portal circulation to the liver where they are converted into glycogen, and stored as such, except a part of the sugars which are carried to the muscles and there converted into glycogen. 516 GENERAL THERAPEUTIC MEASURES The glycogen undergoes combustion in the liver and muscles with a production of heat equal to 4.18 calories for each gram of carbohydrates. CO, and water are end-products. Sugar metabolism is under the control of the internal secretions of the pancreas, adrenal, thyroid and pituitary glands. These either aid in the storage of sugar as glycogen in the liver (pancreas), or, in excessive and abnormal amount (adrenal, pituitary and thyroid glands), hinder this action and allow sugar to pass through the liver unchanged and escape into the blood and urine, thus causing diabetes. The heat production, as in the case of the combustion of proteids, is of great importance in sustaining nerve action. Fat in the food is emulsified by the bile and by the pancreatic and intestinal secretions and is absorbed as fatty acids, glycero] and soaps by special cells of the intestinal mucous membrane and passes into the lymphatics as emulsions of fat; thence into the thoracic duct, and is finally oxidized into carbonic dioxide and water with produc- tion of heat and energy. In what part of the body oxidation of fat occurs is unknown. In the combustion of 1 gram of fat heat equal to 9.4 calories is liberated. Carbohydrates do not directly furnish tissue elements, but do so indirectly in preventing decomposition (to some extent) of protein in the body, and in lessening its consumption. In this way the comparatively inexpensive carbohydrates will compensate for an in- sufficient ration of costly proteids. It is asserted that this action of carbohydrates is explained by the fact that these nutrients have a greater affinity for oxygen than proteids and so are the first to undergo combustion. The term albuminoid was formerly used as synonymous with | proteid, but is now employed to include nitrogenous bodies (gelatin) derived from protein in the body but not convertible into proteids. These bodies do not take the place of proteids, but appear to fulfil the functions of circulating protein, and, like carbohydrates, con- serve protein consumption, but are not tissue builders. Carbohydrates aid directly in the production of fat. Fat in the food may be directly assimilated as such if there is a sufficient carbohydrate and proteid ration to protect it from decomposition. The réle carbohydrates play includes: 1. The formation of tissue indirectly by protecting the proteid elements from combustion with an insufficient nitrogenous diet. 2. The generation of heat, energy, or mechanical work. 3. The production of fat. Carbohydrates cannot be relied upon as sole articles of food. The fat of the body is derived from the decomposition of proteids and carbohydrates, and directly from fat contained in the food. FOOD AND FEEDING 617 Fat lubricates the tissues, and a reasonable accumulation serves as a store of potential energy to be called upon in time of need, when its action is similar to that of carbohydrates. The main source of muscular energy, movement, or mechanical work, is thought to reside in the carbohydrates, because with excessive muscular work there is increased evolution of heat, carbonic dioxide and water, but no material increase in excretion of nitrogen in the urine. In so far as muscular energy and power depend upon a good machine, in so far do the proteids aid the work of the machine by keeping it in good repair and working order. From this point of view the pro- _teids represent the mechanism by which the work is done; the car- bohydrates the fuel necessary for its performance. It must be kept in mind that this is but a general statement, since muscular work is also done by protein, and may be wholly done by it, as shown by dogs living on lean meat. The exact relative value of carbohydrates and proteids in the production of the vital forces is still sub judice. The classes of food stuffs for the larger animals embrace both green and dry fodder, consisting of the whole plant minus the roots; parts from which the more valuable portions have been removed, as straw; tubers and roots containing a large percentage of water; the seeds or grains, constituting the most concentrated food; and the seed coverings or chaff. Refuse and bye-products of manufacture are extensively used, as bran, cottonseed meal, linseed meal, and brewers’ grains. In addition, animal matter, as flesh meal, bone meal, and dried blood, are sometimes of value. Pasture grass may be taken as a standard of comparison for green fodders. In 100 lbs. of grass there are ap- proximately digestible: Proteineccmnece cic Us Fates Aeiare eet es 1.04 Ibs. PE Eee See ey ane avers avecaianonons evenelionelise 0.5 “ Carbohydrates ........eeseeeeeeecees 10.34 “ Green clover contains considerably more, green rye slightly more, and green oats somewhat. less protein ; while in green corn fodder there is only about half as much protein. Roots, as com- pared with green pasture grass, possess only one-third the quantity of protein and solids. Potatoes, however, have double the nutritive value of roots. Comparison is made in reference to protein, as that is by far the most valuable nutrient, and the amount of carbohydrates and fat do not vary much in similar kinds of fodder. Meadow hay, including such common varieties as timothy and red top, may be taken as a standard of comparison for dry fodder. In 100 lbs. of timothy hay there are approximately digestible: 618 GENERAL THERAPEUTIC MEASURES PROUGIN « si-)2-h.c.cm comes eee sees 3.65 Ibs MEU, cua Sotace aches bigig alesis eh keene 5( 3. ae Carbohydrates: s5.(nti:n swe e exnene aes 45.8 “ Clover hay has double the amount, and rowen or aftermath about one-third more protein than is contained in ordinary meadow hay. Oats may be selected as a standard of comparison for grains. 100 Ibs of oats contain of digestible nutrients as follows: PrOteleat orto ive ciuets serene ere nae 8.36 Ibs. LT Fae SEP RORY Ps I eed Menon SY fist ee 9 45 * Carbohydratest a3. 2s fe eeieec eens 45.0 “ Corn yields slightly less protein and considerably more carbo- hydrates and fat, while cottonseed meal contains nearly three times as much protein, and four times as much fat as are found in oats. Bran (or shorts) has approximately the same chemical composition as oats. The straw of wheat, barley, rye, oats, and corn have a somewhat similar value. In 100 lbs. of wheat straw there are di- gestible: Protein: scsawss est aekee eaten ne terete 0.37 Ibs. atin wn eat « Gaahe 4 aorcuk dst ate eee 0.3 “ Carbohydrates ...0s%.3..9546 60 sajs4008 es 36.00 “ In order to compare the composition of food with that of the tissues into which it is converted, we submit the following: PERCENTAGE COMPOSITION OF LIVE ANIMAT. IN 100 LBS. OF WELL FED LIVE OX THERE ARF: Proteins fy ante cps atte coe ne ee 15.8 Ibs. Patt recuatetaies cre Oey eee ae Sie ei Seated a ous SN eee Ts Ag eit y kiran tend ae ee ae eer: 4.8 “ Woatersarire cuvette ere tases uae hee 54.3 “ Contents of digestive tract............ 18:0) * Certain of the fodders are especially adapted or otherwise for the various domestic animals. Green clover is prone to fermentation and the formation of flatuleney if given in large quantities to any animal. A sudden change from dry to luxuriant green food is al- ways undesirable for a similar reason. Green grass cut short by a lawn mower should not be given horses, as it is swallowed in an unmasticated condition and leads to indigestion and colic. Corn chop is a frequent cause of colic and alfalfa of impaction of the colon in horses. Pasturing on the tops of sugar beets, after the beets have FOOD AND FEEDING 619 been removed is responsible for colic in horses and gastro-enteritis in cattle, sheep and swine in parts of this country. Potatoes and roots are more suitable for ruminants than for horses; yet upon the latter they act as natural and agreeable laxatives, and form a palatable addition to dry fodder, particularly carrots. The best variety of hay for horses consists of good bright timothy or herds grass with a slight admixture of red top and clover. Carrots should be sliced longi- tudinally to prevent choking when given to horses. Clover hay is dusty and apt to provoke “heaves” in horses, and that, together with rowen, is more appropriate for ruminants. Bran is but poorly digested by horses, yet acts favorably as a laxative when given once or twice a week mixed with boiling water and plenty of salt, constituting a “bran mash.” Bran takes the place of oats as a nitrogenous food for ruminants, and is less expensive. Cottonseed meal, being extremely rich in nitrogen, and usually in oil or fat, is not easily digested by any animal, but may be given in quantities of a quart or two to ruminants, and from half a pint to a pint to horses, daily. Cottonseed meal is supplied cattle to compen- sate for a deficiency of nitrogen in the food, while in horses it acts as a slight laxative and may improve the general condition. Straw and corn fodder are not readily digested by horses unless cut and steamed, but are suitable for ruminants and are often preferable to a poor quality of hay. The demands of the system for food vary in relation to tissue change, which is diminished by rest, increased by work, and either accelerated or decreased by disease. The require- ments for nutriment are greater during the growing period and for the formation of the various natural products, as milk or wool. The state of the digestive organs and assimilative powers guide us in selecting the kind and quantity of food desirable. In acute disease it is advisable to feed little and often, the food being prepared in the most digestible and palatable form, and in as great a variety as at- tainable. We may restrict the diet as a whole or in part. Starving diminishes circulatory protein, increases tissue waste, weakens an animal, and lessens the natural resistance against disease. Restrict- ing the diet is useful in controlling unmanageable animals, in dimin- ishing sexual excitement, and in the treatment of plethora when com- bined with proper exercise. In most acute inflammatory diseases, as in acute laminitis, a restricted laxative diet is desirable, as steamed oats with bran and salt, roots and green fodder. In acute indigestion, or in acute inflammation of the alimentary tract, and in acute ne- phritis, all food should be withheld for at least 24 hours. In acute peritonitis all food is contraindicated, by the mouth. In the milder forms of acute gastro-enteritis we must restrict the diet to smal] quan- tities of easily digested food, as cracked or steamed oats, chopped hay 620 GENERAL THERAPEUTIC MEASURES and gruels, with the addition of a little green fodder or roots for horses; while carnivora are given milk and lime water. In chronic digestive disorders the food must be readily digestible and as- similable, and of a nitrogenous character, since anemia and mal- nutrition follow the defective digestion and absorption. Jn chronic indigestion or gastro-enteritis of horses, Zuill recommends oats (boiled, scalded or steamed, and allowed to stand 12 hours), 2 parts; bran, 1 part; and malted barley, 1 part. The addition of salt and a little green fodder to this ration is palatable and desirable. The dietary for constipation in horses should consist of bran mashes twice a week with plenty of salt; roots and green fodder at frequent inter- vals, combined with suitable exercise and appropriate drug treat- ment. Dogs suffering from constipation may be given raw liver twice a week, or may be put on an occasional or exclusive diet of one of the commercial dog breads or biscuits. These are laxative and are invaluable in eczema of dogs. Avoid oatmeal, and feed bread, soup and milk in acute eczema. If constipation is very obstinate, total abstinence from all food, water excepted, for a time, followed by the use of lean meat with salt and beef tea, are indicated till the bowels are emptied manually or by enemata. The ration for diarrhea embraces the partial restriction of water, which increases the bulk and fluidity of the intestinal contents and so stimulates the move- ments of the bowels. If the diarrhea is so severe as to endanger life, an abundance of pure or boiled water should be allowed in order to compensate for the loss of fluid from the blood. Theoretically, an albuminous diet is indicated in diarrhea be- cause of the loss from the blood and tissues, and because intestinal digestion is disordered and starchy food would be undigested and cause fermentation, ete. Practically, a certain amount of starchy food seems to be serviceable in the treatment of diarrhea. Horses and cattle should be given cooked flour or barley gruel and roasted oatmeal and cracked oats. Coarse foods, as bran and straw and green fodder, are not allowable. Swine should be supplied with eruels of boiled milk and barley, flour or oatmeal (strained). Fowl] with diarrhea may be fed on boiled rice and given a few drops of landanum two or three times daily. Dogs and cats should have boiled milk, boiled rice or strained rice gruel, cooked lean meat and crackers. Beef juice and white of egg in water are of value. Young calves, with diarrhea, should receive whey, broths and rice flour gruel. These dietaries should be employed in conjunction with other measures, as the preliminary use of a laxative, rest, the avoid- ance of too rich milk, quiet, and external heat and drug treatment. Young suckling animals, as foals and calves, may be fed on cooked and strained oatmeal or barley gruel made with milk, if the mother’s FOOD AND FEEDING §21 milk does not agree. In severe attacks of gastro-enteritis, or in gas- tric or intestinal ulceration with hemorrhage from the stomach or bowels (after preliminary starving), the food should be bland and fluid, as soaked bread, oatmeal, barley or flour gruels, linseed tea (made by boiling linseed in a muslin bag immersed in water), and small quantities of green fodder for the larger animals; while milk and lime water, white of egg and water, broths and beef juice are indicated for carnivora. In the latter animals we may have to resort to predigested food given by the mouth, or, if vomiting is persistent, by the rectum, The diet in cases of catarrhal jaundice should be easily digesti- ble, bland, and such as will not require much bile for its digestion. The larger patients should be given gruels, steamed cracked oats, young and tender green food, cooked potatoes, together with alkalies and other appropriate remedies. Dogs are allowed milk and lime -water, crackers, bread and cooked lean meat. Feeding in heino- globinuria or “black water’ of horses must be restricted to the use of gruels, green fodder and a little hay in the early stages of the disorder. Food is usually withheld 12 hours before surgical opera- tions, and this, in addition to the administration of a cathartic, will prevent injury in casting the larger animals, which might follow were the digestive tract overfull. It will also lessen the danger of intestinal fermentation and absorption of toxins from the bowels, which may occur after operation, owing to an enfeebled digestive action. If dogs are starved before surgical operation, vomiting is prevented during or after etherization. Water alone may be re- stricted to advantage in obesity, cardiac disease with edema, or in the treatment of chronic exudations, as in hydrothorax. Water may be allowed in these conditions only once daily, or even every other day; and this treatment may be combined with the use of saline cathartics in strong animals. The specific gravity and density of the blood and the tendency to absorption from the tissues and cavities are increased. By the same process the quantity of blood is dimin- ished and the load put upon the heart is lessened, both of which may prove beneficial in cardiac diseases. A full, or restorative diet should be especially rich in protein. Generous feeding is distinctly in order in the treatment of general debility, malnutrition, anemia, weakness of the digestive organs, con- valescence from acute diseasés and in animals particularly sensitive to cold, or in those which sweat easily. A full diet is also useful in overworked animals and in those subject to losses from increased secretion, excretion, or exudation, as in chronic suppuration, diar- rhea, albuminuria, ascites and edema. A restorative diet for herbiv- ora includes grain, as corn, bran, oats and cottonseed meal; hay 622 GENERAL THERAPEUTIC MEASURES and grass, with occasionally beef meal, milk and eggs. For omnivora, corn, potatoes, blood, beef meal, milk and soups. For carnivora, meat extracts, cream, milk, eggs, broths and meat juice. In most wasting diseases, fat, protein and water are the food elements espe- cially needful. An abundance of water stimulates the appetite, secre- tions, excretions, tissue changes and vital processes generally. Salt should be given freely as an aid to digestion in increasing the formation of hydrochloric acid, and indirectly that of pepsin. Alcohol, being a nutritive and capable of easy absorption, assimilation and decomposi- tion in the body, forms a most valuable adjunct to a restorative diet. A deficiency of lime in the food is occasionally the cause of rickets in the young, and fragilitas ossium in the old, but more frequently these diseases are due to defective digestion, assimilation, or excessive lactation. Bone meal may be fed to advantage in such affections. It contains both lime and phosphoric acid and should be given in small quantities (1 tablespoonful to large animals; 1 teaspoonful to small patients) on the food in connection with the administration of hydrochloric acid and bitters. In fever a restricted diet is often necessary in the more acute stages, with loss of appetite, diminished secretions, and movements of the stomach, but as soon as convalescence sets in the increased tissue waste produces an excessive demand for food and the digestive organs may become overtaxed. The initial dietetic treatment of fevers consists in the use of oats, bran mashes, and gruels, with the addition of a small quantity of grass or roots for horses. The change from this diet should be very gradual to a dry, coarse fodder, in order to avoid digestive disorders. The bitters, aleohol, hydrochloric acid, and salt, together with a copious supply of water, will further- more aid convalescence. Carnivora, with fever, should be fed milk, beef juice, broth, bread, oatmeal and a small quantity of cooked lean meat. Obesity is treated most advantageously by proper feeding. A certain amount of fat is essential in the body in lubricating the tissues, in acting as a protection against cold, in serving as an en- veloping and shielding cushion to the underlying tissues, and finally in supplying a store of nutrition. Animals living in cold climates are covered symmetrically by fat, but those indigenous in hot countries have accumulations of fat in masses to avoid over-heating the body. This is seen in the hump of the camel, zebu and Brahmin bull. When the camel is severely taxed, the fat is consumed and the hump becomes loose and flabby. House dogs overfed and insufficiently exercised, horses, and other animals kept for breeding purposes, are those most commonly afflicted with obesity. Fat in the body mav be formed from fat, albuminoids, and carbohydrates of the food. Carbohy- . FOOD AND FEEDING 623 drates, if in excess of the needs of the economy, protect the fat in the food from decomposition and so enable it to be stored in the body. Protein may also protect the consumption of fat of the food, for it is broken up into nitrogenous and non-nitrogenous elements, and the latter may be transformed into body fat. The accumulation of fat proceeds most readily when there is an abundance of fat in the food, in addition to the other nutrients; less so when the ration consists of fat and albuminoids, or of carbohydrates and albuminoids; and least of all with a diet consisting of pure protein. ‘The latter, then, is the food to be approached as near its purity as advisable. If a proteid ration is followed too closely, digestive disorders, loss of strength and nervous disturbances are likely to occur. The fat resulting from the decomposition of a pure protein fodder is usually not sufficient to supply the needs of the body, and the organized fat is gradually called upon to supply the deficiency in the food. Exercise, cathartics, diuretics and diaphoretics, together with venesection, are synergistic measures. As emaciation proceeds, we must add more and more non-nitrogenous material to our ration. Fat is said to accumulate most readily in the vicinity of vascular areas where the flow of blood is retarded, and therefore oxidation, combustion, and solecular activity diminished. Exercise, on the other hand, stimulates the circulation, while deprivation of water makes the blood-current more rapid by decreasing the amount of blood. Both therefore favor the destruction of fat. Vogel has reported good results in reducing obesity by the use of the following rations. From 19 to 26 weeks are required for a cure. DAILY BATION FOR THE HORSE. Oatmeal peers screxs siete rey stie clei Iotortiaielo.o8 sretsiln ols 7 ~ Ibs Straw ay aiesymoryeicysiarortons) alley steues oie ayers ana rg ohare Sys IBEAY oA ad0eeb bod ab ee ODIO Ets CoDG lb OadOmen A ee Thimseediemen! lerreyeretaleisitel retort rel 1 se SHlle’ Gece duccanedosscesougocuDahogaudar 5 per cent. of above. DAILY RATION FOR DOG WEIGHING 115 LBS. WERR oolnc oo suo OnOdOOO Rd coUUgRoCaODD SND Ty @atreailge eh se retectave eterecer coc beater oieie eaves Ti wb: Mesh meal jeiecie eioteisteteterereihavelalcretercl sleet oilessi/~ ye“ Wag ene cio ietaiiciolclercielefatelecvel ister eis els) sferels Ariss 624 GENERAL THERAPEUTIC MEASURES DAILY RATION FOR FAT SETTER OR POINTER. Li@EiTh MCE oro. Sie 5 fe lets, oleate etsy er donee ttalta & 114 lbs. ISVOA is xb. da share ke wane peters ficients @eletle cheats ly * a secseiirs at aaciig "se ei eiiev onthe eae snes a tate eae ob eens 3 OZ. Animals suffering from fatty degenerative changes do not stand such a rigid diet as the foregoing. These animals are affected with a weak heart, due to fatty degeneration of the myocardium, with atrophy of its muscular fibres. They have dyspnea on exertion. The cardiac insufficiency leads, in its turn, to secondary troubles, as catarrh of the digestive and respiratory organs, and disorder of the liver and kidneys, following general passive congestion. The treat- ment should be directed in such cases to lessening the amount of blood and the work put upon the heart, by limiting the ingestion of water, and by strengthening the heart with appropriate stimulants. The activity of the skin should be excited by frequent grooming and the use of diaphoretics, while the activity of the kidneys should be enhanced by the employment of diuretics. We are prevented from feeding an exclusively nitrogenous diet in these cases, as the oxidizing power of the blood is not sufticient to decompose it, neither is it safe or advisable to quickly remove the fat, as cardiac failure might ensue. Small quantities of water are allowed, given two hours after feeding. The general ration should be rich in proteids and also contain a moderate amount of fat and carbohydrates. ARTIFICIAL FEEDING. Artificial feeding consists in the introduction of food into the body other than in the ordinary way by the mouth. Rectal feeding is the only procedure of much value. The agents employed must be bland, and capable of easy absorption and assimilation. If the food is at all irritating, tenesmus and ejection quickly occur. From two to four ounces of liquid nourishment may be given to small or me dium-sized dogs; from four to eight ounces to large dogs. One quart may be employed for horses. The nutrient enema should be introduced into the bowel through a flexible rubber tube carried up into the colon. An hour before the enema is given the bowel is to be washed out thoroughly with cold water. The nutrient injection should not be given oftener than once in six hours, and if the bowel is irritable, not oftener than once in twelve hours. The absorptive power of the rectum is slight, but that of the colon is considerably greater. Predigested food is most valuable. Leube’s Beef Peptone may be used. A bullock’s pancreas is finely chopped and rubbed up with eight ounces of glycerin. This extract will keep fresh several weeks in a cold place. To one-third of the extract are added five FOOD AND FEEDING 62 COU ounces of finely chopped beef, and the mixture is ready for immediate use. The peptonizing powders of Fairchild Brothers & Foster are most convenient in preparing digested food. Each powder consists of five grains of pancreatic extract and fifteen grains of sodium bi- carbonate. oe A useful nutrient enema for a large dog may be made of two eggs and six ounces of milk. Four to six eggs may be added to a quart of milk for use as an enema for a horse. The mixture is then to be peptonized and introduced into the rectum at the temperature of the body. In using the peptonizing powders, one is placed in a quart glass jar together with a teacupful of cold water. Then a pint of the mixture to be peptonized is poured into the jar, and the latter placed in a vessel containing water as hot as the hand will easily bear. The jar is kept in the hot water for twenty minutes and put on ice. When the mixture is used it should be heated to 100° F. If predigested food is to be given by the mouth, it is well not to keep the glass jar immersed in hot water more than five minutes, as otherwise the taste will be bitter and disagreeable. A small dose of laudanum is always useful to prevent the expulsion of enemata. Brandy may be added in the proportion of one ounce to the pint of milk after peptonizing. The addition of salt to ege-albumin greatly facilitates absorption. Panapeptone and brandy, each one ounce, in six ounces of normal salt solution form a good substitute for the peptonized milk enema. Gruels of all kinds, and broths, may be peptonized, as well as milk. It is not essential, however, to pepton- ize milk and other fluids, although absorption is rendered somewhat more complete. The digestive powers of the large intestines are but slight. Sugar is absorbed unaltered; undigested proteids (with cer- tain exceptions) and fat are not absorbed. Peptones, soluble pro- teids, as milk, meat juice, egg albumen, and emulsified fat are ab- sorbed. Nevertheless, absorption from the lower bowel is trivial compared with that from the small intestines generally, and as the extent of surface with which rectal injections come in contact is small, and their sojourn short, it follows that rectal feeding cannot take the place of normal alimentation. In tetanus, paralysis of muscles of deglutition, fracture of the jaw in horses, persistent vomiting and convulsions in dogs, and in all animals refusing food, rectal feeding is indicated. It is possible to feed animals through a stomach tube (or catheter), and, in hos- pital cases, this method may be preferable. 626 GENERAL THERAPEUTIC MEASURES Counter-Irritants. A counter-irritant is an irritant which acts counter, or against an existing irritation, result of irritation, or pain. In applying a “twitch” to a horse, we are inflicting an irritation to relieve some other source of irritation elsewhere. It is taken for granted that the damage and pain caused by the artificial irritant are not so severe as those already existing. The amount of injury produced by an irritant depends upon the nature of the material, its strength, the duration of its action, the mode of application, and the part to which it is applied. We may consider the effects occasioned by a mild and increasing action following the continued use of a single agent, or representing the action of materials of different degrees of potency. There first appears redness of the skin, accompanied by some burning or pain (rubefacient action), and if the irritation progresses there is a serous exudate poured out into the mucous layer of the skin. This leads to swelling and edema. Greater irritation causes more exuda- tion of serum and an elevation of the epidermis in a circumscribed area or areas, and the formation of blebs or blisters (vesication). If the irritation ceases at this point, the blisters break open and their contents dry on the surface, covering the parts with a thick scab. Synchronous with vesication we observe a similar process attacking the hair follicles. The hairs are loosened and fall, but as the papille are usually unaffected, the growth of hair is soon renewed. The re- covery of hair is facilitated by the application of grease to parts. Certain agents cause circumscribed inflammation of the gland orifices of the skin, with the formation of pustules (pustulants), as croton oil, and these create necrosis of the hair papille, and, therefore, per- manent loss of hair. If the irritant is severe, suppuration follows vesication; or, if an ordinary irritant is applied with violent fric- tion, is covered with a bandage, or placed over an already inflamed part, the same result happens. The terms referring to the degree of action inherent in agents are as follows: 1. A rubefacient, causing hyperemia. 2. A vesicant, or epispastic, inducing blistering. 3. A pustulant, creating pustules. 4, An escharotie, or caustic, occasioning death of the tissues. The same agent, as has already been pointed out, may produce one or more of these actions according to circumstances. The inner aspect of limbs and the flexures of joints are peculiarly sensitive, owing to the thinness of the skin over these areas. If a counter- irritant is rubbed properly into the skin it may penetrate into the mucous layer. COUNTER-IRRITANTS 627 Reference has been made to the local influence of irritants. We will now direct attention to their remote effect. It is certainly known that irritation of the surface decidedly affects distant organs. Brown- Séquard noted contraction of vessels in one arm when the other was immersed in cold water. Severe burns of the surface are followed by duodenal ulcers. The preceding and succeeding remarks enable us to partially account for the remote influence of counter-irritants, but although we know their practical value, it is not within our pres- ent knowledge to offer theories wholly explaining their effect. The influence of counter-irritants may be summed up in reflex action; 1.¢., the production and conduction of an impulse from the periphery to nerve centres, thereby modifying the nerve functions and blood supply in distant parts. The skin is commonly the point of application. It normally is an organ of protection, respiration, sccretion and special sense, and, through its medium, a regulator of temperature, responding to such natural! stimuli as heat, cold, moisture and dryness. Such an unnatural and considerable stimulation as is produced by counter- irritants consequently creates very sensible alterations in the bodily functions. Extensive counter-irritation causes the breathing to be- come slower and deeper by reflex stimulation of the respiratory centre, and also by making the respiratory movements more painful, if the application be made to the chest wall. The circulation is likewise affected by stimulation of the vagus and vasomotor centres, and both the force of the heart and blood pressure are increased, unless the irritation is very widespread and severe, when the reverse happens. The abdominal vessels are those constricted; the vessels of the skin and limbs ‘are unaffected. In accordance with the foregoing remarks, the use of considerable heat, together with mustard or turpentine, is of great value in conditions of vital depression, surgical shock, col- lapse and coma. Moreover, the effect on local blood supply is still ereater and full of importance, since it may explain the beneficial action obtained in the ordinary use of counter-irritants. In experi- ments conducted upon animals, it has been observed that when sina- pisms are placed over the head, the blood vessels in the pia mater are first dilated, but soon contract and remain in that condition for some time. Likewise there was seen, following energetic counter-irri- tation of the chest, anemia of the underlying parts, including the muscles, pleura, and even the pulmonary tissue. It is essential to bear in mind, then, that while counter-irritants induce local congestion in their immediate vicinity, they also causc reflexly vascular con- traction in more remote areas. In accordance with this demonstra- tion, the importance of these agents in remote inflammation lies not so much in their bringing blood to the surface, as in forcing it out of 628 GENERAL THERAPEUTIC MEASURES distant parts. This fact is not generally appreciated. The use of the word ‘‘drawing” signifies the common idea of a counter-irritant, and implies the first proposition. Temperature is not materially affected by the therapeutic use of counter-irritants, and they are not necessarily contraindicated in fevers. Experiments, however, appear to show that mild counter- irritation may lead to a slight elevation of body-heat, owing to stimu- lation of the calorifacient centres, while extensive and prolonged action lowers temperature by depression of the heart and heat centres, and because more blood flows through the peripheral vessels owing to constriction of the vessels in the abdominal organs. Counter-irritants notably relieve pain. This result is not only due to overcoming congestion, but occurs when pain is purely neu- ralgic. The phenomenon is not altogether explicable. The subdu- ing influence of a twitch in the case of pain inflicted upon a horse is an analogous example. Wechsberg, in some late experiments, notes, as a most striking effect of counter-irritants, edematous infiltration of the skin, subcutaneous tissue and muscle in sub-adjacent parts, with compression of blood vessels in the deeper-lying structures. He at- tributes the relief of pain afforded by counter-irritants to anemia and rapid compression brought to bear on the nerves in these under- lying parts. Still this explanation does not interpret the relief of pain some- times seen in parts remote from the point of application of counter- irritants. In disease of internal organs Head has constantly found certain corresponding areas of skin tenderness. This because both the inter- nal organ and the skin area are innervated from the same segment of the brain or cord. ‘Theoretically and practically counter-irritation of a skin area affects the internal organ corresponding (by nervous connection) to this area more than other parts. These areas of skin tenderness for diseased internal organs, and for application of skin irritants to relieve these conditions, have been mapped out in man. In the case of the chest and belly they are situated pretty nearly over the site of the internal organ. In the head the sensitive skin-sites are not over the diseased part. Pain is usually referable to the peripheral ends of an affected nerve. It is good practice to apply counter-irritation directly over a deep-seated inflammation or seat of pain (see above), but in as- suaging superficial pain it is found, that where the treatment can be made over the root of the painful nerve, better results are obtained. In pain in the chest wall a blister should be placed next the spine over the root of the spinal nerve involved; in pain in the head in man, counter-irritation is applied over the back of the neck. Counter: COUNTER-IRRITANTS 629 irritation should be done over the temple, in pain in the eye (iritis) ; behind the ear, for pain in that organ. In the treatment of enlarged glands and in acute inflammations, as abscess, boils and carbuncles, by counter-irritants, the application should be about the lesions rather than directly upon them. Among other actions accomplished by counter-irritants are: pos- sible stimulation of trophic nerves and nutrition of a part; augmenta- tion of tissue change, locally and generally, and dilatation of vessels (when applied after the subsidence of acute inflammation or in chron- ically inflamed parts), with renewed activity of the circulation and consequent absorption of inflammatory exudations. The local action of skin irritants increases the leucocytes and opsinins in the inflam- matory area (acted upon) and leads to bacterial destruction. The toxins are also more rapidly removed by their influence. Further- more, counter-irritants reflexly overcome spasm and pain occurring in colic, by stimulating and replacing normal peristaltic action in place of abnormal localized contractions. In like manner they excite uter- ine contractions by stimulation of the involuntary muscular fibres of the womb. INDICATIONS FOR COUNTER-IRRITANTS. . To overcome congestion and inflammation in remote parts. . To promote absorption of inflammatory products locally. . To relieve pain. . To stimulate the heart, respiration and nervous functions. Rubefacients.—In this class are included the volatile oils—tur- pentine, oil of wintergreen, ete.—-alcohol, chloroform, balsams, resins, iodine, tincture of camphor, tincture of cantharides, mustard, and heat. ‘These agents are used when it is desirable to stimulate the nervous system rapidly, and to relieve pain and congestion. To attain this end, we employ comparatively mild agents in order that we may apply them over an extensive surface without causing serious or permanent results. Mustard is rubbed with warm water into a thin paste (a sinapism), and rubbed over the chest of horses in con- gestion of the lungs, in acute bronchitis, or in the first stage of pleuritis, to obtund pain and _ lessen congestion. Sinapisms also relieve obstinate cough, revive failing respiration, and stimnlate re- flexly the vital functions in collapse, shock and narcotic coma. Ap- plied over the cardiac region, they avert syncope. To assist the action of mustard, we often cover the application with hot blankets, and then with dry ones. Stimulating liniments are sometimes pre- ferred. One volume of oil of mustard may be combined with fifteen volumes of oil of turpentine; or ammonia water, thirty parts, and H OF bo H+ 630 GENERAL THERAPEUTIC MEASURES oil of turpentine, fifteen parts, are added to spirit of camphor and soap liniment, each fifty parts. Turpentine is more valuable in abdominal disorders in horses. It is sprinkled on hot blankets, and applied as a stupe to stop pain, spasm, and stimulate normal peristalsis in colic; and to relieve pain and congestion in enteritis, peritonitis, diarrhea and other difficulties. The beneficial result accruing from the use of external counter-irri- tants in bowel troubles is often facilitated by the injection of hot (115° F.) rectal enemata. Stimulating liniments are serviceable in aiding resolution of swelling following the acute stage of cellulitis, lymphangitis, neuritis, mammitis, rheumatism, strains and bruises. They are often em- ployed in laryngitis. In chronic skin diseases, as eczema, mild counter-irritants (tar, oil of cade, Peruvian balsam, ete.) substitute an active reparative process, tend to aid absorption of exudation and induration, and relieve pain and itching. The tincture of iodine may abort incipient inflammatory lesions, as boils and abscess, by means of its counter-irritant and antiseptic properties. VESICANTS AND THE ACTUAL CAUTERY. Cantharides, red iodide of mercury, and croton oil, are more commonly used in veterinary medicine to cause blistering. Refer- ence will be had, hereafter, to cantharidal blisters. Blisters and the cautery are especially indicated to cause resolution of inflam- matory products and modification of inflammatory processes; to secure fixation and rest of parts, and to relieve pain. It is im- possible to enumerate all the conditions in which they are useful. In the treatment of severe sprains, as curb and “breakdown”; and in exostoses, as ringbone and spavin, the actual cautery (firing) is used before and in conjunction with blistering to exaggerate the counter-irritant effect. Absorption is attained in the foregoing con- ditions by the production of an acute inflammation, with increase of vascularity, tissue change and fatty degeneration. In “breakdown,” the formation of scar tissue is thought (without reason) to assist in supporting the limb. Sometimes, on the other hand, osseous deposit is unabsorbed, but anchylosis and freedom from pain in a diseased joint is secured by the enforced maintenance of rest and fixation of the joint, together with the production of new bone. In exudative diseases of serous membranes, as pleuritis, peri- carditis, peritonitis, meningitis, arthritis, and synovitis, blisters fa- cilitate absorption and recovery after the acute stage is over. This favorable result is not due to loss of serum, but to modification of the inflammatory process. In the first three diseases named above. COUNTER-IRRITANTS 631 blisters—flying blisters—may be applied in spots every few days in different places over the affected area. Blisters reflexly stimulate the nerve centres in meningitis, in addition to their action on the inflammatory lesion. They should be applied over the poll or spine according to the location of the trouble. Absorption in chronically enlarged glands is assisted by blisters. They also hasten “ripening” of suppurating glands or ab- scess when this process is slow, and hasten their resolution after evacuation of pus. The blister should be rubbed on about the in- flamed area in these lesions. Vesicants are also valuable in pharyngitis and Jaryngitis for severe cases, when stimulating liniments are ineffectual; and, in lessening pain, exudation and swelling of the throat, may avert the necessity of tracheotomy. A blister applied about the coronet in diseases of the feet is serviceable in stimulating the growth of the hoof and promotes repair in navicular disease, laminitis, and earti- laginous quittor, after the acute stage is passed. In arthritis and synovitis, the whole diseased area, with the exception of the flexure of the joint, is covered with a blister. Since it is often impossible to immobilize a part, in veterinary practice, by splints, blisters are sometimes employed for this end after reduction of dislocations. The hair should be clipped from an area to be blistered, the skin washed with soap and water, and the animal tied up or re- strained in some way from biting the part. It is the custom to cover immediately the surrounding parts with grease, but protection from the acrid discharge can be secured more effectively by frequent spong- ing with soap suds and water; or painting the skin, under the blis- tered surface, with a solution of rosin in alcohol. Grease is not so good a protective, since it is a solvent for cantharides. Vaseline should be applied following the active stage. Caustics or E'scharotics are agents which destroy tissue. They comprise such substances as the caustic alkalies, mineral acids, silver nitrate; iron, zinc and copper sulphates; ferric, zinc and mercuric chlorides; carbolic acid, arsenic, together with the actual cautery. They are indicated in the treatment of exuberant granulations, mor- bid growths, septic, sloughing and necrotic parts, pyogenic mem- branes, fistulous tracts, and for the destruction of poisons, as in rabid dog and snake bite. Escharotics stimulate and modify nutrition in unhealthy wounds and ulcers. Many form chemical compounds with the tissue elements. Heat oxidizes animal tissues, and also coagu- lates albumin and abstracts water from them. The alkalies produce greasy compounds with the proteids, saponify the fats and withdraw water from the tissues. They are the most widely destructive agents. Silver nitrate forms an in- 632 GENERAL THERAPEUTIC MEASURES soluble albuminate with the tissues to which it is applied, and pro- tects the underlying structures from further action. It is most superficial in its action, but possesses specifie properties in altering the condition of unhealthy wounds for the better. Extreme heat, exemplified by the white-hot iron, acts as a counter-irritant in stimu- lating reflexly the nervous system; in increasing the vascularity of surrounding parts, and in favoring revulsion of blood; in aiding absorption and resolution, and in relieving pain apart from its direct destructive effect. Caustics may be applied in either the solid or liquid state, and in various forms, as the stick, powder, paste and ointment. Caustics are sometimes employed to stop hemorrhage. The reader is referred to articles on special agents for further details. Suppurants.—Any of the more active counter-irritants, as croton oil, may induce suppuration. Under this head may be mentioned setons and issues of rowel. A seton is a piece of tape or other material, introduced through an incision in the skin and thence under the skin in the connective tissue, and finally out through the skin at a short distance from the point of entrance. The loose ends are then knotted together, and the whole loop is drawn through the wound once daily to keep up constant irritation and suppuration. An issue of rowel is a piece of gauze or tow, which is passed into an incision, where the substance remains, and causes continual irritation and suppuration. To intensify their irritant action, both setons and is- sues of rowel may be first saturated with cantharides ointment or oil of turpentine. They have been employed in acute disease of the eye, meningitis, “strangles,” and in joint and shoulder lameness, near the seat of trouble. Setons and issues of rowel are barbarous and dirty, and fortunately have become obsolete. Cold and Heat. Cold.—Cold and heat. are only relative terms. As used here, they refer, respectively, to a thermal intensity below or above that of the body. Cold is usually applied by means of water in some form. In veterinary practice we are limited in the employment of cold air, as a medium, to the use of free ventilation and protection of animals from the solar heat.* Cool air is especially desirable in the treatment of most febrile affections by lowering temperature and serving as a stimulus to the respiratory, circulatory and nervous func- *The cold air treatment—of pneumonia, especially—is now exceedingly popular in human medicine. The patients are kept outdoors even in the coldest weather under shelter and well-covered. Reduction of fever and stimulation of the vital centres are among the chief advantages accruing. The same treatment applies to animals. In pneumonia of horses an abundance of fresh, cold air should be secured with the animal well blanketed and the limbs bandaged. COLD AND HEAT 633 tions generally. Locally, cold causes contraction of the peripheral vessels and muscles of the skin, forcing out fluids from the part and reducing local temperature. This is more distinctly noticeable in congested areas. If the application is very severe or long continued, the vessels lose their tone, become paralyzed, and we have passive congestion, inflammation, and finally death. Ordinarily, reaction sets in after the use of cold, more particu- larly if followed by heat, when an active hyperemia is substituted for the ischemia. This is brought about both -by reflex stimulation of the heart by the cold, and local dilation of the vessels. Therefore, when we wish to constringe parts, we use moderate cold continuously ; but, by alternating cold and heat we may accelerate the blood supply, and by first foreing out, and then bringing back the fiuids of the tissues, we can maintain such an activity of the circulation that even solid exudations are absorbed. Cold, locally, lessens nervous irrita- bility and pain directly, and, also, by contracting the afferent vessels, it diminishes the impact of the blood on sensitive parts. Moderate heat is said, nevertheless, to produce much the same result by relaxing the capillaries of the collateral circulation, thus draining off the blood and relieving tension in the inflamed part. Tissue change is diminished, locally, by the action of cold. Suppuration and slough- ing proceed but slowly under its retarding influence. Acute abscess is converted into what might be logically termed a “cold abscess” in the most literal sense of the word. Remotely, moderate cold applied to the body for a short period actually increases general temperature by stimulating reflexly the heat centres, increasing oxidation and lessening radiation from the contracted superficial vessels. If cold is in contact with the whole body for a longer time, the temperature gradually sinks and the reduction continues for some hours when, in healthy animals, the temperature rises above normal. Such effects are much more pronounced in pyrexia. The action upon the nervous system is exceedingly important therapeutically. The most powerful stimulating action is exerted upon the centres of innervation con- trolling the circulatory, respiratory, digestive and excretory organs. In fever, this treatment invigorates the failing digestive functions, relieves the nervous irritability by cooling the blood going to the great nerve centres in the medulla, and strengthens and stimulates the entire nervous organization. Cold applications and drinks stimulate the circulation reflexly, increase blood tension, and, therefore, the seerction of urine in fever, which is very important for the elimina- tion of toxins. Locally, heat and cold are often used interchangeably in medicine. In human practice it is a rule to be guided in the choice of one or the other by the desire of and effect upon the patient, and this should apply, as far as possible, in veterinary practice. 634 GENERAL THERAPEUTIC MEASURES Cold is employed, locally, in congestions of superficial parts, and tends to abort inflammation and relieve pain. In meningitis, rubber ice bags or continual irrigation of the head and spine are used. Laryngitis may be successfully treated by ice poultices (cracked ice and sawdust in linen bags) or by thin rubber ice bags surrounding the throat. In the same way are treated sprained tendons, capped hocks, broken knees, recent curbs, and lymphangitis. In fact, most superficial inflammatory surgical affec- tions are benefited by cold applications. Ice and ice water are use- ful in checking venous or capillary hemorrhage, although hot water is often more serviceable. Cold water enemata are valuable in atonie constipation, diarrhea, and to reduce temperature in fever. In the uterus, ice in small lumps will arrest metrorrhagia, and, in the rectum, aid in reducing prolapse. Ice bags, placed along the spine over the sympathetic ganglia, will cause dilatation of arterioles in regions corresponding to the point of application. MODES OF EMPLOYING COLD WATER. Ablution is the simplest method of applying water to the sur- face of the body. It is merely bathing. Water at the temperature of 50° to 60° F. is apphed by a rough, coarse cloth. The water is thrown on in considerable quantities, beginning with the head and going rapidly over the neck, trunk and limbs successively, rubbing the skin briskly all the while with the cloth. Two attendants are required for the application of an ablution to the larger animals. The patient is finally dried and warmly blanketed. The process may be repeated each half hour in fever, or twice daily as a tonic measure in chronic diseases. The rationalé consists in the stimulus afforded by the cold to the nervous system, accompanied by contrac- tion and subsequent dilatation of the peripheral blood vessels, with consequent cooling of the blood and increased radiation of heat from the surface. In most hydriatic methods for reducing temperature in fever, friction of the skin should be the sine qua non, as otherwise the physical cooling of the body is confined entirely to the periphery, the contraction of the surface vessels driving the blood inward to the vital organs. The superficial muscles then act as non-conductors, and heat production being stimulated reflexly by the cold, an actual increase of internal temperature may obtain. It is only by securing dilatation of the superficial vessels by friction that the result first described can be prevented, for after the first shock the peripheral vessels dilate, an increased supply of blood is brought to the surface, is rapidly cooled and courses inward, only sey COLD AND HEAT 635 to be replaced by more over-heated blood. The internal temperature is thus lowered, and instead of an internal congestion being brought about, as may happen when the skin is simply exposed to cold, we have a constant withdrawal of heated blood from the interior. In this perpetual interchange not only does cooling of the blood and body oceur, but the circulation is equalized and congestions are over- come. The Sheet Bath.—Whole baths are impracticable for our larger patients, and the sheet bath may be substituted to advantage for antipyretic and other purposes to which the cold bath is adapted. A cloth soaked in cold water, or ice poultice, is placed on the poll to prevent determination of blood to the head, and a linen sheet, wet in water, of from 50° to 80° F., is placed over the animal, the surface being rubbed, while dashing on the sheet water at the temperature of 50° to 60° F. This process is continued for fifteen or twenty minutes, unless rigor is induced. The method is valuable in the treatment of fever and insolation. The general rationale is the same as in the case of ablutions, but the antipyretic effect is more marked and permanent. The sheet may be covered, while wet, by blankets, and converted into a wet pack. The Wet Pack is applicable for general or local use, and for various purposes. A linen sheet is dipped in water at a temperature of 50° to 70° F., and wrung out very thoroughly. A cold appli- cation is put on the head and the sheet applied and covered with dry woolen blankets. The duration of application is from one quar- ter to three hours, according to the object in view. If it is used as a strictly antipyretic measure, it should be changed frequently. The wet pack differs materially from other hydriatic procedures in that reaction occurs slowly, for there is no artificial stimulus in the shape of friction to accelerate it. The primary contraction _of the vessels is succeeded by partial dilatation of them, when the blood from the interior of the over-heated body is cooled on the sur- face by contact with the sheet and by vaporization of the water. Vascular contraction again occurs owing to the cooling, forcing the chilled blood inward. So there is continual interchange of cooled and heated blood, until the wet sheet has become thoroughly warmed. After the wet pack is removed, the skin should be dried and the patient well blanketed. The interchange of blood is useful in relieving congestion of the internal organs, in aiding nutrition by bringing to the periphery nutriment absorbed from the gastro-intestinal tract, and for its tonic effect on the nervous system. In fever, it abates cerebral hyperemia, delirium and excitement, and proinotes rest and quiet. 636 GENERAL THERAPEUTIC MEASURES The Priessnitz Poultice* is similar to the wet pack, but a waterproof protective is interposed between the wet blanket, sheet, sponges or cloths on the inside and outside woolen coverings. Evap- oration is thus prevented, but not vaporization. Such an application may be used with safety in febrile diseases, as pleuritis and pneu- monia. If it is not renewed frequently, hyperemia of the surface oceurs, and this may be beneficial in aborting or relieving internal congestion. It then acts as an ordinary poultice, and is of value in various local inflammations resulting from strains, blows and bruises; also, in laryngitis. Besides relieving internal congestion, the Priess- nitz poultice stimulates absorption, removes induration and hastens suppuration, locally. The wet pack and Priessnitz poultice are more appropriate for practical use than the other methods in veterinary practice, since the evaporation from the hair of animals contraindi- cates methods suitable in human medicine. Cold Baths are only practicable for the smaller animals. Dogs may be immersed in water at 90° F., which is rapidly cooled down to 60°. The bath should last about fifteen minutes, the surface of the body being rubbed constantly. Ice water should be frequently poured over the head. After removal from the water, the patient must be thoroughly dried, wrapped in warm blankets, and a stimu- lant given if necessary. Such treatment may be used as an anti- pyretic measure if the temperature is over 103° F. in the rectum. Douches.—A douche is a forcible impact of water against the surface of the body. It is not used for its antipyretic effect, but acts as a stimulant to the nervous system at large, whereby the re spiratory action is deepened and strengthened, and the circulation invigorated. The douche is given advantageously in the treatment of coma, of alcohol, chioroform, ether or opium, applied to the head. The water may be dashed from a pail or applied by means of a garden hose or from a tap. Rheumatic lameness and peripheral paralysis are suitable cases for the douche treatment, followed by vigorous rubbing and dry bandaging. Syneope may often be quickly relieved by douching of the head and chest. Local Baths are good, especially in inflammatory conditions of the feet in horses. Tubs may be employed for the animals to stand in, the water being changed frequently or being kept cool by ice. It is not advisable to allow animals to stand in large bodies of water on account of the danger they incur of “‘catching cold” from surface evaporation. The value of the local use of water in acute laminitis * The Priessnitz’scher umschlag (poultice) of the Germans is often defined as a cold water compress, without waterproof covering. It must be renewed frequently, as it soon dries. Its effect is cooling and not as a poultice in sup- plying moist heat, and it does not aid phagocytosis COLD AND HEAT 637 is worth mentioning here. After the shoes have been removed the extreme pain may be alleviated by standing the horse in quite hot water, sufficient to reach up to or above the fetlocks. Good re- sults are obtained by changing to ice water after the first day and continuing this for several days, in this way causing a contraction of the arteries, lessening the amount of blood supplied to the part and the danger of chronic laminitis and dropped sole. If convenient to a running stream, about the same results may be obtained by standing the animal in it. Irrigation with cold water is done in inflammatory diseases of the joints, tendons and feet. Running water may be permitted to flow continuously through perforated rubber tubes, connected with a tap, or used as siphons and closed at their distal extremities. The holes may be made in the tube with red-hot needles. The rubber tubes should be wound about the limb or part and held in position by bandages. Leiter’s expensive block tin tubes are easily bent and rendered useless by the movements of our patients. The treatment of lacerated wounds by means of a stream of water from a convenient hydrant, causes the part to granulate quickly and greatly facilitates the healing process, but care should be taken not to allow the water to run over the wound more than three or four hours at a time each day, otherwise the part will become “waterlogged” and tend to break down and slough rather than to fill in with healthy granulation tissue. Cold Drinks are both refreshing and antipyretic in action. Cool water should be placed where the patient can take it as he desires. In stomatitis, tetanus and angina, cool water is distinctly grateful and comforting. In the latter two diseases, it should be arranged so that the animal can reach it without bending the neck. The mouth can be rinsed out continually, removing decomposing food and mucus, the thirst be slaked and heat and inflammation relieved. Cold Enemata are valuable antipyretic agencies. From five to fifteen quarts of cold water may be thrown up through a flexible rubber tube, six feet long, far into the bowel of the horse. Evaporating Solutions—Ethyl chloride or ether spray may be applied for a short time by means of an atomizer, to induce local anesthesia of a part, through the powerful refrigeration produced in their evaporation, and is most satisfactorily employed in conjunc- tion with cocaine injections. One turn of a cotton or linen bandage, or a single thickness of similar stuff, put about a part and wet con- tinuously with cold water, forms a good evaporating medium in allaying superficial inflammation and pain. A mixture of clay, and equal parts of water, vinegar and diluted solution of lead acetate, 638 GENERAL THERAPEUTIC MEASURES make a cheap and efficient cooling application for external use in the treatment of bruises and sprains. The paste should be removed as quickly as it dries. é Refrigerants.—Certain medicines either produce a subjective feeling of coolness or actually cause it, applied externally or given internally. The subjective sensation is due to some inexplicable action on the local nerve supply. Some are stimulants and as tringents, and diminish the circulation in the part. Externally, acetate of lead, chloride of ammonium, nitrate of potash, and vine- gar, are used most frequently as refrigerants. The mineral acids and salts of potassium and sodium, especially potassium nitrate, are administered more commonly, internally, both for their cooling effect and to allay thirst. . HEAT. Water at a moderate degree of heat—what is termed lukewarm —1.e., 86° to 95° F., applied to the body, stimulates the action of the skin, relaxes peripheral vessels and diminishes nervous excita- bility, pain and spasm in neighboring parts. Water at a temperature of 112° to 120° F. contracts blood vessels of underlying parts, re- lieving congestion and pain. Such a degree of heat resembles cold in its effect, and they may often be used interchangeably. Still stronger heat has much the same effect as excessive cold, only acting more quickly, causing dilatation of the vessels, pain, inflamma- tion and destruction of tissue. The action of powerful heat on the whole body, or upon single organs, is similar to that of counter- irritants. Mild, moist heat is beneficial in the treatment of wounds in poorly vascular parts where there is a tendency to indolent granu- lation, as about the feet in horses; Again, in low grades of inflam- mation with induration, as in strains of tendons, where moderate heat tends to stimulate the circulation and hasten absorption. In the treatment of abscess and burns, with destruction of tissue and suppuration, moist heat applied locally macerates the dead tissue, hastens sloughing and relieves pain, and in softening parts prevents the burrowing of pus and the formation of deep-seated pockets and sinus’s. | A modern view of poulticing is that it aids the migration of leucocytes, and therefore is productive of good in assisting their phagoeytie action. Hot applications increase exudation, congestion, collection of leucocytes and opsinins, locally. All these results are inimical to bacterial growth. The abscess can thus be more speedily formed and more quickly defined. Herein heat differs from cold. In irritable and spasmodic troubles of muscular origin in various COLD AND HEAT 639 organs, heat is distinctly remedial, as in pelvic and abdominal pain and colic, when employed in the form of rectal injections. Heat may, in many conditions, be used interchangeably with, or in the place of, cold, according to the preference of the practitioner or the effect upon the patient. As, for instance, in the case of pneumonia, pleuritis, angina, and in checking hemorrhage. Heat may be utilized in simply preventing the natural radiation of it from the body. Thus, simple, warm, dry blankets, applied all over the surface of the body, may abort catarrhal or rheumatic conditions by merely causing retention of the body heat, dilatation of the peripheral ves- sels and equalization of the circulation. Covering a portion of the skin with such dense preparations as tar, pitch or collodion, in mild superficial inflammatory lesions, is said to produce favorable results by restraining radiation and increasing heat and blood supply in the part. Even thickened tendons and indurated glands may be bene- fited thereby. The Priessnitz poultice continuously applied has a similar action. In vasomotor paralysis, seen in collapse, following loss of blood or poisoning, and in shock due to traumatism or surgical operation, heat is eminently a life-saving means. In such conditions the loss of vascular tone and dilatation of the vessels lead to danger- ous, and even fatal, cooling of the body. Heated dry blankets, or those wrung out in hot water, should be applied to the larger animals, together with hot rectal injections; while the smaller animals may be placed in baths at the temperature of 105° F-., till the temperature becomes normal. Such treatment should be combined with the use of vascular and cardiac stimulants, camphor, adrenalin, atropine, digitalis and strychnine, and saline infusions. MODES OF APPLYING HEAT. Poultices or Oataplasms.*—Cataplasms are compositions for the local application of heat and moisture. They are made, com- monly, of flaxseed meal, bran, oatmeal, bread, potatoes and carrots. One or other of these is stirred up in boiling water until a thick, pasty consistency is reached. This mass may then be applied, while very hot, directly to the part when we wish to produce a softening of the tissues, as in abscess or tender feet in horses, and the whole is covered by a cloth. In poulticing horses’ feet, the material—usually bran and flaxseed meal, equal parts—is mixed in a pail, with boiling water, and spread on a piece of bagging (double thickness, and about two feet square), in sufficient quantity to surround and cover * Cataplasma Kaolini (U.S. P.) consists of kaolin, or porcelain clay, and ig applied externally as a poultice. It acts to retain the body heat and is very similar to “Antiphlogistine,” an excellent substitute for the ordinary poultice. 640 GENERAL THERAPEUTIC MEASURES the entire foot. The bagging is then folded and tied about the pas- terns, and over around the front and sole of the foot. The whole should occasionally be immersed in water to prevent drying of the poultice. When a poultice is used merely for its continued heat, in relieving heat and congestion, the material should be enclosed in a flannel bag, in order the longer to retain and radiate its warmth. A very hot poultice acts as a counter-irritant in contracting blood vessels in more remote parts, besides its effect in abating pain. A warm, moist poultice causes a mild local hyperemia, softens broken down and dead issues, and aids suppuration and sloughing. Poul- tices are not employed very much, except in the treatment of horses’ feet, as they are clumsy, laborious contrivances, and difficult to keep in place. If long-continued, they cause tissues to become swollen, sodden and macerated, destroying their vitality. Antiseptic poul- tices are made by soaking sheet cotton, gauze or other absorbent material, in hot antiseptic solutions, as corrosive sublimate, 1-1000; ereolin or lysol, 1-100. The material is very lightly wrung out, wrapped about with dry gauze, covered with oil paper, silk or rubber protective, and applied to the part with a bandage. Antiseptic poul- tices are useful in the treatment of septic injuries, and when there is much pain, destruction of tissue, sloughing and suppuration. Otherwise, poultices are decidedly contraindicated in the case of wounds, as dry antiseptic or aseptic absorbent dressings are far preferable in securing one of the cardinal requirements in the process of healing, 1.e., dryness. As substitutes for ordinary poultices, we have spongio-pilene. counter-irritants, stupes and fomentations. Spongio-pilene occurs in sheets, about an inch in thickness, made of a mixture of sponge and felt, backed with a flexible covering of gutta- percha. Its main objection is the expense. It forms, when soaked in water, a cleanly and easily applied poultice for non-suppurating parts. Counter-writation, as has been pointed out, is produced by hot poulticing as well as by drugs. A combination of the two is obtained in stupes. Stupes, Stupa.—A stupe consists of a flannel or other cloth, wrung out in plain or medicated hot water, and applied to the skin. These are often covered by waterproof protection, the better to retain heat. In the veterinary art, hot blankets are often applied over the whole chest or abdomen to relieve internal congestion and pain in pleuritis, pneumonia and colic. Turpentine stupes are more in favor with abdominal troubles. These are made by simply sprinkling oi] of turpentine over the hot blankets, or by saturating flannel cloths in turpentine and wringing them out in very hot water. To get a verv COLD AND HEAT 641 active counter-irritant effect, a mustard paste may be rubbed over the chest, and then hot blankets applied. Hot Water Bags, made of rubber, and enclosing water at a tem- perature of 120° F., may be placed along the spine, and by stimu- lating the cord and sympathetic ganglia, cause stimulation of vaso- constrictors in regions corresponding to the controlling areas over which the heat is applied. In this manner inflammatory conditions of the throat, chest, and abdomen are said to have been aborted, and internal hemorrhage effectually arrested. Conversely, cold may be used over the spine to dilate distal arterioles. Fomentations are simply local baths. As technically employed, the word refers to bathing parts with plain or medicated hot water, by means of sponge or cloths. They may be used to cleanse wounds or parts of dried discharges; they act as counter-irritants if very hot, or as mild, stimulating, soothing and softening applications if warm. In order to produce much effect, besides a mere detergent one, they should be applied for a considerable length of time—one half hour at least—and be followed by drying and bandaging. Fo- mentations reduce swelling and pain, and hasten repair in bruises, strains and local inflammatory lesions. Injections of hot water are employed to cleanse wounds, stop bleeding and relieve pain and spasm. Injections may be thrown into the rectum or vagina at a temperature of 115° to 120° F. In the vagina, hot water may stop postpartum hemorrhage, pain and con- gestion in the pelvis, by producing uterine contractions, and atonic constriction of vessels in neighboring parts, which lasts for several hours following its use. Hot rectal injections (115° F.) subdue abdominal and pelvic pain or spasm, as intestinal or renal colic and spasm of the neck of the bladder. The heat per se in such injections may be invaluable in shock and collapse as noted above. The water may either be led off through a rubber tube, from a stop-cock in a pail or reservoir, placed above the patient, or else siphonage may be done off-hand through a bit of small-sized hose. Having hung a pail filled with water one or two feet above the patient, the hose is filled with water, and, closing the ends to keep it full, the upper part is put in the pail, while the lower, smooth and greased, is passed into the rectum or vagina; or water may be poured through a large tin funnel into the upper end of the tube. The ordinary fountain syringe is the best apparatus for smaller ani- mals. Dry Heat may be applied by means of hot blankets, hot water bags, hot salt or sand in cloth bags, a flatiron or hot, wet cloths be- tween waterproof coverings. Dry heat is often preferable to moist heat for simply relieving pain and congestion, as animals are less 642 GENERAL THERAPEUTIC MEASURES apt to become chilled by drafts and evaporation from the surface afterwards. It is generally more difficult to obtain, however. Inhalations of plain or medicated steam are given for their local effect on the mucous membranes of the upper air passages. The moist heat has a soothing action on the nerves, and tends to loosen dry exudations. Agents may be incorporated in the inhalation hav- ing a sedative, stimulating or antiseptic action. (Vid. “Agents Act- ing on the Respiratory Organs,” pp. 41, 42.) The technique consists in placing a bucket containing a boiling mash under the horse’s nose, or in pouring cool water over a heated brick or iron in the bottom of a pail. The practice of tying a bag over a horse’s head, aud steaming him therein, is bad, if the animal is suffering from respiratory troubles, as insufficient pure air is obtainable. A dog may be placed on the seat of a cane bottomed chair, and covered loosely with a sheet over the whole, the steam being generated in a vessel beneath. Hot Baths at a temperature of 98° to 110° ¥. are impracticable for larger animals. They can be given to the smaller animals in collapse, shock, rheumatism, and to abort cold after exposure. Glow- ing heat is applied by means of heated metal, and is treated under the section on counter-irritation. ACTION OF HEAT CONTRASTED WITH THAT OF COLD. The action of intense heat or cold on animal tissue is very simi- lar in effect, producing vasomotor paralysis, congestion, inflammation, destruction of tissue and death. Even the sensations to which they give rise resemble each other so closely, that coolies on first han- dling ice said they could not hold it because it burned their fin- gers. Strong heat (115° to 120° F.) contracts blood vessels in underlying parts and overcomes pain and congestion. Heat of this degree approaches cold in similarity of action. A moderate degree of heat dilates vessels, while cold of like intensity contracts them. Moderate heat relieves pain by relaxing tissue, diminishes vascular tension by dilating efferent vessels of the collateral circulation, and draining off blood from the congested areas. Moderate cold, on the other hand, accomplishes a similar result in benumbing nervous sensation and lessening the impact of blood in the painful region by constringing the afferent vessels. Tissue change is in- creased by moderate heat, but decreased by cold applied locally, or generally in fever. Swelling of tissue is reduced by cold directly ; only indirectly by heat, which may, indeed, increase it. Softening and sloughing of parts, suppuration and “ripening” of abscesses and “cleaning off of wounds, are facilitated by moderate heat, but hin- dered by cold. DISINFECTANTS, ANTISEPTICS AND DEODORANTS 643 Disinfectants, Antiseptics and Deodorants. Disinfectants, or germicides, are agents which destroy the micro- organisms, causing infectious and contagious diseases, fermentation and putrefaction. Antiseptics are agents which prevent or retard the growth and development of the micro-organisms occasioning fermentation, putrefaction and disease, more especially the micro- cocei producing suppuration. Deodorizers, or deodorants, are agents which destroy or counter- act afoul odor. They are not necessarily antiseptics or disinfectants. Considerable confusion exists in relation to the terms disinfectant and antiseptic, because the latter is often described as an agent which inhibits the growth, or destroys the life of the micro-organisms of fermentation, putrefaction, and disease. This definition makes antiseptics synonymous with disinfectants. The distinction exists, however, according to common usage, that while disinfectants ray, in dilution, act as antiseptics, antiseptics are not often disinfectants, and in the nature of things are not strong enough to kill germs, al- though they may hinder their growth. Antiseptics may then be regarded as a subdivision of disinfectants. The two terms are un- necessary and misleading, as either might embrace both interference with the growth and destruction of micro-organisms. Disinfection may fall short of sterilization ; i.e., death of all germs. Repeated boiling of a fluid containing micro-organisms wholly kills them; but, while dis- infectants may destroy the germs of disease, they often fail to kill more resistant and harmless organisms, as the spores of B. subtilis. A discrimination between disinfectants and antiseptics may be made in relation to their connection with the body. Those agents employed to kill germs, in matter distinct from the living body, are disinfectants; while those agents applied on the surface, or intro- duced within the body, may be classed as antisepties, since they can rarely be used in such strength as to kill all micro-organisms without injuring or killing their host. DISINFECTANTS AND DISINFECTION. Air, sunlight, heat and water are naturally the best disinfectants. Air seatters and dilutes micro-organisms, making them pathologically inactive. There is no more effective way to disinfect a stable, in which animals are living, than by free ventilation with pure alr. It is well known that animals are less liable to contract infectious diseases in the comparatively pure air of the country than in closely crowded and ill-ventilated city buildings. Likewise, the contagious 644 GENERAL THERAPEUTIC MEASURES diseases of children mostly occur in winter, when they are herded together in schools and in poorly ventilated dwellings. To attempt to disinfect the air surrounding a patient is the height of absurdity. The generation of chlorine and sulphurous acid gases for this purpose, although recommended in text books, is futile, and by irritating the respiratory mucous membrane, accom- plishes more harm than good, since a congested surface offers a more suitable field for bacterial growth. Air, on the other hand, may be % medium of infection when contaminated with dust containing pathogenic bacteria (B. tuberculosis). Sunlight is prejudicial to the vitality of bacteria. Whereas the bacilli of tuberculosis will live almost indefinitely in dark, damp places, they quickly succumb to sunlight and dry air. Sunlight and pure air are, then, imperative for both the immediate and preventive treatment of germ diseases. Heat is the most powerful agency for disinfection at our command. Dry heat, to be efficacious, must be applied at a temperature of 140° C. (284° F.) for three hours to kill all bacteria and spores; but this degree of heat scorches most fabrics and destroys many materials. Boiling water quickly kills all non-spore-bearing pathogenic bacteria. and these include most of the organisms causing the common con- tagious and infectious diseases (anthrax excepted). Two hours of continuous boiling will not destroy the most resistant micro-organ- isms—the spores of the hay bacillus—but moist or saturated steam, at 280° F., will infallibly kill any spores whatsoever within a few minutes. ire is the most complete disinfectant, because it not only destroys germs, but their food and products. Water, like air. dilutes germs and aids oxidation and destruction of organic matter; but, again like air, drinking water may be the source of infection when sufficiently contaminated. MECHANICAL MEANS OF PROCURING. ASEPSIS. Hitherto the placing of sole reliance on chemical agents to se- cure surgical sterility of the skin and fresh infected wounds has been a mistake. It has been impossible to render living, infected tissue sterile by merely bathing it in chemical solutions. In other words asepsis has been procured most satisfactorily by mechanical means and the chemical has played a secondary part. Thus the most efficient method has been to remove the hair from the skin surrounding a wound or operative area, and to shield the wound with sterile gauze meanwhile. Then the skin was actively scrubbed for 10 minutes with green soap and water and followed with 70 per cent. aleohol. The wound was then exposed, foreign matter and loose tissue removed by forceps and scissors, and the DISINFECTANTS, ANTISEPTICS AND DEODORANTS 645 wound scrubbed, syringed or douched for 10 minutes with normal salt lysol, or other solution. Now we have learned we can sterilize the skin and infected raw tissue without the scrubbing, and washing, and other laborious methods and with apparently as good results by using iodine (See p. 650). CHEMICAL AGENTS. Mercurie bichloride, carbolic acid, quicklime, chlorinated lime, sulphurous acid, and chlorine, are more frequently employed as dis- infectants. Corrosive sublimate solutions are decomposed by keep- ing, and by contact with albumin and ammonia. Acids, or common salt, added to bichloride solutions prevent, in a measure, this decom- position; but, nevertheless, mercuric bichloride is rendered unfit for the disinfection of masses of decomposing albuminous matter, as manure. One of the best solutions, employed by the Paris Disin- fection Service, is composed of corrosive sublimate 2 grammes; tar- taric acid, 4 grammes; and water, 1 litre (1-500), colored with 5 drops of a 5 per cent. solution of indigo carminate. An English solution, in common use, consists of corrosive sublimate, 1 ounce; hydrochloric acid, 2 ounces, and water to make 3 gallons (1-768). The usual strength of corrosive sublimate solutions, for disinfection, varies from 1-500 to 1-1000. These solutions are suitable for arti- cles made wholly, or in part, of leather, rubber and fur; for blankets, cotton and woolen fabrics, and for floors, walls, and wood work of stables. Surgical instruments, and other metallic implements and fixtures, are injured by corrosive sublimate solutions. Carbolic acid is more expensive than corrosive sublimate, and less efficient in cases where the latter is applicable. Carbolie acid can, however, be used to disinfect albuminous material and metallic substances. It is em- ployed on animal excreta in 5 per cent. aqueous solution (about 8 ounces to the gallon of hot water). This solution will cause the hands to dry, crack and fissure if they are immersed in it for any length of time. A two per cent. solution of commercial eresol is as efficient and cheaper than a five per cent. carbolic acid solution; or a four per cent. solution of the U. 8. P. Compound Solution of Cresol may be used. Chlorinated lime and quicklime are good disinfectant agents to mix with animal evacuations. In fact, bleaching powder is prob- ably the best and cheapest disinfectant we possess for use in privies, drains, sinks, cesspools, and sewers, and for the destruction of micro- organisms on floors, and in feces and urine. A few pounds of this preparation may be thrown into privies or cesspools once a week, and the pure compound, or a saturated 646 GENERAL THERAPEUTIC MEASURES solution, may be scattered over floors or mixed with manure. A 5 per cent. solution is used to disinfect harness, which should be washed and greased directly afterwards. Stagnant and putrid water may be rendered safe and drinkable, after some hours, by the addition of 44 to 1 ounce to each 65 gallons of water hlorinated lime is a, powerful deodorant as well as disinfectant, wut is of no value in either capacity unless the compound contains so much chlorine gas that the face cannot be held near it without the production of great irritation to the eyes. It is used in 5 to 10 per cent. solution in water (or in whitewash) for disinfection of premises and on excreta. Bleaching powder should be placed upon decomposing animal bodies, - and sheets wet with a saturated solution should be wrapped about the carcasses of animals dead from contagious diseases, to prevent in- fection during transportation. Disinfection by sulphurous acid and chlorine gas is done to destroy germs which cannot be reached by other methods. Three pounds of sulphur and two ounces of turpentine or alcohol (to afford moisture and aid combustion) are needful for every 1000 cubic feet of air space. Sulphur is generally burned in an ~ iron vessel placed on sand, or floating in a tub of water. If the building is sufficiently tight to insure proper disinfection, it is diffi- cult to secure combustion of the proper amount of sulphur. To obviate this, the sulphur may be saturated with turpentine, ignited and placed in an iron kettle on a tripod over an alcohol lamp. Chlorine is disengaged from chlorinated lime, to which is added crude muriatie acid, one pound of former to three of latter for every 5,000 cubic feet of air space. Buildings must be tightly sealed and made completely irrespirable for animals during the space of three hours. Sulphurous acid disinfection will not kill the spores of an- thrax and should never be allowed to replace thorough mechanical cleansing and disinfection with other chemical agents, but may be utilized, as an additional safeguard. Chlorine gas is more reliable. Formaldehyde is now being employed by most boards of health for general disinfectant purposes, and it appears to be the best means of gaseous disinfection. (See p. 310.) In most barns gaseous dis- infection is useless because the premises cannot be made air-tight. ANTISEPTICS. It is perhaps well to consider here the sources of infection and the natural defenses or immunity possessed by animals against para- sitic invasion. Pathogenic micro-organisms are commonly brought in contact with the body through the agency of the air, drinking water and food, and insects (flies, ticks and mosquitoes). and gain entrance by means of the air passages, digestive canal and blood; but even in DISINFECTANTS, ANTISEPTICS AND DEODORANTS 647 the two former cases, the micro-organisms are in a certain sense outside of the body, since it is not easy for them to penetrate the intact and healthy ciliated mucous membrane of the respiratory tract. But when the mucous membrane is damaged by inflammation, and the ciliz become paralyzed, and abnormal secretions are formed, then a favorable opportunity is offered for their growth and entrance into the circulation. In the digestive tract the hydrochloric acid of the gastric juice and bile* act as natural antiseptics, while the liver is thought to destroy toxins resulting from bacterial life. When digestion is in a normal condition, putrefaction and fer- mentation do not occur; but when its activity is diminished, and the secretion of the digestive juices is lessened, and the hepatic functions are depressed, then a chance is offered for bacterial growth, fermentation and absorption of toxins, or even actual trans- migration of micro-organisms through the intestinal walls. To these natural agencies of defense, which may be likened to outlying pickets shielding the animal from bacterial invasion, we must add the in- trinsic power of resistance vested in the tissues, blood serum (op- sinins, bacteriolysins, agglutinins), and leucocytes in combating mi- ero-organisms; and the production of antibodies in the system antagonizing the toxins formed by bacterial acticn. Micro-organisms are always to be found on the surface of the body and within its natural cavities open to the air, but pathogenic bacteria are less likely to do harm if the animal is in a healthy condition. A limited num- ber of bacteria (micrococci) may even exist within the blood in health, and this fact accounts for suppuration occurring when the tissues are severely injured, without solution of continuity. The internal use of antiseptics is of comparatively little value, even when these agents come in direct contact with germs in the digestive tract. This follows because it is impossible to administer antiseptics in sufficient amount to seriously interfere with bacterial growth in the tissues, without injuring or even killing the patient. There are certainly known but two instances (quinine in malaria and salyersan in syphilis) where the exhibition of an antiseptic will inhibit the development of micro-organisms of a general infectious disease, and so absolutely arrest it. It is probable, however, that salicylates in rheumatism, and carbolic acid in tetanus, act thera- peutically as internal antiseptics. Antiseptics are of benefit im rendering the contents of the digestive tube more or less aseptic, and (after absorption) they exert some antiseptic action on the mucous membrane of the respiratory tract (volatile oils), and also on the urinary tract (urotropin), during their elimination. The principal * Experiments in human patients show that many forms of pathogenic bac- teria may live in bile. It is but moderately bactericidal. 648 GENERAL THERAPEUTIC MEASURES agents used as antiseptics for surgical purposes are: iodine, carbolie acid, creolin, lysol, hydrogen dioxide, corrosive sublimate, potassium permanganate, zine chloride, iodoform, salicylic acid, aristol, iodol, and boric acid. Those employed internally include naphthol, salol, ereolin, carbolic acid, bismuth salicylate and subnitrate, quinine, salicylic acid, and many others. For a more detailed description the reader is referred to special articles on these agents in the pre ceding pages. DEODORIZERS OR DEODORANTS. Deodorants are not of any practical value in simply exchanging one odor for another, but, as in the case of chlorine, they sometimes actually destroy compounds which give rise to the stench. Sewer and other malodorous gases, resulting from foul decomposing matter and excreta, may be freer from bacteria than ordinary air, and are not usually the carriers of micro-organisms, nor the cause of specific infectious diseases. These gases do, however, occasion indefinite symptoms of ill-health. Deodorizers, which are also disinfectants, are of service in destroying noxious emanations and their source; but, to accomplish this, it is necessary that they come into direct contact with putrefying material, and should not be placed about the habi- tations of man or animals, with the ridiculous idea that they are achieving more than the production of a vile odor. PRACTICAL DISINFECTION. The premises occupied by animals suffering from contagious dis- eases, together with all articles contained therein, such as harness, blankets, stable implements, and evacuations, must be disinfected after the removal of all animals and isolation of the sick First, all parts of the premises must be cleaned. The woodwork of the floors, ceilings, walls must be swept, and filth removed by scraping if neces- sary. Floors that are too old to readily clean should be taken up and burned. Manure and valueless infected objects should be burned or the manure mixed with five per cent. solution of chlorinated lime. Where the floors are of earth, the earth should be removed for a depth of four inches and mixed with the chlorinated lime (5 per cent.) solution. Blankets and clothing should be boiled or soaked for 12 hours in a solution (1 to 500) of corrosive sublimate. Harness should be washed with soap and water and then with 4 per-cent. liq. cresolis comp. The best way to apply the disinfectant is by means of a hand DISINFECTANTS, ANTISEPTICS AND DEODORANTS 649 force or spray pump to every part of the building. In some eases, where only a stall or small area requires disinfection, a brush will do. The best outfit consists of a strong spray pump with 20 feet of hose and 5 feet of straight iron pipe connected to the same, to the end of which is attached a spray nozzle. The disinfectants which are most suitable are 4 per cent. solution of compound cresol solution, or 2 per cent. solution of eresol. This is known as liquid carbolic acid in the market and should contain 90 to 98 per cent. of cresylic acid to be efficient. Either of these disinfectants may be used alone or, in the strengths mentioned, in whitewash. ‘Thus one slakes 714 lbs. of lime with hot water and mixes it to a creamy consistency. Then to this one stirs in either 15 ounces of cresol, or 30 ounces of compound cresol solution, and adds water to make 5 gallons.* A specially liberal application of the disinfectant must be made to feed boxes, gutters and drains. If one uses the disinfectant alone it is well, after it is dry, to apply a coat of whitewash to the premises. A 1 to 500 corrosive sublimate solution may be used in place of the agents recommended when the avoidance of odor is necessary as in the production of milk. This should be followed by a coat of white- wash. Gaseous disinfection is now in order where the stable can be made air-tight and the animals removed. Formaldehyde (p. 310) or sulphur (p. 238) may be employed. Live steam is the most useful when a suitable apparatus for its applications to woodworks, hay- mows, etc., is obtainable. After thorough ventilation healthy ani- mals which have not been exposed to infection may be allowed to return to the disinfected quarters. SURGICAL ANTISEPSIS AND ASEPSIS. It may be fitting, and not out of place, to briefly outline here the use of antiseptics and asepsis in veterinary surgery. Since the days when Lister introduced antisepsis, surgery has advanced in a manner which appears, however, like retrogression. It is now con- ceded that asepsis can be attained more satisfactorily and safely without the general use of antiseptics. For antiseptics, as has been noted, inflict a certain amount of damage upon denuded surfaces, and, in so far, lessen the resistance of the body to the inroads of bacteria. Modern surgery attempts to secure a comparative asepsis by mechanical cleanliness, which is more efficient, simpler, and harm- less to the body. Antiseptics are indicated to assist asepsis in the toilet of the unbroken skin, and when sepsis has already occurred, or is unavoidable. The gross neglect of aseptic precautions, often seen * Farmers Bull., No. 480 U. S. Dept. Agric., 1912. 650 GENERAL THERAPEUTIC MEASURES in the operations of veterinary surgery, would be considered criminal practice in human surgery. Asepsis is, nevertheless, very difficult to secure in the lower ani- mals living among filthy surroundings and lying on fecal discharges. In addition to these disadvantages the trouble of controlling animal movements during operation, and of keeping dressings in place, make the attainment of asepsis embarrassing and frequently impossible. The more common administration of anesthetics would facilitate asepsis by preventing movements of the patient and contact of the operative field with dirt. But there are all degrees of infection, and while, with the best methods of securing cleanliness at our command, it is impossible to completely sterilize normal skin and tissues, yet the surgical result may be perfect. Therefore, in surgical operations, we should en- deavor to procure as small an amount of infection, or dosage of micro- organisms, as possible, consistent with existing environment and’ con- ditions. The following aseptic technique is especially applicable in the ease of any surgical operation undertaken upon a noninfected part. Tf it is possible to carry out all the details, and the result is success- ful, healing will take place without suppuration. To prepare the surface of the body for operations, the hair is first clipped and shaved, the skin is thoroughly serubbed with a brush, green soap and water for ten minutes, and then with 70 per cent. aleohol. Since tineture of iodine has come into vogue the preceding method has been superseded by iodine with many operators. In this case the hair should be shaved the day before when water and soap may be used. Before the operation the dry skin is cleansed with gasoline, or when this is undesirable on account of its inflammability, ether may be used. Then tincture of iodine is painted all over the operative field and allowed to dry before the operation is begun. On delicate parts the tincture should be diluted with an equal amount of aleohol. After the skin is incised there is no further necessity for antiseptics unless the wound is already infected, or becomes so by exposure to impure air or contact with dirt. The hands of the operator, including the finger nails, should be brushed until clean with green soap and water, and then with 70 per cent. alcohol. Tn accidental wounds the tincture of iodine is the most efficient agent. As we have seen the skin must not be wetted with water in order that the iodine penetrate into its “pores.” Washing also earries germs into the wound. The hair should be cut from the dry skin with scissors or by shaving the dry skin with a razor. The DISINFECTANTS, ANTISEPTICS AND DEODORANTS 651 skin is cleansed by mopping with gasoline or ether and the dirt re moved from the wound by forceps and scissors and gauze. Then a large surrounding area of skin and the wound itself should be swabbed with pure tincture of iodine by means of a brush, or absorbent cotton on a stick. After suturing the wound it is best to swab over the line of sutures with tincture of iodine and allow it to dry before dressing. In burns and all accidental wounds and emergency cases the iodine treatment is the thing. On delicate skin and mucous membranes the dilution of the official tincture with an equal amount of alcohol is indicated. It is well for all participating in an operation to wear thin rubber surgical gloves after thorough hand-disinfection—in pus cases, to prevent contamination of the hands; in clean cases, to avoid infection of the wound from the hands. If gloves are not worn in operating upon clean cases, they are all the more useful in dressing or operating upon pus cases to avoid contamination of the hands which later might give rise to wound infection when the naked hands come in contact with a clean wound. Instruments are thoroughly scrubbed with soap and water, and boiled for ten min- utes in an aqueous solution of sodium bicarbonate (1 teaspoonful to the quart), and then placed in a solution of carbolic acid (1-40), or removed to a sterile towel. New sponges only should be employed, which have been previously cleansed, and then soaked in carbolic acid (1-40) solution, or pieces of sterile gauze may he used. If irrigation is desirable, normal salt solution (1 heaping tea- spoonful to the quart of sterile water) is appropriate. Nothing else but this is allowable within the non-infected abdominal cavity.* Sutures of silk, and needles, are prepared by boiling in water for thirty minutes. The area about the operative field is to be sur- rounded with cloths, or towels, which have been boiled or baked, and instruments and sponges may be laid on these. Dressings may consist of gauze + which has been exposed for three hours to dry heat at 140° C. (284° F.), or placed in an oven of an ordinary cooking stove, in closed tin cans, until it becomes scorched and slightly brown. The same gauze may be used for sponges. Unsterilized articles are not to be suffered to come in con- tact with the operator, or wound, during the operation. Wound infection from exposure to the air and other media, is prevented by immediate dressing and bandaging, or by collodion ap- plications. + Sterilized gauze is now sold by all druggists. 652 GENERAL THERAPEUTIC MEASURES Venesection. Venesection, or blood-letting, formerly abused, has, for that reason, fallen into almost complete disuse. This is unfortunate, since blood-letting is a valuable and often life-saving measure. The indications for venesection are chiefly limited to conditions associated with a general high arterial pressure and local engorgement of some organ. In such cases venesection very rapidly reduces general blood- tension to a point lower than that existing in the engorged region, so that congestion is relieved. A full, incompressible pulse is said to indicate the desirability of venesection in severe acute disorders in accordance with the above—but this is not by any means invariably the fact, as will be shown. Venesection leads to a reduction of temperature, and vascular tension is lowered for from 3 to 48 hours, according to the quantity of blood withdrawn, but the blood vessels quickly adjust themselves to the smaller mass of blood, and the original quantity of this vital fluid is soon restored (24 to 48 hours) through absorption from the tissues and alimentary canal. The heart beats more rapidly, owing to the lessened resistance in the vessels, and venesection is accom- panied by nausea and prostration. The blood is less dense and more fluid after blood-letting, and for this reason, if inflammatory processes follow, exudation is more apt to ensue. The fibrin is first regained, then the normal number of white, and finally that of red corpuscles, in from one to five weeks. Circulatory depressants—as veratrum viride—accomplish much the same results as blood-letting, by causing general reduction of vascular tension and relief from local congestion, thus “bleeding an animal into its own veins” without loss of blood, it is true, but with less rapid and certain effect. Cathartics, diuretics and diaphoretics also lower blood pressure by abstraction of fluid from the vessels, but their action is slow. The following disorders are those most suitable for treatment by venesec- tion when they exist in an alarming form in robust animals: Cerebral congestion. In insolation and | Passive pulmonary congestion in car- tympanites. | diac disease. Apoplexy, particularly parturient apo- | Sthenic pneumonia. plexy of cows. | Sthenie pleuritis. Encephalitis. Urticaria. | Acute cerebral meningitis. | Lymphangitis. Active pulmonary congestion and apo- | Hemoglobinuria. plexy | VENESECTION 653 Toxemia Toxemia st bacterial, — ts vegetable, my mineral, (Followed by saline infusion. ) Venesection from the jugular in cerebral congestion is, in fact, a species of local blood-letting by directly draining blood away from the brain; and it preserves life by preventing pressure on, and paralysis of, the great vital medullary centres controlling the res- piration and heart. Moderate blood-letting is sometimes advisable in the early stages of severe inflammatory attacks of the brain or its membranes. In cerebral congestion, and dyspnea due to gastric tympany and pressure on the diaphragm, bleeding may give relief. Blood- letting was formerly used in the treatment of parturient apo- plexy of cows, and, when the disease has once occurred, it may be employed as a prophylactic measure in plethoric animals immediately before parturition. Venesection alleviates dangerous pulmonary congestion, removes the venous load on the right heart, and relieves dyspnea and cyanosis by making it possible for the heart to force a smaller quantity of blood through the less obstructed lungs. A feeble and easily compressible pulse does not necessarily con- traindicate venesection in engorgement of the lungs, for this con- dition leads to stasis in the pulmonary circulation, prevents the proper flow of blood into the left ventricle, and thus causes arterial anemia. Therefore, so far from contraindicating blood-letting, this condition urgently demands it. Alarming dyspnea, great cyanosis, together with a general plethorie state, should guide us in blood-letting in sthenic pneumonia and pulmonary congestion, rather than the state of the pulse. Venesection is serviceable in advanced cases of cardiac disease in dogs—with failing compensation, venous engorgement of the lungs, and dyspnea—by relieving the obstruction to the right heart. Moderate blood-letting is occasionally useful in severe cases of acute pleuritis, laminitis, lymphangitis and urticaria in plethoric horses. Finally, in various toxemias, blood-letting drains away both the plood and its contained poison. The mass of blood removed may be advantageously replaced by injection of normal salt solution into a vein or under the skin. This method is not in prevalent use in veterinary medicine, but is applied with notable success in human practice. Every veterinary practitioner should be competent to bleed an animal. An amount greater than % of the total quantity of blood should not be withdrawn. The total quantity of blood is equal to about 13.5 per cent. of the body weight in horses; to 2.2 per cent. of the body weight of fat swine; to 6.6 per cent. of the body weight in dogs, and to 7.7 per cent. of the body weight in man. Large 654 GENERAL THERAPEUTIC MEASURES horses or cattle may be bled to the extent of from 4 to 6 qts.; smaller subjects, 2 to 4 qts.; sheep, 14 to 1 pt.; dogs, 4 oz. to 1 pt. Blood-letting is generally done to animals in the upright position by shaving the hair and sterilizing the skin over the jugular vein in the upper “part of the neck. The vein is made prominent by pressure below the site of operation, and a fleam, or knife carefully guarded, is plunged transversely into the vein, making a good clean incision. The blood should be quickly withdrawn and carefully measured ‘and the effect on the pulse noted, and the blood-letting maintained until there is noticeable reduction in the vascular tension and other symp- toms, for the relief of which venesection is employed. The bleeding is arrested by suturing the lips of the wound and by pressure with a bandage. Local Blood-letting, or Scarification, is often useful in relieving tension and pain in locally congested or inflamed tissues, and may even avert death of the part. Furthermore, stasis is removed and exudation from the engorged vessels may be prevented, while a fresh supply of arterial blood flows in to reinstate the vital processes. Searification is practiced by making numerous small, parallel incisions into the skin, fascia or other tissues in the long axis of a limb or part. In inflammation of the periosteum it is necessary to puncture this membrane. Bleeding is facilitated by warm poultic- ing, and is arrested by packing the incisions with sterile gauze. INDICATIONS. Lampas. Mastitis. Glossitis. Laminitis. Periostitis. (To secure blood for microscopic ex- Cellulitis. amination. ) Conjunctivitis. Sometimes the veins leading from an inflamed area are opened, thus securing local abstraction of blood, e.g., the digital veins in laminitis ; the milk veins in mammitis. Scarification, or puncture, is indicated in the etocamennioned conditions whenever there is great swelling, pain and tension in the affected parts, and not otherwise. Transfusion. Transfusion is the transfer, directly or indirectly, of blood from one living animal to another. In this process the blood must be obtained from an animal of the same species as the patient. Trans- fusion has been discarded in the past because of the dangers of sepsis, SALINE INFUSION 655 embolism, destruction of the infused blood corpuscles and nephritis. Within the last few years direct transfusion has been widely done, and with very little danger, in human surgery. Crile in this country has been the chief means of making the method popular and practicable. He has devised a special tube for performing anastomosis so that the intima of the artery of the donor will come into contact with that of the vein of the recipient. The author has many times done transfusion in dogs with this tube, using the femoral vein of the recipient and an artery of the donor. Now there are many substitutes for Criles’ tubes, one of the simplest being glass tubes coated with paraffine, or sterile, liquid vaseline, which are perfectly satisfactory. Direct union by suture of artery of the donor with vein of the recipient is now commonly practised. The technique belongs to the domain of surgery. Transfusion is particularly indicated to supply loss of blood in the recipient following severe hemorrhages. In some diseases of the blood and in poisoning by gas it has also proved of life saving value. The injection of warm, normal salt solution (.6 of 1 per cent.) has been found to fill many of the indications for transfusion of blood, and ‘yet is free from the dangers and difficulties besetting the latter. Saline Infusion. Saline infusions are intended to replace the normal blood plasma, and, therefore, should contain approximately the amount of sodium chloride—.6 of 1 per cent.—contained in this fluid. The solutions should be filtered and boiled previous to their use, when this is possi- ble, and are made by adding a heaping teaspoonful of sodium chloride to the quart of sterile water, which is used at a temperature of usually 103° to 115° F., according to the mode of introduction and circum- stances. * Simple distilled and ordinary water are noxious to the tissues, *The true proportion of sodium chloride in blood plasma of mammals is .8 per cent., or 123 grains to the quart. 0.6 of 1 per cent. of sodium chloride is not really “normal”? for mammals, but was deduced from that found in the plasma of frogs. The injection of a too dilute saline solution will cause. the red blood cells to swell and part with their hemoglobin and will lead to great sweating and diuresis in the effort of nature to restore the plasma to its proper composition. A more exact solution for saline infusion consists of: Sodium chloride, .8 per- cent.; potassium chloride, .03 per cent.; calcium chloride, 02 per cent.; water, 100. In emergencies, ordinary table salt (which contains a slight amount of calcium chloride, causing its deliquescence) , in the proportion of 123 grains to the quart or a level teaspoonful to pint of sterile water, may be employed for intravenous infusion or hypodermoclysis. 656 GENERAL THERAPEUTIC MEASURES while salt solution is entirely innocuous unless it contains three times the quantity of sodium chloride normally present in the blood. Mode of Introduction.—Saline infusions are introduced within the body (1) by intravenous injection; (2) by injection into mus- cular tissue (hypodermoclysis); and (3) by rectal injection (en- teroclysis). Intravenous injection is the most rapid and certain method, but not so simple and practicable as hypodermoclysis. Any superficial vein which can be readily seen and isolated, may be utilized; preferably the jugular or internal saphena vein in ani- mals; the median basilic, or cephalic, at the bend of the elbow in man. The apparatus consists of a glass funnel or rubber bag connected by four or more feet of rubber tubing, with a canula or curved piece of glass tubing 4 inches long and 14 inch in diameter for horses; 14 | inch in diameter for dogs. The apparatus should be boiled imme- diately before using. The vein is made prominent by manual pres- sure exerted by an assistant, or by a bandage, applied proximally to the seat of operation. The hair is shaved from the part, which is sterilized, and an incision 114 to 21% inches long is made by lifting a transverse fold of the skin directly over the vein and snipping off the top of the fold with scissors parallel to its long axis. The sheath of the vein is exposed, raised by dissecting forceps, and divided. The vein is then lifted from its bed with an aneurism needle, and two silk or catgut ligatures are drawn under it about an inch apart. The vein is now incised longitudinally, and, as the blood begins to spurt out, the distal ligature is tied about the vessel. The canula is next passed into the incision in the vein toward the heart and proximal ligature is tied, with the first part of a surgeon’s knot, about the vein and canula, holding the latter in place and preventing leaking of the salt solution from the vessel. When the injection is completed, the tube is withdrawn and the proximal suture is tied on the heart side of the incision, and thus the vessel is occluded on either side of the seat of operation. A simpler method consists in connecting the tubing with a sterile, hollow aspirating needle which is plunged into the vein through the skin or, more certainly, after expos- ing the vein as above. The apparatus filled with salt solution— including the funnel, tubing, and canula—at a temperature of 103° to 110° F. before its introduction into the vein, and the funnel should be kept full during its use to prevent the entrance of air into the vessel. Any pressure, previously employed between the incision and the heart, should of course be removed before beginning the in- jection. A little sterile absorbent cotton may be placed at the bottom of the funnel before the salt solution is poured into it, if the solution HYPODERMOCLYSIS 657 has not been previously filtered. In using the apparatus the funnel is raised about two feet above the vein. The quantity of salt solution to be injected will vary from a few ounces to two pints in the case of dogs; from 2 to 6 quarts for horses. Enormous quantities of normal salt solution may be introduced into the blood without harm, even an amount equal to four times that of the blood, pro- viding the inflow is not too rapid; 7.¢., exceeding one fluid drachm to the pound of live weight in fifteen minutes. When this amount is exceeded the heart and kidneys cannot take care of the great quan- tity of fluid in the vessels and tissues. A return to the normal volume, force, and rate of the pulse, and of color to the mucous mem- branes, will lead us to stop the saline infusion. The use of intra- venous saline injections is frequently followed by a reaction within half an hour, characterized by a severe rigor, succeeded by sweating, labored breathing, a strong pulse and increased urinary secretion. Hypodermoclysis. Injection of warm (103° to 105° F.) normal salt solution into the muscular tissue of the neck, abdomen or flank, is done aseptically with the same apparatus employed for intravenous saline infusions, using a large hollow needle to thrust under the skin instead of the glass tube for intravenous injection; or a fountain syringe filled with saline solution and attached to a sterile aspirating needle may be used; or a reversed aspirator apparatus may be utilized: 7.e., by filling the jar with salt solution and forcing the air into the jar, thus displacing the fluid. The fountain syringe is the best apparatus. Hypodermoclysis may be employed in the same cases as intravenous infusion, and is a better method on account of its simplicity. We are guided as to the quantity of solution desirable by the same indi- cations noted above as referring to intravenous saline injections. Hypodermoclysis may be done in several places, and absorption is assisted by massage. Salt solutions are injected under the udder in females, and are occasionally thrown into the peritoneal cavity, par- ticularly after operations in this region, before closing the abdominal walls. Enteroclysis. Enteroclysis applies to slow, rectal injection of normal salt so- lution (105° to 120° F.) to secure absorption. This method may be applied in cases not so urgent as to demand intravenous saline infusion or hypodermoclysis, more especially moderate degrees of hemorrhage, shock, collapse and circulatory depression, when the in- 658 GENERAL THERAPEUTIC MEASURES trinsic heat of the injection is valuable in restoring the normal bodily temperature. USES. INDICATIONS FOR SALINE INFUSIONS. Grave hemorrhage. | Bacterial. Shock, traumatic, operative, and elec- | loxemia Mineral. tric. Vegetable. Suppression of urine. In threatened death from any acci- Severe diarrhea. | dental cause. Eclampsia. In any disease with feeble heart and Purpura hemorrhagica. low vascular tension. Hemoglobinuria Hypodermoclysis, or the intravenous injection of saline in- fusions, find their greatest usefulness as life-saving measures in severe hemorrhage. While these methods are not in vogue in veter- inary practice,* they have become recognized procedures of great value in human medicine. The indications, following hemorrhage, are to fill up the vessels and to restore vascular tension, since danger is Imminent, not from loss of blood corpuscles, but from lack of a circulating medium. There is a sufficient number of red corpuscles to carry on the respiratory and oxygen-bearing functions even after the greatest loss of blood possible from ordinary causes. In fact, respiration is but slightly impaired in human subjects suffering from pernicious anemia, when there is a 90 per cent. reduction in the normal number of red corpuscles, and two-thirds of the blood may be withdrawn from animals and replaced with normal salt solutions without serious damage resulting. In shock there is general vasomo- tor paralysis, so that most of the blood collects in the abdominal veins, while the ventricles and arteries are emptied. In this condition saline infusions (105° to 110° F.) are of infinite value, because absorption of drugs from the digestive canal and subcutaneous tissue is impaired. Saline infusions greatly dilute the blood—and, there- fore, poisons in the blood—in toxemia, while they increase the activ- ity of the kidneys and elimination of toxins. The intrinsic heat of the injections is thought to stimulate antitoxin formation, and the * Since writing the above, favorable reports of the use of saline infusions have been accumulating. Thus G. W. Dunphy (Amer. Vet. Review, June, 1905) writes that he treated two cases of purpura hemorrhagica in the horse by in- jection of 6 liters of normal salt solution following the removal of 5 liters of blood from the jugular (by means of a trocar and canula), and, at the end of twenty-four hours, bled 2 more liters and injected 3 more liters of salt solution with very happy results. He also demonstrates the wonderful life- saving influence of intravenous saline infusion after the loss (by a horse) of 25 liters of blood. KUNSEL’S TREATMENT 659 restoration of vascular tension is believed to assist the natural bodily resistance of the patient. : A great variety of disorders have been treated successfully in human medicine with saline infusions, on this basis, including: septi- cemia, pneumonia, uremia, diabetic coma, purpura hemorrhagica, tetanus, ulcerative endocarditis, pyelitis; acute alcohol, ether, chloro- form, carbonic monoxide, arsenic and mushroom poisoning; and toxemias resulting from acute infectious disorders. The same treat- ment might be applied to hemoglobinuria and other toxemias pe- culiar to the domestic animals. Venesection for the purpose of removing the poisoned blood should, in most eases, be resorted to prior to practising saline injection in the toxemias. Excluding shock and hemorrhage, where heat is invaluable, saline infusions are generally given at the temperature of 103° F. by the rectum, under the skin, or into a vein. Kunsel’s Treatment for Milk Fever in Cows. This special form of treatment merits the attention of the veter- inary profession because of the remarkably successful results which have been almost universally secured in the ease of milk fever, which is not only a very common disease, but one which has hitherto baffled the best therapeutic attempts of the veterinarian. Following the Schmidt treatment with his intramammary injections of potassium iodide—which was productive of great diminution of the mortality of milk fever, but was often followed by local injury to the udder— M. Kunsel, of Lucerne, in March, 1903, made his first report of the method under discussion. This consists in the following: A tank of compressed oxygen, which can be had of any of the wholesale drug houses, is connected by rubber tubing six feet in length to a milking tube and firmly wired to the nozzle on the tank and to the tube, which should be boiled previous to use. The udder of the cow af- fected with milk fever should be stripped of milk and thoroughly washed with warm water and soap and the teats cleansed with 70 per cent. alcohol or some other effective antiseptic. The milking tube is then introduced into one of the upper teats and the oxygen gas is allowed to flow slowly into the teat until the corresponding quarter of the udder is tense and well distended. While pinching the teat to prevent the escape of gas, the tube is withdrawn and a strip of bandage or tape is bound about the lower part of the teat to retain the oxygen. The same procedure is repeated in each of the remaining teats. The ligatures on the teats may be permitted to remain in place for an hour and a half, when they should be removed. The inflation of the udder may be repeated in six hours, if necessary, 660 GENERAL THERAPEUTIC MEASURES owing to the non-improvement of the patient. As synergistic meas- ures, the subcutaneous injection of one-half grain of strychnine ni- trate, the use of enemata to empty the bowels, and catheterization are important in aiding recovery. The animal should also be comfortably propped up with bags of hay. If oxygen can not be readily obtained, the use of a bicycle pump connected with a milking tube may be employed with much success; some veterinarians claiming that the results are as good as with the use of oxygen, providing the air is pure which is pumped into the udder. This purity of the air may be attained bv blowing the air through a wash bottle containing 2 per cent. carbolic acid solution. Very convenient arrangements are now commonly sold at a small price for inflating the cows udder with air. These consist of a rubber bulb and tubing, a chamber containing sterile cotton (through which the air is filtered) and a milking tube for introduction into the teat. They may be used by the laity, and their employment has been as satis- factory as when oxygen was injected. The cow with milk fever should not be milked for ten or twelve hours after inflation of the udder, and only partially milked for several days following this time. Either emptying the udder of air by rubbing, or of milk by milking, within a few hours of inflation, has frequently led to a renewal of the disease in its worst form. The use of the tape to retain the in- jected air is said to be unnecessary, provided one compresses the teat for a few minutes after inflation. This needs further endorsement before general acceptance. The results of the Kunsel treatment are wonderful. Kunsel reported a series of twenty-two cases of milk fever, without a death, following the use of his method. Similar results have been secured in this country. The rationale of the treatment has yet to be eluci- dated. Various hypotheses have been advanced, such as the effect of the oxygen on a hypothetical anerobic bacillus in the udder; the action of the oxygen on the blood and general metabolism in destroy- ing toxic products in the economy; the action of air-compression in the udder in overcoming congestion in this part, and thus preventing anemia of the central nervous system; and a possible stimulation of the secretory function of the mammary gland with elimination of toxins. The hypothesis most in vogue is that of a cerebral anemia following rapid emptying of the udder of milk and resulting udder congestion. The fact that injection of milk into the mammary gland has produced a condition simulating milk fever appears to augur a local cause of the disease. The latest and most rational theory is that of Healy and Kastle who find the first colostrum of cows with parturient paresis to be LAVAGE 661 extraordinarily toxic when injected into other animals, whereas colos- trum from normal cows is inert. ‘They believe the disease to be caused by a toxin elaborated in the udder through faulty metabolism and that inflation cures parturient paresis by preventing the absorp- tion of this toxin. Lavage. Lavage is a term applied to washing out the stomach with the stomach tube. This process, while an every-day occurrence in human medicine, has been too long neglected in Veterinary practice. For- tunately, new interest was awakened in this useful procedure by Phillips, of St. Louis, who has perfected a tube and demonstrated the practicability of its use.* The passage of the tube is chiefly of value in acute indigestion of the horse, with gastric flatulence and distention, where pain and danger of rupture of the organ are averted by permitting escape of gas, and by further washing out the stomach in such conditions and in gastritis and engorgement, toxic, fermenting ingesta are immediately removed and the evil results, as tympanites and local inflammation of the stomach and of the intestines, are prevented. In choking, as by oats, the passage of the tube may afford relief, while in poisoning the washing out of the stomach is the one essential treatment. Gas- tric indigestion and flatulence are shown by colic, distention in the region of the stomach, difficulty in thoracic breathing and eructa- tions of gas by the mouth, or attempts at retching and vomiting. To pass the tube, the horse may be backed into a stall. The operator stands to the animal’s left and an assistant, holding up the horse’s head and the distal end of the tube, to the patient’s right. The tube is placed in warm water and the surface is dusted with powdered slippery elm or smeared with vaseline. The left nos- tril of the horse is also lubricated in the same way. The operator pushes the tube gently along the floor of the left nasal fossa with the left hand, while guiding its direction with the right hand. . The first obstruction is likely to be met, when the tube has been entered about a foot, by its contact with the turbinates. The point of the tube should then be held downwards, by the pressure of the right forefinger pushed as far as possible into the nostril, while the outer part of the tube is lifted upward to force the point down into the pharynx. When the tube enters the pharynx attempts at swal- lowing are likely to occur and these are just what are needed to close the epiglottis over the larynx and to force the tube into the gullet. * Amer. Vet. Review, May, 1904. 662 GENERAL THERAPEUTIC MEASURES If swallowing is not evident it may be brought on by pushing the end of the tube gently backward and forward into the pharynx, and, when an attempt at deglutition occurs, the tube should be thrust forward. If the tube goes into the trachea instead of the esophagus, it will meet with little resistance and expired air may be felt coming from it, while coughing often results. If it is in the gullet, the tube will be held more firmly by its walls and only fetid gas may escape with stomach contents. It should by these means be definitely established then that the tube is in the gullet before introducing it farther. The tube should be made with white marks on the rubber to show when it may be expected to have reached the gullet and again the stomach, During the course of passing the tube it must be well lubricated. When the stomach is reached the gas may have already escaped and fluid contents may be siphoned off by filling the tube with warm water from a funnel or syringe, holding the distal end tightly closed and lowering it to the ground so as to permit of the escape of stomach contents by siphonage. If the contents are largely solid, the stomach must be repeatedly filled with 2 to 4 quarts of warm water and allowed to escape again by lowering the outer end of the tube to the ground. If the flow stops, owing to choking of the tube, it may be started again by injection of water into the tube with a syringe or pump. The latter must not be used to suck out the contents of the stomach except so far, if necessary, as to start the siphonage. The stomach should thus be repeatedly washed until the water comes away clear. If water is injected with a syringe, care must be taken to avoid forcing air into the stomach. When passage of the tube beeomes impossible through one nos- tril, the other one may be tried. Phillips reports failure to pass the tube in the horse in only 5 per cent. of trials. The tube is best made of red Para rubber and long enough to reach from the stomach to the ground when in place. Occasionally in impacted stomachs it is impossible to pass the tube through the lower portion of the gullet unless a stilette is used in the tube. For this purpose a wire bent double has proven satisfactory and is easily carried about. The apparatus consisting of an inner and an outer tube is not so generally serviceable as the single stomach tube. Lavage of the stomach of dogs is accomplished by fastening the animal to a table on its side by tying the feet and a band about the body to the table. A gag made of wood is placed in the mouth to hold the jaws apart. Through a hole in the gag a tube is passed. The tube should be about 5 ft. long and different sizes are required. SERUM THERAPY 663 A large human catheter, or small human rectal tube, are commonly suitable. To the catheter or rectal tube a funnel is attached by means of a piece of rubber tube and glass tube. After the stomach tube is passed water is poured into the funnel, to the amount of a pint or so, and the stomach is emptied by lowering the funnel to the floor and allowing the water to syphon off. The tube must of course be filled with water when it is lowered, in order to act as a syphon. Lavage of the stomach and indeed the whole alimentary canal may also be accomplished in dogs by inverting the animals or hang- ing them up with head downwards and allowing several gallons of warm water to run into the rectum from a tube with funnel attached and raised some 6 ft. above the patient. Water is allowed to flow until vomiting begins. It is well to introduce the rectal tube slowly for several ft. and to compress the anus about the tube to prevent the water from escaping. This method is valuable after foreign bodies or poisons have been swallowed. Serum Therapy.* Antitoxic Serum.—The microscopic organisms which cause in- fectious diseases—of which the bacteria are the most common— act chiefly through the production of certain complex, poisonous, pro- teid bodies called toxins, which combine with the cells of the vital organism and destroy their vital functions. Indeed, all the classic symptoms of some of the infectious diseases may be caused by in- jection of the toxins of the bacteria which cause these diseases; such is the case with tetanus and diphtheria. Our understanding of the effect of antitoxins is based on Ehr- lich’s classic theory of immunity. Tissue cells possess supposed prolongations or receptors. These combine with special food-prod- ucts in the blood for which they have an affinity. As soon as a recep- tor has become attached to a food-product the cell makes one or many new receptors to replace it. These new receptors when abundant are thrown off and exist unattached in the blood. The toxins of disease are proteids and, in their relations to the receptors, take the place of food-products. They unite with the receptors of cells and cause their death. *In the use of serum therapy the strictest aseptic precautions are to be used. The animal is prepared by shaving off the hair from the dry skin and painting the skin with tincture of iodine. The syringe and needle must be boiled for five minutes before using. When many animals are injected at one time, it may be sufficient to wipe off the needle after each injection with 70 per cent. alcohol. The puncture may be covered with collodion to advantage. Glass syringes, with asbestos packing on plunger, are most suitable for boiling, the needle connected by rubber tubing. 664 GENERAL THERAPEUTIC MEASURES Acquired immunity is brought about when so many free recep- tors are produced in the blood that the toxins of a disease unite with these—rather than with the receptors of the cells—and thus the ani- mal is not overcome. These free receptors in the blood are antitoxins and are produced in abundance in the blood of horses injected with diphtheria or tetanus toxins. The free receptors or antitoxins are specific against the particular toxin with which they combine. Natural immunity may be due to the fact that the animal has not any cell receptors capable of uniting with the specific toxin of the given disease. To illustrate the method of artificially manufacturing antitoxins, we will take as an example the production of tetanus antitoxin. Tetanus Antitoain.—Tetanus bacilli are grown in bouillon for two or three weeks in an incubator, when the culture is filtered free of bacilli and furnishes tetanus toxins. A horse is injected with one-half a cubic centimeter of toxin and an equal amount of Lugol’s solution to lessen its virulence. The injections are repeated in in- creasing quantities till the seventy-second day, when as much as 150 ec. are injected. The horse is very susceptible and reacts with local inflammation at the site of each injection and generally by the pro- duction of antitoxins in its blood. A few days after the last in- jection the horse’s immunity is at its maximum—that is, its blood is highest in antitoxic strength. The horse’s blood is then withdrawn under strictest aseptic precautions and the serum is decanted after a day or two. The serum is placed in aseptic bottles holding 10 cce., which are sealed. They are put in an incubator for several days to prove their sterility ; if the serum turns cloudy it is rejected. Most serums will keep a year if preserved with a slight amount of carbolic acid or if treated by repeated sterilization below 100° C. Cloudiness in a serum indicates that it 1s unfit for use. The activity of a serum is estimated in two ways. First, the amount of antitoxic serum required to neutralize a given volume of toxin of known strength. Second, the strength is stated in units. Thus in tetanus antitoxin the unit is ten times the least amount of serum necessary to save the life of a 350-gram guinea pig for 96 hours against the official test dose of the standard toxin. The test dose is 100 minimal lethal doses of a precipitated toxin preserved under special conditions at the Hygienic J.aboratory of the Public Health and Marine Hospital Service; or, to put it in other ways, one tenth unit of antitoxin neutralizes 100 minimum fatal doses of toxin, or 1 unit neutralizes 1000 lethal doses of toxin for a 350 gm. guinea pig. ; The dosage is, then, reckoned in units of antitoxin which is the most accurate method. This mode of standardization is SERUM THERAPY 665 now a legal requirement in relation to diphtheria and tetanus anti-— toxin for use in human medicine. The same should apply in veter- inary tetanus antitoxin and the dosage should be reckoned in units and not in Ce. which means nothing as showing the strength of the serum. The better makers now standardize their antitoxin according to the human standard. Thus 1 Ce. of veterinary tetanus antitoxin (Mulford) equals 50 American units as defined above. While the human prophylactic dose is 1500 units that for the horse is only 500 units (10 Ce. Mulford) because one uses a homol- ogous serum, or serum from the horse for the horse. Horse serum is not so potent for man. The toxin of tetanus is developed by the bacteria of this disease, which gain entrance through wounds of the tissues of the body. The bacilli of tetanus are not distributed by the blood, but remain at the site of infection, and the toxins they produce are taken up by the peripheral nerve endings in the vicinity and carried along the axis cylinders of the motor nerves to the central nervous system. The same thing happens in rabies. When the toxins reach the spinal cord the symptoms of tetanus appear and finally death oceurs, when the important centers of the medulla become intoxicated. But the major part of the toxins are absorbed by the lymphatics of the in- fected area and so pass into the general blood stream where they are neutralized or absorbed by the motor nerves all over the body. Tetanus germs live normally in the intestines of horses, cattle and dogs but neither they or their toxins are absorbed unless the mucous membranes are wounded. Manure, and dust containing it, is there- fore especially dangerous. Tetanus bacilli live in the soil, and wounds which are contaminated with dirt or foreign bodies, and those which do not have free access to air—as bruised or punctured wounds— are chiefly liable to the development of tetanus. Tetanus is com- mon for this reason in mules employed in coal mines. It will thus be seen that tetanus does not become apparent until some time after the involvement of the nervous system, and for this reason the use of tetanus antitoxin is not so actively preventive at this period when the toxins have combined with the receptors of the nervous system and are therefore unable to combine with and be neutralized by the antitoxin. Nevertheless, tetanus antitoxin is of some value as a curative remedy in tetanus if used within thirty hours of the beginning of the attack. Tetanus is fatal in proportion to the shortness of its incubation. When antitoxin is given to cases having a short incubation (5-8 days) there is little hope of its success. Bacilli’s treatment is preferable (p. 302). When the period of development has been longer (1 to 2 weeks) the chance of recovery is much better with than without antitoxin. 666 . GENERAL THERAPEUTIC MEASURES As a preventive agent when employed before infection, or imme- diately after it, tetanus antitoxin is almost certain. Nocard injected 2,727 horses with tetanus antitoxin in a certain district, and while none of these developed tetanus, there were 259 cases in the same region in unprotected horses. Pecus reports 500 cases of horses with nail pricks of the feet in which not a single case of tetanus developed after one immunizing dose of tetanus antitoxin. The immunity produced by tetanus antitoxin is thought to last from fifteen to thirty days. So-called idiopathic tetanus is in reality traumatic, resulting from small unseen wounds of the mucous membranes or integument. Tetanus antitoxin is then indicated for use in the horse when the case is not acute, or as a preventive where tetanus is prevalent or following wounds the character of which (see above) suggests the possibility of the development of the disease. {n such localities it is wise to immunize animals against tetanus with a dose of antitoxin before undertaking surgery (as castration) upon them. The remedy may be employed without fear of doing any damage if properly ad- ministered. There are three ways of giving tetanus antitoxin: as a pre- ventive it may be given under the skin, unless there are reasons to require rapid action, when it should be given intravenously; as a cure, after symptoms have developed, it should be given intraven- ously or intraspinally. The latter method has proved rather more successful in human practice but large doses of antitoxin given intra- venously yield almost as good curative results. It has been found that 3 days are required, after a subcutaneous injection of antitoxin, to produce the same antitoxic result which will occur within one hour after the intravenous injection of the same dose. If the antitoxic serum is from the same species as the patient (homologous) it is eliminated as slowly as if it had been produced naturally in the body, so there appears to be no reason to repeat the dose of tetanus antitoxin in the horse, if the first intravenous injec- tion is sufficiently large. As a prophylactic, a dose of 10 ec. or 500 units should be in- jected subcutaneously in horses and repeated at the end of the first and third week, and later, if there is danger from wound infection. As a curative agent antitoxin is useless in rapidly developing cases but in chronic and slowly developed cases it may be employed. For treatment of the horse 20,000 units of tetanus antitoxin should be given intravenously at the earlest possible instant. There does not appear to be any reason for repeating the dose until the end of 5 days, when a second dose of 10,000 units may be given if toxin is being produced from a sloughing wound. Formerly daily doses of tetanus antitoxin were advised and, while these do no harm, the expense is great and experiments by Ransom show that the antitoxic SERUM THERAPY 667 strength of the serum persists a long time if it is homologous. The local treatment of the wound is as important as general treatment. The free opening of punctures to the air, removal of foreign bodies, and thorough washing with antiseptics and drainage are essential, as well as the use of nervous sedatives to control spasms. An influenza antitoxin is now prepared by some makers of biological products (Parke, Davis & Co.). This is of chief value in affording passive immunity to the disease in horses which are to be exposed to diseased animals or infected premises, as in shipping young horses. A single dose of 30 cc. injected subcutaneously will protect a horse, if given 10 days before exposure. As a curative agent this antitoxin is of most service in the very beginning of the disease in the same dose (30 ce.) and repeated every 12 hours for 2 or 3 doses. After the disease is well advanced the curative power of the antitoxin is correspondingly less but it may be given in large doses (90 ec.). If given early it shortens the attack and lessens the mortality. It is not possible at present to esti- mate its precise value. Human diphtheria antitoxin is used with success for the same purpose. Anti-Strangles Antitoxin.—An Anti-Strangles Serum is now on the market. That made by the Pasteur Laboratories of America is obtained from horses which are given the strangles streptococcus (S. equi) in gradually increasing doses for a year. The serum from these immunized horses is an efficient prophylactic agent and of some value in the early stages of the disease as a curative remedy. All young horses liable to be exposed to the disease from recently bought animals, or by coming in contact with diseased ones in the barn, pas- ture, road, or in shipping should receive prophylactic doses. Also in receiving horses, recently shipped, it is wise to use the antitoxin, unless it has already been employed. The immunity conferred is thought to last 2 months. The minimum preventive dose is 30 ce. Anti-infectious Serum.—Antistreptococcus serum is included un- der this head because it appears to be especially antagonistic to streptococci themselves and to possess antitoxic power. In the prepa- ration of this serum (after Marmorek) streptococci are grown in serum or serous exudate mixed with two parts of peptonized bouillon, and their virulence is greatly increased by repeatedly injecting them from rabbit to rabbit. This virulence becomes in this process so ereat that an amount of culture equivalent to one single streptococcus will certainly kill a rabbit. Small doses of a culture of living viru- lent streptococci from the rabbit are injected into the horse from time to time, this animal reacting vigorously to the injections. It is not until the horse has undergone this treatment for a year and has recovered from each injection that a serum is obtained of a sufficient strength to combat living streptococci and their toxins. The blood 668 ' GENERAL THERAPEUTIC MEASURES of the horse being withdrawn furnishes anti-streptococcic serum. It is now thought by many authorities that the serum to be most ef- fective should be polyvalent—that is, should be active against the many varieties of streptococci by the cultivation of large numbers of streptococci to represent their different toxins. Marmorek holds, however, that the streptococci causing ery- sipelas, cellulitis, abscess, sore throat, parturient infections, scarlet fever, ete., are identical; that all produce the same toxins, and that all are antagonized by an anti-infectious or antitoxic serum made from any one or all of them. The therapeutic results of antistreptococcic serum are not so certain as those following the use of some other serums—notably anti-diphtheritic serum in man—because so-called streptococcic in- fection is often a mixed infection, by which is meant that produced in part by other bacteria, and because serums produced by the cul- tivation and inoculation of apparently the same varieties of strep- tocoeci seem to differ considerably in their protective value. As in the case of other serums, the therapeutic result is much more favor- able when antistreptococcic serum is used as a prophylactic or in the early stages of the infection. The injection of antistreptocoecic serum is practically devoid of danger. With the qualifications above noted, antistreptococcie serum has " proven serviceable in the following morbid conditions: Strangles, medical and surgical septicemia, pyemia, parturient infections, pur- pura hemorrhagica, influenza, traumatic infections, peritonitis, em- pyema, cellulitis, erysipelas, broncho and contagious pneumonia of horses, and cerebro-spinal meningitis. 10 cc., used as a prophylactic dose, may prevent strangles and influenza in horses and septic ar- thritis in calves exposed to the disease; and a full dose, durin” in- fluenza, may avert purpura as a sequel. As some of the above dis- eases are often caused by infections other than streptococcus, the employment of antistreptococcic serum may be unavailing in them unless the etiology is known to be streptococcic invasion. On the other hand, any form of horse serum increases the re sistance to infection and, according to Metchnikoff, is more valuable than bacterial vaccines to stimulate antibodies and phagocytosis. This may explain why antidiphtherie serum or antitoxin is useful in influenza as well as antistreptococcic serum. Anti-streptocoecie serum is especially useful in septicemia of the new-born, derived from navel infection, and attacking foals, calves, and lambs. As a preventive in endemics 10 ee. should be given at birth and, for treatment, 10 ec. should be injected daily— in addition to care of the navel fad joints. Dosage.—In the larger animals from 20 to 55 ce. are injected at HOG CHOLERA SERUM 669 all ages at a single operation, and the dose should be repeated every 12 or 24 hours until symptoms abate. A fresh specimen of antistreptococcic serum is always desirable, as its power to destroy streptococci is soon lost. Hog Cholera Serum. The prophylactic treatment of hog cholera and the treatment in the early stages of the disease by serum is now on a firm basis. The serum is made by hyperimmunizing immune hogs (those which have recovered from the disease) with intravenous injections of blood serum from hogs sick with hog cholera. After a week or so has elapsed the hyperimmunized hog is bled and the serum from this hog (mixed with 0.5 of 1 per cent. phenol) is employed in prophylaxis and treatment of the disease. It is given subcutaneously into the thigh by two methods: 1. The simultaneous method by which the sterile serum from a sick hog (with 0.5 of one per cent. phenol) is injected together with the serum as above prepared. The serum is taken from hogs which have been inoculated with hog cholera and which sicken on the seventh day and are about to die on the fifteenth, to avoid securing blood contaminated with other infec- tions. The doses by the simultaneous method are in a general way 1 c¢. ¢c. of virus (serum from the sick hog) injected with 35 c. c. of the im- munizing serum for hogs of 50 to 75 lbs. weight, or in this ratio of 1 to 35 for all hogs over 50 lbs. Young pigs should be injected by the simultaneous method when 10 or 12 days old and when 3 months old, to secure immunity for life. At the first injection the pigs receive 0.1 to 0.2 c. c. of virus with 8 to 10 ¢. ce. of immunizing serum, while at the second injection they should weigh about 50 lbs. and receive 1 «. c. of virus and 20 c. c. of immunizing serum. The doses of virus and serum for young pigs, as given by Salmon, are as follows: Pigs Virus Immunizing Serum 2— 3 lbs .05 @. ¢ 5 ¢. c 38— 6 lbs all ©; © 8 ee 6—10 lbs PAL OSS 10 c. c 10—15 lbs. 3c. ¢@. 15 ee 15—25 lbs. 4¢.¢ 20 c. ¢. In the case of animals to be slaughtered within a month or so the use of the immunizing serum alone will afford sufficient protection. Thus immunization of the animal is made permanent but the animal is given a mild form of disease and may therefore communi- cate a virulent form to unprotected hogs. 2. The immunizing serum is injected alone, in doses varying from 5 to 10 cc., for 75 lbs., live weight, for animals which have not been exposed; and 20 cc., per 50 lbs., live weight, for animals which have been exposed. The immunizing serum gives a transient, passive immunity lasting some weeks, unless the animal becomes shortly exposed to hog 670 _ GENERAL THERAPEUTIC MEASURES cholera when the immunity becomes lasting. The serum is supplied free by certain states and also is prepared by makers of biological products. Statistics show that the immunizing serum protects hogs to the extent of 100 per cent., if given just before exposure has occurred, the immunity not being permanent. In herds which have been exposed, of those inoculated with serum only 4 per cent. die, while of those untreated 90 per cent. perish. In herds, in which hog cholera already exists, of the inoculated 15 per cent. died, as against 75 per cent. among the uninoculated. As a curative agent it is not so satisfactory, the result depending on the day of disease in which it is used. At the outset it is very successful, in doses of 40 or more cc. per 100 lbs., and is the only remedy which offers any promised success. Bacterial Filtrates. Tuberculin.—Koch’s tuberculin is prepared by growing tubercle bacilli in flasks, containing peptonized bouillon and glycerin, in an incubator at 37° C. for six weeks. The cultures are boiled and fil- tered through porcelain to remove the dead bacilli, and the toxie substance is concentrated to one-tenth of its bulk by boiling. The result is a solution of the endotoxins of the tubercle bacilli in glycerin, and to this is added a 14 per cent aqueous solution of carbolic acid for injection. Tuberculin is used in veterinary medicine solely as a diagnostic test for tuberculosis in animals, chiefly cattle. It may be used with almost entire certainty for this purpose, Koch claiming 99 per cent. of correct results from its injection. Injections in tuberculous animals cause a rise of temperature of from one to three or more degrees I. in about twelve hours from the time of injection. - If there is any focus of tuberculosis, as in the joints or bones, open to inspection, there will be a notable reaction observed in this loeal- ity, with heat, redness and decrease of function of the part. Ehrlich formerly attributed the fever following the injection of tuberculin to a reaction of the zone of cells about the tuberculous focus which are made unusually susceptible by the toxins of the disease so that they become inflamed by. the sudden extra amount of toxin injected. In a tuberculous guinea pig, which has been killed by the injection of an overdose of tuberculin, zones of hyperemia may be seen sur- rounding each of the gray nodules characteristic of the disease. It is now believed that the fever in the subcutaneous tuberculin test, and the local redness and swelling at the site of application in this and in the eye and skin tuberculin tests, are due to anaphylaxis or serum disease. Anaphylaxis means the hypersusceptibility to a toxin or foreign proteid by an animal which has survived a non-fatal dose of the same substance. If repeated injections of a foreign proteid are made at short intervals, less than seven days, no untoward result occurs, but if BACTERIAL FILTRATES 671 given at longer intervals than ten days then the outcome may be fatal im man and animals. Thus the serum from another species of animal injected into a patient after a long interval, following the primary dose, may cause slowing of the respiration, dyspnea, cyanosis, convulsions and death from paralysis of the heart muscle. Digitalis and atropine given under the skin are the best antidotes. Vaughan explains the phenomenon of anaphylaxis on the as- sumption that when foreign proteids (antigen) enter the tissues un- changed the cells form enzymes (antibodies) capable of destroying the proteids. In their destruction the cleavage-products produce toxic Symptoms. Thus in tuberculosis the enzymes are already formed in the eells and on the injection of tuberculin there is a sudden production of cleavage-products, especially in the region of the sensitized cells of the diseased area, and at the site of injection. The reason the sensitization does not occur commonly till after a second injection or a serum, and after an interval of 7 to 10 days, is because the cells require time to form the specific enzymes which are thereafter stored in the cell to attack the specific foreign proteid whenever it enters the body unchanged. Sensitized animals split up proteids rapidly while in normal animals the proteid is split so slowly as to cause no disturbance. In man the injection of horse serum (diphtheria antitoxin) has occasionally caused severe anaphylaxis and death, though the repeated injection of antitoxin at month intervals is the routine practice in - many children’s hospitals and no casualties have resulted. As most of the antitoxins are horse serum the repetition of injections of anti- toxin in the horse at long intervals is not fraught with danger, since the serum is homologous, or natural to the animal. The same applies to the use of human serum in man. All animal serums, but that of the horse and rabbit, are toxic to man. The injection of an ordinary dose of tuberculin is practically harmless and does not even render the milk of a cow unfit for food. In an advanced stage of tuberculosis the animal may not react to tuberculin, and this may be explained by the fact that the tissues are perhaps habituated to the toxins. There are two other periods in tuberculous infections during which the animal does not react to tuberculin. These are the incu- bation and latent periods. Thus after an animal has become in- fected it may be two months before the animal will react to tuber- culin. When tests are made every six months it frequently happens that, after two or more positive reactions occur in an animal, it may cease to react. The animal is then called a “ceased reactor.” This follows because the lesions have healed through the curative action of the tuberculin injections or through natural agencies. Thus seven 672 ' GENERAL THERAPEUTIC MEASURES animals reacted to tuberculin at two successive six month tests. They ceased to react to the following tests and were slaughtered three years after the last positive reaction. At this time all but one of the seven animals proved to be tuberculous at autopsy. They had healed lesions and the disease was in the latent or dormant state. Whenever there is a large percentage of reacting animals in a herd the non-reactors will be found reacting at later tests in considerable numbers. ‘The only way to free a herd permanently from tubercu- losis is to retest it every 2 months until there are no reactors. The annual and semi-annual tests allow incubative cases, not reacting at the previous test, to develop and communicate tuberculosis to other animals and so the disease is perpetuated in the herd indefi- nitely. It is always advisable to purchase animals from a herd al- together free from tuberculosis. Moore of Cornell found in a herd of 491 animals that all re- acted to the tuberculin test save 96 animals. These 96 non-reactors were segregated in non-infected quarters and tested every six months. At the end of four years only 19 remained which had not reacted to the tuberculin test. The explanation of these figures lies in the fact that some cows were in the incubation stage, that others became infected, and that in others a latent or healed lesion became active or open. . The Test.—It is best to take the temperature of the animal from 6 a.m. every two hours until the tubereulin is injected on the evening of the same day between 8 and 10 o’clock. The test is unreliable in animals whose temperature reaches 103.2° F. (except in the young, when this may be considered a normal, maximum temperature) during this period prior to the injection, and some- times in those in advanced stages of the disease. The test is also misleading when the animal is “in heat’? and within a few days of parturition, either before or after. The injection is made aseptically into the subcutaneous tissue in the side of the neck or back of the left scapula with a syringe and needle previously boiled. The ani- mals should be kept in the stable during the time required for the test, and should not be allowed to drink large quantities of cold water to reduce their temperature while the test is being made. The tem- perature of the animal should be taken at 6 o’clock on the morning following the injection and from that time every two hours till 8 P.M. A rise of two degrees F. is necessary for a positive reaction ; that is, a rise of two degrees over the maximum temperature of the animal in the fourteen to sixteen hours before the injection. Those animals in which the temperature does not rise to 103° F. within fifteen sr at most twenty-four hours after injection may be BACTERIAL FILTRATES 673 considered non-tuberculous; when the temperature is between 103° and 104° I. the test is doubtful, and the animals should be re-tested atter two months ; when the temperature rises gradually to 104° F., or over, within fifteen hours after the injection, the animals may be classed positively tuberculous, provided the temperature constitutes a rise of two degrees over the maximum temperature recorded prior to the injection. Before admitting new cows to a herd they should be isolated until tested twice with tuberculin without reacting. This is necessary because cows may not react in the incubative or latent stage and because previous injection of tuberculous cows with tuberculin may prevent them from reacting to small doses. There fore after a first test with negative result the cows are kept isolated for three months, when a second test is made with three times the first dose of tuberculin. Milk from these cows may be sold as certi- fied milk during the isolation period. Animals should be kept at rest before the tuberculin test is made. Tasteless antipyretics are sometimes put in food to prevent the action of tuberculin. The average dose of tuberculin as prepared and diluted for immediate use by the U. S. Government is 2 ¢.c., representing 0.25 e.¢c., of old tuberculin. If tuberculin is to be kept for any period, it is better to procure the concentrated toxin and dilute it with a 14 of one per cent. carbolic acid solution prior to injection. In old and emaciated animals double the ordinary dose of tubereulin should be used, and in re-tests (as has been noted above) three times the usual dose of tuberculin should be injected. Tubereulin should be kept in a cool, dark place and should be rejected if it becomes cloudy. The dosage is adjusted somewhat to the weight of the animal. Yearlings and 2-year-olds may be given 1 to 1.5¢.c. Bulls and large animals may receive 3 ©.c. Ophthalmo-Tuberculin Diagnostic Test.—Simultaneously both Calmette of Lille and Wolff-Eisner of Berlin announced this test in - June, 1907. It consists in dropping one drop of a 1 per cent. solu- tion of tuberculin in the eye. In tuberculous subjects this is fol- lowed by hyperemia, lachrimation, and redness of the eyelids, which begins in about 3 to 8 hours, reaches the maximum in 8 to 14 hours, and remains 1 to 4 days. There is often edema of the lids and purulent discharge. The reaction is caused by an acquired ana- phylaxis to tuberculin as shown by local leucocytosis and hyperemia. No harm results to the normal eye. The solution is made by precipitating crude tuberculin with aleohol, the precipitate is collected and dried and dissolved in normal salt solution. It is best to perform the test early in the morning to observe the 674 ' GENERAL THERAPEUTIC MEASURES results. One should hold down the eyelid in making the instillation and gently massage the lids afterwards. If the ocular test proves negative on its first trial it may be repeated in the other eye after the lapse of three days. It should not be repeated much later than this, or one may get a reaction in the eye of any healthy animal owing to sensitization of the subject (anaphylaxis). Tablets for dilution (and glass tubes containing single doses) of tuberculin for the eye reaction may now be bought of makers of biological products—together with the pipette and directions for using. The eye test may be used in the case of newly-arrived animals, and in animals having fever, in pregnant animals, in those remain- ing out-of-doors and in those which have had a course of tuberculin treatment. A positive reaction may later be substantiated by the subeutaneous test with which it does not interfere. Tubereulin especially prepared for the eye test contains no car- bolic acid. The animals should be inspected on the 12th and 24th hour after the instillation for redness and swelling of the lid-con- junctiva with that of the haw and caruncle, and for increased vas- cularity and redness of the white of the eye and muco-purulent dis- charge. Intradermic Method.—When tuberculin (2 to 4 m. of a 10 per cent. solution) is injected into the skin of one of the subcaudal folds in cattle, or at the base of the ear in hogs, a specific swelling and redness occurs in cases of tuberculosis. Moussu and Mantoux have shown that it is reliable and useful in that it is much easier to perform than the subcutaneous or ophthalmic tests. The injection into cattle is made in the skin of the middle or upper part of one of the folds, seen on lifting the tail, without any aseptic pre- cautions. Within 24 hours an oval or elongated edematous swelling oceurs about the size of a hazel nut or walnut, if the test is positive. This begins to diminish in 4 days and disappears in 10 days. In the non-tuberculous there may be a swelling as large as a grain of wheat. In comparing the two folds, on lifting the tail, it will be seen that the injected fold is twice or three times as thick as the other in positive reactions. Tn the hog the injection is made into the skin of the base of the ear, after the animal is thrown as for castration. Within 4 to 48 hours a swelling the size of a hazel nut or walnut appears behind the base of the ear surrounded by a red areola as large as the palm of the hand while, at the site of injection, there appears a bright-red area growing as large as a quarter dollar in unpigmented skins, when the test is positive. The reaction begins to diminish on the third day and disappears by the 15th day. In non-tuberculous animals BACTERIAL FILTRATES 675 occasionally some swelling and redness occurs within an hour at the site of injection but this disappears entirely at the time the positive reaction is at its height (24 to 48 hours). Luckey* believes both the eye and skin tuberculin tests untre- liable but finds the intradermal test fully as accurate as the sub- cutaneous test and preferable to it in being suitable for all animals, old and young alike, without regard to circumstances unfavorable for the temperature test. Thus animals “in heat,” recently in calf, advanced in pregnancy, or those heated and excited are suitable for the intradermal test. The great saying in time, in not taking tem- peratures, makes the test much more simple and economical than the old test. In the testing of 3458 animals, checked by 103 autopsies, there were but three errors. Luckey thinks it unnecessary to pick up the caudal fold but injects about three minims of tuberculin through a medium sized needle wherever, in this vicinity, the skin is soft and pliable. The needle should be thrust just as near the surface of the skin as possible and yet not allow the tuberculin to escape. Three days later the animals are examined. Cutaneous Test.—In the ordinary skin reaction (Von Pirquet’s Test) a drop of 25 per cent. solution, or pure, old tuberculin is rubbed on the abraded skin, as in human vaccination. Within 24 or 48 hours a papule forms at the site of the test, surrounded by a zone of hyperemia, if the reaction is positive. SIGNIFICANCE OF THE VARIOUS TUBERCULIN TESTS. It is commonly taught that reactions to the different tests have different values. Thus the subcutaneous test is properly regarded as the most reliable, in showing active lesions, but it is often stated that a positive reaction sometimes is observed in a tuberculous lesion long healed (Hare). Again, in regard to the eye test, it has been reported positive in 18.5 per cent. of normal subjects and negative in 20 to 30 per cent. of known tuberculous lesions, active or otherwise. The skin test is so often positive in humans that it is considered of little value in showing an active lesion, except in children. A lesion existing in the young may be considered active since it is of recent origin. But it is probable that a fully healed tuberculous lesion will never cause a positive tuberculin reaction in any of the tests. The reaction is caused by antibodies which are brought into existence by the toxins of tuberculosis. As long as these toxins escape into the circulation so long will the antibodies be formed. But when the lesion is healed, or shut off completely by encapsulation and no toxins * Amer. Vet. Review, June, 1912. 676 GENERAL THERAPEUTIC MEASURES enter the circulation, then, or within a short period thereafter, will reaction to tuberculin cease. Rapidity of reaction to any of the tuberculin tests is most important as showing the activity of the lesion. Thus a test which gives a maximum reaction within, or as early as 12 hours, indicates an active lesion. While a test in which reac- tion begins in 24+ hours and is at its maximum on the second or third. day signifies an inactive or latent lesion. Sometimes a very marked reaction occurs during these later hours. Malleon.—This is made, like Koch’s old tuberculin, by steriliz- ing and filtering a culture of B. mallei to remove the dead bacilli. It is an extract containing the toxins. The usual diagnostic dose is one c.c. (as prepared by the U. S. Bureau of Animal Industry) for the average sized apparently healthy horse, but a larger dose (not to exceed 2 cc.) should be given to suspicious cases, and to extra large horses, and weakened and old animals. Small animals may receive a proportionately smaller dose. Animals with acute diseases or those with suppurating lesions are unfit subjects for the injection of mallein. The actual mode of making the test is as follows: The tem- perature should be taken at 2, 5 and 8 p.m. and a careful clinical -ex- amination should be made and the animal numbered or lettered, if several are to be tested. In suspicious cases a separate syringe and thermometer should be used for each patient and, in other cases, the syringe, needle and thermometer should be sterilized each time before using, the latter by washing and immersion in alcohol and then 5 per cent. carbolie solution, while the syringe and needle should be boiled. The hair should be clipped from the side of the neck over an area 3 inches in diameter and if the temperature does not exceed 101° F. on the three occasions it has been taken, then on the evening of the same day (8 to 10 p.m.) mallein may be injected aseptically under the skin of the neck. Temperature recording should be again begun 10 hours from the time of injection and be continued every 2 hours for a period of 20 hours, and longer where the temperature is rising and there is a local reaction as well. The following rules for condemning an animal have been adopted by the U. 8. B. A. I. 1. In order that a reaction produced by mallein may be consid- ered positive it should evince the characteristics of a typical reaction ; that is, a combination of thermal, local, and general reactions. 2. By a typical reaction is to be understood a gradual rising of temperature at least 3° F. and to above 104° F., the maximum temperature being sustained in the form of a single or double plateau. It should be accompanied by a local as well as a general reaction. The local reaction consists of an infiltration at the site of injection SPECIFIC VACCINES 677 forming a large, abrupt, painful swelling, with radiating lymphatics appearing as raised cords, generally attaining greatest prominence at from 18 to 21 hours after injection. The general reaction is ex- hibited by a stiffened gait, depression, loss of appetite, and acceler- ated breathing. 3. The presence of a local reaction, especially when associated with a general reaction, should be regarded as an evidence of glan- ders, even if the thermal reaction be slight or absent. 4, Animals giving an atypical reaction and those reaching a maximum temperature of 103° F. should be retested after the ex- piration of not less than 15 days. In the normal animal, a swelling occurs at the site of injection, without rise of temperature, but the swelling is much smaller and has almost disappeared at the end of 24 hours, whereas in the glandered animal the swelling persists until the third or fourth day. The U. S. Bureau of Animal Industry has recently (1914) an- nounced that the opthalmic mallein test for the diagnosis of glanders is as accurate and simpler than any other. Several drops of undiluted raw mallein (prepared for this purpose) are dropped in one eye of the suspect with a medicine dropper. The same dropper may be used for all animals in one stable. All animals show immediately some reddening and lachrimation. The true positive reaction begins in 5 hours and lasts 24 to 36 hours with swelling and gluing of the lids, and a purulent discharge which is the important point. There may be only a little pus at the inner canthus. The severity of the reaction has no relation to the extent of the disease, however. Examination of the eyes in a good light should be made 12 to 24 hours after the instillation of mallein. There may be fever occasionally, and a rise of 1.5° F is in itself a positive reaction. If, during the test, only tears and mucus are secreted it is negative. If the test is doubtful it may be repeated once within 24 hours in the same eye, but not again for 3 months. In doubtful eye tests the subcutaneous, agglutination or complement-fixation tests should also be employed. After several mallein injections glandered animals may cease to react and such have been thought cured. Rutherford has shown that these “ceased reactors” not infrequently communicate glanders to healthy animals. When the mallein reaction is not typical and doubt exists as to the presence of the disease the animal should be quarantined and the complement fixation test applied. Also when apparently normal animals react they should be given the complement fixation test since a certain percentage of such harbor parasitic nodules (not glanders) in the liver and lungs which are wholly harmless. The results of the mallein reaction were satisfactory in 89 per cent. of all tests in 6,870 cases (Mohler and Eichorn). 678 GENERAL THERAPEUTIC MEASURES Specific Vaccines. Vaccination consists in introducing, within the animal body, bacteria (or their products) of a disease—with the intention of pro- tecting the animal against the disease. The beneficent action of vaccines is produced by modifying the virulence or action of the bacteria in some way, whereby antibodies are developed in the in- oculated animal. These not only prevent the occurrence of the inocu- lated disease, but even the development of disease thereafter when introduced by natural channels. The activity of bacteria is lessened in various ways. Thus in preparing the vaccines against anthrax and blackleg the bacteria are exposed to heat. Then by inoculating the bacteria in a way, different from that in which they naturally gain entrance to the body, their activity may be diminished; ¢.g., the bacillus of blackleg is introduced under the skin or intravenously, and the tail is sometimes chosen as a site, the blood supply being poor. The vaccines of blackleg and anthrax do not prove curative if employed after the development of the disease, against which they are preventives, and often they are ineffectual if used after the ex- posure of the animal to the disease. This is not the case in antirabic inoculation, however, as the treatment proves successful after the patient has been bitten and infected by a rabid animal. So in smallpox -in the human, vaccination will modify and possibly prevent smallpox if done within four days after exposure to infection. The duration of the period of immunity conferred by vaccination differs in the case of the different vaccines. Blackleg or Quarter E'vil.—This disease is caused by B. Chauveei and is distinct from anthrax. Calves should be vaccinated when six months old and again within a year. The best time is that before the usual occurrence of the disease, and no surgery, as branding, castration, marking, dehorning or spaying, should be done before, or within two weeks after, vaccination. Vaccination is done with a powder obtained by drying and triturating a piece of affected muscle and heating. Either one or two vaccines are used, the first being the weakest and prepared by heating to 103° and the second being heated to 93° ©. and used eight days later. The Chief of the Bureau of Animal Industry, U. S. Agricult. Dep’t., Washington, D. C., supplies gratis to stock owners black leg vaccine and directions for using the same. One dose given subcutaneously is usually suff- cient to protect the animal for life against black leg, if used after the animal is 6 months old. In localities where the disease develops in younger animals the vaccine must be given at an earlier age and— in these cases—repeated the following year. GENERAL VACCINE THERAPY 679 Immunity begins in 10 to 12 days following vaccination. Anthrax.—Anthrax is the most fatal disease attacking horses, sheep, goats, mules and cattle. It occurs in the United States, more often in Mississippi and Louisiana. Vaccination was done by Pas- teur in 1880 and was the first attempt made in establishing artificial immunity in practice. Great crowds gathered to see the result of his treatment. He subjected 24 sheep, 1 goat and 5 cattle to vac- cination, and then 60 animals (including the vaccinated and unvac- cinated) were inoculated with anthrax. Forty-eight hours later the sight presented to the public beggars description. In the paddock were seen dead and dying all the unvaccinated animals, while the vaccinated ones appeared in perfect health. A small number of animals—especially sheep and goats—die from the treatment. In countries where anthrax is endemic, vaccination has reduced the mortality from 10 to 14 of 1 per cent. Statistics also show that less than 1 per cent. of vaccinated animals die of the disease. When unvaccinated herds are attacked usually 80 per cent. die. The vac- cination should be usually practiced in summer or fall, as these are the favorite seasons for development in infected regions. The pro- tection lasts from six to twelve months. Two vaccines are used. Number one, the weaker, is made by growing bacilli in a current of air at 109° F. for twenty-four days; number two is prepared in the same manner during twelve days. After growth at this temperature the cultures retain their attenuation when grown for vaccines at body heat (98.6°). The weaker number one is injected and followed in ten days by number two. Sick animals may infect a pasture for ten years, but vaccination will practically permit of pasturing on the infected land. The method of inoculation requires minute directions, which may be obtained from manufacturers of biological products. There are some other specific vaccines which are yet in the experimental stage but promise much. Thus cultures of the dead bodies of B. bronchisepticus of Ferry which are prepared by Parke, Davis & Co., will prevent canine distemper if given one month before exposure and, combined with the vaccine of staphylococci and strep- tococci, will cure the disease after it has made its appearance, accord- ing to Ferry in a personal letter to the author. The prophylactic doses, one month before exposure, consist of 3 doses at 3 day intervals of 350, 700 and 1,000 million specific organisms. Treatment after exposure, or as soon as diagnosis of distemper is made, is carried out with 175 million of the combined organisms—increasing the dose every three days by 175 million and using but half this dose for very small dogs. A streptococcus vaccine made from S. equi of strangles given in the dose of 1 to 2 ce. will apparently act as a valuable prophylactic agent in that disease. Vaccination against strangles, influenza and con- tagious pneumonia is made with a polyvalent vaccine consisting of 680 GENERAL THERAPEUTIC MEASURES staphylococci, streptococci and pneumococci which are found as sec- ondary infections in the first two diseases and may aid in preventing the more serious complications. As a prophylactic remedy for influenza, strangles or pneumonia, 3 doses of 1,000, 4,000 and 6,000 million of these combined organisms are injected at 3 to 5 day intervals (%4 this dose for colts). After exposure, or after these diseases are actually present, the dosage is about 300 million—gradually increasing according to the symptoms. A vaccine prepared from the various strains of streptococci from septicemia of calves will prevent that infection if given 24 hours after birth. Vaccines made from the dead bodies of micrococcus melitensis seem to offer protection against that disease. The matter of vaccines is still in that experimental stage when one cannot lay down positive statements concerning the indications, dosage, results and other details which are desirable in a text book. - General Vaccine Therapy. By General Vaccine Therapy we refer to the use of so-called vaccines, or bacterins, for infections generally. These vaccines are suspensions of killed bacteria in sterile salt solution. The vaccines may be used against any given infection by injecting subcutaneously small doses of the killed bacteria of the same species as that causing the infection. Thus in the case of staphylococcus infection one must know by examination of pus from the infection what variety of staphylococcus is causing the trouble and use the killed germ of that same variety of staphylococcus in order to get the best results. This treatment is based on the fact that the injections of the dead bacilli and their toxins stimulate the formation of antibodies in the serum of the patient—more particularly opsonins—and_ probably _ bac- teriolysins and agglutinins as well. These antibodies further act by enhancing phagocytosis or the power that the leucocytes have to enclose and destroy bacteria—apparently by some action on the bac- teria. The antitoxins and antisera contain antibodies, which are immediately imparted to the patient on their injection and so confer a temporary and passive immunity. The vaccines. on the contrary, act to stimulate the production of antibodies, and tend to confer an active and permanent immunity. The earliest and simplest form of vaccine treatment is autogenous and coeval with the existence of animals themselves. This consists in the licking of wounds. Absorption from the mouth and alimentary tract gives rise to specific antibodies in the serum. The wounds which heal most badly in eats and dogs are those about the head where they cannot be licked by the animals. But if, in these eases, a little wound dis- GENERAL VACCINE THERAPY 681 charge is given by the mouth, according to Duncan, then wound healing becomes good. Acting on these premises Duncan * gives to human patients with recent infected wounds a few drops, by the mouth, of the early serous or purulent discharge from the wounds, without causing infection in the throat and with reported success. In acute general infections the use of vaccines is generally not. so successful, since in them there is already enough toxin in the blood (causing fever and other symptoms) to enable the patient to produce his own antibodies and so to recover. But some systemic infections have been successfully treated with vaccines, as puerperal infection, pyemia and septicemia. Local infections are more amena- ble to vaccine therapy, but treatment should be begun early before a mixed infection occurs and before the part becomes surrounded by an impermeable barrier of pyogenic membrane or bacteria. Thus staphylococcus infection, causing boils, acne and local suppurations ; pneumococcus infection, producing empyema, cystitis, ete.; colon ba- eillus infection, inducing cystitis and other local infections, have been apparently cured by injections of vaccines. Sir A. E. Wright, of London, who has introduced the vaccine treatment of infections to the medical profession, believes that the treatment should be guided by the opsonic index. This means practically the comparison of the power of leucocytes to invest bacteria in the serum of the patient, with the same action of leucocytes on the same bacteria in the serum of the normal person or animal. Thus 100 leucocytes may ingest 500 staphylococci in the presence of healthy serum. Employing the serum of an animal with furunculosis, 100 leucocytes may take up but 250 staphylococci. The opsonic index of the healthy individual is regarded as one and that of the example quoted would be 0.5. The determination of the opsonic index is an elaborate pro- cedure and is not essential for vaccine treatment. In a general way, after the injection of vaccines, the power of phagocytosis is lessened, but, after a few days, it is increased. So that injections are commonly made every 4-10 days or so, or after any general or local symptoms—caused by the injections—have passed. In sys- temic infections it may be necessary to inject daily, to secure the formation of antibodies, and the patient may be too depressed to be stimulated by the vaccines at all. : Both antisera and vaccines may be used at the same time, as antistreptococcie serum and streptococeus vaccine. Then comes the question of the source of vaccines. They may be prepared from bacterial cultures obtained from locally infected tissue, or discharges, or from the blood of the patient (autogenous). Or stock vaccines may be used which are now sold by makers of biological laboratory *N. Y. Med. Record, Sept. 16, 1911. 682 GENERAL THERAPEUTIC MEASURES products, that is, vaccines kept on hand ready-made. The autogen- ous vaccine is theoretically preferable in securing just the strain of infecting bacteria. Now in regard to the use of vaccine in veterinary practice. While the preceding facts form the basis of vaccine therapy yet more experience with the treatment has caused us to modify our views and to ignore some of the requirements hitherto accepted as essential. Under this head we may consider the following points: 1. The necessity for isolation of the specifie organism responsible for the infection. 2. Knowledge of the exact number of killed ba- cilli which is given at a dose. 38. The avoidance of reactions. 4. The uselessness of vaccine treatment in acute infections. 1. While the discovery of the infecting organism is theoretically necessary yet as a matter of experience it has been found not to be essential for successful vaccine treatment, in many cases. In the or- dinary wound infections, for example, the infection is usually mixed or due to several common organisms. The predominating bacteria are the Staphylococcus albus, aureus and citreus, Streptococcus pyogenes of many strains, B. coli communis and some others, as B. pyocyaneus. Stock vaccines made from pus often act very favorably in wound infections. Indeed some surgeons affirm that they get better results from mixed varieties of the same species of organism, or what is called a polyvalent stock vaccine, than from a pure cul- ture of the infecting organism, or organisms, derived from the pa- tient. In urinary infections in which the B. coli communis com- monly preponderates, with also the staphylococci and other bacteria participating, in many cases a mixed vaccine containing the above organisms has often proved satisfactory. 2. An arbitrary dosage is not of so much importance as it has formerly been thought for the reason that individuals vary so in response to the action of vaccines. The writer has noted such a difference in the susceptibility of two patients with colon infection of the urinary tract that one required a hundred times greater dose of killed bacteria to produce a reaction than the other. It is feasible to inject a small amount of vaccine, without knowing the number of contained bacilli, and thereafter to regulate the dose according to the action on the patient. 3. It has been commonly taught that one should avoid marked reactions but it has been found that patients often do very well after such. This remark includes both the local reaction, consisting of swelling and heat at the site of injection, and the general reaction —which includes anorexia, depression, stiffened gait, rapid breath- ing and possibly slight fever. GENERAL VACCINE THERAPY 683 The essential point in spacing the doses consists in waiting till the local reaction has wholly subsided and the general reaction has entirely passed away before the dose is repeated (4 to 10 days). On the other hand the dose may be repeated to advantage and doubled in amount every 2 days until either a marked local, or general reac- tion, is observed. Then the dosage may gradually be increased until another reaction occurs. 4. The production of antibodies is often progressing at the highest point in acute general infections and, at other times, the leucocyte count is low and the system is so overwhelmed by toxins that there is no attempt at bodily repulse. In neither of these cases are vaccines indicated. They are, however, often prophylactic when given to patients likely to be exposed to acute infections, as in the ease of the B. bronchisepticus of canine distemper and in strep- tococeus infection of strangles, and in the case of typhoid fever in man. In some acute infections where the body is not producing all the antibodies possible vaccines may be used to stimulate their production and in these cases the leucocyte count is the best guide taken 4 hours before and 8 hours after vaccination. If the count is increased by the vaccine one may wait several days and then double the dose; if the leucocyte count is not increased then one may increase the dose on the following day. Tn acute wound infections the use of vaccines is undoubtedly of value. Indeed Jewell* affirms that vaccine treatment is as useful in acute as in chronic wound infections and that, if employed in all infected recent wounds, healing will progress in half the usual time —providing proper drainage is secured and necrotic tissue and foreign bodies are removed from the wound. Jewell finds Kinsley’s method of making vaccines most simple and satisfactory for the treatment of recent and serious infected wounds, especially those of tendons—sheaths and joints, and in punctures about the feet of horses. The vaccine is also applicable in more chronic suppurative conditions, as in fistulous withers and poll evil. Jewell has followed an arbitrary rule which is to give 2 c.c. of Kinsley’s vaccine under the skin at the side of the neck at the earliest moment of infection and to give another dose of 4 ¢.c. after 4 days. He states that not more than two doses are commonly needed for cure. If, however, a cure does not at once follow he gives, at 4 day intervals, 2 ¢.c. doses of the vaccine. Local and general reaction does not deter him from continuing the treatment until pus disappears from the wound. Kins- ley’s method is as follows: A culture medium is prepared from * Amer. Vet. Review, Oct. 1911. 684 GENERAL THERAPEUTIC MEASURES Liebig’s beef extract, 2 gms; soluble peptone, 10 gms; pure sodium chloride, 5 gms; water, 1 litre, Boil 2 or 3 minutes, test to see if it is neutral or slightly nee line. Filter through ordinary filter paper and place in 100 «ae. sterile flasks. Sterilize the flasks and contents at 212° F. for 15 minutes on 3 consecutive days. Take a sterile platinum loop and place two loopfuls of pus from a wound, not treated with vaccines, into a flask of culture medium. The flask should then be incubated at 38° ©. for 48 hours and taken out and sterilized for one hour at 60° C. in a dry sterilizer. To each 100 cc. of the product add seven drops of phenol as a preservative. The product or vaccine is placed in sterile vials holding 2 ec. and 4 ec, both the corks and vials being previously sterilized at 160° C. for one hour by dry sterilization. The corks are dipped in melted paraffine and the vials sealed with them. In making the vaccine one can judge of the activity of the culture by observing the growth on the medium and also by examining smears of the vaccine under the microscope. All that is necessary is a good growth and the exact number of killed bacteria per ¢.c. is not ascertained. In using this method one may use a box enclosing a small electric light, for an incubater, and a wash boiler with gas heating for dry or steam sterilizing. Mangan has pursued the method of Duncan in veterinary practice (Amer. Vet. Review, July, 1912). He believes that organisms grown in a culture medium have less effect in stimulating immunity than those taken directly from the patient. He uses 15: Cc. of pus, or scrapings of necrotic tissue when pus is unobtainable, taken from the wound which is to be treated. This is shaken with 180 Ce. of water in a brown bottle to dis- guise the contents. The dose of the mixture is 30 Ce. hourly for 4 doses, by the mouth, repeating the same every fourth day. Or 1 to 3 Ce. of pus (according to its density) are shaken with 20 to 30 Oc. of water and kept at room temperature for 10 hours, shaking the mixture occasionally. This mixture is then placed in a Berkefeld filter (No. 3-N- Med.). The filtrate is kept in a sterile container and from 1 to 2.5 Ce. are injected subcutaneously every four days, or as circumstances dictate. Mangan has had great success with this treatment in badly infected wounds of horses in a limited number of cases and it cer- tainly has simplicity to commend it. ‘ There are various forms of stock vaccines on the market. The H. K. Mulford Co. put out the following vaccines in glass ampuls, each representing a single dose of which part may, however, be used. 1. Colon bacilli in, 2, 4, 8, 12, 16 and 20 hundred million killed bacteria in separate ampuls. The initial dose is from 1 to 4 hundred GENERAL VACCINE THERAPY 685 million bacteria and the vaccine may be used especially in urinary infections and infections connected with the digestive tract. 2. Staphylococcus vaccine. This contains polyvalent strains of the three common species of staphylococcus from equine sources. It is prepared in about the same doses as the colon vaccine and the initial dose is from 2 to 4 hundred million. This vaccine is useful in abscess, fistule, poll evil, quittor, boils, acne, and suppurating lesions. 3. Streptococcus vaccine. ‘This is a polyvalent streptococcus vaccine prepared in the same doses as the colon vaccine and the initial dose is from 1 to 4 hundred million. It is indicated in spreading in- fections as erysipelas, cellulitis, lymphangitis, strangles, fistula and poll evil, etc. 4. A mixed vaccine, containing from 200 million to 6 billion polyvalent streptococci, mixed with from 1 to 6 billion of the three species of staphylococci, in six separate ampuls, each con- taining a single dose. This vaccine is perhaps most useful, espe- cially when the infecting organisms have not been isolated. The initial dose is 1 billion staphylococci with 200 million streptococci. It is indicated in all wound infections, fistule, poll evil, parturient infections, septic omphalitis and arthritis of the new born, strangles and cellulitis. Parke, Davis & Co. prepare vaccines for veterinary use consist- ing of 100 to 500 million killed bacteria in tablets for hypodermatic use. These represent four formule: 1. Combined varieties of staphylococci. 2. Streptococeus pyogenes. 3. Streptococcus pyog- enes with the three species of staphylococci. 4. Colon bacilli. The use of vaccines representing the specific organism of various diseases is in its infaney but the future is bright with promise, especially as prophylactic agents. The subcutaneous injection of minute and gradually increasing doses of tuberculin (1/2000 to 10 mgm.) as treatment for tubercu- losis in human medicine—now much in vogue—is an example of vaccine treatment to stimulate antibodies in the serum of the patient. Sometimes only the toxin of the tubercle bacillus is used (Koch’s old tuberculin) and sometimes a suspension of killed tubercle bacilli. Strangles is caused by a specific streptococcus (s. equi). The use of vaccines of. killed streptococci will induce immunity to the disease. The disease may also be prevented, and even cured in its early stage, by immunizing serum obtained from horses’ receiving increasing doses of the specific cocci. The latter are sometimes pro- tected against the immediate effects of the streptococci by immuniz- ing serum. This method of combining the use of a protective serum and injections of active bacteria is now being employed against rabies, anthrax and rinderpest. The immunizing serum in rinderpest is ob- 686 GENERAL THERAPEUTIC MEASURES tained from animals recovering from the disease and the protective value of their serum is much augmented if these animals are injected with blood from animals affected with a fatal form of rinderpest. In rabies the combined method of injecting active organisms and protective serum bids fair to supersede the Pasteur method of prolonged vaccination, as but one injection may suffice and the treat- ment may be given at a much later stage of incubation to protect from the disease. The immunizing serum for this method is ob- tained from sheep receiving intrajugularly and subcutaneously in- creasing doses of an emulsion of the brain of a dead, rabid rabbit. When an animal is bitten by a rabid patient the bitten animal is given subcutaneously an injection consisting of the protective serum, made as above, and an emulsion of brain from a rabid rabbit. Re- ports have been most favorable and in epidemics of rabies immuniza- tion of all animals by this method may be required in the future. Tn anthrax also the combined, or simultaneous, method is said to be yielding much better results than the double inoculation with the weak and stronger vaccine of Pasteur. AN EPITOME OF MODERN TREATMENT OF DIS- HASES OF THE DOMESTIC ANIMALS. For details concerning the use of drugs or measures recommended in this section the reader is referred to the text of this book. ABORTION. (1) Accidental, all animals; (2) Epizoétic, in cows and ewes. The complement fixation test is useful in diagnosis. Ingestion of food contaminated with infected vaginal discharge is chief source of the infection. 1. To prevent, give opium; rest, laxative diet. 2. To prevent contagious abortion all the herd should be given 14 ounce of methylene blue in capsules with balling gun twice daily (during the whole period of preg- nancy), for seven day periods, with intervals of 4 weeks when the drug is withheld. Isolate, burn fetus and membranes; disinfect premises; empty uterus, Antiseptic vaginal injections; lysol, creolin, carbolic acid, corrosive sublimate. Separate attendant and utensils; patients must not go to bull till vaginal discharge ceases; bull apt to become infected and if has balanitis is unfitted for service of healthy animals. Animals which have aborted may be wlsely fattened for market. ABSCESS. To abort, paint with tincture of iodine; or inject 10 or more m. of 2 per cent carbolic acid solution; poultices, fly blister, open with knife or actual cautery under ethylchloride spray, and cocaine. After opening, inject anti- septics, as hydrogen dioxide, and iodoform with vaseline or glycerin. To aid resolution, a blister of cantharides, vaccines. Ansczss, Corp. Open with actual cautery or knife; inject antiseptics, as carbolic acid in glycerin; Peruvian balsam. - Dress with powder, equal parts of tannic acid, borie acid, iodoform and charcoal, Acartasis. See Mange. ACNE. Prevent by avoiding rough harness and by constant cleansing with sulphur soap after removal of harness. Abort by applying pure carbolic acid. When acute, hot fomentations with borax, 3ii-Oi; dry sulphur, sulphur ointment. Fowler’s solution in chronic cases. Vaccine of acne bacilli and staphylococci in obstinate cases. AcTINOMYCOSIS. Chiefly in young cattle, affecting the jaw and tongue, soft parts of head, pharynx, larynx, skin and internal organs. Excise, curette, chisel. Apply tincture or compound solution of iodine to wound, or iodoform. Large doses of potassium iodide internally; good food and tonics. 687 688 EPITOME OF MODERN TREATMENT OF A¥rrer-Patns. Remove membranes and clots; opium, morphine. If fever and foul vag- inal discharge are present, see Puerperal Fever. Acrep ANnIMALs, destruction of. Strychnine, bullet, chloroform, prussic acid. ALoPprcia (BAaLpDNEss). If general, due to debility, give good food, iron, arsenic, bitters; and apply to skin tinct. cantharis, 31; lin. saponis, 3 viii. With scaling, use sulphur ointment, and add later to it Peruvian balsam; also groom very thoroughly. In alopecia areata, use ung. chrysarobini; or equal parts alco- hol and tine. iodi; or creolin and alcohol (1-10-20); or balsam of Peru and alcohol (1-10). AMAUROSIS. Treatment depends on cause. If owing to debility, loss of blood, trauma or quinine poisoning, give strychnine internally; and apply fly blister about temples. In amaurosis due to cerebral disease (concussion, hydatids, par- . turient apoplexy), to renal disorder, convulsions, lead poisoning, etc., treatment depends upon the causative factor. . AMMENORRHEA. See Sterility. ANEMIA. Remove primary cause. Full diet; fresh air and exercise; comfortable housing; sodium chloride and HCl; iron, arsenic, quinine, gentian, strych- nine, cupric sulphate. Cod liver oil, myrrh. Clip horses with thick coats. In pernicious form, Fowler’s solution in increasing doses till the maximum dose is reached; H., 3 ii twice daily; D., Mxxx thrice daily. Anemia, Infectious, of Horses, Asses and Mules. Treatment is purely symptomatic and is not very successful. Give anti- pyretics for fever: acetanilid 3ii and quinine sulph. gr. 40 t.id. sodium cacodylate, gr. xxx every other day subcutaneously. When fever subsides give pulv. ferri sulph 3 ii, ‘acid arsenosi gr.2, quin. sulph. gr.xxx, pulv. nucis vom. 3i, pulv. gent. 3i; M. et f. pulv. I.; give one such t.i.d. Give laxative food and daily enemata of cold water to excite peristalsis and reduce fever. ANEURISM. sf Radical cure by ligation of aneurism on either side of sac and excision of sac. When impossible, ligate proximal side. Employ Matas’ operation, in which temporary ligation on either side of sac and obliteration of orifices and sae with layers of buried chromic gut sutures are done and continuity of vessel remains intact. Continuous pressure by hands or truss; potassium iodide; ergot injections into sae in early stages; needling; acupuncture; introduction of foreign bodies into sac, as wire. Aworexta (APPETITE, loss of). Gentian, cinchona, quinine, quassia, cascarilla, calumba, taraxacum, hy- drastis, hydrastine, hydrastin, calamus, capsicum. Remove cause as carious or sharp teeth, and digestive or general disorders. DISEASES OF THE DOMESTIC ANIMALS 689 ANTHRAX. CuHarBon. In Cattle, Horses and Sheep. Treatment is chiefly preventive; bodies of dead burned or buried 7 feet deep, with hide intact. Flesh of the dead may communicate the disease, if eaten. Isolate or kill patients; infected premises and discharges must be thoroughly disinfected; avoid infected pastures; anthrax vaccine confers immunity; medical treatment is generally unsuccessful and may lead to infection of attendants or other animals and therefore inadvisable. In- ternally, calomel and salts, in cattle, and carbolic acid or creolin in enor- mous doses have aided recovery in some cases; injection of 5 per cent. carbolic acid solution at many points in anthrax carbuncles has proven curative in human patients. AputHa. See Stomatitis. Aputuous Frver. See Foot and Mouth Disease. APOPLEXY, CEREBRAL. Raise head, ice bag to poll; venesection, 4-8 quarts in horse; veratrum. Mustard paste to legs and bandage; croton oil; dark, quiet quarters; gruels and mashes, if swallowing is possible. Change in position im- portant; also use of the catheter and enemata. To aid resolution, potas- sium iodide, strychnine, massage and electricity. ApoPpLexy, PArturtIent. In Cows. Prevent by withholding grain last six weeks of pregnancy, except bran mashes; also give Epsom salts occasionally. Milk twice daily before par- turition unless animal dry. Kunsel’s treatment, successful in 90 per cent of cases. Enemata, ice to poll; bandage legs; prop patient up on sternum and change position every few hours. Catheterize and use enemata, caffeine, strychnine, alcohol, if collapse. Avoid drenches if animal unconscious; otherwise, give Epsom salts. For resulting paralysis, use potassium iodide; strychnine; blister over lumbar region; gruels and mashes during con- valescence. ApopLexy, Putmonary. See Pulmonary Congestion and Edema. ApopLexy, Sprentc. See Anthrax. Apprtire, Drpravep. See Depraved Appetite. AprretirE, Loss or. See Anorexia. ARTHRITIS. 1. In horses, traumatic and septic; 2, in new-born, due to umbilical infection; 3, may be variety of acute infection known as acute articular rheumatism; in this form use salicylic acid or salicylates; salol; externally, formalin and glycerin infections, methyl salicylate, sodium bicarbonate, iodine ointment; later stages, salicylates and potassium iodide; diet, milk for small, and gruels and mashes for large patients in acute stage. 2. When disease prevalent segregate pregnant animals. Ligate aseptically the cord of new-born at birth and sterilize the stump with tinc. iodine. As preventive, give new born within 24 hours of birth 10 c.c. antistreptococcus serum subcut. or specific vaccine. Disinfect the stall before another birth occurs. May be due to B. necro- 690 EPITOME OF MODERN TREATMENT OF phorous, staphylococcic, or other infection; see Umbilical Infection. In traumatic arthritis, cold irrigations or hot fomentations; internally, cal- omel; Priessnitz poultice; rest, splints and slings; later, blisters; red mercuric iodide; iodine. An arthritis may occur as a complication of almost any acute infection. Use formalin and glycerin in acute infec- tions. Ascaripes. See Parasites. Ascites. See Dropsy. AstHMA, Broncuiat, 1n Dogs. In attack, chloroform, amyl nitrite, morphine, fumes of stramonium leaves and saltpetre, equal parts. Chloral, bromides, belladonna, potassium iodide, inhalations, arsenic, cod liver oil, between attacks. Azoturta. See Hemoglobinuria. BALANITIS. Withdraw penis. Cleanse with lysol. If the urethra discharges, give ure- thral injection, 1 per cent. zinc sulphate and lead acetate mixed; hydrastis. Horse or bull may have to be cast and glans cleansed with lysol (2 per cent.) and touched with stick silver nitrate. Rest, cathartic and sloppy food. BarRENESS, STERILITY. Remove the immediate cause, if possible, after careful examination of body and generative organs. In the female, injection of yeast (cow) has given favorable results; one cake of fresh, compressed yeast dissolved in quart of tepid water, after standing 2 hours, is used as a vaginal injection once daily for a few days; the vagina should first be cleansed with soap and water. Aphrodisiacs, yohimbine, emmenagogues. Examine semen for spermatozoa. Exercise, reduce obesity (see Obesity). In debility, bitters, iron and good food. In female, change male; may try intrauterine in- jection of semen; dilatation of constricted os uteri. Bites. Of Snakes: Calmette’s serum injected into muscle (10 ¢.c. human dose) very successful; immediate cautery with hot iron, or free incision of the bite, and ligature above the injury on a limb must be done. Inject 1 per cent. solution of potassium permanganate or 15 grains of chlorinated lime in 2 ounces of sterile water about the bite in several places; strychnine subcutaneously in enormous doses; and adrenalin. Of Rabid Animals:—Cauterize with hot iron, nitric acid followed by saturated sodium bicarbonate solution and then by alcohol, or excise the bite, even 24 hours after injury; human patients should receive Pasteur’s anti-rabic vaccine. Of Insects:—Aromatiec spirit of ammonia, potassa; or a 10 per cent solution of sodium bicarbonate should be applied to bite; also wet dressing, clay, antiphlogistine. Briack-Quarter. Bracx-Lre. Prevention secured by vaccine; avoid infected pastures; bury dead with hide intact, 7 feet below surface in quicklime; disinfect premises; free in- DISEASES OF THE DOMESTIC ANIMALS = Loo cision of swellings (endangers spread of infection) and injection of hydrogen dioxide and other antiseptics in mild cases. Buappver, IrrrraBye. Sloppy food, linseed tea. A cathartic; rest; hot enemata. Remove smegma, calculi and other sources of irritation. Belladonna, hyoscyamus, potassium citrate, potassium acetate, spirit of nitrous ether, camphor, buchu, salol, urotropin. Brapprr, Pararysis or. Empty by sterile catheter or, in horse, pressure through rectum. Treat- ment directed to cause. BLEPHAROSPASM. Atropine. Brirepine. See Hemorrhage. Boag Spavin. See Synovitis. Rest; irrigation; hot fomentations; Priessnitz poultice; high heel shoe or slings, in bad cases; after acute stage passes, cantharidal blister. Borrs orn Furuncies. Aborted by touching with tincture of iodine, or pure carbolic acid, or painting with collodion, or 20 per cent silver nitrate solution; injection of 2 per cent carbolic solution. Puncture central opening with pure carbolic acid on toothpick and dress with carbolized vaseline; or creolin in Peruvian balsam (1-10); poultices inadvisable as they spread infection, Staphylococcic vaccine, for recurrence, internal remedies of doubtful advantage; calcium sulphide, H, gr. 20-30; D, gr. 4-3, thrice daily; or sodium sulphite, or compressed yeast cake, 1 daily to dogs in pills. In anemia, bitters, iron and arsenic. Paracentesis in severe cases; dress with Peruvian balsam and ereolin, as above, or iodoform, and avoid chafing of parts. Bots tn Horsss. Give carbon disulphide in capsules; 2 drams at hourly intervals for three doses, followed in 24 hours by a pint of linseed oil. Laxative diet of green fodder. Destroy larve in feces in spring, then give bitters, iron and arsenic for a fortnight. Broxen Kyers. Horses. For mere abrasion of skin, tie head up, to prevent the animal from lying down for 2 or 3 days, and apply white lotion on a compress continuously. When the skin is cut, shave or clip hair from surrounding skin, but use no water. Wipe away dirt with sterile gauze or remove by means of forceps and scissors. Paint wound and skin area with pure tine. iodine and use sterile silk sutures, dry, aseptic gauze and bandage. Apply splint to leg, and tie the head up. If the wound suppurates, remove stitches, apply wet dressing (2 per cent. lysol), covered with oil silk or rubber, for few days, and then Peruvian balsam, aseptic dressing and bandage. Tf the sheath of extensor tendon is opened and tendon exposed, or joint opened, place the animal in slings (with splints on leg) and treat with tincture of iodine and wet dressings (if suppuration occurs) as above exactly as for the lesser injuries. Treatment is unavailing if the tendon 692 EPITOME OF MODERN TREATMENT OF is much lacerated, the bones of the knee fractured or joint opened—except in the case of invasion of the carpo-metacarpal articulation alone. Broxgen Winp, or Haves 1n Horses. Avoid water before hard or fast work; give water in moderation between meals; give mashes of bran and oats with carron oil; also small amount of moistened hay. Arsenic for long periods; iron and nux vomica in anemia and anorexia. If heart at fault, give tine. of digitalis and stro- phanthus, 2 drams each, thrice daily. If bronchitis is a cause, see treat- ment under that disease. If there is true asthma, give spirit of chloroform, 51; in 3ii of whiskey, and remedies advised for asthma in dogs. Broncuitis, AcuTE anp CHRONIC. In acute in horses, to shorten attack give full dose of Dover’s powder; also apply hot blanket and rubber sheet and dry blanket to chest, fre- quently changed; rub mustard paste on legs and bandage. Give bran mash, roots or grass and pint of linseed oil or enema; furnish a well-ventilated box stall. If there is fever, aconite; spirit of nitrous ether; and potassium citrate; mixed in a drench, thrice daily. Employ inhalations of sodium bicarbonate (3ss to Oi) to inerease secretion; later, inhalations of oil of turpentine (3ss to Oi) to lessen secretion. In dogs with dyspnea give tablespoonful of syrup of ipecac to produce emesis; also, to increase secre- tion, ipecac; with syrup of squill; or ammonium chloride or carbonate; in chloroform water. With excessive secretion, prescribe internally oil of turpentine; or terpin hydrate or terebin; or belladonna; with tincture of nux vomica. If cough is constant and wearing, administer chloral hy- drate; or codeine; or heroin; or paregoric. In the horse, instead of ex- pectorants, use mustard, or stimulating liniments and Priessnitz poultice, to chest and throat, and inhalations; if cough is persistent, potassium iodide. Chronic Form. Treat as regards diet, fresh air, external applications and inhalations as in acute form. In dry cough, inhalations of sodium bicarbonate; with much secretion, use turpentine by inhalation. To increase secretion, ad- minister internally sodium iodide, ammonium chloride; and carbonate. To lessen secretion, oil of turpentine; or creosote. When there is heart weak- ness, digitalis or strychnine. In young or debilitated, fat in some form, as cream, olive oil; or cod liver oil; housing must be dry, warm, and well-ventilated. Other remedies include the following:—Nitrites, strophan- thus, quinine, arsenic, linseed tea, tar, benzoin, Eucalyptol, resin, balsam of Peru, balsam of tolu, myrrh, asafetida, ammoniacum, buchu, compound spirit of juniper, camphor, sulphur, sulphurous anhydride, alum, tannic acid, eserine, cantharides. Broncnitis, Verminovus. See Hoose. Broncnocet4, Tuyror EntarGemMEent In Docs. Gortre. Paint tumor repeatedly with tincture of iodine; give 1-3 grs. dessicated thyroid gland, or potassium iodide internally twice daily. Or inject into gland 10 or 15 drops of iodine tincture at intervals of three days for 10-20 injections, although there is some danger of hemorrhage or embolism. DISEASES OF THE DOMESTIC ANIMALS 693 Insert hollow needle, before attaching syringe, to avoid entering a blood vessel. Surgery, partial resection or enucleation prove most successful, but goitre usually disappears in puppies with drug treatment. Bruises. : At the onset use:—Priessnitz poultice; hot fomentations; or antiphlo- gistine or refrigerants; or astringents, as compresses, wet with white lotion, and bandaging. Or alcohol; or arnica; or hamamelis, may be used. Anodynes, as laudanum, are indicated. To aid resolution, massage with stimulating liniments; with camphor liniment; with soap liniment; with ichthyol; with olive oil. Burns. In burns of Ist degree:—Carron oil; or flour, starch, saleratus; dusted over burn. In burns of 2nd degree:—Soak sterile gauze in 1 per cent solution of picric acid, cover with absorbent cotton and bandage; reapply in 3 days and 2nd dressing may remain a week; also boric acid in 10 per cent ointment (vaseline) is harmless and efficient. In 3rd degree:—Wet dressings of saturated boric acid solution, covered with oil silk, or equal parts of Peruvian balsam and castor oil; remove dead tissue and treat as ordinary wound. In shock, stimulate with alcohol, strychnine and opium. Other agents of service include:—Tine. iodine, orthoform, aristol, boroglyc- eride, carbolic acid, iodoform, salicylic acid, chalk, menthol, oil of tur- pentine, chlorinated lime, chlorinated soda. Bursitis (inflammation of the burse of the knee, elbow, hock, stifle, fetlock, cannon bone, withers and poll. In acute cases—Cold compresses and pressure by use of flannel bandages; cold irrigations, or ice poultices; compresses wet with white lotion. In chronie conditions (Hygroma).—Aspiration and injection of iodine or carbolic acid; excision, also blisters, red mercuric iodide or cantharides. See Capped Elbow, Hock, Knee. Catcuit, Brrtary. See Gall Stones. Carcunt, Inrestinan. See Colic. Removal by high enemata, by hand in rectum or abdominal section. Pain relieved by morphine and atropine under the skin. Obstruction by sand may be overcome by physic ball. Catcuit, Renat anp VusIcat. No *medical treatment will dissolve or remove stone from the urinary tract although such may naturally escape. The medical treatment is there- fore wholly prophylactic. In Cattle and Sheep—Give sodium bicarbonate on the food, and allow an abundance of water; feeding sheep should be compelled to move thrice daily 100 yards to cause them to urinate. Ammonium and sodium benzoate, in the horse, or hydrochloric or sulphuric acid. In Dogs, lithium salts may be placed in the drinking water, or lycetol (dose, gr. 15). These agents may prevent calculus formation but no drug will dissolve calculi in the body. 694 EPITOME OF MODERN TREATMENT OF In Oxen—Work forward urethral stone by massage or do ischial ure- throtomy. In Sheep—Stroke the urethra to remove stone or sediment about meatus. Success is only secured by amputation of the appendix in many cases; lithotomy, lithotrity, or urethrotomy are often required. To relieve pain and spasm in urinary calculus, give hot enemata, and morphine, and atropine, under the skin. Canker oF Ear. See Otorrhea. Canker OF Frrr in Horszs. Throw the animal and remove by actual cautery or knife all the diseased horn of the sole and frog down to the sensitive tissue. Tight bandage above fetlock to prevent hemorrhage after animal up. Dress foot with one of following:—Salicylic acid; stick silver nitrate; formaldehyde (10 per cent); equal parts of alum, or tannic acid, and iodoform; creolin or iodine ointment (5 per cent.); equal parts of zine, copper and iron sulphates, vaseline to make paste, and enough creolin to equal 5 per cent. Then cover with tow, false sole of leather or iron, and shoe. Dress daily with one of above agents and remove any specks of canker, if present. When horn forms, dress with tar or calomel. After first days of treat- ment animal may do best at work. Capprep Ersow, Hock, KNrs. Treatment as for bursitis (see Bursitis) in acute stage; in bursitis (of perforatus) or capped hock, apply high-heeled shoe; in capped elbow, pre- vent increase of trouble by use of heel or ring pad; when large amount of induration has formed it must be excised. Cararru. See Coryza, Rhinitis, Acute. CaTarRH, CHRONIC. Symptomatic of chronic rhinitis, disease of accessory sinus, and guttural pouches, glanders, carious teeth and new growth. Isolate and test for glanders. In general give tonics as iron and arsenic, graze or feed from floor, rest from work and fresh air. Inhalations of phenol or co. tine. benzoin. Treatment mainly surgical—trephining, drainage and irrigation of maxillary sinus; hyovertebrotomy in disease of the guttural pouches. In sheep, see Oestrus Larve. CararriaL Frver. See Malignant Catarrhal Fever of Cattle. Orreprart ANEMIA. Shown by fainting (syncope). See Syncope. Crreprat Hemorruace. See Apoplexy, Cerebral. CErREBRAL HyPEREMIA. Raise head, ice bag to poll; venesection, 4-8 quarts in horse; veratrum. Mustard paste to legs and bandage. Warm covering; croton oil; dark, quiet quarters; if swallowing possible, gruels and mashes. Crresritis. See Hncephalitis. DISEASES OF THE DOMESTIC ANIMALS 695 Crrrepro-SprnaLt Mentinairts. Chiefly enzodtic and epizodtic in horses and sheep. See also Encephalitis for general treatment. Quiet, dark, cool quarters; slings for horses if animal cannot stand. Physic ball with calomel for horse, or barium chloride intravenously if the horse cannot swallow; ice to head, ergot, atropine, strychnine, cantharides; catheterize; avoid moldy food and stagnant water; secure food from other regions; dry stable; disinfect quarters after occu- pancy. Cuoxine. See Oesophagus. In Cattle: fasten wooden gag in mouth to cause salivation, swallowing and eructation, or give olive oil by the mouth and try to push foreign body upward in gullet with one hand externally, while the other is in the mouth. This failing, pass probang or do esophagotomy. Severe tym- panites demands massage of left flank or passage of stomach tube; if this ineffective, puncture most prominent point in left flank between last rib and angle of the haunch. In Horses first try apomorphine, if foreign body may not be removed by the hand in the pharynx, pass probang. In dogs and pigs apomorpbine subcut., or use expanding probang. Cuotrera. See Fowl Cholera and Hog Cholera. CHOREA. Occurs in dogs often after distemper or from indigestion or irritation of worms. In distemper, an outdoor life in the country, and diet with much fat and proteids—as bread or oatmeal with cream, strong broths, and meat once daily—are indicated; iron is also advisable, as Blaud’s pills, each gr.v. thrice daily; arsenic, as Fowler’s solution, may be prescribed in in- creasing doses until Mxxx are given daily. If movements severe, give dogs chloral, gr. v, and sodium bromide, gr. xx-xxx, thrice daily (with laudanum, TM v, if necessary). For the horse, chloral and sodium bromide, each 3ss, with fluidextract belladonna, 3i, twice daily. If due to worms or indigestion, treat these troubles; if arthritis precedes chorea, give sodium salicylate. The Priessnitz poultice may afford relief. Other remedies in- elude:—Antipyretics, hyoscyamus, cannabis, anesthetics, eserine, gelsemium, conium, valerian, zine valerianate, camphor, strychnine, quinine, asafetida. Coccrptosts. Affects liver and intestine of cattle, sheep, pigs, dogs, rabbits, fowl, ete. Due to cyst-like parasites (Coccidia) which invade the mucous mem- brane and biliary tubes. Prevent by cleanliness of premises, removal of feces, disinfection. One form of white diarrhea of chicks (C. cuniculi), and prevented by giving sterile water and food and keeping the brooder aseptic. Curative treatment unsatisfactory, give physic of oil, and dis- infectants by mouth, glycerin and ferrous sulphate, sodium thiosulphate, ereolin, sulphur. Comnurosis. Srurpy. Grp. Turn-sick In SHEEP. Prevention: Brains of sheep and cattle must never be fed to dogs; twice annually sheep dogs must be starved and given areca nut, with male 696 EPITOME OF MODERN TREATMENT OF fern, followed by a cathartic, and feces burned. Repeat this in two days. Sheep’s brains, when infested, must be burned or boiled; young sheep must not be pastured in infested regions. Treatment by trephining cysts, when they can be localized in the brain by soft spots on skull, and only in those which definitely circle about. On the range; open skull of dead affected sheep with axe, mash brain and cover it with 2 ounces tur- pentine, formalin, or sheep dip to kill embryos and keep dogs from eating brain. Meat good for market in early stage or for dogs, pelts may be sold. Cotp, Exposure To. Applications of hot blankets and mustard paste; alcohol. Coxic In THE Horsz. Place in box stall with plenty of bedding; in mild spasmodic colic, walking exercise, but in no other cases; morphine and atropine, under the skin. In mild cases of spasmodic colic, ether and aromatic spirit of am- monia (each, §ii) with spirit of chloroform, 3i, may be given; or chloral, 3i in one pint of linseed oil. Hot turpentine stupes, useful in all kinds of colic. In flatulent colic, oil of turpentine, 38s; carbolic acid. Mx; ether and spirit of chloroform (each 5i), may be prescribed together in a pint of linseed oil. A purge is indicated at the earliest moment—an aloes ball, or linseed oil, and hot enemata, in spasmodie colic; in flatulent colic, give arecoline, or barium chloride, 3 i, by mouth, or gr. xv intravenously, and enema; also puncture with trocar between last rib and angle of ilium on right, or left side (when most distension here), if tympanites is in- creasing. In colic from overloading the stomach, use the stomach tube; also barium chloride. With impaction of colon, alternate linseed oil and Glauber’s salts and give strychnine with atropine on tongue thrice daily; empty rectum by hand and use enemata as above; if all fails, try arecoline, physostigmine, or barium chloride. Colic due to enteroliths and volvulus cured by surgery. In twist of colon eserine or arecoline often relieves. Colic from invagination may be treated by elevation of hind quarters, enemata in enormous quantity, or laparotomy. Physostigmine may re- lieve but purgatives generally aggravate intussusception. Colic from new growth or stricture of gut can be alleviated by manual removal of feces twice daily and by enemata. Worm colic is cured by remedies found under Worms. Recurrent colic of influenza is treated with salicylates thrice daily and a physic ball (aloes 3iv with gr. xx of calomel), and pain is relieved as in mild spasmodic colic. Coma. Apply ice to head; use cold douche or alternate hot and cold douches; mustard paste and bandaging to legs; venesection, purgatives, aloes, eserine, arecoline, or barium, croton oil, stimulants, if collapsed—ether or am- monia, or strychnine. In diabetic coma, sodium bicarbonate, see Diabetes Mellitus. Congestion or Lunes. See Pulmonary Congestion. DISBASES OF THE DOMESTIC ANIMALS 697 ConJUNCTIVITIS. In mild form, drop in eye boric acid (2 per cent.) solution, or zine sul- phate (gr. i-3i1); also alum or cupric sulphate, or silver nitrate may be used. In muco-purulent and purulent forms, wash frequently in boric acid solution (2 per cent.), and drop in the eye argyrol, in 10 per cent. solution thrice daily after boric acid irrigation; in addition, shade both eyes and make constant applications of ice water in severe cases. In muco-purulent cases, Silver nitrate (gr. ii-3i) may be painted on everted lid (instead of argyrol) once daily, in addition to frequent boric acid irrigations. Other remedies include: cocaine, protargol, mercuric oxides, citrine ointment, ereolin, lysol, corrosive sublimate, scarification. Apply hydrargyri oxidum flavum in vaseline (gr. i-3i) at night to lids, to prevent them from ad- hering. CoNsTIPATION. Diet, exercise. Dogs.—TIwo or three compound cathartic pills or castor oil. Injections of 311 sweet oil followed by warm water, combined with massage of belly and removal of feces by finger or blunt curette from rectum, in obstinate constipation. Until constipation relieved, give nothing but broth and lean cooked meat with salt. In chronic constipation give some cooked liver and dog biscuit, with mixed diet, and Sharp and Dohme’s aromatic fluidextract cascara sagrada, 3ss, once or more daily, pill laxative comp., or phenolph- thalein; calomel occasionally. Horses :—Aloes, linseed oil, calomel, Epsom salts, arecoline, eserine, barium chloride, enemata. Cattle: —Epsom salts, calomel, linseed oil, croton oil, gamboge. Foals and Calves:—Carron oil, Gregory’s powder. Puppies:—Suppositories, soap or glycerine; small doses of castor oil (3i-iv) phenolphthalein, or calomel (gr. i). Birds:—Fowl, calomel, gr. i on food; castor oil, 31; cold enemata, tinc. rhei, rhubarb (gr. iii-vii), or senna (gr. xv-xx), in pill. Small birds, empty rectum with bulb-tipped probe and oil. Give artificial Carlsbad salts in drinking water (gr. liss to 31). Other agents include the following: Buckthorn, jalap, colocynth, elaterin, podophyllin, arecoline, ox gall, pilocarpine, veratrine, strychnine, glycerin, belladonna, hyoscyamus, sulphur, myrrh, asafetida. CoNVALESCENCE. Diet, fresh air, exercise; hydrochloric acid, pepsin, bitters, strychnine, gentian, quinine, calumba, quassia, hydrastin, iron, cod liver oil. Convurstons, Ecrampsia, EF PpILepsy. Remove cause when possible by use of cathartics or emetics in indigestion and overloaded stomach; by incising gums in teething; by anthelmintics in worms. In attack, owner may immerse puppy in warm bath; the veterinarian should give chloroform inhalation, and afterwards administer fluidextract ipecac, ™30, and enema. To prevent further attacks in dogs or horses, administer chloral with sodium bromide, thrice daily in water. When fits are recurrent, epilepsy is to be suspected. In this case, give 698 EPITOME OF MODERN TREATMENT OF sodium bromide thrice daily for considerable time; and tinc. belladonns or chloral, if bromides ineffectual. Or acetanilid with monobromated cam- phor may be prescribed in capsules thrice daily for dogs. In puerperal eclampsia of bitches, inject morphine (gr. ss-i) under the skin, or employ chloroform inhalation, and an enema of chloral in boiled starch solution. CorneaL OPACITIES. When recent, apply yellow oxide of mercury ointment to upper lid once daily (gr. i-ii to 3i), or calomel. After a year, opacity becomes permanent; do iridectomy under clear area in cornea. CorneaL Utcer. Yellow oxide of mercury, as for opacities; calomel, as for opacities; or touch ulcer with silver nitrate solution (2-4 per cent.) by means of pointed camel’s hair brush; atropine during treatment. Instil 2 per cent. solution of fluorescein to stain and locate ulcer. In suppurating keratitis, touch yellow infiltrated area of ulcer with point of knitting needle heated cherry red, after using cocaine. Corns In Foor or Horse. Remove shoe and cut away discolored area to remove pressure or exuda- tion under sole; disinfect with pure phenol or tincture of iodine; flaxseed poultices if much lameness; bar or wide-web shoe with rubber or leather. Coryza, in Horsss. Fresh air, outdoors in suitable weather; moderate covering, legs band- aged and mustard paste rubbed on them in stable. Diet:—roots, bran mashes with few ounces of linseed oil. Fluidextract belladonna (5ss every 2 hours, first day or two). Inhalations, co. tine. benzoin. Other remedies are:—Spirit of nitrous ether, aconite, Dover’s powder, opium, cocaine, adren- alin, menthol, quinine, arsenic, bismuth. . Coven. Well-ventilated quarters, warm clothing; inhalations, turpentine stupes, mustard to throat and chest, Priessnitz poultice. From catarrh in upper air-passages, see Coryza, Pharnygitis, Laryngitis. Bronchial Cough. See Bronchitis. Dry Cough—Ammonium chloride and carbonate, ipecac, Dover’s powder, sodium bicarbonate or potassium citrate. With excessive secretion—oil of turpentine; terpin hydrate or terebin, tar, belladonna, balsam of tolu, creosote, internally or by inhalation. Constant, Harassing or Reflex Cough—Opium, heroin, chloral, chloroform, phenacetin, bromides, belladonna, wild cherry, prussic acid, cannabis indica, gelsemium, camphor. Verminous Cough. See Hoose. Coven, Curonic, or Horsss. See Brenchitis, Chronic and Broken Wind. Laryngitis. Cracks or Fissures. See Fissures. CRAMPS. Atropine, belladonna. Cris Brrine. See Wind-Sucking. DISEASES OF THE DOMESTIC ANIMALS 699 Croup, or Roup. Psrupo-Memsranovs Croup. “Drputruerta.” True diphtheria is rarely seen in cats and dogs (Klebs-Leeffler bacillus). Croup common in fowl. Isolate sick and newly-bought fowl. Infected premises disinfected and whitewashed. Dead fowl burned, utensils dis- infected. Paint affected parts in throat with mixture of Dobell’s solution and hydrogen dioxide with feather. Internally, give twice daily to fowl, potassium chlorate, gr. v, and tine. of ferric chloride, Mv, in a little glycerine and water. Diarrhea relieved by 10-151 of 2 per cent. tannin solution, for fowl. Open distended sinus’s under eye. Wash eyes with borie solution (2 per cent.) Croup in Calves, Lambs and Pigs. Isolate, disinfect premises. Tine. ferric chloride and potassium chlorate, of each one-half dram thrice daily in glycerin and water. Cleanse nose with normal salt solution, and throat with saturated boric acid solution with syringe and swab. Whiskey and milk and eggs; green food and Carlsbad salts. Cours. Fomentations, cold irrigation, Priessnitz poultices, cantharidal blistering and actual cautery. Rest and high-heeled shoe. Cow Pox. See Variola. Cystitis, AcuTE anp CHRONIC. Diet:—-Large animals, barley water and mashes; small animals, milk. Rest important. In acute form, ice water or hot enemata. Purge with salts or linseed oil, large patients; with castor oil in dogs; morphine and extract of belladonna in suppository to dogs (each gr. %-4+). Large animals, spirit of nitrous ether, laudanum (each Ji), may be given together every 4 hours, sodium bicarbonate, potassium citrate or acetate. When acute symp- toms pass, prescribe one of the following: hexamethylenamine, sodium benzoate with boric acid. If urine is alkaline, use acid; when cystitis is persistent employ colon, or mixed vaccine containing the B. coli communis. In chronic form, buchu; but bladder irrigation then most valuable— silver nitrate (1-1,000), boric acid or borax (1-2 per cent), creolin (1-200). Other remedies are:—Hyoscyamus, oil of juniper, acacia, cantharides, lysol, balsam of tolu and Peru, salol, turpentine, eucalyptol, thymol, myrrh. DeEsiILity. Nourishing diet—milk, eggs, linseed and cotton seed meal. Small ani- mals—bovinine, broths, beef juice, cream; olive oil, cod liver oil, alcohol and bitters in convalescence, as quinine, strychnine, gentian, calumba, iron and arsenic in anemia. To stimulate appetite and digestion, with bitters in large animals: ginger, cardamon and coriander, fennel and funugreek. In the young and in nervous debility: calcium phosphate, glycerophos- phates and phosphorus. Decunitus. Brp Sores. Change position often or use slings; sufficient bedding and cleanliness. 700 EPITOME OF MODERN TREATMENT OF Alcohol with tannic acid (5 per cent.) to harden skin. Aristol, chlorinated lime. Drirrium. In acute inflammations and injuries of head, ice to poll, venesection, purges, as for Cerebritis. With exhaustive diseases—alcohol, strychnine. Sedatives, if severe, as morphine; chloral, bromides. Dentition Fever. In horses give soft, laxative food of mashes, green fodder with carron oil. Lance gums, if swollen, and extract milk teeth where interfere with eruption of permanent teeth. In dogs, when dentition delayed, give syr. of calcium lactophosphate. Drpravep Appetirge. Pica. Licxine Hasrtr. Cattle—Remove primary digestive disorder; generous feeding with plenty of salt; outdoor existence. Apomorphine, gr. ii hypodermatically, once a week for 3 injections. Calves and Lambs—Calves segregated; lambs isolated when not sucking; apomorphine (gr. #) subcutaneously. Foals—Keep in stable, give salt by mouth and apomorphine (gr. }-$) subcutaneously once or twice weekly. Diazetres [ysiprpus. Horses. Commonly due to musty or moldy fodder, or symptomatic of other dis- eases. Change diet, or steam, boil or kiln-dry moldy food; give physic ball; place sodium bicarbonate in drinking water to relieve thirst, 4 3 daily. Lugol’s solution or potassium iodide, most successful remedies. Contract renal vessels with ergot. Tonics: iron, nux vomica, arsenic. Restrict water to slight degree. Diasetes Mexuitus. In dogs, restrict diet to cooked meat and fat and broths; avoid liver. Sodium bicarbonate in enormous doses to prevent coma, codeine, opium, Fowler’s solution, urotropin. TDiapuracm, Spasm or. Hiccoveu. Trumps. Horses, compound spirit of ether; chloral, spirit of chloroform. Give purge and use lavage; morphine subcutaneously, with atropine; inhalation of amyl nitrite or chloroform. Fomentations over diaphragm, traction on tongue. Enema, laudanum (jiv) with sodium bromide (31), in pint of boiled starch solution. Dogs:—Emetic: Ipecac. DIARRHEA. Laxatives to remove source of irritation in all cases at the onset. Horses:—Linseed oil, castor oil or calomel. Cattle:—Magnesium sulphate, calomel, castor oil. Foals and calves:—Castor oil, 3ss; gray powder or rhubarb. Special diet and restriction of water. Rest and warm covering. Opium most useful after purge, with one of the following astringents: bismuth, chalk, catechu, kino, tannic acid, aluminum hydroxide, lead acetate, mineral DISEASES OF THE DOMESTIC ANIMALS 701 acids. Antiseptics, especially with flatulence and foul discharges; carbolic acid, ereolin, salol, naphthalene, boric acid. In Fowl:—Dry, warm housing. Boiled rice and boiled milk. Laudanum, TL i-v. White diarrhea (White Scours) of calves. From absorption of colon bacilli from dirty teats or through infected navel. Also occasionally due to B. necrophorous which may cause omphalophlebitis and arthritis and necrosis of navel. Prevention. Give colostrum and then pasteurized milk in sterile pail. Sterilize the mother’s perineum and udder before and after birth; disinfect navel with tincture of iodine; isolate sick. Disinfect the dead and stable. Give colon vaccine or horse serum from animal im- munized to polyvalent colon bacilli, as preventive. White diarrhea of new- born chicks—l. Due to B. pullorum in ovaries and eggs of infected hens. Resemble typhoid bacilli. Disease communicated from hen ta egg and from infected chicks during first four days of life. Use eggs from un- infected farms for 1 year. Keep new-born in dark place so will not pick up droppings for first four days. Keep absorptive litter on floor of brooder and food and water in un- contaminated vessels. Feeding sour milk useful. Only strongest birds at 8 to 10 weeks selected for. breeding. 2. White diarrhea of chicks due to Coccidium avium. Oocysts in droppings and live in soil 1 year. Outside of egg infected. Sterilize eggs in alcohol and use incubators for hatching. Remove newly fledged chicks to new premises. Kill infected birds. Sur- face soil removed 3 inches down and burned, disinfect the houses, roosts, premises and utensils. See also Enteritis and Dysentery. Arsenic in chronic cases. DIPHTHERIA. Diphtheria, due to Klebs-Loeffier bacillus in man, is occasionally seen in eats and dogs. They should be killed to prevent spread of the disease to man. See Croup, Pseudo-Membranous. DIsINFECTION OR STERILIZATION OF Sxry. See Wounds. Of vagina, swab out with green soap and warm water and sterile gauze and 2 per cent. lysol solution, or swab with 3 strength tincture of iodine without washing. Of uterus, irrigate with 2 per cent. lysol solution. Of horses’ feet. Remove shoe, trim horn and paint with tincture of iodine. Of eye, irrigate with 2 per cent. boric acid solution. Tears act as normal salt solution and prevent sepsis. Distocations. LuxaTIoNs. Reduce by aid of anesthetics. After reduction, fix joint by plaster of Paris splint for 10 days, and rest (in slings, if necessary). When splint not possible, apply fly blister to secure rest of joint. DistEMPER in Docs anp Cars. A vaccine prepared from B. bronchisepticus by Parke, Davis & Co. is the surest mode of prophylaxis if given a month before exposure.: 702 EPITOME OF MODERN TREATMENT OF Treatment of the disease is most successful with a vaccine composed of the former, combined with staphylococci and streptococci, and is said to cure over 80 per cent. of cases. Keep the patient constantly clean with 2 per cent. lysol baths. The kennels must be frequently washed with same and feces constantly removed to avoid secondary staphylococcie infection which is generally the cause of death. Give gr. ii. calomel night and morning at onset, till free catharsis pro- duced. For conjunctivitis, boric acid gr. x; and zinc sulphate, gr. 1; in 3i. water. If severe, 5 per cent. argyrul solution. If opacity or ulcer or cornea, see Corneal Opacities and Ulcers for treatment. Cough:—Wet flannel bandage and oil silk about neck; also syrup ipecac (Mv-xv), in syrup squill (3i), with codeine (gr. %-14), if necessary. Anorexia overcome by tine. nucis vomice (Tv-xx), with equal amount of H Cl in water after eating. Vomiting and diarrhea treated with bismuth subnitrate (gr. x-xxx) with tannigen (gr. v-x) and laudanum (MTv-x). In delirium, use chloral (gr. v-xv) with bromides (gr. xx-xxx), by mouth or rectum. With weakness and paralyses, syrup of the phosphates of iron, quinine and strychnine (3ss-il); strychnine. In anemia, reduced iron in pills. In eruption, use zine oxide ointment. Diet:—Milk, scraped beef, bovinine, beef juice, strong broths, brandy with milk and white of egg. Boiled milk in diarrhea. Patients isolated, and when recovered the premises mone be cleaned and disinfected. Country air favors recovery. Dovurtne. See Maladie du Coit. Dropsy, Carprac, Renar., Hepatic. Ascites. Increase function of heart, kidneys and liver by stimulants to these organs, and use purges and diaphoretics. Digitalis, and with squill are often combined with spirit of nitrous ether and potassium citrate or acetate. Restrict fluids; give horse physic ball; cattle: magnesium sulphate in concentrated solution; dogs: comp. jalap powder (3ss) in capsules three times daily; potassium iodide to absorb exudate. In Ascites, aspirate dogs just behind navel and bandage belly; cattle: aspirate belly midway between navel and stifle, right side. Diet. Other remedies are: Caffeine, strophanthus, oil of juniper, pilocarpine, calomel, colocynth, elaterin, sugar of milk. Withhold salt from the food when there is nephritis. See also Hydrothoras. DysENTERY. Common in new-born, especially calves, in which it is usually fatal. Prevent by antiseptic treatment of aborting and parturient cows; by isola- tion of patients and disinfection of their discharges; by segregation of cows about to calve. Treatment of little value in calves. In other ani- DISEASES OF THE DOMESTIC ANIMALS 703 mals, give purge, calomel, or magnesium sulphate, or castor oil. Ipecac is a specific, especially Dover’s powder. Irrigations of rectum with creolin, or lysol, or silver nitrate. Internally, opium with astringents, as: lead acetate, white oak, catechu, kino, tannic acid, hematoxylon. Rest; external warmth; and diet. Antiseptics: naphtalin, turpentine. Arsenic. Dysrentery, Chronic Bacterial, of Cattle. Jounen’s Disnase. Treatment is chiefly prophylactic. Isolate and destroy diseased animals. Feces burned or buried deeply. Scrub and scrape fecal contamination from barns and apply quicklime to floors and 3 per cent. formalin to walls and whitewash containing the same. Internally, salol, bismuth subnitrate, turpentine, etc., have little but temporary effect, as the disease is fatal. Dyspepsia. See Indigestion. Dyspnra. See Laryngitis, Broken Wind, Croup, Asthma. Pulmonary and Heart Diseases: Nitroglycerin, nitrites, chloroform in- halation or morphine in asthma or angina pectoris. In chest diseases, counter-irritation externally. Tracheotomy in mechanical obstruction. Treat causal disease. Ecrtampsia. See Convulsions. Ectuyma 1n Horses, Does anp SHEEP. Deep-seated pustules leading to formation of dark crusts, communicated by contact with other animals, or by brushes, harness, or objects touching the lesions. Isolate patients and secure cleanliness and proper hygienic surroundings. Give tonics, bitters and good feeding. Remove crusts with soap and water. Apply to lesions, salve containing salicylic acid (gr. xv- %i) in zine ointment; or, when animal can not lick it off, hydrargyrum ammoniatum (gr. v-3i) in zine ointment. Ulcerations are treated with Peru balsam covered with zine ointment. Disinfection of premises and utensils. EozEeMa. In Dogs—Avoid water except to remove crusts after soaking in sweet oil for 24 hours; in chronic cases, shampoo skin with green soap and water; clip hair; employ muzzle or bandaging to prevent biting and scratching and avoid external preparations which will poison if swallowed. In acute eczema, carron oil or calamine lotion. In moist stage, zine oxide ointment after the application of black wash. In weeping patches, silver nitrate solution (2-6) per cent. after cleansing with hydrogen dioxide. If suppuration, astringent dusting powders: bismuth, starch, dermatol, glycerite of tannin. With much itching, zinc ointment with creolin (5 per cent.). In Chronic Eczema with scaly, thickened skin, tar ointment, oil of cade in olive oil (1-8), ov with zine ointment (1-8). Relieve constipation by cascara sagrada; give liver occasionally and dog biscuit. Avoid fleas, dirt, friction. In acute cases, bread, soup or milk and avoid oatmeal ; starving in overfed animals, and 2-3, co. cathartic pills. Fowler’s solution in chronic form. In the Horse—In the scaly form (wrongly styled psoriasis), thorough grooming and destruction of parasites. Remove scales by soaking in olive 704 EPITOME OF MODERN TREATMENT OF oil and washing. Apply oil of cade, liquid tar or creolin in alcohol (1-10). Pustular form on mane and tail, avoid constant wetting and common soap; clip hair; and apply hydrogen dioxide and 5 per cent. silver nitrate solution and dust with tannic acid and iodoform (1-3), or use tar ointment. In eczema of heels (grease), in acute stage apply zine ointment, or white lotion, or pink ointment. In later stages, with moisture and scabs, cleanse and apply balsam of Peru, wool dressing and bandage, or tannic acid and iodoform (1-3). Exuberant granulations treated with lunar caustic or actual cautery. -In Cattle—Treatment similar to eczema in horse. With total loss of hair use liquid tar in alcohol (1-10). Other remedies include:—lIcthyol, sulphurated potash, sulphur, yellow wash, iodine, boric acid, chalk, lead acetate, zinc sulphate, white precipitate ointment, citrine ointment, carbolic . acid, salicylic acid, oleate of mercury, blue ointment, thymol, chrysarobin, hamamelis, glycerite of starch, pilocarpine, phosphorus, cod liver oil. Erepuantiasis or Horses. Chronic swelling or dermatitis with proliferation of dermal tissues and deformity of limbs following repeated lymphangitis. Bad cases with skin in folds incurable. Laxative diet, iodine ointment, fibrolysin, potassium iodine internally, exercise. Tonics, see Grease. EmpuysEMa, SUBCUTANEOUS. ) Air generally becomes absorbed without treatment. If external wound, try to prevent sepsis. If absorption delayed, strap with adhesive plaster, or make pressure by bandage. Incision and puncture undesirable as aid to sepsis. Empuysema, Putmonary. Chief lesion in “Broken Wind.” See Broken Wind. Empyema THoRACTIS., Incision into intercostal space, or better, excision of a portion of a rib for drainage, and great care in asepsis, under no (or partial) anesthesia, to facilitate expansion of lung through coughing. All adhesions to lung must be broken; bleeding is stopped by hot, normal salt solution from pitcher; drainage tube, self-retaining, of spool shape. Collargol. Irrigation of the chest not usually advisable unless discharge very fetid. In localized abscess, aspiration is suflicient sometimes. Encernaritis. Crrepriris. Mrninco CErRrEpBRitis. Quiet, dark, cool quarters. Box stalls with slings for horses, if animal unable to stand. At onset, horse, aloes ball with calomel. Cattle—Glauber’s salts with croton oil. With high fever and bounding pulse, venesection and aconite, or veratrum. In excitement and mania, morphine, chloral, bromides. Collargol. Lumbar puncture behind 5th lumbar vertebra, to re- lieve pressure and for bacterial examination of cerebro-spinal fluid. In convalescence, overcome paralysis by ergot, given with potassium iodide. ENDOCARDITIS. Acute—Prevent in acute rheumatism by giving sodium bicarbonate, and blis- tering over heart; collargol. If pulse strong, give aconite, and fasten ice-bag DISEASES OF THE DOMESTIC ANIMALS ~— 705 over heart in acute stage. Morphine, under skin to quiet dyspnea. Digitalis in irregular pulse, with nux vomica. Aconite only at onset; later, whiskey, quinine and strychnine. Nourishing, concentrated diet, absolute rest. Chronic Form. See Heart Disease. ENTERITIS. In Horse—No solid food allowed, warm water in moderation. At onset only: castor oil, laudanum and belladonna, or calomel with powdered opium in ball. To quiet peristalsis: opium or morphine every few hours. With _ high fever and strong pulse: venesection, aconite or veratrum. Turpentine stupes. Stimulants: alcohol and strychnine, in case of threatened col- lapse. In convalescence: cooked gruels, followed by scalded oats and a little green food. In Dogs—Avoid food or drink in vomiting. Calomel, followed by opium and bismuth subnitrate. In convalescence: meat juice, broths, lime water and milk. In Cattle—Glauber’s salts at onset. Externally, turpentine stupes. Laud- anum with chalk to stop diarrhea. With bloody diarrhea: laudanum with tannic acid; also ergotin under the skin. Strychnine and alcohol. Diet: boiled milk, raw eggs, flour gruel with sodium bicarbonate, cooked roots. In Calves—In those not suckling, replace milk by whey, made by adding rennet to warm milk and straining. Also by broths, rice or barley water or thin flour gruel. When milk is again given, it should be scalded and diluted with an equal part of water. Give at onset castor oil (31). Suck- lings fed every three hours, so as not to gorge. Cows giving milk containing over 44 per cent. fat may be unfit mothers. After castor oil, give bismuth subnitrate (gr. xxx.) three times daily. Brandy for debility, and paregoric (31i.) if much pain and diarrhea. ENTROPIUM. If only inturned eyelashes, they may be pulled out at intervals. The application of a finely pointed stick of caustic potash in a line parallel and near to ciliary border of under lid on the skin—once or more—may cause lid to regain its norma] shape. Otherwise remove elliptical piece of skin from eyelid and suture. At same time split margin of lid length- wise, leaving all eyelashes on outer flap, and lengthen palpebral fissure at outer canthus by cutting with scissors. , Epitepsy. See Convulsions. Eprstaxis. Nose Bieep. Inject adrenalin with syringe (1-5,000). Pack nostril with gauze soaked in same. Vinegar and water (1-2). Insufflation of powdered alum or tannic acid. Internally, ergot, hamamelis or turpentine. In purpura inject fresh horse serum; ergot, calcium chloride, gelatin. Raise head and place ice-bag on forehead. Examine for polypus, or causative general disease of brain, heart, lungs. ERYSIPELAS. In Horses on head, enzodtic. In Sheep, attacks head. Swine, as Mal Rouge or Swine Erysipelas. See Hog Cholera. 706 EPITOME OF MODERN TREATMENT OF Antistreptococcus serum, or vaccine, in horse. Generous diet with alco- hol, milk and eggs. Isolate patient and after recovery disinfect premises. Well-ventilated quarters. Antiseptic treatment of any wound present. In- jections of carbolic acid or painting affected area with pure phenol fol- lowed by alcohol. Cold compresses of saturated boric acid solution. Heavy coat of collodion about lesion to limit spread, first shaving hair. If pus forms, it must be liberated by incisions; otherwise avoid the use of knife. Quinine and tine. ferric chloride. ERYTHEMA. In Horses, “Mud Fever,” or “Scratches.” Leave hair long on pasterns; do not wash legs after driving but wait until dry and brush off dirt. Pink ointment, white lotion, calamine lotion, zine oxide and starch, lead acetate, boric acid, camphor, vaseline, hamamelis, tar. When erythema results in a dermatitis, as in Cracked Heels of horses, stimulate with stick silver nitrate, or Peruvian balsam, and use astringents, as pink ointment and white lotion. In general erythema, give purge and light diet. EXosTOSEs. In early stages treat as for Periostitis, which see. For later outgrowth of bone, iodine or cantharides. Red mercuric iodide, point firing; rest. Farntine. See Syncope. Fatse QuarRTER. Blister coronet; cantharis. Treat wound in coronary band which causes defect in wall of hoof. Apply bar shoe. Cut dead horn away. Keep dirt out of fissure by filling it with gutta percha and ammoniacum. Farcy. See Glanders. Favus, in Cats, Dogs, Horses, Cattle, Fowl. Remove crusts by soaking in sweet oil and washing in green soap and water. Sulphur ointment, or 5-10 per cent. ointments of the following: Naphthol, resorcin, thymol, tar, or creolin and salicylic acid. Sulphur and salicylic acid least toxic. Or apply tinc. of iodine and goose grease (1-8). Frver. Cold air and moderate covering, and bandaging of limbs (horses). Cold applications. Cold drinks, cold enemata. Spirit of nitrous ether with aconite and potassium citrate, especially in catarrhal conditions. With intestinal autointoxication, calomel, magnesium sulphate, castor oil. In hyperpyrexia, phenacetin, acetanilid, antipyrin. Diet. In most infec- tions, as influenza, septicemia, pneumonia, and in continued low fevers: quinine, alcohol, strychnine. In convalescence, seé Convalescence. Fissure. Of Anus—Expose with speculum and touch with pure phenol on a small swab. Iodoform in carbolized vaseline (1-8), applied daily after enema. Keep bowels loose with salts or oil. Orthoform, belladonna. Of Teats—Udder and teats thoroughly washed with soap and water and DISEASES OF THE DOMESTIC ANIMALS 707 saturated boric acid solution. Milk removed with boiled milking. tube. Touch fissure with solid silver nitrate, and coat with co. tine. of benzoin frequently, and keep covered with boric acid in vaseline (10 per cent.). Also Peru balsam or tannin, Fistruna. The following ointment has proved of surprising value. The ointment is softened by heat and injected with a sterile syringe of glass or metal, through the nozzle alone, or through a sterile rubber tube—until the fistula is filled. Every third day enough more is injected to replace that which has escaped. J. Bismuth subnitrate, 6 parts; white wax and soft paraftin, each 1 part; vaseline, 12 parts. Boil and mix and place in a sterile jar. Substitute chalk for bismuth to avoid poisoning when several ounces are required. Or inject daily with hydrogen dioxide (8 oz.) containing 2 m. of formalin, if free opening. To secure healing, inject daily—after above— carbolic acid in glycerine, or tine. of iodine; or 3 per cent. silver nitrate solution. Curette and open up sinuses. If milder measures fail, use arsenic or corrosive sublimate. If fistula refuses to heal, suspect foreign body or dead bone or tendon in wound. In fistulous withers and poll evil the use of a mixed vaccine has been very successful. Fraturence. See Tympanites, Colic, Indigestion. Freas. Pulex irritans var. Canis et Felis. In Dog and Cat—Frequent grooming and 2 per cent. oneal or lysol baths, followed by clean water and drying. Clean bedding of sawdust or shavings, frequently changed. Application of pyrethrum to dampen hair, but not in puppies and kittens. Carbolic soap. Oil of anise. Fry-Biow rn SHrEep. Dress wounds with tar, and 2 per cent. solutions of lysol or creolin. Foot-anp-Mourn Disrasp. Epizootic Kozma. In Cattle, Sheep, Swine and Goats—The only rational treatment is prophylactic. Strict quarantine of infected premises and animals, and kill all exposed and diseased animals as soon as possible. After diseased ani- mals removed, disinfect premises. Healthy animals not put in disin- fected premises for month. Burn or bury dead carcasses and infected manure. Older treatment follows: Diet: Gruels, mashes, green fodder, pulped roots. Wash mouth often with saturated boric acid, hydrogen dioxide, or potassium chlorate solution on swab. Drinking water con- stantly at animal’s command. Clean, dry bedding. Feet washed with 2 per cent. lysol or creolin. Compresses wet with white lotion containing phenol, 1 per cent., constantly kept about coronets of cattle. Tar ulso applied to feet. Carbolized vaseline is used on the teats. Milk of patients unfit for food; boil 20 minutes before feeding it to animals. Two weeks after recovery, cleansing and disinfection of premises. During enzoitic, inoculation of saliva of patient into well animal will cause a milder form of disease. 708 EPITOME OF MODERN TREATMENT OF Foot-Rot 1n SHEEP. Two forms, 1. Infectious, due to B. necrophorous. 2. Traumatic from long journeys over rough ground. Segregate newly bought animals for three weeks. Isolate patients and treat by driving (thrice weekly) through foot baths of creolin 3 per cent. or ferrous sulphate, 4 per cent., or milk of lime. Furnish clean litter and dry quarters. If severe, treat feet locally by removing dead horn, applying ointment of cresol, 5; sulphur, 10; lard, 100; or carbolic acid in glycerin (1-10), or iodine or creolin ointment (5 per cent.). Cauterize fungous growths with pure phenol and protect parts with tar. In the form orig- inating in bruises of sole, and purely traumatic, treatment consists in putting sheep on soft, dry pastures, cutting away dead horn and applying tar. Founpver. See Laminitis. Forrian Bopres in Atrmentary Tracr. See Choking. Dogs—When swallowing of foreign body is known to occur, give bread and porridge as diet. Cathartic 36 hours after ingestion, providing it is a blunt body. Remove from within anus if symptoms of straining and lodgement there. Abdominal section, if body not passed. In ruminants the treatment is purely surgical. Four. iw tue Foot or Catrrp. CanKEr. Often due to B. necrophorous. Isolate the sick. Lameness, swelling, heat and tenderness of claws with resulting abscesses, ulcers and sinuses about the heels and pasterns. Curette necrotic areas, apply Lugol’s solution, and dust with calomel. Avoid wet, dirty stables and litter. Remove all loose horn and expose sensitive diseased parts for treatment. May also apply carbolic acid in glycerin (1-10), 2 per cent. creolin or lysol, and protect with oil of cade or tar on tow and bandaging. Stimulate by applications of nitric acid, and dress with powdered alum and iodoform, or iodoform and tannin, equal parts. Fowr CuHoLrra. Treat with acid. hydrochlor. dil. (m. v.), and ferrous sulphate (gr. v), or tannic acid (gr. v), in ounce of peppermint water; dose: 3ss. hourly for fowl; 1 teaspoonful for pigeons (Friedberger). Few drops of carbolic acid solution (5 per cent.) under skin. Prevent by isolation of well in new quarters. Burn dead and discharges. Before reoccupation of premises, hen yard must have surface soil removed and replaced by new earth. Thorough cleaning, disinfection and whitewashing of hen house. FRACTURES. ; ; Examine and set under anesthetic. Large animals, slings. Plaster of Paris or starch bandages or splints. In non-union, rub ends of bone to- gether; or puncture ends of bones with drill; or suture with silver wire or chronic cat-gut. Compound fractures treated antiseptically through window in plaster of Paris splint. Fracture of jaw, rectal feeding. DISEASES OF THE DOMESTIC ANIMALS 709 Frontat anp Maxttzary Sinus, Diszasrs. See Catarrh Chronic, Oestrus Larvae. Frost Brre. ‘Rub part with snow or cold water to gradually restore warmth—tem- perature of premises low for first twenty-four hours. In mild cases, rub on turpentine liniment. With vesiculation and destruction of tissue, treat as advised in burns of second and third degree. Ichthyol, glycerite of tannin. Founevus HarmMatopss. A sarcomatous growth protruding from the orbit in cattle and sheep, less . often in horses. Enucleate the eyeball and fatten for butcher. Gait Stones. Also see Colic. No medical treatment will remove gall stones when they are once formed in the gall bladder. Gattis, Winp. See Teno-synovitis. GANGRENE. Apply antiseptics to wound, as compress wet with corrosive sublimate (1-3,000) while waiting for line of demareation to form. Remove dead tissue by knife or actual cautery. Or apply bromine with glass rod, or phenol and glycerine (1-8), to slough. In moist gangrene, apply following paste: phenol (3ss.), powd. charcoal (3ii.), glycerine (3iv.). Tonics: tine. of ferric chloride and quinine. Garrs (In Poultry). See Parasites. GarceT. See Mammitis or Mastitis. GAsTRITIS AND GastTro-Entrritis. See Indigestion, Acute. GasTRopUODENITIS. See Jaundice. Gm. See Cenurosis. GLANDERS. After isolation of suspicious cases in a cow barn, the premises previously occupied must be most carefully cleaned, including harness, utensils, stable fittings, mangers, walls, floors, and disinfected. Exposed or suspicious cases tested with mallein, or 50 to 100 c.c. of blood withdrawn from the jugular by aspirating syringe or trochar and canula. The serum which separates should be sent to a laboratory for complement fixation test. All animals reacting to this test should be removed and killed and stable cleaned and disinfected. The remaining animals should be retested by complement fixation test every 3 weeks until no more react and stable redisinfected after each test, including harness, stable utensils, fittings, mangers, walls and floors. GLANDULAR SWELLINGS. eles Into acute swellings inject phenol; or inject or apply externally iodine, to abort or hasten suppuration. Apply a mixture of icthyol and mercury and belladonna ointments and lard, equal parts, in acute and subacute cases, to aid resolution. May prevent abscess by fly blister.. When abscess Tlu EPITOME OF MODERN TREATMENT OF inevitable, hot poultice. See also mercury and mercuric oxides. Red mer- curie iodide. Internally, to avert abscess, calcium sulphide, sodium sul- phite or yeast. See Boils. GLAUCOMA. In the inflammatory form, give a smart purge and low diet. Drop eserine sulphate solution (gr. iv to 3i) in the eye thrice daily. After acute at- tack subsides, mild eserine solution (gr. 4-3i.). Iridectomy, in most cases. In chronic form, weaker eserine solution (as above) and potassium iodide internally. In traumatic form, treatment depends upon injury and is chiefly surgical. Grossitis, [pioparHic or TRAUMATIC. Swab often with saturated solution of boric acid in boiled solution of starch or barley flour. Ice water at animal’s command constantly. If much swelling and edema, scarification of the tongue superficially in many places. If difficulty in swallowing, rectal feeding or stomach tube through nose in horse. When tongue lacerated, save all of the organ possible, and suture. If caused by alkalies, use vinegar and water (1-2) on swab. Guiycosurta. See Diabetes Mellitus. Gorrre. See Bronchocele. Graprs. See Grease. Grease. Dermatitis seborrhoeica of pasterns and fetlocks in horses. In the early stage apply white lotion or pink ointment (2 per cent.). To either, with fetid discharge, carbolic acid may be added. In the later stages, with copious greasy discharge, the hair should be clipped and the parts cleansed with soap and water and lysol solution (2 per cent.). Then balsam of Peru should be applied and a dry wool dressing and bandage. For exuberant granulations, use a powder of tannic acid and iodoform (1-3). When these become large and of fungoid character (‘‘Grapes”), they must be removed by knife, scissors or white-hot shovel or firing iron and parts dressed first with gauze moistened with creolin solution (5 per cent.) and later with Peru balsam and dry dressing. In chronic swelling of the legs (Elephantiasis) with grease, give a course of tonics: iron, arsenic, bitters. : Grocetness. See Navicular Disease. Harmatemesis. See Hemorrhage. Heart Disease, CHronic. 1. Valvular Lesions, 2. Enlargement (Hypertrophy, Dilatation). 3. Myocarditis, Acute and Chronic. Myocardial Insufficiency. In Hypertrophy with violent action of the heart or palpitation, spirit of chloroform and tincture of aconite; also in palpitation, belladonna may be useful with aconite or bromides. In palpitation, with feeble heart-beat and weak sounds, give digitalis, or strophanthus, or camphor. See Nervous Palpitation of Heart. In valvular disease, with dyspnea, weakness, and other signs of failing compensation, give fluidextract of digitalis, or this with strychnine. As DISEASES OF THE DOMESTIC ANIMALS TAL substitutes for digitalis: strophanthus and caffeine. With high-tension pulse, combine nitro-glycerin with digitalis. With urgent dyspnea, give morphine. In dropsy, give H. and C. aloes and salts; D., co. jalap powder (3ss). Also digitalis with squill and potassium acetate; see Dropsy. With dilated heart and urgent dyspnea and cyanosis, venesection. Atheroma as a cause of heart disease in the old is treated with potassium iodide (H., 3i; D gr. x) thrice daily. In chronic heart disease, rest, concentrated, nutritious diet, with water between meals and not directly before exercise, are indicated. Myocardial weakness demands treatment as for valvular disease—rest, diet, stimulants, iodides. In myocardial weakness of over-fat animals, ve- duce fat. See Obesity. In chronic heart disease with infrequent pulse, digitalis is contraindi- cated; use camphor, ether, alcohol or aromatic spirit of ammonia. When there is anemia, iron is of great value. "9 Heat Srroxr. See Sun Stroke. HEMATURIA. Ice to loins. Aqua hamamelidis. Ergotin under the skin, or extract ergot internally. In hematuria of acute nephritis, after first week, give tine. eantharis (H., 3ss; D., m.i) with same amount of fluidextract of cannabis indica. In bleeding from bladder, irrigate with adrenalin with 1-5,000 solu- tion; also inject water at 120 deg. F. Urethral hemorrhage stopped by re- tention of catheter in urethra. If adrenalin stops bleeding, when injected into bladder, the source of the trouble is proven. Hematuria in young cows: This is enzodtic in low-lying pastures; change pastures, drain pastures and fertilize them with lime and phosphates. Hemocrozinuria. Azorurta In Horses. Support in slings in box stall. Empty bladder by pressure through the rectum or by catheter. Adrenalin solution intravenously or intramuscu- larly, 3ii-iv, purge with arecoline hydrobromide barium or eserine. Apply hot blankets. Venesection, and replace by saline infusion in strong animals. Allow normal salt solution to flow slowly into rectum to stimulate kidneys. In restlessness, chloral; with heart weakness, strychnine. Diet—Bran mashes, hay, roots, green food, little hay. Prevent by light feeding, when not working, or by exercise every day. Hemociosinvria In Cartier. Texas Fever. Piroplasmosis. This is caused by a protozoan parasite conveyed by ticks or their ova to cattle. Prevention—Remove ticks from cattle by brushing or scraping them off; or by spraying cattle with following mixture: Dipping cattle (15 to 30 seconds) in this mixture in concrete or wooden vats 5%4 ft. deep and 40 ft. long is most successful in eradicating ticks in large numbers of cattle. Boil white arsenic (10 Ibs.) and sal soda (25 lbs.) in 25 galls. of water for 15 minutes, or till arsenic dissolves. Cool with cold water to 140° F. and add 1 gall. pine tar gradually, while stirring. Bring the mix- ture to 500 galls. by adding sufficient water (U. S. Dept. Agic.). (12 EPITOME OF MODERN TREATMENT OF Application of dip or spray must be made every 3 weeks till ticks dis- appear, or only twice (a week apart) when cattle can be placed in tick- free pastures. Cattle must not be dipped when tired or thirsty, or allowed to drip on grass or to form pools which they may drink. They must not be driven hard or overheated for a week after treatment. By keeping cattle in spring in tick-free inclosures, three weeks in each in turn, the ticks fall off and the cattle are not reinfested. The inclosures are then disinfected by spraying with kerosene and burning. Freeing Pastures of Ticks.—Exclude animals from June to November. Cultivate or burn over pastures. Pasture rotation. Treatment. Quinine and Urea hydrochloride. Immunizing— Young stock may be immunized by inoculation with 1-3 c.c. of defibrinated blood from an immune animal. The treatment involves a mortality about 7 per cent. HEMOPHILIA. In “bleeders,” inject fresh normal horse serum or antidiphtheric serum (H., 5iv; D., 3ss) and make local application of adrenalin chloride solution or subcutaneous injection of it into bleeding part (1-10,000). Very hot or cold water, compression. Pure tannic acid. Internally, calcium chloride and gelatin. Hrmoptysis. See Hemorrhage. HEMoRRHAGE FROM Wovunns. See Wounds. Hemorruace, INTERNAL. Quiet and rest of animal and bleeding part, with lowering of blood pressure in internal hemorrhage; opium. Infusion of salt solution after ar- rest of bleeding. Gelatin and calcium chloride to coagulate blood. Adrena- lin chloride best hemostatic when can reach bleeding spot. Subcutaneous injections of fresh horse serum (antidiphtheric serum is most convenient, but fresh serum is much more effective) has recently given most successful results in persistent hemorrhages of all kinds. The serum should not be repeated at intervals longer than 10 days. That from the same species of animal as the patient is best. : The dose is about 3ss for small animals; 32-4 for large patients. Gastric (hematemesis) and Intestinal (enterorrhagia) hemorrhage, hot blankets externally; ice water internally; and bandaging of the limbs. In hematemesis, adrenalin by the mouth or Monsel’s salt in pill (H., 3i; D., gr. x) every fifteen minutes for an hour, if adrenalin is inefficient; or tannic acid; or ergot by mouth or subcutaneously. In enterorrhagia, ergot, tannic acid with opium, or Monsel’s salt, as above. Hamamelis. Diet, oil of turpentine in slight enterorrhagia. In bleeding from rectum, enemata (H., Oi; D., 32-4). Enemata to con- tain either adrenalin (3ss to Oi), Monsel’s salt, or alum, or tannic acid (§ss-Oi). In Hemoptysis, amyl nitrite by inhalation, morphine under the skin, or chloral and bromide by mouth. Inhalation of Monsel’s solution (3ss-Oii). To prevent recurrence, give calcium chloride every 2 hours, and gelatin DISEASES OF THE DOMESTIC ANIMALS 713 by mouth. Also complete rest to avert pneumonia, and aconite to lower circulation. Ice applied to chest during hemorrhage. Hemorruace, Post-Parrum. Remove fetal membranes. Intrauterine injections of hot sterile water (115-120 deg. F.). Pack uterus with aseptic gauze. Ergotin subcuta- neously. Raise hind quarters. Secure quiet by morphine under the skin, or laudanum by mouth. Tight binder about abdomen to support uterus. In laceration of uterus, tight packing of sterile gauze or suture. If severe bleeding, saline infusion. Strychnine under skin and alcohol, to avert col- lapse. Hernta. Umbilical Hernia in New-Born—Give purge, and, after 12 hours’ fast, east and return protrusion and draw 2 folds of skin together covering um- bilical ring. The folds are held together by wooden or iron clamps, with not sufficient pressure to cause the skin to slough; or by skewers intro- duced down to fascia, on either side ring, and held together by string wrapped around folds of skin, not tight enough to cause sloughing. Ventral Hernia—This occurs in any part of belly wall from injury to wall, except at natural rings. Treatment is not often required. If small, same method as for umbilical hernia may be used, or blister applied over protrusion. If strangulated or large, an open operation under strictest asepsis with’ return of contents of sac and suture of wall in layers, and overlapping of external oblique aponeurosis, may be done. Inguinal Hernia—Rare in gelding; return bowel by taxis under anesthesia if possible, and apply clamps to skin as for umbilical hernia. If taxis fails, open operation with division of the ring must be done. In the stallion, covered castration operation, followed by clamps applied to skin, or suture. Herpes, Pempuicus, Burra. A vesicular eruption at the juncture of the skin and mucous membranes, especially about mouth and genitals. Laxative in indigestion. In adult horses there may be pustulation. Tine. camphor; a mixture of equal parts, starch and zine oxide; bismuth nitrate as dusting powder; zine ointment. Hog CHoreErRa. Under this title three distinct diseases are sometimes confounded—l. Hog Cholera or Swine Fever, in U. S. and Great Britain. 2. Swine Plague or Contagious Swine Pneumonia. 3. Swine Erysipelas or Mal Rouge. Pro- tection and, to some degree, successful treatment in hog cholera is now assured by the serum of hyperimmunized hogs. In erysipelatous form immunity which lasts a year is secured by vaccination with an at- tenuated virus, but is attended with 1-2 per cent mortality. Not common in U. S. Compulsory inspection’ and control; notification; isolation of diseased, suspects and new arrivals; examination of live and dead animals in markets; burning or deep burying of dead, with thorough disinfection of premises and feces, are indicated. Much the same course for all three diseases. 714 EPITOME OF MODERN TREATMENT OF Impaction or Rumen 1n Suerp anp Cartup. To relieve tympany, puncture with trocar in most prominent point in left flank. Follow with daily doses of Glauber’s salts and linseed oil, and fluidextract of nux vomica thrice daily, and light diet of hay and mashes. Or give subcutaneously eserine (C. gr. i), and pilocarpine (C. gr. ii), in urgent cases. In less urgent cases give the salts, nux vomica and mashes as above. In acute and chronic cases, gastrotomy is indicated when medical treatment is unsuccessful, except in febrile cases and old cows; not more than two- thirds of stomach-contents should be removed (Moussu). * Incontinence or Urtne. See Urinary Retention and Incontinence. Impotence, Lyapinity To CopuLare. 1. Loss of sexual desire and power (functional).—Regulate exercise and work, by decreasing or increasing, if either excessive. Avoid excessive or early copulation. Yohimbine hydrochloride. Give tine. cantharis and fluidextract nux vomica well diluted, thrice daily. 2. Organic impotence—Growths, disease and malformations or paralysis rarely yield to drugs. 3. Premature ejaculation in male—Prevent masturbation and excessive copulation. Cold enemata and improvement in hygiene by outdoor life. InpicEstion, AcUTE, IN THR Horss. Includes Acute Gastro-intestinal Catarrh. Use stomach tube with eructations, retching, pain and distension of stomach. With flatulence, aloes ball with calomel, (3ss). With violent pain, see Colic. Lysol (3iv) in ball of use in flatulence. Follow later with powdered sodium bicarb., ginger and nux vomica thrice daily. After an acute attack give HCl and fluidextract of nux vomica to stimulate gastric functions. When diarrhea is chief feature, give calomel (3ss) in a quart of linseed oil; then prescribe opium and tannic acid (each 3ii) twice daily in ball. If dysentery with straining and mucus, enema of 1 per cent. tannic acid. Diet—Fasting first 24 hours; then gruels, green food, chopped hay. InpicEstion, AcuTE, In Carrie. AcurEr Gasrritis, RumMENITTS, Recricutitis, Omasitis, ABOMASITIS. Apply fly blister over affected stomach. In abomasitis, venesection (2-4 qts.) in severe cases. serine with pilocarpine under the skin. Daily doses of Glauber’s salts. Nux vomica in convalescence. Diet—Gruels, milk, bran mashes and little hay. InpicEstion, Curonic. Onronic Gastro-Enteritis (Horsr). Diet. Attend to condition of teeth. Powder (sodium bicarb., ginger and nux vomica) thrice daily on feed. HCl in some cases. Carlsbad salts (Ji) on feed for constipation. Also daily, soapsuds enema. With diarrhea, cop- per sulphate or lysol (3ss) daily with putrid feces. InpigEstIon, Curonic, iy Carrie. CuHronic TyMPAnNiITEs. Without diarrhea or constipation, give fluidextract nux vomica with Carls- bad salts (2 tablespoonfuls) on feed thrice daily. In constipation with mucus, add to Carlsbad salts sodium bicarb. With diarrhea, give HCl DISEASES OF THE DOMESTIC ANIMALS 715 Hoosz. Husx. Verrminous Broncuitis. Due to presence in the bronchial tubes of S. filaria in lambs; S. micrurus in calves. Lambs—Internally, oil of turpentine (3i), or oil of turpentine and tine. camphor; of each 3i once daily in milk; or creosote (3ii), benzine (3i), and water (2 qts.) in teaspoonful doses for week (Moussu) once daily. By inhalation—Calves, 3ii each of oil of turpentine and ether poured in each nostril of upturned head for one or more treatments (Read). In- halation equal parts tar, sulphur and turpentine from kettle for 25 minutes for three treatments. Intratracheal Injections—Calves, oil of turpentine (3ii), phenol (m.xx), with chloroform (3ss) for one injection. Generous feeding. Iron and bitters. Slaughter of. severe cases. Hypatips In Catttr AND SHEEP. See Coenurosis. Hyprocrerr (Dropsy) or Scrotum. Distinguish from hernia by failure to reduce and translucency. Insert hypodermic needle, and then completely empty with aspirator or fine trocar. Screw on hypodermic syringe to needle and inject pure phenol (m. x-xxx small animals; 3ii or more in large animals). In failure to cure, open scrotum, swab tunica vaginalis with pure phenol, and drain. HyprocerHarus (Drorsy or Lateran VENTRICLES). SLEEPY STAGGERS. In Horses; rare in Cattle, Dogs and Swine. Impossible to effect a cure. General care as to excess in exercise, with laxative, restricted, nutritious diet. Quiet and cool quarters. Potassium iodide. Tap lateral ventricle. Hypropuopia. See Rabies. HyproTHORAX. , Purge with concentrated solution of salts in large animals; in dogs, give co. jalap powder (3ss) in capsule. Internally, digitalis and oil of juniper, and sweet spirit of nitre thrice daily to horse. For dogs, calomel and digitalis. Also give strychnine as heart stimulant. Externally, applications of mustard paste. Pilocarpine (Friedberger) sub- cutaneously. In severe dyspnea and in large effusions, aspirate pleural cavity. Impaction or Coton in Horsz. See Colie from Impaction. Tmpaction or Omasum, Dry Morratn, Farpet Bounp, Sromacn or Grass STAGGERS. In Cattle; more rarely in Sheep and Goats. Epsom and common salt, with croton oil (C., m. xx). In non-febrile cases, two or three pails of linseed tea daily. Eserine (gr. i) with pilocarpine (gr. iii), in urgent eases given under the skin. HEnemata—Fluidextract of nux vomica thrice daily. With head symptoms, ice to poll. After free purgation, give sloppy food with plenty of salt and continue nux vomica thrice daily. 716 EPITOME OF MODERN TREATMENT OF (3i-iii) in drinking water twice daily, and nux vomica and salt on feed. When blood in feces, give fluid diet (milk and gruels) and sodium bicarb. on food. InpIGgEstion In Catyrs. Mirx Inpigestion. AsBomasar INDIGES- TION. To stop vomiting and diarrhea, use only sterile, feeding utensils and clean warm milk in hand-fed patients. In sucklings, see that mother’s milk is not over rich and feed at short intervals. Skim milk from cream- eries must be scalded. Im hand-fed, give scalded milk and pure water (half and half) mixture, warmed, till digestion good. At onset, castor oil (3Zii). Pepsin, scald utensils after feeding. Do not give meal at too early age. See also Enteritis in Calves. See that udder and perineum of mother are clean in sucklings. InpigEstion, AcuTn, In Swing. Acurp Gasrniris. Calomel and tartar emetic (each gr. v) or calomel (gr. v) and ipecac (gr. xxx) in pill with meat. To check severe diarrhea, chalk (3ii) or bismuth subnitrate (3ss) on food thrice daily. Avoid improper food, sour swill, hotel washings, etc. Give boiled milk and gruels. Clean utensils, trough and pen. Inpieestion, AcutrE. Acurre Gastrorntrertitis in Dogs. Restrict water and starve patient. Encourage vomiting by fluidextract ipecac (3i). If emesis prolonged, bismuth subnitrate and cerium oxalate in capsules. Also potassium bromide (3i), with chloral (gr. xx-xxx) in enema in boiled starch solution. Diarrhea is checked by castor oil (3i-ii), followed by bismuth (gr. xx), and salol (gr. v) with food thrice daily; or pills of lead acetate (gr. i), and camphor and powd. opium (each gr. ss), three times a day. Enemata (1 per cent. tannin) if much straining. Diet—Milk and lime water; raw scraped beef. In diarrhea, boiled milk and rice. In convalescence, tine. nux vomica thrice daily. INDURATION. Apply Priessnitz poultice. Rub into parts frequently, equal parts, ich- thyol, ung. hydrargyri and ung. belladonna, or employ a fly blister. Fibroly- sin. INFLAMMATION. Acute—General treatment with aconite, veratrum, or, in robust patients and with very urgent symptoms, venesection. Cool, airy, box stall, mod- erate body covering and bandage for limbs, in case of horses. Internally, laxatives. Calomel is an intestinal disinfectant as well. Externally, coun- ter-irritation in some form. When trouble localized, hot poultices or ice. To relieve pain and quiet animal, opium, bromides, chloral. Stimulate renal secretion: spirit of nitrous ether, potassium citrate, or nitrate. Diet. Stimulants to support the heart, strychnine. In convalescence, bitters and aleohol, HCl. In Chronic inflammation, supportive treatment. Internally, iodides to aid resolution. Externally, in local troubles, counter-irritants. DISEASES OF THE DOMESTIC ANIMALS Tale Iyriunnza in Horses. Distemper. Pinx Eye. Cool, airy box stall. Moderate covering of body and bandaging of limbs. Clean and disinfect floors, walls and feed boxes daily. Provide separate attendants for sick. Move bowels by enemata or mild laxatives. Diet —Bran mashes, boiled oats, milk, beef tea, eggs, green food. Strychnine solution dropped on tongue thrice daily and turpentine liniment rubbed daily onto limbs and belly to prevent edema. Steaming with co. tine. benzoin and application of turpentine liniment and bandage to throat, to relieve catarrh of upper air passages. With laryngitis, apply fly blister to larynx. With weak, feeble pulse, give strychnine as above and alcohol, as gin and digitalis; or strophanthus, or camphor, or caffeine, or coffee. Antipyretics rarely desirable, except in hyperpyrexia, then a few doscs of phenacetin (3ii) at 3 hours’ interval. Spirit of nitrous ether, aconite, and solution of ammonium acetate may be given. Alcohol as food and nerve sedative. With icterus, give 1 pint of linseed oil and sodium bicarbonate on food. When conjunctivitis, keratitis and iritis complicate, see these disorders. Influenza antitoxin is of great value as a prophylactic, and of less worth as a curative agent. Also diphtheria antitoxin (Immunizing Serum for Influenza, Mulford) in 20 e.c. acts as prophylactic and curative agent in first stage when temperature begins to rise. Polyvalent Antistrep- tococcic serum as a prophylactic (10 c. ¢c.) and curative agent (dose, 30 c. ce.) has yielded good results and is said to prevent purpura. Suspects showing rise of temperature and all cases of influenza should be isolated. Communication of influenza by utensils and attendants should be avoided. Disinfect premises when cases no ionger exist. For special complications, ag Pneumonia, Purpura, Enteritis, Cerebral Hyperemia, Paraplegia, Syno- vitis, Laminitis, etc., see titles of these disorders. INTERFERING. Improve the general condition and shoeing. Set shoes a little away from inner margin of feet or employ three-quarter shoe, or a shoe thin on inside web, without heel on outside. Apply an interfering strap on fetlock which is struck. IntertTRIGo. See Hrythema. Intestinat Hemorruacr. See Hemorrhage, Hnterorrhagia. Inrestinat InptgEstion AND Cararru. See Indigestion and En- teritis. InrussuscEPTion or Invacination. See Colte. Tritis. Darkened quarters. Brisk purge. Hot fomentations to eye for one-half hour thrice daily. Two or three leeches on temples, after shaving hair. 1 per cent. atropine solution four to six times daily in large animals; m. i three times daily in smaller animals; dropped in the eye. Internally, sodium salicylates and potassium iodide in acute rheumatism. Enucleation of an injured and useless eye when it threatens sympathetic iritis in the other. Iridectomy for sequels of iritis, as occluded pupil or posterior synechiae. 718 EPITOME OF MODERN TREATMENT OF JaunpbicE. Gastrro-Duopenitis. Cuoranaitis. In Docs ann Horsrs. Priessnitz poultices over liver. In dogs, calomel at outset, and bismuth subnitrate, and sodium bicarb., thrice daily in capsules. Diet, skim milk and lime water, lean meat, broths and bread. Massage over gall bladder and cold enemata. In the horse, artificial Carlsbad salts on feed thrice daily. Diet—Green fodder, pulped roots, boiled potatoes, steamed and cracked oats. An abun- dance of water. Jounn’s Diszase. See Dysentery. Krratitis. Agsscress anp Utorr or Cornea. Brisk Purges. Quinine in good doses. Extr. opii (gr. x), borie acid (gr. lv) in water (3iv), on gauze and oil silk, bandaged over eye. Atropine (gr. i-iv to 3i) dropped in eye thrice daily (stronger solution with much photophobia and lachrimation) with application to lids of yellow oxide of mercury ointment (gr. iv-3ss). Or holocain hydrochlorate (gr. ii-3i) in place of atropine. In spreading ulcer, apply very carefully pure phenol] to cocainized eye on a toothpick. Then flush eye with normal salt solution (3i i-Oi). Fine galvano-cautery may be used instead. In abscess of cornea and pus in anterior chamber, rarely advisable to incise. Kerraroma AnD. KpRAPHYLLOCELE. Horny tumor from sole or horny lamin of horse’s foot. Excision and antiseptic dressings. Recurrence is frequent. Laminitis, Horses anp Cartier. Horses—Remove shoes, thin horn on soles and place in well-bedded box stall. Let animal stand several hours at a time in hot water (frequently changed) and apply poultice in intervals. Or use cold water foot baths and ice poultices with bran. Diet. Give aconite, or bleed from jugular or toe in severe cases. Inject adrenalin, employ enemata and linseed oil, and encourage animal to lie down, or cast or sling in very acute cases. After subsidence of acute inflammation, keep heels low and toe short, apply thick, wide, rocker, bar shoes; exercise in soft, wet ground and apply blister to coronet. Neurectomy for prolonged lameness. In Cattle, same general treatment. Full dose of salts and mustard to chest at the beginning. Larynetrtis, AcuTE. Chiefly in Horses and Dogs. Locally, cold wet compress applied to throat and covered with oiled silk; or thick coat of antiphlogistine; or ice bag; or turpentine and sweet oil (equal parts); or, in severe cases, mustard paste or fly blister. Steam inhalations with 2 per cent. carbolic acid solution. Internally, tine. aconite with spirit of nitrous ether every few hours for fever. Laryngeal cough and spasm relieved by morphine or Dover’s powder (horse), and by codeine (dogs). Larynotris, Crrontc. Chiefly in Horses and Dogs. DISEASES OF THE DOMESTIC. ANIMALS é 719 Locally to throat, wet compresses, antiphlogistine or stimulating tur- pentine liniment, as above. Dogs—Application to larynx of 2 per cent. silver nitrate solution on human applicator, or inhalations of benzoin and ipecac. Also insufflation of larynx with bismuth and orthoform equal parts with powder-blower. In the horse, injections into the larynx, through the crico-tracheal liga- ment, with a hollow needle (1-2 per cent. solutions of alum or lead acetate) are most effective. Also give ammonium chloride and Carlsbad salts on the feed thrice daily. Larynaitis, MEMBRANOUS. Chiefly in Cattle, occasionally in calves, lambs, pigs, dogs and cats, see Croup. animals at onset. To throat, hot poultices frequently changed, or sinapisms. Potassium iodide thrice daily. Salts on feed, Diet—Mashes, green food and milk. Tracheotomy in threatened suffocation. In dogs and cats, give dram doses of syrup of ipecac in threatened asphyxia. Edema of the glottis occurs as result of acute laryngitis and proves rapidly fatal unless tracheotomy is done. Leucorrues. See Vaginitis, Septic Metritis, Metritis, Puerperal Fever. Symptomatic treatment with injections of 1 per cent. liq. cresolis co., 1 per cent. sol. of alum, or zine sulphate. Tron and gentian in young and under-nourished. Generally secondary to endometritis, metritis, contagious abortion, tuberculosis, granular and B. necrophorous vaginitis, ete. LEvuKeMIA. Rare in Horses, Cattle, Swine, Dogs and Cats. Generally fatal. Fowler’s solution of arsenic pushed to fullest extent—H. and C., from 3ss to Jii; D., from m.v to m.xxx, twice daily. Otherwise the treatment is as for Anemia, Pernicious. Lior, Prnrcurosts, Prrnirerasis. Horse: Hematopinus macrocephalus, Trichodectes pilosus, and T. pube- scens. Cattle: H. eurysternus, large ox-louse; H. vituli, calf-louse; and T. scalaris, small ox-louse. Sheep: T. spherocephalus. The pupiparous dipteran, Melophagus ovinus, ked or fag, also infests the skin of the sheep. Dog: 4H. piliferus, and T. latus. Cat: TT. subrostratus. Pig: H. urius. Goat: H. stenopsis and T. climax. Fowls. Goniodes dissimilis, Gonicoctes hologaster, G. gigas, Lipeurus variabilis, L. heterographus, Menopon pallidum, M. biseriatum. In large animals, apply pure kerosene night and morning for two days, then wash off with soap and water. Hair washed with vinegar for a few days to remove nits or eggs. In dogs, use tine. staphisagria, or oil of anise in sweet oil (1-10); also creolin in 5 per cent. solution; and cor- rosive sublimate in 1 per cent. solution, applied in spots and carefully 720 EPITOME OF MODERN TREATMENT OF dried, may be used. Blue ointment often applied in cattle, but not if there is dermatitis. When the animal is greatly infested and the hair is long, the hair may be clipped, but this is usually not necessary. In sheep, use dip as for scab. Fowl. Sulphur may be used in nests or dust that or pyrethrum in feathers. Apply kerosene to roosts and nests. Wash floors and sprinkle with sulphur. Whitewash walls. Keep hens out of stable to prevent hen lice from infesting horses. Isolate infested animal till cured and disinfect its former quarters. Employ general cleanliness and generous feeding. Licnen. See Hezema. Licktne Hasir. See Depraved Appetite. Lip-anp-Lee UxLcreratrion in SIEEP. Enzoétic, communicable, due to B. necrophorus. Cuts, bruises and abra- sions about mouth and limbs exciting cause. 1. Lips swell and covered with papules, pustules and scabs, nasal discharge and conjunctivitis. Nose and lip sloughs. May be similar lesions about coronets and pastern joints and foid of fetlock. Lameness ensues. Chin, cheeks, gums, roof of mouth, feet, penis, vulva, udder, may be attacked by necrotic process. 2. In lambs. Sudden swelling of lips, warty patches or fissured crusts on lip and muzzle with suppurating ulcers underneath. Necrotic areas at corner of mouth. Usually heal in time. 3. Venereal. Angry ulcerating sheath, and penis sometimes swollen and ulcerated. In ewes ulceration about perineum, vulva, and anus. 4. Foot rot. Ulceration about cleft and claw with foul, purulent dis- charge. Prevention. Isolate newly-bought animals for 2 weeks and frequent ex- amination of exposed with segregation of sick. Disinfect infected premises, remove manure and surface soil from corrals and disinfect with saturated chlorinated lime solution. Transfer healthy sheep to new pastures and bed grounds. Frost kills bacteria in pastures. Scrape off crusts and scabs with sharp stick and apply cresol, 5 parts; sulphur, 10; and lard, 100. Apply thrice weekly to ulcerations nitric acid (1 to 70), after removing scabs, and follow with ointment as above. In foot cases same treatment or drive sheep through 5% cresol solution thrice weekly. Venereal lesions clip wool and apply lysol solution (2%) daily and stimulate occasionally with nitric acid solution. On warty lips in lambs, use 5% cresol ointment and swab sore mouths with 2% potassium chlorate. Resistant cases killed. Dip sheep in 5 per cent. cresol solution before returning to flock. Lrrmiasts. See Calculi. Liver Ror iw Suerp. (Occasionally in Cattle.) Due to Distomum hepaticum and other species of Distomata or Fluke Worms, Order, Trematoda. Aspidium is of some value, treatment chiefly preventive. Give concentrated, dry food with plenty of salt. Avoid over- stocking pastures or give up pastures, if seriously infested. Sprinkle lime and salt or copperas (250 to 400 Ibs. to the acre) on pastures from May to August. Drain pastures to destroy snails, the intermediary host of DISEASES OF THE DOMESTIC ANIMALS 2a the Distomata. Diseased animals should be slaughtered and their livers burned. Keep sound sheep away from infested pastures. Disinfect manure of infested animals with quick lime. Loupine Ii. 1 SHEEP. Due to bacteria conveyed by ticks living in tall grass and damp spots. No cure; treatment wholly preventive. Isolate and kill diseased sheep. Dip the rest of fiock as for Scab. Wet pastures avoided or drained. Long grass and rushes must be avoided. Luxations. See Dislocations. LymMpHanNeitis. Crtiuritis. Inrrammarory Enema. idiopathic in Horse in hind legs. Apply from the beginning hot cem- presses of 2 per cent. lysol or creolin solution, covered with waterproof protective and bandage, to whole limb; change frequently. Give aloes, 3iv, calomel, 3i, in ball, and light diet—mashes, green food and hay. Enforce absolute rest. Tine. of aconite and spirit of nitrous ether may be used for fever every two hours, but local treatment most useful. Alcohol and milk in debilitated subjects. When acute symptoms subside, use dry band- aging, friction with oil of turpentine and sweet oil (equal parts), and gentle exercise to reduce swelling of limb. Internally, potassium iodide may be given to hasten resolution, together with laxatives to remove water from the system, as artificial Carlsbad salts on the food. Lymeuanaitis, Mycotic or Epizoétic, of Horses. Excise or remove limited area of diseased lymphatics with actual cautery and knife. Incise, curette and cauterize abscess cavities with Paquelin cautery. Isolate diseased animals and disinfect harness, contaminated ob- jects and premises contaminated by affected animals. Lymeuatics, Inrramep. See Glandular Enlargements. Maccots From Frysrow. Apply kerosene, or turpentine and oil. Other antiseptics. Marapre pu Corr. Dovurinr in Starrtions anp Marrs CavsEpd BY Trypanosoma EQurrEerpuUM. Prevention. Kill the diseased mares, and kill or castrate the diseased stallions. Kill, or quarantine for three months the exposed stallions. Quarantine and inspect frequently the exposed mares. Medical treatment is rarely advisable in the United States. Avoid sexual excitement or copulation of patients. Seen in stallions and mares. 1. Vesicles, ulcers and swelling of penis, urethral discharge and swelling of inguinal glands, edema of belly and legs, and often orchitis. Mares, vesicles, papules and ulcers about vulva, con- gestion and vaginal discharge. Animal acts as if in heat. White, puckered scars left on vulva. 2. After 2 months to year weakness, emaciation and paraplegia occur. Gait is swaying, there are large urticarial swellings, pruritus, and discharge from nose and eyes. Does not occur in geldings. Treatment. Kill diseased mares, castrate infected stallions, castrate or isolate exposed stallions and frequent inspection of exposed mares. Cas- T22 EPITOME OF MODERN TREATMENT OF tration cures if done before nervous symptoms appear. Copulation starts up disease in mares when apparently well. The U. S. Gov’t enforces above treatment. Where medical treatment allowable may use antiseptic irriga- tions of penis and vagina. Stallion, 2 per cent. lysol or creolin, or 1-2,000 solution of corrosive. In mares, injections of 2 per cent. lysol. Also apply local application of 5 per cent. argyrol solution after cleansing as abeve. Great swelling is reduced by constant hot fomentation (saturated boric acid solution), or by incisions. After acute conditions subside, may inject sheath and vagina with 1 per cent. lead acetate or zine sulphate solution, and use black wash externally. Treat ulcerations with 10 per cent. silver nitrate solution. In the beginning, sloppy food, mashes, green food and milk may be given. Iron and arsenic are indicated. With the appearance of emaciation, urticaria or paresis, give twice daily under the skin for 5 days sodium cacodylate (gr. x), followed by an intermission of a week. Also give strychnine thrice daily. The treatment must be persisted in for months; three years should elapse before a stallion is safe for service. Vesicular Exanthema may be treated locally, as advised for Dourine, but often disappears spontaneously. Marienantr Catrarruat Frver iv Carrie. Prophylaxis: clean, dry, well ventilated stables and removal of infected soil under barns. Isolate sick and disinfect discharges. Give creolin (3ii) twice daily in a pint of milk. Irrigate nose with 2 per cent. lysol solution; eyes with saturated boric acid solution. Soft diet with milk and gruels. Enemata or laxatives. Matrienpers AnD SariEenpers in Tie Horse. Squamous Kozmma. See Hezema. Attacks flexures of hock and knee. Soak over night in sweet oil. Wash next morning with green soap and warm water, to remove scales. Apply oil of cade, liquid tar, or creolin, in alcohol (1-10). Carlsbad salts on the food. Regular exercise. Arsenic and iron. Marnurtrition. See Debility. Marta Fever. In goats and sheep, occasionally solipeds, ruminants, dogs, cats, rabbits, rats, fowl and duck. Has occurred in this country in Mississippi valley region. Infection through milk and urine and by copulation with infected animal. Infection also by food and bedding contaminated with urine. Possible that dust and mosquitoes convey the infection. In man infection is gained by ingestion of infected goat’s milk, and vegetables contaminated by animals. Also by direct exposure to infected animals. Abortion in fourth month in goats and sheep and failure of lactation with lameness, vaginal discharge and conjunctivitis. Orchitis and lameness in rams and goats. Absence of symptoms in other animals. Causes severe and pro- longed febrile illness in man. Diagnosis by agglutination test of serum of infected animal. Prophylaxis only of importance. A vaccine is still in the experimental stage. Animals showing symptoms should be killed and premises thor- DISEASES OF THE DOMESTIC ANIMALS 723 oughly disinfected. All suspected animals must be tested by the agglutina- tion test. Those reacting should be quarantined until test negative. Flesh of killed animals may be used for food under supervision. Milk from infected ani- mals must be pasteurised before use. Herd restocked with immune progeny of infected animals, or from uninfected regions. Entire males in infected regions should be tested before copulation is permitted, if they react they should be castrated and quarantined until the test is negative. The removal of animals from infected districts must not be permitted. Infected solipeds should be isolated from other animals, although they may be worked. Mammitis. Masrirris. GARGeErT. At onset, milk every hour and give frequent massage of udder with full dose of Glauber’s salts and common salts. In no case of mastitis is the milk fit for human consumption, it may be boiled for animals, in mild cases, or else boiled and thrown away. Restrict food and water. Attend to abrasions of teats. (See Teats, Fissured, etc.) Also, to abort, either use constant hot fomentations or ice bag, and support udder by band- age and wide band about body. The surgeon should cleanse udder thor- oughly and irrigate each quarter of the udder with warm 3 per cent. borax solution through sterile milking tube, in parenchymatous form. Aiter gentle manipulation, draw off fluid in 15 minutes. If suppuration threatens, apply mercury binodide ointment (10 per cent.). With inter- stitial form and surrounding edema, puncture swelling in points by actual cautery, avoiding the veins. Then apply boric. acid ointment (10 per cent.). For suppuration of udder, incise and drain, and, if severe, amputate in part or altogether. In chronic suppuration, the pus poisons the milk; remove teats with scissors for drainage; fatten and kill. Separate milkers in mammitis to avoid infection of sound cows. To prevent mammitis, cleanliness of animal and premises; use of proper stalls, so that teats are not stepped upon; immediate treatment of abrasions of the teats. Mammitis, Conractous Srreprococcus. Curdling of milk on standing, later hard nodule above teat and milk thin and blue. Segregate diseased cows and provide separate milker for them. Cleanliness of udder and compelling milkers to wash hands after each cow is milked will prevent spread of the disease. After isolation of sick, disinfect premises and keep newly-bought cows away from exposed cows and infected stable for a month. Treat mild cases with warm injection of 3 per cent. boric acid solution in teats. In more severe cases use one per cent. sodium fluoride. Chronic mastitis due to tuberculosis, actinomycosis, botryomycosis. Also mastitis caused by colon bacilli, B. necrophorous and staphylococci. Maner. Acartasts. Scasres. Itrcu. Soar. In the Horse—Sarcoptes scabei, beginning on head, neck and shoulders. Also Dermatodectes communis infesting inner thighs, root of mane and tail, sheath; and Symbiotes equi, seen on feet and pasterns. Clip hair, apply cottonseed oi] with 5 per cent. creolin over night. Remove scabs 724 EPITOME OF MODERN TREATMENT OF with green soap and water next morning. Rub in one of the following remedies with brush and, when rubbed off by animal, reapply daily for a week. Then wash off and after a few days, repeat the treatment two or three times. Use liquid tar and sulphur, each 3i; soft soap and alcohol, each 3ii; or creolin and soft soap each 3i; alcohol 3viii (Frohner). Also balsam of Peru and sulphur ointment, (1-7), 3 per cent. lysol or creolin solutions. Ointments in localized mange. In dermodectic and symbiotic mange, milder remedies—Peruvian balsam, carbolic soap, or ereolin and glycerin (1-10). In Dogs—Follicular mange, caused by Dermodex foliculorum, var. canis, attacks head, neck and limbs, invading hair follicles and sebaceous glands; very difficult of cure. Sarcoptic mange, caused by Sarcoptes squamiferus, attacks head, chest, belly, elbows, root of tail and claws, and spreads to whole body. Readily cured. Isolate to prevent spread to man or dogs. Apply muzzle and clip hair over lesions. In sarcoptic mange, Peru balsam and sulphur ointment (3i-3i), or 1 part each, liquid tar and soft soap, and 8 parts of alcohol. For follicular mange, weeks or months are required and result is doubtful. Shave hair from affected area. Give bath of potassa sulphurata (3 of 1 per cent.) for 15 minutes; follow by friction with pure Peru balsam. Creolin in 2 per cent. bath, followed by friction with equal parts creolin and alcohol, once or twice daily. Squeeze pus from all pustules. Try staphylococcus vaccine for suppuration. MastTurRBATION. ONANISM. Dogs and Rams; Bulls and Stallions. Regular exercise or work, and light diet. Punishment; moderate amount of copulation. Castration, if habit incurable. Merecrims. See Vertigo, Blind Staggers. Metanosis. Mertanoric Sarcoma. Seen chiefly in grey horses. Remove by knife; recurrence rather the rule. Menineitis. See Encephalitis and Cerebro-Spinal Meningitis. Merritis, Acctz anp Curonic. See also Puerperal Fever or Septic Metritis. Examine uterus with speculum. Treatment purely local and takes time and money. Animal may recover spontaneously at pasture. Otherwise, irrigate with 2 per cent. lysol solution daily. Apply Churchill’s tine. iodine to lacerations of cervix and eroded os; or light application of actual cautery. Also dilate cervix and curette uterus, followed by loose packing with iodo- form gauze for a few days. Afterwards daily lysol irrigations. Mouscutar RuEuMATISM. Warm covering. Give a purge: H., physic ball, C., Glauber’s salts, D., two compound cathartic pills. Rest of affected parts. Give sodium salicy- late and potassium iodide in combination, to dogs in capsules, large animals in solution, thrice daily. Or the iodide may be reserved for subacute and chronic cases. Externally, rub into affected part methyl salicylate or chloroform liniment. Heat is also very efficacious; hot wet blankets cov- ered with rubber sheet and dry blanket, or apply dry blanket and iron over it with hot flat iron. Puncture of affected muscles with sterile DISEASES OF THE DOMESTIC ANIMALS 725 needles, or injection of sterile water, sometimes effective. Shoulder lame- ness—Inject veratrine into muscle (H., gr. ¢ to 13 in alcohol, m.xxx), followed by walking exercise. Chronic cases—Tonic treatment; cod liver oil; massage with liniment, moderate exercise and attention to hygiene. Myareta, Myosiris. See Muscular Rheumatism. _ Myocarpitis. See Heart Disease. Nagana or Tsetse—F ty Disease. Horses, Cattle and Dogs. Caused by Trypanosoma Brucei conveyed by Glossina morsitans or tsetse fly. Arsenical preparations as atoxyl, sodium cacodylate most useful. Nasar Cararru or Rurnitis, Curonic. Greer (In the Horse}. Use cleansing, antiseptic, astringent solutions by atomizer, or fountain syringe and rubber tube in nostrils, by trephining chambers above, or by stomach tube introduced through posterior nasal openings. Cleansing and antiseptic solution, sodium bicarbonate and biborate (of each, 3iiss to Oi), with 3i tine. iodine. Dobell’s solution. Astringents, cupric sulphate or alum (4 per cent); tannic acid or zinc sulphate (4 per cent. solution). Solutions changed each two weeks. Outdoor life, feeding off ground; good food; bitters and iron. Isolation, unless glanders can be surely excluded. Gleet very often secondary and due to ulceration of pituitary membrane, carious teeth, facial sinusitis, glanders, catarrh of guttural pouches, tumors, parasites, abscess, etc. Employ a rhinoscope and inject mallein or use complement fixation or agglutination test. Discharge from one nostril is not usually simple gleet. Naver Disrase. See Umbilical Infection. Navicutar Disrase (in Horse). In acute cases remove shoes and use foot bath of hot or cold water, for hours at a time, with flaxseed poultice each night. Give green food, mashes and hay. Prescribe a physic ball. When heat and tenderness in foot subsides, apply fly blister about coronet after clipping hair. Shoe with rubber pad (shoe thick at heels and thin at toe), after a few weeks of rest. If lameness persists, plantar neurectomy may be done in animals with good feet and limbs. Necropacitiosis. See Lnp-and-Leg Ulceration in Sheep. Nepuritis, Acurr. (In Horses, Cattle and Dogs.) Prophylaxis—In acute infections, avoid draughts, and use warm covering _for patients; enforce rest, secure activity of bowels and skin and give abstemious diet. In acute nephritis, withhold all food and drink for the first few days. Diet—D., milk; large animals, mashes, green food and milk, after starving period. Give aloes ball (horse), Glauber’s salts to cattle; co. jalap powder to dogs (3i) at onset. Hot blankets over whole body and mustard paste over loins. Pilocarpine under skin in a single dose, with strychnine. With marked hematuria, fluidextract ergot thrice daily. In later stages, as a diuretic, tinc. digitalis with potassium citrate. In convalescence, tine. ferric chloride. Uremia is combated by cathartics 126 EPITOME OF MODERN TREATMENT OF and venesection; and convulsions by chloral hydrate, chloroform inhalation and morphine under the skin. Nepuritis, Curonic. (All Animals.) Tine. chloride of iron and sweet spirit of nitre thrice daily. In dropsy, see Dropsy. Withhold common salt from the food. Protect animal from exposure to cold. In dogs, chiefly milk diet. Im Uremia, treat as recom- mended for Acute Nephritis. Nepuritis, Suppuratrive. Pypro-Nepuritis. Pyexiris. Seen in all animals; often in Cows and Mares following septic parturient states. In Cattle it is often best to fatten and slaughter. Secure drinking of large amounts ot water by placing an abundance of salt upon food. In early stage, spirit of nitrous ether and potassium acetate thrice daily. Hexamethylenamine, best remedy in all stages of disease. When urine alkaline, give sodium benzoate to large animals; to small animals, give urotropin with salol and boric acid, as urinary antiseptics. In chronic conditions in dogs, give sandalwood oil in capsules (m.x). In large animals in chronic pyelitis, give fluidextract buchu. Accompanying anemia is treated with strychnine and tine. of ferric chloride on the tongue. Isolation of patients is desirable to prevent infection of parturient animals. Nervous Parprration or THE Heart. Seen in Horses and Dogs from over-exertion, indigestion, ‘nervousness.” In severe cases, morphine under the skin. Also spirit of chloroform in less urgent cases. Or chloral and potassium bromide may be given. In asthenia and over-exertion, especially with irregular pulse, prescribe tine. digitalis with tine. aconite thrice daily. In anemia, give ferrous sulphate and nux vomica to horses. Indigestion, as a cause, demands a physic and restriction of food. NetrrierasH. Surreir. Hives. See Urticaria. Nervrareia. NeEvritis. Give laxatives, especially castor oil. In debility and anemia, give strych- nine in increasing doses; also iron, arsenic and phosphorus in combination (in pill or otherwise). Locally, freeze nerve with ethyl chloride spray, or apply Priessnitz poultice, or menthol, or blister over root of, or along course of, nerve, or nerve-stretching or cutting. Potassium iodide in rheu- matic cases. To simply relieve pain, morphine injected locally under the skin, antipyrin, internally. Aconitine locally, gelsemium internally. In wound or injury, apply antiseptic poultice. In asthenia, see Debility. Nympuomanta. See Sexual Hacitement. OBESITY. Diet the chief remedy. In dogs, tablets of dessicated thyroid gland, (gr. v. each) thrice daily. Restlessness and palpitation show overdosage; other- wise increase above dose. Potassium iodide, after meals thrice daily. Daily laxative and exercise. DISEASES OF THE DOMESTIC ANIMALS LOH OxsopuAcus. (Dilation and Obstruction. Inflammation and Pa- ralysis. ) In dilatation, feed frequently with small amounts of concentrated and soit food. Resect esophageal pouch. In obstruction—If foreign body, give soft food. In dogs, pass a bristle probang or coin catcher; in horses, use stomach tube and stilet and inject water. Or expose gullet and ligate (temporarily) gullet about stomach ~ tube, above obstruction, and forcibly inject water. Oesophagotomy. Apo- morphine subcutaneously in dogs, but dangerous. Inflammation of esophagus due to irritants—Give linseed gruel with 1 per cent. boric acid, cold milk. Externally, Priessnitz poultice. Later, rub externally with equal parts oil of turpentine and sweet oil. In paralysis, apply fly blister, give strychnine internally, pass sound. Orstrus Eaur. See Bots. Oxrstrus Larvar in Accessory Sinus’s or Surrp. Fatse Gin or Sturpy. GapFiy VERTIGO. Treatment is unsatisfactory. Tar on nose of sheep to prevent entrance of gadflies. Impossible to insufflate or inject agents to expel larvae. LHarly slaughter often most satisfactory. Trephine either side of medium line between eyes and remove with forceps and irrigation (2 per cent. lysol), or by injection of a little benzine and water (Moussu). OmpuaLoputesitis. See Umbilical Infection. Opacity or Corns. See Corneal Opacities. Open JoInT. In recent wound, shave adjacent parts, wash them carefully with soap and water and 70 per cent. alcohol. Douche wound with force for 15 to 30 minutes, using corrosive sublimate (1-2,000), or lysol (2 per cent.), or other antiseptic solution. Often best to simply cover puncture with sterile gauze, shave hair away without wetting skin, wash skin with gasoline, and then swab wound and surrounding skin with tincture iodine. Then suture and close wound with iodoform collodium (1-10), sterile gauze and bandage, if latter possible. If suturing impossible, apply fly blisters about joint. If bandaging is not feasible, apply constant cold antiseptic irrigation to the joint for next few days. Try Bier’s hyperemia. Remove shoes from horses and place in slings. Prescribe purge. Whenever possible, place over bandage a firm plaster of paris, wood or tin splint. Orrn Jornt, [yrEcrep. Open so as to irrigate and drain thoroughly. Bandage and dress with sterile gauze daily, after thorough irrigation with antiseptic fluid, as above. Fixation by splint, if possible. (Bier’s hyperemia.) Repeated blisters in large animals may aid. Recovery only occurs with stiffness, or anchylosis, in most cases. Treatment in large animals of open, infected joints having much motion is not usually profitable. Laxative diet—H. and C., mashes, gruels, roots and green food. Dogs, gruels and milk, during acute stage. * 728 EPITOME OF MULERN TREATMENT OF OpuTHatmiaA. (Prrioptc 1n Horszs.) Confine in dark quarters. Foment eye with hot boric acid (2 per cent.) solution for one-half hour at time, thrice daily. Drop 1 per cent. solution of atropine sulphate in eye four to six times daily. Internally, give physic ball, and sweet spirit of nitre and Sodium salicylate (3ii), thrice daily, and sloppy or green food. Iron and gentian during convalescence. OPHTHALMIA, Stmpte. See Conjunctivitis. Orcuitis or Eprprpymo-Orcuiris. Seen in males owing to infections, trauma and tuberculosis. Support and compress testicle by thick pad and bandage. In acute stage, apply ice-bag to testicle, or hot fiaxseed poultices, or lead and opium lotion, or antiphlogistine in a thick coating. Give smart purge and restrict diet to soft food. After acute symptoms subside, touch scrotum lightly in 10 or 12 points with Paquelin cautery every few days and cover with compress of cotton and bandage. Also, to aid resolution, ointments of guaiacol (10 per cent.), or ichthyol (20 per cent.), or mercury may be rubbed in daily. Aspiration of fluid in tunica vaginalis advisable if done aseptically. In hematoma resulting in abscess, incise tunica vaginalis and stitch it to edge of skin incision; wipe out with pure phenol and drain sac. Tuberculous form associated with tuberculosis of kidneys, bladder and prostate (examine per rectum); if only testicle affected, castrate. OsTEOMALACTA. In enzodtic cases treatment is unavailing. Treatment must be under- taken early. Food from other localities best. Beef meal, peas, beans, oats, bran, linseed or cotton seed meal, green clover or alfalfa are among the best foods. Change water and pasture. Apply phosphatic fertilizers on pastures or meadows. Mix equally bone meal and precipitated lime phos- phate, give C. 3i; Sh. and Sw., 3i-ii. To this add equal parts ferrous sulphate and nux vomica; and give cattle, of the latter mixture, 3ii; Sh. and Sw. gr.xx on feed twice daily (Moussu). . Adrenalin. Ostitis. See Spavin, Ring Bone. Sometimes tuberculous. In acute stage, rest of part and cold application, as cold swab or continuous irrigation, or ice bag. Physic, soft and re stricted diet. In subacute and chronic stages, firing, blistering and rest. Ororruza (In Dogs). Canker or tHE Ear. Orrris Exrerwa. In the acute stage, with much pain, give frequent and long-continued injections of hot solution of saturated boric acid, or 3 per cent. carbolic, or 1-8,000 corrosive sublimate. Use fountain syringe and avoid any forcible injection, allowing water to flow in slowly. Carbolic solution most anes- thetic. Dry out canal after syringing and blow in dry pure boric acid. It is well to keep loose absorbent cotton plug in ear during treatment. If there is much swelling of the canal, scarify it. In the acute stage, give two to three co. cathartic pills. Diet of milk, broths and bread. When the acute stage subsides, use astringent injections, as 2 to 4 per cent. solutions of lead acetate, zine or copper sulphate, or silver nitrate. To avoid pain of injection one may blow in a little powdered cocaine first. Diachylon ointment is also useful in chronic form, and boric acid in alco- DISEASES OF THE DOMESTIC ANIMALS 729 hol (1-20). The occurrence of granulations in the canal calls for use of stick nitrate after cocainization. Over-Reacu, Wounp or Coronet From, (In Horse). Treat wound with continuous wet compress of 2 per cent. lysol for a few days, then with Peru balsam and bandage. ‘To avoid: protect coronet with pad, and rasp off toes of hind feet, setting shoes back and rounding off toes of hind shoes. OxyuripEs. See Parasites. Parprration. See Nervous Palpitation of Heart. PARALYSIS. 1. Hemiplegia, one-sided paralysis. Rare, due to apoplexy, cerebral thrombosis or embolism, tumor, fracture of skull, abscess, parasites, ete. Attend to bladder and rectum, change position of patient and supply good bedding. Later use electricity, and administer potassium iodide and strych- nine. Treatment generally inadvisable, as recovery is protracted and par- tial. 2. Paraplegia or paralysis of the posterior extremities. Treatment de- pends upon the cause. Thus spinal inflammation (meningitis), fracture, hemorrhage, tumor, may induce it. In Dogs, obstinate constipation, worms, indigestion, abnormal dentition, nephritis, cystitis, lumbago and heart disease (disturbed spinal circula- tion or thrombosis of the femoral arteries), occasion paraplegia. Make a thorough physical examination to eliminate heart disease, lumbago, nephritis and cystitis. In teething, lance the gums if inflamed. Usually, thorough evacuation of the bowels by castor oil and enema or manual removal of feces, and light diet of broth, will lead to a cure, when constipation is a cause. If there is vomiting, give 2-3 co. cathartic pills or calomel, cerium and bismuth by the mouth, and use enemata and manual removal of feces. In the Horse, paraplegia occurs sometimes transiently during colic, and in mares in heat. There is also an infectious enzodtic form. Paraplegia in the horse is often mistaken for hemoglobinuria. Treat causative disease. In Cattle, paraplegia is seen in impaction of the rumen and parturient apoplexy. (See Indigestion and Apoplexy, Parturient.) In general, evac- uate the rectum and bladder and apply hot fomentations and sinapisms to loins, and later give strychnine and blister loins (unless there is a nephritis), and potassium iodide. 3. Local Paralysis due to a neuritis, from blows, pressure, injuries, cold, or central lesion. Commonest form of paralysis in the horse. Paralysis of the facial, trigeminus, radial, crural, tibial, obturator, etc., not infre- quent, and recovery commonly occurs. Treatment—Remove sources of pressure or irritation, as halter in facial paralysis. Use preferably gal- vanic current from the onset of paralysis over the nerve root and paralyzed area, or faradic current, if it causes contraction of muscles and is not too painful. Also apply sinapisms or capsicum, or light applications of ther- mocautery over the course of the affected nerve. In chronic stage, employ massage with a liniment, hot and cold douches, alternately; electricity, as above, and strychnine under the skin in large doses. 730 EPITOME OF MODERN TREATMENT OF ParasitEs, INTESTINAL. Order, Cestoda. Family, Taeniae or Tape Worms. Of the Dog—Genus ‘laenia; species: T. cucumerina, T. marginata, serrata, coenurus, echinococcus and serialis. 5 Sheep—T. expansa, alba, and fimbriata in West. U. S. Cattle—T. expansa, alba, and denticulata. Horses—T. perfoliata, plicata and mamillana. Poultry—T. infundibuliformis and 19 other species. Treatment—Withhold all food for 24 hours, give anthelmintic, purge fol- lowing it, and repeat dose within a few days .if ineffective. Isolate the infected, burn feces and taeniae, avoid infected pastures, or disinfect same, and prevent animals from eating raw entrails of other animals. Special Treatment.—Dogs—Oleoresin of male fern or areca nut in cap- sules, and follow by compound cathartic pills. Enemata to remove the worm. If the head of the worm is not removed, repeat the treatment in three days. Also oil of turpentine, pelletierine, pomegranate, kousso, naph- thol and ether are used as taeniacides. Sheep—Give areca nut (3i-ii) on food to lambs and repeat in three days if not effective. For T. fimbriata, give sheep thymol (3ss-iiss) suspended in milk and repeat on succeeding days if ineffective. ; Cattle—Tartar emetic (3iss-iiss), or arsenous acid (gr. xv), once daily for two or three days and follow with 1 lb. of Glauber’s salts. Horses—Treat same as for round worms. Poultry—Areca nut in pills with butter (gr. xxx) and repeat in three days. Class—Nemathelminthes, Round Worms. Order—Nematoda. Family— Ascaridae. Genus—Ascaris. In the Horse and Ass—A. megalocephala. Give tartar emetic (3ii-iv) in a physic ball of aloes. Oil of turpentine (3iv) with oleoresin of as- pidium (3i) in pint of linseed oil; or, santonin (3iv) in oil, or calomel (31) with santonin in ball. Follow this treatment with course of iron and nux vomica on feed thrice daily for weeks. . Dog—A. marginata; Cat—A. mystax. Santonin in castor oil or in pill with calomel; or areca nut in capsules or fluidextract. Poultry—Hens, areca nut (gr. 45); pigeons (gr. xv); in pills with but- ter every third day. Other remedies include: Arsenic, creolin, naphthol, ether, copper sulphate, tannic acid, kamala, tobacco. Genus—Oxyuris, Whip, Thread or Pin Worm. Horse—O. curvula, mastigodes, vivipara. Enemata of strong solutions of common salt, of quassia, or of lime water after flushing bowel with soap and water. Also give internal treatment as for round worms (see above). Tobacco, ether and kamala are also remedies. Dog—O. vermicularis. Treat as for thread worms in the horse. Family—S. Strongylidae. Genus—Strongylus. Horse—S. armatus and tetracanthus. Oil of turpentine, as recommended for round worms, or thymol (H. 3ii; Foals, 3i), in ball coated with keratin, for five mornings, followed at end of treatment by aloes ball. Dog—S. (or Uncinaria) trigonocephalus. Hookworm disease, Uncinaria- DISEASES OF THE DOMESTIC ANIMALS: 731 sis. Thymol given hourly for three doses (gr. v-xx), preceded by 24 hours of starvation and followed by 3 compound cathartic pills. Or oleoresin of aspidium (xv-3i), after 24 hours, fast, and repeated in one hour and followed in 12 hours by dose of castor oil. Strongylidae in Cattle, Sheep, Lambs and Goats. Several different species. Isolate sick, destroy feces and litter by fire; isolate sick and disinfect infested pastures, as below, for preventive measures. Internally, oil of turpentine (Jiv), to cattle. To sheep; thymol (lambs), 3ss; Sheep, (di-iiss). Strongylosis in Sheep—Several species occur in, abomasum, and, with tape worm, in bowels and feces. Prophylaxis: isolate sick, disinfect pas- tures with copperas (80 lbs. to acre in 10 per cent. solution); generous diet with plenty of salt. Give internally, on bran, areca nut (gr. 100), with arsenous acid (gr. ii), once daily for five or six doses. S. micrurus and filaria. See Verminous Bronchitis, Hoose or Husk. Gapes in Poultry and Birds, due to Strongulus (or Syngamus) trachealis. Oil of turpentine on feather in trachea; or tracheotomy. Inject a few drops of turpentine or ether into trachea. Inject a 5 per cent. solution of sodium salicylate intratracheally. Clean thoroughly and disinfect premises and utensils, and isolate. PAarRoriris. Secondary to various infections as strangles, pharyngitis; idiopathic; traumatic; and actinomycosic. Also due to salivary calculus. In acute inflammations, treat as recommended under Glandular Enlargements. In chronic, idiopathic, massage with turpentine liniment and give pilocarpine internally. Parturipnr APopLEexy, Paratysis, on Mammary Toxremia. See A poplexy. Parrurient Fuver. See Puerperal Fever. Paterza, Distocarion or. (In Horses and Cattle; Foals and Calves. ) . Reduce by pulling the leg forward and upward toward the elbow of the same side, with side line about neck and attached to fetlock of dislocated limb, while the operator pushes the patella into position. To prevent re- currence, the limb is kept in a less degree of this position for several hours and a smart fly blister is at once applied to the patella region. Prevent the animal from lying down by tying up head. In the horse, apply shoe with high and projecting toe for three weeks to avoid recurrence. Perricarpitis, ACUTE. In Horses and Dogs, from acute infections and trauma. In Cattle and Goats, from swallowing sharp bodies which penetrate the pericardium. The treatment of the latter form is unsuccessful. At the onset, bind an ice bag over the heart and give morphine and atropine under the skin to quiet the heart. For same purpose, with fever, also prescribe aconite every two hours till frequency of pulse is decreased. As the pulse begins to weaken with progress of the disease, administer strychnine with whiskey oo, EPITOME OF MODERN TREATMENT OF and aromatic spirits of ammonia and digitalis. With large effusion and much dyspnea and cyanosis, puncture pericardial sac. Incision over an- terior border of 5th or 6th rib, four inches above lowest point on the breast, and wall punctured with trocar and canula. Apply fly blister over the cardiac area, and give potassium iodide internally to aid absorption of exudate. Absolute rest and digestible, laxative diet. Prrironitis, ACUTE AND CHRONIC. Acute form—In all animals; generally secondary to some local inflam- mation, injury, as operation for hernia and castration, or lesion in the belly, as perforation of stomach or intestines, or pelvis. Parturient sepsis is a frequent cause. Treatment must be chiefly directed to primary cause. In dogs, the treatment should be laparotomy, to remove the cause, and drain, if need be. Medically, use opium heroically to quiet pain and peris- talsis and enable nature to wall off infection with protective barrier of lymph. Withhold all food by mouth for week or more. Move bowels by enemata and give normal saline and food per rectum. Apply externally hot turpentine stupes, frequently renewed. Tympanites relieved by. turpen- tine or asafetida, per rectum. Chronic form—Treatment depends on cause, as inflammation of abdominal and pelvic viscera, tuberculosis, new growths. Ascites is often present (see Dropsy). Repeated blistering in small areas, and the use of tinc. ferric chloride with oil of juniper and sweet spirit of nitre—in combination— are of service in ascites. If unsuccessful, potassium iodide may be tried. In dry peritonitis, with formation of adhesions, medical treatment is un- availing. Puarynettis, ACUTE. Occurs in Horses, Dogs, Pigs; less often in Cattle and Cats; rare in Sheep and Birds, except pseudo-membranous form. In enzodtic type, isolate patient. Good ventilation and housing; liquid or soft diet. Gruels, cooked roots, mashes, milk and green food for larger animals. Milk, gruels and soups for smaller patients. Drenches are dangerous in leading to foreign body pneumonia. Tincture of aconite hourly is useful till fever is re- duced. In large animals, an electuary of kermes mineral and potassium chlorate (each 3ii in dose) is beneficial. Externally, applications of ice, hot poultices, stimulating liniments and blisters are of advantage. 230 hydrocyan’ic, diluted ........ 313 hydrochlo’ric .........--+--: 242 Giluted ae. ere oerene cs) -¥ 242 IVR “bo geodosauoeoUbOD Goo 247 WARES! Gagooooodu oo Ud0000 242 MBO GooouasdseboocodmEn ge 244 abbey “Gbooascoosnaeons 244 nitrohydrochlo’ric ........--- 244 diluted ........----+--- 245 - nitromuriat/ic ..........---- 244 phosphor’ic ......---+--+-+:: 245 diluted ........2+-0-:: + 245 salicyl’ic .......---+++seree 444 sulphu’ric. ..-..-.-+-+++-+°° 243 PAGE Acid, sulphu’ric, diluted ......... 243 ANOMAGICH ane cisco iene eeer 243 sulphu’rous or sul’phurous... 240 EATITIICS Seis viaccess sc ecielences 527 CAMAMUCUIN Gas. isgsncyeitees vers conse 527 CAT GANIC earns sietneiarsee estore 246 INGIG Eo 3. e SCRE ORAS Cra 17, 242 Ac‘idum acet’icum .............. 245 Gh MANY Socighoneiagoeoo 246 MEKGEMOS Ganududooudodor 246 ATSENOsSUMM mercy cpeyene sierenet ere ores! s 206 DeNZOsICUIM Fey sects eestor: 462-465 LWOABKOIM © on Sn Gobo doo ood DOU 252 carbolmeumiy eee eres s cee 297 CHU GUM gcees acutccce(ecie esncles 297 liquefact’um ........... 298 chrysophan’icum ........... 514 GUMB Obi “GoSeoueocoulla000N 247 GEMS “Geeooeocoungsoc 526-530 hydriod/icum .............. 230 hydrochlo’ricum ..........-. 242 GHA “Googocgoocb aod 242 hydrocyan’icum dilu’tum .... 313 IbGHatebin gqgnooodcadnuGCDdG 247 TMECOM MG UIN Pere eye aiers oy sie) lellols 322 TMMABAIGUNE cogaccoop0uudeOO OHO 244 GHAI | SoboooodacnuGe 244 nitrohydrochlo’ricum ....... 244 Ghigo Salgcoogobo ou 245 PIC'TICUM cee eee ee lee eo oe 251 phosphor’icum ...........-- 245 phosphor’icum dilu’tum ..... 245 SaliGyW CUM 2. No sce eis erate one 444 sulphur’icum ..........--+: 243 Ghai “soogaugcooDoeS 243 ALOMALACUM: s.. 6) clay erenc hate 243 sulphuro’sum ........+++++- 240 TMM GU) BHodeasanondodedD 527 tartar/‘icum ........222+e--> 246 ING, Gadoogdasouao0UbooDDCOS 418 INOS: “GooededdsoodoncuDUdCUNy.S 418 INGMBOATE, “oo odoaaddosuccKpesd009 418 WHAM onda eoooddonDuoUsO00 418 PNconuitine eters arto teieiele stele 418 UHI) “SdouceaGsedoonuDoade 418 INcomURIN “5 ocoees0000d000u00RaC 418 INEGini soogguooooO OG KKdOaUO DDS 504 Ac’riny] sulphocy’anide ......... 467 * The accented syllable is indicated by the sign ’. 760 GENERAL INDEX PAGE PAGE Action of drugs— [eAMLUMINOT Woreemte ties hs eee eee 157 CUMUlALIVE! Goy-2t2ts wees nests tel 4, 410 CXS1CCACUIMpeacc a8 eee 158 influenced by— US HUI osetia ereccteiet Snciaie, avert tenets 158 LING UVC siete oct oaeteean a 12) | Alumina hydrated) 27). 2c2. eee 158 ADIL: encroaree ste os sheerereus ES> |}, Alutminy chy’ drasice tes vo eae 158 CISCASE. 25.6. cscieus cisisueas exe she 13 Dy. drOx CUM eye se en. eevee eete 158 LOJOSYNCTASY at. aea 13 Bul plas avery che canes aes 159 MOGOWOL* se cuceueoa somes 2), ATU Bagie cree aeare te sees ace eae 157 on animals compared with WYVGTALE! F5se,his acs sees 158 its Rar Pare Sore ee me e « 11 Hy @TOXIde 4.0 wake hae see eas 158 on horses compared with other Sulphate’ hive sec hauthclaliecie « 159 SMMUINALS: gays citey seiorepereexouere revoke 11 and potassium sulphate...... 157 OD ICS cand COGS. yaa as opens 12) | Alt ypine-*ss.5.0 soe eed cues se meee 397 ON) TUMINANES, ic rs ogee wc eeter 12 | American hellebore ............. 422 Action of heat contrasted with Ammo’nia, aromatic spirit of..... 141 COld hice coe: niin toe tate: 642 liniment ...............0.5. 138 ACtUAD CATILELY: on. ang ess 2 ols cle 630 spirit of ............. +s eee 138 AOIEPB iisenins 3c apeene haw Giessen 577-578 aromatic .. 1... esses eee 14] benzoina’tus ............ 464, 578 Water... eee eee eee e ee eeeee 137 Tecate ee 579 stronperc/G. shaq tose 138 Adjuvants frei t.cc taku era moks go | Ammoniated mercury ........... 198 Administration of drugs....... 6, 12 | Ammoniated mercury ointment... 198 Adrenalin chlo’ride ............ 569 | Ammo‘nii ben’zoas .............. gaily Mther coc alin saw te thats : 268 bromid’am ss -osg isis 2 a “a Hthylis chloridum-.............- 320 CORR OUR OS siiee ee ae lea African pepper .........00ese0ee 475 aul PLU 245 Sis sete eee mene 142 Albaspid’in . s2sincees oe cee 549 val’eras .- 1s. see e eee ener eee 483 AMCONO] oaweistase oatint ein betes Er alps eee eee a8 Fee By -Senpaniita: ack eee 95g | Ammo’nium ...............+45. 137 absolaltyiw cs tee 258 acetate, solution of.......... 143 AIIV LAG: eitearts Ceci eeane 259 benZoate sojec puke onfoeediies ak 465 AMY MICU (52s sh gree toteuc usec aaron 259 nap oni Tes Ses as ieee al deod'ora tum’ y,2:..i scree cae 259 chlo Nui eee toa ob Tee GUNICCD ona arats Wetec tne 258 ich’thyol sul’phonate ........ 587 dila’tum — ..ictana es ose onde 258 WaGnR Sgr ich seen erie ae Eble cet hor vue eee 257 | Amyg’dalin 1 ...-....sesee eee ees 544 ethylicum .......0.ss0s00-, Pill Reema pei gtdencsrso Soest oC 0 288 phe’nyl Cea te eM AN 997 | Am’yl ni’trite ...........0..eeee 283 AS ' ; Cee in i a 261 AmylVie al/cohol ice ire nts deo! o's 259 Alkaline earths ........0s.. 500. 145 | Sen Sh a eae ae Metals. Piss ac acess Sale eet E ae A A BR yas hie Alkaloi’dea. 64 wees ee th eat, Oe ae ee er ete ANMErS Of trina aise lepers eae sid Sta caaag eens ee nrectieal DAS AT ene 280 yl sulphides os,;urisuree shee Sati ee ee oe : Al’lyl sulphocy’anide ............ 468 aa fe rer as ana he gis Ale or. al 08 nil enna Serenata 504 Se a iene 35 DaArbAGeNSIS7 t.jcics, cect meyras 505 Bani nh Cigna ica cl aca URAL 3 CAPENISIS) yee cite subs. tocspnceressa eis 505 Sa, Wet a an acd a een Res SOCObrE Ta “ata ccteiaceas tee ee 505 | Analge’sics .......+--+-+++++ 35, 292 Aloin: fod Nd een tts SOR ae 506 | Anaphrodis’iacs ...........++++- 52 Altervative® 5 osc ts. pooe ences 54 | Anatomy influencing the action of ATEN sa: och rsa Gieae eter eee 546 QRUES: cit alate cle wenatchee eieke otters 11 AVI ieee ee creme ee eee 157 | Anhydrotiics .........+..eeeeee- 60 AMMOMIO ferric! soc wer o sesle BS. | AMMBS OM antag ol wae ero irae 479 DUTT Ea eriess eecods itterareote cine Seek 158 ODI sa2yn tetercycten ee teecenensiys cnet nel 480 OXGICCA LEM i.e faidee'lapefearer sees feds 158 Spirit OL. eee eas oe 480 POtAS SIUM cies caseerescvees eae 157 Water, yeisis crore srepomitos cuelens eer 480 GENERAL INDEX PAGE PAMIUGSTORT TUS CLUS = ..c2 6 6 sss oben bee 479 PAMNIESUTTI He eeen aes. 6,2 esses ss 516 PATE COO ete sc siece ssa e W'S bet 550 WN sp osacuad conaouneode bins 550 PATOLCAIT Che bt ier ye am eres ow odiciodonet 550 PATOCOMINE fn. to ates ciicie ss oe uss eles 550 hiydrobropMide ae. ee 642e-ce 550 761 PAGE Argenitr cyanidum .22)....5. 167, 318 LOGIGUM eel I aie 167 MEET AS ste tie tetas ee ae 166 MAHEASS HVA Gooosdosmnous 167 NiLGTAS MH LULSUSEEST ie eres = 167 Oxmidumeecacteeeee ace 167, 168 NES CNC U IM ea Ketavae oak tyaicreistere ainieten 166 INTL OM EON Gr ceace wre oars ceo eka ciclabett 170 ATIStONS soars cee eee, Saute ene 234 Amistosumeecm eso neces 239 ATomatie® bitters! 14.0405 cee 15 OMI Sta eee ete are, tke 65, 451 spirit of ammonia........... 141 EAT OMAIEIES ie ee teee ate esl aaa) Ure ate care et 15 ANP NAA Alhibil oe ood do ooone as 206 ATISCNUC ny eee pce te teh ees et 206 administration of .......... 212 antidotes. vate eee 186, 210 Fowler’s solution of......... 207 CHIOKS Cer Mca tetere ete En RL 206 Whiter eigen eee 206 Ar’senous or arse’nous acid...... 206 - solutiontot a coe oe oe es 207 Ar’senum or arse/num........... 206 ATUINCI a leteC IMs a peruse ae eters 624 GAT et da riMoe in fon a ty ce tee oe 485 Asataettidane seas dota Ais ihn 48: Asepsis, means of procuring..... 644 SUTSICAlL sya. wee wee wae 649 INSDATLACIN 55 acca see 500, 543, 547 NS DIGI Mis semis sinic wae seen ee ete 549 INS PI GINIMG wrt isys tte esheets 549 AS GUM ees apeltg cists eidesee tee al 549 AS ipid Olea crete coun ticles ts invectice: 549 ASOD UTAN Gis aac resets: enesnet= arate aakele oesee lait 449 NSETAN CMDS Gein ceerisserelstetorents ol iorers 58 JO Al, soc cio Babe COO Od atOd HOOne 207 AGT OPIN Deseo oc cys Sicpeus cierers cree ye 341 Atropine: sulphasies.. loc. ere «is 342 INUYOPINOM cee Neis aie scsi neds severe eyes 34] ARO) GUAM Saoeano oon dor 342 Bacellitsstreatments seis eee 302 Bactenialunltratessseieneeceece een 670 AKIN GE SOMA eroraerclasclott ives cis 128 Balsammoteberleneerin cere 462 ONG tole ees ener 463 O Deira tenants cose rig or tas, 458 Bau S atin aie = arc avsutcne ac cara ee as 65 ail Sans woteseaca, chen ercicla svevece cas ens ene ake 65 Bal’samum Peruvia’/num ........ 462 UNoiieMT IN Se oaaacs «douceee 463 SD Sipe eh ees etre sila ee bate te Oe renee 72 iBarbaydoesalloesi ss... eens 505 Barbalvoimens.tyme ce masiois-e)-feneleyate 506 Balrimchlowidumy 4. eee oe cere 152 PAGE Barium: 6.0 foe cra eae Caio 152 Ba’rium chlo’ride .........20200. 152 IBATOSGMANED, sccveucetsee vere contact cio 486 Basil’‘icon ointment ............. 459 BASIS tir celsaane eet Bo onerolotone ons cise caret 80 Bais SOR sayeed adeesrcnhche e's Cesee 485, 546 Baths col dimer nv jc ghstenets cea ots 636 NOU Saker telnet eA te eee 642 NOGA, city Grisecronewcrn eee 636 SIGUE sated -cdceasseiebareteae tee 635 Beers, icalis dauierur ase eae kee 261 Belladon naar: swat sats ste ee ee 339 Belladon‘ne: follia (00st eo. oe 339 Mal UX eewe dasvenenaier Passes Mae ees 340 Benzovie @end siscetc d ee econ 462-465 Ben’zoinated lard. ......6i.<<.4. 464 Ben Zou nirnie” 2705,) aes See ee ae 464 BenzyVic) alcohol. .¢5. 0. cs. 20 463 Benzyl'ic, benzoate ... 26... ..-.6 463 CIN NamMates peeehe cee 463 Berberine: ss. -.hsh 6c a ee es 499, 501 Beta napthol as oknees ote enor 308 Be’tal nut or be’tel nut .......... 550 BAW Om, ates Sect area cts oe rare austen tee Ce 355 Bichlo’ride of mer’eury.......... 196 Bile, drugs acting on............ 23 Bisimuthe yews ce mec. eT AC 178 salic’ylate or sal’icylate...... 179 subearb’onate ........0.ce0. 178 subgal late 26 s/scs,2 0500 eee 179 SUbniGrate = seis cesears Gia 179 Bubsaliclylatey acs asssce tec 179 Bismu’thi subearbo’nas ......... 178 Subral lag ends Pets Hale ook 179 SUUMIGrAS eae state he ere cto cee cae 179 SUDSALIC’VIAS.” 57055 Maleictes ote favs 179 Ispishoahei A ahbadihy Mey MPI R Aon ae BS 178 IBittersprs toe ee. aches cree 15 Blackeomustard 0.6. once stteessan 467 WAS caine ecicctests deepen 204 Black-leg vae’cine .............. 678 Bleaching powder .............. 220 Bleeding is os.sserse. waren eee ats 652 NOG a es i ie eter eee, te 653 Blistersbeetlesi2... so ccs., 6 ae 574 Blistering collo’dion ............ 568 Blood, drugs acting on........... 28 vessels, drugs acting on...... 32 Bluesmasstyn pene eee 194 MOLL ere ele k wets eins ater 194 SUONCH scinc is oGsee vie creer ene 176 Ointment’ ote eievseicatsceeicte 194 VICTION Fees ee hare leet 176 BORE ei agte tons: Seer orca eevee ernie 72 Bodily heat, drugs influencing... Bo’luses ry GENERAL INDEX PAGE Bone’ 2 oo reed ee 219 Gathartoman nit: .2.55.2.5..--2- 517 | Cho'lagogues ..<..5.2.62....:: 23 Caucas’ian insect powder ........ HGH] Clygeicinin Goaceoedecomocosdacc6 578 (CEIEMnt IhbEN? Go54qqnoub coded oO 16% | Chrysaroibin’ =: : 322.5 224: 514, 516, 517 764 PAGE Chrysarobi(mum days shat o ers ee eceiseere 516 CUrY SOP Ha ie.:.i.(eivs saisrerei eee cree 514, 516 Chrysophan’ic acid .......... 514, 516 Chur TUS, sc sey ccsseloe onthe seek eo ee 355 Cider vie Sees ais 8s dhe eyeairere ees 261 Oincholng. vs ss cee elo oecers oud eee 432 TGQ ss skae, chore ener a tole efacacccalaeyetnel 3 435 TUT A Soxerefe. ob betaes ele Res cus ronenanseae 435 Cincho’ns: cortex): sesie csc sce be oe 432 CinchonidiNa. 26 «acres cea oe ee ee 433 Cinchonidi’ne sul’phas .......... 438 Cincho nidiney sw, 8S se siete orserts 433 Sil PHALer ery svatuerettene seater ents 438 Cinchoni/nine sul’phas .......... 438 G@in{Ghonines Pee sieoe cers pee telnet 433 Sulphate ais cscs scccw'eraciete trorcis 438 Gin’chonism: 23.5 .c.41c0e8 «ese oes 440 Cinchotan’nic acid ..........006. 434 Cinseolees sam aisiaesstatieeteleaaey vetoes 471, 554 @innamein= 45% tec. Hs sue Ce ences 462 CinmmMam de ACs sie sess coats ates 462, 463 Circulation, drugs acting on...... 28 Citiratedcaheine.a.%,. «ctsusce eos. ca 359 Citric: Bela sto eb Sais awe svecwlee 247 Citrine ointment. 7: & vie wae cates 197 Citlriwlline Fossa techs eretete eccwske siete tere 523 Classification si. cers sraeiepetere cic 110 CU ys TERS 556551 gins ohestareiene ce Suerte: 9, 26 WO! CAT a cise Rovere oo ave Balarole ee Meat etal 388 Cocai‘ne hydrochlo’ridum ....... 388 Co’caine or coca’ine ............. 388 CWOd eM Mares cher So cre eke ae Gtvo lt aleneiolee 326 Cod diver OU \..020 Beec.8s eh 585 COomeen ws cack Saisie ah ole e 358, 359 @olehie’eime: 5 3S. oievs oc mh eaeecenene 563 Gol’chicine: jy... )oscds.o0 se acceso eee see 563 Col’chicuimy <4 42s essere eestor 562 COTM: £.o%5 2.7 ss Risvever cutie eae exeraevee 562 SCGd) sc Vaindse Mee ete ee 563 Cold asia remedyae< see as ches srs 632 baths: ees Sea oe ea saceciile 636 Grinks shod apie wee serene 637 ONO MATA, 2 aces sce wresswei eters Gutiene 634 Collar’ sol ais dajcece ees over as 170 Colldine > sce ted soe pastas sackets 382 Colloi’dal ‘silver .3..46.. se scesaess- 170 Collodi 8... § Soke a kel Gholers 72, 568 Collo’dion 33255 eels otter eae 568 DLiSterin 6) ee coer. ci aystes seas tenets ye 568 Cantharidallescictc ctceaercnner teres: 568 flextblel es 75s hate paemekeioie 568 SLY PUIC! ahersteteseitere cfovetavetercienerens 568 Collodions:...).d46c.ueione tone 72, 568 Collo’diuim? (e571 en wre Seen aeons 568 eantharida‘tums eit tistsieie!s ia clare a oetoe 523 @olocyn’theinie aye neste 523 Wolocym thine ee sais a wteieis cunt cet 523 Colocyn this? cei ot warciessye ore 523 Colocyn{thitina <4... 2... oi. eee 523 Colophony. a05.30% scant ene 459 Colum DOs 6355 bs eS eee eee 499 Common salty. snitne ss ce eee iae 132 Compound cathartic pills........ 197 liquorice powder ......... 236, 517 powder of catechu .......... 532 hela ey in Riehstetscasetarel aeetuate oes teyene 521 powder Of kainoge cise: c's 534 solution of iodine........... 225 ot ‘chlorine: cients coos: 219 SYRUP! OL SQ UM tetra sensceegs eee 417 tincture sasmbin a. acts 532 Conféctiones**, .4.2 a2 stones eae ee 71 Confections. = 2)ck Si. sso nee 71 @onhydrines 7 iit tinct eee 385 Comines aa feces eee ers 384 Coni‘nine hydrobro’mas ......... 385 Conan aie setcon ok eat 384 Convallamariin= .cne.ns seen 415 Convalaria 7. ceiccches oe tescos Seto hae 415 Conval larinig.eis2d one he Adige nee 415 Convol’vulling siic.et onic oa ee pay. COP Pers so veieyers Gossrayovels evei bes alpaca 176 ACTELATE: shied Sues aes os Sees 178 stil’ phates. .ficcersian cuir o close secre 176 Gop peralsis w.:zcocapcicvenc cuss ie eae ceereeionere 183 Coriander > tessibysecs. cosh oickereis Henebts 48] Corian‘dri fructus. tectcnion sae 481 Corian’drum \ jc cise ce aes ae 481 Cotridines ease eee on ae 382 Corros’ive mereur’ie echlo’ride..... 196 Cos’moline= 72s scien ee eke 318 COEGOT oases soe desolate ae 567 ADSOTDENE, -o55.o o10lcie Sous! wesueaeeeee 567 purified a. ee ence 567 Toot “barks 52iecict ec eee 561 Seed Ok yet ears eo aetna 538 solublepoum gee ars orstaie sicrsestenale: 568 Gounter-1rritants? 7.2.4 eine 57, 626 GOUS SO Pe is ees oe ieee eee agrees 551 Cox’sthiverSyrupe-aciioieiteactons eens 417 @reammoni tar! tarcyte cscs 125 Créde’s ointment ......... eal 171 Crelolimi as. fore oleoeoes pees ened one 306 Creolinumy) ache eee ea 306 One! OSoter itera Clee heres shee oetotarene 304 Wreoso tum sesh roe ee ete let eeoreeoe 304 Cre’solisa te cree on eae Ponce 305 GENERAL INDEX PAGE Gre tappreparayta sco... .< osiclgaies 145 EO LOTU OU Gv cus forse jose)~ > vcs ele euctels 518 SERGEY “LS ceSp pe eOR eI ins and 518 CRORBONO Nerney) cece ses ola we delaye he 518 Grotonoleiciacid 6. 3... 66.6 cance 518 G@rude) carbol’ic acid............ 304 WmYECOWIMer crc) lehi Sc ces Ove eee: 322 (CUIRGanere rch oiee e's 6s eRe a os 388 Cumulative action ............. 4, 410 Grgpritiace/tas! (0. os. 's 5.6 hs wees oaks 178 BUMPS MPs «. Shevctor ors ceva cca iteyerets 176 Cutpric’ sul’phate 0). ss./o 5 ice Gsnrs'-cicraccratatanere ele tte es 557 HT EOUOS ING: Usk shave cet eee 557 HirTIMes s/o sgtycuereusievege ote ete eleuecere e 42 HYYy thor etim, | oo sien ean eee hoes. 514 Erythrox’ylon coca ............. 388 Escharot‘ies .%..2..66ec65050% 58, 631 Wser'idine: “oo eeternc sae eae 372 MIS(OVING! “hele cyano ae eee rae see 372 Salicylate: sco ah eee eee oe 372 Bil phate’ “Ai esse cates 373 Essence of peppermint ......... 478 MESSENGER cthra: dire ye ieee ol ara susie gee 70 Wssentiiee shivers a oleae eee ee 70 Hssental onls' 2%... cect maces 65, 45] HH CHOY'aSAsa ces sia esayece teeta ental 268 ni’trous spir’it of........... 283 SPIT ILWOP B55 ci crekeaerevece sence 269 GENERAL INDEX PAGE E’ther, spirit of, compound ....... 269 Stl ph TICs. sc:s.0.0 oie rece. 268 Hthemeal Moisi «toe cae 65, 451 Ethyl al’cohol: 4 2.525 si s5 temo 257 Chilotride nie... dices detours 320 TEV TACO oe lactate areas 283 ORCC va ois aster nt aierese sean 268 Eu’cain hydrochlo’rate .......... 396 Bacal py teme * *s a:.%0-5 caine mmrtinic ts ane 471 HUCa ly; pUOl oit.= aa situste ero eye ereuceeeete 471 HU CallivsOsGU Sige cs scyet oucutes eos tottsteeyeree: 470 Hiphor/ Diss se 6 -ejeet i - seeaeet nee 569 WUPhors Pon's eres siecege: sctepstey oes anne 569 Evaporating solutions ........... 637 EX CEP MENbS: ee tehs esos ese ees ekesie aur 68 HWxCreC1ON! ayers iaiaie a sre ctonenesetefe etal 5 Hixpe chionamtsing siete share taceyote ais eeatenscers 44 CEPRESSINGS eile wcrete ehrernensuce: 44 SUUMUIAGING sre . stere suessce ohare so reeorae 584 Hien CMe] yes scasi 183 Fer’rous i/odide, syrup of.......-. 184 sul’phate ......-+sseeeeee es 183 Ghaeil ~ goo goodoaaGgdaooD. 183 exsicca/ted .......-0-2eseers 183 granula’ted ........---- 183 WeL/WUIM 2 ce «cee ce eile ere see cols 182 reduc’tum ....2..+--eceeeees 182 Ferulaic acid ......-...--+--250-: 485 Fibrol’ysin ......--+--++seeeeeee 470 TOMI Averiny <4 dice Se oleic ciclo pig oes cn cro 549 Mili Mas ccnee os aces essen. 548 WMalicsie: Acid “oo ..c ee ee 549 AWA OM Pacts cle sie creleleloned ss cicheselerennie 549 Intwacl Gui} ZoosouesapouuooodUD 64, 71 Flavaspidinin .......---++++-+++:: 549 iMlepe Seal Contlcgsbecomdous code 544 GRE nt Sea OeeentO an oe aed noo ene 509 Fleming’s tincture ......--.---:- 419 Flexible collo’dion ........-.---: 568 Flies, Spanish ......-------++:> 574 Flowers of sulphur........------ 236 Fluidextracta ......0+---eesee%> al Fluidextracts .......e2+cesseeee: 71 Fluidextrae’/tum aconi’ti ........ 419 belladon’ne rad’icis ......-.-- 341 ipiGnh soseseno oben dconvioe on 487 alam -sasccdacgocco0c0e@bo pe 504 cailiilors, SououpeosopoccubeD 499 can’nabis in’dice ........-- 356 4 04-3 (eC 475 CGNOEDS- gasacoocodv0 evs S000 434 GOVAN! Beoaoooedacsodganae 564 OGIN seadecccgdsuaoduoud00d 385 convalla/ris ........+++--+-:: 415 GURU) cused oooenoocooooEdus 552 digitalis ...-...---++++e0+: 407 ergo’te ..-.--- eee e este ees 558 eucalyp’ti ......-e- seer eee 471 frang’ule ....-.-----++-+-+s> 513 PAGE Fluidextractum gelsem’ii ........ 379 gentia‘N® .......2..sseeeees 496 glycyrrhi’ze@ .........s20e00- 543 gossypii rad/icis .........-- 562 grama’ti .. eee. ee eee e cesses 553 hamamel’idis ......2.--+-s+e: 537 hydras’tis .%....+++seeeeee 501 hyosey’ami .......+--+-+0--- 352 ipecacuan’he ......+--++++-- 429 KYAMC/TIC 2.20 ccc s ese eeee 539 nu’cis -VOM'/iCH ......+--02 0s 364 pilocar’pi ....--..++eeeeeee 400 QUuas’SIA «2. eee ee ee eee cere 498 Quer’CUS ....-- cece cere eee 531 rham/ni purshian’@ .....-.-.- 512 aromatic ......-.2-++-+:- 512 IL gcudoandocgooddaccdooT 515 Babi wists ie ckve cielo siczeielesevers 48y Toibing Seen cbeoocepol ooaDOD 416 Gaines) Hip poe minr cabo oe Goon 517 taraX/iGl .200) 2. cw ess ec ewes 500 valeria‘ne ......2+eeeereres 483 aE SheabengoosuguaUdeRGoS 423 zingib’eris .....--+++e+eeeee 476 Fenic’uli fructus .......-+-+--- 481 Fenic’ulum ......->: Beeidie cc lcraraiaees 481 Fon’ugreek ....---++sseeecreres 482 Fomen’ta ....-.seeecseretteeee? 641 Fomenta’tions ......--++-+eeere: 641 Food and feeding .....----+++->> 612 artificial ......-+2ecesseees 624 in anemia ........+2+.2ee5: 621 in black water .....-----++++5 621 in chronic indigestion .....- 620 in constipation ........----- 620 Food in convalescence ..-..------: 621 in debility .......--.-++---: 621 in diarrhoea .......---++ee+- 620 inl fOVETI 2 sicher crevetersnnrele seteie.s 622 in gastroenteritis ....-.----- 619 in hemorrhage from stomach and bowels ....----++-+9° 621 in jaundice ......---+--+++:: 621 in laminitis .......---++--+--- 619 in obesity ....----++++ee> 622 Formal/dehyde ......---++--+:++> 310 For’malin .....--.-+eece es errees 310 For’mic acid ..:...---e+ee secre 483 For’mic aldehyde ......--------: 310 Box. glove ....2.52 5-48.22 52% 405 Fowler’s solution .....+.--++++:- 207 Bran/oula). 0... 2 ese ee oe 512 Fran’gulin .....62---esseeee ee 513 Friar’s balsam ...:..++.+-see:+- 464 lineal ol _aeegoomecocroscoUuoo oO 259 768 PAGE Gad any ais 8 ies oie toate 585 Galac’'tagogue .......cccees siecoe 04 Goal st cece ies ascetics aascener ae 526 (Geer tV a eae ces ave oe treet erento eee 526 Gal'lie salcid: 23.25 ccs ee ee dies 526, 530 Gam boven a yciacce rate sles eorereie spe 522 Gammbog ie acld 2 ceiim sc eice ous 523 Gane are Asem. tec sioclesaieten 355 Gas‘tric antisep’tics ............. 18 Sed/atives snk csi eid nei a nts 20 Gash oles ies ave recor ccm eceuei ere ee fououe 17 Grail thelr ai a cae eich ee eyes ekeneeke ce 450 OUP casas ees Sleieistetetereieens 450 Geltatins ova cadre sae e rete 151 Gelseniimm’ tthe. eases oe eee 379 Gelsemiing one a> sare ee 379 Gelsemin’i¢_ aids 6222 0: oo see ee 379 Gelseminine tes << sctciss etd siesta 379 General action of drugs.......... 2 therapeutics 2... 00. ceceeeee 1 therapeut’ic measures ....... 612 Chari Grainy ut cereesty WG ane crete des cote satin Nae 495 Goentia! 19) cs envivs tw eoaee adatom aues > 495 Gentiopicrin is sees Sane Hee steerer s 496 Gentistte.taeldi ses). ictehouctets eiacalintecess 496 Gen tisin, ie ses < es sirccore a Saree ha eee 496 Germicides. Girsioccc add ates aren 61, 643 Gains Bake Rk Bee eee ie ie ores 260 Gaim Pere eo aie tee eyeterectcnele any oats 476 Gainaerol ns aan Wak fie pets eects 476 Gla’cial ace’tic acid............. 246 Glan’dule suprarena/les sic’ce.... Glauiber's ‘salts: i sites sieve. inves 130 GlOMO1Ne #7: sips hieere sietevor ate laieiete ote ane 284 APIVIb Oba secre ww eke wae e es 284 Glonoi mum oes geesciecetsce se srererevecis).acs 284 Glucost’deéay. © ii. 6 ciscsr.secessisiscs 2 visseeks< 64 Gl cosides) icc. 0s 1S bus oo caeencon 64 GTO saya tise a of este cttuetenn cts 313 Guycleritien aye cies eke yon 541 suppositories Of «4.0525 196 | Hydrarg’yrum ....--+++++ssre0 194 | Hydrarg’yrum ammonia’tum..... 198 Te Yeum cre’ta ......-+---+--> 194 | [SG 7G hes O Urge cp OOOO Cao iat 502 | Hydras’tine .....-.++-.22200020° 501 | Hydrastine hydrochlo’ridum . 502 | IB /GUISMINIS) yo ho Spo OOS tac 501 Hy’drated alu’mina ......------- 158 Hydrio’dic acid, syrup ipondo ane 230 Hydrochlo’ric acid ...---+++-+--- 242 solution of arsenic ....------ 207 Hydrocyan’ic acid, diluted”. 3.52. - 313 Hy’drogen diox’ide, solution of... 115 perox’ide, solution. Offs ooessiar: 115 Hy’drous wood fat ....-+-++++--> 578 Hydro’xide, potas’sium ....-.--- 118 Rekebnm oop gacDoddoUg D004 s 126 Hyosci’ne hydrobro’mide .......-- 353 FEM OBCIMC 4. fee ei = ie 351, 353 Hy’oscine hydrobro’mide ....----- 353 Hiyosey’amine ....-2--s2e++2see* 351 hydrobro’mide ....---------- 353 SU phate a. fo so ose 352 Hyosey’ami fo’lia ...---.-------: 351 Hyosey’amus ...------essrrrcee 351 Hiypnotiics 2+. -+-420y02t tect: 35 Hypodermat’ic injections .....--- 7 Hypodermoc’lysis .---++-+-++++7- 657 Hypophos’phites ..---+-+++s+00° 218 RCEMD AGS pu aye oii icc inie eine ons 634 POUNLICES) .oeeeer = en 634 Te'thyol (ik-the-ol) ..---------:: 587 NehthyOlum: -3.-'2 3.2): 587 Idiosynerasy in action of drugs... 13 Measuric acid) .\-- (Bi e02 2s: 363 Incompatibility, chemical.....-.- 75 | ply sical ciao ere anes 15: | physiological ...---+++---:° 75 | Index for diseases and remedial | MEASULES 2... eee eee e steerer 687 | In’dian can’nabis ...-------+-++-> 355 Indian hemp ...------++++sss+*7"* 355 in itO! Las boon op Oe aeO OO ae Oe 413 IbitkKG, cocusouooupoeeep ooo ROeIc 69 INDEX 769 PAGE IMU “Geo cecoonoouGSonouCD 69 RAMS oes ceaeosunocoddoE Ec 655 Imialsumycalamiiies cs. 2 seein: 503 CHIGNHNES oo onobon dooce do 434 GliestPMING, SSRs eooomcopoasnoud 407 mh alalgrvonsieaeccciirecie cies wales Ue CY Injec’tio apomorphi’ne hypoder’- MNNKE! Geo Boog o oD ODDO SaS 338 cocai’ne hypoderm’ica ....... 388 ergoti‘ni hypoder’mica....... 558 morphi’ni hypoder’mica ..... 326 Injec’tions, intramam’mary..... 6, 9 intratra/cheal ..........---- 8 ANUGAVIEAMOUS! “trees rei sie le wreltenels = 6, 656 RES lab booodnonpeo coo GoD om subcuta’neous .....--+++-++> 7 Intes’tinal antisep’tics-.........-. 18 _ Intramam’mary injection ...... 6,9 | Intratra’cheal injection ........ aes Intrave’nous injection ........-. 6 lenApihti Yisiss Gomes on omoneooo ao oH 500 Inune’tionS ........+--+seee-- ee 9 WModides le creras ccc seeiereqese’s nleloieile) -F2 229 MUP) GoodhosopoHousOUUOObO NUE 225 compound solution of........ 225 ointment ......cesesereoees 226 tincture of ......6...25---- 226 Io’doform .......- SPaholeherelonetetertels 231 Iodoform’/um .........- Sooo ce 231 Mell sacdeconoecu0dod soomodor 233 Todo/lum ....-.-seccerer sectors 233 TOA we eeerere se ccore olevels wielle =n- sho ohsi 225 Tp’ecac 2... eee eee e cece cece es 428 Ipecacuan’ha .....--.--+++-+++0> 428 Tpecacuan’hic acid ......++---++: 429 TA OM leis ic leieteleksreredel sierei ele ellen lay ie 182 and ammo’/nium cit/rate..... 186 and potas’sium tar’trate.... 186 and qui’nine cit/rate.......-. 187 soluble ...1...-c2-see-e: 187 by hydrogen .....-----+-+-: 182 metallic ....2.-ceeceeeeeees 182 Quevenne’S ....--++22+eeee: 182 reduced .....-.-+eceeercees 182 | Irriga’tion ....-------++-ees eee: 637 | Trritants ...---2+--escseserreee 626 Isoamylam’ine ......--+++++++++> 557 Isopellet’ierine .....-----+-+--+++- 553 Jabora’ndi ......02+-5258++--+-> 399 Pernambuco .......---+++--- 399 Rio Jamiero .....-.-+--+--:: 399 Jab/orine .....-.-eeeeeee essere? 400 JaVapy we alone oc ecictee sents ore es 521 UE We Aislbie eit Sicko ono diss Onto 521 Javapin, ice eres 26s ee eee §22 770 PAGE LAAT! OI ». 7. Ss ecens adelante cues, AOI 522 Jasmine; yellow fos aves. beuy due. 379 RET WANG 256 ctete 38 crass ote we 423, 424 Juniper sll (Of. 238 gate eee 487 Samia! lat oe Anais me een ae ey te 551 Ker’mes mineral ............... 213 ULSTBTHATORE Voi Uo Maraharecee gee tne th eter is Das SIS O Myeegete eee aN Sar ee tee 533 KRG ged ines Soc) ene Sats ec 533 AKGIis so) i cheapie eset Ae on AR 533 TRUM WaT ae ore eee ae ets So 434 Kino-tan’nie acid ........... 434, 533 KNOG: AGIG ates ats Pen ee 434 Sto CVs 0 eee i Cree ne 359 KOmbe porsouhtGns sauna ote 413 Wom bic-aeid? fc 5 hav oe, 413 W008 O'S. dead oe SEE Pee 551 TQOUSIN Se eee tec eae nee ae ee 552 FPOIIS (SIN, Gigkee Sse ee ee ee. 552 ISOUNISO) stidity cote ae a kee 551 IGGATAG Tig peers AN hte ah ea acne 534 Kramero-tan’nic acid............ 535 Kunsel’s treatment, milk fever ... 659 Labarraq’ue’s solu’tion ......... 220 Bae sul Phung tain beac ee e o, 236 NUACEOSG Net arog oucge tata Ree RNIN 581 TancOliny ye ates Cae oo ota ek 578 Wh Oe ewe ce eee Meme oe 577 ben’zoinated or ben’zoated ... 578 Latin nouns and endings......... 93 Latin words and phrases........ 78 atdiantuime 2a 3) eae tes ee 323 TLaur’el cam’phor................ 490 | Bid: Sn ee Pe A ee eS Oe 661 Law of dissolution....34, 36, 263, 275 Nba ATI VES! SMe teeta net opines eee PALL GAG: 2:55 eke eal erahin Oks eae 161 Acetate, tse ees ce Sroraees cee 162 Caribonate te ane Wau ee 163 VMOU ere. thee oer cman 163 OIntments seu case ere 163 pOB UAT) 21 P yee anti on go Scr ee ane Aurea np NE 163 OXMIOESE yee cca ote eee ee 161 Plasteng. cnc conch sa rettoweie eens 162 POTSOMED ec scstire eases autem tore orate 164 subac’etate, ce’rate of....... 163 BOMMEION OL ceeeyencrcicte ote eee 162 BUbAT. Of. Garoseaceemn eens oe 162 Whites x sc herslethadscrenn crentoraet 163 WAGET ace, osesisslty eter et eke mean Tene 163 Lev’ant or levant’ wormseed ..... 553 Levigation). 2..cctrteametine © satatse ns 66 LAGNE MAGNESIA. ris sore cs saage te ue 156 Lie’orice powder, compound, Tire’orice TOOL! <6 Shai cittersuci sue osonttass 543 236, 517, 544 GENERAL INDEX PAGE ily sof yalleyarmur %, . sp... 5 eee 415 UI Gh tery es ves ce eens 147 chlorinastedie sc .c8 dy ages eee 220 chlotridewongsen 2 cacccenRae 151 Lin TONGS Bethe: tak cc epee 148 phos’phate, precip’itated..... 149 Solution Of ssi: ernie ete 147 SYPAp Of te hee aa wen eae 148 WALEED: econ aes uae ee 147 bim‘onene’ 17: eo elena) See 453 Driimen ba, : 2 Se ise” sic’ een eee coe 72 Lintiments: °aiancs fo cokareneat: 72 Linimen’tum ammo’ni# ......... 138 belladom ng 7 Acie. rence siete eds 341 Callieig hii sg dus uae ain accra 148 CAIN PHOT Ba tise. haew nese «oh 491 chiloroform/awe ee: See nee 272 BAPO MIS. Gdali iin. a5 ees ae eee 539 MTO LIS ie elae nt ose tN cae cota hey rate 539 terebinthime 22a o.40 cia ors 453 Tain’seed@ srs. sonte eohaee seaeis 544 OL OL ae ince aes ene «neon 509 imo lein grass ice cht cette eae 509 EY hut: 5. ot es eee eet 544 LANG ei oeste ciety stents eet ae eas 568 Liquid petrola‘tum.< 'o..73. 2064 318 QUOT: Gee 3 5 cones eo teen Seas 69 Li’quor ac’idi arseno’si.......... 207 AMMO NIG ss ryicta es o/s uncle eee Sie 137 Aceta CIT isa). oe.cs eis Hele oe 143 Li’‘quor ammo’nie for’tis......... 138 arsenica lis’ La.vrc tee reir eyes 207 arsen’ici hydrochlo’ricus..... 207 CAVCIS " Sascac et tute tee 147 Chilo! nineitee tee cesar ae ies 220 chlo’ri‘composdtuse 4 ens 48 220 cre’solis compos’itus ........ 307 fer’ri: Chlo{ridi eect sists. we ae 184 perchlo'ridi tie s.aie ns oe 184 subsulpha/tis) —..053 520. 185 formaldehyidis Wes ss a0 cee 310 hydroge’nii diox’idi ......... 115 V’odi composiitus: ...).....0.5 225 morphi/ne aceta’/tis ......... 326 hy drochlomridiy = ycsseresetes 326 PLUCIS» CATOOMIS ise ten were: 460 plum’bi subaceta’tis ........ 163 potas’sit hydroxidi ..2...0.0 a 118 AVSCNI Lisve pa. ceekeuslenncttenr: 207 QUaS Slee: Uu2hsisalt so ois, selene ane 498 Soldit Jhydrox/idiq arm ncpcisse 127 sofde' chlorinattesw sss aneieict: 220 Liquor: zin’eichlo'Trdi ccc caer dees 12 Liquo’res: «23: cvctsdepea tyne. testa cae 69 Liq Morice Toot iaec sme taes. sultak sate 543 powder, compound .......... 544 Tbh! ape’ se cw teiete sietevne eels bn 16] GENERAL INDEX PAGE Hercheinebenm¢ZOas: 25... sce. ca. oe ee 465 DROMMIdUM. ees. cos oe 223 CALEDOMAB ES iiss. oyec.s so ceoe coeuete 144 GUGM AS rmavakela ev iw aot eae tes 144 BOMICWIASH gic... 5% ialnale, Se 145, 445 HBUE MAUI c coos sieha alcie coo eee 144 Liver, drugs acting on........... 23 oOfseuliphur: 650.14) 52 See: 240 HeIXAVIAnCLONs Seeecsi sins o 3 Leia A he 67 Wocalaction > 2.5.0. .ks sake ee tee 2, PTMOUY MOS Fake e's ccaiseersteneieters 38 anesthetdtese ne meatier 38 blood lettin oe. .0 sce: 654 HA LAATIN TAM ayia cta ts ie casey sess wodse more gaan 363 BOR OO MMe 21 -beteisierssns a efeis caste seen 535 ME OU OM ASV AW, cceic Sree is hens erestioshan ane 203 MUTA este ei cts oc''s 2: «cabal oi ciat seas sens 204 Puvsolis solution». os... . 5 oes 225 UN ATM CAUSTICH it inesecierise fhe aes 167 IDeA Bria Lia Xe) Fa oes eee roe eee 382 MEAS O Ui Die Arte. Goes reusnc, cece sieveiaie etejeeieua 307 MBN SO GUUS Dice sc tatre eae ss ches wuld octes 307 IMAGO AGbION Mimteaccestayeis Ges Gr See cakes 68 INA IGYSI relat nig OCB OD cciimoinen 156 CACINe Maa eesarsis cs be eee ee 156 IGE NA? 4 ah aan SOSA SERS ri 156 Wont ee. act Bae tie veiens ae te svist acct 156 MmiilkewOr ee Philips. ssc fi «oe 157 PPONGOLO/ BAe fais c06 syo)cceysis cteiesereis > 156 Magne’sii carbo’nas ............. 156 OXGUGUIN Bes Syn Soa aloe ciertiate 156 PONeTO'SA: fee he ee ons 156 SUMP MAS Hee creis geese sissieioverenerauel 154 MVE OTVE! SUTIN tye soso o's sores sree 154 carbonate... 6 s.< Siitisen lim 167 INTOWAIS/SES Sete ceeeasiaevs vo cent cela core 547 Monobro’/mated cam’phor ........ 49] Mon’sel’s solu’tion .............. 185 WKN, segaanancocvdoo00pHoos 32 772 GENERAL INDEX PAGE Morphi'ne: ace’ tas) i. iss Sores stds 325 hydrocho'riG uM vases seas ye 324 SUT SPH ASI tyes. vekee os cuchs Poneto ake 325 Moriphinel sis tee. etaera skit ee 324 ACIOUALE Pe Si ste tels Sesfera ioe ted keseaele 325 hydrochlo'ridums y= 4e46- ee 324 esl phates’ wae ategpene eee 325 Mor rhioly is 53 cece ie rare sess ie 585 Motor nerves, drugs acting on... 39 Moulded silver nitrate........... 167 Mau‘cilage “Of Sa Ca cialis ities dps aocuess 545 Miucila? oO aca Clee iii daietarens she 4 os 545 tragacan’ thes 5... as -cyits'sciie oe 546 Mrus’carimey ci) > sai cusiatita aia agentta teers 347 Muriatae acid iii. c2 cles eee st 242 diluted, 7. ete ere ee aren » 242 Mis tard’. 45, suiaiss ae meee eee 467 black: -.%. stuntens sees wees 467 WHILE: fe Sete weg otepouuakts stags ate e SAO T MUtGON: ISUCT 2'55 ae cts cousnthovene ans cuevens 578 MEV Art B01 CS) re etic re ooo nals cystaxcrnen ects 40 | IMEV OP 'SIM ais susts shes) o 8 foyshnte, of oe enero tees 583 ME YVOUTCS 2 cnet sinate stays om a riphar ert arate 40 MVPIC CLIN g cicioss labs hsasioero ctlsa Msce eps sh ec 579 Mimigtbitiy £2 onc a Mtcrd sane Sejceate 509, 510 MPV TOSI st eo c¥el preps hennaeesi cha sts kters 467 Miryrras iv <5 is, 3cs5, lovandt ae cous eraeoaeticha Boe cae 473 Miyrer hate seieset ascus deacon cuemiebens ita aa 473 Myr rhin Sissi dei te ner Seon ra 473 Myr rhol oir osscawis b.3's aie sietant ces seek 473 Napth/talene. (20h. 5he gocher ems 308 Naph’talin or naph’taline ........ 308 INaph’ thalentimal 6 182i eerste. 308 Naphtole es wae shuiclis gue hare sie ators Ges 308 IN aT COIN) eevee olens. te petaethersee seseie cons 321 INT COLMCS: a yic%e sie sen eters fol eteicusy aol 35 Nar’ cotines ii. is diedicen Same ehoee 321 Nataloimit, 2 . Gieccaeste Giese enol oss 506 Nativelle’s):disitatlin 7.)-e06a. te 406 Nerves, drugs acting on......... 38 of special. ‘sense’. .!4). i685 eet). 39 Nervous system, drugs acting on. 33 Nid’ otine). 7). Sz Siaeues, ge atte enema 381 Nightshade; ‘deadly; -: Gahan aie. 339 INUCTICPACIG. cyack tee creceeerre ee 244 Giltnted iss. cytes ihe sarcie aye 244 ING EFIGES ee cisesiatsgele ue teehee seein 283 INV ETE asses Gites ea oe eee a 122 Ni’tre, sweet spirit of........... 283 Nitroplye’ erin’ cies ee to 284 Spirit Olea saat peo vests 284 Nitrohydrochlo’rie acid ......... 244 Cilttedy ror osern cheats eave eee 245 Ni‘trous e’ther, spirit of......... 283 Normal ‘salt solution si... 2% asin. 655 INOVOCRING! fect ete nntct eee 395 PAGE Nutgall so. ei Ries cise steerer. 526 OINCMENT Apso kocas bea soewonueteehe 527 INU VOMI TCA) aise on cise ites 363 Males pup Hitengreins. dtateie ete taal lee shales Holl Oakca mii sets ee Netiteta sis ten eee 568 Official preparations ............ 69 Oil Of anise Fy es si8) ohare epee 480 Deva laie stags chee or astnermen ens *,. 450 DORD EMILY: ce a sistieveletaveveren eyewear 450 CCE: Ko (cape One ar ar ia AUT EA ee a 460 GAY TON Se Acero voteleuerohteeteee 148 CASCOT wh tdiicne wasn eeetere semen is 510 checker berry (Vieescssisi tote oes 450 COG iver Rae reset ase fs rene creas 585 cottonseed Aon dine She eae 538. GEOCON: wuseacs piven cemieeien 518 etheirealnte tir: diverse 0 tee 451 CUCALY PiEUS a). Gisr estate te amen crate 471 Fen Nel tA Sovsat Aes eee 482 flaxseed’ sy, Stasi sre siete foes 509 LOCNMUGTEC RT et vccetn eis conch eters 482 PuUlseliwia isan ghee stirs Cee 259 gaulthel nial sctecdieser sate emcrera: 450 DEEL AM Maes ac, eeretere eeonoe eee 450: Synthetic arene ice eee 450 IMAP Or ertc.cer eens renee ee pa 487 lin/seed ou, teh, cndercuke sheer ate 509 mustard, svolatiley afar citees a oes 468 Olive? e.Peek eee ee eee 537 Peppermints ss nes cis oe 477 phos’phorated ...........+.% 217 BAV ANCE fo S.d55 5 See ce eater eee 489 SWEGL), . ssa gall tenen eke eerie 537 SPOATMAME pve clare, shen este neresiaeee 479 CAT eZ sisi Moos, dee nieve Beare 460: theobro! matter cetera ieee 567 turpentine: icrieeies eles cerns 452 LEC tiEd ie iarevaicrs wot laeieeeee te 453 Of wintergreen... cise'-f oe 450 artificial Qui ccecs hia 450 of wintergreen! {< sci50). aicyacene s 450 synthetic 2.4.3.2: pane DO} QHTS: Aint oo ane ee 65 distilled sire oe tnererek ore 65 essen’ tial! Merce eee renee 65 ethe!realiiciiwasstameee ee 65 FiK COM eee ee eee. ae ens este eeeeae 65 VOL abile ii Aer eich ete eens 65 Ointment; <% 2 2h oi emetoce nine 578 Ollea Here: su ihe eet heen 65, 72 Olesen: c.jarc.c creek eitevetts eretuetots 72 O’leate of co’caine .............. 388 MAKIN LE oooOD Ono omdnOUD 196 VELAULING eer peuoeysicustetee mODOU ESO 426 OMeates me Racies corvette ne ere toler (C4 GENERAL INDEX PAGE Olenybumi cocaine =... . ie. oss 388 | AT AY OTN os 0 55.5: osainje\eta'% yer 196 POU ALT IT ai vevsys,o\s-s.clehsscie¥ohers cae 426 OMlenrieee to scien 5 o/s = saventomre 538, 578 OleonesimalASpid/T ... 2/5... cjereeter v= 549 CATV SICUM Mace 2 sioy eerste 118 Vodide Ls, .%. oi. arelelcle os 23 GbR HCE ane ean inl eee 22 PNY AAAS OOUC = (jatd7s ota wiars ole sss 5c 22 NEURA IV CN youn) cys ice lapetonctskslen eee 21 Sala e peeves «forays cicaisdstOrersuiat oars 22 SMO oe eae msec ouadeuKe 22 RUISES HOE Gy. sate sats, sheer eteicperel. 24 Purimiedscotton.... si... 5 3 cleans 567 Oxe) CEN” Ueeeeigeiones gancooos 6 584 IAD EMAIRMMS Sad eas enneoaeUooCudS 58 AVC GUIATGUIIINE Veta tests siiehs aie 2 ssi ota ety 556 PAAMIGIDISS Bosom e Hon his en oaG ano 382 ARO thle ona Shee oom neo 533 IEW ARO GENIC: EXON Sapeeacoue neon c 530 PAO ENV: (oe oles aio pheno ona ce mee 530 NVA ORY UUTN Sopa sacs cccincs sae esy sunnier sy ecere: 568 IP waropeerdlle ah pha Ct enete scat otis, oink Aol nea 568 @uarter evil’ vac cine......2. 06.6508 678 TAS IST ees wee nN Beh ntarae shee 497 QUGIGFEII: Aero eeming siaercko aie eee 497 @rrenseimii nates cas dics ootasevetere wien ee 531 Ouercitangievachdes sve ac ess 531 QUGIMCHD "s'c Son Ghso oma odbop Hae 531 (Quieimtenis)” GNU enon ooenmoeo aoobe 531 Quevenne’s digita’lin ............ 406 @invekstlverseace essai oe sucieusrsiceha te 194 PAGE Q@uanvamines ce chcvete eyaeeo eetesooe 433 Quiniiesacidec kw Gas ei ree ene 434 Qminsireinese iste ee cece tiate Soc: 433: Quiniduince sul phase soreness 438: Quasi dane: We eee es ete 433: Stulplvate ee gs ceuscsey orci chs iallonaue ie 438 (OhiHb ante tis heeainionrn cr Uick Sieur er Rte rater 433 Quini‘ne: bisul’phas 7.50.23... 436 et u’ree hydrochlo’ridum . 437 hydrobro Mas <2 sis ,. besten 436 hydrochloMmidums ss 310... .1 cle 437 salie’ylas or sal’icylas ....... 437 SUM OMS eS a senpodaee poo o 438 WNUCREIS Genomes ua ons ood bod 437 Qui/nine (or kwin-een) ...... 433, 435 bisulsph ates sec sets cre vonsrateretare 436 hyatobro’mate, 30... or + 436 hy dnochlosraster ce rts) siete ets oe 437 hydrochloride <...\.\) chs. « < 437 salic’ylate or sal’icylate ..... 437 MUONS) Soe so Son gondooogd on 435 Valleraten css eens jevega cee 437 OQurinoidines che Gem eid kocthie Merete 437 OhniionChambin shou odoonobodogooe 437 Rational therapeu’tics .......... 1 Recta li teedinies eet it... eyee ns ares ieroseus 624 NSA Son peeoouDOoUoKee 9 Rectified oil of turpentine ....... 453 Rectiticatione tacerricke eels «feels ss 68 Red corpuscles, drugs acting on.. 28 Redmcimchoinaiecsele eee sewers 435 mereu’ric ox’ide ...........-- 195 PEPPER. oe eer ete cg ayers ee cece 475 precipitate ..........------ 195 ONCE weve ceelaveterens ters 195 VRALEE isc /AN Go Gals too Crom oop nae 260 TReGhnCaGl WO Pda be ebooagobogode 182 Refrigerants: 15.0 0.6.2 eo ois 2 «i> 638 Remote sacbion ire sci ceclaletola cher 2 Restingiceimaite: sheers cei an ans cues 459 HEA Go esol oa moubougeocn5 459 IREST Ma eee en Neato er) Simaoreit mere e eis 459 Resianaj alan ers cre sasiefersl ee cjele 521 POGOP Vlei rises ceacte eieteeie her 525 Rabari! Geo Goudn ooaeeanD 521 IRSA Mee 64-6 acolo cia a Ome oe moon 65 RESINS] earth erate rotate cite recone cereye acer stone 65 IRESOLCIN rs 4 rscekco ete ashe cts essen Sas 309 RHE GOll Soopoowobousooeoo oboe 369 IRCCOMCIAMINM, GosgoauudcunescounD 309 Respiratory organs, drugs acting OMe Ge esa aan Aine are Ons mucous membrane, drugs act- PON hobo obUCOD Madooet 4) Ram’ Nose cre cies chee 513 Rham/nus cathar’ticus .......... 513 jOUNIMEIEY Soon ederogooc05 2 511 776 PAGE Rhatan/in 6 sehen sree 535 Rhatan/nicunedieso.. sss f chteakn ee 535 PUR aUAMA ys crate cis iese etary erensy tel eee 534 Rheotan’nie acid .......0.008.06: 514 Refuse ei os ecw esase cs Gib wis» eee eae 514 Rune a1 2 cee? seccate strc cnace Sheetoretane 514, 516 Rhigolenes 3 csidicisiegseriaies aroun eiver care 319 Rhubarb: cca jaca cgtice seco ee toe 514 RiCINS sect.y pale eee penne 511 Ric inne ees eee ch eee cates 510 Ricimolein's ccesis ee webster eae eae eae 510 ROSIN as se BE ee Are atone ERE 459 Rotilera. 2 a acieh atte onsen 551 Rot{tlerin= ere. ck ec cckee ete a See 551 Rubefactents <2. 27.2 i sri tee and 58, 629 Rut bidine:o1, Ss: cenev.cieies cae 382 Ruberiyer Wine) se ).cuaia vases. cevers stele 423 Rules: for genitive.....5...0s.0% 90-97 RUT 75. eis soe sts 3 costa Ooi oatteureiens 260 Routine wc adie lopeie on eiceielos eatane 486 Sabi nar ieee ac veeaek wee eee 489 Sacchara’ted fer’rous car’bonate.. 183 Sacichari efeexa 4.52.50 5 sieet siete oe 547 Saccharum -4 242 eces cours eee. 547 Tae TIS 25 ces, hottetecis on te ches 581 Sail saMMO'NIBE <2: wecctel as, s seo ele os 142 SO Gap od acersnes Sage cian 127 VOlALTION. f.oh/cscperstelayeivs entice 140 Salticinves . cece ee are Serene es 445 Salicinumsy) sis scan eee eale waene 445 Salicylict acid’ 163 bro‘midum ....--- 5 A ee 223 cubes Dee oF On 133 Memiglate) vos sss scees : ; 501. | Solutions ....---cessereesseeres 69 Pe anas te abla oes, Soporiffies .:...++e2eeeeereee 35 BPRS eg od safes 128 Mens Ce 574 chlo'ridum ....-. 198 | Spearmint. f0cceee cee ce SIG) ee Saar a 2 | EIU Wi enieacon Gaukre a iat ay 479 hydrox'idum ....-+++-+2+0++ 126 oil of ...-.-+++-- 479 hyposul’phis ....--++++-+ +7 136 ee 479 jo’didum www eee eee ee eee 229 ep 479 prope Ley Som RUE Wart 135 Spermace’ti ...----+: : : ; ‘ : : ; : . 580 at yee of ae a Ee aes ao Spinal cord, drugs acting on...-- 37 ae ee re Spirit of ammo‘nia Sate eis a ote ehnioha at 138 oO eee ee 36 Grichia aeacona upon co Comoe 480 ae P Lees eet ee ees ee: oe Bea hig es a ase ae 141 Bee eae ae eam’phor ...--.+eeeseerreee 491 et a | chlo’roform ARs, ey cit avisietishis ss, ote 272 bicar’bonate : : : : ; ; : : : : : : : : . ios | res ther Reais ob lel sizanelieneneuerisy 2.0.92) 269 Recinhie fkocie ae | compound Dae asicv tie lest ales 269 pee Le oe | glyceryl ni'trate ....-2++0: 284 eee ; ; sop Reo PSE ye ee glon’oin CG Ml See UE So SR Nar ate etches 284 ter compan aun, pe ae | ; compound ...----+++- 260, 488 Pepe ee ee 130 ni'trous e’ther ...---++-se+9:: 283 eiienter : : ; a 10 peppermint DRE SPR USA Astle he oneis 478 ee 251 Ran iof eco cueea see 107 | Spinto orb wes ees 70 hyposul’phite Sea Ry ea 136 Spiritus; osceece ce: Soh at 70 RGGI Givauis « cecisterseneleiie 299 | e’theris eee ee monohydra’tus ..--+-++++°° 128 compos’itus .--ss+eerr° 269 ph os’phate Piers ee ae 3, 135 | nitro’Si .---+--eerrernee 283 sone or salicylate .... 445 ammonia .----+sstt* neds sul’phate ...----eeeererrcee aromat’i aS sul’phite ....--+-esersc e's 136 | sata Se ee re thiosul’phate ...--+-ss++9°" 136 | cam’phori eg eg ea ee Soft petrola’tum ...-----+++-*: 318 | frumen’ti ee coe 250 ae ointment .....--- aa glyceryl'is nitra’tis ..---++-: 284 ae se Mii oes ce aes ey Aue a junip’er1 compos/itus ..--+-+- 260 aciuitt > 257 ar’senite of potas’sium... ; 207 tepnilor Pie Sea aging a ae ad arse’nous or ar’senous acid... 207 py Bal NCE a oe eae Be chlo’ride of iron F Aie heen 184 Squill hoy BE AS 8 Oe eae 416 rfiies page spor eo yecoeas 172 compound syrup OL tee ere 417 chlorina’ted lime ...---+--: 220 Geaphisag ria -s--s-o2y | 556 a eerie aes 220 Sfaphisag TING Mae es) ik 556 hydrogen dioxide .....--+-> 115 Searels corti site tes alt 566 mor’phine Agictatem tcc: 326 Stavesacre (stavz-a-ker) Paap I eked 556 Solution of mor’phine hydrochlo’- Sirol GopeoeD eer sapien ye. 583 de MRS eh ee the 8S a8 Sao Pati nes Me Sects laialiess (oe 510, 578 pd PATODseW sani ss ce) Sc mae 490 Sok compound ...+---+++: 995 | Sternuw’atories .--------777707 77" 42 et : Gale iat bee SUGANO ae oeme acer nero eRo 222 462 778 GENERAL INDEX PAGE PAGE punters cerebral: . Se inti.ieeed oe Suppositene glyceri’nis 24010. 542 CDAUIC Heri hat cyestate Veleyemnicrelets 1GdOfOr Mis, Hens Steet ee 232 Stomach, drugs acting on........ 15 MOT p himse ete a aisle eta ae eae 326 tilbe, ses Of a cise s vite 15." Suppos‘itoriesvesi-:. . cc tunaes vil StOMAGCI ICR HE css cite a stereo sterarere exnere 15.) VSup[purants cence ke one tees 632 SEGUE oy eetoehs soovel ed a ret eeneenee 261 | Surgical asepsis and antisepsis.. 649 Sele ee ohctiae & cl aang aes gp6 svar are: influencing the secre- 4 Strangles vaccine ....-.......... LOW SOLS folct ayer siekele.s stsieter cies ccseances Stron’til- bro’midum= -:....%...2.: O23c! Sweet Nagscost an ss dauie wml tee 503 Stron’tium bro’mide ............ 223 | OU ges aes revettr ere esate tela, at ccagee Maeeeee 537 salic’ylate or sal’icylate ..... 445 | SPIFIt Of MUGTO 5 ns tnoete 283 Strophan’thidin ........... Keir eee 2 413 | -Symbols-and signs... . 200.2% << 82, 85 na Sis a eioucba iatonseere aiategl 414 | Synthet’ie oil of wintergreen..... 450 MOPHANC AUS a reneetegeeyeectecetauelee nore 4S eS yr Ups sim pley thts rordee cece 70, 547 SUryehmiina sorcerer Mi Ue cberes seteeescteo, 6 364 Syra'ps ie F 2 ie ahareeial aiuravece tsa Beas 70, 547 hydrochlo’ridum ............ 365.;) (Synapse: lene Sie ae 70, 547 ni’tras SEUNG Ce Sones D 365.) “Syru' pus weal Cia etc: sas cote 545 sul phas .......... vette eens 364 | AC LdTeCit vic. eee etal od 247 Strych MINE eee seer reed eee eee 364 | ac/idi hydriod‘ici ........... 230 Sinyeh Mine; Nitrate 25 een ent as woes 365 althmte*= 3.2.0 be eee ae 547 ee sul phate «1.1... sees eee oe | ceal’cii lactophospha’tis ...... 150 td AS, Dei he te ena. oui CBU CIS Fah. i iale S ne cubaeasheae le Stas 148 Styp/tice-collo’dion = .4..ics/c% ac cies oe 568 | re 5 Ae SLY P bicSennsacei sista raid ce oe veratetereto 59 | on roe see b: aromaticl.. 512 SG y/LACIi en) es wh oe cereus es cutee 463 | fer’ri io’didi .............-. 184 Styicol. se enue ce ee 462 fUS’CL ©. eee eee eee eee eee eee 547 Subcutaneous injections ......... fe Ipecacuan’hee — Dh aoe cpth St 430 Sub’limate, corrosive ........... 196 ier Malek tenet tees 318 Sublimation. .%..a1e austere sient en 68 rham’ni cathar’tici............ 513 Sublimed ‘sulphur .6 0.04 4ise0.8 236 SCI lee ee eee eee teehee 417 Suc’cus; hyosey’ami'...<. ¢s'.g5 so. 352 CONDOS MIbUIS os enter eteke ere 417 Sudorifiies? 1 MUMS pA Cae ran eer het sid aye camiean steelers 547 HEObTO MINE! oy. We acs sss csse elas 567 BUR RIMO erste a! clacosci ties). a. «are eyotetmusya Gee 588 ennolum: Wiqsnidum .2).:00- 26 ace © 588 MC Gli "Saas do ooemaonadameme 588 PTO SINAINMeD Been cua icaderaseie sia 469 Phnsyarrvo ley (cum ON) ite weaver -telcnetenshcrelohels 494 pba ON TOGIGE: } iy oie 8 ois solels(oie o,01 os 234 BoM C ACIG Wis clone orale wi 518 ITI C UZ ACCOM EI. S75 scctetonenenone nels 532 Cinchopnce ewer closes cierckereeijerore 434 COMIpPOSMmibayes src. s crests ene 435 col’chici sem/inis ........... 564 Gelli iit seyie sepa apace leeanensiters 556 UGG ATS ass aiciaetrs ce eels 407 er’gote ammonia’te .,....... 558 erin GUOAnChsoecas sconces 185 perchlotridie eee cle see 185 gam’bir compos/ita .......... 532 CSET ea sicig os arc obese auesele 6s 379 gentia’ne compos/ita ........ 496 HY, CAS (EIS) H fap oescaraie wteuetieaussohefers fe 502 lnyOSeyv “ENN Gogongovecouuouas 352 WOM srAes aye Rtn ccc foneers Saves sis 226 ipecacuan’he et opii ........ 323 Ki Osa rarscenccaieatcyeee sa rintl seta scs 533 Kopamme rigs what stats ARs oe oie ee ss 535 TOV TE THA pects tetra eee es oes 474 MUCUS “VOMMICH Yes sce oe ale 364 OAPs Neesh es sey sevaelas elem es 323 camphora/te ........... 323 deod orate We Wea Wanvatioetes 324 GQUAS S198 to sch cters scant rey eae 498 PAGE Aine, IVES oo As Sedook Gad eue 416 Strophancthit ir vee sip anie 414 valerian ers ee Nias 483 AMMIOMIALT ee oe re 483 Minetulrsevs) Hoos es ook Sisieieie eS eieroe LO Mine FLUTES wees sea ere melee tease cae 70 EODACCOP iis Noreen ee 381 NOUR MAG SR Ge BRE aa a rec 463 MOMS sites ee keira Se sh ee aie sietaeOO: ROW an ap Nites eee tage DS UR 568 Toxicol’ogy, definition of....... Sealed Pragacanthy ..cvse< sac cre ciiy + wie 546 Mrasacan thay oer tvatelsqvoyes oo ce eore on 546 Pransfuli sion wey eel enccraicee eee ae 654 AERO LAGCTE! Nat. yars iris ore Bete agu econ eee 547 MTA CTESO likey eis ee eee eae Roce Mees 305 ri turatlon yes ad sea ae cece es 66 era GUT AION So color ctarioresseeteteraicte 71 PICU Aa tlONS 0h se eisvoteco oie ster elses at 71 dirochisicwsantonienie 255 ee 554 ARK Y PASI Nea sseescvtnses Goosen oe aradeienaks eect 583 uber culine tests. vos. sae 670-676 HIT ADENLUMCN We xe eits Seare- neko lan via: 453 Camadarn na eek, olen iets eaG. 458 laTNIIMEN Ga ee era sages ena 453 OUR ae eres eR ENROL ipa 452 Sy NAMAUINE Sects aovorestoysie ate serie ee 557 Wnguenta yer eres scie's civics cee ee 72 Wino ue tues ee Gan SNe eee te 578 acid Dorie) os Boe eae 253 CAMDOWICT ass oie ste siento 298 TOSI seer ar ek ieee mes 459 Tame Ni Cie yeh een ape 527 ACONIUG/ AND eee aera aie 419 belladoninser ee nen oe ee 340 Camthargdism wrest cee 574 Cotbalceie St aaiereh tanec eae 580 chrysaropieni- aarseciscis sere ire 516 COCAINE! 1 ees chica eres 388 LO raat eee ran inure Ds Mla 171 eucalypt aeaee st ciara ss a 471 CENAES. Bai ere pp rien ou Seems 527 CUMIO/ PION Fete ete enevels lei 527 hamlamelidis fies ec ceeie ose 537 hy drargyy rie wits eas 53 194 ammonia’ti ....... feas LOS TUG AGI Sg tens tere sess sorre oie eve 197 @:diGht TiAl tenga éaoseace 196 TUDE ie arene ie cisce wes 195 DUO G BI eas BN ar Se gO 226 VOMOPOTAM IG erie s ts eeio ees wre shes 232 PEWAIG! 93 6 casgencho Go enCR one 318 ON OAN ONS eae sihee salts eco c's a's 298 PHCIS MQ Id. oi. cis... ss oso 460 PlumrbN Od eeei... oe eo os 164 potas’sii io’didi ............ 229 TE SIGILOS aa ire ase hae ES: core 459 780 PAGE Unguen’tum sabi/ne ............ 490 SUL PWUTIS oss [eee on oh shores 236 Ne Hoan Pel anmeeennn come oe 426 ZAM CUM OXON a. sre euetecrsterehersiheyeis 173 United States Pharmacope’ia.... 68 Urinary tract, drugs acting on.... 47 sedatives? Sasathasclserentcis 51 ANCISEPLICS oss eet store: eons 51 Urine, drugs altering the composi- LOM GOT Bate si feveratatemers) nee tghn es iets 50 drugs increasing secretion of. 48 BGLUTT YUM re Ae ase orate si ort 50 drugs making alkaline ...... 50 making aseptic ......... 51. Wrotrompink, tertote greveys sisgelsverensciowecre 312 | Uterus, drugs acting on.......... 53 Uterine action, drugs restraining. 53 Vae’cines, anthrax, black leg or Gulartér-evil ods hear 678-679 general therapy of............ 680 SPCCIH Cue aera cette teas 678-679 staphylococcus vaccine..682-685 streptococcus vaccine.. .682-685 GENERAL INDEX PAGE NVA OU XOTSIGUINIE «a ctetsleretstdefet.totsne 26) ex ViEGIIOL! “DUC vie ccretve sus syerst ects evar orecere 176 OTCON it eemieotes elects ale everanar peters 183 Volatile: Ol sii re sieie cs io ose sieee 65, 451 OLVOL MmUstAard 25 cic sana creanieys 468 Warm wba thsisituten. sa vccronoe lances 642 Wash; ablackiterite., stsercaa ater 204 VOR OW. iseetesecs: decals soa teie Wiha ane 203 Washed sulphur .........c.005-- 236 Washing Soda ites canals cassteuag 127 Waiter idee sk airtiont' tee ctane e oites 118, 634 Wid CeLsice” wife, tere metl stcpees cA ctauens te hatatere 69 [MWe Sa leckenw GsNoratreie ue etogane, ata 579 VOLO W 2 580 2k we eles ceare renee eee 579 WIGE Hon senting edecceutenarentcetts 579 Weights and measures....... 9, 82-85 Weetie pack tai cn fon cusiqsisruers eva ee 635 Wihiskey, S:cischseretsy: vee ene ae 259 White, “anaemic yaa. 20s 6 sears ora, oueteyane 206 CAStIIE“SOAP! picts a:h o ears tatels cue tats 539 corpuscles, drugs acting on... 29 nelW@eborei is. sccis test tte epee 425 Lend? Sraipitta.veructeronus reiserccne yen 163 TOtion) weiii.ve tosis Wuetaieyaine emer: 166 MUStarde c.cercstey haters 5 ovels @ eegepeectereeste 260 WINGS © 2). ccterdepe te deters ashe a srtoreane 70 Wintergreen, 01) Of (2)... 0.35). sn oie 450 artificial on Ont iiss. «heer 450 SYNtHEL ACO Of tts ces vice 450 Wiatehhazeli ic. tcs src) semeteiateteyotereve taste 536 Wool fat DyGrons tise. < eaieale nonce 579 WiormsGeden. satan ccutatlonaie.tvcdaaione 554 OU OE Ws aan a erlasens cette ere 553 Vell ows Jas aime tye cepeteter ke ep ane aterene 379 merev’ric ox’ide ............ 195 WASH! ci ciounmtriehebeusterens cvorterstotdeks 203 MeO W GWAR. ss fiateteus scenetensee clevenevoretete 579 _ Yohim’bine hydrochlo’ride ...... 397 VAL aries By CCE CRATES GRINGO OAC, 172 acletater, 2 al. iis suersuereveccperetere ee 174 car’bonate, precip’itated ..... 173 Gubpakily sear ops okopouducas 172 >, d5 6 (sr awinea vito 6 cobb ooo oC 173 OINtme nye ariels civelecstere 173 phosphidesy 72). <\erey-toieis)